Abstract
IntroductionIntensive Care Units (ICUs) provide life-supporting treatment; however, resources are limited, so demand may exceed supply in the event of pandemics, environmental disasters, or in the context of an aging population. We hypothesized that comprehensive national data on ICU resources would permit a better understanding of regional differences in system capacity.MethodsAfter the 2009–2010 Influenza A (H1N1) pandemic, the Canadian Critical Care Trials Group surveyed all acute care hospitals in Canada to assess ICU capacity. Using a structured survey tool administered to physicians, respiratory therapists and nurses, we determined the number of ICU beds, ventilators, and the ability to provide specialized support for respiratory failure.ResultsWe identified 286 hospitals with 3170 ICU beds and 4982 mechanical ventilators for critically ill patients. Twenty-two hospitals had an ICU that routinely cared for children; 15 had dedicated pediatric ICUs. Per 100,000 population, there was substantial variability in provincial capacity, with a mean of 0.9 hospitals with ICUs (provincial range 0.4-2.8), 10 ICU beds capable of providing mechanical ventilation (provincial range 6–19), and 15 invasive mechanical ventilators (provincial range 10–24). There was only moderate correlation between ventilation capacity and population size (coefficient of determination (R2) = 0.771).ConclusionICU resources vary widely across Canadian provinces, and during times of increased demand, may result in geographic differences in the ability to care for critically ill patients. These results highlight the need to evolve inter-jurisdictional resource sharing during periods of substantial increase in demand, and provide background data for the development of appropriate critical care capacity benchmarks.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-015-0852-6) contains supplementary material, which is available to authorized users.
Highlights
Intensive Care Units (ICUs) provide life-supporting treatment; resources are limited, so demand may exceed supply in the event of pandemics, environmental disasters, or in the context of an aging population
We hypothesized that comprehensive national data on ICU resources would permit a better understanding of regional differences in system capacity in Canada, inform the potential need for inter-jurisdictional resource sharing during periods of increased national and provide background data for the development of appropriate critical care capacity benchmarks
There were 286 hospitals with at least one self-designated ICU that was capable of providing invasive mechanical ventilation
Summary
Intensive Care Units (ICUs) provide life-supporting treatment; resources are limited, so demand may exceed supply in the event of pandemics, environmental disasters, or in the context of an aging population. We hypothesized that comprehensive national data on ICU resources would permit a better understanding of regional differences in system capacity. ICUs provide life-supporting treatments to critically ill patients. Clinicians must consider the possible benefits of admission to ICU, and hospital administrators must coordinate the provision of procedures and surgeries requiring critical care with existing capacity [1,2]. There is substantial global variation in the capacity to provide critical care [7]. Previous estimates using national health administrative data indicate that Canada has far fewer ICU beds per capita than the United States, but similar numbers of ICU beds to those in many Western European nations [8].
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