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Review Article
Pulmonary
Prolonged intensive care: muscular functional, and nutritional insights from the COVID-19 pandemic
Miguel Ángel Martínez-Camacho, Robert Alexander Jones-Baro, Alberto Gómez-González, Dalia Sahian Lugo-García, Pía Carolina Gallardo Astorga, Andrea Melo-Villalobos, Bárbara Kassandra Gonzalez-Rodriguez, Ángel Augusto Pérez-Calatayud
Acute Crit Care. 2024;39(1):47-60.   Published online February 2, 2024
DOI: https://doi.org/10.4266/acc.2023.01284
  • 7,639 View
  • 281 Download
AbstractAbstract PDF
During the coronavirus disease 2019 (COVID-19) pandemic, clinical staff learned how to manage patients enduring extended stays in an intensive care unit (ICU). COVID-19 patients requiring critical care in an ICU face a high risk of experiencing prolonged intensive care (PIC). The use of invasive mechanical ventilation in individuals with severe acute respiratory distress syndrome can cause numerous complications that influence both short-term and long-term morbidity and mortality. Those risks underscore the importance of proactively addressing functional complications. Mitigating secondary complications unrelated to the primary pathology of admission is imperative in minimizing the risk of PIC. Therefore, incorporating strategies to do that into daily ICU practice for both COVID-19 patients and those critically ill from other conditions is significantly important.
Original Articles
Nursing
Intensive care unit professionals during the COVID-19 pandemic in Spain: social and work-related variables, COVID-19 symptoms, worries, and generalized anxiety levels
Fernando J. García-Hedrera, Fernanda Gil-Almagro, F. Javier Carmona-Monge, Cecilia Peñacoba-Puente, Patricia Catalá-Mesón, Lilian Velasco-Furlong
Acute Crit Care. 2021;36(3):232-241.   Published online August 31, 2021
DOI: https://doi.org/10.4266/acc.2021.00213
  • 9,313 View
  • 123 Download
  • 17 Web of Science
  • 16 Crossref
AbstractAbstract PDF
Background
The severe acute respiratory syndrome coronavirus 2 outbreak has been identified as a pandemic and global health emergency. It presents as a severe acute respiratory disease. The rapid dissemination of the disease created challenges for healthcare systems and forced healthcare workers (HCWs) to deal with many clinical and nonclinical stresses. The aim of our research is to describe work conditions, symptoms experienced by HCWs, worries about contagion, and generalized anxiety symptoms and compare those findings across regions in Spain.
Methods
This cross-sectional study was conducted using an online survey. Critical care units throughout Spain were included. The sample comprised HCWs working in intensive care units from March to May 2020. We assessed work variables, physical symptoms, worries about contagion, and anxiety (generalized anxiety disorder-7 questionnaire).
Results
The final sample comprised 448 surveys. Among the respondents, 86.9% (n=389) were nursing professionals, and 84.8% (n=380) were women. All participants cared for coronavirus disease 2019 (COVID-19) patients during the study period. Workload during the pandemic in Madrid was judged to be higher than in other regions (P<0.01). The availability of personal protective equipment was found to be higher in Cataluña. The most frequently experienced symptom was headaches (78.1%). Worries about self-infection and the possibility of infecting others received mean scores of 3.11 and 3.75, respectively. Mean scores for generalized anxiety levels were 11.02, with 58.7% of the professionals presenting with generalized anxiety syndrome during the assessment.
Conclusions
In this study, we found high levels of anxiety among HCWs caring directly for COVID-19 patients, which could produce long-term psychological alterations that still need to be assessed.

