Working in ICU is like Flying a Plane: The Secret World of Intensive Care

Stepping on to the ICU during this period was like entering another world. In a way intensive care has always seemed like a place removed from life outside said Mike Brunner, an intensive care doctor at Northwick Park hospital... read more

Aerosol and Surface Distribution of SARs-CoV-2 in Hospital Wards

In a hospital treating COVID-19 patients, SARS-CoV-2 RNA was found widely distributed in surface and air samples. Contamination was greater in intensive care units (54/124 samples) than general wards (9/114 samples). A... read more

Is it Safe to Look Yet?

As we start to move to the next stage of the COVID-19 pandemic, it feels like a moment to take stock. The country has gone through huge changes to our way of life over the last few months, and those changes have been mirrored... read more

A Guide to Performance Evaluation for the Intensivist

Currently, there is no standard process to develop Ongoing Professional Practice Evaluation and Focused Professional Practice Evaluation processes in critical care medicine. Departments and institutions can tailor metrics... read more

Longitudinal Analyses Reveal Immunological Misfiring in Severe COVID-19

Recent studies have provided insights into the pathogenesis of COVID-19. Yet, longitudinal immunological correlates of disease outcome remain unclear. Here, we serially analysed immune responses in 113 COVID-19 patients with... read more

High Breath-by-Breath Variability Is Associated With Extubation Failure in Children

High respiratory variability during spontaneous breathing trials is independently associated with extubation failure in children, with very high rates of extubation failure when these children develop postextubation upper... read more

Presence of Genetic Variants Among Young Men With Severe COVID-19

In this case series of 4 young male patients with severe COVID-19, rare putative loss-of-function variants of X-chromosomal TLR7 were identified that were associated with impaired type I and II IFN responses. These preliminary... read more

Who Gets to Live? How Doctors Make Impossible Decisions as COVID-19 Surges

Triage aims to provide the greatest amount of good for the greatest number, but medical staff are grappling with how to stay true to this principle as coronavirus surges. 18 states are currently in what's considered the... read more

Risks Of VAP in Patients With Viral ARDS Related or Not To COVID-19

In this retrospective case-control study, we have observed a higher prevalence of ventilator-associated pneumonia (VAP) and MDR VAP in C-ARDS as compared with NC-ARDS patients. Further, probably multicenter, research work... read more

Factors Associated With Death in Critically Ill Patients With COVID-19 in the US

This study identified demographic, clinical, and hospital-level risk factors that may be associated with death in critically ill patients with COVID-19 and can facilitate the identification of medications and supportive therapies... read more

Infectious Meningitis and Encephalitis in ICU

Infectious meningitis and encephalitis are a major concern in ICU since they are associated with high mortality and permanent neurological injury. About 3% of central nervous system infections will be admitted in the ICU. Three... read more

Managing COVID-19 in Hospital Settings

A series of papers to be published across a variety of journals provides a potential roadmap for treating COVID-19 patients within a hospital setting. It tells practitioners in these healthcare environments how to prepare... read more

Approach to New Fever or Rigors in the ICU Patient

Failure to recognize neutropenic fever as a separate entity that requires immediate treatment. Routinely ordering urinalysis and sputum cultures (for most patients, this will only lead to false-positive results and unnecessary... read more

Elective Tracheostomy During COVID-19: To Whom, When, How?

We suggest to wait at least 14 days to perform tracheostomy. In patients with SOFA score > 6 and D dimer > 4, tracheostomy should not be performed or should be postponed. Optimized procedures and enhanced personal... read more

Manual of ICU Procedures

Manual of ICU Procedures is a comprehensive, step-by-step guide to intensive care procedures. The book is divided into four anatomical sections, and a final miscellaneous section. Section one covers airway and respiratory,... read more

Communication Strategy for Families of Patients Dying in the ICU

Providing relatives of patients who are dying in the ICU with a brochure on bereavement and using a proactive communication strategy that includes longer conferences and more time for family members to talk may lessen the... read more

Avoiding Common ICU Errors

This pocket book succinctly describes 318 errors commonly made by attendings, residents, interns, nurses, and nurse-anesthetists in the intensive care unit, and gives practical, easy-to-remember tips for avoiding these errors.... read more

Avoiding Common ICU Errors

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

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

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

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

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