Abstract:
:The rapid spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to a global pandemic. The 2019 coronavirus disease (COVID-19) presents with a spectrum of symptoms ranging from mild to critical illness requiring intensive care unit (ICU) admission. Acute respiratory distress syndrome is a major complication in patients with severe COVID-19 disease. Currently, there are no recognized pharmacological therapies for COVID-19. However, a large number of COVID-19 patients require respiratory support, with a high percentage requiring invasive ventilation. The rapid spread of the infection has led to a surge in the rate of hospitalizations and ICU admissions, which created a challenge to public health, research, and medical communities. The high demand for several therapies, including sedatives, analgesics, and paralytics, that are often utilized in the care of COVID-19 patients requiring mechanical ventilation, has created pressure on the supply chain resulting in shortages in these critical medications. This has led clinicians to develop conservation strategies and explore alternative therapies for sedation, analgesia, and paralysis in COVID-19 patients. Several of these alternative approaches have demonstrated acceptable levels of sedation, analgesia, and paralysis in different settings but they are not commonly used in the ICU. Additionally, they have unique pharmaceutical properties, limitations, and adverse effects. This narrative review summarizes the literature on alternative drug therapies for the management of sedation, analgesia, and paralysis in COVID-19 patients. Also, this document serves as a resource for clinicians in current and future respiratory illness pandemics in the setting of drug shortages.
journal_name
J Intensive Care Medjournal_title
Journal of intensive care medicineauthors
Ammar MA,Sacha GL,Welch SC,Bass SN,Kane-Gill SL,Duggal A,Ammar AAdoi
10.1177/0885066620951426subject
Has Abstractpub_date
2021-02-01 00:00:00pages
157-174issue
2eissn
0885-0666issn
1525-1489journal_volume
36pub_type
杂志文章abstract::Cirrhotic patients admitted to the medical intensive care unit (ICU) are associated with high mortality rates. The prognosis of critically ill cirrhotic patients is determined by the extent of hepatic and extrahepatic organ dysfunction. This study was conducted to assess and compare the accuracy of the Child-Pugh clas...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066603261991
更新日期:2004-03-01 00:00:00
abstract:RATIONALE:The feasibility and clinical outcomes of conservative fluid management after sepsis resuscitation remain unknown. OBJECTIVES:To evaluate the effect of a conservative fluid management protocol on fluid balance and intensive care unit (ICU)-free days among patients with sepsis. METHODS:In a single-center phas...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618823183
更新日期:2020-12-01 00:00:00
abstract::Periodic epileptiform discharges (PEDs) are frequently encountered during continuous electroencephalography monitoring in the intensive care unit. Their implications and management are variable and highly dependent on the clinical context. This article is intended for the nonneurologist intensivist, reviews basic term...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066613513411
更新日期:2015-10-01 00:00:00
abstract::Pulmonary embolus (PE) is estimated to cause 200 000 to 300 000 deaths annually. Many deaths occur in hemodynamically unstable patients and the estimated mortality for inpatients with hemodynamic instability is between 15% and 25%. The diagnosis of PE in the critically ill is often challenging because the presentation...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066610392658
更新日期:2011-09-01 00:00:00
abstract::Video laryngoscopy has demonstrated utility in airway management. For the present case series, we report the use of video laryngoscopy to evaluate the airway of critically ill, mechanically ventilated patients, as a means to reduce the risk of immediate postextubation stridor by assessing the degree of laryngeal edema...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066612437528
更新日期:2013-01-01 00:00:00
abstract::Transfusion-related acute lung injury (TRALI) refers to a clinical syndrome of acute lung injury that occurs in a temporal relationship with the transfusion of blood products. Because of the difficulty in making its diagnosis, TRALI is often underreported. Three not necessarily mutually exclusive hypotheses have been ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066607312994
更新日期:2008-03-01 00:00:00
abstract:PURPOSE:The aim of this study was to check if serum lactate was independently associated with mortality among critically ill patients. MATERIALS AND METHODS:This was a single-center, retrospective cohort study. All adult patients (>18 years of age) who had at least 1 measurement of lactate within 24 hours of admission...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619854355
