International Journal of Critical Illness and Injury Science最新文献

{"title":"Cardiac dysfunction in patients of cirrhosis of the liver and its correlation with Child-Pugh score: A cross-sectional study at a tertiary care center in Northern India.","authors":"Suman Roy, Anubha Garg, Kashish Mittal, Ashwani Kumar","doi":"10.4103/ijciis.ijciis_31_25","DOIUrl":"10.4103/ijciis.ijciis_31_25","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic liver disease is the destruction and regeneration process of the liver parenchyma. Liver cirrhosis is associated with a wide range of cardiovascular abnormalities including hyperdynamic circulation, cirrhotic cardiomyopathy (CCM), and pulmonary vascular abnormalities. CCM was first defined in 2005 at the Montreal World Congress of Gastroenterology. It is considered a condition of latent heart failure that manifests only under stress, resulting in a blunted increase in cardiac output during exercise.</p><p><strong>Methods: </strong>A total of 100 cases as per the diagnostic criteria of liver cirrhosis were enrolled from the Department of General Medicine of PGIMS, Rohtak. The assessment of cardiac function was done in all the patients. Two-dimensional echocardiogram was done to find evidence of cardiomyopathy and electrocardiogram (ECG) was done to find QT-interval prolongation. Child Turcotte Pugh (CTP) score was calculated for severity. The cardiac dysfunction was compared to the seriousness of the CTP score.</p><p><strong>Results: </strong>In our study, 57% of patients showed diastolic dysfunction while systolic dysfunction was not seen in any case. Furthermore, 56% of the cases had prolonged QTc interval in ECG. Our study also shows that there is a definitive association between QTc prolongation and disease severity.</p><p><strong>Conclusion: </strong>CCM is considered an important predictor of morbidity and mortality. The left ventricular ejection fraction at rest is normal in CCM, but there is a blunted increase in cardiac index and cardiac output during exercise. This is difficult to identify because these symptoms are similar to fatigue and exercise intolerance commonly seen in cirrhotic patients.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"15 3","pages":"114-117"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of core to skin temperature gradient and capillary refill time in determining prognosis for patients with septic shock: A prospective observational study.","authors":"Sujeet Rai, Arti Goutam, Manoj Tripathi, Virendra Kumar, Deepak Malviya, Arvind Kumar Singh, Rajiv Ratan Singh Yadav","doi":"10.4103/ijciis.ijciis_35_25","DOIUrl":"10.4103/ijciis.ijciis_35_25","url":null,"abstract":"<p><strong>Introduction: </strong>Septic shock is characterized by heterogeneous microcirculatory alterations that may contribute to organ hypoperfusion and eventual death. The microcirculatory alteration can manifest in various clinical indicators, such as the core-to-skin temperature gradient (CSTG) and capillary refill time (CRT), reflecting the microcirculatory state. This prospective observational study explored the prognostic significance of the CSTG and CRT in septic shock.</p><p><strong>Methods: </strong>The study involved 54 patients over 18 months. The primary objective was to investigate the association between the CSTG measured using infrared thermography with an esophageal temperature probe and 8-day mortality in septic shock cases. Secondary objectives included comparing this gradient with CRT and assessing other parameters such as mean arterial pressure, arterial lactate values, urine output, vasopressor doses, and intensive care unit (ICU) length of stay.</p><p><strong>Results: </strong>The results indicated a meaningful correlation between the CSTG and 8-day mortality. The mean difference between CSTG was 1.21°C (0.65°C-1.77°C) higher in patients who died within 8 days of ICU admission than in those alive after 8 days of ICU admission. Notably, this temperature gradient demonstrated superior predictive capabilities compared to CRT, as at 6 h after admission, CRT of >4 s could predict 8-day mortality with a sensitivity of 25.6%. At the same time, CSTG of >7°C could predict 8-day mortality with a sensitivity of 87.2%.</p><p><strong>Conclusion: </strong>The CSTG is a robust predictor of 8-day mortality in septic shock with superior predictive capabilities compared to CRT.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"15 3","pages":"118-122"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of rapid emergency medicine score (REMS) and emergency trauma score (EMTRAS) against traditional trauma scoring systems-namely the injury severity score (ISS), new injury severity score (NISS), revised trauma score (RTS), and trauma and injury severity score (TRISS) in predicting trauma outcomes.","authors":"D G S R Krishna Moorthy, K Rajesh, K J Devendra Prasad","doi":"10.4103/ijciis.ijciis_8_25","DOIUrl":"10.4103/ijciis.ijciis_8_25","url":null,"abstract":"<p><strong>Introduction: </strong>Trauma scoring systems are essential for predicting outcomes in trauma patients, guiding clinical decisions, and optimizing resource allocation. Common systems include the Injury Severity Score (ISS), New ISS (NISS), Revised Trauma Score (RTS), Trauma and ISS (TRISS), Emergency Trauma Score (EMTRAS), and Rapid Emergency Medicine Score (REMS). This study aims to evaluate the predictive accuracy of REMS and EMTRAS in comparison to traditional trauma scoring systems.