Echocardiographic Evaluation of the Acute Cardiovascular Effects of an Endothelin-Like Peptide Extracted from the Venom of Atractaspis irregularis.

Sarafotoxin-i3 from Atractaspis irregularis is a long sarafotoxin with an extended C terminus extension. Sarafotoxin-b from Atractaspis engaddensis is shorter by four amino acids. These peptides belong to the endothelin-like peptide family with a high sequence homology and similar three-dimensional structure. They act on endothelin receptors situated on the membrane of endothelial and smooth muscle cells. However, SRTX-i 3, despite a high toxicity, has a very low affinity for endothelin receptors compared to SRTX-b. The present work was carried out in order to compare the precise in vivo cardiovascular effect of SRTX-b and SRTX-i3. Male Wistar rats were anesthetized and mechanically ventilated. Doppler echocardiography was performed to measure left and right ventricular functions. The rats were divided into three groups that received intravenous injections of: saline, SRTX-b or SRTX-i3. All measurements were taken at baseline, at 1 min and at 6 min after injection. Both toxins impaired cardiac output. SRTX-b impaired left ventricular function, while SRTX-i3 increased airway pressures and led to acute right ventricular dilatation associated with a decreased tricuspid annulus peak systolic velocity. SRTX-b and SRTX-i3 appear to exert toxic effects via different mechanisms, SRTX-b impairs left ventricular function, while SRTX-i3 increases airway pressures and impairs right ventricular function.

Burnout syndrome in critical care team members: A monocentric cross sectional survey.

INTRODUCTION: There has been a growing interest in evaluating the occurrence of burnout syndrome (BOS) among intensive care units (ICU) team over recent years. The aims of this study were to determine the prevalence of BOS among staff working in the Amiens University Hospital and to assess associated factors. PATIENTS AND METHODS: Prospective observational study based on self-administered questionnaires filled in by physicians and non-physicians working in 3 ICUs. Demographic data, well-being assessment, work relationships, level of BOS and depressive symptoms were investigated. Logistic regression analysis was performed to identify variables independently associated with BOS. RESULTS: One hundred and sixty-one questionnaires were analysed. Participation rate was 90%. Thirty-two respondents were physicians and 129 were non-physicians. The prevalence of BOS was 51% and was not significantly different between physicians and non-physicians (56% versus 50%; P=0.501). Respondents who reported BOS less frequently had regular leisure activities (54 [66%] versus 70 [87%], P=0.001). In the BOS group, well-being was significantly lower (4.8±2.5/10 versus 6±2/10, P=0.001), a desire to leave the job was more frequently expressed (50 [61%] versus 32 [40%], P=0.009) and depressive symptoms were significantly more frequent (41 [50%] versus 21 [27%], P=0.002). Factors independently associated with BOS were regular leisure activities (OR 0.24 [0.1-0.59]; P=0.002), the presence of depressive symptoms (OR 2.71 [1.26-5.84]; P=0.011) and a well-being visual analogue scale≥5 (OR 0.40 [0.18-0.89]; P=0.024). CONCLUSIONS: BOS affects all ICU workers and is determined by multiple factors. Leisure activities and measures designed to improve well-being should be promoted.