Indian Journal of Critical Care Medicine

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2024 | February | Volume 28 | Issue 2

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EDITORIAL

Palepu B Gopal

Lurking Danger: Emerging Evidence

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:2] [Pages No:93 - 94]

Keywords: Clostridium difficile-associated diarrhea, Fecal microbiota transplantation, Hematopoietic stem cell transplantation

   DOI: 10.5005/jp-journals-10071-24644  |  Open Access |  How to cite  | 

386

EDITORIAL

Justin A Gopaldas

Nurse Education in Care of Delirium: Achieving a Change from Transcription and Translation to Interpretation for Reduced Strain

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:2] [Pages No:95 - 96]

Keywords: Critical care nurses, Hyperactive delirium, Intensive care unit delirium, Knowledge on delirium, Machine learning, Nurse education, Strain index, Web-based instructional module

   DOI: 10.5005/jp-journals-10071-24650  |  Open Access |  How to cite  | 

217

EDITORIAL

Prashant Nasa, Nimisha A Majeed, Deven Juneja

Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury: Current Understanding and Therapeutic Options

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:3] [Pages No:97 - 99]

Keywords: Acute brain injury, Autonomic dysfunction, Autonomic instability, Autonomic storm, Brain injuries traumatic, Paroxysmal sympathetic hyperactivity

   DOI: 10.5005/jp-journals-10071-24647  |  Open Access |  How to cite  | 

399

EDITORIAL

Vaishali Solao

Acute on Chronic Liver Failure: Lessons from a Decade of EASL-CLIF Definition and Scoring Systems

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:3] [Pages No:100 - 102]

Keywords: 28-day mortality, 90-day mortality, Acute on chronic liver failure, Cirrhosis, CLIF-SOFA score, CLIF-C ACLF SCORE, CTP score, MELD, MELD-Na

   DOI: 10.5005/jp-journals-10071-24648  |  Open Access |  How to cite  | 

294

COMMENTARY

Arun Kumar, Rajani S Bhat, Raj K Mani

Terminal Extubation or Terminal Weaning: Is it Feasible in Indian Intensive Care Units?

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:3] [Pages No:103 - 105]

Keywords: End-of-life care, Terminal weaning, Terminal extubation

   DOI: 10.5005/jp-journals-10071-24631  |  Open Access |  How to cite  | 

Abstract

Terminal extubation (TE) and weaning have long been suggested as a modality of intervention when the continuation of mechanical ventilation is not expected to achieve its therapeutic aim and is merely prolonging the dying process. The decision, however, is complex considering limited evidence regarding the best practices and is often defied due to inherent ethical, legal, and medical dilemmas. The article attempts a brief overview of available literature on this subject and discusses its feasibility in Indian intensive care units (ICUs).

767

Original Article

Parikshit S Prayag, Sampada Ajeet Patwardhan, Preeti Shankarrao Ajapuje, Sameer Melinkeri, Harshal Gadhikar, Sachin Palnitkar, Ramya Simbasivam, Rasika Saheel Joshi, Abhijit Baheti, Urmi Sitanshu Sheth, Amrita Parikshit Prayag

Fecal Microbiota Transplantation for Clostridium difficile-associated Diarrhea in Hematopoietic Stem Cell Transplant Recipients: A Single-center Experience from a Tertiary Center in India

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:5] [Pages No:106 - 110]

Keywords: Clostridium difficile, Clostridium difficile-associated diarrhea, Fecal microbiota transplantation, Hematopoietic stem cell transplantation

   DOI: 10.5005/jp-journals-10071-24607  |  Open Access |  How to cite  | 

Abstract

Objectives: Fecal microbiota transplantation (FMT) is an emerging option for recurrent or refractory Clostridium difficile-associated diarrhea (CDAD). We describe a single-center experience of FMT in hematopoietic stem cell transplant (HSCT) recipients with CDAD in India. Methods: A prospective observational study of HSCT recipients with CDAD who received FMT in our center. Results: A total of 13 patients were included. All the patients were allogenic HSCT recipients; FMT was performed in seven patients due to refractory CDAD, in five patients due to the presence of both CDAD and graft vs host disease (GVHD), and in 1 patient due to recurrent CDAD. The approach to FMT was colonoscopic in 10 (77%) patients. Only one patient reported bacteremia and one patient had candidemia, both of which were unrelated to FMT. Of the 10 patients who had complete resolution of CDAD, only one patient presented with a recurrence of CDAD within 8 weeks post-FMT. Conclusion: This is the first study from India using FMT as a therapeutic modality for CDAD in the setting of HSCT. Here we demonstrate that FMT in India is an effective option, especially when patients have refractory CDAD, recurrent CDAD, or both GVHD and CDAD. Further studies should explore the efficacy and feasibility of FMT in India.

