PulmCrit (EMCrit)

Prognostication is tough.  The challenge is often not that we have too little data, but rather that we have too much data.  There are now about two dozen risk factors for poor outcomes with COVID-19.  How are we supposed to integrate all these bits of information at the bedside?  Which pieces of information are redundant […]

The story began in early March.  With COVID-19 bearing down upon us, it became clear that we could run out of ventilators.  This sparked interest in the concept of splitting ventilators between several patients.  Some articles and videos were circulated on twitter describing how this could be done.  These mostly described splitting a ventilator set […]

A lot has happened since the last post on Lopinavir/Ritonavir (it was only March 4, but it seems like a year ago).  Here is a quick reminder of where we left off:  Lopinavir/ritonavir (tradename KALETRA) is a combination of protease inhibitors used in HIV, which might also be effective in COVID-19. Prior studies on SARS […]

COVID-19 patients seem to behave in a somewhat unique fashion, compared to other patients with ARDS.  This isn’t based on high-level data, but it seems to be a theme emerging from a variety of centers (including my experience with one patient).  Some salient points are: Low driving pressures are seen among ventilated patients.  Thus, it […]

COVID-19 might out-strip the number of mechanical ventilators available to us.  This has led to interest in using a single ventilator to support multiple patients.  This post will review the theory and evidence regarding this (with the admission that I don’t have experience with this). basic principles Bedrock principle:  Patient-Ventilator Independence Normally, we adjust the […]