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Fatal cerebral arterial gas embolism after endoscopic retrograde cholangiopancreatographyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the case of a 50-year-old woman undergoing elective endoscopic retrograde cholangiopancreatography, who developed coma and hemiparesis secondary to severe cerebral artery gas embolism. Despite prompt diagnosis and early hyperbaric oxygen therapy (HBO 2 ) she developed severe cerebral edema and died within 24 h. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Rangappa Pradeep, Uhde Britta, Byard Roger W, Wurm Alex, Thomas Peter D Source Type: journals

An unusual cause of status epilepticusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Ghosh Supradip, Ahlawat Alok, Rai Krishna Kumar, Arora AshuIndian Journal of Critical Care Medicine 2009 13(2):106-107A 24-year-old female presented with status epilepticus following ingestion of a pyrethroid insecticide Deltamethrin. The pathophysiology, clinical features, and management of pyrethroid poisoning are discussed in this article. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Ghosh Supradip, Ahlawat Alok, Rai Krishna Kumar, Arora Ashu Source Type: journals

Plasmodium vivax malaria: An unusual presentationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the case of a 42-year-old male living in a malaria-endemic area who presented with ARDS and was diagnosed as having Plasmodium vivax malaria. A diagnosis of Plasmodium vivax malaria was established by a positive Plasmodium LDH immunochromatographic assay while a negative PfHRP2 based assay ruled out P. falciparum malaria. After specific anti-plasmodial therapy and intensive supportive care, the patient recovered and was discharged from hospital. The use of NIPPV in vivax-malaria related ARDS was associated with a good outcome. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Kasliwal Prasad, Rao Manimala S, Kujur Rash Source Type: journals

Hepatic portal venous gas: A case report and review of literatureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Kesarwani Vikas, Ghelani Dhaval R, Reece GrahamIndian Journal of Critical Care Medicine 2009 13(2):99-102Hepatic portal venous gas (HPVG) results from mesenteric ischemia and a wide variety of other causes. The primary factors that favour the development of this pathologic entity are intestinal wall alterations, bowel distension, and sepsis. Findings of HPVG during an ultrasound or computed tomography (CT) scan should be carefully evaluated in the context of the clinical picture. In the absence of features of bowel ischemia, the prognosis of patients with HPVG is usually good. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Kesarwani Vikas, Ghelani Dhaval R, Reece Graham Source Type: journals

Airway bleed after percutaneous tracheostomy is not always procedure-relatedEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present a case of major hemorrhage that occurred in the intensive care unit during an elective percutaneous dilational tracheostomy in a 46-year-old female diagnosed with multiple myeloma. The patient was later taken to the operation theatre and procedure-related cause of bleeding was ruled out. It was subsequently realized that the cause of bleeding was intrapulmonary and occurred coincidently with the tracheostomy. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Patil Vijaya P, Singhal Amit, Pramesh C S Source Type: journals

Spontaneous rupture of adrenal pheochromocytoma in a patient with Von Recklinghausen's diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe a 35-year-old Iranian female with previously diagnosed von Recklinghausen ' s disease who suffered spontaneous rupture of an adrenal pheochromocytoma, misdiagnosed as renal colic followed by an extensive retroperitoneal hematoma, irreversible hemodynamic shock, and death. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Azhough Ramin, Barband Ali Reza, Motayagheni Negar, Niafar Mitra, Pourfathi Hojjat Source Type: journals

U turn to venous air embolismEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Singh Harsimran, Tewari Anurag, Kaur Balvinder, Garg SuchitaIndian Journal of Critical Care Medicine 2009 13(2):92-93There is a definitive risk of venous air embolism when the fluid infusion is complete and the drip set is still open in a glass bottle.We have devised a novel way of preventing the chances of air embolism when the fluid in the glass bottle finishes. It really gives a &quot;U&quot; turn to the chances of venous air embolism. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Singh Harsimran, Tewari Anurag, Kaur Balvinder, Garg Suchita Source Type: journals

