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...

Original Investigation Caring for the Critically Ill PatientDecember 8, 2021 Effect of Use of a Bougie vs Endotracheal Tube With Stylet on Successful Intubation on the First Attempt Among Critically Ill Patients Undergoing Tracheal Intubation: A Randomized Clinical Trial Brian E. Driver, Matthew W. Semler, Wesley H. Self, et al JAMA. Published online December 8, 2021. doi:10.1001/jama.2021.22002 Abstract Importance  For critically i...

EDITORIAL Booster Doses and Prioritizing Lives Saved Minal K. Patel N Engl J Med 2021; 385:2476-2477DOI: 10.1056/NEJMe2117592 Globally, more than 5 million people have died from Covid-19 since the start of the pandemic.1 This is certainly a grim number, but we are starting to see the lifesaving effect of vaccines.2 From the global public health perspective, the initial primary objective of Covid-19 vaccination is to decrease the severe consequences o...