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National Research Action Plan on Long COVID

The Research Plan provides the first U.S. government-wide national research agenda focused on advancing prevention, diagnosis, treatment, and provision of services and supports for individuals and families experiencing Long COVID. The reports represent the federal government’s response to ensure the acceleration of scientific progress and to provide individuals with Long COVID with the support and services they need. They affirm the U.S. government’s commitment to addressing the impacts of Long COVID with federal government resources, in collaboration with the private sector, and improving our Nation’s health and well-being. 


Services and Supports for Longer-Term Impacts of COVID-19

The Services Report outlines federal services and mechanisms of support available to the public in addressing the longer-term effects of COVID-19. The reports represent the federal government’s response to ensure the acceleration of scientific progress and to provide individuals with Long COVID with the support and services they need. They affirm the U.S. government’s commitment to addressing the impacts of Long COVID with federal government resources, in collaboration with the private sector, and improving our Nation’s health and well-being. 


Concise Critical Appraisal: COVID-19 Pandemic Impacts Burnout Critical Care Professions Differently

The COVID-19 pandemic created a new challenging environment in which healthcare workers must survive. Before the pandemic, healthcare workers experienced burnout due to resource allocation and shortages, mental anguish, and long work hours. The pandemic further exacerbated this situation, creating a new crisis within our already frayed healthcare system. This Concise Critical Appraisal dives into an article published in Critical Care Medicine that reviewed the causes of burnout and the correlation between the COVID-19 pandemic and workplace burnout.


​​COVID-19 Therapeutics Thr​esholds, Orders, and Replenishment by Jurisdiction

On April 25, 2022, the distribution process for COVID-19 therapeutics to state and territorial health departments transitioned from the previous allocation process to one that more closely aligns with the allocation and ordering process for vaccines. 


CDC Resources: Neurology

SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Neurology


NIH Resource: Drug-Drug Interactions Between Ritonavir-Boosted Nirmatrelvir (Paxlovid) and Concomitant Medications

Ritonavir, a strong cytochrome P450 (CYP) 3A4 inhibitor and a P-glycoprotein inhibitor, is coadministered with nirmatrelvir to increase the blood concentration of nirmatrelvir, thereby making it effective against SARS-CoV-2. Ritonavir may also increase blood concentrations of certain concomitant medications. Because ritonavir-boosted nirmatrelvir (Paxlovid) is the only highly effective oral antiviral for the treatment of COVID-19, drug interactions that can be safely managed should not preclude the use of this medication.


FDA Updates Sotrovimab Emergency Use Authorization

The Centers for Disease Control and Prevention (CDC) Nowcast data from April 5, 2022,  estimates that the proportion of COVID-19 cases caused by the Omicron BA.2 variant is above 50% in all Health and Human Services (HHS) U.S. regions. Data included in the health care provider fact sheet show the authorized dose of sotrovimab is unlikely to be effective against the BA.2 sub-variant. Due to these data, sotrovimab is not authorized in any U.S. state or territory at this time. 


New Paxlovid Dose Pack Author​ized by FDA

On April 14, 2022, the FDA revised the Emergency Use Authorization (EUA) for the COVID-19 oral antiviral therapeutic Paxlovid to authorize an additional dose pack presentation with appropriate dosing for patients with moderate renal impairment within the scope of the EUA. As a result, Paxlovid will soon be available in two package presentations. 


NIH Resource: Study Looks for Long COVID Risk Factors 

In a study supported by the National Institute of Allergy and Infectious Diseases (NIAID), the National Center for Advancing Translational Sciences, and the National Institute on Drug Abuse, researchers enrolled 209 people ages 18 to 89 who had laboratory-confirmed SARS-CoV-2 infections. 


Post-ICU COVID-19 Clinics

Post-ICU COVID-19 clinics are newly established programs providing care for patients with post-intensive care syndrome (PICS) related to COVID-19. During this webcast, subject matter experts discussed how post-ICU COVID-19 clinics developed with an interdisciplinary model improve outcomes and support patients, family members, and transitions of care.


SCCM ICU Heroes: The Love Army

The ICU Heroes Award recognizes that patients and families are an integral part of intensive care unit (ICU) care. The award is given to an ICU patient and family and to the multiprofessional team that delivered the care.


Characteristics of Post-ICU and Post-COVID Recovery Clinics in 29 U.S. Health Systems

From Critical Care Explorations The authors describe the structure and process characteristics of existing and newly implemented ICU-RCs and COVID-RCs in a subset of large health systems in the United States.


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.


The Third Wave: Comparing Seasonal Trends in COVID-19 Patient Data at a Large Hospital System in New York City

From Critical Care Explorations The authors compare the demographics and outcomes of hospitalized patients during New York City’s third wave of COVID-19 to the first two waves.


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. 


Influence of Geopolitics on Severity and Outcome in COVID-19*

From Critical Care Medicine In this Editorial the authors write an accompanying piece to Mesotten 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.


Differences and Similarities Among COVID-19 Patients Treated in Seven ICUs in Three Countries Within One Region: An Observational Cohort Study*

From Critical Care Medicine The authors investigated healthcare system–driven variation in general characteristics, interventions, and outcomes in coronavirus disease 2019 (COVID-19) patients admitted to the ICU.


WHO resource: WHO updates its treatment guidelines to include molnupiravir

WHO has updated its living guidelines on COVID-19 therapeutics to include a conditional recommendation on molnupiravir, a new antiviral medicine.

This is the first oral antiviral drug to be included in the treatment guidelines for COVID-19. As this is a new medicine, there is little safety data. WHO recommends active monitoring for drug safety, along with other strategies to mitigate potential harms.


Fact Sheet: COVID-19 Test to Treat

Through this program, people are able to get tested and – if they are positive and treatments are appropriate for them – receive a prescription from a health care provider, and have their prescription filled all at one location. These “One-Stop Test to Treat” sites are available at hundreds of locations nationwide, including pharmacy-based clinics, Health Resources Services Administration (HRSA)-supported federally-qualified health centers (FQHCs), and long-term care facilities. People can continue to be tested and treated by their own health care providers who
can appropriately prescribe these oral antivirals at locations where the medicines are distributed. 


IDSA Resources: Professional Development

SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Infectious Diseases Society of America (IDSA) COVID-19 Real-Time Learning Network. These resources are categorized as Professional Development


CDC Resources: Pulmonary

SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Pulmonary


2022 Critical Care Congress Plenary: Health System Readiness 2.0

Brendan G. Carr, MD, MA, MS, will address some of the realities of the COVID-19 pandemic and how health systems can prepare during the Peter Safar Memorial Lecture at the 2022 SCCM Congress.


Clinical Tips: Caring for Pregnant COVID-19 Patients (Infographic)

This infographic highlights key points from the SCCM Free webcast Caring for pregnant patients with COVID-19.


