Indian Journal of Critical Care Medicine最新文献

{"title":"A Two-year Retrospective Observational Cohort Study of Benzodiazepine Overdose Cases in the Emergency Department.","authors":"John Giftson, Darpanarayan Hazra, Gina M Chandy","doi":"10.5005/jp-journals-10071-24925","DOIUrl":"10.5005/jp-journals-10071-24925","url":null,"abstract":"<p><strong>Background: </strong>Deliberate self-harm (DSH) is a significant health concern in developing countries, associated with high morbidity and mortality. Several factors influence patient outcomes. This study aimed to better understand the profile and outcomes of patients with benzodiazepine (BZD) overdose.</p><p><strong>Materials and methods: </strong>This two-year analysis conducted in the Emergency Department (ED) focused on patients with DSH and BZD toxicity. Key factors and outcomes were recorded and analyzed.</p><p><strong>Results: </strong>The study included 95 patients with BZD overdoses, some of whom had also taken other drugs. The mean age was 36.52 (SD: 14.2) years, with a female predominance (59.9%). The most common reasons for DSH were interpersonal issues, such as relationship failure (<i>n</i> = 48; 50.5%) and domestic fights or abuse (<i>n</i> = 37; 38.9%). Single-drug BZD overdose was more frequent among individuals aged 46-60 years. The predominant symptoms were drowsiness (<i>n</i> = 45; 47.4%) and nausea or vomiting (<i>n</i> = 32; 33.7%). Six patients (6.3%) required definitive airway stabilization in the ED, while two patients (2.1%) required inotropic support. Flumazenil was administered to 19 (20%) patients with no reported side effects. A majority (<i>n</i> = 49; 51.6%) of patients were admitted to the hospital, of whom 30 (61.2%) were discharged in stable condition, while 19 (38.8%) left against medical advice. No deaths were reported.</p><p><strong>Conclusion: </strong>Middle-aged females were most frequently involved in DSH cases. Single-drug BZD overdose was more common in this age-group. The predominant symptoms included drowsiness and gastrointestinal complaints. Most patients required hospital admission.</p><p><strong>How to cite this article: </strong>Giftson J, Hazra D, Chandy GM. A Two-year Retrospective Observational Cohort Study of Benzodiazepine Overdose Cases in the Emergency Department. Indian J Crit Care Med 2025;29(3):230-235.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"230-235"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665151","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":"Behavior of the Perme Scale and Correlation with Clinical Outcomes in the Postoperative of Coronary Artery Bypass Grafting.","authors":"André Luiz Lisboa Cordeiro, Hayssa Mascarenhas, Lucas Oliveira Soares, Vitória Pimentel, Eduarda Gomes, Larissa Pinto, Gabriel Ferreira, Luiz Alberto Forgiarini Junior, André Guimarães","doi":"10.5005/jp-journals-10071-24922","DOIUrl":"10.5005/jp-journals-10071-24922","url":null,"abstract":"<p><strong>Background: </strong>There are limiting factors that influence the assessment of mobility after cardiac surgery. Therefore, the Perme intensive care unit mobility score scale becomes more appropriate because it analyzes physical and psychological limitations in the intensive care unit (ICU), taking into account extrinsic problems.</p><p><strong>Objective: </strong>Describe the behavior of the Perme scale and its correlation with clinical outcomes in the postoperative stage of cardiac surgery.</p><p><strong>Materials and methods: </strong>This is a prospective cohort study. The patients were evaluated in four moments, to analyze the perception of pain, the degree of dyspnea, muscle strength, and functionality according to the Perme scale which ranges from 0 to 32 points. It was applied at hospital admission, ICU discharge, admission to the ward (UI), and hospital discharge. Values expressed as Delta 1 (d1) and Delta 2 (d2) were used to determine the comparison of preoperative and hospital discharge, respectively.