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Analgesic, Sedative, and Paralytic Strategies in COVID-19 Patients During Critical Shortages

This presentation provides an overview of strategies for triaging analgesic, sedative, and paralytic agents patients with COVID-19. This is SCCM curated COVID-19 microlearning content.


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

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


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

From Critical Care Medicine. The authors tested the hypothesis that patients with coronavirus disease 2019–associated acute respiratory distress syndrome are at higher risk of in-hospital mortality due to prolonged coma compared with other patients with acute respiratory distress syndrome matched for disease severity.


SCCM Pod-VCCR4 Common Sedatives and Paralytics for Rapid Sequence Intubation

Sean P. Kane, PharmD, BCPS, speaks with Joseph Muench, PharmD, BCPS about airway pharmacology.


Because of the need for such high doses of sedatives and narcotics, how are you preventing post-intensive care syndrome and delirium?

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.


Can you discuss sedation, nutritional needs, and CPR?

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.


Clinical Pearls on Sedative Weaning

This resource details tips for sedative weaning for COVID-19 patients.

This is SCCM curated COVID-19 microlearning content.


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

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


COVID-19 Pharmacology Debates: Management of Delirium, Pain and Sedation

The Society of Critical Care Medicine (SCCM) and the American Society of Health-System Pharmacists (ASHP) in their third series of therapeutic debates in the management of COVID-19.


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.


Editorial: Do Our Sedation Practices Contribute to Increased Mortality in Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome?

From Critical Care Medicine. In this Editorial, the authors discuss the 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” and suggest that reemploying the use of evidence-based strategies developed over the past 20 years through rigorous controlled trials is one of the best mechanisms by which to help critically ill adults with COVID-19 liberate from the ICU and transition toward recovery and survivorship.


Editorial: Do Our Sedation Practices Contribute to Increased Mortality in Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome?

From Critical Care Medicine. In this Editorial, the authors discuss the 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” and suggest that reemploying the use of evidence-based strategies developed over the past 20 years through rigorous controlled trials is one of the best mechanisms by which to help critically ill adults with COVID-19 liberate from the ICU and transition toward recovery and survivorship. 


Evaluation of Hypertriglyceridemia in Critically Ill Patients With Coronavirus Disease 2019 Receiving Propofol

From Critical Care Explorations. In this study, the authors report the prevalence of, and evaluate risk factors for, the development of hypertriglyceridemia (defined as a serum triglyceride level of > 400 mg/dL) in patients with coronavirus disease 2019 who received propofol.


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

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on March 10, 2021


Increased Glucocorticoid Receptor Alpha Expression and Signaling in Critically Ill Coronavirus Disease 2019 Patients

From Critical Care Medicine. In this study, the authors found that ICU coronavirus disease 2019 patients showed upregulated glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper expression, along with cortisol levels, compared with ICU noncoronavirus disease 2019 patients. Thus, they concluded, on ICU admission, critical coronavirus disease 2019 appears to be associated with hypercortisolemia, and increased synthesis of glucocorticoid receptor alpha and induced proteins.


Intubation Medications/Sedation Requirements for Intubating COVID-19 Patient - Infographic

This resource is an infographic that details intubation medications and sedation requirement for intubating COVID-19 patients. This is a community developed COVID-19 microlearning resource.


Once a patient is intubated and on mechanical ventilation, how do you keep the patient sedated appropriately without reaching extremely high doses of sedatives and narcotics?

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.


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.”


Sedation Practices

Focus on ABC elements of the ICU Liberation Bundle, specifically, 1) depth of sedation, 2) choosing the right agent, 3) daily interruption of sedation. This is SCCM curated COVID-19 microlearning content.

Curriculum Topic: ICU Liberation Bundle Implementation & Challenges


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.


Strategies During NeuroMuscular Blocking Agent (NMBA) Shortages

This presentation covers how to manage neuromuscular blocking agent (NMBA) shortages. This is SCCM curated COVID-19 microlearning content.


What is the recommended Richmond Agitation-Sedation score goal for patients who had “happy hypoxia” and who then decompensate and require intubation?

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