Ventilatory Support

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

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 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.

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.

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.

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. 

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.

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.

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. 

Critical Impact: COVID-19: Highlights Session 1

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

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. 

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.

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.

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

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.  

What insight do you have on the use of high-flow nasal cannula versus CPAP or BiPAP in patients with COVID-19?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on August 11, 2021

What are some of the best strategies for ventilating 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 July 14, 2021

Long-Term Acute Care Hospital Outcomes of Mechanically Ventilated Patients With Coronavirus Disease 2019

From Critical Care Medicine. In this study, the authors reported that most patients with coronavirus disease 2019 transferred to two Chicago-area long-term acute care hospitals successfully weaned from prolonged mechanical ventilation.

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

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on June 9th, 2021.

Soluble Suppression of Tumorigenicity-2 Associates With Ventilator Dependence in Coronavirus Disease 2019 Respiratory Failure

From Critical Care Explorations. In this study, the authors hypothesized that elevated soluble suppression of tumorigenicity-2 concentrations, a marker of pulmonary epithelial injury, reflects ongoing lung injury in acute hypoxemic respiratory failure due to coronavirus disease 2019 and associate with continued ventilator dependence.

Letter to the Editor: Lung Abscess in Critically Ill Coronavirus Disease 2019 Patients With Ventilator-Associated Pneumonia: A French Monocenter Retrospective Study

From Critical Care Explorations. In this Letter to the Editor, the authors report that 17 of 119 coronavirus disease 2019 patients (14%) with ventilator-associated pneumonia developed a lung abscess.

Tracheostomy for Coronavirus Disease 2019 Patients on Mechanical Ventilation Should Not Be Arbitrarily Delayed

From Critical Care Medicine. This Editorial accompanies an article by Angel et al. entitled “Tracheostomy for Coronavirus Disease 2019 Patients Requiring Mechanical Ventilation.”

Operationalizing Ethical Guidance for Ventilator Allocation in Minnesota: Saving the Most Lives or Exacerbating Health Disparities?

From Critical Care Explorations. In this article, the authors note that the Ventilator Allocation Score can accurately identify patients with high rates of short-term mortality. However, these high mortality patients only represent 27% of all the patients who died, limiting the utility of the score for allocation of scarce resources. The score may unfairly prioritize older patients and inadvertently exacerbate racial health disparities through the inclusion of specific comorbidities such as end stage renal disease. Triage frameworks that include age should be considered. Purposeful efforts, the authors say, must be taken to ensure that triage protocols do not perpetuate or exacerbate prevailing inequities.

Awake Proning with High Flow Nasal Cannula in COVID-19 ARDS

This resource details an the usage of awake proning with high flow nasal cannula in COVID ARDS.
This is SCCM curated COVID-19 microlearning content.

Epidemiological and Clinical Characterization of Superinfections in Critically Ill Coronavirus Disease 2019 Patients

From Critical Care Explorations. Prevalence of superinfections in coronavirus disease 2019 patients requiring mechanical ventilation was high in this series, and bacterial superinfections were independently associated with ICU or 28-day mortality (whichever comes first).

Awake Extracorporeal Membrane Oxygenation in Coronavirus Disease 2019 Patients Without Invasive Mechanical Ventilation

From Critical Care Explorations. This is a case report on the use of awake extracorporeal membrane oxygenation as a “treatment” for barotrauma due to severe acute respiratory distress syndrome in a coronavirus disease 2019 patient, without the need for invasive mechanical ventilation.

Online Letter to the Editor: Reasons for the Overuse of Sedatives and Deep Sedation for Mechanically Ventilated Coronavirus Disease 2019 Patients

From Critical Care Medicine. This Online Letter to the Editor was written in response to an article by Wongtangman et al. entitled “Association of Sedation, Coma, and In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019-Related Acute Respiratory Distress Syndrome: A Retrospective Cohort Study.”

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.

Can you discuss sedation strategies for COVID-19 patients who are on mechanical ventilation or ECMO?

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 14th, 2021

Can you discuss ventilator management for the novice clinician and the optimal time for intubation 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 April 14th, 2021

Which strategies have you found to be most useful in keeping patients off mechanical ventilation and out of 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 April 14th, 2021

Frugal Innovation: Enabling Mechanical Ventilation During Coronavirus Disease 2019 Pandemic in Resource-Limited Settings

From Critical Care Explorations. In this commentary, the authors note that low-quality care has become a greater determinant of mortality than lack of access. To address this, they suggest a systems-wide approach to improving the quality of mechanical ventilation in resource-limited settings, which includes consideration of the interdependent ventilator design constraints such as cost and complexity, hospital infrastructure, availability of medications, and trained personnel.

Coronavirus Disease 2019 ICU Patients Have Higher-Than-Expected Acute Physiology and Chronic Health Evaluation–Adjusted Mortality and Length of Stay Than Viral Pneumonia ICU Patients

From Critical Care Medicine. The authors compared APACHE-IV–adjusted mortality and length of stay outcomes of adult ICU patients who tested positive for coronavirus disease 2019 with patients admitted to ICU with other viral pneumonias.

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

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

Percutaneous Dilational Tracheostomy for Coronavirus Disease 2019 Patients Requiring Mechanical Ventilation

From Critical Care Medicine. The authors assess the impact of percutaneous dilational tracheostomy in coronavirus disease 2019 patients requiring mechanical ventilation and the risk for healthcare providers.

Early Tocilizumab Dosing Is Associated With Improved Survival in Critically Ill Patients Infected With Severe Acute Respiratory Syndrome Coronavirus-2

From Critical Care Explorations. The authors identify the most efficacious timing for tocilizumab administration in critically ill patients infected with severe acute respiratory syndrome coronavirus-2.

Mechanical Ventilation and Coronavirus Disease 2019: A Case-Control Analysis of Clinical Characteristics, Lung Mechanics, and Mortality

From Critical Care Explorations. The authors investigated the differences in clinical course, ventilator mechanics, and outcomes of patients with coronavirus disease 2019 secondary to acute respiratory distress syndrome infection compared with a historical cohort of acute respiratory distress syndrome.

Online Letter to the Editor: Is Mortality Rate of Ventilated Patients With Coronavirus Disease 2019 So High?

From Critical Care Medicine.  This is an online Letter to the Editor in response to “De Novo Renal Failure and Clinical Outcomes of Patients With Critical Coronavirus Disease 2019” by Forest et al.

Standard Sedation and Sedation With Isoflurane in Mechanically Ventilated Patients With Coronavirus Disease 2019

From Critical Care Explorations. The authors describe sedative and analgesic drug utilization in a cohort of critically ill patients with coronavirus disease 2019 and compare standard sedation with an alternative approach using inhaled isoflurane.

Prone Positioning and Survival in Mechanically Ventilated Patients With Coronavirus Disease 2019–Related Respiratory Failure

From Critical Care Medicine In this study, the authors found that in-hospital mortality was lower in mechanically ventilated hypoxemic patients with coronavirus disease 2019 treated with early proning compared with patients whose treatment did not include early proning.

What is the most appropriate ventilation mode for patients with COVID-19 and how long should patients be on that ventilation mode?

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 February 24, 2021

Cardiovascular Disease and Severe Hypoxemia Are Associated With Higher Rates of Noninvasive Respiratory Support Failure in Coronavirus Disease 2019 Pneumonia

From Critical Care Explorations. The authors describe outcomes with high-flow oxygen delivered through nasal cannula and noninvasive positive pressure ventilation in coronavirus disease 2019 acute hypoxemic respiratory failure and identify individual factors associated with noninvasive respiratory support failure.

SCCM’s 50th Critical Care Congress: Surviving Sepsis Campaign COVID-19 Guidelines Therapeutics Update

From SCCM's 50th Critical Care Congress. Learn more about the guidelines therapeutics update and the methodology and its application to public health emergencies.

Process Adaptations for Airway Management in COVID patients

This is an infographic that details process adaptations for airwary management. This is a community developed COVID-19 microlearning resource.

Association Between Early Invasive Mechanical Ventilation and Day-60 Mortality in Acute Hypoxemic Respiratory Failure Related to Coronavirus Disease-2019 Pneumonia

From Critical Care Explorations. In this study, the authors assessed the effect of early invasive mechanical ventilation in coronavirus disease-2019 with acute hypoxemic respiratory failure on day-60 mortality.

