In 2023, the Indian Journal of Critical Care Medicine, issue 27(2), featured articles on pages 135 through 138.
MC Anton, Shanthi B, and E Vasudevan undertook a study to define the prognostic cut-off values of the D-dimer coagulation marker for COVID-19 patients requiring intensive care. Within the Indian Journal of Critical Care Medicine, 2023, volume 27, number 2, articles 135 through 138 are featured.
The Curing Coma Campaign (CCC), launched by the Neurocritical Care Society (NCS) in 2019, sought to create a unified platform for coma scientists, neurointensivists, and neurorehabilitation experts from diverse fields.
This initiative's target is to venture beyond the constraints of current coma definitions, researching and implementing methods for improved prognostication, discovering and evaluating therapeutic possibilities, and affecting outcomes. At this time, the comprehensive approach adopted by the CCC seems both ambitious and challenging in its entirety.
This proposition likely holds true solely within the framework of Western societies, including countries in North America, Europe, and a limited number of advanced nations. In spite of this, the complete CCC methodology may encounter challenges within lower-middle-income economies. To achieve the envisioned meaningful outcome in the CCC, several impediments facing India require and warrant future attention.
We intend to examine several potential challenges India might face in this article.
Among the contributors are I Kapoor, C Mahajan, KG Zirpe, S Samavedam, TK Sahoo, and H Sapra.
The Indian Subcontinent grapples with concerns about the Curing Coma Campaign. Published in the Indian Journal of Critical Care Medicine, 2023, pages 89 through 92 of volume 27, issue 2, cover various topics.
Kapoor, I., Mahajan, C., Zirpe, K. G., Samavedam, S., Sahoo, T. K., Sapra, H., et al. Concerns for the Curing Coma Campaign are evident within the Indian Subcontinent. The 2023 second issue of the Indian Journal of Critical Care Medicine contained articles on pages 89 through 92.
Melanoma patients are increasingly finding nivolumab a valuable treatment option. In spite of that, its use comes with the possibility of serious side effects impacting every organ in the body. In a specific case, nivolumab treatment was associated with a severe and debilitating dysfunction of the diaphragm. Given the increasing utilization of nivolumab, these complications are anticipated to be observed more frequently, prompting every clinician to recognize their potential manifestation in patients on nivolumab treatment who exhibit dyspnea. For the evaluation of diaphragm dysfunction, ultrasound serves as a readily available method.
JJ Schouwenburg. Nivolumab-Associated Diaphragm Dysfunction: A Clinical Case Study. Indian Journal of Critical Care Medicine, 2023, volume 27, number 2, pages 147-148.
Specifically, JJ Schouwenburg. Diaphragm Dysfunction Induced by Nivolumab: A Case Report. Research concerning critical care medicine in India, published in the Indian J Crit Care Med 2023, volume 27, issue 2, is located on pages 147-148.
Exploring the influence of ultrasound-guided fluid resuscitation protocols in conjunction with clinical assessment on the prevention of fluid overload on day three in children with septic shock.
Within the pediatric intensive care unit (PICU) of a government-funded tertiary care hospital in eastern India, a prospective, parallel-limb, open-label, randomized controlled superiority trial was implemented. read more Patient selection activities took place from June 2021 to the conclusion of March 2022. Children, diagnosed with or suspected of having septic shock, aged between one month and twelve years (fifty-six in total), were randomized into groups receiving either ultrasound-guided or clinically-guided fluid boluses (in an 11:1 ratio), and were subsequently observed for various outcomes. The frequency with which fluid overload presented on day three post-admission was the principal outcome. Fluid boluses, ultrasound-guided and clinically directed, were administered to the treatment group, while the control group received identical boluses, but without ultrasound guidance, up to a maximum volume of 60 mL/kg.
The ultrasound group demonstrated a substantially lower rate of fluid overload on day three of their hospital stay (25%) when compared with the control group (62%).
On day 3, the median (IQR) cumulative fluid balance percentage was 65 (33-103) in one group, while in another, it was 113 (54-175).
Return a JSON array composed of ten novel sentences, each bearing a different structure and perspective from the original. Ultrasound-determined fluid bolus administration was considerably less, with a median of 40 mL/kg (30-50 mL/kg) compared to 50 mL/kg (40-80 mL/kg).
With meticulous precision, each sentence is formulated to convey a unique and meaningful idea. Resuscitation time was found to be considerably faster in the ultrasound group, averaging 134 ± 56 hours, in contrast to the control group, whose average resuscitation time was 205 ± 8 hours.
= 0002).
Preventing fluid overload and its complications in children with septic shock saw a marked improvement with the utilization of ultrasound-guided fluid boluses over clinically guided therapy. For children with septic shock in the PICU, ultrasound is a potentially helpful tool due to these factors.
