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Increasing Mortality in Venovenous Extracorporeal Membrane Oxygenation for COVID-19–Associated Acute Respiratory Distress Syndrome

From Critical Care Explorations The authors determine the factors associated with mortality in venovenous extracorporeal membrane oxygenation (V-V ECMO) patients with COVID-19 infection and provide an updated report of clinical outcomes for patients treated with V-V ECMO for COVID-19 in Minnesota.


Albumin Kinetics in Sepsis and COVID-19

From Critical Care Explorations In this Letter to the Editor the authors concluded that the pattern of albumin kinetics may be predictive of outcome in COVID-19 and sepsis-induced ARDS.


Airway Pressure Release Ventilation in Acute Respiratory Failure Due to COVID-19: When One Door Closes

From Critical Care Medicine In this Letter to the Editor the authors write in reponse to Ibarra-Estrada et al. 


Etiopathogenetic Particularities and Prognostic Impact of Right Ventricular Involvement in COVID-19–Related Acute Respiratory Distress Syndrome

From Critical Care Medicine In this Letter to the Editor the authors write in response to Chotalia et al. 


Prone Position in COVID-19 and -COVID-19 Acute Respiratory Distress Syndrome: An International Multicenter Observational Comparative Study*

From Critical Care Medicine The authors quantify the response to prone position, describe the differences between coronavirus disease 2019 acute respiratory distress syndrome and acute respiratory distress syndrome, and explore variables associated with survival.


Hospital Variation in Management and Outcomes of Acute Respiratory Distress Syndrome Due to COVID-19

From Critical Care Explorations The authors describe hospital variation in use of “guideline-based care” for acute respiratory distress syndrome (ARDS) due to COVID-19.


Proning in COVID-19 Acute Respiratory Distress Syndrome: Role of Paralytics

From Critical Care Explorations The authors studied impact of paralysis on prone-induced gas exchange improvements and provider attitudes regarding paralytics.


Abnormal Right Ventricular Free Wall Strain Prior to Prone Ventilation May Be Associated With Worse Outcome of Patients With COVID-19–Associated Acute Respiratory Distress Syndrome

From Critical Care Explorations In this Letter to the Editor the authors investigated the effect of prone ventilation on right ventricular (RV) function of intubated patients with COVID-19–associated acute respiratory distress syndrome.


American Thoracic Society: Elevator Pitch: COVID-19 ARDS Subphenotypes (Podcast)

In this "Breathe Easy Elevator Pitch" podcast, Dr. Siva Bhavani interviews Dr. David Furfaro, and they discuss the study "Latent Class Analysis Reveals COVID-19-related ARDS Subgroups", recently published in the Blue Journal.


Evaluation of Albumin Kinetics in Critically Ill Patients With Coronavirus Disease 2019 Compared to Those With Sepsis-Induced Acute Respiratory Distress Syndrome

From Critical Care Explorations  In this paper, the authors aimed to characterize the kinetics of serum albumin in critically ill patients with coronavirus disease 2019 compared with critically ill patients with sepsis-induced acute respiratory distress syndrome.


Concise Critical Appraisal: Rapid Implementation of an Intensivist-Led VV ECMO Cannulation Program

This Concise Critical Appraisal explores an article published in Critical Care Medicine on a program at Cooper University Hospital in Camden, New Jersey, USA, that implemented a previously published successful ECMO model, in which ECMO cannulation primarily performed by cardiothoracic surgeons is transitioned to medical intensivist-led cannulation. This article is significant in advancing the role of the medical intensivist in the cannulation of patients who require ECMO.


ARDS: Will Precision Approaches Move the Needle?

This article was first published in the Summer 2021 issue of Critical Connections. Daniel S. Talmor, MD, MPH, chair of the Department of Anesthesia, Critical Care and Pain Medicine at Beth Israel Deaconess Medical Center in Boston and a professor of anesthesiology at Harvard Medical School, addressed the past, present, and future of ARDS treatment in one of the most highly attended sessions of the Society of Critical Care Medicine’s (SCCM) 50th Critical Care Congress, held virtually in 2021.