Are you using more advanced ventilation modes, such as airway pressure ventilation (APRV) or oscillator?

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.

Once you intubate a patient for COVID-19, what is your starting ventilation strategy?

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.

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

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on January 13, 2021.

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

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on January 13, 2021.

Do you have a preference between CPAP and BiPAP? Does it depend on the etiology of the respiratory failure? What is your experience with current patients?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on January 13, 2021.

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

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on January 13, 2021.

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. 

Letter to the Editor: Predictors of Mortality and Effect of Drug Therapies in Mechanically Ventilated Patients With Coronavirus Disease 2019: A Multicenter Cohort St

From Critical Care Explorations

The authors conducted a multicenter cohort study to determine the effect of drug therapies on survival in mechanically ventilated patients with coronavirus disease 2019.

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

From Critical Care Explorations

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

A Novel Low-Cost Ventilator for Use in a Worldwide Pandemic: The Portsmouth Ventilator

From Critical Care Explorations

In this study, the authors found that the Portsmouth Ventilator was able to perform well across all simulated pathologies and in vivo.

Timing of Intubation and In-Hospital Mortality in Patients With Coronavirus Disease 2019

From Critical Care Explorations

The authors examined whether increasing time between admission and intubation was associated with mortality in patients with coronavirus disease 2019 who underwent mechanical ventilation.

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.

High-Flow Nasal Cannula (HFNC) Use in COVID-19 Respiratory Failure

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

Is tracheostomy a possibility in some COVID-19 patients? What is the longest time a patient has been on mechanical ventilation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on November 4, 2020.

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

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on November 4, 2020.

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

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on August 12, 2020.

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

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on August 12, 2020.

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

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on August 12, 2020.

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

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on August 12, 2020.

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

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

What is your center’s approach to supporting another center if it has a COVID-19 patient who may need intubation? What advice do you have for smaller centers that may have a potential COVID-19 patient who needs ventilation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on October 14, 2020.

What is your perspective on the approach to mechanical ventilation for 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 October 14, 2020.

Should dexamethasone or remdesivir be started on a patient who requires oxygen via nasal cannula and is highly suspected of having COVID-19 if test results are still pending?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on September 9, 2020.

What is the best way to determine when mechanically ventilated patients should be transitioned to noninvasive ventilation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on September 9, 2020.

How should patients who require mechanical ventilation be identified and how should initial ventilator settings be determined?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on September 9, 2020.

Persevering With Prone Ventilation in Coronavirus Disease 2019 Pneumonia

From Critical Care Explorations. In this case study, the authors present a 53-year-old patient with a severe coronavirus disease 2019 pneumonia who has made a remarkable recovery after a difficult period on intensive care.

Letter to the Editor: Declines in Mortality Over Time for Critically Ill Adults With Coronavirus Disease 2019

From Critical Care Medicine. In this Letter to the Editor, the authors report an update to a previous study, finding a decline in mortality rates in critically ill patients with COVID-19.

Clinical Outcomes Following Tocilizumab Administration in Mechanically Ventilated Coronavirus Disease 2019 Patients

From Critical Care Explorations. In this study, the authors examined the outcomes of critically ill coronavirus disease 2019 patients treated with tocilizumab and factors associated with clinical improvement.

Three-Dimensional Printed Ventilators: A Rapid Solution to Coronavirus Disease 2019–Induced Supply-Chain Shortages

From Critical Care Explorations. In this paper, the authors report that three-dimensional printed ventilators, such as "CRISIS," propose a potential solution to increase the available number of vents for the United States and abroad, one that is dynamic and able to absorb the massive influx of hospitalized patients for the foreseeable future.

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

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

Letter to the Editor: Weaning by Surgical Tracheostomy and Portable Ventilators Released ICU Ventilators During Coronavirus Disease 2019 Surge in London

From Critical Care Explorations. In this Letter to the Editor from London, the authors share experiences with an integrated model of surgical tracheostomy weaning of respiratory critical care patients by a specialist mobile weaning team, using tracheostomy-licensed ventilators, and noted that it appears safe, effective and may be transferrable to other healthcare systems where ICU resource limitation is a reality during the COVID-19 pandemic.

