Late Breaking Abstract - Management of COVID-19 pneumonia in an enhanced respiratory step down unit: a novel approach

Throughout the COVID-19 pandemic, patients have received escalated care on specialist respiratory wards outside of intensive care units (ICU) in various forms. We performed this study to review the effectiveness of an enhanced respiratory step-down unit (ECU) during the COVID-19 pandemic at Warrington and Halton Teaching Hospitals NHS Foundation Trust.This was a retrospective observational study of patients admitted to the ECU from ICU between April 2020 and January 2021. Data collected included demographics, treatments given and outcomes.We accepted patients to the ECU following level 2-3 care but still requiring specialised respiratory support: weaning off Continuous Positive Airway Pressure (CPAP via domiciliary machines) and High Flow Nasal Oxygen Therapy (HFNO).266 patients were admitted to ICU with COVID-19 pneumonia. 161 were stepped down to the ECU. 62% were men. The average age was 61 years and average BMI 31.2kg/m2. Median time from hospital admission to ICU was 1 day. Post step-down mortality was 11.8%.10.6% were intubated and all survived. 69.6% were weaned down to CPAP & HFNO prior to step-down while only 5.6% were on CPAP throughout the day. 7.4%  received only HFNO as escalation and only 1 did not survive following a stroke. 7.5% (12/161) were readmitted to ICU, out of which 25% (3/12) were intubated (all survived) and 41.7% (5/12) died. Overall mean duration of stay was 10 days in ICU and 2.7 days in ECU (21.25% reduction).An enhanced respiratory step...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Respiratory infections and bronchiectasis Source Type: research