Pub Date : 2023-01-01DOI: 10.4103/theiaforum.theiaforum_98_22
Lokman Manish, Michell Gulabani, M. Mohta, G. Chilkoti
Background: Etomidate is a popular induction agent, due to its several advantages for example, an extremely stable hemodynamic profile with no effects on sympathetic nervous system and baroreceptors, minimal effect on respiration and also prevents histamine release in healthy patients or in those with reactive airway disease. It, however, may be associated with myoclonus whose incidence has been reported as 50%–80% in nonpremedicated patients. Ideally, a pretreatment drug for preventing myoclonic movements should be short acting, not have significant effects on respiration and hemodynamics, and not prolong recovery from anesthesia. Midazolam has been used as a pretreatment to attenuate myoclonus in different doses with varied results, but the optimal dose has not been established. The present study was planned to compare the effect of three doses of midazolam, i.e., 0.015 mg/kg, 0.03 mg/kg, and 0.05 mg/kg in preventing etomidate-induced myoclonus. Materials and Methods: This study comprised 164 American Society of Anesthesiologists I/II consenting patients between 18 and 60 years. They were randomly divided into four groups after which pretreatment with normal saline in group M0, midazolam 0.015 mg/kg in group M0.015, 0.03 mg/kg in group M0.03, and 0.05 mg/kg in group M0.05 was administered. The primary outcome was the incidence of myoclonus after etomidate. The secondary outcome measures included severity of myoclonus and changes in hemodynamic parameters. One-way analysis of variance with Bonferroni's correction was used to compare quantitative data. Chi-square test was applied for qualitative data. Further, as there were four groups with multiple comparisons, Bonferroni's correction was applied and P < 0.01 was considered statistically significant. Results: We observed a significant reduction in the incidence of myoclonus of group M0.015 as compared to group M0 (P < 0.001). A significant reduction in severity of myoclonus was observed in all the three midazolam groups compared to the control group (P < 0.001) without any significance among the patients receiving different doses of midazolam. Conclusion: We recommend using midazolam pretreatment in a dose of 0.015 mg/kg for prevention of etomidate-induced myoclonus.
{"title":"Comparative assessment of different doses of midazolam to prevent etomidate-induced myoclonus – A randomized, double-blind, placebo-controlled trial","authors":"Lokman Manish, Michell Gulabani, M. Mohta, G. Chilkoti","doi":"10.4103/theiaforum.theiaforum_98_22","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_98_22","url":null,"abstract":"Background: Etomidate is a popular induction agent, due to its several advantages for example, an extremely stable hemodynamic profile with no effects on sympathetic nervous system and baroreceptors, minimal effect on respiration and also prevents histamine release in healthy patients or in those with reactive airway disease. It, however, may be associated with myoclonus whose incidence has been reported as 50%–80% in nonpremedicated patients. Ideally, a pretreatment drug for preventing myoclonic movements should be short acting, not have significant effects on respiration and hemodynamics, and not prolong recovery from anesthesia. Midazolam has been used as a pretreatment to attenuate myoclonus in different doses with varied results, but the optimal dose has not been established. The present study was planned to compare the effect of three doses of midazolam, i.e., 0.015 mg/kg, 0.03 mg/kg, and 0.05 mg/kg in preventing etomidate-induced myoclonus. Materials and Methods: This study comprised 164 American Society of Anesthesiologists I/II consenting patients between 18 and 60 years. They were randomly divided into four groups after which pretreatment with normal saline in group M0, midazolam 0.015 mg/kg in group M0.015, 0.03 mg/kg in group M0.03, and 0.05 mg/kg in group M0.05 was administered. The primary outcome was the incidence of myoclonus after etomidate. The secondary outcome measures included severity of myoclonus and changes in hemodynamic parameters. One-way analysis of variance with Bonferroni's correction was used to compare quantitative data. Chi-square test was applied for qualitative data. Further, as there were four groups with multiple comparisons, Bonferroni's correction was applied and P < 0.01 was considered statistically significant. Results: We observed a significant reduction in the incidence of myoclonus of group M0.015 as compared to group M0 (P < 0.001). A significant reduction in severity of myoclonus was observed in all the three midazolam groups compared to the control group (P < 0.001) without any significance among the patients receiving different doses of midazolam. Conclusion: We recommend using midazolam pretreatment in a dose of 0.015 mg/kg for prevention of etomidate-induced myoclonus.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"24 1","pages":"29 - 35"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44357500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/theiaforum.theiaforum_7_23
Manav S. Sharma, Sharmishtha Pathak
{"title":"Curious case of central venous catheter leak","authors":"Manav S. Sharma, Sharmishtha Pathak","doi":"10.4103/theiaforum.theiaforum_7_23","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_7_23","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"24 1","pages":"84 - 85"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47740337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Aims: Videolaryngoscopes have attained prime importance in securing the airway in children in the present era. McGrath videolaryngoscope is available with single-use non-channeled fog-free disposable blades of various sizes showing its efficacy for intubation in adults but still lacunae in data related to children. Materials and Methods: In this prospective randomized controlled trial, a total of 88 children of the American Society of Anesthesiologists Grade I and II aged 1–10 years, weighing 10–20 kg undergoing general anesthesia