Bronchoscopy During Coronavirus Disease 2019 Pandemic: A Bronchoscopist’s Perspective

From Critical Care Explorations. In this Commentary, that authors discuss bronchoscopy in patients with coronavirus disease 2019 and conclude that bronchoscopy should be strongly considered when clinically indicated.


Editorial: Bursting at the Seams: Barotrauma in Coronavirus Disease 2019 Acute Respiratory Distress Syndrome Patients

From Critical Care Medicine. This Editorial accompanies an article by Belletti et al. entitled “Barotrauma in Coronavirus Disease 2019 Patients Undergoing Invasive Mechanical Ventilation: A Systematic Literature Review.”


A Review of Acute Respiratory Distress Syndrome and COVID-19 - Part 2

Is COVID-19 just atypical acute respiratory distress syndrome (ARDS)? Multidisciplinary faculty will discuss the research and varying answers to this question in this SCCM webcast.


SCCM Pod-440 Optimal Sedation in Patients Who Receive Neuromuscular Blocking Agent Infusions for Treatment of ARDS

Two previously published trials presented equivocal evidence on the effect of neuromuscular blocking agent infusions in patients with acute respiratory distress syndrome. Host Kyle B. Enfield, MD, FCCM, is joined by Matthias Eikermann, MD, to discuss the different sedation regimens between these two trials, different regimens within the ROSE trial between treatment and control groups, and the hypothesis that the proportion of deeper sedation is a mediator of the effect of neuromuscular blocking agent infusions on mortality.


Right Ventricular Dysfunction and Its Association With Mortality in Coronavirus Disease 2019 Acute Respiratory Distress Syndrome

From Critical Care Medicine  In this article, the authors assessed whether right ventricular dilation or systolic impairment is associated with mortality and/or disease severity in invasively ventilated patients with coronavirus disease 2019 acute respiratory distress syndrome.


Online Letter to the Editor: The Janus Face of Coronavirus Disease 2019–Associated Coagulopathy

From Critical Care Medicine. This Online Letter to the Editor is in response to an article by Doyle et al. entitled “A comparison of thrombosis and hemorrhage rates in patients with severe respiratory failure due to coronavirus disease 2019 and influenza requiring extracorporeal membrane oxygenation.”


A Review of Acute Respiratory Distress Syndrome and COVID-19

Is COVID-19 just atypical acute respiratory distress syndrome (ARDS)? Multidisciplinary faculty will discuss the research and varying answers to this question in this SCCM webcast. During this webcast faculty covered evidence-based best practices for airway management now that more is known about COVID-19. The Society of Critical Care Medicine and the American Association of Respiratory Care partnered to produce this webinar on COVID-19. Webcast Recorded on Wednesday, May 26, 2021


Timing of Intubation in Coronavirus Disease 2019: A Study of Ventilator Mechanics, Imaging, Findings, and Outcomes

From Critical Care Explorations  The authors sought to determine the variation in outcomes and respiratory mechanics between the subjects who are intubated earlier versus later in their coronavirus disease 2019 course.


For patients who have acute respiratory distress syndrome from COVID-19 and are on a ventilator, how do you identify secondary lung infections?

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 March 10, 2021


Do you favor pressure or volume control ventilation in patients with acute respiratory distress syndrome from COVID-19?

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 March 10, 2021


For patients with severe acute respiratory distress syndrome from COVID-19, how do you prevent delirium when you cannot provide a sedation vacation or spontaneous breathing trial?

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 March 10, 2021


Which environmental and medical therapies do you believe are most effective in preventing delirium in the ICU?

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 March 10, 2021


Awake Self-Proning in COVID-19 ARDS

This resource details methods for awake self-proning for COVID-19 patients with ARDS. This is SCCM curated COVID-19 microlearning content.


