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Publisher: Medknow Publishers   (Total: 426 journals)

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Showing 1 - 200 of 426 Journals sorted alphabetically
Acta Medica Intl.     Open Access   (SJR: 0.101, CiteScore: 0)
Advanced Arab Academy of Audio-Vestibulogy J.     Open Access  
Advanced Biomedical Research     Open Access  
Advances in Human Biology     Open Access   (Followers: 4)
Advances in Skeletal Muscle Function Assessment     Open Access  
African J. for Infertility and Assisted Conception     Open Access  
African J. of Medical and Health Sciences     Open Access   (Followers: 2)
African J. of Paediatric Surgery     Open Access   (Followers: 7, SJR: 0.25, CiteScore: 1)
African J. of Trauma     Open Access   (Followers: 1)
Ain-Shams J. of Anaesthesiology     Open Access   (Followers: 3)
Al-Azhar Assiut Medical J.     Open Access  
Al-Basar Intl. J. of Ophthalmology     Open Access   (Followers: 1)
Alexandria J. of Pediatrics     Open Access  
Ancient Science of Life     Open Access   (Followers: 5)
Anesthesia : Essays and Researches     Open Access   (Followers: 10)
Annals of African Medicine     Open Access   (Followers: 2, SJR: 0.258, CiteScore: 1)
Annals of Bioanthropology     Open Access   (Followers: 4)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 14, SJR: 0.308, CiteScore: 1)
Annals of Indian Academy of Neurology     Open Access   (Followers: 3, SJR: 0.434, CiteScore: 1)
Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery     Open Access  
Annals of Indian Psychiatry     Open Access  
Annals of Maxillofacial Surgery     Open Access   (Followers: 6)
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 11, SJR: 0.352, CiteScore: 1)
Annals of Saudi Medicine     Open Access   (SJR: 0.238, CiteScore: 1)
Annals of Thoracic Medicine     Open Access   (Followers: 6, SJR: 0.524, CiteScore: 1)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 13, SJR: 0.152, CiteScore: 0)
Annals of Tropical Pathology     Open Access  
Apollo Medicine     Open Access  
APOS Trends in Orthodontics     Open Access   (Followers: 1)
Arab J. of Interventional Radiology     Open Access  
Archives of Cardiovascular Imaging     Open Access   (Followers: 2, SJR: 0.187, CiteScore: 0)
Archives of Intl. Surgery     Open Access   (Followers: 10, SJR: 0.302, CiteScore: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Medicine and Surgery     Open Access  
Archives of Pharmacy Practice     Open Access   (Followers: 10, SJR: 0.102, CiteScore: 0)
Archives of Trauma Research     Open Access   (Followers: 3, SJR: 0.37, CiteScore: 2)
Asia Pacific J. of Clinical Trials : Nervous System Diseases     Open Access  
Asia-Pacific J. of Oncology Nursing     Open Access   (Followers: 5)
Asian J. of Andrology     Open Access   (Followers: 1, SJR: 0.856, CiteScore: 2)
Asian J. of Neurosurgery     Open Access   (Followers: 2)
Asian J. of Oncology     Open Access   (Followers: 2)
Asian J. of Transfusion Science     Open Access   (Followers: 1, SJR: 0.35, CiteScore: 1)
Asian Pacific J. of Reproduction     Open Access   (SJR: 0.227, CiteScore: 1)
Asian Pacific J. of Tropical Biomedicine     Open Access   (Followers: 2, SJR: 0.491, CiteScore: 2)
Asian Pacific J. of Tropical Medicine     Open Access   (Followers: 1, SJR: 0.561, CiteScore: 2)
Astrocyte     Open Access  
