COV-AID Trial: Effect of Anti-Interleukin Drugs in COVID-19 The coronavirus infection continues to cause significant morbidity and mortality. COVID-19 is a new illness, and clinicians are still trying to find the most effective treatment strategies. Interleukin (IL)-1 and IL-6 blockade have been proposed as one possible option. However, study results so far are conflicting. COV-AID, a prospective, multicentre, open-label, randomised controlled trial, was co...

Editorial January 24, 2022 Defining Optimal Respiratory Support for Patients With COVID-19 Fernando G. Zampieri, Juliana C. Ferreira JAMA. Published online January 24, 2022. doi:10.1001/jama.2022.0067 Noninvasive respiratory support is an essential component of critical care. Both noninvasive ventilation, with its different interface types and modes (including helmet and face masks), and high-flow nasal oxygen (HFNO) are successfully used to man...

Impact of Treatment Variability on ARDS Mortality Acute Respiratory Distress Syndrome (ARDS) is a potentially fatal condition characterised by acute hypoxaemia, and bilateral radiographic infiltrates and a mortality of 36 to 47%. Interventions like lung protective ventilation (LPV) and prone positioning have been shown to improve survival but remain underused. Other treatment methods such as neuromuscular blockade, extracorporeal membrane oxygenation, steroids and ...

Pathophysiology and Management of COVID-19 Pneumonia COVID-19 pneumonia is an evolving disease. In this review, the authors focus on the development of its pathophysiologic characteristics over time and how these changes determine modifications in treatment. The clinical features of COVId-19 are highly variable, ranging from asymptomatic patients to patients with a severe form of respiratory failure. These clinical features also tend to change with time. Althoug...

COMMENT|ONLINE FIRST Understanding of COVID-19 from infection–fatality ratio Xiaoying Gu, Bin Cao Lancet Published: February 24, 2022 DOI:https://doi.org/10.1016/S0140-6736(22)00281-1 Since the emergence of the COVID-19 pandemic, confirmed cases and cumulative deaths have been the most important numbers released by WHO and raised worldwide attention.1 The two numbers can help to roughly estimate the COVID-19 mortality rate (COVID-19 deaths to population num...

RECOVERY Trial: Use of Aspirin in Patients With COVID-19 The use of aspirin has been proposed as a treatment for COVID-19 because of its anti-thrombotic properties. Thrombosis is a key feature of COVID-19, with 5-30% of hospitalised patients having a major venous thromboembolic event and up to 3% having an arterial thromboembolic event. The Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial is the first randomised controlled trial to report on the effect...

Viewpoint February 11, 2022 Time to Retire the Concept of Transient Ischemic Attack J. Donald Easton, S. Claiborne Johnston JAMA. 2022;327(9):813-814. doi:10.1001/jama.2022.0300 Transient ischemic attack (TIA) has been a useful clinical term even though agreement on the diagnosis for individual cases has been far from perfect even among experts.1 The utility of the diagnosis has waned with improvements in brain imaging and a deeper understa...

Ventilator-Associated Pneumonia in Patients With COVID-19 A major challenge in ICUs even before the COVID-19 pandemic was ventilator-associated pneumonia (VAP). However, now that the ICUs are even more overwhelmed with the complex and prolonged acute care of patients with COVID-19, VAP has become an even bigger issue. It has an overall incidence of 40 to 60%, but the problem is that the variation on VAP definitions used in different countries makes it very difficul...

Respiratory Management Strategies for AHRF Acute hypoxaemic respiratory failure (AHRF) is one of the most common causes of admission to the ICU. It has a mortality rate of nearly 30%. Non-invasive respiratory management strategies are recommended to avoid the risk of endotracheal intubation. However, patients with de novo acute hypoxaemic respiratory failure (AHRF) are often at high risk of treatment failure. De-novo AHRD refers to a condition that occurs without p...

ICU Management & Practice, Volume 21 - Issue 6, 2021 CAR-T Cell Therapy – What An Intensivist Should Know CAR-T therapy is a promising treatment for B-cell malignancies but is also associated with toxicities such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Frequent monitoring, timely recognition and prompt management in ICU are paramount to ensure good outcomes. Introduction Chimeric antigen r...