</p><p><strong>Methods: </strong>This prospective observational study involved 1090 trauma patients admitted to the Department of Emergency Medicine from January 2021 to December 2023. Eligible patients were aged 18 or older with documented trauma. Data collection encompassed demographics, clinical parameters, and trauma severity, assessed using six scoring systems. Outcomes were monitored until patient discharge or death.</p><p><strong>Results: </strong>The cohort consisted of 915 (83.9%) male patients with a mean age of 36.1 years. Road traffic accidents were the leading cause of trauma, 934 (85.6%). Intensive care unit patients exhibited higher ISS and lower RTS scores (<i>P</i> < 0.0001), indicating more severe injuries. Nonsurvivors showed higher ISS and NISS and lower RTS and TRISS scores. EMTRAS demonstrated higher sensitivity and specificity than REMS, while TRISS proved the most effective in predicting trauma outcomes.</p><p><strong>Conclusions: </strong>REMS and EMTRAS had reasonable sensitivity and specificity but were less effective than traditional systems such as ISS, NISS, RTS, and TRISS. TRISS emerged as the most reliable tool for predicting outcomes, supporting its continued use as the gold standard in trauma assessment.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"15 3","pages":"101-107"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High mobility group box 1 as a biomarker for lumbar disc herniation severity in chronic low back pain.","authors":"Rosa Dwi Wahyuni, Dachruddin Ngatimin, M Sabir, Adhar Arifuddin, A Fahira Nur, Abd Farid Lewa","doi":"10.4103/ijciis.ijciis_1_25","DOIUrl":"10.4103/ijciis.ijciis_1_25","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic low back pain (LBP) is a widespread condition that significantly affects daily life. High mobility group box 1 (HMGB1), a proinflammatory cytokine, may contribute to the pathophysiology of LBP, particularly in relation to nucleus pulposus herniation (NHP). This study aimed to examine the correlation between herniation severity and lumbosacral HMGB1 levels in chronic LBP patients.</p><p><strong>Methods: </strong>This analytical observational study with a cross-sectional design was conducted in 2023 at Anutapura General Hospital, Palu. A total of 64 chronic LBP patients participated. Serum HMGB1 levels were measured, and magnetic resonance imaging was used to assess herniation severity. Pain severity was evaluated using the Numeric Pain Rating Scale (NPRS).</p><p><strong>Results: </strong>The mean HMGB1 level was 4701 (±1001.88). LBP onset was most common between 4 and 12 months (mean duration: 11.52 ± 5.54 months), with pain more frequently located on the right side (59%). Grade 3 herniation occurred most often (59%), and moderate pain (NPRS score 6) was the most common. HMGB1 levels peaked in Grade 2 herniation (5939.10 ± 873.26). NPRS scores increased with herniation severity, but weak correlations were found between NHP and HMGB1 (<i>r</i> = 0.174) and between HMGB1 and NPRS (<i>r</i> = 0.114).</p><p><strong>Conclusions: </strong>No strong relationship was found between NHP and HMGB1 levels in chronic LBP patients. Further studies are needed to clarify HMGB1's role in LBP pathophysiology and its potential as a biomarker for disease severity or treatment response.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"15 2","pages":"66-73"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's new in critical illness and injury science? Enhancing anesthetic recovery - Evaluating the role of sugammadex in major abdominal surgeries.","authors":"Sekhar Jyoti Sharma","doi":"10.4103/ijciis.ijciis_67_25","DOIUrl":"10.4103/ijciis.ijciis_67_25","url":null,"abstract":"","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"15 2","pages":"49-50"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and microbiological perspectives on multidrug-resistant gram-negative pathogens in bloodstream infections.","authors":"Mohan Bilikallahalli Sannathimmappa, Chhaya Akshay Divecha, Reem Sulaiman Mohammed Al Balushi, Al-Shifa Khalifa Al-Saidi, Rajeev Aravindakshan, Vinod Nambiar, Elham Said Al-Risi, Salima Al-Maqbali","doi":"10.4103/ijciis.ijciis_75_24","DOIUrl":"10.4103/ijciis.ijciis_75_24","url":null,"abstract":"<p><strong>Introduction: </strong>Bloodstream infections (BSIs) caused by multidrug-resistant (MDR) Gram-negative bacilli pose a significant challenge in healthcare settings around the world. The main objective of this research was to determine the incidence, etiology, risk factors, and sources of BSIs among patients treated at Sohar Hospital in Oman.