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

Sedation, Analgesia, and Paralysis in COVID-19 Patients in the Setting of Drug Shortages

Sedation, Analgesia, and Paralysis in COVID-19 Patients in the Setting of Drug Shortages

The rapid spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to a global pandemic. The 2019 coronavirus disease (COVID-19) presents with a spectrum of symptoms ranging from mild to critical... read more

COVID-19: Dual Oxygen Concentrator System for Mechanical Ventilation

COVID-19: Dual Oxygen Concentrator System for Mechanical Ventilation

Sabah in Malaysian Borneo is among the Malaysian states which reported a high number of detected COVID-19 cases during the current pandemic. Due to geographical challenges and limited resources, clinicians developed novel... read more

Promoting Evidence-Based Practice in ARDS

Promoting Evidence-Based Practice in ARDS

There is a dearth of literature addressing interventions to improve implementation of evidence-based practices in acute respiratory distress syndrome (ARDS). Existing interventions to improve clinician knowledge and facilitate... read more

Remestemcel-L reduces ARDS mortality in those under 65 years old

Remestemcel-L reduces ARDS mortality in those under 65 years old

New data shows patients with COVID-19-related Acute Respiratory Distress Syndrome (ARDS) were up to 75 percent less likely to die when treated with remestemcel-L and dexamethasone. The data shows remestemcel-L reduced... read more

Prone Positioning in Spontaneously Breathing Subjects With Moderate or Severe ARDS During Invasive Ventilation

Prone Positioning in Spontaneously Breathing Subjects With Moderate or Severe ARDS During Invasive Ventilation

In a retrospective analysis of consecutive intubated subjects with moderate or severe ARDS, related or not to COVID-19, spontaneous breathing during prone positioning (PP) was well tolerated and achieved significant improvement... read more

Critical Care Emergency Medicine

Critical Care Emergency Medicine

The groundbreaking text on critical care emergency medicine – updated with the latest evidence and recommendations. Critical Care Emergency Medicine has become the standard reference for all clinicians who wish to understand... read more

Prone Positioning of Nonintubated Patients with COVID-19

Prone Positioning of Nonintubated Patients with COVID-19

Despite the significant variability in frequency and duration of prone positioning and respiratory supports applied, prone positioning was associated with improvement in oxygenation variables without any reported serious... read more