ICU Management & Practice, Volume 20 - Issue 1, 2020
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Editorial
COVID -19 Challenges
Coronavirus disease (COVID-19) continues to spread. While nations that were hit early are now seeing a flattening of the curve from mitigation strategies, countries that have been hit more recently continue to suffer. It is true that the majority of the population experiences mild symptoms of the disease, but age, comorbidity, and male sex are important risk factors that are still resulting in poor outcome...
Cover Story
Challenges and Management in Italy and Lessons Learned
Prof. Maurizio Cecconi is the President-Elect of the European Society of Intensive Care Medicine (ESICM). He is also the Head of Anaesthesia and Intensive Care Department at Istituto Clinico Humanitas and a full professor of Anaesthesia and ICU at the Humanitas University. Prof. Cecconi has worked in different healthcare systems, including the UK NHS & Private and Italy NHS & Private. He has a stro...
From Hydroxychloroquine and Remdesivir to Plasma Administration
Clinicians are faced with a serious disease with no effective therapy. Several options are being considered to treat COVID-19, but how promising are these drugs? A number of colleagues and friends from outside the hospital have asked me whether they should take hydroxychloroquine for their COVID-19. A friend asked me whether he should take lopinavir-ritonavir even though he is not HIV-positive. A hospit...
Infographic
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Adaptive Strategies for Intensive Care During the Spread of COVID-19: The Brussels Experience
Structured interventions and bottom-up initiatives at a tertiary Intensive Care Unit in Brussels, Belgium. Optimisation of medical response to no-notice events has been an important focus of research in the field of disaster medicine (Debacker et al. 2016). However, evidence-driven development of medical response protocols in novel domains of hospital medicine is time-consuming, and time is lacking in unf...
Tracheal Intubation in the ICU
Making tracheal intubation safe for both patients and their health care providers. COVID-19 is a newly recognised viral infection which first appeared in Wuhan, China in late 2019. It is caused by a novel Coronavirus, Severe Acute Respiratory Syndrome-CoronaVirus-2. For the most part it results in a mild, self-limiting flu-like illness but unfortunately, severe type one respiratory failure complicates b...
An Adaptive Response to COVID-19
John Nosta is the founder of NostaLab, a digital health think tank. He is regarded as one of the top global strategic and creative thinkers in digital health. He's also a member of the Google Health Advisory Board and a technology expert for the WHO. John is a contrarian with a sharp focus on the future, and it is this quality that makes him a defining force in dissecting and deliberating global events and...
Ultrasound in Times of COVID-19
The potential clinical utility of ultrasound modalities in the COVID-19 patient, the limitations, evidence base and governance over point of care ultrasound images during a pandemic and a discussion on whether the hype surrounding Lung Ultrasound (LUS) is justified. The use of ultrasound outside radiology has already become well established within many of the acute specialties, such as critical care and...
Nutrition for Critically Ill Patients with COVID-19
This article discusses the nutritional implications for critically ill patients admitted to intensive care for the management of COVID-19, and considers the inflammatory metabolic processes, nutrition-impacting symptoms, medical therapy, and the impact of a pandemic on staff resourcing and remote practice. The global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is pred...
The Calm Before the Storm
The Calm Before the Storm
Preparing intensive care capacity for the COVID-19 pandemic at a tertiary hospital in South Africa. The COVID-19 pandemic caused by the novel severe acute respiratory syndrome Coronavirus-2 (SARS-Cov-2) has wrought havoc on hospitals throughout the world. As of 25th April 2020, the burden of disease in South Africa remains relatively low with just over 4220 confirmed cases and 79 attributable deaths (sa...
Personal Experience With Severe COVID-19 After 66 days in Wuhan
COVID-2019 has become a worldwide pandemic. After working in Wuhan as intensive care physicians for 2 months, we have gained significant experience and would like to share our experience about daily care and supportive therapies for severe COVID-19 patients with our colleagues all over the world. The goal is for all of us to gain victory over COVID-19. According to the SSC guidance (Alhazzani et al. 202...
COVID-19: Masks in Intensive Care Units
With the number of COVID-19 cases increasing in the intensive care units, there is a high risk of infection for healthcare professionals. What kind of masks can be used and what are the most effective strategies to protect against airborne particles? Currently, there is an increasing number of patients in the intensive care units (ICUs) due to COVID-19 all over the world (some more than others). Since t...
COVID-19 and the History of Pandemics
How are we dealing with the COVID-19 pandemic and the lessons we can learn from similar diseases over the last few centuries. The face of human history has always been pockmarked by disease, in more ways than one. In our current privileged world of technology, gene sequencing and micro RNA, the possibility of a new disease that kept us inside our houses seemed an impossible dystopia. However it has prove...
