Indian Journal of Critical Care Medicine最新文献

{"title":"Aminotransferase-to-platelet Ratio Index for Sepsis-associated Liver Dysfunction: Promising Triage Signal but Phenotype Confounding and Implementation Calibration must be Intensive Care Unit Ready.","authors":"Mulavagili Vijayasimha, Mulavagili Srikanth, Devadass Jayarajan, Logesh Babu, Masilamani Malinidevi","doi":"10.5005/jp-journals-10071-25122","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-25122","url":null,"abstract":"<p><p><b>How to cite this article:</b> Vijayasimha M, Srikanth M, Jayarajan D, Babu L, Malinidevi M. Aminotransferase-to-platelet Ratio Index for Sepsis-associated Liver Dysfunction: Promising Triage Signal but Phenotype Confounding and Implementation Calibration must be Intensive Care Unit Ready. Indian J Crit Care Med 2026;30(2):177-178.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"30 2","pages":"177-178"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500223","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":"Diagnostic and Prognostic Value of Presepsin in Sepsis: A Prospective Observational Study.","authors":"Abhishek Nimbal, Arun Bahulikar, Deepak Phalgune, Ajit Tambolkar","doi":"10.5005/jp-journals-10071-25146","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-25146","url":null,"abstract":"<p><strong>Background and aims: </strong>Presepsin is hypothesized to be more specific for the diagnosis of sepsis, as it is directly involved in the pathogenesis of the syndrome. Several studies have investigated the clinical validity of presepsin; however, the results have shown considerable variability. The present study aimed to determine the diagnostic accuracy of presepsin as a biomarker for the diagnosis of sepsis.</p><p><strong>Patients and methods: </strong>This prospective observational study included 140 patients, aged 18 years and older, who presented with suspected sepsis, a quick sequential organ failure assessment (qSOFA) score ≥2, and radiological or microbiological evidence of infection. The study was conducted from April 2024 to February 2025 at a tertiary care hospital in Western India. The SOFA score and presepsin levels were measured at the time of presentation. Receiver-operating characteristic (ROC) curve analysis was performed to determine the optimal presepsin cutoff value for predicting sepsis and mortality.</p><p><strong>Results: </strong>Presepsin levels were significantly higher in patients with sepsis and in those who died. They showed a strong correlation with the SOFA score (<i>r</i> = 0.45; <i>p</i> = 0.01). Receiver-operating characteristic analysis demonstrated that presepsin is a strong predictor of sepsis [area under the curve (AUC) = 0.926 (95% CI: 0.881-0.971; cutoff > 195 pg/mL; sensitivity, 87.2%; specificity, 88.9%]. For mortality, ROC analysis showed good predictive value [AUC = 0.843 (95% CI: 0.755-0.931); cutoff > 1,364 pg/mL; sensitivity, 78.0%; specificity, 80.0%].</p><p><strong>Conclusion: </strong>Presepsin is a reliable biomarker for the diagnosis and prognosis of sepsis.</p><p><strong>How to cite this article: </strong>Nimbal A, Bahulikar A, Phalgune D, Tambolkar A. Diagnostic and Prognostic Value of Presepsin in Sepsis: A Prospective Observational Study. Indian J Crit Care Med 2026;30(2):117-121.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"30 2","pages":"117-121"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500286","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":"Personalized Parenteral Nutrition-Comparing Apples and Oranges?","authors":"Anirban Bhattacharjee, Gargi Pal, Riddhi Kundu","doi":"10.5005/jp-journals-10071-25128","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-25128","url":null,"abstract":"<p><p><b>How to cite this article:</b> Bhattacharjee A, Pal G, Kundu R. Personalized Parenteral Nutrition-Comparing Apples and Oranges? Indian J Crit Care Med 2026;30(2):179-180.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"30 2","pages":"179-180"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500345","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 if the Intensive Care Unit Abandoned the Physiology Myth-The Case of \"Physiological PEEP\".","authors":"Ganesh K Manjunatha, Marcus J Schultz, Prashant Nasa","doi":"10.5005/jp-journals-10071-25141","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-25141","url":null,"abstract":"<p><p>There is something deeply appealing about the concept of \"physiological positive end-expiratory pressure (PEEP)\" because it sounds scientific, natural, and evidence-based. The rationale for physiological PEEP is glottic closure at the end of expiration, which helps in preventing alveolar collapse and optimizing gas exchange. However, the translation of physiological PEEP to a minimum preset PEEP in mechanically ventilated patients is standard practice, though it lacks evidence. Moreover, PEEP is not innocuous in positive-pressure ventilation and can cause harm by altering respiratory and cardiovascular mechanics. We present a viewpoint challenging the dogma of the application of \"physiological PEEP\" during invasive mechanical ventilation. The PEEP, like any other ventilation setting, should be based on pathology and lung mechanics and needs to be individualized.</p><p><strong>How to cite this article: </strong>Manjunatha GK, Schultz MJ, Nasa P. What if the Intensive Care Unit Abandoned the Physiology Myth-The Case of \"Physiological PEEP\". Indian J Crit Care Med 2026;30(2):95-98.