Interdisciplinary COVID-19 Ventilator Management (Infographic)

This infographic reviews strategies to develop a multiprofessional team approach to COVID-19 ventilator management with highlights from the SCCM Free webcast Interdisciplinary COVID-19 Ventilator Management.


COVID-19 Infection Control and PPE Update (Infographic)

This infographic highlights key points from the Free SCCM webcast revisiting precautions, engineering and hazard controls. 


Managing Patients With COVID-19 in Resource-Limited Areas

During this webcast, subject matter experts addressed questions on how to manage patients with COVID-19 in a rural location with limited resources, how to treat patients with limited equipment, and how to manage resources when there are bed shortages.


Wellness for Leaders: Rejuvenating Colleagues

Discuss strategies for personal and professional well-being.


Tips for Speaking with the Media (Infographic)

During the COVID-19 pandemic, healthcare providers have received many requests for media appearances and interviews to help inform the public. This infographic provides strategies and techniques to increase confidence of providers participating in media communications.


COVID-19 Ventilator Management

Review strategies to develop a multiprofessional team approach to COVID-19 ventilator management in this FREE SCCM webcast. A multiprofessional panel of experts will discuss how each clinician’s role contributes to optimal ventilator management.


Conflict Management: Vaccination Status

Review the three part approach to management of Vaccination Status Conflicts.


Burnout: Coping Skills

Discuss coping skills and strategies to assist health care providers or colleagues experiencing burnout.


Acute Kidney Injury in COVID-19: Risk Factors

Review the risk factors for AKI in COVID-19 patients and mechanism for renal injury in COVID-19 patients.


Acute Kidney Injury in COVID-19: Incidence and Mortality

Review the incidence of acute kidney injury (AKI) and renal replacement therapy (RRT) in COVID-19 versus other diseases, mortality and long-term prognosis. 


Clinical and Histopathologic Features of Myocarditis in Multisystem Inflammatory Syndrome (Adult)–Associated COVID-19

From Critical Care Explorations The authors report three cases of healthy young adults diagnosed with severe acute respiratory syndrome-CoV-2 related (MIS-A).


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.


Augmented Renal Clearance: An Under-Recognized Phenomenon Associated With COVID-19

From Critical Care Explorations The authors aim to increase clinician awareness of, and risk factors for ARC in patients with COVID-19, especially in comparison to other critical illnesses.


Impaired Microvascular Function in Patients With Critical COVID-19

From Critical Care Explorations The authors investigate microvascular function in patients with critical coronavirus disease 2019.


In COVID-19 Patients Who Suffer In-Hospital Cardiac Arrest, Cardiopulmonary Resuscitation Outcomes May Be Impacted by Arrest Etiology and Local Pandemic Conditions

From Critical Care Explorations The authors describe outcomes after cardiopulmonary resuscitation for in-hospital cardiac arrest in two COVID-19 patient cohorts.


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.


Characteristics and Outcomes of Patients With Frailty Admitted to ICU With Coronavirus Disease 2019: An Individual Patient Data Meta-Analysis

From Critical Care Explorations The authors evaluated the characteristics and outcomes across the range of frailty in patients admitted to ICU with coronavirus disease 2019.


Functionality of Scarce Healthcare Resource Triage Teams During the COVID-19 Pandemic: A Multi-Institutional Simulation Study

From Critical Care Explorations The authors conducted eleven team triage simulations from December 2020 through February 2021. 


Serial Thromboelastography and the Development of Venous Thromboembolism in Critically Ill Patients With COVID-19

From Critical Care Explorations The authors test the hypothesis that relatively lower clot strength on thromboelastography maximum amplitude (MA) is associated with development of venous thromboembolism (VTE) in critically ill patients with COVID-19.


Brief Report: Rapid Clinical Recovery From Critical Coronavirus Disease 2019 With Respiratory Failure in a Pregnant Patient Treated With IV Vasoactive Intestinal Peptide

From Critical Care Explorations The authors report successful treatment in such a patient who is ineligible for phase 3 trials of Aviptadil.


Coronavirus Disease 2019 Temperature Trajectories Correlate With Hyperinflammatory and Hypercoagulable Subphenotypes

From Critical Care Medicine The authors determined the association between temperature trajectories and distinct manifestations of coronavirus disease 2019.


Palliative Care During the Pandemic (Podcast)

Top officials for the American Hospital Association and the Center to Advance Palliative Care (CAPC) convened virtually for a fireside chat to discuss the impact and importance of palliative care practices during the pandemic and share stories from experts in the field. 


FDA Resource: Fact Sheet for Healthcare Providers: Emergency Use Authorization for Bebtelovimab

The U.S. Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) for the emergency use of bebtelovimab for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adults and pediatric patients (12 years of age and older weighing at least 40 kg): with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death, and for whom alternative COVID-19 treatment options approved or authorized by FDA are not accessible or clinically appropriate.


Center to Advance Palliative Care: Online Clinical Training Courses For All Clinicians

All specialties and disciplines can strengthen their care of patients living with a serious illness. For CAPC members, CAPC’s online training curriculum provides free continuing education credits for physicians, nurses, social workers, and case managers at member organizations. Free ABIM MOC (Maintenance of Certification) credits are also available for physicians.


Center to Advance Palliative Care: COVID-19 Response Hub

Whether your organization is in the middle of a COVID-19 surge or planning forward, Center to Advance Palliative Care (CAPC) has tools, technical assistance, clinical training, and convening opportunities to help. 


Center to Advance Palliative Care: CAPC Toolkits

Drawn from best practices, CAPC toolkits are curated, proven resources for improving the care of people living with serious illness. Toolkits include technical assistance and tools for palliative care teams; serious illness strategies for health systems, health plans, and ACOs; resources for skill-building among clinicians from all specialties and disciplines; and much more.


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.


SCCM Pod-453 Extracorporeal Blood Purification

Because COVID-19 can create a status of systemic inflammation, which can affect multiple organs, including the kidneys, the adjuvant therapy of blood purification has gained some recognition. Host Pamela Peeke, MD, MPH, FACP, FACSM is joined by Javier Neyra, MD, MS to discuss clinical cases and the use of extracorporeal blood purification in COVID-19 patients.


2022 Critical Care Congress Plenary: What Has COVID-19 Taught Us About ECMO?

Peta M.A. Alexander, MBBS, FRACP, FCICM, will present the Max Harry Weil Memorial Lecture titled, “What Has COVID-19 Taught Us About ECMO?” during SCCM’s 2022 Critical Care Congress.


Caring for Pregnant Patients with COVID-19

During this webinar, experts will address questions related to caring for mechanically ventilated pregnant patients with COVID-19. Review the safety of extracorporeal membrane oxygenation in pregnancy, drug safety for critically ill patients with COVID-19, vaccination strategies, and post-ICU care for unvaccinated pregnant patients. This webcast will also benefit non-ICU clinicians who may need to care for critically ill and injured patients.


COVID-19 Infection Control and PPE Update

Revisit isolation precautions, engineering controls, and aerosol-generating procedures, and review personal protective equipment updates, including the evolution of masking recommendations.


