id sid tid token lemma pos cord-341527-03rh966o 1 1 key key NN cord-341527-03rh966o 1 2 : : : cord-341527-03rh966o 2 1 cord-341527 cord-341527 NNP cord-341527-03rh966o 2 2 - - HYPH cord-341527-03rh966o 2 3 03rh966o 03rh966o JJ cord-341527-03rh966o 2 4 authors author NNS cord-341527-03rh966o 2 5 : : : cord-341527-03rh966o 2 6 Stockton Stockton NNP cord-341527-03rh966o 2 7 , , , cord-341527-03rh966o 2 8 John John NNP cord-341527-03rh966o 2 9 ; ; : cord-341527-03rh966o 2 10 Kyle Kyle NNP cord-341527-03rh966o 2 11 - - HYPH cord-341527-03rh966o 2 12 Sidell Sidell NNP cord-341527-03rh966o 2 13 , , , cord-341527-03rh966o 2 14 Cameron Cameron NNP cord-341527-03rh966o 2 15 title title NN cord-341527-03rh966o 2 16 : : : cord-341527-03rh966o 2 17 Dexmedetomidine Dexmedetomidine NNP cord-341527-03rh966o 2 18 and and CC cord-341527-03rh966o 2 19 worsening worsen VBG cord-341527-03rh966o 2 20 hypoxemia hypoxemia NN cord-341527-03rh966o 2 21 in in IN cord-341527-03rh966o 2 22 the the DT cord-341527-03rh966o 2 23 setting setting NN cord-341527-03rh966o 2 24 of of IN cord-341527-03rh966o 2 25 COVID-19 covid-19 NN cord-341527-03rh966o 2 26 : : : cord-341527-03rh966o 2 27 A a DT cord-341527-03rh966o 2 28 case case NN cord-341527-03rh966o 2 29 report report NN cord-341527-03rh966o 2 30 date date NN cord-341527-03rh966o 2 31 : : : cord-341527-03rh966o 2 32 2020 2020 CD cord-341527-03rh966o 2 33 - - HYPH cord-341527-03rh966o 2 34 05 05 CD cord-341527-03rh966o 2 35 - - HYPH cord-341527-03rh966o 2 36 27 27 CD cord-341527-03rh966o 2 37 journal journal NN cord-341527-03rh966o 2 38 : : : cord-341527-03rh966o 3 1 Am be VBP cord-341527-03rh966o 3 2 J J NNP cord-341527-03rh966o 3 3 Emerg Emerg NNP cord-341527-03rh966o 3 4 Med Med NNP cord-341527-03rh966o 3 5 DOI DOI NNP cord-341527-03rh966o 3 6 : : : cord-341527-03rh966o 4 1 10.1016 10.1016 CD cord-341527-03rh966o 4 2 / / SYM cord-341527-03rh966o 4 3 j.ajem.2020.05.066 j.ajem.2020.05.066 NNP cord-341527-03rh966o 4 4 sha sha NNP cord-341527-03rh966o 4 5 : : : cord-341527-03rh966o 5 1 f256d57d72ea0553b161f7b6aae3a062832ba248 f256d57d72ea0553b161f7b6aae3a062832ba248 NNP cord-341527-03rh966o 5 2 doc_id doc_id CD cord-341527-03rh966o 5 3 : : : cord-341527-03rh966o 5 4 341527 341527 CD cord-341527-03rh966o 5 5 cord_uid cord_uid NNS cord-341527-03rh966o 5 6 : : : cord-341527-03rh966o 5 7 03rh966o 03rh966o ADD cord-341527-03rh966o 6 1 Emergency emergency NN cord-341527-03rh966o 6 2 department department NN cord-341527-03rh966o 6 3 management management NN cord-341527-03rh966o 6 4 of of IN cord-341527-03rh966o 6 5 hypoxemia hypoxemia NN cord-341527-03rh966o 6 6 in in IN cord-341527-03rh966o 6 7 the the DT cord-341527-03rh966o 6 8 setting setting NN cord-341527-03rh966o 6 9 of of IN cord-341527-03rh966o 6 10 COVID-19 COVID-19 NNP cord-341527-03rh966o 6 11 is be VBZ cord-341527-03rh966o 6 12 riddled riddle VBN cord-341527-03rh966o 6 13 with with IN cord-341527-03rh966o 6 14 uncertainty uncertainty NN cord-341527-03rh966o 6 15 . . . cord-341527-03rh966o 7 1 The the DT cord-341527-03rh966o 7 2 lack lack NN cord-341527-03rh966o 7 3 of of IN cord-341527-03rh966o 7 4 high high JJ cord-341527-03rh966o 7 5 - - HYPH cord-341527-03rh966o 7 6 quality quality NN cord-341527-03rh966o 7 7 research research NN cord-341527-03rh966o 7 8 has have VBZ cord-341527-03rh966o 7 9 translated translate VBN cord-341527-03rh966o 7 10 to to IN cord-341527-03rh966o 7 11 an an DT cord-341527-03rh966o 7 12 absence absence NN cord-341527-03rh966o 7 13 of of IN cord-341527-03rh966o 7 14 clarity clarity NN cord-341527-03rh966o 7 15 at at IN cord-341527-03rh966o 7 16 the the DT cord-341527-03rh966o 7 17 bedside bedside NN cord-341527-03rh966o 7 18 . . . cord-341527-03rh966o 8 1 With with IN cord-341527-03rh966o 8 2 disease disease NN cord-341527-03rh966o 8 3 spread spread VBD cord-341527-03rh966o 8 4 outpacing outpace VBG cord-341527-03rh966o 8 5 treatment treatment NN cord-341527-03rh966o 8 6 consensus consensus NN cord-341527-03rh966o 8 7 , , , cord-341527-03rh966o 8 8 provider provider NN cord-341527-03rh966o 8 9 discretion discretion NN cord-341527-03rh966o 8 10 has have VBZ cord-341527-03rh966o 8 11 taken take VBN cord-341527-03rh966o 8 12 on on RP cord-341527-03rh966o 8 13 a a DT cord-341527-03rh966o 8 14 heightened heightened JJ cord-341527-03rh966o 8 15 role role NN cord-341527-03rh966o 8 16 . . . cord-341527-03rh966o 9 1 Here here RB cord-341527-03rh966o 9 2 , , , cord-341527-03rh966o 9 3 we -PRON- PRP cord-341527-03rh966o 9 4 report report VBP cord-341527-03rh966o 9 5 a a DT cord-341527-03rh966o 9 6 case case NN cord-341527-03rh966o 9 7 of of IN cord-341527-03rh966o 9 8 dexmedetomidine dexmedetomidine JJ cord-341527-03rh966o 9 9 use use NN cord-341527-03rh966o 9 10 in in IN cord-341527-03rh966o 9 11 the the DT cord-341527-03rh966o 9 12 setting setting NN cord-341527-03rh966o 9 13 of of IN cord-341527-03rh966o 9 14 worsening worsen VBG cord-341527-03rh966o 9 15 hypoxemia hypoxemia NN cord-341527-03rh966o 9 16 , , , cord-341527-03rh966o 9 17 whereby whereby WRB cord-341527-03rh966o 9 18 oxygenation oxygenation NN cord-341527-03rh966o 9 19 improved improve VBD cord-341527-03rh966o 9 20 and and CC cord-341527-03rh966o 9 21 intubation intubation NN cord-341527-03rh966o 9 22 was be VBD cord-341527-03rh966o 9 23 avoided avoid VBN cord-341527-03rh966o 9 24 . . . cord-341527-03rh966o 10 1 Well well UH cord-341527-03rh966o 10 2 known know VBN cord-341527-03rh966o 10 3 pharmacologic pharmacologic JJ cord-341527-03rh966o 10 4 properties property NNS cord-341527-03rh966o 10 5 of of IN cord-341527-03rh966o 10 6 the the DT cord-341527-03rh966o 10 7 drug drug NN cord-341527-03rh966o 10 8 , , , cord-341527-03rh966o 10 9 namely namely RB cord-341527-03rh966o 10 10 the the DT cord-341527-03rh966o 10 11 lack lack NN cord-341527-03rh966o 10 12 of of IN cord-341527-03rh966o 10 13 respiratory respiratory JJ cord-341527-03rh966o 10 14 depression depression NN cord-341527-03rh966o 10 15 and and CC cord-341527-03rh966o 10 16 its -PRON- PRP$ cord-341527-03rh966o 10 17 anti anti JJ cord-341527-03rh966o 10 18 - - JJ cord-341527-03rh966o 10 19 delirium delirium JJ cord-341527-03rh966o 10 20 effects effect NNS cord-341527-03rh966o 10 21 , , , cord-341527-03rh966o 10 22 as as RB cord-341527-03rh966o 10 23 well well RB cord-341527-03rh966o 10 24 as as IN cord-341527-03rh966o 10 25 other other JJ cord-341527-03rh966o 10 26 possible possible JJ cord-341527-03rh966o 10 27 physiologic physiologic JJ cord-341527-03rh966o 10 28 effects effect NNS cord-341527-03rh966o 10 29 , , , cord-341527-03rh966o 10 30 suggest suggest VBP cord-341527-03rh966o 10 31 potential potential JJ cord-341527-03rh966o 10 32 benefit benefit NN cord-341527-03rh966o 10 33 for for IN cord-341527-03rh966o 10 34 patients patient NNS cord-341527-03rh966o 10 35 being be VBG cord-341527-03rh966o 10 36 managed manage VBN cord-341527-03rh966o 10 37 with with IN cord-341527-03rh966o 10 38 a a DT cord-341527-03rh966o 10 39 delayed delay VBN cord-341527-03rh966o 10 40 intubation