were enrolled. Using the sealed envelope technique, the children were randomly allocated between Group G, in whom McGrath videolaryngoscope and Group M, in whom Macintosh laryngoscope was used for intubation. The primary aim was to compare intubation time between the two videolaryngoscopes. The secondary outcomes included glottic exposure time, Cormack and Lehane grading, number of attempts of intubation, intubation difficulty scale and complications. Statistical analysis was done using MedCalc software. The Student's t-test and Chi-square test were used for quantitative and categorical data, respectively. Results: The mean intubation time was comparable in both the groups (18.14 ± 17.80 s in Group G vs. 17.30 ± 16.74 s in Group M, P = 0.821). The mean time to glottic exposure was shorter (5.66 ± 4.58 vs. 8.50 ± 5.59 s, P = 0.0108) with decreased number of attempts of tube insertion and less incidences of trauma observed in patients with Group G as opposed to Group M. The Cormack and Lehane grading showed better glottic view in Group G. Conclusion: McGrath videolaryngoscope is as useful as the Macintosh laryngoscope for intubation in children with the added advantages of a better view of the larynx, lesser attempts to intubation, and fewer incidence of trauma.
{"title":"Comparison of McGrath videolaryngoscope with conventional Macintosh laryngoscope for tracheal intubation in pediatric patients with normal airway","authors":"Stuti Bhamri, Devyani Desai, Darshit Chauhan, Neha Cheraya","doi":"10.4103/theiaforum.theiaforum_104_22","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_104_22","url":null,"abstract":"Background and Aims: Videolaryngoscopes have attained prime importance in securing the airway in children in the present era. McGrath videolaryngoscope is available with single-use non-channeled fog-free disposable blades of various sizes showing its efficacy for intubation in adults but still lacunae in data related to children. Materials and Methods: In this prospective randomized controlled trial, a total of 88 children of the American Society of Anesthesiologists Grade I and II aged 1–10 years, weighing 10–20 kg undergoing general anesthesia were enrolled. Using the sealed envelope technique, the children were randomly allocated between Group G, in whom McGrath videolaryngoscope and Group M, in whom Macintosh laryngoscope was used for intubation. The primary aim was to compare intubation time between the two videolaryngoscopes. The secondary outcomes included glottic exposure time, Cormack and Lehane grading, number of attempts of intubation, intubation difficulty scale and complications. Statistical analysis was done using MedCalc software. The Student's t-test and Chi-square test were used for quantitative and categorical data, respectively. Results: The mean intubation time was comparable in both the groups (18.14 ± 17.80 s in Group G vs. 17.30 ± 16.74 s in Group M, P = 0.821). The mean time to glottic exposure was shorter (5.66 ± 4.58 vs. 8.50 ± 5.59 s, P = 0.0108) with decreased number of attempts of tube insertion and less incidences of trauma observed in patients with Group G as opposed to Group M. The Cormack and Lehane grading showed better glottic view in Group G. Conclusion: McGrath videolaryngoscope is as useful as the Macintosh laryngoscope for intubation in children with the added advantages of a better view of the larynx, lesser attempts to intubation, and fewer incidence of trauma.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"24 1","pages":"43 - 48"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49280329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/theiaforum.theiaforum_102_22
Vinod Krishnagopal, R. Murugan, K. Sharanya, R. Sethuraman
{"title":"Is it popliteal artery? Is it popliteal vein? No it is persistent sciatic vein","authors":"Vinod Krishnagopal, R. Murugan, K. Sharanya, R. Sethuraman","doi":"10.4103/theiaforum.theiaforum_102_22","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_102_22","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"24 1","pages":"81 - 82"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43085691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/theiaforum.theiaforum_112_22
Naveen Paliwal, Pooja Bihani, S. Rao, Rishabh Jaju, S. Mohammed, A. Khare, S. Dhawan, V. Rajpurohit, M. Tak, Geeta Singariya
Background: The COVID-19 has a varied mode of presentation in different regions of the world. This multicentric study was planned to evaluate the survival outcomes in intensive care unit-admitted patients admitted during the third wave of the COVID-19 pandemic on the basis of clinicodemographic profile and vaccination status. Methodology: Data from 299 patients admitted to three tertiary care centers in Western India were collected and analyzed. Based on survival outcomes, all patients were divided into two groups: survivors and nonsurvivors. Univariate analysis of the demographic profile, comorbidities, vaccination status, and disease severity was performed, whereas multivariate analysis was performed to predict independent factors associated with mortality. Results: Among total 299 studied patients, 208 (69.5%) patients survived and 91 (30.4%) did not. The number of elderly patients and patients with comorbidities such as diabetes, tuberculosis, chronic obstructive pulmonary disease, cardiovascular and respiratory diseases, and malignancy were more prevalent among nonsurvivors. Patients who did not receive a single dose of vaccine were higher in the nonsurvivor group (P = 0.037); however, no significant difference in survival outcome was found if patients had received the first or both doses of vaccine. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score at 24 h after admission and Sequential Organ Failure Assessment (SOFA) score at admission were significantly higher in nonsurvivors compared to survivors (P < 0.0001). On multivariate analysis, APACHE II and SOFA scores were found to be independent predictors of outcome. Conclusions: Older age, presence of comorbidities, nonvaccination and higher disease severity scores affected mortality during the third wave of COVID-19.