Prevalence of Select New Symptoms and Conditions Among Persons Aged Younger Than 20 Years and 20 Years or Older at 31 to 150 Days After Testing Positive or Negative for SARS-CoV-2

Understanding the frequency with which new symptoms and conditions emerge in the months following SARS-CoV-2 infection is important to inform patients’ expectations for recovery and allow health care professionals and health systems to address patients’ needs. Shortness of breath, fatigue or muscle weakness, and mild subjective cognitive dysfunction (ie, “brain fog”) are among the most commonly reported persistent symptoms in the months following SARS-CoV-2 infection.


Long-Term Cardiovascular Outcomes of COVID-19

The cardiovascular complications of acute coronavirus disease 2019 (COVID-19) are well described, but the post-acute cardiovascular manifestations of COVID-19 have not yet been comprehensively characterized. Here we used national healthcare databases from the US Department of Veterans Affairs to build a cohort of 153,760 individuals with COVID-19, as well as two sets of control cohorts with 5,637,647 (contemporary controls) and 5,859,411 (historical controls) individuals, to estimate risks and 1-year burdens of a set of pre-specified incident cardiovascular outcomes.


Get The Facts: COVID-19, Myocarditis, and Vaccines (Infographic)

Myocarditis is inflammation of the heart muscle. This can happen after viral infections like COVID-19 and, very rarely, after receiving mRNA COVID-19 vaccines. Most people with myocarditis following vaccination recover completely with rest and simple treatment. However, myocarditis from COVID-19 can be very severe.


PASC Dashboard: Post-Acute Sequelae of SARS-CoV-2 Infections (PASC) Estimates and Insights

The American Academy of Physical Medicine and Rehabilitation (AAPM&R) has undertaken comprehensive efforts to support our call for a national plan to address Post-Acute Sequelae of SARS-CoV-2 infection (PASC or Long COVID) and the millions Americans it is affecting. The PASC Dashboard serves to estimate those affected including state and county level data and trends over time.


Parallel Pandemics From the Mind of Medicine (Podcast)

This is a podcast series accounting for the parallel pandemics of COVID-19 and clinician burnout, while introducing the story of one undocumented patient who helped to reveal the authentic feelings and values of his healthcare team. With historically high mortality rates in the ICU and pervasive emotional and physical fatigue, this ICU team in Marietta, Georgia had the courage to hope and the commitment to care.


WHO Resource: WHO recommends two new drugs to treat COVID-19

WHO has recommended two new drugs for COVID-19, providing yet more options for treating the disease. The extent to which these medicines will save lives depends on how widely available and affordable they will be.

The first drug, baricitinib, is strongly recommended for patients with severe or critical COVID-19. WHO has also conditionally recommended the use of a monoclonal antibody drug, sotrovimab, for treating mild or moderate COVID-19 in patients who are at high risk of hospitalization.


HHS Resource: HHS/ASPR Project ECHO COVID-19 Clinical Rounds

List Serve registration link for upcoming COVID-19 Clinical Rounds and catalog of prior presentations. This initiative supports a series of teleECHO programs that follow the needs of participants based on the trajectory of the pandemic. The aim is to create peer-to-peer learning networks where clinicians who have more experience treating patients with COVID-19 share their challenges and successes with clinicians across the U.S. and around the world with a wide variety of experience treating COVID-19.


HHS Resource: Federal Response to COVID-19 - Therapeutics Clinical Implementation Guide

HHS Presentation - Topics include: Introduction to COVID-19
Outpatient Therapeutics & Product
Selection, Tools to Assist in COVID-19 Outpatient Therapeutic Selection, Overview of Emergency Use
Authorizations, Oral Antiviral Indications and Dosing, Provider and Patient EUA Fact Sheets, Overview of Outpatient
Therapeutic Distribution Process


HHS Resource: COVID-19 Therapeutics Locator

The national map below displays public locations that have received shipments of U.S. Government-procured COVID-19 therapeutics under U.S. Food and Drug Administration (FDA) Emergency Use Authorization (EUA) authority. The locations displayed in the locator have reported stock on hand within the last day.


CMS Resource: Coverage of Monoclonal Antibody Products to Treat COVID-19 (Infographic)

Medicare & COVID-19 Monoclonal Antibody Products: Coverage, Coding, Payment and Billing. Monoclonal antibody products to treat Coronavirus disease 2019 (COVID-19) help the body fight the virus or slow the virus’s growth. Medicare beneficiaries have coverage without beneficiary cost sharing for these products when used as authorized or approved by the Food and Drug Administration (FDA).


CDC Resources: Procedures

SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Procedures


Media Training in the Era of COVID-19

During the COVID-19 pandemic, healthcare providers receive many requests for media appearances and interviews to help inform the public. This training will provide strategies and techniques to increase confidence of providers participating in media communications.


NIH Resource: The COVID-19 Treatment Guidelines Panel’s Interim Statement on Patient Prioritization for Outpatient Anti-SARS-CoV-2 Therapies or Preventive Strategies When There Are Logistical or Supply Constraints

The COVID-19 Treatment Guidelines Panel (the Panel) has recommended several therapeutic agents for the treatment and prevention of SARS-CoV-2 infection in individuals who are at high risk for progression to severe COVID-19. These anti-SARS-CoV-2 therapeutics are of greatest benefit for nonhospitalized patients who have risk factors for progression to severe COVID-19. With the increase in cases of COVID-19 and the emergence of the Omicron (B.1.1.529) variant of concern, there may be logistical or supply constraints that make it impossible to offer the available therapy to all eligible patients, making patient triage necessary. 


CDC Resources: Epidemiology-Outcomes

SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Epidemiology-Outcomes


2022 Critical Care Congress Thought Leaders: Critical Care Nurses and COVID-19

John J. Gallagher, DNP, RN, CCNS, CCRN-K, TCRN, RRT, FCCM, will bring his experiences and teaching enjoyment to SCCM’s 2022 Critical Care Congress, where he will lead the thought leader session “Critical Care Nurses and COVID-19.”


Mini-Bronchoalveolar Lavage for Diagnosing Coronavirus Disease 2019–Associated Invasive Pulmonary Aspergillosis

Critical Care Explorations  The authors found a similar percentage of positive test results in mini-bronchoalveolar lavage and bronchoalveolar lavage samples in patients with suspected coronavirus disease 2019–associated pulmonary aspergillosis, indicating that mini-bronchoalveolar lavage could be a useful tool for coronavirus disease 2019–associated pulmonary aspergillosis screening in ICU patients.


Plasma Soluble CD14 Subtype Levels Are Associated With Clinical Outcomes in Critically Ill Subjects With Coronavirus Disease 2019

Critical Care Explorations  In this study, the authors concluded that soluble CD14 subtype levels may have prognostic utility in coronavirus disease 2019.


