RECOVERY Trial: Tocilizumab in Hospitalised COVID-19 Patients A large majority of COVID-19 infections are mild or asymptomatic. However, there is a significant portion of individuals who develop severe respiratory illness that requires hospital care, and that could progress to critical illness with hypoxic respiratory failure requiring prolonged ventilatory support.  This hypoxic respiratory failure is associated with systemic inflammation. Beneficial effects o...

Research Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries Jiangmei Liu, Lan Zhang,  Yaqiong Yan, et al BMJ 2021; 372: n415 doi: https://doi.org/10.1136/bmj.n415 (Published 24 February 2021) Abstract Objective To assess excess all cause and cause specific mortality during the three months (1 January to 31 March 2020) of the coronavirus disease 2019 (covi...

Practice Rapid Recommendations A living WHO guideline on drugs for covid-19 Bram Rochwerg, Reed AC Siemieniuk, Thomas Agoritsas, et al BMJ 2020; 370: m3379 doi: https://doi.org/10.1136/bmj.m3379 (Published 04 September 2020) Abstract Clinical question What is the role of drug interventions in the treatment of patients with covid-19? New recommendation Increased attention on ivermectin as a potential treatment for covid-19 triggered this recomm...

Research Letter February 17, 2021 Discriminant Accuracy of the SOFA Score for Determining the Probable Mortality of Patients With COVID-19 Pneumonia Requiring Mechanical Ventilation Robert A. Raschke, Sumit Agarwal, Pooja Rangan, et al JAMA. Published online February 17, 2021. doi:10.1001/jama.2021.1545 The coronavirus disease 2019 (COVID-19) pandemic has raised concern regarding the capacity to provide care for a surge of critically ill patient...

ARTICLES|ONLINE FIRST Azithromycin for community treatment of suspected COVID-19 in people at increased risk of an adverse clinical course in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial PRINCIPLE Trial Collaborative Group Lancet Published:March 04, 2021 DOI:https://doi.org/10.1016/S0140-6736(21)00461-X Summary Background Azithromycin, an antibiotic with potential antiviral and anti-inflammatory properties, has b...

HOW TO VENTILATE COVID-19 PATIENTS? TWINSTREAM® ICU WITH P-BLV® (PULSATILE BILEVEL VENTILATION) The Austrian critical care ventilator TwinStream® ICU was designed with the explicit purpose of saving critically respiratory-distressed patients. In particular those patients with severe lung diseases (e.g. ARDS) who can no longer be supported with conventional ventilation. Its unique p-BLV® mode has become an established value in many Intensive Care Units in Austrian...

ARTICLES|ONLINE FIRST Identification and validation of clinical phenotypes with prognostic implications in patients admitted to hospital with COVID-19: a multicentre cohort study Belén Gutiérrez-Gutiérrez, María Dolores del Toro, Alberto M Borobia, et al Lancet Infect Dis Published:February 23, 2021 DOI:https://doi.org/10.1016/S1473-3099(21)00019-0 Summary Background The clinical presentation of COVID-19 in patients admitted to hospital is heterogen...

Early and Late Intervention for Intubation-Related Laryngeal Injury A study was conducted to determine if there were differences in functional outcomes between early and late intervention for intubation-related laryngeal injury.  Approximately 13 million to 20 million patients are intubated in the ICU every year. Clinical evidence shows that 57% of patients who are intubated for more than 12 hours develop acute laryngeal injury after extubation. Acute laryngeal...

Research High flow oxygen and risk of mortality in patients with a suspected acute coronary syndrome: pragmatic, cluster randomised, crossover trial Ralph A H Stewart, Peter Jones, Bridget Dicker, et al BMJ 2021; 372: n355 doi: https://doi.org/10.1136/bmj.n355 (Published 02 March 2021) Abstract Objective To determine the association between high flow supplementary oxygen and 30 day mortality in patients presenting with a suspected acute coronary syndrome...

Ventilator-Associated Events in Mechanically Ventilated Patients Critically ill patients in the ICU often require life-saving mechanical ventilation. For many, this is an unavoidable intervention, despite the multiple complications associated with it. Ventilator-associated event (VAE) surveillance was proposed in 2013 by a working group of the Centers for Disease Control and Prevention (CDC). Three tiers of VAEs were defined by this group: Ventilator-associated cond...