</p><p><strong>Results: </strong>Twenty-one patients were included. Among the correlation variables at the different moments, it was perceived that cardiopulmonary bypass time d1 (<i>r</i> = 0.19; <i>p</i> = 0.42); d2 (<i>r</i> = 0.07; <i>p</i> = 0.98); ICU time d1 (<i>r</i> = 0.34; <i>p</i> = 0.17); d2 (<i>r</i> = 0.35; <i>p</i> = 0.16); hospital time d1 (<i>r</i> = 0.17; <i>p</i> = 0.54); d2 (<i>r</i> = 0.21; <i>p</i> = 0.47) and mechanical ventilation (MV) time d1 (<i>r</i> = 0.09; <i>p</i> = 0.70); d2 (<i>r</i> = 0.44; <i>p</i> = 0.06) showed no statistically significant difference. The variables hospital admission (31 ± 1) and ICU discharge (20 ± 4) showed significant losses in the length of stay in these units.</p><p><strong>Conclusion: </strong>The evaluation performed with the Perme scale showed significance when comparing the values between ICU admission and discharge. However, in relation to the clinical outcomes of this study, no relevant correlations were proven.</p><p><strong>How to cite this article: </strong>Cordeiro ALL, Mascarenhas H, Soares LO, Pimentel V, Gomes E, Pinto L, <i>et al</i>. Behavior of the Perme Scale and Correlation with Clinical Outcomes in the Postoperative of Coronary Artery Bypass Grafting. Indian J Crit Care Med 2025;29(3):273-277.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"273-277"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665157","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":"Author Response: The Range of Nonpharmacological Measures to Prevent Delirium on Intensive Care Units is Broader than Assumed.","authors":"Moirangthem Sonia, Sukhpal Kaur, Nikhil Kothari","doi":"10.5005/jp-journals-10071-24916","DOIUrl":"10.5005/jp-journals-10071-24916","url":null,"abstract":"<p><p>Sonia M, Kaur S, Kothari N. Author Response: The Range of Nonpharmacological Measures to Prevent Delirium on Intensive Care Units is Broader than Assumed. Indian J Crit Care Med 2025;29(3):280-281.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"280-281"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665154","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 MACOCHA Score for Predicting Difficult Intubation in Critically Ill Cancer Patients: A Prospective Observational Study.","authors":"Atul P Kulkarni, Shilpushp J Bhosale, Kushal R Kalvit, Swapna Cherian, Anjana M Shrivastava, Manoj R Gorade","doi":"10.5005/jp-journals-10071-24934","DOIUrl":"10.5005/jp-journals-10071-24934","url":null,"abstract":"<p><strong>Introduction: </strong>Tracheal intubation (TI) is often needed in the intensive care unit (ICU) but can have disastrous consequences. The MACOCHA score was developed for prediction of difficult intubation (DI) in critically ill.</p><p><strong>Material and methods: </strong>After Institutional Ethics Committee approval, we conducted this prospective, single-center observational study. Evaluated the ability of MACOCHA score to predict difficult intubation in our ICU. We included 500 adults undergoing TI in our ICU. We collected the demographic data, details of ICU admission, and intubation-related data for calculating MACOCHA score. We used Statistical Package for the Social Sciences (version 21) for analysis. The accuracy of MACOCHA score for predicting DI was determined by area under the receiver operating characteristic (AUROC) curve. The Hosmer-Lemeshow goodness-of-fit statistics was used to determine calibration.</p><p><strong>Results: </strong>Since complete dataset was available for 449/500 patients, we analyzed their data. Acute renal failure and shock were the most frequent reasons for TI. Ketamine and rocuronium were most commonly used drugs for TI. The incidence of DI was 13.5% (60/449). There were 30 patients whose Mallampati score was either III and IV, while 84 and 45 patients had severe hypoxemia and coma before TI, respectively. The AUROC curve for the MACOCHA score was 0.659 (confidence interval, 0.574-0.743), suggesting a moderate discrimination. The Hosmer-Lemeshow goodness-of-fit test showed moderate calibration (χ² = 3.142, with <i>p</i> = 0.208). One hundred and seventy-one (26.5%) complications occurred in the entire cohort. Some patients had multiple complications.