Invasive pulmonary aspergillosis (IPA) is a common cause of fungal infection acquired in intensive care unit (ICU) whose clinical landscape may differ according to SARS-CoV2 infection status. We included all mechanically ventilated patients hospitalized (≥ 48 h) participating in ICU of the REA-REZO network during a 6-year period. Among IPA patients, initial characteristics and outcomes were compared according to COVID-19. Additionally, to account for potential confounders, we performed an inverse probability of treatment weighting (IPTW). Rates of IPA were also compared according to SARS-CoV2 infection. Finally, we investigated risk factors associated with mortality among IPA patients using a Cox model regression. Among 120 993 patients included during the study period, IPA was diagnosed in 254 patients. COVID-19 Associated Pulmonary Aspergillosis (CAPA) patients were significantly older (median age 69 [62–73] years versus 63 [56–70] years; p < 0.001), less immunosuppressed (23.5
Patients in the intensive care unit (ICU) with unhealthy alcohol use often experience agitation during mechanical ventilation, which can contribute to post-traumatic stress disorder (PTSD). The BACLOREA trial investigated whether high-dose baclofen could reduce agitation in these patients, but its long-term effects on PTSD symptoms remained unclear. This study aimed to assess whether baclofen administered during ICU stay to reduce the incidence of agitation could reduce the 5-year PTSD symptoms in adult patients with unhealthy alcohol use and improve long-term quality of life and psychological status. This observational follow-up study was conducted between September 2021 and February 2024 and included patients alive five years after participation in the BACLOREA trial, a randomized, placebo-controlled trial evaluating high-dose baclofen for the prevention of agitation-related events during mechanical ventilation in critically ill patients with unhealthy alcohol use. The primary outcome was the prevalence of PTSD symptoms measured using the Impact of Event Scale-Revised (IES-R), with a score ≥ 33 indicating PTSD symptoms. Secondary outcomes included the prevalence of PTSD symptoms using the PTSD Checklist Scale (PCL-S), the quality of life assessed through the SF-36, EQ-5D, and HADS scales. Among the 152 patients who survived five years after ICU admission, 94 (61.8
Advance directives (AD) are a key tool within advance care planning (ACP), intended to support patient autonomy and guide end-of-life care. Despite their legal recognition in France, their use in the general population remains limited. Moreover, data on AD use among patients with advanced cancer, a population particularly concerned by end-of-life decisions, remain scarce. This study aimed to assess the knowledge and opinions regarding AD among patients with advanced cancer in France who were receiving specialized palliative care. Between 2016 and 2020, we conducted a multicenter cross-sectional study across 14 palliative care departments in France. Patients with advanced cancer completed a standardized questionnaire assessing their awareness, use, and perceptions of AD, along with sociodemographic and clinical characteristics. A total of 331 patients were included. Among them, 53.5
Non-surgical alternatives to rhinoplasty are gaining interest but, despite its popularity, research on the long-term psychological impact and post-rhinofiller patients’ satisfaction is limited. This study evaluates patient-reported satisfaction and quality of life immediately after and 6 months post-non-surgical rhinoplasty using the FACE-Q questionnaire. This prospective study was conducted from May 2023 to March 2024, involving 83 patients who underwent rhinofiller treatments for esthetic purposes. The FACE-Q questionnaire, assessing satisfaction with facial appearance, psychological function, and specific satisfaction with the nose, was administered before treatment, immediately after, and six months post-procedure. Statistical analyses compared pre- and post-treatment scores. Sixty-six patients fully responded to the FACE-Q questionnaire. Significant improvements were noted in satisfaction with facial appearance, psychological function, and specific satisfaction with the nose immediately after treatment (p < 0.05). Six months post-treatment, improvements were slightly reduced according to natural filler resorption. Nevertheless, this decrease was not statistically significant, meaning that the overall satisfaction was maintained after the procedure. Rhinofiller significantly enhances patient satisfaction and quality of life, with effects lasting much more than 6 months. In literature, this is the first article in which rhinofiller efficacy, durability and its impact on patient psycho-physical well-being are demonstrated through a validated method. The FACE-Q assessments confirm that rhinofiller is a viable, less invasive alternative to traditional rhinoplasty, offering substantial psychosocial benefits. Further research with larger samples and different populations is recommended to validate these findings and expand understanding of rhinofiller’s long-term impact. This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
BACKGROUND:Acute respiratory failure is a common reason for admission to the intensive care unit, and patients are frequently treated with high-flow nasal cannula oxygen therapy (HFNC). Intra-hospital transport of critically ill patients, such as between hospital wards and the intensive care unit or for diagnostic exams, is common. Transportable HFNC can be used during these intra-hospital transports. We aimed to evaluate the complications associated with intra-hospital transport of patients treated with HFNC. METHODS:We conducted a prospective, descriptive multicenter study between May 2022 and May 2024, involving critically ill adult patients who were treated with HFNC prior to transport and required intra-hospital transport for any reason, accompanied by an intensive care unit team. The primary objective was to evaluate the incidence of severe adverse events including severe hypoxemia (with pulse oxygen saturation of less than 80%), need for intubation, need for non-invasive ventilation or cardiorespiratory arrest during transport. Secondary objectives were to assess the incidence of non-severe adverse events, defined as the need for increased inspired oxygen fraction, switching HFNC for standard oxygen therapy, nasal cannula removal or dysfunction of the HFNC device. RESULTS:We included 165 patients and analyzed 187 transports. Eight (4.3%) severe adverse events occurred in 7 patients including 6 cases of severe transient hypoxemia and 2 cases of non-invasive ventilation. All of them were transient severe hypoxemia that occurred during the first transport. Forty-three (23%) non-severe adverse events occurred, including 29(15.6%) cases of increased inspired oxygen fraction requirement, 7/187 (3.74%) cases of nasal cannula removal, 6/187 (3.2%) cases of HFNC device dysfunction, and 1 (0.5%) case involved replacing HFNC with standard oxygen therapy. CONCLUSION:HFNC during intra-hospital transport of critically ill patients had a low incidence of severe adverse events. Non-severe adverse events were more frequent, but their potential impact could not be assessed in this study and warrants further investigation. TRIAL REGISTRATION:Clinicalstrials.gov, NCT05311007, registered 23 March 2022, https://clinicaltrials.gov/study/NCT05311007?term=hospiflow&rank=1 .