{"title":"Mortality predictors during the third wave of COVID-19 pandemic: A multicentric retrospective analysis from tertiary care centers of Western India","authors":"Naveen Paliwal, Pooja Bihani, S. Rao, Rishabh Jaju, S. Mohammed, A. Khare, S. Dhawan, V. Rajpurohit, M. Tak, Geeta Singariya","doi":"10.4103/theiaforum.theiaforum_112_22","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_112_22","url":null,"abstract":"Background: The COVID-19 has a varied mode of presentation in different regions of the world. This multicentric study was planned to evaluate the survival outcomes in intensive care unit-admitted patients admitted during the third wave of the COVID-19 pandemic on the basis of clinicodemographic profile and vaccination status. Methodology: Data from 299 patients admitted to three tertiary care centers in Western India were collected and analyzed. Based on survival outcomes, all patients were divided into two groups: survivors and nonsurvivors. Univariate analysis of the demographic profile, comorbidities, vaccination status, and disease severity was performed, whereas multivariate analysis was performed to predict independent factors associated with mortality. Results: Among total 299 studied patients, 208 (69.5%) patients survived and 91 (30.4%) did not. The number of elderly patients and patients with comorbidities such as diabetes, tuberculosis, chronic obstructive pulmonary disease, cardiovascular and respiratory diseases, and malignancy were more prevalent among nonsurvivors. Patients who did not receive a single dose of vaccine were higher in the nonsurvivor group (P = 0.037); however, no significant difference in survival outcome was found if patients had received the first or both doses of vaccine. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score at 24 h after admission and Sequential Organ Failure Assessment (SOFA) score at admission were significantly higher in nonsurvivors compared to survivors (P < 0.0001). On multivariate analysis, APACHE II and SOFA scores were found to be independent predictors of outcome. Conclusions: Older age, presence of comorbidities, nonvaccination and higher disease severity scores affected mortality during the third wave of COVID-19.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"24 1","pages":"58 - 64"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43086997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/theiaforum.theiaforum_32_23
B. Krishna, D. Khurana, Santvana Kohli, K. Sharma, R. Gandhi
Pheochromocytomas are rare adrenal tumors that produce excessive catecholamines and their surgical removal poses significant risks of intraoperative hemodynamic instability (HI) due to catecholamine release. This review article discusses the perioperative factors that impact hemodynamic lability and its management in patients undergoing surgical removal. A literature review was conducted by searching the electronic databases - Ovid MEDLINE, Embase, and Cochrane Library using appropriate Medical Subject Heading terms and keywords such as phaeochromocytoma, HI, and perioperative hemodynamic monitoring. The advancements in surgical and anesthetic techniques and appropriate preoperative medical optimization have contributed to a significant decrease in mortality rates. However, perioperative HI remains the biggest surgical and anesthetic challenge in treating pheochromocytomas. Patients with larger and more hormonally active tumors are at higher risk for extreme hypertensive episodes during surgery. Preoperative α-blockade, higher phenoxybenzamine doses, and laparoscopic approach improve the outcomes in phaeochromocytoma removal. Anesthetic techniques and drugs used during surgery may help prevent HI, but careful intraoperative management is essential. Perioperative HI can lead to increased surgical blood loss, patient morbidity, and prolonged intensive care unit (ICU) and hospital stay. Therefore, a multidisciplinary approach involving the surgeon, anesthesiologist, and ICU team is essential to ensure optimal perioperative management of patients with pheochromocytoma. Intensive hemodynamic monitoring may be required in the postoperative period to manage hypotension seen after tumor removal. In conclusion, perioperative HI is a significant risk during the surgical removal of pheochromocytomas, even with preoperative pharmacological treatment. Therefore, the use of appropriate preoperative medical optimization, surgical and anesthetic techniques, and careful intraoperative management can significantly improve the outcomes.