Recognizing Vaccine-Induced Immune Thrombotic Thrombocytopenia

From Critical Care Medicine  The authors review the pathogenesis, clinical presentation, diagnosis, and treatment of vaccine-induced immune thrombotic thrombocytopenia, an unexpected consequence of the coronavirus disease 2019 pandemic era. 


Assessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study

From Critical Care Explorations  This international study suggests that in patients with coronavirus disease 2019 on invasive mechanical ventilation, older age and clinically relevant variables monitored at baseline or sequentially during the course of invasive mechanical ventilation are associated with 28-day invasive mechanical ventilation mortality hazard. 


Identification of Aggravation-Predicting Gene Polymorphisms in Coronavirus Disease 2019 Patients Using a Candidate Gene Approach Associated With Multiple Phase Pathogenesis: A Study in a Japanese City of 1 Million People

From Critical Care Explorations  In this observational study, the authors successfully identified significant genetic factors in OAS1 and IL1B genes using a candidate gene approach study as valuable information for further mechanistic investigation and predictive model building.


Caring for Unvaccinated Patients in the ICU: Beyond Frustration, Toward Beneficial Relationships

From Critical Care Explorations   In this essay, the authors propose a number of questions that recognize the existential frustrations critical care professionals experience when carting for unvaccinated patients in the ICU, while also uncovering the ethical obligations that remain. 


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.


Immunothrombosis Biomarkers for Distinguishing Coronavirus Disease 2019 Patients From Noncoronavirus Disease Septic Patients With Pneumonia and for Predicting ICU Mortality

From Critical Care Explorations  This hypothesis-generating study suggests that the pathophysiology of immunothrombosis differs between coronavirus disease 2019 patients and noncoronavirus disease septic patients.


Altered Heart Rate Variability Early in ICU Admission Differentiates Critically Ill Coronavirus Disease 2019 and All-Cause Sepsis Patients

From Critical Care Explorations  In this descriptive statistical study, heart rate variability measures were found to be statistically different across critically ill patients infected with severe acute respiratory syndrome coronavirus 2 and distinct from bacterial sepsis.


One-Year Outcomes of Postintensive Care Syndrome in Critically Ill Coronavirus Disease 2019 Patients: A Single Institutional Study

From Critical Care Explorations  In this study, the authors found that Patients who suffered critical illness from coronavirus disease 2019 had a high frequency of postintensive care syndrome after 1 year. 


WHO Resource: WHO Therapeutics and COVID-19: living guideline

The WHO Therapeutics and COVID-19: living guideline contains the Organization’s most up-to-date recommendations for the use of therapeutics in the treatment of COVID-19. The latest version of this living guideline is available in pdf format (via the ‘Download’ button) and via an online platform, and is updated regularly as new evidence emerges.


AHA Resource: How a Bold, New Strategy Took on Health Care Inequities During the Pandemic (Blog)

AHA published a new blog post from an LLN member hospital titled,  The Pandemic. “How a Bold, New Strategy Took on Health Care Inequities During the Pandemic,” authored by Luminis Health Chief Diversity Officer Tamiko Stanley.  


FDA Resource: Paxlovid received EUA approval from the FDA

December 22, 2021, the FDA issued an emergency use authorization (EUA) for Pfizer’s Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) for the treatment of mild-to-moderate coronavirus disease (COVID-19) in adults and pediatric patients (12 years of age and older weighing at least 40 kilograms or about 88 pounds) with positive results of direct SARS-CoV-2 testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death. Paxlovid is available by prescription only and should be initiated as soon as possible after diagnosis of COVID-19 and within five days of symptom onset.


FDA Resource: Molnupiravir received EUA approval from the FDA

The FDA has granted molnupiravir emergency use authorization (EUA) to treat mild to moderate COVID-19 in adults at high risk of severe illness. High risk people include adults aged 65 and over and people with certain medical conditions. The FDA also states that molnupiravir should only be used when other COVID-19 treatments are unavailable. 


ATS Resource: Critical Perspective: Bacterial Superinfection in Patients Mechanically Ventilated for COVID-19 Pneumonia (Podcast)

In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Dr. Richard Wunderink They discuss Dr. Wunderink's recent publication in the Blue Journal about bacterial superinfection in patients intubated and mechanically ventilated for COVID-19 pneumonia. Dr. Wunderink is a Professor of Medicine in Pulmonary and Critical Care at Northwestern University in Chicago, Illinois.


AHA Resource: Nurse leaders discuss COVID-19 nursing challenges, solutions (Podcast)

The fourth and current wave of the COVID-19 pandemic has created a worrisome landscape for the nursing profession. Nurses across the country report that they no longer feel celebrated as heroes as they did in the early days of the pandemic. This AHA Podcast covers nurse leaders discussing COVID-19 nursing challenges, and solutions.


HHS Resource: Surgeon General Releases Community Toolkit for Addressing Health Misinformation

During the COVID-19 pandemic, people have been exposed to an abundance of information from a large number of sources.


FDA News Release: FDA Expands Authorization of Two Monoclonal Antibodies for Treatment and Post-Exposure Prevention of COVID-19 to Younger Pediatric Patients, Including Newborns

On December 3, 2021, the U.S. Food and Drug Administration revised the emergency use authorization (EUA) of bamlanivimab and etesevimab (previously authorized for pediatric patients 12 years of age and older weighing at least 40 kilograms, or about 88 pounds), to additionally authorize bamlanivimab and etesivimab administered together for the treatment of mild to moderate COVID-19 in all younger pediatric patients, including newborns, who have a positive COVID-19 test and are at high risk for progression to severe COVID-19, including hospitalization or death. This revision also authorizes bamlanivimab and etesevimab, to be administered together, for post-exposure prophylaxis for prevention of COVID-19 in all pediatric patients, including newborns, at high risk of progression to severe COVID-19, including hospitalization or death. 


Family Presence Policy Decision-Making Toolkit for Nurse Leaders

Questions to Guide Evidence-Informed, Data Driven and Person-Centered Decision-Making. Summary of evidence and sources


CHEST Resource: Pulmonary Thrombosis and Thromboembolism in COVID-19

In this review, the epidemiologic and pathophysiologic features, diagnosis, and treatment of COVID-19 pulmonary thrombosis and thromboembolism are discussed.


CHEST Resource: Post intensive Care Syndrome (PICS)

Infographic: Symptoms, Risk Factors, Screening, Recovery Programs


CHEST Resource: COVID-19 and Risk of VTE in Ethnically Diverse Populations

Research Question: Does the rate of VTE among adults hospitalized with COVID-19 differ from matched hospitalized control participants without COVID-19?


CHEST Resource: Cardiopulmonary Resuscitation in the COVID-19 Era

COVID in Focus: Perspectives on the Literature. Brief summary and highlights specific studies in the COVID-19 literature is a curated review of key information and literature about this topic. It is not comprehensive of all data related to this subject.