intubation NN cord-341527-03rh966o 10 41 approach approach NN cord-341527-03rh966o 10 42 . . . cord-341527-03rh966o 11 1 If if IN cord-341527-03rh966o 11 2 dexmedetomidine dexmedetomidine NN cord-341527-03rh966o 11 3 can can MD cord-341527-03rh966o 11 4 improve improve VB cord-341527-03rh966o 11 5 compliance compliance NN cord-341527-03rh966o 11 6 with with IN cord-341527-03rh966o 11 7 non non JJ cord-341527-03rh966o 11 8 - - JJ cord-341527-03rh966o 11 9 invasive invasive JJ cord-341527-03rh966o 11 10 oxygen oxygen NN cord-341527-03rh966o 11 11 support support NN cord-341527-03rh966o 11 12 ( ( -LRB- cord-341527-03rh966o 11 13 the the DT cord-341527-03rh966o 11 14 current current JJ cord-341527-03rh966o 11 15 recommended recommend VBD cord-341527-03rh966o 11 16 first first JJ cord-341527-03rh966o 11 17 - - HYPH cord-341527-03rh966o 11 18 line line NN cord-341527-03rh966o 11 19 therapy therapy NN cord-341527-03rh966o 11 20 ) ) -RRB- cord-341527-03rh966o 11 21 while while IN cord-341527-03rh966o 11 22 promoting promote VBG cord-341527-03rh966o 11 23 better well JJR cord-341527-03rh966o 11 24 oxygenation oxygenation NN cord-341527-03rh966o 11 25 , , , cord-341527-03rh966o 11 26 it -PRON- PRP cord-341527-03rh966o 11 27 may may MD cord-341527-03rh966o 11 28 also also RB cord-341527-03rh966o 11 29 decrease decrease VB cord-341527-03rh966o 11 30 the the DT cord-341527-03rh966o 11 31 need need NN cord-341527-03rh966o 11 32 for for IN cord-341527-03rh966o 11 33 mechanical mechanical JJ cord-341527-03rh966o 11 34 ventilation ventilation NN cord-341527-03rh966o 11 35 and and CC cord-341527-03rh966o 11 36 thus thus RB cord-341527-03rh966o 11 37 improve improve VB cord-341527-03rh966o 11 38 mortality mortality NN cord-341527-03rh966o 11 39 . . . cord-341527-03rh966o 12 1 As as IN cord-341527-03rh966o 12 2 of of IN cord-341527-03rh966o 12 3 this this DT cord-341527-03rh966o 12 4 writing writing NN cord-341527-03rh966o 12 5 , , , cord-341527-03rh966o 12 6 there there EX cord-341527-03rh966o 12 7 have have VBP cord-341527-03rh966o 12 8 been be VBN cord-341527-03rh966o 12 9 over over IN cord-341527-03rh966o 12 10 1,300,000 1,300,000 CD cord-341527-03rh966o 12 11 confirmed confirm VBN cord-341527-03rh966o 12 12 cases case NNS cord-341527-03rh966o 12 13 of of IN cord-341527-03rh966o 12 14 COVID-19 covid-19 CD cord-341527-03rh966o 12 15 and and CC cord-341527-03rh966o 12 16 80,000 80,000 CD cord-341527-03rh966o 12 17 deaths death NNS cord-341527-03rh966o 12 18 in in IN cord-341527-03rh966o 12 19 the the DT cord-341527-03rh966o 12 20 United United NNP cord-341527-03rh966o 12 21 States States NNP cord-341527-03rh966o 12 22 [ [ -LRB- cord-341527-03rh966o 12 23 1 1 CD cord-341527-03rh966o 12 24 ] ] -RRB- cord-341527-03rh966o 12 25 . . . cord-341527-03rh966o 13 1 While while IN cord-341527-03rh966o 13 2 early early JJ cord-341527-03rh966o 13 3 intubation intubation NN cord-341527-03rh966o 13 4 was be VBD cord-341527-03rh966o 13 5 the the DT cord-341527-03rh966o 13 6 initial initial JJ cord-341527-03rh966o 13 7 recommended recommend VBN cord-341527-03rh966o 13 8 strategy strategy NN cord-341527-03rh966o 13 9 for for IN cord-341527-03rh966o 13 10 COVID-19 COVID-19 NNP cord-341527-03rh966o 13 11 hypoxemia hypoxemia NN cord-341527-03rh966o 13 12 , , , cord-341527-03rh966o 13 13 a a DT cord-341527-03rh966o 13 14 large large JJ cord-341527-03rh966o 13 15 case case NN cord-341527-03rh966o 13 16 series series NN cord-341527-03rh966o 13 17 in in IN cord-341527-03rh966o 13 18 the the DT cord-341527-03rh966o 13 19 US US NNP cord-341527-03rh966o 13 20 as as RB cord-341527-03rh966o 13 21 well well RB cord-341527-03rh966o 13 22 as as IN cord-341527-03rh966o 13 23 data datum NNS cord-341527-03rh966o 13 24 coming come VBG cord-341527-03rh966o 13 25 out out IN cord-341527-03rh966o 13 26 of of IN cord-341527-03rh966o 13 27 Britain Britain NNP cord-341527-03rh966o 13 28 , , , cord-341527-03rh966o 13 29 China China NNP cord-341527-03rh966o 13 30 , , , cord-341527-03rh966o 13 31 and and CC cord-341527-03rh966o 13 32 Italy Italy NNP cord-341527-03rh966o 13 33 suggests suggest VBZ cord-341527-03rh966o 13 34 a a DT cord-341527-03rh966o 13 35 high high JJ cord-341527-03rh966o 13 36 mortality mortality NN cord-341527-03rh966o 13 37 for for IN cord-341527-03rh966o 13 38 patients patient NNS cord-341527-03rh966o 13 39 requiring require VBG cord-341527-03rh966o 13 40 invasive invasive JJ cord-341527-03rh966o 13 41 ventilation ventilation NN cord-341527-03rh966o 13 42 [ [ -LRB- cord-341527-03rh966o 13 43 2 2 CD cord-341527-03rh966o 13 44 ] ] -RRB- cord-341527-03rh966o 13 45 . . . cord-341527-03rh966o 14 1 The the DT cord-341527-03rh966o 14 2 National National NNP cord-341527-03rh966o 14 3 Institute Institute NNP cord-341527-03rh966o 14 4 of of IN cord-341527-03rh966o 14 5 Health Health NNP cord-341527-03rh966o 14 6 now now RB cord-341527-03rh966o 14 7 recommends recommend VBZ cord-341527-03rh966o 14 8 high high JJ cord-341527-03rh966o 14 9 flow flow NN cord-341527-03rh966o 14 10 nasal nasal NN cord-341527-03rh966o 14 11 cannula cannula NN cord-341527-03rh966o 14 12 ( ( -LRB- cord-341527-03rh966o 14 13 HFNC HFNC NNP cord-341527-03rh966o 14 14 ) ) -RRB- cord-341527-03rh966o 14 15 as as IN cord-341527-03rh966o 14 16 first first JJ cord-341527-03rh966o 14 17 line line NN cord-341527-03rh966o 14 18 oxygen oxygen NN cord-341527-03rh966o 14 19 support support NN cord-341527-03rh966o 14 20 [ [ -LRB- cord-341527-03rh966o 14 21 3 3 CD cord-341527-03rh966o 14 22 ] ] -RRB- cord-341527-03rh966o 14 23 . . . cord-341527-03rh966o 15 1 The the DT cord-341527-03rh966o 15 2 following following JJ cord-341527-03rh966o 15 3 case case NN cord-341527-03rh966o 15 4 addresses address VBZ cord-341527-03rh966o 15 5 the the DT cord-341527-03rh966o 15 6 management management NN cord-341527-03rh966o 15 7 of of IN cord-341527-03rh966o 15 8 one one CD cord-341527-03rh966o 15 9 patient patient NN cord-341527-03rh966o 15 10 on on IN cord-341527-03rh966o 15 11 HFNC HFNC NNP cord-341527-03rh966o 15 12 , , , cord-341527-03rh966o 15 13 with with IN cord-341527-03rh966o 15 14 specific specific JJ cord-341527-03rh966o 15 15 reference reference NN cord-341527-03rh966o 15 16 to to IN cord-341527-03rh966o 15 17 dexmedetomidine dexmedetomidine NNP cord-341527-03rh966o 15 18 . . . cord-341527-03rh966o 16 1 A a DT cord-341527-03rh966o 16 2 58-year 58-year JJ cord-341527-03rh966o 16 3 - - HYPH cord-341527-03rh966o 16 4 old old JJ cord-341527-03rh966o 16 5 female female NN cord-341527-03rh966o 16 6 with with IN cord-341527-03rh966o 16 7 hypertension hypertension NN cord-341527-03rh966o 16 8 presented present VBN cord-341527-03rh966o 16 9 to to IN cord-341527-03rh966o 16 10 a a DT cord-341527-03rh966o 16 11 New New NNP cord-341527-03rh966o 16 12 York York NNP cord-341527-03rh966o 16 13 City City NNP cord-341527-03rh966o 16 14 emergency emergency NN cord-341527-03rh966o 16 15 department department NN cord-341527-03rh966o 16 16 for for IN cord-341527-03rh966o 16 17 shortness shortness NN