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Critical Care & Emergencies (all articles)

RCT: In patients with severe Covid-19, high-flow oxygen therapy reduced the likelihood of invasive mechanical ventilation and decreased the time to clinical recovery compared to conventional oxygen therapy.

8 Dec, 2021 | 10:15h | UTC

Effect of High-Flow Oxygen Therapy vs Conventional Oxygen Therapy on Invasive Mechanical Ventilation and Clinical Recovery in Patients With Severe COVID-19: A Randomized Clinical Trial – JAMA

Related:

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”.

[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.

 

Raising awareness for time-limited trial discussion upon ICU triage and admission.

8 Dec, 2021 | 09:57h | UTC

Raising awareness for time-limited trial discussion upon ICU triage and admission – Intensive Care Medicine (if the link is paywalled, try this one)

 

Commentary on Twitter

 

Case series with 139 adolescents and young adults with suspected myocarditis following mRNA vaccination showed most cases had a mild clinical course and rapid resolution of symptoms.

7 Dec, 2021 | 10:19h | UTC

Clinically Suspected Myocarditis Temporally Related to COVID-19 Vaccination in Adolescents and Young Adults – Circulation

News Release: Young people recover quickly from rare myocarditis side effect of COVID-19 vaccine – American Heart Association

 

The risk of postoperative complications following major elective surgery in active or resolved COVID-19 in the United States – Major, elective surgery 0–4 weeks after Covid-19 is associated with greatly increased risk of postoperative complications; surgery performed 4–8 weeks after infection is still associated with an increased risk of pneumonia.

7 Dec, 2021 | 10:23h | UTC

The Risk of Postoperative Complications following Major Elective Surgery in Active or Resolved COVID-19 in the United States – Annals of Surgery

Related:

Guideline: SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery

Study from 116 countries suggests surgery should be delayed for at least seven weeks following a COVID-19 diagnosis to reduce mortality risk

ASA Guidance: Preoperative testing for COVID-19 is essential, regardless of vaccination.

Position statement: Perioperative management of post-COVID-19 surgical patients.

Cohort study: Postoperative in-hospital mortality of patients with COVID-19 infection was more than double that in patients without COVID-19

 

Care of older people and people requiring palliative care with COVID-19: guidance from the Australian National COVID-19 Clinical Evidence Taskforce.

7 Dec, 2021 | 10:12h | UTC

Care of older people and people requiring palliative care with COVID-19: guidance from the Australian National COVID-19 Clinical Evidence Taskforce – Medical Journal of Australia

 

IDSA Guidance on the Treatment of AmpC β-lactamase-Producing Enterobacterales, Carbapenem-Resistant Acinetobacter baumannii, and Stenotrophomonas maltophilia Infections.

7 Dec, 2021 | 08:49h | UTC

Infectious Diseases Society of America Guidance on the Treatment of AmpC β-lactamase-Producing Enterobacterales, Carbapenem-Resistant Acinetobacter baumannii, and Stenotrophomonas maltophilia Infections – Clinical Infectious Diseases

 

S2k guideline: diagnosis and treatment of carbon monoxide poisoning.

7 Dec, 2021 | 08:48h | UTC

S2k guideline diagnosis and treatment of carbon monoxide poisoning – German Medical Science

 

Clinical Review: Management of pneumonia in critically ill patients.

7 Dec, 2021 | 08:41h | UTC

Management of pneumonia in critically ill patients – The BMJ

 

Randomized clinical trials in critical care: past, present and future.

3 Dec, 2021 | 10:10h | UTC

Randomised clinical trials in critical care: past, present and future – Intensive Care Medicine

 

Commentary on Twitter

 

Retrospective Cohort Study: Except for Rituximab, most immunosuppressive medicines were not associated with increased risk of mechanical ventilation or death in patients hospitalized with Covid-19.

2 Dec, 2021 | 10:07h | UTC

Long-term use of immunosuppressive medicines and in-hospital COVID-19 outcomes: a retrospective cohort study using data from the National COVID Cohort Collaborative – The Lancet Rheumatology

Commentaries:

What does endemic COVID-19 mean for the future of rituximab? – The Lancet Rheumatology

Outcomes for hospitalized COVID-19 patients taking immunosuppressive medications similar to non-immunosuppressed patients, study finds – Johns Hopkins University Bloomberg School of Public Health

Study: Immune-suppressed not at higher risk of poor COVID outcomes – CIDRAP

 

Commentary on Twitter

 

Fluvoxamine for the early treatment of SARS-CoV-2 Infection: a review of current evidence.

