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 · Jan 2015
Confirmation of endovenous placement of central catheter using the ultrasonographic "bubble test".
Insertion of central venous catheter (CVC) is the most common procedure to be performed in Intensive Care Units. Addition of ultrasonographic guidance to this procedure, which was initially performed blindly, has improved safety of this procedure. Confirmation of endovenous placement of CVC though, is tricky, as methods for confirmation are either operator dependent, time-consuming or not available at bedside. ⋯ After insertion of CVC in the internal jugular, subclavian or axillary vein, a 10 ml bolus of shaken saline microbubble is injected through port of CVC, and opacification of right atrium is observed in xiphoid view on ultrasonography. The Sonobubble test was helpful for dynamic confirmation of endovenous placement of CVC and prevented complications such as arterial puncture and cannulation. We recommend its use following CVC insertion.
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Indian J Crit Care Med · Jan 2015
Comparison of monitoring performance of bioreactance versus esophageal Doppler in pediatric patients.
Cardiac output (CO) monitoring and goal-directed therapy during major abdominal surgery is currently used to decrease postoperative complications. However, few monitors are currently available for pediatric patients. Nicom(®) is a noninvasive CO monitoring technique based on the bioreactance principle (analysis of frequency variations of a delivered oscillating current traversing the thoracic cavity). Nicom(®) may be a useful monitor for pediatric patients. ⋯ Simultaneous CI estimations made by bioreactance and TED showed high percentage of errors that is not clinically acceptable. Bioreactance cannot be considered suitable for monitoring pediatric patients.
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Indian J Crit Care Med · Jan 2015
Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India.
The increased morbidity and mortality associated with nosocomial infections in the intensive care unit (ICU) is a matter of serious concern today. ⋯ Nosocomial infections increase morbidity of hospitalized patients. These findings can be utilized for planning nosocomial infection surveillance program in our setting.
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Indian J Crit Care Med · Dec 2014
Griggs percutaneous tracheostomy without bronchoscopic guidance is a safe method: A case series of 300 patients in a tertiary care Intensive Care Unit.
Percutaneous tracheostomy (PCT) is being increasingly done by intensivists for critical care unit patients requiring either prolonged ventilation and/or for airway protection.[1] Bronchoscopic guidance considered a gold standard,[23] is not always possible due to logistic reasons and ventilation issues. We share our experience of Griggs PCT technique without bronchoscopic guidance with simple modifications to ensure safe execution of the procedure. ⋯ Percutaneous tracheostomy can be safely performed without bronchoscopic guidance by adhering to simple steps as described.
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Indian J Crit Care Med · Dec 2014
Do Intensive Care Unit treatment modalities predict mortality in geriatric patients: An observational study from an Indian Intensive Care Unit.
Ageing being a global phenomenon, increasing number of elderly patients are admitted to Intensive Care Units (ICU). Hence, there is a need for continued research on outcomes of ICU treatment in the elderly. ⋯ Intensive Care Unit mortality rates increased in the geriatric population requiring mechanical ventilation and inotropes during ICU stay. Only inotropic support could be identified as independent risk factor for mortality.