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

Outcomes With the Use of Bag-Valve-Mask Ventilation During Out-of-hospital Cardiac Arrest in the Pragmatic Airway Resuscitation Trial

Bag-valve-mask-only ventilation is associated with improved OHCA outcomes. Despite similar rates of ROSC and 72-hour survival, BVM-rescue ventilation was associated with improved survival to discharge and neurologically intact... read more

A Transdisciplinary COVID-19 Early Respiratory Intervention Protocol

In the days after COVID-19 arrived in our region, there were many such stories of patients sent to the floor from the Emergency Department who were intubated shortly after admission. Many of those patients subsequently... read more

Hydroxychloroquine or Azithromycin for COVID-19 Treatment

The use of hydroxychloroquine, azithromycin, or both were not associated with differences in in-hospital mortality. Cardiac arrest was more likely in patients receiving hydroxychloroquine and azithromycin. In this retrospective,... 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

Copeptin as a Marker of Outcome After Cardiac Arrest

Copeptin is an independent marker of severity of the post cardiac arrest syndrome, partially related to circulatory failure. 690 patients were included in the analyses, of whom 203 (30.3%) developed cardiovascular deterioration... 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

Supine Body Position As a Risk Factor for Nosocomial Pneumonia in Mechanically Ventilated Patients

The frequency of clinically suspected nosocomial pneumonia was lower in the semirecumbent group than in the supine group. This was also true for microbiologically confirmed pneumonia. Supine body position were independent... read more

COVID-19: Two More Trials Just Published on Remdesivir

Currently, there are no approved medications for the treatment of COVID-19, but, there are many investigational agents that have shown antiviral activity against SARS-CoV-2 in vitro. Unfortunately in vitro studies do... read more

Pandemic Science Out of Control

A toxic legacy of poor-quality research, media hype, lax regulatory oversight, and vicious partisanship has come home to roost in the search for effective treatments for COVID-19. The rush to offer unproven treatments... read more

COVID-19: Thrombosis and Anticoagulation

Early reports have shown that COVID-19 is most likely causing a hypercoagulable state, however the prevalence of acute VTE and exactly how to treat it is an evolving area. Limited data suggest pulmonary microvascular thrombosis... read more

Low-dose Dopamine in Patients with Early Renal Dysfunction

Administration of low-dose dopamine by continuous intravenous infusion to critically ill patients at risk of renal failure does not confer clinically significant protection from renal dysfunction. The groups assigned dopamine... read more

Expert Panel Develops NIH Treatment Guidelines for COVID-19

A panel of U.S. physicians, statisticians, and other experts has developed treatment guidelines for coronavirus disease 2019 (COVID-19). These guidelines, intended for healthcare providers, are based on published and preliminary... read more

Pharmacokinetics and Sedative Effects of Intranasal Dexmedetomidine in Ambulatory Pediatric Patients

These results demonstrate that intranasally (IN) dexmedetomidine is relatively rapidly absorbed and causes significant sedation in pediatric patients. Pharmacokinetics of IN dexmedetomidine in pediatric patients show quite... read more

Richard Lehman’s COVID-19 Reviews

Between the asymptomatic cases and those in intensive care, there are hundreds of thousands suffering with covid-19. They have a constant painful cough, which prevents sleep. They cannot breathe properly and are intensely... read more

BCG Vaccination Might Protect Healthcare Workers Against COVID-19

Australian and European researchers are testing if the Bacille Calmette-Guerin (BCG) vaccine, introduced in the 1920s to fight tuberculosis, will be deployed to combat COVID-19, the respiratory disease caused by the novel... read more

Plasma Transfusion Shows Promise for COVID-19 Treatment

Donor blood plasma from people who have recovered from COVID-19 appears to work as a treatment for the virus, a new analysis has revealed. In this preliminary uncontrolled case series of 5 critically ill patients with... read more

A Comparison of Albumin and Saline for Fluid Resuscitation in the ICU

In this randomized trial, we found that the use of 4 percent albumin or normal saline for intravascular volume resuscitation in a heterogeneous population of patients in the ICU resulted in equivalent rates of death from... read more

Focus on Clinical Trial Interpretation

In a recently published meta-epidemiological study of 604 randomised clinical trials (RCTs) published between 1977 and 2018 from 53 Cochrane systematic reviews in critical care, less than 7% of the RCTs had overall low risk... read more

Decrease Delirium in Older ICU Adults Using Music

Researchers from the Regenstrief Institute and Mayo Clinic are leading the first study to test whether exposure to music can decrease delirium in older adults who are receiving mechanical ventilation in the Intensive Care... read more

Instrumental Activities of Daily Living Related to ARDS Survivors’ Quality of Life

Instrumental Activities of Daily Living (IADL), not body functions & structures measures, are related to ARDS survivors' quality of life and should be included in future studies. Bringing greater consistency to outcomes... read more

Impact of Protocolized Diuresis for De-resuscitation in the ICU

Using a diuresis protocol for volume de-resuscitation, we demonstrated a significant decrease in net cumulative fluid balance at 72 h following shock resolution, with potential benefit on clinical outcomes including renal... read more