The Coronavirus Disease 2019 Pandemic's Effect on Critical Care Resources and Health-Care Providers: A Global Survey.

Abstract:

BACKGROUND:The coronavirus disease 2019 (COVID-19) pandemic has severely affected ICUs and critical care health-care providers (HCPs) worldwide. RESEARCH QUESTION:How do regional differences and perceived lack of ICU resources affect critical care resource use and the well-being of HCPs? STUDY DESIGN AND METHODS:Between April 23 and May 7, 2020, we electronically administered a 41-question survey to interdisciplinary HCPs caring for patients critically ill with COVID-19. The survey was distributed via critical care societies, research networks, personal contacts, and social media portals. Responses were tabulated according to World Bank region. We performed multivariate log-binomial regression to assess factors associated with three main outcomes: limiting mechanical ventilation (MV), changes in CPR practices, and emotional distress and burnout. RESULTS:We included 2,700 respondents from 77 countries, including physicians (41%), nurses (40%), respiratory therapists (11%), and advanced practice providers (8%). The reported lack of ICU nurses was higher than that of intensivists (32% vs 15%). Limiting MV for patients with COVID-19 was reported by 16% of respondents, was lowest in North America (10%), and was associated with reduced ventilator availability (absolute risk reduction [ARR], 2.10; 95% CI, 1.61-2.74). Overall, 66% of respondents reported changes in CPR practices. Emotional distress or burnout was high across regions (52%, highest in North America) and associated with being female (mechanical ventilation, 1.16; 95% CI, 1.01-1.33), being a nurse (ARR, 1.31; 95% CI, 1.13-1.53), reporting a shortage of ICU nurses (ARR, 1.18; 95% CI, 1.05-1.33), reporting a shortage of powered air-purifying respirators (ARR, 1.30; 95% CI, 1.09-1.55), and experiencing poor communication from supervisors (ARR, 1.30; 95% CI, 1.16-1.46). INTERPRETATION:Our findings demonstrate variability in ICU resource availability and use worldwide. The high prevalence of provider burnout and its association with reported insufficient resources and poor communication from supervisors suggest a need for targeted interventions to support HCPs on the front lines.

journal_name

Chest

journal_title

Chest

authors

Wahlster S,Sharma M,Lewis AK,Patel PV,Hartog CS,Jannotta G,Blissitt P,Kross EK,Kassebaum NJ,Greer DM,Curtis JR,Creutzfeldt CJ

doi

10.1016/j.chest.2020.09.070

subject

Has Abstract

pub_date

2020-09-11 00:00:00

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(20)34438-X

pub_type

杂志文章

相关文献

CHEST文献大全
  • Diagnostic accuracy of coronary angiography utilizing computer-based digital subtraction methods. Comparison to conventional cineangiography.

    abstract::To evaluate the efficacy of mask-mode digital subtraction angiography in selective coronary arteriography, we compared computer-based digital subtraction angiograms to standard film-based angiograms in 77 patients. Digital angiography was performed utilizing a 512(2) matrix and a framing rate of 30 frames/second. Radi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.90.6.793

    authors: Goldberg HL,Moses JW,Fisher J,Tamari I,Borer JS

    更新日期:1986-12-01 00:00:00

  • Transmitral flow changes during dipyridamole-induced ischemia. A Doppler-echocardiographic study.

    abstract::Myocardial ischemia results in altered left ventricular (LV) diastolic compliance, reflected by an abnormal mitral inflow pattern on Doppler echocardiography. To investigate the relationship of Doppler echocardiography and regional myocardial systolic function during dipyridamole infusion, we evaluated transmitral flo...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.95.5.1037

    authors: Lattanzi F,Picano E,Masini M,De Prisco F,Distante A,L'Abbate A

    更新日期:1989-05-01 00:00:00

  • Oropharyngeal Gram-negative bacillary carriage: a survey of 120 healthy individuals.

    abstract:BACKGROUND:The presence of aerobic Gram-negative bacilli (AGNB) in the oropharynx can be either temporary or persistent. Prolonged colonization (ie, carriage) is distinguished from transient presence (ie, acquisition), which often occurs in healthy individuals but less frequently in those with underlying disease. Preva...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.115.6.1570

    authors: Mobbs KJ,van Saene HK,Sunderland D,Davies PD

    更新日期:1999-06-01 00:00:00

  • Maximum cardiac output during incremental exercise by first-pass radionuclide ventriculography.

    abstract:STUDY OBJECTIVE:To validate a noninvasive first-pass radionuclide ventriculographic (FPRV) measurement of maximum cardiac output (Qv) during exercise. DESIGN:Comparison of Qv to that measured by the Fick principle (Qf) at peak exercise. SETTING:Academic cardiopulmonary exercise laboratory. PATIENTS:Seventy-eight con...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.114.2.457

    authors: Maroni JM,Oelberg DA,Pappagianopoulos P,Boucher CA,Systrom DM

    更新日期:1998-08-01 00:00:00

  • Intrapleural talc for the prevention of recurrent pneumothorax.

