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Assessment of the Level of Awareness and Degree of Implementation of Central Line Bundles for Prevention of Central Line-associated Blood Stream Infection: A Questionnaire-based Observational Study. 评估对预防中心管路相关血流感染的中心管路捆绑包的认识水平和实施程度:基于问卷的观察研究。
IF 1.5 Q3 CRITICAL CARE MEDICINE Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.5005/jp-journals-10071-24785
Shailendra Singh, Abhishek Sharma, Manish Dhawan, Seerat P Sharma

Aim: The objective of this study was to assess the extent of knowledge and application of central line bundles in the intensive care unit (ICU) of a tertiary care hospital for the purpose of avoiding central line-associated bloodstream infections (CLABSI). This assessment was conducted through the use of a questionnaire.

Materials and methods: A cross-sectional study was conducted in the ICU, involving doctors and nurses. The study was observational in nature. The study employed a methodical validated questionnaire to evaluate the level of knowledge, attitude, and practice of central line bundles for the prevention of central line-associated bloodstream infections (CLABSI). The questionnaire was designed using preexisting awareness surveillance systems, infection control measures, and patient care practices that were specifically relevant to CLABSIs in the ICU. The data were analyzed utilizing SPSS.

Results: The research involved a total of 93 healthcare professionals, consisting of 67 physicians and 26 nurses. The mean knowledge score among participants was 82%, with higher scores reported in individuals who had training in central line bundles. Healthcare professionals exhibited robust compliance with hand cleanliness, antiseptic skin preparation prior to insertion, aseptic draping of the patient, utilization of utmost sterile barriers, verification of central venous catheter (CVC) tip placement using chest X-ray or fluoroscopy, and preservation of a sterile environment.

Conclusion: The study emphasized the significance of training in enhancing understanding and adherence to central line bundling protocols in ICUs. Participants exhibited a high level of knowledge and commitment to recommended practices, indicating that this training can have a favorable effect on CLABSI rates.

How to cite this article: Singh S, Sharma A, Dhawan M, Sharma SP. Assessment of the Level of Awareness and Degree of Implementation of Central Line bundles for Prevention of Central Line-associated Blood Stream Infection: A Questionnaire-based Observational Study. Indian J Crit Care Med 2024;28(9):847-853.

目的:本研究旨在评估一家三级医院重症监护室(ICU)对中心管路捆绑系统的了解和应用程度,以避免中心管路相关血流感染(CLABSI)。这项评估是通过问卷调查进行的:在重症监护室开展了一项横断面研究,参与人员包括医生和护士。研究具有观察性质。研究采用了一份经过方法验证的调查问卷,以评估预防中心管路相关血流感染(CLABSI)的中心管路捆绑的知识、态度和实践水平。调查问卷是根据与重症监护室中 CLABSIs 特别相关的现有意识监测系统、感染控制措施和患者护理实践设计的。数据使用 SPSS 进行分析:研究共涉及 93 名医护人员,其中包括 67 名医生和 26 名护士。参与者的平均知识得分率为 82%,接受过中央管路捆绑培训的人员得分更高。医护人员在以下方面表现出了很强的依从性:手部清洁、插入前的消毒备皮、为患者无菌铺巾、使用最大限度的无菌屏障、使用胸部 X 光或透视检查验证中心静脉导管 (CVC) 尖端的位置以及保持无菌环境:该研究强调了培训对于加深重症监护病房对中心静脉管路捆绑协议的理解和遵守的重要意义。参加培训的人员对推荐的操作方法表现出了高度的了解和承诺,这表明培训对降低 CLABSI 感染率有积极作用:Singh S, Sharma A, Dhawan M, Sharma SP.评估对预防中心静脉相关血流感染的认识水平和中心静脉捆绑措施的实施程度:基于问卷的观察研究。Indian J Crit Care Med 2024;28(9):847-853.
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引用次数: 0
Author Response: Outcome Predictors of an Intracerebral Hemorrhage also Depend on the Causes of the Bleeding. 作者回复:脑出血的预后因素也取决于出血原因。
IF 1.5 Q3 CRITICAL CARE MEDICINE Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.5005/jp-journals-10071-24788
Darpanarayan Hazra

How to cite this article: Hazra D. Author Response: Outcome Predictors of an Intracerebral Hemorrhage also Depend on the Causes of the Bleeding. Indian J Crit Care Med 2024;28(9):892-893.