Avicenna J. of Medicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
Benha Medical J.     Open Access  
Biomedical and Biotechnology Research J.     Open Access  
BLDE University J. of Health Sciences     Open Access  
Brain Circulation     Open Access   (Followers: 1)
Bulletin of Faculty of Physical Therapy     Open Access   (Followers: 1)
Canadian J. of Rural Medicine     Full-text available via subscription   (SJR: 0.202, CiteScore: 0)
Cancer Translational Medicine     Open Access   (Followers: 2)
Cardiology Plus     Open Access   (Followers: 1)
Chinese Medical J.     Open Access   (Followers: 10, SJR: 0.52, CiteScore: 1)
CHRISMED J. of Health and Research     Open Access   (Followers: 2)
Clinical Cancer Investigation J.     Open Access  
Clinical Dermatology Review     Open Access   (Followers: 4)
Clinical Trials in Degenerative Diseases     Open Access  
Clinical Trials in Orthopedic Disorders     Open Access  
Community Acquired Infection     Open Access  
Conservation and Society     Open Access   (Followers: 9, SJR: 0.811, CiteScore: 2)
Contemporary Clinical Dentistry     Open Access   (Followers: 4, SJR: 0.353, CiteScore: 1)
Current Medical Issues     Open Access   (Followers: 1)
CytoJ.     Open Access   (Followers: 2, SJR: 0.543, CiteScore: 1)
Delta J. of Ophthalmology     Open Access  
Dental Hypotheses     Open Access   (Followers: 4, SJR: 0.152, CiteScore: 0)
Dental Research J.     Open Access   (Followers: 12, SJR: 0.416, CiteScore: 1)
Dentistry and Medical Research     Open Access  
Digital Medicine     Open Access  
Drug Development and Therapeutics     Open Access  
Education for Health     Open Access   (Followers: 6, SJR: 0.242, CiteScore: 0)
Egyptian J. of Bronchology     Open Access  
Egyptian J. of Cardiothoracic Anesthesia     Open Access  
Egyptian J. of Cataract and Refractive Surgery     Open Access   (Followers: 1, SJR: 1.799, CiteScore: 2)
Egyptian J. of Chest Diseases and Tuberculosis     Open Access   (Followers: 3, SJR: 0.155, CiteScore: 0)
Egyptian J. of Dermatology and Venerology     Open Access   (Followers: 1)
Egyptian J. of Haematology     Open Access   (Followers: 1)
Egyptian J. of Internal Medicine     Open Access   (Followers: 1)
Egyptian J. of Obesity, Diabetes and Endocrinology     Open Access   (Followers: 1)
Egyptian J. of Otolaryngology     Open Access   (Followers: 2)
Egyptian J. of Psychiatry     Open Access   (Followers: 2)
Egyptian J. of Surgery     Open Access   (Followers: 1)
Egyptian Nursing J.     Open Access  
Egyptian Orthopaedic J.     Open Access   (Followers: 2)
Egyptian Pharmaceutical J.     Open Access   (Followers: 3)
Egyptian Retina J.     Open Access  
Egyptian Rheumatology and Rehabilitation     Open Access   (Followers: 2)
Endodontology     Open Access  
Endoscopic Ultrasound     Open Access   (SJR: 0.822, CiteScore: 2)
Environmental Disease     Open Access   (Followers: 3)
Eurasian J. of Pulmonology     Open Access  
European J. of Dentistry     Open Access   (Followers: 2, SJR: 0.749, CiteScore: 2)
European J. of General Dentistry     Open Access   (Followers: 1, SJR: 0.12, CiteScore: 0)
European J. of Prosthodontics     Open Access   (Followers: 3)
European J. of Psychology and Educational Studies     Open Access   (Followers: 11, SJR: 0.113, CiteScore: 0)
Fertility Science and Research     Open Access  
Formosan J. of Surgery     Open Access   (SJR: 0.112, CiteScore: 0)
