The COVID-19 pandemic has meant that home respiratory services have needed to be reviewed. As a result, new solutions have been developed and implemented. The Vivo 45™ (Breas, Mölnlycke, Sweden) is a ventilator that offers clinicians the ability to attach effort belts to the device. This allows the clinician to review ventilator traces with the addition of thoracic and abdominal activity. This allows more flexibility for the monitoring of patients at home and in the hospital, with detection of patient ventilator asynchrony (PVA). Decreasing PVA may improve ventilator adherence and increased ventilator usage improves survival. We report three cases of patients undergoing overnight monitoring with the Vivo 45™, highlighting the benefit of ventilator integrated polygraphy. In our three cases we demonstrate a simple safe tool to optimize NIV treatment over one or two-night recordings using ventilator downloaded software with the addition of effort belts and pulse oximetry without involving more than one machine and without hospitalization in a sleep unit.

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Background: Physicians appear to be particularly vulnerable to burnout during the COVID-19 pandemic. This may have significant adverse consequences for workers' well-being and health. The relationship between burnout and gastrointestinal (GI) symptoms is not fully understood. Aim: We aimed to determine the prevalence rate of burnout among physicians and investigate its impact on gastrointestinal symptoms. Subjects and Methods: A cross-sectional study was carried out among physicians (n=167) in teaching hospitals in Ismailia city, Egypt. An interview questionnaire was used to collect data. The questionnaire assessed burnout syndrome using Maslach Burnout Inventory and assessed the GI symptoms through Gastrointestinal Symptom Rating Scale. Results: More than half of studied physicians (56.3%) exhibited burnout criteria, with a prevalence rate of 74.9%, 53.9%, 5and 2.1% for emotional exhaustion, depersonalization, and reduced professional accomplishment, respectively. Emotional exhaustion and depersonalization were identified as predictors of pain or discomfort in the upper abdomen, and nausea. Only emotional exhaustion was found to be a significant predictor of heartburn, bloating, and urgent need to have a bowel movement. While burnout had a significant association with the majority of upper and lower GI symptoms. Conclusion: Burnout is highly prevalent among physicians. Burnout dimensions have significant associations with GIT symptoms. Upper GI symptoms are influenced by burnout dimensions more than lower ones. These findings highlight the importance of implementing urgent interventions that minimize both burnout among physicians and the resulting physical consequences.

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