Cardiothoracic Surgery at the Time of the Coronavirus Disease–2019 Pandemic: Lessons From the East (and From a Previous Epidemic) for Western Battlefields
Antonio Pisano, MDGiovanni Landoni, MD Luigi Verniero, MDAlberto Zangrillo, MD
Published:May 29, 2020DOI:https://doi.org/10.1053/j.jvca.2020.04.051
https://www.jcvaonline.com/article/S1053-0770(20)30410-9/fulltext
Bis vor kurzem war Italien das Land mit der weltweit höchsten Zahl an bestätigten COVID-19-Fällen.1 Am 15. April 2020 betrug die Gesamtzahl der Menschen mit dokumentierter SARS-CoV-2-Infektion in Italien 165.155, mit mehr als 21.000 Verletzten,11 verglichen mit 3.252 Fällen (und 10 Todesfällen) in Singapur.1 Die beiden Krankenhäuser, in denen die Autoren arbeiten, stehen bei der Behandlung von COVID-19-Patienten an vorderster Front und sind gleichzeitig wichtige Referenzzentren für die Herz-Thorax-Chirurgie in Nord- bzw. Süditalien. Insbesondere das San Raffaele-Krankenhaus ist das Referenzzentrum für kardiovaskuläre Dringlichkeiten/Notfälle in der Lombardei, der am stärksten von der Epidemie betroffenen italienischen Region. Wie aus Tabelle 1 hervorgeht, blieb die Zahl der herzchirurgischen Eingriffe in den Zentren der Autoren trotz der Reduzierung oder Aussetzung der gewöhnlichen Krankenhausaufenthalte und der elektiven chirurgischen Tätigkeit ziemlich signifikant.
Fast reshaping of intensive care unit facilities in a large metropolitan hospital in Milan, Italy: Facing the COVID-19 pandemic emergency
Critical Care and Resuscitation
Volume 22 Issue 2 (Jun 2020)
https://search.informit.com.au/...mmary;dn=196484700544171;res=IELHEA
Zangrillo, Alberto1; Beretta, Luigi2; Silvani, Paolo3; Colombo, Sergio4; Scandroglio, Anna Mara5; Dell'Acqua, Antonio6; Fominskiy, Evgeny7; Landoni, Giovanni8; Monti, Giacomo9; Azzolini, Maria Luisa10; Monaco, Fabrizio11; Oriani, Alessandro12; Belletti, Alessandro13; Sartorelli, Marianna14; Pallanch, Ottavia15; Saleh, Omar16; Sartini, Chiara17; Nardelli, Pasquale18; Lombardi, Gaetano19; Morselli, Federica20; Scquizzato, Tommaso21; Frontera, Antonio22; Ruggeri, Annalisa23; Scotti, Raffaella24; Assanelli, Andrea25; Dagna, Lorenzo26; Rovere-Querini, Patrizia27; Castagna, Antonella28; Scarpellini, Paolo29; di Napoli, Davide30; Ambrosio, Alberto31; Ciceri, Fabio32; Tresoldi, Moreno33
Abstract: At the end of 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak spread from China all around the world, causing thousands of deaths. In Italy, the hardest hit region was Lombardy, with the first reported case on 20 February 2020.
San Raffaele Scientific Institute - a large tertiary hospital and research centre in Milan, Italy - was immediately involved in the management of the public health emergency. Since the beginning of the outbreak, the elective surgical activity of the hospital was rapidly reduced and large areas of the hospital were simultaneously reorganised to admit and assist patients with coronavirus disease 2019 (COVID-19). In addition, the hospital became the regional referral hub for cardiovascular emergencies in order to keep ensuring a high level of health care to non-COVID-19 patients in northern Italy.
In a few days, a COVID-19 emergency department was created, improving the general ward capacity to a total number of 279 beds dedicated to patients with COVID-19. Moreover, the number of intensive care unit (ICU) beds was increased from 28 to 72 (54 of them dedicated to patients with COVID-19, and 18 to cardiology and cardiac surgery hub emergencies), both converting pre-existing areas and creating new high technology spaces.
All the involved health care personnel were rapidly trained to use personal protection equipment and to manage this particular category of patients both in general wards and ICUs.
Furthermore, besides clinical activities, continuously important research projects were carried out in order to find new strategies and more effective therapies to better face an unprecedented health emergency in Italy.
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