Genome Integrity     Open Access   (Followers: 2, SJR: 0.153, CiteScore: 0)
Glioma     Open Access  
Global J. of Transfusion Medicine     Open Access   (Followers: 1)
Gynecology and Minimally Invasive Therapy     Open Access   (SJR: 0.311, CiteScore: 1)
Hamdan Medical J.     Open Access  
Heart and Mind     Open Access  
Heart India     Open Access   (Followers: 1)
Heart Views     Open Access   (Followers: 2)
Hepatitis B Annual     Open Access   (Followers: 3)
Ibnosina J. of Medicine and Biomedical Sciences     Open Access  
IJS Short Reports     Open Access  
Imam J. of Applied Sciences     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 3)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 7, SJR: 0.478, CiteScore: 1)
Indian J. of Burns     Open Access   (Followers: 1)
Indian J. of Cancer     Open Access   (Followers: 1, SJR: 0.361, CiteScore: 1)
Indian J. of Cerebral Palsy     Open Access   (Followers: 1)
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.37, CiteScore: 1)
Indian J. of Dental Research     Open Access   (Followers: 5, SJR: 0.266, CiteScore: 1)
Indian J. of Dental Sciences     Open Access  
Indian J. of Dentistry     Open Access   (Followers: 1)
Indian J. of Dermatology     Open Access   (Followers: 2, SJR: 0.468, CiteScore: 1)
Indian J. of Dermatology, Venereology and Leprology     Open Access   (Followers: 4, SJR: 0.445, CiteScore: 1)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access   (Followers: 1, SJR: 0.791, CiteScore: 1)
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4, SJR: 0.568, CiteScore: 1)
Indian J. of Health Sciences and Biomedical Research KLEU     Open Access   (Followers: 2)
Indian J. of Medical and Paediatric Oncology     Open Access   (SJR: 0.425, CiteScore: 1)
Indian J. of Medical Microbiology     Open Access   (Followers: 2, SJR: 0.503, CiteScore: 1)
Indian J. of Medical Research     Open Access   (Followers: 4, SJR: 0.656, CiteScore: 1)
Indian J. of Medical Sciences     Open Access   (Followers: 2, SJR: 0.102, CiteScore: 0)
Indian J. of Multidisciplinary Dentistry     Open Access   (Followers: 1)
Indian J. of Nephrology     Open Access   (Followers: 2, SJR: 0.347, CiteScore: 1)
Indian J. of Nuclear Medicine     Open Access   (Followers: 2, SJR: 0.23, CiteScore: 0)
Indian J. of Occupational and Environmental Medicine     Open Access   (Followers: 3, SJR: 0.225, CiteScore: 1)
Indian J. of Ophthalmology     Open Access   (Followers: 4, SJR: 0.498, CiteScore: 1)
Indian J. of Oral Health and Research     Open Access  
Indian J. of Oral Sciences     Open Access   (Followers: 1)
Indian J. of Orthopaedics     Open Access   (Followers: 8, SJR: 0.392, CiteScore: 1)
Indian J. of Otology     Open Access   (Followers: 1, SJR: 0.199, CiteScore: 0)
Indian J. of Paediatric Dermatology     Open Access   (Followers: 2)
Indian J. of Pain     Open Access   (Followers: 2)
Indian J. of Palliative Care     Open Access   (Followers: 6, SJR: 0.454, CiteScore: 1)
Indian J. of Pathology and Microbiology     Open Access   (Followers: 2, SJR: 0.276, CiteScore: 1)
Indian J. of Pharmacology     Open Access   (SJR: 0.412, CiteScore: 1)
Indian J. of Plastic Surgery     Open Access   (Followers: 12, SJR: 0.311, CiteScore: 0)
Indian J. of Psychiatry     Open Access   (Followers: 3, SJR: 0.408, CiteScore: 1)
