Indian Journal of Critical Care Medicine最新文献

{"title":"Targeted Heart Rate Control in Sepsis: A Promising Path or a Double-edged Sword?","authors":"Kiran K Gudivada","doi":"10.5005/jp-journals-10071-24868","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24868","url":null,"abstract":"<p><p><b>How to cite this article:</b> Gudivada KK. Targeted Heart Rate Control in Sepsis: A Promising Path or a Double-edged Sword? Indian J Crit Care Med 2024;28(12):1093-1095.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 12","pages":"1093-1095"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933032","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":"Before Acute Liver Failure is Attributed to High Altitude, Other Causes Must be Ruled Out.","authors":"Josef Finsterer","doi":"10.5005/jp-journals-10071-24843","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24843","url":null,"abstract":"<p><p><b>How to cite this article:</b> Finsterer J. Before Acute Liver Failure is Attributed to High Altitude, Other Causes Must be Ruled Out. Indian J Crit Care Med 2024;28(12):1180.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 12","pages":"1180"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933143","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":"Red Cell Distribution Width as a Marker of Disease Severity and In-hospital Mortality in Patients with ST-segment Elevation Myocardial Infarction.","authors":"Raj Raval, Sunita Gupta, Nitin Gupta, Mohammad Abu Bashar","doi":"10.5005/jp-journals-10071-24845","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24845","url":null,"abstract":"<p><strong>Background: </strong>The red cell distribution width (RDW) has been investigated as a predictive factor for complications and mortality in several critical illnesses, including cardiovascular diseases.</p><p><strong>Objective: </strong>The current study aimed to assess the relationship of RDW with severity and in-hospital mortality in patients with ST-elevation myocardial infarction (STEMI).</p><p><strong>Materials and methods: </strong>A prospective hospital-based observational study was conducted at a tertiary care institute of Northern India. Fifty patients of STEMI who underwent coronary angiography/primary coronary intervention were enrolled as cases and equal number of age- and sex-matched individuals not suffering from any cardiac disease were taken as controls. The RDW admission values of the cases were compared with that of controls. Red cell distribution width values were also compared across the outcome groups among cases.</p><p><strong>Results: </strong>The mean RDW-SD of the cases was 49.0 ± 4.6 fL whereas it was 44.7 ± 3.5 fL for controls, the difference being statistically significant (<i>p</i> < 0.001). Among the total patients, 4 (8.0%) expired during hospital stay and the rest 46 (92.0%) were discharged alive. The mean RDW-SD of expired patients was significantly higher than that of patients who remained alive (<i>p</i> = 0.002). There was a significant positive correlation between RDW and global registry of acute coronary events (GRACE) score (<i>p</i> = 0.02) and a significant negative correlation between RDW and left ventricular ejection fraction (LVEF) (<i>p</i> = 0.04). Area under the receiver operating characteristics (ROC) curve for RDW was higher than that of LVEF, showing superiority of RDW to LVEF in predicting mortality among the STEMI patients.</p><p><strong>Conclusion: </strong>Red cell distribution width may serve as a promising prognostic biomarker and tool for risk stratification in patients with STEMI.</p><p><strong>How to cite this article: </strong>Raval R, Gupta S, Gupta N, Bashar MA. Red Cell Distribution Width as a Marker of Disease Severity and In-hospital Mortality in Patients with ST-segment Elevation Myocardial Infarction. Indian J Crit Care Med 2024;28(12):1101-1106.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 12","pages":"1101-1106"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933017","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":"Is SOLUTE the Solution to Which Solution (to Use)?","authors":"Atul P Kulkarni, Ruchira W Khasne","doi":"10.5005/jp-journals-10071-24867","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24867","url":null,"abstract":"<p><p><b>How to cite this article:</b> Kulkarni AP, Khasne RW. Is SOLUTE the Solution to Which Solution (to Use)? Indian J Crit Care Med 2024;28(12):1096-1100.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 12","pages":"1096-1100"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932509","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":"Is Red Cell Distribution Width the Universal Biomarker of Disease Severity and Outcome?","authors":"Amarja Ashok Havaldar","doi":"10.5005/jp-journals-10071-24866","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24866","url":null,"abstract":"<p><p><b>How to cite this article:</b> Havaldar AA. Is Red Cell Distribution Width the Universal Biomarker of Disease Severity and Outcome? Indian J Crit Care Med 2024;28(12):1087-1088.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 12","pages":"1087-1088"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932239","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":"Study of the Role of C-reactive Protein/Procalcitonin Ratio as a Prognostic Tool in ICU Patients with Sepsis: A Prospective Observational Study.","authors":"Eman M Abdellatif, Emad H Hamouda","doi":"10.5005/jp-journals-10071-24855","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24855","url":null,"abstract":"<p><strong>Background: </strong>Prediction of prognosis in sepsis is an essential research area aiming to improve disease outcomes. In this study, we investigated the role of the C-reactive protein (CRP)/procalcitonin (PCT) ratio as a prognostic tool in sepsis patients.</p><p><strong>Materials and methods: </strong>This prospective observational study was conducted at the intensive care unit (ICU) of Alexandria Main University Hospital in the period from January to June 2024. One hundred and seventy patients with a diagnosis of sepsis were enrolled. Sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHEII) score and CRP/PCT ratio were calculated on admission (day 1), and as a follow-up on day 3. Patients were subsequently divided into survivor and non-survivor groups, and the data were compared.</p><p><strong>Results: </strong>The CRP/PCT ratio was significantly lower, on admission and on follow-up, in non-survivor patients than in survivor patients. The ratio median (minimum-maximum) in non-survivors was 4.82 (1.51-23.28) vs 11.23 (1.85-136.7) in survivors on admission, and it was 7.37 (2.27-26.36) in non-survivors vs 11.37 (2.78-110.9) in survivors on day 3. The ratio was significantly lower in patients with septic shock than in non-septic shock patients. The ratio had a significant negative correlation with both SOFA and APACHEII scores. The receiver operating characteristic (ROC) curve showed high accuracy of the day 1 CRP/PCT ratio to predict mortality [area under curve (AUC = 0.835)], which is comparable to the day 1 SOFA score (AUC = 0.878) and higher than the day 1 PCT and day 1 APACHE scores.</p><p><strong>Conclusion: </strong>Our results suggest a potential role for the CRP/PCT ratio, on admission and on follow-up, as a marker for predicting prognosis in sepsis patients, where low ratio values can predict poor disease outcome.</p><p><strong>How to cite this article: </strong>Abdellatif EM, Hamouda EH. Study of the Role of C-reactive Protein/Procalcitonin Ratio as a Prognostic Tool in ICU Patients with Sepsis: A Prospective Observational Study. Indian J Crit Care Med 2024;28(12):1130-1138.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 12","pages":"1130-1138"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933029","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":"Microbiological Concordance of Subglottic Secretion and Tracheal Aspirate Cultures of Critically Ill Patients with Invasive Airway Devices: A Prospective Observational Study.","authors":"Pritam Panigrahi, Venkata Ganesh, Archana Angrup, Neeru Sahni, Manisha Biswal, Lakshminarayana Yaddanapudi","doi":"10.5005/jp-journals-10071-24856","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24856","url":null,"abstract":"<p><strong>Background: </strong>Development of ventilator-associated pneumonia (VAP) is attributed to the microaspiration of pooled secretions around the cuff of airway devices. Despite the emphasis on the use of endotracheal tubes (ET) with subglottic secretion (SS) drainage ports to prevent VAP, the quality of the evidence for this recommendation remains moderate. This prospective observational study analyzed microbiological concordance between SS and endotracheal aspirate (ETA) cultures to generate further evidence in this regard.</p><p><strong>Materials and methods: </strong>Paired samples (SS and ETA) of 100 consenting patients admitted to intensive care unit (ICU) were sent on day 1, 4, and 7 to the microbiology laboratory where they were transcultured and species identification was performed. The SS and ETA were considered concordant or discordant based on isolated organisms and antibiotic sensitivity profile. Clinical surveillance for VAP was done according to CDC criteria during the first week of ventilation.</p><p><strong>Results: </strong>For a total of 197 paired samples, the overall concordance of SS and ETA cultures was 71.5%, with day-wise concordances of 68, 76.2, and 73.5% for D1, D4, and D7, respectively. Gram-negatives bacteria were the most frequently isolated, with 125 (31.7%) samples reporting <i>A. baumannii.</i> Amongst 18 patients clinically diagnosed with VAP during the first week of MV, the concordance between SS and ETA was 73.5%, and day-wise concordance was 77.2, 72.2, and 76.9% on D1, D4, and D7, respectively.</p><p><strong>Conclusion: </strong>A fairly high microbiological concordance was observed in SS and ETA samples obtained from patients with invasive airway devices, and similar concordance was found in patients developing VAP during the first week of ventilation.</p><p><strong>How to cite this article: </strong>Panigrahi P, Ganesh V, Angrup A, Sahni N, Biswal M, Yaddanapudi L. Microbiological Concordance of Subglottic Secretion and Tracheal Aspirate Cultures of Critically Ill Patients with Invasive Airway Devices: A Prospective Observational Study. Indian J Crit Care Med 2024;28(12):1139-1146.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 12","pages":"1139-1146"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933013","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 Outcomes of Hypocaloric/Hyperproteic vs Normocaloric Enteral Feeding in the Acute Phase of Critical Illness among Patients Admitted in the Intensive Care Unit: A Systematic Review with Meta-analysis.","authors":"Chito C Permejo, Teresita Joy Ples Evangelista","doi":"10.5005/jp-journals-10071-24831","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24831","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the effect of hypocaloric/hyperproteic enteral feeding vs normocaloric feeding on the survival of critically ill patients in the acute phase in the intensive care unit (ICU).