Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine最新文献

{"title":"The Dominance of <i>Candida auris</i>: A Single-center Experience of 79 Episodes of Candidemia from Western India.","authors":"Parikshit S Prayag,&nbsp;Sampada Patwardhan,&nbsp;Shweta Panchakshari,&nbsp;Prasad A Rajhans,&nbsp;Amrita Prayag","doi":"10.5005/jp-journals-10071-24152","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24152","url":null,"abstract":"<p><strong>Introduction: </strong>Invasive candidiasis is a serious infection seen in hospitalized or immunocompromised patients. Mortality rates for candidemia can be as high as 30-60%. <i>Candida auris</i> is an emerging species of <i>Candida</i> and is increasingly becoming a global public health problem.</p><p><strong>Methods: </strong>This was a retrospective observational study, in which we analyzed 79 episodes of candidemia. Blood cultures were done using the Bactec™ FX blood culturing instrument (Becton, Dickinson and Company Sparks, Maryland, USA). Species identification was done using VITEK® 2 YST panels (bioMérieux Inc., Durham, North Carolina, USA). Antifungal susceptibility testing was performed using VITEK® 2 AST-YSO8 panels (bioMérieux Inc., Durham, North Carolina, USA).</p><p><strong>Results: </strong>Among the 79 episodes, the most common species was found to be <i>C. auris</i> (43.03% of all the episodes). <i>Candida tropicalis</i> was found to be the second most common species in patients admitted to our hospital with candidemia. All the isolates of <i>C. auris</i> were resistant to fluconazole, while 32.35 % of the isolates were also resistant to amphotericin B. Crude mortality in patients with <i>C. auris</i> candidemia was higher than the crude mortality for the other species.</p><p><strong>Conclusion: </strong>This is the first study from India where <i>C. auris</i> was seen as the most predominant species among patients admitted with candidemia. This is a serious issue given the high rates of fluconazole resistance, mortality, and cost of therapy associated with <i>C. auris</i> bloodstream infections. Urgent attention needs to be diverted to infection control practices and antimicrobial stewardship programs.</p><p><strong>How to cite this article: </strong>Prayag PS, Patwardhan S, Panchakshari S, Rajhans PA, Prayag A. The Dominance of <i>Candida auris</i>: A Single-center Experience of 79 Episodes of Candidemia from Western India. Indian J Crit Care Med 2022;26(5):560-563.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"560-563"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/b3/ijccm-26-560.PMC9160635.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40012089","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 Profile, Treatment, and Outcome of Patients with Secondary Hemophagocytic Lymphohistiocytosis in Critically Ill Patients: A Prospective Observational Study.","authors":"Farhan Fazal,&nbsp;Nitin Gupta,&nbsp;Manish Soneja,&nbsp;D K Mitra,&nbsp;G Satpathy,&nbsp;S K Panda,&nbsp;P K Chaturvedi,&nbsp;Naval K Vikram,&nbsp;R M Pandey,&nbsp;Naveet Wig","doi":"10.5005/jp-journals-10071-24136","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24136","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of the study was to evaluate the clinical profile and outcome of patients with secondary hemophagocytic lymphohistiocytosis (HLH) in critically ill patients.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted where critically ill adult patients presenting with fever and bicytopenia were evaluated according to the HLH-2004 diagnostic criteria for the presence of secondary HLH. The underlying trigger, clinical profile, treatment, and outcome of patients with HLH were analyzed.</p><p><strong>Results: </strong>Of the 76 critically ill patients with fever and bicytopenia, 33 (43%) patients were diagnosed with HLH. The following triggers for HLH were identified: bacterial infections (23%), fungal infections (10%), viral infections (10%), parasitic infections (10%), autoimmune diseases (13%), and malignancy (8%). A total of 78% of the HLH cases received steroids, but the use of steroids was not associated with improvement in mortality.</p><p><strong>Conclusion: </strong>There is a high prevalence of HLH in patients presenting with fever and bicytopenia in critically ill adult patients. Infections were identified as the most common trigger of HLH.</p><p><strong>How to cite this article: </strong>Fazal F, Gupta N, Soneja M, Mitra DK, Satpathy G, Panda SK, <i>et al</i>. Clinical Profile, Treatment, and Outcome of Patients with Secondary Hemophagocytic Lymphohistiocytosis in Critically Ill Patients: A Prospective Observational Study. Indian J Crit Care Med 2022;26(5):564-567.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"564-567"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/f0/ijccm-26-564.PMC9160626.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40012925","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":"Veterans Health Administration COVID-19 Index to Risk Stratify the Geriatric Population with COVID-19 Infection.","authors":"Ashima Sharma,&nbsp;Aravind Ranjan","doi":"10.5005/jp-journals-10071-24176","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24176","url":null,"abstract":"<p><p>The risk for severe illness with coronavirus disease-2019 (COVID-19) increases with age, with older adults at highest risk. Adults 65-years-old and older who were fully vaccinated with an mRNA COVID-19 vaccine had a 94% reduction in risk of COVID-19 hospitalizations, and vaccination was 64% effective among those who were partially vaccinated.