Evaluation of Diurnal Changes of Mental Fatigue Using a New Portable Device for Visual Cognitive Evoked Potentials.

In the age homogenous group of 13 healthy volunteers, we examined visual evoked potentials (VEP) visually evoked cognitive potentials (event-related potentials - ERP) and choice reaction time (CRT) five times during the day (from 10.00 a.m. up to midnight) to verify whether there are significant changes of the measured parameters of the cortical evoked potentials and CRT which might reflect the level of the mental fatigue. The electrophysiological testing was done with the use of a new portable VEP device named "VEPpeak" enabling to perform the examination outside standard labs in almost any conditions. It was found that the latency of ERP (P300 peak time) and CRT displayed significant prolongation toward midnight while VEP latency and all amplitudes did not change significantly. This pilot study supports our idea that the portable VEP device possibly might be used for the objective examination of mental fatigue that is needed in many situations. This should be confirmed in a larger study also including a comparison with non-electrophysiological fatigue testing.

Endothelial glycocalyx damage in patients with severe COVID-19 on mechanical ventilation - A prospective observational pilot study.

BACKGROUND: Coronavirus disease (COVID-19) associated endotheliopathy and microvascular dysfunction are of concern. OBJECTIVE: The objective of the present single-center observational pilot study was to compare endothelial glycocalyx (EG) damage and endotheliopathy in patients with severe COVID-19 (COVID-19 group) with patients with bacterial pneumonia with septic shock (non-COVID group). METHODS: Biomarkers of EG damage (syndecan-1), endothelial cells (EC) damage (thrombomodulin), and activation (P-selectin) were measured in blood on three consecutive days from admission to the intensive care unit (ICU). The sublingual microcirculation was studied by Side-stream Dark Field (SDF) imaging with automatic assessment. RESULTS: We enrolled 13 patients in the non-COVID group (mean age 70 years, 6 women), and 15 in the COVID-19 group (64 years old, 3 women). The plasma concentrations of syndecan-1 were significantly higher in the COVID-19 group during all three days. Differences regarding other biomarkers were not statistically significant. The assessment of the sublingual microcirculation showed improvement on Day 2 in the COVID-19 group. Plasma levels of C-reactive protein (CRP) were significantly higher on the first two days in the COVID-19 group. Plasma syndecan-1 and CRP were higher in patients suffering from severe COVID-19 pneumonia compared to bacterial pneumonia patients. CONCLUSIONS: These findings support the role of EG injury in the microvascular dysfunction in COVID-19 patients who require ICU.