IDSA Resources: Neurology

SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Infectious Diseases Society of America (IDSA) COVID-19 Real-Time Learning Network. These resources are categorized as Neurology


I Cannot Let It Go

From Pediatric Critical Care Medicine. In this Editorial, the authors discuss the article by Vacheron et al. on the epidemiology of ventilatory-associated pneumonia among patients with COVID-19.


Editorial: Is Ventilator-Associated Pneumonia More Frequent in Patients With Coronavirus Disease 2019?

From Critical Care Medicine  In this Editorial, the authors discuss the article by Vacheron et al. on the epidemiology of ventilatory-associated pneumonia among patients with COVID-19.


Multisystem Inflammation and Organ Dysfunction After BNT162b2 Messenger RNA Coronavirus Disease 2019 Vaccination

From Critical Care Explorations  While the overall safety profile of the BNT162b2 coronavirus disease 2019 vaccine remains excellent for the general population, rare serious events have been reported. In this case report, the authors describe a case of multisystem inflammation and organ dysfunction of unknown mechanism beginning shortly after administration of the first dose of BNT162b2 coronavirus disease 2019 vaccine in a previously healthy recipient.


Assessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study

From Critical Care Explorations. This international study suggests that in patients with coronavirus disease 2019 on invasive mechanical ventilation, older age and clinically relevant variables monitored at baseline or sequentially during the course of invasive mechanical ventilation are associated with 28-day invasive mechanical ventilation mortality hazard. 


Variation in Use of Repurposed Medications Among Patients With Coronavirus Disease 2019. From The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study: Coronavirus Disease 2019 Registry Investigator Group

From Critical Care Explorations. In this study the authors found that hospital variation in the use of repurposed medications varied widely across hospitals early in the pandemic and later converged with the emergence of randomized clinical trials. 


Identification of Aggravation-Predicting Gene Polymorphisms in Coronavirus Disease 2019 Patients Using a Candidate Gene Approach Associated With Multiple Phase Pathogenesis: A Study in a Japanese City of 1 Million People

From Critical Care Explorations. In this study, the authors successfully identified significant genetic factors in OAS1 and IL1B genes using a candidate gene approach study as valuable information for further mechanistic investigation and predictive model building.


Dorsal Push and Abdominal Binding Improve Respiratory Compliance and Driving Pressure in Proned Coronavirus Disease 2019 Acute Respiratory Distress Syndrome

From Critical Care Explorations. Dorsal Push and Abdominal Binding Improve Respiratory Compliance and Driving Pressure in Proned Coronavirus Disease 2019 Acute Respiratory Distress Syndrome


Critical Impact: COVID-19: Highlights Session 3

This webinar covers highlights from the Critical Impact:  Ethics and Supply Chain course.


Current Approved Therapies for COVID-19

Stay up to date on the mass vaccination efforts in the United States with this SCCM webcast. Thought leaders will address current COVID-19 variants and vaccine efficacy and review pediatric vaccination considerations. This webcast is the second in a series of updates that SCCM is producing to better educate clinicians as vaccination efforts continue. The webinar was held on December 8, 2021.


What Will Endemic COVID-19 Mean in the ICU?

Learn how COVID-19 is becoming an endemic condition in intensive care units in this FREE SCCM webcast. Subject matter experts will also discuss COVID-19 myths and misconceptions and how COVID-19 has changed the continuum of care.

The Society of Critical Care Medicine and the Infectious Diseases Society of America partnered to produce this webcast. The webinar was held on December 14, 2021.


Managing Moral Distress During a Pandemic

To help understand what moral distress looks like and how to manage and prevent it, the Society of Critical Care Medicine recently hosted the webcast Managing Moral Distress During a Pandemic.


COVID-19 Experiences from the Front Lines

With the average rate of daily new cases of COVID-19 on the rise—and the delta and omicron variants causing concern—the Society of Critical Care Medicine (SCCM) asked members in states with high rates of infection to share their experience and advice. Here are some of their insights.


Best Practices for Managing Staff Shortages

In SCCM's webcast “Best Practices for Managing Staff Shortages,” a multiprofessional panel of experts discussed how staffing challenges arise in overwhelmed healthcare systems and how they have managed staff shortages.


Preparing Adult Clinicians to Treat Pediatric Patients

With the rise in cases among children across the country, more healthcare professionals who typically work with adult patients are being tasked with treating pediatric patients. SCCM’s latest blog post summarizes two webcasts SCCM hosted to help smooth this transition.


Critical Impact: COVID-19: Highlights Session 2

This webinar covers highlights from the Critical Impact: Infrastructure and Workforce course.


COVID-19 Vaccine Update

Stay up to date on the mass vaccination efforts in the United States with this FREE SCCM webcast. Thought leaders will address current COVID-19 variants and vaccine efficacy and review pediatric vaccination considerations. This webcast is the second in a series of updates that SCCM is producing to better educate clinicians as vaccination efforts continue. The webcast was held on November 17, 2021.


CDC Resources: Quality and Patient Safety

SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Quality and Patient Safety.


Critical Impact: COVID-19: Highlights Session 1

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


The Role of a Statewide Critical Care Coordination Center in the Coronavirus Disease 2019 Pandemic—and Beyond

From Critical Care Explorations. The authors describe statewide implementation of a critical care coordination center designed to optimize ICU utilization.


A Modified Delphi Process to Prioritize Experiences and Guidance Related to ICU Restricted Visitation Policies During the Coronavirus Disease 2019 Pandemic

From Critical Care Explorations. The authors created evidence-based consensus statements for restricted ICU visitation policies to support critically ill patients, families, and healthcare professionals during current and future pandemics.


Interhospital Transfer Outcomes for Critically Ill Patients With Coronavirus Disease 2019 Requiring Mechanical Ventilation

From Critical Care Explorations. In this single-center retrospective cohort, no significant differences in hospital mortality or length of stay between interhospital transfers and emergency department admits were found. 


Some Patients Are More Equal Than Others: Variation in Ventilator Settings for Coronavirus Disease 2019 Acute Respiratory Distress Syndrome

From Critical Care Explorations. The authors claim this to be the first study to clearly demonstrate significant practice variation between ICUs related to mechanical ventilation parameters that are under direct control by intensivists. Their effect on clinical outcomes for both coronavirus disease 2019 and other critically ill mechanically ventilated patients could have widespread implications for the practice of intensive care medicine and should be investigated further by causal inference models and clinical trials.


Differences and Similarities Among Coronavirus Disease 2019 Patients Treated in Seven ICUs in Three Countries Within One Region: An Observational Cohort Study

From Critical Care Medicine. In this study, the authors found that COVID-19 patients admitted to ICUs within one region, the Euregio Meuse-Rhine, differed significantly in general characteristics, applied interventions, and outcomes despite presumed genetic and socioeconomic background, admission diagnosis, access to international literature, and data collection are similar. 


