Respiratory Subphenotypes of COVID-19-Related ARDS Patients with COVID-19 related ARDS present with distinct respiratory subphenotypes. But most phenotyping schema is limited by sample size, disregard for temporal dynamics and insufficient validation. In the PRoVENT-COVID study, researchers aimed to identify respiratory subphenotypes of COVID-19-related ARDS. This was an investigator-initiated observational cohort study at 22 ICUs in the Netherlands. COVID-19 pa...

ARTICLES|ONLINE FIRST Immunogenicity, safety, and reactogenicity of heterologous COVID-19 primary vaccination incorporating mRNA, viral-vector, and protein-adjuvant vaccines in the UK (Com-COV2): a single-blind, randomised, phase 2, non-inferiority trial Arabella S V Stuart, Robert H Shaw, Xinxue Liu, et al Lancet Published:December 06, 2021 DOI:https://doi.org/10.1016/S0140-6736(21)02718-5 Summary Background Given the importance of flexible use of di...

ICU Management & Practice, Volume 21 - Issue 5, 2021 The Role of the Microbiome and Nutritional Therapy in Critical COVID-19 Dysbiosis has been closely related to inflammation and severe-to-critical COVID-19, a reason why nutritional therapy could be important in the prevention and management of critical disease. Introduction Infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease (COVID-19), inv...

Feature BMJ Investigation Covid-19: Researcher blows the whistle on data integrity issues in Pfizer’s vaccine trial Paul D Thacker BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2635 (Published 02 November 2021)Cite this as: BMJ 2021;375:n2635 Revelations of poor practices at a contract research company helping to carry out Pfizer’s pivotal covid-19 vaccine trial raise questions about data integrity and regulatory oversight. Paul D Thacker repo...

ICU Management & Practice, Volume 21 - Issue 5, 2021 The Intestinal Microbiome in Critical Illness Critical illness alters the intestinal microbiome, resulting in a loss of microbial diversity and induction of a pathobiome. Manipulating the intestinal microbiome offers a potential treatment approach in ICU patients. The intestinal microbiome is comprised of diverse, robust microbial communities within the intestine, modified by the host’s interaction wit...

ARTICLES| VOLUME 398, ISSUE 10318, P2258-2276, DECEMBER 18, 2021 Safety and immunogenicity of seven COVID-19 vaccines as a third dose (booster) following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK (COV-BOOST): a blinded, multicentre, randomised, controlled, phase 2 trial Alasdair P S Munro, Leila Janani, Victoria Cornelius, et al Lancet 2021; 398: 2258-2276 Summary Background Few data exist on the comparative safety and immunogenicity of differen...

ICU Management & Practice, Volume 21 - Issue 5, 2021 Safer Intubation Practices in Critically Ill Patients What We Learned During the COVID-19 Pandemic That Should Not Be Forgotten An overview of the available evidence on safe intubation practices in critically ill patients in light of new discoveries due to the coronavirus pandemic. Introduction Orotracheal intubation is a life-saving procedure in critically ill patients with acute respiratory fai...

Original Investigation December 13, 2021 Effect of Minimally Invasive Surfactant Therapy vs Sham Treatment on Death or Bronchopulmonary Dysplasia in Preterm Infants With Respiratory Distress Syndrome: The OPTIMIST-A Randomized Clinical Trial Peter A. Dargaville, C. Omar F. Kamlin, Francesca Orsini, et al JAMA. Published online December 13, 2021. doi:10.1001/jama.2021.21892 Abstract Importance  The benefits of surfactant administrati...

ICU Management & Practice, Volume 21 - Issue 5, 2021 Methylene Blue for Vasoplegic Syndrome Post Cardiac Surgery Post-operative cardiac surgical patients are encountered commonly in the intensive care unit. Methylene blue might be a useful treatment for patients with vasopressor-refractory vasoplegia but high quality evidence is lacking. Cardiac surgery is one of the most frequently performed major surgical procedures, with more than 1 million operations...

Transgastric Abdominal Ultrasonography in Anaesthesia and Critical Care Transoesophageal echocardiography (TEE) is a test that provides clinicians with pictures of the heart. It uses ultrasound to produce detailed pictures of the heart and the arteries. TEE differs from a standard echocardiogram. The echo transducer that produces the sound waves is attached to a tube that passes through the patient’s mouth, down their throat and into the oesophagus. The test can pr...