The DOI matches its Crossref record; 35 of the 36 references it cites were found in a registry or an index.
ICU Occupancy and Mechanical Ventilator Use in the United States*
Open accessAbstract
OBJECTIVES: Detailed data on occupancy and use of mechanical ventilators in U. S. ICU over time and across unit types are lacking. We sought to describe the hourly bed occupancy and use of ventilators in U.S. ICUs to improve future planning of both the routine and disaster provision of intensive care. DESIGN: Retrospective cohort study. We calculated mean hourly bed occupancy in each ICU and hourly bed occupancy for patients on mechanical ventilators. We assessed trends in overall occupancy over the 3 years. We also assessed occupancy and mechanical ventilation rates across different types and sizes of ICUs. SETTING: Ninety-seven U.S. ICUs participating in Project IMPACT from 2005 to 2007. PATIENTS: A total of 226,942 consecutive admissions to ICUs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Over the 3 years studied, total ICU occupancy ranged from 57.4% to 82.1% and the number of beds filled with mechanically ventilated patients ranged from 20.7% to 38.9%. There was no change in occupancy across years and no increase in occupancy during influenza seasons. Mean hourly occupancy across ICUs was 68.2% ± 21.3% (SD) and was substantially higher in ICUs with fewer beds (mean, 75.8% ± 16.5% for 5-14 beds vs 60.9% ± 22.1% for 20+ beds, p = 0.001) and in academic hospitals (78.7% ± 15.9% vs 65.3% ± 21.3% for community not-for-profit hospitals, p < 0.001). More than half of ICUs (53.6%) had 4+ beds available more than half the time. The mean percentage of ICU patients receiving mechanical ventilation in any given hour was 39.5% (± 15.2%), and a mean of 29.0% (± 15.9%) of ICU beds were filled with a patient on a ventilator. CONCLUSIONS: Occupancy of U.S. ICUs was stable over time, but there is uneven distribution across different types and sizes of units. Only three of 10 beds were filled at any time with mechanically ventilated patients, suggesting substantial surge capacity throughout the system to care for acutely critically ill patients.
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“However, the mechanically ventilated population (40%) was fairly representative of the national average of ICU beds receiving mechanical ventilation.34”
From Feasibility of a virtual reality intervention in the intensive care unit (2021) · cites this paper as [34]
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Halpern, N. A., & Pastores, S. M. (2009) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181b090d0 · Cited by 818
Variation in critical care services across North America and Western Europe*
Wunsch, H., Angus, D. C., Harrison, D. A., Collange, O., Fowler, R., Hoste, E. A. J., de Keizer, N. F., Kersten, A., Linde‐Zwirble, W. T., Sandiumenge, A., et al. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e318186aec8 · Cited by 626
Self-citationThe epidemiology of mechanical ventilation use in the United States*
Wunsch, H., Linde‐Zwirble, W. T., Angus, D. C., Hartman, M. E., Milbrandt, E. B., & Kahn, J. M. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181ef4460 · Cited by 541
Self-citationHospital Volume and the Outcomes of Mechanical Ventilation
Kahn, J. M., Goss, C. H., Heagerty, P. J., Kramer, A. A., O'Brien, C. R., & Rubenfeld, G. D. (2006) · New England Journal of Medicine · doi:10.1056/nejmsa053993 · Cited by 507
Self-citationAngus, D. C., Shorr, A. F., White, A., Dremsizov, T. T., Schmitz, R. J., & Kelley, M. A. (2006) · Critical Care Medicine · doi:10.1097/01.ccm.0000206105.05626.15 · Cited by 437
Aylwin, C. J., König, T. C., Brennan, N. W., Shirley, P. J., Davies, G., Walsh, M., & Brohi, K. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69896-6 · Cited by 419