What COVID-19 Has Taught Me…
A personal narrative of Adrian Wong’s experience while battling COVID-19 at King’s College Hospital. These are the author’s personal opinions and do not represent the views of the institution and professional societies to which they belong. The global COVID-19 pandemic has changed healthcare throughout the world and the specialty of Intensive Care Medicine has never been under such scrutiny. The e...
Intensive Care in the Coronavirus Era: Keep in Mind Your Collective Intelligence
Above and beyond the logistical and organisational aspects, shaken by the COVID-19 pandemic, here is an overview of our experience as an intensive care team in Switzerland. We will not parade the efficient measures implemented in our institution in preparation for welcoming COVID-19 patients; rather, we will discuss the impact of this epidemic on the clinical and emotional intelligence of intensivists....
Thoughts on COVID-19 from the International Fluid Academy
An overview of what has been published on fluid strategies in COVID-19, guidelines available and reflections on personal practice. The global COVID-19 pandemic has sharply focused the attention of the world onto critical care as a specialty. At the moment, there are no proven treatments for COVID-19, although several trials and case series extolling the merits of various agents have been published. As a...
COVID-19: Overview of Nurse Assessment
Managing COVID-19 patients in south of Switzerland with lung ultrasound for the evaluation of SARS-CoV-2 infection. Everything started at the beginning of March 2020. In one week, we went from eight to forty-five beds due to COVID-19 patients. The pandemic virus in place has been scientifically called SARS-CoV-2: • SARS stands for Severe Acute Respiratory Syndrome • Co means Corona • V means vir...
Point-of-View
Vasoactive Agent Management for Haemodynamic Support in COVID-19 Patients
An overview of the Surviving Sepsis Guidelines for the vasoactive agent management of COVID-19 patients with septic shock and the use of arginine vasopressin in this patient population. The SARS-CoV-2 has caused a global health crisis. Thousands of people across the globe have been affected by COVID-19. Clinicians are in urgent need of guidance and recommendations to treat patients and improve outcomes....
A COVID-19 Dashboard: Data Analytics to Aid Resource Allocation in Intensive Care Units
In this article, we focus on clinical and practical application of current available cloud-based data analysis to track and benchmark in real-time suspect and confirmed COVID-19 cases, resource use and availability. The COVID-19 pandemic represents an unprecedented challenge to intensive care units (ICU) due to the surge of severe cases of pneumonia posing great stress to hospitals and healthcare system...
Continuous Monitoring of Urine Flow in COVID-19 and Other Critical Care Patients: Why and How
Acute Kidney Injury (AKI) develops in over 55% of ICU patients patients (Hoste et al. 2015). As infections and the need for mechanical ventilation are known to be among the high-risk factors for the development of AKI (Bellomo et al. 2017), the incidence may be even higher in the COVID-19 era. For ICU patients with COVID-19 or other complex conditions, essential physiological functions such as cardiac ou...
Noninvasive Haemodynamic Check to Guide Educated Decisions in the Management of COVID-19 Patients
The rapid global distribution of COVID-19 is challenging healthcare systems worldwide. In many countries hospitals and ICU departments are overloaded or fear a potential collapse - the optimal allocation of healthcare resources is required. Healthcare professionals are forced to treat severely ill patients with limited access to ventilation equipment, qualified intensive care personnel or protective patien...
Precise Automated Resuscitation with RESPIRA
One of the major problems for hospitals fighting the COVID-19 pandemic has been the lack of emergency ventilation devices. GPAINNOVA, a multinational company from Spain, has a simple and efficient solution to this – RESPIRA. RESPIRA is an ICU ventilator based on AMBU automation for assisted ventilation. It has been designed specifically for the needs of intensive care doctors involved in the COVID-19 t...
Informatics and Technology
Feasibility and Potential Benefits of Immersive Virtual Reality in the Intensive Care Unit
Virtual reality (VR) is a developing technology with much current interest in its potential to improve patient outcome in a variety of clinical settings. Critically ill patients, their relatives and intensive care unit (ICU) staff are all at high risk of stress and anxiety and patients often experience pain. This study explores the potential benefits of virtual reality for stress, anxiety and pain managemen...
Agenda
Agenda
SEPTEMBER 3-5 16th Emirates Critical Care Conference Dubai, UAE https://iii.hm/133m 5-9 European Respiratory Society (ERS) International Congress 2020 Virtual conference https://iii.hm/133n 14-15 British Association of Critical Care Nurses (BACCN) Conference 2020 Virtual conference https://iii.hm/133o 15-18 ISICEM 2020 - 40th International Symposium on Intensive Care and Emergency Medicine Brussels...