Analgesia and sedation in patients with ARDS
 pardo.emmanuel le 15/11/2020

Analgesia and sedation in patients with ARDS

Acute Respiratory Distress Syndrome (ARDS) is one of the most demanding conditions in an Intensive Care Unit (ICU). Management of analgesia and sedation in ARDS is particularly challenging. An expert panel was convened to produce a “state‑of‑the‑art” article to support clinicians in the optimal management of analgesia/sedation in mechani‑cally ventilated adults with ARDS, including those with COVID‑19. Current ICU analgesia/sedation guidelines promote analgesia first and minimization of sedation, wakefulness, delirium prevention and early rehabilitation to facilitate ven‑tilator and ICU liberation. However, these strategies cannot always be applied to patients with ARDS who sometimes require deep sedation and/or paralysis. Patients with severe ARDS may be under‑represented in analgesia/sedation studies and currently recommended strategies may not be feasible. With lightened sedation, distress‑related symp‑toms (e.g., pain and discomfort, anxiety, dyspnea) and…

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Clinical Characteristics and Day-90 Outcomes of 4,244 critically ill adults with COVID-19: a prospective cohort study
 pardo.emmanuel le 02/11/2020

Clinical Characteristics and Day-90 Outcomes of 4,244 critically ill adults with COVID-19: a prospective cohort study

Abstract: PURPOSE: To describe acute respiratory distress syndrome (ARDS) severity, ventilation management, and the outcomes of ICU patients with laboratory-confirmed COVID-19 and to determine risk factors of 90-day mortality post-ICU admission. METHODS: COVID-ICU is a multi-center, prospective cohort study conducted in 138 hospitals in France, Belgium, and Switzerland. Demographic, clinical, respiratory support, adjunctive interventions, ICU lengthof-stay, and survival data were collected. RESULTS: From February 25 to May 4, 2020, 4,643 patients (median [IQR] age 63 [54-71] years and SAPS II 37 [28-50]) were admitted in ICU, with day-90 post-ICU admission status available for 4,244. On ICU admission, standard oxygen therapy, high-flow oxygen, and non-invasive ventilation were applied to 29%, 19%, and 6% patients, respectively. 2,635 (63%) patients were intubated during the first 24-hours whereas overall 3,376 (80%) received invasive mechanical ventilation at one point during their ICU…

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