cord-341527-03rh966o 16 18 of of IN cord-341527-03rh966o 16 19 breath breath NN cord-341527-03rh966o 16 20 for for IN cord-341527-03rh966o 16 21 one one CD cord-341527-03rh966o 16 22 day day NN cord-341527-03rh966o 16 23 in in IN cord-341527-03rh966o 16 24 the the DT cord-341527-03rh966o 16 25 setting setting NN cord-341527-03rh966o 16 26 of of IN cord-341527-03rh966o 16 27 known know VBN cord-341527-03rh966o 16 28 COVID-19 covid-19 CD cord-341527-03rh966o 16 29 diagnosed diagnose VBN cord-341527-03rh966o 16 30 one one CD cord-341527-03rh966o 16 31 week week NN cord-341527-03rh966o 16 32 prior prior RB cord-341527-03rh966o 16 33 . . . cord-341527-03rh966o 17 1 Initial initial JJ cord-341527-03rh966o 17 2 vital vital JJ cord-341527-03rh966o 17 3 signs sign NNS cord-341527-03rh966o 17 4 revealed reveal VBD cord-341527-03rh966o 17 5 an an DT cord-341527-03rh966o 17 6 SpO2 spo2 NN cord-341527-03rh966o 17 7 of of IN cord-341527-03rh966o 17 8 95 95 CD cord-341527-03rh966o 17 9 % % NN cord-341527-03rh966o 17 10 on on IN cord-341527-03rh966o 17 11 room room NN cord-341527-03rh966o 17 12 air air NN cord-341527-03rh966o 17 13 . . . cord-341527-03rh966o 18 1 On on IN cord-341527-03rh966o 18 2 examination examination NN cord-341527-03rh966o 18 3 , , , cord-341527-03rh966o 18 4 the the DT cord-341527-03rh966o 18 5 patient patient NN cord-341527-03rh966o 18 6 was be VBD cord-341527-03rh966o 18 7 tachypneic tachypneic NNS cord-341527-03rh966o 18 8 . . . cord-341527-03rh966o 19 1 Her -PRON- PRP$ cord-341527-03rh966o 19 2 chest chest NN cord-341527-03rh966o 19 3 x x NN cord-341527-03rh966o 19 4 - - NN cord-341527-03rh966o 19 5 ray ray NN cord-341527-03rh966o 19 6 showed show VBD cord-341527-03rh966o 19 7 pulmonary pulmonary JJ cord-341527-03rh966o 19 8 infiltrates infiltrate VBZ cord-341527-03rh966o 19 9 consistent consistent JJ cord-341527-03rh966o 19 10 with with IN cord-341527-03rh966o 19 11 COVID-19 COVID-19 NNP cord-341527-03rh966o 19 12 . . . cord-341527-03rh966o 20 1 Initially initially RB cord-341527-03rh966o 20 2 placed place VBN cord-341527-03rh966o 20 3 on on IN cord-341527-03rh966o 20 4 a a DT cord-341527-03rh966o 20 5 non non JJ cord-341527-03rh966o 20 6 - - JJ cord-341527-03rh966o 20 7 rebreather rebreather JJ cord-341527-03rh966o 20 8 mask mask NN cord-341527-03rh966o 20 9 , , , cord-341527-03rh966o 20 10 the the DT cord-341527-03rh966o 20 11 patient patient NN cord-341527-03rh966o 20 12 's 's POS cord-341527-03rh966o 20 13 SpO2 SpO2 NNS cord-341527-03rh966o 20 14 gradually gradually RB cord-341527-03rh966o 20 15 dropped drop VBD cord-341527-03rh966o 20 16 and and CC cord-341527-03rh966o 20 17 she -PRON- PRP cord-341527-03rh966o 20 18 was be VBD cord-341527-03rh966o 20 19 started start VBN cord-341527-03rh966o 20 20 on on IN cord-341527-03rh966o 20 21 HFNC HFNC NNP cord-341527-03rh966o 20 22 ( ( -LRB- cord-341527-03rh966o 20 23 40L 40l CD cord-341527-03rh966o 20 24 and and CC cord-341527-03rh966o 20 25 88 88 CD cord-341527-03rh966o 20 26 % % NN cord-341527-03rh966o 20 27 FiO2 FiO2 NNS cord-341527-03rh966o 20 28 ) ) -RRB- cord-341527-03rh966o 20 29 . . . cord-341527-03rh966o 21 1 On on IN cord-341527-03rh966o 21 2 day day NN cord-341527-03rh966o 21 3 2 2 CD cord-341527-03rh966o 21 4 1 1 CD cord-341527-03rh966o 21 5 , , , cord-341527-03rh966o 21 6 oxygen oxygen NN cord-341527-03rh966o 21 7 requirements requirement NNS cord-341527-03rh966o 21 8 continued continue VBD cord-341527-03rh966o 21 9 to to TO cord-341527-03rh966o 21 10 increase increase VB cord-341527-03rh966o 21 11 and and CC cord-341527-03rh966o 21 12 her -PRON- PRP$ cord-341527-03rh966o 21 13 HFNC HFNC NNP cord-341527-03rh966o 21 14 was be VBD cord-341527-03rh966o 21 15 titrated titrate VBN cord-341527-03rh966o 21 16 up up RP cord-341527-03rh966o 21 17 to to TO cord-341527-03rh966o 21 18 100 100 CD cord-341527-03rh966o 21 19 % % NN cord-341527-03rh966o 21 20 at at IN cord-341527-03rh966o 21 21 60L 60L NNP cord-341527-03rh966o 21 22 , , , cord-341527-03rh966o 21 23 with with IN cord-341527-03rh966o 21 24 a a DT cord-341527-03rh966o 21 25 non non JJ cord-341527-03rh966o 21 26 - - JJ cord-341527-03rh966o 21 27 rebreather rebreather JJ cord-341527-03rh966o 21 28 placed place VBN cord-341527-03rh966o 21 29 over over IN cord-341527-03rh966o 21 30 it -PRON- PRP cord-341527-03rh966o 21 31 . . . cord-341527-03rh966o 22 1 On on IN cord-341527-03rh966o 22 2 day day NN cord-341527-03rh966o 22 3 8 8 CD cord-341527-03rh966o 22 4 ( ( -LRB- cord-341527-03rh966o 22 5 day day NN cord-341527-03rh966o 22 6 15 15 CD cord-341527-03rh966o 22 7 of of IN cord-341527-03rh966o 22 8 illness illness NN cord-341527-03rh966o 22 9 by by IN cord-341527-03rh966o 22 10 symptomatology symptomatology NN cord-341527-03rh966o 22 11 ) ) -RRB- cord-341527-03rh966o 22 12 , , , cord-341527-03rh966o 22 13 SpO2 SpO2 NNP cord-341527-03rh966o 22 14 worsened worsen VBD cord-341527-03rh966o 22 15 from from IN cord-341527-03rh966o 22 16 92 92 CD cord-341527-03rh966o 22 17 % % NN cord-341527-03rh966o 22 18 to to IN cord-341527-03rh966o 22 19 84 84 CD cord-341527-03rh966o 22 20 % % NN cord-341527-03rh966o 22 21 , , , cord-341527-03rh966o 22 22 despite despite IN cord-341527-03rh966o 22 23 J J NNP cord-341527-03rh966o 22 24 o o NNP cord-341527-03rh966o 22 25 u u NN cord-341527-03rh966o 22 26 r r NN cord-341527-03rh966o 22 27 n n NN cord-341527-03rh966o 22 28 a a DT cord-341527-03rh966o 22 29 l l NN cord-341527-03rh966o 22 30 P p NN cord-341527-03rh966o 22 31 r r NN cord-341527-03rh966o 22 32 e e NN cord-341527-03rh966o 22 33 -p -p NN cord-341527-03rh966o 22 34 r r NN cord-341527-03rh966o 23 1 o o UH cord-341527-03rh966o 24 1 o o UH cord-341527-03rh966o 24 2 f f NN cord-341527-03rh966o 24 3 maximal maximal JJ cord-341527-03rh966o 24 4 oxygen oxygen NN cord-341527-03rh966o 24 5 support support NN cord-341527-03rh966o 24 6 . . . cord-341527-03rh966o 25 1 The the DT cord-341527-03rh966o 25 2 patient patient NN cord-341527-03rh966o 25 3 appeared appear VBD cord-341527-03rh966o 25 4 uncomfortable uncomfortable JJ cord-341527-03rh966o 25 5 , , , cord-341527-03rh966o 25 6 intermittently intermittently RB cord-341527-03rh966o 25 7 attempting attempt VBG cord-341527-03rh966o 25 8 to to TO cord-341527-03rh966o 25 9 displace displace VB cord-341527-03rh966o 25 10 her -PRON- PRP$ cord-341527-03rh966o 25 11 oxygen oxygen NN cord-341527-03rh966o 25 12 devices device NNS cord-341527-03rh966o 25 13 . . . cord-341527-03rh966o 26 1 A a DT cord-341527-03rh966o 26 2 dexmedetomidine dexmedetomidine JJ cord-341527-03rh966o 26 3 infusion infusion NN cord-341527-03rh966o 26 4 was be VBD cord-341527-03rh966o 26 5 initiated initiate VBN cord-341527-03rh966o 26 6 , , , cord-341527-03rh966o 26 7 after after IN cord-341527-03rh966o 26 8 which which WDT cord-341527-03rh966o 26 9 saturations saturation NNS cord-341527-03rh966o 26 10 increased increase VBD cord-341527-03rh966o 26 11 , , , cord-341527-03rh966o 26 12 she -PRON- PRP cord-341527-03rh966o 26 13 appeared appear VBD cord-341527-03rh966o 26 14 more more RBR