</p><p><strong>Conclusion: </strong>The MACOCHA score showed moderate discrimination and calibration in predicting DI in our study.</p><p><strong>How to cite this article: </strong>Kulkarni AP, Bhosale SJ, Kalvit KR, Cherian S, Shrivastava AM, Gorade MR. Evaluation of MACOCHA Score for predicting Difficult Intubation in Critically Ill Cancer Patients: A Prospective Observational Study. Indian J Crit Care Med 2025;29(3):208-214.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"208-214"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665171","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":"HFNC Oxygen Therapy vs COT in Prolonged Upper Gastrointestinal Endoscopy Inside the ICU: A Prospective, Randomized, Controlled Clinical Study.","authors":"Ahmed M Mohamed, Wessam Z Selima","doi":"10.5005/jp-journals-10071-24919","DOIUrl":"10.5005/jp-journals-10071-24919","url":null,"abstract":"<p><strong>Aims and background: </strong>Hypoxemia is a common and serious complication occurring during deep sedation for prolonged upper gastrointestinal endoscopy (UGE). We evaluated and compared the efficacy of high-flow nasal cannula (HFNC) oxygen therapy vs conventional nasal cannula oxygen therapy (COT) in preventing hypoxemia in patients admitted to the intensive care unit (ICU) and who underwent prolonged (>15 minutes) UGE under deep sedation.</p><p><strong>Materials and methods: </strong>Seventy patients aged 20-60 years with American Society of Anesthesia (ASA) I, II, or III who were admitted to the ICU and were scheduled for an anticipated prolonged UGE were included. They were randomly assigned to be administered either oxygen through a standard nasal cannula (COT group) or oxygen through an HFNC (HFNC group). The primary outcome was any occurrence of at least moderate hypoxemic episodes [oxygen saturation (SpO₂) < 90%] of any duration.</p><p><strong>Results: </strong>Regarding the occurrence of hypoxemic episodes, 18 patients (51.4%) in the COT group experienced hypoxemia with 11 (31.4%) experiencing mild hypoxemia, six (17.1%) experiencing moderate hypoxemia, and only one patient (2.9%) experienced severe hypoxemia, with a total of seven patients (20.0%) whose SpO₂ was <90%. Conversely, only two patients (5.7%) in the HFNC group had mild hypoxemia, and no patients had SpO₂ < 90%. Additionally, nine patients in the COT group experienced clinically significant hypoxemia, whereas no patients in the HFNC group (<i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>High-flow nasal cannula (HFNC) oxygen therapy was safe, well tolerated, and significantly decreased the incidence of hypoxemic episodes, compared to COT, among high-risk ICU patients who underwent prolonged UGE under propofol deep sedation.(<b>Registered at ClinicalTrials.gov with ID:</b> NCT06350864).</p><p><strong>How to cite this article: </strong>Mohamed AM, Selima WZ. HFNC Oxygen Therapy vs COT in Prolonged Upper Gastrointestinal Endoscopy Inside the ICU: A Prospective, Randomized, Controlled Clinical Study. Indian J Crit Care Med 2025;29(3):223-229.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"223-229"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665184","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":"MACOCHA Score to Predict Difficult Intubation in Critically Ill: Expectation-Reality Dissonance?","authors":"Mozammil Shafi","doi":"10.5005/jp-journals-10071-24937","DOIUrl":"10.5005/jp-journals-10071-24937","url":null,"abstract":"<p><p>Shafi M. MACOCHA Score to Predict Difficult Intubation in Critically Ill: Expectation-Reality Dissonance? Indian J Crit Care Med 2025;29(3):199-200.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"199-200"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665187","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":"Optimizing Oxygenation during Gastrointestinal Endoscopy: The Rise of HFNC Therapy.","authors":"Pavan Kumar Vala, Suhail S Siddiqui","doi":"10.5005/jp-journals-10071-24927","DOIUrl":"10.5005/jp-journals-10071-24927","url":null,"abstract":"<p><p>Vala PK, Siddiqui SS. Optimizing Oxygenation during Gastrointestinal Endoscopy: The Rise of HFNC Therapy. Indian J Crit Care Med 2025;29(3):201-202.