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Background. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread throughout Europe. However, there is a lack of data on the full clinical course of patients infected with SARS-CoV-2 in Europe, especially in the population that developed acute respiratory failure (ARF). Objectives. To identify risk factors associated with developing ARF during SARS-CoV-2 infection. Material and methods. This was an observational study of 60 adult patients with laboratory-confirmed SARS-CoV-2 infection. Data were collected from March 26, 2020 to May 26, 2020 in a tertiary academic hospital in Poland. All patients reached final outcome (discharge from the hospital or death). We divided patients into 2 groups based on whether they developed ARF, compared their clinical data, and performed multivariate logistic regression. Results. Twenty-two patients (36%) from the observed cohort developed ARF. Logistic regression identified that a high sequential organ failure assessment score at admission (odds ratio (OR) = 6.97 (1.57-30.90, p = 0.011)), and a long time from admission until pneumonia (OR = 1.41 (1.06-1.87, p = 0.016)), correlated with ARF development. D-dimer, lactate dehydrogenase, neutrophil to lymphocyte ratio, C-reactive protein (CRP), and interleukin 6 (IL-6) differed both statistically and clinically between ARF and non-ARF groups. The mortality rate in the observed cohort of patients was 13.3%, and it was 32% in the group that developed ARF. Conclusions. Routine vigilant examination of the above markers may identify patients at the highest risk of ARF early on during COVID-19 infection. [ABSTRACT FROM AUTHOR]

In Poland, chronic pain is experienced by 27% of the population, while neuropathic pain, which is the greatest therapeutic challenge, occurs in approximately 7-10% of the general population and in approximately 30% of cancer patients. One of the mechanisms responsible for the occurrence of pain sensations and its chronification is known as the central sensitization consisting in the hypersensitivity of spinal cord neurons and the upper levels of the central nervous system. The stimulation of the N-methyl-D-aspartate receptor complex (NMDAR) by excess of excitatory amino acids plays an important role in the emergence and maintenance of this phenomenon. Ketamine, which is one of the NMDAR antagonists, reduces central hypersensitivity, especially in relation to neuropathic pain components such as allodynia (pain responses to pain stimuli) and hyperalgesia (increased sensitivity to pain stimuli). The article presents characterization and application of ketamine, taking into account all its mechanisms of action based on the results of selected studies. [ABSTRACT FROM AUTHOR]

Background: Current pain assessment and treatment does not address every patient's requirements. Although the Polish national guidelines for post-operative pain management have been published, many patients experience severe pain in the postoperative period. The main goal of our study was to assess pain severity among patients from different types of hospitals (primary, secondary, and tertiary centers) after similar types of surgeries. We also aimed to determine if there were any differences in pain severity associated with anesthesia technique, type of surgery, and the patient's age and sex. Methods: This was a prospective, observational study. A questionnaire form was used to collect demographic data, type of hospital, surgery, anesthesia, and patient satisfaction of pain control in the postoperative period. The visual analogue scale (VAS) was used to measure pain severity at four time points after surgery (4, 8, 12, and 24 h). Results: The study was conducted from November 2015 to June 2016 in seven hospitals in Eastern Poland, and 269 women and 293 men participated. At the 4-h measurement, 39.32% of patients assessed the pain as moderate and 19.75% as severe. A difference was found in pain intensity between patients treated in primary and secondary hospitals. Vascular surgery patients had the lowest pain intensity (19 (13–26)), especially in comparison to those undergoing thoracic surgery (30 (27–33)). A sudden elevation in pain severity among patients anesthetized with single-shot spinal technique was observed. Only 4.9% of participants received strong opioids during the first 24 h after surgery. Conclusions: Postoperative pain control seems to be unexpectedly poor after single-shot subarachnoid anesthesia. Despite concerns, the use of analgesics may be insufficient in some groups of patients. Our study indicates new variables that influence the severity of pain, such as operated region, anesthetic technique, and type of surgical department. The results obtained in our study are in discrepancy with recommendations presented by the national guidelines for post-operative pain management. [ABSTRACT FROM AUTHOR]

