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

{"title":"Medium-chain Triglyceride Ketogenic Diet as a Treatment Strategy for Adult Super-refractory Status Epilepticus.","authors":"Kaustuv Dutta,&nbsp;Parthasarathy Satishchandra,&nbsp;Monjuri Borkotokey","doi":"10.5005/jp-journals-10071-24073","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24073","url":null,"abstract":"<p><p><b>How to cite this article:</b> Dutta K, Satishchandra P, Borkotokey M. Medium-chain Triglyceride Ketogenic Diet as a Treatment Strategy for Adult Super-refractory Status Epilepticus. Indian J Crit Care Med 2022;26(1):139-140.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"139-140"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/43/96/ijccm-26-139.PMC8783258.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882365","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":"Utility of Stewart's Approach to Diagnose Missed Complex Acid-Base Disorders as Compared to Bicarbonate-anion Gap-based Methodology in Critically Ill Patients: An Observational Study.","authors":"Rohit Paliwal,&nbsp;Adrian Pakavakis,&nbsp;Jigeeshu V Divatia,&nbsp;Atul P Kulkarni","doi":"10.5005/jp-journals-10071-24077","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24077","url":null,"abstract":"<p><strong>Background: </strong>Traditional arterial blood gas (ABG) analysis may miss out on some metabolic acid-base disorders. We prospectively compared Stewart's approach in critically ill patients to traditional bicarbonate-anion gap-based methods (with and without correction for albumin) to diagnose acid-base disorders.</p><p><strong>Patients and methods: </strong>Five hundred ABG samples from medical or surgical patients in the ICU were analyzed with traditional bicarbonate-anion gap-based methodology with and without correction for albumin and Stewart's biochemical approach. The primary outcome identification of additional metabolic disorders diagnosed with Stewart's approach in comparison to bicarbonate system-based approaches. We also looked at the correlation between the strong ion gap (SIG) and the albumin-corrected anion gap (acAnion Gap).</p><p><strong>Results: </strong>Stewart's approach detected missed metabolic disorders in 58 (11.6%) blood gas results reported as \"within normal limits\" with the bicarbonate-uncorrected anion gap approach. In 50 (10%) of these ABGs, the acAnion Gap approach was able to diagnose the missed metabolic disorders. Thus, the albumin-corrected anion gap method had a similar diagnostic performance to Stewart's approach, as it missed additional disorders in only eight (1.6%) blood gases.</p><p><strong>Conclusion: </strong>In this study, we found that the acAnion Gap approach was similar in diagnostic performance to Stewart's approach. We feel that the corrected anion gap approach can be safely used if a ready calculator for Stewart's approach is not available.</p><p><strong>How to cite this article: </strong>Paliwal R, Pakavakis A, Divatia JV, Kulkarni AP. Utility of Stewart's Approach to Diagnose Missed Complex Acid-Base Disorders as Compared to Bicarbonate-anion Gap-based Methodology in Critically Ill Patients: An Observational Study. Indian J Crit Care Med 2022;26(1):23-32.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"23-32"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/e0/ijccm-26-23.PMC8783259.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579897","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":"Assessment of Risk Factors for Mortality in Patients in Medical Intensive Care Unit of a Tertiary Hospital.","authors":"Burhan Sami Kalın,&nbsp;Süleyman Özçaylak,&nbsp;İhsan Solmaz,&nbsp;Jehat Kılıç","doi":"10.5005/jp-journals-10071-24092","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24092","url":null,"abstract":"<p><strong>Background: </strong>Knowing the risk factors for patients in intensive care units (ICUs) facilitates patient's management. The goal of this study was to determine the risk agents that influence our medical ICU mortality.</p><p><strong>Patients and methods: </strong>This 11-month retrospective trial was managed in the medical ICU. In this study, 340 patients who were followed up for at least 24 hours in ICUs were accepted. The clinical data on patients were recorded retrospectively, and the mortality-related factors were analyzed. A regression analysis was also performed to determine the independent risk factors for ICU mortality.