Outcome predictors and patient progress following delivery in pregnant and postpartum patients with severe COVID-19 pneumonitis in intensive care units in Israel (OB-COVICU): a nationwide cohort study.

Background: A key unresolved controversy in severe COVID-19 pneumonitis in pregnancy is the optimum timing of delivery and whether delivery improves or worsens maternal outcomes. We aimed to assess clinical data on every intensive care unit (ICU) day for pregnant and postpartum women admitted to the ICU with COVID-19, with a particular focus on the days preceding and following delivery.

Methods: In this multicentre, nationwide, prospective and retrospective cohort study, we evaluated all pregnant women who were admitted to an ICU in Israel with severe COVID-19 pneumonitis from the 13th week of gestation to the 1st week postpartum.

Contribution of information about acute and geriatric characteristics to decisions about life-sustaining treatment for old patients in intensive care.

Background: Life-sustaining treatment (LST) in the intensive care unit (ICU) is withheld or withdrawn when there is no reasonable expectation of beneficial outcome. This is especially relevant in old patients where further functional decline might be detrimental for the self-perceived quality of life. However, there still is substantial uncertainty involved in decisions about LST.

The nature and sources of the emotional distress felt by intensivists and the burdens that are carried: A qualitative study.

Background: Work in intensive care units is often traumatic and emotionally distressing, sometimes leading to growth but at other times to negative outcomes such as worker burnout and mental illness. The type and origin of distresses to intensivists has been poorly characterised in the literature. This evidence gap makes it difficult to develop tailored educational process or cultural interventions for all who work within the specialty.

Propensity-Adjusted Comparison of Mortality of Elderly Versus Very Elderly Ventilated Patients.

Background: The growing proportion of elderly intensive care patients constitutes a public health challenge. The benefit of critical care in these patients remains unclear. We compared outcomes in elderly versus very elderly subjects receiving mechanical ventilation.

On predictions in critical care: The individual prognostication fallacy in elderly patients.

Predicting the future course of critical conditions involves personal experience, heuristics and statistical models. Although these methods may perform well for some cases and population averages, they suffer from substantial shortcomings when applied to individual patients. The reasons include methodological problems of statistical modeling as well as limitations of cross-sectional data sampling.

Comparison of Patients Undergoing Tracheostomy in the Intensive Care Unit versus in the Wards.

Background: In Israel, critically ill patients are ventilated and managed in intensive care units or general wards.

Objectives: To compare the mortality rates and long-term cognitive and functional outcomes of ventilated patients who underwent tracheostomy insertion in the Medical ICU (MICU) versus those cared for in the in-patient wards.

Methods: The study comprised 170 patients who underwent percutaneous dilatational tracheostomy (PDT) over an 18-month period in the MICU (n=102) and in in-patient wards (internal medicine and neurology) (n=68).

The good, the bad and the ugly: pandemic priority decisions and triage.

In this analysis we discuss the change in criteria for triage of patients during three different phases of a pandemic like COVID-19, seen from the critical care point of view. Availability of critical care beds has become a hot topic, and in many countries, we have seen a huge increase in the provision of temporary intensive care bed capacity. However, there is a limit where the hospitals may run out of resources to provide critical care, which is heavily dependent on trained staff, just-in-time supply chains for clinical consumables and drugs and advanced equipment.

Brain death determination in Australia and New Zealand: a survey of intensive care units.

Background: The Australian and New Zealand Intensive Care Society (ANZICS) guidelines for the determination of brain death involve clinical testing and/or the use of brain blood flow analysis techniques. Recently, there has been professional and lay discussion regarding the role of brain blood flow analysis in the determination of brain death.

Objective: To determine the current practices in Australian and New Zealand intensive care units for the determination of brain death.

Extracorporeal membrane oxygenation for critically ill patients with influenza A (H1N1) 2009: a case series.

In this case series, we report on five patients with influenza A (H1N1) who received extracorporeal membrane oxygenation (ECMO) treatment between July and December 2009 in the intensive care unit of Sir Charles Gairdner Hospital in Perth, Western Australia. In considering these cases, we highlight the indications, risks and potential benefits associated with ECMO, whose role remains, as yet, largely undefined in the setting of H1N1 critical illness.

Equitable resource allocation in the intensive care unit: a descriptive ethical case.

A patient with respiratory failure due to undiagnosed tuberculosis in the presence of HIV infection presents to the ICU in a foreign country. This raises many ethical questions, quite apart from the medical management issues raised by the patient's serious condition. Six of these ethical questions have been presented to leading physicians and an ethicist, from a range of national, cultural and religious backgrounds, for their comment.

The selective pulmonary vasodilatory effect of inhaled DETA/NO, a novel nitric oxide donor, in ARDS-a pilot human trial.

Objectives: To examine the effects of inhaled NONOates in patients with acute respiratory distress syndrome (ARDS).

Design: Case-series, phase I clinical trial.

Setting: A multidisciplinary intensive care unit in a tertiary teaching hospital.

Closed-loop glucose control in critically ill patients using continuous glucose monitoring system (CGMS) in real time.

A study was conducted to determine if continuous subcutaneous glucose monitoring (from MiniMed CGMS) could be used in real-time to control blood sugar level (BSL) in patients with critical illness. A closed-loop control system was constructed to use CGMS in a real-time manner, coupled with a proportional integral (PI) control algorithm based on a sliding scale approach, for automatic intravenous infusion of insulin to patients. A total of five subjects with high BSL (> 10 mmol/L) participated in formal studies of the closed-loop control system.