{"title":"MICROBIAL LANDSCAPE OF THE NEONATAL INTENSIVE CARE UNIT: A RETROSPECTIVE ANALYSIS","authors":"D. Surkov, O. Kapustina","doi":"10.25284/2519-2078.1(94).2021.230608","DOIUrl":"https://doi.org/10.25284/2519-2078.1(94).2021.230608","url":null,"abstract":"Objective. To investigate the structure, antenatal and intranatal risk factors and results of treatment of neonatal sepsis.Materials and methods. This study used analysis of 137 case histories of newborns from 2015 to 2019. We evaluated maternal risk factors, intrapartum asphyxia, duration of treatment, number of days on mechanical ventilation, the presence of sepsis, necrotic enterocolitis, mortality.Results and discussion. Most children were over 2500 g (69.3%). In infants with a birth weight lower than 1500 g were 10.9%. 70.8% of newborns received in the first 24 hours after birth. From the moment of admission to the department, among all infected children was 71%, mortality was 14%. In children under 29 weeks of gestation, the risk of developing sepsis is 17.2 times higher. (р˂0.001) In children under 1 kg of weight, the risk of manifestation of sepsis is 42.2 times higher. (р˂0.001)The maternal colonization have the risk of developing a child’s infection is 4.36 times higher. (р˂0.001)With a diagnosis of sepsis most infants were more than 2.5 kg and mortality remained significantly high 31.6-36.8% in all weight groups (0.00001), depending on birth weight.The majority of the applicants were children over 37 weeks, but mortality was significantly higher in the group from 29-37 weeks (0.00001), depending on the term of gestation.Among the studied mothers, up to 53% were maternal colonization and in this group the mortality of children was significantly higher than 23% (p=0.020).However, in the group of children where there were signs of ascending infection of the placenta (there were 25%) mortality was still significantly higher by 1.4 times, 32% (p=0,008).Conclusions. The risk of developing neonatal sepsis was increased in ascending infection (clinical chorioamnionitis) in 6.65 times, (р˂0.001), the presence of a coagulase-negative culture by 5.83 (р˂0.011) and invasive respiratory therapy by 18.52 times. (р˂0.002) Mortality rates are affected by gestational age OR=13.81 (р˂0.001), birth weight 1-1.5 kg OR=13.15 (р˂0.001), 1.5-2.5 kg OR=2.86 (р=0.043), maternal factors (vaginal colonization, ascending infection) OR=3,22 (р˂0.023), infection of placental membranes OR=4,32 (р˂0.008), the presence of sepsis OR=15,56 (р˂0.001), necrotic enterocolitis OR=8,06 (р˂0.001) and CoNS OR=4,98 (р˂0.033).","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":"10 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89078085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Teamwork in chronic pain management and the way forward in low and middle-income countries","authors":"A. Siddiqui, Usman Bashir","doi":"10.35975/APIC.V25I2.1477","DOIUrl":"https://doi.org/10.35975/APIC.V25I2.1477","url":null,"abstract":"Assessment and management of patients with chronic pain is a challenging task due to its complex multidimensional nature and biopsychosocial impact. It requires a collaborative effort by an interdisciplinary team. Evidence showed that in low and middle-income countries (LMICs), 33% patients among general adult population, and 56% of general elderly population, suffer from chronic painful conditions. Women are more likely to report chronic pain than men. In this narrative review, we attempted to search published literature to know the status of assessment and management of patients with chronic pain in low resource countries and to know the most appropriate chronic pain management strategies used in developed countries. We used broad electronic database (January 2010- December 2020) through common search engines. \u0000Lack of trained pain physicians and staffs, lack of interest, empathy and lack of integrated multidisciplinary approach are some of the barriers to achieve teamwork in chronic pain management. Authors strongly recommend the need of further research in this area, improvement in training programs for physicians and nursing staff for proper pain assessment and management of patients with chronic pain in low resource countries. \u0000Key words: Chronic pain management; Teamwork; Low resource; Multidisciplinary team; Interdisciplinary approach; Low and middle-income countries \u0000Citation: Siddiqui AS, Usman B. Teamwork in chronic pain management and the way forward in low and middle-income countries. Anaesth pain intensive care 2021;25(2):229-235. DOI: 10.35975/apic.v25i2.1477 \u0000Received: 18 January 2021, Reviewed: 20 January, 10 February 2021, Accepted: 9 March 2021","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47378760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Amin Younesieh Heravi, A. Gazerani, M. Yaghubi, Zakiehe A. Amini, P. Salimi, Zahra Z. Falahi
