Man made fiber fibroin while biomaterial with regard to navicular bone executive

Kayarat B, Khanna P, Sarkar S
Superadded Coinfections and Antibiotic Resistance in the Context of COVID-19 Where do We Stand? Indian J Crit Care Med 2021;25(6)699-703.
Kayarat B, Khanna P, Sarkar S. Superadded Coinfections and Antibiotic Resistance in the Context of COVID-19 Where do We Stand? Indian J Crit Care Med 2021;25(6)699-703.
This systematic review aims to provide insight into the outcome of extracorporeal membrane oxygenation (ECMO) and invasive mechanical ventilation use in critically ill COVID-19 patients.
Electronic databases PubMed Central and PubMed were searched from January 2020 to June 2020 for published studies about ECMO and/or invasive mechanical ventilation use in COVID-19 patients. Data Extraction and Study Selection The search strategy retrieved 766 articles, of which 19 studies consisting of 204 patients fulfilled the inclusion criteria and were included in the analysis.
Primary outcomes evaluated were discharge and/or clinical improvement and mortality rate. Secondary outcomes evaluated included reported complications and the mean number of days of hospitalization for survivors. Weighted averages of included studies were calculated, and data were pooled in forest plots. Nearly, 68.1% of the patients received invasive mechanical ventilation without ECMO support, and 31.9% were placed on ECMO. Also, 22.5% of the patients were discharged and/or clinically improved and 51.5% died. Twenty-six percent of the study population deteriorated but remained alive or experienced no improvement in clinical condition. And 75.2% of those who died belonged to the non-ECMO group and 24.8% to the ECMO group. GSK4362676 The mortality rate in the non-ECMO group was 56.8% compared to 40% in the ECMO group.
The utility of ECMO during a pandemic is uncertain as it is a resource-intensive modality, especially when the mortality rate in severely ill patients infected with COVID-19 virus is already known to be high.
Nagraj S, Karia R, Hassanain S, Ghosh P, Shah VR, Thomas A. Role of Invasive Mechanical Ventilation and ECMO in the Management of COVID-19 A Systematic Review. Indian J Crit Care Med 2021;25(6)691-698.
Nagraj S, Karia R, Hassanain S, Ghosh P, Shah VR, Thomas A. Role of Invasive Mechanical Ventilation and ECMO in the Management of COVID-19 A Systematic Review. Indian J Crit Care Med 2021;25(6)691-698.
Tidal volume challenge pulse pressure variation (TVC-PPV) is considered one of the recent reliable dynamic indices of fluid responsiveness (FR); also, passive leg raising (PLR)-induced changes in cardiac output (CO) detected by echocardiography are considered a reliable reversible self-fluid challenge test; many patients share eligibility for both tests.
The study aimed to compare the sensitivity and specificity of both tests for the prediction of FR in mechanically ventilated patients with hemodynamic instability.
We studied 46 patients. Hemodynamic parameters including PPV and CO (detected by velocity time integral (VTI) using echocardiography) recorded at tidal volume (VT) of 6 mL/kg/ideal body weight (IBW) in semi-recumbent position then recorded again after one-minute increase in TV from 6 to 8 mL/kg/IBW then recorded with PLR at TV of 6 mL/kg/IBW and finally with actual volume expansion in semi-recumbent position by 4 ml/kg bolus of crystalloid solution to define actual responders with increase ofal Volume Challenge with a Passive Leg Raising Test to Predict Fluid Responsiveness in Patients Ventilated Using Low Tidal Volume. Indian J Crit Care Med 2021;25(6)685-690.
Elsayed AI, Selim KAW, Zaghla HE, Mowafy HE, Fakher MA. Comparison of Changes in PPV Using a Tidal Volume Challenge with a Passive Leg Raising Test to Predict Fluid Responsiveness in Patients Ventilated Using Low Tidal Volume. Indian J Crit Care Med 2021;25(6)685-690.
Nursing Delirium Screening Scale (Nu-DESC) is a new instrument for determining delirium by nurses. The study aimed to investigate the psychometric properties of Nu-DESC and determined the sensitivity and specificity of it.
Two evaluators assessed delirium by Nu-DESC in nonintubated patients admitted to intensive care unit (ICU) wards of Ardabil educational and medical centers. For determining psychometric properties of the instrument, the methods of determining content validity, structural validity, criterion validity (the DSM-5 criteria was used as a standard tool), internal consistency, and inter-rater reliability were used.
Ninety-six participants were assessed two times using the Nu-DESC. The mean age of the participants was 58.84, and 51 (53.1%) of them were male. Due to the high correlation of the Nu-DESC with the study criterion (DSM-5), the criterion validity of the instrument is confirmed. By using DSM-5 instrument, the cutoff score of 2 shows the best sensitivity and specificity. The kappa and alpha coefficients were obtained as
= 0.96 and
= 0.86, which indicate a good agreement between the evaluators and acceptable consistency.
Nu-DESC can be used as an efficient and reliable instrument by nurses in the ICU. It was also found that taking medical history can help nurses to better interpret the Nu-DESC score at diagnosing delirium.
Amirajam Z, Noran EA, Molaei B, Adiban V, Heidarzadeh M, Darghah MH. Psychometric Properties of Nursing Delirium Screening Scale in Patients Admitted to Intensive Care Units. Indian J Crit Care Med 2021;25(6)680-684.
Amirajam Z, Noran EA, Molaei B, Adiban V, Heidarzadeh M, Darghah MH. Psychometric Properties of Nursing Delirium Screening Scale in Patients Admitted to Intensive Care Units. Indian J Crit Care Med 2021;25(6)680-684.
