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  1. Article ; Online: COVID-19 and ethics in the ICU.

    Nelson, Sarah E

    Critical care (London, England)

    2020  Volume 24, Issue 1, Page(s) 519

    MeSH term(s) COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Ethics, Medical ; Humans ; Intensive Care Units/ethics ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; United States/epidemiology
    Keywords covid19
    Language English
    Publishing date 2020-08-25
    Publishing country England
    Document type Editorial
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-020-03250-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: COVID-19 and ethics in the ICU

    Nelson, Sarah E.

    Critical Care

    2020  Volume 24, Issue 1

    Keywords Critical Care and Intensive Care Medicine ; covid19
    Language English
    Publisher Springer Science and Business Media LLC
    Publishing country us
    Document type Article ; Online
    ZDB-ID 2041406-7
    ISSN 1364-8535
    ISSN 1364-8535
    DOI 10.1186/s13054-020-03250-5
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: COVID-19 and ethics in the ICU

    Sarah E. Nelson

    Critical Care, Vol 24, Iss 1, Pp 1-

    2020  Volume 3

    Keywords Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9 ; covid19
    Language English
    Publishing date 2020-08-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Ethical Criteria for the Admission and Management of Patients in the ICU Under Conditions of Limited Medical Resources: A Shared International Proposal in View of the COVID-19 Pandemic.

    Tambone, Vittoradolfo / Boudreau, Donald / Ciccozzi, Massimo / Sanders, Karen / Campanozzi, Laura Leondina / Wathuta, Jane / Violante, Luciano / Cauda, Roberto / Petrini, Carlo / Abbate, Antonio / Alloni, Rossana / Argemi, Josepmaria / Argemí Renom, Josep / De Benedictis, Anna / Galerneau, France / García-Sánchez, Emilio / Ghilardi, Giampaolo / Hafler, Janet Palmer / Linden, Magdalena /
    Marcos, Alfredo / Onetti Muda, Andrea / Pandolfi, Marco / Pelaccia, Thierry / Picozzi, Mario / Revello, Ruben Oscar / Ricci, Giovanna / Rohrbaugh, Robert / Rossi, Patrizio / Sirignano, Ascanio / Spagnolo, Antonio Gioacchino / Stammers, Trevor / Velázquez, Lourdes / Agazzi, Evandro / Mercurio, Mark

    Frontiers in public health

    2020  Volume 8, Page(s) 284

    MeSH term(s) COVID-19 ; Health Care Rationing/ethics ; Hospitalization ; Humans ; Intensive Care Units/organization & administration ; Internationality ; Triage/ethics
    Keywords covid19
    Language English
    Publishing date 2020-06-16
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711781-9
    ISSN 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2020.00284
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  6. Article ; Online: Die Schwangere mit COVID-19-ARDS auf der Intensivstation.

    Kalbhenn, J / Marx, O / Müller-Peltzer, K / Kunze, M / Bürkle, H / Bansbach, J

    Die Anaesthesiologie

    2024  

    Abstract: ... of pregnant COVID-19 patients on the intensive care unit (ICU) is challenging and requires careful ... treatment strategies and perinatal anesthesiological management in patients with COVID-19 acute respiratory ... in the anesthesiological ICU of a German university hospital between March and November 2021.: Results: The cohort ...

    Title translation Pregnant women with COVID-19 ARDS on the intensive care unit.
    Abstract Background: Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk of severe disease progression. Comorbidities, such as chronic arterial hypertension, diabetes mellitus, advanced maternal age and high body mass index, may predispose to severe disease. The management of pregnant COVID-19 patients on the intensive care unit (ICU) is challenging and requires careful consideration of maternal, fetal and ethical issues.
    Objective: Description and discussion of intensive care treatment strategies and perinatal anesthesiological management in patients with COVID-19 acute respiratory distress syndrome (CARDS).
    Material and methods: We analyzed the demographic data, maternal medical history, clinical intensive care management, complications, indications and management of extracorporeal membrane oxygenation (ECMO) and infant survival of all pregnant patients treated for severe CARDS in the anesthesiological ICU of a German university hospital between March and November 2021.
    Results: The cohort included 9 patients with a mean age of 30.3 years (range 26-40 years). The gestational age ranged from 21 + 3 weeks to 37 + 2 weeks. None of the patients had been vaccinated against SARS-CoV‑2. Of the nine patients seven were immigrants and communication was hampered by inadequate Central European language skills. Of the patients five had a P
    Conclusion: High survival rates are possible in pregnant patients with CARDS. The peripartum management of pregnant women with CARDS requires close interdisciplinary collaboration and should prioritize maternal survival in early pregnancy. In our experience, prolonged prone positioning, an essential evidence-based cornerstone in the treatment of ARDS, can also be safely used in advanced stages of pregnancy. Inhaled nitric oxide (iNO) and ECMO should be considered as life-saving treatment options for carefully selected patients. For cesarean section, neuraxial anesthesia can be safely performed in patients with mild CARDS if well planned but the therapeutic anticoagulation recommended for COVID-19 may increase the risk of bleeding complications, making general anesthesia a more viable alternative, especially in severe disease.
    Language German
    Publishing date 2024-04-26
    Publishing country Germany
    Document type English Abstract ; Journal Article
    ISSN 2731-6866
    ISSN (online) 2731-6866
    DOI 10.1007/s00101-024-01405-5
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  7. Article: Ethical criteria for the admission and management of patients in the icu under conditions of limited medical resources: A shared international proposal in view of the covid-19 pandemic