    abstract::The ipsilateral recurrence rate after the first spontaneous pneumothorax treated with tube thoracostomy is reported to be between 23 percent and 52 percent. The incidence of recurrence after the first recurrence is substantially higher. Chemical pleurodesis has been attempted to decrease the recurrence rate. Tetracycl...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.106.4.1162

    authors: Milanez JR,Vargas FS,Filomeno LT,Fernandez A,Jatene A,Light RW

    更新日期:1994-10-01 00:00:00

  • Daytime Cheyne-Stokes respiration in ambulatory patients with severe congestive heart failure is associated with increased mortality.

    abstract:BACKGROUND:Cheyne-Stokes respiration (CSR) frequently occurs in patients with severe heart failure during sleep and may increase mortality. Daytime CSR supposedly poses an even greater risk, but its prevalence and prognostic importance remain elusive. Therefore, we investigated the circadian prevalence of CSR and its i...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.07-0121

    authors: Brack T,Thüer I,Clarenbach CF,Senn O,Noll G,Russi EW,Bloch KE

    更新日期:2007-11-01 00:00:00

  • Massive hemoptysis from a pulmonary artery aneurysm associated with an emphysematous bulla.

    abstract::A 66-year-old man with a history of COPD and Aspergillus fumigatus infection developed massive hemoptysis. Pulmonary artery angiography revealed an aneurysm which was successfully treated with coil embolization. This is the first known report of a pulmonary artery aneurysm causing massive hemoptysis in a patient with ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.113.4.1130

    authors: Bowler RP,Durham J,Schwarz MI

    更新日期:1998-04-01 00:00:00

  • The bronchial response, but not the pulmonary response to inhaled methacholine is dependent on the aerosol deposition pattern.

    abstract::The clinical effect of inhaled radio-labeled (Technetium-99m diethylenetriamine-pentaacetic acid) methacholine was studied in two separate experiments performed in eight symptom-free asthmatics with bronchial hyperresponsiveness. Aerosols were formed by two different nebulizers, producing either mainly small aerosol p...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.106.6.1781

    authors: Schmekel B,Hedenström H,Kämpe M,Lagerstrand L,Stålenheim G,Wollmer P,Hedenstierna G

    更新日期:1994-12-01 00:00:00

  • Bronchogenic cancer in patients under 40 years old. The experience of a Latin American country.

    abstract::Lung cancer in young patients is increasing in frequency, as documented by data from the United States, Canada, Japan, and European countries. However, to date and to our knowledge, there have not been any reports from Latin America on this topic. The published reports show that lung cancer in young patients is associ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.5.1477

    authors: Green LS,Fortoul TI,Ponciano G,Robles C,Rivero O

    更新日期:1993-11-01 00:00:00

  • Performance and Interpretation of Invasive Hemodynamic Exercise Testing.

    abstract::Exertional dyspnea is a common complaint for patients seen in pulmonary, cardiac, and general medicine clinics, and elucidating the cause is often challenging, particularly when physical examination, echocardiography, radiography, and pulmonary function test results are inconclusive. Invasive cardiopulmonary exercise ...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1016/j.chest.2020.05.552

    authors: Jain CC,Borlaug BA

    更新日期:2020-11-01 00:00:00

  • Operable non-small cell lung cancer diagnosed by transpleural techniques : do they affect relapse and prognosis?

    abstract:STUDY OBJECTIVE:We assessed whether transpleural methods for diagnosing peripheral lung cancer, such as needle aspiration or tumor excision, affect relapse and prognosis, because these techniques have potential to spread malignant cells from the tumor. DESIGN:A retrospective study. SETTING:National referral hospital....

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.120.5.1595

    authors: Sawabata N,Maeda H,Ohta M,Hayakawa M

    更新日期:2001-11-01 00:00:00

  • Catheter-induced tricuspid regurgitation. Incidence and clinical significance.

    abstract::The incidence and severity of catheter-induced tricuspid regurgitation has not been studied extensively. Given the frequency with which right heart catheters are employed to measure cardiac output, it is important to know whether the severity of catheter-induced tricuspid regurgitation is sufficient to invalidate the ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.3.651

    authors: Stewart D,Leman RB,Kaiser J,Mann DL

    更新日期:1991-03-01 00:00:00

  • Bronchoscopy specimens in adults with AIDS. Comparative yields of cytology, histology and culture for diagnosis of infectious agents.

