Journal of Anaesthesiology, Clinical Pharmacology最新文献

{"title":"Safety of subarachnoid block in pediatric patients with dilated cardiomyopathy in congestive cardiac failure","authors":"Niranjan K. Sasikumar, Sunil Rajan, Annu S. Abraham, Jerry Paul","doi":"10.4103/joacp.joacp_287_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_287_22","url":null,"abstract":"Sir, Dilated cardiomyopathy (DCM) is characterized by enlargement and dilation of one or both ventricles along with impaired contractility with left ventricular ejection fraction (LVEF) of <40% which is progressive with poor survival rates.[1] A 4-year-old boy, weighing 14kg, was posted for wound debridement of bilateral below knee ulcers. He was admitted with breathlessness and swelling over legs. He had history of viral myocarditis, severe left ventricular (LV) dysfunction, ejection fraction (EF) of 20%, dilated LV/global hypokinesia, and was diagnosed with DCM with congestive heart failure. He was treated with intravenous (IV) frusemide 2mg/kg/day and levosimendan infusion 0.1mcg/kg/min. Currently, he was on milrinone 0.5 mcg/kg/min and frusemide 2mg/kg/day infusions; oral digoxin 1mg on alternate days; and intravenous fluid (IVF) 45mL/hour. Poor prognosis and chance of sudden cardiac death (SCD) were explained to parents. Echo on day of surgery showed DCM, severe biventricular dysfunction, mild pulmonary artery hypertension, dilated ventricles, severe global LV hypokinesia, and severe left and right ventricular dysfunction with LVEF of 14%. Serum electrolytes were normal. Chest X-ray showed cardiomegaly [Figure 1].Figure 1: X-ray chest showing cardiomegalyAs the child was irritable and not cooperative, surgery under nerve blocks and, in view of poor cardiac status, general anesthesia (GA) was not opted for. In the theater, infusions of milrinone, frusemide, and IVF were continued at the same rates through central line. Electrocardiogram, pulseoximeter, and invasive blood pressure (BP) monitors were attached. BP was 86/58 mmHg, and heart rate was 88 beats per minute. 10mg of ketamine was given IV and subarachnoid block was given with 1.6 mL of 0.5% bupivacaine heavy using a 25G spinal needle in a slightly head-up position. Systolic BP remained 90–95 mm Hg after spinal, with block upto T12 level. The surgery lasted one hour. The child underwent wound debridement three more times and skin grafting on the fourth sitting, over a period of three weeks. With gradual deterioration of cardiac status, GA was never considered. All procedures were done under subarachnoid block and were uneventful. He developed no complications pertaining to frequent dural punctures. A previous myocarditis is the most frequent cause of DCM in children with 40% mortality. Children with DCM predominantly experience SCD from pump failure and risk factors are early age at diagnosis, LV dilatation, LV posterior wall thinning (<14 mm) at presentation, heart failure, and low EF.[2,3] The main goals of anesthetic management in patients with DCM are to avoid myocardial depression, maintain adequate preload and prevent increases in afterload, avoid tachycardia, and prevent sudden hypotension by careful titration of anesthetic agents. Central neuraxial blockade may reduce afterload and improve cardiac output, but accompanying hypotension resulting in myocardial hypoperfusion must be","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135207760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of subtenon and intravenous dexmedetomidine on patients undergoing cataract surgery: A comparative randomized controlled double-blind study.","authors":"Ashraf Magdy Eskandr Saad, Osama Abd-Allah Elmorsy, Sadik Abd-Elmaseeh Sadik","doi":"10.4103/joacp.joacp_362_21","DOIUrl":"10.4103/joacp.joacp_362_21","url":null,"abstract":"<p><strong>Background and aims: </strong>This prospective randomized study designed to evaluate the efficacy of dexmedetomidine either added to LA mixture or administered IV during subtenon block for cataract surgery.</p><p><strong>Material and methods: </strong>75 patients, undergoing cataract surgery with subtenon anesthesia, were assigned randomly into three equal groups, Group I received subtenon bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml) + saline 0.9% (0.5 ml) and IV infusion of normal saline. Group II received subtenon bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml) + 0.5 μg/kg dexmedetomidine (0.5 ml) and IV infusion of normal saline. Group III received subtenon bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml) + saline 0.9% (0.5 μl) and IV infusion of 0.5 mg/kg dexmedetomidine over 10 min. before subtenon block. We recorded onset and duration of sensory and motor block, pain during subtenon injection, intraoperative hemodynamics, intraocular pressure, sedation and postoperative pain score.</p><p><strong>Results: </strong>There was a significant decrease in the onset of action and an increase in the duration of sensory block in Group II. Pain during subtenon injection was significantly less in group III. Sedation Score was higher in Group III, while heart rate showed a significant reduction in the same group. The VAS was significantly decreased in group II. After the end of surgery, the intraocular pressure was significantly decreased in Groups II and III.