Tag: hypoxemia
ECMO for COVID-19 patients in Europe and Israel
As of October 17th the novel coronavirus (SARS-CoV-2) caused a pandemic disease (coronavirus disease 2019, COVID-19) 40 million people worldwide, with almost one million deaths. Although most patients have an uncomplicated... read more
Transfusion Associated Circulatory Overload
A 67-year-old female with a history of congestive heart failure and CKD was brought in by ambulance from her nursing home for a gastrointestinal bleed. The patient’s total fluid balance from her nursing home was 2.5L over... read more
Clinical characteristics of critically ill patients with COVID-19
In this study of critical patients infected by SARS-CoV-2 in a high-complexity hospital, the majority were comorbid elderly men, a large percentage required invasive mechanical ventilation, and ICU mortality was 25%. Design... 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
Increased Dead Space Ventilation and Refractory Hypercapnia in Patients with COVID-19
We speculate that thromboinflammation with pulmonary microvasculature occlusion leads to a sudden increase in dead space and shunt resulting in severe hypercapnia and hypoxemia in coronavirus disease 2019 patients. Early... read more
Utility of RV Remodeling Over Risk Stratification in COVID-19
This study contributes to the growing body of literature illustrating the adverse prognostic implications of RV dilation and dysfunction in the setting of severe COVID-19. Mechanistic explanations for RV failure in this population... read more
Lung Histopathology in COVID-19 as Compared to SARS and H1N1 Influenza
Diffuse alveolar damage (DAD) was reported in 88% of patients with COVID-19. This is similar to both H1N1 (90%) and SARS (98%). Pulmonary microthrombi was reported in 57% of patients with COVID-19. This was similar to... read more
Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with high-flow nasal oxygen therapy
To the best of our knowledge, this is the first multicenter study that prospectively evaluated the benefits and the role of HFNO combined with awake prone positioning in the prevention of intubation in an adjusted large cohort... read more
Factors Associated to ICU Mortality in Critically Ill Patients Infected with COVID-19 in Spain
Older COVID-19 patients with higher APACHE II scores on admission, those who developed AKI grades II or III and/or septic shock during ICU stay had an increased risk-of-death. ICU mortality was 31%. A total of 663 patients... read more
Dual Therapy Using Sildenafil and Milrinone Superior to Monotherapy in Neonates with Severe PPHN
Dual therapy using sildenafil and milrinone was superior to monotherapy with either drug in neonates with severe persistent pulmonary hypertension (PPHN) and is recommended for use in resource-constrained settings. A double-blind... read more
ECMO During the Coronavirus Disease 2019 Pandemic
In the midst of the 2009 influenza A H1N1 pandemic, clinicians turned to extracorporeal membrane oxygenation (ECMO) as a strategy to save lives. Based on the H1N1 experience, and the ECMO to Rescue Lung Injury in Severe... read more
Awake Prone Positioning for COVID-19 Hypoxemic Respiratory Failure
Infection with SARS-CoV-2 can result in Coronavirus Disease–19 (COVID-19). While the majority of patients are asymptomatic or have mild disease, approximately 14% develop more severe disease including hypoxemic respiratory... read more
When Should I Worry About a PE in a Patient with COVID-19
PE diagnosis in COVID-19 patients is challenging. Many of the features of PE, such as shortness of breath and hypoxemia, are very common in patients with COVID-19, even in the absence of PE. Further, the diagnostic tests... read more
COVID-19: A Hypothesis Regarding the Ventilation-Perfusion Mismatch
We believe that a severe V/Q mismatch underlies the pathophysiology of moderate to severe COVID-19 cases, in which downregulation of ACE2 secondary to viral endocytosis plays a key role. There is low V/Q ratio in areas of... 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
The Perils of Premature Phenotyping in COVID-19
The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) poses an unprecedented global healthcare challenge. Severe novel Coronavirus disease (COVID-19) pneumonia frequently causes hypoxemic respiratory failure, manifesting... read more
Prone Positioning in Nonintubated Patients with COVID-19 and Hypoxemic Acute Respiratory Failure
In this study of patients with COVID-19 and hypoxemic respiratory failure managed outside the ICU, 63% were able to tolerate PP for more than 3 hours. However, oxygenation increased during PP in only 25% and was not sustained... read more
