Critical Care & Emergencies (All Articles)
Opinion | Tocilizumab in COVID-19 therapy: who benefits, and how? – the researchers suggest that maybe IL-6 inhibitors should be given only to patients with high IL-6.
23 Jul, 2021 | 10:51h | UTCTocilizumab in COVID-19 therapy: who benefits, and how? – The Lancet
Related: A living WHO guideline on drugs for covid-19 – interleukin-6 receptor blockers are now recommended for patients with severe or critical covid-19. AND M-A: Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19 – “The 4% absolute risk reduction in mortality from 25% to 21% with IL-6 inhibition added to glucocorticoids may not translate to patients with a lower baseline mortality risk and likely do not justify the additional expense and risk for toxicities for patients hospitalized with modest oxygen requirements and a stable clinical course (from editorial)”. AND RECOVERY trial: In hospitalized COVID-19 patients with hypoxia and systemic inflammation (C-reactive protein ≥75 mg/L), tocilizumab improved survival and other clinical outcomes AND Secondary analysis of RCT finds Tocilizumab was beneficial to patients hospitalized with Covid-19 if CRP levels were greater than 15.0 mg/dL, but not if CRP levels were 15.0 mg/dL or less. AND M-A: Tocilizumab in COVID-19 – “For hospitalized COVID-19 patients, there is some evidence that tocilizumab use may be associated with a short-term mortality benefit, but further high-quality data are required”.
Secondary sclerosing cholangitis: an emerging complication in critically ill COVID-19 patients.
23 Jul, 2021 | 10:47h | UTC
Review: Treatment strategies for new onset atrial fibrillation in patients treated on an intensive care unit.
23 Jul, 2021 | 10:30h | UTC
Review: Ethics in extracorporeal life support.
23 Jul, 2021 | 10:29h | UTCEthics in extracorporeal life support: a narrative review – Critical Care
Review: The routes of administration for acute postoperative pain medication.
22 Jul, 2021 | 10:46h | UTCThe Routes of Administration for Acute Postoperative Pain Medication – Pain and Therapy
Review: Personalized mechanical ventilation in acute respiratory distress syndrome.
22 Jul, 2021 | 10:40h | UTCPersonalized mechanical ventilation in acute respiratory distress syndrome – Critical Care
Related: M-A of randomized trials: In patients with acute respiratory distress syndrome, there was no difference in mortality between higher vs. lower positive end-expiratory pressure strategies. AND Seminar | Acute respiratory distress syndrome. AND Short review: Diagnosis and management of acute respiratory distress syndrome
A Narrative Review on the Role of Staphylococcus aureus Bacteriuria in S. aureus Bacteremia.
22 Jul, 2021 | 10:37h | UTC
Commentary on Twitter
✨If you have Staph in urine check blood culture✨
💥Excellent narrative review on the role of Staphylococcus aureus Bacteriuria in S. aureus Bacteremia
Epidemiology and pathogenesis of SABU in patients with SAB💥 #IDTwitter #ofid https://t.co/wioI3I528z pic.twitter.com/54jVQEBeDW— Antibiotic Steward 🇵🇸💔Bassam Ghanem (@ABsteward) March 30, 2021
RCT: Immediate oral refeeding in patients with mild and moderate acute pancreatitis.
22 Jul, 2021 | 10:32h | UTCImmediate Oral Refeeding in Patients With Mild and Moderate Acute Pancreatitis: A Multicenter, Randomized Controlled Trial (PADI trial) – Annals of Surgery (link to abstract – $ for full-text)
Cohort study: Sickle cell disorders and severe COVID-19 outcomes – “Our analysis estimated a 4-fold increased risk for COVID-19–related hospitalization and a 2.6-fold increased risk for COVID-19–related death for sickle cell disease”.
21 Jul, 2021 | 10:44h | UTCSickle Cell Disorders and Severe COVID-19 Outcomes: A Cohort Study – Annals of Internal Medicine
Expert review | Postpartum preeclampsia or eclampsia: defining its place and management among the hypertensive disorders of pregnancy.
21 Jul, 2021 | 10:37h | UTC
Commentary on Twitter
AJOG Expert Review in Preeclampsia: Postpartum preeclampsia or eclampsia: defining its place and management among the hypertensive disorders of pregnancy https://t.co/xdZbn51ymU pic.twitter.com/N90GdbdBBw
— AJOG (@AJOG_thegray) July 20, 2021
ICU Survivorship—The relationship of delirium, sedation, dementia, and acquired weakness.
21 Jul, 2021 | 10:32h | UTC
WHO Guidance for clinical case management of thrombosis with thrombocytopenia syndrome (TTS) following vaccination to prevent coronavirus disease (COVID-19).
20 Jul, 2021 | 10:29h | UTCRelated Guidance: AHA/ASA Guidance: Diagnosis and Management of Cerebral Venous Sinus Thrombosis with Vaccine-Induced Thrombotic Thrombocytopenia – “No heparin products in any dose should be given.” AND ISTH Interim Guidance for the Diagnosis and Treatment on Vaccine Induced Immune Thrombotic Thrombocytopenia
WHO warns that HIV infection increases risk of severe and critical COVID-19.
20 Jul, 2021 | 10:24h | UTCNews release: WHO warns that HIV infection increases risk of severe and critical COVID-19 – World Health Organization
Commentary on Twitter (thread – click for more)
🆕 report confirms that #HIV infection is a significant independent risk factor for both severe/critical #COVID19 presentation at hospital admission & in-hospital mortality. 23.1% of all people living with HIV who were hospitalized with COVID-19, died.