Prevalence of occult adrenal insufficiency and the prognostic value of a short corticotropin stimulation test in patients with septic shockEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: A short corticotropin test using low-dose corticotropin (1 &#956;g) has a good prognostic value. High basal cortisol and a low increase in cortisol on corticotropin stimulation test are predictors of a poor outcome in patients with septic shock. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Maqbool Muzaffar, Shah Zafar Amin, Wani Fayaz Ahmad, Wahid Abdul, Parveen Shaheena, Nazir Arjumand Source Type: journals

Cyclophosphamide in pulmonary alveolar hemorrhage due to leptospirosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Cyclophosphamide improves survival in cases of severe pulmonary alveolar hemorrhage due to leptospirosis. Statistically, the improvement is highly significant. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Trivedi Samir V, Vasava Ashwin H, Patel Tinkal C, Bhatia Lovleen C Source Type: journals

Cytokine profile in elderly patients with sepsisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Serial estimation of cytokines in elderly patients with sepsis will help in prediction of mortality. Female gender was an independent predictor of increased morality in critically ill patients with sepsis. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Kumar Anil T, Sudhir U, Punith K, Kumar Rahul, Ravi Kumar V N, Rao Medha Y Source Type: journals

An evaluation of serial blood lactate measurement as an early predictor of shock and its outcome in patients of trauma or sepsisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Serial lactate values followed over a period of time can be used to predict impending complications or grave outcome in patients of trauma or sepsis. Interventions that decrease lactate values to normal early may improve chances of survival and can be considered effective therapy. Lactate values need to be followed for a longer period of time in critical patients. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Krishna Uma, Joshi Suresh P, Modh Mukesh Source Type: journals

Left atrial function for outcome prediction in severe sepsis and septic shock: An echocardiographic studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: In septic patients, left atrial function unlike the ventricular function and BNP levels can not be used as an independent predictor of mortality. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Omar Amr S, ur Rahman Masood, Abuhasna Said Source Type: journals

GAP between knowledge and skills for the implementation of the ACCM/PALS septic shock guidelines in India: Is the bridge too far?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: In view of the lack of skills and suboptimal knowledge, the ACCM/PALS sepsis guidelines may be inappropriate in its current format in the Indian setting. More emphasis needs to be placed on educating community pediatricians with a simpler clinical protocol, which has the potential to save many more children. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Santhanam Indumathy, Kissoon Niranjan, Kamath S R, Ranjit Suchitra, Ramesh Jayanthi, Shankar Janani Source Type: journals

Colistin and polymyxin B: A re-emergenceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Gupta Sachin, Govil Deepak, Kakar Prem N, Prakash Om, Arora Deep, Das Shibani, Govil Pradeep, Malhotra AshimaIndian Journal of Critical Care Medicine 2009 13(2):49-53One of the greatest achievements of modern medicine is the development of antibiotics against life-threatening infections, but the emergence of multidrug-resistant (MDR) gram negative bacteria has drastically narrowed down the therapeutic options against them. This limitation has led clinicians to reappraise the clinical application of polymyxins, an old class of cationic, cyclic polypeptide antibiotics. Polymyxins are active against selected gram-negative bac...
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Gupta Sachin, Govil Deepak, Kakar Prem N, Prakash Om, Arora Deep, Das Shibani, Govil Pradeep, Malhotra Ashima Source Type: journals

Misplacement of an internal jugular hemodialysis catheter due to stenosis caused by previous short-term catheterizationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Dubey Prakash KIndian Journal of Critical Care Medicine 2009 13(1):44-45 (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Dubey Prakash K Source Type: journals

Severe myocardial depression in a patient with aluminium phosphide poisoning: A clinical, electrocardiographical and histopathological correlationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case where the heart was the predominantly affected organ. We describe the clinical symptoms and signs and their correlation with electrocardiographic and histopathological examinations. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Shah Viral, Baxi Seema, Vyas Tanmay Source Type: journals

