14-Day Occurrence of Hypoxia, ICU Admission, and Death Among Patients with COVID-19
Uncertainty surrounding COVID-19 regarding rapid progression to acute respiratory distress syndrome (ARDS) and unusual clinical characteristics make discharge from a monitored setting challenging. Model derivation and... read more
Caring for the Sickest COVID-19 Patients: An ICU Story
In an article for the latest issue of Stanford Medicine magazine, I provide a glimpse into the journey Free and his front-line Stanford Health Care colleagues took -- from Day 1 through the following weeks and months -- to... read more
Expert Consensus on Methodology for Conducting and Reporting Echocardiography Research Studies
Echocardiography is a common tool for cardiac and hemodynamic assessments in critical care research. However, interpretation (and applications) of results and between-study comparisons are often difficult due to the lack... read more
Early prediction of impending septic shock in children using age-adjusted Sepsis-3 criteria
Sepsis is a syndrome which afflicts both adults and children, with many disease courses and diverse outcomes. Understanding of sepsis pathophysiology has changed over time; the Sepsis-3 criteria define sepsis in adults as... read more
COVID-19 and ARDS: The Baby Lung Size Matters
COVID-19 in its initial manifestations has strikingly peculiar characteristics (e.g., hypoxemia with vasocentric injury and high gas lung volume), is so evident that atypical ARDS should not be a matter of further discussion.... read more
What’s new about pulmonary hyperinflation in mechanically ventilated critical patients
Pulmonary hyperinflation is the increase in the relaxation volume of the respiratory system at the end of a tidal expiration (end-expiratory volume). This can occur due to a number of factors, acting alone or in combination,... read more
Fishman’s Pulmonary Diseases and Disorders
Since 1980, Fishman's Pulmonary Diseases and Disorders has delivered unparalleled coverage of pulmonary medicine and the underlying basic and applied science upon which clinical practice is based. The Fifth Edition, with... read more
Sick Meningitis, POCUS for Pneumoperitoneum, and Treatment of CHS
Today on the emDocs cast with Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER) we cover three posts: the sick meningitis patient, ultrasound for pneumoperitoneum, and treatment of cannabiniod hyperemesis syndrome. Part... read more
Mechanical Ventilators for Non-invasive Ventilation
This book analyzes and describes the whole spectrum of technical elements related with non-invasive mechanical ventilators technologies, ventilator modes and complementary technologies for correct interpretation and clinical... read more
Predictors of QT Interval Prolongation in Critically-ill Patients with SARS-CoV-2 Infection Treated with Hydroxychloroquine
Hydroxychloroquine (HCQ) has been described as a potential treatment for SARS-CoV-2 infection. However, there are safety concerns regarding its QT interval and pro-arrhythmic effects. This trial aimed to determine the... read more
CDC cuts COVID-19 Quarantine Recommendation
The CDC released new COVID-19 guidelines Dec. 2, reducing the previous 14-day quarantine recommendation for people who were exposed to 10 days without symptoms, reports CBS. The recommendation is further reduced to seven... read more
Myorelaxants in ARDS patients
Neuromuscular blocking agents (NMBAs) inhibit patient-initiated active breath and the risk of high tidal volumes and consequent high transpulmonary pressure swings, and minimize patient/ ventilator asynchrony in acute respiratory... read more
Failing to Learn and Learning to Fail
Last week saw the publication of yet another damning report shining a spotlight on the culture of cover up and denial in our healthcare system. Bill Kirkup’s report—”The Life and Death of Elizabeth Dixon: A Catalyst... read more
Emerging pharmacological therapies for ARDS: COVID-19 and beyond
ARDS, first described in 1967, is the commonest form of acute severe hypoxemic respiratory failure. Despite considerable advances in our knowledge regarding the pathophysiology of ARDS, insights into the biologic mechanisms... read more
Airway closure, more harmful than atelectasis in intensive care?
Since the mid-1980s, atelectasis has been demonstrated during anesthesia in lung healthy subjects and in intensive care patients suffering from acute respiratory failure and requiring ventilator support. In the latter... read more
Assessment of Cancer Therapy Evaluation Program Advocacy and Inclusion of People With HIV in Anti–PD1/PDL1 Trials
This study identified encouraging trends in the inclusion of PLWH in anti–PD1/PDL1 cancer trials that occurred in the period following the initiation of CTEP advocacy. Work is needed to examine what impact this will have... read more
CDC to vote on who gets COVID-19 vaccine priority in emergency meeting
Ahead of a COVID-19 vaccine authorization, the CDC's Advisory Committee for Immunization Practices plans to vote during a Dec. 2 emergency meeting on who should be the first to receive a vaccine, reports CNN. The CDC... read more
Missouri physician starts petition calling for governor to implement mask mandate
Michah Luderer, MD, PhD, internal medicine resident at St. Louis based-Barnes Jewish Hospital recently started a petition urging Gov. Mike Parson to issue a statewide mask mandate, reports local CBS affiliate KMOV. "We're... read more
Decompensated Hypothyroidism: Why do we miss it, and how do we improve?
A 75-year-old female is brought to the Emergency Department (ED) by emergency medical services (EMS) for altered mental status. Vital signs include BP 87/64, HR 55, T 92.6 rectal, RR 12, SpO2 95% on room air. She is oriented... read more
Electronic Nicotine Delivery System Use and Cigarette Smoking Among Young Adults
This cohort study uses propensity score matching analyses of 3 years of data from the Population Assessment of Tobacco and Health Study to assess whether there is an association between electronic nicotine delivery system... read more
Antibody levels decline after 2 months, CDC finds
COVID-19 antibody levels declined within two months in 156 front-line healthcare workers involved in a CDC study published Nov. 27. Researchers collected blood samples from 3,248 front-line healthcare professionals between... read more
Miles Sibley: We need to change the hierarchy of evidence-based medicine
In July 2020, the Independent Medicines and Medical Devices Safety Review published a report entitled “First Do No Harm”. Also known as the Cumberlege Review, the report set out extensive evidence of avoidable harm in... read more