cord-341527-03rh966o 26 15 comfortable comfortable JJ cord-341527-03rh966o 26 16 , , , cord-341527-03rh966o 26 17 and and CC cord-341527-03rh966o 26 18 she -PRON- PRP cord-341527-03rh966o 26 19 remained remain VBD cord-341527-03rh966o 26 20 compliant compliant JJ cord-341527-03rh966o 26 21 with with IN cord-341527-03rh966o 26 22 her -PRON- PRP$ cord-341527-03rh966o 26 23 oxygen oxygen NN cord-341527-03rh966o 26 24 devices device NNS cord-341527-03rh966o 26 25 . . . cord-341527-03rh966o 27 1 Her -PRON- PRP$ cord-341527-03rh966o 27 2 SpO2 SpO2 NNS cord-341527-03rh966o 27 3 remained remain VBD cord-341527-03rh966o 27 4 in in IN cord-341527-03rh966o 27 5 the the DT cord-341527-03rh966o 27 6 86 86 CD cord-341527-03rh966o 27 7 % % NN cord-341527-03rh966o 27 8 to to TO cord-341527-03rh966o 27 9 100 100 CD cord-341527-03rh966o 27 10 % % NN cord-341527-03rh966o 27 11 range range NN cord-341527-03rh966o 27 12 and and CC cord-341527-03rh966o 27 13 on on IN cord-341527-03rh966o 27 14 day day NN cord-341527-03rh966o 27 15 12 12 CD cord-341527-03rh966o 27 16 , , , cord-341527-03rh966o 27 17 she -PRON- PRP cord-341527-03rh966o 27 18 was be VBD cord-341527-03rh966o 27 19 transitioned transition VBN cord-341527-03rh966o 27 20 from from IN cord-341527-03rh966o 27 21 HFNC HFNC NNP cord-341527-03rh966o 27 22 to to TO cord-341527-03rh966o 27 23 nasal nasal VB cord-341527-03rh966o 27 24 cannula cannula NN cord-341527-03rh966o 27 25 ( ( -LRB- cord-341527-03rh966o 27 26 6L 6L NNP cord-341527-03rh966o 27 27 ) ) -RRB- cord-341527-03rh966o 27 28 and and CC cord-341527-03rh966o 27 29 admitted admit VBN cord-341527-03rh966o 27 30 . . . cord-341527-03rh966o 28 1 At at IN cord-341527-03rh966o 28 2 the the DT cord-341527-03rh966o 28 3 time time NN cord-341527-03rh966o 28 4 of of IN cord-341527-03rh966o 28 5 this this DT cord-341527-03rh966o 28 6 writing writing NN cord-341527-03rh966o 28 7 , , , cord-341527-03rh966o 28 8 she -PRON- PRP cord-341527-03rh966o 28 9 remains remain VBZ cord-341527-03rh966o 28 10 on on IN cord-341527-03rh966o 28 11 nasal nasal NN cord-341527-03rh966o 28 12 cannula cannula NN cord-341527-03rh966o 28 13 and and CC cord-341527-03rh966o 28 14 is be VBZ cord-341527-03rh966o 28 15 doing do VBG cord-341527-03rh966o 28 16 well well RB cord-341527-03rh966o 28 17 ( ( -LRB- cord-341527-03rh966o 28 18 ambulating ambulate VBG cord-341527-03rh966o 28 19 , , , cord-341527-03rh966o 28 20 tolerating tolerate VBG cord-341527-03rh966o 28 21 a a DT cord-341527-03rh966o 28 22 regular regular JJ cord-341527-03rh966o 28 23 diet diet NN cord-341527-03rh966o 28 24 and and CC cord-341527-03rh966o 28 25 with with IN cord-341527-03rh966o 28 26 a a DT cord-341527-03rh966o 28 27 normal normal JJ cord-341527-03rh966o 28 28 mental mental JJ cord-341527-03rh966o 28 29 status status NN cord-341527-03rh966o 28 30 ) ) -RRB- cord-341527-03rh966o 28 31 . . . cord-341527-03rh966o 29 1 Severe severe JJ cord-341527-03rh966o 29 2 COVID-19 covid-19 JJ cord-341527-03rh966o 29 3 pulmonary pulmonary JJ cord-341527-03rh966o 29 4 disease disease NN cord-341527-03rh966o 29 5 is be VBZ cord-341527-03rh966o 29 6 characterized characterize VBN cord-341527-03rh966o 29 7 by by IN cord-341527-03rh966o 29 8 hypoxemia hypoxemia NN cord-341527-03rh966o 29 9 and and CC cord-341527-03rh966o 29 10 requires require VBZ cord-341527-03rh966o 29 11 a a DT cord-341527-03rh966o 29 12 multimodal multimodal NN cord-341527-03rh966o 29 13 approach approach NN cord-341527-03rh966o 29 14 . . . cord-341527-03rh966o 30 1 Our -PRON- PRP$ cord-341527-03rh966o 30 2 patient patient NN cord-341527-03rh966o 30 3 received receive VBD cord-341527-03rh966o 30 4 the the DT cord-341527-03rh966o 30 5 standard standard JJ cord-341527-03rh966o 30 6 medical medical JJ cord-341527-03rh966o 30 7 therapy therapy NN cord-341527-03rh966o 30 8 endorsed endorse VBN cord-341527-03rh966o 30 9 by by IN cord-341527-03rh966o 30 10 our -PRON- PRP$ cord-341527-03rh966o 30 11 department department NN cord-341527-03rh966o 30 12 at at IN cord-341527-03rh966o 30 13 the the DT cord-341527-03rh966o 30 14 time time NN cord-341527-03rh966o 30 15 of of IN cord-341527-03rh966o 30 16 her -PRON- PRP$ cord-341527-03rh966o 30 17 care care NN cord-341527-03rh966o 30 18 : : : cord-341527-03rh966o 30 19 supplemental supplemental JJ cord-341527-03rh966o 30 20 oxygen oxygen NN cord-341527-03rh966o 30 21 , , , cord-341527-03rh966o 30 22 azithromycin azithromycin NN cord-341527-03rh966o 30 23 , , , cord-341527-03rh966o 30 24 anticoagulation anticoagulation NN cord-341527-03rh966o 30 25 and and CC cord-341527-03rh966o 30 26 corticosteroids corticosteroid NNS cord-341527-03rh966o 30 27 . . . cord-341527-03rh966o 31 1 She -PRON- PRP cord-341527-03rh966o 31 2 was be VBD cord-341527-03rh966o 31 3 placed place VBN cord-341527-03rh966o 31 4 in in IN cord-341527-03rh966o 31 5 trials trial NNS cord-341527-03rh966o 31 6 for for IN cord-341527-03rh966o 31 7 tocilizumab tocilizumab JJ cord-341527-03rh966o 31 8 and and CC cord-341527-03rh966o 31 9 convalescent convalescent JJ cord-341527-03rh966o 31 10 plasma plasma NN cord-341527-03rh966o 31 11 and and CC cord-341527-03rh966o 31 12 received receive VBD cord-341527-03rh966o 31 13 chest chest NN cord-341527-03rh966o 31 14 physical physical JJ cord-341527-03rh966o 31 15 therapy therapy NN cord-341527-03rh966o 31 16 and and CC cord-341527-03rh966o 31 17 awake awake JJ cord-341527-03rh966o 31 18 intermittent intermittent JJ cord-341527-03rh966o 31 19 proning proning NN cord-341527-03rh966o 31 20 . . . cord-341527-03rh966o 32 1 However however RB cord-341527-03rh966o 32 2 , , , cord-341527-03rh966o 32 3 there there EX cord-341527-03rh966o 32 4 are be VBP cord-341527-03rh966o 32 5 several several JJ cord-341527-03rh966o 32 6 reasons reason NNS cord-341527-03rh966o 32 7 to to TO cord-341527-03rh966o 32 8 believe believe VB cord-341527-03rh966o 32 9 dexmedetomidine dexmedetomidine NNP cord-341527-03rh966o 32 10 contributed contribute VBD cord-341527-03rh966o 32 11 significantly significantly RB cord-341527-03rh966o 32 12 to to IN cord-341527-03rh966o 32 13 her -PRON- PRP cord-341527-03rh966o 32 14 course course NN cord-341527-03rh966o 32 15 . . . cord-341527-03rh966o 33 1 As as IN cord-341527-03rh966o 33 2 Figure figure NN cord-341527-03rh966o 33 3 1 1 CD cord-341527-03rh966o 33 4 demonstrates demonstrate VBZ cord-341527-03rh966o 33 5 , , , cord-341527-03rh966o 33 6 during during IN cord-341527-03rh966o 33 7 the the DT cord-341527-03rh966o 33 8 first first JJ cord-341527-03rh966o 33 9 seven seven CD cord-341527-03rh966o 33 10 days day NNS cord-341527-03rh966o 33 11 her -PRON- PRP$ cord-341527-03rh966o 33 12 SpO2 SpO2 NNS cord-341527-03rh966o 33 13 generally generally RB cord-341527-03rh966o 33 14 remained remain VBD cord-341527-03rh966o 33 15 > > XX cord-341527-03rh966o 33 16 90 90 CD cord-341527-03rh966o 33 17 % % NN cord-341527-03rh966o 33 18 . . . cord-341527-03rh966o 34 1 Nevertheless nevertheless RB cord-341527-03rh966o 34 2 , , , cord-341527-03rh966o 34 3 her -PRON- PRP$ cord-341527-03rh966o 