{"title":"Perioperative hemodynamic management in surgery for phaeochromocytoma: A narrative review","authors":"B. Krishna, D. Khurana, Santvana Kohli, K. Sharma, R. Gandhi","doi":"10.4103/theiaforum.theiaforum_32_23","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_32_23","url":null,"abstract":"Pheochromocytomas are rare adrenal tumors that produce excessive catecholamines and their surgical removal poses significant risks of intraoperative hemodynamic instability (HI) due to catecholamine release. This review article discusses the perioperative factors that impact hemodynamic lability and its management in patients undergoing surgical removal. A literature review was conducted by searching the electronic databases - Ovid MEDLINE, Embase, and Cochrane Library using appropriate Medical Subject Heading terms and keywords such as phaeochromocytoma, HI, and perioperative hemodynamic monitoring. The advancements in surgical and anesthetic techniques and appropriate preoperative medical optimization have contributed to a significant decrease in mortality rates. However, perioperative HI remains the biggest surgical and anesthetic challenge in treating pheochromocytomas. Patients with larger and more hormonally active tumors are at higher risk for extreme hypertensive episodes during surgery. Preoperative α-blockade, higher phenoxybenzamine doses, and laparoscopic approach improve the outcomes in phaeochromocytoma removal. Anesthetic techniques and drugs used during surgery may help prevent HI, but careful intraoperative management is essential. Perioperative HI can lead to increased surgical blood loss, patient morbidity, and prolonged intensive care unit (ICU) and hospital stay. Therefore, a multidisciplinary approach involving the surgeon, anesthesiologist, and ICU team is essential to ensure optimal perioperative management of patients with pheochromocytoma. Intensive hemodynamic monitoring may be required in the postoperative period to manage hypotension seen after tumor removal. In conclusion, perioperative HI is a significant risk during the surgical removal of pheochromocytomas, even with preoperative pharmacological treatment. Therefore, the use of appropriate preoperative medical optimization, surgical and anesthetic techniques, and careful intraoperative management can significantly improve the outcomes.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"24 1","pages":"11 - 20"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44986109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/theiaforum.theiaforum_28_22
Rashmi Syal, P. Sethi, M. Kaur, P. Bhatia
{"title":"Communication is the key – Let's not forget it!!","authors":"Rashmi Syal, P. Sethi, M. Kaur, P. Bhatia","doi":"10.4103/theiaforum.theiaforum_28_22","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_28_22","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"24 1","pages":"78 - 79"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47321506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/theiaforum.theiaforum_26_23
Nirav Parikh, Hasmukh Patel, Deepal Prajapti, Ankit Chauhan, Mrugesh Prajapati, R. Patel, Himani Pandya, V. Arora, Deepti Dhawalikar
Background and Aims: Cardiovascular (CV) complications of coronavirus disease 2019 (COVID-19) are neither well-defined nor comprehensively characterized. Hence, long-term studies are required to monitor silent but progressive CV complications postrecovery in COVID-19 patients. Our aim of the study was to assess and determine the presence of CV morbidity and mortality in COVID-19 patients. Materials and Methods: A retrospective study was conducted at our institute. All COVID-19-positive patients who were admitted in the intensive care unit during April 3, 2020–May 23, 2021, were recruited for the study. A total of 1460 patients were enrolled and monitored until discharge/death. Patients were evaluated based on demographics, clinical data, and laboratory values and 42 patients among them underwent coronary angiography for an adequate understanding of CV complications. Results: The total reported deaths among the study sample were 453 (31%). Common preexisting clinical conditions among them were hypertension 520 (35.6%), diabetes 211 (14.45%), CV disease 88 (6.02%), and hypothyroidism 61 (4.17%). A total of 149 patients displayed elevated creatine phosphokinase-MB (CPK-MB) levels, while 141 patients displayed elevated hs-TnI levels. The absolute rise of cardiac troponin (hs-TnI) and CPK-MB displayed a technically positive correlation, but a weaker relationship (r: 0.2113, P < 0.01 for correlation). Twenty-two out of 42 patients showed the presence of single/multivessel disease and 31 patients displayed mild-to-severe left ventricular dysfunction. Conclusions: The results of the current study provide evidence for the risk and burden of CV complications among COVID-19 patients. Hence, attention to long-term CV health and disease among COVID-19 survivors is necessary.
