Combined advances in haematopoietic cell transplantation (HCT) and intensive care
management have improved the survival of patients with haematological malignancies
admitted to the intensive care unit. In cases of refractory respiratory failure or
refractory cardiac failure, these advances have led to a renewed interest in advanced
life support therapies, such as extracorporeal membrane oxygenation (ECMO), previously
considered inappropriate for these patients due to their poor prognosis. Given the
scarcity of evidence-based guidelines on the use of ECMO in patients receiving HCT
and the need to provide equitable and sustainable access to ECMO, the European Society
of Intensive Care Medicine, the Extracorporeal Life Support Organization, and the
International ECMO Network aimed to develop an expert consensus statement on the use
of ECMO in adult patients receiving HCT.
The Trinidad and Tobago Guardian is the longest running daily newspaper in the country, marking its centenary in 2017. The paper started life as the Trinidad Guardian on Sunday 2nd September 1917 by the newly formed Trinidad Publishing Company Limited.
Although crude mortality did not differ between variants, adjusted risk of death was
highest for patients treated with ECMO infected with the delta variant of SARS-CoV-2.
The higher virulence and poorer outcomes associated with the delta strain might relate
to higher viral load and increased inflammatory response syndrome in infected patients,
reinforcing the need for a higher rate of vaccination in the population and updated
selection criteria for ECMO, should a new and highly virulent strain of SARS-CoV-2
emerge in the future.
Improvements in the acute management of critically ill patients have contributed to
increased survival in the intensive care unit (ICU), yet up to two-thirds of survivors
after mechanical ventilation struggle with post-intensive care syndrome, which consists
of new or worsened cognitive impairment, physical disability, or mental health disorders.
Of these, cognitive impairment affects a third of survivors and persists a year or
more after critical illness;1 however, little is known about the pathogenesis of post-intensive
care syndrome, and evidence-based treatments are scarce.