Pub Date : 2021-01-01DOI: 10.2991/icres.k.211006.001
Amarjeet Kumar, Ajeet Kumar, C. Sinha, Prabhat K. Singh, C. Vamshi, Gayatri D Sagdeo
Acute Kidney Injury (AKI) is one of the major complication of the Coronavirus Disease 2019 (COVID-19) infection, commonly manifested during the second week of infection. The pathophysiology and mechanisms of AKI in patients with COVID-19 have not been fully elucidated and seem to be multifactorial. There is currently no common consensus regarding the optimal amount of fluid resuscitation specifically for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients in shock. There is paucity of knowledge regarding prevention of post-intubation hypotension and oliguria in COVID-19 patients. We suggest fluid resuscitation by 1 L of crystalloid immediately following endotracheal intubation of adult COVID ARDS patients to compensate vasodilation and improve renal perfusion. Conservative fluid strategies should be followed in patient having history of congestive heart failure, chronic kidney disease, adrenal insufficiency and in patient who have already developed AKI with oliguric phase.
{"title":"Post-Intubation Empirical Fluid Resuscitation as an Early Step to Prevent Acute Kidney Injury in Mechanically Ventilated COVID-19 Patient","authors":"Amarjeet Kumar, Ajeet Kumar, C. Sinha, Prabhat K. Singh, C. Vamshi, Gayatri D Sagdeo","doi":"10.2991/icres.k.211006.001","DOIUrl":"https://doi.org/10.2991/icres.k.211006.001","url":null,"abstract":"Acute Kidney Injury (AKI) is one of the major complication of the Coronavirus Disease 2019 (COVID-19) infection, commonly manifested during the second week of infection. The pathophysiology and mechanisms of AKI in patients with COVID-19 have not been fully elucidated and seem to be multifactorial. There is currently no common consensus regarding the optimal amount of fluid resuscitation specifically for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients in shock. There is paucity of knowledge regarding prevention of post-intubation hypotension and oliguria in COVID-19 patients. We suggest fluid resuscitation by 1 L of crystalloid immediately following endotracheal intubation of adult COVID ARDS patients to compensate vasodilation and improve renal perfusion. Conservative fluid strategies should be followed in patient having history of congestive heart failure, chronic kidney disease, adrenal insufficiency and in patient who have already developed AKI with oliguric phase.","PeriodicalId":73403,"journal":{"name":"Intensive care research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69872448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.2991/icres.k.211028.001
Huw F. Mayberry, A. Burgart, C. Kanaris
In this paper, we argue that paralysis-only intubation is almost never acceptable practice. We look at the evidence suggesting that this practice remains commonplace worldwide, its frequency has been exacerbated further by anaesthetic drug shortages secondary to the COVID-19 pandemic. We make a strong case that intubating a patient without sedation has such profound psychological and physiological risks that the practice is unethical and should be banned from medical practice with the exception of two clinical settings. These exceptions include (a) newborn intubation immediately after birth if there is immediate risk to life and (b) awake fibreoptic intubation whereby the patient has consented in advance, co-operative, and the
{"title":"Intubated, Awake, and Paralysed: A Never Event","authors":"Huw F. Mayberry, A. Burgart, C. Kanaris","doi":"10.2991/icres.k.211028.001","DOIUrl":"https://doi.org/10.2991/icres.k.211028.001","url":null,"abstract":"In this paper, we argue that paralysis-only intubation is almost never acceptable practice. We look at the evidence suggesting that this practice remains commonplace worldwide, its frequency has been exacerbated further by anaesthetic drug shortages secondary to the COVID-19 pandemic. We make a strong case that intubating a patient without sedation has such profound psychological and physiological risks that the practice is unethical and should be banned from medical practice with the exception of two clinical settings. These exceptions include (a) newborn intubation immediately after birth if there is immediate risk to life and (b) awake fibreoptic intubation whereby the patient has consented in advance, co-operative, and the","PeriodicalId":73403,"journal":{"name":"Intensive care research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69872457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Secondary Hemophagocytic Syndrome (HPS), also known as Hemophagocytic Lymphohistocytosis (HLH), is a life-threatening syndrome caused by secondary overstimulation of the immune system, with a high mortality rate even after appropriate treatment. HLH is often triggered by malignancies, infections or autoimmune diseases with the Malignancy-Associated Hemophagocytic Syndrome (MAHS) accounting for the highest proportion of secondary HLH (about 48%), and Lymphoma Associated Hemophagocytic Syndrome (LAHS) being the most common [1–3]. Among the LAHS cases, T/NK-cell lymphoma is much more common than the rarely seen B-cell lymphoma [4]. B-cell LAHS (B-LAHS) is predominantly described in Asian populations but larger sets are rare. Early clinical manifestations of HLH are nonspecific, mostly manifesting in persistent fever, pancytopenia and hepatosplenomegaly with an aggressive disease progress [5]. Therefore, early diagnosis and immediate introduction of appropriate treatment are crucial for these patients.
{"title":"Clinical Features and Prognosis of B-cell Lymphoma-associated Hemophagocytic Syndrome: A Retrospective Single Center Study","authors":"H. Hou, Xudong Zhang, Siyu Qian, Zeyuan Wang, M. Dong, Xiaojuan Zhang, X. Duan, Yue Zhang, Qing Wen, Jing-Ru Ge, Yaxin Lei, Mingzhi Zhang, Qingjiang Chen","doi":"10.2991/icres.k.211129.001","DOIUrl":"https://doi.org/10.2991/icres.k.211129.001","url":null,"abstract":"Secondary Hemophagocytic Syndrome (HPS), also known as Hemophagocytic Lymphohistocytosis (HLH), is a life-threatening syndrome caused by secondary overstimulation of the immune system, with a high mortality rate even after appropriate treatment. HLH is often triggered by malignancies, infections or autoimmune diseases with the Malignancy-Associated Hemophagocytic Syndrome (MAHS) accounting for the highest proportion of secondary HLH (about 48%), and Lymphoma Associated Hemophagocytic Syndrome (LAHS) being the most common [1–3]. Among the LAHS cases, T/NK-cell lymphoma is much more common than the rarely seen B-cell lymphoma [4]. B-cell LAHS (B-LAHS) is predominantly described in Asian populations but larger sets are rare. Early clinical manifestations of HLH are nonspecific, mostly manifesting in persistent fever, pancytopenia and hepatosplenomegaly with an aggressive disease progress [5]. Therefore, early diagnosis and immediate introduction of appropriate treatment are crucial for these patients.","PeriodicalId":73403,"journal":{"name":"Intensive care research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69872001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-24DOI: 10.1007/s44231-022-00015-2
Wenqi Huang, Pengfei Wang, Bin Huang, Xiao-dong Chen, Hu Du, Yunxing Cao, Hang Sun, An Zhang
{"title":"Efficacy and Safety of Different Mechanical Ventilation Strategies for Patients with Acute Respiratory Distress Syndrome: Systematic Review and Network Meta-analysis","authors":"Wenqi Huang, Pengfei Wang, Bin Huang, Xiao-dong Chen, Hu Du, Yunxing Cao, Hang Sun, An Zhang","doi":"10.1007/s44231-022-00015-2","DOIUrl":"https://doi.org/10.1007/s44231-022-00015-2","url":null,"abstract":"","PeriodicalId":73403,"journal":{"name":"Intensive care research","volume":"3 1","pages":"50 - 60"},"PeriodicalIF":0.0,"publicationDate":"2020-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48497974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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