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Background: Investigating the health-related quality of life (HRQoL) after intensive care unit (ICU) discharge is necessary to identify possible modifiable risk factors. The primary aim of this study was to investigate the HRQoL in COVID-19 critically ill patients one year after ICU discharge. Methods: In this multicenter prospective observational study, COVID-19 patients admitted to nine ICUs from 1 March 2020 to 28 February 2021 in Italy were enrolled. One year after ICU discharge, patients were required to fill in short-form health survey 36 (SF-36) and impact of event-revised (IES-R) questionnaire. A multivariate linear or logistic regression analysis to search for factors associated with a lower HRQoL and post-traumatic stress disorded (PTSD) were carried out, respectively. Results: Among 1003 patients screened, 343 (median age 63 years [57–70]) were enrolled. Mechanical ventilation lasted for a median of 10 days [2–20]. Physical functioning (PF 85 [60–95]), physical role (PR 75 [0–100]), emotional role (RE 100 [33–100]), bodily pain (BP 77.5 [45–100]), social functioning (SF 75 [50–100]), general health (GH 55 [35–72]), vitality (VT 55 [40–70]), mental health (MH 68 [52–84]) and health change (HC 50 [25–75]) describe the SF-36 items. A median physical component summary (PCS) and mental component summary (MCS) scores were 45.9 (36.5–53.5) and 51.7 (48.8–54.3), respectively, considering 50 as the normal value of the healthy general population. In all, 109 patients (31.8%) tested positive for post-traumatic stress disorder, also reporting a significantly worse HRQoL in all SF-36 domains. The female gender, history of cardiovascular disease, liver disease and length of hospital stay negatively affected the HRQoL. Weight at follow-up was a risk factor for PTSD (OR 1.02, p = 0.03). Conclusions: The HRQoL in COVID-19 ARDS (C-ARDS) patients was reduced regarding the PCS, while the median MCS value was slightly above normal. Some risk factors for a lower HRQoL have been identified, the presence of PTSD is one of them. Further research is warranted to better identify the possible factors affecting the HRQoL in C-ARDS.

Additional file 11: Appendix 2. Survey sent to residents.

Additional file 3: e-Figure 3. Number of exams required by the residency school according to residents and considered adequate for training by residency school directors. VA: vascular access; LUS: lung ultrasound; TTE: transthoracic echocardiography; FAST: focused assessment with sonography in trauma; TCD: transcranial Doppler; RA: regional anaesthesia; DUS: diaphragm ultrasound. The comparison excluded those answering: ”I don’t know”, being expected among residents only.

Additional file 6: e-Figure 6. Expected additional value in clinical activity of ultrasound techniques in the residents’ view. VA: vascular access; LUS: lung ultrasound; TTE: transthoracic echocardiography; FAST: focused assessment with sonography in trauma; TCD: transcranial Doppler; RA: regional anaesthesia; DUS: diaphragm ultrasound.

Additional file 2: e-Figure 2. Mentors for ultrasound training as perceived by residents and directors.

Additional file 4: e-Figure 4. Assessment of ultrasound competencies during residency school as perceived by residents and directors.

Additional file 7: e-Figure 7. Adequacy of ultrasound training as perceived by residents in the different ultrasound techniques. VA: vascular access; LUS: lung ultrasound; TTE: transthoracic echocardiography; FAST: focused assessment with sonography in trauma; TCD: transcranial Doppler; RA: regional anaesthesia; DUS: diaphragm ultrasound.

Additional file 9: e-Figure 9. Need of improvement in ultrasound teaching in their own residency school as perceived by directors. VA: vascular access; LUS: lung ultrasound; TTE: transthoracic echocardiography; FAST: focused assessment with sonography in trauma; TCD: transcranial Doppler; RA: regional anaesthesia; DUS: diaphragm ultrasound.

Additional file 5: e-Figure 5. Impact of ultrasound competencies on future working activity by residents. VA: vascular access; LUS: lung ultrasound; TTE: transthoracic echocardiography; FAST: focused assessment with sonography in trauma; TCD: transcranial Doppler; RA: regional anaesthesia; DUS: diaphragm ultrasound.

Additional file 8: e-Figure 8. Confidence in performing ultrasound examination and procedures as perceived by residents. VA: vascular access; LUS: lung ultrasound; TTE: transthoracic echocardiography; FAST: focused assessment with sonography in trauma; TCD: transcranial Doppler; RA: regional anaesthesia; DUS: diaphragm ultrasound.

Diastolic dysfunction in intensive care unit: a pilot study in the general intensive care unit of l'aquila - ItalyAuthor(s):Biancofiore V.1, Salve G.2, Ciccozzi A.3, Angeletti P.M.4, Prof. Marinangeli F.3, Zugaro A.5Institute(s):1Universitu00e0 degli studi dell'Aquila sede aggregata Chieti, Dept of Anaesthesiology & Intensive Care, L'Aquila, Italy. 2Universitu00e0 degli studi dell'Aquila, L'Aquila, Italy. 3Universitu00e0 degli studi dellu2019Aquila, Dept of Anaesthesiology & Intensive Care, L'Aquila, Italy. 4Ospedale Mazzini di Teramo, Dept of Anaesthesiology & Intensive Care, Teramo, Italy. 5 Ospedale S. Salvatore di Lu2019Aquila Dept of Anaesthesiology & Intensive Care L'Aquila, Italy.Diastolic Dysfunction (DD) is a known cause of heart failure, related to frequent systemic diseases in ICU patients; but the real prevalence of DD in ICU remains uncertain.The aim of this prospective observational study is to investigate the prevalence of DD in a general ICU, and to value the relationship between DD and expected mortality (according to SAPS-2 score) and diagnosis on admission. All patients admitted to our ICU were part of the study, except patients whose recovery lasted less than 24h, patients with atrial fibrillation and patients with thoracic trauma. We collected anamnestic data, vital signs, SAPS-2 score and admission diagnosis. 4 TTE views (PSLAX, PSSAX, A4C, SC) were studied; a score was assigned to each view (2=optimal, 1=suboptimal, 0=unviewable) to identify the best one. Presence/absence of DD was studied through E/A transmitralic flow (presence if< 1); relationship between DD and hypertension, age, gender, expected mortality and admission diagnosis was analyzed. The differences between the two groups (presence/absence of DD) were analyzed with t-test, with u03c72-test and fisher exact for categorical variables. Data were collected in an Excelu00ae table and processed with a statistic package: STATA/IC 12.0. Our sample consisted of 110 patients, 64 males and 46 females, with an average age of 64,5 years. 59 patients had hypertension. Diagnoses on admission were multifactorial shock, cardiac arrest, respiratory failure, neurosurgical, polytrauma and septic shock. 59 patients (66,3%) had DD; DD resulted statistically related with hypertension (P=0.001) and old age (P< 0.0001), as already known in literature. Relation between DD and all the mentioned admission diagnosis, resulted statistically relevant (P=0.016). Expected mortality (P=0.087) and gender (P=0.49) resulted not statistically related to DD. The study also revealed that the best TTE view was A4C followed by PSLAX. 52,27% of our patients had at least 2 optimal views, only 5,45% had none.To conclude, this study underlines that DD is a frequent cause of heart failure in ICU patients, related to old age, hypertension and diagnosis on admission. Identifing a DD is useful in terms of therapy and patient's outcome. The 2 main TTE views (PSLAX, A4C) are viewable also in mechanically ventilated and not mobilized patients; it allows obtaining a wide range of information about heart function. A bigger sample should be needed to study more detailed relations between DD, treatments and outcome.