Tag Archives: death

The effect of pre-existing sarcopenia on outcomes of critically ill patients treated for COVID-19

Thomas Bradier1, Sébastien Grigioni2, Céline Savoye-Collet3, Gaétan Béduneau1,4, Dorothée Carpentier1, Christophe Girault1,4, Maximillien Grall1, Grégoire Jolly1, Najate Achamrah2, Fabienne Tamion1,5, Zoé Demailly1,5

1 Intensive Care Unit, Charles Nicolle University Hospital, Rouen, France
2 Department of Nutrition, Charles Nicolle University Hospital, Rouen, France
3 Radiology Department, QUANTIF-LITIS EA 4108, Charles Nicolle University Hospital, Rouen, France
4 Normandie Univ, UNIROUEN, UR 3830-GRHVN, CHU Rouen, F-76000 Rouen, France.
5 Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, France

DOI: 10.2478/jccm-2024-0045

Background: Sarcopenia, defined by a loss of skeletal muscle mass and function, has been identified as a prevalent condition associated with poor clinical outcome among critically ill patients. This study aims to evaluate the impact of pre-existing sarcopenia on outcomes in critically ill patients with acute respiratory failure (ARF) due to COVID-19.
Material and Methods: A retrospective study was carried out on COVID-19 patients admitted to intensive care. Pre-existing sarcopenia was assessed using early CT scans. Clinical outcomes, including duration of high-flow oxygenation (HFO), mechanical ventilation (MV), length of hospital stay (LOS) and ICU mortality, were evaluated according to sarcopenia status.
Results: Among the studied population, we found a high prevalence (75 patients, 50%) of pre-existing sarcopenia, predominantly in older male patients. Pre-existing sarcopenia significantly impacted HFO duration (6.8 (+/-4.4) vs. 5 (+/-2.9) days; p=0.005) but did not significantly affect MV requirement (21 (28%) vs. 23 (37.3%); p=185), MV duration (7 vs. 10 days; p=0.233), ICU mortality (12 (16%) vs. 10 (13.3 %); p=0.644) or hospital LOS (27 vs. 25 days; p=0.509). No differences in outcomes were observed between sarcopenic and non-sarcopenic obese patients.
Conclusions: Pre-existing sarcopenia in critically ill COVID-19 patients is associated with longer HFO duration but not with other adverse outcomes. Further research is needed to elucidate the mechanisms and broader impact of sarcopenia on septic critically ill patient outcomes.

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End-of-life Care in the Intesive Care Unit and Nursing Roles in Communicating with Families

Anastasios Tzenalis1, Helen Papaemmanuel2, George Kipourgos2, George Elesnitsalis2

1 University Of Patras, Patra, Greece
2 General Hospital of Thessaloniki Papageorgiou, Greece

DOI: 10.2478/jccm-2023-0013

Introduction: Professionals in Intensive Care Units face death, shifting their role from therapists to caregivers in end-of-life management. The nursing attitude and response to death has been shown to affect the quality of palliative care and end-of-life services that are interrelated services. Aim of the study: The aim of this research was to evaluate the professional attitude of nurses towards the care of the families of critically ill patients in the ICU, leading to the emergence of specific attitudes, relating them to their demographic and professional characteristics, with the aim of drawing conclusions for the improvement of quality in end-of-life care.
Material and Methods: The sample of the study was 81 nurses from a large tertiary hospital. Participants completed the “Nurse Activities for Communicating with Families” (NACF) questionnaire. The questions are about ways in which nurses can help the patient’s family during the patient’s stay in the ICU.
Results: The results revealed that the nurses took actions related to the information and psychological support of the patient’s family. On the contrary, they did not focus on the spiritual / religious needs of the patient and the needs of the family based on their cultural background.
Conclusions: The professional treatment of staff is characterized by compassion and empathy, but it is necessary to train them on important issues related to diversity, including the religious, spiritual values ​​and beliefs of patients and their relatives.

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