</p><p><strong>Conclusion: </strong>Subtenon dexmedetomidine shortens onset time, prolongs sensory block durations and significantly decreases the postoperative pain score with hemodynamic stability, while, IV dexmedetomidine substantially reduces pain during subtenon block and produces intra-operative sedation.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"39 1","pages":"360-365"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49053588","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":"Suppression of perioperative stress response in elective abdominal surgery: A randomized comparison between dexmedetomidine and epidural block.","authors":"Rashmi Salhotra, Vishal Kamal, Asha Tyagi, Mohit Mehndiratta, Rajesh S Rautela, Edelbert A Almeida","doi":"10.4103/joacp.joacp_559_21","DOIUrl":"10.4103/joacp.joacp_559_21","url":null,"abstract":"<p><strong>Background and aims: </strong>Stress response after surgery induces local and systemic inflammation which may be detrimental if it goes unchecked. Blockade of afferent neurons or inhibition of hypothalamic function may mitigate the stress response.</p><p><strong>Material and methods: </strong>A total of 50 consenting adult ASA I/II patients undergoing elective abdominal surgery were randomized to receive either dexmedetomidine (<b>Group D</b>) or epidural bupivacaine (<b>Group E</b>) in addition to balanced general anesthesia. Laparoscopic surgery, contraindications to epidural administration, history of psychiatric disorders, obesity (BMI >30 kg/m²), on beta blockers or continuous steroid therapy for >5 days over last 1 year, and known case of endocrine abnormalities or malignancy were excluded. Serum cortisol, blood glucose, and blood urea were estimated. Hemodynamic parameters, total dose of dexmedetomidine, bupivacaine, emergence characteristics, and analgesic consumption over 24 h postoperatively were recorded. Statistical comparisons were done using Student's t-test, repeated measure analysis of variance followed by Dunnett's test, generalized linear model and Chi-square/Fisher's exact test. A <i>P</i> value <0.05 was considered significant.</p><p><strong>Results: </strong>Serum cortisol levels were significantly lower in group E than group D 24 h after surgery (<i>P</i> = 0.029). Intraoperative and postoperative glucose level was lower in group E compared with group D. Time to request of first rescue analgesic was longer in group E than group D (<i>P</i> = 0.040). There was no significant difference between the number of doses of paracetamol required in the postoperative period (<i>P</i> = 0.198).</p><p><strong>Conclusion: </strong>Epidural bupivacaine was more effective than intravenous dexmedetomidine for suppression of neuroendocrine and metabolic response to surgery. Dexmedetomidine provided better hemodynamic stability at the time of noxious stimuli and postoperatively.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"39 1","pages":"397-403"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70810629","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":"Airway management of a child with complete cleft mandible and lower lip with bifid tongue for mandibular distraction.","authors":"Sunil Rajan, Niranjan Kumar Sasikumar, Jerry Paul, Lakshmi Kumar","doi":"10.4103/joacp.joacp_558_21","DOIUrl":"10.4103/joacp.joacp_558_21","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"39 1","pages":"511-512"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42329077","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":"Sugammadex and blood loss during cervical spine fusion surgery.","authors":"Ryan J Keneally, Luis H Lemos Lopes, Mary E Heekin, Jonathan H Chow, Eric R Heinz, Michael K Rosner, Michael A Mazzeffi","doi":"10.4103/joacp.joacp_551_21","DOIUrl":"10.4103/joacp.joacp_551_21","url":null,"abstract":"<p><strong>Background and aims: </strong>Sugammadex (SUG) has been associated with changes in coagulation studies. Most reports have concluded a lack of clinical significance based on surgical blood loss with SUG use at the end of surgery. Previous reports have not measured its use intraoperatively during ongoing blood loss. Our hypothesis was that the use of SUG intraoperatively may increase bleeding.</p><p><strong>Material and methods: </strong>This was a single site retrospective study. Inclusion criteria were patients undergoing a primary posterior cervical spine fusion, aged over 18 years, between July 2015 and June 2021. The primary outcomes compared were intraoperative estimated blood loss (EBL) and postoperative drain output (PDO) between patients receiving SUG, neostigmine (NEO) and no NMB reversal agent. The objective was to determine if there was a difference in primary endpoints between patients administered SUG, NEO or no paralytic reversal agent. Primary endpoints were compared using analysis of variance with a <i>P</i> value of 0.05 used to determine statistical significance. Groups were compared using the Chi-squared test, rank sum or student's <i>t</i> test. A logistic regression model was constructed to account for differences between the groups.</p><p><strong>Results: </strong>There was no difference in median EBL or PDO between groups. The use of SUG was not associated with an increase in odds for >500 milliliters (ml) of EBL. Increasing duration of surgery and chronic kidney disease were both associated with an increased risk for EBL >500 ml.