Timing of Antibiotic Therapy in the Intensive Care Unit Severe infections are common among patients in the ICU. According to findings from the Extended Study on Prevalence of Infection in Intensive Care III (EPIC III), 54% of the study patients had at least one suspected or proven infection on the study day, and 24% of these patients had more than one suspected or proven infection. These infections are generally either bacterial or fungal in origin and...

Outcomes of Mechanically Ventilated COVID-19 Patients Millions of people worldwide have been infected with COVID-19, with many requiring hospitalisation. Approximately 30% of hospitalisaed patients with COVID-19 are started on invasive ventilation for several pneumonia. Invasive ventilation portend a poor prognosis as approximately 40% of these patients do not survive hospitalisation. Even those who survive usually have a prolonged duration of ventilatory support. ...

Omicron Puts Scientists on Alert There is panic around the globe as news of a new variant of coronavirus circulated this week. The variant is believed to harbour a large number of mutations and is spreading quickly across the world. The World Health Organization (WHO) has identified it as a variant of concern and named it Omicron. Omicron is the latest in line of SARS-CoV-2 variants and joins Delta, Alpha, Beta and Gamma. The variant has sparked the interest of ...

ICU Management & Practice, Volume 21 - Issue 5, 2021 Microbiome and Pneumonia in Children A significant research gap exists in the field of the lung microbiome and pneumonia development in paediatric population. Its study may improve nosocomial pneumonia prevention and help to achieve zero pneumonia rates. Most frequent hospital acquired infections (HAI) in Paediatric Intensive Care Units (PICU), are ventilator associated pneumonia (VAP), catheter-relate...

COMMENT|ONLINE FIRST Mixing mRNA, adenoviral, and spike-adjuvant vaccines for protection against COVID-19 Christopher D Richardson Lancet Published:December 06, 2021 DOI:https://doi.org/10.1016/S0140-6736(21)02757-4 Supply and availability issues for government-approved vaccines, together with worries about rare side-effects (such as thrombotic thrombocytopenia), have necessitated the switch to heterologous COVID-19 vaccination schedules—an approach commonl...

Respiratory Subphenotypes of COVID-19-Related ARDS Patients with COVID-19 related ARDS present with distinct respiratory subphenotypes. But most phenotyping schema is limited by sample size, disregard for temporal dynamics and insufficient validation. In the PRoVENT-COVID study, researchers aimed to identify respiratory subphenotypes of COVID-19-related ARDS. This was an investigator-initiated observational cohort study at 22 ICUs in the Netherlands. COVID-19 pa...

ICU Management & Practice, Volume 21 - Issue 5, 2021 The Role of the Microbiome and Nutritional Therapy in Critical COVID-19 Dysbiosis has been closely related to inflammation and severe-to-critical COVID-19, a reason why nutritional therapy could be important in the prevention and management of critical disease. Introduction Infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease (COVID-19), inv...

Feature BMJ Investigation Covid-19: Researcher blows the whistle on data integrity issues in Pfizer’s vaccine trial Paul D Thacker BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2635 (Published 02 November 2021)Cite this as: BMJ 2021;375:n2635 Revelations of poor practices at a contract research company helping to carry out Pfizer’s pivotal covid-19 vaccine trial raise questions about data integrity and regulatory oversight. Paul D Thacker repo...

ICU Management & Practice, Volume 21 - Issue 5, 2021 The Intestinal Microbiome in Critical Illness Critical illness alters the intestinal microbiome, resulting in a loss of microbial diversity and induction of a pathobiome. Manipulating the intestinal microbiome offers a potential treatment approach in ICU patients. The intestinal microbiome is comprised of diverse, robust microbial communities within the intestine, modified by the host’s interaction wit...

ICU Management & Practice, Volume 21 - Issue 5, 2021 Safer Intubation Practices in Critically Ill Patients What We Learned During the COVID-19 Pandemic That Should Not Be Forgotten An overview of the available evidence on safe intubation practices in critically ill patients in light of new discoveries due to the coronavirus pandemic. Introduction Orotracheal intubation is a life-saving procedure in critically ill patients with acute respiratory fai...