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Critical Care

Systematic Review: Anticoagulants for acute ischemic stroke.

30 Nov, 2021 | 10:01h | UTC

Summary: Early treatment with blood-thinning drugs for people who have had a stroke – Cochrane Library

Original Study: Anticoagulants for acute ischaemic stroke – Cochrane Library

 

Podcast: Metabolic Alkalosis and Hypokalemia.

30 Nov, 2021 | 09:57h | UTC

#308 Metabolic Alkalosis and Hypokalemia: Kidney Boy Returns! – The Curbsiders

 

Preliminary RCT found prostacyclin may improve outcomes in mechanically ventilated patients with COVID-19 and severe endotheliopathy.

30 Nov, 2021 | 08:42h | UTC

Prostacyclin in Mechanically Ventilated Patients with COVID-19 and Severe Endotheliopathy: A Multicenter, Randomized, Clinical Trial – American Journal of Respiratory and Critical Care Medicine

News release: Well-known drug could help the most severely affected COVID-19 patients in intensive-care departments – by University of Copenhagen

 

Commentary from the author on Twitter (thread – click for more)

 

Electrocardiogram monitoring in the prone position in Covid-19 acute respiratory distress syndrome.

30 Nov, 2021 | 08:38h | UTC

Electrocardiogram monitoring in the prone position in coronavirus disease 2019 acute respiratory distress syndrome – European Journal of Cardiovascular Nursing

 

Commentary on Twitter

 

ESCMID COVID-19 Living guidelines: drug treatment and clinical management.

30 Nov, 2021 | 08:40h | UTC

ESCMID COVID-19 Living guidelines: drug treatment and clinical management – Clinical Microbiology and Infection

 

[Press release – not published yet] Merck’s new Covid-19 pill Molnupiravir updated data shows reduced efficacy (30%) for preventing hospitalization and death compared to initial results (50%). Absolute risk reduction of hospitalization and death fell from 7% to 3%.

28 Nov, 2021 | 21:30h | UTC

News Release: Merck and Ridgeback Biotherapeutics Provide Update on Results from MOVe-OUT Study of Molnupiravir, an Investigational Oral Antiviral Medicine, in At Risk Adults With Mild-to-Moderate COVID-19

Commentary: New data, analyses take some of the shine off Merck’s Covid pill – STAT

Related:

8 lingering questions about the new Covid pills from Merck and Pfizer.

COVID antiviral pills: what scientists still want to know – “Drugs like Molnupiravir and Paxlovid could change the course of the pandemic if clinical trial results hold up in the real world”.

[Press release – not published yet] RCT: Pfizer’s novel Covid-19 oral antiviral treatment candidate reduced risk of hospitalization or death by 89% in interim analysis of phase 2/3 EPIC-HR study.

A prominent virologist warns new COVID-19 pill could unleash dangerous mutants. Others see little cause for alarm.

The U.K. approves Merck’s COVID-19 antiviral pill, calling it a world first.

Merck to allow other nations to produce new COVID-19 antiviral.

Video: Merck’s Covid pill could transform treatment. Here’s how it works.

How antiviral pill Molnupiravir shot ahead in the COVID drug hunt.

What we know — and don’t know — about Merck’s new Covid-19 pill.

[Press release – not published yet] Merck announces oral antiviral Molnupiravir reduced the risk of hospitalization or death by approximately 50 Percent compared to placebo for patients with mild or moderate COVID-19.

Merck’s Covid-19 pill is great news but may not be a game-changer.

Video | A Pill For COVID? A Doctor Explains Molnupiravir.

 

Commentaries on Twitter

 

Review: Prevention and management of thrombosis in hospitalized patients with COVID-19 pneumonia.

26 Nov, 2021 | 08:44h | UTC

Prevention and management of thrombosis in hospitalised patients with COVID-19 pneumonia – The Lancet Respiratory Medicine

 

Promises and challenges of personalized medicine to guide ARDS therapy.

25 Nov, 2021 | 10:25h | UTC

Promises and challenges of personalized medicine to guide ARDS therapy – Critical Care

 

Basics of extracorporeal membrane oxygenation.

