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Background and Objectives: The COVID-19 disease has significantly burdened the healthcare system, including all units of severe patient treatment. Non-intensive care units were established to rationalize the capacity within the Intensive Care Unit (ICU) and to create a unit where patients with Acute Respiratory Distress Syndrome (ARDS) could be treated with non-invasive Continuous Positive Air Pressure (CPAP) outside the ICU. This unicentric retrospective study aimed to assess the efficacy of NIV Treatment in Patients of the fourth pandemic wave and how its application affects the frequency and mortality of ICU-treated patients at University Hospital Rijeka compared to earlier waves of the COVID-19 pandemic. Furthermore, the study showcases the effect of the Patient/Nurse ratio (P/N ratio) on overall mortality in the ICU. Materials and Methods: The study was conducted on two groups of patients with respiratory insufficiency in the second and third pandemic waves, treated in the COVID Respiratory Centre (CRC) (153 patients). We also reviewed a cohort of patients from the fourth pandemic wave who were initially hospitalized in a COVID-6 non-intensive unit from 1 October 2021 to 1 November 2022 (102 patients), and some of them escalated to CRC. Results: The introduction of the CPAP non-invasive ventilation method as a means of hypoxic respiratory failure treatment in non-intensive care units has decreased the strain, overall number of admissions, and CRC patient mortality. The overall fourth wave mortality was 29.4%, compared to the 58.2% overall mortality of the second and third waves. Conclusions: As a result, this has decreased CRC patient admissions and, by itself, overall mortality. [ABSTRACT FROM AUTHOR]

This consensus conference report summarizes discussions on sleep apnea care and management. Our goal is to simplify the journey to optimize success for individuals at risk of obstructive sleep apnea and to facilitate diagnostics, monitoring and communication among the entire healthcare team including patients, primary care physicians, sleep specialists, sleep dentists and other key providers. The statement identifies five key problems or unmet needs and contemplates four potential future directions.

Background and Objectives: The COVID-19 disease has significantly burdened the healthcare system, including all units of severe patient treatment. Non-intensive care units were established to rationalize the capacity within the Intensive Care Unit (ICU) and to create a unit where patients with Acute Respiratory Distress Syndrome (ARDS) could be treated with non-invasive Continuous Positive Air Pressure (CPAP) outside the ICU. This unicentric retrospective study aimed to assess the efficacy of NIV Treatment in Patients of the fourth pandemic wave and how its application affects the frequency and mortality of ICU-treated patients at University Hospital Rijeka compared to earlier waves of the COVID-19 pandemic. Furthermore, the study showcases the effect of the Patient/Nurse ratio (P/N ratio) on overall mortality in the ICU. Materials and Methods: The study was conducted on two groups of patients with respiratory insufficiency in the second and third pandemic waves, treated in the COVID Respiratory Centre (CRC) (153 patients). We also reviewed a cohort of patients from the fourth pandemic wave who were initially hospitalized in a COVID-6 non-intensive unit from 1 October 2021 to 1 November 2022 (102 patients), and some of them escalated to CRC. Results: The introduction of the CPAP non-invasive ventilation method as a means of hypoxic respiratory failure treatment in non-intensive care units has decreased the strain, overall number of admissions, and CRC patient mortality. The overall fourth wave mortality was 29.4%, compared to the 58.2% overall mortality of the second and third waves. Conclusions: As a result, this has decreased CRC patient admissions and, by itself, overall mortality.

Obstructive sleep apnea (OSA) creates a complex and dynamic substrate for atrial fibrillation (AF), which is characterized by structural remodeling as a result of long-term OSA as well as transient and acute apnea-associated transient atrial electrophysiological changes. OSA is present in 21% to 74% of patients with AF, and nonrandomized studies suggest that treatment of OSA by continuous positive airway pressure may help to maintain sinus rhythm after electrical cardioversion and improve catheter ablation success rates. Management of OSA in patients with AF requires a close interdisciplinary collaboration between the electrophysiologist/cardiologist and sleep specialists., Competing Interests: Disclosure Dr D. Linz is supported by a Beacon Research Fellowship by the University of Adelaide. Drs J.M. Kalman and P. Sanders are supported by Practitioner Fellowships from the National Health and Medical Research Council of Australia. Dr P. Sanders is supported by the National Heart Foundation of Australia. Dr D. Linz reports having served on the advisory board of LivaNova, Respicardia, and Medtronic. Dr D. Linz reports having received lecture and/or consulting fees from LivaNova, Biosense-Webster, Medtronic, Pfizer, Bayer, and ResMed. Dr D. Linz reports having received research funding from Sanofi, ResMed, and Medtronic. Dr P. Sanders reports having served on the advisory board of Biosense-Webster, Medtronic, St Jude Medical, Boston Scientific, and CathRx. Dr P. Sanders reports having received lecture and/or consulting fees from Biosense-Webster, Medtronic, St Jude Medical, and Boston Scientific. Dr P. Sanders reports having received research funding from Medtronic, St Jude Medical, Boston Scientific, Biotronik, and Sorin. The other authors have nothing to disclose., (Copyright © 2020 Elsevier Inc. All rights reserved.)