Indian Journal of Critical Care Medicine最新文献

{"title":"Getting to the HEART of Major Adverse Cardiac Events.","authors":"Srinivas Samavedam","doi":"10.5005/jp-journals-10071-24782","DOIUrl":"10.5005/jp-journals-10071-24782","url":null,"abstract":"<p><p><b>How to cite this article:</b> Samavedam S. Getting to the HEART of Major Adverse Cardiac Events. Indian J Crit Care Med 2024;28(8):724-725.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 8","pages":"724-725"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141428","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":"Contradictory Recommendation in the Guideline for Antibiotic Prescription.","authors":"Praveen K Das, Soumya S Nath, Samiksha Parashar","doi":"10.5005/jp-journals-10071-24736","DOIUrl":"10.5005/jp-journals-10071-24736","url":null,"abstract":"<p><p><b>How to cite this article:</b> Das PK, Nath SS, Parashar S. Contradictory Recommendation in the Guideline for Antibiotic Prescription. Indian J Crit Care Med 2024;28(7):713-714.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 7","pages":"713-714"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591712","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":"Experiences of the Parents of Children Admitted to PICU.","authors":"Sashisenla Kichu, Poonam Joshi, Sunidhi Bhandari, Rakesh Lodha, K Jaykrishnan","doi":"10.5005/jp-journals-10071-24653","DOIUrl":"10.5005/jp-journals-10071-24653","url":null,"abstract":"<p><strong>Introduction: </strong>A pediatric intensive care unit (PICU) is a highly technological and fast-paced setting in a hospital.</p><p><strong>Objective: </strong>To explore the experiences of the parents in the critical care area of a selected tertiary care facility.</p><p><strong>Materials and methods: </strong>In a qualitative study, we interviewed 10 purposively selected parents of the children admitted to PICU using a pre-validated in-depth interview schedule. All parents, whose children were admitted to PICU for more than 5 days, who understood Hindi or English and were willing to participate in the study, were enrolled in the study. Parents of critically ill children having readmission to PICU or prolonged stay of more than 15 days and not accompanied by parents were excluded.</p><p><strong>Results: </strong>Parents had unmet needs, such as the need for information, counseling and education from the healthcare team (HCT) members, having trusting relationship with the HCT, and expecting receiving orientation of the routines and the protocols of PICU, and empathy from the various levels of PICU team. The majority of subjects expressed the desire to talk to a dedicated person for their queries. The parents had multiple feelings of distress, hopelessness, helplessness, guilt, and the fear of losing the child and used various coping strategies.</p><p><strong>Conclusion: </strong>Parents of critically ill children in the PICU have unmet needs. Healthcare team members should take initiative in relieving parental distress and improving their coping abilities.</p><p><strong>How to cite this article: </strong>Kichu S, Joshi P, Bhandari S, Lodha R, Jaykrishnan K. Experiences of the Parents of Children Admitted to PICU. Indian J Crit Care Med 2024;28(7):696-701.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 7","pages":"696-701"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591715","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":"Mirror, Mirror on the Wall; He Had a \"Bypass\" After All!","authors":"Rohan Magoon, Jes Jose, Mukesh Kumar","doi":"10.5005/jp-journals-10071-24684","DOIUrl":"10.5005/jp-journals-10071-24684","url":null,"abstract":"<p><p><b>How to cite this article:</b> Magoon R, Jose J, Kumar M. Mirror, Mirror on the Wall; He Had a \"Bypass\" After All! Indian J Crit Care Med 2024;28(7):706-707.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 7","pages":"706-707"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591718","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":"Unanswered Questions in the Guidelines for Antibiotic Prescription in Critically Ill Patients.","authors":"Soumya S Nath, Nandhini Nachimuthu, Bhagyashree, Supriya Singh","doi":"10.5005/jp-journals-10071-24704","DOIUrl":"10.5005/jp-journals-10071-24704","url":null,"abstract":"<p><p><b>How to cite this article:</b> Nath SS, Nachimuthu N, Bhagyashree, Singh S. Unanswered Questions in the Guidelines for Antibiotic Prescription in Critically Ill Patients. Indian J Crit Care Med 2024;28(7):715-716.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 7","pages":"706-707"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591734","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: Mirror, Mirror on the Wall; He Had a \"Bypass\" After All!","authors":"Manish P Shukla","doi":"10.5005/jp-journals-10071-24739","DOIUrl":"10.5005/jp-journals-10071-24739","url":null,"abstract":"<p><p><b>How to cite this article:</b> Shukla MP. Author Response: Mirror, Mirror on the Wall; He Had a \"Bypass\" After All! Indian J Crit Care Med 2024;28(7):708.