ICU Management & Practice, Volume 20 - Issue 1, 2020 Tracheal Intubation in the ICU Making tracheal intubation safe for both patients and their health care providers. Introduction COVID-19 is a newly recognised viral infection which first appeared in Wuhan, China in late 2019. It is caused by a novel Coronavirus, Severe Acute Respiratory Syndrome-CoronaVirus-2. For the most part it results in a mild, self-limiting flu-like illness but unfortunately, s...

COVID-19: Universal Masking in Hospitals The SARS-Cov-2 pandemic has all healthcare institutions scrambling for protocols to prevent virus transmission. The name of the game is to protect both patients and healthcare providers from the virus. However, every hospital has its protocol with respect to precautionary measures that have been undertaken to prevent transmission. While some hospitals advocate universal masking, other institutions are more selective and only enc...

Hydroxychloroquine and QT Prolongation As the healthcare community attempts to deal with the coronavirus disease (COVID-19), there is an intense effort to develop an effective treatment strategy. While research on the development of a vaccine continues, clinicians have been forced to use treatments that lack robust clinical evidence. With many patients succumbing to acute respiratory distress syndrome, multi-organ failure, severe pneumonia, and a variety of cardiac com...

Association of ACE Inhibitors and COVID-19 Severity or Risk of Death The COVID-19 pandemic has resulted in a significant number of deaths worldwide. Clinicians are still unclear as to who might be more susceptible to the infection and the factors associated with increased mortality. Laboratory data have shown that the angiotensin-converting enzyme-2 (ACE-2) serves as the receptor for severe acute respiratory syndrome coronavirus to gain entry into airway cells. Thus, a...

Convalescent Plasma for COVID-19 Deaths from COVID-19 continue to increase, forcing clinicians to try therapies that are not backed by strong clinical evidence.  One such treatment is convalescent plasma. This century old treatment has been used on and off during infectious disease outbreaks. In 1893, German scientists used this strategy to treat patients with diphtheria. In 1901, Emil von Behring won the first Nobel Prize in Medicine or Physiology for research...

Clinical Course and Prognosis of COVID-19 - Experience from Wuhan In early December 2019, the coronavirus disease (COVID 19) outbreak was first reported in the city of Wuhan, China. Early reports indicated that the virus was acquired from bats. Several epidemiological studies have linked the exposure to COVID-19 to the Wuhan meat market, which sold a variety of wild live animals. Today, it is well known that human to human transmission is a common mode of spread. Once ...

Managing COVID-19 Respiratory Distress Acute respiratory stress syndrome is one of the primary ways COVID-19 infection manifests in the patient. COVID-19 injures the vascular endothelium, which can lead to multiorgan failure even in young patients without any comorbidities. A wide variation in mortality rates indicates that the key to improving outcomes of ventilatory support could be in a case-adjusted management approach.  The goal of ventilatory support in ARDS i...

Can We Trust COVID-19 Research? The COVID-19 pandemic has inspired an unprecedented amount of healthcare-related research in various fields, from drug and vaccine development to epidemiological modelling. Preprints abound, but some warn about the dangers of releasing research without proper verification. You may also like: Warnings about Potential Treatments for COVID-19 “I am impressed by how quickly the scientific community has put together a lot...

EDITORIAL Inhibitors of the Renin–Angiotensin–Aldosterone System and Covid-19 John A. Jarcho, Julie R. Ingelfinger, Mary Beth Hamel, et al N Engl J Med May 1, 2020DOI: 10.1056/NEJMe2012924 SARS-CoV-2, the coronavirus that causes Covid-19, enters human cells by binding of its viral spike protein to the membrane-bound form of the aminopeptidase angiotensin-converting enzyme 2 (ACE2).1 From the viewpoint of human physiology, ACE2 plays an important regulator...

COVID-19 Pandemic: The Ethical Dilemma of Allocating Scarce Resources Coronavirus pandemic continues to intensify as does the shortage of ventilators and beds. In countries where cases are multiplying at a tremendous rate, a critical question that is being asked is: what criteria should be used to guide rationing decisions? What should be done when demand for ventilators and other intensive treatment exceeds the supply? A new viewpoint addresses these concerns and...