Resumen de Optimization of the management of essential drugs in the covid-19 pandemic through mathematical correlations
Daniel Echeverría Esnal, Marta de Antonio Cuscó, Xènia Fernández Sala, Jaime Barceló Vidal, María Eugenia Navarrete Rouco, Pablo Acin, Carlos López Mula, Laura Comella Anaya, Alicia Rodriguez Alarcón, Joan Ramon Masclans Enviz
Background: The coronavirus disease-19 (COVID-19) led to an exponential increase in the number of people affected, with a higher need for ICU admission in those of greater severity. In this context, the risk of drug shortages of essential ICU drugs increases. An accurate knowledge on the consumption of these medications is therefore needed to foresee future COVID-19 outbreaks or other pandemics. The aim of the study was to describe the consumption of commonly used ICU drugs, which were essential during the COVID-199 pandemic, and to annalyze their correlation with the number of admitted patients.
Method : This was a retrospective observational sttudy conducted in the ICU of a 420-bed tertiary care hospital in Barcelona, Spain from 14th March to 30th April.Drugs analyzed included morphine, sufentanil, cisatracurium, norepinephrine, dexmedetomidine,rocuronium, propofol and midazolam.
Results: A total of 159 patients were admitted to the COVID-19 ICU during the study period. The consumption of all the analyzed drugs was significantly in- creased compared to the previous year: norepinephrine 118.7%, midazolam 285.2%, propofol 190%, dexmedetomidine 147%, sufentanil 665.6%, morphine 56.2% and cisatracurium 369.7. On the day of higher consumption, at least two-fold higher consumption compared to the median of all period was detected. The average daily dose for each drug was: propofol 3,050.3 (736.1) mg, cisatracurium 292.4 (128.9) mg, midazolam 203.6 (64) mg, morphine 39.3 (6.6) mg, norepinephrine 16.7 (5.2) mg,sufentanil 1.2 (0.3) mg, dexmedetomidine 0.9 (0.4) mg. A positive and significant correlation was observed in all drugs with both the number of treated and admitted patients.
Conclusions: A striking increase in the drug consumption of 56.2-665% was noticed throughout the study period. There was a significant correlation between the consumption of essential drugs in the ICU and the number of critically ill pa- tients. These findings allow the optimization of the management of essential drugs for critically ill patients and prevent the development of drug shortages in future outbreaks of pandemics
