Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
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We report a case of 27-year-old male with lung contusions related acute respiratory distress syndrome (ARDS) managed by ARDSNet guidelines and additional hypothermia. On 4(th) day, post trauma partial pressure of oxygen dropped to 38 mm of mercury (Hg), not improving even on high positive end-expiratory pressure of 18 cm water (H2O), inverse ratio ventilation and fraction of inspired oxygen of 1. ⋯ Thereafter, hypothermia along with muscle paralysis was considered to reduce total body oxygen consumption. Patient's condition improved under hypothermia, and he was extubated and taken up for fracture fixation surgeries and discharged later in stable condition.
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Indian J Crit Care Med · Jun 2015
Association between a prolonged corrected QT interval and outcomes in patients in a medical Intensive Care Unit.
Patients admitted into a medical Intensive Care Unit (ICU) have varying illnesses and risk factors. An electrocardiogram (ECG) is a useful tool to assess the cardiac status. The aim of the study was to determine the prevalence of QT prolongation of the ECG in patients admitted to a medical ICU in a tertiary hospital, to assess outcomes in terms of mortality, cardiovascular events, and duration of ICU stay. ⋯ We found that prolonged QTc is common (30%) in our medical ICU at admission and a large proportion (35%) received drugs capable of prolonging QT interval. These patients with QTc prolongation have a higher odds ratio for adverse outcomes.
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Indian J Crit Care Med · Jun 2015
Early clinical prediction of neurological outcome following out of hospital cardiac arrest managed with therapeutic hypothermia.
Therapeutic hypothermia (TH) may improve neurological outcome in comatose patients following out of hospital cardiac arrest (OHCA). The reliability of clinical prediction of neurological outcome following TH remains unclear. In particular, there is very limited data on survival and predictors of neurological outcome following TH for OHCA from resource-constrained settings in general and South Asia in specific. ⋯ Status myoclonus within 24 h, absence of brainstem reflexes and motor response worse than flexion on day 3 reliably predict unfavorable neurological outcome in comatose patients with OHCA treated with TH.