Indian J. of Psychological Medicine     Open Access   (SJR: 0.368, CiteScore: 1)
Indian J. of Public Health     Open Access   (Followers: 1)
Indian J. of Radiology and Imaging     Open Access   (Followers: 4)
Indian J. of Research in Homoeopathy     Open Access  
Indian J. of Respiratory Care     Open Access  
Indian J. of Rheumatology     Open Access   (Followers: 1, SJR: 0.119, CiteScore: 0)
Indian J. of Sexually Transmitted Diseases and AIDS     Open Access   (Followers: 2, SJR: 0.34, CiteScore: 0)
Indian J. of Social Psychiatry     Open Access   (Followers: 2)
Indian J. of Transplantation     Open Access  
Indian J. of Urology     Open Access   (Followers: 3, SJR: 0.434, CiteScore: 1)
Indian J. of Vascular and Endovascular Surgery     Open Access   (Followers: 2)
Indian Spine J.     Open Access  
Industrial Psychiatry J.     Open Access   (Followers: 2)
Intervention     Open Access   (Followers: 1)
Intl. Archives of Health Sciences     Open Access  
Intl. J. of Abdominal Wall and Hernia Surgery     Open Access   (Followers: 1)
Intl. J. of Academic Medicine     Open Access  
Intl. J. of Advanced Medical and Health Research     Open Access  
Intl. J. of Applied and Basic Medical Research     Open Access  
Intl. J. of Clinical and Experimental Physiology     Open Access   (Followers: 1)
Intl. J. of Clinicopathological Correlation     Open Access   (Followers: 1)
Intl. J. of Community Dentistry     Open Access  
Intl. J. of Critical Illness and Injury Science     Open Access   (Followers: 1, SJR: 0.192, CiteScore: 0)
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 4)
Intl. J. of Environmental Health Engineering     Open Access   (Followers: 1)
Intl. J. of Forensic Odontology     Open Access   (Followers: 1)
Intl. J. of Green Pharmacy     Open Access   (Followers: 5, SJR: 0.142, CiteScore: 0)
Intl. J. of Growth Factors and Stem Cells in Dentistry     Open Access  
Intl. J. of Health & Allied Sciences     Open Access   (Followers: 3)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 3)
Intl. J. of Heart Rhythm     Open Access  
Intl. J. of Medicine and Public Health     Open Access   (Followers: 6)
Intl. J. of Mycobacteriology     Open Access   (SJR: 0.535, CiteScore: 1)
Intl. J. of Noncommunicable Diseases     Open Access  
Intl. J. of Nutrition, Pharmacology, Neurological Diseases     Open Access   (Followers: 4, SJR: 0.17, CiteScore: 0)
Intl. J. of Oral Health Sciences     Open Access   (Followers: 3)
Intl. J. of Orofacial Biology     Open Access   (Followers: 1)
Intl. J. of Orofacial Research     Open Access   (Followers: 1)
Intl. J. of Orthodontic Rehabilitation     Open Access   (Followers: 1)
Intl. J. of Pedodontic Rehabilitation     Open Access  
Intl. J. of Pharmaceutical Investigation     Open Access   (Followers: 2)
Intl. J. of Preventive Medicine     Open Access   (Followers: 1, SJR: 0.623, CiteScore: 1)
Intl. J. of Shoulder Surgery     Open Access   (Followers: 5, SJR: 0.653, CiteScore: 1)
Intl. J. of the Cardiovascular Academy     Open Access   (SJR: 0.105, CiteScore: 0)
Intl. J. of Trichology     Open Access   (SJR: 0.4, CiteScore: 1)
Intl. J. of Yoga     Open Access   (Followers: 15)
Intl. J. of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 6)
Iranian J. of Nursing and Midwifery Research     Open Access   (Followers: 3)
Iraqi J. of Hematology     Open Access  
J. of Academy of Medical Sciences     Open Access  

