The critically ill patient with COVID-19 and ARDS: Providing rational solutions to new and old challenges

The onset of COVID-19 has bought many aspects of critical care to the forefront both locally and internationally with infected patients presenting to Intensive Care Units (ICU) with an Acute Respiratory Distress (ARDS) type picture. Many of the challenges posed by COVID-19 are not new to Intensive Care Medicine, albeit unfamiliar to those outside the specialty. In the patient with ARDS, although established standards of care exist, there still remain unanswered questions on optimal ventilation settings, decisions to intubate and the use of adjunctive therapy. In this review we discuss some of the challenges of COVID-19 and its interaction with these foundational issues in critical care.