Cerebritis: An unusual complication of Klebsiella pneumoniaeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of Klebsiella cerebritis in an adult patient with a proven extracranial focus of infection. We suggest considering cerebritis as a differential diagnosis for altered level of consciousness in patients of severe sepsis, even if an extracranial source of infection is proven. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Majumdar Mainak, Simes David C, Prabha Ramesh D Source Type: journals

Acute fatty liver of pregnancy: A case report of an uncommon diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Vora Kalpana S, Shah Veena R, Parikh Geeta PIndian Journal of Critical Care Medicine 2009 13(1):34-36A 24-year-old female at 34-week gestation, presented with malaise, nausea, vomiting, jaundice, and absent foetal movements. A clinical diagnosis of acute fatty liver of pregnancy was made. Although early caesarean section was performed, postoperative course was complicated by acute respiratory distress syndrome (ARDS) sepsis, and continuing coagulopathy. Supportive management in an intensive care unit resulted in successful outcome. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Vora Kalpana S, Shah Veena R, Parikh Geeta P Source Type: journals

Organophosphate or organochlorines or something else....?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present here such a case of deltamethrin poisoning. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Aggarwal Ritesh, Diddee Shekhar Source Type: journals

Contralateral diaphragmatic palsy in acute stroke: An interesting observationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Kumar Sudhir, Reddy Rajesh, Prabhakar SubhashiniIndian Journal of Critical Care Medicine 2009 13(1):28-30Diaphragmatic palsy in hemiparetic stroke is not well recognized. Further, its implications on stroke outcome have not been studied. Here, we report a patient with left-sided diaphragmatic palsy due to an acute right middle cerebral artery territory infarction. The diagnosis was suspected on finding an elevated dome of the diaphragm on the left side in a routine chest radiograph and was confirmed by finding decreased movements of the left hemidiaphragm on fluoroscopic examination. We hypothesize that this condition is p...
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Kumar Sudhir, Reddy Rajesh, Prabhakar Subhashini Source Type: journals

Challenges in critical care services in Sub-Saharan Africa: Perspectives from NigeriaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Okafor U VIndian Journal of Critical Care Medicine 2009 13(1):25-27Critical care services in Nigeria and other West African countries had been hampered by economic reversals resulting in low wages, manpower flight overseas, government apathy towards funding of hospitals, and endemic corruption. Since then things have somewhat improved with the government's willingness to invest more in healthcare, and clampdown on resource diversion in some countries like Nigeria. Due to the health needs of these countries, including funding and preventive medicine, it may take a long time to reach reasonably high standards. Things ...
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Okafor U V Source Type: journals

Aluminum phosphide poisoning: Effect of correction of severe metabolic acidosis on patient outcomeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Jaiswal S, Verma R K, Tewari NIndian Journal of Critical Care Medicine 2009 13(1):21-24Forty patients of aluminum phosphide poisoning who were admitted to the ICU of Sir Sunder Lal Hospital, Banaras Hindu University, were studied. Restlessness, excessive thirst, shock, arrhythmias, tachypnoea, and severe metabolic acidosis were the common clinical findings. Only repeated and full correction with intravenous sodium bicarbonate was able to cope up with the severity and rapidity of acidosis. There was no significant change in blood pressure, pulse rate, and respiratory rate after full correction but gradually pulse and systol...
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Jaiswal S, Verma R K, Tewari N Source Type: journals

A comparative study to assess the effect of amikacin sulfate bladder wash on catheter-associated urinary tract infection in neurosurgical patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Amikacin sulfate bladder wash was effective in preventing CAUTI. It can thus decrease the antibiotic usage thereby preventing the emergence of antibiotic resistance. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Zacharias Sumi, Dwarakanath Srinivas, Agarwal Meena, Sharma Bhavani Shankar Source Type: journals