Mortality Rates in a Diverse Cohort of Mechanically Ventilated Patients With Novel Coronavirus in the Urban Midwest

From Critical Care Explorations. In this study, the authors found mortality rates in mechanically ventilated patients with coronavirus disease 2019 to be lower than some previously reported with longer lengths of stay.
 

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. 
 

Letter to the Editor: Tracheostomy for Coronavirus Disease 2019 Patients: Maintaining the Standard of Care

From Critical Care Explorations. In this Letter to the Editor, the authors respond to the new recommendations for delaying tracheostomy for coronavirus disease 2019 patients to day 21 post-intubation to ensure viral clearance.
 

Editorial: Delivering Care From an Unstable Evidence Base: The Evolving Care of Coronavirus Disease 2019 Through the Lens of High-Flow Nasal Oxygen

From Critical Care Medicine. In this Editorial, the authors discuss the challenges of caring for patients with COVID-19 without evidence to guide them through the lens of high-flow nasal oxygenation and how there have been slow changes for improvement.

Increased Dead Space Ventilation and Refractory Hypercapnia in Patients With Coronavirus Disease 2019: A Potential Marker of Thrombosis in the Pulmonary Vasculature

From Critical Care Explorations. This case series highlights clinical findings and management of coronavirus disease 2019 patients with refractory hypercapnia despite maximal/optimal ventilatory support.

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.

Obesity and the Risk of Intubation or Death in Patients With Coronavirus Disease 2019

From Critical Care Medicine. In the study, obesity was an independent risk factor for intubation or death.

Timing of Intubation and Mortality Among Critically Ill Coronavirus Disease 2019 Patients: A Single-Center Cohort Study

From Critical Care Medicine. The authors examined the impact of time to intubation and use of high-flow nasal cannula on clinical outcomes in patients with coronavirus disease 2019.

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: Coronavirus Disease 2019: Withdrawing Mechanical Ventilation to Reallocate Life Support Under Crisis Standards of Care-Nonequivalence of the Equivalence Thesis

From Critical Care Medicine. The authors look at Sprung et al. article ("Adult ICU Triage During the Coronavirus Disease 2019 Pandemic: Who Will Live and Who Will Die? Recommendations to Improve Survival" and the question: Is it ever ethical to remove a ventilator from a patient in order to reallocate it to another we believe would derive more benefit from it?

Statewide Real-Time Tracking of Beds and Ventilators During Coronavirus Disease 2019 and Beyond

From Critical Care Explorations. This brief report describes the rapid deployment of a real-time electronic tracking board for all hospitals in the state of Oregon.

Mechanical Ventilation During the Coronavirus Disease 2019 Pandemic: Combating the Tsunami of Misinformation From Mainstream and Social Media

From Critical Care Medicine. The editorial authors discuss the role of mainstream and social media in creating the narrative that intubation and mechanical ventilation were "the cause of suboptimal outcomes" for critically ill COVID-19 patients, without accounting for hospital staffing and equipment shortages.

Clinical Features of Coronavirus Disease 2019 Patients With Mechanical Ventilation: A Nationwide Study in China

From Critical Care Medicine. Mechanical ventilation (MV) is life-saving for respiratory distress; this study was designed to delineate the clinical features of the COVID-19 patients with MV from a national cohort in China.

Critical Care for Non-ICU Clinicians: Expert Panel Series

This webcast series engages a panel of critical care experts who will address questions from non-ICU clinicians caring for critically ill patients during the COVID-19 pandemic. Participants are encouraged to ask about any related topics at the time of registration or live during the session.

What is the latest data or anecdotal evidence on ventilation modes for patients with acute respiratory distress syndrome?

In this question and answer webcast series, attendees had an opportunity to pose questions about managing critically ill patients with COVID-19 and other issues. Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were also answered. Recorded on: Friday, May 22, 2020

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

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on May 27th, 2020.

What strategies are used for fluid resuscitation and intubation timing?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on May 13th, 2020.

