ICU Management

The Least Bad Decision: Crisis Standards of Care After the Pandemic

2024 19 Apr

COVID-19 was an emergency that lasted for years and left few regions of the world untouched. The pandemic shone a spotlight on both the strengths and weaknesses of our disaster planning. What worked, what did not, and how can we better plan for future emergencies?   The COVID-19 pandemic forced hospitals and health systems around the world... Read more

ICU Management

Patient and Family Partnerships in the ICU: History, Benefits, and Strategies for the Future

2024 19 Apr

  The seamless integration of patient- and family-centred care in the critical care setting remains elusive. This review discusses the history and benefits of patient- and family-centred care, plus strategies for partnering with patients and families in the critical care setting.   Introduction Patient and family partnerships in the... Read more

ICU Management

Just Published: The HOT-COVID Clinical Trial - ISICEM 2024

2024 19 Mar

Findings from the HOT-COVID Randomised Clinical Trial, just published in JAMA, were presented at #ISICEM24.    COVID-19 pneumonia often leads to hypoxaemic respiratory failure, necessitating high levels of supplemental oxygen and intensive care. Previous recommendations suggested maintaining peripheral oxygen saturation (Spo2) between 90% and... Read more

ICU Management

Cell-Based Therapies for ARDS 

2024 13 Feb

  Cell-based therapies, particularly mesenchymal stromal cells (MSCs), hold significant promise for treating acute respiratory distress syndrome (ARDS). MSCs exhibit therapeutic effects such as reducing inflammation, improving lung function, and promoting tissue repair. These cells can be sourced from different tissues, affecting their ease of harvest... Read more

ICU Management

Ultra-Low Tidal Volume Ventilation for COVID-19-ARDS

2023 18 Jul

A new study aimed to evaluate the effectiveness of ventilation with ultra-low tidal volume (ULTV) compared to low tidal volume (LTV) in patients suffering from COVID-19-related acute respiratory distress syndrome (ARDS). COVID-19-related ARDS is associated with a high mortality rate and extended mechanical ventilation duration.   The study... Read more

ICU Management

Critical Care Staffing in Pandemics

2023 11 Jul

The COVID-19 pandemic has had significant impact on healthcare, with millions of cases and deaths reported globally. Healthcare workers have been particularly affected, experiencing increased mental health issues, burnout, and moral distress. The pandemic has led to higher levels of anxiety, depression, stress reactions, sleep disturbances, and posttraumatic... Read more

ICU Management

#EA23: Outcome in Patients With Postponed Elective Surgery During COVID-19

2023 06 Jun

The 30-day outcome findings in patients undergoing postponed elective surgery during the COVID-19 pandemic (TRACE II) were presented at a poster session at Euroanaesthesia 2023.   The COVID-19 pandemic significantly affected the ability to perform elective surgeries worldwide. To understand the consequences of delayed surgery, the TRACE II study... Read more

ICU Management

#ISICEM23: Time to Get Strategic About ICU Burnout

2023 22 Mar

In an interesting session at #ISICEM23, Michelle Chew, Professor of Anesthesiology, Intensive care, and Acute Medicine Care at Linköping University Hospital, Sweden, talked about stress, anxiety, and burnout.   Prof Chew discussed a study conducted by her group on perceived and physiological stress, anxiety, and burnout among ICU staff in an area... Read more

ICU Management

#ISICEM23: Effects of Therapeutic-Dose Heparin in Hospitalised Patients With COVID-19

2023 21 Mar

At the #ISICEM23 this week in Brussels, the benefits and harms of therapeutic-dose heparin varied by hospitalised COVID-19 patient characteristics were discussed, and the importance of considering the heterogeneity of treatment effect (HTE) in the design and analysis of randomised clinical trials was highlighted.   To date, RCTs that have tested... Read more

ICU Management

New German Law: Ex-post Triage Criminalised

2023 13 Mar

What will be the consequences of the new German law of criminalising ex-post triage? Will it result in more legal disputes, ethical dilemmas and preventable deaths? Or will it achieve its goal? As the COVID-19 pandemic hit mankind, many healthcare systems worldwide faced a widely unprecedented shortage of personnel, pharmaceuticals, equipment... Read more

