The Ethics of Allocation
One of the greatest challenges in health care - and in generations - is upon us COVID-19 continues to detrimentally affect every aspect of our healthcare system. Clinicians have been faced with grim life-and-death decisions... read more
TOP KNIFE: The Art & Craft of Trauma Surgery
A practical guide to operative trauma surgery for residents and registrars, for general surgeons with an interest in trauma, and for isolated surgeons operating on wounded patients in military, rural or humanitarian settings.... read more
Why, When, and How to Use Lung Ultrasound During the COVID-19 Pandemic
The COVID-19 pandemic has further highlighted the usefulness of LUS in different clinical scenarios, underlining its advantages in terms of availability, operator- and patient-friendliness, relatively low cost and expertise... read more
Therapeutic Alternatives and Strategies for Drug Conservation in the ICU During Times of Drug Shortage
During the coronavirus disease (COVID-19) global pandemic, urgent strategies to alleviate shortages are required. Evaluation of the feasibility, practicality, and value of drug conservation strategies and therapeutic alternatives... read more
High Risk of Thrombosis in Patients With Severe SARS-CoV-2 Infection
Despite anticoagulation, a high number of patients with ARDS secondary to COVID-19 developed life-threatening thrombotic complications. Higher anticoagulation targets than in usual critically ill patients should therefore... read more
ICU Delirium Management During SARS-CoV-2 Pandemic
The novel coronavirus, SARS-CoV-2-causing Coronavirus Disease 19 (COVID-19), emerged as a public health threat in December 2019 and was declared a pandemic by the World Health Organization in March 2020. Delirium, a dangerous... read more
Cardiovascular Phenotypes in Ventilated Patients with COVID-19 ARDS
Approximately two-thirds of patients admitted to the intensive care unit (ICU) for coronavirus disease-19 (COVID-19) pneumonia present with the acute respiratory distress syndrome (ARDS). COVID-19-associated acute cardiac... read more
Prophylaxis and Treatment of Venous Thromboembolic Disease in COVID-19
Patients with COVID-19 appear to be at elevated risk for thrombotic complications, including venous thromboembolism (VTE).1 In addition to traditional risk factors for VTE, indirect effects of the severity of illness as well... read more
Effectiveness and Safety of the Awakening and Breathing Coordination, Delirium Monitoring/Management, and Early Exercise/Mobility Bundle
Critically ill patients managed with the Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility bundle spent three more days breathing without assistance, experienced less delirium,... read more
Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe COVID-19
Among patients with severe or life-threatening COVID-19, convalescent plasma therapy added to standard treatment, compared with standard treatment alone, did not result in a statistically significant improvement in time to... read more
Difficult Bag-Mask Ventilation in Critically Ill Children Is Independently Associated With Adverse Events
Difficult bag-mask ventilation is reported in approximately one in 10 PICU patients undergoing tracheal intubation. Given its association with adverse procedure–related events and oxygen desaturation, future study is warranted... read more
Supporting the Shielded – Results from a National Survey of Shielding Doctors
In spring, NHS staff responded to the looming COVID-19 pandemic with an impressive level of strategic planning. As operating theatres closed and ICU beds were created, anaesthetists and intensivists faced new challenges on... read more
COVID-19 and AKI
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 5,449 hospitalized COVID-19 patients, acute... read more
What is the Diagnostic Accuracy of Antibody Tests for the Detection of Infection with the COVID-19 Virus?
The sensitivity of antibody tests is too low in the first week since symptom onset to have a primary role for the diagnosis of COVID-19, but they may still have a role complementing other testing in individuals presenting... read more
A Systematic Review of Risk Factors for Sleep Disruption in Critically Ill Adults
This systematic review summarizes all premorbid, illness-related, and ICU-related factors associated with sleep disruption in the ICU. These findings will inform sleep promotion efforts in the ICU and guide further research... read more
Together: The Healing Power of Human Connection in a Sometimes Lonely World
The book we need NOW to avoid a social recession, Murthy’s prescient message is about the importance of human connection, the hidden impact of loneliness on our health, and the social power of community. Humans are social... read more
The Case for Routine Screening for COVID-19 Before Surgery
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused more than 5 million cases of coronavirus disease (COVID-19) worldwide and 345,000 deaths as of 25 May 2020. Based on accumulating international experience... read more
Perhaps something isn’t always better than nothing
It is not unreasonable to say the COVID-19 pandemic caught most of us by surprise. We did not know how infectious the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) virus leading to COVID-19 disease was, nor... read more
From despair to hope: advanced therapy gives a lifeline to the sickest COVID-19 patients
More than two months later, that piece of paper still lies on her coffee table with four letters on it: "E-C-M-O." Irena Veronese had never heard that acronym before, but when it was first mentioned to her, it meant moving... read more
Effect of Dexamethasone in Hospitalized Patients with COVID-19
Although the paper is not even officially published yet, everyone has already heard the results. We have our first treatment that appears to reduce mortality in COVID-19 patients. For a week or so, we only had press release,... read more
Hydrocortisone Prevents Immunosuppression by interleukin-10+ Natural Killer Cells After Trauma-Hemorrhage
These data demonstrate that trauma-induced immunosuppression is characterized by an interleukin-10-dependent elimination of dendritic cell by natural killer cells and that hydrocortisone improves outcome by limiting this... read more
Procedural Sedation in the COVID-19 Era
Resuming procedural sedation services for elective procedures during the COVID-19 pandemic requires unique considerations to ensure safety for patients and providers. Guidelines for resuming these procedures, including timing,... read more
