Issue 2 – March 2021

COVID-19, a remarkable year

01 maart 2021

The past year will forever be remembered as the year of the outbreak of a novel coronavirus. From the moment the first Dutch patient was admitted to hospital, healthcare providers received a crash course in recognising and treating these patients. Intensivists, ICU nurses and all others working with the most…

Volume 29, Issue 2 – March 2021

01 maart 2021

REMAP-CAP: delivering research in the pandemic

01 maart 2021

Abstract The Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV-2) pandemic is an unprecedented global health crisis. For hospitalised patients with Coronavirus Disease 2019 (COVID-19) mortality and morbidity is high. A case fatality rate of 49% for critically ill patients was reported in early studies. We urgently need effective treatments for…

Effect of high-dose methylprednisolone in mechanically ventilated ICU patients with COVID-19: a retrospective observational study

01 maart 2021

Abstract Background: COVID-19 is associated with clinical features that closely resemble acute respiratory distress syndrome and causes hypoxic respiratory failure requiring ventilator support. The primary purpose of this study is to investigate the effects of high-dose methylprednisolone on the respiratory condition of COVID-19 patients on the intensive care unit (ICU)…

Sharing is caring: how COVID-19 led to large scale collaboration for icudata.nl

01 maart 2021

For many intensivists worldwide, the pandemic will have created long-lasting memories. Some of them grim, such as massively overwhelmed ICUs, the dehumanising appearance of seemingly interchangeable and mostly proned patients, and healthcare professionals hidden behind personal protective equipment. Some of them energising, including surprising patient recoveries as well as the…

Fraction of inspired oxygen (FiO2) to modulate respiratory drive in a mechanically ventilated patient

01 maart 2021

Dear editor, With great interest we read the review by Jonkman, de Vries and Heunks, extensively explaining the physiology of respiratory drive in ICU patients, published recently in Critical Care.[1] We would like to present a recent clinical observation of a patient’s respiratory drive that was possibly influenced by subtle…

When to start spontaneous breathing in mechanically ventilated COVID-19 patients? Oxygenation index and PaO2 /FiO2 ratio can help

01 maart 2021

Dear editor, Patients with COVID-19 induced respiratory failure are initially treated with lung-protective controlled mechanical ventilation to prevent ventilator-induced lung injury.[1] Adequate timing of the switch to a support ventilation mode seems critical. Prolonged sedation and neuromuscular blocking may increase ICU-acquired weakness, whereas premature transition to spontaneous breathing may result…

Neurological complications in COVID-19 patients admitted to a general ICU in the Netherlands

01 maart 2021

Abstract Coronavirus disease 2019 (COVID-19) predominantly affects the respiratory system. However, the viral infection has been associated with brain involvement. In the literature multiple routes are described through which this neurotrophic virus enters the central and peripheral nervous system, including direct and indirect pathways. This can cause various neurological complications,…

Endotracheal tube obstruction in patients diagnosed with COVID-19

01 maart 2021

Abstract In this case report, two COVID-19 patients with acute respiratory distress are presented. In both cases the acute respiratory distress was due to occlusion of the endotracheal tube. Patient A had an occlusion due to a blood clot. Patient B had an occlusion due to mucus secretions. In general,…

Cerebral microbleeds in a COVID-19 patient

01 maart 2021

Abstract A 31-year-old male was admitted to the intensive care unit with respiratory failure due to SARS-CoV-2 infection. A persistent altered mental state, with agitation and subsequently persistent coma, was one of the complications he suffered during his illness. Brain MRI showed diffuse cerebral microbleeds (CMBs). The pattern of distribution…