</p><p><strong>Results: </strong>The median age was 73 (53-82) years. The death rate was 23.8%. Length of stay (LOS) in ICU was 3 (2-5) days, and APACHE-II (acute physiologic and chronic health evaluation) score was 19 (13-25). The prevalence of chronic diseases was not dissimilar except acute and chronic renal failures among survivors and deceased patients (<i>p</i> >0.05). Acute and chronic renal failures were higher in deceased patients than in survivors and were statistically important [107 (41.3%) vs 47 (58%), <i>p</i> = 0.008] and 38 (14.7%) vs 22 (27.2%), <i>p</i> = 0.01], respectively. In the binary logistic regression analysis, age, APACHE II score, need for invasive mechanical ventilation (IMV), decreased serum albumin levels, and increased creatinine levels were established to be independent risk factors for death [(OR (odds ratio): 1.045 (1.009-1.081), <i>p</i> = 0.013, OR: 1.076 (21.008-1.150), <i>p</i> = 0.029, OR: 19.655 (6.337-60.963), <i>p</i> = 0.001), OR: 2.673 (1.191-6.024), <i>p</i> = 0.017, OR: 1.422 (1.106-1.831), <i>p</i> = 0.006)], respectively.</p><p><strong>Conclusion: </strong>The most significant risk agents of death were determined through high APACHE II score, decreased serum albumin levels, and increased creatinine levels.</p><p><strong>How to cite this article: </strong>Kalın BS, Özçaylak S, Solmaz İ, Kılıç J. Assessment of Risk Factors for Mortality in Patients in Medical Intensive Care Unit of a Tertiary Hospital. Indian J Crit Care Med 2022;26(1):49-52.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"49-52"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e5/54/ijccm-26-49.PMC8783230.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579901","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":"Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review.","authors":"Armin Ahmed,&nbsp;Sulekha Saxena,&nbsp;Amita Pandey,&nbsp;Prabhakar Mishra,&nbsp;Afzal Azim","doi":"10.5005/jp-journals-10071-24083","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24083","url":null,"abstract":"<p><strong>Background: </strong>Epidemiology of liver disease in obstetric patients shows geographical variation depending upon the prevalence of preeclampsia, viral hepatitis, and tropical vector-borne diseases like malaria, leptospirosis, etc. We undertook the current systematic review to analyze the causes of hepatic dysfunction in obstetric patients in India and identify the gaps in the literature and reporting.</p><p><strong>Materials and methods: </strong>We did a systematic review of studies reporting the causes of hepatic dysfunction in obstetric patients in India. A methodological quality assessment was done using a five-point questionnaire.</p><p><strong>Results: </strong>A total of 21 studies qualified for evaluation. The rate of hepatic dysfunction among obstetric patients in India ranged from 0.15 to 3.3% with a mean and median rate of 1.49 and 0.93%, respectively. Preeclampsia/HELLP (mean = 36.0%, median = 31.4%, range: 3.6-83.8%) and viral hepatitis (mean = 34.1%, median = 35.5%, range: 5.1-61.8%) were the commonest causes of hepatic dysfunction. Other causes were intrahepatic cholestasis of pregnancy, acute fatty liver of pregnancy, tropical fever (malaria, leptospirosis, dengue, scrub typhus), etc. Maternal mortality ranged from 1.4 to 40% (mean = 12.6%, median = 10.0%) and perinatal mortality was between 16.4 and 38.70% (mean = 31.75%, median = 35.5%).</p><p><strong>Conclusion: </strong>There is moderate quality evidence to show that preeclampsia/HELLP and viral hepatitis are the commonest causes of hepatic dysfunction in obstetric patients in India.</p><p><strong>How to cite this article: </strong>Ahmed A, Saxena S, Pandey A, Mishra P, Azim A. Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review. Indian J Crit Care Med 2022;26(1):114-122.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"114-122"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f5/24/ijccm-26-114.PMC8783245.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882359","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":"Prediction of Mortality in the Medical Intensive Care Unit with Serial Full Outline of Unresponsiveness Score in Elderly Patients.","authors":"Jamileh Ramazani,&nbsp;Mohammad Hosseini","doi":"10.5005/jp-journals-10071-24094","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24094","url":null,"abstract":"<p><strong>Background: </strong>Advanced age is one of the key risk factors for mortality and morbidity in intensive care units. The full outline of unresponsiveness (FOUR) score has been developed and introduced to address the limitations of the Glasgow Coma Scale (GCS). The current study aimed to evaluate the ability of the FOUR score in predicting the outcomes (survivors, nonsurvivors).