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 7","pages":"708"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592622","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 Potential of Serum Interleukin-6 in Predicting Bacteremia in Adult Patients with Sepsis: A Prospective Observational Study.","authors":"Penna Rv Reddy, Mounika Cherukuri, Vandana K Eshwara, Chandrashekar Udyavara Kudru, Rv Krishnananda Prabhu","doi":"10.5005/jp-journals-10071-24754","DOIUrl":"10.5005/jp-journals-10071-24754","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the potential of serum interleukin-6 (IL-6) as a diagnostic marker in predicting bacteremia and to determine its association with severity and outcome among sepsis patients.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted, comprising a cohort of 118 patients admitted to the ICU with suspected sepsis from January 2019 to April 2020.</p><p><strong>Results: </strong>Among the 108 patients analyzed, 60 (55.6%) were bacteremic and 48 (44.4%) were nonbacteremic. Of 60 patients with bacteremia, 13 (21.6%) had sepsis and 47 (78.3%) had septic shock. In predicting bacteremia, the area under the curve (AUC) for IL-6 was 0.512 [95% CI, 0.400-0.623]. The AUC for IL-6 in differentiating sepsis from septic shock was 0.724 [95% CI, 0.625-0.823]. The sensitivity and specificity for predicting bacteremia for IL-6 were 66% and 67%, respectively (<i>p</i> < 0.001). Multivariate analysis revealed that C-reactive protein (CRP) (<i>p</i> = 0.04) and APACHE II score (<i>p</i> = 0.025) were significant predictors of bacteremia, whereas lactate (<i>p</i> = 0.04), and APACHE II score (<i>p</i> < 0.001) were significant predictors of sepsis severity. Patients with elevated levels of procalcitonin PCT (<i>p</i> = 0.024), APACHE II (<i>p</i> = 0.003), and SOFA (<i>p</i> = 0.002) scores had significantly higher mortality rates.</p><p><strong>Conclusion: </strong>C-reactive protein and APACHE II score, lactate and APACHE II score, and PCT, SOFA, and APACHE II scores performed better in predicting bacteremia, sepsis severity, and clinical outcome, respectively compared with IL-6.</p><p><strong>How to cite this article: </strong>Reddy PRV, Cherukuri M, Eshwara VK, Kudru CU, Prabhu RVK. Diagnostic Potential of Serum Interleukin-6 in Predicting Bacteremia in Adult Patients with Sepsis: A Prospective Observational Study. Indian J Crit Care Med 2024;28(7):637-644.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 7","pages":"637-644"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592624","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":"Acoustic Shadowing to Facilitate Ultrasound Guided Arterial Cannulation: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Lipi Mishra, Chandra Rath, Bradley Wibrow, Matthew Anstey, Kwok Ho","doi":"10.5005/jp-journals-10071-24751","DOIUrl":"10.5005/jp-journals-10071-24751","url":null,"abstract":"<p><strong>Aim and background: </strong>Ultrasound-guided arterial catheterization is a frequently performed procedure. Additional techniques such as acoustic shadowing-assisted ultrasound may be useful in improving success rate. This systematic review aimed to assess the efficacy of acoustic shadowing assisted ultrasound for arterial catheterization.</p><p><strong>Materials and methods: </strong>PubMed, Medline, EMBASE, Cochrane Library, EMCARE, and MedNar were searched in January 2024. Randomized controlled trials comparing the first attempt success rate of arterial catheterization using acoustic shadowing ultrasound vs unassisted ultrasound were included. Data were pooled for risk ratios (RRs) using the random-effects model. Subgroup analysis was conducted based on a single or double acoustic line. Sensitivity analysis was undertaken after excluding pediatric data. The certainty of evidence (COE) was assessed using the GRADE framework.</p><p><strong>Results: </strong>Six randomized controlled trials (<i>n</i> = 777) were included. A meta-analysis found the first attempt success rate is significantly higher in the acoustic ultrasound group (<i>n</i> = 6, RR: 0.47, 95% CI: 0.34-0.66, <i>p</i> ≤ 0.00001). Hematoma formation was significantly less in the acoustic ultrasound group (<i>n</i> = 6, RR: 0.52, 95% CI: 0.34-0.80, <i>p</i> = 0.003). First attempt success was significantly higher in the single acoustic line ultrasound (USG) group compared to the unassisted ultrasound group (<i>n</i> = 3, RR: 0.41, 95% CI: 0.28-0.59, <i>p</i> ≤ 0.00001). Sensitivity analysis after excluding pediatric data was similar to the primary analysis (<i>n</i> = 5, RR: 0.50, 95% CI: 0.33-0.70, <i>p</i> ≤ 0.00001). Certainty of evidence was \"Moderate\" for the first attempt cannulation.