Acute Gastrointestinal Injury in Critically Ill Patients in a South Indian Intensive Care Unit: A Prospective, Observational, Preliminary Study.

Introduction The acute gastrointestinal injury (AGI) score was proposed by the Working Group on Abdominal Problems of the European Society of Intensive Care Medicine (ESICM) as a tool to define and grade gut dysfunction. There have not been any studies in India to validate this tool. The objective of this preliminary study was primarily to study the frequency of AGI in the first week of ICU stay in critically ill patients in our intensive care unit (ICU).

Correlation of Common Carotid Artery Blood Flow Parameters With Transthoracic Echocardiographic Cardiac Output for Assessing Fluid Responsiveness After Passive Leg Raising (PLR) Test in Critically Ill Patients.

Introduction The passive leg raising (PLR) test is a simple, non-invasive method of knowing fluid responsiveness by acting as an internal-fluid challenge. The PLR test coupled with a non-invasive assessment of stroke volume would be the ideal method to assess fluid responsiveness. This study aimed to determine the correlation between transthoracic echocardiographic cardiac output (TTE-CO) and common carotid artery blood flow (CCABF) parameters in determining fluid responsiveness with the PLR test.

Cefoperazone-induced Coagulopathy in Critically Ill Patients Admitted to Intensive Care Unit.

Background: N-methylthiotetrazole side chain (NMTT) of cefoperazone was attributed to inhibit the vitamin K epoxide enzyme. This mechanism is similar to warfarin; thus, vitamin K was suggested to antagonize the hematological effects of cefoperazone. The literature on critically ill patients receiving cefoperazone and its clinical significance on bleeding diathesis is sparse.

Fogging of Protective Eyewear in Intensive Care Unit and a Comparative Study of Techniques to Reduce It.

Background: Fogging of protective eyewear (PEW) can hinder routine work in the intensive care unit (ICU). The prevalence of fogging impairing vision (FIV) and the technique that reduces fogging have not been evaluated previously.

Methods: After donning personal protective equipment (PPE) with an N95 mask, the healthcare workers (HCWs) sequentially tried plain PEW, soap-coated PEW, PEW worn at a distance over the PPE hood, and the use of tape over a mask.

Antioxidant micronutrient supplements for adult critically ill patients: A bayesian multiple treatment comparisons meta-analysis.

Background & Aims: Antioxidant micronutrients (AxMs) have been administered to critically ill adults attempting to counteract the oxidative stress imposed during critical illness. However, results are conflicting and relative effectiveness of AxMs regimens is unknown. We conducted a Bayesian multi-treatment comparison (MTC) meta-analysis to identify the best AxM treatment regimen that will improve clinical outcomes.

Data Analysis will not Result in Knowledge Production about Sepsis.

Sampath S. Data Analysis will not Result in Knowledge Production about Sepsis. Indian J Crit Care Med 2021;25(7):750-751.

Clinical Utility of Arterial Blood Gas Test in an Intensive Care Unit: An Observational Study.

Background: Arterial blood gas (ABG) analysis is a common test ordered in critically ill patients. Often, it is performed very frequently without influencing patient care. Hence, we decided to check the utility of the ABG test in our intensive care unit (ICU).

Simulation Training in Hemodynamic Monitoring and Mechanical Ventilation: An Assessment of Physician's Performance.

Background: Simulation is to imitate or replicate real-life scenarios in order to improve cognitive, diagnostic and therapeutic skills. An ideal model should be good enough to output realistic clinical scenarios and respond to interventions done by trainees in real time. Use of simulation-based training has been tried in various fields of medicine.

Antioxidant micronutrient supplementation in critically ill adults: A systematic review with meta-analysis and trial sequential analysis.

Background: The role of antioxidant micronutrient (AxM) supplementation in the critically ill patients has been controversial, and recent trials have suggested a tendency to harm. Therefore, we performed a systematic review with meta-analysis and trial sequential analysis (TSA) of randomized controlled trials (RCT) to examine the effect of AxM supplementation on clinical outcomes among critically ill adults.

Methods: PubMed, EMBASE, Cochrane, CINAHL, LILACS, DARE, SCOPUS, and Web of sciences databases were searched from inception to March 2019.

Between Many Rocks and Hard Places.

Varma MMK, Krishna B, Sampath S. Between Many Rocks and Hard Places. Indian J Crit Care Med 2019;23(8):388.

Secular Trends in an Indian Intensive Care Unit-database Derived Epidemiology: The Stride Study.

Context: The Indian Society of Critical Care Medicine (ISCCM), had taken an initiative to enable all Indian ICUs (Intensive Care Unit) to capture and store relevant data in a systematic manner in an electronic database: "CHITRA" (Customized Health in Intensive Care Trainable Research and Analysis tool).

Aims: This study was aimed at capturing, and summarising longitudinal epidemiological data from a single tertiary care hospital ICU (Intensive Care Unit), based on a pre-existing database and the CHITRA system.