    abstract::Bronchoscopy specimens from 183 known/suspected acquired immunodeficiency syndrome patients were evaluated for pathogens. In each case, transbronchial biopsies were evaluated and bronchoalveolar lavage material was cultured for viruses, fungi and mycobacteria and examined cytologically. A specimen was considered posit...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.1.24

    authors: Weldon-Linne CM,Rhone DP,Bourassa R

    更新日期:1990-07-01 00:00:00

  • Mid-systolic sound associated with aortic insufficiency and bisferiens pulse.

    abstract::Systolic ejection clicks, often associated with cardiac disease, can be distinguished from mid-systolic clicks of mitral and tricuspid origin, which are frequently benign. A different mid-systolic sound has been recognized, with timing similar to the mid-systolic clicks, which is associated with aortic insufficiency. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.83.1.141

    authors: Robertson WS,Tavel ME

    更新日期:1983-01-01 00:00:00

  • Lung MRI as a possible alternative to CT scan for patients with primary immune deficiencies and increased radiosensitivity.

    abstract:BACKGROUND:Patients with common variable immunodeficiency (CVID) suffer from respiratory infections leading over time to permanent lung damage. Increased radiosensitivity has been described, and clinicians should consider a risk-benefit assessment when ordering a CT scan, in that the exact level of "safe" radiation exp...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.10-3147

    authors: Serra G,Milito C,Mitrevski M,Granata G,Martini H,Pesce AM,Sfika I,Bonanni L,Catalano C,Fraioli F,Quinti I

    更新日期:2011-12-01 00:00:00

  • Crosslinking and carbohydrate studies on the hydroxylated glycopeptides which accumulate in alveoli and lamellar bodies.

    abstract::These data suggest that the alveolar lining layer and lamellar body membranes contain the same saline-insoluble proteins, two of which are unusual in that they contain hydroxyproline and large amounts of glycine. Neither the function nor the origin of these glycopeptides has been established, and we are currently eval...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.67.2_supplement.28s

    authors: Passero MA,Bhattacharyya SN,Sahu S,Lynn WS

    更新日期:1975-02-01 00:00:00

  • Differential response in the male and female tracheal epithelium following exposure to tobacco smoke.

    abstract::Histochemical quantification of goblet cells and measurements of the epithelial thickness were made in the trachea of male and female rats exposed to fresh whole tobacco smoke for 30 consecutive days. Exposure to tobacco smoke resulted in an increase in the total goblet cell count in both sexes, with the female rats d...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.73.4.515

    authors: Hayashi M,Sornberger GC,Huber GL

    更新日期:1978-04-01 00:00:00

  • The Burden of Community-Acquired Pneumonia Requiring Admission to ICU in the United States.

    abstract:BACKGROUND:A paucity of studies have assessed the epidemiology of community-acquired pneumonia (CAP) that require ICU admission. We conducted a study on this group of patients with the primary objective of defining the incidence, epidemiology, and mortality rate of CAP in the ICUs in Louisville, Kentucky. The secondary...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2020.03.051

    authors: Cavallazzi R,Furmanek S,Arnold FW,Beavin LA,Wunderink RG,Niederman MS,Ramirez JA

    更新日期:2020-09-01 00:00:00

  • Clinical staging of patients with non-small cell lung cancer.

    abstract::This article is the first in a planned series from the Section on Lung Cancer of the ACCP addressing the important and clinically relevant aspects of what is now the most common malignancy in the world, lung cancer. This initial report addresses the problem of staging of lung cancer. Staging, or identifying the anatom...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.6.1431

    authors: Little AG,Stitik FP

    更新日期:1990-06-01 00:00:00

  • Acceptance of CPAP therapy for sleep apnea.

    abstract::Although NCPAP is the most efficient nonsurgical treatment for patients with OSA, many patients do not accept sleeping with a nose mask. To determine the factors influencing acceptance, treatment with NCPAP was offered to 95 patients with an AHI greater than 15. After the first night on NCPAP, 47 of 65 patients decide...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.100.4.1019

    authors: Rauscher H,Popp W,Wanke T,Zwick H

    更新日期:1991-10-01 00:00:00

  • The echocardiographic diagnosis of rupture of a papillary muscle.

    abstract::The echocardiographic diagnosis of acute rupture of a papillary muscle is described. The pertinent findings included (1) decreased systolic motion of the posterior wall, (2) exaggerated septal motion, (3) left ventricular enlargement and pattern suggesting left ventricular diastolic overload, and (4) bizarre flutterin...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.73.2.232

    authors: Ahmad S,Kleiger RE,Connors J,Krone R

    更新日期:1978-02-01 00:00:00

  • Hemianomalous pulmonary venous connection of the left lung surgically corrected.

