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Communication improvement and family satisfaction in intensive care unit (ICU) are the main indicators of care quality. Our study aims were to evaluate family satisfaction in our intensive care and identify factors influencing the satisfaction level.We performed a descriptive prospective study in the ICU of Ben Arous régional hospital conducted between October 2016 and June 2018. We included parents of patients hospitalized for more than 48 hours, with available contact details and they agreed to reply to the questionnaire.One hundred and twelve family representatives were included. Ten (9%) were illiterate and 40 (36%) had a primary level education. Noninvasive ventilation and hemodialysis were, respectively, used in 53 and 9.8% of cases. Thirteen patients had sequelae at their hospital discharge. The median satisfaction score was 133.5 (120; 145.7). Ninety-five (85%) relatives were always satisfied with cleanliness of the unit. The medical and paramedical staff availability was appreciated as excellent, respectively, by 65 (56%) and 66 (59%) family members. The information provided by doctors and paramedical staff was considered very clear by 75 (65%) and 65 (58%) parents, respectively. The medical secret was respected by medical (Family members were satisfied with the unit environment, the communication, the healthcare management, and the patient care. Low education level, hemodialysis use, and sequelae at hospital discharge influence negatively the satisfaction.Fathallah I, Drira H, Habacha S, Kouraichi N. Can We Satisfy Family in Intensive Care Unit? A Tunisian Experience. Indian J Crit Care Med 2022;26(2):185-191.

Laboratory medicine has an important role in the management of COVID-19. The aim of this study was to analyze routinely available blood parameters in intensive care unit COVID-19 patients and to evaluate their prognostic value.This is a retrospective, observational, single-center study including consecutive severe COVID-19 patients who were admitted into the intensive care unit of Ben Arous Regional Hospital in Tunisia from 28 September 2020 to 31 May 2021. The end point of the study was either hospital discharge or in-hospital death. We defined two groups based on the outcome: survivors (Group 1) and non-survivors (Group 2). Demographical, clinical, and laboratory data on admission were collected and compared between the two groups. Univariate and multivariate logistic regression analysis were performed to determine the predictive factors for COVID-19 disease mortality.A total of 150 patients were enrolled. Eighty patients (53.3%) died and 70 (46.7%) survived during the study period. Based on statistical analysis, median age, Simplified Acute Physiology Score (SAPS II) with the serum levels of urea, creatinine, total lactate dehydrogenase (LDH), creatine kinase, procalcitonin and hs-troponin I were significantly higher in non-survivors compared to survivors. On multivariate analysis, LDH activity ≥ 484 U/L (OR=17.979; 95%CI [1.119-2.040]; p = 0.09) and hs-troponin I ≥ 6.55 ng/L (OR=12.492; 95%CI [1.691-92.268]; p = 0.013) independently predicted COVID-19 related mortality.Total LDH and hs-troponin I were independent predictors of death. However, further clinical investigations with even larger number of patients are needed for the evaluation of other laboratory biomarkers which could aid in assessing the prediction of mortality.

Cardiac arrest (CA) is a public health problem, with various etiologies and a fatal issue in 90-95% of cases. Toxin-induced cardiac arrests (TICA) are poorly described. Scarcity of national data prompted us to carry-out this study.To determine TICA frequency in a Tunisian reference center in toxicology and its hospital prognosis, and to describe its clinical and therapeutic aspects Methods : Data were collected retrospectively over an 8-years period. We included patients admitted for post-CA care with highly suspected or confirmed TICA. Clinical and toxicological data were recorded.We recorded 21 cases of TICA, which represented 48.8% of CA. A single toxic agent was incriminated in 90% of cases. Main causative agents identified in our series were pesticides and betablockers: chloralosed (n = 6), carbamate inhibitor of cholinesterase (n = 5), acebutolol (n = 4) and organophosphate (n = 2). One case of opiates and cocaine poisoning was reported. Median duration of "no flow" was 0 minutes. Mean duration of "low flow" was 13.74±9.15 minutes. An initial shockable rhythm was noted only in three patients. Mortality rate was 76% (16/21). Four of the five survivors had a Cerebral Performance Category Scale (CPC) 1, only one patient survived with a CPC 3. Factors associated with mortality were : the duration of "low flow" (p=0.02) and APACHE II score (p=0.014). APACHE II≥29 was the only independent factor (OR=2.0, 95%CI [1.07;3.71]).TICA were most frequently provoked by pesticides, mortality was high and was independently predicted by APACHE II score.

Strain has shown a promising diagnostic and prognostic value in acute coronary syndromes. With, however, less data in non-ST elevation myocardial infarction (NSEMI).to evaluate in NSTEMI patients, the ability of strain to predict the severity of the disease, by assessing correlations to established prognostic parameters, and to predict culprit and occluded coronary arteries (CA). Secondary, to determine factors associated to strain changes during follow-up.The study was prospective, NSTEMI patients with significant coronary lesion and without significant non-ischaemic disease were included. Angiographic and echocardiographic investigation including global (GLS) and territorial (TLS) longitudinal strain were performed within 24h from admission. Syntax I score was calculated. Severe coronary artery disease (CAD) was defined by left main of three-vessel disease.Seventy NSTEMI patients aged 60.2±10.1 years were enrolled; 61% were smokers, 54% diabetics and 46% hypertensive. 34% had a severe CAD, 7% had an acute coronary occlusion (ACO) and 14% a chronic coronary total occlusion (CTO). GLS-15.3% predicted a left ventricular ejection fraction (LVEF)50% with 80% Sensitivity (Se) and 78% Specificity (Sp). GLS was associated to CAD complexity and severity. GLS-14.1% detected severe CAD with 83% Se and 80%Sp. TLS determined the culprit artery in 74% of cases and TLS-9.2% predicted ACO with 85% Se and 85% Sp. TLS was also associated to CTO. At a 10 months median follow-up [3-12months], GLS significantly improved, baseline LVEF, GLS, wall motion score index and revascularization were the predictors of this improvement.In NSTEMI patients, GLS detected severe CAD and poor myocardial function. TLS predicted the culprit vessel and its occlusion. GLS improvement at midterm was predicted by baseline systolic LV function parameters and myocardial revascularization.