{"title":"Pain estimation after coronary angiography based on vital signs by using artificial neural networks","authors":"Mohammad Amin Younesieh Heravi, A. Gazerani, M. Yaghubi, Zakiehe A. Amini, P. Salimi, Zahra Z. Falahi","doi":"10.35975/APIC.V25I1.1433","DOIUrl":"https://doi.org/10.35975/APIC.V25I1.1433","url":null,"abstract":"Background: Coronary angiography is gold standard method to diagnose coronary arteries diseases. The aim of this study was to estimate pain after coronary angiography based on vital signs for determining best position by using artificial neural networks ANN. \u0000Methodology: This study used a database containing 86 subjects that refer to angiography center. For each subject Vital signs were measured that included blood pressure, percent of blood oxygen saturation, heart rate, respiratory rate and temperature. The Numeric Rating scale (NRS) was used to determine pain intensity. The vital signs were the inputs and the pain value was the corresponding output. These data were applied to train the ANN in the learning process. The model was implemented in MATLAB software. The results of pain estimation were compared with the results of NRS method and the error rate was calculated. \u0000Results: The absolute error and error percentage between NRS method and the present method were 5.41 ± 2.63 mmHg, 4.09 ± 1.59%. The results indicated that the pain measurement by NRS method and pain value predicted with trained ANN differ by only less than 11%. It is obvious that the neural network prediction fit properly to the NRS results. \u0000Conclusion: The results of proposed method were closely in agreement with the results of the NRS. so this method can be suggested for reliving the pain and determining the best patient's position after the angiography procedure. \u0000Key words: Artificial neural network; Coronary angiography; Pain \u0000Citation: Heravi MAY, Yaghubi MS, Amini ZA, Salimi PS, Falahi ZZ, Gazerani AG. Pain estimation after coronary angiography based on vital signs by using artificial neural networks. Anaesth. pain intensive care 2021;25(1):27–32. \u0000DOI: 10.35975/apic.v25i1.1433 \u0000Received: 21 November 2020, Reviewed: 2 December 2020, Accepted: 12 December 2020","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43595715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Optimizing training programs and opportunities for professional development in the era of digital pain interventions: A unique opportunity for collaboration","authors":"H. MahmoodSyed, Amara Nasir","doi":"10.35975/APIC.V25I1.1444","DOIUrl":"https://doi.org/10.35975/APIC.V25I1.1444","url":null,"abstract":"Introduction: New digital health technologies provide accessible adjuncts to alleviating pain in the general population. The advent novel digital pain interventions have resulted in a rapidly evolving learning environment. Improving knowledge and understanding of these digital patient-centric approaches to treating pain is vital for our current practitioners and new cadre of trainees. The objective of this manuscript is to initiate a discussion about digital pain intervention educational needs of residents as well as attendings in PM&R, anesthesia and neurology. \u0000Methodology: After reviewing Accreditation Council Graduate Medical Education (ACGME) and relevant American Board of Medical Specialties policies and best available evidence, including grey literature, we interviewed a group of practicing physicians in physiatry, anesthesiology and neurology, including program directors, to provide expert opinion, guidance and formulate recommendations on educational requirements, research endeavors, and learning techniques and opportunities in utilizing digital health interventions for management of pain. IRB approval was not required. \u0000Conclusions: We hope that this manuscript will serve as the basis of designing a comprehensive educational program and outlining