Prognostic and Predictive Biomarkers in Patients With Coronavirus Disease 2019 Treated With Tocilizumab in a Randomized Controlled Trial

From Critical Care Medicine.  In this study, the authors explored candidate prognostic and predictive biomarkers identified in retrospective observational studies (interleukin-6, C-reactive protein, lactate dehydrogenase, ferritin, lymphocytes, monocytes, neutrophils, D-dimer, and platelets) in patients with coronavirus disease 2019 pneumonia after treatment with tocilizumab, an anti–interleukin-6 receptor antibody, using data from the COVACTA trial in patients hospitalized with severe coronavirus disease 2019 pneumonia.


End-of-Life Care During the Coronavirus Disease 2019 Pandemic: The 3 Wishes Program

From Critical Care Explorations. The authors evaluated how the 3 Wishes Program evolved to allow continued provision of compassionate end-of-life care for critically ill patients during the coronavirus disease 2019 pandemic.


ICU Mortality in Patients With Coronavirus Disease 2019 Infection: Highlighting Healthcare Disparities in Rural Appalachia

From Critical Care Explorations.  The authors found that critically ill and mechanically ventilated coronavirus disease 2019 acute respiratory distress syndrome patients transferred from Appalachian critical access hospitals/rural facilities have increased mortality compared with noncoronavirus disease 2019 acute respiratory distress syndrome controls, suggesting that lack or delay in access to tertiary care may impact coronavirus disease 2019 outcome in rural areas. 


Fewer Intubations but Higher Mortality Among Intubated Coronavirus Disease 2019 Patients During the Second Than the First Wave

From Critical Care Explorations. In this study, the authors sought to compare the rate of intubation and mortality of intubated patients in our ICUs between the first and second waves of the pandemic.


Respiratory Non-Invasive Venous Waveform Analysis for Assessment of Respiratory Distress in Coronavirus Disease 2019 Patients: An Observational Study

From Critical Care Explorations. In this Original Clinical Report, the authors conclude that respiratory non-invasive venous waveform analysis respiratory index represents a novel physiologic respiratory measurement with a promising ability to triage early care and predict the need for oxygen support therapy in coronavirus disease 2019 patients.


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.


Preparing Adult Clinicians to Treat Pediatric Patients: Part 2

As pediatric cases of COVID-19 increase, it is vital to prepare for surges that may overwhelm capacity in pediatric intensive care units (ICUs). Pediatric critical care experts will address questions related caring for critically ill pediatric patients and steps to prepare for the next pediatric surge. We know children are not little adults. Whether you are practicing in an adult ICU environment or are a non-ICU clinician who may benefit from critical care training, this webcast will prepare you to treat critically ill pediatric patients. This webinar was held on October 15, 2021.


Managing Moral Distress During a Pandemic

Review the concept of moral distress and how it can lead to burnout during a pandemic. Thought leaders will teach conflict management strategies and ways to better support your teams to avoid burnout. The Managing Moral Distress During a Pandemic webinar was held on November 11, 2021.


Innovating Consistency in Care Through the STOP-VIRUS ICU Learning Collaborative

In the preliminary analysis of the VIRUS COVID-19 Registry of Discovery, the Critical Care Research Network, investigators discovered significant variations in mortality that were not readily explained by patient comorbidities, demographics, or severity of illness. It became evident that much of the disparity in outcomes was tied to variations in processes of care from one intensive care unit (ICU) to another. This realization inspired the creation of the STOP-VIRUS Learning Collaborative, which seeks to help participants rapidly evaluate and effectively implement best practice recommendations from the ever-evolving body of knowledge related to the care of critically ill patients with COVID-19.


UCHealth COVID-19 Pharmacotherapy Guidance

This community developed resource is a quick reference guide for utlization of various COVID-19 pharmacotherapies.


Best Practices for Managing Staff Shortages

During the COVID-19 pandemic, healthcare systems have been overwhelmed with patients, leading to clinician burnout and staffing issues. In this free webcast, learn how leaders from various intensive care units are managing staff shortages Webcast Recorded on Thursday, October 7, 2021. This webcast is cosponsored by the American Association of Critical-Care Nurses.


COVID-19: Lessons from the Frontline

COVID-19 case presentation from the team at Mayo Clinic - Florida that brings together many of the STOP-VIRUS Collaborative lessons learned over the course of the past 6 months.


Supporting Our Community: Well Being, Moral Distress, and Burnout

Erin Strong, BSN, RN, CCRN from the University of Pennsylvania, Amanda Frary, MSN, RN; Sydney O'Brien, RRT and Amber Dewey, RRT from Valleywise Health focus on the bedside experience during the Pandemic.  Karen Korzick, MD from Geisinger Medical Center, discusses how these experiences can lead to moral distress, and place providers at risk for burnout. Closing the discussion, Karen Korzick, MD, Elly Fitzpatrick, DNP, RN, from Thomas Jefferson University, and Greg Martin, MD, from Emory University and current SCCM President, talk about team, unit, and organizational solutions that have been attempted to prevent, combat burnout.

Curriculum Topic: Shared Decision-Making and End-of-Life Care


Challenges and Some of the Potential Solutions to Delivering Patient and Family Centered Care

The Patient Perspective (Ken Burkhom)
What the Bedside Nurse Sees (Erin Strong)
How the ICU Team Adapts (Jackie Guiliani, Preeti John)
Addressing the Repercussions of “Social Distancing”
Requests for inappropriate care, managing conflict (Alex Kon)
Shared decision making, care at the end of life & Social justice considerations (Giora Netzer)
Impact of contingency, crisis operations on communication challenges (Mary Faith Marshall)

Curriculum Topic: Shared Decision-Making and End-of-Life Care


Managing Health Disparities in the Setting of Triage Decisions

Julia F. Taylor, MD, MA, HEC-C from the University of Virginia presents on the topic of Health Disparities; Katherine Fischkoff, MD from Columbia University presents on Resource Allocation; and Erin S. DeMartino, MD from Mayo Clinic presents on Pandemic Planning. 

Curriculum Topic: Shared Decision-Making and End-of-Life Care


COVID Associated Acute Kidney Injury (AKI)

Dr. Marlies Ostermann from Guy’s & St. Thomas’ NHS Foundation Hospital in London, UK, who covered the evaluation and management of acute kidney injury in patients with COVID-19, including a review of the COVID ADQI Work Group AKI consensus report. 

Curriculum Topic: Fluids, Electrolytes, and Acute Kidney Injury


Arterial Ischemia in COVID-19; Is Ischemic Stroke More Prevalent with COVID?

Dr. Daniel Temas from Prisma Health will present a case study presentation.  Paul Nyquist, MD,  from MPH, the Johns Hopkins University School of Medicine, will provide an update on Stroke literature related to COVID and speak to thrombosis and Ischemic stroke impact. 

Curriculum Topic: Cardiovascular Complications: Venous Thromboembolism, Myocarditis, and Shock


Interleukin-6 in Critical Coronavirus Disease 2019, a Driver of Lung Inflammation of Systemic Origin?

