Category: Crisis Management
What medication adjuncts can clinicians use for the patient with severe hypoxemia who is receiving 100% oxygen but only getting an oxygen reading of 90%? What are some strategies clinicians can use to reduce some of these difficulties?
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on December 9, 2020.
For patients who fail to adequately oxygenate with less invasive methods, what are your triggers for starting mechanical ventilation? What would you want the non-ICU clinician to know before going down that path? When do you decide to intubate someone?
How do you decide which patients will need more rapid forms of respiratory support, such as high-flow nasal cannula?
What is a general go-to ventilator setting? Once you have intubated the patient, how would you recommend that the clinician set up the ventilator for a hypoxemic patient with evolving ARDS?
Coronavirus Disease 2019 Calls for Predictive Analytics Monitoring—A New Kind of Illness Scoring System
From Critical Care Explorations The authors believe that current illness severity scoring systems, which usually update only when clinicians measure vital signs or laboratory values, are poorly suited for early detection of this kind of rapid clinical deterioration, and t...
Thromboembolism, Hypercoagulopathy, and Antiphospholipid Antibodies in Critically Ill Coronavirus Disease 2019 Patients: A Before and After Study of Enhanced Anticoagulation
From Critical Care Explorations In this study, the authors sought to determine the prevalence of thrombotic events, functional coagulation tests, inflammatory biomarkers, and antiphospholipid antibodies before and after enhanced anticoagulation in critically ill coronaviru...
Effects of Inhaled Epoprostenol and Prone Positioning in Intubated Coronavirus Disease 2019 Patients With Refractory Hypoxemia
From Critical Care Explorations In this study, the authors found that, in critically ill, mechanically ventilated patients with coronavirus disease 2019 who had refractory hypoxemia, oxygenation improved to a greater extent with combined use of inhaled epoprostenol and pr...
Propofol-Associated Hypertriglyceridemia in Coronavirus Disease 2019 Versus Noncoronavirus Disease 2019 Acute Respiratory Distress Syndrome
From Critical Care Explorations In this study, the authors found that patients with coronavirus disease 2019 acute respiratory distress syndrome experienced a higher rate of propofol-associated hypertriglyceridemia than noncoronavirus disease 2019 acute respiratory distre...
An Algorithm for Classifying Patients Most Likely to Develop Severe Coronavirus Disease 2019 Illness
From Critical Care Explorations The authors developed an algorithm to assess whether someone is at high risk of admission to the ICU or dying from coronavirus disease 2019, should he or she test positive for coronavirus disease 2019.
Clinical Outcomes With the Use of Prophylactic Versus Therapeutic Anticoagulation in Coronavirus Disease 2019
From Critical Care Explorations In this study, the authors found an increase in inhospital mortality was observed among patients on preemptive therapeutic anticoagulation.
Letter to the Editor: Breaking Silos: The Team-Based Approach to Coronavirus Disease 2019 Pandemic Staffing
From Critical Care Explorations The authors describe experiences and lessons learned at NewYork-Presbyterian (NYP), one of the largest healthcare delivery systems in the United States, in creating an intercampus leadership teams to combat COVID-19.
Risk Factors for Invasive Pulmonary Aspergillosis in Critically Ill Patients With Coronavirus Disease 2019-Induced Acute Respiratory Distress Syndrome
From Critical Care Explorations The authors retrospectively evaluated cases of coronavirus disease 2019 acute respiratory distress syndrome patients and identified six patients that met the diagnosis of invasive pulmonary aspergillosis according to previously established ...
Harmonizing Heterogeneous Endpoints in Coronavirus Disease 2019 Trials Without Loss of Information
From Critical Care Medicine The authors aim to provide hands-on statistical guidelines for harmonizing heterogeneous endpoints in coronavirus disease 2019 clinical trials.
Inflammatory Response and Phenotyping in Severe Acute Respiratory Infection From the Middle East Respiratory Syndrome Coronavirus and Other Etiologies
From Critical Care Medicine The authors evaluated the inflammatory response in patients with severe acute respiratory infection due to the Middle East respiratory syndrome and non-Middle East respiratory syndrome and assessed the presence of distinct inflammatory subpheno...
Camostat Mesylate May Reduce Severity of Coronavirus Disease 2019 Sepsis: A First Observation
From Critical Care Explorations The authors present a case series of eleven patients, five treated with camostat mesylate and six treated with hydroxychloroquine.
A Propensity-Matched Cohort Study of Tocilizumab in Patients With Coronavirus Disease 2019
From Critical Care Explorations The authors assessed the impact of tocilizumab therapy and found that it was associated with significantly improved survival in coronavirus disease 2019 patients.
Intravenous Immunoglobulin Plus Methylprednisolone Mitigate Respiratory Morbidity in Coronavirus Disease 2019
From Critical Care Explorations The authors piloted a randomized trial of IV immunoglobulin in coronavirus disease 2019 patients and found significantly improved hypoxia and reduced hospital length of stay.
Rescue Treatment With High-Dose Gaseous Nitric Oxide in Spontaneously Breathing Patients With Severe Coronavirus Disease 2019
From Critical Care Explorations The authors present a case series of patients who received nitric oxide inhalation as a rescue therapy for coronavirus disease 2019.
Timing of Tracheostomy for Prolonged Respiratory Wean in Critically Ill Coronavirus Disease 2019 Patients: A Machine Learning Approach
From Critical Care Explorations The authors found that the optimal window for consideration of tracheostomy for ventilatory weaning in coronavirus disease 2019 patients is between day 13 and 17.
Frequency and Analysis of Unplanned Extubation in Coronavirus Disease 2019 Patients
From Critical Care Explorations The authors found that coronavirus disease 2019 patients have a higher incidence of unplanned extubation that requires reintubation than noncoronavirus disease 2019 patients.
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