113,421 results match your criteria mechanical ventilation

Recent Trends in Marijuana-Related Hospital Encounters in Young Children.

Acad Pediatr 2021 Jul 26. Epub 2021 Jul 26.

Division of General Pediatrics, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA; National Clinician Scholars Program, University of Pennsylvania, Blockley Hall, 423 Guardian Drive, 13th Floor, Philadelphia, PA 19104, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104.

Objectives: Multiple states have passed legislation permitting marijuana use. The impact of legalization on trends in hospital encounters for marijuana exposures in young children across states remains unknown. We aimed to describe trends in marijuana-related hospital encounters over time in children <6 years and assess the association of state-level marijuana legislation with the rate of marijuana-related hospitalizations. Read More

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Trends in COVID-19 cases and clinical management in Veterans Health Administration medical facilities: A national cohort study.

PLoS One 2021 29;16(7):e0246217. Epub 2021 Jul 29.

White River Junction Veterans Affairs Medical Center, White River Junction, Vermont, United States of America.

Objective: We explored longitudinal trends in sociodemographic characteristics, reported symptoms, laboratory findings, pharmacological and non-pharmacological treatment, comorbidities, and 30-day in-hospital mortality among hospitalized patients with coronavirus disease 2019 (COVID-19).

Methods: This retrospective cohort study included patients diagnosed with COVID-19 in the United States Veterans Health Administration between 03/01/20 and 08/31/20 and followed until 09/30/20. We focused our analysis on patients that were subsequently hospitalized, and categorized them into groups based on the month of hospitalization. Read More

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Case-control analysis of prehospital death and prolonged field care survival during recent US military combat operations.

J Trauma Acute Care Surg 2021 Aug;91(2S Suppl 2):S186-S193

From the Joint Trauma System, Defense Health Agency (S.A.S., D.J.d.J., E.L.M., R.S.K., H.R.M., M.A.R., J.M.G., S.K.), Joint Base San Antonio Fort Sam Houston, Texas; 10th Special Forces Group (Airborne) (J.C.R.), US Army Special Operations Command, Fort Carson, Colorado; West Virginia University Heart and Vascular Institute (D.P.), Morgantown, West Virginia; USASOC Surgeon's Office (D.P.), Fort Bragg, North Carolina; Armed Forces Medical Examiner System (E.L.M.), Defense Health Agency, Dover AFB, Delaware; U.S. Army John F. Kennedy Special Warfare Center and School (P.L.), Fort Bragg, North Carolina and; US Army Institute of Surgical Research (J.M.G.), Joint Base San Antonio Fort Sam Houston, Texas.

Background: Quantification of medical interventions administered during prolonged field care (PFC) is necessary to inform training and planning.

Materials And Methods: Retrospective cohort study of Department of Defense Trauma Registry casualties with maximum Abbreviated Injury Scale (MAIS) score of 2 or greater and prehospital records during combat operations 2007 to 2015; US military nonsurvivors were linked to Armed Forces Medical Examiner System data. Medical interventions administered to survivors of 4 hours to 72 hours of PFC and nonsurvivors who died prehospital were compared by frequency-matching on mechanism (explosive, firearm, other), injury type (penetrating, blunt) and injured body regions with MAIS score of 3 or greater. Read More

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Extracorporeal Membrane Oxygenation Support for Antineutrophil Cytoplasmic Antibody-associated Vasculitides: An ELSO Registry Analysis.

ASAIO J 2021 Jul 27. Epub 2021 Jul 27.

From the Department of Pediatrics, Baylor College of Medicine, Houston, Texas Children's National Hospital, Washington, District of Columbia The Extracorporeal Life Support Organization, Ann Arbor, Michigan.

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides with pulmonary involvement include granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis, and can present with life-threatening pulmonary hemorrhage in up to 40% of patients. Mortality in those patients who require intubation and mechanical ventilation can reach 77%. Extracorporeal membrane oxygenation (ECMO) can be used to support these patients through definitive diagnosis and treatment, although minimizing the risk of ventilator-induced lung injury. Read More

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An Extracorporeal Membrane Oxygenation First Strategy in COVID-19 Acute Respiratory Distress Syndrome.

ASAIO J 2021 Jul 28. Epub 2021 Jul 28.

MD Candidate 2022 Howard University Medical School Washington DC 20059 Medical Director, Adult ECMO Program, Methodist Hospital, 7700 Medical Drive, San Antonio, TX 78229 Clin. Professor Cardiovascular Surgery, Division of Cardiac Surgery, George Washington University, Washington DC 20037 Nurse Practitioner, Adult ECMO Program, Methodist Hospital, 7700 Floyd Curl Drive, San Antonio, TX 78229.

