Current stage of the intensive care unit structure in Argentina: results from the Sociedad Argentina de Terapia Intensiva self-assessment survey of intensive care units.
Ramiro Gilardino, Antonio Gallesio, María Pilar Arias-López, Nancy Boada, Verónica Mandich, Judith Sagardia, Maria Elena Ratto, Ariel Fernández
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Abstract
Objective: To describe and compare the structure of Argentinean intensive care units that completed the "self-assessment survey of intensive care units" developed by the Sociedad Argentina de Terapia Intensiva.
Methods: An observational crosssectional study was conducted using an online voluntary survey through the Sociedad Argentina de Terapia Intensiva member database and other social media postings. Answers received between December 2018 and July 2020 were analyzed. Descriptive statistics and nonparametric tests were used.
Results: A total of 392 surveys were received, and 244 were considered for the analysis. Seventy-seven percent (187/244) belonged to adult intensive care units, and 23% (57/244) belonged to pediatric intensive care units. The overall completion rate was 76%. The sample included 2,567 ICU beds (adult: 1,981; pediatric: 586). We observed a clear concentration of intensive care units in the Central and Buenos Aires regions of Argentina. The median number of beds was 10 (interquartile range 7 - 15).The median numbers of multiparameter monitors, mechanical ventilators, and pulse oximeters were 1 per bed with no regional or intensive care unit type differences (adult versus pediatric). Although our sample showed that the pediatric intensive care units had a higher mechanical ventilation/bed ratio than the adult intensive care units, this finding was not linearly correlated.
Conclusion: Argentina has a notable concentration of critical care beds and better structural complexity in the Buenos Aires and Centro regions for both adult and pediatric intensive care units. In addition, a lack of accurate data reported from the intensive care unit structure and resources was observed. Further improvement opportunities are required to allocate intensive care unit resources at the institutional and regional levels.
目的:描述和比较阿根廷重症监护病房的结构,完成“重症监护病房自我评估调查”由阿根廷重症监护协会制定。方法:通过Sociedad Argentina de Terapia Intensiva会员数据库和其他社交媒体帖子进行在线自愿调查,进行观察性横断面研究。对2018年12月至2020年7月收到的答案进行了分析。采用描述性统计和非参数检验。结果:共收到问卷392份,其中244份纳入分析。成人重症监护病房占77%(187/244),儿科重症监护病房占23%(57/244)。总体完成率为76%。样本包括2567张ICU床位(成人:1981张;儿科:586)。我们观察到重症监护病房明显集中在阿根廷中部和布宜诺斯艾利斯地区。床位数中位数为10张(四分位数间距7 - 15)。多参数监护仪、机械呼吸机和脉搏血氧仪的中位数为每张病床1台,没有地区或重症监护病房类型差异(成人与儿科)。虽然我们的样本显示儿科重症监护病房的机械通气/床位比高于成人重症监护病房,但这一发现并不是线性相关的。结论:阿根廷的布宜诺斯艾利斯和中部地区的成人和儿童重症监护病房的重症监护床位明显集中,结构更复杂。此外,观察到缺乏来自重症监护病房结构和资源的准确数据。需要有进一步改进的机会,以便在机构和区域两级分配重症监护病房资源。