Care bundles for COVID-19 patients in intensive care (search done on 26 October 2020)
Citation: Smith V, Devane D, Nichol A, et al. Care bundles for improving outcomes in patients with COVID‐19 or related conditions in intensive care – a rapid scoping review. Cochrane Database of Systematic Reviews. 2020;(12):CD013819.
What is this? Some patients with COVID-19 will become critically ill and need treating in an intensive care unit (ICU). Care bundles (evidence‐based interventions delivered together and consistently) may improve clinical outcomes for such patients.
In this Cochrane rapid scoping review, the authors searched for studies where at least three evidence‐informed practices were delivered collectively and consistently for COVID-19 patients or those with acute respiratory distress syndrome (ARDS), viral pneumonia or pneumonitis who were in ICU. They did not restrict their searches by type or language of publication and did the search on 26 October 2020. They included 21 studies (>2100 participants), which were published between 1999 and 2020, Where reported, the studies were from Chile (2 studies), China (5), France (1), Germany (1), India (1), Korea (1), UK (3) and USA (4). The authors also identified 3 ongoing studies.
What was found: At the time of this review, the included studies had tested a variety of care bundles and found that these typically involved care practices related to breathing support, ventilator use or position of a patient (e.g. face down) for patients with ARDS and COVID-19.
At the time of this review, COVID-19 specific studies had focused on infection control and use of personal protective equipment (PPE).
At the time of this review, evidence gaps included a lack of care bundles focused on preparing patients to leave the ICU, preventing infections caused by giving medicines intravenously and the long-term effects of COVID-19.