Videolaryngoscopy in the Intensive Care Unit: We could Improve ICU Patients Safety

Tracheal intubation is one of the most common and dangerous procedures in the intensive care units (ICU), and is usually done in more difficult conditions than in the operating room. Intubation failure can occur unexpectedly, and is the second most common event reflected in the ICU in the NAP4. Complications associated with airways were more likely to occur in ICU than in the operating room (severe hypoxemia, arrhythmia, hypotension, cardiovascular collapse, etc.), and generates more frequent damage to the patient. The theoretical benefits of videolaryngoscopes, as proper and correct use, offer the potential to reduce the difficulty of intubation in the ICU. In recent years, the role of videolaryngoscopes in ICU has been the subject of debate. Numerous studies have shown increased morbidity when performing multiple attempts at tracheal intubation. Videolaryngoscopes allow a view of the entrance of glottis independent of the line of sight, and have also been shown to improve glottis and intubation success rates in emergency and emergency services, in the prehospital setting, and specifically in patients with known predictors of difficult airway (DA)

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality