COVID-19: instruments for the allocation of mechanical ventilators-a narrative review

• Published in: Critical care (London, England) England), 2020-09, Vol.24 (1), p.582-582, Article 582
• Main Authors: Dos Santos, Marcelo José, Martins, Maristela Santini, Santana, Fabiana Lopes Pereira, Furtado, Maria Carolina Silvano Pacheco Corrêa, Miname, Fabiana Cristina Bazana Remédio, Pimentel, Rafael Rodrigo da Silva, Brito, Ágata Nunes, Schneider, Patrick, Dos Santos, Edson Silva, da Silva, Luciane Hupalo
• Format: Article
• Language: English
• Subjects: Analysis; Betacoronavirus; Clinical decision making; Coronavirus Infections - therapy; COVID-19; Critical care; Decision Making; Epidemics; Ethics; Health care rationing; Humans; Medical ethics; Pandemics; Pneumonia, Viral - therapy; Public Health; Rationing; Resource Allocation; Resource management; Review; SARS-CoV-2; Triage - methods; Ventilators; Ventilators (Medical equipment); Ventilators, Mechanical
• ISSN: 1364-8535; 1466-609X; 1364-8535; 1366-609X
• DOI: 10.1186/s13054-020-03298-3

After the World Health Organization declared COVID-19 to be a pandemic, the elaboration of comprehensive and preventive public policies became important in order to stop the spread of the disease. However, insufficient or ineffective measures may have placed health professionals and services in the position of having to allocate mechanical ventilators. This study aimed to identify instruments, analyze their structures, and present the main criteria used in the screening protocols, in order to help the development of guidelines and policies for the allocation of mechanical ventilators in the COVID-19 pandemic. The instruments have a low level of scientific evidence, and, in general, are structured by various clinical, non-clinical, and tiebreaker criteria that contain ethical aspects. Few instruments included public participation in their construction or validation. We believe that the elaboration of these guidelines cannot be restricted to specialists as this question involves ethical considerations which make the participation of the population necessary. Finally, we propose seventeen elements that can support the construction of screening protocols in the COVID-19 pandemic.