Awake Prone Positioning and Risk of Intubation in COVID-19 Many COVID-19 patients develop severe bilateral viral pneumonia, which evolves into acute respiratory distress syndrome (ARD). High-flow nasal oxygen therapy (HFNO) has been shown to be effective in decreasing the need for endotracheal intubation with patients with acute hypoxaemic respiratory failure (ARF). However, in patients with COVID-19, the recommendation is of early intubation and invasive mechanical ve...

Intensive Care Medicine ONLINE FIRST (FREE ACCESS)  Editorial - Arabi Y. et al. - The ten reasons why corticosteroid therapy reduces mortality in severe COVID-19Original ~ Labeau S.O. et al. - Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs studyOriginal ~ Richards-Belle A. et al. - COVID-19 in critical care: epidemiology of the first epidemic wave across England, Wales and Northern IrelandLetter ...

Do We Need to Diagnose ARDS? Acute respiratory distress syndrome (ARDS) is the clinical expression of acute, non-haemodynamic lung oedema. It is typically diagnosed by hypoxaemia, and bilateral lung infiltrates in the absence of increased capillary hydrostatic pressure. ARDS represents nearly a quarter of the ICU patients who require mechanical ventilation. There is significant research and literature on ARDS, with over 13,000 articles published on this syndrome since ...

Research Letter September 3, 2020 Cytokine Levels in Critically Ill Patients With COVID-19 and Other Conditions Matthijs Kox, Nicole J. B. Waalders, Emma J. Kooistra, et al JAMA. 2020;324(15):1565-1567. doi:10.1001/jama.2020.17052 An abnormally strong proinflammatory response known as “cytokine storm” may play an important role in the pathophysiology of coronavirus disease 2019 (COVID-19), although cytokine storm remains ill defined.1 Sinha and colleagues...

Increasing Efficiency Without Affecting Patient Outcomes The economic and clinical fragilities of healthcare systems around the globe have never been more visible than during the COVID-19 pandemic. In particular, the importance of resource allocation has been at the forefront. Weighing safety against costs when dealing with critically ill patients has been a source of dilemma for many healthcare professionals. When we evaluate the use of imaging in the ICU, we see that...

Editorial October 12, 2020 Excess Deaths and the Great Pandemic of 2020 Howard Bauchner, Phil B. Fontanarosa JAMA. Published online October 12, 2020. doi:10.1001/jama.2020.20016 Two new reports in JAMA provide updated estimates regarding the mortality associated with the coronavirus disease 2019 (COVID-19) pandemic in the US. In a research letter by Woolf and colleagues, the authors update their analysis of the number of “excess” deaths in the U...

Lung Histopathology: COVID-19 Compared to SARS, H1N1 The coronavirus disease has spread throughout the world and has resulted in many challenges for healthcare systems. It is a new disease with a significant burden of respiratory failure. This has led to questions about the pathogenesis and pulmonary pathology of COVID-19.  Patients with severe COVID-19 have respiratory failure with hypoxaemia, and acute bilateral pulmonary infiltrates. This is consistent with ...

Research Drug treatments for covid-19: living systematic review and network meta-analysis BMJ 2020; 370: m2980 doi: https://doi.org/10.1136/bmj.m2980 (Published 30 July 2020) Abstract Objective To compare the effects of treatments for coronavirus disease 2019 (covid-19). Design Living systematic review and network meta-analysis. Data sources US Centers for Disease Control and Prevention COVID-19 Research Articles Downloadable Database, which inc...

ICU Management & Practice, Volume 20 - Issue 3, 2020 PCT-guided Antibiotic Stewardship in COVID-19 Patients Professor Michael Mansour is a physician-scientist with a research concentration in immune responses against invading pathogens. He attends on the Clinical Transplant Infectious Diseases and Immunocompromised Host Service at the Massachusetts General Hospital - Division of Infectious Diseases, where he cares for solid and stem cell transplant recipien...

Research Effect of exercise training for five years on all cause mortality in older adults—the Generation 100 study: randomised controlled trial BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3485 (Published 07 October 2020)Cite this as: BMJ 2020;371:m3485 Abstract Objective To evaluate the effect of five years of supervised exercise training compared with recommendations for physical activity on mortality in older adults (70-77 years). Design Ra...