Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial

Beatrice Vergnano
,
Davide Signori
* ORCID logo ,
Annalisa Benini
,
Serena Calcinati
,
Francesca Bettini
,
Luisa Verga
,
Lorenza Maria Borin
,
Fabrizio Cavalca
,
Carlo Gambacorti-Passerini
,
Giacomo Bellani
ORCID logo ,
Giuseppe Foti
Version 1 : Received: 6 September 2023 / Approved: 7 September 2023 / Online: 8 September 2023 (13:26:58 CEST)

A peer-reviewed article of this Preprint also exists.

Vergnano, B.; Signori, D.; Benini, A.; Calcinati, S.; Bettini, F.; Verga, L.; Borin, L.M.; Cavalca, F.; Gambacorti-Passerini, C.; Bellani, G.; Foti, G. Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial. J. Clin. Med. 2023, 12, 6281. Vergnano, B.; Signori, D.; Benini, A.; Calcinati, S.; Bettini, F.; Verga, L.; Borin, L.M.; Cavalca, F.; Gambacorti-Passerini, C.; Bellani, G.; Foti, G. Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial. J. Clin. Med. 2023, 12, 6281.

Abstract

Historically, admission of hematological patients in the ICU shortly after the start of a critical illness is associated with better survival rates. Early intensive interventions administered by MET could have a role in the management of hematological critically ill patients, eventually reducing ICU admission rate. In this retrospective and monocentric study, we evaluate the safety and effectiveness of intensive treatments administered by the MET in a medical ward frame. The administered interventions were mainly helmet CPAP and pharmacological cardiovascular support. Frequent reassessment by the MET at least every 8 to 12 hours was guaranteed. We analyze data from 133 hematological patients that required MET intervention. In hospital mortality was 38%; mortality doesn’t increase in patients not immediately transferred to the ICU. Only 3 patients died without a former admission in ICU; in these cases, mortality was not related to the acute illness. Moreover, 37% of patients overcame the critical episode in the hematological ward. Higher SOFA and MEWS scores were associated with a worst survival rate, while neutropenia and pharmacological immunosuppression were not. The MET approach seems to be safe and effective. SOFA and MEWS confirmed to be effective tools for prognostication.

Keywords

Medical Emergency Team; ICU admission; CPAP; Hematological critically ill patients; Prognostication

Subject

Medicine and Pharmacology, Emergency Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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