COMMENT| VOLUME 397, ISSUE 10285, P1599-1601, MAY 01, 2021 Tocilizumab in COVID-19: some clarity amid controversy Shruti Gupta, David E Leaf Lancet 2021; 397: 1599-1601 Hyperactivation of the immune response, including release of pro-inflammatory cytokines such as interleukin-6 (IL-6), might play a key role in the pathophysiology of severe illness from COVID-19.1Consistent with this notion, one of the few therapies that reduces mortality in hosp...

CORRESPONDENCE|ONLINE FIRST Guidelines should not pool evidence from uncomplicated and severe COVID-19 Nicholas J White, Nathalie Strub-Wourgaft, Abul Faiz, Philippe J Guerin Lancet Published: March 22, 2021 DOI:https://doi.org/10.1016/S0140-6736(21)00469-4 The WHO Global Development Group guidelines on COVID-19 therapeutics are meant to provide evidence-based advice to all countries on the medical management of patients with COVID-19.1, 2The only smal...

ARTICLES| VOLUME 397, ISSUE 10285, P1637-1645, MAY 01, 2021 Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial RECOVERY Collaborative Group Lancet 2021; 397: 1637-1645 Summary Background In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods This ran...

ICU Management & Practice, Volume 21 - Issue 1, 2021 Important Questions Answered During the question/answer session, Prof Vito Marco Ranieri discussed some important questions with Prof Salvatore Maurizio Maggiore and Prof Boris Jung regarding sedation regimen, respiratory muscle paralysis, sedation in COVID-19 patients specifically and how it is different from other regular ICU patients. Ranieri: What is your opinion on deep sedation using remifentanil...

ARTICLES| VOLUME 397, ISSUE 10280, P1204-1212, MARCH 27, 2021 Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study Christian Holm Hansen, Daniela Michlmayr, Sophie Madeleine Gubbels, et al. Lancet 2021; 397: 1204-1212 DOI:https://doi.org/10.1016/S0140-6736(21)00575-4 Summary Background 背景 The degree to which infection with SA...

ICU Management & Practice, Volume 21 - Issue 1, 2021 How Should We Manage Sedation in Critically-Ill COVID-19 Patients? Clinical Practice Guidelines The Choosing Wisely top five guidelines published a few years ago by the Chest Association of Physicians, the American Thoracic Society, the Society of Critical Care Medicine, and the American Association of Critical Care Nurses state that mechanically ventilated patients should not be deeply sedated without...

Editorial March 25, 2021 Respiratory Support During the COVID-19 PandemicIs It Time to Consider Using a Helmet? Laveena Munshi, Jesse B. Hall JAMA. Published online March 25, 2021. doi:10.1001/jama.2021.4975 Acute hypoxemic respiratory failure (AHRF) is the most common organ failure and cause of admission to the intensive care unit (ICU) among patients with COVID-19. As with all forms of AHRF, ICU management is supportive while treating the unde...

ICU Management & Practice, Volume 21 - Issue 1, 2021 Why Do We Need Sedation in Critically-Ill COVID-19 Patients? COVID-19 patients present to the hospital with lung involvement and interstitial pneumonia eventually associated with lung collapse. The clinical picture is dominated by severe hypoxaemia without dyspnoea/tachypneoa and normal respiratory mechanics; this condition has been defined as silent hypoxia. The picture may evolve, and these patients may...

ICU Management & Practice, Volume 21 - Issue 1, 2021 Rethinking Critical Care - Use and Challenges of Artificial Intelligence Why digitalisation of intensive care medicine means less rather than more data Intensive Care Medicine is generating an amount of data that is hardly analysable by humans. Digitalising and using artificial intelligence has to focus on providing less rather than more data. Introduction - AI in Intensive Care Medicine: Ghost or G...

Original Investigation Caring for the Critically Ill PatientMarch 25, 2021 Effect of Helmet Noninvasive Ventilation vs High-Flow Nasal Oxygen on Days Free of Respiratory Support in Patients With COVID-19 and Moderate to Severe Hypoxemic Respiratory Failure: The HENIVOT Randomized Clinical Trial Domenico Luca Grieco, Luca S. Menga, Melania Cesarano, et al JAMA. Published online March 25, 2021. doi:10.1001/jama.2021.4682 Abstract Importance 背...