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"30 2","pages":"95-98"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500353","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":"Beyond the Mean: The Dynamic Fingerprint of Vasoplegia in Septic Shock.","authors":"Abhishek P Singh, Deepak Govil","doi":"10.5005/jp-journals-10071-25145","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-25145","url":null,"abstract":"<p><p><b>How to cite this article:</b> Singh AP, Govil D. Beyond the Mean: The Dynamic Fingerprint of Vasoplegia in Septic Shock. Indian J Crit Care Med 2026;30(2):85-87.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"30 2","pages":"85-87"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500348","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":"Impact of Death Work Competence on Emergency Nurses' Perspectives in the Organ Donation Process.","authors":"Sinu Jose, Maneesha C Cyriac, Manju Dhandapani, P V Gayathri","doi":"10.5005/jp-journals-10071-25132","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-25132","url":null,"abstract":"<p><strong>Background and aims: </strong>Deceased organ donation is a vital but underutilized solution to the global organ shortage. As frontline responders, emergency nurses are pivotal to the donation process; however, their involvement may be limited by their death work competence or their ability to manage the complexities of end-of-life care. This study explores the relationship between death work competence and emergency nurses' perspectives on organ donation, specifically focusing on their knowledge, attitudes, and communication readiness.</p><p><strong>Patients and methods: </strong>A descriptive cross-sectional study was conducted among 107 emergency nurses in a North Indian teaching hospital. Data were collected using a structured self-administered questionnaire and the Self-Competence in Death Work Scale (SC-DWS). Descriptive and correlational analyses were performed to examine associations between knowledge, attitudes, and self-competence.</p><p><strong>Results: </strong>Most participants supported organ donation (97.4%), and 69.2% had considered donor registration. Nurses demonstrated moderate knowledge (mean 8.41 ± 1.53) and attitudes (mean 6.21 ± 1.36), with overall moderate death work competence (mean 55.21 ± 9.13). A significant positive correlation was observed between knowledge and death work competence (<i>r</i> = 0.296, <i>p</i> = 0.009), suggesting that higher competence enhances understanding and positive perspectives toward organ donation.</p><p><strong>Conclusion: </strong>Death work competence seems to influence emergency nurses' perspectives and readiness to engage in organ donation discussions.</p><p><strong>How to cite this article: </strong>Jose S, Cyriac MC, Dhandapani M, Gayathri PV. Impact of Death Work Competence on Emergency Nurses' Perspectives in the Organ Donation Process. Indian J Crit Care Med 2026;30(2):134-139.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"30 2","pages":"134-139"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500320","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 Non-invasive Ventilation Compared with Invasive Mechanical Ventilation in Cardiogenic Shock: A Systematic Review and Meta-analysis.","authors":"Tanawat Attachaipanich, Kotchakorn Kaewboot, Suthinee Attachaipanich","doi":"10.5005/jp-journals-10071-25140","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-25140","url":null,"abstract":"<p><strong>Background: </strong>Cardiogenic shock has a high mortality rate, and ventilation support is commonly required. Non-invasive ventilation (NIV) provides several advantages over invasive mechanical ventilation (IMV) and is safe in cardiogenic pulmonary edema. However, its efficacy in cardiogenic shock remains unclear. This study aimed to evaluate the efficacy and safety of NIV compared to IMV in this population.</p><p><strong>Data sources: </strong>A systematic search was conducted across four databases, including PubMed, Embase, Web of Science, and Cochrane CENTRAL, from inception to February 12, 2025, without language restrictions.</p><p><strong>Study selection: </strong>Studies were included if they compared NIV vs IMV in patients diagnosed with cardiogenic shock and reported relevant clinical outcomes.</p><p><strong>Data extraction: </strong>Two reviewers independently extracted data on study characteristics, patient demographics, and outcomes. Risk of bias was independently assessed using appropriate tools for the included studies.</p><p><strong>Data synthesis: </strong>A total of 6 observational, non-randomized studies involving 2,302 participants were included in this meta-analysis, using a random-effects model. Non-invasive ventilation was associated with a significantly lower risk of in-hospital mortality [odds ratio (OR) 0.55 (95% confidence interval (CI): 0.38-0.79), <i>p</i> < 0.01; <i>I</i> ² = 35.85%] and 30-day mortality (OR: 0.47 (95% CI: 0.35-0.63), <i>p</i> < 0.01; <i>I</i> ²= 0%) compared to IMV. Non-invasive ventilation also reduced the length of hospital stays and intensive care unit/coronary care unit stays. Sensitivity analyses, including two studies using propensity score adjustment, showed the consistent benefit of NIV in reducing in-hospital mortality and length of hospital stay.