NIH-convened Expert Panel Proposes Standardized Definition of Placental COVID-19 Infection
A panel of experts convened by the National Institutes of Health has recommended standardized criteria to define infection of the placenta with SARS-CoV-2, the virus that causes COVID-19. The panel also offers guidance... read more
The Harriet Lane Handbook: Mobile Medicine Series
Written "by residents, for residents" and reviewed by expert faculty at The Johns Hopkins Hospital, Lauren Kahl, MD and Helen K. Hughes, MD, MPH, The Harriet Lane Handbook, 21st Edition, remains your #1 source of pediatric... read more
Use of Bivalirudin for Anticoagulation in Pediatric ECMO
This study describes the use of bivalirudin in children on extracorporeal membrane oxygenation (ECMO). Pediatric patients receiving bivalirudin were compared to patients receiving heparin as the anticoagulant on ECMO. Data... read more
Expanding ECMO Cannulation Strategies in Neonatal Respiratory Failure
Infants with refractory respiratory failure who require extracorporeal membrane oxygenation (ECMO) have traditionally been cannulated via the venoarterial route or by using a dual-lumen venovenous cannula in the right internal... read more
Should We Prolong the Observation Period for Neurological Recovery After Cardiac Arrest?
Up to 9.6% of cardiac arrest patients with favorable outcomes recover consciousness after the recommended 7 days of observation, indicating the observation time of 7 days seems justified but longer duration may be needed.... read more
Variations in End-of-Life Practices in ICUs Worldwide
Limitation of life-sustaining therapies is common worldwide with regional variability. Withholding treatment is more common than withdrawing treatment. Variations in type, frequency, and timing of end-of-life decisions were... read more
Imputation Strategies for Missing Baseline Neurological Assessment Covariates After TBI
Statistical models for outcome prediction are central to traumatic brain injury (TBI) research and critical to baseline risk adjustment. Glasgow coma score (GCS) and pupil reactivity are crucial covariates in all such models... read more
COVID-19, Online Shaming, and Health-care Professionals
Stigma and shame have been features of past pandemics. The stigma associated with disease can be experienced as shame by those who spread it. In almost all human cultures, there is shame attached to being “contaminated”,... read more
Junior Doctors Write to Young People to Acknowledge Vaccine Concerns
A group of junior doctors from Scotland have written to young people in their age group to try to ease concerns they may have about receiving the covid-19 vaccine. In an open letter sent on Friday 6 August the doctors,... read more
RECOVERY-RS trial finds CPAP reduces need for invasive ventilation in hospitalised COVID-19 patients
The NIHR-supported Respiratory Strategies in COVID-19; CPAP, High-flow, and Standard Care (RECOVERY-RS) trial has demonstrated that treating hospitalised COVID-19 patients who have acute respiratory failure with continuous... read more
Adaptive Randomized Controlled Trial of Non-invasive Respiratory Strategies in ARF Patients with COVID-19
Continuous positive airway pressure (CPAP), compared with conventional oxygen therapy, reduced the composite outcome of intubation or death within 30 days of randomisation in hospitalized adults with acute respiratory failure... read more
Cystic Fibrosis in the COVID-19 Pandemic
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the development of life-threatening COVID-19 are believed to disproportionately affect certain at-risk populations. However, it is not clear whether... read more
Progressive Increase in Virulence of COVID-19 Variants
The progressive increase in transmissibility and virulence of SARS-CoV-2 VOCs will result in a significantly larger, and more deadly, pandemic than would have occurred in the absence of variants of concern (VOC) emergence. The... read more
Eosinophilic Esophagitis
Once considered a rare condition, eosinophilic esophagitis is now one of the most common conditions diagnosed during the assessment of feeding problems in children and during the evaluation of dysphagia and food impaction... read more
Carotid Blowout Syndrome: Modern Trends in Management
Carotid blowout syndrome (CBS) refers to rupture of the carotid artery and is an uncommon complication of head and neck cancer that can be rapidly fatal without prompt diagnosis and intervention. CBS develops when a damaged... read more
Electrical Storm and Incessant Ventricular Tachycardia
Electrical storm, also referred to as arrhythmic storm, refers to multiple recurrences of ventricular arrhythmias over a short period of time. In most instances, the arrhythmia is ventricular tachycardia (VT), but polymorphic... read more
Intubation Timing As Determinant Of Outcome in Patients with ARDS By COVID-19 Infection
In COVID-19 patients, late intubation, Pafi ... read more
Discordance Between Respiratory Drive and Sedation Depth in Critically Ill Patients Receiving Mechanical Ventilation
Sedation depth is not a reliable marker of respiratory drive during critical illness. Respiratory drive can be low, moderate, or high across the range of routinely targeted sedation depth. 56 patients undergoing 197 bedside... read more
Higher ICU Sepsis Case Volume Associated with Significantly Lower Hospital Mortality
In this cohort study of 273,001 patients with sepsis at 231 ICUs in the UK, a higher annual sepsis case volume in the ICU was associated with significantly lower hospital mortality, and this association had no significant... read more
Reliability of Mechanical Ventilation During Continuous Chest Compressions
All investigated transport ventilators were able to provide alveolar ventilation even though chest compressions considerably decreased tidal volumes. Our results support the concept of using ventilators to avoid excessive... read more
Artificial Intelligence Hold Promise in the ICU
In a 2018 article entitled “Human Cognitive Limitations”, the University of Utah's Alan Morris estimated the number of variables an intensivist has to take into account for a patient on mechanical ventilation. He... read more
Floating Feathers: A Doctor’s Harrowing Experience as a Patient Within Conventional Medicine and an Impassioned Call for the Future of Care in America
Dr. Ross I.S. Zbar spent his career as a plastic surgeon, in the US as well as abroad in developing countries, mending disease- and trauma-related deformities--and he was never hesitant to make his voice heard as an advocate... read more
