IAR Journal of Anaesthesiology and Critical Care最新文献

{"title":"Effect of Magnesium Sulphate and Clonidine on Propofol Consumption, Hemodynamics and Postoperative Recovery Using Bispectral Index (BIS) In Elective Surgeries\"","authors":"D. Koli, T. Patil, S. Manjrekar","doi":"10.47310/iarjacc.2022.v03i02.001","DOIUrl":"https://doi.org/10.47310/iarjacc.2022.v03i02.001","url":null,"abstract":"The purpose of this placebo-controlled, double-blind study was to see how magnesium sulphate and clonidine affected perioperative hemodynamics, propofol consumption, and postoperative recovery. Ninety ASA I–II patients undergoing elective laparoscopic surgery were randomized into three groups. Group M Patients received Inj. magnesium sulphate (40mg/kg) in 20 ml saline infused over a period of 15 minutes before induction. Group C received Patients received Inj. Clonidine (3mcg/kg) before induction. The Group S (Control group) received 20ml normal saline over 15mind before induction. Propofol was used for induction of anaesthesia and for maintenance propofol infusion was used which was adjusted as per bispectral index along with intermittent fentanyl bolus and vecuronium as muscle relaxant According to type of data, different tests of statistical significance like Chi-square test, Kruskal Wallis test and one-way ANOVA were used. In the presence of magnesium sulphate and clonidine, propofol induction was rapid. The time it took for BIS to reach 60 was significantly shorter in groups M and C (P0.0001), and compared to clonidine and control group post-operative recovery was more delayed in magnesium sulphate group (P0.0001). There was no statistically significant difference between the groups in heart rate or arterial blood pressure. Preoperative use of magnesium sulphate and clonidine resulted in significant reduction in propofol requirements for induction as well as for maintenance (P0.0001).To conclude use of magnesium sulphate caused delayed recovery and hypotension and bradycardia was observed with clonidine, but both can be used as adjuvants with caution.","PeriodicalId":225934,"journal":{"name":"IAR Journal of Anaesthesiology and Critical Care","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127200836","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":"Role of Low Dose Ketamine (0.05 and 0.1 Mg/Kg) in Alleviating Propofol Injection Pain","authors":"Amal Hilal Sulaiman Al Mamari, Abdullah Al Jadidi, R. Khan, N. Kaul","doi":"10.47310/iarjacc.2022.v03i02.003","DOIUrl":"https://doi.org/10.47310/iarjacc.2022.v03i02.003","url":null,"abstract":"Introduction: Pain from propofol injection can be severe and distressing in some patients. Various methods and agents has been used to alleviate this pain. One of the agents is ketamine which has been used in different sub-anaesthetic doses to reduce propofol injection pain in comparison with different agents. None of the studies till date have used ketamine in dose less than 0.1 mg/kg. The aim of the present study was to compare ketamine in doses of 0.05 and 0.1 mg /kg to attenuate propofol injection pain. Material and Method: 48 ASA I and II adult patients undergoing different elective surgical procedures under general anaesthesia were randomised into 3 groups of 16 patients each. Group A patients received ketamine 0.05 mg/kg in 2 ml while group B patients received ketamine 0.1mg/kg in 2ml. Group C patients served as placebo control and were administered 2ml 0.9% normal saline intravenously. The venous drainage was occluded manually by rubber tourniquet at mid-arm. Subsequently the study drug or the placebo was administered as per group allocation. One minute later, 25 % of calculated propofol induction dose was injected over 5 seconds. VAS score for pain of propofol injection was assessed at 0, 1 and 2 minutes after the propofol injection. Thereafter, general anaesthesia technique was continued as per standard technique giving the remaining 75% of propofol. Patient’s heart rate and blood pressure were recorded at 0, 1 and 2 minutes after the administration of 25% of the calculated dose of propofol. Any evidence of hallucination was observed in the recovery room. Results: Demographic profile and the ASA grade of