</p><p><strong>Conclusion: </strong>Intraoperative use of SUG was not associated with increased bleeding. Any coagulation laboratory abnormalities previously noted did not appear to have an associated clinical significance.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"39 1","pages":"468-473"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43652380","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":"Unexpected values of mixed venous blood analysis: Back to basics before sampling.","authors":"Ajmer Singh, Chinmaya Nanda, Yatin Mehta","doi":"10.4103/joacp.joacp_537_21","DOIUrl":"10.4103/joacp.joacp_537_21","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"39 1","pages":"509-510"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48632134","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":"Comparison between presepsin, procalcitonin, and CRP as biomarkers to diagnose sepsis in critically ill patients.","authors":"Deven Juneja, Navin Jain, Omender Singh, Amit Goel, Shweta Arora","doi":"10.4103/joacp.joacp_560_21","DOIUrl":"10.4103/joacp.joacp_560_21","url":null,"abstract":"<p><strong>Background and aims: </strong>Mortality associated with sepsis continues to remain high. Early diagnosis and aggressive management may improve outcomes. Biomarkers may help in early diagnosis, but the search for an ideal biomarker continues. Presepsin has been introduced as a new biomarker, however, it still needs validation before its use becomes routine. In this study, we aimed to compare the efficacy of various biomarkers in patients with suspected sepsis.</p><p><strong>Material and methods: </strong>A retrospective analysis of 100 patients with suspected infection, admitted in the medical intensive care unit (ICU) was conducted. Diagnosis of sepsis was made on the basis of the current surviving sepsis guidelines criteria.</p><p><strong>Results: </strong>Out of 100 patients, 70 were diagnosed to have sepsis, and overall ICU mortality was 22%. Overall, C-reactive protein (CRP) was positive in 98, procalcitonin in 75, and presepsin in 64 patients. For diagnosis of sepsis the sensitivity, specificity, and AUC, respectively, for CRP was 98.6%, 3.3%, and 0.725. For procalcitonin (>0.5 ng/ml) it was 87.1%, 53.3%, and 0.776, and for procalcitonin (>1 ng/ml) 70%, 70%, and 0.816, respectively. For presepsin sensitivity, specificity, and AUC, respectively, for diagnosis of sepsis was 77.1%, 66.7%, and 0.734. For ICU mortality, sensitivity and specificity for CRP was 95.5% and 1.3%, for procalcitonin (>0.5) 72.7% and 24.4.%, for procalcitonin (>1) 59.1% and 42.3%, and for presepsin 61.5% and 27.3%, respectively.</p><p><strong>Conclusion: </strong>Inflammatory markers may be raised in a large proportion of ICU patients, even in those without sepsis. Procalcitnonin and presepsin had similar efficacy in diagnosing sepsis. However, none of the three biomarkers studied were accurate in predicting ICU mortality.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"39 1","pages":"458-462"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42245099","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":"Comparison of the effects of caffeine, aminophylline, and saline on the recovery from total intravenous anesthesia in laparoscopic surgeries: A randomized controlled trial.","authors":"R Hari Prasad, Bharat Paliwal, Manoj Kamal, Pradeep Kumar Bhatia","doi":"10.4103/joacp.joacp_528_21","DOIUrl":"10.4103/joacp.joacp_528_21","url":null,"abstract":"<p><strong>Background and aims: </strong>The return of consciousness (ROC) after general anesthesia (GA) is by stopping the administration of anesthetic agents. At present, no drug is given to reverse the loss of consciousness produced by general anesthetic agents. This study is conducted to find whether caffeine and aminophylline hasten the ROC.</p><p><strong>Material and methods: </strong>This study was conducted on 75 American Society of Anesthesiologists (ASA) I and II female patients undergoing laparoscopic hysterectomy, aged between 18 and 60 years. The patients were divided into three equal groups (Group C: caffeine citrate, Group A: aminophylline, and Group S: saline) of 25 each by a computer-generated random number table. GA was induced with propofol, fentanyl, and maintained with propofol infusion. On completion of the surgery, the neuromuscular blocking agent was reversed and then the infusion of propofol was stopped. The study drug was administered intravenously when the BIS 60 was achieved. Time to achieve BIS 90, return of first gag reflex, eye-opening on verbal command, and extubation after study drug administration were noted. Hemodynamic parameters and SpO2 were also monitored.</p><p><strong>Results: </strong>The time for BIS 60 to 90 was 10 (4.25) min in the caffeine group, 13 (4.25) min in the aminophylline group, and 26 (9.0) min in the saline group. The time to return of gag reflex and time to extubation were shorter in the caffeine and aminophylline group compared to the saline group. The time to eye-opening on verbal command was shorter in the aminophylline group compared to the saline group. Hemodynamic parameters after infusion of the study drug were comparable in all three groups.