Hemodynamic Support

Critical Impact: COVID-19: Highlights Session 1

This webinar covers highlights from the Critical Impact: Clinical Practice course.

COVID-19 Respiratory Support and Oxygenation Review

Conventional oxygen therapy is often insufficient to meet the significant oxygen needs of a patient with COVID-19 pneumonia. Several options for providing enhanced oxygen delivery have been studied throughout the COVID-19 pandemic. This webcast held on November 10, 2021, reviewed how some of these strategies are of particular use in patients with COVID-19 who have profound hypoxic respiratory failure.

What are your recommendations for patients on high-flow nasal cannula or noninvasive positive-pressure ventilation who are not adherent with treatment because of anxiety or agitation?

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 September 8, 2021

Can hyperbaric oxygen be used in patients with hypoxia? Are there any data to suggest that it might work?

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 August 11, 2021

How do you perform advanced cardiovascular life support on a patient with COVID-19 who has a cardiac arrest? How does this apply to hemodynamic instability and vasopressor strategies?

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 July 14, 2021

Noninvasive Management of Respiratory Failure during COVID-19: Case Presentation; Nutrition Support for the COVID19 Patient = NIV/HFNC

Noninvasive Management of Respiratory Failure during COVID-19: Case Presentation & Nutrition Support for the COVID19 Patient = NIV/HFNC. This is SCCM curated COVID-19 microlearning content. 

Curriculum Topic: Approach to Respiratory Failure in the COVID-19 Patient

What do you think of the concept of silent hypoxia or happy hypoxia?

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 June 9th, 2021

How should a patient be managed who does not look terrible and has oxygen saturation 83% and low blood pressure?

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 June 9th, 2021.

In permissive hypoxemia and acute respiratory distress syndrome, the literature typically talks about a partial pressure of oxygen of 60 mm Hg. How low should this pressure get for intubated patients?

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 January 13, 2021.

Is there any difference in outcome between patients who are intubated earlier from mechanical ventilation compared with those who are intubated later?

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 January 13, 2021.

For patients being treated for COVID-19, do you switch back and forth between high-flow nasal cannula and noninvasive ventilation?

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 January 13, 2021.

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.

Which medications are used for a hemodynamically unstable intubated patient who is progressing toward or has developed acute respiratory distress syndrome? Are remdesivir or steroids used? What about anticoagulation, given the high risk of thrombosis?

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 November 4, 2020.

What happens when a patient’s condition starts to deteriorate? What are the criteria for ICU admission and what percentage of patients eventually need ICU admission? Of those patients admitted to the ICU, what percentage become septic and hemodynamically

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 November 4, 2020.

For a stable patient on the ward who needs 2 to 4 liters of oxygen, is hemodynamically stable, and does not seem to be deteriorating, would you start a medication such as remdesivir or steroids or would you wait until the patient’s condition starts to det

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 November 4, 2020.

What are the criteria for extubation? I have noticed that when COVID-19 patients are extubated using the same criteria used for other patients, they seem to have a tremendous air hunger and don't do as well. What has been your experience?

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 August 12, 2020.

Regarding respiratory support of COVID-19 patients both in and outside the ICU, can you discuss noninvasive ventilation, BiPAP, CPAP, and high-flow nasal cannula versus intubation? What are the indications for intubation? Intubate early or later?

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 August 12, 2020.

Did you manage any acutely ill patients on the ward with noninvasive ventilation and proning? Did you prone nonintubated patients?

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 August 12, 2020.

Improving Survival of Critical Care Patients With Coronavirus Disease 2019 in England: A National Cohort Study, March to June 2020

From Critical Care Medicine. The authors measured temporal trends in survival over time in people with severe coronavirus disease 2019 requiring critical care (high dependency unit or ICU) management, and assessed whether temporal variation in mortality was explained by changes in patient demographics and comorbidity burden over time.

What is the difference between pulse oximetry and arterial oxygen tension

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 September 9, 2020.

Treatment for Severe Coronavirus Disease 2019 With the Seraph-100 Microbind Affinity Blood Filter

From Critical Care Explorations. The authors sought to determine whether Seraph-100 (Exthera Medical Corporation, Martinez, CA) treatment provides clinical benefit for severe coronavirus disease 2019 cases that require mechanical ventilation and vasopressor support.

How would you describe the overall big picture of oxygen therapies?

