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Category: Crisis Management

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Letter to the Editor: Bias Due to Cohort Construction in the Study of Timing of Invasive Ventilation

From Critical Care Explorations. In this Letter to the Editor, the authors respond to an article by Dupuis et al., congratulating the contribution to the problem of identifying which patients with hypoxemic respiratory failure truly benefit from invasive ventilation and suggesting future studies of invasive ventilation consider using the target trial concept in order to minimize bias and maximize the clinical applicability of results.


Coronavirus Disease 2019–Associated PICU Admissions: A Report From the Society of Critical Care Medicine Discovery Network Viral Infection and Respiratory Illness Universal Study Registry

From Pediatric Critical Care Medicine. This study delineates significant clinically relevant differences in presentation, explanatory factors, and outcomes among children admitted to PICU with severe acute respiratory syndrome coronavirus 2–related illness stratified by multisystem inflammatory syndrome in children.


Post-Acute Sequelae of COVID-19 (PASC): What Can Be Done in and after the ICU to Lower the Risk of "Long COVID"?

This webinar panel discussed ways to mitigate the risk of post-acute sequelae of COVID-19 (PASC) in hospitalized COVID-19 patients. The panelists and attendees participated in an interactive discussion format with case presentations, polling, and given access to a downloadable infographic to use as a resource tool. The Society of Critical Care Medicine and the American Association of Respiratory Care partnered to produce this webinar on COVID-19. Webcast Recorded on Thursday, April 29, 2021


Which strategies have you found to be most useful in keeping patients off mechanical ventilation and out of the ICU?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on April 14th, 2021


How is it determined whether early intubation is a good strategy for a patient?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on April 14th, 2021


When should furosemide be used in COVID-19 patients? Some COVID-19 patients are presenting with diarrhea rather than respiratory symptoms. Is there any evidence-based treatment for this?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on April 14th, 2021


Many intubated COVID-19 patients are requiring renal replacement therapy. How is acute renal failure prevented in these patients?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on April 14th, 2021


Now that patients are being vaccinated, when ruling out COVID-19 in patients who might have pneumonia or pulmonary embolism, how should their vaccination status be taken into account?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on April 14th, 2021


What is the most appropriate practice for handling information about COVID-19 patients when talking with patients’ families?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on April 14th, 2021


When should a bacterial superinfection be suspected in COVID-19 patients?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on April 14th, 2021


Do you suggest encouraging families to delegate a single spokesperson for the family to receive information?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on April 14th, 2021


Characteristics, Comorbidities, Complications, and Outcomes Among 802 Patients With Severe Acute Respiratory Syndrome Coronavirus 2 in a Community Hospital in Florida

From Critical Care Explorations.  In this study, the authors reviewed the demographics, characteristics, comorbidities, complications, and outcomes of hospitalized patients with severe acute respiratory syndrome coronavirus 2, and their association with mortality at medical center in Orlando, Florida.


Timing of Intubation in Coronavirus Disease 2019: A Study of Ventilator Mechanics, Imaging, Findings, and Outcomes

From Critical Care Explorations  The authors sought to determine the variation in outcomes and respiratory mechanics between the subjects who are intubated earlier versus later in their coronavirus disease 2019 course.


Letter to the Editor: Cytokine Blockade in Coronavirus Disease 2019: Keeping an Open Mind

From Critical Care Explorations.  This Letter to the Editor was written in response to the article by Rizvi and Gallo De Moraes entitled “New Decade, Old Debate: Blocking the Cytokine Pathways in Infection-Induced Cytokine Cascade.”


A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients

From Critical Care Explorations.  In-hospital cardiac arrest survival among coronavirus disease 2019 patients has been reported to range from 0% to 12% -- significantly lower than reported prepandemic in-hospital cardiac arrest survival rates of approximately 20% to 25% in the United States for non–coronavirus disease 2019 patients. In this multi-center study, the authors report a 22% survival to discharge after in-hospital cardiac arrest in coronavirus disease 2019 patients, a survival rate similar with before the coronavirus disease 2019 pandemic.


A High Neutrophil-Lymphocyte Ratio Is Associated With Increased Morbidity and Mortality in Patients With Coronavirus Disease 2019

From Critical Care Explorations.  This study aimed to evaluate the prognostic potential of admission neutrophil-lymphocyte ratio in patients admitted to the medical ICU with coronavirus disease 2019. The authors concluded that the neutrophil-lymphocyte ratio at the time of hospital admission is an independent risk factor for morbidity and mortality. This prognostic indicator may assist clinicians appropriately identify patients at heightened risk for a severe disease course and tailor treatment accordingly.


Outcome Improvement Between the First Two Waves of the Coronavirus Disease 2019 Pandemic in a Single Tertiary-Care Hospital in Belgium

From Critical Care Explorations.  In this article, the authors note that the main therapeutic changes between the first wave of the coronavirus disease 2019 pandemic and the second wave of the coronavirus disease 2019 pandemic were use of steroids, unrestrictive use of high-flow nasal oxygen for hypoxemic patients, and transfer of patients to other geographic areas in the case of ICU overcrowding. They found that these changes were associated with a decrease in 30-day mortality, ICU admission, and organ support.


Letter to the Editor: Less Lumping and More Splitting: Why We Should Not Call COVID Sepsis

From Critical Care Medicine. This Letter to the Editor is in response to an editorial by Shappell et al. entitled “Does Severe Acute Respiratory Syndrome Coronavirus 2 Cause Sepsis?”


Increased Glucocorticoid Receptor Alpha Expression and Signaling in Critically Ill Coronavirus Disease 2019 Patients

From Critical Care Medicine. In this study, the authors found that ICU coronavirus disease 2019 patients showed upregulated glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper expression, along with cortisol levels, compared with ICU noncoronavirus disease 2019 patients. Thus, they concluded, on ICU admission, critical coronavirus disease 2019 appears to be associated with hypercortisolemia, and increased synthesis of glucocorticoid receptor alpha and induced proteins.


Editorial: Do Our Sedation Practices Contribute to Increased Mortality in Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome?

From Critical Care Medicine. In this Editorial, the authors discuss the article by Wongtangman et al. entitled “Association of Sedation, Coma, and In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome” and suggest that reemploying the use of evidence-based strategies developed over the past 20 years through rigorous controlled trials is one of the best mechanisms by which to help critically ill adults with COVID-19 liberate from the ICU and transition toward recovery and survivorship.