Development and evaluation of an influenza pandemic intensive care unit triage protocol.
Identifieur interne : 000C08 ( PubMed/Corpus ); précédent : 000C07; suivant : 000C09Development and evaluation of an influenza pandemic intensive care unit triage protocol.
Auteurs : Winston Cheung ; John Myburgh ; Ian M. Seppelt ; Michael J. Parr ; Nikki Blackwell ; Shannon Demonte ; Kalpesh Gandhi ; Larissa Hoyling ; Priya Nair ; Melissa Passer ; Claire Reynolds ; Nicholas M. Saunders ; Manoj K. Saxena ; Govindasamy ThanakrishnanSource :
- Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine [ 1441-2772 ] ; 2012.
English descriptors
- KwdEn :
- MESH :
- geographic : New South Wales, Ontario.
- epidemiology : Influenza, Human.
- mortality : Influenza, Human.
- Clinical Protocols, Humans, Intensive Care Units, Pandemics, Triage.
Abstract
To develop an influenza pandemic ICU triage (iPIT) protocol that excludes patients with the highest and lowest predicted mortality rates, and to determine the increase in ICU bed availability that would result.
PubMed: 22963212
Links to Exploration step
pubmed:22963212Le document en format XML
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<author><name sortKey="Cheung, Winston" sort="Cheung, Winston" uniqKey="Cheung W" first="Winston" last="Cheung">Winston Cheung</name>
<affiliation><nlm:affiliation>Concord Repatriation General Hospital, Sydney, NSW, Australia. winston.cheung@sswahs.nsw.gov.au.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Myburgh, John" sort="Myburgh, John" uniqKey="Myburgh J" first="John" last="Myburgh">John Myburgh</name>
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<author><name sortKey="Seppelt, Ian M" sort="Seppelt, Ian M" uniqKey="Seppelt I" first="Ian M" last="Seppelt">Ian M. Seppelt</name>
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<author><name sortKey="Parr, Michael J" sort="Parr, Michael J" uniqKey="Parr M" first="Michael J" last="Parr">Michael J. Parr</name>
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<author><name sortKey="Blackwell, Nikki" sort="Blackwell, Nikki" uniqKey="Blackwell N" first="Nikki" last="Blackwell">Nikki Blackwell</name>
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<author><name sortKey="Demonte, Shannon" sort="Demonte, Shannon" uniqKey="Demonte S" first="Shannon" last="Demonte">Shannon Demonte</name>
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<author><name sortKey="Gandhi, Kalpesh" sort="Gandhi, Kalpesh" uniqKey="Gandhi K" first="Kalpesh" last="Gandhi">Kalpesh Gandhi</name>
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<author><name sortKey="Hoyling, Larissa" sort="Hoyling, Larissa" uniqKey="Hoyling L" first="Larissa" last="Hoyling">Larissa Hoyling</name>
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<author><name sortKey="Nair, Priya" sort="Nair, Priya" uniqKey="Nair P" first="Priya" last="Nair">Priya Nair</name>
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<author><name sortKey="Passer, Melissa" sort="Passer, Melissa" uniqKey="Passer M" first="Melissa" last="Passer">Melissa Passer</name>
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<author><name sortKey="Reynolds, Claire" sort="Reynolds, Claire" uniqKey="Reynolds C" first="Claire" last="Reynolds">Claire Reynolds</name>
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<author><name sortKey="Saunders, Nicholas M" sort="Saunders, Nicholas M" uniqKey="Saunders N" first="Nicholas M" last="Saunders">Nicholas M. Saunders</name>
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<author><name sortKey="Saxena, Manoj K" sort="Saxena, Manoj K" uniqKey="Saxena M" first="Manoj K" last="Saxena">Manoj K. Saxena</name>
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<author><name sortKey="Thanakrishnan, Govindasamy" sort="Thanakrishnan, Govindasamy" uniqKey="Thanakrishnan G" first="Govindasamy" last="Thanakrishnan">Govindasamy Thanakrishnan</name>
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<author><name sortKey="Seppelt, Ian M" sort="Seppelt, Ian M" uniqKey="Seppelt I" first="Ian M" last="Seppelt">Ian M. Seppelt</name>
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<author><name sortKey="Parr, Michael J" sort="Parr, Michael J" uniqKey="Parr M" first="Michael J" last="Parr">Michael J. Parr</name>
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<author><name sortKey="Blackwell, Nikki" sort="Blackwell, Nikki" uniqKey="Blackwell N" first="Nikki" last="Blackwell">Nikki Blackwell</name>
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<author><name sortKey="Demonte, Shannon" sort="Demonte, Shannon" uniqKey="Demonte S" first="Shannon" last="Demonte">Shannon Demonte</name>
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<author><name sortKey="Gandhi, Kalpesh" sort="Gandhi, Kalpesh" uniqKey="Gandhi K" first="Kalpesh" last="Gandhi">Kalpesh Gandhi</name>
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<author><name sortKey="Hoyling, Larissa" sort="Hoyling, Larissa" uniqKey="Hoyling L" first="Larissa" last="Hoyling">Larissa Hoyling</name>
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<author><name sortKey="Nair, Priya" sort="Nair, Priya" uniqKey="Nair P" first="Priya" last="Nair">Priya Nair</name>
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<author><name sortKey="Passer, Melissa" sort="Passer, Melissa" uniqKey="Passer M" first="Melissa" last="Passer">Melissa Passer</name>