</p><p><strong>Materials and methods: </strong>This observational study of 168 consecutive elderly patients admitted to medical intensive care during the 14 months carried out prospectively. FOUR score in the 24, 48, and 72 hours of admission, and demographic characteristics of all elderly patients were calculated, then recorded. The receiver operating characteristic (ROC) curve, logistic regression, and Hosmer-Lemeshow test were used (95% confidence interval) for statistical analysis.</p><p><strong>Results: </strong>FOUR scores in 24, 48, and 72 hours between survivors and nonsurvivors (<i>p</i> <0.0001, <i>p</i> <0.0001, and <i>p</i> <0.0001, respectively) were statistically different. The discrimination power of FOUR score 24 hours of admission was excellent [area under ROC (AUC): 85.7% [standard error (SE)]: 2.8%]; it was acceptable for 48 and 72 hours of admission [AUC: 76.3% (SE: 3.6%), AUC: 75/0% (SE: 3.8%), respectively]. The FOUR score of 24 and 48 hours (x² = 10.06, <i>p</i> = 0.261, x² = 6.82, <i>p</i> = 0.448, respectively) showed acceptable calibration.</p><p><strong>Conclusions: </strong>The FOUR score is a suitable scoring system for prognostication of outcomes in critically ill elderly patients. The FOUR score 24 hours of admission was superior in terms of discrimination power than 48 and 72 hours, but better calibration power belonged to FOUR score 48 hours.</p><p><strong>How to cite this article: </strong>Ramazani J, Hosseini M. Prediction of Mortality in the Medical Intensive Care Unit with Serial Full Outline of Unresponsiveness Score in Elderly Patients. Indian J Crit Care Med 2022;26(1):94-99.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"94-99"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/db/ijccm-26-94.PMC8783249.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882372","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":"Differentiating Cardiac and Pulmonary Causes of Dyspnea Using Ultrasonography and Dyspnea Discrimination Index.","authors":"Gina M Chandy,&nbsp;Sowmya Sathyendra,&nbsp;Kishore Pichamuthu,&nbsp;Darpanarayan Hazra,&nbsp;Kundavaram Pp Abhilash","doi":"10.5005/jp-journals-10071-24089","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24089","url":null,"abstract":"<p><strong>Background: </strong>One of the most common reasons for emergency room (ER) visits is acute dyspnea. The challenge is in differentiating a cardiac and pulmonary cause of acute breathlessness. Hence, we have studied the effectiveness of the dyspnea discrimination index (DDI) used in conjunction with ultrasonography (USG) in distinguishing between cardiac and pulmonary causes of dyspnea.</p><p><strong>Methods: </strong>This was a prospective study conducted in the ER and general medicine wards to evaluate the efficacy of the DDI and USG in dyspneic patients. Data were entered in a standard data sheet and analysis was done using SPSS software.</p><p><strong>Results: </strong>The majority of the patients were between the ages of 45 and 60, with a male predominance. Risk factors like smoking were more common in the pulmonary group (36%). Pulmonary cause of breathlessness was seen in 62% of patients and cardiac pathology was noted in 28%. The mean (SD) DDI value and DDI% are as follows: pulmonary group (DDI)-5.47 (SD: 2.82); cardiac group (DDI)-8.34 (SD: 3.75); pulmonary group (DDI%)-1.31 (SD: 0.68); cardiac group (DDI%)-2.34 (SD: 1.14). There was a significant difference in DDI% between the pulmonary and cardiac groups (<i>p</i> = 0.001). DDI was found to have a sensitivity and specificity of 77.3% and 70%, respectively. While for DDI%, sensitivity and specificity were 72.7% and 72%, respectively. Lung USG had 98% sensitivity and 95.5% specificity, with a narrow confidence interval. The positive likelihood ratio was noted to be 21.6, indicating a very high post-test probability.</p><p><strong>Conclusion: </strong>The DDI and USG in conjunction had good discriminative power, when it came to distinguishing between cardiac and pulmonary causes of dyspnea. USG had a high specificity and sensitivity, making it suitable for identifying the cause of dyspnea in a tertiary care ER setting.</p><p><strong>How to cite this article: </strong>Chandy GM, Sathyendra S, Pichamuthu K, Hazra D, Abhilash KPP. Differentiating Cardiac and Pulmonary Causes of Dyspnea Using Ultrasonography and Dyspnea Discrimination Index. Indian J Crit Care Med 2022;26(1):33-38.