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Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
Risk factors for transfer from Respiratory Intermediate Care Unit to Intensive Care Unit in COVID-19
Enrico Buonamico1, Vitaliano Nicola Quaranta2, Esterina Boniello1
1Institute of Respiratory Disease, Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70125, Bari, Italy.
Insights
Elevated C-reactive protein and lymphopenia predict transfer from Respiratory Intermediate Care Units (RICUs) to Intensive Care Units (ICUs) for COVID-19 patients. Early risk factor identification is crucial for better patient stratification.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Pulmonology
Background:
- COVID-19 pneumonia frequently requires ventilatory support in Respiratory Intermediate Care Units (RICUs) and Intensive Care Units (ICUs).
- Predictors for transfer from RICU to ICU for acute respiratory distress syndrome (ARDS) in COVID-19 patients lack consensus.
- Effective patient stratification is needed for optimal resource allocation.
Purpose of the Study:
- To identify early risk factors for ICU transfer in COVID-19 patients admitted to RICU.
- To evaluate predictors of transfer from RICU to ICU based on clinical and laboratory data.
- To improve clinical stratification for patients at risk of ICU admission.
Main Methods:
- Retrospective observational single-center study of 96 COVID-19 patients.
- Analysis of demographic data, baseline laboratory profiles, and clinical outcomes.
- Comparison of patients transferred to ICU versus those remaining in RICU.
Main Results:
- Elevated C-reactive protein and lymphopenia were the strongest predictors for ICU transfer.
- Mortality was lower in RICU compared to ICU.
- Demographics of deceased patients differed between RICU and ICU.
Conclusions:
- Specific inflammatory markers like C-reactive protein and lymphopenia can predict ICU transfer needs.
- Enhanced clinical stratification using early risk profiles is vital for RICU patients.
- Proactive identification of high-risk patients can optimize care during the COVID-19 pandemic.
Background:
Patients hospitalized for COVID-19-related pneumonia often need several degrees of ventilatory support, which are performed between Respiratory Intermediate Care Units (RICUs) and Intensive Care Units (ICUs), and which depend on the severity of acute respiratory distress syndrome. There is no firm consensus on transfer predictors from the RICU to the ICU.
Methods:
In this retrospective observational single center study, we evaluated 96 COVID-19 patients referred to the RICU for acute respiratory failure (ARF) according to their transferal to the ICU or their stay at the RICU. We compared demographic data, baseline laboratory profile, and final clinical outcomes to identify early risk factors for transfer.
Results:
The best predictors for transfer to the ICU were elevated C-reactive protein and lymphopenia. The mortality rate was lower in the RICU than in the ICU, where transferred patients who died were mostly younger men and with less comorbidities than those in the RICU.
Conclusions:
Few inflammatory markers can predict the need for transfer from the RICU to the ICU. Due to the ongoing COVID-19 pandemic, we urge better clinical stratification by early and meaningful profiles in patients admitted to the RICU who are at risk of transferal to the ICU.
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