Indian Journal of Critical Care Medicine最新文献

{"title":"Validation of Global Definition of Acute Respiratory Distress Syndrome in COVID-19 Patients: A Retrospective Study.","authors":"Souvik Maitra, Dalim K Baidya, Bikash R Ray, Choro A Kayina, Damarla Haritha, Parvathy R Nair, Sulagna Bhattacharjee","doi":"10.5005/jp-journals-10071-25006","DOIUrl":"10.5005/jp-journals-10071-25006","url":null,"abstract":"<p><strong>Background and aims: </strong>A recent acute respiratory distress syndrome (ARDS) definition included patients receiving high-flow nasal oxygen (HFNO) when fulfilling the oxygenation and radiological criteria of ARDS Berlin definition. However, outcome of patients treated may be better than those who fulfilled the corresponding class of Berlin definition. This study was aimed to compare the survival between patients fulfilling Berlin definition and patients managed by HFNO initially.</p><p><strong>Patients and methods: </strong>Patients fulfilling the World Health Organization case definition of severe or critical COVID-19 infection requiring HFNO (at least 30 L/minute of flow), noninvasive ventilation (NIV) (at least a positive end-expiratory pressure (PEEP) of 5 cm H₂O), or invasive mechanical ventilation (at least a PEEP of 5 cm H₂O) were included in this study provided they fulfilled oxygenation and radiological criteria of ARDS as per Berlin definition.</p><p><strong>Results: </strong>All-cause hospital mortality rate in patients who fulfilled Berlin definition (<i>n</i> = 193) was 47.6% (mild ARDS), 64.9% (moderate ARDS), and 67.9% (severe ARDS) (<i>p</i> = 0.23). Multivariable survival analysis reported that hazard of death was higher in patients who fulfilled Berlin definition as opposed to those who were initially managed by HFNO (adjusted hazard ratio (95% confidence interval) 1.68 (1.15-2.45), <i>p</i> = 0.007) after adjustment for age, Charlson comorbidity index, and baseline PaO₂/FiO₂ ratio. Multiple pairwise comparison reported that hazard of death was lower in patients with moderate ARDS requiring HFNO as compared with the moderate ARDS patients as per Berlin definition (<i>p</i> = 0.024). However, no difference was observed in patients of mild (<i>p</i> = 0.39) and severe ARDS (<i>p</i> = 0.24).</p><p><strong>Conclusion: </strong>We have found a statistically significant higher survival in ARDS patients managed by HFNO in the first 24 hours after intensive care unit (ICU) admission when compared with the patients receiving NIV or invasive mechanical ventilation. So, we conclude that outcome of patients fulfilling the global definition of ARDS is largely different from those who fulfilled Berlin definition. Hence, prospective multicentric validation is required before its bedside use.</p><p><strong>How to cite this article: </strong>Maitra S, Baidya DK, Ray BR, Kayina CA, Haritha D, Nair PR, <i>et al</i>. Validation of Global Definition of Acute Respiratory Distress Syndrome in COVID-19 Patients: A Retrospective Study. Indian J Crit Care Med 2025;29(7):556-561.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 7","pages":"556-561"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745517","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: Letter on \"Impact of Noninvasive Ventilation on Quality of Sleep among Patients Admitted to the Critical Care Unit\" - Limitations and Recommendations.","authors":"Aiswarya Kunjappan, Madhura M Reddy","doi":"10.5005/jp-journals-10071-25012","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-25012","url":null,"abstract":"","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 7","pages":"634-635"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745498","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":"Continuous Infusion of Linezolid: Explaining the Discrepant Survival Outcomes between Two Studies.","authors":"Aurélien Gonze, Thibault Gennart, Nathan De Lissnyder, Alexis Lefevre, Sydney Blackman, Patrick M Honore","doi":"10.5005/jp-journals-10071-24982","DOIUrl":"10.5005/jp-journals-10071-24982","url":null,"abstract":"","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 7","pages":"621-622"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745504","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":"Patients with Benzodiazepine Intoxication Require Neurological and Psychiatric Examination in Order to Guide and Monitor Withdrawal.","authors":"Sinda Zarrouk, Josef Finsterer","doi":"10.5005/jp-journals-10071-24983","DOIUrl":"10.5005/jp-journals-10071-24983","url":null,"abstract":"","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 7","pages":"626"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745510","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 Sleep Quality of Intensive Care Unit Patients on Noninvasive Ventilation Depends Not Only on Noninvasive Ventilation- and ICU-related Factors but Also on Numerous Other Factors.","authors":"Sinda Zarrouk, Josef Finsterer","doi":"10.5005/jp-journals-10071-25003","DOIUrl":"10.5005/jp-journals-10071-25003","url":null,"abstract":"","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 7","pages":"629-630"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745515","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":"Conversion of Lactate from mg/dL to mmol/L: Beware of the AI-derived Google Search Error!","authors":"Ak Ajith Kumar","doi":"10.5005/jp-journals-10071-24970","DOIUrl":"10.5005/jp-journals-10071-24970","url":null,"abstract":"","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 6","pages":"549-550"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498418","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":"Critical Appraisal of the Bayesian Application of Modified Nutrition Risk in Critically Ill Score: Caution Against Overextension as a Mortality Predictor.","authors":"Sritam Mohanty, Sagarika Panda","doi":"10.5005/jp-journals-10071-24981","DOIUrl":"10.5005/jp-journals-10071-24981","url":null,"abstract":"","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 6","pages":"546"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498419","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":"Rectus