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Category: Crisis Management

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Critical Care for Coronavirus Disease 2019: Perspectives From the PICU to the Medical ICU

From Critical Care Medicine. The authors describe the unique perspective of pediatric intensivists caring for critically ill adults during the coronavirus disease 2019 pandemic.


Editorial: Coronavirus Disease 2019: A Tsunami of Data and a Plethora of Unanswered Questions

From Pediatric Critical Care Medicine. In this editorial, the author discusses issues emerging from the study by Bhumbra et al. (Clinical features of critical coronavirus disease 2019 in children) that are worthy of discussion and further exploration, including the predilection for racial minorities, similarities and differences to sepsis, wide expression of clinical disease, and the conundrum of providing family centered care.


Evaluation of Coronavirus Disease 2019 Severity Using Urine Biomarkers

From Critical Care Explorations. The authors conducted a study to determine whether noninvasive urine biomarkers can predict the clinical severity of coronavirus disease 2019.


Letter to the Editor: Early Clinical Experience in Using Helmet Continuous Positive Airway Pressure and High-Flow Nasal Cannula in Overweight and Obese Patients With Acute Hypoxemic Respiratory Failure From Coronavirus Disease 2019

From Critical Care Explorations. In this Letter to the Editor, the authors present their retrospective review of COVID-19 patients admitted to the ICUs within two academic urban hospitals (1,012 total hospital beds), comparing helmet continuous positive airway pressure and high-flow nasal cannula in patients with a body mass index greater than or equal to 25 kg/m2 who had persistent hypoxemia.


In Silico Modeling of Coronavirus Disease 2019 Acute Respiratory Distress Syndrome: Pathophysiologic Insights and Potential Management Implications

From Critical Care Explorations. In this study, the authors adapted a high-fidelity computational simulator to develop quantitative insights into the key pathophysiologic differences between the coronavirus disease 2019 acute respiratory distress syndrome and the conventional acute respiratory distress syndrome and to assess the impact of different positive end-expiratory pressure, Fio2, and tidal volume settings.


Letter to the Editor Treatment of Critically Ill Coronavirus Disease 2019 Patients With Adjunct Therapeutic Plasma Exchange: A Single-Center Retrospective Case Series

From Critical Care Explorations. In this Letter to the Editor, the authors describe their experience with a series of eight patients receiving adjunct therapeutic plasma exchange for severe coronavirus disease pneumonia complicated by sepsis with multiple organ dysfunction in which C-reactive protein and ferritin levels significantly decreased with therapeutic plasma exchange, whereas D-dimer decreased to a lesser degree.


Inpatient Mortality According to Level of Respiratory Support Received for Severe Acute Respiratory Syndrome Coronavirus 2 (Coronavirus Disease 2019) Infection: A Prospective Multicenter Study

From Critical Care Explorations. In this study, the authors describe patients according to the maximum degree of respiratory support received and report their inpatient mortality due to coronavirus disease 2019.


Subcutaneous Emphysema, Pneumomediastinum, and Pneumothorax in Critically Ill Patients With Coronavirus Disease 2019: A Retrospective Cohort Study

From Critical Care Explorations. In this observational study, the authors describe patients with barotrauma, which appears to be a common complication of severe coronavirus disease 2019. 


Coronavirus Disease 2019 Acute Respiratory Distress Syndrome: Guideline-Driven Care Should Be Our Natural Reflex

From Critical Care Medicine. In this Viewpoints article, the authors discuss the value of evidence-based, guidelines-driven care in ARDS in patients with COVID-19.
 


Coronavirus Disease 2019 and Acute Respiratory Distress Syndrome: Why the Intensivist Is More Important Than Ever

From Critical Care Medicine. In this Viewpoints article, the authors discuss the challenges of ARDS in COVID-19 patients.


Editorial: Delivering Care From an Unstable Evidence Base: The Evolving Care of Coronavirus Disease 2019 Through the Lens of High-Flow Nasal Oxygen

From Critical Care Medicine. In this Editorial, the authors discuss the challenges of caring for patients with COVID-19 without evidence to guide them through the lens of high-flow nasal oxygenation and how there have been slow changes for improvement.


Tokyo and New York: A Study in the Contrasting Effects of Socioeconomic Status on Coronavirus Disease 2019 Outcomes

From Critical Care Explorations. The authors examined the association between socioeconomic status and the rate of coronavirus disease 2019 infections using public data from Tokyo.


Placenta-Derived Cell Therapy to Treat Patients With Respiratory Failure Due to Coronavirus Disease 2019

From Critical Care Explorations. The authors sought to determinewhether placental cell therapy PLacental eXpanded (PLX)-PAD (Pluristem Therapeutics, Haifa, Israel) was beneficial to treating critically ill patients suffering from acute respiratory distress syndrome due to coronavirus disease 2019.
 


Probative Value of the D-Dimer Assay for Diagnosis of Deep Venous Thrombosis in the Coronavirus Disease 2019 Syndrome

From Critical Care Medicine.The authors describe the predictive utility of the D-dimer assay among patients with the coronavirus disease 2019 syndrome for unprovoked lower extremity deep venous thrombosis.


Letter to the Editor: Transforming a PICU Into an Adult ICU During the Coronavirus Disease 2019 Pandemic: Meeting Multiple Needs

From Critical Care Explorations. In this Letter to the Editor, the authors describe the process converting half of their 40-bed PICU into a negative-pressure biocontainment ICU dedicated to adult coronavirus disease 2019 patients within a 1,003-bed academic quaternary hospital.


Disseminated Multifocal Intracerebral Bleeding Events in Three Coronavirus Disease 2019 Patients on Extracorporeal Membrane Oxygenation As Rescue Therapy

From Critical Care Explorations. In this article, the authors describe three coronavirus disease 2019 patients suffering from acute respiratory distress syndrome under venovenous extracorporeal membrane oxygenation therapy and tight anticoagulation monitoring presenting a novel pattern of multifocal brain hemorrhage in various degrees in all cerebral and cerebellar lobes.
 


Thromboelastography to Detect Hypercoagulability and Reduced Fibrinolysis in Coronavirus Disease 2019 Acute Respiratory Distress Syndrome Patients

From Critical Care Explorations. In this study, the authors investigated thromboelastography in patients with coronavirus disease 2019-associated acute respiratory distress syndrome with the goal of characterizing suspected coagulopathy and impaired fibrinolysis.
 


Does Pulmonary Aspergillosis Complicate Coronavirus Disease 2019?

From Critical Care Explorations. In this article, the authors summarize what is known about coronavirus disease 2019 complicated by Aspergillus, introduces coronavirus disease 2019–associated pulmonary aspergillosis as a possible clinical entity, and describes reasons clinical suspicion of Aspergillus is warranted in the critical care setting.
 


Endothelial Injury and Glycocalyx Degradation in Critically Ill Coronavirus Disease 2019 Patients: Implications for Microvascular Platelet Aggregation

From Critical Care Explorations. The authors found that thrombosis profiling identified endothelial activation and glycocalyx degradation in coronavirus disease 2019 positive patients and believe that the data from this study suggest that medications to protect and/or restore the endothelial glycocalyx, as well as platelet inhibitors, should be considered for further study.


Plasma Exchange: An Effective Rescue Therapy in Critically Ill Patients With Coronavirus Disease 2019 Infection

From Critical Care Medicine. In this single center study, the authors found that plasma exchange mitigates cytokine storm, reverses organ failure, and could improve survival in critically ill patients with coronavirus disease 2019 infection.