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Summary: Background: Reducing waste is an important component in comprehensive efforts to create greener intensive care units (ICU). Personal protective equipment (PPE) constitutes a significant share of the waste produced during ICU care. During the COVID-19 pandemic, the availability and supply of PPE posed substantial challenges globally. We aimed to investigate the lessons learned from the use of PPE during the pandemic (regarding the reduction of PPE consumption) and impact on hospital-acquired infections in healthcare workers. Methods: Conducting a retrospective analysis, we examined all newly issued standard operating procedures for the ICU related to the pandemic. We observed for a potential effect on the use of PPE and scrutinized PPE consumption and patient day data focusing on potential differences between 2020 and the following years until 2023. The primary objective was to evaluate the impact of the protocols and measures on PPE consumption. Results: Our analysis revealed that the implementation of four key infection control measures (cohorting, limitation of visits, institutional protocols for PPE use, staff training) lead to a substantial reduction in the use of masks and isolation gowns during the initial stages of the COVID-19 pandemic with no recorded hospital-acquired infections among healthcare workers. Conclusion: It is possible to reduce PPE consumption without compromising the safety of our healthcare professionals. Our observations may guide future policies to reduce PPE consumption with the intent of reducing the environmental impact.

Abstract Currently, there is a lack of methods for simultaneous assessment of readiness for decannulation of the veno-venous (V-V) and veno-arterial (V-A) components during veno-arteriovenous (V-AV) extracorporal membrane oxygenation (ECMO) support. We describe a novel approach using a simultaneous off-sweep and controlled backflow test to assess readiness for decannulation from V-AV ECMO. This method needs testing in future clinical trials.

Background. The diagnosis of acute myocarditis (AMC) and inflammatory cardiomyopathy (DCMi) can be difficult. Speckle tracking echocardiography with accurate assessments of regional contractility could have an outstanding importance for the diagnosis. Methods and Results. N=25 patients with clinically diagnosed AMC who underwent endomyocardial biopsies (EMBs) were studied prospectively. Speckle tracking imaging was examined at the beginning and during a mean follow-up period of 6.2 months. In the acute phase patients had markedly decreased left ventricular (LV) systolic function (mean LV ejection fraction (LVEF) 40.4±10.3%). At follow-up in n=8 patients, inflammation persists, correlating with a significantly reduced fractional shortening (FS, 21.5±6.0%) in contrast to those without inflammation in EMB (FS 32.1±7.1%, P