Author: A/Prof Chris Nickson
COVID-19 has posed a huge challenge to intensive care globally. While we have been comparatively lucky in Australia so far, we have still faced enormous change while preparing for unprecedented strain on our ICU capacity. We are not out of the woods yet. There is still potential for recurrent outbreaks, especially as attempts to de-escalate the public health measures controlling COVID-19 are made in the coming weeks and months. As intensive care clinicians, we need to be ready.
Recently, with renowned clinician researchers Jack Iwashyna (@iwashyna) and Paul Young (@dogICUma), I wrote a series of blogposts on LITFL discussing some of the controversies in the intensive care management of COVID-19 patients. The threads running through all of the posts are that, while COVID-19 is a new disease, we need to (1) build upon our existing knowledge of acute respiratory distress syndrome (ARDS) and critical illness, (2) ensure that new innovations are adequately tested, (3) support more high quality clinical research including clinical trials of novel therapeutic agents, and (4) prioritise the resourcing and training of staff capable of delivering the highest quality critical care.
In other words, we need to “keep the baby in the bath” – not throw the baby out with the bathwater – by staying true to the principles that have made modern intensive care so successful.
You can read the full series on LITFL via these links:
- COVID-19: Keeping the baby in the bath (Introduction)
- “Silent hypoxaemia” and COVID-19 intubation
- Is COVID-19 ARDS? What about lung compliance?
- COVID-19: “To PEEP, or not to PEEP”?
- MacGyverism and “hacking COVID-19”
- Novel drug therapies and COVID-19 clinical trials
- Overcoming uncertainty in the Age of COVID-19