PulmCrit (EMCrit)

the battle between the ivory tower academics vs. the rogue cowboys An internecine war is brewing about the treatment of COVID-19.  You can hardly open up a journal or look at social media without getting caught in the cross-fire. The cause of the schism is pretty simple.  There are no proven treatments for COVID-19.  Based […]

We’re beginning to start to see some information about lung pathology due to COVID-19.  But before jumping into that, a little background… background: lung pathology, DAD, and AFOP Lung pathology & treatment:  the bigger picture In an ideal world, different insults to the lung would cause specific histologic patterns.  These patterns would be related to […]

Currently, three publications are available describing coronavirus outcomes among hospitalized patients in New York: Goyal et al:  393 patients at Cornell. Cummings et al:  described 257 patients who were critically ill (among a total of 1,150 patients at Columbia and a community affiliate). Richardson et al:  5700 patients at Northwell Health System (including North Shore […]

Guideline recommendations on steroid use in COVID are contradictory.  For example, the Surviving Sepsis Campaign recommends steroid for intubated patients with COVID and ARDS,​1​ whereas the IDSA guidelines recommend that steroid should be restricted to randomized controlled trials.  Reviewing these documents shows that they often lean on data from influenza and MERS, which may not […]

In the past few weeks, there has been considerable debate regarding whether or not early COVID respiratory failure is ARDS.  This is a linguistic mess, but it has real implications for treatment.  So, it’s worth trying to sort it out… definition(s) of ARDS When clinicians use the term “ARDS” they are referring to a variety […]