Purpose: Several initiatives have recently focused on raising awareness about limitations of treatment in Poland. We aimed to assess if the propensity to limit LST among elderly patients in 2018-2019 increased compared to 2016-2017., Methods: We analysed Polish cohorts from studies VIP1 (October 2016 - May 2017) and VIP2 (May 2018 - May 2019) that enrolled critical patients aged >80. We collected data on demographics, clinical features limitations of LST. Primary analysis assessed factors associated with prevalence of limitations of LST, A secondary analysis explored differences between patients with and without limitations of LST., Results: 601 patients were enrolled. Prevalence of LST limitations was 16.1% in 2016-2017 and 20.5% in 2018-2019. No difference was found in univariate analysis (p = 0.22), multivariable model showed higher propensity towards limiting LST in the 2018-2019 cohort compared to 2016-2017 cohort (OR 1.07;95%CI, 1.01-1.14). There was higher mortality and a longer length of stay of patients with limitations of LST compared to the patients without limitations of LST. (11 vs. 6 days, p = 0.001)., Conclusions: The clinicians in Poland have become more proactive in limiting LST in critically ill patients ≥80 years old over the studied period, however the prevalence of limitations of LST in Poland remains low., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Elderly patients pose a significant challenge to intensive care unit (ICU) clinicians. In this study we attempted to characterise the population of patients over 80 years old admitted to ICUs in Poland and identify associations between clinical features and short-term outcomes., Material and Methods: The study is a post-hoc analysis of the Polish cohort of the VIP2 European prospective observational study enrolling patients > 80 years old admitted to ICUs over a 6-month period. Data including clinical features, clinical frailty scale (CFS), geriatric scales, interventions within the ICU, and outcomes (30-day and ICU mortality and length of stay) were gathered. Univariate analyses comparing frail (CFS > 4) to non-frail patients and survivors to non-survivors were performed. Multivariable models with CFS, activities of daily living score (ADL), and the cognitive decline questionnaire IQCODE as predictors and ICU or 30-day mortality as outcomes were formed., Results: A total of 371 patients from 27 ICUs were enrolled. Frail patients had significantly higher ICU (58% vs. 44.45%, P = 0.03) and 30-day (65.61% vs. 54.14%, P = 0.01) mortality compared to non-frail counterparts. The survivors had significantly lower SOFA score, CFS, ADL, and IQCODE than non-survivors. In multivariable analysis CFS (OR 1.15, 95% CI: 1.00-1.34) and SOFA score (OR 1.29, 95% CI: 1.19-1.41) were identified as significant predictors for ICU mortality; however, CFS was not a predictor for 30-day mortality ( P = 0.07). No statistical significance was found for ADL, IQCODE, polypharmacy, or comorbidities., Conclusions: We found a positive correlation between CFS and ICU mortality, which might point to the value of assessing the score for every patient admitted to the ICU. The older Polish ICU patients were characterised by higher mortality compared to the other European countries.

Background: It is known that job satisfaction has an important impact on efficacy or burnout syndrome of medical personnel. Many studies have concerned job satisfaction among critical care nurses. Not as many have focused on anesthesia nurses working in operating theaters. In Poland, anesthesia and intensive care is a combined specialty for nurses. However, nurses work in an intensive care unit (ICU) or in an operating room (OR), and very rarely in both settings. We would like to compare satisfaction between ICU and OR nurses., Methods: It was a multicenter cross-sectional study. 406 nurses from thirteen hospitals participated in this study. All respondents filled in the questionnaire that contained fifteen Likert-like questions reflecting different aspects of job satisfaction. Demographic data were also collected., Results: We did not find a significant difference between ICU and OR nurses in the overall job satisfaction. Furthermore, the type of hospital did not significantly influence satisfaction of our study participants. The most important factor which differentiated the level of satisfaction among nurses was the region of Poland in which they worked. Interestingly, nurses who worked in ICUs were significantly younger in comparison to their colleagues from ORs., Conclusion: The results of our study suggest that the region of the country in which nurses work might play a very important role in their satisfaction.