Background Effective antiviral therapy against the severe acute respiratory syndrome virus 2 (SARS-CoV-2) remains elusive. Convalescent plasma is an anti-viral approach currently under investigation. We aimed to assess the laboratory and clinical parameters of patients with COVID-19 pneumonia treated with convalescent plasma containing high levels of neutralizing anti-SARS-CoV-2 antibodies.

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A 32-year-old man was in a parking lot trying to jump-start a car battery when the engine exploded. He suffered 18% total body surface area (TBSA) burns as well as inhalation injury. At initial presentation at the A&E, the patient was alert but disorientated and moaning in pain. He was in an altered mental state with a Glasgow ABSTRACT Inhalation injury is a serious consequence of a fire or an explosion, with potential airway compromise and respiratory complications. We present a case series of five patients with inhalational burns who presented to Singapore General Hospital and discuss our approach to their early management, including early evaluation and planning for the upper and lower airway, coexisting cutaneous burns, and monitoring their ICU (intensive care unit) severity of illness, sepsis and acute respiratory distress syndrome. All five patients suffered various grades of inhalation injury. The patients were initially assessed by nasolaryngoscopy, and three patients were prophylactically intubated before being sent to the emergency operating theatre for definitive airway and burns management with fibreoptic bronchoscopy. All patients were successfully extubated and discharged stable. Various complications can arise as a result of an inhalation injury. Based on our cases and literature review, we propose a standardised workflow for patients with inhalation injury.

The COVID-19 global pandemic has overwhelmed health services with large numbers of patients presenting to hospital, requiring immediate triage and diagnosis. Complications include acute respiratory distress syndrome, myocarditis, septic shock, and multiple organ failure. Point of care ultrasound is recommended for critical care triage and monitoring in COVID-19 by specialist critical care societies, however current guidance has mainly been published in webinar format, not a comprehensive review. Important limitations of point of care ultrasound include inter-rater variability and subjectivity in interpretation of imaging findings, as well as infection control concerns. A practical approach to clinical integration of point of care ultrasound findings in COVID-19 patients is presented to enhance consistency in critical care decision making, and relevant infection control guidelines and operator precautions are discussed, based on a narrative review of the literature.

Multiple and complex aetiological factors contributes to anaemia in critically ill patients. This article sets out to examine the clinical evidence and physiological rationale for transfusion, traditionally based on an arbitrary haemoglobin trigger of 10 g=dL. Maintenance of haemoglobin concentration level of 10 g=dL or above may benefit only a small group of patients with an acute myocardial infarction, unstable angina or those who have severe coronary artery disease. However, most critically ill patients tolerate anaemia very well due to physiological compensatory mechanisms and clinical studies suggest that there is an increase in adverse outcome if transfusion is carried out using this traditional trigger threshold.

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