Changes of splanchnic perfusion after applying positive end expiratory pressure in patients with acute respiratory distress syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: PEEP of 10-20 cmH 2 O does not affect splanchnic perfusion and is hemodynamically well tolerated in most patients with ARDS, including those receiving inotropic supports. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Sarkar Suman, Bhattacharya Prithwis, Kumar Indrajit, Mandal Kruti Sundar Source Type: journals

The diagnosis of brain deathEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Goila Ajay Kumar, Pawar MridulaIndian Journal of Critical Care Medicine 2009 13(1):7-11Physicians, health care workers, members of the clergy, and laypeople throughout the world have accepted fully that a person is dead when his or her brain is dead. Although the widespread use of mechanical ventilators and other advanced critical care services have transformed the course of terminal neurologic disorders. Vital functions can now be maintained artificially for a long period of time after the brain has ceased to function. There is a need to diagnose brain death with utmost accuracy and urgency because of an increased awarene...
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Goila Ajay Kumar, Pawar Mridula Source Type: journals

Alveolar recruitment maneuvers in acute lung injury/acute respiratory distress syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Chacko Jose, Rani UshaIndian Journal of Critical Care Medicine 2009 13(1):1-6Mechanical ventilation can worsen lung damage in acute lung injury and acute respiratory distress syndrome. The use of low tidal volumes is one of the strategies that has been shown to reduce lung injury and improve outcomes in this situation. However, low tidal volumes may lead to alveolar derecruitment and worsening of hypoxia. Recruitment maneuvers along with positive end-expiratory pressure may help to prevent derecruitment. Although recruitment maneuvers have been shown to improve oxygenation, improved clinical outcomes have not been demonstr...
Source: Indian Journal of Critical Care Medicine - July 1, 2009 Category: Intensive Care Authors: Chacko Jose, Rani Usha Source Type: journals

Cerebral malaria caused by Plasmodium vivax in adult subjectsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sarkar Suman, Bhattacharya PrithwisIndian Journal of Critical Care Medicine 2008 12(4):204-205Cerebral malaria is a diffuse encephalopathy associated with seizures and status epilepticus which can occur in up to one-third of patients with severe malaria, particularly that caused by Plasmodium falciparum. In this article, we report three cases of Plasmodium vivax malaria (all adult male patients) complicated by seizures and symptoms of diffuse meningoencephalitis. Two patients had predominantly meningeal signs, while in the third...
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: Sarkar Suman, Bhattacharya Prithwis Source Type: journals

A rare malposition of the thoracic venous catheter introduced via the left internal jugular veinEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Ghosh Supradip, Dewan Himanshu, Bhattacharyya SandipIndian Journal of Critical Care Medicine 2008 12(4):201-203A rare malposition of central venous catheter in the left superior intercostal vein is described. The diagnostic features and the possible ways to prevent this complication are discussed. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: Ghosh Supradip, Dewan Himanshu, Bhattacharyya Sandip Source Type: journals

Indoxacarb poisoning: An unusual presentation as methemoglobinemiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe the management of a case of methemoglobinemia secondary to ingestion of indoxacarb, an oxadiazine insecticide. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: Prasanna Lakshmi, Rao Manimala S, Singh Vishal, Kujur Rash, Gowrishankar Source Type: journals

Post intubation tracheal stenosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
De Sajal, De SarmishthaIndian Journal of Critical Care Medicine 2008 12(4):194-197Tracheal stenosis following prolonged intubation is a relatively rare but a serious problem. However, some degree of airway injury is common following intubation, no matter whether it is prolonged or of short duration. Here, we are reporting a fifty six year old male patient who developed multiple web like tracheal stenosis following intubation with high volume low pressure cuff endotracheal tube. Subsequently, the stenosis was successfully dilated by balloon bronchoplasty. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: De Sajal, De Sarmishtha Source Type: journals