From Critical Care Explorations. In this Brief Report the authors examined whether interleukin-6 in critical coronavirus disease 2019 is higher in arterial than in central venous blood, as a sign of predominantly local pulmonal rather than systemic interleukin-6 production.


Coronavirus Disease 2019 Tracheostomy Candidacy, Ceteris Paribus Assumptions, and Tracking Survivorship Data

From Critical Care Medicine. This Editorial accompanies the article by Angel et. al titled "Percutaneous Dilational Tracheostomy for Coronavirus Disease 2019 Patients Requiring Mechanical Ventilation".


Thrombocytopenia After Coronavirus Disease 2019 Vaccination: Remember to Put the Blame on Others Too

From Critical Care Medicine. This Editorial accompanies the article by Iba et. al titled "Recognizing vaccine-induced immune thrombotic thrombocytopenia".


Accelerating Coronavirus Disease 2019 Therapeutic Interventions and Vaccines—Selecting Compounds for Clinical Evaluation in Coronavirus Disease 2019 Clinical Trials

From Critical Care Medicine. In this Review Article the authors established a uniform data collection process required to perform an assessment of any agent type using review criteria that were identified and differentially weighted for each agent class,


Barotrauma in Coronavirus Disease 2019 Patients Undergoing Invasive Mechanical Ventilation: A Systematic Literature Review

From Critical Care Medicine. In this Review Article the authors performed a systematic literature review to identify rates of barotrauma, pneumothorax, and pneumomediastinum in coronavirus disease 2019 acute respiratory distress syndrome patients receiving invasive mechanical ventilation.


The Coronavirus Disease 2019 Pandemic Impacts Burnout Syndrome Differently Among Multiprofessional Critical Care Clinicians—A Longitudinal Survey Study

From Critical Care Medicine. In this Clinical Investigation the authors determined the impact of coronavirus disease 2019 on burnout syndrome in the multiprofessional ICU team and identified factors associated with burnout syndrome.


Increased Incidence of Ventilator-Acquired Pneumonia in Coronavirus Disease 2019 Patients: A Multicentric Cohort Study

From Critical Care Medicine. In this Clinical Investigation the authors estimated the overall incidence of ventilator-associated pneumonia, the cumulative incidence, and hazard rate of the first and the second ventilator-associated pneumonia.


Prone Position in Coronavirus Disease 2019 and Noncoronavirus Disease 2019 Acute Respiratory Distress Syndrome: An International Multicenter Observational Comparative Study

From Critical Care Medicine. In this Clinical Investigation the authors quantified 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.


Beneficial Effect of Prone Positioning During Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019

From Critical Care Medicine. In this Clinical Investigation the authors investigated the impact of prone positioning during venovenous extracorporeal membrane oxygenation support for coronavirus disease 2019 acute respiratory failure on the patient outcome.


Vascular Thrombosis in Severe Coronavirus Disease 2019 Requiring Extracorporeal Membrane Oxygenation: A Multicenter Study

From Critical Care Medicine. In this Clinical Investigation the authors conducted a multicenter study using whole-body CT to examine the prevalence, severity, and nature of vascular complications in coronavirus disease 2019 in comparison with patients with other viral pneumonias.


Characterization and Outcomes of Hospitalized Children With Coronavirus Disease 2019: A Report From a Multicenter, Viral Infection and Respiratory Illness Universal Study (Coronavirus Disease 2019) Registry

From Critical Care Medicine. In this Clinical Observation the authors describe the characteristics, ICU admissions, and outcomes among children hospitalized with coronavirus disease 2019 using Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study: Coronavirus Disease 2019 registry.


Effectiveness of High-Flow Nasal Cannula in Coronavirus Disease 2019 Pneumonia: A Retrospective Cohort Study

From Critical Care Medicine. In this Clinical Observation, the authors aimed to assess time to discharge and time to death in severe coronavirus disease 2019 in patients treated with high-flow nasal cannula compared with matched controls.


The Rural Rapid Response Team

This article was first published in the Summer 2021 issue of Critical Connections. This article describes how embedded Navy teams provided COVID-19 response in small South Texas hospitals.
 


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.


SARI-PREP Research Collaborative Aims To Revolutionize the Future

Groundbreaking study of hospitalized COVID-19 and influenza patients charts new path in critical care research
 
Severe Acute Respiratory Infection – Preparedness (SARI-PREP) is a groundbreaking new research platform from SCCM’s Discovery, the Critical Care Research Network, that is leading the way in revolutionizing how critical care research is conducted in the United States. It will inform clinical management of patients with severe acute respiratory infection (SARI) and help ensure that health systems are better prepared for future pandemics.


Preparing Adult Clinicians to Treat Pediatric Patients

As pediatric cases of COVID-19 increase, it is vital to prepare for surges that may overwhelm capacity in pediatric intensive care units (ICUs). During this FREE webcast, pediatric critical care experts will address questions related caring for critically ill pediatric patients and steps to prepare for the next pediatric surge. We know children are not little adults. Whether you are practicing in an adult ICU environment or are a non-ICU clinician who may benefit from critical care training, this webcast will prepare you to treat critically ill pediatric patients. Webcast Recorded on Wednesday, September 22, 2021


Can you discuss point-of-care ultrasound and its use 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 September 8, 2021


What do you recommend for clinicians who manage patients in the emergency department in need of a critical care bed? How do you suggest a clinician proceed beyond calling the ICU or step-down unit?

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 you comment on any current literature on the use of IV vitamin C, as well as ivermectin?

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


For permissive hypercapnia, elevated CO2, and pH, how do you adjust the ventilator, circuit, heat and moisture exchanger, tubing, and positioning?

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


What are reasonable initial ventilator settings? How do you manage FIO2 and PEEP? How much tolerance is there for permissive hypercapnia?

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


In your experience, how does management differ among pregnant 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 September 8, 2021


When monitoring hospitalized COVID-19 patients, both critically ill and noncritically ill, to prevent Stenotrophomonas or other secondary infections or fungal infections, when should prophylactic antibiotics be administered?

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


If an intubated patient worsens, how would you code a patient in the prone position? When would you consider escalating to venovenous extracorporeal membrane oxygenation in the current COVID-19 environment?

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


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


What suggestions do you have for pharmacists, physician assistants, nurses, and physicians who work in a traditionally non-ICU environment who want to obtain further skills and knowledge to care for critically ill, difficult-to-manage 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 September 8, 2021


Would you discuss positioning, including proning, also considering unintubated patients and self-proning?

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


When should paralytics be initiated, when should they be weaned off, and how do you decide whether to monitor neuromuscular blockade?

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


Regarding fluid management, inotropes, and vasopressors in critically ill patients, which drugs are concerning with excessive fluid volume?

