Safety of Enhanced Thromboprophylaxis Strategies for COVID-19 Patients COVID-19 is associated with a high incidence of thrombotic complications. The burden of thrombin complications, in particular, pulmonary embolism, remains high in patients with COVID-19, especially those requiring admission to the ICU. Data suggest an incidence of thromboembolic events between 27 to 57% in COVID-19 patients despite standard thromboprophylaxis. A review of studies including 1765 ...

The Evolution of Cerebrovascular Critical Care The Society of Critical Care Medicine (SCCM) was founded in 1970. At that time, there was little to offer for the acute management of patients suffering from an acute cerebrovascular condition other than supportive care. Patients suffering from stroke were rarely found in the intensive care unit. During the 1960s, 25% of stroke patients would die within 24 hours. Approximately 50% would die within 2 to 3 weeks. Even...

Editorial September 3, 2021 Safety Surveillance of COVID-19 mRNA Vaccines Through the Vaccine Safety Datalink Kimberly G. Blumenthal, Neelam A. Phadke, David W. Bates JAMA. 2021;326(14):1375-1377. doi:10.1001/jama.2021.14808 Vaccines represent one of the greatest public health achievements of modern medicine. They must pass rigorous and predetermined efficacy and safety metrics prior to licensure. Additionally, postmarketing safety surveillance is essenti...

ICU Management & Practice, Volume 19 - Issue 4, Winter 2019/2020 Future ICU Design: Return to High Visibility Future ICU designs must feature high visibility to ensure safety. The ability for critical care nurses, physician intensivists, and other caregivers to visualise their patients has always been a high priority as it plays a major role in patient and staff safety. Architects and designers have responded with configurations for intensive care units ...

Early vs Late Tracheostomy and Ventilator-Associated Pneumonia Surgically opening the windpipe, or trachea, within the first seven days of the start of mechanical ventilation decreases the time patients spend on ventilators, shortens their ICU stay and lowers their risk of ventilator-associated pneumonia, according to a new systematic review. "We analysed the existing medical literature to unravel a question that is very pertinent to adult critical care," said s...

RAPID Trial: Therapeutic Heparin vs Prophylactic Heparin in COVID-19 Patients A study was conducted to evaluate the effects of therapeutic heparin compared with prophylactic heparin among moderately ill patients with COVID-19 admitted to the hospital. Heparin has anticoagulant properties, anti-inflammatory effects and potential antiviral effects and may also improve endothelial function. Early initiation of therapeutic heparin can decrease the thrombo-inflammato...

Prone Positioning During ECMO for ARDS There is sufficient evidence to show that prone positioning improves oxygenation and respiratory mechanics and is also associated with lower mortality in patients with moderate to severe ARDS. However, some patients can develop refractory hypoxaemia and hypercapnia that could require the use of venovenous extracorporeal membrane oxygenation (VV-ECMO) support and need to be cared for in a supine position. Hence, the physiologic...

AKI in Critically Ill Patients With COVID-19 Acute kidney injury is highly prevalent among severely ill COVID-19 patients. However, there is very limited data on the progression of AKI and long-term outcomes in these patients. In this study, researchers aimed to describe the prevalence and risk factors for the development of acute kidney injury, its clinical course and progression and renal recovery or dialysis dependence and survival. The study was conducted...

Ethics in Extracorporeal Life Support Extracorporeal life support has had a significant impact on modern medicine. However, the use of this technology has significant ethical challenges. In this review, the authors identify three ethical discourses: trials and evidence accompanying the use of ECLS, the ECLS allocation, decision-making and limiting care and death on ECLS and ECLS in organ donation. They then provide a narrative synthesis of all major arguments ex...

Trends in Sepsis-Related Mortality in the U.S. Sepsis is a life-threatening organ dysfunction. It is the leading cause of death in the U.S. It is also one of the most expensive conditions to treat. However, the burden of sepsis-related mortality in the U.S. in recent years is not well-characterised. Previous studies utilise hospital databases and electronic health records to determine trends, but these have been limited to only a few hospital systems and geogr...