329

Original Article

Sinu Jose, Maneesha C Cyriac, Manju Dhandapani

Nurses' Knowledge and Subjective Strain in Delirium Care: Impact of a Web-based Instructional Module on Nurses Competence

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:9] [Pages No:111 - 119]

Keywords: Delirium, Emergency wards, Hyperactive delirium, Intensive care units, Nurses, Nurses knowledge about delirium, Subjective strain, Web-based instructional module

   DOI: 10.5005/jp-journals-10071-24626  |  Open Access |  How to cite  | 

Abstract

Background: Delirium, a prevalent condition among elderly individuals admitted to hospitals, particularly in intensive care settings, necessitates specialized medical intervention. The present study assessed the proficiency of nurses in the management of delirium and their subjective experience of stress while providing care for patients with delirium in emergency rooms and critical care units. Materials and methods: The study adopted a quantitative descriptive approach, utilizing standardized self-reporting measures that assessed the nurses’ expertise and perceived burden of care. A cohort of 86 nurses from a tertiary care hospital in North India participated in the study. Additionally, the impact of the web-based instructional module in enhancing the nurses’ knowledge in delirium management was assessed by one group pretest–posttest quasi-experimental study. Findings: The research revealed that nurses exhibited significant deficiencies in their knowledge, particularly in relation to the symptoms and causes of delirium. The most significant source of subjective stress was attributed to hyperactive delirium-associated behaviors, characterized by uncooperative and aggressive conduct. The utilization of the web-based instructional program significantly enhanced the comprehension of nurses about the management of delirium. Conclusion: This study revealed a significant knowledge gap among nurses in delirium management and emphasizes the considerable subjective stress, particularly in dealing with hyperactive delirium-associated behaviors. The positive impact of the web-based instructional program underscores its potential as a valuable tool for enhancing nurses’ knowledge and addressing these challenges in healthcare settings.

293

Original Article

Ritu Singh, Suruchi Ambasta, Prateek Singh Bais, Afzal Azim, Sanjeev Kumar, Bhawesh Upreti, Siddharth Singh, Prabhakar Mishra

Role of Gabapentin in Traumatic Brain Injury: A Prospective Comparative Study

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:6] [Pages No:120 - 125]

Keywords: Gabapentin, Paroxysmal sympathetic hyperactivity, Traumatic brain injury

   DOI: 10.5005/jp-journals-10071-24634  |  Open Access |  How to cite  | 

Abstract

Background: Traumatic brain injury (TBI) is a major cause of mortality among young individuals, accounting for 65% of deaths in road traffic accidents. Paroxysmal sympathetic hyperactivity (PSH) is a common syndrome associated with TBI. This study represents the first prospective investigation aimed at assessing the impact of gabapentin on TBI patients, focusing on the prevention of secondary brain injury and brain edema while enhancing the Glasgow Coma Scale (GCS). Materials and methods: The study was conducted from September 2019 to July 2021 after receiving ethical committee approval. It included adult ICU patients (≥18 years) with moderate and severe GCS. Patients below 18 years, death within 48 hours, non-consenting, pregnant females, and individuals allergic to gabapentin were excluded from the study. Patients were randomly allocated in two groups: study group received 300 mg of gabapentin orally twice daily and control group received multivitamin tablets twice daily. The treatment period spanned 2 weeks. Follow-up occurred in the ICU and continued for up to 3 months post-discharge, including telephonic conversations. Results: About 60 patients were involved for analysis. Significant differences were found in GCS change from admission to discharge, Glasgow Outcome Scale (GOS) at 30 and 90 days, PSH episodes, and sedation bolus per day. Glasgow Coma Scale change was 53% in the study group compared with 25% in the control group (p = 0.009). Mortality was significantly lower in the study group. Glasgow Outcome Scale change between 30 and 90 days showed a 25% improvement in cases and no change in controls (p = 0.001). Conclusion: This pioneering study underscores the potential of gabapentin in managing traumatic brain injuries.

