There is obvious decrease in thrombotic events during the second wave as early use of glucocorticoids and thromboprophylaxis

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Article Comparison between first and second wave among critically il...

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Primero. Hay más conocimiento sobre la respuesta inflamatoria de la enfermedad COVID-19, aunque no tengamos el tratamiento específico. Si conocemos más sobre el soporte general de la enfermedad grave, tanto médica como de soporte ventilatorio. Al igual que el seguimiento

Segundo la reflexión humana y ética nos ha hecho mirar más hacia los derechos humanos en la atención de calidad, derecho a la informacion, a la salud y a la no discriminación.

La segunda ola nos hizo más conscientes que la primera y la tercera más científicos y humanos

As an ICU RN I can tell you that the first wave was a mess. We had no idea what worked and what didn't. We threw everything at it and NOTHING really worked. Pts were put on ventilators as we would do with ARDS and it seemed to worked then it failed. Very few of my patients ever came off the vent and none went home. Co Morbidities were important in the clinical outcome but not totally so. I had 35yo's w/o Hx that came in with poor P/F ratios and were intubated then died. ETOH pts actually seemed somewhat better outcome.

In second wave we were giving high dose steroids and heparin or Lovenox for micro DVTs but this also was not a fix of the problem. It address some of secondary disease process but the disease and did not fix the ARDS. Pt were also placed on ECMO to try and give the heart lungs a rest. This was a death sentence as any patient that was placed on ECMO was a last ditch to save them, none came off. I think we were more prepared psychological but we still had nothing to give our patients. If they came to the ICU with Covid and got intubated 99% died.

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Hi;

International experts have published a consensus to improve the management of patients infected with Covid-19 in order to reduce the risk of thrombotic complications, especially in the intensive care setting. The recommended measures include preventive anticoagulant treatment of patients with respiratory difficulties, with a preference for the parenteral route.

Dexamethasone, a synthetic corticosteroid known for its anti-inflammatory and immunosuppressive effects, is "given intravenously and is given earlier and in a higher dose as soon as oxygen is needed. According to the first results, dexamethasone treatment reduces mortality at four weeks by about 11% in patients receiving oxygen. In mechanically ventilated patients, relative mortality decreased by nearly 30%.

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second wave much effected the younger one as they are un vaccinated in my country

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