This review describes the management of mechanical ventilation in patients with acute respiratory distress syndrome, including in those with coronavirus disease 2019. Low tidal volume ventilation with a moderate to high positive end-expiratory pressure remains the foundation of an evidence-based approach. We consider strategies for setting positive end-expiratory pressure levels, the use of recruitment maneuvers, and the potential role of driving pressure. Rescue therapies including prone positioning and extracorporeal membrane oxygenation are also discussed.
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http://dx.doi.org/10.1016/j.ccc.2021.05.008 | DOI Listing |
J Glob Health
December 2024
Department of Anesthesiology, Critical Care and Pain Medicine, UTHealth, Houston, Texas, USA.
Background: Previous studies have shown that hypertonic saline nasal irrigation and gargling reduced the duration of symptoms in upper respiratory infections caused by coronavirus. This study aims to investigate the effects of two saline regimens on symptoms associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).
Methods: Between 2020 and 2022, individuals aged 18-65 years who tested positive for SARS-CoV-2 infection via polymerase chain reaction (PCR) were randomly assigned to either low- or high-saline regimens for 14 days.
J Glob Health
December 2024
Amsterdam UMC, location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands.
Background: Risk prediction tools for acutely ill children have been developed in high- and low-income settings, but few are validated or incorporated into clinical guidelines. We aimed to assess the performance of existing paediatric early warning scores for use in low- and middle-income countries using clinical data from a recent large multi-country study in Africa and South-Asia.
Methods: We used data (children across three nutritional strata) from the Childhood Acute Illness and Nutrition (CHAIN) Network cohort study (n = 3101).
Cureus
December 2024
Department of Critical Care Medicine, St. Luke's International Hospital, Tokyo, JPN.
Systemic capillary leak syndrome (SCLS) is a rare and life-threatening disorder characterized by acute hypotension, hypoalbuminemia, and hemoconcentration, which often results in severe respiratory complications, such as pulmonary edema. SCLS can be triggered by infections, including COVID-19, and is associated with a high mortality rate. Here, we report a case of COVID-19-associated SCLS in a 68-year-old man.
View Article and Find Full Text PDFCureus
December 2024
Pulmonology and Critical Care, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Malignant hyperthermia is a pharmacogenetic disorder that manifests clinically as a hypermetabolic crisis when a patient with a mutation in the ryanodine or dihydropyridine receptor genes is exposed to neuromuscular blocking agents. Depolarizing neuromuscular agents are known to cause malignant hyperthermia, but cases caused by nondepolarizing agents are rarely reported. We present a case consistent with malignant hyperthermia after receipt of cisatracurium, a nondepolarizing anesthetic agent.
View Article and Find Full Text PDFVaccine X
October 2024
WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
We conducted a test negative study from November 2023 to June 2024, enrolling 4,367 children hospitalized with acute respiratory illness in Hong Kong. Among the children who tested negative for influenza virus and SARS-CoV-2, 56.8 % had received influenza vaccination.
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