Safe Liberation During Weaning from VV-ECMO The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) in patients with severe acute respiratory distress syndrome (ARDS) has increased substantially over the last few years. However, conclusive evidence supporting its use is still lacking, and mortality of patients treated with VV-ECMO for ARDS is still high. Optimal strategies of mechanical ventilation (MV) during VV-ECMO have been reported, but there is...

Intubation Timing and COVID-19 ARDS Outcomes COVID-19 associated ARDS is associated with high mortality risk. Many patients with COVID-19 have been admitted with pneumonia and arterial hypoxaemia, increased work of breathing or impending fatigue. It is a common clinical practice to intubate patients with severe hypoxaemia. However, during the pandemic, there was a high demand for ICU beds. Therefore, some experts recommended a more conservative approach and promote...

Prone Positioning and Survival in Mechanically Ventilated COVID-19 Patients Coronavirus disease is still fairly new for clinicians who are constantly searching for therapies for patients with respiratory failure from COVID-19. Early implementation of prone positioning ventilation has been shown to improve survival in patients with ARDS. However, data on the effect of probing on survival in patients with COVID-19 is still scarce. The American Thoracic Society, Eu...

ECMO for COVID-19 Extracorporeal membrane oxygenation (ECMO) has been used in patients with COVID-19 who develop severe acute respiratory distress syndrome (ARDS). ECMO has previously been used in other infectious outbreaks, including the 2009 influenza A (H1N1) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreak. The Extracorporeal Life Support Organisation (ELSO), the World Health Organization and the Surviving Sepsis Campaign (SSC) guidel...

Impact of Multimorbidity on Long-Term Outcomes After ICU Discharge Critical care admissions continue to increase year after year. There is also increasing evidence that demonstrates discharge from critical care as the start of a challenging process for both patients and caregivers, with many survivors going through physical, social, cognitive, and emotional problems in the years following discharge. It is clinically proven that people who survive critical i...

VIEWPOINT| VOLUME 9, ISSUE 8, P933-936, AUGUST 01, 2021 The Berlin definition of acute respiratory distress syndrome: should patients receiving high-flow nasal oxygen be included? Michael A Matthay, B Taylor Thompson, Lorraine B Ware Lancet Respir Med 2021; 9: 933-936 Summary The 2012 Berlin definition of acute respiratory distress syndrome (ARDS) provided validated support for three levels of initial arterial hypoxaemia that correlated with ...

Protective Ventilation and Outcomes in Patients with COVID-19 The coronavirus pandemic continues to be a global health issue. Clinical outcomes data of patients from China, Europe and the U.S. show high mortality among critically ill patients with COVID-19, especially those who required mechanical ventilation. Among patients with COVID-19, approximately 5% develop respiratory failure that requires ventilatory support. However, very little is known about the impa...

Passive Leg Raising in Out-of-Hospital Cardiac Arrest Survival among patients with out-of-hospital cardiac arrest (OHCA) is typically quite low. Survival in OHCA is dependent on several factors, including the performance of early bystander cardiopulmonary resuscitation (CPR), the use of public automatic external defibrillators (AEDs), and the performance of high-quality CPR or the post-resuscitation care provided in the hospital. High-quality CPR that optimises car...

FRISC Study: Fluid and Resuscitation Protocols in Sepsis-Induced Hypotension in Cirrhosis One of the most common causes of hospitalisation and mortality in patients with cirrhosis is sepsis and septic shock. However, despite the routine presence of this condition, there is very limited data on the choice of fluid and resuscitation protocols in sepsis-induced hypotension in cirrhosis. The Fluid Resuscitation in Sepsis Induced Hypotension ...

Editorial August 31, 2021 Titrating Oxygen Therapy in Critically Ill Patients Martin Urner, Carolyn S. Calfee, Eddy Fan JAMA. Published online August 31, 2021. doi:10.1001/jama.2021.9843 The development of oxygen therapy is one of the major advances of modern medicine. Oxygen therapy laid the groundwork for intensive care medicine as a specialty and has saved millions of lives. During the COVID-19 pandemic, millions of patients survived due to p...