Initially I wasn't planning to write a chapter on influenza, because there is precious little evidence regarding ICU management. However, even in the absence of solid evidence, we will be called upon to treat these patients. Currently flu season is afoot, and it looks like it might be a bad one (with a predominance of H1N1 and some younger patients already presenting with ARDS). This chapter explores what little is known about the optimal management of ICU-grade influenza.
A new set of IDSA guidelines on influenza was just released a couple weeks ago. These guidelines are incorporated into the chapter. Unfortunately even these cutting-edge, evidence-based guidelines leave a lot of grey areas with regards to ICU management.
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The IBCC chapter is located here.
- The podcast & comments are below.
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What is your threshold to begin VV ecmo.
Does that threshold change when you’re in an institution that has Ecmo capability, versus not. At what point should those of us who don’t have ECMO get on the phone with an institution that does for transfer ecmo?
Love the post.
Just wanted to point out that the reference:
29. Fowler I, Kim C, Lepler L, et al. Intravenous vitamin C as adjunctive therapy for enterovirus/rhinovirus induced acute respiratory distress syndrome. World J Crit Care Med. 2017;6(1):85-90. [PubMed]
This is referred to as an RCT but reading the abstract it looks like a case report.