opportunities for research that prioritizes optimal care for pain patients and leverages the unique and complementary knowledge base within our fields. \u0000Key words: Digital pain; Physiatry; anesthesiology; Neurology; Competency; Accreditation Council Graduate Medical education \u0000Citation: Nasir A, Mahmood SH. Optimizing training programs and opportunities for professional development in the era of digital pain interventions: A unique opportunity for collaboration. Anaesth. pain intensive care 2021;25(1): 76–80. \u0000D0I: 10.35975/apic.v25i1.1444 \u0000Received: 24 October 2020; Reviewed: 22 November 2020; Accepted: 5 December 2020","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41919150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effect of mother’s voice on pain and physiological parameters during arterial blood sampling in children hospitalized in PICUs","authors":"M. Shoghi, M. Ahmadi, Mahboubeh Rasouli","doi":"10.35975/APIC.V25I1.1440","DOIUrl":"https://doi.org/10.35975/APIC.V25I1.1440","url":null,"abstract":"Introduction: Arterial blood sampling is a painful procedure, and is frequently performed in PICUs. Listening to mother's voice may be effective in reducing pain during arterial blood sampling in children. This study was aimed to determine the effect of mother’s recorded voice on pain and physiological parameters during arterial blood sampling in children hospitalized in PICUs. \u0000Methodology: This study was a single blind randomized clinical trial with crossover design. Fifty children hospitalized in PICUs participated in this study. The participants were selected through “sequential sampling” and randomly allocated into two groups; e.g., Group AB (n = 25) and Group BA (n = 25). Physiological parameters and pain in each child were measured before and during arterial blood sampling with (B) and without (A) listening to their mothers’ voices with a minimum of 24 hrs interval. To measure the pain, COMFORT pain scale was used and the physiological parameters were measured using the monitoring devices connected to the children. Data were analyzed with SPSS version 22, repeated measure test, paired and non-paired t-test, Wilcoxon and Mann-Whitney test. \u0000Results: Means of pain scores and physiologic parameters did not show a significant difference before the intervention on the first and second day between the two groups (AB-BA). The results showed the period effect (f = 0.581 and p = 0.89) and carry over effect (f = 0.055, p-value = 0.881) were not significant. Results of paired t-test showed that the mean pain score during arterial blood sampling with (B: 21.82 ± 5.53) and without (A: 22.40 ± 4.76) listening to their mothers’ voices was significantly different (p = 0.002). That is, with the mother’s voice, the children felt a lower level of pain. The SpO2 decline during the sampling was less with the mother’s voice. Additionally, the heart rate declined less during the sampling compared to the rate before the sampling with the mother’s voice; still, the difference was not significant (p > 0.05). \u0000Conclusion: Listening to mothers’ recorded voice was effective to alleviate pain during arterial blood sampling in children hospitalized in PICUs. The use of this method to reduce pain during this painful procedure is effective even in the absence of the mother. \u0000Key words: Pain; Mother’s voice; Arterial blood sampling; Physiological indices; PICU \u0000Citation: Shoghi M, Ahmadi M, Rasouli M. The effect of mother’s voice on pain and physiological parameters during arterial blood sampling in children hospitalized in PICUs. Anaesth. pain intensive care 2021;25(1):40-47.DOI: 10.35975/apic.v25i1.1440 \u0000 Received: 20 June 2020, Reviewed: 16 September 2020, Accepted: 25 November 2020","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45193917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ivermectin for COVID-19;to use or not to use?","authors":"Y. Morimoto","doi":"10.35975/apic.v25i5.1651","DOIUrl":"https://doi.org/10.35975/apic.v25i5.1651","url":null,"abstract":"COVID-19 has engulfed the continents into a pandemic, filling the hospitals with this viral disease, heavily taxing the healthcare facilities and claiming thousands of lives in almost every country. In the absence of a known evidence based remedy, many treatment options have been tried with variable results. Multiple vaccines have been developed by the drug industry, but none can be claimed to be 100% effective in prevention of the disease. There has been some evidence about the beneficial effects of ivermectin - an anthelmintic drug. This editorial discusses the various aspects of the use of ivermectin for the treatment of active COVID-19.","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":"46 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76373537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olayinka Rasheed Ibrahim, T. Oloyede, H. Gbadamosi, Y. Musa, R. Aliu, S. Bello, M. Alao, B. Suleiman, O. Adedoyin