361

Original Article

Gunda J Hareesh, Ramu Ramadoss

Clinical Profile, Short-term Prognostic Accuracies of CLIF-C ACLF Score and Serial CLIF-C OF Scores in Acute-on-chronic Liver Failure Patients: A Prospective Observational Study

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:8] [Pages No:126 - 133]

Keywords: Cirrhosis, CTP score, EASL, MELD, MELD-Na, 28-day mortality, 90-day mortality

   DOI: 10.5005/jp-journals-10071-24640  |  Open Access |  How to cite  | 

Abstract

Background: Acute-on-chronic liver failure (ACLF) is a recently defined entity that carries high short-term mortality. The European Association for Study of Liver (EASL) has given a different definition for ACLF and derived two scores called Chronic Liver Failure-Consortium Organ Failure (CLIF-C OF) and CLIF-C ACLF to diagnose and predict the short-term outcome, respectively. Materials and methods: This was the prospective observational study, included 40 ACLF patients diagnosed as per the EASL definition and calculated CLIF-C ACLF as well as other scores (CTP, MELD, MELD-Na, CLIF-C OF) on admission. Serial CLIF-C OF scores were also calculated (Day 3 and Day 7). The 28-day and 90-day mortality was recorded. Results: Alcohol was the predominant etiology of cirrhosis (32 patients—80%). Infection was the chief precipitating factor in 19 patients (47.5%). The 28-day and 90-day mortality was 45% and 52.5%. Mean (SD) of CLIF-C ACLF scores of survivors and non-survivors on Day-90 were 44.11(6.62) and 53.86 (7.83). The prognostic accuracy of the CLIF-C ACLF score (Area Under Receiver Operating Characteristic Curve—AUROC) to predict 28-day and 90-day mortality was 0.86 and 0.84, respectively. MELD-Na and CLIF-C ACLF scores had higher AUROC for predicting 28-day and 90-day mortality, respectively. The AUROC of the CLIF-C OF score on Day 3 was found to be higher than the values of Day 1 and Day 7, but it was not statistically significant. Conclusion: CLIF-C ACLF has good short-term prognostic accuracy and it is as good as other available scores. Serial CLIF-C OF scores were equally good in predicting in short-term mortality.

Supplementary Files

236

Original Article

Pratibha Todur, Anitha Nileshwar, Souvik Chaudhuri, Vishal Shanbhag, Celine Cherisma

Changes in Driving Pressure vs Oxygenation as Predictor of Mortality in Moderate to Severe Acute Respiratory Distress Syndrome Patients Receiving Prone Position Ventilation

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:7] [Pages No:134 - 140]

Keywords: Acute respiratory distress syndrome, Driving pressure, Mortality, Prone position ventilation

   DOI: 10.5005/jp-journals-10071-24643  |  Open Access |  How to cite  | 

Abstract

Background: Prone position ventilation (PPV) causes improvement in oxygenation, nevertheless, mortality in severe acute respiratory distress syndrome (ARDS) remains high. The changes in the driving pressure (DP) and its role in predicting mortality in moderate to severe ARDS patients receiving PPV is unexplored. Methods: A prospective observational study, conducted between September 2020 and February 2023 on moderate-severe ARDS patients requiring PPV. The values of DP and oxygenation (ratio of partial pressure of arterial oxygen to fraction of inspired oxygen [PaO2/FiO2]) before, during, and after PPV were recorded. The aim was to compare the DP and oxygenation before, during and after PPV sessions among moderate- severe ARDS patients, and determine the best predictor of mortality. Results: Total of 52 patients were included; 28-day mortality was 57%. Among the survivors, DP prior to PPV as compared to post-PPV session reduced significantly, from 16.36 ± 2.57 cmH2O to 13.91 ± 1.74 cmH2O (p-value < 0.001), whereas DP did not reduce in the non-survivors (19.43 ± 3.16 to 19.70 ± 3.15 cmH2O (p-value = 0.318)]. Significant improvement in PaO2/FiO2 before PPV to post-PPV among both the survivors [92.75 [67.5–117.75]) to [205.50 (116.25–244.50)], (p-value < 0.001) and also among the non-survivors [87.90 (67.75–100.75)] to [112 (88.00–146.50)], (p-value < 0.001) was noted. Logistic regression analysis showed DP after PPV session as best predictor of mortality (p-value = 0.044) and its AUROC to predict mortality was 0.939, cut-off ≥16 cmH2O, 90% sensitivity, 82% specificity. The Kaplan–Meier curve of DP after PPV ≥16 cmH2O and <16 cmH2O was significant (Log-rank Mantel-Cox p-value < 0.001). Conclusion: Prone position ventilation-induced decrease in DP is prognostic marker of survival than the increase in PaO2/FiO2. There is a primacy of DP, rather than oxygenation, in predicting mortality in moderate-severe ARDS. Post-PPV session DP ≥16 cmH2O was an independent predictor of mortality.

