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Journal Article Ppublish 21 citations

PubMed: 32458267 DOI: 10.1007/s12630-020-01713-5

Therapeutic alternatives and strategies for drug conservation in the intensive care unit during times of drug shortage: a report of the Ontario COVID-19 ICU Drug Task Force.

Can J Anaesth 67(10):1405-1416

Authors: Salmaan Kanji, Lisa Burry, David Williamson, Michelle Pittman, Samuel Dubinsky, Deep Patel, Sabrina Natarajan, Robert MacLean, Jin-Hyeun Huh, Damon C Scales, David Neilipovitz

Affiliations

  • Department of Pharmacy, The Ottawa Hospital, The Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada.
  • Mount Sinai Hospital, Toronto, ON, Canada.
  • Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada.
  • Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
  • Sacré Coeur Hospital, Université de Montréal, Montreal, QC, Canada.
  • The Ottawa Hospital, Ottawa, ON, Canada.
  • University Health Network, Toronto, ON, Canada.
  • Sunnybrook Health Sciences Center, Toronto, ON, Canada.

Abstract

During the coronavirus disease (COVID-19) global pandemic, urgent strategies to alleviate shortages are required. Evaluation of the feasibility, practicality, and value of drug conservation strategies and therapeutic alternatives requires a collaborative approach at the provincial level. The Ontario COVID-19 ICU Drug Task Force was directed to create recommendations suggesting drug conservation strategies and therapeutic alternatives for essential drugs at risk of shortage in the intensive care unit during the COVID-19 pandemic. Recommendations were rapidly developed using a modified Delphi method and evaluated on their ease of implementation, feasibility, and supportive evidence. This article describes the recommendations for drug conservation strategies and therapeutic alternatives for drugs at risk of shortage that are commonly used in the care of critically ill patients. Recommendations are identified as preferred and secondary ones that might be less desirable. Although the impetus for generating this document was the COVID-19 pandemic, recommendations should also be applicable for mitigating drug shortages outside of a pandemic. Proposed provincial strategies for drug conservation and therapeutic alternatives may not all be appropriate for every institution. Local implementation will require consultation from end-users and hospital administrators. Competing equipment shortages and available resources should be considered when evaluating the appropriateness of each strategy.

MeSH

Risk, Pharmaceutical Preparations, Therapeutics, Intensive Care Units, Anesthesiology, Pandemics, Covid-19

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