Prolonged Prone Position Ventilation for SARS-CoV-2 Patients is Feasible and Effective

Recently, novel coronavirus 2019 (nCOV-19) is spreading all around the world causing severe acute respiratory syndrome (SARS-CoV-2) requiring mechanical ventilation in about 5% of infected people. Prone position ventilation... read more

Predictors of Care in Persons Under Investigation for COVID-19

The healthcare burden of the coronavirus disease 2019 (COVID-19) pandemic extends beyond patients who test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), according to a retrospective cohort study... read more

ICU Isolation Hood Decreases Risk of Aerosolization During Noninvasive Ventilation with COVID-19

The treatment of patients with coronavirus disease (COVID-19) needs to take into consideration not only the disease process but also the availability of medical resources and the risks of transmission to healthcare providers.... read more

Phenotypic Heterogeneity by Site of Infection in Surgical Sepsis

There are notable differences in baseline predisposition, host responses, and clinical outcomes by site of infection in surgical sepsis. While previous studies have focused on differences in hospital mortality, this study... read more

Unfractionated Heparin (UFH), LMWH, Fondaparinux, Argatroban, and Bivalirudin

Unfractionated heparin (UFH) binds to anti-thrombin III (AT-III), which enhances antithrombin's inhibition of several coagulation factors – especially factor Xa and factor IIa (thrombin). Low Molecular-Weight Heparin... read more

Prevention of Pathogen Transmission During Ultrasound Use in the ICU

The Australasian Society for Ultrasound in Medicine (ASUM) and the Australasian College for Infection Prevention Control (ACIPC) published guidelines on minimum standards for reprocessing/cleaning of ultrasound transducers... read more

Enteral Fluid Resuscitation? The WHO to the rescue in the ED/ICU?

Prior to the 1970's, restricting oral intake was a "cornerstone" therapy of diarrheal illness, due to the pervasive belief that the GI tract needed time to heal and recover before resuming normal function. This was felt... read more

Effects of Paracentesis on Hemodynamic Parameters and Respiratory Function in Critically Ill Patients

Paracentesis in critically ill patients is safe regarding hemodynamic function, renal function and intervention-related complications. Furthermore, paracentesis in critically ill and mechanically ventilated patients results... read more

Clinical Distancing of Patients with Advanced Heart Failure and Cardiac Transplantation During COVID-19

Our hospital system includes a central 825-bed, short term, acute care teaching facility where heart transplantation is performed under regulatory approval. Located 5.5 miles north of this main campus is a 107-bed cardiac... read more

The Utility of Diaphragm Ultrasound in Reducing Time to Extubation

Predicting the optimal time for extubation is challenging, especially in patients with underlying diaphragm dysfunction. Incorporating ultrasound information on diaphragm function into usual care allowed clinicians to identify... read more

Risk Score for Development of Critical Illness in Patients with COVID-19

In this study, we developed a risk score and web-based calculator to estimate the risk of developing critical illness among patients with COVID-19 based on 10 variables commonly measured on admission to the hospital. Estimating... read more

An ICU Doctor on How We Can Emerge from the Storm Into a Place to Mend

As we emerge from the storm of preparation and uncertainty, where are we now but in a quiet place. A place to mend. A time to dream. For many the effects of lockdown have been devastating; there were never any easy choices... read more

Critical Care Clinician Reports on COVID-19

This national ICU clinician survey indicates that hospitals are expanding ICU bed capacity to prepare for coronavirus disease 2019 patient surge. Importantly, amid this preparation, ICU clinicians harbor concerns regarding... read more

Preparing ICUs for COVID-19: an Australian Experience

In this article, we describe the response from our intensive care unit (ICU) within a large tertiary private metropolitan Australian hospital. We hope this information may be useful to other ICUs in Australia, for any second... read more

A Mass Casualty In Slow Motion: Emergency Medicine During the COVID-19 Surge in New York City

The first time I really took notice of coronavirus was when a few providers started wearing masks during their shifts. This was in mid-February when the virus was a Wuhan problem, and we were screening people with travel... read more

Prevention and Treatment of ALI with Time-controlled Adaptive Ventilation

Neither the current lung protect and rest nor open lung approach (OLA) ventilation strategies have been effective at reducing VILI and ARDS-related mortality below that in the ARMA study. For a protective ventilation strategy... read more

The Pandemic Is a Perfect Storm for ICU Delirium

Spending time in the ICU, especially for anyone with COVID-19, is a dangerous, physically taxing experience: Only the most seriously ill patients land in intensive care, where many undergo a number of complex medical treatments... read more

Provider Burnout and Fatigue During the COVID-19 Pandemic

The novel Coronavirus Disease 2019 (COVID-19) pandemic has resulted in an overall surge in new cases of depression and anxiety and an exacerbation of existing mental health issues, with a particular emotional and physical... read more

COVID-19: Tube Exchange

Emergency physicians rarely are involved in tube exchanges; I can't remember the last time I had to do one. However, during the COVID19 surge, we found ourselves boarding intubated patients for days and even weeks as our... read more

50 Studies Every Intensivist Should Know

50 Studies Every Intensivist Should Know presents key studies that have shaped the practice of critical care medicine. Selected using a rigorous methodology, the studies cover topics including: sedation and analgesia, resuscitation,... read more

50 Studies Every Intensivist Should Know

Let’s Save Some Lives: A Doctor’s Journey Into the Pandemic

There is no hope of outrunning the suffering that has settled into the hospital and the world around it, so Andrew Ibrahim laces up his blue waterproof sneakers and walks. In the time it has taken the daffodils to poke... read more

30 Days as a Medical Resident in New York City

The coronavirus pandemic has reshaped everyone's lives. But for health-care workers, the impact of covid-19 is felt acutely, tragically, every day. To capture the lived reality of this, we asked Shaoli Chaudhuri, 29,... read more