296

Original Article

Avanish Jha, Darpanarayan Hazra, Bijesh Yadav, Anand Zachariah, Reginald Alex

Prognostication and Prediction of Outcomes in Patients with Organophosphorus and Carbamate Poisoning: A Prospective Cohort Study

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:7] [Pages No:141 - 147]

Keywords: Acetylcholinesterase, Carbamate poisoning, ChE check mobile, Organophosphorus poisoning, Pseudocholinesterase, RBC cholinesterase

   DOI: 10.5005/jp-journals-10071-24617  |  Open Access |  How to cite  | 

Abstract

Background: Organophosphorus (OP) and carbamate poisoning are significant concerns in developing nations. This study evaluates the effectiveness of the ChE check mobile, a cholinesterase-rapid bedside diagnostic test, in the diagnosis and management of OP and carbamate poisoning. Materials and methods: We conducted this prospective observational study, involving patients with OP and carbamate poisoning over 1 year (June 2016 to June 2017) at a single tertiary care center. Levels of RBC cholinesterase (E-AChE), butyl cholinesterase (BChE), and various other determinants were systematically coded and analyzed. Results: The study population (n = 60) consisted primarily of males (n = 43; 71.7%), with a mean age of 30.6 (SD: 13.7) years. Monocrotophos (n = 10; 20.4%) and carbofuran (n = 4; 8.1%) were the commonest OP and carbamate compounds, respectively. The median initial atropinization dose was 10 (IQR: 0, 61.5) mg, with a median total administered atropine dose of 116 (IQR: 32, 320) mg. A significant negative correlation was found between E-AChE levels and both the initial atropinization dose (ρ: –0.653, p-value < 0.001) and total atropine requirement (ρ: –0.659, p-value < 0.001) during admission. An E-AChE cut-off of 4 units/g hemoglobin provided an area under the curve of 0.73 (sensitivity: 80.0%, specificity: 68.6%, p-value < 0.001) for predicting moderate to severe peradeniya organophosphorus poisoning. Conclusion: The check mobile device can be a valuable tool for prognosticating patients. There was a significant correlation between low E-AChE levels and the atropine requirement and severity.

244

Original Article

Ashok Reddy, Fawaz Poonthottathil, Rani Jonnakuti, Roney Thomas

Efficacy of the Canadian CT Head Rule in Patients Presenting to the Emergency Department with Minor Head Injury

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:4] [Pages No:148 - 151]

Keywords: Canadian CT head rule, Efficacy, Emergency medicine, Minor head injuries

   DOI: 10.5005/jp-journals-10071-24620  |  Open Access |  How to cite  | 

Abstract

Introduction: Approximately, one in three computed tomography (CT) scans performed for head injury may be avoidable. We evaluate the efficacy of the Canadian CT head rule (CCHR) on head CT imaging in minor head injury (MHI) and its association of Glasgow Coma Scale (GCS) and structural abnormality. Materials and methods: We conducted a prospective cross-sectional study from May 2018 to October 2019 in the Department of Emergency Medicine, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala. The CCHR is applied to patients with MHIs (GCS 13–15) after initial stabilization and it is ascertained, if they require a non-contrast CT head and imaging is done. For those who do not require CT head as per the CCHR are excluded from this study. After imaging the patients who have a positive finding on CT head are admitted and followed up if they underwent any neurosurgical intervention, those with no findings in CT head are discharged from the hospital. A total of 203 patients were included during study period. Results: A total of 203 patients were included in study with mean age of 49.5 years. Approximately, 70% (142) were male. Sensitivity of CCHR for predicting positive CT finding in the present study sample was 68% and specificity was 42.5%. Conclusion: Canadian CT head rule is a useful tool in the Emergency Department for predicting the requirement of CT in patients with MHI. Canadian CT head rule can reduce the number of CT scans ordered following MHI in ED, thus improving the healthcare costs.

