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Some #medtwitter #CritCareControversies musings on #COVID19 after my first week. (Thread)
1. It’s a new disease. Normal ICU routines don’t seem to work. When you think they are ready to wean from the vent, they are not. Desaturation is common and deep.
2. They seem to like high PEEP as reported before. You can’t wean this fast as with a “normal” pneumonia. All this means light sedation doesn’t work and causes asynchrony. AKI is common and if caught early responds well to diuretics combo. Bloods are weirdly normal.
Still don’t understand what’s the best way to catch superinfection. CRP is up after day 2. We use PCT and it’s fine when sky high, but what about 2.0-3.0?? More data needed. Patients tolerate drying out without haemodynamic instability. Shock is not a prominent feature.
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