Indian Journal of Critical Care Medicine

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2019 | September | Volume 23 | Issue S3

EDITORIAL

Success is the Sum of Small Efforts!

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/jp-journals-10071-23245  |  Open Access |  How to cite  | 

INVITED ARTICLE

Pratik Tantia

Physiology of Oxygen Transport and its Determinants in Intensive Care Unit

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

Keywords: Arterial blood gas analysis, Hemoglobin, Hyperbaric oxygen therapy, Hypoxia, Oxygen saturation, Pulse oximetry

PDF  |  DOI: 10.5005/jp-journals-10071-23246  |  Open Access |  How to cite  | 

Abstract

Transport of oxygen is one of the most important functions of blood. How oxygen moves from the air, where its partial pressure is about 150 mm Hg to mitochondria, where it drops down to a single digit is an evolutionary marvel. In this article, we discuss the physiology of oxygen transport from the alveoli to the tissue, the alveolar gas equation and the oxyhemoglobin dissociation curve. In the applied physiology section, we discuss the impact of high altitude, hyperbaric conditions, carbon monoxide poisoning on the transport of oxygen. Some common pitfalls in the interpretation of pulse oximetry and arterial blood gas are also discussed. Finally, we talk about the methods of increasing oxygen delivery, the compensation for hypoxia and some indications of venous oxygen saturation measurement.

INVITED ARTICLE

Approach to an Anemic Critically Ill Patient

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/jp-journals-10071-23247  |  Open Access |  How to cite  | 

INVITED ARTICLE

Jose Chacko, Gagan Brar

Red Blood Cell Transfusion Thresholds in Critically Ill Patients

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

Keywords: Anemia, Blood transfusion, Critical illness, Hemoglobin

PDF  |  DOI: 10.5005/jp-journals-10071-23248  |  Open Access |  How to cite  | 

Abstract

Anemia of multifactorial etiology is common among critically ill patients and several arbitrary transfusion thresholds have been proposed. Transfusion of red blood cells has been well established to increase morbidity and even mortality among critically ill patients. Several randomized controlled studies have evaluated the use of a restrictive compared to a more liberal transfusion strategy in the critically ill. A transfusion threshold of 7 g/dL appears to be generally safe, especially in the younger age group without significant comorbidities. Besides, a restrictive transfusion strategy reduces the incidence of transfusion-related complications. However, the decision to transfuse needs to be individualized depending on the clinical situation, balancing putative benefits against possible complications.

INVITED ARTICLE

Thrombocytopenia in Intensive Care Unit

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/jp-journals-10071-23249  |  Open Access |  How to cite  | 

INVITED ARTICLE

Sunil Karanth

Transfusion Triggers for Platelets and Other Blood Products

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/jp-journals-10071-23250  |  Open Access |  How to cite  | 

INVITED ARTICLE

Bindiya Salunke, Sukhada Savarkar

Hemophagocytic Syndrome—An Approach to the Management

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/jp-journals-10071-23251  |  Open Access |  How to cite  | 

INVITED ARTICLE

Clotting Catastrophies in the Intensive Care Unit

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

Keywords: Coagulopathy, Intensive Care Unit, Thrombotic microangiopathy

PDF  |  DOI: 10.5005/jp-journals-10071-23252  |  Open Access |  How to cite  | 

Abstract

Clotting catastrophies are rarely encountered challenges in the Intensive Care Unit (ICU) and their presentation and progress maybe devastating and fulminant. Dramatic onset and involvement of multiple vascular beds should alert the clinician to look for these disorders. Outcomes may be improved with rapid diagnosis and prompt institution of specific therapies and interdisciplinary liaison holds the key to success.

INVITED ARTICLE

Point-of-care Testing of Coagulation in Intensive Care Unit: Role of Thromboelastography

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/jp-journals-10071-23253  |  Open Access |  How to cite  | 

INVITED ARTICLE

Ruchira Wasudeo Khasne, Pradnya Atul Kulkarni

Landmark Papers on Blood and Component Transfusion Therapy in the Critically Ill: A Critical Analysis

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

Keywords: Acute coagulopathy of trauma, Blood transfusion, Coagulopathy, Fresh frozen plasma, Packed red blood cell

PDF  |  DOI: 10.5005/jp-journals-10071-23254  |  Open Access |  How to cite  | 

INVITED ARTICLE

How to Audit Transfusion Practices in the Intensive Care Unit?

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

Keywords: Audit, Blood transfusion, Guidelines

PDF  |  DOI: 10.5005/jp-journals-10071-23255  |  Open Access |  How to cite  | 

Abstract

Blood transfusions are one of the most commonly prescribed interventions in the critically ill patients. Apart from being a life saving intervention, they can also be associated with life threatening complications. Despite multiple trials and guidelines, there is a wide variability and lack of adherence to the guideline\'s. Auditing transfusion practices help us in introspecting and modifying our prescriptions as per the recommended standards.

INVITED ARTICLE

Approach to the Coagulopathic Patient in the Intensive Care Unit

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

Keywords: Bleeding and hemorrhage, Coagulation reversal, Coagulation tests, Coagulopathy, Factor concentrate, Fresh frozen plasma, Haemostasis, Recombinant coagulation products

PDF  |  DOI: 10.5005/jp-journals-10071-23256  |  Open Access |  How to cite  | 

Abstract

Key learning objectives: • Evaluating patients with coagulopathy in intensive care • Managing coagulopathy in intensive care • Understand the complications and limitations of various therapies

INVITED ARTICLE

John Victor Peter, Kandasamy Subramani

Reversal of Anticoagulants in Critical Care

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

Keywords: Anticoagulant, Critical care, Direct thrombin inhibitors, Protamine, Reversal, Vitamin K antagonists

PDF  |  DOI: 10.5005/jp-journals-10071-23257  |  Open Access |  How to cite  | 

Abstract

There has seen an increase in anticoagulant consumption worldwide over the past few decades. With this widespread utilization of anticoagulants, clinicians are increasingly likely to encounter situations where anticoagulants would need to be withheld. This includes emergency and elective procedures or surgeries as well as major or minor bleeding as a direct result of over anticoagulation or consequent to other intercurrent illnesses such as sepsis or trauma with multiorgan failure, where the anticoagulant may contribute to coagulation abnormalities. Clinicians are required to have a thorough understanding of the indications for anticoagulant prescription, drug interactions and monitoring, indications and options of reversal of anticoagulation and management of bleeding in the situations described above. Once the acute process is managed, the ongoing need and timing of reinitiation of anticoagulation is also crucial. This article provides an overview on the indications for reversal of anticoagulation, the agents used for reversal and the timing of reinitiation of anticoagulants.

INVITED ARTICLE

Saurabh Kumar Das, Maheeja Maddi Reddy

Hemostatic Agents in Critically Ill Patients

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/jp-journals-10071-23258  |  Open Access |  How to cite  | 

INVITED ARTICLE

CS Pramesh

An Introduction to Statistics: Understanding Hypothesis Testing and Statistical Errors

[Year:2019] [Month:September] [Volume:23] [Number:S3] [Pages:1] [Pages No:0 - 0]

Keywords: Biostatistics, Research design, Statistical bias

PDF  |  DOI: 10.5005/jp-journals-10071-23259  |  Open Access |  How to cite  | 

Abstract

The second article in this series on biostatistics covers the concepts of sample, population, research hypotheses and statistical errors.

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