The SARS-CoV-2 coronavirus pandemic has tested the capacity of the entire healthcare system to the limit. This is particularly true of critical care units, which have had to double or triple their capacity to cater for demand. Post anaesthesia care units and other units in the surgical suite have played a fundamental role in preventing the collapse of critical care units. These units, which include certain Reanimation units, Post Anaesthesia Care Units (PACU) and operating rooms managed by the Anaesthesiology and Reanimation Service, are overlooked by hospital management and health services because they are not part of the critical care bed management system in many hospitals, even though they have all the intensive care units resources recommended by anaesthesiology scientific societies.1
The transition in recent years from acute care hospitals to institutions aimed primarily at surgical patients has made Anaesthesiology and Resuscitation Services one of the largest hospital departments. A crisis such as the current pandemic inevitably involves suspending a large proportion of elective surgeries, and this has freed up expert personnel such as qualified anaesthesiologists and allowed them to be reassigned to critical care units.2
At the beginning of the pandemic, the Catalan Society of Anaesthesiology, Reanimation and Pain Therapy (SCARTD) contacted the service managers in Catalan hospitals to ask how many care units they had available. Once the stage of surgery cut-backs had been reached, a 12-item online survey was designed to evaluate the real participation of personnel from the Anaesthesiology Services. The questionnaire was sent to all the heads of Anaesthesiology and Reanimation Services in tertiary, secondary and regional public and private hospitals in Catalonia. A total of 41 completed questionnaires were received between 30 April and 6 May 2020.
The main conclusions that can be drawn from this survey are as follows: (1) The hospitals polled had, in aggregate, 796 critical care beds officially available before the COVID-19 pandemic. Of these, 199 (25%) were administratively assigned to the Anaesthesiology Services of these hospitals. (2) During the COVID-19 pandemic, the number of beds assigned to critical patients increased from 796 to 1674 (210%), of which 729 (43% of the total) were managed and staffed by Anaesthesiology Services. This is an increase of over 350% compared to the number of pre-pandemic beds available (from 199 to 729 critical beds). (3) All the hospitals polled reported that a large number of anaesthesiologists have been involved in the care of critical COVID-19 patients. In 53.7% of hospitals, anaesthesiologists have been in charge of the medical care of critical patients, and in the remaining hospitals anaesthesiologists have formed part of multidisciplinary teams. (4) To take on these responsibilities, members of the Anaesthesiology Services have had to change their work schedules and have been responsible for airway management in COVID-19 patients. (5) A total of 732 anaesthesiologists, 67% of the entire staff of anaesthesiologists, were assigned to the direct care of COVID-19 patients. The remaining 33% were assigned to urgent and/or non-deferrable surgery, with occasional contact with COVID-19 patients.
The survey shows that successful management of future health crises will depend on the availability of clinical structures that can be effectively and efficiently adapted to care needs arising at any given moment. Another key component is qualified personnel, such as anaesthesiologists, who have the technical know-how and clinical expertise required to care for critically ill patients.2 It is essential to factor in the beds and staff available in the Surgical Suite when the need arises to increase the capacity of critical care units. Including these multipurpose spaces attended by anaesthesiologists in bed management systems would allow hospitals to maintain their quality of care and would provide a cost-effective solution to the problem of increased demand in future crises, such as COVID-19 or other pandemics, mass casualty incidents, etc.
1Board of the Societat Catalana d’Anestesiologia, Reanimació i Terapèutica del Dolor (SCARTD)
1 Rosa Ma Villalonga Vadell. Chair
1 Xavier Sala Blanch. Vice-chair
1,2 Jaume Roigé Solé. Secretary
1 Xavier Garcia Eroles. Treasurer
1,2 Carles Morros Viñoles. Member
1 Ricard Valero Castell. Member
1 Marc Bausili Ribera. Member in charge of Internet
1 Ana Pedregosa Sanz. Member in charge of education
1 Gerard Sergi Angeles Fite. Member in charge of residents.
2Head of Service,3Head of Anaesthesiology and Reanimation Critical Care Unit in Catalonia, and4Member of the SCARTD critical care division
2 Santiago Abreu Paradell. Head of Service. Hospital d’Igualada.
3,4 Ramón Adalia Bartolomé. Head for critical care H. del Mar – Parc de Salut Mar.
