Critical Care
NICE COVID-19 rapid guideline: vaccine-induced immune thrombocytopenia and thrombosis.
30 Jul, 2021 | 12:14h | UTCNews release: NICE publishes new rapid guideline to diagnose and treat rare blood clotting condition associated with COVID-19 vaccination – National Institute for Health and Care Excellence
Related: 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)
Vaccine-induced immune thrombotic thrombocytopenia: what we know and do not know.
30 Jul, 2021 | 12:12h | UTCVaccine-induced immune thrombotic thrombocytopenia: what we know and do not know – Blood
Related: 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)
Observational study: Positive Fluid balance linked to worse outcomes in critically ill patients with traumatic brain injury.
1 Aug, 2021 | 23:57h | UTCFluid balance and outcome in critically ill patients with traumatic brain injury (CENTER-TBI and OzENTER-TBI): a prospective, multicentre, comparative effectiveness study – The Lancet Neurology (link to abstract – $ for full-text)
Commentary: Traumatic Brain Injury: Fluid Overload Tied to Higher Mortality in ICU Patients – Physician’s Weekly
Commentary on Twitter
Happy with our paper in @TheLancetNeuro on comparative effectiveness of fluid management strategies in TBI patients in the ICU. Successful example of treatment effect estimation in observational data. @CenterTBI @Menon_Cambridge @Dr_Cit @ESteyerberghttps://t.co/TMzhkd1SZz
— Hester Lingsma (@hesterlingsma) July 23, 2021
Risk of acute myocardial infarction and ischemic stroke following COVID-19 in Sweden – “the true risk is increased by between three and eight times for acute myocardial infarction and by between three and seven times for ischaemic stroke following COVID-19.”
30 Jul, 2021 | 12:06h | UTCInvited commentary: What is the association of COVID-19 with heart attacks and strokes? – The Lancet
Commentary on Twitter
Is Covid a risk factor for heart attack and stroke?https://t.co/6KRaKzPgI5 @TheLancet
This new paper says yes, but the absolute increased risk is small, and likely due to predisposition to clotting in the post-infection phase pic.twitter.com/HQjxo63Yby— Eric Topol (@EricTopol) July 29, 2021
Study: Recommended approaches to minimize aerosol dispersion of SARS-CoV-2 during noninvasive ventilatory support can cause ventilator performance deterioration.
30 Jul, 2021 | 11:59h | UTC
Brazilian Guidelines on Unstable Angina and Acute Myocardial Infarction without ST-Segment Elevation – 2021.
30 Jul, 2021 | 11:54h | UTC
Systematic review: no evidence to support the use of Ivermectin for treating or preventing COVID-19.
29 Jul, 2021 | 11:38h | UTCIvermectin for preventing and treating COVID‐19 – Cochrane Library
Summary: Ivermectin for preventing and treating COVID-19 – Cochrane Library
Commentary: Ivermectin treatment in humans for COVID-19 – Liverpool School of Tropical Medicine
Related:
Why was a major study on ivermectin for covid-19 just retracted?
RCT: Ivermectin does not prevent hospitalizations in patients with COVID-19.
RCT: Ivermectin does not improve time to resolution of symptoms among adults with mild COVID-19
What’s new in intensive care: environmental sustainability.
30 Jul, 2021 | 11:32h | UTCWhat’s new in intensive care: environmental sustainability – Intensive Care Medicine
Evidence Analysis: Is piperacillin-tazobactam safe in patients with penicillin allergy?
29 Jul, 2021 | 11:05h | UTCIs piperacillin-tazobactam safe in patients with penicillin allergy? – PulmCrit
M-A: Global prevalence of turnover intention among intensive care nurses – “27% of the intensive care nurses had the intention to leave worldwide”.
29 Jul, 2021 | 11:07h | UTCGlobal prevalence of turnover intention among intensive care nurses: A meta-analysis – Nursing in Critical Care (link to abstract – $ for full-text)
Commentary on Twitter
Every fourth ICU nurse has the intention to leave, according to a meta-analysis incl 23,140 nurses from 23 countries in 18 studies (2007-2020), even higher in younger nurses.
Authors recommend social support, better working conditions, and evaluationshttps://t.co/f19iD0GLPL pic.twitter.com/NIM9nrVKiL— Peter Nydahl (@NydahlPeter) July 28, 2021
COVID-19 and mucormycosis superinfection: the perfect storm.
28 Jul, 2021 | 10:09h | UTCCOVID-19 and mucormycosis superinfection: the perfect storm – Infection
Related:
What is mucormycosis, the fungal infection affecting COVID patients in India?
[Preprint] The Emergence of COVID-19 Associated Mucormycosis: Analysis of Cases From 18 Countries.
Mucormycosis: The ‘black fungus’ maiming Covid patients in India
Global Guideline for the Diagnosis and Management of Mucormycosis
CDC Report: Transmission of pan-resistant Candida auris in health care facilities.
