Prone Positioning and Survival in Mechanically Ventilated Patients with COVID-19

Prone Positioning and Survival in Mechanically Ventilated Patients with COVID-19

In-hospital mortality was lower in mechanically ventilated hypoxemic patients with coronavirus disease 2019 treated with early proning compared with patients whose treatment did not include early proning. Among 2,338 eligible... read more

A Rational Approach on the use of ECMO in Severe Hypoxemia

A Rational Approach on the use of ECMO in Severe Hypoxemia

Veno-venous extracorporeal membrane oxygenation (ECMO) is a helpful intervention in patients with severe refractory hypoxemia either because mechanical ventilation cannot ensure adequate oxygenation or because lung protective... read more

Oxygen Therapy in COVID-19 Patients: The Role of HFNC and CPAP

Oxygen Therapy in COVID-19 Patients: The Role of HFNC and CPAP

Oxygen therapy and non-invasive ventilation in COVID-19 should be based on pathophysiological changes and a step-by-step approach should be adopted in choosing the right therapeutic strategy for each patient. Continuous... read more

Clinical Trials Design Evaluating Sedation in Critically Ill Adults Requiring Mechanical Ventilation

Clinical Trials Design Evaluating Sedation in Critically Ill Adults Requiring Mechanical Ventilation

These recommendations are intended to assist researchers in the design, conduct, selection of endpoints, and reporting of clinical trials involving sedative medications and/or sedation protocols for adult ICU patients who... read more

Percutaneous Dilational Tracheostomy for COVID-19 Patients Requiring Mechanical Ventilation

Percutaneous Dilational Tracheostomy for COVID-19 Patients Requiring Mechanical Ventilation

Patients with COVID-19 who survive the early days of MV experience severe and prolonged respiratory failure. An early modified percutaneous dilational tracheostomy (PDT) was safe for patients and healthcare providers and... read more

Breath-holding as a Novel Approach to COVID-19 Risk Stratification

Breath-holding as a Novel Approach to COVID-19 Risk Stratification

Despite considerable progress, it remains unclear why some patients admitted for COVID-19 develop adverse outcomes while others recover spontaneously. Clues may lie with the predisposition to hypoxemia or unexpected absence... read more

No Such Thing As a Simple Sedation Case

No Such Thing As a Simple Sedation Case

In my CA-2 year I encountered an elderly gentleman who needed an angiogram of his dialysis fistula. After starting the propofol infusion I placed an oral airway because his tongue obstructed his breathing by flipping back... read more

Non-invasive Respiratory Support and P-SILI in COVID-19

Non-invasive Respiratory Support and P-SILI in COVID-19

Coronavirus disease 2019 (COVID-19) pneumonia is associated with hypoxemic respiratory failure, ranging from mild to severe. Due to the worldwide shortage of intensive care unit beds, a relatively high number of patients... read more

Protocol and statistical analysis plan for the PREPARE II randomised clinical trial

Protocol and statistical analysis plan for the PREPARE II randomised clinical trial

Cardiovascular collapse is a common complication during tracheal intubation of critically ill adults. Whether administration of an intravenous fluid bolus prevents cardiovascular collapse during tracheal intubation remains... read more

Why and How to Open ICU to Family Visits During the Pandemic

Why and How to Open ICU to Family Visits During the Pandemic

Since the lockdown because of the pandemic, family members have been prohibited from visiting their loved ones in hospital. While it is clearly complicated to implement protocols for the admission of family members, we believe... read more

Steer Clear of Magnesium for COPD

Steer Clear of Magnesium for COPD

Knowingly or not, we in emergency medicine tend to lean into the Dutch hypothesis, a 1960s postulate that asthma and COPD are part of a spectrum of common disease (chronic obstructive lung disease), and should be considered... read more

NIV After Early Extubation Reduces Total Days Spent on i-MV

NIV After Early Extubation Reduces Total Days Spent on i-MV

Patients recovering from an episode of hypoxemic acute respiratory failure (hARF) may benefit from a weaning strategy based on early extubation followed by immediate noninvasive ventilation (NIV) application. Compared... read more

Risk of Clinical Severity by Age and Race/Ethnicity Among Adults Hospitalized for COVID-19

Risk of Clinical Severity by Age and Race/Ethnicity Among Adults Hospitalized for COVID-19

Older adults and people from certain racial and ethnic groups are disproportionately represented in coronavirus disease 2019 (COVID-19) hospitalizations and deaths. Using data from the Premier Healthcare Database on 181,813... read more

Clinical strategies for implementing lung and diaphragm-protective ventilation

Clinical strategies for implementing lung and diaphragm-protective ventilation

Mechanical ventilation may have adverse effects on both the lung and the diaphragm. Injury to the lung is mediated by excessive mechanical stress and strain, whereas the diaphragm develops atrophy as a consequence of low... read more