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"33-38"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/db/ijccm-26-33.PMC8783246.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579898","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":"Unilateral Pulmonary Contusion after Cardiopulmonary Resuscitation Complicated by Delayed Obstructive Atelectasis: A Case Report and Review of the Literature.","authors":"Pongpat Klumusuk,&nbsp;Pattarin Pirompanich","doi":"10.5005/jp-journals-10071-24082","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24082","url":null,"abstract":"<p><p>We present a previously healthy 57-year-old man who had a sudden cardiac arrest intraoperatively and developed unilateral pulmonary contusion shortly after cardiopulmonary resuscitation. He was gradually improved by supportive management. But, several days later he had worsening of respiratory symptoms and obstructive atelectasis was proven by bronchoscope finding of thick mucus plugging left main bronchus. These are rarely recognized but important post-resuscitation complications. Early detection is crucial to improve outcome. <b>How to cite this article:</b> Klumusuk P, Pirompanich P. Unilateral Pulmonary Contusion after Cardiopulmonary Resuscitation Complicated by Delayed Obstructive Atelectasis: A Case Report and Review of the Literature. Indian J Crit Care Med 2022;26(1):133-135.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"133-135"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/ae/ijccm-26-133.PMC8783248.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882363","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":"A Retrospective Study on Experience of High-flow Nasal Cannula Oxygen in Critically Ill COVID-19 Adult Patients Admitted to Intensive Care Unit.","authors":"Sukhyanti Kerai,&nbsp;Rahil Singh,&nbsp;Kirti N Saxena,&nbsp;Suraj D Desai,&nbsp;Anju R Bhalotra","doi":"10.5005/jp-journals-10071-24097","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24097","url":null,"abstract":"<p><strong>Background: </strong>The use of high-flow nasal cannula (HFNC) in coronavirus disease-2019 (COVID-19) patients is debated due to its uncertain benefits and risks of aerosol dispersion. This retrospective study was aimed to assess the outcome of treatment with HFNC therapy in adult COVID-19 patients with acute hypoxemic respiratory failure (AHRF) admitted in intensive care units (ICU) and to assess the factors affecting outcome.</p><p><strong>Material and methods: </strong>We retrieved electronic medical records of all COVID-19 patients who received HFNC for respiratory support after failure to maintain adequate oxygenation with conventional oxygen devices, between June 1 and August 31, 2020. The data retrieved were statistically analyzed.</p><p><strong>Results: </strong>A total number of 558 COVID-19 patients were admitted to ICUs, out of which 139 patients were identified to be on HFNC and 85 met the inclusion criteria for the study. The success rate of 48.2% with HFNC was observed in these patients. The patients recorded to experience HFNC success were of young age and having higher baseline oxygen saturation compared to those who had its failure. The ROX indices post-initiation were observed to be significantly higher in the success group (<i>p</i> ≤0.001). Awake-prone positioning while receiving HFNC was followed by around more patients in the success group (<i>p</i> <0.001). On multivariate logistic regression analysis, baseline oxygen saturation, awake-prone positioning, and number of days on HFNC were found to be independently affected outcome with HFNC.</p><p><strong>Conclusion: </strong>Almost half of the cases of moderate-to-severe COVID-19 pneumonia can be managed successfully with HFNC, without the need of mechanical ventilation.</p><p><strong>How to cite this article: </strong>Kerai S, Singh R, Saxena KN, Desai SD, Bhalotra AR. A Retrospective Study on Experience of High-flow Nasal Cannula Oxygen in Critically Ill COVID-19 Adult Patients Admitted to Intensive Care Unit. Indian J Crit Care Med 2022;26(1):62-66.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"62-66"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/ba/ijccm-26-62.PMC8783255.