</p><p><strong>Conclusions: </strong>Non-invasive ventilation was associated with improved short-term outcomes compared with IMV in carefully selected patients with cardiogenic shock. However, all included studies were observational, with potential for residual confounding; therefore, further randomized studies are warranted.</p><p><strong>How to cite this article: </strong>Attachaipanich T, Kaewboot K, Attachaipanich S. Efficacy of Non-invasive Ventilation Compared with Invasive Mechanical Ventilation in Cardiogenic Shock: A Systematic Review and Meta-analysis. Indian J Crit Care Med 2026;30(2):148-154.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"30 2","pages":"148-154"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500311","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":"Paraquat Peril: A Retrospective Study from the Frontlines of a Quaternary Care Hospital in South India.","authors":"George Pp Neeraj, Adarsh J Philip, Gokul Prakash, Chandra S Praneeth, Vignesh K Chandiraseharan, Anand Zachariah, Sudha J Rajan, Arun J Nellickal, Ramya Iyyadurai, Kishore K Pichamuthu, Samuel G Hansdak, Karthik Gunasekaran, Kundavaram Pp Abhilash, John V Peter, Bijesh Yadav","doi":"10.5005/jp-journals-10071-25131","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-25131","url":null,"abstract":"<p><strong>Background and aim: </strong>Paraquat (PQ) dichloride is a commonly used herbicide across agricultural sectors worldwide. Despite being banned in over 70 countries, PQ is still frequently misused in India for suicidal and homicidal poisoning. The study aims to evaluate the clinical and laboratory predictors of survival and to estimate time-to-event outcomes of patients admitted to a quaternary care center in South India with a history of PQ poisoning.</p><p><strong>Patients and methods: </strong>This retrospective study included patients aged 16 and above who presented with PQ poisoning over 10 years (January 2015 to October 2024). Data were collected from the emergency department (ED) triage registry and hospital electronic database. Statistical analyses were conducted to identify factors predicting survival.</p><p><strong>Results: </strong>During the study period, 166 patients with PQ poisoning were included. The majority were young males, with 79.5% experiencing poor outcomes. Acute kidney injury (AKI) (92.2%) and lung injury (57.6%) were common complications. The overall survival rate was 20.5%, with a median survival time of 5 days. Multivariate Cox regression analysis identified N-acetylcysteine, ascorbic acid, cyclophosphamide, and steroids (NACS) combination therapy, a low acute physiology and chronic health evaluation (APACHE) II score, and activated charcoal as independent predictors of survival. A meta-analysis of 15 Indian studies revealed a pooled bad outcome rate of 79%.</p><p><strong>Conclusion: </strong>High morbidity and mortality associated with PQ poisoning in India have been highlighted in our study. The authors suggest that a combination therapy using NACS may improve survival; however, this needs to be explored further. Despite these interventions, delayed presentation with multiorgan system involvement points toward a poor prognosis. Further research is needed to standardize treatment protocols and guide policy interventions to limit PQ use and enhance outcomes.</p><p><strong>How to cite this article: </strong>Neeraj GPP, Philip AJ, Prakash G, Praneeth CS, Chandiraseharan VK, Zachariah A, <i>et al</i>. Paraquat Peril: A Retrospective Study from the Frontlines of a Quaternary Care Hospital in South India. Indian J Crit Care Med 2026;30(2):107-116.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"30 2","pages":"107-116"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500349","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":"Noninvasive Ventilation in Cardiogenic Shock: Reconsidering Contraindications.","authors":"Bhuvana Krishna","doi":"10.5005/jp-journals-10071-25148","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-25148","url":null,"abstract":"<p><p><b>How to cite this article:</b> Krishna B. Noninvasive Ventilation in Cardiogenic Shock: Reconsidering Contraindications. Indian J Crit Care Med 2026;30(2):90-91.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"30 2","pages":"90-91"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500266","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":"Letter in Response to the Article: Utility of Extracellular Nicotinamide Phosphoribosyl Transferase as a Novel Biomarker in Predicting Early Severe Organ Dysfunction and Mortality in Acute Respiratory Distress Syndrome: A Prospective Observational Study.","authors":"Tanmoy Ghatak, Payel Bose","doi":"10.5005/jp-journals-10071-25144","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-25144","url":null,"abstract":"<p><p><b>How to cite this article:</b> Ghatak T, Bose P. Letter in Response to the Article: Utility of Extracellular Nicotinamide Phosphoribosyl Transferase as a Novel Biomarker in Predicting Early Severe Organ Dysfunction and Mortality in Acute Respiratory Distress Syndrome: A Prospective Observational Study. Indian J Crit Care Med 2026;30(2):173-174.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"30 2","pages":"173-174"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500325","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}