Femoris Cross-sectional Area Remains a Vague Outcome Predictor of Polyradiculitis as Long as Not All Influencing Factors are Considered.","authors":"Josef Finsterer","doi":"10.5005/jp-journals-10071-24973","DOIUrl":"10.5005/jp-journals-10071-24973","url":null,"abstract":"","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 6","pages":"538-539"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Performance of Pediatric Risk of Mortality IV and Pediatric Index of Mortality 3 in Critically Ill Children with Cancer: A Prospective Observational Study.","authors":"Kushal R Kalvit, Shilpushp J Bhosale, Jacob G Pulinilkunnathi, Swapna C Vijayakumaran, Anjana M Shrivastava, Atul P Kulkarni","doi":"10.5005/jp-journals-10071-24979","DOIUrl":"10.5005/jp-journals-10071-24979","url":null,"abstract":"<p><strong>Background and aims: </strong>In pediatric critical care, pediatric risk of mortality (PRISM) and pediatric index of mortality (PIM) scoring systems are the most widely used severity of illness scoring systems. The current versions of these scoring systems (PRISM IV and PIM 3) have not been validated in critically ill oncology patients. The aim of this study was to evaluate the comparative performance of PRISM IV and PIM 3 in critically ill children with cancer.</p><p><strong>Patients and methods: </strong>About 415 critically ill pediatric patients were recruited at a single-center, mixed medical-surgical ICU in a prospective observational study. Patients with an expected ICU stay of greater than 24 h were included. Demographic, physiological, and laboratory parameters required to calculate the PRISM IV and PIM 3 scores were collected; laboratory data from 2 hours prior to 4 hours after admission, and physiological data within 4 hours of admission were collected. The worst value was considered for calculating the scores. Both scores and their predicted mortality risk were calculated using online calculators.</p><p><strong>Results: </strong>The mortality at ICU discharge and at hospital discharge was 32.7% and 36.1%, respectively. For the prediction of hospital mortality, the AUROC for PRISM IV score was 0.71and the PIM 3 estimated mortality (%) was 0.78, respectively. There was a statistically significant positive correlation between the PRISM IV score and PIM 3 estimated mortality (%) with the hospital mortality. The logistic model for PRISM IV score also passed the goodness-of-fit test indicating a good model fit. The goodness-of-fit test for the PIM 3 model suggests that the model may not fit the data well and may require further investigation or improvement.</p><p><strong>Conclusions: </strong>Both PRISM IV and PIM 3 scores showed acceptable discriminative ability between survivors and non-survivors in the critically ill pediatric oncology population. However, only the PRISM IV score showed good calibration in the prediction of survival.</p><p><strong>How to cite this article: </strong>Kalvit KR, Bhosale SJ, Pulinilkunnathi JG, Vijayakumaran SC, Shrivastava AM, Kulkarni AP. Comparative Performance of Pediatric Risk of Mortality IV and Pediatric Index of Mortality 3 in Critically Ill Children with Cancer: A Prospective Observational Study. Indian J Crit Care Med 2025;29(6):486-491.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 6","pages":"486-491"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498417","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":"Cross-sectional Study: Diagnostic Accuracy of Next-generation Sequencing in a Tertiary Care Intensive Care Unit.","authors":"Mihika Sawale, Rishabh Raj, Mugdha Bhide, Gunjan Chanchalani","doi":"10.5005/jp-journals-10071-24987","DOIUrl":"10.5005/jp-journals-10071-24987","url":null,"abstract":"<p><strong>Background and aims: </strong>Infectious diseases are a major cause of intensive care unit (ICU) mortality, where rapid pathogen identification is crucial. Traditional culture methods are slow and may miss fastidious organisms. Next-generation sequencing (NGS) offers rapid, comprehensive pathogen detection. This study assessed NGS accuracy compared to culture in a tertiary care ICU in India.</p><p><strong>Patients and methods: </strong>A retrospective observational analysis of 187 ICU patients with suspected infections was conducted with IRB approval. Paired samples from blood, urine, bronchoalveolar lavage fluid (BALF), cerebrospinal fluid (CSF), and other body fluids underwent NGS and culture testing. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using culture as the reference. Concordance was also assessed.</p><p><strong>Results: </strong>Next-generation sequencing demonstrated a sensitivity of 75%, specificity of 59.6%, PPV of 62.23%, and NPV of 72.84%. It detected pathogens in 56.68% of cases vs 47.06% by culture, identifying 17 atypical organisms in culture-negative cases. Sensitivity was highest in CSF (100%) and BALF (87.5%), while specificity was highest in pleural fluid (100%) and blood (87.5%). Overall concordance was 57.2%.</p><p><strong>Conclusion: </strong>Next-generation sequencing has improved pathogen detection, identifying organisms missed by culture. High sensitivity across sample types suggests its value in ICU diagnostics. However, lower specificity, high cost, and standardization challenges limit standalone use.</p><p><strong>Clinical significance: </strong>Next-generation sequencing facilitates an earlier ICU infection diagnosis, allowing for prompt targeted treatment and potentially reducing antimicrobial resistance. However, false positives and cost remain barriers. Combining NGS with conventional culture techniques could improve diagnostic accuracy and patient outcomes in the right subset of patients.</p><p><strong>How to cite this article: </strong>Sawale M, Raj R, Bhide M, Chanchalani G. Cross-sectional Study: Diagnostic Accuracy of Next-generation Sequencing in a Tertiary Care Intensive Care Unit. Indian J Crit Care Med 2025;29(6):498-503.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 6","pages":"498-503"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498420","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}