</p><p><strong>Methods: </strong>The study employed a retrospective methodology at Sohar Hospital, Oman, analyzing patients with BSIs from January 2018 to December 2019 utilizing electronic health data. Demographic data, bacterial etiology, antibiotic susceptibility, and patient outcomes were obtained from electronic health records. The statistical tools employed comprised <i>t</i>-tests, Mann-Whitney tests, Chi-square tests, and Fisher's exact tests for variable comparison, alongside univariate odds ratios computed for mortality correlations utilizing the R package GTSUMMARY. Bacterial identification and testing was performed in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines utilizing both traditional methods and automated technologies.</p><p><strong>Results: </strong>The majority of BSIs occur in elderly individuals with comorbidities. Surgical intervention was identified as a predominant risk factor for adverse consequences. MDR infections were linked with higher mortality rates. <i>Klebsiella pneumoniae</i> and <i>Acinetobacter baumannii</i> were prevalent, with <i>K</i>. <i>pneumoniae</i> exhibiting resistance to several antibiotics.</p><p><strong>Conclusions: </strong>The study highlights the urgent requirement for effective monitoring, management and infectious control measures to reduce the impact of BSIs and MDR pathogens on patient outcomes. It contributes valuable insights into the local epidemiology of BSIs in Oman. It emphasizes the significance of tailored interventions and precise medications to address the growing threat of antimicrobial resistance in healthcare settings.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"15 2","pages":"74-81"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing myocardial stunning during continuous renal replacement therapy in critically ill patients.","authors":"Hajar Berrichi, Safaa Bekkaoui, Younes Oujidi, Ilyass Laaribi, Houssam Bkiyar, Brahim Housni","doi":"10.4103/ijciis.ijciis_95_24","DOIUrl":"10.4103/ijciis.ijciis_95_24","url":null,"abstract":"<p><strong>Introduction: </strong>Myocardial stunning, a temporary reduction in cardiac contractility, is well-recognized in chronic hemodialysis patients but less studied in critically ill patients undergoing continuous renal replacement therapy (CRRT).</p><p><strong>Methods: </strong>A prospective observational 11-month study included 38 intensive care unit (ICU) patients with acute kidney injury at Mohammed V University Hospital. Myocardial stunning was evaluated using echocardiographic parameters such as global longitudinal strain and left ventricular ejection fraction.</p><p><strong>Results: </strong>Myocardial stunning was observed in 60.5% of patients. It was strongly associated with increased vasopressor requirements, longer ICU stays, and higher mortality (47.8% vs. 6.7%).</p><p><strong>Conclusion: </strong>The high incidence of myocardial stunning in critically ill patients undergoing CRRT highlights the need for vigilant cardiac monitoring and targeted interventions to improve patient outcomes.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"15 2","pages":"57-65"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early perfusion computed tomography in severe acute pancreatitis: Predicting necrosis and guiding care.","authors":"Ritika Agarwal, Mukesh Kumar Agarwal, Ujjwal Gupta, Amit Gupta","doi":"10.4103/ijciis.ijciis_9_25","DOIUrl":"10.4103/ijciis.ijciis_9_25","url":null,"abstract":"<p><strong>Introduction: </strong>Early identification of pancreatic necrosis in severe acute pancreatitis (SAP) is essential for timely intervention and improved outcomes. While prior studies have established the diagnostic value of perfusion computed tomography (PCT), they often lacked early follow-up and clinical integration. This study aims to evaluate PCT not only as a predictive tool for early necrosis but also as a clinically actionable modality for risk stratification and management planning.</p><p><strong>Methods: </strong>A prospective cross-sectional study was conducted on 50 SAP patients who underwent PCT within 72 h of symptom onset. PCT was performed to assess pancreatic blood flow (PBF), pancreatic blood volume (PBV), mean transit time, and time to peak. Follow-up contrast-enhanced CT was performed at 2 weeks to confirm necrosis. Perfusion parameters were compared between necrosis and non-necrosis groups. Diagnostic performance metrics (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) were calculated.</p><p><strong>Results: </strong>Perfusion defects were identified in 21 patients, with 18 (85.7%) subsequently confirmed to have necrosis. The necrosis group had significantly lower PBF (35.49 ± 21.62 mL/100 mL/min) and PBV (11.16 ± 4.84 mL/100 mL) than the non-necrosis group (125.72 ± 50.37 and 17.67 ± 3.80, respectively, <i>P</i> < 0.05). PCT achieved 100% sensitivity, 90.6% specificity, 85.7% PPV, and 90.6% NPV. Optimal cutoff values were BF ≤57.87 and BV ≤14.90.