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There is little information of intensive care unit (ICU) performance when it's relocated to a totally new and equipped area.To analyze the clinical performance and use of resources of a new respiratory-ICU (nRICU) in a large third-level care hospital.Cross-sectional, comparative study using prospective data of patients admitted from July 17, 2017 to July 17, 2018. The Rapoport adjusted method was used to obtain the standardized clinical performance index (SCPI) and the standardized resource use index (SRUI).Out of 354 patients, those who were readmissions or remained hospitalized and those whose treatment was withheld or withdrawn where excluded from the analysis. In 301 patients, the observed survival at hospital discharge was 63% while the expected survival was 67.7%. Values of SCPI and SRUI were -1.03 and 0.05 respectively, placing results in coordinates within two standard deviations when plotted in the Rapoport chart. There was a statistically significant difference in survival when comparing the study period with outcomes obtained in the RICU before its relocation (63% vs. 55%, p = 0.01).In its 1st year of operation, the nRICU had better clinical performance compared to the former RICU, with no change in the use of resources.Existe poca información acerca del desempeño de una unidad de cuidados intensivos (UCI) cuando es reubicada en un área totalmente nueva y equipada.Analizar el rendimiento clínico y el uso de recursos de la nueva UCI respiratoria (UCIR) de un hospital grande de tercer nivel.Estudio transversal, comparativo, con datos prospectivos de pacientes ingresados del 17 de julio de 2017 al 17 de julio de 2018. Se usa el método ajustado de Rapoport para obtener el índice de rendimiento clínico estandarizado (IRCE) y el índice de uso de recursos estandarizado (IRURE).De 354 pacientes fueron excluidos los reingresos, los pacientes aún hospitalizados y aquellos a quienes se limitó o retiró el tratamiento. En 301 pacientes la sobrevida hospitalaria fue del 63%, mientras que la sobrevida esperada fue del 67.7%. El IRCE fue −1.03 y el IRURE fue 0.05, situando el resultado en coordenadas dentro de dos desviaciones estándar en el gráfico de Rapoport. Hubo una diferencia estadísticamente significativa en la sobrevida comparando el periodo de estudio con resultados de la UCIR obtenidos antes de su reubicación (63 vs. 55%, p = 0.01).En su primer año de funcionamiento, la nueva UCIR tuvo mejor rendimiento clínico que la antigua, sin modificación en el uso de recursos.

COVID-19-associated mortality in patients who require mechanical ventilation is unknown in the Mexican population.To describe the characteristics of Mexican patients with COVID-19 who required mechanical ventilation.Observational cohort study carried out in an intensive care unit from March 25 to July 17, 2020. Data were obtained from a prospective database and electronic medical records, and were analyzed with the chi-square test, Fisher's exact test or Mann-Whitney's U-test.One hundred patients required mechanical ventilation; median age was 56 years, 31 % were females and 97 % were Latin American. Most common comorbidities were obesity (36 %), diabetes (26 %), hypertension (20 %), and chronic or end-stage kidney disease (10 %). At the end of the analysis, 11 patients remained in the ICU, 31 had been discharged alive and 58 (65.2 %) died; survivors were younger, had lower scores on severity and organ dysfunction scales, lower levels of C-reactive protein at ICU admission, were less likely to receive hemodialysis and vasopressors, and had longer hospital and ICU stays.This study adds information on the presentation and results of SARS-CoV-2-infected patients who require mechanical ventilation.La mortalidad por COVID-19 en quienes requieren ventilación mecánica se desconoce en la población mexicana.Describir las características de pacientes mexicanos con COVID-19 que requirieron ventilación mecánica.Estudio de cohorte observacional en una unidad de terapia intensiva, del 25 de marzo al 17 de julio de 2020. Los datos se obtuvieron de una base de datos prospectiva y de registros clínicos electrónicos; fueron analizados con cCien pacientes recibieron ventilación mecánica, la edad media fue de 56 años, 31 % era del sexo femenino y 97 %, latinoamericano. Las comorbilidades más comunes fueron obesidad (36 %), diabetes (26 %), hipertensión (20 %) y enfermedad renal crónica o renal terminal (10 %). Al término del análisis, 11 pacientes permanecían en la UCI, 31 egresaron vivos y 58 (65.2 %) fallecieron; los sobrevivientes fueron más jóvenes, con menores puntuación en las escalas de gravedad y disfunción orgánica, menores niveles de proteína C reactiva al ingreso a la UCI, menor propensión a hemodiálisis, necesidad de, necesidad de vasopresores y con mayor estancia hospitalaria y en la UCI.Este estudio agrega información sobre la presentación y resultados de pacientes con ventilación mecánica infectados con SARS-CoV-2.

