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COVID-19 and Acute Kidney Injury Incidence and risk factors for acute kidney injury (AKI) in COVID-19 patients Recent reports from China, Italy, and the US indicate that there is a 25-37% incidence of AKI among critically ill COVID-19 patients (Singh 2020, Hirsch et al. 2020). In a study of 5449 hospitalized COVID-19 patients, AKI was observed primarily in patients with respiratory failure, with AKI developing in 89.7% of patients on mechanical ventilation compared ...
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Pulmonary Pathobiology of COVID-19 The primary cause of death with COVID-19 is progressive respiratory failure. However, despite the widespread infection rates associated with COVID, very little is known about the pathophysiology of the disease. What clinicians do know is that the pathological features resemble acute respiratory distress syndrome (ARDS) and progressive hypoxia. But the underlying molecular and biochemical alterations caused by the virus still remain un...
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ICU Management & Practice, Volume 20 - Issue 1, 2020 Nutrition for Critically Ill Patients with COVID-19 This article discusses the nutritional implications for critically ill patients admitted to intensive care for the management of COVID-19, and considers the inflammatory metabolic processes, nutrition-impacting symptoms, medical therapy, and the impact of a pandemic on staff resourcing and remote practice. Introduction The global pandemic caused by...
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Imaging in Neurological Disease of Hospitalised COVID-19 Patients Originating in Wuhan, China, COVID-19 soon spread throughout the world and has been declared a pandemic by the World Health Organization. Italy was the second country to be hit as hard as China, with a total of 222,104 cases and 31,106 deaths (at time of publication). A study was conducted to understand the characteristics of neurological symptoms and neuroimaging features of COVID-19 patients admitte...
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Reappraisal of Biomarkers in Sepsis Management Sepsis biomarkers have an important role in the diagnosis, prognosis, and treatment of sepsis management. If timely and accurate information about biomarkers becomes available, the physician can not only make better therapeutic choices but also monitor the efficacy of the intervention in progress and adjust it accordingly.   In a previous review published in 2010, researchers found 3370 references on 178 sepsi...
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Mechanical Ventilation in COVID-19 There is no specific treatment for COVID-19 patients. For those who develop respiratory failure and are unable to oxygenate with non-invasive methods, critical care doctors are providing supportive therapy. Since the pandemic started, mechanical ventilation has routinely been employed to oxygenate seriously ill COVID-19 patients. Each hospital has developed its own criteria for identifying patients who require mechanical ven...
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Prone Positioning in Non-Intubated COVID-19 Patients The COVID-19 pandemic has placed unprecedented stress on health care institutions everywhere. Among other interventions, researchers and physicians have been trying to reevaluate the use of mechanical ventilation. The rise of social media has accelerated the spread of biased information about therapies that have not been peer-reviewed and have little to no evidence about its efficacy. Therefore, the question is wheth...
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COVID-19: Therapies Targeting Interleukin-6-Mediated Cytokine Release Syndrome The current pandemic will be remembered for a long time for the huge loss of lives and disruption it caused to the way of life as we know it. In the absence of a viable vaccine, physical distancing and symptomatic management are the only interventions health care providers have at hand. Studies have demonstrated the association of interleukin-6 (IL-6)-mediated cytokine release syndrome and m...
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COVID-19: Risk Score to Predict Critical Illness The coronavirus disease (COVID 19) continues to create havoc around the globe. Millions of people have been infected with the virus and thousands have died. The infection is spread via droplet particles. Many infected patients remain asymptomatic; others develop a mild upper respiratory infection-like illness and some develop a serious lung infection that requires admission to the ICU. COVID-19 cases that are of a severe...
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Is COVID-19 Pneumonia ARDS or Not? COVID-19 pneumonia meets the ARDS Berlin definition. However, it is a specific disease with peculiar phenotypes. The primary characteristic is the dissociation between the severity of the hypoxaemia and the maintenance of respiratory mechanics. Patients with respiratory compliance that is lower or higher than the median value experience severe hypoxaemia. In a recent editorial published in Critical Care, the authors propose ...
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