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Indian Journal of Respiratory Care
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2277-9019 - ISSN (Online) 2321-4899
Published by Medknow Publishers Homepage  [426 journals]
  • Scientific writing

    • Authors: Anitha Nileshwar
      Pages: 1 - 3
      Abstract: Anitha Nileshwar
      Indian Journal of Respiratory Care 2018 7(1):1-3

      Citation: Indian Journal of Respiratory Care 2018 7(1):1-3
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_27_17
      Issue No: Vol. 7, No. 1 (2018)
       
  • Strategies to prevent ventilator-associated lung injury in critically Ill
           patients

    • Authors: Alex Joseph, Muhammad Faisal Khan, Rajkumar Rajendram
      Pages: 4 - 13
      Abstract: Alex Joseph, Muhammad Faisal Khan, Rajkumar Rajendram
      Indian Journal of Respiratory Care 2018 7(1):4-13
      Life-saving mechanical ventilation (MV) induces or exacerbates a range of pulmonary pathologies, collectively known as ventilator-induced lung injury if there is evidence of direct causation (i.e., in the research laboratory). However, in clinical practice, the term ventilator-associated lung injury (VALI) is more appropriate. While several factors are involved, the main drivers of the pathogenesis are regional overdistention and clinical atelectasis. This understanding has led to search for strategies to attenuate VALI and improve survival. The current approaches focus on reduction of lung stress and strain by limitation of alveolar–plateau pressure and tidal volume. Recent data suggest that control of driving pressure (plateau pressure–positive end-expiratory pressure) and mechanical power applied during ventilation may also be beneficial. More exciting are the various new techniques for MV (e.g., airway pressure release ventilation and neurally adjusted ventilatory assist), emerging alternative modalities for gas exchange (e.g., extracorporeal membrane oxygenation), and novel biological therapies (e.g., anti-inflammatory stem cells) that promise to revolutionize the management of respiratory failure and relegate VALI to the ash heap of history. However, there are currently insufficient data to recommend their use in routine clinical practice.
      Citation: Indian Journal of Respiratory Care 2018 7(1):4-13
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_6_17
      Issue No: Vol. 7, No. 1 (2018)
       
  • Infection control in intensive care units

    • Authors: Chiranjay Mukhopadhyay
      Pages: 14 - 21
      Abstract: Chiranjay Mukhopadhyay
      Indian Journal of Respiratory Care 2018 7(1):14-21
      Infections acquired in the hospitals, especially in the intensive care unit (ICU) settings, ranging between 15% and 20%, may further lead to complications in >40% in critically ill patients. The order of incidence may vary in different settings, but the most usual causes are ventilator-associated pneumonia, intravascular catheter-associated bloodstream infection, catheter-associated urinary tract infection, posttraumatic intra-abdominal infection, and surgical site infection. These can be prevented by adequate and appropriate application of preventive strategies, which can be implemented strictly at the bedside. The basic norms for surveillance strategies, general preventive measures such as standard and isolation precautions and monitoring of antibiotic use should be followed without fail. Specific practical measures for ICU-related infections should be in place, and the monitoring of activities should be documented regularly as “bundle-care” in view of standardizing the practice, irrespective of place or person. Adequate attention, unfortunately, has not been paid for infection control measures in India for years. It is now mandatory that the essential practices are prioritized and integrated fully into regular hospital administrative procedure as a continuous process for improving quality health care.
      Citation: Indian Journal of Respiratory Care 2018 7(1):14-21
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_9_17
      Issue No: Vol. 7, No. 1 (2018)
       
  • Strategies in patients with right ventricular failure on mechanical
           ventilation

    • Authors: Nitin Tanajirao Patil
      Pages: 22 - 27
      Abstract: Nitin Tanajirao Patil
      Indian Journal of Respiratory Care 2018 7(1):22-27
      Right ventricular failure is a complex clinical syndrome, and is a challenge for the intensivist to diagnose in critically ill patients, more so in patients receiving mechanical ventilation. Acute RV failure is a sudden deterioration of RV function and an inability of the RV to pump adequate cardiac output to the pulmonary circulation, thereby leading to inadequate cardiac output to the systemic circulation. The most common causes of acute RV failure are acute RV myocardial infarction, massive pulmonary embolism, congenital heart diseases, and severe pulmonary arterial hypertension. Over the years, RV has been considered a passive chamber of the heart and has received less focus about the way it functions and how efficiently the RV dysfunction can be managed. The National Heart Lung and Blood Institute in 2006 convened a working group to better understand the mechanisms of right ventricular dysfunction and the various ways and means to diagnose and manage right ventricular dysfunction.
      Citation: Indian Journal of Respiratory Care 2018 7(1):22-27
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_22_17
      Issue No: Vol. 7, No. 1 (2018)
       
  • Temperature monitoring in the intensive care unit

    • Authors: Binila Chacko, John Victor Peter
      Pages: 28 - 32
      Abstract: Binila Chacko, John Victor Peter
      Indian Journal of Respiratory Care 2018 7(1):28-32
      Close monitoring and management of temperature abnormalities are crucial in the critically ill to minimize the physiological and biochemical ill effects of extremes of temperature. In the intensive care unit, core temperature monitoring using either urinary, nasopharyngeal, or esophageal temperatures is recommended. One needs to be aware of the pitfalls and fallacies of other commonly used sites.
      Citation: Indian Journal of Respiratory Care 2018 7(1):28-32
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_13_17
      Issue No: Vol. 7, No. 1 (2018)
       
  • Screening for obstructive sleep apnea using epworth sleepiness score and
           berlin questionnaire: Which is better?

