TY - JOUR T1 - Editor’s Commentary JF - Respiratory Care SP - i LP - i VL - 68 IS - 3 A2 - , Y1 - 2023/03/01 UR - http://rc.rcjournal.com/content/68/3/i.abstract N2 - This Month’s Editor’s Choice evaluates inhaled sedation in mechanically ventilated subjects with COVID-19. In a retrospective cohort study Gómez Duque et al compared intravenous (IV) sedation to inhaled sedation using the need for high-dose opioids (≥ 200 µg/h), opioid analgesia, midazolam, need for muscle relaxants, and risk of delirium as endpoints. Of 283 subjects, 230 were administered IV sedation and 53 received inhaled sedation. They found that inhaled sedation was associated with lower doses of opioids, benzodiazepines, and muscle relaxants. An accompanying editorial by de Lima and colleagues reviews the promise and technical issues related to inhaled sedation.Miller and colleagues evaluated a quality improvement project of an extubation readiness test (ERT) association with time to first extubation and re-intubation rate in 320 children following cardiac surgery. The new ERT used a fixed pressure support (PS) of 5 cm H2O while the previous ERT allowed a variable PS up to 10 cm H2O. The fixed PS group demonstrated a longer time to first extubation but no change in re-intubation rate. Confounding variables in the fixed PS group included a greater incidence of cardiac arrest and higher level of post-extubation respiratory support. After multivariable regression, there were no differences in time to first extubation or extubation failure. … ER -