About 70% of patients who were treated in 2020 in the Intermediate Respiratory Care Unit (UCRI) of Bellvitge University Hospital for severe pneumonia due to Covid-19 did not need to be admitted to the ICU. The Bellvitge UCRI reached 500 Covid patients last December, with an average stay of 7 days.
UCRIs care for severe patients with a situation of complex acute respiratory failure, but who have not yet required orotracheal intubation and mechanical ventilation, which leads to admission to the Intensive Care Unit. In the semi-critical respiratory unit, patients are treated with non-invasive ventilation and high-flow oxygen therapy, which involves providing the patient with a flow of oxygen through a nasal cannula.
Prior to the pandemic, UCRI would annually receive an average of 100 patients in need of noninvasive ventilatory support with a different clinical profile (mostly chronic acute respiratory patients). The pandemic has meant a change in the patient's profile and a considerable increase in activity in the unit.
As Dr. Salud Santos, head of the Pulmonology Service at Bellvitge University Hospital, “many patients manage to overcome the ascending phase of Covid pneumonia respiratory failure with us, which facilitates the management of ICU beds. These 500 patients demonstrate the fundamental role of non-invasive therapies and UCRIs throughout the pandemic. At the beginning of the year, before the outbreak of the virus, the UCRI of Bellvitge Hospital had 4 beds. In order to respond to the health emergency in the most serious peaks of the pandemic they reached 72.
As of now, the respiratory semi-critical unit has almost twenty beds to attend to the volume of patients with the scenario. current pandemic, with flexibility to suit needs. "This extraordinary response has been possible thanks to the commitment of pulmonology, nursing and physiotherapy professionals and the real-time reaction of the hospital's management to adapt to the different scenarios," underlines Dr. Santos.
Bellvitge Hospital’s UCRI has also played a key role as a benchmark for networking with county hospitals that do not have care facilities for respiratory semi-critics. In this sense, the unit has treated a large number of patients from the hospitals of Viladecans and Martorell, among others.
In this line, Dra. Mònica Ruiz, head of the Internal Medicine Service of the Hospital de Viladecans, considers that the articulation of protocols to allow the drainage of patients from one center to another and the fluid communication with the Hospital de Bellvitge have been fundamental “To guarantee continuity of care. We have worked as a real team and this has allowed an agile drainage of patients and thus the possibility of offering non-invasive therapies as early as possible, trying at all times to stabilize the patient without having to enter intensive care units ”. Personal contact is essential in this networking, and the teams of Viladecans and Bellvitge meet at least once a week by video conference to manage different issues and other organizational aspects.