Care for Critically Ill Patients With COVID-19 Initial reports suggest that COVID-19 is associated with severe disease that requires intensive care in approximately 5% of proven infections. Given how common the disease is becoming, as in prior major severe acute respiratory infection outbreaks—SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), avian influenza A(H7N9), and influenza A(H1N1)pdm09—critical care will be an integral component of the global response to this emerging infection. Management of severe COVID-19 is not different from management of most viral pneumonia causing respiratory failure. The principal feature of patients with severe disease is the development of ARDS: a syndrome characterized by acute onset of hypoxemic respiratory failure with bilateral infiltrates. Evidence-based treatment guidelines for ARDS should be followed, including conservative fluid strategies for patients without shock following initial resuscitation, empirical early antibiotics for suspected bacterial co-infection until a specific diagnosis is made, lung-protective ventilation, prone positioning, and consideration of extracorporeal membrane oxygenation for refractory hypoxemia. To read complete article- https://jamanetwork.com/journals/jama/fullarticle/2762996 Source- JAMA Authors- Srinivas Murthy, MD, CM, MHSc; Charles D. Gomersall, MBBS; Robert A. Fowler, MD, CM, MSc

40yrs/F presented to ED with C/o Severe Respiratory distress and altered mental status.Patient started noticing symptoms 5 days after operated for hysterectomy (Uterine fibroid) at some other hospital.Emergently intubated after acute respiratory failure,patient had to be deeply sedated and paralysed. O/e - Crackles and wheezes,BP -140/80,PR -72,Spo2 -98,Temp -103°F. DIAGNOSIS AND SUGGEST MANAGEMENT PLAN?

CXR is from a patient with Miliary Tuberculosis. How to proceed with the case?

A 67 yrs old male K/C/O DM ,HTN C/o SOB, Dyspnea ,uncontrol diabetes Covid RT-PCR Negative CT score -19/25 TLC -16400 N-90,L-15 CRP-4.10 D Dimer-350 S.creat 1.46 Sgot 75 Sgpt 58 RBS-430 Chest x ray B/L pneumonia Patient on bipap maintained spo2 92-93 But When the patient is removed from the bipap, oxygen immediately comes to 70 %. TLC gradually raised day by day (1 st day-14500, second day-15800) Please suggest Rx and management

30hrs newborn male child having severe respiratory distress with feeble peripheral pulse. H/0 TERM/AGA/NVD/SBA. VITALS- HR-157/min, RR->85/min, SPO2-74-76%with O2. We intubate the child and put on high frequency ventilation. Inotropic support dopamine, dobutamine, adr. , With antibiotics Mero+Amika and IVF nd calcium gluconate and anticonvulsants. Inj vit.k od for 5days and FFP transfusion done. Adv Management and DDX