Pandemic influenza-implications for critical care resources in australia and new zealand☆
Section snippets
Methods
A postal survey was conducted in May 1999 of 180 Australasian Level I, II, and III, adult and pediatric, public and private sector, and critical care units listed on the database of the ANZICS Research Centre for Critical Care Resources. (A copy of the survey form can be found in the appendices of the published report at www.anzics.com.au/admc/registry_publications.htm).3
The study was conducted simultaneously with the annual resource survey (1998 calendar year data) with the latter dataset an
Supply of beds and mechanical ventilation
There was an overall survey response rate of 87.5% (public sector 91%, private sector 76%). Public sector critical care beds included those for both Australia and New Zealand, whilst private sector critical care beds were estimated solely for Australia. Four units were classified as high dependency units and omitted from the dataset as these sites did not have ventilatory capacity or capability.
There were 164 critical care complexes identified in both public and private sectors, 72 of these
Study limitations
This study had several limitations. The resource capabilities were determined for critical care units only, with increased ventilatory capacity generated from emergency, anesthesia, and operating room services. Not addressed were: the impact of vaccination and antivirals on demand for intensive care bed days and mechanical ventilation; quality of care issues; rapid recruitment of additional health care personnel; use of defense service medical capability and logistic support; provision of
Discussion
There are sophisticated surveillance mechanisms in place to monitor the types and spread of influenza. Pandemic influenza has not occurred in Australasia in over 30 years, however, there is little room for complacency. Recent events in North America such as the September 11 attack in 2001 focus our attention on the need for vigilance and preparedness for untoward incidents that may have a significant impact on critical care resources. The focus of the model described in the study is on planning
Classification of influenza
To estimate resource requirements for influenza pandemic, it is necessary to look at the number of admissions and bed days currently utilised by patients with influenza and pneumonia. Unfortunately, existing data sources do not distinguish influenza-specific pneumonia from other causes of community-acquired pneumonia because of previous paucity of diagnostic tests and joint classification by principal diagnostic groupings in ICD-10-AM (International Classification of Diseases, Version 10 -
Conclusion
Additional emergency ventilator bed capacity could be generated from a variety of sources and current critical care activity and bed usage decreased through a reduction in elective procedures. Currently available ICD10-AM public health data for influenza and pneumonia is an inadequate descriptor of respiratory disease activity. The number of patients requiring intensive care for influenza and pneumonia or its resultant complications can not be tracked at present. Meltzer et al5 provided a
References (23)
- et al.
Assessment of prognosis in patients with community-acquired pneumonia who require mechanical ventilation
Chest
(2000) - et al.
Variations in length of stay in patients with community-acquired pneumoniaare shorter stays associated with worse outcomes?
Am J Med
(1999) - et al.
A consensus driven method to measure the required number of intensive care nurses in Australia
Aust Critical Care
(2001) Influenza Pandemic Planning Committee of the Communicable Diseases Network Australia New ZealandA Framework for an Australian Influenza Pandemic Plan
(1999)Influenza Pandemic Plan. The Role of WHO and Guidelines for National and Regional Planning
(1999)- et al.
Influenza Pandemic Planning for Intensive Care
(2001) - et al.
ANZICS Intensive Care SurveyAn Overview of Australian and New Zealand Critical Care Resources
(1998) - et al.
The economic impact of pandemic influenza in the United StatesPriorities for intervention
Emerg Infect Dis
(1999) Australian Hospital Statistics 1998–99. AIHW Catalogue No. HSE 11
(2000)Health Statistics-Public Hospital Patient Statistics
(2001)
Treatment and outcomes of community-acquired pneumonia at Canadian hospitals
CMAJ
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2010, Critical Care and ResuscitationSimultaneous ventilation of two healthy subjects with a single ventilator
2009, ResuscitationContingency plan for the intensive care services for the COVID-19 pandemic
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2020, Enfermeria Intensiva
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This work was supported by Quality and Care Continuity Branch, Department of Human Services, Melbourne, Australia; State and Territory Departments of Health (Australian Health Ministers’ Advisory Council), Ministry of Health (New Zealand); and National Influenza Pandemic Planning Committee, Australia.