Fit-testing of N95/P2-masks to Protect Healthcare Workers

In the context of COVID-19, well fitted respirators e.g. N95/P2-masks are recommended as part of personal protective equipment when performing aerosol generating procedures. Fit-checking is recommended prior to donning... read more

Automated vs. Conventional Ventilation in the ICU

Automated ventilation (AV) appears to reduce the incidence and severity of blood oxygen desaturation during daily nursing procedures (DNPs) in comparison to Conventional Ventilation (CV). Of the 265 included patients,... 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

Respiratory Strategies for Patients with Suspected or Proven COVID-19 Respiratory Failure

The trial objective is to determine if Continuous Positive Airway Pressure (CPAP) or High-Flow Nasal Oxygen (HFNO) is clinically effective compared to standard oxygen therapy in patients with confirmed or suspected COVID-19. The... read more

Development of Persistent Respiratory Morbidity in Previously Healthy Children After ARF

Persistent respiratory morbidity develops in up to potentially 44% of previously healthy children less than or equal to 24 months old at follow-up after acute respiratory failure (ARF) requiring mechanical ventilation. This... 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

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

Difficult Bag-Mask Ventilation in Critically Ill Children Is Independently Associated With Adverse Events

Difficult bag-mask ventilation is reported in approximately one in 10 PICU patients undergoing tracheal intubation. Given its association with adverse procedure–related events and oxygen desaturation, future study is warranted... read more

COVID-19 and AKI

Recent reports from China, Italy, and the US indicate that there is a 25-37% incidence of AKI among critically ill COVID-19 patients (Singh 2020, Hirsch et al. 2020). In a study of 5,449 hospitalized COVID-19 patients, acute... read more

Exhaled Air Dispersion During Bag-mask Ventilation and Sputum Suctioning

Mask ventilation and coughing during oro-tracheal suctioning produce aerosols that enhance nosocomial transmission of respiratory infections. We examined the extent of exhaled air dispersion from a human-patient-simulator... read more

COVID-19 – Effective Triage During a Pandemic

The UK is likely on the brink of a major COVID-19 outbreak. About 6% to 10% of infected people are likely to be critically ill, most of whom will require ventilation support in an intensive care environment. Italy is already... read more

Ethnicity and Outcomes in Patients Hospitalised with COVID-19

Preliminary studies suggest that people from Black, Asian and Minority Ethnic (BAME) backgrounds experience higher mortality from COVID-19 but the underlying reasons remain unclear. Prospective analysis of registry data... read more

Managing Theatre Processes for Planned Surgery Between COVID-19 Surges

As we emerge from the first pandemic surge, there is a widespread desire to restart planned surgery using patient pathways that seek to minimise COVID-19 risk to patients and healthcare workers (HCWs). Some hospitals... read more

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

How to Intubate the Critically Ill Like a Boss

Despite decades of experience with endotracheal intubation, we continue to find approaches to improving the process of how we intubate. In today's post we are not only going to talk about how to avoid post intubation cardiac... read more

Implantation of Impella CP LV Assist Device Under the Guidance of 3D Intracardiac Echocardiography

This translational study in ovine model confirms that three-dimensional intracardiac echocardiography is a feasible option to guide implantation of the Impella CP® for left ventricular mechanical support and should be considered... 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

COVID-19 Acute Lung Injury

There is a lot we still do not know when it comes to COVID-19 pathophysiology. We are learning every day, and as we navigate the waters of the unknown, there are a few that boldly dare to try and understand what is happening... 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

Respiratory Physiology of Mechanically Ventilated Patients with COVID-19

In this "Breathe Easy Critical Perspective" podcast, Dr. Dominique Pepper interviews Drs. Jehan Alladina and Corey Hardin. They discuss the respiratory physiology of mechanically ventilated patients with COVID-19. Dr.... read more

Acute Respiratory Failure in COVID-19: Typical ARDS?

COVID-19 is highly infectious and can lead to fatal comorbidities especially ARDS. There are currently no recommended specific anti-COVID-19 treatments, so supportive treatment is important. Fully understanding the characteristics... 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