2 Dec, 2021 | 10:04h | UTC

Fluvoxamine for the Early Treatment of SARS-CoV-2 Infection: A Review of Current Evidence – Drugs

Related:

RCT: Early treatment with fluvoxamine reduced the risk of emergency care and hospitalization among patients with COVID-19.

[Preprint] RCT: Fluvoxamine reduced the risk for ER visits and hospitalization among patients with Covid-19.

Opinion | Could this be our first effective, inexpensive, widely available outpatient treatment for COVID-19? (It’s fluvoxamine).

Preliminary study shows fluvoxamine may reduce clinical deterioration in outpatients with symptomatic COVID-19

 

Complete countrywide mortality in COVID patients receiving ECMO in Germany throughout the first three waves of the pandemic.

1 Dec, 2021 | 09:52h | UTC

Complete countrywide mortality in COVID patients receiving ECMO in Germany throughout the first three waves of the pandemic – Critical Care

 

FDA panel narrowly recommends authorization of first antiviral pill to treat COVID.

1 Dec, 2021 | 09:56h | UTC

FDA panel narrowly recommends authorization of first antiviral pill to treat COVID – STAT

See also: An FDA panel supports Merck COVID drug in mixed vote – NPR

Related:

[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%.

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.

 

Using wearable data, a real-time alerting system can be used for the early detection of Covid-19 and other stress events.

1 Dec, 2021 | 09:59h | UTC

Real-time alerting system for COVID-19 and other stress events using wearable data – Nature Medicine

Commentary: Scientists develop a smartwatch-based device for early detection of COVID-19 – News Medical

 

Commentary on Twitter

 

Another randomized trial showed convalescent plasma does not benefit patients hospitalized with Covid-19.

1 Dec, 2021 | 09:49h | UTC

Effect of High-Titer Convalescent Plasma on Progression to Severe Respiratory Failure or Death in Hospitalized Patients With COVID-19 Pneumonia: A Randomized Clinical Trial – JAMA Network Open

Related:

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

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.

 

Commentary on Twitter

 

RCT: Intravenous or intraosseous calcium does not improve the return of spontaneous circulation in adults with out-of-hospital cardiac arrest.

1 Dec, 2021 | 08:46h | UTC

Effect of Intravenous or Intraosseous Calcium vs Saline on Return of Spontaneous Circulation in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial – JAMA

 

Commentary on Twitter

https://twitter.com/expensivecare/status/1465778134632972290

 

M-A: Efficacy of non-invasive and invasive respiratory management strategies in adult patients with acute hypoxemic respiratory failure.

1 Dec, 2021 | 08:44h | UTC

Efficacy of non-invasive and invasive respiratory management strategies in adult patients with acute hypoxaemic respiratory failure: a systematic review and network meta-analysis – Critical Care

 

RCT: Small caliber 14-Fr percutaneous catheters (pigtail) were as effective as 28- to 32-Fr chest tubes in their ability to drain traumatic hemothorax with no difference in complications.

30 Nov, 2021 | 10:11h | UTC

The small (14 Fr) percutaneous catheter (P-CAT) versus large (28–32 Fr) open chest tube for traumatic hemothorax: A multicenter randomized clinical trial – Trauma and Acute Care Surgery (link to abstract – $ for full-text)

 

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

 

Transient Ischemic Attack: Emergency Department Evaluation and Disposition.

30 Nov, 2021 | 09:56h | UTC

TIA: Emergency Department Evaluation and Disposition – emDocs

Related:

AHA/ASA Guideline: Prevention of stroke in patients with previous stroke and transient ischemic attack – prevention efforts should be based on the cause of the first ischemic event.

Stroke and transient ischaemic attack in over 16s: diagnosis and initial management – National Institute for Health and Care Excellence

Canadian Stroke Best Practice Recommendations for Acute Stroke Management

Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke – The BMJ

2 recent meta-analysis highlight the benefits of short term (30 days) dual antiplatelet therapy with aspirin + clopidogrel in patients within 24 hours of high-risk transient ischemic attack or mild-moderate ischemic stroke.

Prospective validation of Canadian TIA Score for subsequent stroke risk after transient ischemic attack

Systematic review: Multiple vs. fewer antiplatelet agents for preventing early recurrence after ischemic stroke or transient ischemic attack

 

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

 

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