{"title":"Acute kidney injury in COVID-19: A single-center experience in Nigeria","authors":"Olayinka Rasheed Ibrahim, T. Oloyede, H. Gbadamosi, Y. Musa, R. Aliu, S. Bello, M. Alao, B. Suleiman, O. Adedoyin","doi":"10.35975/apic.v25i4.1567","DOIUrl":"https://doi.org/10.35975/apic.v25i4.1567","url":null,"abstract":"Background & objective: Despite available data from developed countries, suggesting a high incidence of acute kidney injury (AKI) in coronavirus disease 2019 (COVID-19), there is scarce data from African countries, including Nigeria. We conducted this study to determine and document the incidence, the associated factors and the outcome (in-hospital mortality) of AKI among COVID-19 patients managed in a center in Nigeria. Methodology: It was a retrospective review of confirmed COVID-19 cases managed at a center in Nigeria. AKI was defined using 2012 Kidney Disease: Improving Global Outcomes (KDIGO) creatinine criteria. We extracted relevant data from the electronic records of the COVID-19 patients admitted to our hospital and analyzed. Fischer's exact tests were used to test factors associated with AKI for discrete variables, Mann-Whitney U test was used for skewed continuous data, and T-test for continuous normal distribution variables. Results: This study involved 41 of the 56 confirmed COVID-19 cases. The mean age was 45 +/- 17.94 y. A majority of the patients were males (33;80.5%). AKI occurred in 6 (14.6%) of the patients. Of the 6 AKI;4 (66.7%) and 2 (33.3%) were in stages 1 and 3 respectively. One patient (16.7%) had had hemodialysis. Of the 6 with AKI, 3 died with a mortality rate of 50.0%. Factors associated with AKI included age above 45 years, body weakness, severe and critical COVID, urea > 10 mmol/l, and serum creatinine > 1.5 mg/dl. Only severe and critical disease was predictive of AKI (adjusted odds ratio 1.777, 95% CI 1.028, 3.074). Conclusion: The results of our study show that AKI is common in severe and critical COVID-19 and is associated with a poor outcome.","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":"26 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72520731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. S. Islam, D. Bhowmick, M. Parveen, M. Kamal, A. Akhtaruzzaman
{"title":"Case fatality rate and survival functions of severe COVID-19 patients in intensive care unit of Bangabandhu Sheikh Mujib Medical University in Bangladesh: an observational study","authors":"M. S. Islam, D. Bhowmick, M. Parveen, M. Kamal, A. Akhtaruzzaman","doi":"10.35975/apic.v25i4.1553","DOIUrl":"https://doi.org/10.35975/apic.v25i4.1553","url":null,"abstract":"Background: Emergence of current pandemic caused by novel SARS-COV-2 has already caused over 963000 deaths. Case fatality rate (CFR) estimation helps understanding the disease severity and the lethality trend, high risk population and subsequently, optimization of quality healthcare facilities. Our observational study aimed to find out existing trends in treating the most vulnerable group with scarce medical resource allocation and to implement necessary support services to comply with the ensuing need for best possible outcomes in our ICU. Methodology: In this observational study, all COVID-19 diagnosed patients admitted in our ICU from July 4, 2020 to September 22, 2020, were enrolled. Data were obtained from the core ICU register of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Information accumulated on predesigned data sheets comprised of particulars of patients, co-morbidities, duration of ICU stay, mode of oxygenation, organ support and quick SOFA scores. Total deaths in ICU (in hospital or referred from outside of BSMMU) were recorded. Results: The results revealed that all patients were either very severe or critically sick with COVID-19 pneumonia at the time of ICU admission. Out of 