A Proof-of-Concept Model for Implementing a "Smart-NICU" to Improve Infant Mortality.

Low- and middle-income countries face limited critical care capacity due to constraints in staffing, resources, and technology. "Smart ICUs" that integrate telehealth to augment care delivery, communication, and data integration have the potential to bridge these gaps and reduce preventable morbidity and mortality. While their efficacy has been well validated in adult populations, applications of Smart-ICU services in the neonatal population have not been studied.

A pragmatic calibration of the ROX index to predict outcome of nasal high-flow therapy in India.

Purpose: Identifying thresholds at which the ROX index would satisfactorily predict HFNC failure across heterogenous resourced contexts is necessary for clinical use.

Methods: Patients ≥18 years admitted to 30 diverse ICUs across 10 states in India who required HFNC for respiratory support were retrospectively included in this study. Patient data and hourly ROX indices were then analyzed and contextualized to clinical outcomes as well as with ROX index thresholds in other regions of the world.

Critical care practice in India: Results of the intensive care unit need assessment survey (ININ2018).

Background: A diverse country like India may have variable intensive care units (ICUs) practices at state and city levels.

Aim: To gain insight into clinical services and processes of care in ICUs in India, this would help plan for potential educational and quality improvement interventions.

Methods: The Indian ICU needs assessment research group of diverse-skilled individuals was formed.

Application of Lung Ultrasound in Critical Care Setting: A Review.

This article reviews the use of thoracic ultrasound in the intensive care unit (ICU). The focus of this article is to review the basic terminology and clinical applications of thoracic ultrasound. The diagnostic approach to a breathless patient, the blue protocol, is presented in a simplified flow chart.

Antibiotic Prescription Practices for Surgical Prophylaxis in India: An Observational Study.

Perioperative prophylactic antibiotics following surgeries have been shown to reduce surgical site infections, and their administration is common practice. Despite clear guidelines regarding this being set forth by the Infectious Disease Society of America (IDSA), adherence to them is yet to translate to common practice in many parts of the world. A retrospective chart review of 409 patients who underwent elective surgeries over a period of 7 months at three different hospitals in India was performed.

Use of home telemedicine for critical illness rehabilitation: an Indian success story.

One-fifth of healthcare beneficiaries in developed nations get discharged from hospitals to physician supervised skilled nursing care facilities. In low-income and middle-income countries like India, postdischarge skilled nursing facilities are at a very nascent stage and largely underequipped in terms of infrastructure, skilled nursing and physician staff to manage complicated patients. Hence the responsibility of management of such patients lies largely with their families.

Polysomnographic Heart Rate Variability Indices and Atrial Ectopy Associated with Incident Atrial Fibrillation Risk in Older Community-dwelling Men.

Background: Autonomic dysfunction contributes to atrial fibrillation (AF).

Objective: We hypothesized that polysomnogram (PSG)-based heart rate variability (HRV) autonomic function biomarkers are associated with incident AF and these associations are modified by measures of sleep disordered breathing (SDB).

Methods: 2350 participants of a multi-center prospective study (Outcomes of Sleep Disorders in Older Men Study) without baseline AF underwent sleep studies with incident adjudicated AF follow up (8.

Utilization of Thoracic Ultrasound for Confirmation of Central Venous Catheter Placement and Exclusion of Pneumothorax: A Novel Technique in Real-Time Application.

Aim: To evaluate the safety and utility of ultrasonography as a tool to confirm central venous catheter (CVC) position and to exclude insertion-related pneumothorax in place of chest radiography (CXR) in a tertiary medical intensive care unit (ICU).

Methods: We randomized 60 consecutive medical ICU patients to conventional or ultrasound groups for CVC placement. Both groups had CVCs inserted under ultrasound guidance.