the patients in the 3 groups was uniformly distributed. The mean VAS score for pain perception in group B patients at 1 and 2 minutes was 0.56 and 1.06 respectively. In contrast, the mean VAS for pain was 3.88 and 5.06 at 1 and 2 minutes respectively in group C. The VAS score of patients belonging to group A was closer to that seen in group B patients. This difference in VAS score was statistically highly significant between the groups at 1 and 2 minutes. A significant fall in systolic blood pressure was noted at 2 minutes after administering 25% of the propofol induction dose in all the 3 groups. In contrast, no significant changes were noted at one minute when compared to baseline. There was insignificant fall in the heart rate at 1 and 2 minutes following the administration of 25 % propofol in group A and B. In contrast, an insignificant rise in heart rate was noted at 1 and 2 minutes in group C. Conclusion: The results of this study demonstrate that 0.01 mg/kg of ketamine administered one minute prior to propofol injection is effective and superior to 0.05 mg / kg of ketamine in relieving propofol injection pain without any side effects.","PeriodicalId":225934,"journal":{"name":"IAR Journal of Anaesthesiology and Critical Care","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114416459","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":"Corticosteroidal Clinical Efficacy In Combating Cytokine Storm In Hospitalized Covid-19 Infected Patients","authors":"A. Hasan, Mohammad Nayef Mufleh Al-Qatarneh, Rami Farah Mfadi Alrabadi, M. Obeidat","doi":"10.47310/iarjacc.v3i01.10109","DOIUrl":"https://doi.org/10.47310/iarjacc.v3i01.10109","url":null,"abstract":"Objectives: It appears that corticosteroidal agents, including Dexamethasone and Methylprednisolone, are the cost-effective therapeutic regarding positive clinical outcomes. The present study aims to explore the comparative positive clinical impacts of 6 mg and 12 mg IV Dexamethasone (DEX Cohorts) versus 20 mg and 40 mg Methylprednisolone (MET Cohorts) in mechanically ventilated intensive care unit (MVICU) SARS-CoV-2 infected patients. Methods: An observational retrospective study was processed on admitted MVICU affected COVID-19 patients between Mar 2020 and Sep 2021. A One-Way ANOVA and Chi Square Tests were conducted to analyze the retrievable patients’ comparative data and to investigate the primary tested clinical outcomes of ICU length of stay and overall, 28-day ICU mortality rate. Results: The overall mean age in SARSO-CoV-2 infected patients was 59.80 ±10.74 years with significantly Male to Female distributed ratio of 2.42: 1. The shock index was significantly lower in the MET Cohorts compared with DEX Cohorts with Mean±SD of (1.12±0.03 bpm/mmHg and 1.22±0.04 bpm/mmHg) vs (1.29±0.17 bpm/mmHg and 1.31±0.23 bpm/mmHg). During an average of 13.40±4.79 days and 19.67±6.81 days of the ICU and hospital stay days, the overall-28-day ICU mortality rate was stated on 136 (55.97%). Conclusion: Higher daily doses of either Dexamethasone (6 mg Q 12 hrs) or Methylprednisolone (40 mg Q 12 hrs) have significantly favorable positive outcomes [Dexamethasone>Methylprednisolone] when compared to lower daily doses of Dexamethasone (6 mg Q 24 hrs) or Methylprednisolone (20 mg Q 12 hours) [Methylprednisolone>Dexamethasone].","PeriodicalId":225934,"journal":{"name":"IAR Journal of Anaesthesiology and Critical Care","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122093364","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":"Comparative Evaluation of Midazolam and Clonidine as Premedicants in Children Undergoing Elective Orodental Surgeries: A Randomized, Double Blind Trial","authors":"Anupriya Gupta, H. Gupta, Anju Jamwal, S. Gulati","doi":"10.47310/iarjacc.2022.v03i01.002","DOIUrl":"https://doi.org/10.47310/iarjacc.2022.v03i01.002","url":null,"abstract":"Background: Preoperative anxiety is common in children that can have impact on induction, emergence from anesthesia and/ or on the psychological state of the child. Intranasal route offers an advantage of rapid and virtually complete absorption due to high mucosal vascularity. Objective: The present study aimed to compare efficacy of midazolam