Volume 27, issue 2, of the Indian Journal of Critical Care Medicine in 2023, contained content on pages 127 through 131.
Salhotra R, Singh A, Bajaj M, Saxena AK, Sharma SK, Singh D, et al. How well do healthcare workers retain and apply the practical skills learned in a hands-on COVID-19 oxygen therapy training session? The Indian Journal of Critical Care Medicine's 2023 second issue, volume 27, documents research on critical care medicine, spanning pages 127 through 131.
Acute disorder of attention and cognition marks delirium, a common, under-recognized, and often fatal complication in critically ill patients. Outcomes suffer from the fluctuations in global prevalence. A limited number of Indian studies have undertaken a systematic evaluation of delirium.
An observational study, conducted prospectively, will explore the incidence, subtypes, risk factors, complications, and ultimate outcomes of delirium in Indian intensive care units (ICUs).
Of the 1198 adult patients screened during the study period from December 2019 to September 2021, 936 were ultimately included in the analysis. The psychiatrist or neurophysician confirmed delirium after the application of the Confusion Assessment Method-Intensive Care Unit (CAM-ICU) and the Richmond Agitation-Sedation Scale (RASS). Risk factors and their consequent complications were compared to a control group's data.
In a substantial portion of critically ill patients, delirium was observed, reaching a rate of 22.11%. The hypoactive subtype was the most prevalent, comprising 449 percent of the cases. Age, APACHE-II score, hyperuricemia, creatinine levels, hypoalbuminemia, hyperbilirubinemia, alcohol use, and smoking all presented as recognizable risk factors. Contributing factors encompassed patients residing in non-cubicle beds, their positioning near the nursing station, the necessity for ventilation, and the use of sedatives, steroids, anticonvulsants, and vasopressors. The delirium group experienced a constellation of complications, including unintentional catheter removal (357%), aspiration (198%), the requirement for reintubation (106%), decubitus ulcer formation (184%), and an alarmingly high mortality rate of 213% compared to a baseline of 5%.
Among the common occurrences in Indian intensive care units, delirium stands out, potentially influencing a patient's duration of stay and mortality. A critical first step towards preventing this important cognitive impairment in the ICU is determining the incidence, subtype, and associated risk factors.
The listed contributors to the research are A.M. Tiwari, K.G. Zirpe, A.Z. Khan, S.K. Gurav, A.M. Deshmukh, and P.B. Suryawanshi.
A prospective observational study from an Indian intensive care unit examined delirium, including its incidence, subtypes, risk factors, and outcomes. The Indian Journal of Critical Care Medicine, 2023, issue 2 of volume 27, offers a collection of studies on pages 111 through 118.
AM Tiwari, KG Zirpe, AZ Khan, SK Gurav, AM Deshmukh, PB Suryawanshi, and colleagues conducted research. SARS-CoV inhibitor A prospective study examining the incidence, subtypes, risk factors, and outcomes of delirium in Indian intensive care units. In the 2023 second issue of the Indian Journal of Critical Care Medicine, the content spans pages 111 to 118.
The HACOR score, factoring in pneumonia, cardiogenic pulmonary edema, ARDS, immunosuppression, septic shock, and the SOFA score, assesses patients presenting to the emergency department prior to non-invasive mechanical ventilation (NIV), impacting NIV success. This score considers modified heart rate, acidosis, consciousness, oxygenation, and respiratory rate. A comparable distribution of baseline characteristics could have been facilitated by employing propensity score matching. A precise set of objective criteria is needed to accurately diagnose respiratory failure requiring intubation.
Analyzing non-invasive ventilation failure, Pratyusha K. and A. Jindal developed methods for prediction and safeguarding strategies. Page 149 of the Indian Journal of Critical Care Medicine, volume 27, issue 2, 2023.
Jindal A. and Pratyusha K. have meticulously studied and provided a detailed report on 'Non-invasive Ventilation Failure – Predict and Protect'. The Indian Journal of Critical Care Medicine, in its 2023 second issue of volume 27, dedicated a page to an article, 149.
Studies on acute kidney injury (AKI), including community-acquired (CA-AKI) and hospital-acquired (HA-AKI) types, are rare among non-COVID-19 patients in intensive care units (ICU) during the coronavirus disease-2019 pandemic. We projected a study on the evolving pattern of patient characteristics, juxtaposed against the data from the pre-pandemic era.