COVID-19 can be associated with acute respiratory distress syndrome (ARDS) which increases the likelihood of morbidity and mortality. Ventilator-induced lung injury (VLI) is a known complication of mechanical ventilation (MV) and can further compound lung injury and recovery. Escalation to extracorporeal membrane oxygenation (ECMO) can be required in patients who deteriorate on MV. Read More

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Audit of low tidal volume ventilation in patients with hypoxic respiratory failure in a tertiary Australian intensive care unit.

Anaesth Intensive Care 2021 Jul 29:310057X21993132. Epub 2021 Jul 29.

Intensive Care Unit, Nepean Hospital, Penrith, Australia.

A low tidal volume ventilation (LTVV) strategy improves outcomes in patients with acute respiratory distress syndrome (ARDS). Subsequently, a LTVV strategy has become the standard of care for patients receiving mechanical ventilation. This strategy is poorly adhered to within intensive care units (ICUs). Read More

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Modified ultrafiltration and postoperative course in patients undergoing repair of tetralogy of fallot.

J Card Surg 2021 Jul 29. Epub 2021 Jul 29.

Departments of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.

Background: Expected benefits of modified ultrafiltration (MUF) include increased hematocrit, reduction of total body water and inflammatory mediators, improved left ventricular systolic function, and improved systolic blood pressure and cardiac index (CI) following cardiopulmonary bypass (CPB). This prospective randomized trial tested this hypothesis.

Methods: Seventy-nine patients undergoing intracardiac repair of tetralogy of fallot were randomized to conventional ultrafiltration (CUF) + MUF (n = 39) or only CUF group (n = 40). Read More

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Cognitive performance was reduced by higher air temperature even when thermal comfort was maintained over the 24-28°C range.

Indoor Air 2021 Jul 29. Epub 2021 Jul 29.

Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China.

This study managed to create thermal comfort conditions at three temperatures (24°C-T24, 26°C-T26, and 28°C-T28) by adjusting clothing and air velocity. Thirty-six subjects (18 males and 18 females) were exposed to each of the three conditions for 4.5 h in a design balanced for order of presentation of conditions. Read More

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Presumed SARS-CoV-2 Viral Particles in the Human Retina of Patients With COVID-19.

JAMA Ophthalmol 2021 Jul 29. Epub 2021 Jul 29.

São Paulo Hospital, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.

Importance: The presence of the SARS-CoV-2 virus in the retina of deceased patients with COVID-19 has been suggested through real-time reverse polymerase chain reaction and immunological methods to detect its main proteins. The eye has shown abnormalities associated with COVID-19 infection, and retinal changes were presumed to be associated with secondary microvascular and immunological changes.

Objective: To demonstrate the presence of presumed SARS-CoV-2 viral particles and its relevant proteins in the eyes of patients with COVID-19. Read More

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Effect of enteral immunomodulatory nutrition formula on mortality and critical care parameters in critically ill patients: A systematic review with meta-analysis.

Nurs Crit Care 2021 Jul 29. Epub 2021 Jul 29.

Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background: Enteral immunomodulatory nutrition is recommended as an adjuvant therapy for patients in intensive care units (ICU), but its effectiveness is incompletely understood.

Aim: The aim of this review was to examine the effect of a commonly used immunomodulatory formula-omega-3 fatty acids, γ-linolenic acid, and antioxidants-on clinical outcomes and mortality risk in critically ill patients.

Design: Systematic review and meta-analysis of randomized controlled trials (RCTs). Read More

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Evaluation of Bivalirudin as the Primary Anticoagulant in Patients Receiving Extracorporeal Membrane Oxygenation for SARS-CoV-2-Associated Acute Respiratory Failure.

Ann Pharmacother 2021 Jul 29:10600280211036151. Epub 2021 Jul 29.

University of Kentucky, Lexington, KY, USA.

Background: Extracorporeal membrane oxygenation (ECMO) is a potential option for the management of severe acute respiratory failure secondary to COVID-19. Conflicting the use of this therapy is the known coagulopathy within COVID-19, leading to an incidence of venous thrombotic events of 25% to 49%. To date, limited guidance is available on optimal anticoagulation strategies in this population. Read More

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In-hospital Outcomes of Transcatheter Versus Surgical Mitral Valve Repair in Patients with Chronic Liver Disease.

Int J Clin Pract 2021 Jul 29:e14660. Epub 2021 Jul 29.

Department of Cardiology, University of Massachusetts Medical School- Baystate Medical Center, Springfield, Massachusetts, USA.