    • Authors: Ramakant Dixit, Satyadeep Verma, Kamender Singh Pawar
      Pages: 33 - 36
      Abstract: Ramakant Dixit, Satyadeep Verma, Kamender Singh Pawar
      Indian Journal of Respiratory Care 2018 7(1):33-36
      Background: Obstructive sleep apnea (OSA) is a highly prevalent, but underdiagnosed and undertreated disorder. There is a need for simple but accurate tool for early detection of patients based on their clinical symptoms and physical findings into high- or low-risk group and give information for urgent polysomnography (PSG) and further treatment to prevent serious consequences. Epworth Sleepiness Score (ESS) and Berlin Questionnaire (BQ) are the most popular and widely acceptable instruments for identification of high-risk patients of OSA. The aim of our study was to compare these two established and well-known sleep questionnaires regarding their ability to find out the probable cases of OSA in Indian scenario. Methods: This cross-sectional study was conducted at a tertiary care center on 72 adult patients with symptoms of sleep-related breathing disorders. All patients were asked to fill both ESS and BQ questionnaires. Subsequently, all patients were subjected to level-1 PSG. For each patient, the Apnea–hypopnoea index was calculated to assess the diagnosis and severity of OSA and to further compare the ESS and BQ questionnaires for their sensitivity (SN) in OSA patients. Results: A total of 14 (19.4%) patients were diagnosed as OSA by ESS while by BQ, 32 (44.4%) patients were diagnosed as having OSA with SN of 31% and 71.11%, respectively (P = 0.00004). The positive predictive value was 82.3% and 88.8% for ESS and BQ, respectively, with a negative predictive value of 43.6% by ESS and 63.8% by BQ questionnaires. Conclusion: ESS is a less sensitive diagnostic tool for early detection of high-risk patients of OSA in general population. BQ is a valid, reliable, and more sensitive parameter to screen patients for OSA and may help in improving the quality of life in such patients with proper OSA management.
      Citation: Indian Journal of Respiratory Care 2018 7(1):33-36
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_20_17
      Issue No: Vol. 7, No. 1 (2018)
       
  • Comparison of extubation outcomes following T-piece trial versus pressure
           support/continous positive airway pressure in postsurgical patients

    • Authors: Lakshmi Kumar, AR Meghalakshmi, Anu Vasudevan, Sunil Rajan, Jerry Paul
      Pages: 37 - 41
      Abstract: Lakshmi Kumar, AR Meghalakshmi, Anu Vasudevan, Sunil Rajan, Jerry Paul
      Indian Journal of Respiratory Care 2018 7(1):37-41
      Background: Pressure support with continuous positive airway pressure (CPAP) and T-piece trials are the most common spontaneous breathing trial used to test readiness for extubation. Aim: We aimed to compare extubation failures defined by the need for reintubation within 48 h following T-piece trial versus extubation directly from pressure support (PS) ventilation in postoperative patients. Patients and Methods: This was a prospective cross-sectional study conducted in the postsurgical patients. Hemodynamic parameters and respiratory variables were measured before and after weaning trials. Outcomes after extubation, need for noninvasive-assist ventilation following extubation, duration of oxygen therapy, and time of shifting from the Intensive Care Unit (ICU) were also recorded. Results: Fifty patients needed mechanical ventilation postoperatively were recruited for the study. No significant differences were seen in the rate of extubation failures between PS- and T-piece groups. Rapid shallow breathing index recorded at the start of weaning was significantly higher in the T-piece group (P < 0.001). The respiratory rate (RR) and heart rate (HR) were significantly higher (P < 0.001) and saturation lower (P = 0.035) in the group on T-piece trial. The need for respiratory assist devices, oxygenation index, length of ICU stay, duration of oxygen therapy, and mortality were comparable between the two groups. Conclusions: Outcomes of weaning are similar between T piece and CPAP/PS in patients undergoing postoperative mechanical ventilation. Weaning on T piece is associated with higher RR, HR, rapid shallow breathing, and lower saturation than weaning from CPAP/PS but does not affect the length of ICU stay, need for oxygen therapy, or mortality.
      Citation: Indian Journal of Respiratory Care 2018 7(1):37-41
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_25_17
      Issue No: Vol. 7, No. 1 (2018)
       
