(1) Background: The present study aims to assess the level of professional burnout and secondary traumatic stress (STS), and to identify potential risk or protective factors among health care workers (HCWs) during the coronavirus disease 2019 (COVID-19) outbreak.; (2) Methods: This cross-sectional study, based on an online survey, collected demographic data and mental distress outcomes from 184 HCWs from 1 May 2020, to 15 June 2020, from 45 different countries. The degree of STS, perceived stress and burnout was assessed using the Secondary Traumatic Stress Scale (STSS), the Perceived Stress Scale (PSS) and Maslach Burnout Inventory Human Service Survey (MBI-HSS) respectively. Stepwise multiple regression analysis was performed to identify potential risk and protective factors for STS; (3) Results: 184 HCWs (M = 90; Age mean: 46.45; SD: 11.02) completed the survey. A considerable proportion of HCWs had symptoms of STS (41.3%), emotional exhaustion (56.0%), and depersonalization (48.9%). The prevalence of STS was 47.5% in frontline HCWs while in HCWs working in other units it was 30.3% (p < 0.023); 67.1% for the HCWs exposed to patients’ death and 32.9% for those HCWs which were not exposed to the same condition (p < 0.001). In stepwise multiple regression analysis, perceived stress, emotional exhaustion, and exposure to patients’ death remained as significant predictors in the final model for STS (adjusted R2 = 0.537, p < 0.001); (4) Conclusions: During the current COVID-19 pandemic, HCWs facing patients’ physical pain, psychological suffering, and death are more likely to develop STS.

The sequential activity of a RICU and a WC resulted in additive weaning success rate of difficult-to wean patients. The cost-benefit ratio of the program warrants prospective investigations.

Neurally adjusted ventilatory assist (NAVA) is a mode of ventilation wherein the delivered assistance is proportional to diaphragm electrical activity (EAdi) throughout inspiration. We assessed the physiologic response to varying levels of NAVA and pressure support ventilation (PSV) in 13 tracheostomised patients with prolonged weaning. Each patient randomly underwent 8 trials, at four levels of assistance either in PSV and NAVA. i - high (no dyspnoea and/or distress); iv - low (associated with dyspnoea and/or distress; ii and iii - at ∼75% and ∼25% of the difference between high and low support respectively. We measured tidal volume (VT), peak EAdi, (EAdipeak) and airway pressure, ineffective efforts and breathing pattern variability. With both NAVA and PSV, decreasing assistance resulted in parallel significant increase in EAdipeak associated with a concomitant reduction in VT and minute ventilation in PSV, but not in NAVA. VT variability significantly increased when reducing ventilatory assistance in PSV only, while remained unchanged varying the NAVA level. The ineffective triggering index was not significantly different between the two modes. In patients with prolonged weaning, with the specific settings adopted, compared to PSV, NAVA reduced the risk of over-assistance and overall improved patient-ventilator interaction, while not significantly affecting patient-ventilator synchrony.

Persisting limitations in respiratory function and gas exchange, cognitive impairment, and mental health deterioration have been observed weeks and months after acute SARS-CoV-2 (COVID-19). The present study aims at assessing the impairment at three-months in patients who successfully recovered from acute COVID-19. We collected data from May to July 2020. Patients underwent a multidimensional extensive assessment including pulmonary function test, psychological tests, thoracic echo scan, and functional exercise capacity. A total of 21 patients (M:13; Age 57.05 ± 11.02) completed the global assessment. A considerable proportion of patients showed symptoms of post-traumatic stress disorder (28.6%), moderate depressive symptoms (9.5%), and clinical insomnia (9.5%); 14.3% of patients exhibited moderate anxiety. A total of eleven patients (52.4%) showed impaired respiratory gas exchange capacity (P-DLCO, DLCO ≤ 79% pred). Compared to patients with normal gas exchange, the P-DLCO subgroup perceived a significant worsening in quality of life (QoL) after COVID-19 (p = 0.024), higher fatigue (p = 0.005), and higher impact of lung disease (p = 0.013). In P-DLCO subgroup, higher echo score was positively associated with hospitalization length of stay (p = 0.047), depressive symptoms (p = 0.042), fatigue (p = 0.035), impairment in mental health (p = 0.035), and impact of lung disease in health status (p = 0.020). Pulmonary function and echo scan lung changes were associated to worsened QoL, fatigue, and psychological distress symptoms.

Aims: To assess the level of professional burnout and secondary traumatic stress, and to identify potential risk or protective factors among health care workers (HCWs) during the coronavirus disease 2019 (COVID-19) outbreak. Materials and Methods: This cross-sectional study, based on an online survey, collected demographic data and mental distress outcomes from 184 HCWs from May 1st, 2020, to June,15th, 2020, from 45 different countries. The degree of secondary traumatization was assessed using the Secondary Traumatic Stress Scale (STSS), the degrees of perceived stress and burnout were assessed with Perceived Stress Scale (PSS) and Maslach Burnout Inventory Human Service Survey (MBI-HSS) respectively. Stepwise multiple regression analysis was performed to identify potential risk and protective factors for STS. Results: 184 HCWs (M=90; Age mean: 46.45; SD:11.02) completed the survey. A considerable proportion of HCWs had symptoms of secondary traumatic stress (41.3%), emotional exhaustion (56.0%), and depersonalization (48.9%). The prevalence of secondary traumatic stress in frontline HCWs was 47.5% while in HCWs working in other units it was 30.3% (p<.023); additionally, the prevalence of the same outcome was 67.1% for the HCWs exposed to patients' death and 32.9% for those HCWs which were not exposed to the same condition (p<.001). In stepwise multiple regression analysis, perceived stress, emotional exhaustion and exposure to patients' death remained as significant predictors in the final model for secondary traumatic stress (adjusted R2 =0.537, p<0.001). Conclusions: During the current COVID-19 pandemic, HCWs facing patients' physical pain, psychological suffering, and death are more likely to develop secondary traumatization.