Background: Mitral valve trans-catheter edge-to-edge repair (TEER) using MitraClip is a treatment option for patients with moderate to severe mitral regurgitation who are not surgical candidate. Liver cirrhosis is associated with higher operative morbidity and mortality however it is not part of preoperative risk assessments calculators. We sought to evaluate the in-hospital outcomes in TEER and SMVR in liver cirrhosis. Read More

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Pulmonary function impairment of asymptomatic and persistently symptomatic patients 4 months after COVID-19 according to disease severity.

Infection 2021 Jul 28. Epub 2021 Jul 28.

Department of Medicine V, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.

Objective: Evaluation of pulmonary function impairment after COVID-19 in persistently symptomatic and asymptomatic patients of all disease severities and characterisation of risk factors.

Methods: Patients with confirmed SARS-CoV-2 infection underwent prospective follow-up with pulmonary function testing and blood gas analysis during steady-state cycle exercise 4 months after acute illness. Pulmonary function impairment (PFI) was defined as reduction below 80% predicted of DLCOcSB, TLC, FVC, or FEV1. Read More

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Particle flow rate from the airways as fingerprint diagnostics in mechanical ventilation in the intensive care unit: a randomised controlled study.

ERJ Open Res 2021 Jul 26;7(3). Epub 2021 Jul 26.

Dept of Cardiothoracic Surgery and Transplantation, Skåne University Hospital, Lund University, Lund, Sweden.

Introduction: Mechanical ventilation can be monitored by analysing particles in exhaled air as measured by particle flow rate (PFR). This could be a potential method of detecting ventilator-induced lung injury (VILI) before changes in conventional parameters can be detected. The aim of this study was to investigate PFR during different ventilation modes in patients without lung pathology. Read More

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Prognostic Factors and Predictors of In-Hospital Mortality Among COVID-19 Patients Admitted to the Intensive Care Unit: An Aid for Triage, Counseling, and Resource Allocation.

Cureus 2021 Jul 23;13(7):e16577. Epub 2021 Jul 23.

Department of Internal Medicine, Kuwait University, Health Sciences Center, School of Medicine, Kuwait, KWT.

Background:  The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains today a global health pandemic. Those with severe infection are at risk of rapid clinical deterioration; as a result, intensive care unit (ICU) admission is not uncommon in such patients. A number of determinants have been identified as predictors of poor prognosis and in-hospital mortality, ranging from demographic characteristics, laboratory and/or radiological findings. Read More

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Case Report: Dexmedetomidine for Intractable Clusters of Myoclonic Jerks and Paroxysmal Sympathetic Hyperactivity in Progressive Encephalomyelitis With Rigidity and Myoclonus.

Front Neurol 2021 12;12:703050. Epub 2021 Jul 12.

Department of Neurology, Kitasato University School of Medicine, Sagamihara, Japan.

Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a severe form of stiff-person spectrum disorder characterized by painful spasms, myoclonic jerks, hyperekplexia, brainstem dysfunction, and dysautonomia, which is sometimes resistant to γ-amino-butyric acid (GABA)-ergic agents. The response to immunotherapy varies depending on identified autoantibodies. We report a dramatic response to dexmedetomidine in a patient with glycine receptor (GlyR) antibody-positive PERM who developed intractable clusters of myoclonic jerks and paroxysmal sympathetic hyperactivity (PSH) that was highly refractory to conventional symptomatic treatment with GABAergic drugs and immunotherapy. Read More

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Detection of Viral and Bacterial Respiratory Pathogens Identified by Molecular Methods in COVID-19 Hospitalized Patients and Its Impact on Mortality and Unfavorable Outcomes.

Infect Drug Resist 2021 21;14:2795-2807. Epub 2021 Jul 21.

Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú.

Purpose: The purpose of this study is to evaluate the frequency of viral and bacterial respiratory pathogens detected by molecular methods in sputum samples of patients hospitalized for COVID-19 and to evaluate its impact on mortality and unfavorable outcomes (in-hospital death or mechanical ventilation).

Patients And Methods: The prospective cohort included patients with diagnosis of COVID-19 hospitalized at Hospital Nacional Hipólito Unanue. Sociodemographic and clinical data were collected from clinical records. Read More

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Secondary pneumonias in critically ill patients with COVID-19: risk factors and outcomes.

Curr Opin Crit Care 2021 Jul 27. Epub 2021 Jul 27.

Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, Centro Hospitalar de Lisboa Ocidental NOVA Medical School, CHRC, New University of Lisbon, Lisbon, Portugal Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, Odense, Denmark Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James's Hospital, St. James Street, Dublin 8, Dublin, Eire, Ireland Hospital Clinic. IDIBAPS. Universided de Barcelona. CIBERes, Barcelona, Spain CHU de Lille, Centre de Réanimation Université de Lille, INSERM U995, Team Fungal Associated Invasive & Inflammatory Diseases, Lille Inflammation Research International Center, Lille, France.

Purpose Of Review: The aim of this review is to provide an overview of the current evidence of secondary pneumonias in COVID-19 patients, its incidence, risk factors and impact outcomes.

Recent Findings: Early studies reported low incidence of hospital-acquired infections in COVID-19 patients. More recent large studies clearly showed that the incidence of secondary pneumonias was markedly high in patients under mechanical ventilation. Read More

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The impact of distance on post-ICU disability.

Aust Crit Care 2021 Jul 25. Epub 2021 Jul 25.

Australian and New Zealand Intensive Care Research Centre, Melbourne, Australia; The Alfred Hospital, Melbourne, Australia; Monash Partners Academic Health Science Centre, Australia. Electronic address:

Background: Nonurban residential living is associated with adverse outcomes for a number of chronic health conditions. However, it is unclear what effect it has amongst survivors of critical illness.

Objectives: The purpose of this study is to determine whether patients living greater than 50 km from the treating intensive care unit (ICU) have disability outcomes at 6 months that differ from people living within 50 km. Read More

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Reliability of mechanical ventilation during continuous chest compressions: a crossover study of transport ventilators in a human cadaver model of CPR.

Scand J Trauma Resusc Emerg Med 2021 Jul 28;29(1):102. Epub 2021 Jul 28.

Division of General Anaesthesiology, Emergency- and Intensive Care Medicine, Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 29, 8036, Graz, Austria.

Background: Previous studies have stated that hyperventilation often occurs in cardiopulmonary resuscitation (CPR) mainly due to excessive ventilation frequencies, especially when a manual valve bag is used. Transport ventilators may provide mandatory ventilation with predetermined tidal volumes and without the risk of hyperventilation. Nonetheless, interactions between chest compressions and ventilations are likely to occur. Read More

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Improving lung compliance by external compression of the chest wall.

Crit Care 2021 Jul 28;25(1):264. Epub 2021 Jul 28.

Department of Anesthesiology, Intensive Care and Emergency Medicine, Medical University of Göttingen, Göttingen, Germany.

As exemplified by prone positioning, regional variations of lung and chest wall properties provide possibilities for modifying transpulmonary pressures and suggest that clinical interventions related to the judicious application of external pressure may yield benefit. Recent observations made in late-phase patients with severe ARDS caused by COVID-19 (C-ARDS) have revealed unexpected mechanical responses to local chest wall compressions over the sternum and abdomen in the supine position that challenge the clinician's assumptions and conventional bedside approaches to lung protection. These findings appear to open avenues for mechanism-defining research investigation with possible therapeutic implications for all forms and stages of ARDS. Read More

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Static compliance and driving pressure are associated with ICU mortality in intubated COVID-19 ARDS.

Crit Care 2021 Jul 28;25(1):263. Epub 2021 Jul 28.

Institute of Anaesthesia and Intensive Care Unit, Padua University Hospital, via V. Gallucci 13, 35125, Padua, Italy.

Background: Pathophysiological features of coronavirus disease 2019-associated acute respiratory distress syndrome (COVID-19 ARDS) were indicated to be somewhat different from those described in nonCOVID-19 ARDS, because of relatively preserved compliance of the respiratory system despite marked hypoxemia. We aim ascertaining whether respiratory system static compliance (Crs), driving pressure (DP), and tidal volume normalized for ideal body weight (VT/kg IBW) at the 1st day of controlled mechanical ventilation are associated with intensive care unit (ICU) mortality in COVID-19 ARDS.

Methods: Observational multicenter cohort study. Read More

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Hospitalization, Mechanical Ventilation, and Mortality After COVID-19 Among Adults With or Without Serious Mental Illness.

Psychiatr Serv 2021 Jul 29:appips202100151. Epub 2021 Jul 29.

Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore (Murphy, Daumit); Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore (Murphy); Department of Health Policy and Management (McGinty), and Department of Mental Health (McGinty, Daumit), Johns Hopkins Bloomberg School of Public Health, Baltimore.

Objective: The authors evaluated the likelihood of hospital admission, mechanical ventilation, and mortality within 30 days after a COVID-19 diagnosis among persons with or without serious mental illness.

