ICU Organization: staffing and processes for patient care under MV
When we evaluated patients on mechanical ventilation (MV) in Brazilian Intensive Care Units, we noted that, before the pandemic, they represented around 15% of patients in private Intensive Care Units and 30% in public Intensive Care Units. During the years 2020 and 2021, these numbers practically doubled, directly impacting mortality rates. In 2022, we resumed a standard closer to normality, as the volume of admissions for COVID-19 was drastically reduced and the course of the disease became more benign, considering the widespread vaccination, the use of corticosteroids, and the best global clinical administration. Even so, although this scenario brings us some relief, a critical evaluation of the outcomes is necessary from the perspective of the numbers generated by large databases, such as the Brazilian Intensive Care Units and LOGIC projects. Patients under MV in Brazil still have average mortality above 40% and long length of stay Intensive Care Unit admissions. As discussed earlier, part of this result can be attributed to a high rate of complications related to Intensive Care Units care processes, especially healthcare-associated infections and excessive use of sedatives, and the higher rate of adverse events in general.
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