In Light of the LANDI-SEP Trial: New Evidence or Double Jeopardy?

Datta PK, Sathe P, Bhattacharjee A, Kundu R. In Light of the LANDI-SEP Trial: New Evidence or Double Jeopardy? Indian J Crit Care Med 2025;29(1):84-85.

Effect of isotonic sodium bicarbonate infusion on perioperative acid-base status among patients undergoing emergency laparotomy for perforation peritonitis (ISABEL trial): a randomized controlled trial.

Purpose: Perioperative metabolic acidosis negatively affects patient outcomes. Perioperative fluid therapy has a clinically significant effect on acid-base balance. This study was conducted to evaluate the effects of isotonic sodium bicarbonate infusion (ISB) versus balanced crystalloid solution (BCS) on perioperative acid-base balance, in terms of postoperative base excess, among patients undergoing emergency laparotomy for perforation peritonitis.

The Clinical Utility of Targeted Heart Rate Control in Septic Shock: A Systematic Review and Meta-analysis of Randomized Controlled Trials with Trial Sequential Analysis.

Objectives: Heart rate control using beta-blockers in sepsis has traditionally been avoided because of concerns with worsening cardiac index and organ perfusion. Recent studies has explored the possible beneficial effects of targeted heart rate control in patients with septic shock who have tachycardia despite initial resuscitation. We performed a systematic review and meta-analysis to explore the effects of heart rate control in septic shock patients.

Role of Novel Glucagon-like Peptide-1 Receptor Analogue Polyethylene Glycol Loxenatide in Type 2 Diabetes: A Systematic Review and Meta-analysis.

Background: Polyethylene glycol loxenatide (peg-loxenatide) is a novel glucagon-like peptide-1 receptor agonist developed and available for clinical use in China. This meta-analysis was performed as no meta-analysis has analysed the efficacy and safety of peg-loxenatide in type 2 diabetes (T2DM).

Methods: Electronic databases were systematically reviewed for RCTs having patients living with T2DM receiving peg-loxenatide in treatment arm and placebo/any other diabetes medicine in control arm.

Nebulised magnesium sulphate as an adjuvant to the treatment of acute exacerbation of COPD: A systematic review and meta-analysis of randomised controlled trials with trial sequential analysis.

The purpose of this meta-analysis was to evaluate the efficacy of nebulised magnesium in the treatment of acute exacerbation of COPD. PubMed and Embase databases were searched for randomised controlled trials comparing any dose of nebulised magnesium sulphate with placebo for treatment of acute exacerbation of COPD, published from database inception till 30 June 2022. Bibliographic mining of relevant results was performed to identify any additional studies.

The use of preoperative inferior vena cava ultrasound to predict anaesthesia-induced hypotension: a systematic review.

Preoperative ultrasound assessment of inferior vena cava (IVC) diameter and the collapsi-bility index might identify patients with intravascular volume depletion. The purpose of this review was to gather the existing evidence to find out whether preoperative IVC ultrasound (IVCUS) derived parameters can reliably predict hypotension after spinal or general anaesthesia. PubMed was searched to identify research articles that addressed the role of IVC ultrasound in predicting hypotension after spinal and general anaesthesia in adult patients.

HFOV in inhalational injury associated ARDS with broncho-pleural fistula - An old friend to the rescue: Case report.

Introduction: Patients with acute respiratory distress syndrome (ARDS) on mechanical ventilation often require high inspiratory pressure and positive end-expiratory pressure (PEEP). However, effective ventilation becomes difficult in cases where a large air leak develops in patients. The management of such a case requires improvisation and the adoption of special ventilation strategies.

Challenges in Anesthesia in Wilson's Disease: A Systematic Review of the Existing Literature.

Wilson's disease (WD) is a disorder of copper metabolism presenting with a wide variety of organ dysfunctions affecting predominantly the neurological, hepatic, and hematological systems. Due to its multi-systemic nature, administering anesthesia to a patient with WD is challenging and requires an in-depth knowledge of the disease pathophysiology. A systematic search for literature pertaining to the anesthetic management of patients with WD yielded 19 case reports, which we have included in this review to explore and summarize peri-operative concerns and the safe anesthesia practices in this condition.

Efficacy and safety of novel thiazolidinedione lobeglitazone for managing type-2 diabetes a meta-analysis.

Background And Aims: No meta-analysis has analysed the safety and efficacy of lobeglitazone in type-2 diabetes (T2DM). We undertook this meta-analysis to address this knowledge-gap.

Methods: Electronic databases were searched for RCTs involving type-2 diabetes patients receiving lobeglitazone in intervention arm, and placebo/active comparator in control arm.

Ketamine and dexmedetomidine (Keto-dex) or ketamine and propofol (Keto-fol) for procedural sedation during endoscopic retrograde cholangiopancreatography: Which is safer? A randomized clinical trial.

Background: Optimum procedural sedation is very essential for conducting non-operating room procedures such as endoscopic retrograde cholangiopancreatography (ERCP). The combination of ketamine and dexmedetomidine (KD) is expected to balance out the undesirable effects of either drug and provide smooth sedation. Together ketamine and propofol (KP) also provide synergistic sedation with stable hemodynamics.

Medical and Surgical Care of Critical Burn Patients: A Comprehensive Review of Current Evidence and Practice.