    Tambone, Vittoradolfo / Boudreau, Donald / Ciccozzi, Massimo / Sanders, Karen / Campanozzi, Laura Leondina / Wathuta, Jane / Violante, Luciano / Cauda, Roberto / Petrini, Carlo / Abbate, Antonio / Alloni, Rossana / Argemi, Josepmaria / Renom, Josep Argemí / Benedictis, Anna De / Galerneau, France / García-Sánchez, Emilio / Ghilardi, Giampaolo / Hafler, Janet Palmer / Linden, Magdalena /
    Marcos, Alfredo / Muda, Andrea Onetti / Pandolfi, Marco / Pelaccia, Thierry / Picozzi, Mario / Revello, Ruben Oscar / Ricci, Giovanna / Rohrbaugh, Robert / Rossi, Patrizio / Sirignano, Ascanio / Spagnolo, Antonio Gioacchino / Stammers, Trevor / Velázquez, Lourdes / Agazzi, Evandro / Mercurio, Mark

    Front. Public Health

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #624441
    Database COVID19

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  8. Article ; Online: Modeling geographic vaccination strategies for COVID-19 in Norway.

    Chan, Louis Yat Hin / Rø, Gunnar / Midtbø, Jørgen Eriksson / Di Ruscio, Francesco / Watle, Sara Sofie Viksmoen / Juvet, Lene Kristine / Littmann, Jasper / Aavitsland, Preben / Nygård, Karin Maria / Berg, Are Stuwitz / Bukholm, Geir / Kristoffersen, Anja Bråthen / Engø-Monsen, Kenth / Engebretsen, Solveig / Swanson, David / Palomares, Alfonso Diz-Lois / Lindstrøm, Jonas Christoffer / Frigessi, Arnoldo / de Blasio, Birgitte Freiesleben

    PLoS computational biology

    2024  Volume 20, Issue 1, Page(s) e1011426

    Abstract: ... Norway faced significant regional variations in COVID-19 incidence and prevalence, with large differences ... Using two models (individual-based and meta-population), we simulated COVID-19 transmission during ... Vaccination was a key intervention in controlling the COVID-19 pandemic globally. In early 2021 ...

    Abstract Vaccination was a key intervention in controlling the COVID-19 pandemic globally. In early 2021, Norway faced significant regional variations in COVID-19 incidence and prevalence, with large differences in population density, necessitating efficient vaccine allocation to reduce infections and severe outcomes. This study explored alternative vaccination strategies to minimize health outcomes (infections, hospitalizations, ICU admissions, deaths) by varying regions prioritized, extra doses prioritized, and implementation start time. Using two models (individual-based and meta-population), we simulated COVID-19 transmission during the primary vaccination period in Norway, covering the first 7 months of 2021. We investigated alternative strategies to allocate more vaccine doses to regions with a higher force of infection. We also examined the robustness of our results and highlighted potential structural differences between the two models. Our findings suggest that early vaccine prioritization could reduce COVID-19 related health outcomes by 8% to 20% compared to a baseline strategy without geographic prioritization. For minimizing infections, hospitalizations, or ICU admissions, the best strategy was to initially allocate all available vaccine doses to fewer high-risk municipalities, comprising approximately one-fourth of the population. For minimizing deaths, a moderate level of geographic prioritization, with approximately one-third of the population receiving doubled doses, gave the best outcomes by balancing the trade-off between vaccinating younger people in high-risk areas and older people in low-risk areas. The actual strategy implemented in Norway was a two-step moderate level aimed at maintaining the balance and ensuring ethical considerations and public trust. However, it did not offer significant advantages over the baseline strategy without geographic prioritization. Earlier implementation of geographic prioritization could have more effectively addressed the main wave of infections, substantially reducing the national burden of the pandemic.
    MeSH term(s) Humans ; Aged ; Pandemics/prevention & control ; COVID-19/epidemiology ; COVID-19/prevention & control ; Vaccination ; Norway/epidemiology ; Vaccines
    Chemical Substances Vaccines
    Language English
    Publishing date 2024-01-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2193340-6
    ISSN 1553-7358 ; 1553-734X
    ISSN (online) 1553-7358
    ISSN 1553-734X
    DOI 10.1371/journal.pcbi.1011426
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  9. Article ; Online: COVID-19: dealing with ventilator shortage.