  • Prospective comparative randomized controlled study to determine the
           optimal priming dose of atracurium

    • Authors: Arun Kumar Handigodu Duggappa, Shaji Mathew, Abhishek Rao Kordcal, Arun Chakravarthi, Shiyad Muhamed
      Pages: 42 - 45
      Abstract: Arun Kumar Handigodu Duggappa, Shaji Mathew, Abhishek Rao Kordcal, Arun Chakravarthi, Shiyad Muhamed
      Indian Journal of Respiratory Care 2018 7(1):42-45
      Introduction: The advantages of the use of muscle relaxants in the current practice of balanced anesthesia are well documented. Most often, nondepolarizing muscle relaxants (NDMR) with minimal side effects are used to serve the purpose. Atracurium is a commonly used NDMR in day-to-day anesthetic practice, although it is not desirable for rapid sequence induction and intubation due to its late onset of action. To overcome this problem priming principle was introduced. Aim: This study aims to determine optimal priming dose of atracurium to speed up the onset of action. Patients and Methods: In this prospective randomized controlled study, 90 patients were allocated into one of the three groups by a computer-generated table of random numbers, i.e., Group A, B, and C. Total dose of atracurium used in all patients was 0.5 mg/kg body weight, including the priming dose. Each group received different priming doses of atracurium as follows: Group A received 0.05 mg/kg body weight, Group B received 0.025 mg/kg body weight, whereas Group C (control) received saline as priming dose. Results: Patients were comparable with respect to demographic data. The mean duration in seconds for train-of-four (TOF) count to reach zero were 147 s, 193, and 218 s in Group A, B, and C, respectively, with statistically significant P values. Of 60 patients who were administered atracurium as priming drug, two patient had ptosis at the end of 3 min after priming with 0.05 mg/kg body weight, with no other side effects. Conclusions: Priming principle employing atracurium reduces the time required for TOF count to reach zero by approximately 71 s while using 0.05 mg/kg body weight and by around 25 s while employing 0.025 mg/kg body weight, with clinically insignificant incidence of adverse effects.
      Citation: Indian Journal of Respiratory Care 2018 7(1):42-45
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_26_17
      Issue No: Vol. 7, No. 1 (2018)
       
  • A clinical audit to assess the adherence of the code blue team to advanced
           cardiac life support protocol and its effect on the patient outcome in a
           Tertiary Care Hospital in Kochi, Kerala

    • Authors: Indhu Aynipully Jayasingh, R Athish Peter Margos, Shoba Philip
      Pages: 46 - 49
      Abstract: Indhu Aynipully Jayasingh, R Athish Peter Margos, Shoba Philip
      Indian Journal of Respiratory Care 2018 7(1):46-49
      Introduction: Cardiopulmonary resuscitation is a sequence of techniques that combines chest compression with artificial ventilation to manually maintain the circulation to preserve intact brain function. The aim is to maintain circulation and breathing in a person who is in cardiac arrest until emergency aid arrives. Effective teamwork by Code Blue team raises chances of a successful outcome. The advanced cardiac life support (ACLS) guidelines were developed by the American Heart Association using the comprehensive review of resuscitation literature performed by the International Liaison Committee on Resuscitation. Aim: To assess adherence of Code Blue team to ACLS protocol, to assess outcome of resuscitation, and to compare outcome between those where ACLS guidelines were followed and those not followed. Patients and Methods: A clinical audit was done between 2014 and 2015 at Lourdes Hospital, Kochi, on inpatients aged between 30 and 80 years, with witnessed cardiac arrests/respiratory arrest. Pregnant and unwilling patients were excluded. Results: The common arrest rhythm was pulseless electrical activity, followed by asystole. ACLS protocol was followed in 58.7%. The most common deviation was usage of inappropriate drugs. Return of spontaneous circulation (ROSC) was attained in 53.3%, of which 28.5% were discharged (P < 0.05), which suggests a significant association between the adherence to ACLS protocol and ROSC. Conclusion: Although Code Blue team is ACLS trained, deviations occurred in nearly half of the resuscitations, which need to be reduced. Outcome was better in those resuscitations where the ACLS protocol was followed.
      Citation: Indian Journal of Respiratory Care 2018 7(1):46-49
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_24_17
      Issue No: Vol. 7, No. 1 (2018)
       