Critically ill burn patients pose several unique challenges to care providers. The concepts of fluid resuscitation, nutritional management, organ support and wound care are rapidly evolving. There is a pressing need to review emerging evidence and incorporate these into practice for the effective management of burn patients.

Trendelenburg in Acute Respiratory Distress Syndrome: Should We Do More than Proning?

Datta PK, Kundu R. Trendelenburg in Acute Respiratory Distress Syndrome: Should We Do More than Proning? Indian J Crit Care Med 2022;26(8):976-977.

Looking for a Silver Lining to the Dark Cloud: A Google Trends Analysis of Contraceptive Interest in the United States Post Roe vs. Wade Verdict.

Background In the wake of the recent Roe vs. Wade judgment, we performed a Google Trends analysis to identify the impact of this decision on the interests regarding contraceptive choices in the United States. Methods A Google Trends search between April 6 and July 5, 2022, with the United States as the area of interest, was performed using the five most popular contraception choices.

Suction Catheter-Guided Technique of ProSeal™ Laryngeal Mask Airway Insertion has a Lower Incidence of Trauma and Sore Throat Compared With a Standard Introducer Tool: A Randomized Controlled Trial.

ProSeal laryngeal mask airway (PLMA) insertion is often difficult. Suction catheter-guided PLMA insertion was compared with the standard introducer tool-assisted technique. One hundred sixty female patients undergoing laparoscopic gynecologic procedures under general anesthesia were randomized into two groups-the suction catheter group (Group SC) and the introducer tool group (Group IT).

Effectiveness of enteral ivabradine for heart rate control in septic shock: A randomised controlled trial.

Persistent tachycardia in patients with septic shock predicts poor outcome. This study sought to investigate the effect of the cardiac pacemaker current inhibitor ivabradine on heart rate and cardio-circulatory function in patients with septic shock. After informed consent, 60 patients with septic shock and persistent tachycardia (heart rate >95 /minute) were prospectively randomly assigned to receive either standard therapy for septic shock (group S) or standard therapy along with enteral ivabradine (group I) for the initial 96 hours after enrolment.

The Inescapable Conundrum of Klippel-Feil Syndrome Airway: Case Reports.

Klippel-Feil syndrome (KFS) is a rare congenital anomaly that is characterized by short neck, low posterior hairline, and restricted neck movements, all of which lead to the possibility of a difficult airway. These patients often have associated multiple systemic anomalies, which add to the challenges in anesthetic management. We describe the anesthetic management of 3 patients with KFS: 2 who underwent modified radical mastoidectomy and 1 patient who underwent vaginoplasty at our institute.

Sevoflurane Consumption During Inhalational Induction in Children: A Randomized Comparison of Minute Ventilation-Based Techniques With Standard Fixed Fresh Gas Flow Technique.

This study was done to ascertain the optimum fresh gas flow (FGF) offering the best balance between rapid induction and minimal waste in pediatric patients. Forty-five children (weighing 10-20 kg) undergoing elective procedures under general anesthesia were randomly assigned into 3 groups: 0.5 minute ventilation (MV), MV, and S (FGF = 6 L/min).

Anesthetic Management of a Unique Case of Double-Outlet Right Ventricle With Glenn Shunt for Cesarean Delivery: A Case Report.

Double-outlet right ventricle is a rare congenital cardiac anomaly resulting in intracardiac mixing of oxygenated and deoxygenated blood. Surgical palliation involves staged conversion to Fontan circulation, with an intermediate stage using a Glenn shunt. We report the case of a patient at 36 weeks of gestation, with a partially palliated double-outlet right ventricle and a Glenn shunt, who presented with severe dyspnea and worsening cyanosis.

Comparison of Two Different Volumes of Ropivacaine Used in Nerve Stimulator Guided Inter-scalene Block for Arthroscopic Shoulder Surgery - A Randomized Controlled Trial.

Background: This study was conducted to compare the analgesic efficacy of 10 ml versus 20 mL of 0.5% ropivacaine in nerve stimulator guided interscalene brachial plexus block, in patients undergoing arthroscopic shoulder surgery.

Methods: A total of 70 American Society of Anesthesiologists physical status classes 1 and 2 patients, aged 18-65 years, undergoing unilateral arthroscopic shoulder surgery, were randomized into two groups.

Comparison of low-fresh gas flow technique to standard technique of sevoflurane induction in children-A randomized controlled trial.

Background: Although sevoflurane is preferred for inhalational induction in children, financial and environmental costs remain major limitations. The aim of this study was to determine if the use of low-fresh gas flow during inhalational induction with sevoflurane could significantly reduce agent consumption, without adversely affecting induction conditions.

Methods: After institutional ethical committee approval, 50 children, aged 1-5 years, undergoing ophthalmic procedures under general anesthesia, were randomized into two groups-standard induction (Group S) and low-flow induction (Group L).

Intrathecal levobupivacaine versus bupivacaine for inguinal hernia surgery: a randomized controlled trial.

Background: Levobupivacaine is an attractive alternative to racemic bupivacaine for spinal anesthesia due to the lower potential for cardio-toxicity and faster recovery profile. This study was designed to compare isobaric levobupivacaine with hyperbaric racemic bupivacaine with respect to intraoperative quality of anesthesia and the postoperative recovery profile in patients undergoing inguinal hernia surgery.

Methods: A total of 100 American Society of Anesthesiologists 1 and 2 patients, aged 18-60 years, undergoing elective daycare unilateral inguinal hernia surgery, were randomized into two groups.