PulmCrit (EMCrit)

The closed mouth catches no flies Benjamin Franklin, Poor Richard’s Almanac, 1742 We’re hopefully nearing the end of the COVID pandemic, with vaccines coming soon.  Unfortunately, vaccines won’t be able to bail us out this winter.  Neither will fancy designer pharmaceuticals.  The main interventions necessary to keep us safe for now are basic public health […]

2020 has been a weird year by any standard.  So, I shouldn’t be surprised that the bamlanivimab story is so weird.  But still.  Anyhow, if you’re ready to go down the rabbit hole, here we go… derivation and early testing The story begins with Eli Lilly designing a monoclonal anti-spike antibody to neutralize COVID-19. The […]

We are continually tasked with triaging COVID patients, a situation which will become more complex as the numbers continue to rise.  This involves making educated guesses about which patients are most likely to deteriorate, and which patients may benefit most from critical care.  That’s enormously difficult. At this point, we’re quite familiar with individual risk […]

background:  what is heparin resistance? Heparin works by binding to antithrombin III and thereby activating antithrombin III, an endogenous anticoagulant which inhibits clotting factors (especially Xa).  Heparin + Anti-thrombin III → [Heparin-Antithrombin-III complex] → Inhibition of Xa activity Heparin resistance refers to situations where unusually large doses of heparin are required to achieve anticoagulation.  This […]

When I saw the infographic for the DAMASK trial (below), it was immediately clear to me that the trial was inconclusive (not positive, not negative – inconclusive). According to this study, masks might be totally worthless. Or masks might reduce infection by ~40%. This is an inconclusive study. It yields no answer.