Preventing infectious diseases in Intensive Care Unit by medical devices remote control: Lessons from COVID-19

Francesco Garzotto; Rosanna Irene Comoretto; Marlies Ostermann; Federico Nalesso; Dario Gregori; Maria Giuseppina Bonavina; Giorgio Zanardo; Gaudenzio Meneghesso

doi:10.1016/j.jcrc.2020.10.014

Preventing infectious diseases in Intensive Care Unit by medical devices remote control: Lessons from COVID-19

J Crit Care. 2021 Feb:61:119-124. doi: 10.1016/j.jcrc.2020.10.014. Epub 2020 Oct 27.

Authors

Francesco Garzotto¹, Rosanna Irene Comoretto², Marlies Ostermann³, Federico Nalesso⁴, Dario Gregori², Maria Giuseppina Bonavina⁵, Giorgio Zanardo⁶, Gaudenzio Meneghesso⁷

Affiliations

¹ Health Directorate Unit, Veneto Institute of Oncology IOV- IRCCS, 64 Via Gattamelata, Padova 35128, Italy; Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy. Electronic address: francesco.garzotto@unipd.it.
² Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy.
³ Department of Critical Care, King's College London, Guy's & St. Thomas' Hospital, London, UK.
⁴ Department of Medicine, Nephrology, Dialysis and Transplantation Unit, University of Padova, Padova, Italy.
⁵ Health Directorate Unit, Veneto Institute of Oncology IOV- IRCCS, 64 Via Gattamelata, Padova 35128, Italy.
⁶ Intensive Care Unit, Veneto Institute of Oncology IOV-IRCCS, 16/Z Via dei Carpani, 31033, Castelfranco Veneto, Italy.
⁷ Department of Information Engineering, University of Padova. 6/B Via Gradenigo, Padova 35131, Italy.

Abstract

The management of COVID-19 patients in the ICUs requires several and prolonged life-support systems (mechanical ventilation, continuous infusions of medications and nutrition, renal replacement therapy). Parameters have to be entered continuously into the device user interface by healthcare personnel according to the dynamic clinical condition. This leads to an increased risk of cross-contamination, use of personal protective equipment and the need for stringent and demanding protocols. Cables and tubing extensions have been utilized to make certain devices usable outside the patient's room but at the cost of introducing further hazards. Remote control of these devices decreases the frequency of unnecessary interventions and reduces the risk of exposure for both patients and healthcare personnel.

Keywords: COVID-19; HAI; Healthcare-associated infections; Infectious diseases; KRT; Medical devices; Monitoring; RRT; Remote control; Renal replacement therapy; Ventilators.

MeSH terms

COVID-19 / prevention & control*
Critical Care / methods*
Cross Infection / prevention & control*
Health Personnel
Humans
Infection Control / instrumentation*
Intensive Care Units
Occupational Exposure / prevention & control*
Personal Protective Equipment*
Renal Replacement Therapy
Respiration, Artificial
Risk
Robotics