Settings And Design: Prospective Observational.

The Need to Start at the Bench.

Sampath S, Kulkarni AP. The Need to Start at the Bench. Indian J Crit Care Med 2019;23(6):245.

Prospective Observational Study on Evaluation of Cardiac Dysfunction Induced during the Weaning Process.

Context: Weaning induced cardiac dysfunction can occur without underlying heart disease. Changes in intrathoracic pressure, systemic vascular resistance, preload and afterload leading to heart-lung interactions are the possible explanatory mechanisms.

Aims: The aim of the current study was whether the assessment and identification of cardiac dysfunction induced during the weaning process could predict the outcome of extubation.

PRactice of VENTilation in Middle-Income Countries (PRoVENT-iMIC): rationale and protocol for a prospective international multicentre observational study in intensive care units in Asia.

Introduction: Current evidence on epidemiology and outcomes of invasively mechanically ventilated intensive care unit (ICU) patients is predominantly gathered in resource-rich settings. Patient casemix and patterns of critical illnesses, and probably also ventilation practices are likely to be different in resource-limited settings. We aim to investigate the epidemiological characteristics, ventilation practices and clinical outcomes of patients receiving mechanical ventilation in ICUs in Asia.

Evaluation of Quality Indicators in an Indian Intensive Care Unit Using "CHITRA" Database.

Background: Quality indicators (QIs) are essential for maintaining quality of care in the critically ill. The Indian Society of Critical Care Medicine proposed benchmarks and enabled Indian Intensive Care Units (ICUs) to capture data in an electronic database: Customized Health in Intensive Care Trainable Research and Analysis (CHITRA) tool. The purpose of this study is to report QIs in an Indian ICU using this database.

Dense Annotation of Free-Text Critical Care Discharge Summaries from an Indian Hospital and Associated Performance of a Clinical NLP Annotator.

Electronic Health Record (EHR) use in India is generally poor, and structured clinical information is mostly lacking. This work is the first attempt aimed at evaluating unstructured text mining for extracting relevant clinical information from Indian clinical records. We annotated a corpus of 250 discharge summaries from an Intensive Care Unit (ICU) in India, with markups for diseases, procedures, and lab parameters, their attributes, as well as key demographic information and administrative variables such as patient outcomes.

Real-time feedback for improving compliance to hand sanitization among healthcare workers in an open layout ICU using radiofrequency identification.

The aim of this study is to increase hand sanitizer usage among healthcare workers by developing and implementing a low-cost intervention using RFID and wireless mesh networks to provide real-time alarms for increasing hand hygiene compliance during opportune moments in an open layout Intensive Care Unit (ICU). A wireless, RFID based system was developed and implemented in the ICU. The ICU beds were divded into an intervention arm (n = 10) and a control arm (n = 14).

The role of non-invasive positive pressure ventilation in post-extubation respiratory failure: An evaluation using meta-analytic techniques.

Background: The use of non-invasive positive pressure ventilation (NIPPV) in post-extubation respiratory failure is not well-established. Meta-analytic techniques were used to assess the effects of prophylactic application of NIPPV (prior to the development of respiratory failure) and therapeutic application of NIPPV (subsequent to the development of respiratory failure).

Materials And Methods: Randomized controlled trials (RCTs) from 1966 to May 2010 were identified using electronic databases.

A low-cost reusable phantom for ultrasound-guided subclavian vein cannulation.

Guidelines support the use of ultrasound (US)-guided central venous cannulation in the intensive care unit. Traditional techniques based on anatomical landmarks are blind procedures and inexpert USG procedures may be hazardous. Commercially available phantoms for simulation and training are expensive.

Clinical Profile and Predictors of Mortality of Severe Pandemic (H1N1) 2009 Virus Infection Needing Intensive Care: A Multi-Centre Prospective Study from South India.

Background: This multi-center study from India details the profile and outcomes of patients admitted to the intensive care unit (ICU) with pandemic Influenza A (H1N1) 2009 virus [P(H1N1)2009v] infection.

Materials And Methods: Over 4 months, adult patients diagnosed to have P(H1N1)2009v infection by real-time RT-PCR of respiratory specimens and requiring ICU admission were followed up until death or hospital discharge. Sequential organ failure assessment (SOFA) scores were calculated daily.

The efficacy of loop diuretics in acute renal failure: assessment using Bayesian evidence synthesis techniques.

Objective: To quantify the therapeutic efficacy of loop diuretics in acute renal failure using Bayesian evidence synthesis, because despite widespread use, the role of diuretics is controversial.

Data Source: Randomized controlled trials or nonrandomized studies, 1966 to January 2007, identified from MEDLINE and EMBASE databases and manual bibliographic search.

Study Selection: Studies with assessable predefined end points, exclusive of those pertaining to acute renal failure prophylaxis or chronic renal failure.