First and Second Waves of Coronavirus Disease 2019 in Madrid, Spain: Clinical Characteristics and Hematological Risk Factors Associated With Critical/Fatal Illness

From Critical Care Explorations  In this study, the authors sought to determine similarities and differences in clinical characteristics between the patients from two waves of severe acute respiratory syndrome coronavirus-2 infection at the time of hospital admission, as well as to identify risk biomarkers of coronavirus disease 2019 severity.


Dysphagia in Patients With Severe Coronavirus Disease 2019—Potential Neurologic Etiologies

From Critical Care Explorations. In this case series, the authors investigate dysphagia in patients with severe coronavirus disease 2019.


Correlation of Respiratory Physiologic Parameters in Mechanically Ventilated Coronavirus Disease 2019 Patients

From Critical Care Explorations. In this article, the authors report simultaneously measured respiratory parameters (static lung compliance, alveolar dead space ventilation, and shunt fraction) in 14 patients with advanced coronavirus disease 2019-related acute respiratory distress syndrome.


Prevalence of Thrombotic Complications in ICU-Treated Patients With Coronavirus Disease 2019 Detected With Systematic CT Scanning

From Critical Care Medicine. In this study, the authors looked for the true prevalence of thrombotic complications in critically ill patients with severe coronavirus disease 2019 on the ICU, with or without extracorporeal membrane oxygenation.


The primary cause of gas exchange impairment in COVID-19 is thought to be different from regular acute respiratory distress syndrome (ARDS). There has been controversy regarding inhaled nitric oxide.

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


Racial Differences in a Detroit, MI, ICU Population of Coronavirus Disease 2019 Patients

From Critical Care Medicine  

Contrary to previously held beliefs surrounding the coronavirus 19 pandemic, this study found that, in critically ill patients infected with coronavirus disease 2019, people of color had a lower 28-day mortality than Whites with no difference in hospital mortality, ICU length of stay, or rates of intubation. 


Cytokine Storm and ARDS - Comparison of Corticosteroid Dosing Strategies

This resource details how to manage cytokine storm and ARDS by comparing corticosteriod dosing strategies for COVID-19 patients. This is SCCM curated COVID-19 microlearning content.


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?

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.


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 distress syndrome patients, even after accounting for differences in propofol administration.


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 definitions. 


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.


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.


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.


The POSITIONED Study: Prone Positioning in Nonventilated Coronavirus Disease 2019 Patients - A Retrospective Analysis

From Critical Care Explorations. In this study, the authors investigated explored whether awake self-proning improved outcomes in coronavirus disease 2019-infected patients treated in a rural medical center with limited resources during a significant local coronavirus disease 2019 outbreak.


Letter to the Editor: Impact of Asynchronies in Acute Respiratory Distress Syndrome Due to Coronavirus Disease 2019

From Critical Care Explorations. In this Letter to the Editor, the authors state that close monitoring of patients with COVID-19 and mechanical ventilation is required; staying at the patient’s bedside is necessary to identify life-threatening asynchronies and must be resolved promptly, as well as finding strategies for prevention of asynchronies. 
 


High-Flow Nasal Oxygen in Coronavirus Disease 2019 Patients With Acute Hypoxemic Respiratory Failure: A Multicenter, Retrospective Cohort Study

From Critical Care Medicine. In this study, the authors analyzed the effectiveness of high-flow nasal oxygen treatment and aimed to identify the variables predicting high-flow nasal oxygen treatment failure in coronavirus disease 2019 patients with acute hypoxemic respiratory failure.
 


Foreword: Does Severe Acute Respiratory Syndrome Coronavirus 2 Cause Sepsis?

From Critical Care Medicine. In this foreword, the authors contend that there should be no debate that SARS-CoV-2 is an important cause of sepsis and that labeling it as such is beneficial and appropriate.


