Background: Response to the outbreak of poliomyelitis in mid-1950 led to recognition and consequent development
of critical care. Seventy years later the humankind was struck by COVID-19, another major challenge for critical care
medicine which was especially big in Low-Resources-Settings where more than two thirds of the world population live,
including the population of the Republic of Srpska (RS).
Design and methods: The main aim was to show an overview of all interventions in order to boost hospitals’ capacities
to the level which is sufficient to manage high amount of critically ill COVID-19 patients in the RS. A before-after
cohort study design was conducted to evaluate the effects of interventions for increase in preparedness and capacity
of ICUs for admission and treatment of COVID-19 critically ill patients in nine hospitals in the RS. Results: Following
interventions, the biggest and university affiliated hospital in the RS has increased ICU capacities: total number of ICU
beds increased by 38% and number of ventilators by 114%. Availability of machines for veno-venous extracorporeal
membrane oxygenation (vvECMO) increased by 100%. Number of doctors who were involved in treatment of critically
ill patients increased by 47% and nurse/patient’s ratio reached 1:2.5. Similarly, all other hospitals experienced boosting
of ICU beds by 189% and ventilators by 373% while number of doctors increased by 108% and nurse/patient’s ratio
reached 1:4.
Conclusion: All interventions implemented during COVID-19 pandemic outbreak in the RS resulted in increasing
capacity for treatment of critically ill patients, but the education of health care professionals was identified as the most
important conducted intervention.
