Low incidence of severe gastrointestinal complications in COVID-19 patients admitted to the intensive care unit: a large, multi-center study

COVID-19 is a contagious multisystem inflammatory disease caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We studied the efficacy of Aprotinin (nonspecific serine proteases inhibitor) in combination with Avifavir® or Hydroxychloroquine (HCQ) drugs, which are recommended by the Russian Ministry of Health for the treatment therapy of moderate COVID-19 patients. This prospective single-center study included participants with moderate COVID-19-related pneumonia, laboratory-confirmed SARS-CoV-2, and admitted to the hospitals. Patients received combinations of intravenous (IV) Aprotinin (1,000,000 KIU daily, 3 days) and HCQ (cohort 1), inhalation (inh) treatment with Aprotinin (625 KIU four times per day, 5 days) and HCQ (cohort 2) or IV Aprotinin (1,000,000 KIU daily for 5 days) and Avifavir (cohort 3). In cohorts 1–3, the combination therapy showed 100% efficacy in preventing the transfer of patients (n = 30) to the intensive care unit (ICU). The effect of the combination therapy in cohort 3 was the most prominent, and the median time to SARS-CoV-2 elimination was 3.5 days (IQR 3.0–4.0), normalization of the CRP concentration was 3.5 days (IQR 3–5), of the D-dimer concentration was 5 days (IQR 4 to 5); body temperature was 1 day (IQR 1–3), improvement in clinical status or discharge from the hospital was 5 days (IQR 5–5), and improvement in lung lesions of patients on 14 day was 100%.

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Intensive care unit physician-delivered point of care renal tract ultrasound in acute kidney injury is feasible

Journal of the Intensive Care Society ◽

10.1177/1751143718762685 ◽

2018 ◽

Vol 19 (4) ◽

pp. 313-318 ◽

Cited By ~ 1

Author(s):

Prashant Parulekar ◽

Ed Neil-Gallacher ◽

Alex Harrison

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Critically Ill ◽

Critically Ill Patients ◽

Point Of Care ◽

Kidney Injury ◽

Diagnostic Quality ◽

The Core ◽

Low Incidence

Acute kidney injury is common in critically ill patients, with ultrasound recommended to exclude renal tract obstruction. Intensive care unit clinicians are skilled in acquiring and interpreting ultrasound examinations. Intensive Care Medicine Trainees wish to learn renal tract ultrasound. We sought to demonstrate that intensive care unit clinicians can competently perform renal tract ultrasound on critically ill patients. Thirty patients with acute kidney injury were scanned by two intensive care unit physicians using a standard intensive care unit ultrasound machine. The archived images were reviewed by a Radiologist for adequacy and diagnostic quality. In 28 of 30 patients both kidneys were identified. Adequate archived images of both kidneys each in two planes were possible in 23 of 30 patients. The commonest reason for failure was dressings and drains from abdominal surgery. Only one patient had hydronephrosis. Our results suggest that intensive care unit clinicians can provide focussed renal tract ultrasound. The low incidence of hydronephrosis has implications for delivering the Core Ultrasound in Intensive Care competencies.

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Prevalence of cutaneous skin lesions in neonatal intensive care unit: A single center study

Journal of Clinical Neonatology ◽

10.4103/2249-4847.159872 ◽

2015 ◽

Vol 4 (3) ◽

pp. 169 ◽

Cited By ~ 4

Author(s):

DoaaM Youssef ◽

MohammedM Khalil ◽

MohammedM Shehab

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Skin Lesions ◽

Single Center ◽

Single Center Study ◽

Center Study

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Mortality of patients with systemic lupus erythematosus admitted to the intensive care unit – A retrospective single-center study

Best Practice & Research Clinical Rheumatology ◽

10.1016/j.berh.2019.01.013 ◽

2018 ◽

Vol 32 (5) ◽

pp. 701-709 ◽

Cited By ~ 3

Author(s):

Guy Zamir ◽

Yael Haviv-Yadid ◽

Kassem Sharif ◽

Nicola Luigi Bragazzi ◽

Abdulla Watad ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Intensive Care Unit ◽

Intensive Care ◽

Lupus Erythematosus ◽

Single Center ◽

Systemic Lupus ◽

Single Center Study ◽

Center Study

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Low Incidence of Biphasic Allergic Reactions in Patients Admitted to Intensive Care after Anaphylaxis

Anesthesiology ◽

10.1097/aln.0000000000002500 ◽

2019 ◽

Vol 130 (2) ◽

pp. 284-291 ◽

Cited By ~ 3

Author(s):

Sofie Højlund ◽

Peter Søe-Jensen ◽

Anders Perner ◽

Morten H. Bestle ◽

Peder Carl ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Allergic Reaction ◽

Respiratory Symptoms ◽

Allergic Reactions ◽

Total Incidence ◽

Skin Symptoms ◽

Initial Symptoms ◽

Patient Groups ◽

Low Incidence

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Biphasic allergic reactions—recurrence of allergy symptoms after a symptom-free period—are reported to occur in 1 to 23% of allergic reactions. Patients admitted to an intensive care unit after anaphylaxis potentially have more severe reactions and a higher risk of biphasic allergic reactions. The purpose of this study was to examine incidence, triggers, symptoms, and treatment of biphasic allergic reactions, in patients admitted to an intensive care unit. Methods Records of patients admitted to intensive care units with anaphylaxis from 2011 to 2014 were reviewed. Only patients with a reaction fulfilling internationally accepted criteria for anaphylaxis were included. Potential biphasic allergic reactions, defined as renewed allergy symptoms 1 to 72 h after initial symptoms had resolved, without further exposure to the trigger, were identified. Results A total of 83 cases of anaphylaxis were identified, and the most frequent triggers were medications (58 of 83 [70%]). Skin symptoms occurred in 69 (83%) cases, and circulatory and respiratory symptoms in 48 (58%) and 45 (54%) cases, respectively. In total, 82 (99%), 80 (96%), and 66 (80%) were treated with antihistamines, corticosteroids, and epinephrine, respectively. Only 10 patients presented with one or more relevant symptoms after the initial allergic reaction. Of these, three were possible, and one was a probable biphasic allergic reaction, giving a total incidence of 4 of 83 (4.8% [95% CI, 1.6 to 12.5]) or 1 of 83 (1.2% [95% CI, 0.1 to 7.46]), respectively. All cases were mild, presenting with skin symptoms only, occurring on average 14 h after initial reactions. Conclusions The authors observed a low incidence of biphasic reactions in patients admitted to an intensive care unit after anaphylaxis, at a rate equivalent to that reported in other patient groups.

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