Characteristics and results of the specialized department of anesthesiology and intensive care for patients with COVID-19 in the Republic of Sakha (Yakutia)

Abstract

Aim: To analyze the work in the specialized anesthesiology and intensive care unit in the Republic of Sakha (Yakutia) for patients with COVID-19 in the context of the pandemic.

Materials and methods: A retrospective observational study was conducted based on work perfomed by anesthesiology and intensive care unit (AICU) in the State Budgetary Institution of the Republic of Sakha (Yakutia) “Yakut Republican Clinical Hospital” (YRCH) for the period since March, 2020, to December, 2021.

Results and discussion: YRCH have repurposed the hospital beds and enhanced the material and technical equipment supply of the AICU. Given the epidemiological situation, the bed capacity and the staff schedule of the unit were in the scope of regulation. The medical staff level was 76.5 % in 2020 and 80 % in 2021. The level of nursing and medical attendant staff for the entire period was 100 %. During the study period 1,796 patients were admitted (488 patients in 2020, 1,308 patients in 2021). The bed turnover was 24.4 and 28.2 patients per bed, the average rate of bed occupancy was 136 and 244.6 days, the average length of stay of patients was 5.5 and 6.0 days in 2020 and 2021, respectively. In total, 1,015 patients have died (mortality rate – 56.5 %), with 281 patients to have died in 2020 (mortality rate — 58.0 %) and 734 in 2021 (mortality rate — 56.2 %). The mortality rate of patients significantly increases with age and amounted to 71.2 % in patients older than 81 years.  The main cause for admission in AICU was acute respiratory failure (ARF), the treatment has used is stepwise respiratory therapy. Standard oxygen therapy (15-20 l/min) was effective in 64 (3.6 %) patients, high-flow oxygen therapy (HFOT) was used in 1,732 (96.4 %) patients, non-invasive mechanical ventilation (NIV) was used in 717 (39.9 %), invasive mechanical ventilation was used in 1,015 (56.5 %) patients.

Conclusion: The complex of measures for the deployment of specialized anesthesiology and intensive care for adults with COVID-19 in the YRCH has allowed to succeed with an overflow of patients suffering a severe course of the disease. The characteristics of the unit indicated the difficulties in managing patients with COVID-19 complicated by viral pneumonia with severe ARF.