34 4 chart chart NN cord-341527-03rh966o 34 5 notes note VBZ cord-341527-03rh966o 34 6 worsening worsen VBG cord-341527-03rh966o 34 7 tachypnea tachypnea NNP cord-341527-03rh966o 34 8 , , , cord-341527-03rh966o 34 9 titration titration NN cord-341527-03rh966o 34 10 of of IN cord-341527-03rh966o 34 11 HFNC HFNC NNP cord-341527-03rh966o 34 12 to to IN cord-341527-03rh966o 34 13 maximal maximal JJ cord-341527-03rh966o 34 14 settings setting NNS cord-341527-03rh966o 34 15 and and CC cord-341527-03rh966o 34 16 eventually eventually RB cord-341527-03rh966o 34 17 requiring require VBG cord-341527-03rh966o 34 18 a a DT cord-341527-03rh966o 34 19 non non JJ cord-341527-03rh966o 34 20 - - JJ cord-341527-03rh966o 34 21 rebreather rebreather JJ cord-341527-03rh966o 34 22 mask mask NN cord-341527-03rh966o 34 23 placed place VBN cord-341527-03rh966o 34 24 over over IN cord-341527-03rh966o 34 25 her -PRON- PRP$ cord-341527-03rh966o 34 26 HFNC HFNC NNP cord-341527-03rh966o 34 27 . . . cord-341527-03rh966o 35 1 As as IN cord-341527-03rh966o 35 2 SpO2 SpO2 NNP cord-341527-03rh966o 35 3 dropped drop VBD cord-341527-03rh966o 35 4 , , , cord-341527-03rh966o 35 5 she -PRON- PRP cord-341527-03rh966o 35 6 became become VBD cord-341527-03rh966o 35 7 agitated agitated JJ cord-341527-03rh966o 35 8 and and CC cord-341527-03rh966o 35 9 at at IN cord-341527-03rh966o 35 10 risk risk NN cord-341527-03rh966o 35 11 of of IN cord-341527-03rh966o 35 12 dislodging dislodge VBG cord-341527-03rh966o 35 13 her -PRON- PRP$ cord-341527-03rh966o 35 14 oxygen oxygen NN cord-341527-03rh966o 35 15 devices device NNS cord-341527-03rh966o 35 16 . . . cord-341527-03rh966o 36 1 Intubation intubation NN cord-341527-03rh966o 36 2 was be VBD cord-341527-03rh966o 36 3 strongly strongly RB cord-341527-03rh966o 36 4 J J NNP cord-341527-03rh966o 36 5 o o NN cord-341527-03rh966o 36 6 u u NN cord-341527-03rh966o 36 7 r r NN cord-341527-03rh966o 36 8 n n NN cord-341527-03rh966o 36 9 a a DT cord-341527-03rh966o 36 10 l l NN cord-341527-03rh966o 36 11 P p NN cord-341527-03rh966o 36 12 r r NN cord-341527-03rh966o 36 13 e e NN cord-341527-03rh966o 36 14 -p -p NN cord-341527-03rh966o 37 1 r r NNP cord-341527-03rh966o 37 2 o o NN cord-341527-03rh966o 37 3 o o NN cord-341527-03rh966o 37 4 f f NN cord-341527-03rh966o 37 5 considered consider VBN cord-341527-03rh966o 37 6 . . . cord-341527-03rh966o 38 1 However however RB cord-341527-03rh966o 38 2 , , , cord-341527-03rh966o 38 3 with with IN cord-341527-03rh966o 38 4 departmental departmental JJ cord-341527-03rh966o 38 5 preference preference NN cord-341527-03rh966o 38 6 toward toward IN cord-341527-03rh966o 38 7 delayed delay VBN cord-341527-03rh966o 38 8 intubation intubation NN cord-341527-03rh966o 38 9 2 2 CD cord-341527-03rh966o 38 10 , , , cord-341527-03rh966o 38 11 consensus consensus NN cord-341527-03rh966o 38 12 developed develop VBD cord-341527-03rh966o 38 13 to to TO cord-341527-03rh966o 38 14 administer administer VB cord-341527-03rh966o 38 15 dexmedetomidine dexmedetomidine NN cord-341527-03rh966o 38 16 instead instead RB cord-341527-03rh966o 38 17 . . . cord-341527-03rh966o 39 1 After after IN cord-341527-03rh966o 39 2 , , , cord-341527-03rh966o 39 3 our -PRON- PRP$ cord-341527-03rh966o 39 4 patient patient NN cord-341527-03rh966o 39 5 's 's POS cord-341527-03rh966o 39 6 SpO2 SpO2 NNP cord-341527-03rh966o 39 7 increased increase VBD cord-341527-03rh966o 39 8 from from IN cord-341527-03rh966o 39 9 84 84 CD cord-341527-03rh966o 39 10 % % NN cord-341527-03rh966o 39 11 to to TO cord-341527-03rh966o 39 12 100 100 CD cord-341527-03rh966o 39 13 % % NN cord-341527-03rh966o 39 14 , , , cord-341527-03rh966o 39 15 with with IN cord-341527-03rh966o 39 16 no no DT cord-341527-03rh966o 39 17 other other JJ cord-341527-03rh966o 39 18 intervention intervention NN cord-341527-03rh966o 39 19 taking take VBG cord-341527-03rh966o 39 20 place place NN cord-341527-03rh966o 39 21 at at IN cord-341527-03rh966o 39 22 the the DT cord-341527-03rh966o 39 23 time time NN cord-341527-03rh966o 39 24 3 3 CD cord-341527-03rh966o 39 25 . . . cord-341527-03rh966o 40 1 Given give VBN cord-341527-03rh966o 40 2 the the DT cord-341527-03rh966o 40 3 context context NN cord-341527-03rh966o 40 4 of of IN cord-341527-03rh966o 40 5 gradually gradually RB cord-341527-03rh966o 40 6 worsening worsen VBG cord-341527-03rh966o 40 7 hypoxemia hypoxemia NN cord-341527-03rh966o 40 8 , , , cord-341527-03rh966o 40 9 timing timing NN cord-341527-03rh966o 40 10 of of IN cord-341527-03rh966o 40 11 administration administration NN cord-341527-03rh966o 40 12 , , , cord-341527-03rh966o 40 13 subsequent subsequent JJ cord-341527-03rh966o 40 14 improvement improvement NN cord-341527-03rh966o 40 15 in in IN cord-341527-03rh966o 40 16 SpO2 SpO2 NNP cord-341527-03rh966o 40 17 and and CC cord-341527-03rh966o 40 18 observed observe VBD cord-341527-03rh966o 40 19 change change NN cord-341527-03rh966o 40 20 in in IN cord-341527-03rh966o 40 21 mental mental JJ cord-341527-03rh966o 40 22 status status NN cord-341527-03rh966o 40 23 ( ( -LRB- cord-341527-03rh966o 40 24 from from IN cord-341527-03rh966o 40 25 agitated agitated JJ cord-341527-03rh966o 40 26 to to TO cord-341527-03rh966o 40 27 calm calm VB cord-341527-03rh966o 40 28 ) ) -RRB- cord-341527-03rh966o 40 29 , , , cord-341527-03rh966o 40 30 dexmedetomidine dexmedetomidine NNP cord-341527-03rh966o 40 31 appeared appear VBD cord-341527-03rh966o 40 32 to to TO cord-341527-03rh966o 40 33 play play VB cord-341527-03rh966o 40 34 a a DT cord-341527-03rh966o 40 35 significant significant JJ cord-341527-03rh966o 40 36 role role NN cord-341527-03rh966o 40 37 . . . cord-341527-03rh966o 41 1 The the DT cord-341527-03rh966o 41 2 patient patient NN cord-341527-03rh966o 41 3 avoided avoid VBD cord-341527-03rh966o 41 4 intubation intubation NN cord-341527-03rh966o 41 5 , , , cord-341527-03rh966o 41 6 now now RB cord-341527-03rh966o 41 7 has have VBZ cord-341527-03rh966o 41 8 a a DT cord-341527-03rh966o 41 9 stable stable JJ cord-341527-03rh966o 41 10 SpO2 SpO2 NNS cord-341527-03rh966o 41 11 on on IN cord-341527-03rh966o 41 12 nasal nasal NN cord-341527-03rh966o 41 13 cannula cannula NN cord-341527-03rh966o 41 14 and and CC cord-341527-03rh966o 41 15 is be VBZ cord-341527-03rh966o 41 16 not not RB cord-341527-03rh966o 41 17 in in IN cord-341527-03rh966o 41 18 multi multi JJ cord-341527-03rh966o 41 19 - - JJ cord-341527-03rh966o 41 20 system system JJ cord-341527-03rh966o 41 21 organ organ NN cord-341527-03rh966o 41 22 failure failure NN cord-341527-03rh966o 41 23 , , , cord-341527-03rh966o 41 24 a a DT cord-341527-03rh966o 41 25 significant significant JJ cord-341527-03rh966o 41 26 victory victory NN cord-341527-03rh966o 41 27 considering consider VBG cord-341527-03rh966o 41 28 the the DT cord-341527-03rh966o 41 29 alternative alternative NN cord-341527-03rh966o 41 30 . . . cord-341527-03rh966o 42 1 The the DT cord-341527-03rh966o 42 2 pharmacokinetics pharmacokinetic NNS cord-341527-03rh966o 42 3 of of IN cord-341527-03rh966o 