背景和目的:2019冠状病毒病(COVID-19)的心血管(CV)并发症既没有明确的定义，也没有全面的特征。因此，需要长期研究来监测COVID-19患者康复后无症状但进展的CV并发症。我们的研究目的是评估和确定COVID-19患者中CV发病率和死亡率的存在。材料与方法:在我院进行回顾性研究。研究招募了2020年4月3日至2021年5月23日期间入住重症监护病房的所有covid -19阳性患者。共有1460名患者入组并进行监测，直至出院/死亡。根据人口统计学、临床数据和实验室值对患者进行评估，其中42例患者接受了冠状动脉造影，以充分了解心血管并发症。结果:研究样本中报告的死亡总数为453例(31%)。其中高血压520例(35.6%)、糖尿病211例(14.45%)、心血管疾病88例(6.02%)、甲状腺功能减退61例(4.17%)。共有149例患者显示肌酸磷酸激酶- mb (CPK-MB)水平升高，141例患者显示hs-TnI水平升高。心肌肌钙蛋白(hs-TnI)绝对升高与CPK-MB呈技术正相关，但相关性较弱(r: 0.2113, P < 0.01)。42例患者中有22例出现单/多血管疾病，31例出现轻至重度左心室功能障碍。结论:本研究结果为COVID-19患者CV并发症的风险和负担提供了证据。因此，有必要关注COVID-19幸存者的长期CV健康和疾病。
{"title":"Cardiovascular complications in coronavirus disease-2019 patients","authors":"Nirav Parikh, Hasmukh Patel, Deepal Prajapti, Ankit Chauhan, Mrugesh Prajapati, R. Patel, Himani Pandya, V. Arora, Deepti Dhawalikar","doi":"10.4103/theiaforum.theiaforum_26_23","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_26_23","url":null,"abstract":"Background and Aims: Cardiovascular (CV) complications of coronavirus disease 2019 (COVID-19) are neither well-defined nor comprehensively characterized. Hence, long-term studies are required to monitor silent but progressive CV complications postrecovery in COVID-19 patients. Our aim of the study was to assess and determine the presence of CV morbidity and mortality in COVID-19 patients. Materials and Methods: A retrospective study was conducted at our institute. All COVID-19-positive patients who were admitted in the intensive care unit during April 3, 2020–May 23, 2021, were recruited for the study. A total of 1460 patients were enrolled and monitored until discharge/death. Patients were evaluated based on demographics, clinical data, and laboratory values and 42 patients among them underwent coronary angiography for an adequate understanding of CV complications. Results: The total reported deaths among the study sample were 453 (31%). Common preexisting clinical conditions among them were hypertension 520 (35.6%), diabetes 211 (14.45%), CV disease 88 (6.02%), and hypothyroidism 61 (4.17%). A total of 149 patients displayed elevated creatine phosphokinase-MB (CPK-MB) levels, while 141 patients displayed elevated hs-TnI levels. The absolute rise of cardiac troponin (hs-TnI) and CPK-MB displayed a technically positive correlation, but a weaker relationship (r: 0.2113, P < 0.01 for correlation). Twenty-two out of 42 patients showed the presence of single/multivessel disease and 31 patients displayed mild-to-severe left ventricular dysfunction. Conclusions: The results of the current study provide evidence for the risk and burden of CV complications among COVID-19 patients. Hence, attention to long-term CV health and disease among COVID-19 survivors is necessary.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"24 1","pages":"54 - 57"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41544959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/theiaforum.theiaforum_109_22
T. Bansal, Mamta Jain, A. Singh, J. Lal
{"title":"Morbidly obese patient for percutaneous nephrolithotomy in prone position – Feasibility of unilateral spinal anesthesia?","authors":"T. Bansal, Mamta Jain, A. Singh, J. Lal","doi":"10.4103/theiaforum.theiaforum_109_22","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_109_22","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"24 1","pages":"85 - 86"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46227488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/theiaforum.theiaforum_82_22
Navneh Samagh, M. Panditrao, M. Panditrao, N. Singh
{"title":"Rhythm disturbances and their management in a case of Ebstein's anomaly","authors":"Navneh Samagh, M. Panditrao, M. Panditrao, N. Singh","doi":"10.4103/theiaforum.theiaforum_82_22","DOIUrl":"https://doi.org/10.4103/theiaforum.theiaforum_82_22","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"24 1","pages":"79 - 80"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47044487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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