If you put it in, you need to be able to take it out.
Search Results for: COVID-19
PulmCrit – I’m so confused about bamlanivimab
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 […]
PulmCrit – Heparin resistance in COVID & implications for DVT prophylaxis
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 […]
PulmCrit- Virus Wars: Return of Lopinavir/Ritonavir (along with ribavirin and interferon)
Background Where were we with the Lopinavir/Ritonavir story? Let’s backtrack for a moment. Lopinavir/Ritonavir showed some efficacy against SARS, but as triple therapy in combination with ribavirin. A while ago, some studies tested lopinavir/ritonavir alone against COVID-19 and this didn’t work. Consequently, that was set aside for a while. However, there were lingering questions about […]
PulmCrit – Understanding happy hypoxemia physiology: how COVID taught me to treat pneumococcus
Happy hypoxemia is severe hypoxemia (poorly responsive to supplemental oxygen) without dyspnea. This isn’t anything especially new – we have occasionally seen this since time immemorial. However, COVID is causing us to re-think how to manage this physiology. understanding the paradox of happy hypoxemia The key to understanding this is thinking about oxygenation and CO2 […]
PulmCrit – Hydroxychloroquine fails first meaningful RCT
Hydroxychloroquine has been a highly controversial potential treatment for COVID-19. To date, available evidence has consisted of in vitro data as well as some heavily flawed studies from France. A new pre-print from China offers the most meaningful investigation of hydroxychloroquine to date. design Tang et al. is a multi-center, open-label RCT involving administration of […]
PulmCrit- Is Lopinavir/Ritonavir down and out?
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 […]
PulmCrit Wee – Some take-home messages about the COVID experience in New York
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 […]
EMCrit 277 – COVID Pulmonary Physiology with Martin Tobin
COVID Pulmonary Physiology
IBCC chapter & cast: Guillain-Barre Syndrome
Guillain-Barre Syndrome is the most common cause of acute-onset neuromuscular weakness requiring ICU admission. COVID-19 appears to be one trigger of Guillain-Barre Syndrome, so this might be even more common in the coming months. There isn’t much high-quality evidence regarding respiratory support in Guillain-Barre Syndrome, particularly when intubation is indicated. Consequently, it’s important to use […]
IBCC chapter & cast – Sedation for the intubated patient
Sedation is one of the details of ICU care which seems unimportant… until it’s not. Over the past decade we’ve seen a burgeoning repertoire of agents used for sedation and agitated delirium. Unfortunately, the number of medications has out-stripped available Level-I evidence regarding how exactly to use them. This chapter attempts to create a framework […]
How should we manage COVID DIC??
This is a comments/discussion page for folks to weigh in on how they are managing COVID-19 DIC. The section in the IBCC discussing this can be found here. Whenever possible, please cite relevant literature and list your name/affiliation. Thanks for sharing your insights!
PulmCrit wee – Why the SCCM/AARC/ASA/APSF/AACN/CHEST joint statement on split ventilators is wrong.
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 […]
IBCC chapter & cast – Sickle Cell Acute Chest Syndrome
Sickle cell disease affects 100,000 people in the United States and far more internationally. One of the most dangerous manifestations of the disease is acute chest syndrome, which involves a vicious cycle of erythrocyte sickling and respiratory failure. Acute chest syndrome can be a presenting feature upon hospital admission, it can arise as a complication […]
EMCrit 335 – APRV TCAV for Lung Rescue Made Simple with Rory Spiegel
Every Resus doc should be able to crash a patient on to APRV for lung rescue…
- « Previous Page
- 1
- 2
- 3
- 4
- 5
- 6
- …
- 8
- Next Page »