In this question and answer webcast, attendees had the opportunity to post questions about managing critically ill patients with COVID-19 and other issues. Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were also addressed. Webcast held on June 19, 2020

What strategies do you use to prevent ventilator-induced lung injury and avoid refractory hypoxemia?

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 May 27th, 2020.

Should patients on oxygen therapy be discharged home or to a long-term acute care hospital?

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 May 13th, 2020.

What strategies are used for fluid resuscitation and intubation timing?

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 May 13th, 2020.

What are your recommendations for ventilation of patients with COVID-19?

In this question and answer webcast series, attendees had an opportunity to pose questions about managing critically ill patients with COVID-19 and other issues.

What is the role of extracorporeal membrane oxygenation in COVID-19?

In this question and answer webcast series, attendees had an opportunity to pose questions about managing critically ill patients with COVID-19 and other issues.

SCCM/AARC: Maximizing the Respiratory Team Dynamic: Effective Patient Care During a Pandemic

This expert panel representatives from Society of Critical Care Medicine (SCCM) and the American Association for Respiratory Care (AARC) teamed up to discuss how ICU respiratory care teams can work together more cohesively when caring for COVID-19 patients. Recorded on: Thursday, May 14, 2020

Time Course of Evolving Ventilator-Induced Lung Injury: The "Shrinking Baby Lung"

From Critical Care Medicine. This paper introduces and highlights several important and /or novel concepts seldom considered by the practicing intensivist.

Can chest radiograph findings change the indication for either intubation or extubation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

What strategies can be used to start hemodynamically unstable patients on mechanical ventilation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

What strategies can be used to reduce rates of reintubation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

At what saturation levels should a patient be intubated and what strategies can be used to avoid intubation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

What are the benefits of proning protocols and the recommendations for timing of proning?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

Does high-flow nasal cannula increase the risk of aerosolization more than a patient coughing?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

Can you comment on the use of nebulizers for chronic obstructive pulmonary disease and other diseases that may respond to bronchodilators?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

If heated high-flow nasal cannula is not available, can continuous positive airway pressure with nasal pillows be used instead?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

ICU Guide for Airway Management in COVID-19 Patients

This is a quick airway management resource guide for treating COVID-19 patients . This is a community developed COVID-19 microlearning resource.

What are the current recommendations for COVID-19 patients undergoing tracheostomy

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

How should airways be secured when proning intubated patients?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

Which ventilator strategies are appropriate for a patient with COVID-19 who is on extracorporeal membrane oxygenation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

How should a COVID-19 patient who is recovering from acute respiratory distress syndrome be weaned off the ventilator?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

Can you discuss the range and ceiling of permissive hypercapnia?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

What are some general recommendation for noninvasive ventilation for moderate respiratory distress (not acute respiratory distress syndrome)?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.

Using the Surviving Sepsis Coronavirus Disease 2019 Guidelines - Anything New Yet?

From Critical Care Explorations. A letter to the editor of Critical Care Explorations about SSC COVID-19 Guidelines and the need to update these guideines and others regularly to help universally optimize sepsis care due to COVID-19 and help flatten the briskly rising morbidity and mortality curve.

Potential for Lung Recruitment and Ventilation-Perfusion Mismatch in Patients With the Acute Respiratory Distress Syndrome From Coronavirus Disease 2019

From Critical Care Medicine. Severe cases of coronavirus disease 2019 develop the acute respiratory distress syndrome, requiring admission to the ICU. This study aims to describe specific pathophysiological characteristics of acute respiratory distress syndrome from coronavirus disease 2019.

ECMO in COVID-19

This presentation is an overview of using ECMO for COVID -19 patients. This is SCCM curated COVID-19 microlearning content.

Mechanical Ventilation

Point of Care (PoC) Refresher Training

Diagnosis and Management of Acute Respiratory Failure

Point of Care (PoC) Refresher Training. While current recommendations for respiratory support in COVID-19 support the use of the high-flow nasal cannula for hypoxia, oxygen supplementation strategies vary by institution. Make sure to follow your institution's protocols.

Surviving Sepsis Campaign COVID-19 Guidelines: Hemodynamics Recommendations Chart

COVID-19 - - Quick Reference Chart. This chart is to be used as a rapid resource when choosing hemodynamic options for managing COVID-19 patients.

How is ECMO being used in patients with COVID-19?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.