如何引用本文:Hazra D. Author Response:脑出血的预后因素也取决于出血原因。Indian J Crit Care Med 2024;28(9):892-893.
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引用次数: 0
Effect of Continuous Infusion vs Bolus Dose of Hydrocortisone in Septic Shock: A Prospective Randomized Study. 脓毒性休克中持续输注与注射氢化可的松的效果:一项前瞻性随机研究。
IF 1.5 Q3 CRITICAL CARE MEDICINE Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.5005/jp-journals-10071-24793
Rashmi Salhotra, Ajeeb Sharahudeen, Asha Tyagi, Rajesh S Rautela, Rajit Kemprai

Aim and background: Corticosteroids are recommended for use in adult patients with septic shock requiring vasopressors for blood pressure maintenance. However, this predisposes them to hyperglycemia, which is associated with a poor outcome. This prospective randomized study compares the effect of continuous infusion with bolus hydrocortisone on blood glucose levels in septic shock.

Materials and methods: Forty adult patients with sepsis and septic shock requiring vasopressor support were randomly allocated to either group C (continuous infusion of hydrocortisone 200 mg/day) or group B (intermittent bolus dose of hydrocortisone 50 mg IV 6 hourly). Blood glucose level (primary objective), number of hyperglycemic and hypoglycemic episodes, daily insulin requirement, shock reversal incidence, time to shock reversal, and nursing workload required to maintain blood glucose within the target range (82-180 mg/dL) were compared.

Results: The mean blood glucose level was comparable in the two groups (136.5 ± 22.08 mg/dL in group C vs 135.85 ± 19.06 mg/dL in group B; p = 0.921). The number of hyperglycemic and hypoglycemic episodes (p = 1.000 each), insulin requirement/day (p = 1.000), and nursing workload (p = 0.751) were also comparable among groups. Shock reversal was seen in 7/20 (35%) patients in continuous group and 12/20 (60%) patients in bolus group (p = 0.113). Time to shock reversal (p = 0.917) and duration of ICU stay (p = 0.751) were also statistically comparable.

Conclusion: Both the regimes of hydrocortisone, continuous infusion, and bolus dose, have comparable effects on blood glucose levels in patients with septic shock.The study was registered prospectively with ctri.nic.in (Ref. No. CTRI/2021/01/030342; registered on 8/1/2021).

How to cite this article: Salhotra R, Sharahudeen A, Tyagi A, Rautela RS, Kemprai R. Effect of Continuous Infusion vs Bolus Dose of Hydrocortisone in Septic Shock: A Prospective Randomized Study. Indian J Crit Care Med 2024;28(9):837-841.

目的和背景:建议对需要使用血管加压剂维持血压的脓毒性休克成人患者使用皮质类固醇。然而,这容易导致高血糖,而高血糖与不良预后有关。这项前瞻性随机研究比较了持续输注和栓塞氢化可的松对脓毒性休克患者血糖水平的影响:40 名需要血管加压支持的脓毒症和脓毒性休克成人患者被随机分配到 C 组(连续输注氢化可的松 200 毫克/天)或 B 组(间歇性栓剂氢化可的松 50 毫克静脉注射,每 6 小时一次)。比较血糖水平(主要目标)、高血糖和低血糖发作次数、每日胰岛素需求量、休克逆转发生率、休克逆转时间以及将血糖维持在目标范围(82-180 毫克/分升)所需的护理工作量:两组的平均血糖水平相当(C 组为 136.5 ± 22.08 mg/dL vs B 组为 135.85 ± 19.06 mg/dL; p = 0.921)。各组的高血糖和低血糖发作次数(p = 1.000)、胰岛素需求量/天(p = 1.000)和护理工作量(p = 0.751)也相当。连续用药组有 7/20 例(35%)患者出现休克逆转,栓剂用药组有 12/20 例(60%)患者出现休克逆转(p = 0.113)。休克逆转时间(p = 0.917)和重症监护室住院时间(p = 0.751)在统计学上也具有可比性:该研究在ctri.nic.in进行了前瞻性登记(编号:CTRI/2021/01/030342;登记日期:2021年1月8日):Salhotra R, Sharahudeen A, Tyagi A, Rautela RS, Kemprai R.脓毒性休克持续输注与静脉注射氢化可的松的效果:前瞻性随机研究。Indian J Crit Care Med 2024;28(9):837-841.
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引用次数: 0
Outcome Predictors of an Intracerebral Hemorrhage also Depend on the Causes of the Bleeding. 脑内出血的预后也取决于出血的原因。
IF 1.5 Q3 CRITICAL CARE MEDICINE Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.5005/jp-journals-10071-24775
Josef Finsterer

How to cite this article: Finsterer J. Outcome Predictors of an Intracerebral Hemorrhage also Depend on the Causes of the Bleeding. Indian J Crit Care Med 2024;28(9):890-891.