Calcium channel blocker overdose: Experience with amlodipineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report two cases of near fatal Amlodipine overdose managed in our ICU with fluid, vasopressors, calcium infusion and Glucagon. Literature is reviewed and other treatment modalities discussed. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: Ghosh Supradip, Sircar Mrinal Source Type: journals

Biological agents targeting beyond TNF-alphaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sharma Rashmi, Sharma Chaman Lal, Mahajan AnnilIndian Journal of Critical Care Medicine 2008 12(4):181-189Biological agents represent an important addition to the therapies for immuno-inflammatory conditions and have a great impact on the disease course and quality of life of these patients. However, recent reports of serious infections like tuberculosis, demyelinating and neurodegenerative diseases, pancytopenia, cardiovascular diseases, etc. after anti-TNF therapy raised questions on their safety. Hence, focus is shifted towards drugs targeting cytokine checkpoints in the inflammatory cascades beyond TNF-a. Existing ther...
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: Sharma Rashmi, Sharma Chaman Lal, Mahajan Annil Source Type: journals

Renal replacement therapy in the intensive care unitEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Chacko JoseIndian Journal of Critical Care Medicine 2008 12(4):174-180Acute renal failure is a frequent complication in critically ill patients that carries with it considerable morbidity and mortality. The management of renal failure in patients with multi-organ failure is different from that of renal failure that presents as a single organ failure. Intermittent haemodialysis, done in the conventional manner may not be tolerated by most critically ill patients. Continuous renal replacement therapy is physiologically superior; however, there is lack of strong evidence to prove a clinical benefit. Hybrid therapies that comb...
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: Chacko Jose Source Type: journals

Effects of mobile phone use on specific intensive care unit devicesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: EMI from mobile phones have an adverse effect on the medical devices used in critical care setup. They should be used at least one foot away from the diameter of the syringe pump. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: Hans Nidhi, Kapadia Farhad N Source Type: journals

Noninvasive ventilation: A survey of practice patterns of its use in IndiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions : NIV is being widely used in clinical practice in India for various indications. COPD is the most common indication for its deployment. There seems to be a marked variability in the patterns relating to actual deployment of NIV, including the site of initiation, protocols for initiation followed, and monitoring of patients. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: Chawla Rajesh, Sidhu U S, Kumar Vijai, Nagarkar Shruti, Brochard Laurent Source Type: journals

Impact of preoperative mild renal dysfunction on short term outcome in isolated coronary artery bypass (CABG) patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Mild renal dysfunction is an important independent predictor of outcome in terms of in-hospital mortality and morbidity in patients undergoing CABG. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: Ramakrishna M N, Hegde Deviprasad V, Kumarswamy G N, Gupta Ratan, Moola Narayana Swamy, Suresh K P Source Type: journals

Safety and efficacy of polymyxin B in multidrug resistant gram-negative severe sepsis and septic shockEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Polymyxin B has acceptable effectiveness against nosocomial multidrug resistant Gram-negative sepsis. The associated nephrotoxicity has been found to be significantly lower than previously reported even in patients with background renal impairment and established risk factors of renal failure. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: Ramasubban Suresh, Majumdar Ayanava, Das Purnendu Sekhar Source Type: journals

Clinical course and spectrum of intensive care unit patients reactivating herpes simplex-1 virus: A retrospective analysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions : Identification of susceptible populations and definition of clinical features of HSV-1 related respiratory disease can enable diagnosis of HSV-1 infection in ICU patients. Although detection by a PCR technique can rapidly diagnose HSV-1 reactivation, prospective studies are required to clarify HSV disease versus mere shedding, and understand the impact of HSV-1 reactivation in hospitalized patients. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - January 14, 2009 Category: Intensive Care Authors: Sundar Krishna M, Ludwig Karl A, Alward William T, Pearce Michael J, Bishop Clark T, Hammond Roy C, Hillyard David R, Freestone Steven W, Ozment Anne, Cahill Barbara C Source Type: journals

