Critical Care & Emergencies (all articles)
Mucormycosis: The ‘black fungus’ maiming Covid patients in India
11 May, 2021 | 09:14h | UTCMucormycosis: The ‘black fungus’ maiming Covid patients in India – BBC
See also: Potentially fatal ‘black fungus’ infections on the rise in India’s COVID-19 patients – LiveScience AND A potentially fatal fungal infection is cropping up among India’s Covid patients. – The New York Times AND WHO says virus strain in India a ‘variant of concern’ as Europe eases curbs – MedicalXpress
Commentary on Twitter (thread – click for more)
Doctors in India are concerned about an increase in a highly fatal fungal infection affecting cases & recently recovered from #COVID19. Mucormycosis, is a mold that attacks the respiratory tract, potentially eroding facial structures & harming the brain.🧵https://t.co/1rHU2nM346
— Eric Feigl-Ding (@DrEricDing) May 10, 2021
Observational study suggests an early head‐to‐pelvis computed tomography can expedite the diagnosis of potential causes in patients with out‐of‐hospital circulatory arrest without obvious etiology
11 May, 2021 | 09:10h | UTCEarly head‐to‐pelvis computed tomography in out‐of‐hospital circulatory arrest without obvious etiology – Academic Emergency Medicine (link to abstract – $ for full-text)
Commentary: Early Head-to-Pelvis CT for OHCA – Journal Feed
New WHO Online Course: Initial approach to the acutely ill patient with COVID-19.
10 May, 2021 | 01:21h | UTC
A restrictive fluid management strategy shows promise for acute kidney injury in a pilot randomized controlled trial.
10 May, 2021 | 00:57h | UTC
Commentary on Twitter
REVERSE-AKI restrictive fluid management vs usual care among critically ill pts with #AKI (proper initial fluid resus), multicenter feasibility RCT:
restriction? ⬇️cumulative fluid balance#RRT ➡️13% vs 30%
diuretics ↔️
usual care? ⬆️adverse events#FOAMcc https://t.co/JdKDo1XeIf pic.twitter.com/P1sOCHjkCS— Intensive Care Medicine (@yourICM) May 7, 2021
Guideline: Diagnosis and treatment of neurogenic dysphagia.
6 May, 2021 | 08:51h | UTC
Cohort study: Increased risk in suicide and self-harm in adult survivors of critical illness.
6 May, 2021 | 08:44h | UTCCommentary: ICU admission linked to increased risk of future suicide and self-harm – The BMJ
Commentary on Twitter
Survivors of critical illness have increased risk of suicide and self-harm, and these outcomes were associated with pre-existing psychiatric illness and receipt of invasive life support, concludes new study @shanfernands https://t.co/WOHBAdnBWK
— The BMJ (@bmj_latest) May 5, 2021
ATS Guideline: Nucleic acid–based testing for noninfluenza viral pathogens in adults with suspected community-acquired pneumonia – Testing should be considered only in patients with severe CAP and in immunocompromised patients
5 May, 2021 | 08:28h | UTCNews Release: New clinical practice guideline on community acquired pneumonia – American Thoracic Society
Opinion | Manual in‐line stabilization during tracheal intubation: effective protection or harmful dogma?
5 May, 2021 | 08:18h | UTC
M-A: Prone positioning of nonintubated patients with Covid-19 improve oxygenation variables without any reported serious adverse events – randomized trials with patient-relevant outcomes such as the need for intubation or mortality rates are required
4 May, 2021 | 08:52h | UTCProne Positioning of Nonintubated Patients With Coronavirus Disease 2019—A Systematic Review and Meta-Analysis – Critical Care Medicine (link to abstract – $ for full-text)
[Preprint] Preventing disproportionate mortality in ICU overload situations: Empirical evidence from the first COVID-19 wave in Europe – “transferring patients proactively out of developing hotspots to less affected regions, well before high ICU workload situations emerge, will improve patient outcomes”
4 May, 2021 | 08:42h | UTC
ISCHEMIA trial – days alive out of hospital endpoint was higher in the conservative management group vs. invasive management group at 1 month (30.8 vs 28.4 days), 1 year (362.2 vs 355.9 days), and 2 years (718.4 vs 712.1 days)
4 May, 2021 | 08:41h | UTCComparison of Days Alive Out of Hospital With Initial Invasive vs Conservative Management: A Prespecified Analysis of the ISCHEMIA Trial – JAMA Cardiology (free for a limited period)
Original study: ISCHEMIA Trial: Health-Status Outcomes with Initial Invasive vs. Conservative Care in Stable Coronary Disease AND ISCHEMIA Trial: Initial Invasive vs. Conservative Strategy for Stable Coronary Disease AND ISCHEMIA Trial: Health Status after Invasive or Conservative Care in Coronary and Advanced Kidney Disease AND ISCHEMIA Trial: Management of Coronary Disease in Patients with Advanced Kidney Disease
Study: Most patients who develop a non-IgE-mediated hypersensitivity reaction to nafcillin can be safely treated with cefazolin
4 May, 2021 | 08:36h | UTC
Commentary on Twitter
New case series found 90% tolerated switching to cefazolin out of 80 patients who experienced non-IgE hypersensitivity reactions to nafcillin.https://t.co/YbFeWS4n4k
Our previous metas-analysis https://t.co/sJBjrx4a3r found higher odds of these reactions with nafcillin. pic.twitter.com/SIWcSuPcct— Antibiotic Tweets (@khalideljaaly) April 28, 2021
M-A: Tocilizumab reduces the need for mechanical ventilation in COVID-19 patients, but the randomized trials included in the analysis showed it has no significant effect on the risk of mortality or adverse events
3 May, 2021 | 05:44h | UTC
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
3 May, 2021 | 05:47h | UTCInvited commentary: Tocilizumab in COVID-19: some clarity amid controversy – The Lancet
Case series of 12 patients with cerebral venous sinus thrombosis with thrombocytopenia after Ad26.COV2.S vaccination – all women younger than 60 years, with symptoms from 6 to 15 days after vaccination
3 May, 2021 | 05:43h | UTCSee also: Safety Monitoring of the Janssen (Johnson & Johnson) COVID-19 Vaccine — United States, March–April 2021 – Centers for Disease Control and Prevention AND Updated Recommendations from the Advisory Committee on Immunization Practices for Use of the Janssen (Johnson & Johnson) COVID-19 Vaccine After Reports of Thrombosis with Thrombocytopenia Syndrome Among Vaccine Recipients — United States, April 2021 – Centers for Disease Control and Prevention
Study: Patients with heart failure have a much higher incidence of pneumonia than matched individuals in the population. The development of pneumonia in these patients is associated with a 3- to 4-fold higher risk of cardiovascular and all-cause death.
