1. Now that three years have passed since the Covid-19 pandemic in our country, how has the approach to this respiratory infection evolved?
We are quite clear on how to manage these patients, both from the pharmacological point of view and mechanical respiratory support, which was established for our country in the consensus document of which I am the co-author.
2. During the pandemic, the NICUs became a key tool to prevent health collapse. What lessons were learned then that have held up to now?
That these units are essential to reduce mortality, guarantee patient safety, as well as improve their experience, since they are friendlier, and minimize costs. They are also essential, as they favor the flow of patients in high-cost strategic units, avoiding “queues and collapses”.
3. What respiratory sequelae are you finding in patients who have been infected with SARS-CoV-2?
Basically, structurally we see fibrosis of the lung tissue, abnormal scarring and a feeling of dyspnea of sometimes uncertain origin.
4. What follow-up do you do for those patients who stayed for long periods of time in the ICU?
There is close follow-up for post-covid consultations for those affected, of a multidisciplinary nature and in which our service naturally participates.
5. So, are units specialized in this new pathology still necessary?
They are necessary and continue to exist. Too many patients were affected. Time will tell us when it can be stopped, but it is too early to tell.
6. Do you think that SARS-CoV-2 will continue to be a common virus in the coming winters and will have less and less impact at the health level?
I think so and I really hope so. But it is early to venture given its high capacity for mutation. However, everything indicates that it wants to live with us and, for this reason, it gives in its lethality and advances in contagiousness. It is adapting to the species and current viral biodiversity on our planet.
7. In addition to Covid-19, what other respiratory infections are causing the most problems for patients in recent months?
Influenza and respiratory syncytial virus are giving us problems, as they have found space in this viral fauna. People have not been exposed for three years and now the infections are more severe, prolonged and are associated with pneumonia as local pulmonary immunity is reduced due to these viruses.
8. Have the pandemic and the use of masks made respiratory infections this winter the most aggressive in recent years?
Yes, I think so and I am convinced of it.
9. I understand that they are planning a new hospitalization project in the NICU with the last name of “virtual”. What does it consist of exactly?
The most severe respiratory patients can go home earlier, since they leave with highly advanced remote monitoring support that allows them to control their vital signs and respirator parameters. In addition, they are visited by expert personnel at their homes made up of doctors from our home mechanical ventilation unit. They have a 24/7 support phone and, as they have NICU guards, if there is a problem they have direct access to the hospital and our unit.
10. What advantages will it bring to patients and professionals?
For patients it implies safety and being in their environment calm before. This is priceless. For the hospital, everything is advantageous, since beds are freed up and the circuit that the UCIR represents is permanently active and in continuous movement. To explain this better, for my unit this has meant being able to care for the entire mass of respiratory patients without the need to open more beds. And if my unit works 100%, the hospital “breathes” better, as we drain emergency, ICU and resuscitation beds, which means being able to reduce medium, high and very high complexity surgical waiting lists, ensuring that the emergency door be fluid, and that all patients already hospitalized, if they worsen, have a location where their safety is paramount, stays are shortened and admissions to high-cost, low-capacity structures are deactivated. If there is fluidity in a hospital, there is life. This virtual hospitalization project is scalable, sustainable, effective and safe. These should be the names of any project that intends to stay and grow. On the other hand, this initiative has more dimensions that go towards the concept of “liquid hospital”, whose objective is to anticipate change to promote it in the situations that are necessary, something that has been especially useful during the Covid-19 pandemic. , when the new habits and the normalization of telematic assistance have become especially evident. In the consolidation of the digital ecosystem we will see how the until now reactive model that analyzed the data a posteriori disappears, and we will see how a predictive model is naturally implemented where the algorithm will be the basis to prepare the organization before the changes happen .
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