2 Astrid Álvarez Pérez. Head of Service. Hospital Universitario Sagrat Cor.
2 Núria Amigó Bonet. Head of Service. Pius Hospital de Valls.
2 Rosa Asbert Sagasti. Head of Service. Hospital Universitario Mútua Terrassa.
2 Francesca Barbal Badia. Head of Service. Hospital Sant Rafael.
4 Albert Carramiñana Dominguez. Critical Care Unit Hospital Clínic.
2 Jordi Castellnou Ferré. Head of Service. Hospital Verge de la Cinta.
2 José Antonio Bernia Gil. Head of Service. Consorci Sanitari de Terrassa.
2 Federico Carol Boeris. Head of Service. Hospital Universitario Parc Taulí.
4 María José Colomina Soler. Critical Care Unit Hospital Universitari de Bellvitge.
2 Antonio Chamero Pastilla. Head of Service. Hospital Comarcal de l’Alt Penedès.
2 María Victoria del Moral García. Head of Service. Hospital de la Santa Creu i Sant Pau.
2 Dolors del Pozo. Head of Service. Hospital Universitari Santa Maria.
2 Fernando Escolano Villén. Head of Service. Hospital del Mar – Parc de Salut Mar.
2 Pere Esquius Jofre. Head of Service. Hospital Sant Joan de Déu – Manresa.
3 Carlos Ferrando Ortolá. Head of Critical Care Unit Hospital Clínic.
2 Carlos García Marqueta. Head of Service. Fundació Privada Hospital de Mollet.
2 Carmen Hernández Aguado. Head of Service. Hospital Universitari Josep Trueta.
2 Daniel Hernando Pastor. Head of Service. Fundació Puigvert.
2 Núria Isach Comallonga. Head of Service. Hospital General de Granollers.
2 Xenia Isern Domingo. Head of Service. Hospital Comarcal Sant Bernabé.
2 L. Cesar Jaramillo Carrión. Head of Service. Hospital Comarcal Sant Jaume de Calella.
3,4 Maylin Koo García. Head of Critical Care Unit Hospital Universitari de Bellvitge.
2 Marta Lacambra Basil. Head of Service. Hospital General de Vic.
2 Juan José Lázaro Alcay. Head of Service. Hospital Sant Joan de Déu – Barcelona.
2 Javier Mailan Bello. Hospital Universitario Quirón Dexeus.
2 Susana Manrique Muñoz. Head of Service. Hospital Universitario Vall d’Hebrón.
2 Graciela Martínez Palli. Head of Service. Hospital Clínic.
2 Lluis Martínez Jérez. Head of Service. Hospital Municipal Badalona.
2 Josep Masdeu Castellví. Head of Service. Hospital Moisès Broggi.
4 Jordi Mercadal Mercadal. Critical Care Unit Hospital Clínic.
2 Antonio Montero Matamala. Head of Service. Hospital Universitario Arnau de Vilanova.
2 Onel Morales Torres. Head of Service. Hospital de Palamós.
2 Ma Lluisa Moret Ferron. Head of Service. Hospital Plató.
2 Enrique Moret Ruiz. Head of Service. Hospital Universitario Germans Trias i Pujol.
2 Lluís Muñoz Falcón. Head of Service. Hospital Sant Joan de Déu – Martorell.
3,4 Miriam de Nadal Clanchet. Head of Critical Care Unit Hospital Universitario Vall d’Hebrón.
2 Pere Miquel Ortells Nebot. Head of Service. Fundació Hospital de l’Esperit Sant.
2 Antoni Prat Vallribera. Head of Service. Hospital Asepeyo. Sant Cugat del Vallés.
2 Fernando Remartinez Fernandez. Head of Service. Consorci Sanitari del Garraf.
2 Pilar Roca Campos. Head of Service. Hospital Sant Pau i Santa Tecla.
2 Julian Roldan Osuna. Head of Service. Hospital General de Catalunya.
2 Antoni Sabaté Pes. Head of Service. Hospital Universitari de Bellvitge.
2 Pilar Sala Francino. Head of Service. Hospital Universitari Sant Joan.
2 Judit Saludes Serra. Head of Service. Hospital Universitari Joan XXIII.
4 Enric Samsó Sabe. Critical Care Unit H. del Mar – Parc de Salut Mar.
2 Eugeni Sarmiento Meneses. Head of Service. Hospital Sant Jaume d’Olot.
2,4 Josep Maria Soto Ejarque. Head of Area. Specialized and Extraordinary Services. SEM.
2 Albert Tomas Torrelles. Head of Service. Hospital Comarcal Sant Bernabé.
2 Antonio Tomás Esteban. Head of Service. Hospital Transfronterer.
2 Montserrat Yuste Graupera. Head of Service. Consorci Sanitari del Maresme.
Please cite this article as: Villalonga Vadell RM, Sala Blanch X, Roigé Solé J, Garcia Eroles X, Morros Viñoles C, Valero Castell R, et al. Implicación en Cataluña de los Servicios de Anestesiología y Reanimación en la pandemia por SARS-CoV-2. Una solución real coste-efectiva para una crisis sanitaria sin precedentes. Rev Esp Anestesiol Reanim. 2021;68:114–116.
