Tag: hypoxemia
Critical COVID-19 Pneumonia Determinants
SARS-CoV-2 infection is benign in most individuals but, in approx. 10% of cases, it triggers hypoxemic COVID-19 pneumonia, which becomes critical in ˜3% of cases. The ensuing risk of death (˜1%) doubles every five years... read more
Treating Hypoxia in Discharged COVID-19 Patients
The ICU technique of placing a hypoxic patient in a prone position is being widely used to care for COVID-19 patients in respiratory distress to improve oxygenation and possibly to avoid intubation. The COVID-19 pandemic... read more
Oxygenation Responses Mechanisms to Proning and Recruitment in COVID-19 Pneumonia
In unresolving COVID-19 pneumonia, the respiratory mechanics and the gas-exchange response to prone positioning and recruitment largely depend on the following two factors: perfusion dysregulation and the amount of consolidated... read more
HIV and COVID-19 Increased Risk of Severe Outcomes
People living with HIV with detectable HIV viraemia, chronic comorbidities, and some subpopulations could be at increased risk of severe outcomes from COVID-19. These groups should be prioritised in clinical management and... read more
ARDS vs. PseudoARDS – Failure of the Berlin Definition
True ARDS might be defined as a histological diagnosis involving diffuse alveolar damage throughout the lungs (characterized by hyaline membrane formation and thickening of the alveolar walls). PseudoARDS refers to patients... read more
Dexamethasone 12 mg vs. 6 mg for COVID-19 Patients with Severe Hypoxia
Among patients with COVID-19 and severe hypoxia, dexamethasone 12 mg did not result in statistically significantly more days alive without life support at 28 days than dexamethasone 6 mg. However, the confidence interval... read more
A Rational Approach on the use of ECMO in Severe Hypoxemia
Veno-venous extracorporeal membrane oxygenation (ECMO) is a helpful intervention in patients with severe refractory hypoxemia either because mechanical ventilation cannot ensure adequate oxygenation or because lung protective... read more
Breath-holding as a Novel Approach to COVID-19 Risk Stratification
Despite considerable progress, it remains unclear why some patients admitted for COVID-19 develop adverse outcomes while others recover spontaneously. Clues may lie with the predisposition to hypoxemia or unexpected absence... read more
Severity of Hypoxemia may Explain Indeterminate Results in Pediatric Trials of iNO
Inhaled nitric oxide (iNO) is used for refractory hypoxemia in acute respiratory distress syndrome (ARDS) via vasodilation of pulmonary arterioles to ventilated alveoli, particularly in pediatrics. However, iNO has not affected... read more
NIV After Early Extubation Reduces Total Days Spent on i-MV
Patients recovering from an episode of hypoxemic acute respiratory failure (hARF) may benefit from a weaning strategy based on early extubation followed by immediate noninvasive ventilation (NIV) application. Compared... read more
New Therapy Could Protect Lung Function in COVID-19 Patients
There is an urgent need for new drugs for ARDS patients, including those with COVID-19. ARDS in influenza-infected mice is associated with reduced levels of liponucleotides (essential precursors for de novo phospholipid synthesis)... read more
Prone Positioning of Nonintubated Patients with COVID-19
Despite the significant variability in frequency and duration of prone positioning and respiratory supports applied, prone positioning was associated with improvement in oxygenation variables without any reported serious... read more
Effect of Helmet Noninvasive Ventilation vs. High-Flow Nasal Oxygen in Patients with COVID-19
Among patients with COVID-19 and moderate to severe hypoxemia, treatment with helmet noninvasive ventilation, compared with high-flow nasal oxygen, resulted in no significant difference in the number of days free of respiratory... read more
Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients
In this observational study of intubation practices in critically ill patients from a convenience sample of 197 sites across 29 countries, major adverse peri-intubation events—in particular cardiovascular instability—were... read more
Balanced Opioid-free Anesthesia with Dexmedetomidine vs. Balanced Anesthesia with Remifentanil for Noncardiac Surgery
This trial refuted the hypothesis that balanced opioid-free anesthesia with dexmedetomidine, compared with remifentanil, would result in fewer postoperative opioid-related adverse events. Conversely, it did result in a greater... read more
High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure
The use of high-flow nasal oxygen upon ICU admission in adult patients with COVID-19 related acute hypoxemic respiratory failure may lead to an increase in ventilator-free days and a reduction in ICU length of stay, when... read more
Helmet CPAP to treat hypoxic pneumonia outside the ICU
Respiratory failure due to COVID-19 pneumonia is associated with high mortality and may overwhelm health care systems, due to the surge of patients requiring advanced respiratory support. Shortage of intensive care unit... read more
Prone Positioning Non-intubated COVID-19 Patients with Severe Hypoxemia Was Safe
In a small sample, prone positioning non-intubated COVID-19 patients with severe hypoxemia was safe; however, many patients did not tolerate prolonged durations. Although patients had improved oxygenation and respiratory... read more
