Current opinion in critical care
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The recent COVID-19 outbreak has clearly shown how epidemics/pandemics can challenge developed countries' healthcare systems. Proper management of equipment and human resources is critical to provide adequate medical care to all patients admitted to the hospital and the ICU for both pandemic-related and unrelated reasons. ⋯ A targeted improvement of hospital and ICU protocols will increase medical care quality for patients admitted to the hospital for any clinical reasons during a pandemic.
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To summarize the current knowledge of pathophysiology and ventilatory management of acute respiratory failure in COVID-19. ⋯ Given the lack of evidence-based specific ventilatory strategies and a large amount of literature showing pathophysiological features similar to non-COVID-19 ARDS, evidence-based lung-protective ventilatory strategies should be pursued in all patients with COVID-19 ARDS.
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To provide an evidence-based approach to improve first pass success in tracheal intubation while maintaining patient safety in the critically ill. ⋯ Recognizing the challenges and using the appropriate interventions to improve first pass tracheal intubation success, while maintaining patient safety are essential during tracheal intubation in critically ill patients. This review will provide recommendations based on the current evidence, various guidelines and expert opinion in the field. Further research will help us better understand the best strategies to improve patient outcomes.
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Ventilator weaning forms an integral part in critical care medicine and strategies to shorten duration are rapidly evolving alongside our knowledge of the relevant physiological processes. The purpose of the current review is to discuss new physiological and clinical insights in ventilator weaning that help us to fasten liberation from mechanical ventilation. ⋯ A thorough understanding of the physiological adaptations during withdrawal of positive pressure ventilation is extremely important for clinicians in the ICU. We summarize and discuss novel insights in this field.