Citations

Citations to this article as recorded by  
  • Evolution of burnout syndrome in Spanish healthcare professionals during and after the COVID-19 pandemic: psychosocial variables involved
    Fernanda Gil-Almagro, F. Javier Carmona-Monge, Fernando J. García-Hedrera, Cecilia Peñacoba-Puente
    Frontiers in Medicine.2025;[Epub]     CrossRef
  • From Anxiety to Hopelessness: Examining Influential Psychological Processes Affecting Mental Health Status of Spanish Nurses During the COVID-19 Pandemic
    Cecilia Peñacoba-Puente, Fernanda Gil-Almagro, Fernando José García-Hedrera, Francisco Javier Carmona-Monge
    Medicina.2025; 61(2): 236.     CrossRef
  • Situación psicoemocional de los profesionales sanitarios de atención primaria vs cuidados intensivos y su evolución
    Fernanda Gil Almagro, Fernando José García Hedrera, Francisco Javier Carmona Monge, Cecilia Peñacoba Puente
    Quaderns de Psicologia.2025; 27(1): e2007.     CrossRef
  • Psychological Care in Spanish Nurses at the Frontline of the COVID-19 Pandemic: A Prospective Study on Symptoms, Burnout and Psychological Variables
    Cecilia Peñacoba-Puente, Fernando José García-Hedrera, Mercedes Gómez-Del-Pulgar García-Madrid, Francisco Javier Carmona-Monge, Fernanda Gil-Almagro
    Healthcare.2025; 13(10): 1108.     CrossRef
  • Psychological impact of the COVID-19 pandemic on Spanish healthcare workers: a systematic review of prevalence and wave-based patterns
    Irene Jaén, Carolina Ausín, Diana Castilla
    Current Psychology.2024; 43(25): 22089.     CrossRef
  • The effects of fear of COVID-19 among Spanish healthcare professionals in three years after the pandemic onset via validation of the FCV-19S: a prospective study
    Cecilia Peñacoba-Puente, Octavio Luque-Reca, Mark D. Griffiths, Fernando J. García-Hedrera, F. Javier Carmona-Monge, Fernanda Gil-Almagro
    Current Psychology.2024; 43(43): 33640.     CrossRef
  • From Anxiety to Hardiness: The Role of Self-Efficacy in Spanish CCU Nurses in the COVID-19 Pandemic
    Fernanda Gil-Almagro, Fernando José García-Hedrera, Francisco Javier Carmona-Monge, Cecilia Peñacoba-Puente
    Medicina.2024; 60(2): 215.     CrossRef
  • Post-Pandemic Insomnia in Healthcare Workers: A Prospective Study including Sociodemographic, Occupational and Psychosocial Variables
    Fernanda Gil-Almagro, Francisco Javier Carmona-Monge, Fernando José García-Hedrera, Cecilia Peñacoba-Puente
    Journal of Clinical Medicine.2024; 13(12): 3498.     CrossRef
  • Headache and Associated Psychological Variables in Intensive Care Unit Nurses during the COVID-19 Pandemic: A Prospective Study
    Fernanda Gil-Almagro, Francisco Javier Carmona-Monge, Fernando José García-Hedrera, Cecilia Peñacoba-Puente
    Journal of Clinical Medicine.2024; 13(13): 3767.     CrossRef
  • Anxiety Evolution among Healthcare Workers—A Prospective Study Two Years after the Onset of the COVID-19 Pandemic Including Occupational and Psychoemotional Variables
    Fernanda Gil-Almagro, Fernando José García-Hedrera, Cecilia Peñacoba-Puente, Francisco Javier Carmona-Monge
    Medicina.2024; 60(8): 1230.     CrossRef
  • Headaches in Healthcare Workers: A Prospective Study of Precipitating and Maintenance Variables and Their Relationship with Burnout as a Post-COVID Syndrome
    Fernanda Gil-Almagro, Francisco Javier Carmona-Monge, Fernando José García-Hedrera, Cecilia Peñacoba-Puente
    Neurology International.2024; 16(6): 1464.     CrossRef
  • Cognitive appraisals and coping strategies of registered nurses in the emergency department combating COVID‐19: A scoping review
    Chia‐Hung Lin, Shu‐Fen Siao, You‐Jie Lin, Pin‐Hsien Hsin, Mack Shelley, Yen‐Han Lee
    Journal of Nursing Scholarship.2023; 55(1): 79.     CrossRef
  • The impact of pandemics on healthcare providers' workloads: A scoping review
    Gemma Doleman, Annemarie De Leo, Dianne Bloxsome
    Journal of Advanced Nursing.2023; 79(12): 4434.     CrossRef
  • Critical care medicine training in the age of COVID-19
    Walter Mickey
    Journal of Osteopathic Medicine.2023; 123(9): 427.     CrossRef
  • Psychological anxiety, professional performance, and the impact of the COVID-19 pandemic: A study of healthcare providers at the University of Jordan Hospital
    Fadia Aied Alsmeheen, Areen Al Ghazawat, Fatima Al Talahin
    International Journal of ADVANCED AND APPLIED SCIENCES.2023; 10(8): 91.     CrossRef
  • The impact of the COVID-19 pandemic on intensive care unit workers: a nationwide survey
    Sangeeta Mehta, Christopher Yarnell, Sumesh Shah, Peter Dodek, Jeanna Parsons-Leigh, Robert Maunder, Jessica Kayitesi, Catherine Eta-Ndu, Fran Priestap, Danielle LeBlanc, Jennifer Chen, Kimia Honarmand
    Canadian Journal of Anesthesia/Journal canadien d'anesthésie.2022; 69(4): 472.     CrossRef
Pulmonary
Experience of percutaneous tracheostomy in critically ill COVID-19 patients
Eun Jin Kim, Eun-Hyung Yoo, Chi Young Jung, Kyung Chan Kim
Acute Crit Care. 2020;35(4):263-270.   Published online November 12, 2020
DOI: https://doi.org/10.4266/acc.2020.00444
  • 10,530 View
  • 170 Download
  • 6 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Background
Coronavirus disease 2019 (COVID-19) is a highly contagious disease that causes respiratory failure. Tracheostomy is an essential procedure in critically ill COVID-19 patients; however, it is an aerosol-generating technique and thus carries the risk of infection transmission. We report our experience with percutaneous tracheostomy and its safety in a real medical setting.
Methods
During the COVID-19 outbreak, 13 critically ill patients were admitted to the intensive care unit (ICU) at Daegu Catholic University Medical Center between February 24 and April 30, 2020. Seven of these patients underwent percutaneous tracheostomy using Ciaglia Blue Rhino. The medical environment, percutaneous tracheostomy method, and COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) results were retrospectively reviewed. After treatment, the COVID-19 infection status of healthcare personnel was investigated by RT-PCR.
Results
The ICU contained negative pressure cohort areas and isolation rooms, and healthcare personnel wore a powered air-purifying respirator system. We performed seven cases of percutaneous tracheostomy in the same way as in patients without COVID-19. Five patients (71.4%) tested positive for COVID-19 by RT-PCR at the time of tracheostomy. The median cycle threshold value for the RNA-dependent RNA polymerase was 30.60 (interquartile range [IQR], 25.50–36.56) in the upper respiratory tract and 35.04 (IQR, 28.40–36.74) in the lower respiratory tract. All healthcare personnel tested negative for COVID-19 by RT-PCR.
Conclusions
Percutaneous tracheostomy was performed with conventional methods in the negative pressure cohort area. It was safe to perform percutaneous tracheostomy in an environment of COVID-19 infection.