3 May, 2021 | 05:18h | UTCCommentaries: Pneumonia in HF Patients Is Common, Lethal, and Preventable – TCTMD AND Outcomes of Pneumonia in Patients With Heart Failure – American College of Cardiology
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.
3 May, 2021 | 05:27h | UTC
ACG Clinical Guideline: Diagnosis and Management of Idiosyncratic Drug-Induced Liver Injury – antimicrobials, herbal and dietary supplements, and anticancer therapeutics are the most common classes of agents
3 May, 2021 | 05:22h | UTC
M-A: Delayed antibiotic prescribing for respiratory tract infections is a safe and effective strategy for most patients
30 Apr, 2021 | 08:33h | UTCCommentaries: Delayed Antibiotic Prescribing Safe for Respiratory Tract Infection – HealthDay
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.”
30 Apr, 2021 | 08:25h | UTCNews release: Guidance on treatment for rare blood clots and low platelets related to COVID-19 vaccine – American Heart Association
Study with 6.9 million people in England shows severe Covid-19 in young people can mostly be explained by obesity – At a BMI of more than 23 kg/m2, there was a linear increase in risk of severe COVID-19
30 Apr, 2021 | 08:22h | UTCCommentaries: Severe COVID in young people can mostly be explained by obesity – new study – The Conversation AND Obesity studies highlight severe COVID outcomes, even in young adults – CIDRAP AND Expert reaction to study looking at a potential link between body weight and risk of severe COVID-19, especially for younger adults – Science Media Centre
Commentary on Twitter (thread – click for more)
NEW—Study of health records of nearly 7 million people in England found that the risk of worse outcomes from #COVID19 starts rising in people with a BMI above 23kg/m2—considered to be in the healthy range.
Read in @TheLancetEndo: https://t.co/5ibn3yb1xO 1/2 pic.twitter.com/4MwnGq95Sz
— The Lancet (@TheLancet) April 29, 2021
Review: COVID-19-associated coagulopathy and antithrombotic agents – In non-critically ill hospitalized patients, therapeutic dose anticoagulation may improve clinical outcomes. In critically ill patients, this same treatment does not improve outcomes, and prophylactic dose anticoagulation is recommended
29 Apr, 2021 | 08:46h | UTCRelated: Full-dose Heparin best for moderate COVID-19 regardless of D-dimer — Data released from ACTIV-4a, ATTACC, and REMAP-CAP trials AND RCT: Intermediate-dose enoxaparin (1 mg/kg/d) not better than standard-dose prophylactic anticoagulation in patients with Covid-19 admitted to the intensive care unit
Commentary on Twitter
🆕💥💥State of the Art Review Article @TheLancetHaem by @MiddeldorpS
COVID-19-associated coagulopathy
Excellent explanation for the pathophysiology and great summary for the major RCTs and clinical guidelines https://t.co/NxP06KP2Hm pic.twitter.com/qHzyDsUZpt— Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 (@ABsteward) April 28, 2021
Ethics Commission Position Statement: Admission criteria and management of critical care patients in a pandemic context – “Age cannot be used as the sole criterion for admission nor denial of access to ICU settings”
29 Apr, 2021 | 08:36h | UTC
ACP Guideline: Appropriate Use of High-Flow Nasal Oxygen in Hospitalized Patients – “use high-flow nasal oxygen rather than noninvasive ventilation in hospitalized adults for the management of acute hypoxemic respiratory failure”
29 Apr, 2021 | 08:34h | UTC
M-A: Administration of vasopressor medications through a peripheral intravenous catheter is associated with low risk of adverse events
29 Apr, 2021 | 08:19h | UTCRelated Meta-Analysis: Complication of vasopressor infusion through peripheral venous catheter (study and commentary on Twitter)