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 · Mar 2017
Republication: All India Difficult Airway Association 2016 Guidelines for Tracheal Intubation in the Intensive Care Unit.
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often lifesaving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. ⋯ Stable hemodynamics and gas exchange must be maintained during rapid sequence induction. It is necessary to implement an intubation protocol during routine airway management in the ICU. Adherence to a plan for difficult airway management incorporating the use of intubation aids and airway rescue devices and strategies is useful.
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Indian J Crit Care Med · Mar 2017
Unplanned Intensive Care Unit Admission following Elective Surgical Adverse Events: Incidence, Patient Characteristics, Preventability, and Outcome.
Adverse events (AEs) are a persistent and an important reason for Intensive Care Unit (ICU) admission. They lead to death, disability at the time of discharge, unplanned ICU admission (UIA), and prolonged hospital stay. They impose large financial costs on health-care systems. ⋯ Our analysis of UIA is a quality control exercise that helps identify high-risk patient groups and patterns of anesthesia or surgical care requiring improvement.
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Indian J Crit Care Med · Mar 2017
Using Ultrasonography to Determine Optimal Head-down Tilt Position Angle in Patients before Catheterization of the Internal Jugular Vein.
It is believed that 15°-25° head-down tilt position increases the internal jugular vein cross-sectional area (IJV CSA). The increase in IJV CSA before puncture reduces the risk of its perforation. This pattern was not observed in all patients. We assumed that the absence of respiratory-based IJV excursion is one of the criteria of head-down tilt position effectiveness. ⋯ In clinical settings, the disappearance of respiratory-based vein excursion on the ultrasound scanner screen can be considered as criteria of the head-down tilt position effectiveness.