28 Jul, 2021 | 09:59h | UTCCommentaries:
CDC reports two outbreaks of pan-resistant Candida auris – CIDRAP
U.S. sees first cases of dangerous fungus resistant to all drugs in untreated people – STAT
Related:
Case reports: Multidrug-resistant Candida auris infections in critically ill Covid-19 patients
Candida auris: A Review of Recommendations for Detection and Control in Healthcare Settings
Global Epidemiology of Emerging Candida Auris (reviews and commentaries on the subject)
The superbug Candida auris is giving rise to warnings — and big questions – STAT
Candida Auris – “A Mysterious Infection, Spanning the Globe in a Climate of Secrecy” (reviews and commentaries on the subject)
Commentaries on Twitter
⛔Breaking⛔
For the 1st time ever, CDC researchers reported 5 cases of people carrying pan-resistant
Candida.auris "3 Washington,D.C.2:Texas" resistant to all classes of antifungal drugs none had been treated with antifungal drugs prior to the diagnosishttps://t.co/uzj6wGI6Ps— Antibiotic Steward ??? Bassam Ghanem (@ABsteward) July 22, 2021
Candida auris is a fungus that spreads easily and can cause dangerous infections. New evidence is emerging that cases of C. auris resistant to all classes of antifungal drugs are spreading in health care settings. Read the report: https://t.co/olhWJZM4r5. #Cauris pic.twitter.com/1MgMSLsKyc
— CDC (@CDCgov) July 23, 2021
M-A of randomized trials: Conservative oxygen therapy for critically ill patients.
28 Jul, 2021 | 09:41h | UTC
NICE Guideline | Clostridioides difficile infection: antimicrobial prescribing.
27 Jul, 2021 | 03:34h | UTCInfographic: Clostridioides difficile infection: antimicrobial prescribing
Related:
Review | My Treatment Approach to Clostridioides difficile Infection.
Review: Managing hyperglycemia in inpatients.
27 Jul, 2021 | 03:21h | UTCManaging hyperglycaemia in inpatients – Clinical Medicine Journal
[Preprint] RCT: In patients with COVID-19 and severe hypoxia, dexamethasone 12 mg did NOT result in statistically significant improved outcomes compared to dexamethasone 6 mg – “Mortality at 28 days was 27.1% and 32.3% in patients assigned to 12 mg and 6 mg, respectively (adjusted relative risk 0.86, 99% CI, 0.68-1.08)”.
26 Jul, 2021 | 03:01h | UTC
Large cohort study finds one in two hospitalized COVID-19 patients develop a complication.
26 Jul, 2021 | 03:00h | UTCCommentaries:
In-hospital complications associated with COVID-19 – The Lancet
CV Complications Common in Hospitalized COVID-19 Patients – TCTMD
Almost Half of Patients Admitted With COVID-19 Have Complications – HealthDay
Commentary on Twitter (thread – click for more)
NEW—An observational study of >70,000 people in the UK hospitalised with severe #COVID19 finds 1 in 2 developed at least one health complication. Authors warn of significant challenges for individuals and health & social care in the coming years.
? https://t.co/CTLsPJcGZ7 pic.twitter.com/voMEDVXO9U
— The Lancet (@TheLancet) July 15, 2021
Case report: Kawasaki-like multisystem inflammatory syndrome associated with SARS-CoV-2 infection in an adult.
26 Jul, 2021 | 02:52h | UTCRelated:
Case report: Multisystem inflammatory syndrome in an adult after SARS-CoV-2 infection.
Case series of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 infection
Case Reports: 2 Adults with Kawasaki-like Multisystem Inflammatory Syndrome Associated with COVID-19
Position paper: Advancing precision medicine for acute respiratory distress syndrome.
26 Jul, 2021 | 02:28h | UTCRelated:
Review: Personalized mechanical ventilation in acute respiratory distress syndrome.
Seminar | Acute respiratory distress syndrome.
ARDS: Contemporary management and novel approaches during COVID-19
Editorial | Antibiotic overuse: managing uncertainty and mitigating against overtreatment.
26 Jul, 2021 | 02:16h | UTCAntibiotic overuse: managing uncertainty and mitigating against overtreatment – BMJ Quality & Safety
Commentary on Twitter
Our editorial in @BMJ_Qual_Saf discusses uncertainty and antibiotic overuse, and identifies 4 strategies to address the tendency to prescribe 'just in case'. @EM_Krockow https://t.co/kvIG5uxxOL pic.twitter.com/eTIuqGOj1o
— Prof Carolyn Tarrant (@carolynctarrant) July 21, 2021
Review: Timing and completeness of revascularization in acute coronary syndromes.
26 Jul, 2021 | 02:21h | UTCTiming and completeness of revascularisation in acute coronary syndromes – Heart
Commentary on Twitter
Education: Timing and completeness of revascularisation in acute coronary syndromes https://t.co/VBQ76c3545 pic.twitter.com/tpNaZfhrxI
— Heart_BMJ (@Heart_BMJ) July 22, 2021
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