Indian Journal of Critical Care Medicine最新文献

{"title":"Continuous Infusion of Propofol or Dexmedetomidine should not be the First Choice to Prevent Postoperative Delirium after Hip Fracture.","authors":"Josef Finsterer, João G Marques","doi":"10.5005/jp-journals-10071-24864","DOIUrl":"10.5005/jp-journals-10071-24864","url":null,"abstract":"<p><p><b>How to cite this article:</b> Finsterer J, Marques JG. Continuous Infusion of Propofol or Dexmedetomidine should not be the First Choice to Prevent Postoperative Delirium after Hip Fracture. Indian J Crit Care Med 2025;29(1):86-87.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 1","pages":"86-87"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972692","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: Insights into Immunomodulatory Therapy for Sepsis.","authors":"Indranil Ghosh, Sukhwinder S Sangha, Gaurav Pandey, Atul Srivastava","doi":"10.5005/jp-journals-10071-24874","DOIUrl":"10.5005/jp-journals-10071-24874","url":null,"abstract":"<p><p><b>How to cite this article:</b> Ghosh I, Sangha SS, Pandey G, Srivastava A. Author Response: Insights into Immunomodulatory Therapy for Sepsis. Indian J Crit Care Med 2025;29(1):91.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 1","pages":"91"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972688","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":"Clinical Predispositions, Features, and Outcomes of Infections with Carbapenem-resistant <i>Enterobacterales</i> among Critical Care Patients.","authors":"Ahmed R El-Karamany Shoala, Yasser Nassar, Amani A El-Kholy, Noha S Soliman, Alia Abdel-Fattah, Helmy El-Ghawaby","doi":"10.5005/jp-journals-10071-24876","DOIUrl":"10.5005/jp-journals-10071-24876","url":null,"abstract":"<p><strong>Background: </strong>Carbapenem-resistant <i>Enterobacterales</i> (CRE) infections pose a significant global public health threat. We aimed to assess the risk variables, clinical characteristics, and outcomes of CRE-caused infections in criticalcare patients.</p><p><strong>Patients and methods: </strong>This prospective study enrolled 181 adult patients infected with <i>Enterobacterales</i> in the intensive care unit (ICU). Patients underwent clinical assessment and monitoring throughout their ICU stay. Carbapenem resistance was identified through antibiotic susceptibility testing and multiplex molecular detection of carbapenemase-encoding genes.</p><p><strong>Results: </strong>The mean age of patients was 67.99 ± 12.89 years, with 71.3% being males. Of 181 patients, 111 (61.3%) were found to have CRE infections, including 39 <i>Klebsiella pneumoniae</i> and 31 <i>Escherichia</i> <i>coli</i> isolates. The CRE isolates showed the predominance of the <i>OXA-48</i> (74.8%), followed by the <i>NewDelhi Metallobetalactamase (NDM) carbapenemase</i> genes (20.7%). The risk factors associated with CRE infection included high sequential organ failure assessment (SOFA) score, prolonged length of stay (LOS) in ICU, prior use of broad-spectrum antimicrobials, hemodialysis, plasma exchange, and prolonged mechanical ventilation. Carbapenem-resistant <i>Enterobacterales</i> infections significantly required longer LOS, more need for mechanical ventilation, and exhibited lower rates of bacterial elimination than carbapenem-susceptible <i>Enterobacterales</i> (CSE) infections. The type of resistance gene did not significantly influence the mortality rate among CRE patients. The successful treatment of <i>OXA-48</i>-positive CRE showed a strong correlation with tigecycline and colistin antibiotics.</p><p><strong>Conclusion: </strong>Carbapenem-resistant <i>Enterobacterales</i> infection in ICU patients was associated with adverse outcomes. Identification of high-risk patients is essential for early diagnosis and appropriate management. Therefore, it is crucial to improve infection control methods and implement antimicrobial stewardship to avoid spreading infections.</p><p><strong>How to cite this article: </strong>Shoala ARK, Nassar Y, El-Kholy AA, Soliman NS, Abdel-Fattah A, El-Ghawaby H. Clinical Predispositions, Features, and Outcomes of Infections with Carbapenem-resistant <i>Enterobacterales</i> among Critical Care Patients. Indian J Crit Care Med 2025;29(1):36-44.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 1","pages":"36-44"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972691","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: Continuous Infusion of Propofol or Dexmedetomidine should not be the First Choice to Prevent Postoperative Delirium in Patients after Hip Fracture.","authors":"Gamonmas Ekkapat, Nalin Chokengarmwong","doi":"10.5005/jp-journals-10071-24869","DOIUrl":"10.5005/jp-journals-10071-24869","url":null,"abstract":"<p><p><b>How to cite this article:</b> Ekkapat G, Chokengarmwong N. Author Response: Continuous Infusion of Propofol or Dexmedetomidine should not be the First Choice to Prevent Postoperative Delirium in Patients after Hip Fracture. Indian J Crit Care Med 2025;29(1):88-89.