👉 https://t.co/UBd0OyFKnd pic.twitter.com/UHLo9RPa1g
— World Health Organization (WHO) (@WHO) July 16, 2021
International Registry: Ischemic and hemorrhagic stroke among critically ill patients with Covid-19.
20 Jul, 2021 | 10:21h | UTCRelated: SARS-CoV-2 and Stroke Characteristics – higher rate of large vessel occlusions and stroke in young patients AND Case series of 18 male adults aged 50 years or younger with acute ischemic stroke during the convalescent phase of asymptomatic Covid-19 AND Case-control study: COVID-19-associated stroke is associated with worse outcomes and increased mortality AND Pictorial essay: Neurological emergencies associated with COVID-19: stroke and beyond AND Characteristics and Outcomes in Patients With COVID-19 and Acute Ischemic Stroke AND Risk of Ischemic Stroke in Patients with COVID-19 vs. Patients with Influenza
RCT: more data showing Azithromycin is not better than placebo in patients with Covid-19.
18 Jul, 2021 | 23:54h | UTCRelated: RCT: Another study shows Azithromycin does not improve outcomes in patients with Covid-19. (several articles on the subject)
Commentary on Twitter
Among outpatients with #SARSCoV2 infection, treatment with a single dose of oral #azithromycin compared with placebo did not result in a greater likelihood of being free of symptoms at day 14 https://t.co/dYDcSyGtwd #COVID19
— JAMA (@JAMA_current) July 16, 2021
Position Paper: Recommendations for the use of topical inhalant budesonide in COVID-19.
18 Jul, 2021 | 23:53h | UTCRecommendations for use of topical inhalant budesonide in COVID-19 – HNO
Related: RCT: Inhaled budesonide shortens recovery time in non-hospitalized patients with COVID-19 AND Phase 2 RCT: Inhaled budesonide shows promise for the treatment of early COVID-19
Review: Acute kidney injury.
18 Jul, 2021 | 23:18h | UTCAcute kidney injury – Nature Reviews Disease Primers (free for a limited period)
Commentary on Twitter
Get Primed on #AcuteKidneyInjury with our NEW PrimeView, FREE to download this week https://t.co/4RAOOaB8ep pic.twitter.com/d5iHCcqJwY
— Nature Reviews Disease Primers (@DiseasePrimers) July 15, 2021
Why was a major study on ivermectin for covid-19 just retracted?
16 Jul, 2021 | 11:11h | UTCWhy Was a Major Study on Ivermectin for COVID-19 Just Retracted? – Grifter Analysis and Review
See also: Huge study supporting ivermectin as Covid treatment withdrawn over ethical concerns – The Guardian AND Some problems in the dataset of a large study of Ivermectin for the treatment of Covid-19 – Nick Brown’s Blog AND Is Ivermectin for Covid-19 Based on Fraudulent Research? – Gideon M-K; Health Nerd
Commentary on Twitter (thread – click for more)
So, one of the biggest studies to date on ivermectin for COVID-19 has issues significant enough that, if not fraud, are so serious that it invalidates the study without further explanation
I promised a thread
Here we go 1/n https://t.co/L9QOChmGtA
— Health Nerd (@GidMK) July 16, 2021
Short review: The gut in COVID-19.
16 Jul, 2021 | 10:54h | UTCThe gut in COVID-19 – Intensive Care Medicine
Commentary on Twitter
Gut & #COVID19, main findings
➡️clinical GI features
➡️pathophysiology: cytotoxic enterocyte injury, microvascular injury/thromboinfammation, non‑specifc critical illness‑related dysfunction
➡️GI dysfunction in severe #SARSCoV2 vs other critical illnesseshttps://t.co/wzzTNldInN pic.twitter.com/DnHLMsSu6v— Intens Care Med (@yourICM) July 9, 2021
Pathophysiology of COVID-19-associated acute kidney injury.
16 Jul, 2021 | 10:52h | UTCPathophysiology of COVID-19-associated acute kidney injury – Nature Reviews Nephrology
AAFP Guideline: Pharmacologic Management of COPD Exacerbations.
16 Jul, 2021 | 10:51h | UTC
M-A of randomized trials: In patients with acute respiratory distress syndrome, there was no difference in mortality between higher vs. lower positive end-expiratory pressure strategies.
16 Jul, 2021 | 10:43h | UTC
Review: Sedation in the Intensive Care Unit.
16 Jul, 2021 | 10:31h | UTCSedation in the Intensive Care Unit – Current Anesthesiology Reports
RCT: Bamlanivimab plus Etesevimab reduce mortality and hospitalization in ambulatory patients with early Covid-19 (within 3 days of a positive test) who are at risk for clinical deterioration (i.e., older people, obese, diabetics, immunocompromised, with CV disease).
15 Jul, 2021 | 09:26h | UTCBamlanivimab plus Etesevimab in Mild or Moderate Covid-19 – New England Journal of Medicine
Tramadol: Where do we go from here? – “Tramadol’s unpredictability, unique potential harms, and lack of advantage over other opioids or NSAIDs are now well recognized”.
15 Jul, 2021 | 09:14h | UTC[131] Tramadol: Where do we go from here? – Therapeutic Initiative