In a collaborative effort, Kaiser RS, Sarkar M, Raut SK, Mahapatra MK, Uz Zaman MA, and Roy O.
Investigating the efficacy of ultrasound-guided versus clinically-directed fluid resuscitation protocols in children experiencing septic shock. Indian Journal of Critical Care Medicine, 2023, volume 27, number 2, pages 139 to 146.
Including Kaiser RS, Sarkar M, Raut SK, Mahapatra MK, Uz Zaman MA, Roy O, and others, et al. Investigating the clinical outcomes of ultrasound-guided versus clinically-guided fluid resuscitation protocols in children with septic shock. read more In the Indian Journal of Critical Care Medicine, 2023, volume 27, issue 2, the research is detailed on pages 139 through 146.
The revolutionary treatment of acute ischemic stroke now utilizes recombinant tissue plasminogen activator (rtPA). For thrombolysed patients, shorter door-to-imaging and door-to-needle times are essential for enhancing treatment outcomes. The observational study investigated the door-to-imaging interval (DIT) and door-to-treatment interval, excluding imaging, (DTN) for all thrombolysed patients.
A study of 252 acute ischemic stroke patients, observed over 18 months at a tertiary care teaching hospital, was cross-sectional and observational; 52 of the patients underwent rtPA thrombolysis. The durations from arrival at the neuroimaging facility until the commencement of thrombolysis were recorded.
Only 10 of the thrombolysed patients had neuroimaging (non-contrast computed tomography (NCCT) head with MRI brain screen) completed within 30 minutes of their arrival at the hospital; 38 patients underwent the imaging between 30 and 60 minutes; while 2 each were imaged in the 61-90 and 91-120 minute windows, respectively. The 30-60 minute DTN time was recorded for 3 patients, while 31 patients were thrombolysed between 61 and 90 minutes, 7 patients between 91 and 120 minutes, with 5 each requiring 121 to 150 minutes and another 5 requiring 151 to 180 minutes for the same procedure. In one patient, the DTN measurement was recorded between 181 and 210 minutes.
Within 60 minutes of their hospital admission, the majority of patients in the study underwent neuroimaging, followed by thrombolysis between 60 and 90 minutes. read more Indian tertiary care centers' stroke management protocols, though not following the ideal timeframes, require significant improvements and streamlining efforts.
Shah A and Diwan A's article, 'Stroke Thrombolysis: Beating the Clock,' provides insight into maximizing treatment effectiveness within the critical window for stroke thrombolysis. In the 27th volume, issue 2, of the Indian Journal of Critical Care Medicine, the publication from 2023 encompasses articles spanning pages 107 to 110.
In their publication, 'Beating the Clock: Stroke Thrombolysis', Shah A. and Diwan A. highlight the importance of speed in treatment. The Indian Journal of Critical Care Medicine, 2023, issue 27(2), dedicated pages 107 to 110 to a research study.
Health care workers (HCWs) at our tertiary care hospital underwent hands-on training in managing COVID-19 patients, focusing on oxygen therapy and ventilatory support. Our study's objective was to assess the influence of practical oxygen therapy training for COVID-19 patients on healthcare workers' knowledge retention, measured six weeks post-training.
With the Institutional Ethics Committee's authorization, the study commenced. A structured questionnaire, comprised of 15 multiple-choice items, was completed by the individual healthcare worker. A structured 1-hour training session on Oxygen therapy in COVID-19 ensued, followed by the same questionnaire, presented to the HCWs in a different order. The identical questionnaire, reconfigured for a Google Form submission, was sent to the participants after six weeks.
In total, 256 responses were recorded from the pre-training and post-training tests respectively. Test scores from the pre-training phase exhibited a median of 8 (interquartile range 7-10), while post-training test scores demonstrated a median of 12 (interquartile range 10-13). A midpoint retention score of 11 was observed, with a spread between 9 and 12. The retention scores exhibited a significant elevation over the baseline pre-test scores.
Almost ninety percent of healthcare personnel demonstrated a considerable enhancement in their knowledge base. A significant proportion of healthcare workers (76%) were able to successfully retain the knowledge acquired, indicating the effectiveness of the training program. A marked advancement in basic understanding was observed subsequent to six weeks of training. After a six-week primary training period, we propose incorporating reinforcement training to optimize knowledge retention.
The list of authors includes A. Singh, R. Salhotra, M. Bajaj, A.K. Saxena, S.K. Sharma, and D. Singh.
How Effective is Hands-on Training in Oxygen Therapy for COVID-19, Measuring Knowledge Retention and Application within Healthcare Professionals?