Antithrombotic Therapy in Arterial Thrombosis and Thromboembolism in COVID-19: An American College of Chest Physicians Expert Panel Report.

Background: Evidence increasingly shows that the risk of thrombotic complications in COVID-19 is associated with a hypercoagulable state. Several organizations have released guidelines for the management of COVID-19-related coagulopathy and prevention of VTE. However, an urgent need exists for practical guidance on the management of arterial thrombosis and thromboembolism in this setting.

Acute Kidney Injury and Postoperative Atrial Fibrillation In Patients Undergoing Cardiac Surgery.

Objective: To test the hypothesis that acute kidney injury (AKI) in the postoperative period could be an additional risk factor for the development of atrial fibrillation (AF) and to examine the risk factors for postoperative AF in the authors' cohort of patients.

Design: A retrospective observational study.

Setting: Large regional cardiothoracic surgical center in the UK.

Hemodynamic effects of lung recruitment maneuvers in acute respiratory distress syndrome.

Background: Clinical trials have, so far, failed to establish clear beneficial outcomes of recruitment maneuvers (RMs) on patient mortality in acute respiratory distress syndrome (ARDS), and the effects of RMs on the cardiovascular system remain poorly understood.

Methods: A computational model with highly integrated pulmonary and cardiovascular systems was configured to replicate static and dynamic cardio-pulmonary data from clinical trials. Recruitment maneuvers (RMs) were executed in 23 individual in-silico patients with varying levels of ARDS severity and initial cardiac output.

Development of an integrated model of cardiovascular and pulmonary physiology for the evaluation of mechanical ventilation strategies.

We describe the development of an integrated cardiovascular and pulmonary model for use in the investigation of novel mechanical ventilation strategies in the intensive care unit. The cardiac model includes the cardiac chambers, the pulmonary circulation and the systemic circulation. The modeling of complex mechanisms for vascular segments, time varying elastance functions of cardiovascular components and the effect of vascular resistances, in health and disease under the influence of mechanical ventilation is investigated.

Evaluation of lung recruitment maneuvers in acute respiratory distress syndrome using computer simulation.

Introduction: Direct comparison of the relative efficacy of different recruitment maneuvers (RMs) for patients with acute respiratory distress syndrome (ARDS) via clinical trials is difficult, due to the heterogeneity of patient populations and disease states, as well as a variety of practical issues. There is also significant uncertainty regarding the minimum values of positive end-expiratory pressure (PEEP) required to ensure maintenance of effective lung recruitment using RMs. We used patient-specific computational simulation to analyze how three different RMs act to improve physiological responses, and investigate how different levels of PEEP contribute to maintaining effective lung recruitment.