  • Platypnea-orthodeoxia: Patent foramen ovale unmasked by pulmonary emboli

    • Authors: Grainne Gallagher, Alex Joseph, Rajkumar Rajendram
      Pages: 50 - 52
      Abstract: Grainne Gallagher, Alex Joseph, Rajkumar Rajendram
      Indian Journal of Respiratory Care 2018 7(1):50-52
      This report describes an 84 year old woman who presented with breathlessness from platypnea-orthodeoxia. This was due to a distortion of a patent foramen ovale by lower thoracic vertebral fractures which allowed a right-to-left intracardiac shunt. The right-to-left shunt was, in this case, triggered by small bilateral pulmonary emboli. Platypnea-orthodeoxia is rare, complex, and underdiagnosed. The pathogenesis requires an anatomical substrate for a shunt and a functional component that triggers reversal of the flow across it. Recognition is critical and may prevent provision of sedation, invasive ventilatory support, and vasopressor; all of which actually exacerbate right-to-left extrapulmonary shunt.
      Citation: Indian Journal of Respiratory Care 2018 7(1):50-52
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_5_17
      Issue No: Vol. 7, No. 1 (2018)
       
  • Therapeutic implications of monitoring end-tidal carbon dioxide in
           submassive pulmonary embolism

    • Authors: Sunil Kumar Garg, Pragya Garg
      Pages: 53 - 55
      Abstract: Sunil Kumar Garg, Pragya Garg
      Indian Journal of Respiratory Care 2018 7(1):53-55
      While managing submassive pulmonary embolism in Intensive Care Unit, it is always a challenge to identify the parameters to identify the deterioration. It is important to understand it as further therapeutic decision about the use of thrombolytics is based on its recognition. Bedside monitoring of end-tidal carbon dioxide which is readily available, continuous, noninvasive, and nonoperator dependent can be of help in deciding on the need of thrombolytics in such cases before development of hypotension.
      Citation: Indian Journal of Respiratory Care 2018 7(1):53-55
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_18_17
      Issue No: Vol. 7, No. 1 (2018)
       
  • Sting to the heart &#8211; Acute pulmonary edema following
           hymenoptera sting

    • Authors: Jijin Satheesh, Deepak Rajkumar Vangipuram, M Rajkumar
      Pages: 56 - 58
      Abstract: Jijin Satheesh, Deepak Rajkumar Vangipuram, M Rajkumar
      Indian Journal of Respiratory Care 2018 7(1):56-58
      Hymenoptera stings have been reported earlier to cause mild local reactions to severe systemic reactions such as anaphylactic shock. Myocardial infarction following insect stings has been widely described. In this case, we describe a 64-year-old male patient who presented with pulmonary edema 4 h after the initial insult followed by a new onset myocardial infarction which was considered to be a variant of Kounis syndrome. The patient was managed in intensive care with diuretics, positive pressure ventilation, and glucocorticoids and made a complete recovery.
      Citation: Indian Journal of Respiratory Care 2018 7(1):56-58
      PubDate: Thu,1 Feb 2018
      DOI: 10.4103/ijrc.ijrc_23_17
      Issue No: Vol. 7, No. 1 (2018)
       
 
 
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