如何引用本文:Finsterer J. 脑内出血的预后因素也取决于出血原因。Indian J Crit Care Med 2024;28(9):890-891.
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引用次数: 0
Oxygenation Indices in Adult COVID ARDS Patients. COVID ARDS 成人患者的氧合指数。
IF 1.5 Q3 CRITICAL CARE MEDICINE Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.5005/jp-journals-10071-24632
Sunitha Palanidurai, Jason Phua, Amartya Mukhopadhyay

How to cite this article: Palanidurai S, Phua J, Mukhopadhyay A. Oxygenation Indices in Adult COVID ARDS Patients. Indian J Crit Care Med 2024;28(9):887-888.

本文引用方式Palanidurai S, Phua J, Mukhopadhyay A. Oxygenation Indices in Adult COVID ARDS Patients.Indian J Crit Care Med 2024;28(9):887-888.
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引用次数: 0
The HScore to Diagnose HLH in Scrub Typhus: Overdiagnosis or under Diagnosis and Does It Really Matter? 诊断恙虫病 HLH 的 HScore:诊断过度还是诊断不足?
IF 1.5 Q3 CRITICAL CARE MEDICINE Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.5005/jp-journals-10071-24802
Ashit Hegde

How to cite this article: Hegde A. The HScore to Diagnose HLH in Scrub Typhus: Overdiagnosis or under Diagnosis and Does It Really Matter? Indian J Crit Care Med 2024;28(9):811-812.

如何引用本文:Hegde A. The HScore to Diagnose HLH in Scrub Typhus:过度诊断还是诊断不足?Indian J Crit Care Med 2024;28(9):811-812.
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引用次数: 0
Prevalence of Diastolic Dysfunction in Critically Ill Patients Admitted to Intensive Care Unit from a Tertiary Care Hospital: A Prospective Observational Study. 一家三级医院重症监护室收治的重症患者舒张功能障碍的患病率:一项前瞻性观察研究
IF 1.5 Q3 CRITICAL CARE MEDICINE Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.5005/jp-journals-10071-24794
Bipin Luitel, Muthapillai Senthilnathan, Anusha Cherian, Srinivasan Suganya, Prashant S Adole

Aim: Critically ill individuals may have left ventricular diastolic dysfunction (LVDD) which can prolong their intensive care unit (ICU) stay. The purpose of this study was to determine the prevalence of LVDD in critically ill adult patients requiring mechanical ventilation in ICU, the effect of LVDD on 28-day survival, and weaning from mechanical ventilation.

Methodology: A total of 227 adults who had been on mechanical ventilation for more than 48 hours in an ICU were recruited for this study. The study's parameters were recorded on the third day of mechanical ventilation using a low-frequency phased array probe. A simplified definition of LVDD in critically ill adults was utilized to determine the presence or absence of LVDD. Weaning failure and 28-day mortality were noted.

Results: The prevalence of LVDD in adults requiring mechanical ventilation in the ICU was found to be 35.4% (n = 79). Patients with LVDD had the odds of having a 28-day mortality increase by 7.48 (95% CI: 3.24-17.26, p < 0.0001). Patients with LVDD had the odds of having weaning failure increase by 5.37 (95% CI: 2.17-13.26, p = 0.0003).

Conclusion: Measures should be taken to detect critically ill adults with LVDD with systolic dysfunction or heart failure with preserved ejection fraction early so that their fluid balance, myocardial contractility, and afterload can be optimized to minimize their morbidity and mortality.

Highlights: Critically ill adults with LVDD may have adverse outcomes. Hence, protocol should be in place for diagnosing LVDD early in critically ill adults thereby, measures can be taken to minimize morbidity in those patients.

How to cite this article: Luitel B, Senthilnathan M, Cherian A, Suganya S, Adole PS. Prevalence of Diastolic Dysfunction in Critically Ill Patients Admitted to Intensive Care Unit from a Tertiary Care Hospital: A Prospective Observational Study. Indian J Crit Care Med 2024;28(9):832-836.