with clonidine for intranasal premedication in pediatric patients scheduled to undergo elective orodental surgeries. Methods: One hundred and five children of either sex, aged between 3-7 years belonging to American Society of Anesthesiologists ASA) physical status 1 and 2 undergoing elective orodental surgeries were randomly assigned to three study groups. Group 1 n=35) received 0.5 ml of 0.2 mg/kg midazolam, Group 2 n=35) received 0.5 ml 1µ/kg clonidine and Group 3 n=35) received 0.5 ml of normal saline in each nostril 40 minutes before inducing anesthesia. Heart rate, mean arterial blood pressure, SpO2, degree of sedation was measured every 10 minutes till 30 minutes according to the 5- point sedation scale. The reaction to intravenous i.v.) cannulation was noted according to 4-point scale and child’s face mask acceptance was noted according to 5-point scale. After induction of anesthesia, vitals were noted every 10 minutes, intraoperatively. Postoperatively, level of sedation was assessed every 10 minutes for one hour using 3- point scale. Results: The difference in sedation score between group 1 and 2 was insignificant at 10 minutes but highly significant at 20 min, 30 min and 40 minutes with more sedation in clonidine group. Heart rate and blood pressure were lower in clonidine group. Children in group 2 had better reaction to i.v. cannulation and mask acceptance scores compared with group 1. Postoperative sedation was highest in clonidine group and these children had better wake up scores than midazolam. Conclusion: Compared to midazolam, intranasal clonidine provides higher sedation level, better mask acceptance and better response to intravenous cannulation.","PeriodicalId":225934,"journal":{"name":"IAR Journal of Anaesthesiology and Critical Care","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125075816","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":"Anesthesia Related Complications and Guidelines","authors":"Reem Hashim Abdalmahdi Shuber, S. A. AL Haddad, Rehab Sabah Abd-Alhussein Otaifa","doi":"10.47310/iarjacc.2022.v03i01.007","DOIUrl":"https://doi.org/10.47310/iarjacc.2022.v03i01.007","url":null,"abstract":"This study focused its objective on knowing the extent of complications that exist and generated by the type of anaesthesia on the patient. A study was conducted of 800 patients collected from different Hospitals Baghdad, Iraq. Complications were found in 120 patients. All statistical analyzes were performed for patients of age, gender, and type of anesthesia used during in addition to that, the type of complications found in patients was identified, and by relying on the statistical analysis program SPSS Soft 20 and MSEXCEL, the data and demographic characteristics of the patients were analyzed.","PeriodicalId":225934,"journal":{"name":"IAR Journal of Anaesthesiology and Critical Care","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127411499","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":"Empirical Piperacillin/Tazobactam versus Imipenem/Cilastatin in Covid-19 Infected Patients","authors":"Sahar Mohammad Jdaitawi, Dema Fahed Abujoudeh, Ghaith Ghazi Khorshid, Shadi Ibrahim Alghonmien, M. Obeidat","doi":"10.47310/iarjacc.v3i01.10106","DOIUrl":"https://doi.org/10.47310/iarjacc.v3i01.10106","url":null,"abstract":"Background/Aim: β-Lactam/β-lactamase inhibitors (BL/BLIs) and carbapenems are often considered for the treatment of sepsis when the main suspected pathogens are Gram-negative bacteria, because of their broad spectrum of coverage. Our aim was to compare the clinical outcomes of the two most widely used empirical broad-spectrum antibiotics in Jordanian SARS-CoV-2 infected patients. Methods: A single-center, retrospectively study was conducted in a specialized COVID-19 isolation center at Queen Alia Military Hospital of the Royal Medical Services (RMS) in Jordan. Over 19 months. All Jordanian mild/moderate-severe/critical SARS-CoV-2 infected patients aged 18 years and above, whose hospital admission days exceeded at least 3 days, and whose COVID-19 diagnosis were suspected or confirmed were included in our study. β-ABs were allocated to Non-PIP/TAZ group (Group I) and PIP/TAZ group (Group