Communication and visiting policies in Italian intensive care units during the first COVID-19 pandemic wave and lockdown: a nationwide survey

Background: During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions. Methods: A national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave. Results: Two hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICUs, 60% were dedicated to COVID-19 patients, 21% were dedicated to patients without COVID-19 and 19% were dedicated to both categories (Mixed). A total of 11,102 adult patients were admitted to the participating ICUs during the study period and only approximately 6% of patients received at least one visit. Communication with family members was guaranteed daily through an increased use of electronic devices and was preferentially addressed to the same family member. Compared to the prepandemic period, clinical psychologists supported physicians more often regarding communication with family members. Fewer patients received at least one visit from family members in COVID and mixed-ICUs than in non-COVID ICUs, l (0 [0–6]%, 0 [0–4]% and 11 [2–25]%, respectively, p < 0.001). Habits of pediatric ICUs were less affected by the pandemic. Conclusions: Visiting policies of Italian ICUs dedicated to adult patients were markedly altered during the first COVID-19 wave. Remote communication was widely adopted as a surrogate for family meetings. New strategies to favor a family-centered approach during the current and future pandemics are warranted

Epidemiology of intensive care unit-acquired sepsis in Italy: results of the SPIN-UTI network

none139BACKGROUND: Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. STUDY DESIGN: Prospective multicenter study. METHODS: The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. RESULTS: During the five editions of the SPIN-UTI project, from 2008 to 2017, 47.0% of HAIs has led to sepsis in 832 patients. Overall, 57.0% episodes were classified as sepsis, 20.5% as severe sepsis and 22.5% as septic shock. The most common isolated microorganisms from sepsis episodes were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The case fatality rate increased with the severity of sepsis and the mean length of ICU-stay was significantly higher in patients with ICU-acquired sepsis than in patients without. CONCLUSION: Our study provides evidence that ICU-acquired sepsis occurs frequently in Italian ICU patients and is associated with a high case fatality rate and increased length of stay. However, in order to explain these findings further analyses are needed in this population of ICU patients.noneAgodi A, Barchitta M, Auxilia F, Brusaferro S3, D'Errico MM, Montagna MT, Pasquarella C, Tardivo S, Arrigoni C, Fabiani L, Laurenti P, Mattaliano AR, Orsi GB, Squeri R, Torregrossa MV, Mura I, Aiello MR, Alliani C, Amatucci MR, Antoci M, Antonelli M, Astuto M, Arnoldo L, Arru B, Baccari G, Barbadoro P, Barbara A, Barilaro C, Battaglia P, Bellocchi P, Bernasconi MO, Bianco A, Bissolo E, Bocchi A, Bruno A, Brusaferro M, Buccheri M, Campanella F, Canino R, Cannistrà A, Carini SA, Catalano S, Castellani P, Castiglione G, Coniglio S, Consolante C, Conte C, Contrisciani R, Corallini R, Crollari P, Damiani G, Denaro C, De Remigis S, Diana F, Di Bartolo R, Di Benedetto A, Di Fabio G, Di Falco C, Digeronimo V, Di Gregorio P, Distefano R, Egitto G, Falciani E, Farruggia P, Fenaroli S, Ferlazzo G, Garofalo G, Girardis M, Giovanelli L, Giubbini G, Graceffa A, Guadagna A, Gregu G, Ingala F, Innocenzi L, La Camera G, La Rosa MC, Lesa L, Longhitano AM, Luppino G, Maida CM, Manta G, Marino G, Masia MD, Maviglia R, Mazzetti M, Maugeri A, Megna MT, Mella LM, Milazzo M, Milia M, Minari C, Minerva M, Mordacci M, Murgia P, Oliveri P, Olori MP, Pagliarulo R, Palermo R, Pandiani I, Pappalardo F, Papetti C, Partenza A, Pascu D, Pasculli M, Pavia M, Pavone ML, Pellegrino MG, Pelligra F, Pillon D, Pintaudi S, Pitzoi L, Pinto A, Piotti P, Pupo S, Quattrocchi R, Righi E, Rigo A, Rigo A, Romeo A, Rosa E, Rutigliano S, Sarchi P, Scimonello G, Seminerio A, Stefanini P, Sticca G, Taddei S, Tessari L, Tetamo R, Ticca M, Tribastoni S, Vallorani S, Venturoni F, Vitagliano E, Vitali P, Zappone A, Zei E, Zeoli MP.Agodi, A; Barchitta, M; Auxilia, F; Brusaferro, S3; D'Errico, Mm; Montagna, Mt; Pasquarella, C; Tardivo, S; Arrigoni, C; Fabiani, L; Laurenti, P; Mattaliano, Ar; Orsi, Gb; Squeri, R; Torregrossa, Mv; Mura, I; Aiello, Mr; Alliani, C; Amatucci, Mr; Antoci, M; Antonelli, M; Astuto, M; Arnoldo, L; Arru, B; Baccari, G; Barbadoro, P; Barbara, A; Barilaro, C; Battaglia, P; Bellocchi, P; Bernasconi, Mo; Bianco, A; Bissolo, E; Bocchi, A; Bruno, A; Brusaferro, M; Buccheri, M; Campanella, F; Canino, R; Cannistrà, A; Carini, Sa; Catalano, S; Castellani, P; Castiglione, G; Coniglio, S; Consolante, C; Conte, C; Contrisciani, R; Corallini, R; Crollari, P; Damiani, G; Denaro, C; De Remigis, S; Diana, F; Di Bartolo, R; Di Benedetto, A; Di Fabio, G; Di Falco, C; Digeronimo, V; Di Gregorio, P; Distefano, R; Egitto, G; Falciani, E; Farruggia, P; Fenaroli, S; Ferlazzo, G; Garofalo, G; Girardis, M; Giovanelli, L; Giubbini, G; Graceffa, A; Guadagna, A; Gregu, G; Ingala, F; Innocenzi, L; La Camera, G; La Rosa, Mc; Lesa, L; Longhitano, Am; Luppino, G; Maida, Cm; Manta, G; Marino, G; Masia, Md; Maviglia, R; Mazzetti, M; Maugeri, A; Megna, Mt; Mella, Lm; Milazzo, M; Milia, M; Minari, C; Minerva, M; Mordacci, M; Murgia, P; Oliveri, P; Olori, Mp; Pagliarulo, R; Palermo, R; Pandiani, I; Pappalardo, F; Papetti, C; Partenza, A; Pascu, D; Pasculli, M; Pavia, M; Pavone, Ml; Pellegrino, Mg; Pelligra, F; Pillon, D; Pintaudi, S; Pitzoi, L; Pinto, A; Piotti, P; Pupo, S; Quattrocchi, R; Righi, E; Rigo, A; Rigo, A; Romeo, A; Rosa, E; Rutigliano, S; Sarchi, P; Scimonello, G; Seminerio, A; Stefanini, P; Sticca, G; Taddei, S; Tessari, L; Tetamo, R; Ticca, M; Tribastoni, S; Vallorani, S; Venturoni, F; Vitagliano, E; Vitali, P; Zappone, A; Zei, E; Zeoli, Mp