Disseminated Multifocal Intracerebral Bleeding Events in Three Coronavirus Disease 2019 Patients on Extracorporeal Membrane Oxygenation As Rescue Therapy

From Critical Care Explorations. In this article, the authors describe three coronavirus disease 2019 patients suffering from acute respiratory distress syndrome under venovenous extracorporeal membrane oxygenation therapy and tight anticoagulation monitoring presenting a novel pattern of multifocal brain hemorrhage in various degrees in all cerebral and cerebellar lobes.
 


Effects of Positive End-Expiratory Pressure in “High Compliance” Severe Acute Respiratory Syndrome Coronavirus 2 Acute Respiratory Distress Syndrome

From Critical Care Medicine. In this study, the authors state their data suggest that a ""higher” positive end-expiratory pressure approach in patients with severe acute respiratory syndrome coronavirus 2 acute respiratory distress syndrome and high compliance improves oxygenation and lung aeration but may result in alveolar hyperinflation and hemodynamic alterations.
 


Placenta-Derived Cell Therapy to Treat Patients With Respiratory Failure Due to Coronavirus Disease 2019

From Critical Care Explorations. The authors sought to determinewhether placental cell therapy PLacental eXpanded (PLX)-PAD (Pluristem Therapeutics, Haifa, Israel) was beneficial to treating critically ill patients suffering from acute respiratory distress syndrome due to coronavirus disease 2019.
 


Coronavirus Disease 2019 and Acute Respiratory Distress Syndrome: Why the Intensivist Is More Important Than Ever

From Critical Care Medicine. In this Viewpoints article, the authors discuss the challenges of ARDS in COVID-19 patients.


Coronavirus Disease 2019 Acute Respiratory Distress Syndrome: Guideline-Driven Care Should Be Our Natural Reflex

From Critical Care Medicine. In this Viewpoints article, the authors discuss the value of evidence-based, guidelines-driven care in ARDS in patients with COVID-19.
 


Inpatient Mortality According to Level of Respiratory Support Received for Severe Acute Respiratory Syndrome Coronavirus 2 (Coronavirus Disease 2019) Infection: A Prospective Multicenter Study

From Critical Care Explorations. In this study, the authors describe patients according to the maximum degree of respiratory support received and report their inpatient mortality due to coronavirus disease 2019.


In Silico Modeling of Coronavirus Disease 2019 Acute Respiratory Distress Syndrome: Pathophysiologic Insights and Potential Management Implications

From Critical Care Explorations. In this study, the authors adapted a high-fidelity computational simulator to develop quantitative insights into the key pathophysiologic differences between the coronavirus disease 2019 acute respiratory distress syndrome and the conventional acute respiratory distress syndrome and to assess the impact of different positive end-expiratory pressure, Fio2, and tidal volume settings.


SCCM Pod-417 COVID-19-Associated Acute Respiratory Distress Syndrome

Clinicians are working to understand and formulate an effective treatment for COVID-19-associated acute respiratory distress syndrome (Marini J. Crit Care Med. 2020 May 13; Epub ahead of print).


SCCM Pod-408 Vaping-Associated Respiratory Distress Syndrome

Kyle B. Enfield, MD, and Craig M. Lilly, MD, discuss the newly released guidance for vaping-associated respiratory distress syndrome, published in Critical Care Explorations (Lilly C, et al. Crit Care Explor. 2020;2(2): e0081).


SCCM Pod-417 COVID-19-Associated Acute Respiratory Distress Syndrome

Clinicians are working to understand and formulate an effective treatment for COVID-19-associated acute respiratory distress syndrome (Marini J. Crit Care Med. 2020 May 13; Epub ahead of print).


Online Letter to the Editor: Bronchiolitis and Potential Pathophysiological Implications in Coronavirus Disease 2019 ARDS Patients With Near-Normal Respiratory Compliance

From Critical Care Medicine. The authors share the following opinions on the recruitment-response COVID-19 ARDS patients, 1) bronchiolitis, in a histologic context, is a plausible pathophysiological mechanism, and 2) a simple bedside physiologic test could potentially determine recruitment potential in resource-limited settings.