Background There is little information of intensive care unit (ICU) performance when it's relocated to a totally new and equipped area. Objective To analyze the clinical performance and use of resources of a new respiratory-ICU (nRICU) in a large third-level care hospital. Method Cross-sectional, comparative study using prospective data of patients admitted from July 17, 2017 to July 17, 2018. The Rapoport adjusted method was used to obtain the standardized clinical performance index (SCPI) and the standardized resource use index (SRUI). Results Out of 354 patients, those who were readmissions or remained hospitalized and those whose treatment was withheld or withdrawn where excluded from the analysis. In 301 patients, the observed survival at hospital discharge was 63% while the expected survival was 67.7%. Values of SCPI and SRUI were -1.03 and 0.05 respectively, placing results in coordinates within two standard deviations when plotted in the Rapoport chart. There was a statistically significant difference in survival when comparing the study period with outcomes obtained in the RICU before its relocation (63% vs. 55%, p = 0.01). Conclusions In its 1st year of operation, the nRICU had better clinical performance compared to the former RICU, with no change in the use of resources.

espanolIntroduccion: Nuevos hospitales estan reemplazando a instalaciones antiguas. Existe poca informacion del desempeno de una unidad de cuidados intensivos (UCI) cuando es reubicada en un area nueva y equipada. Objetivo: Analizar el impacto del cambio de instalaciones de un ambiente compartido a camas individuales en la ocurrencia de eventos adversos en la UCI. Metodo: Estudio transversal, comparativo, con datos prospectivos de pacientes ingresados del 1 de marzo de 2014 al 28 de febrero de 2017 a la antigua UCI (aUCI) y del 17 de julio de 2017 al 17 de enero de 2019 a la nueva UCI (nUCI) de un hospital-escuela publico. La tasa de eventos adversos se midio en eventos por 1000 dias-paciente. Resultados: En 1188 pacientes (aUCI, n = 681 versus nUCI, n = 507) se observo reduccion en la tasa de paro cardiaco no previsto (razon de tasas 0.31, IC 95 % = 0.12-0.80) e incremento en la tasa de extubacion no planeada (razon de tasas 2.49, IC 95 % = 1.24-5.01), estadisticamente significativos; los otros nueve eventos adversos monitoreados no mostraron cambios. Conclusiones: Com- parada con la aUCI, la mayor parte de eventos adversos monitoreados no se modificaron significativamente en los 18 meses de inicio de actividades de la nUCI. EnglishIntroduction: New hospitals are replacing old facilities. There is little information on the performance of an intensive care unit (ICU) when it is relocated in a new and equipped area. Objective: To analyze the impact of the change of ICU facilities from a shared environment to individual beds on the occurrence of adverse events. Method: Cross-sectional, comparative study, with prospectively collected data from patients admitted from March 01, 2014 to February 28, 2017 to the former ICU (f-ICU) and from July 17, 2017 to January 17, 2019 to the new ICU (n-ICU) of a public teaching hospital. The rate of adverse events was measured in events per 1,000 patient-days. Results: Among 1,188 patients (f-ICU, n = 681 vs. n-ICU, n = 507), a reduc- tion in the rate of unforeseen cardiac arrest (rate ratio: 0.31; 95% confidence interval [CI] = 0.12–0.80) and an increase in the rate of unplanned extubation (rate ratio: 2.49; 95% CI = 1.24–5.01) were observed, with both being statistically significant. The other nine monitored adverse events showed no changes. Conclusions: In comparison with the f-ICU, most of the monitored adverse events did not significantly change within the first 18 months of activities at the n-ICU.