Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
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Portable ultrasound machines are highly valuable in ICUs, where a patient's condition might not permit shifting the patient to the USG department for imaging. Traditionally central lines are put blindly using anatomical landmarks, which often result in complications such as difficulty in access, misplaced lines, pneumothorax, bleeding from inadvertent arterial punctures, etc. Ultrasonography provides "real time" imaging, i.e., the needle can be visualized entering the vein. ⋯ USG-guided CVC is thus easier, quicker, and safer than landmark approach.
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Indian J Crit Care Med · Oct 2009
Role of noninvasive ventilation in weaning from mechanical ventilation in patients of chronic obstructive pulmonary disease: an Indian experience.
Endotracheal intubation and mechanical ventilation (MV) are often needed in patients of chronic obstructive pulmonary disease (COPD) with acute hypercapnic respiratory failure. The rate of weaning failure is high and prolonged MV increases intubation associated complications. ⋯ NIV is as useful as PSV in weaning and can be better in weaning failure especially in COPD for earlier weaning, decrease ICU stay, complications and mortality.
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Indian J Crit Care Med · Jul 2009
A computer-assisted recording, diagnosis and management of the medically ill system for use in the intensive care unit: a preliminary report.
Computerized medical information systems have been popularized over the last two decades to improve quality and safety, and for decreasing medical errors. ⋯ The use of a computer-assisted monitoring, recording and diagnostic system appears promising. It is envisaged that further software refinements following beta testing would facilitate the improvement of quality and safety in the critical care environment.
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Indian J Crit Care Med · Jul 2009
How correct is the correct length for central venous catheter insertion.
Central venous catheters (CVC) are important in the management of critically ill patients. Incorrect positioning may lead to many serious complications. Chest radiograph is a convenient means of determining the correct position of the catheter tip. The present study was designed to evaluate the depth of CVC placed through the right and left internal jugular vein (IJV) in order to achieve optimum placement of the catheter tip. ⋯ By cannulating the IJV through a central approach, the catheters can be fixed at a length of 12-13 cm in males and 11-12 cm in females in the right IJV and at a length of 13-14 cm in males and 12-13 cm in females in the left IJV in order to achieve correct positioning.
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Indian J Crit Care Med · Jul 2009
Role of steroids in septic shock: assessment of knowledge, attitudes and practices among intensivists practising in Hyderabad.
Use of steroids in septic shock is an issue of contention, more so with two major trials reporting conflicting results. ⋯ There is a lot of ambiguity in the knowledge, attitudes or practices regarding role of steroids in septic shock among intensivists in Hyderabad. Uniform policies and protocols need to be devised at institutional level, with multispecialty inputs, and doctors need to be familiarized accordingly.