174 patients, 46 (26.44%) were put on invasive ventilation and the rest received noninvasive ventilation in the form of NRM, high flow nasal cannula (HFNC), continuous positive airway pressure (CPAP or BiPAP), CTEX CPAP and non-invasive ventilation (NIV) as appropriate. Male and female ratio was 74:26. Age of patients ranged between 19-95y. The median age of patients was 65 y (IQR: 57-70).Quick SOFA scores were more than 2 in 65.37% of patients. Regarding co-existing organ dysfunction 13.8% had 3 or more co-morbidities;while 74.1% had 2 and 9.8% had a single systemic illness along with COVID-19. Most common diseases encountered among 135 deceased were hypertension (64%), IHD (49%), diabetes mellitus (45%), bronchial asthma or COPD (32%), renal failure (either ARF or CRF) (20%). Overall CFR due to COVID-19 pneumonia associated with co-morbidities was 77.6%. Relatively higher CFR (82.6%) was evident harboring multi-organ dysfunction especially among COVID-19 patients aged 50y or more. Gender linked CFR were 81.4% and 66.7% in males and females respectively. Conclusion: High CFR demonstrates significant correlation with increasing age and co-morbidities and survival functions. Late presentation to the hospital and invasive mechanical ventilation also contributed to high CFR.","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":"7 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74393040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anesthesiologist as a perioperative physician, clinician, administrator, educator, and a researcher","authors":"K. Shibli, S. Shibli","doi":"10.35975/apic.v25i5.1649","DOIUrl":"https://doi.org/10.35975/apic.v25i5.1649","url":null,"abstract":"Anesthesia is an acute care specialty with a much wider scope in the current clinical practice. The addition of new clinical subspecialties puts additional pressure on already demanding workload with limited global anesthesia workforce. Doctors' burnout reports and currently exhausted doctors struggling with their clinical duties during COVID-19 pandemic are ample evidence of it. Due to COVID-19 crisis, a lot of subspecialty crossover care is provided by the anesthetists, and they have to work outside their normal clinical comfort zones. Anesthesiologists have been entrusted with the responsibilities of perioperative physicians in the last two decades. An anesthesiologist has to adopt several roles in a healthcare institution, including 'administrative', 'academic', 'clinical' and 'research' attributes. An ideal anesthesiologist is expected to have a fine blend of all of these traits, though the proportion of each will vary according to the work environment and the personal choices and preferences.","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":"7 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78611788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The impact of corona pandemic on critical care medicine","authors":"Faraz Mansoor","doi":"10.35975/apic.v25i4.1563","DOIUrl":"https://doi.org/10.35975/apic.v25i4.1563","url":null,"abstract":"Y A pandemic is defined as an epidemic of an infectious etiology that crosses the international boundaries and infects a large number of people. This has happened several times in the human history;influenza, smallpox, bubonic plaque and cholera being some of the examples. Smallpox alone has resulted in death of 300-500 million people. As a frontline healthcare professional fighting against the COVID-19 pandemic, the author has experienced its socioeconomic and psychological consequences. In addition, critical care units faced ethical challenges to meet with the bed requirement. Dedicated and modified COVID-19 critical care services were started in both the public and private sectors. Because of high workload and lack of trained medical and nursing staff, extra staff ha to be recruited on temporary basis. Some commonly performed procedures were modified to decrease the risk of infection spread. ICUs faced shortage of personal protective equipment and ventilators. Training programs were developed to help improve the understanding of novel COVID-19 infection. ICU staff was probably at lower risk of acquiring this infection as compared to other hospital staff.","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":"14 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82892798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}