Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
-
Indian J Crit Care Med · Jul 2017
A Study on the Psychometric Properties of Revised-nonverbal Pain Scale and Original-nonverbal Pain Scale in Iranian Nonverbal-ventilated Patients.
The nonverbal pain scale is one of the instruments which study pain in nonverbal-ventilated patients with regard to the changes of behavioral and physiological indices. The purpose of the study is to survey the psychometric properties of revised-nonverbal pain scale (R-NVPS) and original-nonverbal pain scale (O-NVPS) in ventilated patients hospitalized in critical care units. ⋯ R-NVPS and O-NVPS can both be used as valid and reliable scales in studying pain in ventilated patient. However, in comparing the items, "respiration" (R-NVPS) had a higher sensitivity than "physiology II" (O-NVPS) in assessing pain.
-
Indian J Crit Care Med · Jul 2017
Intra- and Inter-observer Reliability of Quadriceps Muscle Thickness Measured with Bedside Ultrasonography by Critical Care Physicians.
Muscle wasting is common among critically ill patients with sepsis and has a significant effect on clinical outcome. However, appropriate tool for measurement of muscle loss is debatable. Ultrasonography (USG) has been used for objective assessment of quadriceps muscle thickness among these patients; however, there is limited data on its reliability. ⋯ This study shows that ultrasound is a reliable tool for the measurement of quadriceps muscle thickness by critical care physicians with excellent inter- and intra-class reliability.
-
Indian J Crit Care Med · Jun 2017
Case ReportsBlunt Trauma Neck with Complete Tracheal Transection - A Diagnostic and Therapeutic Challenge to the Trauma Team.
Survival following trachea-esophageal transection is uncommon. Establishing a secure airway has the highest priority in trauma management. Airway management is a unique and a defining element to the specialty of emergency medicine. ⋯ Here, we report a case of blunt trauma following high-velocity road traffic accident, presenting in the peri-arrest state, in whom we noticed "failed airway" which turned out to be due to complete tracheal transection. In our patient, although we had secured the airway immediately, he had already sustained hypoxic brain damage. This scenario emphasizes the importance of prehospital care in developing countries.
-
Indian J Crit Care Med · May 2017
Reliability of Ultrasonography in Confirming Endotracheal Tube Placement in an Emergency Setting.
Over the past few years, ultrasonography is increasingly being used to confirm the correct placement of endotracheal tube (ETT). In our study, we aimed to compare it with the traditional clinical methods and the gold standard quantitative waveform capnography. Two primary outcomes were measured in our study. First was the sensitivity and specificity of ultrasonography against the other two methods to confirm endotracheal intubation. The second primary outcome assessed was the time taken for each method to confirm tube placement in an emergency setting. ⋯ Ultrasonography confirmed tube placement with comparable sensitivity and specificity to quantitative waveform capnography and clinical methods. But then, it yielded results considerably faster than the other two modalities.
-
Indian J Crit Care Med · May 2017
Case ReportsTitration of Ideal Positive End-expiratory Pressure in Acute Respiratory Distress Syndrome: Comparison between Lower Inflection Point and Esophageal Pressure Method Using Volumetric Capnography.
The tenets of mechanical ventilation in acute respiratory distress syndrome (ARDS) include the utilization of low tidal volume and optimal application of positive end-expiratory pressure (PEEP). Optimal PEEP in ARDS is characterized by reduction in alveolar dead space along with improvement in the lung compliance and resultant betterment in oxygenation. There are various methods of setting PEEP in ARDS. Herein, we report a patient of ARDS, wherein we employed measurement of dead space using volumetric capnography to compare two different PEEP strategies, namely, the lower inflection point and transpulmonary pressure monitoring.