Just-in-Time Simulation to Guide Workflow Design for Coronavirus Disease 2019 Difficult Airway Management

From Pediatric Critical Care Medicine. Integration of table-top planning, in situ simulations, and debriefing of real COVID19 cases can enhance planning, training, job aids, and feasible policies/procedures that address human factors, team communication, equipment choice, and patient/provider safety in the COVID19 pandemic era.

Implications of Obesity for the Management of Severe Coronavirus Disease 2019 Pneumonia

From Critical Care Medicine. The authors report on their experience from their first 44 cases of 95 COVID-19 critically ill patients and analyze the link between obesity and this new form of 96 ARDS caused by the SARS-CoV-2 with its potential implications for patients' management.

ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019

From Critical Care Medicine. To help address the growing concern that critical illness, and specifically mechanical ventilation, are associated with a high risk of death, the authors conducted a retrospective cohort study of critically ill patients with COVID-19 across their academic health system.

SCCM Pod-416 COVID-19 Learning: Multiple Patients on a Single Ventilator

In a situation where ventilators are in short supply, multiple patients on a single ventilator could be a strategy of last resort.

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

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

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

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

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

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

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

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

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

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

What strategies can be used to reduce rates of reintubation?

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

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

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

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

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

ICU Guide for Airway Management in COVID-19 Patients

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

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

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

How should airways be secured when proning intubated patients?

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

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

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

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

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

Can you discuss the range and ceiling of permissive hypercapnia?

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

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

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

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

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

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

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

How should respiratory failure be treated in patients with COVID-19 in terms of ventilator 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 April 15, 2020.

SCCM Pod-409 SSC COVID-19 Guidelines

Explore the Surviving Sepsis Campaign’s Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) (Alhazzani W, et al. Crit Care Med. 2020 Mar 27; Epub ahead of print) with host Kyle B. Enfield, MD, and authors Mitchell M. Levy, MD, MCCM, and Waleed Alhazzani, MD, MSc, FRCPC.

Mechanical Ventilation

Point of Care (PoC) Refresher Training

Diagnosis and Management of Acute Respiratory Failure

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

Clinical Perspectives: The Front Lines

This webinar discusses COVID-19 cases from the front-line at the University of Nebraska Medical Center Recorded on: April 17, 2020

Do ICU patients with COVID-19 require a high amount of sedation or paralysis?

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 Question and Answer Webcast Series - Webcast 2 held on April 10, 2020.

Surviving Sepsis Campaign COVID-19 Guidelines (Chinese Translation)

COVID-19 Guideline Resource. SCCM has released its Surviving Sepsis Campaign COVID-19 guidelines to manage critically ill adults with COVID-19 in the intensive care unit (ICU).

Surviving Sepsis Campaign COVID-19 Guidelines: Ventilation Recommendations Chart

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

Consensus Statement on Multiple Patients Per Ventilator

COVID-19 - SCCM Joint Statement. This joint society consensus statement provides advice to clinicians considering placing multiple patients on a single mechanical ventilator.

Initial Management of Hypoxic COVID-19 Patients

COVID-19 SSC Guidelines Infographic. This rapid resource is aligned with the SSC COVID-19 Guidelines.

SCCM-ASA Joint Statement to Address the COVID-19 Pandemic

COVID-19 - SCCM Joint Statement. The Society of Critical Care Medicine (SCCM) and the American Society of Anesthesiologists (ASA) announce their plans to collaborate to address the COVID-19 crisis.

Joint Statement of the Critical Care Society Collaborative to the US Congress and the Trump Administration

COVID-19 - SCCM Joint Statement. Production and distribution of personal protective equipment (PPE) and life-saving equipment.

Because patients with COVID-19 seem to remain intubated for long periods of time, do you have any recommendations regarding early versus late tracheostomy?

It seems COVID-19 patients remain intubated for a long period of time. Do you have any recommendations for early vs. late tracheostomy?

Do you have any comments on airway management, instrumentation, or intubation protocols?

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

What are the recommendations for proning in patients with COVID-19 and how early should proning be instituted?

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

What are the limits of PEEP and plateau pressure?

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

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.

Surviving Sepsis Campaign COVID-19 Guidelines - Updated 1/29/2021

COVID-19 Guideline Resource.