On his IG page (@zentensivist) Dr. Siuba asked the question, "are we intubating COVID patients too late?" As another wave of COVID lingers over our head, this question is an important one. One year ago, we watched as COVID patients were intubated early only to face the cascade of complications to follow. Similarly, now we watch some COVID patients struggle on noninvasive ventilation only to inevitably need emergent intubation. Is there a right time to intubate these patients? Will we ever find the sweet spot?
Dr. Matt Siuba is a medical intensivist at the Cleveland Clinic in Cleveland, OH. He focuses on circulatory shock as well as severe forms of respiratory failure, especially Acute Respiratory Distress Syndrome (ARDS). Additionally, he's interested in ICU procedures, particularly point-of-care ultrasound (POCUS) and difficult vascular access.
He's a passionate medical educator and serves as the associate program director for the Critical Care Medicine fellowship. He's also a senior editor and regular content contributor at CriticalCareNow.com, focused on mechanical ventilation, respiratory care, and airway management.
References for the episode:
2020 Lippincott Advisor - Nursing Care Plans for Medical Diagnoses: Coronavirus disease 2019 (COVID-19) https://www.nursingcenter.com/nursingcenter_redesign/media/nursingcenter/coronavirus%20files%20from%20Lippincott%20Solutions/©-2020-Lippincott-Advisor-Nursing-Care-Plans-for-Medical-Diagnoses_-Coronavirus-disease-2019-(COVID-19).pdf
Ricard, JD., Roca, O., Lemiale, V. et al. Use of nasal high flow oxygen during acute respiratory failure. Intensive Care Med 46, 2238–2247 (2020). https://doi.org/10.1007/s00134-020-06228-7
When should we intubate a COVID patient?
COVID invasive vs noninvasive ventilation
Would you agree to be intubated as a COVID patient?
Work of breathing vs respiratory rate
What happened with the different COVID phenotypes theory?
RNMD interventions for COVID
Focusing on the process of care vs outcomes@RNMDPodcast
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