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:Visualization of B-lines via lung ultrasound provides a non-invasive estimation of pulmonary hydration. Extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI) assessed by transpulmonary thermodilution (TPTD) represent the most validated parameters of lung water and alveoloc...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620967655
更新日期:2020-11-05 00:00:00
abstract:BACKGROUND:Aspiration past the tracheal tube cuff has been recognized to be a risk factor for the development of ventilator-associated pneumonia (VAP). This study investigated the effect of closed tracheal suctioning on aspiration of fluid past the tracheal tube cuff in an in vitro benchtop model. METHODS:High-volume ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066610392516
更新日期:2011-09-01 00:00:00
abstract:PURPOSE:Methods to optimize positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS) remain controversial despite decades of research. The pressure-volume curve (PVC), a graphical ventilator relationship, has been proposed for prescription of PEEP in ARDS. Whether the use of PVC's improves ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066613488747
更新日期:2014-11-01 00:00:00
abstract:PURPOSE:Etomidate causes adrenal insufficiency. Yet in critically ill patients, it is controversial whether it increases mortality rates above that of comparator anesthetic induction agents. We postulated that etomidate would increase relative mortality rates correspondingly to the severity of illness as defined by SAP...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620957596
更新日期:2020-09-10 00:00:00
abstract::We report the success rate and complications of peripherally inserted central catheters (PICCs) in patients hospitalized in an intensive care unit (ICU). We performed a cohort study in the ICU of a large tertiary care, university-affiliated community hospital. All ICU patients for whom their attending physicians reque...
journal_title:Journal of intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1177/088506669601100107
更新日期:1996-01-01 00:00:00
abstract:PURPOSE:Timely recognition of critical illness is associated with improved outcomes, but is dependent on accurate triage, which is affected by system factors such as workload and staffing. We sought to first study the effect of delayed recognition on patient outcomes after controlling for system factors and then to ide...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620967901
更新日期:2020-10-29 00:00:00
abstract:INTRODUCTION:Percutaneous dilational tracheostomy (PDT) is a common and increasingly used procedure in the intensive care unit (ICU). It is usually performed with bronchoscopy guidance. Ultrasound has emerged as a useful tool in order to assist PDT, potentially improving its success rate and reducing procedural-related...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,meta分析
doi:10.1177/0885066618755334
更新日期:2020-05-01 00:00:00
abstract::Cardiac transplantation has now become accepted therapy for the treatment of end-stage heart disease in both children and adults, and literally thousands of patients are bearers of cardiac grafts. Because of these patients' susceptibility to infections, rejection, coronary disease, and malignancy, as well as to serio...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/088506669100600201
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of high-flow nasal cannula oxygen (HFNO) therapy on hospital length of stay (LOS) and postoperative pulmonary complications (PPCs) in adult postoperative patients. DATA SOURCES:PubMed, Embase, the Cochrane Library, Web of Science of Studies, China National Knowledge Index, and Wan Fang...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618817718
更新日期:2020-10-01 00:00:00
abstract::Primary and acquired abdominal pathology accounts for a significant proportion of sepsis and SIRS in the ICU population. Abdominal processes often present a difficult diagnostic dilemma in the truly critically ill patient who, due to hemodynamic instability or severe acute respiratory distress syndrome (ARDS) requirin...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066613492102
更新日期:2015-07-01 00:00:00
abstract::Patients undergoing surgery for pituitary tumors represent a heterogeneous population each with unique clinical, biochemical, radiologic, pathologic, neurologic, and/or ophthalmologic considerations. The postoperative management of patients following pituitary surgery often occurs in the context of a dynamic state of ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066605275247
更新日期:2005-05-01 00:00:00
