Notes

Factors Impacting on Lovemaking Vocalization in Man Ladies.
cm in DW-MRI and outcome in union with the common practice instrumental tests.

Abbas NI, Sayed O, Samir S, Abeed N. D-dimer Level is Correlated with Prognosis, Infarct Size, and NIHSS in Acute Ischemic Stroke Patients. Indian J Crit Care Med 2021;25(2)193-198.
Abbas NI, Sayed O, Samir S, Abeed N. D-dimer Level is Correlated with Prognosis, Infarct Size, and NIHSS in Acute Ischemic Stroke Patients. Indian J Crit Care Med 2021;25(2)193-198.
To evaluate the utility of noninvasive electrocardiometry (ICON®) for hemodynamic categorization and assessment of fluid responsiveness in pediatric septic shock.

Pilot prospective observational study in a 12-bedded tertiary pediatric intensive care unit (PICU) in children aged between 2 months and 16 years with unresolved septic shock after a 20 mL/kg fluid bolus. Those with cardiac index (CI) <3.3 L/min/m
and systemic vascular resistance index (SVRI) >1600 dyn sec/cm
/m
were classified as vasoconstrictive shock-electrocardiometry (VCEC) and those with CI >5.5 L/min/m
and SVRI <1000 dyn sec/cm
/m
as vasodilated shock-electrocardiometry (VDEC). Fluid responsiveness was defined as a 10% increase in CI with a 20 mL/kg fluid bolus. Sepsis-induced myocardial dysfunction (SMD) was diagnosed on echocardiography. Outcomes studied included clinical shock resolution, length of PICU stay, and mortality.

Thirty children were enrolled over 6 months with a median (interquartile range) age and p 12 hours (
= 0.01), and lesser mortality (
= 0.002). Five (16.6%) children with VCEC had SMD and were less fluid responsive (
= 0.04) with higher mortality (
= 0.01) compared to those without SMD.

Continuous, noninvasive hemodynamic monitoring using electrocardiometry permits hemodynamic categorization and assessment of fluid responsiveness in pediatric septic shock. This may provide real-time guidance for optimal interventions, and thus, improve the outcomes.

Rao SS, Reddy M, Lalitha AV, Ghosh S. Electrocardiometry for Hemodynamic Categorization and Assessment of Fluid Responsiveness in Pediatric Septic Shock A Pilot Observational Study. Indian J Crit Care Med 2021;25(2)185-192.
Rao SS, Reddy M, Lalitha AV, Ghosh S. Electrocardiometry for Hemodynamic Categorization and Assessment of Fluid Responsiveness in Pediatric Septic Shock A Pilot Observational Study. Indian J Crit Care Med 2021;25(2)185-192.
To study if protocolized monitoring of endotracheal tube (ETT) cuff pressure every 6 hours is better than adjusting endotracheal tube cuff inflation by the only bedside clinical assessment.

This was a single-center prospective randomized controlled study done between July 1, 2017 and March 31, 2019. Children between 1 month and 18 years, intubated with cuffed ETT by our trained doctors were included. After obtaining consent, patients were randomized into two groups, standard group (SG) and cuff pressure monitoring group (MG). read more Sample size was calculated with 80 patients in each group with a power of 80%, significance level (alpha 0.05 and beta 0.2). In the SG, ETT cuff inflation was adjusted by clinical assessment (bedside minimal leak technique and monitoring the percentage of leak displayed on ventilator display) at 6 hours interval. In the MG, cuff pressures were monitored by the device every 6 hours to maintain between 20 and 25 mm Hg.

Out of 543 mechanically ventilated children during the study periJanaapureddy YR, Mohanty S, Reddy PK, Sachane K, Dekate PS, et al. Utility of Endotracheal Tube Cuff Pressure Monitoring in Mechanically Ventilated (MV) Children in Preventing Post-extubation Stridor (PES). Indian J Crit Care Med 2021;25(2)181-184.
Traumatic pneumothorax is an ominous condition necessitating urgent appropriate action. It is typically detected on chest X-rays; however, these may not be able to detect the presence of a subtle pneumothorax, especially in supine position. Lung ultrasound is emerging as a promising modality for detecting pneumothorax in trauma patients. The aim of our study was to compare ultrasound with supine chest radiography for the detection of pneumothorax in trauma patients.

This was a prospective, single-blinded study carried out on 212 adult thoracoabdominal trauma patients who underwent ultrasound FAST and supine (AP) chest radiography. During the FAST sonography, ultrasound thorax was done to rule out pneumothorax. Only those cases were considered (118) in which the presence or absence of pneumothorax could be confirmed on CT done subsequently or where pneumothorax was confirmed by air escape on chest tube placement, wherever indicated, and the results were compared with sonographic and chest X-ray findings.

d and Supine Chest Radiographs. Indian J Crit Care Med 2021;25(2)176-180.
Bhoil R, Kumar R, Kaur J, Attri PK, Thakur R. Diagnosis of Traumatic Pneumothorax A Comparison between Lung Ultrasound and Supine Chest Radiographs. Indian J Crit Care Med 2021;25(2)176-180.
Arterial blood gas (ABG) analysis is a common test ordered in critically ill patients. Often, it is performed very frequently without influencing patient care. Hence, we decided to check the utility of the ABG test in our intensive care unit (ICU).

The data of the previous day ABGs were captured by reviewing the chart in an online pro forma which was filled by the authors. Data relating to patient's details, who ordered ABGs, reason for ordering ABGs, and did the ABG influence patient's management were entered. A total of 985 ABGs were performed in 173 patients for 2 months which was analyzed.

Out of 985 ABGs, in 259 instances (26.29%), interventions were done after reviewing an ABG. The major interventions among these ABGs were ventilator settings adjustment in 134 ABGs (13.6%). A total of 790 ABGs were done routinely with no specific indication (80.20%), while doctors ordered one following an event for 195 ABGs (19.80%).

Our data suggest that 80% of ABG tests were ordered as part of a routine test.

Chandran J, D'Silva C, Sriram S, Krishna B. Clinical Utility of Arterial Blood Gas Test in an Intensive Care Unit An Observational Study. Indian J Crit Care Med 2021;25(2)172-175.
Chandran J, D'Silva C, Sriram S, Krishna B. Clinical Utility of Arterial Blood Gas Test in an Intensive Care Unit An Observational Study. Indian J Crit Care Med 2021;25(2)172-175.
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