So I had an awesome time talking and learning from some of the smartest and most progressive thinkers I know, some of the usual suspects at H&R, and some amazing docs from Italy and NYC who are at the front lines of this COVID war.
- HFNC & NIV – do we dare use them?
- when do we intubate?
- how do we ventilate? prone ventilation routine or rescue?
- Adjuncts: suction, bronchoscopy
- When do we wean?
- Q&A if time allows.
Dr. Laura V. Duggan MD FRCPC (Anesthesiology and Pediatrics), Associate Professor, Department of Anesthesiology and Pain Medicine, University of Ottawa, Canada @drlauraduggan. www.airwaycollaboration.org
Dr. Marco Garrone, MD, ED doc from Mauriziano Ospedale, Torino, Italy. @drmarcogarrone.
Dr. Cameron Kyle-Sidell, MD, ED-ICU, Maimonides Hospital, New York. @cameronks
Dr. Josh Farkas, ICU, University of Vermont, Creator, The Internet Book of Critical Care (IBCC), @pulmcrit.
Dr. Adam Thomas, ED doc & CC Fellow, University of British Columbia, co-author, The Internet Book of Critical Care, @adamdavidthomas.
Dr. Philippe Rola, ICU, Santa Cabrini Hospital, Montreal, Quebec. @thinkingcc
Dr. Rory Spiegel, ED-CC doc, Washington Hospital Center, Washington, DC. @emnerd
Dr. Scott Weingart, ED-CC doc, Creator, EmCrit.org, Stony Brook Hospital, New York. @emcrit
Here is the audio, am working on editing the video and should have it up soon.
I realize many questions came from the audience regarding L and H phenotypes, a concept which was rapidly assimilated by those reading and discussing day and night to stay at the cutting edge of the understanding of COVID physiology, so I am including the Gattinoni paper which is the source. For those still thinking of this as ARDS, understand that the single most published author and pre-eminent authority on that disorder states “this is not ARDS,” even if the H type, for those who progress to it – or evolve towards it due to initial management strategies, is fairly similar.
A huge thanks again to my all star cast for making this happen and for their continuing efforts to learn and teach. Please refer to Josh and Adam’s IBCC covid page which is constantly evolving, and Scott’s emcrit.org for ongoing info.
There were a lot of comments and questions, many very interesting, will try to address them in the next webinar likely in a week or so.
cheers and stay safe
I found Chinese ICU specialists reporting experience in Wuhan very similar to yours. This is a similar webinar in Chinese, with English and French subtitles. Will confirm your experience.
Has anyone looked at the heart of these patients ??
Any experiences on how the heart behaves during the illness
Dr Deepa Kane
of course. we look at every patient’s heart by bedside sonography. it is very variable.