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...

Early Prediction of Sepsis From Clinical Data Sepsis continues to be a leading cause of death in hospitalised patients. Approximately 1.7 million individuals develop sepsis each year in the US and of these, around 270,000 die from the infection. Sepsis affects nearly 30 million patients worldwide and nearly 6 million die from sepsis each year. Billions of dollars are required to manage sepsis, far exceeding the cost of most other healthcare disorders. Sepsis is trea...

Viewpoint October 26, 2020 Preventing the Spread of SARS-CoV-2 With Masks and Other “Low-tech” Interventions Andrea M. Lerner, Gregory K. Folkers, Anthony S. Fauci JAMA. 2020;324(19):1935-1936. doi:10.1001/jama.2020.21946 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), has caused a global pandemic of historic proportions in the 10 months since cases were first reported in Wuhan, China, in Dec...

BLAZE Trial: Efficacy and Safety of LY-CoV555 COVID-19 patients can have a wide range of disease severity, with some patients experiencing only mild symptoms while others are infected quite severely. However, approximately 10% of asymptomatic and mild cases lead to severe outcomes, including respiratory distress that would require hospitalisation. Many risk factors for severe disease have been proposed, including old age, obesity, hypertension and underlying medic...

Lung Histopathology: COVID-19 Compared to SARS, H1N1 The coronavirus disease has spread throughout the world and has resulted in many challenges for healthcare systems. It is a new disease with a significant burden of respiratory failure. This has led to questions about the pathogenesis and pulmonary pathology of COVID-19.  Patients with severe COVID-19 have respiratory failure with hypoxaemia, and acute bilateral pulmonary infiltrates. This is consistent with ...

Corticosteroids and Mortality in COVID-19 Patients The use of corticosteroids to treat severe infections has been a controversy for quite a long time. Now, as we face the COVID-19 pandemic, clinical research on corticosteroids has received a significant push. During the first six months of 2020, 55 studies of corticosteroids for the treatment of COVID-19 have been registered. The RECOVERY trial has reported its findings demonstrating that 6mg/d of dexamethasone resu...

COVID-19 and Antimicrobial Stewardship COVID-19 is a new disease. On initial presentation, clinicians can find it difficult to differentiate between coronavirus disease and bacterial community-acquired pneumonia. COVID-19 patients often develop a hyperinflammatory phase during the disease process, which could again be difficult to distinguish from a secondary bacterial infection. That is why nearly 72% of patients suffering from COVID-19 receive antibiotic therapy...

Tocilizumab and COVID-19 Pneumonia Tocilizumab is a humanised monoclonal antibody that binds human interleukin 6 (IL-6) receptors. It is generally used in inflammatory arthritis, giant cell arteritis and cytokine release syndrome after chimeric antigen receptor T-cell therapy.  Tocilizumab has come under close scrutiny during the COVID-19 pandemic. Early observations from China showed an increased risk of death in COVID-19 patients with elevated IL-6 levels, an...

Venous Doppler to Predict Adverse Kidney Events In patients admitted to the ICU following surgery, trauma or septic shock, fluid boluses are often used to increase cardiac output and blood pressure. However, clinical evidence shows that excess fluid administration could be detrimental for patients and could lead to increased rates of acute kidney injury (AKI), prolonged days of mechanical ventilation and death. There are currently no established ultrasound measures of ...

Use of Non-Invasive Ventilation in Critically Ill Older Adults In seriously ill older adults or those near the end of life, acute respiratory failure is a common cause of hospitalisation. These hospitalisations are generally complicated by distressful respiratory symptoms and transitions that require the use of high-intensity, high-risk interventions, including invasive mechanical ventilation (IMV) and non-invasive ventilation (NIV).  Trends in both invasive an...