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 1","pages":"88-89"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972687","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":"Effectiveness of Balanced Electrolyte Solution vs Normal Saline in the Resuscitation of Adult Patients with Diabetic Ketoacidosis: An Updated Systematic Review and Meta-analysis.","authors":"Priyanka Gupta, Prashant Nasa, Shuib Mohammed Shahabdeen","doi":"10.5005/jp-journals-10071-24861","DOIUrl":"10.5005/jp-journals-10071-24861","url":null,"abstract":"<p><strong>Aim and background: </strong>Fluid resuscitation is the first-line treatment for patients with diabetic ketoacidosis (DKA). However, the optimal choice of resuscitative fluid remains controversial. This study aims to evaluate the impact of balanced electrolyte solution (BES) compared to 0.9% sodium chloride (NS) on various physiological and clinical outcomes in adult DKA patients.</p><p><strong>Materials and methods: </strong>An extensive search of electronic databases, including Embase, PubMed, Cochrane Library, Web of Science, and Google Scholar, was conducted to select studies that directly compared BES and NS in adult DKA patients. This systematic review and meta-analysis included nine studies, comprising both randomized controlled trials and retrospective studies. Combined estimates were expressed as mean differences (MDs) with 95% confidence intervals (CIs). The primary outcomes were time to resolution of DKA and length of hospital stay. The secondary outcomes were post-resuscitation chloride and bicarbonate levels and adverse events.</p><p><strong>Results: </strong>No significant difference was observed between BES and NS in the time to DKA resolution (MD: -1.63; 95% CI: -7.66-4.41; <i>p</i> = 0.60) or length of hospital stay (MD: -0.07; 95% CI: -0.44-0.31; <i>p</i> = 0.73). However, BES resulted in significantly higher post-resuscitation bicarbonate levels (MD: 1.63; 95% CI: 0.86-2.39; <i>p</i> < 0.001) and lower post-resuscitation chloride levels (MD: -2.37; 95% CI: -3.56 to -1.19; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The use of BES is associated with improved post-resuscitation electrolyte balance and preventing hyperchloremic metabolic acidosis in DKA patients. While BES may offer some biochemical advantages, both BES and NS are safe for treating DKA.</p><p><strong>How to cite this article: </strong>Gupta P, Nasa P, Shahabdeen SM. Effectiveness of Balanced Electrolyte Solution vs Normal Saline in the Resuscitation of Adult Patients with Diabetic Ketoacidosis: An Updated Systematic Review and Meta-analysis. Indian J Crit Care Med 2025;29(1):65-74.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 1","pages":"65-74"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972756","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":"Epidemiology of Neurotrauma in Pediatric Intensive Care Unit: A Single-center Experience of 10 Years.","authors":"Chandrakant G Pujari, A V Lalitha, John M Raj, Ashwini A Meshram","doi":"10.5005/jp-journals-10071-24877","DOIUrl":"10.5005/jp-journals-10071-24877","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) in children can lead to grave consequences. The mechanism, mode, and management of pediatric neurotrauma are different from adult neurotrauma, and there is a growing demand to study the clinicoepidemiology of pediatric TBI.</p><p><strong>Objective: </strong>To explore the clinicoepidemiological profile and outcome of pediatric neurotrauma.</p><p><strong>Methods: </strong>This single-center retrospective study was conducted at a tertiary referral hospital in the PICU involving children (1 month to 18 years) sustaining TBI (2012-2022). Demographic, clinical, and laboratory details at the onset of admission were collected. Predictors of mortality were compared between survivors and non-survivors.</p><p><strong>Results: </strong>Demographic, clinical, and laboratory data of 316 children with traumatic brain injuries at admission were collected and analyzed. The median (IQR) age was 72 months (36-132 months), with 68% of the cohort being male. The majority of the study population (49.1%) was under the age of 5 years. Injury from a fall was the most frequent mechanism of injury (53.5%), followed by road traffic accidents (5%). More than half of the study population suffered mild-TBI (55%). The overall mortality was 8.9% (28/316), and it was highest in the severe TBI group (31.6%) and under-5 years population (42.9%). Lower pediatric trauma score (PTS) (AOR: 0.52; 95% CI: 0.34-0.82) and polytrauma were significantly associated with mortality (AOR: 4.61; 95% CI: 1.02-20.86).</p><p><strong>Conclusion: </strong>Traumatic brain injury is a significant concern in the pediatric population, particularly those under the age of 5 years. Lower PTS and polytrauma predicted poor outcome.