42 4 dexmedetomidine dexmedetomidine NNP cord-341527-03rh966o 42 5 make make VB cord-341527-03rh966o 42 6 it -PRON- PRP cord-341527-03rh966o 42 7 ideal ideal JJ cord-341527-03rh966o 42 8 in in IN cord-341527-03rh966o 42 9 nonintubated nonintubated JJ cord-341527-03rh966o 42 10 COVID-19 COVID-19 NNP cord-341527-03rh966o 42 11 patients patient NNS cord-341527-03rh966o 42 12 . . . cord-341527-03rh966o 43 1 It -PRON- PRP cord-341527-03rh966o 43 2 has have VBZ cord-341527-03rh966o 43 3 a a DT cord-341527-03rh966o 43 4 minimal minimal JJ cord-341527-03rh966o 43 5 effect effect NN cord-341527-03rh966o 43 6 on on IN cord-341527-03rh966o 43 7 respiratory respiratory JJ cord-341527-03rh966o 43 8 drive drive NN cord-341527-03rh966o 43 9 , , , cord-341527-03rh966o 43 10 a a DT cord-341527-03rh966o 43 11 rapid rapid JJ cord-341527-03rh966o 43 12 onset onset NN cord-341527-03rh966o 43 13 and and CC cord-341527-03rh966o 43 14 elimination elimination NN cord-341527-03rh966o 43 15 and and CC cord-341527-03rh966o 43 16 is be VBZ cord-341527-03rh966o 43 17 easily easily RB cord-341527-03rh966o 43 18 titratable titratable JJ cord-341527-03rh966o 43 19 [ [ -LRB- cord-341527-03rh966o 43 20 4 4 CD cord-341527-03rh966o 43 21 ] ] -RRB- cord-341527-03rh966o 43 22 . . . cord-341527-03rh966o 44 1 Its -PRON- PRP$ cord-341527-03rh966o 44 2 side side NN cord-341527-03rh966o 44 3 effect effect NN cord-341527-03rh966o 44 4 of of IN cord-341527-03rh966o 44 5 bradycardia bradycardia NN cord-341527-03rh966o 44 6 appears appear VBZ cord-341527-03rh966o 44 7 to to TO cord-341527-03rh966o 44 8 be be VB cord-341527-03rh966o 44 9 well well RB cord-341527-03rh966o 44 10 tolerated tolerate VBN cord-341527-03rh966o 44 11 . . . cord-341527-03rh966o 45 1 On on IN cord-341527-03rh966o 45 2 a a DT cord-341527-03rh966o 45 3 behavioral behavioral JJ cord-341527-03rh966o 45 4 level level NN cord-341527-03rh966o 45 5 , , , cord-341527-03rh966o 45 6 patients patient NNS cord-341527-03rh966o 45 7 with with IN cord-341527-03rh966o 45 8 worsening worsen VBG cord-341527-03rh966o 45 9 hypoxia hypoxia NN cord-341527-03rh966o 45 10 are be VBP cord-341527-03rh966o 45 11 often often RB cord-341527-03rh966o 45 12 very very RB cord-341527-03rh966o 45 13 anxious anxious JJ cord-341527-03rh966o 45 14 and and CC cord-341527-03rh966o 45 15 prone prone JJ cord-341527-03rh966o 45 16 to to IN cord-341527-03rh966o 45 17 agitation agitation NN cord-341527-03rh966o 45 18 . . . cord-341527-03rh966o 46 1 This this DT cord-341527-03rh966o 46 2 becomes become VBZ cord-341527-03rh966o 46 3 especially especially RB cord-341527-03rh966o 46 4 dangerous dangerous JJ cord-341527-03rh966o 46 5 when when WRB cord-341527-03rh966o 46 6 fully fully RB cord-341527-03rh966o 46 7 dependent dependent JJ cord-341527-03rh966o 46 8 on on IN cord-341527-03rh966o 46 9 supplemental supplemental JJ cord-341527-03rh966o 46 10 oxygen oxygen NN cord-341527-03rh966o 46 11 , , , cord-341527-03rh966o 46 12 where where WRB cord-341527-03rh966o 46 13 acute acute JJ cord-341527-03rh966o 46 14 decline decline NN cord-341527-03rh966o 46 15 from from IN cord-341527-03rh966o 46 16 dislodgement dislodgement NN cord-341527-03rh966o 46 17 of of IN cord-341527-03rh966o 46 18 support support NN cord-341527-03rh966o 46 19 devices device NNS cord-341527-03rh966o 46 20 is be VBZ cord-341527-03rh966o 46 21 always always RB cord-341527-03rh966o 46 22 a a DT cord-341527-03rh966o 46 23 concern concern NN cord-341527-03rh966o 46 24 . . . cord-341527-03rh966o 47 1 Dexmedetomidine Dexmedetomidine NNP cord-341527-03rh966o 47 2 has have VBZ cord-341527-03rh966o 47 3 been be VBN cord-341527-03rh966o 47 4 shown show VBN cord-341527-03rh966o 47 5 in in IN cord-341527-03rh966o 47 6 randomized randomized JJ cord-341527-03rh966o 47 7 controlled control VBN cord-341527-03rh966o 47 8 trials trial NNS cord-341527-03rh966o 47 9 to to TO cord-341527-03rh966o 47 10 decrease decrease VB cord-341527-03rh966o 47 11 agitated agitated JJ cord-341527-03rh966o 47 12 delirium delirium NN cord-341527-03rh966o 47 13 in in IN cord-341527-03rh966o 47 14 critically critically RB cord-341527-03rh966o 47 15 ill ill JJ cord-341527-03rh966o 47 16 patients patient NNS cord-341527-03rh966o 47 17 [ [ -LRB- cord-341527-03rh966o 47 18 5 5 CD cord-341527-03rh966o 47 19 ] ] -RRB- cord-341527-03rh966o 47 20 . . . cord-341527-03rh966o 48 1 This this DT cord-341527-03rh966o 48 2 benefit benefit NN cord-341527-03rh966o 48 3 is be VBZ cord-341527-03rh966o 48 4 likely likely RB cord-341527-03rh966o 48 5 amplified amplify VBN cord-341527-03rh966o 48 6 in in IN cord-341527-03rh966o 48 7 elderly elderly JJ cord-341527-03rh966o 48 8 populations population NNS cord-341527-03rh966o 48 9 , , , cord-341527-03rh966o 48 10 who who WP cord-341527-03rh966o 48 11 have have VBP cord-341527-03rh966o 48 12 higher high JJR cord-341527-03rh966o 48 13 mortality mortality NN cord-341527-03rh966o 48 14 and and CC cord-341527-03rh966o 48 15 baseline baseline JJ cord-341527-03rh966o 48 16 conditions condition NNS cord-341527-03rh966o 48 17 that that WDT cord-341527-03rh966o 48 18 predispose predispose VBP cord-341527-03rh966o 48 19 them -PRON- PRP cord-341527-03rh966o 48 20 to to IN cord-341527-03rh966o 48 21 delirium delirium NN cord-341527-03rh966o 48 22 and and CC cord-341527-03rh966o 48 23 noncompliance noncompliance NN cord-341527-03rh966o 48 24 with with IN cord-341527-03rh966o 48 25 HFNC HFNC NNP cord-341527-03rh966o 48 26 . . . cord-341527-03rh966o 49 1 Dexmedetomidine Dexmedetomidine NNP cord-341527-03rh966o 49 2 may may MD cord-341527-03rh966o 49 3 promote promote VB cord-341527-03rh966o 49 4 oxygenation oxygenation NN cord-341527-03rh966o 49 5 on on IN cord-341527-03rh966o 49 6 a a DT cord-341527-03rh966o 49 7 physiologic physiologic JJ cord-341527-03rh966o 49 8 level level NN cord-341527-03rh966o 49 9 as as RB cord-341527-03rh966o 49 10 well well RB cord-341527-03rh966o 49 11 . . . cord-341527-03rh966o 50 1 The the DT cord-341527-03rh966o 50 2 mechanism mechanism NN cord-341527-03rh966o 50 3 of of IN cord-341527-03rh966o 50 4 hypoxemia hypoxemia NN cord-341527-03rh966o 50 5 in in IN cord-341527-03rh966o 50 6 COVID-19 COVID-19 NNP cord-341527-03rh966o 50 7 is be VBZ cord-341527-03rh966o 50 8 thought think VBN cord-341527-03rh966o 50 9 to to TO cord-341527-03rh966o 50 10 be be VB cord-341527-03rh966o 50 11 disrupted disrupt VBN cord-341527-03rh966o 50 12 pulmonary pulmonary JJ cord-341527-03rh966o 50 13 vasoregulation vasoregulation NN cord-341527-03rh966o 50 14 due due IN cord-341527-03rh966o 50 15 to to IN cord-341527-03rh966o 50 16 viral viral JJ cord-341527-03rh966o 50 17 induced induce VBN cord-341527-03rh966o 50 18 endothelial endothelial JJ cord-341527-03rh966o 50 19 damage damage NN cord-341527-03rh966o 50 20 of of IN cord-341527-03rh966o 50 21 pulmonary pulmonary JJ cord-341527-03rh966o 50 22 capillaries capillary NNS cord-341527-03rh966o 50 23 and and CC cord-341527-03rh966o 50 24 ensuing ensue VBG cord-341527-03rh966o 50 25 V v NN cord-341527-03rh966o 