Higgins, T. L., Teres, D., Copes, W. S., Nathanson, B. H., Stark, M., & Kramer, A. A. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000257337.63529.9f · Cited by 333
Self-citationRationing critical care beds: A systematic review*
Sinuff, T., Kahnamoui, K., Cook, D. J., Luce, J. M., & Levy, M. M. (2004) · Critical Care Medicine · doi:10.1097/01.ccm.0000130175.38521.9f · Cited by 271
Comparison of Medical Admissions to Intensive Care Units in the United States and United Kingdom
Wunsch, H., Angus, D. C., Harrison, D. A., Linde‐Zwirble, W. T., & Rowan, K. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201012-1961oc · Cited by 256
Self-citationRationing of Intensive Care Unit Services
Strauss, M. J. (1986) · JAMA · doi:10.1001/jama.255.9.1143 · Cited by 245
Research works printed but not linked: 1
- Strauss, 1986, JAMA, 255, 1143, 10.1001/jama.1986.03370090065021 · DOI
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Pun, B. T., Balas, M. C., Barnes‐Daly, M. A., Thompson, J. L., Aldrich, J. M., Barr, J., Byrum, D. G., Carson, S. S., Devlin, J. W., Engel, H. J., et al. (2018) · Critical Care Medicine · doi:10.1097/ccm.0000000000003482 · Cited by 1,153
Balas, M. C., Vasilevskis, E. E., Olsen, K. M., Schmid, K. K., Shostrom, V., Cohen, M. Z., Peitz, G. J., Gannon, D. E., Sisson, J. H., Sullivan, J., et al. (2014) · Critical Care Medicine · doi:10.1097/ccm.0000000000000129 · Cited by 527
Economic significance of biofilms: a multidisciplinary and cross-sectoral challenge
Cámara, M., Green, W., MacPhee, C. E., Rakowska, P. D., Raval, R., Richardson, M. C., Slater-Jefferies, J. L., Steventon, K., & Webb, J. S. (2022) · npj Biofilms and Microbiomes · doi:10.1038/s41522-022-00306-y · Cited by 364
Halpern, N. A., Goldman, D. A., Tan, K. S., & Pastores, S. M. (2016) · Critical Care Medicine · doi:10.1097/ccm.0000000000001722 · Cited by 224
Ventilator Weaning and Discontinuation Practices for Critically Ill Patients
Burns, K. E. A., Rizvi, L., Cook, D. J., Lebovic, G., Dodek, P., Villar, J., Slutsky, A. S., Jones, A., Kapadia, F. N., Gattas, D. J., et al. (2021) · JAMA · doi:10.1001/jama.2021.2384 · Cited by 197
Metadata
- Authors
- Wunsch, H., Wagner, J., Herlim, M., Chong, D. H., Kramer, A. A., & Halpern, S. D.
- Affiliations
- Columbia University (US)
- University of Pennsylvania (US)
- Leonard Davis Institute of Health Economics (US)
- Venue
- Critical Care Medicine
- Published
- 2013-12
- Volume
- 41
- Issue
- 12
- Pages
- 2712-2719
- ISSN
- 0090-3493 (ISSN-L)
- PMC
- PMC3840149
- OpenAlex
- W2050845046
- Cited by
- 287
- References
- 36
- Citations by year
- 2026: 17 · 2025: 27 · 2024: 34 · 2023: 25 · 2022: 24 · 2021: 27 · 2020: 39 · 2019: 24 · 2018: 17 · 2017: 13 · 2016: 11 · 2015: 17 · 2014: 9 · 2013: 1
- FWCI
- 19.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Agency for Healthcare Research and Quality (K08HS018406)
- National Institute on Aging (K08AG038477)
- National Center for Research Resources (UL1RR024156)
- Topics
- Social Sciences › Decision Sciences › Management Science and Operations Research › Healthcare Operations and Scheduling Optimization
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- ICU bed occupancy, mechanical ventilation, intensive care unit, surge capacity, academic vs community hospitals, influenza season, disaster preparedness, project impact, critically ill patients
- MeSH terms
- Academic Medical Centers, Adult, Aged, Bed Occupancy, Female, Hospitals, Community, Hospitals, Voluntary, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Respiration, Artificial, Retrospective Studies, Time Factors, United States
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