PulmCrit (EMCrit)

Takotsubo’s cardiomyopathy may be perceived as a zebra, but it is extremely common in the ICU (as a secondary consequence of endogenous stress and exogenous catecholamines).  With increasing recognition, Takotsubo cardiomyopathy is also noted to underlie ~1-2% of patients presenting with chest pain and a similar fraction of cath lab activations. The IBCC chapter is […]

So, Gilead’s first RCT on remdesivir was just published, and it’s very interesting.​1​  Gilead’s, you say?  Yep.  The study was designed, monitored, analyzed, and written by Gilead:  Before getting into the study, let’s take a moment and think about what Gilead’s first RCT could look like.  Gilead knows more about remdesivir than anyone (they built […]

Anticoagulation is ubiquitous in critical care.  Considering the use of DVT prophylaxis, the majority of critically ill patients will receive some form of anticoagulation during their ICU stay.  Anticoagulants are potentially high-risk medications, with relatively narrow therapeutic windows.  Thus, it’s important to understand the pharmacology of various agents to select and monitor anticoagulation optimally. The […]

The basics often aren’t exciting, but it’s important to get them right.  DVT prophylaxis is a good example of this.  Most critically ill patients will receive DVT prophylaxis at some point during their ICU stay (that’s 5 million patients per year in the United States alone).  Thus, even minor tweaks in the optimal treatment for […]

The preliminary report of the Adaptive COVID-19 Treatment Trial (ACTT-1), a multi-center, placebo-controlled RCT on remdesivir is here!​1​  The one we’ve all been waiting for!  Patients Patients were recruited from 60 sites in several countries.  Inclusion criteria were patients who were hospitalized due to COVID-19 with evidence of lower respiratory tract infection, defined in terms […]