P: Critically ill patients
I: #Etomidate as an induction agent for intubation
C: Any comparator
O: Mortality at the main timepoint defined by authors
S: Randomized controlled trials
Direction/magnitude consistent for mortality at longest follow-up available even if statistical significance was lost (27% vs 25%; RR=1.07 [0.95–1.21]; P=0.27), corresponding to 86% probability of any harm from #Etomidate
#Etomidate was associated with a significantly increased risk of adrenal insufficiency (21% vs. 10%; risk ratio = 2.01 [1.59–2.56]; P < 0.001), confirming the findings of previous meta-analyses.
P: adults with #COVID19 not receiving oxygen
I: intravenous or oral #glucocorticoids
C: any
O: all-cause mortality at the longest follow-up available
S: RCTs, matched studies
➡️ 5 RCTs and 1 propensity-matched study (total 6634 pts) were included
Here we report the 1st case of intraoperative use of VA-#ECMO in a patient with resectable lung cancer and bivasal critical coronary artery disease with prohibitive low EF (23%), and describe the benefits of this new indication.
Cardiovascular comorbidities often prevent patients with otherwise resectable early-stage lung cancer from undergoing surgery due to prohibitive peri-operative risk.
In non-COVID-19 pneumonia/ARDS filling defects are found in pulmonary arteries branches vascularizing healthy lung segments. Instead, in #COVID19 there is an almost perfect topographical overlap of filling defects distribution & pneumonia extent.
We demonstrated that pulmonary vascular thrombosis in #COVID19 is due to local inflammatory endothelial damage with a superimposed thrombotic late complication and not to recurrent thromboembolism from peripheral deep vein thrombosis.
51% of pts showed pulmonary vascular thrombosis, with a median time from symptoms of 18 days.
We identified a specific radiological pattern of #COVID19 pneumonia with a unique spatial distribution of pulmonary vascular thrombosis overlapping areas of ground-glass opacities.
How we’ll we manage the first ten #COVID19 patients of 2021 (if any) hospitalized for #ARDS (compared to the first 10 patients we managed in February 2020). A multidisciplinary brain storming after managing approx 1000 such patients within the end of Apr 2020. A thread 1/ #FOAMed
2/ Not all our clinical impressions have already published evidence (but the majority was published), but our hospital #COVID19 mortality went close to zero in late April 2020 and we hope medical management accounts for at least part of these results.
We just published the largest, most detailed case series of mechanically ventilated #COVID19 patients with ARDS in a western country and with the longest follow-up.