Our mission: to provide an intensive care bed to whoever needs one

From the beginning of the COVID 19 outbreak, the ICU Lombardy Network established two key priorities: to maximize ICU capacity and to implement containment measures. During an interview with JN Learning, Professor of Humanitas University and Head of ICU at Humanitas Research Hospital Maurizio Cecconi explains that the aim is not only to provide intensive care to patients that require it but also to minimize the spread by avoiding transmission between patients. It is important to prepare for surge capacity and put a plan in action from the beginning to avoid wasting time.

Lombardy initially had an ICU capacity of 720 beds but within a week an additional 200 beds had been added. The people occupying these beds are almost entirely patients that require invasive mechanical ventilation. Prof. Cecconi explains that without the support of the ICU Lombardy network and the ECMO Respiratory Failure Network (RESPIRA) this would not have been possible. Hospitals were asked to create ICU cohorts for COVID-19 patients, develop triage protocols for patients with respiratory symptoms, establish triage areas where patients could receive mechanical ventilation, provide personal protective equipment (PPE) to healthcare workers, and report positive or suspected COVID-19 cases to adequate authorities. Moreover, hospitals in the region cancelled non-urgent elective surgeries to free up operating theatre resources, including ventilators; established intensive care areas in other wards, and provided Level 2 organ support, such as monitoring and non-invasive ventilation, outside the ICU areas.

Reaching capacity and implementing containment was possible thanks to the sacrifice and effort of the healthcare staff.

“To save a life of an intensive care patient now is the effort of the whole hospital, of all the healthcare authorities, of everyone that works in healthcare. Everyone is working beyond what was asked of them” commented prof. Cecconi.

In order to protect the staff, in addition to provide them with PPE, they were also trained, thanks to the simulations conducted immediately in order to train staff in donning and doffing procedures and to prepare them for working in difficult situations. Treating patients with full protection means neither resting, nor drinking water nor even going to the toilet during 6 hour shifts, and in some cases for an even longer period.

“To win this battle we have to increase capacity but also implement containment and mitigation measures, which are possibly more important to stop the pandemic. For this to happen we need a strong collaboration between governments, health authorities and the citizens” prof. Cecconi concluded.