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A questionnaire-based survey of physician perceptions of the prevalence of antimicrobial resistance and their antibiotic prescribing patterns
Conclusion: This study reveals that the prevalence of MDR Gram-negative pathogens is perceived to be on the rise. Prescription patterns indicate high levels of variability. Hence, antibiotic stewardship is essential to standardize antibiotic prescriptions not only for efficacy but also to reduce the burden of multiple drug resistance. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - July 17, 2018 Category: Intensive Care Authors: Vaishali Gupte Jaideep Gogtay Raj Kumar Mani Source Type: research

Comparison of mechanical insufflation & #8211;Exsufflation and endotracheal suctioning in mechanically ventilated patients: Effects on respiratory mechanics, hemodynamics, and volume of secretions
Conclusions: The mechanical insufflation–exsufflation does not alter respiratory mechanics and hemodynamic stability, and it does not improve airway clearance in mechanically ventilated patients. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - July 17, 2018 Category: Intensive Care Authors: William M Coutinho Paulo J. C. Vieira Fernanda M Kutchak Alexandre S Dias Marcelo M Rieder Luiz Alberto Forgiarini Source Type: research

The association between arterial oxygen tension, hemoglobin concentration, and mortality in mechanically ventilated critically ill patients
Conclusions: Hb is an effect modifier on the association between oxygenation and mortality. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - July 17, 2018 Category: Intensive Care Authors: Mahesh Ramanan Nick Fisher Source Type: research

Deadly Nipah outbreak in Kerala: Lessons learned for the future
AK Ajith Kumar, AS Anoop KumarIndian Journal of Critical Care Medicine 2018 22(7):475-476 (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - July 17, 2018 Category: Intensive Care Authors: AK Ajith Kumar AS Anoop Kumar Source Type: research

Ultrasonography-guided internal jugular venous catheterization: Unusual position and unusual circumstances
Mayank Kumar, Tuhin Mistry, Subrata Kumar Singha, Mamta SinhaIndian Journal of Critical Care Medicine 2018 22(6):468-469 (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Mayank Kumar Tuhin Mistry Subrata Kumar Singha Mamta Sinha Source Type: research

A letter in response to & #8220;Diagnosing catheter-associated urinary tract infection in critically ill patients: Do the guidelines help ? & #8221;
Bijayini BeheraIndian Journal of Critical Care Medicine 2018 22(6):467-468 (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Bijayini Behera Source Type: research

Fatal cerebellar hemorrhage complicating pneumococcal meningitis: Are anticoagulants the hidden enemy ?
Ali Jendoubi, Mouna Rkhami, Skander GuedicheIndian Journal of Critical Care Medicine 2018 22(6):466-467 (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Ali Jendoubi Mouna Rkhami Skander Guediche Source Type: research

Hyperammonemia presenting as refractory status epilepticus after lung transplant in a patient positive for Ureaplasma parvum
We present the case of a 65-year-old male with idiopathic pulmonary fibrosis who developed refractory status epilepticus secondary to hyperammonemia following lung transplant. The patient presented on postoperative day 7 with super-refractory status epilepticus and normal computed tomography scan of the head. Hyperammonemia was suspected due to refractory seizures and confirmed with peak ammonia level >1000 μmol/L. Despite aggressive treatment, the patient developed global cerebral edema and died. Postmortem investigations revealed that the patient was positive for Ureaplasma parvum. Additional studi...
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Diane C McLaughlin Jorge M Mallea Lauren K Ng Source Type: research

Keep an eye on the intracranial pressure, thanks to the optic nerve sheath diameter
We report the case of a patient deeply sedated for the management of acute respiratory distress syndrome secondary to pneumonia. Delay in awakening led to cerebral exploration by transcranial Doppler (TCD) and measurement of optic nerve sheath diameter (ONSD). Abnormal values of ONSD prompted immediate brain computed tomography scan that confirmed high intracranial pressure (ICP) due to multiple deep parenchymal hematomas. Despite raised ICP, values obtained by TCD were normal, thanks to the persistence of cerebral autoregulation. This case highlights the interest of combining noninvasive techniques for neurological examin...
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Alexandre Vagh Weinmann Charlotte Beaucreux Kevin Kearns Cl & #233;ment Dubost Source Type: research

Therapeutic red cell exchange transfusion as an adjuvant therapy for management of sickle cell crisis in adults
We report an adult case of sickle cell crisis managed with therapeutic red cell exchange transfusion in Intensive Care Unit and successful outcome in patient management. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Anand Bandachar Mamdapur Maddani Shanmukhappa Sagar R Madhusudan Mustafa Samir Source Type: research

Hepatomyoencephalopathy secondary to Cassia occidentalis poisoning: Report of three cases from North India
Viswas Chhapola, Sandeep Kumar Kanwal, Ankita Goel Sharma, Virendra KumarIndian Journal of Critical Care Medicine 2018 22(6):454-456Cassia occidentalis is an annual tropical shrub causing toxicity in cattle. However, human case reports of its poisoning are scarce. We, here, report three young children, residents of Western Uttar Pradesh in North India, who presented with lethargy, jaundice, and altered sensorium after consumption of Cassia seeds. The toxidrome was defined as hepatomyoencephalopathy. The children were resuscitated, managed for acute liver failure, and subsequently discharged without sequel. Although few stu...
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Viswas Chhapola Sandeep Kumar Kanwal Ankita Goel Sharma Virendra Kumar Source Type: research

Is my patient still alive ?
Arun Kumar, Tewari Vineeta, Sandhu MeghaIndian Journal of Critical Care Medicine 2018 22(6):449-453The modern-day health-care firmament is fighting one of its biggest battles of mistrust, the seeds of which have been sown over the years and the roots seem to run deep. There is a substantial misunderstanding about the complexities of intensive care treatments, especially the life support interventions. A critically ill patient on ventilator is often perceived by the families to be dead. Such misconceptions have a huge negative impact on the already friable doctor–patient relationship. The paper presents an over...
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Arun Kumar Tewari Vineeta Sandhu Megha Source Type: research

A comparative study of midazolam and target-controlled propofol infusion in the treatment of refractory status epilepticus
Conclusions: The choice of anesthetic agent does not seem to affect the overall outcome in RSE and SRSE. Target-controlled propofol infusion was found to be equal in its efficacy to midazolam for the treatment of RSE. High mortality might be due to SRSE secondary to the underlying brain pathology. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Dheeraj Masapu KN Gopala Krishna Sinha Sanjib Dhrithiman Chakrabarti RC Mundlamuri Nitin Manohar P Mariamma P Satishchandra GS Umamaheswara Rao Source Type: research

Comparison of lung ultrasound-based weaning indices with rapid shallow breathing index: Are they helpful ?
Conclusion: In Intensive Care Unit, RSBI is the best clinical tool for weaning, and DC is found to be the best parameter for weaning among the US-based weaning parameters. It can even be a substitute for RSBI, in today's world of real-time monitoring methods. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Abhinav Banerjee Gesu Mehrotra Source Type: research

Study on clinical profile and predictors of mortality in Cerbera odollam poisoning
Conclusions: C. odollam poisoning is a common method of deliberate self-harm in Kerala. It carries a high mortality rate, and the predictors of mortality include vomiting, bradycardia, hypotension, hyperkalemia, and the presence of severe ECG changes. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: B Renymol Dhanya Sasidharan Palappallil NR Ambili Source Type: research