196

Original Article

Vaibhav R Suryawanshi, Atmaram Pawar, Bharat Purandare, Niveda Vijayvargiya, Sandesh Sancheti, Susan Philip, Prasad Nagare

Microbial Profile, Antimicrobial Susceptibility, and Prevalence of MDR/XDR Pathogens Causing Medical Device Associated Infections: A Single Center Study

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:13] [Pages No:152 - 164]

Keywords: Antimicrobial susceptibility, Medical device-associated infections, MDR/XDR, Microbial profile

   DOI: 10.5005/jp-journals-10071-24623  |  Open Access |  How to cite  | 

Abstract

Background: There is a scarcity of studies evaluating the microbial profile, antimicrobial susceptibility, and prevalence of MDR/XDR pathogens causing medical device-associated infections (MDAIs). The present study was sought in this regard. Materials and methods: An ambispective-observational, site-specific, surveillance-based study was performed for a period of 2 years in the intensive care unit (ICU) and high dependency unit (HDU) (medicine/surgery) of a Tertiary-care University Hospital. Three commonly encountered MDAIs including central-line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and ventilator-associated pneumonia (VAP), were targeted. Results and conclusion: Of the total 90 patients, 46 (51.1%) were admitted to the ICU (medicine/surgery), and the remaining 44 (48.8%) were admitted to the HDU (medicine/surgery). The median (P25–P75) age of the total patients was 55 (43.1–62.3) years. Male 61 (67.8%) preponderance was observed. Sixty-two of 90 (68.9%) were immunocompromised. A total of 104 pathogens causing MDAIs were isolated. Staphylococcus epidermidis (CoNS), and Staphylococcus capitis were commonly isolated multi-drug resistant (MDR) gram-positive pathogens causing MDAIs. Similarly, carba-resistant Klebsiella pneumoniae, Stenotrophomonas maltophilia, and carba-resistant Acinetobacter baumanni were commonly isolated MDR gram-negative pathogens causing MDAIs. Five of 9 (55.5%) K. pneumoniae and three of 9 (33.3%) S. maltophilia isolates were found to be extensively drug resistant. Among Candida, C. parapsilosis was the most prevalent fungal pathogen causing CLABSI and CAUTI in patients admitted to ICU/HDU.

335

Original Article

Mayank Rajpal, Vandana Talwar, Bhavya Krishna, Saurav Mitra Mustafi

Assessment of Extravascular Lung Water Using Lung Ultrasound in Critically Ill Patients Admitted to Intensive Care Unit

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:5] [Pages No:165 - 169]

Keywords: B-lines, Bedside lung ultrasound, Extravascular lung water, Intensive care unit, Learning ultrasound in critical care, Ultrasound

   DOI: 10.5005/jp-journals-10071-24635  |  Open Access |  How to cite  | 

Abstract

Background: Lung ultrasound (LUS) is a simple bedside tool to assess overhydration. Our study aimed to assess extravascular lung water (EVLW) using B-lines and correlate it with weaning, duration of mechanical ventilation, and mortality in critically ill patients admitted to the intensive care unit (ICU). Patients and methods: 150 mechanically ventilated ICU patients prospectively observed over 18 months, with their demographic and clinical data noted. Extravascular lung water was monitored using LUS in four intercostal spaces (ICS) from day 1 to day 5, day 7, day 10, and weekly thereafter. Pulmonary fluid burden was graded as low (1–10), moderate (11–20), and high (21–32). Weaning outcome, duration of weaning, mechanical ventilation, ICU stay, and mortality were compared in patients with and without EVLW. Results: Out of 150, 54 patients (36.0%) had EVLW. The mean lung score amongst our patients was 8.57 ± 6.0. The mean time for detection of EVLW was 1.43 ± 2.24 days. Lung score was low in 40 (26.67%) patients, moderate in 9 (6.00%) patients, and high in 5 (3.33%) patients. Incidence of weaning failure (p-value = 0.006), duration of weaning, mechanical ventilation, ICU stay (p-value < 0.0001 each), and overall mortality were significantly higher in patients with EVLW (p-value = 0.006). Conclusion: We conclude that a good proportion of critically ill patients have EVLW. Extravascular lung water significantly increases the duration of weaning, mechanical ventilation days, ICU stay, and overall mortality in critically ill patients.

