PulmCrit – Awake Proning for COVID-19 May 5, 2020 by Josh Farkas Recently, many on twitter have been engaged in a furious debate about how to ventilate patients with COVID-19.  Is it ARDS or not?  High PEEP or low PEEP?…  As an intensivist, these issues are near and dear to my heart.  However, the truth is that humble methods to keep patients off invasive ventilation altogether are probably more important.  One such technique is awake pronin...

ARTICLES|ONLINE FIRST Defining persistent Staphylococcus aureus bacteraemia: secondary analysis of a prospective cohort study Richard Kuehl, Laura Morata, Christian Boeing, et al Lancet Infect Dis Published:August 04, 2020 DOI:https://doi.org/10.1016/S1473-3099(20)30447-3 Summary 摘要 Background 背景 Staphylococcus aureus persistent bacteraemia is only vaguely defined and the effect of different durations of bacteraemia on mortality is not well establish...

HealthManagement, Volume 20 - Issue 6, 2020 Improved Patient Assessment with MR-proADM Prof. Carlo Tascini is Head of Infectious Diseases Clinic at Udine University Hospital. Prior to that, he was the Head of First Division of Infectious Diseases Unit at Cotugno Hospital. His field of interests include endocarditis, meningitis, sepsis, MDR bacterial infection and fungal infections. HealthManagement.org spoke to Prof. Tascini about the clinical benefits of MR-pr...

ICU Management & Practice, Volume 20 - Issue 2, 2020 Is COVID-19 the Black Swan? Nassim Taleb, in his book, "The Black Swan: The Impact of the Highly Improbable," describes the term Black Swan as a rare, unknown event, which with hindsight is rationalised. Taleb talks about the human tendency to always find simplistic explanations for unknown events, what he calls the Black Swan theory. Is COVID-19 a black swan? Introduction Physicians working with cr...

ARTICLES| VOLUME 396, ISSUE 10251, P603-611, AUGUST 29, 2020 Effects of a major deletion in the SARS-CoV-2 genome on the severity of infection and the inflammatory response: an observational cohort study Barnaby E Young, Siew-Wai Fong, Yi-Hao Chan, et al Lancet 2020; 396: 603-611 Summary 摘要 Background 背景 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with a 382-nucleotide deletion (∆382) in the open reading frame 8 (ORF8) regio...

COVID-19: Hydroxychloroquine With or Without Azithromycin Hydroxychloroquine and azithromycin have been used to treat COVID-19 patients, but there is very little evidence with respect to the safety and efficacy of this treatment strategy.  Hydroxychloroquine has antiviral effects, and combined with azithromycin, it was believed that it could decrease SARS-CoV-2 viral load (based on results from a small, nonrandomised study). Based on this evidence, some practit...

COVID-19-associated hyperinflammation and escalation of patient care: a retrospective longitudinal cohort study Jessica J Manson, Colin Crooks, Meena Naja, et al Lancet Rheumatol Published:August 21, 2020 DOI:https://doi.org/10.1016/S2665-9913(20)30275-7 Summary Background 背景 A subset of patients with severe COVID-19 develop a hyperinflammatory syndrome, which might contribute to morbidity and mortality. This study explores a specific phenotype of COVID-1...

Corticosteroids in COVID-19 ARDS: Evidence and Hope During the Pandemic Hallie C. Prescott, ToddW. Rice JAMA. Published online September 2, 2020. doi:10.1001/jama.2020.16747 Corticosteroids, such as hydrocortisone and dexamethasone, have anti-inflammatory, antifibrotic, and vasoconstrictive effects, which intensivists have been trying to leverage for decades to improve outcomes in patients with acute respiratory distress syndrome (ARDS) and septic shock. In the f...

ARTICLES| VOLUME 20, ISSUE 4, P425-434, APRIL 01, 2020 Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study Heshui Shi, Xiaoyu Han, Nanchuan Jiang, et al Lancet Infect Dis 2020; 20: 425-434 Summary 摘要 Background 背景 A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuh...

COMMENT|ONLINE FIRST ECMO for severe ARDS associated with COVID-19: now we know we can, but should we? Kiran Shekar, Arthur S Slutsky, Daniel Brodie JAMA Published:August 13, 2020 DOI:https://doi.org/10.1016/S2213-2600(20)30357-X The initial months of the COVID-19 pandemic were dominated by studies reporting poor and varied outcomes in patients who developed severe acute respiratory distress syndrome (ARDS) associated with the disease. Variable mortality could...