</p><p><strong>Conclusion: </strong>Caffeine hastens the recovery from total intravenous anesthesia with propofol and fentanyl in laparoscopic hysterectomy as effectively as aminophylline.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"39 1","pages":"404-410"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43827370","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":"Preliminary experience on systemic effects of perineural dexamethasone sodium phosphate and methylprednisolone acetate through adductor canal block in total knee arthroplasty: A single center retrospective study.","authors":"Jinlei Li, Feng Dai, Bin Zhou, Milaurise Cortes, Khushboo Baldev","doi":"10.4103/joacp.joacp_433_21","DOIUrl":"10.4103/joacp.joacp_433_21","url":null,"abstract":"<p><strong>Background and aims: </strong>Glucocorticoids are commonly utilised as adjuvants to enhance nerve block quality and prolong the analgesic duration. Its systemic effects, after a single-injection adductor canal block (ACB) followed by a continuous infusion, are unclear. The aim of the study was to assess the systemic effects of a single dose of dexamethasone sodium phosphate (DEX), or a combination of DEX and methylprednisolone acetate (MPA), on fasting blood glucose (FBG) and white blood cell count (WBC) when administered perineurally via ACB.</p><p><strong>Material and methods: </strong>A single-center retrospective study on total knee arthroplasty (TKA) was performed and a total of 95 patients were included in the final analysis. Patients were divided into three groups based on adjuvants received in ACB: Control group (N = 41) and two treatment groups, DEX group (N = 33) and DEX/MPA group (N = 21). Our primary outcomes were the change of FBG from its preoperative baseline value on postoperative day (POD) 2. The secondary outcomes included change of FBG on POD 0 and POD 1, and change of WBC on POD 0, POD 1, and POD 2.</p><p><strong>Results: </strong>The FBG change from baseline in the DEX group was significantly higher than that in the control group (difference = 14.04, 95% CI: 1.3 to 26.77), <i>P</i> = 0.031) on POD 0. The WBC change from baseline in the DEX/MPA group was statistically significant higher than control on POD 0 (2.62 (1.52 to 3.37), <i>P</i> < 0.0001). No significant differences between DEX and DEX/MPA group were found on any given postoperative days for FBG and WBC.</p><p><strong>Conclusion: </strong>This study provided preliminary safety data on the use of a combination of glucocorticoids with hydrophilic (DEX) and lipophilic (MPA) properties as local anesthetic adjuvants in ACB, which induced similar levels of changes on FBG and WBC as those from both control and DEX alone group.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"39 1","pages":"385-391"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44749927","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":"Surveillance of central line associated bloodstream infection (CLABSI) - comparison of current (CDC/NHSN) and modified criteria: A prospective study.","authors":"Durgesh Rai, Pravin Kumar, Poonam Gupta, Pardeep K Verma","doi":"10.4103/joacp.joacp_393_21","DOIUrl":"10.4103/joacp.joacp_393_21","url":null,"abstract":"<p><strong>Background and aims: </strong>There is a huge load of central line-associated bloodstream infection (CLABSI) being reported in developing countries, with increased mortality and healthcare costs. Effective surveillance is a must to reduce the incidence of CLABSI. The current criteria (Centre for Disease Control and Prevention/National Healthcare Safety Network [CDC/NHSN]) for CLABSI surveillance have their own shortcomings. For diagnosing CLABSI, current CDC/NHSN CLABSI surveillance criteria are laborious and time consuming with low predictive power. Hence, modified criteria have been postulated, which are simple and implementable at resource-constrained setups. The primary objective was to compare modified criteria with CDC criteria. The secondary objective was to determine the prevalence of CRBSI.</p><p><strong>Material and methods: </strong>A total of 98 patients with central line <i>in situ</i> or having the central venous line removed ≤24 hrs prior to the date of the event were enrolled. Paired blood cultures were obtained and results were analyzed using differential time to positivity.</p><p><strong>Results: </strong>The incidence of CLBSI was 8.16% and the device utilization rate was 11.6%. The negative predictive value of both the surveillance criteria was found to be excellent and comparable (96.2% for modified criteria and 97.1% for CDC criteria), therefore both can be used for screening purposes. AUC for current CDC/NHSN criteria was better than modified criteria (0.76 versus 0.66, <i>P</i> < 0.0001), suggesting it to be a better criterion for surveillance of CLABSI.</p><p><strong>Conclusion: </strong>Modified criteria were not superior to CDC/NHSN criteria for surveillance. Thus, there is a scope of improving the modified criteria for the purpose of surveillance. CLBSI load was higher; CLABSI bundle for prevention is thus highly recommended.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"39 1","pages":"349-354"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49560991","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}