All right, so welcome back to the Internet Book of Critical Care Podcast. I'm here with Adam

Thomas, and we're on update number six of the COVID chapter. Josh, good to hear you sounding healthy.

I have to say, of course I was wrong, and I was wrong again. Caledra's back. All these things are going to go in it out of favor.

Oh, man.

Just the emotional roller coaster continues.

So today we'll give you an update on awake proning.

We'll go back into the thrombosis picture.

We'll talk about antiviral specifically with caledra, lupus anticoaglant, and then we'll have some immune modulatory therapies.

Josh, let's get straight into the proning.

We want to highlight the Caputo trial here.

So this was a study done in New York City under extremely rough situations.

And basically, we've talked earlier about this kind of approach of early intubation.

And rather than early intubation, these authors basically

took patients who had refractory hypoxemia and prone to them, simply rolled them on their belly,

and they also actually had a protocol of multiple different positions. And have managed to avoid

intubation, 64% of those patients. I think that's really tremendous and on par with the efficacy

of bi-PAP and COPD. So I think this is really

important and it would have been nice to see this published in New England or JAMA, honestly. But I

think this is really a great paper. What we're doing is we're throwing high flow on these patients

and we can't get their stats up. So normally what we would say is let's proceed to RSI. But what

you're saying is that this is a low-cost, effective intervention to prevent that

next step.

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