</p><p><strong>How to cite this article: </strong>Sharma A, Ranjan A. Veterans Health Administration COVID-19 Index to Risk Stratify the Geriatric Population with COVID-19 Infection. Indian J Crit Care Med 2022;26(5):632-633.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"632-633"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/19/36/ijccm-26-632.PMC9160614.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40011623","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":"Primary Hypothyroidism Presenting as Cardiac Tamponade.","authors":"Prasan K Panda,&nbsp;Shridhar Pattar,&nbsp;Budha O Singh,&nbsp;Taranjeet Cheema","doi":"10.5005/jp-journals-10071-24210","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24210","url":null,"abstract":"<p><p>Hypothyroidism is commonly associated with pericardial effusion, but it can be rarely complicated by cardiac tamponade. We report a case series of two patients who presented with shortness of breath and distension of the abdomen, progressing to generalized edema. Each of them was found to have cardiac tamponade at presentation and eventually diagnosed with hypothyroidism. They were managed by urgent pericardiocentesis followed by intermittent drainage of the collected pericardial effusion along with thyroxine replacement to which they responded. The presence of cardiac tamponade with bradycardia should raise a suspicion of a hypothyroid etiology. Early diagnosis and treatment of hypothyroidism are essential to prevent such complications.</p><p><strong>How to cite this article: </strong>Panda PK, Pattar S, Singh BO, Cheema T. Primary Hypothyroidism Presenting as Cardiac Tamponade. Indian J Crit Care Med 2022;26(5):655-657.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"655-657"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/3a/ijccm-26-655.PMC9160608.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40012088","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":"Effect of Percutaneous Tracheostomy on Optic Nerve Sheath Diameter (TONS Trial).","authors":"Ilenia Di Paola,&nbsp;Mario Graziano,&nbsp;Palmiro Cornetta","doi":"10.5005/jp-journals-10071-24208","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24208","url":null,"abstract":"<p><p><b>How to cite this article:</b> Di Paola I, Graziano M, Cornetta P. Effect of Percutaneous Tracheostomy on Optic Nerve Sheath Diameter (TONS Trial). Indian J Crit Care Med 2022;26(5):653.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"653"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/ab/ijccm-26-653.PMC9160624.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40012498","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":"Professional Quality of Life in Intensive Care Unit Professionals during COVID-19 Pandemic: A Prospective Observational Cross-sectional Study.","authors":"Sukhyanti Kerai,&nbsp;Pallavi Doda,&nbsp;Kirti N Saxena","doi":"10.5005/jp-journals-10071-24212","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24212","url":null,"abstract":"<p><strong>Background and aims: </strong>The coronavirus disease-2019 (COVID-19) has significant positive and negative impacts on the professional life of intensive care unit (ICU) professionals. This study was conducted to evaluate compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in ICU professionals and to study demographic and occupational variables related to them.</p><p><strong>Methods: </strong>This prospective observational study was undertaken on ICU professionals involved in direct care of critically ill COVID-19 patients. The online questionnaire consisting of demographic, work-related parameters, and professional quality of life scale version 5 (ProQOL 5) was sent to 1,080 ICU healthcare workers. The subgroups of ProQOL 5, CS, BO, and STS were calculated and compared across study parameters. Linear regression was performed to evaluate variables which were independently associated with ProQOL.</p><p><strong>Results: </strong>The response rate in the present study was 39.8%, and after evaluation, 320 responses were found eligible for final analysis. There was predominance of average levels of CS, BO, and STS. Female gender, contractual job, lesser work experience, greater workload, and COVID-19 infection in close acquittance of participants were factors observed to independently associated with increase in negative aspects of ProQOL (BO and STS). Further, increase in duty hours and COVID-19 infection in close social circle were observed to independently decrease positive aspects (CS).</p><p><strong>Conclusion: </strong>This study shows that despite majority of respondents reporting moderate levels BO and STS, CS is maintained during the COVID-19 crisis. The identification of risk factors is vital to support ICU professionals by targeted interventions.</p><p><strong>How to cite this article: </strong>Kerai S, Doda P, Saxena KN. Professional Quality of Life in Intensive Care Unit Professionals during COVID-19 Pandemic: A Prospective Observational Cross-sectional Study. Indian J Crit Care Med 2022;26(5):604-612.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"604-612"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/81/ijccm-26-604.PMC9160612.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40012921","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":"Encephaloradiculoneuropathy: A Rare Manifestation of COVID-19 Infection.","authors":"Rahul T Chakor,&nbsp;Prachi P Barvalia,&nbsp;Swaleha Nadaf,&nbsp;Varun Manjunath","doi":"10.5005/jp-journals-10071-24222","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24222","url":null,"abstract":"<p><p>Neurological complications are being recognized as important outcomes of the coronavirus disease-2019 (COVID-19) pandemic. We report a rare case of both the central nervous system (CNS) and peripheral nervous system (PNS) involvement, encephalitis with polyradiculoneuropathy in a single patient of COVID infection.