Practice and knowledge of extracorporeal cardiopulmonary resuscitation (ECPR) in an Indian setting is not known. The etiology could be multifactorial, such as lack of awareness, lack of facilities, and lack of finances. Unless we identify and rectify the underlying problems, utilization of this aspect of extracorporeal membrane oxygenation (ECMO) support would be difficult.
This cross-sectional observational study was done over 6 months in three phases (A) Formation of questionnaire/tool kit by Delphi method for 1 month (July 2019), (B) circulation of questionnaire to participants in the form of Google Forms and data collection for 2 months (August and October 2019), and (C) analysis, compilation of data, and writing the final report over 1 month (November 2019).
Sixty-four participants responded. The majority of the respondents were intensivists (50%). Only six respondents (9.5%) had done ECPR at their center with median ECPRs per year of 2 (1-10). All ECPRs were being done in private sector hospitals.io A Web-based Survey. Indian J Crit Care Med 2021;25(6)675-679.
High-altitude pulmonary edema (HAPE) is a common cause of hospitalization in high altitude areas with significant morbidity. The clinical presentation of HAPE can overlap with a broad spectrum of cardiopulmonary diseases. Also, it is associated with varied radiological manifestations mimicking other conditions and often leading to unnecessary and inappropriate treatment.
The primary aim of the study was to study the various radiological manifestations of HAPE through real-world chest radiographs. We present six different chest X-ray patterns of HAPE as a pictorial assay, at initial presentation, and after the resolution of symptoms with supplemental oxygen therapy and bed rest alone.
HAPE can present as bilateral symmetrical perihilar opacities, bilateral symmetrical diffuse opacities, unilateral diffuse opacities, bilateral asymmetrical focal opacities, and even lobar consolidation with lower zone or less commonly upper zonal predilection. These presentations can mimic many common conditions like heart failure, acute respiratory distress syndrome, pulmonary embolism, aspiration pneumonitis, pneumonia, malignancy, and tuberculosis.
A holistic clinical-radiological correlation coupled with analysis of the temporal course can help high-altitude physicians in differentiating true HAPE from its mimics.
Yanamandra U, Vardhan V, Saxena P, Singh P, Gupta A, Mulajkar D,
. Radiographical Spectrum of High-altitude Pulmonary Edema A Pictorial Essay. Indian J Crit Care Med 2021;25(6)668-674.
Yanamandra U, Vardhan V, Saxena P, Singh P, Gupta A, Mulajkar D, et al. Radiographical Spectrum of High-altitude Pulmonary Edema A Pictorial Essay. Indian J Crit Care Med 2021;25(6)668-674.
Data are lacking on the role of cellular components of hematological system as biomarkers for prognosis of sepsis. We planned to identify if these parameters measured at admission to ICU and at 72 hours can be useful as prognostic marker in septic critically ill patients.
In this prospective observational study, 130 adult patients with sepsis were recruited. Various hematological study parameters (total, differential, and absolute leukocyte count, platelet count, platelet distribution width, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio) were noted at day 1 and day 3 of admission. Primary outcome was 28-day mortality, and secondary outcomes were duration of mechanical ventilation, vasopressor requirement, ICU length of stay, and requirement of renal replacement therapy. The variables were compared between two groups and using binary regression model and were evaluated as prognostic markers for 28-day mortality.
Data from
= 129 were analyzed. At day-28,
= 58 (44.96%) patients suraniam R, et al. Epidemiology and Prognostic Utility of Cellular Components of Hematological System in Sepsis. Indian J Crit Care Med 2021;25(6)660-667.
With a rapidly rising geriatric population, the magnitude of elderly patients requiring intensive care is a major cause of concern. Data on critically ill geriatric patients is scarce, especially in developing countries.
The aim of the study is to identify the etiology, clinical profile, and outcome in elderly patients admitted to the intensive care unit (ICU) and to predict their survival using the sequential organ failure assessment (SOFA) score.
A prospective observational study was performed over a period of 18 months with analysis of 100 patients admitted to the ICU, above the age of 60 years, with multi-organ dysfunction. The outcome of discharge or death was studied using the SOFA score on admission, on day 2, and the delta SOFA score.
In this study of 100 patients, 88% of patients were in the 60-70 years age-group. The number of male and female patients was equal. Seventy percent of patients had comorbidities, of which hypertension was most common. The two most common etiologies were acute feb a Tertiary Care Hospital Using SOFA Score. Indian J Crit Care Med 2021;25(6)655-659.
Whether age would impact the outcomes in subjects with acute respiratory distress syndrome (ARDS) remains unclear. Herein, we study the effect of age as a predictor of mortality in ARDS.
We categorized consecutive subjects with ARDS as either ARDS
(age >65 years) or ARDSnon
(age ≤65 years) admitted to the respiratory intensive care unit (ICU) of a tertiary care hospital in North India between January 2007 and December 2019. We compared the baseline clinical and demographic characteristics, lung mechanics, and mortality between the two groups. We also analyzed the factors predicting ICU survival using multivariate logistic regression analysis.
We included 625 patients (ARDS
, 140 [22.4%] and ARDS
, 485 [77.6%]) with a mean (standard deviation) age (56.3% males) of 40.6 (17.8) years. The ARDS
were more likely (
= 0.0001) to have the presence of any comorbid illness compared to ARDS
. The elderly subjects had significantly higher pulmonary ARDS than the younger group. The severity of ARDS was however, similarly distributed between the two study arms.