25 Nov, 2021 | 10:09h | UTC

Basics of Extracorporeal Membrane Oxygenation – Surgical Clinics of North America

 

Review: Noninvasive ventilation and oxygenation strategies.

25 Nov, 2021 | 10:08h | UTC

Noninvasive Ventilation and Oxygenation Strategies – Surgical Clinics of North America

 

Review: COVID-19-associated Invasive Fungal Infection.

24 Nov, 2021 | 08:48h | UTC

COVID-19-associated Invasive Fungal Infection – Open Forum Infectious Diseases

Related:

Taskforce report on the diagnosis and clinical management of COVID-19 associated pulmonary aspergillosis.

M-A: Incidence and mortality of COVID‐19‐associated pulmonary aspergillosis – The incidence and mortality in the ICU were estimated to be 10.2% and 54.9%, respectively.

Consensus Guideline: Defining and managing COVID-19-associated pulmonary aspergillosis

Bacterial and fungal superinfections in critically ill patients with COVID-19

Invasive Fungal Disease complicating COVID-19: when it rains it pours

A national strategy to diagnose COVID-19 associated invasive fungal disease in the ICU

Epidemiology of invasive pulmonary aspergillosis among COVID-19 intubated patients

 

Commentary on Twitter

 

A prospective cohort study showed a 3.1% risk for recurrent venous thromboembolism at 90 days in patients with subsegmental pulmonary embolism managed without anticoagulation.

24 Nov, 2021 | 08:31h | UTC

Risk for Recurrent Venous Thromboembolism in Patients With Subsegmental Pulmonary Embolism Managed Without Anticoagulation: A Multicenter Prospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

 

Commentary on Twitter

 

M-A: Colchicine doesn’t lessen COVID-19 severity or stave off risk of death.

23 Nov, 2021 | 08:55h | UTC

News release: Gout drug colchicine doesn’t lessen COVID-19 severity or stave off risk of death – BMJ

Original Study: Efficacy and safety of colchicine in COVID-19: a meta-analysis of randomised controlled trials – RMD Open

Related:

RECOVERY Trial: In patients admitted to hospital with COVID-19, Colchicine did not reduce 28-day mortality, duration of hospital stay, or risk of progressing to invasive mechanical ventilation or death.

[Preprint] PRINCIPLE RCT: Colchicine does not improve time to recovery in outpatients with Covid-19 at higher risk of complications.

COLCORONA RCT: Colchicine for community-treated patients with COVID-19 – findings suggest it may lower death and hospital admission rates, but further studies are required.

[Preprint] RECOVERY Trial: Colchicine does not improve outcomes in patients admitted to hospital with COVID-19.

 

The COVID-19 Patient in the Surgical Intensive Care Unit.

23 Nov, 2021 | 08:46h | UTC

The COVID-19 Patient in the Surgical Intensive Care Unit – Surgical Clinics of North America

 

IDSA Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections.

23 Nov, 2021 | 08:45h | UTC

IDSA Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections – Infectious Diseases Society of America

 

Commentary on Twitter

 

Non-invasive respiratory support in the management of acute COVID-19 pneumonia: considerations for clinical practice and priorities for research – “The two randomized controlled trials indicate superiority of non-invasive ventilation over high-flow nasal oxygen in reducing the need for intubation”.

21 Nov, 2021 | 23:15h | UTC

Non-invasive respiratory support in the management of acute COVID-19 pneumonia: considerations for clinical practice and priorities for research – The Lancet Respiratory Medicine

Related: [Preprint] RCT: non-invasive respiratory strategies in acute respiratory failure in patients with COVID-19 – CPAP reduced the composite outcome of intubation or death within 30 days; high-flow nasal oxygenation was not associated with better outcomes.

 

Commentary on Twitter

 

M-A: Convalescent plasma does not reduce mortality in COVID-19.

21 Nov, 2021 | 23:09h | UTC

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials – BMC Infectious Diseases

Related:

RCT: Another study shows convalescent plasma does not improve outcomes in critically ill patients with Covid-19.

RCT: Convalescent plasma does not improve outcomes and may be harmful to hospitalized patients with COVID-19.