</p><p><strong>How to cite this article: </strong>Chakor RT, Barvalia PP, Nadaf S, Manjunath V. Encephaloradiculoneuropathy: A Rare Manifestation of COVID-19 Infection. Indian J Crit Care Med 2022;26(5):646-648.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"646-648"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/df/ae/ijccm-26-646.PMC9160632.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40012922","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":"Cardiac Pacing a Rare Cause of Ventilator Auto Triggering.","authors":"M Nithish Mukunthan,&nbsp;Vimal Bhardwaj","doi":"10.5005/jp-journals-10071-24219","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24219","url":null,"abstract":"<p><p>Ventilator auto triggering is an avoidable complication in ventilators, if left unnoticed can lead to deleterious effects. There are various causes for ventilator auto triggering. Though rare, there are some cardiac causes for inadvertent ventilator triggering. We report a case of 44-years-old male paced with atrial epicardial wires postcoronary artery bypass. The wires were close to the right phrenic nerve, causing the right diaphragm to contract in synchronization with the heartbeat. This caused ventilator auto triggering and ended up delivering inadvertent breaths. The pacemaker output was immediately reduced to the required minimum to continue pacing the heart and decrease phrenic nerve stimulation. This caused immediate changes in ventilator waveform and auto triggering was completely stopped and the patient could be successfully weaned off the ventilator. This case report emphasizes he need for timely recognition of alteration in ventilator waveforms and early intervention to avert any untoward events.</p><p><strong>How to cite this article: </strong>Mukunthan MN, Bhardwaj V. Cardiac Pacing a Rare Cause of Ventilator Auto Triggering. Indian J Crit Care Med 2022;26(5):643-645.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"643-645"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/b4/ijccm-26-643.PMC9160607.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40012090","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 Significance of Serum Lactate Kinetics in Sepsis as Mortality Predictor.","authors":"Mit Chaudhari,&nbsp;Nagina Agarwal","doi":"10.5005/jp-journals-10071-23935","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-23935","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis is one of the leading causes of death worldwide. Serum lactate is being used in sepsis for diagnostic and prognostic purposes for years now. In this study, we shed light over a novel use of lactate in form of various clearance parameters to determine mortality in septic patients at the 28th day.</p><p><strong>Materials and methods: </strong>In our study, 200 patients with sepsis were included using quick sequential organ failure assessment (qSOFA) score and their lactate levels were measured at the time of admission (0 hour) and 24 hours after admission. Lactate clearance parameters (absolute and relative lactate clearance, lactate clearance rate) were calculated. All patients were followed up for a period of 28 days to determine the outcome, and data analysis was done accordingly.</p><p><strong>Results and conclusion: </strong>Our study showed that higher SOFA score, qSOFA score, and serum lactate levels were associated with increased 28th-day mortality. Low absolute, relative lactate clearance and lactate clearance rate were also associated with poor outcomes. The best cutoffs to predict poor outcomes were serum lactate level at 24 hours ≥4 mmol/L and relative lactate clearance ≤40.3% with good sensitivity and specificity.</p><p><strong>How to cite this article: </strong>Chaudhari M, Agarwal N. Study of Significance of Serum Lactate Kinetics in Sepsis as Mortality Predictor. Indian J Crit Care Med 2022;26(5):591-595.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"591-595"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/4a/ijccm-26-591.PMC9160631.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40011621","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":"Dengue and HELLP: Beware of the Masquerade.","authors":"Rohit Patnaik,&nbsp;Shruthi Kulkarni,&nbsp;Nupur Karan","doi":"10.5005/jp-journals-10071-24213","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24213","url":null,"abstract":"<p><p>HELLP is a syndrome characterized by hemolysis, elevated liver enzymes, and low platelets. It is a rare complication of pregnancy and is usually associated with pre-eclampsia. However, 10-20% cases of HELLP can present without hypertension. Dengue fever is an arboviral-borne tropical illness that is characterized with fever, thrombocytopenia, and bleeding manifestations. We present a case of a primigravida with HELLP syndrome masquerading in the background of dengue fever. Unique features to this case report include delayed presentation of HELLP syndrome with normotension which can have overlapping features with dengue fever, especially in term pregnancy. This case highlights the need of strict vigilance in cases of dengue fever with pregnancy.</p><p><strong>How to cite this article: </strong>Patnaik R, Kulkarni S, Karan N. Dengue and HELLP: Beware of the Masquerade. Indian J Crit Care Med 2022;26(5):639-640.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"639-640"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/e1/ijccm-26-639.PMC9160621.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40012504","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}