CORRESPONDENCE|DECEMBER 19, 2020 Renal replacement therapy in acute kidney injury Vincenzo Sepe, Teresa Rampino, Carmelo Libetta Lancet 2020; 396: 1974 DOI:https://doi.org/10.1016/S0140-6736(20)32399-0 Stéphane Gaudry and colleagues1 found that early renal replacement therapy (RRT) in critically ill patients with acute kidney injury does not affect survival compared with a delayed RRT strategy. A major limitation of their meta-analysis is the clinical discreti...

Editorial December 9, 2020 Searching for the Optimal PEEP in Patients Without ARDS: High, Low, or in Between? Sarina K. Sahetya, Ewan C. Goligher, Arthur S. Slutsky JAMA. Published online December 9, 2020. doi:10.1001/jama.2020.23067 Positive pressure ventilation is lifesaving for patients with acute respiratory failure and has been the cornerstone of care for critically ill patients since the polio epidemic in the 1950s. Increasing end-expirato...

JAMA Insights November 23, 2020 Diagnosis, Management, and Pathophysiology of Arterial and Venous Thrombosis in COVID-19 Gregory Piazza, David A. Morrow JAMA. 2020;324(24):2548-2549. doi:10.1001/jama.2020.23422 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with arterial and venous thrombotic complications. In a US registry of patients with coronavirus disease 2019 (COVID-19), thrombotic complications occurred in 2.6%...

FeatureHPE6-A44 HPE6-A43 Covid-19: What now for remdesivir? Jeremy Hsu BMJ 2020; 371: m4457 doi: https://doi.org/10.1136/bmj.m4457 (Published 20 November 2020) The spectre of past pandemics looms large over remdesivir, one of the first drug treatments for covid-19. With a WHO trial finding little benefit, Jeremy Hsu asks if the expensive drug is just Tamiflu redux? It’s a cautionary tale worth remembering amid the coronavi...

ICU Management & Practice, Volume 20 - Issue 4, 2020 COVID-19, Corticosteroids and the Road to Enlightenment The use of corticosteroids for respiratory diseases has been a matter of discussion. Here, we present recent evidence of corticosteroids benefits for COVID-19, including improvements in mortality and ventilator-free days. More than six months riding treacherous waves in the COVID-19 storm had passed until a glimpse of a rudimentary old harbour app...

Intensive Care Ventilators - A Primary Option For Treatment Of COVID-19 Patients In The ICU Summary &recommendations regarding ventilators Intensive care ventilators are normally found in the hospital Intensive Care Unit. This category of ventilators support lung protective ventilation recommended by several international guidelines and the World Health Organization (WHO). An intensive care ventilator must be considered as the primary option during the monito...

Treating Early COVID-19 Infection There have been over 47 million cases of COVID-19 globally and 1.2 million deaths. According to Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), the treatment of patients with early COVID-19 infection requires urgent focus. Treating these patients early in the course of infection could help speed up their recovery and could also reduce the likelihood of severe outcomes. Early treatment would...

Editor's Note November 12, 2020 COVID-19 Infection—Preventing Clinical Deterioration Christopher W. Seymour, Howard Bauchner, Robert M. Golub JAMA. Published online November 12, 2020. doi:10.1001/jama.2020.21720 More than 38 million individuals worldwide have been infected with severe acute respiratory syndrome coronavirus 2, the virus causing coronavirus disease 2019 (COVID-19). For primary prevention, traditional public health approaches inclu...

Life After COVID-19 Hospitalisation Findings from a new study show that surviving a case of COVID-19 that is severe enough to require hospitalisation can be quite challenging, but life after the ICU stay is also not a bed of roses.  The study includes data from 1250 patients treated in 38 hospitals. The average age of the participants is 62 years, and 83% of the patients lived at home after being hospitalised for COVID-19.  The study reports that approximately 7%...

Improving Outcomes for ICU Survivors In response to the many challenges faced by ICU survivors today, there has been an increasing need to relieve this burden. Despite that many clinical trials have been implemented to find new strategies, postintensive care syndrome is still a common possibility for both patients and families. A recent study has identified key enablers and barriers faced by hospitals and patients when implementing ICU follow-up clinics and peer sup...