ICU Management


2023 15 Feb

There is increasing evidence supporting the use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) in patients that do not respond to maximal medical therapy. ARDS can occur in some COVID-19 patients who are hospitalised, and ECMO can be utilised as a treatment option in some cases. Using ECMO can help... Read more

ICU Management

#LIVES2022: High-Flow Nasal Cannula Oxygen vs Standard Oxygen Therapy - SOHO-COVID

2022 24 Oct

At the Presidents' Ground Breaking Research Release session at ESICM LIVES 2022 in Paris, Jean-Pierre Frat (Poitiers, France) presented the findings from the Standard Oxygen Versus High Flow Cannula Oxygen Therapy in Patients With Acute Hypoxemic Respiratory Failure (SOHO-COVID) trial.  COVID-19 has resulted in over six million deaths worldwide... Read more

ICU Management

Does Antimicrobial Resistance Affect Clinical Outcomes in the ICU?

2022 14 Oct

An overview of antimicrobial resistance and its impact on clinical outcomes in the ICU.  Antimicrobial resistance (AMR) has been defined as a major threat to healthcare and to humanity by the World Health Organization (WHO 2015). The level of evidence for the association between AMR and hospital deaths, hospital length of stay and healthcare-associated... Read more

ICU Management

Dexamethasone and Oxygen Support Strategies for COVID-19 Hypoxaemic Respiratory Failure

2022 20 Sep

Acute hypoxaemic respiratory failure (AHRF) is one of the main manifestations of severe COVID-19. The RECOVERY trial showed that dexamethasone 6 mg/d for ten days reduced 28-day mortality in patients with the most severe COVID-19. Another study described the benefit of high-dose dexamethasone in ARDS. However, Munch et al. found no difference between... Read more

ICU Management

Vitamin D Supplements and Risk of COVID-19

2022 13 Sep

Findings from two large clinical trials show that increasing vitamin D levels in adults during the COVID-19 pandemic was not associated with protection against coronavirus or other respiratory tract infections.  Vitamin D has long been recognised to support innate immune responses to respiratory viruses and bacteria. Some studies show that vitamin... Read more

ICU Management

Surge Mechanical Ventilation During COVID-19

2022 09 Aug

During the COVID-19 pandemic, many hospitals in the U.S. exceeded their mechanical ventilation capability. As COVID-19 spread to communities with limited immunity, challenges associated with providing surge mechanical ventilation were reported. Hospitals, healthcare systems, and jurisdictional authorities purchased more ventilators. But the fear that the... Read more

ICU Management

The Influence of COVID-19 on Intensivist Wellbeing

2022 09 Aug

The COVID-19 pandemic has been challenging for healthcare systems around the world. In particular, the pandemic has resulted in critical care staffing shortages and has affected the quality of care.  In this review, the researchers examine the emergency response of hospitals to the pandemic and how it influenced the well-being of frontline intensivists.... Read more

ICU Management

Capnodynamic Monitoring to Assess PEEP in COVID-19

2022 02 Aug

Optimal positive end-expiratory pressure (PEEP) level during mechanical ventilation for COVID-19 pneumonia remains debated. A third of experts in a recent consensus statement supported a low-level PEEP for COVID-19-related acute respiratory failure (C-ARDS), with half of the panel remaining neutral without agreement on PEEP titration. However, the... Read more

ICU Management

Neurologic Manifestations of COVID-19

2022 19 Jul

Approximately 10-15% of patients with COVID-19 require ICU treatment. Respiratory failure and multi-organ dysfunction are the most common indications for ICU admission. However, nearly 1/3 of COVID-19 patients also present with neurologic manifestations. Neurologic manifestations are believed to predict mortality and functional outcome. While there... Read more

ICU Management

Extended Prone Positioning for COVID-19 ARDS

2022 12 Jul

COVID-19 has resulted in an estimated 270,000 hospitalisations in ICUs in Europe between May 2020 and March 2022. Nearly 80% of these patients have required tracheal intubation and invasive mechanical ventilation. While there is still an ongoing debate whether acute respiratory distress syndrome (ARDS) physiopathology is the same in COVID-19 and non-COVID-19... Read more