</p><p><strong>Conclusions: </strong>Acoustic shadowing-assisted ultrasound improved first-attempt arterial catheterization success rate and was associated with reduced hematoma formation.</p><p><strong>How to cite this article: </strong>Mishra L, Rath C, Wibrow B, Anstey M, Ho K. Acoustic Shadowing to Facilitate Ultrasound Guided Arterial Cannulation: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Indian J Crit Care Med 2024;28(7):677-685.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 7","pages":"677-685"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591708","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 Electrical Cardiometry to Assess Fluid Responsiveness in Patients with Acute Circulatory Failure: A Comparative Study with Transthoracic Echocardiography.","authors":"Shashikant Sharma, Rashmi Ramachandran, Vimi Rewari, Anjan Trikha","doi":"10.5005/jp-journals-10071-24753","DOIUrl":"10.5005/jp-journals-10071-24753","url":null,"abstract":"<p><strong>Aim: </strong>Acute circulatory failure is commonly encountered in critically ill patients, that requires fluid administration as the first line of treatment. However, only 50% of patients are fluid-responsive. Identification of fluid responders is essential to avoid the harmful effects of overzealous fluid therapy. Electrical cardiometry (EC) is a non-invasive bedside tool and has proven to be as good as transthoracic echocardiography (TTE) to track changes in cardiac output. We aimed to look for an agreement between EC and TTE for tracking changes in cardiac output in adult patients with acute circulatory failure before and after the passive leg-raising maneuver.</p><p><strong>Materials and methods: </strong>Prospective comparative study, conducted at a Tertiary Care Teaching Hospital.</p><p><strong>Results: </strong>We recruited 125 patients with acute circulatory failure and found 42.4% (53 out of 125) to be fluid-responsive. The Bland-Altman plot analysis showed a mean difference of 2.08 L/min between EC and TTE, with a precision of 3.8 L/min. The limits of agreement (defined as bias ± 1.96SD), were -1.7 L/min and 5.8 L/min, respectively. The percentage of error between EC and TTE was 56% with acceptable limits of 30%.</p><p><strong>Conclusion: </strong>The percentage error beyond the acceptable limit suggests the non-interchangeability of the two techniques. More studies with larger sample sizes are required to establish the interchangeability of EC with TTE for tracking changes in cardiac output in critically ill patients with acute circulatory failure.</p><p><strong>How to cite this article: </strong>Sharma S, Ramachandran R, Rewari V, Trikha A. Evaluation of Electrical Cardiometry to Assess Fluid Responsiveness in Patients with Acute Circulatory Failure: A Comparative Study with Transthoracic Echocardiography. Indian J Crit Care Med 2024;28(7):650-656.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 7","pages":"650-656"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591714","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":"Investigating the Variability among Indicators for Quantifying Antimicrobial Use in the Intensive Care Units: Analysis of Real-world Evidence.","authors":"Prity R Deshwal, Pramil Tiwari","doi":"10.5005/jp-journals-10071-24745","DOIUrl":"10.5005/jp-journals-10071-24745","url":null,"abstract":"<p><p>This study investigated variability among four indicators for quantifying antimicrobial use in intensive care units (ICUs): defined daily doses (DDD), prescribed daily doses (PDD), duration of therapy (DOT), and length of therapy (LOT) and recommended the most clinically relevant approach. Retrospective data from patients who had received at least one antimicrobial was analyzed. Patients whose records were incomplete or expired were excluded. Duration of therapy (24433/1000 PDs) and LOTs (12832/1000 PDs) underestimated the overall consumption of antimicrobials compared with DDD of 28391/1000 PDs. Whereas PDD (46699/1000 PDs) overestimated it. Comparison analysis detected % differences of 13.94, 23.92, and 54.80% between DDD and DOT, DDD and PDD, and DDD and LOT, indicators respectively. Linear regression revealed stronger (<i>r</i> ² = 0.86), moderate (<i>r</i> ² = 0.50), and moderate (<i>r</i> ² =0.60) correlation between DDD and DOT, DDD and PDD and DDD and LOT indicators respectively. According to findings, combining DOT and DDD is a more practical method to quantify antimicrobial consumption in hospital ICUs.</p><p><strong>How to cite this article: </strong>Deshwal PR, Tiwari P. Investigating the Variability among Indicators for Quantifying Antimicrobial Use in the Intensive Care Units: Analysis of Real-world Evidence. Indian J Crit Care Med 2024;28(7):662-676.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 7","pages":"662-676"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591717","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}