Indian Journal of Critical Care Medicine

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2019 | January | Volume 23 | Issue 1

ORIGINAL ARTICLE

Epidemiology of Multidrug Resistant Infections after Inter ICU Transfer in India

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:6] [Pages No:1 - 6]

Keywords: Inter ICU transfer,MDR organisms,Non MDR organisms

PDF  |  DOI: 10.5005/jp-journals-10071-23103  |  Open Access |  How to cite  | 

Abstract

The patients in the intensive care unit (ICU) are often infected with multi-drug resistant (MDR) organisms. When they are transferred to other ICUs, they can expand the reservoir of MDR organisms and pose a threat to the infection control programme. The present observational study was undertaken to describe the epidemiology and compare the outcome of MDR and non-MDR infections after inter ICU patient transfer.

ORIGINAL ARTICLE

Audit of Antibiotic Practices: An Experience from a Tertiary Referral Centre

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:4] [Pages No:7 - 10]

Keywords: Audit,Antibiotic,De-Escalation

PDF  |  DOI: 10.5005/jp-journals-10071-23104  |  Open Access |  How to cite  | 

Abstract

To estimate the prevalence of antibiotic de-escalation at admission in patients referred to a tertiary hospital in India. The secondary outcomes were the adequacy of empirical antibiotic therapy and culture positivity rates in the de-escalated group.

ORIGINAL ARTICLE

Role of C-reactive Protein as an Indicator for Determining the Outcome of Sepsis

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:4] [Pages No:11 - 14]

Keywords: C-reactive protein,Sepsis,Sequential organ failure assessment score

PDF  |  DOI: 10.5005/jp-journals-10071-23105  |  Open Access |  How to cite  | 

Abstract

It has been observed that after any injury which is acute and also in the setting of inflammation or infection, the synthesis and secretion of C-reactive protein (CRP) rises within a few hours. The current study monitors CRP in patients presenting with sepsis and attempts to prove that it is one of the most reliable tests in determining the resolution and predicting the outcome.

ORIGINAL ARTICLE

Prospective Observational Study on Evaluation of Cardiac Dysfunction Induced during the Weaning Process

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:5] [Pages No:15 - 19]

Keywords: Cardiac dysfunction,Doppler echocardiography,PS-PEEP,Spontaneous breathing trial,Weaning

PDF  |  DOI: 10.5005/jp-journals-10071-23106  |  Open Access |  How to cite  | 

Abstract

Context: Weaning induced cardiac dysfunction can occur without underlying heart disease. Changes in intrathoracic pressure, systemic vascular resistance, preload and afterload leading to heart-lung interactions are the possible explanatory mechanisms

Aims: The aim of the current study was whether the assessment and identification of cardiac dysfunction induced during the weaning process could predict the outcome of extubation.

ORIGINAL ARTICLE

Long Term Survival and Functional Neurological Outcome in Conscious Hospital Survivors Undergoing Therapeutic Hypothermia

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:7] [Pages No:20 - 26]

Keywords: Disability rating scale,Functional neurological outcome,Long-term survival,Post-cardiac arrest,Therapeutic hypothermia

PDF  |  DOI: 10.5005/jp-journals-10071-23107  |  Open Access |  How to cite  | 

Abstract

Therapeutic hypothermia (TH) is the neuroprotective strategy for comatose survivors of cardiac arrest. It improves neurological outcomes at hospital discharge. However, data regarding long-term outcomes are limited. We aimed to study functional ability and survival of the patients after discharge.

ORIGINAL ARTICLE

Time to Detection of Yeast Isolates in Pediatric and Adult Patients with Fungemia and its Relevance to Clinical Profile and Outcome

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:4] [Pages No:27 - 30]

Keywords: Continuous monitoring automated blood culture systems,Time to detection,Yeast

PDF  |  DOI: 10.5005/jp-journals-10071-23108  |  Open Access |  How to cite  | 

Abstract

Context: Time to detection (TTD) given by continuous monitoring automated blood culture systems (CMABS) have been found to be a predictor of clinical outcome, drug resistance and type of microorganism in cases of bacteremia but the studies evaluating TTD with respect to fungemia are scarce especially from India.

Aims: To evaluate TTD for yeast isolates in fungal bloodstream infections with respect to the type of yeast isolates, risk factors and outcome and to study yeast susceptibility and distribution of yeast isolates with respect to patient population.

ORIGINAL ARTICLE

Effect of Using Eye Masks and Earplugs on the Risk of Post-traumatic Stress Disorder Development in Patients Admitted to Cardiac Surgery Intensive Care Units

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:4] [Pages No:31 - 34]

Keywords: Ccritically ill patient,Incidence risk,Intensive care unit,Post-traumatic stress disorder,Psychological disorders

PDF  |  DOI: 10.5005/jp-journals-10071-23109  |  Open Access |  How to cite  | 

Abstract

Context: Critically ill patients are at risk of post-traumatic stress disorder development.

Aim: The purpose of this study was to investigate the effect of using eye masks and earplugs on the risk of post-traumatic stress disorder development in patients admitted to cardiac surgery intensive care units.

ORIGINAL ARTICLE

Interchangeability of Sodium and Potassium Result Values of Arterial Blood Gas with Laboratory Analyzer: Narrative Review

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:8] [Pages No:35 - 42]

Keywords: Analyser,Ion-selective electrode,Potassium,Sodium

PDF  |  DOI: 10.5005/jp-journals-10071-23110  |  Open Access |  How to cite  | 

Abstract

The major extracellular electrolytes, sodium, and potassium are often requested together and form a large percentage of the requested tests in routine clinical chemistry laboratories. Two types of devices that use direct and indirect ion-selective electrode (ISE) methods are used in hospitals for electrolyte measurements: blood gas analyzers (BGA), which use direct ISE technology, and the indirect ISE method, which is often used in a central-laboratory autoanalyzer (AA).

