Sedation, narcotic and neuromuscular blockade in mechanically ventilated patients with COVID-19

OBJECTIVE: To describe the sedation, narcotic and neuromuscular blockade usage in ventilated patients with COVID-19 pneumonia. DESIGN: Single-Center Retrospective Review. SETTING: George Washington University Hospital in Washington, D.C. PATIENTS: 62 patients with COVID-19 respiratory failure requiring mechanical ventilation admitted from March 2020 to June 2020. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: Patients with COVID-19 respiratory failure required multiple sedative/narcotic infusions to achieve sedation requirements and at doses that were significantly more when compared to a general medical-surgical ICU population (represented by the MIND-USA cohort). The most common infusions were Dexmedetomadine and Propofol. Approximately 17% of our patients required a neuromuscular blockade infusion as well. Prior to intubation, narcotic utilization was stable and low. CONCLUSION: Patients with COVID-19 respiratory failure requiring mechanical ventilation have higher sedation and narcotic requirements than general ICU patients.