II). An Independent T and One –Sample T Tests, and Chi Square Test will be used to analyze the parametric and non-parametric outcomes’ data, respectively. Results: 718 eligible studied patients were finally included in this study (718/4183, 18.67%) in which 247 patients (31.6%) had suspected COVID-19 infection and 534 (68.4%) had confirmed COVID-19 infection. The mean age of the whole study cohort was 59.40±10.60. Insignificantly, males were distributed in the study in approximately 2.309:1 ratio compared to females. The main finding of our study was that an investigated overall 28-day SARS-CoV-2 infected patients’ mortality were insignificantly recorded between the two ABs based categorized cohorts [75 (19.8%) vs 80 (19.9%), p-Value=0.997] over also insignificantly overall hospital length of stay (LOS) [11.17±2.79 days vs 11.28±2.91 days, -0.11±0.20 days, p-Value=0.595] for Cohort I and Cohort II, respectively. Conclusion: In summary, our results demonstrate that there were insignificant differences between Piperacillin/Tazobactam and Carbapenems regarding overall clinical impacts, when they were empirically administered in SARS-CoV-2 infected patients. Also, we explored that significant higher %cNa12 in PIP/TAZ Cohort (Cohort II) may have positive clinical advantages over Carbapenems in Non-PIP/TAZ (Cohort I).","PeriodicalId":225934,"journal":{"name":"IAR Journal of Anaesthesiology and Critical Care","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132772987","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":"Comparison of the Hemodynamic Changes in Normotensive and Severe Preeclamptic Pregnant Woman Posted For Cesarean Section under Spinal Anaesthesia","authors":"Ashwani Kumar, H. Gupta, Shipra Gupta","doi":"10.47310/iarjacc.2022.v03i01.001","DOIUrl":"https://doi.org/10.47310/iarjacc.2022.v03i01.001","url":null,"abstract":"Background: Spinal anesthesia is widely considered a technique of choice for cesarean delivery. But due to fear of sudden and extensive sympathetic blockade, spinal anesthesia may not be considered safe in severe preeclampsia. Objectives: The aim of the present study was to compare the heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), incidence of hypotension, phenyl ephrine requirement and neonatal outcome between normotensive and severe pre-eclamptic women undergoing cesarean section under spinal anesthesia. Material and Methods: A total of 35 severe pre-eclamptic (BP > 160/110 mmHg) 3(Group A) and 35 healthy parturients (group B), meeting the inclusion criteria were included in the study. After preloading with 10 ml/kg of ringer lactate (RL) solution spinal anesthesia was administered with 12.5 mg of hyper baric bupivacaine. Heart rate and blood pressure were recorded before spinal anesthesia and thereafter at 3 minute intervals upto 60 minutes. Hypotension was defined as MAP LESS,THAN 30% of the baseline or a decrease in SBP to LESS THAN 100 mm Hg over the same time interval and was treated with 50 mcg phenylephrine intravenously (i.v). Apgar score was noted 1 and 5 min after birth. Results: The incidence rate of hypotension among the preeclamptic patients was lower than that of the healthy parturients (55.6% vs. 34.1%). The minimum SBP, DBP, and MAP recorded were lower in normotensive, and the difference between two groups was statistically significant. The mean phenylephrine requirement in the normotensive group (151.1 ± 70) was significantly greater (P LESS THAN 0.0001) than that of pre-eclamptic group (48.3 ± 35). The total doses of IV Phenylephrine for treating hypotension were significantly lower among the preeclamptic patients (72 mcg in preeclamptic patients versus 188 mcg in normotensive patients) (P LESS THAN 0.05). There was no statistical difference in the neonatal outcome and Apgar score in the study groups. Conclusion: Pre-eclamptics experienced less hypotension following subarachnoid block (SAB) than normotensives and required less phenylephrine with comparable fetal Apgar scores.","PeriodicalId":225934,"journal":{"name":"IAR Journal of Anaesthesiology and Critical Care","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121146830","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 