A catalogue of tools and variables from crisis and routine care to support decision-making about allocation of intensive care beds and ventilator treatment during pandemics: Scoping review

Magnolia Cardona, Claudia Caroline Dobler, Eyza Koreshe, Daren K Heyland, Rebecca H Nguyen, Joan PY Sim, Justin Clark, Alex Psirides

Research output: Contribution to journalReview articleResearchpeer-review

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Abstract

Purpose: This scoping review sought to identify objective factors to assist clinicians and policy-makers in making
consistent, objective and ethically sound decisions about resource allocation when healthcare rationing is inevitable.
Materials and methods: Review of guidelines and tools used in ICUs, hospital wards and emergency departments
on how to best allocate intensive care beds and ventilators either during routine care or developed during previous
epidemics, and association with patient outcomes during and after hospitalisation.
Results: Eighty publications from 20 countries reporting accuracy or validity of prognostic tools/algorithms, or significant correlation between prognostic variables and clinical outcomes met our eligibility criteria: twelve pandemic guidelines/triage protocols/consensus statements, twenty-two pandemic algorithms, and 46 prognostic tools/variables from non-crisis situations. Prognostic indicators presented here can be combined to create locally-relevant triage algorithms for clinicians and policy makers deciding about allocation of ICU beds and ventilators during a pandemic. No consensus was found on the ethical issues to incorporate in the decision to admit
or triage out of intensive care.
Conclusions: This review provides a unique reference intended as a discussion starter for clinicians and policy makers to consider formalising an objective a locally-relevant triage consensus document that enhances confidence in decision-making during healthcare rationing of critical care and ventilator resources.
Original languageEnglish
Pages (from-to)33-43
Number of pages11
JournalJournal of Critical Care
Volume66
Early online date23 Aug 2021
DOIs
Publication statusE-pub ahead of print - 23 Aug 2021

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