• COVID Activated Emergency Scaling of Anesthesiology Responsibilities (CAESAR) ICU

      Verdiner, Ricardo E.; Choukalas, Christopher G.; Siddiqui, Shahla; Stahl, David L.; Galvagno, Samuel M., Jr; Jabaley, Craig S.; Bartz, Raquel R.; Lane-Fall, Meghan; Goff, Kristina L.; Sreedharan, Roshni; et al. (Ovid Technologies (Wolters Kluwer Health), 2020-05-07)
      In response to the rapidly evolving coronavirus disease 2019 (COVID-19) pandemic and the potential need for physicians to provide critical care services, the American Society of Anesthesiologists (ASA) has collaborated with the Society of Critical Care Anesthesiologists (SOCCA), the Society of Critical Care Medicine (SCCM), and the Anesthesia Patient Safety Foundation (APSF) to develop the COVID-Activated Emergency Scaling of Anesthesiology Responsibilities (CAESAR) Intensive Care Unit (ICU) workgroup. CAESAR-ICU is designed and written for the practicing general anesthesiologist and should serve as a primer to enable an anesthesiologist to provide limited bedside critical care services.
    • Mortality and Advanced Support Requirement for Patients With Cancer With COVID-19: A Mathematical Dynamic Model for Latin America

      Ruiz-Patiño, A.; Arrieta, O.; Rolfo, C. (American Society of Clinical Oncology, 2020)
      PURPOSE: In the midst of a global pandemic, evidence suggests that similar to other severe respiratory viral infections, patients with cancer are at higher risk of becoming infected by COVID-19 and have a poorer prognosis. METHODS: We have modeled the mortality and the intensive care unit (ICU) requirement for the care of patients with cancer infected with COVID-19 in Latin America. A dynamic multistate Markov model was constructed. Transition probabilities were estimated on the basis of published reports for cumulative probability of complications. Basic reproductive number (R0) values were modeled with R using the EpiEstim package. Estimations of days of ICU requirement and absolute mortality were calculated by imputing number of cumulative cases in the Markov model. RESULTS: Estimated median time of ICU requirement was 12.7 days, median time to mortality was 16.3 days after infection, and median time to severe event was 8.1 days. Peak ICU occupancy for patients with cancer was calculated at 16 days after infection. Deterministic sensitivity analysis revealed an interval for mortality between 18.5% and 30.4%. With the actual incidence tendency, Latin America would be expected to lose approximately 111,725 patients with cancer to SARS-CoV-2 (range, 87,116-143,154 patients) by the 60th day since the start of the outbreak. Losses calculated vary between < 1% to 17.6% of all patients with cancer in the region. CONCLUSION: Cancer-related cases and deaths attributable to SARS-CoV-2 will put a great strain on health care systems in Latin America. Early implementation of interventions on the basis of data given by disease modeling could mitigate both infections and deaths among patients with cancer.
    • Projecting the demand for ventilators at the peak of the COVID-19 outbreak in the USA

      Wells, C.R.; Fitzpatrick, M.C.; Sah, P. (Lancet Publishing Group, 2020)
      The coronavirus disease 2019 (COVID-19) pandemic has been straining health-care systems worldwide. For countries still in the early phase of an outbreak, there is concern regarding insufficient supply of intensive care unit (ICU) beds and ventilators to handle the impending surge in critically ill patients. To inform pandemic preparations, we projected the number of ventilators that will be required in the USA at the peak of the COVID-19 outbreak.
    • Rapid spread and control of multidrug-resistant gram-negative bacteria in covid-19 patient care units

      Patel, A.; Emerick, M.; Cabunoc, M.K.; Williams, M.H.; Preas, M.A.; Schrank, G.; Rabinowitz, R.; Luethy, P.; Johnson, J.K.; Leekha, S. (Centers for Disease Control and Prevention (CDC), 2021-04)
      We describe rapid spread of multidrug-resistant gramnegative bacteria among patients in dedicated coronavirus disease care units in a hospital in Maryland, USA, during May-June 2020. Critical illness, high antibiotic use, double occupancy of single rooms, and modified infection prevention practices were key contributing factors. Surveillance culturing aided in outbreak recognition and control. Copyright 2021 Centers for Disease Control and Prevention (CDC). All rights reserved.