PulmCrit (EMCrit)

One of the most controversial issues regarding management of COVID-19 is the appropriate dosing of anticoagulation.  It’s universally agreed upon that patients with COVID-19 should receive some dose of anticoagulation (at least prophylaxis), barring contraindications.  However, the optimal dose is unclear.  Numerous reports indicate that patients with COVID-19 have high rates of venous thromboembolic disease, […]

During this epoch of COVID-19, it might be nice to take a little breather and have an angry argument about a different topic – vitamin C!  Where were we?  The last chapter of this story was the VITAMINS trial, which found no benefit from vitamin C.​1​  However, critics of this trial suggested that patients were […]

Recently, many on twitter have been engaged in a furious debate about how to ventilate patients with COVID-19.  Is it ARDS or not?  High PEEP or low PEEP?…  As an intensivist, these issues are near and dear to my heart.  However, the truth is that humble methods to keep patients off invasive ventilation altogether are […]

There has been considerable speculation in the literature regarding the physiology of intubated patients with COVID, but little actual data.  A fresh study describing the physiology of intubated patients at Massachusetts General Hospital and Beth Israel offers to finally answer some questions.  This is a retrospective case series involving 66 patients intubated during March 11-30.  […]

Remdesivir is being promoted as an anti-viral agent for the treatment of COVID-19.  The first randomized, blinded, placebo-controlled trial of remdesivir was just released (Wang et al.).  But before we dig into this trial, a little background… Background:  Animal studies on Remdesivir Remdesivir is an anti-viral agent with strong efficacy against COVID-19 both in vitro […]