ABSTRACT
Objectives: Besides in-centre ECMO care, the certificated ECMO centre of the University Hospital Regensburg (UKR) offers out-of-centre ECMO initiation with mobile equipment. During the pandemic situation, this treatment was especially meant for patients with critical cardiopulmonary failure in remote hospitals who present themselves as too unstable for interhospital transfer. We evaluated if treatment with outof-centre ECMO initiation could benefit patients;outcome, by comparing this group with a group of COVID-19 patients who received ECMO therapy at the UKR by in-hospital initiation. Method(s): Retrospective single-centre study including 169 patients who received ECMO due to COVID-19- induced cardiopulmonary failure between March 2020 till March 2022. Patients;population was separated into two groups according to the location of ECMO initiation, out-of-centre or in-centre, and into two subgroups by the used ECMO mode, venovenous (VV) or venoarterial (VA). We compared demographics, treatment duration, adverse events and patient;s outcome. The primary endpoint of the investigation was patients;survival to hospital discharge rate or death on ECMO or after ECMO explant. Result(s): Regarding the total study population, 98 (58.0%) of the 169 patients could be discharged from the UKR. Before initiation of ECMO therapy and with regard to complications during the course of intensive care, such as renal failure requiring dialysis or bleeding, there were no relevant differences between the two groups and subgroups. The out-of-centre group showed a significantly higher survival rate with 70 (63.6%) survivors out of 110 externally cannulated patients. Conclusion(s): In the study population, external ECMO cannulation was beneficial in terms of survival, although the reasons did not show significant differences between the groups. A possible approach for the good overall survival of the study groups in international comparison could be the existing centre expertise. (Figure Presented).
ABSTRACT
Coronavirus disease 2019 (COVID-19) has affected the conditions of work in healthcare institutions and the quality of patient care around the world. Emerging healthcare robotic technology may facilitate and improve the overall quality of life, as well as the diagnostics, rehabilitation, and intervention services. This paper reports the lessons learned from actions carried out in the implementation of the DIH-HERO project call across Europe for robotic solutions that support healthcare activities. Conclusion remarks are as follows: i) technology pull and the urgent need together accelerate the innovation development and deployment, ii) it takes time to establish safety and legal regulations for the deployment of human-machine devices, so the ethical, safety, and reliability aspects of robotic application need to be carefully considered, iii) technology adoption depends on the trust of the users to the technology, iv) existing robotic technology for prevention, diagnosis, hospital admission, rehabilitation, and intervention is mature enough for the adaptation and deployment, v) unskilled general population should be trained for the usage of robotic technology. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Introduction: Candida auris is an emerging pathogen in hospital infections that can present multi-resistance to antifungals and causes outbreaks. Objectives: The aim is to describe the infection prevention and control for C. auris. Methods: Identification of yeast isolates was performed by MALDITOF and confirmed by ITS sequencing. Infection control measures were decided by a multi-disciplinary ad hoc outbreak panel. Patient screening once or twice a week and extensive environmental testing for C. auris was conducted. Results: C. auris was isolated from a urine sample of a COVID-19 patient who had been transferred from an Egyptian hospital to our COVID-19 intensive care unit (ICU). Immediately, disinfection routine was changed, because C. auris is insensitive to quaternary ammonium compounds. The patient had already been isolated from admission due to evidence of 4MRGN Klebsiella pneumoniae. Six days after confirmation of C. auris in the index patient, a second COVID-19 patient was identified with C. auris. Both patients were isolated in a separated area of the ICU. Strict hygiene and infection control measures were implemented promptly. In the nine weeks from initial confirmation of C. auris and discharge of the two affected patients, C. auris was repeatedly identified in clinical samples of them. However, it was not detected in any other patient on the ICU (n = 7) or discharged from it (n = 13) nor in any environmental sample (n = 129). The two C. auris patients had been intubated using the same video laryngoscope seven days apart. Although the equipment and the spatulas had been manually reprocessed using chlorine dioxide-soaked wipes they might serve as transmission vehicle. Therefore, it was recommended to use disposable spatulas. Conclusion: A rapid confirmation of a C. auris in the lab and the immediate implementation of adequate hygiene measures at the ward are crucial in order to prevent transmission of C. auris to other patients.
ABSTRACT
The use of robotics in health care has seen a recent rise in interest due to its potential for use during the SARS-CoV-2 pandemic. The transmission rate of COVID-19 has meant that health-care workers are under increasing pressure, risks, and workload to manage the requirements of personal protective equipment, strict disinfection procedures, and the heightened medical needs of patients. Patients are suffering from isolation, and not just in hospitals: higher-risk individuals must shelter, meaning social interactions, particularly in care homes, are limited. Robots can help by providing disinfection and logistics services that support patients and health-care professionals, by acting as devices to be used for rehabilitation at home (for both pre-existing conditions and for COVID-19-related treatment), and via interventional systems that can widely distribute future vaccinations.