Impact of implantation time on early function of cardiac transplant
Data on out-of-ice implantation ischemia in heart transplant are scarce. We examined implantation time's impact on allograft dysfunction.METHODS: We conducted a single-site retrospective review of all primary adult heart... read more
Dr. Atul Gawande on why COVID-19 vaccinations will test American society
The distribution of COVID-19 vaccines in America will test a deeply divided society, and not just because of mistrust in vaccinations, Atul Gawande, MD, told New Yorker Editor David Remnick. Dr. Gawande, longtime contributor... read more
CDC update calls for universal mask-wearing
The CDC calls for universal mask use at all times indoors, except when within one's own household, and outside when distances of 6 feet or more cannot be maintained. Additional strategies in the report are social distancing... read more
Experience Caring for a Severe COVID-19 Patient With ARDS in the ICU
The author's experience caring for a patient with COVID-19 whose condition deteriorated rapidly into a critical illness in the negative pressure room of the ICU is described in this article. The onset of severe acute... read more
Apoptotic cells for therapeutic use in cytokine storm associated with sepsis
Sepsis has no proven specific pharmacologic treatment. Reported mortality in sepsis ranges from 30%-45%. This study was designed to determine the safety preliminary efficacy of allogenic apoptotic cells administered for immunomodulation... read more
Appendiceal Perforation at a Children’s Hospital During COVID-19 vs 2019
Although studies in the adult literature and case series in the pediatric literature have reported delays in medical care attributable to COVID-19, we report a statistically significant increased rate of appendiceal perforation... read more
Overlooked bias with thermometer evaluations using quickly retaken temperatures in EHR
Studies related to COVID-19 increasingly use electronic health records (EHR) to obtain large-scale evidence. However, EHR-based research must be performed with care because it can involve new study design problems that are... read more
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