Prognostic Capabilities of Positive Acute Phase Reactants in Stratifying Hospitalized Covid-19 Infected Patients","authors":"A. Hasan, Mohammad Nayef Mufleh Al-Qatarneh, Rami Farah Mfadi Alrabadi, M. Obeidat","doi":"10.47310/iarjacc.v3i01.10108","DOIUrl":"https://doi.org/10.47310/iarjacc.v3i01.10108","url":null,"abstract":"Background/Aim: Several biochemical parameters in mechanically ventilated intensive care unit severe acute respiratory syndrome conronavirus-2 (MVICU-SARS-CoV-2) are strongly correlated with affected COVID-19 patients’ clinical outcomes. Of particular, C-reactive protein (CRP) and ferritin (FER) levels are commonly used in clinical practices for theirs diagnostic and prognostic performances. So, in this study we aimed to explore the two tested positive acute-phase reactants prognosticating capabilities in MVICU-affected COVID-19 patients. Methods: A single-center study was retrospectively processed for eligible admitted MVICU-SARS-CoV-2 infected patients between March 2020 and September 2021. One-Sample and Independent T-Tests were conducted to analyze parametric data while in contrary, Mann Whitney-U and Chi Square Tests were conducted to analyze non-parametric data. A Receiver Operating Characteristic Test followed by Sensitivity Analysis were also conducted to plot the area of each tested prognosticator and to pick the operating optimal dichotomous levels with their corresponding sensitivity indices. Results: Overall 28-day ICU mortality was detected in 94 (48.70%) during an average of 12.40±4.79 days of ICU length of stay. The whole study cohort mean age was 58.37±9.96 years. and the Non-Survivors Cohort were insignificantly younger than the Survivors Cohort (58.09±10.05 years vs 58.55±9.95 years, respectively, p>0.05). Significantly, males were distributed in the study in approximately a 2: 1 ratio compared to females. Biochemically, the c-reactive protein and ferritin were significantly higher in the Non-Survivors Cohort than in the Survivors Cohort [143.09±59.28 mg/dl and 891.51±377.82 ng/ml vs 88.38±34.38 mg/dl and 465.76±154.07 ng/ml, respectively, p LESS THAN 0.05]. Conclusion: In global ever-shrinking in medical teams and facilities, elevated levels of CRP and FER can be potentially used for their reasonable performances and prognostic utilities in early risk stratification and clinical trending tracking in MVICU-SRAS-CoV-2 infected patients. Both tested biochemical prognosticators may facilitate in optimum resource provision and swift management protocols implementation.","PeriodicalId":225934,"journal":{"name":"IAR Journal of Anaesthesiology and Critical Care","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115665086","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 Predictive Value of Shock Index versus Modified Shock Index in Critically Ill COVID-19 Infected Patients","authors":"Mohamed Sulaiman Abuzaid, Ali Kathm Mohammad Ali Alqatarneh, Zaid Majed Shafaqouj, Intisar Jum'ah Ghadfan Alshadid, Audai Ali Sulaiman AL-Shawabkeh, A. Alshawabkeh","doi":"10.47310/iarjacc.v3i01.10110","DOIUrl":"https://doi.org/10.47310/iarjacc.v3i01.10110","url":null,"abstract":"Background/Aim: Having reliable indicators and markers that would help in prognosticating the survival are invaluable and would consequently assist in the course of effective treatment. Our objectives in this study were to compare the ability of SI and mSI to predict the primary outcomes of overall 28-day mortality rate in SARS-CoV-2 infected hemodynamic unstable critically ill patients. Methods: This study was retrospectively conducted and both of confirmed and suspected affected critically ill COVID-19 patients were included in our study. Hemodynamics variables of SI and mSI were mathematically calculated after dividing HR over SBP and MAP. All tested variables and others were comparatively compared across the two studied affected COVID-19 patients; Survivors Cohort (Cohort I) and Non-Survivors Cohort (Cohort II) using One Sample and Independent-T Tests in addition to Chi Square Test for categorical retrievable data. ROC curves were constructed for SI and mSI, and the area under the ROC curves (AUROCs) were statistically compared using proposed Delong