</p><p><strong>Methodology: </strong>Randomized clinical trials utilizing hypocaloric, hyperproteic, and normocaloric enteral feeding in the ICU were searched using the following terms ((((critically ill) OR (intensive care) OR (mechanically ventilated)) AND ((low-calorie enteral feeding) OR (high-protein enteral feeding)))) in MEDLINE, PubMed, Scopus, and Google Scholar by two independent authors.</p><p><strong>Results: </strong>There were no significant differences in hospital mortality [odds ratio (OR), 1.0; 95% confidence interval (CI), 0.77, 1.31; <i>p</i> = 0.99, <i>I</i> ² = 0%], days on mechanical ventilation (MD, -0.05; 95% CI, -0.37, 0.28; <i>p</i> = 0.78, <i>I</i> ² = 0%), the odds of acquiring infectious complications (OR, 0.90; 95% CI, 0.71, 1.14; <i>p</i> = 0.38, <i>I</i> ² = 0%), and the length of ICU stay (MD, 0.60; 95% CI, -2.39, 3.59; <i>p</i> = 0.69, <i>I</i> ² = 96%). The length of hospital stay was significantly lower by 4.18 days in the normocaloric group (MD, 4.18; 95% CI, 2.50, 5.85; <i>p</i> < 0.00001, <i>I</i> ² = 0%).</p><p><strong>Conclusion: </strong>This meta-analysis showed no significant differences in mortality, infectious complications, days of mechanical ventilation, and ICU length of stay between groups. Findings on hospital length of stay were interpreted with caution due to the low quality of evidence and clinical heterogeneity.</p><p><strong>How to cite this article: </strong>Permejo CC, Evangelista TJP. Clinical Outcomes of Hypocaloric/Hyperproteic vs Normocaloric Enteral Feeding in the Acute Phase of Critical Illness among Patients Admitted in the Intensive Care Unit: A Systematic Review with Meta-analysis. Indian J Crit Care Med 2024;28(11):1069-1083.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"1069-1083"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068866","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":"Lung Ultrasound Score for Prognosticating Ventilator-associated Pneumonia (VAP): Evidence and Wisdom.","authors":"Anuj M Clerk","doi":"10.5005/jp-journals-10071-24837","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24837","url":null,"abstract":"<p><p><b>How to cite this article:</b> Clerk AM. Lung Ultrasound Score for Prognosticating Ventilator-associated Pneumonia (VAP): Evidence and Wisdom. Indian J Crit Care Med 2024;28(11):991-992.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"991-992"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068422","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":"Point-of-care Ultrasonography in Patients with Hepatorenal Syndrome: A Single Center Observational Study.","authors":"Vedaghosh Amara, Anand V Kulkarni, Anand Gupta, Shantan Venishetty, Shanthi R Sripathi, L Siva K Reddy, Arun Kumar Tirumala, Puja Karandikar, Manasa Alla, Sowmya Iyengar, Mithun Sharma, Padaki N Rao, D Nageshwar Reddy","doi":"10.5005/jp-journals-10071-24827","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24827","url":null,"abstract":"<p><strong>Aim and background: </strong>A combination of terlipressin and albumin is the standard of care for patients with hepatorenal syndrome-acute kidney injury (HRS-AKI). The study aimed to compare the venous congestion using lung ultrasound score (LUS) and radiographic assessment of lung edema (RALE) scores among terlipressin responders and nonresponders and survivors and non-survivors.</p><p><strong>Materials and methods: </strong>In this single-center, prospective, observational study, we included adult patients with HRS-AKI who had received terlipressin and albumin from 28th April 2022 to 16th October 2022.</p><p><strong>Results: </strong>Of the 102 patients included, 74.5% (95%CI: 58.7-93.2) responded to terlipressin. The median dose of terlipressin and albumin was 2 (1-8) mg/day and 100 (40-200) g for a duration of 5 (2-10) days. On Kaplan-Meier analysis, survival was 26.9% of patients in the nonresponder group compared to 61.4% in the responder group (<i>p</i> = 0.001). Day 3 LUS score worsened in 76.9% of patients in nonresponders group compared to 52.6% in responder group (<i>p</i> = 0.03). There was a significant increase in RALE score in those who died [6 (-6-48) vs alive: 0 (-4- 30); <i>p</i> < 0.001]. Lung ultrasound score had improved or been maintained in 63.6% of patients who were alive, compared to 14.9% in those who had died (<i>p</i> < 0.001). On multivariable Cox regression analysis, age [HR, 1.02 (1.002-1.05)], terlipressin non-response [HR, 2.8 (1.47-5.34)], APACHE score [HR, 1.07 (1.03-1.12)], duration of terlipressin therapy [HR, 0.37 (0.27-0.5)] and worsening of LUS [HR, 2.9 (1.81-7)] predicted mortality.</p><p><strong>Conclusion: </strong>Lung ultrasound score and chest X-ray can accurately identify venous congestion in the lungs, which is common in patients with advanced liver disease who receive terlipressin and albumin in the intensive care unit (ICU).</p><p><strong>How to cite this article: </strong>Amara V, Kulkarni AV, Gupta A, Venishetty S, Sripathi SR, Reddy LSK, <i>et al.</i> Point-of-care Ultrasonography in Patients with Hepatorenal Syndrome: A Single Center Observational Study. Indian J Crit Care Med 2024;28(11):1015-1022.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"1015-1022"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068647","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}