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
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.
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Indian J Crit Care Med · Jul 2014
Effects of fentanyl on procedural pain and discomfort associated with central venous catheter insertion: A prospective, randomized, double-blind, placebo controlled trial.
Central venous catheter (CVC) insertion induces pain and discomfort to a conscious patient despite application of a local anesthetic (LA) field block and this pain can be greatly lessened by using additional analgesics. ⋯ Preprocedural bolus fentanyl infusion provides adequate analgesia and can be safely used for alleviating pain during CVC insertion in conscious patients.
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A 19-year-old female patient presented with alleged history of hair dye "Super Vasmol 33" intake. She presented with cervicofacial edema with upper airway obstruction. ⋯ Cardiac resuscitation could not be started at that point of time because managing airway was the priority in a patient who in hypoxic cardiac arrest. As soon as the airway was secured by emergency tracheostomy, cardiac resuscitation was initiated and the patient was successfully revived.