We aimed to summarize the current scientific knowledge based on whether the electrolyte test results, using Na and K test results obtained with BGA and an AA, can be used interchangeably.

We searched Medline (PubMed), Google Scholar, and Web of Science up to 31st March 2018. In addition, references of the included studies were also examined.

Fourteen studies with a risk of bias were included in the analysis. Limits of agreement differences were variable among BGA and AA sodium and potassium test results in clinical practice.

The results of both BGA and AA measures should not be used interchangeably under the assumption that they are equivalent to each other.

ORIGINAL ARTICLE

Incidence of Deep Vein Thrombosis in Neurointensive Care Unit Patients–Does Prophylaxis Modality Makes Any Difference?

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:4] [Pages No:43 - 46]

Keywords: Deep vein thrombosis,Heparin,Intracranial malignancy,Neurocritical care,Thromboprophylaxis

PDF  |  DOI: 10.5005/jp-journals-10071-23111  |  Open Access |  How to cite  | 

Abstract

To determine the incidence of upper and lower limb deep vein thrombosis (DVT) using ultrasonography (USG) in adult patients admitted to neuro-medical and neurosurgical intensive care unit (ICU).

BRIEF COMMUNICATION

Life-threatening Episodes of Malignant Hyperthermia Following Halothane Anesthesia in Three Children: A Case Series and Review of Literature

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:4] [Pages No:47 - 50]

Keywords: Anaesthesia,Dantrolene,Halothane,Malignant hyperthermia,Ryanodine receptor

PDF  |  DOI: 10.5005/jp-journals-10071-23112  |  Open Access |  How to cite  | 

Abstract

Malignant hyperthermia (MH) is an inherited, pharmacogenetic disorder of the skeletal muscle, characterized by dangerous hypermetabolic state after anaesthesia with succinylcholine and/ or volatile halogenated anesthetic agents, clinically manifested as hyperpyrexia and related complications like tachycardia, tachypnoea, increased carbon dioxide production, increased oxygen consumption, acidosis, rigid muscles, rhabdomyolysis and disseminated intravascular coagulation (DIC). Here we present a series of three cases of MH, admitted in our hospital in a span of 8 months for three different operative procedures to be done under general anaesthesia (Cleft lip repair, Duhamel’s operation for Hirschsprung’s disease and surgical repair of development dysplasia of hip), who developed probable hyperthermia owing to Halothane being used as an anaesthetic agent.

CASE REPORT

A Mysterious Case of Spontaneous Cervical Epidural Hematoma and Bilateral Primary Spontaneous Pneumothorax Caused by a Rare Etiology

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:3] [Pages No:51 - 53]

Keywords: Primary spontaneous pneumothorax,Spontaneous spinal epidural hematoma,Vasculopathy

PDF  |  DOI: 10.5005/jp-journals-10071-23113  |  Open Access |  How to cite  | 

Abstract

Spontaneous spinal epidural hematoma (SSEH) is a rare disorder that can present as an acute onset of pain and radicular symptoms that mimic disc herniation. Primary spontaneous pneumothorax (PSP) can be defined as the presence of air in the pleural space without apparent underlying lung disease or trauma. We describe a rare case of SSEH in the cervical spine (C5-7) presenting with a novel association, a bilateral PSP, which has never been documented before. Both SSEH and spontaneous pneumothorax, though rare, can be associated with vasculopathy and our patient had signs of vasculopathy of intracranial vessels and pulmonary vasculature. Vasculopathy also needs to be considered while evaluating a case of PSP without emphysema-like changes (ELC) and if diagnosed as the cause, pleurodesis could be considered as a part of the management to avoid the sequel of recurrent pneumothorax and prolonged ICU stay in this subset of patients.

CASE REPORT

Post-traumatic Anterior Cerebral Artery Rupture After a Severe Traumatic Brain Injury

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:2] [Pages No:54 - 55]

Keywords: Anterior cerebral artery,Blunt cerebrovascular injury,Traumatic brain injury

PDF  |  DOI: 10.5005/jp-journals-10071-23114  |  Open Access |  How to cite  | 

Abstract

Blunt cerebrovascular injuries (BCVI) have been increasingly recognized in the past decade due to the initiation of different screening protocols. We present the case of an anterior cerebral artery rupture with free contrast extravasation following a severe traumatic brain injury. Epidemiology, modalities of screening and treatment of BCVI are discussed. This report reminds that the screening of BCVI may be essential after a severe TBI.

LETTERS TO THE EDITOR

Role of Domiciliary Noninvasive Ventilation in Chronic Obstructive Pulmonary Disease Patients Requiring Repeated Admissions with Acute Type II Respiratory Failure: A Prospective Cohort Study

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:2] [Pages No:56 - 57]

PDF  |  DOI: 10.5005/jp-journals-10071-23115  |  Open Access |  How to cite  | 

LETTERS TO THE EDITOR

Snake Tooth in the Finger!

[Year:2019] [Month:January] [Volume:23] [Number:1] [Pages:1] [Pages No:58 - 58]

Keywords: Envenomation,Non-venomous snakes,Retained snake tooth

PDF  |  DOI: 10.5005/jp-journals-10071-23116  |  Open Access |  How to cite  | 

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