    abstract::Hemianomalous pulmonary venous connection is a rare congenital abnormality that leads to significant left-to-right shunt and complications related to that. Earlier surgical correction of this disorder was associated with the problem of stenosis at the anastomotic site with the left atrium. We describe the diagnosis of...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.101.6.1718

    authors: Murali VP,Bahuleyan CG,Jayakumar K,Ramanarayan PV,Nair GR

    更新日期:1992-06-01 00:00:00

  • Pulmonary rehabilitation: a classic tune with a new beat, but is anyone listening?

    abstract::Comprehensive pulmonary rehabilitation and respiratory therapy services benefit patients with chronic lung disease and other diseases of the lung by reducing symptoms and restoring independent function. Although the science of these therapies is not new, commercial payers and Medicare have generally been slow to suppo...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.10-2392

    authors: Birnbaum S

    更新日期:2011-06-01 00:00:00

  • Treatment strategies for acute myocardial infarction complicated by cardiogenic shock in a community hospital.

    abstract::The risk and benefits of three treatment strategies were examined in 64 consecutive patients with acute myocardial infarction and cardiogenic shock. Thirteen patients received thrombolytic therapy (group 1), 29 patients received intra-aortic balloon pump counterpulsation support (group 2), and 22 patients were treated...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.105.4.997

    authors: Stomel RJ,Rasak M,Bates ER

    更新日期:1994-04-01 00:00:00

  • VATS (video-assisted thoracic surgery) of undefined pulmonary nodules. Preoperative evaluation of videoendoscopic resectability.

    abstract::Peripheral undefined pulmonary nodules have become a favorable indication for the videoendoscopic approach in thoracic surgery. In our latest experience, we also successfully applied this technique in centrally located lesions of the lung. In reviewing our first 29 cases, we looked for preoperative features of videoen...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.106.5.1570

    authors: Schwarz CD,Lenglinger F,Eckmayr J,Schauer N,Hartl P,Mayer KH

    更新日期:1994-11-01 00:00:00

  • Chronic necrotizing pulmonary aspergillosis in pneumoconiosis: clinical and radiologic findings in 10 patients.

    abstract:STUDY OBJECTIVE:To characterize clinical, radiographic, and CT findings of chronic necrotizing pulmonary aspergillosis (CNPA) in patients with pneumoconiosis. METHODS:We studied 10 patients with pneumoconiosis who were seen at Asahi Rosai Hospital and received a clinical diagnosis of CNPA during a 15-year period, and ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.121.1.118

    authors: Kato T,Usami I,Morita H,Goto M,Hosoda M,Nakamura A,Shima S

    更新日期:2002-01-01 00:00:00

  • Value of in situ elemental microanalysis in the histologic diagnosis of silicosis.

    abstract::Pulmonary specimens obtained from ten normal subjects and 53 patients with various pulmonary diseases were studied with energy-dispersive x-ray analysis. The amount of silicon in the pulmonary tissue was determined and expressed as a silicon/sulfur (Si/S) ratio. This Si/S ratio was below 0.2 in the ten normal subjects...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.85.4.506

    authors: Funahashi A,Schlueter DP,Pintar K,Siegesmund KA

    更新日期:1984-04-01 00:00:00

  • Anti-inflammatory action of erythromycin. Its inhibitory effect on neutrophil NADPH oxidase activity.

    abstract::The effects of erythromycin on the NADPH oxidase activity in the neutrophils of normal subjects and patients with bronchiolitis were investigated. In the patients receiving erythromycin, NADPH oxidase activity was significantly lower in a whole-cell system than that before therapy. Erythromycin was also found to inhib...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.4.1191

    authors: Umeki S

    更新日期:1993-10-01 00:00:00

  • Pharmacologic therapy for pulmonary arterial hypertension in adults: CHEST guideline and expert panel report.

    abstract:OBJECTIVE:Choices of pharmacologic therapies for pulmonary arterial hypertension (PAH) are ideally guided by high-level evidence. The objective of this guideline is to provide clinicians advice regarding pharmacologic therapy for adult patients with PAH as informed by available evidence. METHODS:This guideline was bas...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.14-0793

    authors: Taichman DB,Ornelas J,Chung L,Klinger JR,Lewis S,Mandel J,Palevsky HI,Rich S,Sood N,Rosenzweig EB,Trow TK,Yung R,Elliott CG,Badesch DB

    更新日期:2014-08-01 00:00:00

  • Gastroesophageal reflux-induced bronchoconstriction. An intraesophageal acid infusion study using state-of-the-art technology.

    abstract:STUDY OBJECTIVE:To study mechanisms of gastroesophageal reflux-induced bronchoconstriction during intraesophageal infusions. DESIGN:Prospective study blinded to the subject. SETTING:Outpatient pulmonary function laboratory at a 908-bed university hospital. PARTICIPANTS:Forty-seven adult subjects divided into four gr...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.106.3.731

    authors: Schan CA,Harding SM,Haile JM,Bradley LA,Richter JE

    更新日期:1994-09-01 00:00:00