EMCrit Project

Passive immunity refers to the infusion of antibodies (either polyclonal antibodies in the form of convalescent plasma, or engineered monoclonal antibodies).  The goal is to neutralize viral particles, reduce viral replication, and thereby improve clinical outcomes.  This is a promising theory, but it requires evidentiary support in the form of randomized controlled trials.  So far, […]

The REMAP-CAP trial recently detected mortality benefit from tocilizumab in patients with COVID-19.  However, several other RCTs have failed to find substantial benefit from tocilizumab.  This begs the question:  Has REMAP-CAP discovered a uniquely beneficial way to use tocilizumab, or is this simply a statistical outlier?   evidence roundup:  RCTs on tocilizumab Let’s review the trials.  […]

Purpura fulminans is a rare form of disseminated intravascular coagulation which requires specific management.  Most commonly it is seen as a complication of septic shock with multi-organ failure.  Unfortunately, purpura fulminans is often treated simply with a generic approach for septic shock. The IBCC chapter is located 👉 here. The podcast & comments are below. […]

Background:  JAK-inhibitors (jakinibs) in the greater context Much of the harm from infections is mediated by hyperactive inflammatory reactions.  To date, most research has focused on two classes of medications to treat this: Corticosteroids have the advantage of being cheap, widely available, and often effective.  The disadvantage is that corticosteroids modulate innumerable molecular pathways, thereby […]

Oximetry is fundamental to critical care.  Consequently, even small biases in pulse oximetry measurements could have real clinical impact (especially when leveraged across innumerable measurements among thousands of patients).    Racial bias in pulse oximetry was the subject of two studies in 2005 and 2007.  The topic was then largely ignored over the past 13 years.  […]