50 26 / / SYM cord-341527-03rh966o 50 27 Q q NN cord-341527-03rh966o 50 28 mismatch mismatch NN cord-341527-03rh966o 50 29 [ [ -LRB- cord-341527-03rh966o 50 30 6 6 CD cord-341527-03rh966o 50 31 ] ] -RRB- cord-341527-03rh966o 50 32 . . . cord-341527-03rh966o 51 1 Recent recent JJ cord-341527-03rh966o 51 2 studies study NNS cord-341527-03rh966o 51 3 suggest suggest VBP cord-341527-03rh966o 51 4 dexmedetomidine dexmedetomidine NNP cord-341527-03rh966o 51 5 may may MD cord-341527-03rh966o 51 6 enhance enhance VB cord-341527-03rh966o 51 7 hypoxic hypoxic JJ cord-341527-03rh966o 51 8 pulmonary pulmonary JJ cord-341527-03rh966o 51 9 vasoconstriction vasoconstriction NN cord-341527-03rh966o 51 10 , , , cord-341527-03rh966o 51 11 improve improve VB cord-341527-03rh966o 51 12 ventilation ventilation NN cord-341527-03rh966o 51 13 / / SYM cord-341527-03rh966o 51 14 perfusion perfusion NN cord-341527-03rh966o 51 15 ratio ratio NN cord-341527-03rh966o 51 16 and and CC cord-341527-03rh966o 51 17 consequently consequently RB cord-341527-03rh966o 51 18 improve improve VB cord-341527-03rh966o 51 19 oxygenation oxygenation NN cord-341527-03rh966o 51 20 [ [ -LRB- cord-341527-03rh966o 51 21 7 7 CD cord-341527-03rh966o 51 22 ] ] -RRB- cord-341527-03rh966o 51 23 . . . cord-341527-03rh966o 52 1 The the DT cord-341527-03rh966o 52 2 uncertainty uncertainty NN cord-341527-03rh966o 52 3 of of IN cord-341527-03rh966o 52 4 COVID-19 COVID-19 NNP cord-341527-03rh966o 52 5 has have VBZ cord-341527-03rh966o 52 6 led lead VBN cord-341527-03rh966o 52 7 to to IN cord-341527-03rh966o 52 8 varying vary VBG cord-341527-03rh966o 52 9 approaches approach NNS cord-341527-03rh966o 52 10 in in IN cord-341527-03rh966o 52 11 treatment treatment NN cord-341527-03rh966o 52 12 which which WDT cord-341527-03rh966o 52 13 have have VBP cord-341527-03rh966o 52 14 yet yet RB cord-341527-03rh966o 52 15 to to TO cord-341527-03rh966o 52 16 be be VB cord-341527-03rh966o 52 17 validated validate VBN cord-341527-03rh966o 52 18 and and CC cord-341527-03rh966o 52 19 are be VBP cord-341527-03rh966o 52 20 not not RB cord-341527-03rh966o 52 21 without without IN cord-341527-03rh966o 52 22 their -PRON- PRP$ cord-341527-03rh966o 52 23 own own JJ cord-341527-03rh966o 52 24 risks risk NNS cord-341527-03rh966o 52 25 4 4 CD cord-341527-03rh966o 52 26 . . . cord-341527-03rh966o 53 1 In in IN cord-341527-03rh966o 53 2 this this DT cord-341527-03rh966o 53 3 case case NN cord-341527-03rh966o 53 4 , , , cord-341527-03rh966o 53 5 we -PRON- PRP cord-341527-03rh966o 53 6 believe believe VBP cord-341527-03rh966o 53 7 dexmedetomidine dexmedetomidine NNP cord-341527-03rh966o 53 8 helped help VBD cord-341527-03rh966o 53 9 one one CD cord-341527-03rh966o 53 10 patient patient JJ cord-341527-03rh966o 53 11 avoid avoid VB cord-341527-03rh966o 53 12 mechanical mechanical JJ cord-341527-03rh966o 53 13 ventilation ventilation NN cord-341527-03rh966o 53 14 by by IN cord-341527-03rh966o 53 15 improving improve VBG cord-341527-03rh966o 53 16 compliance compliance NN cord-341527-03rh966o 53 17 with with IN cord-341527-03rh966o 53 18 non non JJ cord-341527-03rh966o 53 19 - - JJ cord-341527-03rh966o 53 20 invasive invasive JJ cord-341527-03rh966o 53 21 ventilation ventilation NN cord-341527-03rh966o 53 22 and and CC cord-341527-03rh966o 53 23 promoting promote VBG cord-341527-03rh966o 53 24 better well JJR cord-341527-03rh966o 53 25 oxygenation oxygenation NN cord-341527-03rh966o 53 26 . . . cord-341527-03rh966o 54 1 Whether whether IN cord-341527-03rh966o 54 2 that that DT cord-341527-03rh966o 54 3 was be VBD cord-341527-03rh966o 54 4 primarily primarily RB cord-341527-03rh966o 54 5 due due JJ cord-341527-03rh966o 54 6 to to IN cord-341527-03rh966o 54 7 behavioral behavioral JJ cord-341527-03rh966o 54 8 or or CC cord-341527-03rh966o 54 9 physiologic physiologic JJ cord-341527-03rh966o 54 10 changes change NNS cord-341527-03rh966o 54 11 induced induce VBN cord-341527-03rh966o 54 12 by by IN cord-341527-03rh966o 54 13 the the DT cord-341527-03rh966o 54 14 drug drug NN cord-341527-03rh966o 54 15 is be VBZ cord-341527-03rh966o 54 16 unknown unknown JJ cord-341527-03rh966o 54 17 . . . cord-341527-03rh966o 55 1 However however RB cord-341527-03rh966o 55 2 , , , cord-341527-03rh966o 55 3 this this DT cord-341527-03rh966o 55 4 case case NN cord-341527-03rh966o 55 5 suggests suggest VBZ cord-341527-03rh966o 55 6 that that IN cord-341527-03rh966o 55 7 the the DT cord-341527-03rh966o 55 8 unique unique JJ cord-341527-03rh966o 55 9 pharmacologic pharmacologic JJ cord-341527-03rh966o 55 10 properties property NNS cord-341527-03rh966o 55 11 of of IN cord-341527-03rh966o 55 12 dexmedetomidine dexmedetomidine NN cord-341527-03rh966o 55 13 may may MD cord-341527-03rh966o 55 14 help help VB cord-341527-03rh966o 55 15 decrease decrease VB cord-341527-03rh966o 55 16 the the DT cord-341527-03rh966o 55 17 need need NN cord-341527-03rh966o 55 18 for for IN cord-341527-03rh966o 55 19 mechanical mechanical JJ cord-341527-03rh966o 55 20 ventilation ventilation NN cord-341527-03rh966o 55 21 , , , cord-341527-03rh966o 55 22 thereby thereby RB cord-341527-03rh966o 55 23 reducing reduce VBG cord-341527-03rh966o 55 24 mortality mortality NN cord-341527-03rh966o 55 25 . . . cord-341527-03rh966o 56 1 In in IN cord-341527-03rh966o 56 2 the the DT cord-341527-03rh966o 56 3 face face NN cord-341527-03rh966o 56 4 of of IN cord-341527-03rh966o 56 5 this this DT cord-341527-03rh966o 56 6 novel novel JJ cord-341527-03rh966o 56 7 and and CC cord-341527-03rh966o 56 8 complicated complicated JJ cord-341527-03rh966o 56 9 disease disease NN cord-341527-03rh966o 56 10 , , , cord-341527-03rh966o 56 11 the the DT cord-341527-03rh966o 56 12 suggestion suggestion NN cord-341527-03rh966o 56 13 of of IN cord-341527-03rh966o 56 14 such such JJ cord-341527-03rh966o 56 15 benefit benefit NN cord-341527-03rh966o 56 16 is be VBZ cord-341527-03rh966o 56 17 deserving deserving JJ cord-341527-03rh966o 56 18 of of IN cord-341527-03rh966o 56 19 further further JJ cord-341527-03rh966o 56 20 investigation investigation NN cord-341527-03rh966o 56 21 . . . cord-341527-03rh966o 57 1 2 2 LS cord-341527-03rh966o 58 1 Informed inform VBN cord-341527-03rh966o 58 2 by by IN cord-341527-03rh966o 58 3 recent recent JJ cord-341527-03rh966o 58 4 experience experience NN cord-341527-03rh966o 58 5 during during IN cord-341527-03rh966o 58 6 the the DT cord-341527-03rh966o 58 7 pandemic pandemic NN cord-341527-03rh966o 58 8 . . . cord-341527-03rh966o 59 1 3 3 CD cord-341527-03rh966o 59 2 Average average JJ cord-341527-03rh966o 59 3 saturations saturation NNS cord-341527-03rh966o 59 4 after after IN cord-341527-03rh966o 59 5 dexmedetomidine dexmedetomidine NNP cord-341527-03rh966o 59 6 were be VBD cord-341527-03rh966o 59 7 93 93 CD cord-341527-03rh966o 59 8 % % NN cord-341527-03rh966o 59 9 compared compare VBN cord-341527-03rh966o 59 10 to to IN cord-341527-03rh966o 59 11 92 92 CD cord-341527-03rh966o 59 12 % % NN cord-341527-03rh966o 59 13 prior prior RB