</p><p><strong>Conclusion: </strong>PCT provides high diagnostic accuracy and valuable prognostic insight in SAP, allowing for early necrosis detection and patient stratification. Its integration into early assessment may improve outcomes and resource utilization.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"15 2","pages":"82-89"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of prophylactic enteral bromocriptine in reducing the neurogenic fever in severe traumatic brain injury patients in the trauma intensive care unit - A randomized placebo-controlled study.","authors":"M Rajesh, Dikshitha Kshirasagar Chetty, Amrita Rath, Reena, Somsubhra Pal, Ghanshyam Yadav","doi":"10.4103/ijciis.ijciis_30_25","DOIUrl":"10.4103/ijciis.ijciis_30_25","url":null,"abstract":"<p><strong>Introduction: </strong>Neurogenic fever (NF) is a noninfectious, centrally mediated hyperthermia seen in patients with traumatic brain injury (TBI) and other neurological conditions. Fever exacerbates secondary brain injury, increases metabolic demand, and worsens patient outcomes. Dopamine agonists such as bromocriptine, which modulate hypothalamic thermoregulation, have been proposed as potential therapeutic agents. This study evaluates the efficacy of prophylactic bromocriptine in preventing NF in patients with severe TBI.</p><p><strong>Methods: </strong>In this randomized, double-blind, placebo-controlled trial, 100 adult patients with isolated severe TBI admitted within 24 h of injury were assigned to receive either bromocriptine (5 mg twice daily, <i>n</i> = 50) or placebo (<i>n</i> = 50) through enteral administration. NF was defined as a temperature >38.3°C for at least one episode over 2 consecutive days after excluding infectious causes. The primary outcome was NF incidence. Secondary outcomes included fever severity, frequency, onset, mortality, and heart rate-temperature correlation. Data were analyzed using parametric and nonparametric statistical methods.</p><p><strong>Results: </strong>After exclusions and dropouts, 43 patients in the bromocriptine group and 45 in the placebo group were analyzed. NF incidence was lower in the bromocriptine group (41.86%) compared to placebo (55.56%), but the difference was not statistically significant (<i>P</i> = 0.199). No differences were observed in fever onset, mortality, or heart rate-temperature correlation. Bromocriptine was associated with a reduction in peak temperature on day 5 (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Prophylactic bromocriptine did not significantly reduce NF incidence in severe TBI but showed trends toward lower fever severity. Further research with larger cohorts and optimized dosing is warranted.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"15 2","pages":"90-95"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of efficacy of sugammadex for reversal of neuromuscular blockade in patients undergoing major upper abdominal surgery.","authors":"Hiba Iqbal Ali, Shilpi Misra, Samiksha Parashar, Kriti Nagar, Praveen Kumar Das","doi":"10.4103/ijciis.ijciis_25_25","DOIUrl":"10.4103/ijciis.ijciis_25_25","url":null,"abstract":"<p><strong>Introduction: </strong>Rapid and complete reversal of neuromuscular blockade (NMB) allows for the adequate return of respiration and motor function, thereby expediting recovery and preventing micro-aspirations postoperatively. Diaphragmatic ultrasonography (DUS) is an easy, noninvasive and reliable diagnostic tool to quantify and assess respiratory function and exclude any postoperative residual curarization (PORC). Sugammadex, a modified gamma cyclodextrin reverses NMB faster and more reliably from a deep or profound blockade. We aimed to evaluate the efficacy of Sugammadex for the reversal of NMB in patients undergoing major upper abdominal surgery and to determine the risk of PORC using DUS.</p><p><strong>Methods: </strong>The present prospective, observational study included patients aged 18-65 years undergoing major upper abdominal surgery. The participants of Group A received Sugammadex and Group B received Neostigmine-Glycopyrrolate as reversal agent. Time of extubation and diaphragmatic thickness was noted at base line, 10 min-30 min postextubation. The statistical analysis was done using SPSS (Statistical Package for the Social Sciences) Version 21.0.</p><p><strong>Results: </strong>The time required to extubate was significantly shorter in Group A as compared to Group B (81.96 ± 37.30 s vs. 204.20 ± 99.91 s, <i>P</i> < 0.001). The diaphragm thickness at 10 min after extubation was higher in Group A compared to Group B (0.42 ± 0.04 cm vs. 0.4 ± 0.04 cm, <i>P</i> = 0.043).</p><p><strong>Conclusion: </strong>Sugammadex is more effective in achieving rapid reversal of NMB compared to neostigmine. The use of diaphragm ultrasonography provides valuable insights into respiratory function and the risk of PORC postoperatively.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"15 2","pages":"51-56"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}