Early vs. Late Awake Prone Positioning in COVID-19 Approximately 25 to 30% of COVID-19 patients develop signs of acute respiratory distress that require higher respiratory support in terms of oxygen therapy, and noninvasive and invasive positive pressure ventilation. Since the beginning of the COVID-19 pandemic, the use of awake prone positioning has increased in the management of patients with COVID-19. Early prone positioning improves oxygenation and pati...

Simultaneous Management of ARDS and sABI Acute respiratory distress syndrome (ARDS) occurs in approximately 40% of patients with severe acute brain injury (sABI), including acute ischaemic stroke, subarachnoid haemorrhage, intracerebral haemorrhage and traumatic brain injury. It is also a major determinant of morbidity and mortality. With the increase in ARDS cases and reports of neurological complications in COVID-19, there is now a need to manage concomitant s...

Optimising Early Mobilisation & Rehabilitation in Intensive Care More than forty randomised trials have evaluated early mobilisation and rehabilitation in ICUs in the last decade. These trials usually aim to reduce the incidence of ICU acquired weakness (ICUAW) which is known to be associated with poor long-term survival, poor physical function and decreased quality of life. Eight international guidelines recommend early mobilisation and rehabilitation in inten...

ICU Management & Practice, Volume 21 - Issue 4, 2021 Sex, Lies and COVID-19 An overview of the impact of gender on the severity of illness, impact and outcomes of COVID-19.The human coronaviruses (HCoVs) include two alpha-CoVs (HCoV-229E and HCoV-NL63) and five beta-coronaviruses (HCoV-OC43, HCoV-HKU1, severe acute respiratory syndrome CoV [SARS-CoV], Middle East respiratory syndrome CoV [MERS-CoV], and most recently (β-CoV SARS-CoV-2). Early data rela...

Editorials Public health measures for covid-19 Paul P Glasziou, Susan Michie, Atle Fretheim BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2729 (Published 18 November 2021)Cite this as: BMJ 2021;375:n2729 Lack of good research is a pandemic tragedy Although the pandemic has seen remarkable trials for vaccines and drug treatments, much less has been done to evaluate the effects of public health and social measures (PHSMs)1; also known as non-pharmaceutical ...

Medical News & Perspectives November 3, 2021 Trials Test Mushrooms and Herbs as Anti–COVID-19 Agents Anita Slomski JAMA. Published online November 3, 2021. doi:10.1001/jama.2021.19388 In the COVID-19 pandemic’s early days, integrative medicine specialists Gordon Saxe, MD, PhD, MPH, and Andrew Shubov, MD, watched in frustration as desperate patients infected with the novel coronavirus tried one ineffective remedy after another. “People were t...

Human Connection in the Time of COVID-19 Human connection has suffered quite significantly during the COVID-19 pandemic. While physical distancing is necessary for our wellbeing, restricting family presence in the ICU has been challenging. There is recent data that show the negative consequences of these policies and restrictions. Moral distress has been reported due to restrictive family visitation policies. It is also believed that patients may be spending mor...

Ventilator-Associated Pneumonia in COVID-19 Patients The coronavirus has a high incidence of patients with severe acute respiratory syndrome (SARS). Many patients infected with COVID-19 need to be admitted to the ICU for invasive ventilation. They are also at a high risk of developing secondary, ventilator-associated pneumonia (VAP). This is because of breach of natural defences by invasive devices, impairment of coughing and mucociliary clearance, sedation and the imm...

Precision Therapies for Heterogeneous ARDS Patients ARDS is a heterogeneous syndrome rather than a distinct disease. It is this heterogeneity that often makes it difficult to study treatments for patients with ARDS. Literature on ARDS is rife with clinical trials that do not show any mortality benefit. Recent evidence suggests different sub-phenotypes within the heterogeneous patient population. These sub-phenotypes have variable clinical responses to specific t...

Editorial October 11, 2021 Antithrombotic Therapy for Outpatients With COVID-19: Implications for Clinical Practice and Future Research Otavio Berwanger JAMA. 2021;326(17):1685-1686. doi:10.1001/jama.2021.17460 COVID-19, the infectious disease caused by the SARS-CoV-2 virus, has been associated with an inflammatory and hypercoagulable state characterized by increases in levels of D-dimers, fibrin, fibrin degradation products, and fibrinogen.1 Observa...