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This guidance outlines British Thoracic Society (BTS) recommended follow up of patients with a clinic radiological diagnosis of COVID-19 pneumonia. The COVID-19 swab status of patients is not relevant to this guidance. The entry point to this guidance is a clinical diagnosis of COVID-19 pneumonia with consistent radiological changes. This document may require updating as more information becomes available. This version was published on Monday 11 May2020. Please check the BTS website for the most up to date version of this document. This guidance focuses on the radiological follow up of the pneumonic process and the subsequent diagnosis and management of respiratory complications of COVID-19 pneumonia.

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The aim of the guideline is to draw attention to the evidence of sub-optimal care in acute hypercapnic respiratory failure (AHRF) in the UK, provide an overview of the evidence supporting the use of invasive and non-invasive ventilation, encourage better communication between admitting clinicians and critical care services, promote the use of AHRF patient pathways, and improve resourcing, training, outcomes and patient experience for all adults who develop AHRF.

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Cam ICU Pocket Cards help the medical practitioner to do "delirium assessment" and " Sedation Assessment".

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Picture cards and questions designed to evaluate a patients' ability to focus.

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With the CAM-ICU, Inattention is evaluated with either a Letters (auditory) test or a Pictures (visual) test. Either test can be used to test for attention. The Letters test is the SAVEAHAART described in the training manual. The Pictures test uses premade picture packets. We have created a Power Point file to make it easier to reproduce the picture packet. Below is a link to the Power Point files. There are two sets of picture packets (Set A and Set B). However, only one packet is needed per assessment.

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This is the pocket card version of RASS scale and new CAM-ICU Flowsheet.

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Specialists in intensive care medicine have long focused on the prevention of short-term mortality. As intensive care unit (ICU) mortality continues to improve, interest in outcome measures has expanded to include the morbidity and mortality of survivors. Over the last 10 years it has been increasingly recognized that critical illness is a medical condition itself, irrespective of the underlying cause for ICU admission, and patients experience physical, psychological, and cognitive dysfunction after hospital discharge (Figure 1). However, because relatively few patients ultimately require critical care, many GPs may have little contact with these patients. It may therefore be difficult to provide the additional support required by ICU survivors. This short paper highlights some of the physical and psychological difficulties that patients face after discharge from ICUs and will hopefully help GPs to plan long-term management of their patients in the community.

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ABCDE= Caregiver
A- Advocacy
B- Burn out
C- Communication
D- Do not Disturb
E- Education & exit – schedules

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Introduced what the caregivers' ABCDE stands for, and explained them in detail.

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Patients with COVID-19 are staying longer than the average three to four days in the intensive care unit (ICU), says Megan Hosey, a rehabilitation psychologist at Johns Hopkins Hospital’s medical ICU. This puts them at greater risk for developing post-intensive care syndrome (PICS). While more patients than ever are surviving after treatment in the ICU, research over the last two decades shows that survival can come with the cluster of physical, psychological and cognitive symptoms associated with PICS — hindering patients’ quality of life for weeks or years to come. Although the exact prevalence of PICS is unknown, “it happens in more patients than we probably realize,” says Hosey, and it is occurring in some patients with COVID-19.

Brief description of media:

Patients with COVID-19 are staying longer than the average three to four days in the intensive care unit (ICU), says Megan Hosey, a rehabilitation psychologist at The Johns Hopkins Hospital’s medical ICU. This puts them at greater risk for developing post-intensive care syndrome (PICS).

While more patients than ever are surviving after treatment in the ICU, research over the last two decades shows that survival can come with the cluster of physical, psychological, and cognitive symptoms associated with PICS — hindering patients’ quality of life for weeks or years to come. Although the exact prevalence of PICS is unknown, “it happens in more patients than we probably realize,” says Hosey, and it is occurring in some patients with COVID-19.

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Sepsis and acute respiratory distress syndrome (ARDS) are life threating diseases with high mortality and morbidity in all the critical care units around the world. After decades of research, and numerous pre-clinical and clinical trials, sepsis and ARDS remain without a specific and effective pharmacotherapy and essentially the management remains supportive. In the last years cell therapies gained potential as a therapeutic treatment for ARDS and sepsis. Based on numerous pre-clinical studies, there is a growing evidence of the potential benefits of cell-based therapies for the treatment of sepsis and ARDS. Several cell types are used in the last years for the treatment of both syndromes showing high efficiency. Embryonic stem cells (ESC), multipotent stem (or stromal) cells (MSC) and epithelial progenitors’ cells (EpPC) have been used for both diseases.

Nowadays, a major part of the pre-clinical studies is using MSC, however other relevant groups are also using induced pluripotent stem cells (iPSC) for the treatment of both syndromes and alveolar type II cells for ARDS treatment. Numerous questions need further study including determining the best source for the progenitor cells isolation, their large-scale production and cryopreservation. Also, the heterogeneity of patients with sepsis and ARDS is massive and establish a target population or the stratification of the patients will help us to determine better the therapeutic effect of these cell therapies. In this review we are going to briefly describe the different cell types, their potential sources and characteristics and mechanism of action. Here, also we elucidate the results of several pre-clinical and clinical studies in ARDS and in sepsis and the future directions of these studies.