Current opinion in critical care
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Curr Opin Crit Care · Feb 2023
ReviewHelmet noninvasive ventilation in acute hypoxic respiratory failure.
Invasive mechanical ventilation is a lifesaving intervention for patients with severe acute hypoxic respiratory failure (AHRF), but it is associated with neuromuscular, cognitive, and infectious complications. Noninvasive ventilation (NIV) may provide sufficient respiratory support without these complications. The helmet interface for NIV could address concerns raised for the use of NIV as first-line therapy in AHRF. This review will summarize and appraise the current evidence for helmet NIV in AHRF. ⋯ There is limited evidence to support or refute the use of helmet NIV in AHRF. Further studies investigating the interface of helmet in NIV as a separate clinical entity are needed.
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Curr Opin Crit Care · Dec 2022
ReviewSelection criteria and triage in extracorporeal membrane oxygenation during coronavirus disease 2019.
Coronavirus disease 2019 (COVID-19) pandemic changed the way we had to approach hospital- and intensive care unit (ICU)-related resource management, especially for demanding techniques required for advanced support, including extracorporeal membrane oxygenation (ECMO). ⋯ http://links.lww.com/COCC/A43.
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While it is now widely established acute kidney injury (AKI) is a common and important complication of coronavirus disease (COVID-19) disease, there is marked variability in its reported incidence and outcomes. This narrative review provides a mid-2022 summary of the latest epidemiological evidence on AKI in COVID-19. ⋯ This review summarises the epidemiology, risk factors, outcomes and treatment of COVID-19-associated AKI across the global pandemic. In particular the long-term impact of COVID-19 disease on kidney health is uncertain and requires further characterisation.
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Curr Opin Crit Care · Dec 2022
ReviewLung transplantation in patients with lung disease secondary to coronavirus disease 2019 infection.
In this article, we describe preoperative patient selection and outcomes of patients with lung disease secondary to infection from COVID-19 who receive lung transplantation. ⋯ Patients with respiratory failure secondary to COVID-19 infection that require a lung transplant generally have a complicated preoperative course and the operations are more complex, but the long-term outcomes are excellent.
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This review will highlight the latest research relevant to the clinical care of traumatic brain injury (TBI) patients over the last 2 years while underscoring the implications of these advances in the understanding of diagnosis, treatment, and prognosis of TBI. ⋯ The current characterization of TBI as mild, moderate, or severe fails to capture the complexity of the disease process and helps little with prognostication. Molecular biomarkers and invasive monitoring devices including brain tissue oxygenation and measures of cerebral autoregulation are being utilized more commonly and can help guide therapy. Extracranial complications following TBI are common and include infection, respiratory failure, coagulopathy, hypercoagulability, and paroxysmal sympathetic hyperactivity.