Brit J Hosp Med
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The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread and have grave health and socioeconomic consequences worldwide. Researchers have raced to understand the pathophysiological mechanisms underpinning the disease caused by SARS-CoV-2 so that effective therapeutic targets can be discovered. This review summarises the key pharmacotherapies that are being investigated for treatment of COVID-19, including antiviral, immunomodulator and anticoagulation strategies.
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Major abdominal surgery is associated with significant morbidity, not least the development of acute kidney injury. As a common perioperative complication, acute kidney injury is associated with increased length of stay, increased risk of perioperative infection and the potential development of chronic kidney disease. Moreover, the development of acute kidney injury is independently associated with an increased risk of death. ⋯ Currently, acute kidney injury is defined by changes in serum creatinine level and urine output criteria, which although robust in heterogenous populations, may not perform as accurately in the perioperative period. This article discusses these issues including the potential role of novel biomarkers for early detection of perioperative acute kidney injury, as well as the use of predictive modelling. Treatment is mainly supportive but evidence suggests that more targeted therapy may lead to improved outcomes.
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Lung-protective ventilation significantly reduces mortality in patients with acute respiratory distress syndrome, but do the advantages of this approach transfer from the intensive care unit to the operating room?