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"201-202"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663978","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":"The Effect of Perioperative Fluid Therapy on Postoperative Renal Functions in Patients Receiving Liver Transplantation from Living Donors: A Retrospective Observational Study.","authors":"Nurcan Kızılcık","doi":"10.5005/jp-journals-10071-24907","DOIUrl":"10.5005/jp-journals-10071-24907","url":null,"abstract":"<p><strong>Background: </strong>Perioperative fluid management (PFM) is critical in liver transplantation, especially regarding its impact on postoperative renal function. Acute kidney injury (AKI) is a common complication in liver transplant recipients, often influenced by the type and volume of fluids administered during the perioperative period. This study investigates the effects of different fluid management strategies on renal outcomes following liver transplantation from living donors.</p><p><strong>Patients and methods: </strong>This retrospective observational study included 91 liver transplant recipients who were categorized into three groups based on their PFM strategy: restrictive (<i>n</i> = 1), moderate (<i>n</i> = 34), and liberal (<i>n</i> = 56). Data were collected from patient medical records, focusing on fluid types, peak serum creatinine levels, urine output, and length of hospital stay. Statistical analyses, including ANOVA and logistic regression, were conducted to assess renal outcomes among the groups.</p><p><strong>Results: </strong>The moderate fluid management group demonstrated the best renal outcomes, with the lowest peak serum creatinine (1.02 ± 0.25 mg/dL) and shorter ICU stays (2.47 ± 0.62 days) compared to the liberal fluid strategy group (1.40 ± 0.92 mg/dL and 2.88 ± 0.83 days, respectively). Moreover, liberal fluid strategies were associated with fluid overload and increased peak serum creatinine levels. Intraoperative fluid administration showed a greater protective effect on renal function compared to postoperative fluid administration.</p><p><strong>Conclusions: </strong>Moderate PFM, particularly with careful intraoperative fluid administration, is optimal for minimizing the risk of AKI and improving renal outcomes in liver transplant patients. These findings emphasize the importance of individualized fluid therapy in reducing renal complications after liver transplantation.</p><p><strong>How to cite this article: </strong>Kızılcık N. The Effect of Perioperative Fluid Therapy on Postoperative Renal Functions in Patients Receiving Liver Transplantation from Living Donors: A Retrospective Observational Study. Indian J Crit Care Med 2025;29(3):251-261.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"251-261"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664921","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":"VExUS Score: Making Waves in an Ocean but Still a Mirage in the Desert.","authors":"Vivek Kumar","doi":"10.5005/jp-journals-10071-24931","DOIUrl":"10.5005/jp-journals-10071-24931","url":null,"abstract":"<p><p>Kumar V. VExUS Score: Making Waves in an Ocean but Still a Mirage in the Desert. Indian J Crit Care Med 2025;29(3):205-207.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"205-207"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665009","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":"Deciphering Oxygenation Metrics in ARDS: A Deep Dive into the OXIVA-CARDS Study.","authors":"Sathwik Gangireddy, Pratyusha Kambagiri, Atul Jindal","doi":"10.5005/jp-journals-10071-24846","DOIUrl":"10.5005/jp-journals-10071-24846","url":null,"abstract":"<p><p>Gangireddy S, Kambagiri P, Jindal A. Deciphering Oxygenation Metrics in ARDS: A Deep Dive into the OXIVA-CARDS Study. Indian J Crit Care Med 2025;29(3):282.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"282"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665168","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}