ICU Management & Practice, Volume 21 - Issue 1, 2021

The COVID-19 pandemic has had a significant impact on ICUs and critical care healthcare providers all across the globe. As of this week, 110 million people have been infected with the virus worldwide, and 2.4 million have died. Many of the infected patients need hospitalisation and admission to the ICU. A high percentage of severely ill patients with COVID-19 require mechanical ventilation. Hence, ICUs have had their work cut out for them and have faced many challenges, including the management of high patient flow, appropriate allocation of resources, the need to balance care of patients with COVID-19 and those with other critical illnesses, restructuring workflows, and ensuring the safety of healthcare workers, patients and their families.

As ICU workers around the world deal with the rapidly changing situation of COVID-19, there is a need for clinicians to evaluate and review how we performed during this crisis, what we did well and what we could have done better. It is time to evaluate the data and synthesise evidence-based guidelines to better guide the management of patients with COVID-19. 

In this issue, our contributors talk about 20 Lessons from 2020. Nicole Juffermans and I talk about these lessons with a focus on the ICU perspective. This year has been quite unusual, and we review what happened and what lessons we learned from our combined experiences. 

Audrey De Jong, Yassir Aarab and Samir Jaber evaluate whether videolaryngoscopy is the new gold standard for intubation following the COVID-19 crisis while Andrej Michalsen and Kateřina Rusinová question whether prioritisation decisions are really a physicians' problem. 

Vitaly Herasevich, Jeremy Clain and Brian Pickering provide an overview of the large-scale transition to telemedicine during the COVID-19 pandemic and how telemedicine could rapidly transform healthcare. 

Lukas Martin, Arne Peine, Gernot Marx and Johannes Bickenbach highlight the use and challenges of digitalisation and artificial intelligence and how the focus should be on providing less rather than more data. Orlando Ruben Perez-Nieto and co-authors talk about prone position in awake, non-intubated patients with ARDS. 

Ashish Khanna, Piyush Mathur, Jacek Cywinski and Kamal Maheshwari discuss the prevention of perioperative patient harm and the importance of continuous and better patient monitoring for early detection and prevention. Jodi Allen, Gabrielle Rossano and Jackie McRae describe the experiences of Speech and Language Therapy and the upper airway challenges associated with extubation and oral management in COVID-19 patients. 

2020 was a challenging year, and as we continue to manage the second wave, we know that there are things that must change. Critical care providers all over the world have faced distress and burnout. Patients and families are equally stressed. There is the challenge of limited resources and critical decisions. Changes must be made, and as we persevere, I am confident that we will come out stronger and better. 

As always, if you would like to get in touch, please email [email protected]

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