    Santini, Alessandro / Messina, Antonio / Costantini, Elena / Protti, Alessandro / Cecconi, Maurizio

    Current opinion in critical care

    2022  Volume 28, Issue 6, Page(s) 652–659

    Abstract: ... of patients in the ward and permit early discharge from the ICU, ethical allocation of mechanical ventilators ... to patients who could benefit more from intensive treatment and short term ICU trials for selected patients ... with uncertain prognosis, respectively. Long-term strategies included education and training of non-ICU ...

    Abstract Purpose of review: To describe different strategies adopted during coronavirus disease 2019 pandemic to cope with the shortage of mechanical ventilators.
    Recent findings: Short-term interventions aimed to increase ventilator supply and decrease demand. They included: redistributing and centralizing patients, repurposing operating rooms into intensive care units (ICUs) and boosting ventilator production and using stocks and back-ups; support by the critical care outreach team to optimize treatment of patients in the ward and permit early discharge from the ICU, ethical allocation of mechanical ventilators to patients who could benefit more from intensive treatment and short term ICU trials for selected patients with uncertain prognosis, respectively. Long-term strategies included education and training of non-ICU physicians and nurses to the care of critically-ill patients and measures to decrease viral spread among the population and the progression from mild to severe disease.
    Summary: The experience and evidence gained during the current pandemic is of paramount importance for physicians and law-makers to plan in advance an appropriate response to any future similar crisis. Intensive care unit, hospital, national and international policies can all be improved to build systems capable of treating an unexpectedly large number of patients, while keeping a high standard of safety.
    MeSH term(s) Humans ; COVID-19/therapy ; Ventilators, Mechanical ; Pandemics ; Intensive Care Units ; Critical Care
    Language English
    Publishing date 2022-10-13
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000001000
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4999: Show issues Location:
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  10. Article ; Online: Extracorporeal hemoadsorption in critically ill COVID-19 patients on VV ECMO: the CytoSorb therapy in COVID-19 (CTC) registry.

    Hayanga, J W Awori / Song, Tae / Durham, Lucian / Garrison, Lawrence / Smith, Deane / Molnar, Zsolt / Scheier, Joerg / Deliargyris, Efthymios N / Moazami, Nader

    Critical care (London, England)

    2023  Volume 27, Issue 1, Page(s) 243

    Abstract: Objectives: The CytoSorb therapy in COVID-19 (CTC) registry evaluated the clinical performance and ... extracorporeal membrane oxygenation (VV ECMO) in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS) and ... and January 2022.: Patients: A total of 100 critically ill adults with COVID-19-related ARDS ...

    Abstract Objectives: The CytoSorb therapy in COVID-19 (CTC) registry evaluated the clinical performance and treatment parameters of extracorporeal hemoadsorption integrated with veno-venous extracorporeal membrane oxygenation (VV ECMO) in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS) and respiratory failure under US FDA Emergency Use Authorization.
    Design: Multicenter, observational, registry (NCT04391920).
    Setting: Intensive care units (ICUs) in five major US academic centers between April 2020 and January 2022.
    Patients: A total of 100 critically ill adults with COVID-19-related ARDS requiring VV ECMO support, who were treated with extracorporeal hemoadsorption.
    Interventions: None.
    Measurements and main results: Baseline demographics, clinical characteristics, laboratory values and outcomes were recorded following individual ethics committee approval at each center. Detailed data on organ support utilization parameters and hemoadsorption treatments were also collected. Biomarker data were collected according to the standard practice at each participating site, and available values were compared before and after hemoadsorption. The primary outcome of mortality was evaluated using a time-to-event analysis. A total of 100 patients (63% male; age 44 ± 11 years) were included. Survival rates were 86% at 30 days and 74% at 90 days. Median time from ICU admission to the initiation of hemoadsorption was 87 h and was used to define two post hoc groups: ≤ 87 h (group-early start, G
    Conclusions: In critically ill patients with severe COVID-19-related ARDS treated with the combination of VV-ECMO and hemoadsorption, 90-day survival was 74% and earlier intervention was associated with shorter need for organ support and ICU stay. These results lend support to the concept of "enhanced lung rest" with the combined use of VV-ECMO plus hemoadsorption in patients with ARDS.
    MeSH term(s) Adult ; Humans ; Male ; Middle Aged ; Female ; COVID-19/complications ; COVID-19/therapy ; Extracorporeal Membrane Oxygenation/methods ; Critical Illness/therapy ; Respiratory Distress Syndrome ; Registries ; Retrospective Studies
    Language English
    Publishing date 2023-06-19
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-023-04517-3
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