abstract::This was a retrospective observational study in a pediatric intensive care unit, in which 19 patients received levosimendan. There were no adverse events attributable to levosimendan and no instances where the clinical condition worsened after administration. Arterial lactate levels decreased significantly following l...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066606287039
更新日期:2006-05-01 00:00:00
abstract:INTRODUCTION:The Surviving Sepsis Campaign guidelines recommend early goal-directed therapy (EGDT) for the resuscitation of patients with sepsis; however, the recent evidences quickly evolve and convey conflicting results. We performed a meta-analysis to evaluate the effect of EGDT on mortality in adults with severe se...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,meta分析
doi:10.1177/0885066616671710
更新日期:2018-05-01 00:00:00
abstract::Cardiomyopathy secondary to toxic shock syndrome (TSS) is an uncommon but potentially life-threatening problem. We report the case of a 51-year-old male who presented with profound cardiogenic shock and multiorgan failure that could not be managed by conventional therapy with intravenous fluids, vasopressors and inotr...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066613517069
更新日期:2015-02-01 00:00:00
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journal_title:Journal of intensive care medicine
pub_type: 杂志文章,实务指引
doi:10.1177/0885066610387988
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:Intrahospital transports (IHTs) of neurosurgical intensive care unit (NICU) patients can be hazardous. Increasing intracranial pressure (ICP) and/or decreasing cerebral perfusion pressure (CPP) as well as cardiopulmonary alterations are common complications of an IHTs, which can lead to secondary brain injury...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619891063
更新日期:2019-11-28 00:00:00
abstract:BACKGROUND::The diagnosis of sepsis is challenging in the absence of a gold standard test. Recent studies have explored the role of neutrophil and monocyte volume, conductivity, and scatter (VCS), derived from automated hematology analyzers, in diagnosing sepsis. We assessed the diagnostic accuracy of VCS parameters in...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066616682940
更新日期:2018-12-01 00:00:00
abstract::Vasopressin has gained wide support as an adjunct vasopressor in patients with septic shock. This agent exerts its vasoconstriction effects through smooth muscle V1 receptors and also has antidiuretic activity via renal V2 receptors. This interaction with the renal V2 receptors results in the integration of aquaporin ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066613507410
更新日期:2015-07-01 00:00:00
abstract::Extracorporeal membrane oxygenation (ECMO) comprises a commonly used method of extracorporeal life support. It has proven efficacy and is an accepted modality of care for isolated respiratory or cardiopulmonary failure in neonatal and pediatric populations. In adults, there are conflicting studies regarding its benefi...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066610384061
更新日期:2011-01-01 00:00:00
abstract::A review of adults with septic arthritis was undertaken to evaluate outcome of treatment and intensive care requirements in a community-based teaching hospital. During an 80-month period (1986-1992), 38 cases of septic arthritis were identified. Underlying joint disease was present in 84% of patients. Mean age was 68 ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/088506669501000507
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Impaired physical functioning is common and long lasting after an intensive care unit (ICU) admission. The 6-minute walk test (6MWT) is a validated and widely used test of functional capacity. This systematic review synthesizes existing data in order to: (1) evaluate 6-minute walk distance (6M...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619885838
更新日期:2019-11-05 00:00:00
abstract:PURPOSE:To use the 2010 to 2011 data collected by structured chart review to provide a detailed up-to-date description of the epidemiology and microbiology of the sepsis syndromes. METHODS:Prospective observational study conducted at a university-affiliated urban teaching hospital and level-1 trauma and burn center. A...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066615592851
更新日期:2017-05-01 00:00:00
abstract::Hypercalcemia may be seen in a variety of clinical settings and often requires intensive management when serum calcium levels are dramatically elevated. All of the many etiologies of mild hypercalcemia can lead to severe hypercalcemia. Knowledge of the physiologic mechanisms involved in maintaining normocalcemia and b...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066613507530
更新日期:2015-07-01 00:00:00