Supplementary Material for: Adult Pulmonary Intensive and Intermediate Care Units: The Italian Thoracic Society (ITS-AIPO) Position Paper

The imbalance between the prevalence of patients with acute respiratory failure (ARF) and acute-on-chronic respiratory failure and the number of intensive care unit (ICU) beds requires new solutions. The increasing use of non-invasive respiratory tools to support patients at earlier stages of ARF and the increased expertise of non-ICU clinicians in other types of supportive care have led to the development of adult pulmonary intensive care units (PICUs) and pulmonary intermediate care units (PIMCUs). As in other European countries, Italian PICUs and PIMCUs provide an intermediate level of care as the setting designed for managing ARF patients without severe non-pulmonary dysfunction. The PICUs and PIMCUs may also act as step-down units for weaning patients from prolonged mechanical ventilation and for discharging patients still requiring ventilatory support at home. These units may play an important role in the on-going coronavirus disease 2019 pandemic. This position paper promoted by the Italian Thoracic Society (ITS-AIPO) describes the models, facilities, staff, equipment, and operating methods of PICUs and PIMCUs.急性呼吸衰竭（acute respiratory failure, ARF）与慢性呼吸衰竭急性加重（acute-on-chronic respiratory failure）患者的患病率，与重症监护病房（intensive care unit, ICU）床位数量之间的供需失衡，亟需新的解决方案。随着用于早期急性呼吸衰竭患者支持治疗的无创呼吸工具应用日益增多，非重症监护病房临床医师在各类支持治疗领域的专业能力不断提升，成人肺部重症监护病房（adult pulmonary intensive care units, PICUs）与肺部过渡监护病房（pulmonary intermediate care units, PIMCUs）应运而生。与欧洲其他国家一致，意大利的成人肺部重症监护病房与肺部过渡监护病房旨在为无严重非肺部功能障碍的急性呼吸衰竭患者提供中等强度的监护服务。此类病房还可作为降级监护病房，协助患者脱离长期机械通气，并为仍需居家呼吸支持的患者提供出院过渡。在当前的2019冠状病毒病（coronavirus disease 2019）大流行中，这些病房发挥着关键作用。本由意大利胸科学会（Italian Thoracic Society, ITS-AIPO）发起的立场文件，详细阐述了成人肺部重症监护病房与肺部过渡监护病房的运营模式、设施配置、人员配备、设备配置及运作流程。