Methods: Adults with and without serious mental illness diagnosed as having COVID-19 in the first year of the pandemic were identified in the TriNetX database, a network of electronic health records from 49 U.S. Read More

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Influence of angiotensin converting enzyme inhibitors/angiotensin receptor blockers on the risk of all-cause mortality and other clinical outcomes in patients with confirmed COVID-19: A systemic review and meta-analysis.

J Clin Hypertens (Greenwich) 2021 Jul 28. Epub 2021 Jul 28.

Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

Since the COVID-19 pandemic, physicians concerned about the potential adverse effects of angiotensin converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs). To explore the relationship between ACEIs/ARBs and the risk of mortality and other clinical outcomes in COVID-19 patients, the authors conducted a systemic review and meta-analysis. An electronic search was performed from inception to November 12, 2020 in PubMed, Medline, EMBASE, ClinicalTrials, TRIP, the Cochrane Library, CNKI, Wanfang, and CBM database. Read More

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Pneumothorax in a COVID-19 Patient Receiving Long-Term Mechanical Ventilation.

Rev Soc Bras Med Trop 2021 23;54:e03762021. Epub 2021 Jul 23.

Giresun University, Faculty of Medicine, Department of Radiology, Giresun, Turkey.

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Epidemiological and clinical aspects of Guillain-Barré syndrome and its variants.

Arq Neuropsiquiatr 2021 Jun;79(6):497-503

Instituto de Neurologia de Goiânia, Goiânia GO, Brazil.

Background: Guillain-Barré syndrome (GBS), an acute polyradiculoneuropathy that occurs because of an abnormal inflammatory response in the peripheral nervous system, is clinically characterized by acute flaccid paresis and areflexia with or without sensory symptoms. This syndrome can lead to disabling or even life-threatening sequelae.

Objective: This study aimed to present the clinical and epidemiological aspects of GBS in patients admitted to a tertiary-level hospital in the Federal District between January 2013 and June 2019. Read More

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High mortality among kidney transplant recipients diagnosed with coronavirus disease 2019: Results from the Brazilian multicenter cohort study.

PLoS One 2021 28;16(7):e0254822. Epub 2021 Jul 28.

Department of Medicine, Nephrology Division, Federal University of São Paulo, São Paulo, SP, Brazil.

Background: Kidney transplant (KT) recipients are considered a high-risk group for unfavorable outcomes in the course of coronavirus disease 2019 (COVID-19).

Aim: To describe the clinical aspects and outcomes of COVID-19 among KT recipients.

Methods: This multicenter cohort study enrolled 1,680 KT recipients diagnosed with COVID-19 between March and November 2020, from 35 Brazilian centers. Read More

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Early but not late convalescent plasma is associated with better survival in moderate-to-severe COVID-19.

PLoS One 2021 28;16(7):e0254453. Epub 2021 Jul 28.

Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America.

Background: Limited therapeutic options exist for coronavirus disease 2019 (COVID-19). COVID-19 convalescent plasma (CCP) is a potential therapeutic, but there is limited data for patients with moderate-to-severe disease.

Research Question: What are outcomes associated with administration of CCP in patients with moderate-to-severe COVID-19 infection?

Study Design And Methods: We conducted a propensity score-matched analysis of patients with moderate-to-severe COVID-19. Read More

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Favipiravir and Hydroxychloroquine Combination Therapy in Patients with Moderate to Severe COVID-19 (FACCT Trial): An Open-Label, Multicenter, Randomized, Controlled Trial.

Infect Dis Ther 2021 Jul 28. Epub 2021 Jul 28.

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Introduction: Antiviral drugs have shown limited effectiveness in treating patients with coronavirus disease 2019 (COVID-19). We aimed to assess the effects of a favipiravir and hydroxychloroquine combination on treating moderate-to-severe COVID-19 patients.

Methods: An investigator-initiated, multicenter, open-label, randomized trial at nine hospitals. Read More

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Pediatric interfacility transport effects on mortality and length of stay.

World J Pediatr 2021 Jul 28. Epub 2021 Jul 28.

University of California, Irvine, Irvine, CA, USA.

Background: We aimed to evaluate the effects of interfacility pediatric critical care transport response time, physician presence during transport, and mode of transport on mortality and length of stay (LOS) among pediatric patients. We hypothesized that a shorter response time and helicopter transports, but not physician presence, are associated with lower mortality and a shorter LOS.

Methods: Retrospective, single-center, cohort study of 841 patients (< 19 years) transported to a quaternary pediatric intensive care unit and cardiovascular intensive care unit between 2014 and 2018 utilizing patient charts and transport records. Read More

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