A prospective observational study examining AKI outcomes and mortality predictors among non-COVID patients was conducted in four ICUs of a North Indian government hospital during the COVID-19 pandemic. Renal and patient survival outcomes, at the time of discharge from the ICU and hospital, duration of stay in both, factors predictive of death, and dialysis necessities at the time of leaving the hospital were evaluated. Exclusions from the study included individuals with a history of COVID-19 infection, previous episodes of acute kidney injury (AKI), chronic kidney disease (CKD), organ donation, or organ transplantation.
Diabetes mellitus, primary hypertension, and cardiovascular diseases represented the predominant comorbidities, in descending order, among the 200 AKI patients who did not have COVID-19. Severe sepsis, systemic infections, and post-surgical patients were the predominant causes of AKI, in that order. SARS-CoV inhibitor During intensive care unit (ICU) admission, and throughout the ICU stay, and extending beyond 30 days, dialysis requirements were observed in 205, 475, and 65% of patients, respectively. While the incidence of CA-AKI and HA-AKI reached 1241, the instances requiring dialysis for more than 30 days stood at 851. The death rate during the initial 30 days was 42%. SARS-CoV inhibitor It was observed that hepatic dysfunction presented with a hazard ratio of 3471, along with septicemia (HR 3342), age exceeding 60 years (HR 4000), and a higher SOFA score (hazard ratio 1107).
Among the diagnoses, 0001, a medical code, and anemia, a blood condition, were noted.
The patient presented with low serum iron, as demonstrated by the 0003 result.
These factors proved to be key determinants of mortality in patients experiencing acute kidney injury.
In comparison to the pre-COVID-19 era, the COVID-19 pandemic, by limiting elective surgeries, resulted in a higher frequency of CA-AKI cases relative to HA-AKI cases. Sepsis, combined with acute kidney injury impacting multiple organs, hepatic impairment, advanced age, and elevated SOFA scores, were identified as indicators of unfavorable renal and patient outcomes.
B. Singh, P.M. Dogra, V. Sood, V. Singh, A. Katyal, and M. Dhawan.
In four intensive care units during the COVID-19 pandemic, an investigation of mortality and outcomes related to acute kidney injury (AKI) in non-COVID-19 patients, examining the disease spectrum. Indian Journal of Critical Care Medicine, 2023, volume 27, number 2, pages 119 to 126.
Researchers B. Singh, P.M. Dogra, V. Sood, V. Singh, A. Katyal, and M. Dhawan, and their associates (et al.) Analyzing outcomes and mortality from acute kidney injury among non-COVID-19 patients during the COVID-19 pandemic, using data from four intensive care units to determine various predictors and the spectrum of injury. Pages 119 to 126 of the Indian Journal of Critical Care Medicine's 2023 second volume (27(2)) contained relevant content.
A study explored the feasibility, safety, and practical application of transesophageal echocardiographic screening in patients with COVID-19 ARDS, who were mechanically ventilated and positioned prone.
A prospective observational study, undertaken in an intensive care unit, involved patients aged 18 and over presenting with ARDS, receiving invasive mechanical ventilation, and being within the post-procedure period (PP). Eighty-seven patients were chosen for the study in total.
The ultrasonographic probe's insertion, ventilator settings, and hemodynamic support remained stable and required no modifications. The average time taken for transesophageal echocardiography (TEE) was 20 minutes. No change in the orotracheal tube's position, no emesis, and no occurrences of gastrointestinal bleeding were documented. The nasogastric tube was displaced in a significant number of patients, 41 (47%), as a frequent complication. The study indicated right ventricular (RV) dysfunction, a severe condition, in 21 (24%) of the patients, and acute cor pulmonale in 36 (41%).
Our data demonstrate the importance of assessing RV function during periods of severe respiratory distress, and the significance of TEE in hemodynamic evaluation for PP patients.
Sosa FA, Wehit J, Merlo P, Matarrese A, Tort B, and Roberti JE.
Can transesophageal echocardiography be practically applied to assess COVID-19 patients with severe respiratory distress when they are in a prone position? A feasibility study. The 2023 second issue of the Indian Journal of Critical Care Medicine contained research published on pages 132 to 134.
The research team, including Sosa FA, Wehit J, Merlo P, Matarrese A, Tort B, Roberti JE, et al., presented their results. A research study to determine the feasibility of using transesophageal echocardiography in patients with COVID-19-induced severe respiratory distress when placed in the prone position. Critical care medicine research published in the Indian Journal of Critical Care Medicine, 2023, volume 27, issue 2, encompasses pages 132-134.
In the critical care setting, securing airway patency with endotracheal intubation using videolaryngoscopes is becoming standard practice, emphasizing the crucial role of expert technique. In intensive care units (ICUs), we evaluate the comparative performance and outcomes of the King Vision video laryngoscope (KVVL) and the Macintosh direct laryngoscope (DL).