In a single-center, retrospective analysis, Sulakshana S, Chatterjee D, and Chakraborty A evaluated the use of extracorporeal membrane oxygenation in managing severe COVID-19 cases in India. The Indian Journal of Critical Care Medicine, in its June 2023 issue (volume 27, number 6), examines critical care medicine, presenting research from pages 381 to 385.
Retrospectively analyzing data from a single center, Sulakshana S, Chatterjee D, and Chakraborty A assessed the effectiveness of extracorporeal membrane oxygenation (ECMO) in addressing severe COVID-19 cases in India. Indian Journal of Critical Care Medicine, volume 27, issue 6, pages 381 to 385, 2023.
In intensive care units (ICUs), the management of gram-negative sepsis remains one of the most complex and demanding tasks. Carbapenems remain a frequent and trusted solution for treating infections linked to Gram-negative bacteria, given their potent and reliable nature. Carbapenem-resistant enterobacteriaceae (CRE) are undeniably a formidable and prominent challenge to the medical community's efforts. Enterobacteriaceae, when resistant to carbapenems, commonly exhibit resistance to all beta-lactam antimicrobials, including carbapenems, and are frequently resistant to other classes of medications. Limited comparative studies exist on the efficacy of polymyxin-based regimens versus ceftazidime-avibactam-based therapies in treating infections due to carbapenem-resistant Enterobacteriaceae (CRE).
A historical case review of patients with CRE bacteremia, evaluating the disparity in treatment outcomes between patients receiving polymyxin-based combination therapy and those treated with a CAZ-AVI-based regimen (including or excluding aztreonam)
Within the 104 patients studied, 78 participants (75%) were in the CAZ-AVI group. Substantial similarities were observed in the underlying comorbidities across both groups. The polymyxin group demonstrated a statistically significant rise in nephrotoxicity cases.
The following list of sentences, structured as a JSON schema, comprises the requested output. Treatment with ceftazidime-avibactam showed a 66% reduced probability of mortality within 14 days, in comparison to other treatment options.
A 0048 association and a 67% diminished likelihood of connection to day 28 mortality were observed.
The efficacy of this therapeutic approach was assessed in contrast to that of polymyxin-based treatment strategies.
Ceftazidime-avibactam-based therapy may be considered a preferable course of treatment over polymyxin-based therapy in situations involving infections stemming from carbapenem-resistant Enterobacteriaceae (CRE). This finding has substantial implications for personalized therapy, minimizing polymyxin use, and optimizing hospital protocols.
Soman RN, Prayag PS, Patwardhan SA, Panchakshari S, Sambasivam R, Dhupad S,
This retrospective study explores treatment outcomes for carbapenem-resistant Enterobacteriaceae by comparing ceftazidime-avibactam, potentially with aztreonam, against polymyxin-based combination therapies. Pages 444 to 450 of the Indian Journal of Critical Care Medicine's 2023 sixth issue of volume 27 contained a significant medical study.
The study was conducted by Prayag PS, Patwardhan SA, Panchakshari S, Sambasivam R, Dhupad S, Soman RN, and their respective teams, thus ensuring comprehensive coverage. A retrospective assessment of carbapenem-resistant enterobacteriaceae treatment options, contrasting ceftazidime-avibactam, possibly in conjunction with aztreonam, against polymyxin-based combination therapy. Within the pages of the Indian Journal of Critical Care Medicine, volume 27, issue 6, the 2023 article titled 'Indian J Crit Care Med 2023;27(6)444-450' can be found.
The clinical effectiveness of gastric lavage in treating organophosphorus (OP) poisoning is not yet substantiated. In an initial evaluation of efficacy, we examined gastric lavage's capacity to eliminate OP insecticides.
Patients experiencing organophosphorus poisoning, within a timeframe of six hours after symptom onset, were incorporated into the study, irrespective of any prior gastric lavage. DNA Purification At least three cycles of gastric lavage, each using 200 mL of water, were performed after a nasogastric tube was placed and gastric contents were aspirated. To determine the presence and amount of the OP compounds, samples were taken from the initial aspirate and the first three lavage cycles and sent for analysis. The patients' health was monitored for complications arising from gastric lavage procedures.
Gastric lavage was performed on approximately forty-two patients. Due to insufficient analytical standards for ingested compounds, eight (190%) participants were excluded from the study. Among the 34 patient lavage samples, 24 (70.6%) contained detectable insecticide residues. Lipophilic organic phosphate (OP) compounds were discovered in 23 of the 24 patients analyzed, in stark contrast to the absence of hydrophilic OP compounds in 6 patients who reported ingesting such compounds. Chlorpyrifos poisoning can have long-lasting and severe consequences.
Of the estimated ingested amount, only 0.065 milligrams (with a standard deviation of 0.012) were measured.