Method. The optimal operating cutoffs on each ROC curve for the two tested prognosticators were also investigated by picking the highest youden’s index. Results: The mean age of the whole study cohort was 51.88±16.22 years, and the Non-Survivors Cohort were significantly older than the Survivors Cohort. Significantly, males were distributed in the study in approximately 2.57: 1 ratio compared to female. There were statistically significant differences regarding serum albumin levels profile during the 1st admission week, among the 3 serial albumin day levels. The overall incidences of NOPST were assessed at 65.9% during an average of 14.08±4.06 days. The Non-Survivors Cohort had also significantly higher SI and mSI compared to Survivors Cohort [1.16±0.14 bpm/mmHg and 1.67±0.23 bpm/mmHg versus 0.92±0.04 bpm/mmHg and 1.30±0.07 bpm/mmHg; +0.24±0.01 bpm/mmHg and -0.37±0.01 bpm/mmHg, respectively, p-Value=0.001]. SI had a higher AUROC than mSI with Area±SEM (95% CI; Range) of 0.983±0.002 (95% CI; 0.978-0.987) versus 0.959±0.004 (95% CI; 0.950-0.967) and the best cut-off values for SI and mSI were 0.99 bpm/mmHg and 1.43 bpm/mmHg, respectively. Conclusion: In summary, our stated hemodynamic based mortality prognosticators may be an early effective, no-cost bedside, realistic, reliable triaging modalities with high sensitivity, specificity, performance. Also, SI may be used as an additional or readily available red flag bedside assessment tool for severe disease.","PeriodicalId":225934,"journal":{"name":"IAR Journal of Anaesthesiology and Critical Care","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127493253","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":"Hyperglycemia as an Independent Predictor for Covid-19 Morbidity and Mortality","authors":"Mohamed Sulaiman Abuzaid, Ali Kathm Mohammad Ali Alqatarneh, Zaid Majed Shafaqouj, Intisar Jum'ah Ghadfan Alshadid, Audai Ali Sulaiman AL-Shawabkeh, A. Alshawabkeh","doi":"10.47310/iarjacc.v3i01.10111","DOIUrl":"https://doi.org/10.47310/iarjacc.v3i01.10111","url":null,"abstract":"Background/Aim: A wealth of immunological evidence points out that hyperglycemic status (regardless of diabetes) makes individuals more susceptible to infection as well as higher in-hospital complications. In this study, we primarily aimed to identify the clinical and biochemical negative impacts of hyperglycemia risk factor across the two comparative cohorts. Secondly, we also explored the prognosticating utilities of three proposed BG related prognosticators in moderate-severe admitted SARS-CoV-2 infected patients. Methods: This study was retrospectively between Mar 2020 and Sep 2021. All retrievable and calculated variables were thereafter divided into two studied cohorts, Survivors Cohort (Cohort I) and Non-Survivors Cohort (Cohort II). Independent and One-Sample T-Tests and Chi-Square Test were used for comparative analysis and relative risk estimation. The Receiver operating characteristic analysis was used to explore the area under the curve and the sensitivity analysis was also performed to investigate the optimal cutoff values for the BG related prognosticators. Results: The mean age of the whole study cohort was 59.40±10.60 years, and the Non-Survivors Cohort were insignificantly younger than the Survivors Cohort. Survivors Cohort had insignificantly higher average blood glucose level than Non-Survivors Cohort. Oppositely, Survivors Cohort had significantly lower average total daily insulin dosing compared to Non-Survivors Cohort. The overall hospital length of stay (LOS) which it was significantly lower in Non-Survivors Cohort compared to Survivors Cohort. Conclusion: As there were many cconcerns for the effect of hyperglycemia on immune cells and subsequently the overall clinical impacts, there is an urgent necessity to track the daily blood glucose levels, the changes in blood glucose from baseline, or alternatively the insulin infusion rate to keep their averages around 149.9 mg/dl, -38%, and 1.35 IU/hr.","PeriodicalId":225934,"journal":{"name":"IAR Journal of Anaesthesiology and Critical Care","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126384274","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}