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882367","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":"Weaning Outcomes and 28-day Mortality after Tracheostomy in COVID-19 Patients in Central India: A Retrospective Observational Cohort Study.","authors":"Sunaina Tejpal Karna,&nbsp;Saurabh Trivedi,&nbsp;Pooja Singh,&nbsp;Alkesh Khurana,&nbsp;Revadi Gouroumourty,&nbsp;Brahmam Dodda,&nbsp;Saurabh Saigal,&nbsp;Jai Prakash Sharma,&nbsp;Amit Karna,&nbsp;Pranav Shrivastava,&nbsp;Aqeel Hussain,&nbsp;Vikas Gupta,&nbsp;Gankalyan Behera,&nbsp;Vaishali Waindeskar","doi":"10.5005/jp-journals-10071-24080","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24080","url":null,"abstract":"<p><strong>Background: </strong>Tracheostomy is integral in long-term intensive care of coronavirus disease-2019 (COVID-19) patients. There is a paucity of studies on weaning outcomes and mortality after tracheostomy in COVID-19 in Indian scenario.</p><p><strong>Materials and methods: </strong>We conducted a retrospective, single-center, observational study of severe COVID-19 patients who underwent elective tracheostomy (<i>n</i> = 65) during critical care in a tertiary care institute in Central India from May 1, 2020, to April 30, 2021. Data were collected from Medical records, ICU charts, and follow-up visits by patient. A primary objective was to study the clinical characteristics, tracheostomy complications, weaning outcomes, and mortality at 28 and 60 days of ICU admission. We categorized the cohort into two groups (deceased and survivor) and studied association of clinical parameters with 28-day mortality. Cox Proportional regression analysis was applied to calculate the hazard ratio among the predictors of mortality with <i>p</i> value <0.05 as significant.</p><p><strong>Results: </strong>Elective tracheostomy was done in 69 of 436 (15.8%) patients on invasive mechanical ventilation, of which 65 were included. Tracheostomy was percutaneous in 45/65 (69%) and surgical in 20/65 (31%) with timing from intubation as early in 41/65 and late in 24/65 with most common indication as weaning failure followed by anticipated prolonged ventilation. Tracheostomy complications were present in 29/65 (45%) patients with no difference in complication rates between timing and type of tracheostomy. Downsizing, decannulation, and weaning were successful in 22%, 32 (49%), and 35/65 (54%) patients after tracheostomy. The 28-day mortality was 30/65 (46%). The fractional inspired oxygen concentration (FiO₂) requirement in survivors was lower (0.4-0.6, <i>p</i> = 0.015) with a higher PaO₂/FiO₂ ratio (118-200, <i>p</i> = 0.033). Early tracheostomy within 7 days of intubation was not associated with weaning or survival benefit.</p><p><strong>Conclusions: </strong>We suggest that tracheostomy should be delayed to after 7 days of intubation, especially till FiO₂ reduces to 0.5 with improvement in PaO₂/FiO₂ for better outcomes and avoiding a wasted procedure (CTRI/2021/07/034768).</p><p><strong>Study highlights: </strong>Tracheostomy is integral in care of COVID-19 patients needing prolonged ventilation. There is no difference in complications in early/late or percutaneous dilatational/surgical technique. We observed successful weaning post-tracheostomy in 54% patients. Mortality at 28 days was 46%. Early tracheostomy within 7 days of intubation did not improve weaning or survival.</p><p><strong>How to cite this article: </strong>Karna ST, Trivedi S, Singh P, Khurana A, Gouroumourty R, Dodda B, <i>et al.</i> Weaning Outcomes and 28-day Mortality after Tracheostomy in COVID-19 Patients in Central India: A","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"85-93"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/5f/ijccm-26-85.PMC8783235.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882371","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":"Multisystem Inflammatory Syndrome in Adults and Adolescents Associated with COVID-19 Infection: A Single-center Experience.","authors":"Rajalakshmi Arjun,&nbsp;Vettakkara Km Niyas,&nbsp;Sujith M Thomas,&nbsp;Muraleedharan Raman,&nbsp;Ajit Thomas,&nbsp;Wilson Aloysius,&nbsp;Bhuvanesh Mahendran","doi":"10.5005/jp-journals-10071-24066","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24066","url":null,"abstract":"<p><p><b>How to cite this article:</b> Arjun R, Niyas VKM, Thomas SM, Raman M, Thomas A, Aloysius W, <i>et al</i>. Multisystem Inflammatory Syndrome in Adults and Adolescents Associated with COVID-19 Infection: A Single-center Experience. Indian J Crit Care Med 2022;26(1):145-148.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"145-148"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/fc/ijccm-26-145.PMC8783257.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39744433","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}