During the last decade, Europe became known as a major climatic hotspot1, due to the world’s highest increase in average temperature; thus, associated with an increase in the frequency and intensity of heat waves and hot summers2. Continue reading
Respiratory failure due to Coronavirus 2019 (COVID-19) disease has triggered a debate about when and how to apply mechanical ventilation in these patients, as it has been proposed that severe "atypical" ARDS of COVID-19 cause an ARDS pandemic. As global database grows, it is evident that about 6% of patients will need admission to the ICU. About 75% of these will require invasive ventilation, and approximately 10% will need ventilation beyond 14 days. Different ventilation strategies are followed yet there is no strong evidence in favor of anyone. The present article attempts to gather the daily evolving evidence on the subject. Continue reading
Coronaviruses are a large family of viruses that cause illnesses ranging from the common cold to more severe diseases. SARS-CoV-2 is a new virus that has not been previously identified in humans. Patients with SARS-CoV-2 commonly develop acute respiratory distress syndrome (ARDS), myocardial injury, ventricular arrhythmias, and shock, all of which increase their risk of cardiac arrest. The main objective of this brief review is to raise the discussion on the possible indication of cardiopulmonary resuscitation in a patient with SARS-CoV-2 in prone position as a way to save time, since the entire process of decubitus change is complex and often slow, due to the number of devices used in these patients, such as catheters, infusion pumps and monitors. In addition to a price of high demand for stressed human resources. Continue reading
Anaesthetic management of patients with comorbidities can be challenging and requires rigorous planning. Peripheral nerve blocks (PNBs) do not compromise haemodynamics or pulmonary function. We present the management of a patient with symptomatic syringomyelia, severe pulmonary hypertension, thrombophilia and obstructive sleep apnoea undergoing hip fixation. Combined psoas compartment and sciatic nerve block was conducted and the patient remained stable perioperatively. She had an uneventful recovery and was discharged three days later. Patients with multiple comorbidities are subject to high perioperative risk and should be managed individually. Regional anaesthesia can be a last resort that leads to a better outcome. Continue reading