</p><p><strong>How to cite this article: </strong>Pujari CG, Lalitha AV, Raj JM, Ashwini A Meshram. Epidemiology of Neurotrauma in Pediatric Intensive Care Unit: A Single-center Experience of 10 Years. Indian J Crit Care Med 2025;29(1):59-64.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 1","pages":"59-64"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972759","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":"Enhanced Surgical Recovery Nursing Program: A Multidisciplinary Approach to Optimize Postoperative Patient Recovery.","authors":"Hezil Reema Barboza, Fatima Dsilva, Amar Sunil Lobo, M S Moosabba, Balakrishna Gurmitkal","doi":"10.5005/jp-journals-10071-24870","DOIUrl":"10.5005/jp-journals-10071-24870","url":null,"abstract":"<p><strong>Background: </strong>Enhanced recovery is currently considered to be the treatment of various elective major surgeries. Enhanced recovery after surgery (ERAS) includes applying various perioperative measures, strategies, and active participation of patients in the recovery process.</p><p><strong>Materials and methods: </strong>A quasi-experimental study was conducted in the surgical units of a hospital in Karnataka, India. Data were collected from patients undergoing elective abdominal surgery (<i>n</i> = 142). Psychological (anxiety) and physiological outcomes (vital capacity, pulse, respiration, and blood pressure) were assessed in experimental and treatment-as-usual groups on preoperative day 1 (2 days before surgery) and preoperative day 2 (1 day before surgery).</p><p><strong>Results: </strong>The results showed a significant decrease in the state-anxiety scores in the experimental group than in the treatment-as-usual group (<i>p</i> < 0.05). Physiological outcomes such as pain, pulse, respiration, and blood pressure showed a significant decrease in the experimental group than the treatment-as-usual group (<i>p</i> < 0.05). Vital capacity was significantly increased in the experimental group and decreased in the treatment-as-usual group in the postoperative days (<i>p</i> < 0.05). A significant decrease in the length of postoperative stay was seen in the experimental group than in the treatment-as-usual group (<i>p</i> = 0.001). In the experimental group, there were less postoperative complications than in the treatment-as-usual group.</p><p><strong>Conclusion: </strong>Enhanced recovery is considered to be the treatment for various elective major surgeries. It is an essential responsibility of healthcare professionals to improve postoperative outcomes by reducing complications and length of postoperative hospital stay.</p><p><strong>How to cite this article: </strong>Barboza HR, Dsilva F, Lobo AS, Moosabba MS, Gurmitkal B. Enhanced Surgical Recovery Nursing Program: A Multidisciplinary Approach to Optimize Postoperative Patient Recovery. Indian J Crit Care Med 2025;29(1):21-26.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 1","pages":"21-26"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972758","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":"Pediatric Neurotrauma: Closing the Gaps.","authors":"Mullai Baalaaji","doi":"10.5005/jp-journals-10071-24886","DOIUrl":"10.5005/jp-journals-10071-24886","url":null,"abstract":"<p><p><b>How to cite this article:</b> Baalaaji M. Pediatric Neurotrauma: Closing the Gaps. Indian J Crit Care Med 2025;29(1):8-9.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 1","pages":"8-9"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972769","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 Insights into Novel Immunomodulatory Therapy for Sepsis: Evaluating Promise Amidst Limitations.","authors":"Varun M Angadi, Pratyusha Kambagiri, Atul Jindal","doi":"10.5005/jp-journals-10071-24847","DOIUrl":"10.5005/jp-journals-10071-24847","url":null,"abstract":"<p><p><b>How to cite this article:</b> Angadi VM, Kambagiri P, Jindal A. Critical Insights into Novel Immunomodulatory Therapy for Sepsis: Evaluating Promise Amidst Limitations. Indian J Crit Care Med 2025;29(1):90.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 1","pages":"90"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972753","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":"Difficult Airway: Is this the Time to Focus on Point-of-care Ultrasonography?","authors":"Mahesha Padyana, Sunil Karanth","doi":"10.5005/jp-journals-10071-24882","DOIUrl":"10.5005/jp-journals-10071-24882","url":null,"abstract":"<p><p><b>How to cite this article:</b> Padyana M, Karanth S. Difficult Airway: Is this the Time to Focus on Point-of-care Ultrasonography? Indian J Crit Care Med 2025;29(1):1-2.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 1","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972755","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}