Review of Viral Testing (Polymerase Chain Reaction) and Antibody/Serology Testing for Severe Acute Respiratory Syndrome-Coronavirus-2 for the Intensivist

From Critical Care Explorations. As the SARS-CoV-2 pandemic develops, assays to detect the virus and infection caused by it are needed for diagnosis and management. In this article, the authors describe to clinicians how each assay is performed, what each assay detects, and the benefits and limitations of each assay.


Letter to the Editor: Corticosteroid Administration Is Associated With Improved Outcome in Patients With Severe Acute Respiratory Syndrome Coronavirus 2-Related Acute Respiratory Distress Syndrome

From Criticial Care Explorations. The authors report on the use of corticosteroids in mechanically ventilated patients with SARSCoV-2 related acute respiratory distress syndrome.


Letter to the Editor: Factors Associated With Pulmonary Embolism Among Coronavirus Disease 2019 Acute Respiratory Distress Syndrome

From Critical Care Explorations. To do better understand the risk factors associated with pulmonary embolism in patients with COVID-19, the authors performed a post hoc analysis from the COVADIS project, a multicenter observational study gathering 21 ICUs from France and Belgium.


What is new in the treatment of acute respiratory distress syndrome in 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 June 10th, 2020.


Children in Critical Care Due to Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Experience in a Spanish Hospital

From Pediatric Critical Care Medicine. This study aims to describe a series of children admitted to a pediatric intensive care unit in Spain, one of the countries severely affected by the coronavirus. disease 2019 (COVID-19).


Letter to the Editor: Evidence of Steroids in Patients With Acute Respiratory Distress Syndrome in Coronavirus Disease 2019

From Critical Care Explorations. A letter to the editor in response to Villar et al. article on corticosteroids and COVID-19.


Editorial: Dealing With the CARDS of COVID-19

From Critical Care Medicine. An editorial associated with the Mauri et al. article on personalized ventilation for COVID-19 ARDS patients.


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.


What Is the Rationale for Using Corticosteroids to Treat Acute Respiratory Failure in COVID-19 Patients?

Steve Pastores, MD, co-author of the Critical Care Explorations article "Rationale for Prolonged Corticosteroid Treatment in the Acute Respiratory Distress Syndrome Caused by Coronavirus Disease 2019," answers question regarding the use of corticosteriod treatment for ARDS caused by COVID-19. This is SCCM curated COVID-19 microlearning content.


Disparities in the Use of Corticosteroids for ARDS Caused by COVID-19 by Different Organizations: What Is the Right Answer?

Steve Pastores, MD, co-author of the Critical Care Explorations article "Rationale for Prolonged Corticosteroid Treatment in the Acute Respiratory Distress Syndrome Caused by Coronavirus Disease 2019," discusses the disparities in the use of corticosteriod treatment for ARDS caused by COVID-19 by different organizations. This is SCCM curated COVID-19 microlearning content.


The Rationale for the Use of Prolonged Corticosteroid Treatment for ARDS Caused by COVID-19

Steve Pastores, MD, co-author of the Critical Care Explorations article "Rationale for Prolonged Corticosteroid Treatment in the Acute Respiratory Distress Syndrome Caused by Coronavirus Disease 2019," discusses the use of corticosteriod treatment for ARDS caused by COVID-19. This is SCCM curated COVID-19 microlearning content.


Is the COVID-19 disease process more similar to high-altitude pulmonary edema than to classic acute respiratory distress syndrome?

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 April 15, 2020.


What are your thoughts about using glucocorticoids in patients with severe ARDS secondary to COVID-19 who remain intubated after 7 days?

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


Concise Critical Appraisal: Dexamethasone Use in the Treatment of ARDs

Villar et al (Lancet Respir Med. 2020;8:267-276) attempted to demonstrate the effect of steroids in patients with moderate to severe acute respiratory distress syndrome (ARDS) along with modern standard ICU practices, including lung-protective mechanical ventilation.