Artificial bloodEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sarkar SumanIndian Journal of Critical Care Medicine 2008 12(3):140-144Artificial blood is a product made to act as a substitute for red blood cells. While true blood serves many different functions, artificial blood is designed for the sole purpose of transporting oxygen and carbon dioxide throughout the body. Depending on the type of artificial blood, it can be produced in different ways using synthetic production, chemical isolation, or recombinant biochemical technology. Development of the first blood substitutes dates back to the early 1600s, and the search for the ideal blood substitute continues. Various manufacture...
Source: Indian Journal of Critical Care Medicine - October 29, 2008 Category: Intensive Care Authors: Sarkar Suman Source Type: journals

Successful management of massive intraoperative pulmonary fat embolism with percutaneous cardiopulmonary supportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a patient who sustained catastrophic pulmonary fat embolism, during open reduction, internal fixation (ORIF) of fracture femur' In our opinion, the use of percutaneous cardiopulmonary support with (PCPS), saved the patient from certain death. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - October 29, 2008 Category: Intensive Care Authors: Sarkar Suman, Mandal Krutisundar, Bhattacharya Prithwis Source Type: journals

Refeeding syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of a fifty-year-old male who was admitted with a three month history of increasing weakness, prostration, decreasing appetite and inability to swallow. The patient was a chronic alcoholic, unemployed, and of very poor socioeconomic background. The patient was initially investigated for upper GI malignancy, Addisons disease, bulbar palsy and other endocrinopathies. Concurrent management was started for severe electrolyte abnormalities and enteral nutritional supplementation was begun. By the fourth day of feeding patient developed severe hypophosphatemia and other life-threatening features suggesting refeed...
Source: Indian Journal of Critical Care Medicine - October 29, 2008 Category: Intensive Care Authors: Tripathy Swagata, Mishra Padmini, Dash S C Source Type: journals

Thrombotic thrombocytopenic purpura and systemic lupus erythematosus: Successful management of a rare presentationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
George Pratish, Das Jasmine, Pawar Basant, Kakkar NaveenIndian Journal of Critical Care Medicine 2008 12(3):128-131Thrombotic thrombocytopenic purpura (TTP) and systemic lupus erythematosus (SLE) very rarely present simultaneously and pose a diagnostic and therapeutic dilemma to the critical care team. Prompt diagnosis and management with plasma exchange and immunosuppression is life-saving. A patient critically ill with TTP and SLE, successfully managed in the acute period of illness with plasma exchange, steroids and mycophenolate mofetil is described. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - October 29, 2008 Category: Intensive Care Authors: George Pratish, Das Jasmine, Pawar Basant, Kakkar Naveen Source Type: journals

Transfusion associated graft versus host disease in an immunocompetent individual following coronary artery bypass graftingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present here a case report of fatal TA-GVHD in a &quot;presumed&quot; immunocompetent patient, post coronary artery bypass grafting surgery after transfusion of blood products. The patient died 24 days after transfusion. There is a perceived increased risk of TA-GVHD following bypass grafting and other surgical procedures where cardiopulmonary bypass is required. TA-GVHD is probably underreported and the incidence is felt to be too low to warrant routine irradiation of cellular products for this group of patients. Clinicians, pathologists, and transfusion centers should be aware of this rare but d...
Source: Indian Journal of Critical Care Medicine - October 29, 2008 Category: Intensive Care Authors: Nagendra Girish T, Ramakrishna M N, Hegde Devi Prasad, Damodar Sharad, Gupta Ratan Source Type: journals