From the gastric lavage, 8600 milligrams (with a standard deviation of 3200 milligrams) were collected. Starting with an initial gastric aspirate removing 794% of the compound, successive cycles saw removals of 115%, 66%, and 27% respectively.
Quantifying lipophilic OP insecticides in the stomach contents of OP poisoning patients is often possible with the initial aspiration or lavage procedure, yielding the best results. Despite the small quantity removed, the routine use of gastric lavage for OP poisoning patients arriving within six hours is unlikely to yield substantial benefits.
Mathansingh AJ, Jose A, Fleming JJ, Abhilash KPP, Chandiraseharan VK, and Lenin A are a group of researchers.
An observational study investigating the quantification of organophosphorus insecticide removal through gastric lavage in acutely poisoned patients. Within the pages 397 to 402 of the Indian Journal of Critical Care Medicine, volume 27, issue 6, 2023, research findings were published.
Among others, Mathansingh AJ, Jose A, Fleming JJ, Abhilash KPP, Chandiraseharan VK, Lenin A, and so forth. In acutely poisoned patients, an observational study assessed the removal of organophosphorus insecticides using gastric lavage. In 2023, the Indian Journal of Critical Care Medicine, issue 6, volume 27, published an article spanning pages 397 to 402.
The vulnerability of critically ill patients, specifically those in an unconscious or sedated state, to ocular surface diseases (OSDs), such as exposure keratopathy, is directly linked to a lack of protective eye care measures. By employing an algorithm-based approach to eyecare, which includes eyecare bundles, this research is focused on reducing the impact of ocular surface diseases (OSDs) in critically ill patients, particularly in settings with limited resources.
Upon receiving ethical clearance from the institutional ethics committee, a six-month quasi-experimental single-site study commenced. The eyecare bundle's influence on exposure keratopathy incidence was assessed by measuring the incidence pre- and post-implementation, followed by a comparative analysis. Study of intermediates A statistical analysis was performed using SPSS version 20.
Any p-value less than 0.05 was considered a marker of statistical significance.
The study cohort, comprising 218 patients, was assembled after obtaining their informed written consent and verifying their fulfillment of inclusion criteria. Patients were categorized into control and experimental groups, sharing similar baseline characteristics concerning gender, age (40 years), APACHE II score, and specialty distribution, except for the notable prevalence of medical patients in the experimental group. Considering the control group,
The control group, consisting of 69 patients (41 categorized as medical, 28 surgical), exhibited exposure keratopathy.
A considerable decrease in the incidence of exposure keratopathy was noted, impacting just 15 patients (6 in medical and 9 in surgical departments). Patients from the experimental group were also monitored further on Days 5 and 7, respectively.
Exposure keratopathy incidence in critically ill patients who were sedated, mechanically ventilated, and vulnerable was substantially lowered by the application of a protocolized algorithm-based eyecare bundle.
Researchers Sama S, Abrol R, Dhasmana R, Sharma N, Khandhuri S, and Chauhan R collaborated on a project.
Determining the efficacy of an implemented eyecare bundle in reducing exposure keratopathy instances within a North Indian tertiary care intensive care unit. Pages 426 to 432 of the 2023 Indian Journal of Critical Care Medicine, volume 27, number 6, contained significant medical content.
In addition to Sama S, Abrol R, Dhasmana R, Sharma N, Khandhuri S, and Chauhan R, there are other contributors, et al. Analyzing the influence of an eye care bundle's implementation on the prevalence of exposure keratopathy within the intensive care unit of a north Indian tertiary care facility. Indian Journal of Critical Care Medicine, 2023, sixth issue of volume 27, covered articles from page 426 to page 432.
This investigation aimed to quantify the incidence of augmented renal clearance (ARC) and to establish the utility of ARC and ARCTIC scores. MPI-0479605 mw A key aspect of our study involved analyzing the correlation and agreement between estimated GFR (eGFR-EPI) and measured creatinine clearance (8 hr-mCL) for 8 hours.
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A prospective, observational study, executed in a mixed medical-surgical intensive care unit (ICU), involved the recruitment of 90 patients. A 8-hour machine cycle is required.
In all patients, ARC, ARCTIC, and eGFR-EPI scores were computed. The presence of ARC was indicated by an 8 hr-mCLcr reading of 130 mL/min.
Four patients were omitted from the data analysis phase. A staggering 314% prevalence was observed for ARC. The study found that the sensitivity and specificity values were 556 and 847, respectively, for ARC scores, and 852 and 678 for ARCTIC scores. Further, the positive and negative predictive values for ARC were 625 and 806, and for ARCTIC were 548 and 909, respectively. The respective AUROC scores for ARC and ARCTIC were 0.802 and 0.765. A positive correlation of considerable strength between eGFR-EPI and 8 hr-mCL was observed, although there was poor agreement between the two.