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


What are the current recommended treatments for critically ill patients with 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 September 8, 2021


Online Letter to the Editor: Right Ventricular Dysfunction and Its Association With Mortality in Coronavirus Disease 2019 Acute Respiratory Distress Syndrome: Do Not Focus on Not Reliable Markers

From Critical Care Medicine. This is an Online Letter to the Editor written in response to Right Ventricular Dysfunction and Its Association With Mortality in Coronavirus Disease 2019 Acute Respiratory Distress Syndrome by Chotalia et al.


One-Year Functional, Cognitive, and Psychological Outcomes Following the Use of Extracorporeal Membrane Oxygenation in Coronavirus Disease 2019: A Prospective Study

From Critical Care Explorations. In this study the authors found that functional impairment was common a year following the use of extracorporeal membrane oxygenation in coronavirus disease 2019, although the majority achieved independence in daily living and about half returned to work. Long-term anxiety, depression, and post-traumatic stress disorder were common, but cognitive impairment was not.


Argatroban for Anticoagulation in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation in Coronavirus Disease 2019

From Critical Care Explorations. In this study, the authors conclude that argatroban, with or without aspirin, is an effective anticoagulation strategy for patients who require venovenous extracorporeal membrane oxygenation support secondary to coronavirus disease 2019.


Comparison of Published Guidelines for the Diagnosis and the Management of Vaccine-Induced Immune Thrombotic Thrombocytopenia

From Critical Care Explorations. In this Narrative Review, the authors conclude that clinicians should be prepared for the early identification of patients with suspicious symptoms and prompt treatment should be initiated to avoid catastrophic deterioration. They note that major societal guidelines provide useful recommendations for the diagnosis and management of patients with vaccine-induced immune thrombotic thrombocytopenia.


Clinical Characteristics, Management, and Outcomes of Cancer Patients With Coronavirus Disease 2019 Admitted to the ICU

From Critical Care Explorations. In this article, the authors report a large case series and intermediate-term follow-up of cancer patients with coronavirus disease 2019 who were admitted to the ICU. Hospital mortality was 45%; intermediate-term outcome after hospital discharge was favorable.


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.


Plasma Exchange in Patients With Severe Coronavirus Disease 2019: A Single-Center Experience

From Critical Care Explorations. The data in this study provide further evidence for plasma exchange as a novel therapeutic strategy in a subset of critically ill coronavirus disease 2019 patients by potentially reversing the complex coronavirus disease 2019 immunopathology.


Nurse Leaders’ Top Challenges, Emotional Health, and Areas of Needed Support July 2020 to August 2021

This video from the  American Organization for Nursing Leadership (AONL) discusses new data from this nursing survey indicates access to PPE and the ability to communicate and implement changing policies have improved, while staffing shortages and the emotional health and well-being of nurse leaders have worsened. 


IDSA Resources: Pediatrics

SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Infectious Diseases Society of America (IDSA) COVID-19 Real-Time Learning Network. These resources are categorized as Pediatrics


Psychologic Distress and Quality of Life After ICU Treatment for Coronavirus Disease 2019: A Multicenter, Observational Cohort Study

From Critical Care Explorations. In this study, the authors found that psychologic distress was common in coronavirus disease 2019 ICU survivors and remained similar until 6 months after hospital discharge.


Adherence to Lung Protective Ventilation in Patients With Coronavirus Disease 2019

From Critical Care Explorations. In this Brief Report, the authors sought to test the hypothesis that patients with acute respiratory distress syndrome due to coronavirus disease 2019, in whom acute respiratory distress syndrome is easily recognized, would be more likely to receive low tidal volume ventilation than concurrently admitted acute respiratory distress syndrome patients without coronavirus disease 2019.  


Safety and Feasibility of an Interdisciplinary Treatment Approach to Optimize Recovery From Critical Coronavirus Disease 2019

From Critical Care Explorations. In this study, the authors examined the safety and feasibility of a multimodal in-person or telehealth treatment program, administered in acute recovery phase for patients surviving critical coronavirus disease 2019. They found that multimodal treatment program combining care from an interdisciplinary team in an ICU Recovery Clinic with physical rehabilitation is safe and feasible in patients surviving the ICU for coronavirus disease 2019 acute respiratory failure.


Machine Learning Prediction of Death in Critically Ill Patients With Coronavirus Disease 2019

From Critical Care Explorations. In this study, the authors aimed compare machine learning algorithms and develop a simple tool for predicting 28-day mortality in ICU patients with coronavirus disease 2019.  


Risk Factors for Critical Coronavirus Disease 2019 and Mortality in Hospitalized Young Adults: An Analysis of the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) Coronavirus Disease 2019 Registry

From Critical Care Explorations. In this study, the authors found that, among hospitalized young adults, obese males with comorbidities are at higher risk of developing critical illness or dying from coronavirus disease 2019.


Characterization and Outcomes of Hospitalized Children With Coronavirus Disease 2019: A Report From a Multicenter, Viral Infection and Respiratory Illness Universal Study (Coronavirus Disease 2019) Registry

From Critical Care Medicine. In this observational, multicenter registry of children with coronavirus disease 2019, the authors found that ICU admission was common. Older age, fever, multisystem inflammatory syndrome in children, and seizure disorder were independently associated with ICU admission, and mortality was lower among children than mortality reported in adults.


Online Letter to the Editor: The Intriguing, Still Undercovered, Clinical Role of Echocardiography in Critically Ill Coronavirus Disease Patients

From Critical Care Medicine. This Online Letter to the Editor was written in response to an article by  Chotalia et al. entitled “Right ventricular dysfunction and its association with mortality in coronavirus disease 2019 acute respiratory distress syndrome.”


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.”


Defining Potential Therapeutic Targets in Coronavirus Disease 2019: A Cross-Sectional Analysis of a Single-Center Cohort

From Critical Care Explorations. In this article, this observational study the authors evaluated whether serum levels of a range of proposed coronavirus disease 2019 therapeutic targets discriminated between patients with mild or severe disease.


Online Letter to the Editor: Coronavirus Disease-Induced Blurred Judgment

From Critical Care Medicine. This Online Letter to the Editor was written in response to the article by Alhazzani et al. entitled “Surviving Sepsis Campaign Guidelines on the Management of Adults With Coronavirus Disease 2019 (COVID-19) in the ICU: First Update.”


What is the most appropriate broad-spectrum antibiotic for a patient with a superimposed infection while in the hospital with 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 August 11, 2021


What type of conversation would you have with a patient in the ICU who is not vaccinated and whose family has been exposed to 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 August 11, 2021


Is there any difference between baricitinib and tocilizumab? Would you choose one over the other?

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 often do COVID-19 patients have a secondary bacterial infection? What is the role of antibiotics in these 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 11, 2021


Would you recommend that a patient who has a negative antibody test after receiving two vaccine doses should have a booster dose?

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 does care differ for transplant patients? What strategies are most useful?

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
 


Can you provide some insight on indications for ECMO and any other insights on ECMO in terms of management or outcomes?

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


Can you offer some guidance on fluid management?

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


Can you provide some insight on appropriate vasopressor selection and dosing in these 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 11, 2021


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