320

Original Article

Shreyas S Walvekar, Vaishali R Mohite

Tracking Health Beyond Recovery: A Study on Identifying Post-COVID Syndrome Symptoms

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:5] [Pages No:170 - 174]

Keywords: COVID-19, Persistent symptoms, Post-COVID syndrome, Symptoms persistence after COVID-19

   DOI: 10.5005/jp-journals-10071-24641  |  Open Access |  How to cite  | 

Abstract

Context: The COVID-19 pandemic had a profound global impact, leaving a lasting legacy in the form of post-COVID syndrome. This condition, experienced after recovering from the virus, manifests in symptoms, such as fatigue, cough, shortness of breath, joint pain, and brain fog, highlighting the virus's lingering influence on the human body. Aim: To Identify post-COVID syndrome symptoms among COVID-19 recovered patients from Karad Taluka. Materials and methods: A study involving 228 COVID-19-recovered individuals from a Karad tertiary care hospital used consecutive sampling. Data were collected via structured questionnaires, focused on post-COVID syndrome symptoms. Statistical analysis used: Frequency and percentage were used to analyze the presence of post-COVID syndrome symptoms. Results: A total of 228 COVID-19-recovered individuals were included in the study, of whom 53% were male and 47% were female. Most of the study subjects had 25 (10.9%) mild, 138 (60.5%) moderate, and 65 (28.5%) severe symptoms. Symptom-wise, the majority of the subjects experienced symptoms: fatigue 116 (50.8% moderate), shortness of breath 135 (58.3% moderate), cough 116 (50.8%), sore throat 115 (50.4% mild), chest pain (57% mild), joint pain 151 (66.2% severe), brain fog 103 (45% severe). Most (43%) experienced symptoms for 12 months, that is, 1 year. Conclusion: The results depict the recovered individuals continue to experience symptoms. The most common symptoms are fatigue, shortness of breath, and cough in varied severity (from mild, moderate, and severe).

209

LETTER TO THE EDITOR

Snehangsh Dash, Suresh Pandalanghat, Yogesh Kumar

An Unusual Case of Hoarseness of Voice and Dysphagia in Multiple Myeloma with Amyloidosis

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:2] [Pages No:175 - 176]

Keywords: Amyloidosis, Dysphagia, Hoarseness of voice, Multiple myeloma

   DOI: 10.5005/jp-journals-10071-24613  |  Open Access |  How to cite  | 

195

LETTER TO THE EDITOR

Rohan Magoon, Anupama Gill Sharma, Nidhi Yadav, Nang Sujali Choupoo

Hemodynamics: Strangers to Lung-kidney Crosstalk in ARDS?

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:2] [Pages No:177 - 178]

Keywords: Acute kidney injury, Acute respiratory distress syndrome, Hemodynamic, Lung-kidney crosstalk, Vasopressors

   DOI: 10.5005/jp-journals-10071-24581  |  Open Access |  How to cite  | 

213

LETTER TO THE EDITOR

Pratibha Todur, Souvik Chaudhuri

Author Response

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:2] [Pages No:179 - 180]

Keywords: Acute kidney injury, Acute respiratory distress syndrome, DRONE score, Subphenotypes

   DOI: 10.5005/jp-journals-10071-24608  |  Open Access |  How to cite  | 

164

LETTER TO THE EDITOR

Josef Finsterer, Fulvio A Scorza

Calibration of Prediction Models of In-hospital Mortality in SARS-CoV-2 Patients Depends also on Data Quality

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:2] [Pages No:181 - 182]

Keywords: Corona virus disease-19, Emergency department, Mortality, Outcome, Severe acute respiratory syndrome-corona virus-2, Scores

   DOI: 10.5005/jp-journals-10071-24564  |  Open Access |  How to cite  | 

194

LETTER TO THE EDITOR

Zahra Rahmatinejad, Benyamin Hoseini, Ali Pourmand, Hamidreza Reihani, Fatemeh Rahmatinejad, Saeid Eslami, Ameen Abu Hanna

Author Response

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:2] [Pages No:183 - 184]

Keywords: COVID-19, Emergency department, Mortality prediction, Performance measures, Scoring systems

   DOI: 10.5005/jp-journals-10071-24609  |  Open Access |  How to cite  | 

198

LETTER TO THE EDITOR

Varun Suresh, Rohan Magoon

Post-cardiac Surgery Delirium: When the Details Matter!

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:3] [Pages No:185 - 187]

Keywords: Cardiac surgery, Cognition, Delirium, Melatonin

   DOI: 10.5005/jp-journals-10071-24606  |  Open Access |  How to cite  | 

216

LETTER TO THE EDITOR

Subhrashis Guha Niyogi, Chandrima Naskar, Avneet Singh, Bhupesh Kumar, Sandeep Grover

Author Response

[Year:2024] [Month:February] [Volume:28] [Number:2] [Pages:1] [Pages No:188 - 188]

Keywords: Cognitive dysfunction, Delirium, Melatonin, Post-cardiac surgery

   DOI: 10.5005/jp-journals-10071-24619  |  Open Access |  How to cite  | 

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