cord-341527-03rh966o 59 14 . . . cord-341527-03rh966o 60 1 During during IN cord-341527-03rh966o 60 2 this this DT cord-341527-03rh966o 60 3 time time NN cord-341527-03rh966o 60 4 , , , cord-341527-03rh966o 60 5 occasional occasional JJ cord-341527-03rh966o 60 6 increases increase NNS cord-341527-03rh966o 60 7 in in IN cord-341527-03rh966o 60 8 agitation agitation NN cord-341527-03rh966o 60 9 ( ( -LRB- cord-341527-03rh966o 60 10 correlated correlate VBN cord-341527-03rh966o 60 11 with with IN cord-341527-03rh966o 60 12 events event NNS cord-341527-03rh966o 60 13 such such JJ cord-341527-03rh966o 60 14 as as IN cord-341527-03rh966o 60 15 bowel bowel NN cord-341527-03rh966o 60 16 movements movement NNS cord-341527-03rh966o 60 17 ) ) -RRB- cord-341527-03rh966o 60 18 were be VBD cord-341527-03rh966o 60 19 accompanied accompany VBN cord-341527-03rh966o 60 20 by by IN cord-341527-03rh966o 60 21 decreases decrease NNS cord-341527-03rh966o 60 22 in in IN cord-341527-03rh966o 60 23 saturation saturation NN cord-341527-03rh966o 60 24 , , , cord-341527-03rh966o 60 25 likely likely RB cord-341527-03rh966o 60 26 lowering lower VBG cord-341527-03rh966o 60 27 the the DT cord-341527-03rh966o 60 28 overall overall JJ cord-341527-03rh966o 60 29 average average NN cord-341527-03rh966o 60 30 . . . cord-341527-03rh966o 61 1 4 4 LS cord-341527-03rh966o 62 1 Delaying delay VBG cord-341527-03rh966o 62 2 intubation intubation NN cord-341527-03rh966o 62 3 , , , cord-341527-03rh966o 62 4 for for IN cord-341527-03rh966o 62 5 example example NN cord-341527-03rh966o 62 6 , , , cord-341527-03rh966o 62 7 risks risk VBZ cord-341527-03rh966o 62 8 suboptimal suboptimal JJ cord-341527-03rh966o 62 9 intubation intubation NN cord-341527-03rh966o 62 10 conditions condition NNS cord-341527-03rh966o 62 11 should should MD cord-341527-03rh966o 62 12 the the DT cord-341527-03rh966o 62 13 patient patient NN cord-341527-03rh966o 62 14 continue continue VB cord-341527-03rh966o 62 15 to to TO cord-341527-03rh966o 62 16 progress progress VB cord-341527-03rh966o 62 17 in in IN cord-341527-03rh966o 62 18 their -PRON- PRP$ cord-341527-03rh966o 62 19 disease disease NN cord-341527-03rh966o 62 20 , , , cord-341527-03rh966o 62 21 and and CC cord-341527-03rh966o 62 22 certainly certainly RB cord-341527-03rh966o 62 23 requires require VBZ cord-341527-03rh966o 62 24 heightened heightened JJ cord-341527-03rh966o 62 25 vigilance vigilance NN cord-341527-03rh966o 62 26 while while IN cord-341527-03rh966o 62 27 a a DT cord-341527-03rh966o 62 28 patient patient NN cord-341527-03rh966o 62 29 remains remain VBZ cord-341527-03rh966o 62 30 on on IN cord-341527-03rh966o 62 31 life life NN cord-341527-03rh966o 62 32 sustaining sustain VBG cord-341527-03rh966o 62 33 non non JJ cord-341527-03rh966o 62 34 - - JJ cord-341527-03rh966o 62 35 invasive invasive JJ cord-341527-03rh966o 62 36 ventilation ventilation NN cord-341527-03rh966o 62 37 . . . cord-341527-03rh966o 63 1 Cases case NNS cord-341527-03rh966o 63 2 in in IN cord-341527-03rh966o 63 3 the the DT cord-341527-03rh966o 63 4 US US NNP cord-341527-03rh966o 63 5 Presenting Presenting NNP cord-341527-03rh966o 63 6 Characteristics Characteristics NNP cord-341527-03rh966o 63 7 , , , cord-341527-03rh966o 63 8 Comorbidities Comorbidities NNPS cord-341527-03rh966o 63 9 , , , cord-341527-03rh966o 63 10 and and CC cord-341527-03rh966o 63 11 Outcomes outcome NNS cord-341527-03rh966o 64 1 Among among IN cord-341527-03rh966o 64 2 5700 5700 CD cord-341527-03rh966o 64 3 Patients patient NNS cord-341527-03rh966o 64 4 Hospitalized hospitalize VBN cord-341527-03rh966o 64 5 With with IN cord-341527-03rh966o 64 6 COVID-19 COVID-19 NNP cord-341527-03rh966o 64 7 in in IN cord-341527-03rh966o 64 8 the the DT cord-341527-03rh966o 64 9 New New NNP cord-341527-03rh966o 64 10 York York NNP cord-341527-03rh966o 64 11 City City NNP cord-341527-03rh966o 64 12 Area Area NNP cord-341527-03rh966o 64 13 19 19 CD cord-341527-03rh966o 64 14 Treatment Treatment NNP cord-341527-03rh966o 64 15 Guidelines Guidelines NNPS cord-341527-03rh966o 64 16 . . . cord-341527-03rh966o 65 1 Care care NN cord-341527-03rh966o 65 2 of of IN cord-341527-03rh966o 65 3 Critically Critically NNP cord-341527-03rh966o 65 4 Ill Ill NNP cord-341527-03rh966o 65 5 Patients Patients NNPS cord-341527-03rh966o 65 6 with with IN cord-341527-03rh966o 65 7 COVID-19 COVID-19 NNP cord-341527-03rh966o 65 8 Alpha-2 Alpha-2 NNP cord-341527-03rh966o 65 9 adrenergic adrenergic JJ cord-341527-03rh966o 65 10 receptor receptor NN cord-341527-03rh966o 65 11 agonists agonist NNS cord-341527-03rh966o 65 12 : : : cord-341527-03rh966o 65 13 a a DT cord-341527-03rh966o 65 14 review review NN cord-341527-03rh966o 65 15 of of IN cord-341527-03rh966o 65 16 current current JJ cord-341527-03rh966o 65 17 clinical clinical JJ cord-341527-03rh966o 65 18 applications application NNS cord-341527-03rh966o 66 1 The the DT cord-341527-03rh966o 66 2 effect effect NN cord-341527-03rh966o 66 3 of of IN cord-341527-03rh966o 66 4 dexmedetomidine dexmedetomidine NN cord-341527-03rh966o 66 5 on on IN cord-341527-03rh966o 66 6 delirium delirium NN cord-341527-03rh966o 66 7 and and CC cord-341527-03rh966o 66 8 agitation agitation NN cord-341527-03rh966o 66 9 in in IN cord-341527-03rh966o 66 10 patients patient NNS cord-341527-03rh966o 66 11 in in IN cord-341527-03rh966o 66 12 intensive intensive JJ cord-341527-03rh966o 66 13 care care NN cord-341527-03rh966o 66 14 : : : cord-341527-03rh966o 66 15 systematic systematic JJ cord-341527-03rh966o 66 16 review review NN cord-341527-03rh966o 66 17 and and CC cord-341527-03rh966o 66 18 meta meta NNP cord-341527-03rh966o 66 19 - - HYPH cord-341527-03rh966o 66 20 analysis analysis NN cord-341527-03rh966o 66 21 with with IN cord-341527-03rh966o 66 22 trial trial NN cord-341527-03rh966o 66 23 sequential sequential JJ cord-341527-03rh966o 66 24 analysis analysis NN cord-341527-03rh966o 66 25 Management Management NNP cord-341527-03rh966o 66 26 of of IN cord-341527-03rh966o 66 27 COVID-19 COVID-19 NNP cord-341527-03rh966o 66 28 Respiratory Respiratory NNP cord-341527-03rh966o 66 29 Distress Distress NNP cord-341527-03rh966o 66 30 Evaluation Evaluation NNP cord-341527-03rh966o 66 31 of of IN cord-341527-03rh966o 66 32 the the DT cord-341527-03rh966o 66 33 effects effect NNS cord-341527-03rh966o 66 34 of of IN cord-341527-03rh966o 66 35 dexmedetomidine dexmedetomidine JJ cord-341527-03rh966o 66 36 infusion infusion NN cord-341527-03rh966o 66 37 on on IN cord-341527-03rh966o 66 38 oxygenation oxygenation NN cord-341527-03rh966o 66 39 and and CC cord-341527-03rh966o 66 40 lung lung NN cord-341527-03rh966o 66 41 mechanics mechanic NNS cord-341527-03rh966o 66 42 in in IN cord-341527-03rh966o 66 43 morbidly morbidly RB cord-341527-03rh966o 66 44 obese obese JJ cord-341527-03rh966o 66 45 patients patient NNS cord-341527-03rh966o 66 46 with with IN cord-341527-03rh966o 66 47 restrictive restrictive JJ cord-341527-03rh966o 66 48 lung lung NN cord-341527-03rh966o 66 49 disease disease NN