TY - JOUR T1 - Usefulness of Inhaled Sedation in Patients With Severe ARDS Due to COVID-19 JF - Respiratory Care SP - 437 LP - 439 DO - 10.4187/respcare.10911 VL - 68 IS - 3 AU - Andres de Lima AU - Brian P O’Gara AU - Elias N Baedorf Kassis Y1 - 2023/03/01 UR - http://rc.rcjournal.com/content/68/3/437.abstract N2 - Sedation is necessary for the majority of mechanically ventilated patients in the ICU to alleviate discomfort and anxiety.1 For patients with ARDS, sedation is often required to facilitate lung-protective ventilation settings and ensure ventilator synchrony. Unfortunately, oversedation is a common and morbid risk when attempting to achieve these goals, as higher cumulative sedative dose (especially when combined with neuromuscular blockade) is among the highest impact risk factors for long-term deconditioning, persistent functional disability, and mortality.2-4 Higher sedative dose has also been associated with increased risk for delirium and higher mortality rates in the general ICU population.5,6 Patients who develop ARDS secondary to COVID-19 infection may be at an even greater risk due to even higher sedative and paralytic dose requirements.7,8Protocols that aim to minimize excessive use of sedatives and paralytics like the ABCDEF bundle include periodic spontaneous breathing and awakening trials. The use of these strategies has been demonstrated to shorten the overall duration of mechanical ventilation, decrease the incidence of post-ICU syndrome, and reduce the rates of delirium.2,9,10 In patients with high sedative requirements or in times of extreme strain on the health care system, these objectives may be difficult to achieve, hence the need for alternative strategies.This issue of Respiratory Care includes a study by Gómez Duque and colleagues11 entitled Usefulness of Inhaled Sedation in Patients With Severe ARDS Due to COVID-19. This retrospective cohort study … Correspondence: Elias N Baedorf Kassis MD, Division of Pulmonary and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215. E-mail: enbaedor{at}bidmc.harvard.edu ER -