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<author><name sortKey="Reynolds, Claire" sort="Reynolds, Claire" uniqKey="Reynolds C" first="Claire" last="Reynolds">Claire Reynolds</name>
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<author><name sortKey="Saunders, Nicholas M" sort="Saunders, Nicholas M" uniqKey="Saunders N" first="Nicholas M" last="Saunders">Nicholas M. Saunders</name>
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<author><name sortKey="Saxena, Manoj K" sort="Saxena, Manoj K" uniqKey="Saxena M" first="Manoj K" last="Saxena">Manoj K. Saxena</name>
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<author><name sortKey="Thanakrishnan, Govindasamy" sort="Thanakrishnan, Govindasamy" uniqKey="Thanakrishnan G" first="Govindasamy" last="Thanakrishnan">Govindasamy Thanakrishnan</name>
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<series><title level="j">Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine</title>
<idno type="ISSN">1441-2772</idno>
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<term>Influenza, Human (epidemiology)</term>
<term>Influenza, Human (mortality)</term>
<term>Intensive Care Units</term>
<term>New South Wales</term>
<term>Ontario</term>
<term>Pandemics</term>
<term>Triage</term>
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<keywords scheme="MESH" type="geographic" xml:lang="en"><term>New South Wales</term>
<term>Ontario</term>
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<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Influenza, Human</term>
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<keywords scheme="MESH" xml:lang="en"><term>Clinical Protocols</term>
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<front><div type="abstract" xml:lang="en">To develop an influenza pandemic ICU triage (iPIT) protocol that excludes patients with the highest and lowest predicted mortality rates, and to determine the increase in ICU bed availability that would result.</div>
</front>
</TEI>
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<DateCompleted><Year>2012</Year>
<Month>11</Month>
<Day>01</Day>
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<DateRevised><Year>2012</Year>
<Month>09</Month>
<Day>11</Day>
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<Article PubModel="Print"><Journal><ISSN IssnType="Print">1441-2772</ISSN>
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<Month>Sep</Month>
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<Title>Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine</Title>
<ISOAbbreviation>Crit Care Resusc</ISOAbbreviation>
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<ArticleTitle>Development and evaluation of an influenza pandemic intensive care unit triage protocol.</ArticleTitle>
<Pagination><MedlinePgn>185-90</MedlinePgn>
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<Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To develop an influenza pandemic ICU triage (iPIT) protocol that excludes patients with the highest and lowest predicted mortality rates, and to determine the increase in ICU bed availability that would result.</AbstractText>
<AbstractText Label="DESIGN AND SETTING" NlmCategory="METHODS">Post-hoc analysis of a study evaluating two triage protocols, designed to determine which patients should be excluded from access to ICU resources during an influenza pandemic. ICU mortality rates were determined for the individual triage criteria in the protocols and included criteria based on the Sequential Organ Failure Assessment (SOFA) score. Criteria resulting in mortality rates outside the 25th and 75th percentiles were used as exclusion criteria in a new iPIT-1 protocol. The SOFA threshold component was modified further and reported as iPIT-2 and iPIT-3.</AbstractText>
<AbstractText Label="MAIN OUTCOME MEASURE" NlmCategory="METHODS">Increase in ICU bed availability.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">The 25th and 75th percentiles for ICU mortality were 8.3% and 35.2%, respectively. Applying the iPIT-1 protocol resulted in an increase in ICU bed availability at admission of 71.7% ± 0.6%. Decreasing the lower SOFA score exclusion criteria to ≤6 (iPIT-2) and ≤4 (iPIT-3) resulted in an increase in ICU bed availability at admission of 66.9% ± 0.6% and 59.4 ± 0.7%, respectively (P < 0.001).</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The iPIT protocol excludes patients with the lowest and highest ICU mortality, and provides increases in ICU bed availability. Adjusting the lower SOFA score exclusion limit provides a method of escalation or de- escalation to cope with demand.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Cheung</LastName>
<ForeName>Winston</ForeName>
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<AffiliationInfo><Affiliation>Concord Repatriation General Hospital, Sydney, NSW, Australia. winston.cheung@sswahs.nsw.gov.au.</Affiliation>
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<Author ValidYN="Y"><LastName>Myburgh</LastName>
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<Author ValidYN="Y"><LastName>Thanakrishnan</LastName>
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<Author ValidYN="Y"><CollectiveName>Influenza Pandemic ICU Triage (iPIT) Study Investigators</CollectiveName>
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