s disease 2019 who received propofol. Neither the cumulative dose nor duration of propofol were identified as a risk factor for the development of hypertriglyceridemia. Due to the incidence of hypertriglyceridemia in this patient population, monitoring of serum triglyceride levels should be done frequently in patients who require more than 24 hours of propofol. Many patients who developed hypertriglyceridemia were able to continue propofol in our analysis after reducing the dose.Acute respiratory distress syndrome secondary to severe acute respiratory syndrome coronavirus-2 pneumonia or coronavirus disease 2019-related acute respiratory distress syndrome is the primary cause of mortality in coronavirus disease 2019. Some studies have described the concept of “high and low” elastance coronavirus disease 2019-related acute respiratory distress syndrome and proposed individualized management for the acute respiratory distress syndrome, deviating from low tidal volume ventilation. We report simultaneously measured respiratory parameters (static lung compliance, alveolar dead space ventilation, and shunt fraction) in 14 patients with advanced coronavirus disease 2019-related acute respiratory distress syndrome. The results were consistent with typical acute respiratory distress syndrome and did not support the concept of high-type coronavirus disease 2019-related acute respiratory distress syndrome and low-type coronavirus disease 2019-related acute respiratory distress syndrome.The primary objective was to evaluate ICU mortality at 28 days in patients with severe hypoxemic respiratory failure due to coronavirus disease 2019 infection who received tocilizumab. The secondary objectives were to evaluate ICU-, hospital-, mechanical ventilation-, and vasopressor-free days at day 28 and development of secondary infections.

Retrospective, observational, multicenter, cohort study between March 15, 2020, and May 31, 2020. Using propensity score matching based on ICU admission source, C-reactive protein, Sequential Organ Failure Assessment score, vasopressor use, age, race, weight, and mechanical ventilation, patients who received tocilizumab were matched to patients who did not receive tocilizumab.

Ten hospitals within the Cleveland Clinic Enterprise.

Adult patients admitted to a medical, surgical, neurosciences, or mixed ICU with severe acute respiratory syndrome coronavirus 2 infection.

None.

Four-hundred forty-four patients were included 342 patients (77%) did not receive tociliztocilizumab administration in critically ill coronavirus disease 2019 patients, with severe hypoxemic respiratory failure, are needed to support these findings.

Tocilizumab use was associated with a significant decrease in ICU mortality in critically ill coronavirus disease 2019 patients with severe hypoxemic respiratory failure. Future randomized controlled trials limited to tocilizumab administration in critically ill coronavirus disease 2019 patients, with severe hypoxemic respiratory failure, are needed to support these findings.Cytokine release syndrome is a systemic inflammatory response that can be triggered by a variety of factors such as infection or exposure to certain drugs, particularly novel T cell-engaging immunotherapies. Severe cytokine release syndrome as a complication following treatment with anti-thymocyte globulin, although recognised, is not well-reported in the literature. We report the case of a 64-year-old man who developed catastrophic cytokine release syndrome after receiving anti-thymocyte globulin during kidney transplantation. We highlight the importance of prompt recognition of severe cytokine release syndrome with strategies to aid survival in life-threatening cases.We report a case of successful tracheal intubation with the combined use of a videolaryngoscope and flexible bronchoscope in a patient with difficult airway when both techniques had individually failed. A 35-year-old man presented with airway obstruction due to massive neck swelling causing hypoxia, stridor and respiratory distress. MMAE supplier He had a history of oral cancer which had been resected with bilateral neck dissection and free flap reconstruction 2 months previously. Due to extensive anterior neck swelling, we judged that front-of-neck airway would not be a suitable approach. After unsuccessful attempts at awake tracheal intubation with videolaryngoscopy and flexible bronchoscopy separately, we combined both techniques with a successful outcome. By using a combined technique to address the specific problems presented by this case, a life-threatening emergency was resolved. This case highlights why it is useful for anaesthetists to be familiar with multiple techniques to awake tracheal intubation, both individually and in combination.Soccer referees move freely on the pitch to place themselves in the best location for making decisions. While Football Association UK (FA) highlights that a referee should never be more than 20 m away from the playing situation, previous studies have been inconsistent in indicating appropriate distance to a situation for increasing the likelihood of a correct decision. Further, appropriate angle and insight are also likely to influence the correctness of referees’ decisions. The aim of this study was to provide an initial investigation of elite referees’ positioning in the field (distance, angle, and insight) when making correct and erroneous decisions in potential penalty situations. An expert panel (EP) consisting of two active referees with relevant academic background analyzed referees positioning when making correct or erroneous decisions regarding penalties. The EP were asked to qualitatively analyze referees positioning in selected video clips by using recommended technical refereeing criteria and pracdecision in potential penalty situations when the distance to the situation is under 10 meters, when the insight to the situation is good and the angle to the incident is good. In contrast, the match referees generally had a poor starting position to assess the penalty situations where they landed on a wrong decision. While previous studies have been somewhat inconsistent in indicating optimal referee positioning in soccer, the present study highlights the potential value of a more qualitative approach to understand referees’ positioning and subsequent decision-making accuracy.