Citations

Citations to this article as recorded by  
  • Sedation and Analgesia in Patients Undergoing Tracheostomy in COVID-19, a Multi-Center Registry
    Christopher M. Kapp, Ardian Latifi, David Feller-Kopman, Joshua H. Atkins, Esther Ben Or, David Dibardino, Andrew R. Haas, Jeffrey Thiboutot, Christoph T. Hutchinson
    Journal of Intensive Care Medicine.2022; 37(2): 240.     CrossRef
  • Percutaneous Tracheostomy in Respiratory Failure Due to COVID-19
    Samuel E. Cohen, Angelena R. Lopez, Philip K. Ng, Oren A. Friedman, George E. Chaux
    Journal of Bronchology & Interventional Pulmonology.2022; 29(2): 125.     CrossRef
  • Expert consensus on the diagnosis and treatment of severe and critical coronavirus disease 2019 (COVID-19)
    You Shang, Jianfeng Wu, Jinglun Liu, Yun Long, Jianfeng Xie, Dong Zhang, Bo Hu, Yuan Zong, Xuelian Liao, Xiuling Shang, Renyu Ding, Kai Kang, Jiao Liu, Aijun Pan, Yonghao Xu, Changsong Wang, Qianghong Xu, Xijing Zhang, Jicheng Zhang, Ling Liu, Jiancheng Z
    Journal of Intensive Medicine.2022; 2(4): 199.     CrossRef
  • Commentary: Coronavirus disease 2019 (COVID-19) tracheostomies—The “how” but not the “why” or “when”
    Benjamin Wei, Peter Abraham
    JTCVS Techniques.2021; 6: 190.     CrossRef
  • Association of Tracheostomy With Outcomes in Patients With COVID-19 and SARS-CoV-2 Transmission Among Health Care Professionals
    Phillip Staibano, Marc Levin, Tobial McHugh, Michael Gupta, Doron D. Sommer
    JAMA Otolaryngology–Head & Neck Surgery.2021; 147(7): 646.     CrossRef
  • Tracheostomy in COVID Times
    Yatin Mehta, Gaurav Kochar
    Journal of Cardiac Critical Care TSS.2021; 5(02): 082.     CrossRef
  • Tracheostomy in Mechanically Ventilated Patients With SARS-CoV-2-ARDS: Focus on Tracheomalacia
    Marcello Guarnieri, Patrizia Andreoni, Hedwige Gay, Riccardo Giudici, Maurizio Bottiroli, Michele Mondino, Gianpaolo Casella, Osvaldo Chiara, Oscar Morelli, Serena Conforti, Thomas Langer, Roberto Fumagalli
    Respiratory Care.2021; 66(12): 1797.     CrossRef

ACC : Acute and Critical Care
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