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Category: Pulmonary

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Corticosteroid Responsive Encephalopathy: Prolonged Coma in Patients Late in the Course of Dreadful Severe Acute Respiratory Syndrome Coronavirus 2 Infection

From Critical Care Explorations. In this case report, the authors describe two cases of prolonged coma after weaning off sedation in severe acute respiratory syndrome coronavirus 2 with rapid neurologic improvement shortly after high-dose corticosteroid regimen.


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.


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.


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.


What treatments are available for both intubated and nonintubated COVID-19 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.


How would a nonintensivist manage a patient who needs high-flow oxygen or noninvasive ventilation but does not require immediate intubation who is admitted to the ward because no ICU beds are available?

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.


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 is your experience with COVID-19 patients and ECMO?

Despite remdesivir, dexamethasone, and twice-daily anticoagulation, a patient’s condition continues to deteriorate. The patient is intubated, and every possible ventilation mode has been tried. The P/F ratio is decreasing, and pressure ventilation is not working. What is your experience with COVID-19 patients and ECMO? This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on November 4, 2020.


Is tracheostomy a possibility in some COVID-19 patients? What is the longest time a patient has been on mechanical 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 November 4, 2020.


If a patient reports shortness of breath but has an oxygen saturation of 95%, is this patient a candidate for dexamethasone?

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.


Almitrine Infusion in Severe Acute Respiratory Syndrome Coronavirus 2-Induced Acute Respiratory Distress Syndrome: A Single-Center Observational Study

From Critical Care Medicine

The authors assessed the effect of almitrine, a selective pulmonary vasoconstrictor, on arterial oxygenation in severe acute respiratory syndrome coronavirus 2-induced acute respiratory distress syndrome.


Volatile Isoflurane in Critically Ill Coronavirus Disease 2019 Patients—A Case Series and Systematic Review

From Critical Care Explorations

The authors evalute the use of isoflurane in patients with coronavirus disease 2019–induced acute respiratory distress syndrome.


Resolution of Coronavirus Disease 2019 Infection and Pulmonary Pathology With Nebulized DAS181: A Pilot Study

From Critical Care Explorations

The authors investigated the safety and effects of nebulized DAS181 on hypoxic coronavirus disease 2019 patients.


Evaluation of the Efficacy and Safety of Inhaled Epoprostenol and Inhaled Nitric Oxide for Refractory Hypoxemia in Patients With Coronavirus Disease 2019

From Critical Care Explorations

In this study, the authors evaluated the efficacy and safety of inhaled epoprostenol and inhaled nitric oxide in patients with refractory hypoxemia secondary to coronavirus disease 2019.


Letter to the Editor: Caution Is Needed When Reporting or Pooling the Prevalence of Venous Thromboembolism in Critically Ill Coronavirus Disease 2019 Patients

From Critical Care Medicine

In this Letter to the Editor, the author discusses the difficulties to ascertain in ICU settings the exact VTE incidence, incidence rate, or prevalence due to various reasons, including the absence of uniform screening at ICU admission to exclude patients with prior VTE, absence of systematic assessment with varying screening guided by clinicians’ suspicion, and varying follow-up time. In addition, the burden of venous thromboembolism in critically ill patients is discussed.


Feasibility and Safety of Prone Position Transport for Severe Hypoxemic Respiratory Failure Due to Coronavirus Disease 2019

From Critical Care Explorations

The authors found that critical care transport of severe hypoxemic respiratory failure patients with coronavirus disease 2019 in the prone position is safe when performed by a dedicated team of critical care nurse and paramedics with an established protocol.


Delirium Incidence, Duration, and Severity in Critically Ill Patients With Coronavirus Disease 2019

From Critical Care Explorations

The authors found that mechanical ventilation was significantly associated with odds of delirium even after adjustment for sedatives.


Editorial: Coronavirus Disease 2019 Acute Respiratory Failure: Almitrine Drug Resuscitation or Resuscitating Patients by Almitrine?

From Critical Care Medicine

In this editorial, the author discusses the seeming benefits of using almitrine for severe hypoxia in patients with coronavirus disease 19 induced acute respiratory distress syndrome.


Early Percutaneous Tracheostomy in Coronavirus Disease 2019: Association With Hospital Mortality and Factors Associated With Removal of Tracheostomy Tube at ICU Discharge. A Cohort Study on 121 Patients

From Critical Care Medicine

This study shows how early percutaneous tracheostomy was safe and effective in coronavirus disease 2019 patients, giving a good chance of survival and of weaning from tracheostomy cannula at ICU discharge.


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.