Thread by @GuerinGreen

Notes from Today’s National #COVID19 Clinical rounds. A thread

Vikram Mukherjee, MD Bellevue

gender M>F
Full spectrum of ages & ethnicities
Many more young patients without comorbidities

25% of hospitalizations end up in ICU, extended stays

Severe ARDS -> Cytokine Storm -> Renal Failure
HCQ - ZPAC (monitor ECG for QT)

Cytokine Storm in almost all ARDS patients
Unclear how to mitigate
50% of ICU patients have acute renal failure
renal replacement failure treatment serious shortfall

no clear data on mitigation of cytokine storms
all approaches FDA off-label

hypoxia despite clear lung X-ray
then show with progression into ARDS

Need for negative pressure ICU capable beds
Mechanical CPR
Butterfly ultrasounds
Not doing shared Vents (last, last resort)

More to come later #COVID19 #coronavirus

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