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2 "pandemics"
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Pediatrics
Prevalence of extracorporeal blood purification techniques in critically ill patients before and during the COVID-19 pandemic in Egypt
Aya Osama Mohammed, Hanaa I. Rady
Acute Crit Care. 2024;39(1):70-77.   Published online February 1, 2024
DOI: https://doi.org/10.4266/acc.2023.00654
  • 1,486 View
  • 110 Download
AbstractAbstract PDF
Background
Extracorporeal blood-purification techniques are frequently needed in the pediatric intensive care unit (PICU), yet data on their clinical application are lacking. This study aims to review the indications, rate of application, clinical characteristics, complications, and outcomes of patients undergoing extracorporeal blood purification (i.e., by continuous renal replacement therapy [CRRT] or therapeutic plasma exchange [TPE]) in our PICU, including before the coronavirus disease 2019 (COVID-19) pandemic in 2019 and during the pandemic from 2020 to 2022. Methods: This study included children admitted for extracorporeal blood-purification therapy in the PICU. The indications for TPE were analyzed and compared to the American Society for Apheresis categories. Results: In 82 children, 380 TPE sessions and 37 CRRT sessions were carried out children, with 65 patients (79%) receiving TPE, 17 (20.7%) receiving CRRT, and four (4.8%) receiving both therapies. The most common indications for TPE were neurological diseases (39/82, 47.5%), followed by hematological diseases (18/82, 21.9%). CRRT was mainly performed for patients suffering from acute kidney injury. Patients with neurological diseases received the greatest number of TPE sessions (295, 77.6%). Also, the year 2022 contained the greatest number of patients receiving extracorporeal blood-purification therapy (either CRRT or TPE). Conclusions: The use of extracorporeal blood-purification techniques increased from 2019 through 2022 due to mainly autoimmune dysregulation among affected patients. TPE can be safely used in an experienced PICU. No serious adverse events were observed in the patients that received TPE, and overall survival over the 4 years was 86.5%.
Pulmonary
The Mount Sinai Hospital Institute for critical care medicine response to the COVID-19 pandemic
Jennifer Wang, Evan Leibner, Jaime B. Hyman, Sanam Ahmed, Joshua Hamburger, Jean Hsieh, Neha Dangayach, Pranai Tandon, Umesh Gidwani, Andrew Leibowitz, Roopa Kohli-Seth
Acute Crit Care. 2021;36(3):201-207.   Published online August 10, 2021
DOI: https://doi.org/10.4266/acc.2021.00402
  • 5,568 View
  • 139 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary Material
Background
The coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of critically ill patients. This was especially true in New York City. We present a roadmap for hospitals and healthcare systems to prepare for a Pandemic.
Methods
This was a retrospective review of how Mount Sinai Hospital (MSH) was able to rapidly prepare to handle the pandemic. MSH, the largest academic hospital within the Mount Sinai Health System, rapidly expanded the intensive care unit (ICU) bed capacity, including creating new ICU beds, expanded the workforce, and created guidelines.
Results
MSH a 1,139-bed quaternary care academic referral hospital with 104 ICU beds expanded to 1,453 beds (27.5% increase) with 235 ICU beds (126% increase) during the pandemic peak in the first week of April 2020. From March to June 2020, with follow-up through October 2020, MSH admitted 2,591 COVID-19-positive patients, 614 to ICUs. Most admitted patients received noninvasive support including a non-rebreather mask, high flow nasal cannula, and noninvasive positive pressure ventilation. Among ICU patients, 68.4% (n=420) received mechanical ventilation; among the admitted ICU patients, 42.8% (n=263) died, and 47.8% (n=294) were discharged alive.
Conclusions
Flexible bed management initiatives; teamwork across multiple disciplines; and development and implementation of guidelines were critical accommodating the surge of critically ill patients. Non-ICU services and staff were deployed to augment the critical care work force and open new critical care units. This approach to rapidly expand bed availability and staffing across the system helped provide the best care for the patients and saved lives.

Citations

Citations to this article as recorded by  
  • The COVID-19 Tracheostomy Experience at a Large Academic Medical Center in New York during the First Year
    Dhruv Patel, Anthony Devivo, Evan Leibner, Atinuke Shittu, Usha Govindarajulu, Pranai Tandon, David Lee, Randall Owen, Gustavo Fernandez-Ranvier, Robert Hiensch, Michael Marin, Roopa Kohli-Seth, Adel Bassily-Marcus
    Journal of Clinical Medicine.2024; 13(7): 2130.     CrossRef
  • Why are there so many hospital beds in Germany?
    Matthias Brunn, Torsten Kratz, Michael Padget, Marie-Caroline Clément, Marc Smyrl
    Health Services Management Research.2023; 36(1): 75.     CrossRef
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    Critical Care Medicine.2023; 51(11): 1552.     CrossRef
  • Sustaining the Australian respiratory workforce through the COVID‐19 pandemic: a scoping literature review
    Emily Stone, Louis B. Irving, Katrina O. Tonga, Bruce Thompson
    Internal Medicine Journal.2022; 52(7): 1115.     CrossRef
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    Sherrie Wang, MaKenzie Chambers, Kelsey Martin, Grace Gilbert, Pietro M. Gentile, Rock Hwang, Rakesh Mashru, Kenneth W. Graf, Henry J. Dolch
    European Journal of Orthopaedic Surgery & Traumatology.2022; 33(6): 2453.     CrossRef
  • Rapid communication for effective medical resource allocation in the COVID-19 pandemic
    Kwangha Lee
    Acute and Critical Care.2021; 36(3): 262.     CrossRef
  • Triage: Medical Details and Words Matter
    Jolion McGreevy, Rosamond Rhodes
    The American Journal of Bioethics.2021; 21(11): 64.     CrossRef

ACC : Acute and Critical Care