目的:重症患者可能存在左心室舒张功能障碍(LVDD),这会延长重症监护病房(ICU)的住院时间。本研究旨在确定需要在重症监护室接受机械通气的成年重症患者中左心室舒张功能障碍的发病率、左心室舒张功能障碍对 28 天存活率的影响以及机械通气的断流情况:本研究共招募了 227 名在重症监护室接受机械通气超过 48 小时的成人患者。研究参数在机械通气第三天使用低频相控阵探头记录。研究采用了重症成人 LVDD 的简化定义来确定是否存在 LVDD。结果表明,断奶失败率和 28 天死亡率均有所下降:结果:在重症监护室需要机械通气的成人中,LVDD 的发病率为 35.4%(n = 79)。LVDD患者的28天死亡率增加了7.48(95% CI:3.24-17.26,P <0.0001)。LVDD患者断奶失败的几率增加了5.37(95% CI:2.17-13.26,p = 0.0003):结论:应采取措施及早发现患有收缩功能障碍或射血分数保留型心力衰竭的 LVDD 重症成人患者,以便优化他们的体液平衡、心肌收缩力和后负荷,最大限度地降低他们的发病率和死亡率:亮点:患有 LVDD 的重症成人可能会出现不良后果。因此,应制定早期诊断成人重症患者 LVDD 的方案,从而采取措施将这些患者的发病率降至最低:Luitel B, Senthilnathan M, Cherian A, Suganya S, Adole PS.一家三级医院重症监护室收治的重症患者中舒张功能障碍的患病率:前瞻性观察研究》。Indian J Crit Care Med 2024;28(9):832-836.
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引用次数: 0
Hydrocortisone for Septic Shock, Bolus or Infusion: Pro, Con, May be. 氢化可的松治疗脓毒性休克,注射还是输注?赞成、反对、可能
IF 1.5 Q3 CRITICAL CARE MEDICINE Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.5005/jp-journals-10071-24798
Subhash Todi

How to cite this article: Todi S. Hydrocortisone for Septic Shock, Bolus or Infusion: Pro, Con, May be. Indian J Crit Care Med 2024;28(9):816-817.

如何引用本文:Todi S. 氢化可的松治疗脓毒性休克,静脉注射还是静脉输注:赞成、反对、可能。Indian J Crit Care Med 2024;28(9):816-817.
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引用次数: 0
Author Response: Nocturnal Infusion of Low-dose Dexmedetomidine and Propofol for Delirium Prevention. 作者回复:夜间输注低剂量右美托咪定和丙泊酚预防谵妄。
IF 1.5 Q3 CRITICAL CARE MEDICINE Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.5005/jp-journals-10071-24791
Gamonmas Ekkapat, Nalin Chokengarmwong

How to cite this article: Ekkapat G, Chokengarmwong N. Author Response: Nocturnal Infusion of Low-dose Dexmedetomidine and Propofol for Delirium Prevention. Indian J Crit Care Med 2024;28(9):896.

如何引用本文:Ekkapat G, Chokengarmwong N. Author Response:夜间输注低剂量右美托咪定和丙泊酚预防谵妄。Indian J Crit Care Med 2024;28(9):896.
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引用次数: 0
Nocturnal Infusion of Low-dose Dexmedetomidine and Propofol for Prevention of Delirium Occurring in the ICU after Hip Fracture Surgery in Elderly Patients. 夜间输注低剂量右美托咪定和丙泊酚预防老年髋部骨折手术后在重症监护室出现谵妄。
IF 1.5 Q3 CRITICAL CARE MEDICINE Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.5005/jp-journals-10071-24780
Ning Cong, Dan-Feng Wang, Fu-Shan Xue

How to cite this article: Cong N, Wang D, Xue F. Nocturnal Infusion of Low-dose Dexmedetomidine and Propofol for Prevention of Delirium Occurring in the ICU after Hip Fracture Surgery in Elderly Patients. Indian J Crit Care Med 2024;28(9):894-895.

本文引用方式Cong N, Wang D, Xue F. 低剂量右美托咪定和丙泊酚夜间输注预防老年髋部骨折术后ICU谵妄的研究.Indian J Crit Care Med 2024;28(9):894-895.
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引用次数: 0
期刊
Indian Journal of Critical Care Medicine
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