Obstructive sleep apnoea and anaesthesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Rudra A, Chatterjee S, Das T, Sengupta S, Maitra G, Kumar PIndian Journal of Critical Care Medicine 2008 12(3):116-123Obstructive sleep apnoea (OSA) correlates positively with obesity and age, both of which are becoming increasingly prevalent. Obstructive sleep apnoea occurs much more frequently in clinical practice than formerly diagnosed, and that this condition represents complex challenges for difficulty in mask ventilation, laryngoscopic intubation, accelerated arterial desaturation, postoperative monitoring and discharge status. In this review article pathophysiology, diagnosis, and perioperative management of this g...
Source: Indian Journal of Critical Care Medicine - October 29, 2008 Category: Intensive Care Authors: Rudra A, Chatterjee S, Das T, Sengupta S, Maitra G, Kumar P Source Type: journals

Physician beliefs and practice regarding end-of-life care in IndiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Pulmonary and critical care physicians in India have a lower rate of withdrawal of life support than western physicians. The reasons seem to be primarily legal and policy related. Culture and religion were not identified as barriers. Clarification of the legal and policy status of withdrawal of life support is needed (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - October 29, 2008 Category: Intensive Care Authors: Barnett V Theodore, Aurora V K Source Type: journals

Platelet counts and outcome in the pediatric intensive care unitEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Thrombocytopenia is common in PICU. Patients requiring cardiopulmonary resuscitation or with circulatory shock, coagulopathy, sepsis and with more severe disease have higher risk of developing thrombocytopenia. Thrombocytopenic patients have a higher risk of bleeding. Drop in platelet counts >27% and thrombocytopenia were independently related to mortality. Serial measurements of platelet counts are better predictors of pediatric intensive care outcome than one-time values. Any drop in platelet counts even without thrombocytopenia needs an urgent and extensive evaluatio...
Source: Indian Journal of Critical Care Medicine - October 29, 2008 Category: Intensive Care Authors: Agrawal Shruti, Sachdev Anil, Gupta Dhiren, Chugh Krishan Source Type: journals

Prediction of arterial blood gas values from arterialized earlobe blood gas values in patients treated with mechanical ventilationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Arterialized earlobe blood gas can accurately predict the ABG values of pH, PCO 2 , BE, and HCO 3 - for patients who do not require regular continuous blood pressure measurements and close monitoring of arterial PO 2 measurements. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - October 29, 2008 Category: Intensive Care Authors: Honarmand Azim, Safavi Mohammadreza Source Type: journals

Incidence and management of diaphragmatic palsy in patients after cardiac surgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The incidence of diaphragmatic palsy was remarkably less in our adult cardiac surgical patients because most of the cardiac surgeries were performed off pump and intensive chest physiotherapy beginning shortly after extubation helped in complete or near complete recovery of diaphragmatic palsy. Chest Physiotherapy led to marked improvement in functional outcome following post cardiac surgery diaphragmatic palsy. We also conclude that ultrasonography is a simple valuable bed-side tool for rapid diagnosis of diaphragmatic palsy (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - October 29, 2008 Category: Intensive Care Authors: Mehta Yatin, Vats Mayank, Singh Ajmer, Trehan Naresh Source Type: journals

Arterialised blood gas sampling in the critically ill: Correct tools for the job?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Singh SuveerIndian Journal of Critical Care Medicine 2008 12(3):89-90 (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - October 29, 2008 Category: Intensive Care Authors: Singh Suveer Source Type: journals

A process for instituting best practice in the intensive care unitEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
George Elisabeth L, Tuite PatriciaIndian Journal of Critical Care Medicine 2008 12(2):82-87Goals of health care are patient safety and quality patient outcomes. Evidence based practice (EBP) is viewed as a tool to achieve these goals. Health care providers strive to base practice on evidence, but the literature identifies numerous challenges to implementing and sustaining EBP in nursing. An initial focus is developing an organizational culture that supports the process for nursing and EBP. An innovative strategy to promote a culture of EBP was implemented in a tertiary center with 152 critical care beds and numerous specia...
Source: Indian Journal of Critical Care Medicine - August 19, 2008 Category: Intensive Care Authors: George Elisabeth L, Tuite Patricia Source Type: journals