Indian Journal of Critical Care Medicine最新文献

{"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":"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}

{"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":"Prokineticin-2 and Procalcitonin's Diagnostic Accuracy for Sepsis in Critically Ill Patients: A Prospective Observational Study.","authors":"Kavyashree Bhat, Nikhil Kothari, Ankur Sharma, Shilpa Goyal, Tanvi Meshram, Bharat Paliwal, Pradeep Bhatia, Shrimanjunath Sankanagoudar","doi":"10.5005/jp-journals-10071-24930","DOIUrl":"10.5005/jp-journals-10071-24930","url":null,"abstract":"<p><strong>Objective: </strong>Sepsis stands as a significant contributor to mortality in ICU settings worldwide. Early diagnosis and appropriate treatment are therefore essential to reduce mortality. We planned this study to investigate the diagnostic significance of prokineticin-2 (PK-2) in patients with sepsis.</p><p><strong>Materials and methods: </strong>Adult patients with sepsis who were admitted to our intensive care unit (ICU) were included in this prospective observational study. On the day of admission and the 7th day of the ICU stay, the levels of procalcitonin (PCT) and PK-2 were assessed. Patients' mortality was observed for 28 days.</p><p><strong>Results: </strong>This research involved 83 patients meeting the inclusion criteria. Prokineticin-2 showed a diagnostic sensitivity of 70.6% for sepsis, outperforming PCT with a sensitivity of 64.7%. In predicting mortality, PCT displayed a sensitivity of 95.5%, whereas Prokineticin-2 demonstrated an even higher sensitivity at 98.4%.</p><p><strong>Conclusion: </strong>Prokinectin-2 can be used for screening adult patients with sepsis admitted to ICU.</p><p><strong>How to cite this article: </strong>Bhat K, Kothari N, Sharma A, Goyal S, Meshram T, Paliwal B, <i>et al</i>. Prokineticin-2 and Procalcitonin's Diagnostic Accuracy for Sepsis In Critically Ill Patients: A Prospective Observational Study. Indian J Crit Care Med 2025;29(3):268-272.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"268-272"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664050","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":"Cracking the Code of AKI: Evaluating the Predictive Power of VExUS Scoring in Critically Ill Noncardiac Patients.","authors":"Waseem Ahmad Khan, Vikas Saini, Alisha Goel, Anas Valiyaparambath","doi":"10.5005/jp-journals-10071-24924","DOIUrl":"10.5005/jp-journals-10071-24924","url":null,"abstract":"<p><strong>Background: </strong>Numerous signs of venous congestion exist, but each has limitations. Previous studies have shown the utility of venous excess ultrasound (VExUS) scoring in predicting acute kidney injury (AKI) in patients postcardiac surgery. This study aimed to evaluate whether serial VExUS scoring could predict AKI in intensive care unit (ICU) patients without cardiac conditions.</p><p><strong>Materials and methods: </strong>This single-center observational study was conducted in the main ICU of PGIMER, Chandigarh, India. Thirty patients with an inferior vena cava (IVC) diameter of ≥2 cm and a normal biventricular function were included. Serial VExUS scoring was performed on admission and daily for up to six days or until AKI developed, whichever occurred first.</p><p><strong>Results: </strong>Among 30 participants, 22 (73.3%) developed AKI. In the AKI group, mean VExUS scores were 1.95 on day 2, 1.92 on day 3, and 3.0 on day 5 (<i>p</i> = 0.001, 0.003, and 0.002, respectively). A significant positive correlation was observed between VExUS scores and fluid balance on day 2 (ρ = 0.375, <i>p</i> = 0.041) and day 3 (ρ = 0.579, <i>p</i> = 0.006). Multivariate analysis showed no correlation between the VExUS score on day 2 and fluid balance, duration of mechanical ventilation, or ICU length of stay. No association was found between VExUS scores and 30-day mortality.</p><p><strong>Conclusion: </strong>In critically ill noncardiac patients, VExUS scores do not predict AKI onset. However, higher daily fluid balance may moderately correlate with VExUS scores.</p><p><strong>How to cite this article: </strong>Khan WA, Saini V, Goel A, Valiyaparambath A. Cracking the Code of AKI: Evaluating the Predictive Power of VExUS Scoring in Critically Ill Noncardiac Patients. Indian J Crit Care Med 2025;29(3):236-243.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"29 3","pages":"236-243"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665165","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}