Publications by authors named "Kothari Nikhil"

Introduction: Delirium is a syndrome commonly seen in intensive care unit (ICU) patients. It is characterized by acute changes in mental status, inattention, disorganized thinking, and altered level of consciousness. Due to its higher prevalence in mechanically ventilated ICU patients, it is crucial to recognize it early and implement standardized evidence-based protocols for preventing it in regular practice.

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Nosocomial bloodstream infections with multidrug-resistant microorganisms have become a common health threat in intensive care settings worldwide. Understanding antimicrobial resistance and the outcomes of these infections is crucial for addressing this issue. This study aimed to investigate the burden, antimicrobial resistance, and 28-day outcomes of nosocomial bloodstream infections in the intensive care unit.

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Background: We compared the modified ROX index and ROX index scores in earlier predictions of high-flow nasal oxygen (HFNO) therapy outcomes in patients with acute respiratory failure.

Methods: We conducted a prospective observational study on 151 acute respiratory failure patients initiated on HFNO therapy. The primary objective of this research was to compare the modified ROX index and ROX index to investigate which score predicted HFNO treatment outcome earlier.

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Article Synopsis
  • * A total of 103 adult patients with CRAB-related VAP were analyzed, comparing outcomes between those treated with dual and triple antibiotic combinations involving sulbactam.
  • * Results indicate that the triple therapy (sulbactam, polymyxin B, and minocycline) significantly reduced 28-day mortality and improved other health markers compared to the dual therapy, suggesting it may be a more effective treatment option.
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Mishra S, Kothari N, Sharma A, Goyal S. Author Response: Oxygen Delivery Devices in Postoperative Patients: Proper Selection of Patients Matters! Indian J Crit Care Med 2024;28(8):803.

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Background: No research has been conducted to compare long-axis in-plane and short-axis out-of-plane techniques for ultrasound-guided posterior tibial artery cannulation in adults. This study compared these two procedures for cannulating the posterior tibial artery.

Methods: This prospective randomized trial included 236 adult patients undergoing general anesthesia who required arterial cannulation.

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Artificial intelligence is an ever-growing modality revolutionizing the field of medical science. It utilizes various computational models and algorithms and helps out in different sectors of healthcare. Here, in this scoping review, we are trying to evaluate the use of Artificial intelligence (AI) in the field of pediatric anesthesia, specifically in the more challenging domain, the pediatric airway.

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Article Synopsis
  • The authors respond to a discussion on various methods of oxygen delivery for post-operative patients experiencing hypoxemia, emphasizing the limitations of traditional nasal prongs.
  • They advocate for a broader exploration of alternative oxygen delivery systems that may offer improved outcomes in critical care settings.
  • The article highlights the importance of individualized patient care and the need for evidence-based practices in managing post-operative hypoxemia effectively.
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  • A significant percentage (16-66%) of COVID-19 patients experience abdominal symptoms, which are often detected through CT scans, but the effectiveness of these scans in diagnosing related issues is unclear.* -
  • This study reviewed data from COVID-19 patients who underwent abdominal CT scans to identify imaging signs of the virus and associated conditions, specifically COVID-19 associated Mucormycosis (CAM), including demographics and lab results.* -
  • Results showed that a majority of patients had abdominal abnormalities, particularly in the hepatobiliary and bowel areas, and there was a correlation between CT severity scores, abdominal symptoms, and elevated D-dimer levels, especially in patients needing ICU care.*
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The physiological transformations accompanying pregnancy, compounded by the implications of obesity, pose intricate challenges for anaesthesiologists attending to obese parturients. Obesity makes it harder to successfully provide epidural analgesia to a parturient. This narrative review explains the most recent data on the safety and complications of providing labour epidural analgesia in obese expectant mothers.

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Article Synopsis
  • Recent advancements in aerosol therapy have prompted a study on its use in critically ill patients in Indian ICUs, noting a lack of prior research in this area.
  • The study tracked 218 patients over four weeks, revealing that a majority (72.48%) received a high volume of aerosols, predominantly bronchodilators, using jet nebulizers.
  • Findings indicate a diverse application of aerosol therapy, with minimal adjustments to ventilator settings during treatment sessions.
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Background: Acute hypoxemic respiratory failure is among the more commonly occurring complications in postoperative patients. Supplemental oxygen and addressing the primary etiology form the basis of its treatment.

Materials And Methods: We conducted an open-labeled randomized control trial with 90 adult patients and compared three oxygen delivery vehicles (ODV), i.

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Background: In adult patients, there has never been an evaluation of short-axis out-of-plane versus long-axis in-plane approaches of ultrasound-guided dorsalis pedis artery cannulation. This research was conducted to compare these two techniques to cannulate the dorsal pedis artery.

Methods: In this trial, 128 adult patients undergoing surgery and necessitating arterial cannulation were examined.

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Background: Carbapenem-resistant Enterobacterales (CRE) are a global health problem with a growing prevalence. India has a high prevalence of CRE. CRE infections are difficult to treat, and are associated with significant morbidity and mortality.

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Medication error has emerged as a significant problem in healthcare, especially in the past 2 decades. In anaesthesia, the paediatric age group is particularly at risk of such events because of complex age- and weight-based drug calculation, drug formulations, serial dilutions, and often limited staff experience in handling such patients. We searched PubMed, Cochrane, and Google Scholar for literature on medication errors in paediatric anaesthesia in children (< 18 years of age).

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Background: We explored the analgesic efficacy of two non-opioid adjuvants (midazolam and dexmedetomidine) with ropivacaine in children undergoing infraumbilical surgeries.

Methods: In this parallel group randomized controlled trial, 135 children aged between 2 and 8 years were recruited. Children were randomly allocated to one of three groups: RD received 1 mL/kg of ropivacaine (0.

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Sahoo P, Kothari N, Sharma A, Goyal S. Author Reply: Comparison of Norepinephrine and Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control Study. Indian J Crit Care Med 2023;27(8):603-604.

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Background: Paediatric patients are a population with a high level of anxiety. The prevention of perioperative stress in a frightened child is important to render the child calm and cooperative for smoother induction. Intranasal premedication is easy and safe, and the drug is rapidly absorbed into the systemic circulation, ensuring early onset of sedation in children and good effectiveness.

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Objective: Early diagnosis of sepsis is crucial to institute appropriate therapy and then to avert a possible negative outcome. We planned this study to evaluate the diagnostic value of presepsin, its sensitivity and specificity for diagnosing sepsis in critically ill patients, and its ability to prognosticate the outcome of sepsis.

Methods: In this prospective observational study, adult patients admitted to the intensive care unit (ICU) at our institute were screened, and those with features suggestive of sepsis were recruited into the study.

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Background: Radial artery cannulation is usually done for monitoring invasive blood pressure during intraoperative period. The dynamic needle tip positioning approach allows continuous visualization of the needle tip during ultrasound-guided cannulation. The acoustic shadowing technique, using two lines on the ultrasound probe, might be used to facilitate radial artery puncture.

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Introduction: Covid 19 epidemic has affected the people making them undergo emergency procedures requiring intubation. A protective box was innovated at our tertiary care centre to safeguard the HCW during intubation and/or extubation and the study was planned to assess its use and safety among the anaesthesiologists.

Methods: A cross sectional, questionnaire base survey was done among anaesthesiologists in various strata of residency.

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