NIH study shows no significant benefit of convalescent plasma for COVID-19 outpatients with early symptoms.

M-A: Convalescent plasma is safe but does not improve outcomes in the treatment of COVID-19.

RECOVERY Trial: No benefit from convalescent plasma in patients admitted to hospital with COVID-19.

 

Clinical Guideline Highlights for the Hospitalist: Management of Upper Gastrointestinal and Ulcer Bleeding.

21 Nov, 2021 | 22:44h | UTC

Clinical Guideline Highlights for the Hospitalist: Management of Upper Gastrointestinal and Ulcer Bleeding – Journal of Hospital Medicine (free for a limited period)

Original Guideline: ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding – RBC transfusion at a threshold of 7 g/dL; Erythromycin infusion is suggested before endoscopy; and endoscopy is suggested within 24 hours after presentation.

 

RECOVERY Trial: Aspirin as an add-on therapy did not reduce mortality in patients hospitalized with COVID-19.

19 Nov, 2021 | 11:01h | UTC

Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial – The Lancet

Invited Commentary: Studying the coagulopathy of COVID-19 – The Lancet

 

Commentary from the author on Twitter (thread – click for more)

 

Consensus and expert recommendations: basic ultrasound head-to-toe skills for intensivists in the general and neuro intensive care unit population.

19 Nov, 2021 | 10:37h | UTC

Basic ultrasound head-to-toe skills for intensivists in the general and neuro intensive care unit population: consensus and expert recommendations of the European Society of Intensive Care Medicine

 

Commentary on Twitter

 

[Preprint] M-A: Inhaled corticosteroids in COVID-19 outpatients.

18 Nov, 2021 | 08:48h | UTC

Inhaled Corticosteroids for Outpatients with Covid-19: A Meta-Analysis – medRxiv

Commentary: Favourable meta-analysis of inhaled corticosteroids in COVID-19 outpatients – News Medical

Related:

PRINCIPLE RCT: Inhaled budesonide improves time to recovery from COVID-19 in people at high risk of complications in the community.

Position Paper: Recommendations for the use of topical inhalant budesonide in COVID-19.

RCT: Inhaled budesonide shortens recovery time in non-hospitalized patients with COVID-19

Phase 2 RCT: Inhaled budesonide shows promise for the treatment of early COVID-19

 

Commentary on Twitter

 

Editorial: Twenty recommendations to individualize interventions in the early resuscitation of patients with sepsis.

18 Nov, 2021 | 08:38h | UTC

Twenty recommendations to individualize interventions in the early resuscitation of patients with sepsis – Critical Care

Related: Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.

 

Demystifying the EEG report for intensivists.

18 Nov, 2021 | 08:36h | UTC

Demystifying the EEG Report – NeuroEMCrit

 

RCT: Intravenous immunoglobulins do not improve outcomes in patients with COVID-19-associated moderate-to-severe acute respiratory distress syndrome.

16 Nov, 2021 | 08:48h | UTC

Intravenous immunoglobulins in patients with COVID-19-associated moderate-to-severe acute respiratory distress syndrome (ICAR): multicentre, double-blind, placebo-controlled, phase 3 trial – The Lancet Respiratory Medicine

 

Commentary on Twitter

 

Review: Vaccine-induced immune thrombotic thrombocytopenia.

16 Nov, 2021 | 08:46h | UTC

Vaccine-induced immune thrombotic thrombocytopenia – The Lancet Haematology

Related:

Vaccine induced immune thrombocytopenia and thrombosis: summary of NICE guidance.

Clinical features of vaccine-induced immune thrombocytopenia and thrombosis.

Review: Clinical characteristics and pharmacological management of COVID-19 vaccine–induced immune thrombotic thrombocytopenia with cerebral venous sinus thrombosis.

Vaccine-induced immune thrombotic thrombocytopenia: what we know and do not know.

Very rare cases of thrombosis with thrombocytopenia syndrome (TTS) after AstraZeneca vaccine: a global safety database analysis – the estimated rate of TTS after the first dose was 8.1 per million vaccinees; after the second dose, the estimated rate was 2.3 per million vaccinees. (several articles and resources on the subject)

 

Commentary on Twitter

 

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