Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
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Indian J Crit Care Med · Jul 2014
ReviewA review of video laryngoscopes relevant to the intensive care unit.
The incidence of difficult direct intubation in the intensive care unit (ICU) is estimated to be as high as 20%. Recent advances in video-technology have led to the development of video laryngoscopes as new intubation devices to assist in difficult airway management. ⋯ They are therefore an important addition to the armamentarium of any clinician performing endotracheal intubation. We present a practical review of commonly available video laryngoscopes with respect to design, clinical efficacy, and safety aspects relevant to their use in the ICU.
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Indian J Crit Care Med · Jul 2014
Comparison of clonidine and dexmedetomidine for short-term sedation of intensive care unit patients.
Patients on mechanical ventilation in intensive care unit (ICU) are often uncomfortable because of anxiety, pain, and endotracheal intubation; therefore, require sedation. Alpha-2 agonists are known to produce sedation. We compared clonidine and dexmedetomidine as sole agents for sedation. ⋯ Both clonidine and dexmedetomidine produced effective sedation; however, the hemodynamic stability provided by dexmedetomidine gives it an edge over clonidine for short-term sedation of ICU patients.
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Indian J Crit Care Med · Jul 2014
Clinical outcome and predictors of mortality in children with sepsis, severe sepsis, and septic shock from Rohtak, Haryana: A prospective observational study.
Information regarding early predictive factors for mortality and morbidity in sepsis is limited from developing countries. ⋯ Mortality among children with sepsis, severe sepsis, and septic shock were not predicted by any individual factors including the time lag to PICU transfer, duration of PICU stay, presence of multiorgan dysfunction, and PRISM score at admission.
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Indian J Crit Care Med · Jul 2014
Case ReportsHypomagnesemia in the intensive care unit: Choosing your gastrointestinal prophylaxis, a case report and review of the literature.
We report a case of symptomatic hypomagnesaemia in medical intensive care unit that is strongly related to proton pump inhibitors (PPIs) and provide literature review. A 65-year-old male with severe gastroesophageal reflux on omeprazole 20 mg orally twice a day, who presented to the hospital with abdominal pain, nausea, diarrhea, and new onset seizures. On admission, his serum magnesium level was undetectable. ⋯ Neurologic and cardiac abnormalities were corrected. This is a life-threatening case of an undetectable magnesium level strongly associated with PPI use. In critically, ill patients with refractory hypomagnesemia, we advocate considering changing gastrointestinal prophylaxis from a PPI to a histamine-receptor blocker.
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Indian J Crit Care Med · Jul 2014
Evaluation of risk of nephrotoxicity with high dose, extended-interval colistin administration.
The aim was to evaluate the risk of nephrotoxicity with high-dose, extended-interval regimen of colistin administration in critical ill patients. ⋯ Our study showed that high-dose, extended-interval colistin can be given to critically ill patients without any significant risk of nephrotoxicity.