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EMERGENCY AND INTENSIVE CRITICAL CARE (121 journals)                     

Showing 1 - 124 of 124 Journals sorted alphabetically
AACN Advanced Critical Care     Full-text available via subscription   (Followers: 36)
Academic Emergency Medicine     Hybrid Journal   (Followers: 90)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acute and Critical Care     Open Access   (Followers: 9)
Acute Cardiac Care     Hybrid Journal   (Followers: 11)
Acute Medicine     Full-text available via subscription   (Followers: 8)
Advances in Emergency Medicine     Open Access   (Followers: 16)
Advances in Neonatal Care     Hybrid Journal   (Followers: 43)
African Journal of Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 7)
African Journal of Emergency Medicine     Open Access   (Followers: 7)
AINS - Anasthesiologie - Intensivmedizin - Notfallmedizin - Schmerztherapie     Hybrid Journal   (Followers: 5)
American Journal of Emergency Medicine     Hybrid Journal   (Followers: 54)
Annals of Emergency Medicine     Hybrid Journal   (Followers: 126)
Annals of Intensive Care     Open Access   (Followers: 37)
Annals of the American Thoracic Society     Full-text available via subscription   (Followers: 15)
Archives of Academic Emergency Medicine     Open Access   (Followers: 6)
Archives of Trauma Research     Open Access   (Followers: 4)
ASAIO Journal     Hybrid Journal   (Followers: 2)
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian Critical Care     Full-text available via subscription   (Followers: 21)
Bangladesh Critical Care Journal     Open Access   (Followers: 1)
BMC Emergency Medicine     Open Access   (Followers: 25)
BMJ Quality & Safety     Hybrid Journal   (Followers: 65)
Burns Open     Open Access  
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine     Hybrid Journal   (Followers: 2)
Case Reports in Acute Medicine     Open Access   (Followers: 3)
Case Reports in Critical Care     Open Access   (Followers: 13)
Case Reports in Emergency Medicine     Open Access   (Followers: 19)
Chronic Wound Care Management and Research     Open Access   (Followers: 7)
Clinical and Applied Thrombosis/Hemostasis     Open Access   (Followers: 32)
Clinical Intensive Care     Hybrid Journal   (Followers: 6)
Clinical Medicine Insights : Trauma and Intensive Medicine     Open Access   (Followers: 3)
Clinical Risk     Hybrid Journal   (Followers: 5)
Crisis: The Journal of Crisis Intervention and Suicide Prevention     Hybrid Journal   (Followers: 15)
Critical Care     Open Access   (Followers: 74)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 29)
Critical Care Clinics     Full-text available via subscription   (Followers: 34)
Critical Care Explorations     Open Access   (Followers: 3)
Critical Care Medicine     Hybrid Journal   (Followers: 279)
Critical Care Research and Practice     Open Access   (Followers: 13)
Current Emergency and Hospital Medicine Reports     Hybrid Journal   (Followers: 5)
Current Opinion in Critical Care     Hybrid Journal   (Followers: 73)
Disaster and Emergency Medicine Journal     Open Access   (Followers: 12)
Egyptian Journal of Critical Care Medicine     Open Access   (Followers: 2)
EMC - Urgenze     Full-text available via subscription  
Emergency Care Journal     Open Access   (Followers: 7)
Emergency Medicine (Medicina neotložnyh sostoânij)     Open Access  
Emergency Medicine Australasia     Hybrid Journal   (Followers: 17)
Emergency Medicine Clinics of North America     Full-text available via subscription   (Followers: 19)
Emergency Medicine International     Open Access   (Followers: 8)
Emergency Medicine Journal     Hybrid Journal   (Followers: 53)
Emergency Medicine News     Full-text available via subscription   (Followers: 7)
Emergency Nurse     Full-text available via subscription   (Followers: 17)
Enfermería Intensiva (English ed.)     Full-text available via subscription  
European Burn Journal     Open Access   (Followers: 10)
European Journal of Emergency Medicine     Hybrid Journal   (Followers: 23)
Frontiers in Emergency Medicine     Open Access   (Followers: 8)
Global Journal of Transfusion Medicine     Open Access   (Followers: 1)
Hong Kong Journal of Emergency Medicine     Full-text available via subscription   (Followers: 5)
Indian Journal of Burns     Open Access   (Followers: 2)
Injury     Hybrid Journal   (Followers: 20)
Intensive Care Medicine     Hybrid Journal   (Followers: 82)
Intensive Care Medicine Experimental     Open Access   (Followers: 2)
Intensivmedizin up2date     Hybrid Journal   (Followers: 4)
International Journal of Critical Illness and Injury Science     Open Access   (Followers: 1)
International Journal of Emergency Medicine     Open Access   (Followers: 9)
International Journal of Emergency Mental Health and Human Resilience     Open Access   (Followers: 2)
International Paramedic Practice     Full-text available via subscription   (Followers: 14)
Iranian Journal of Emergency Medicine     Open Access  
Irish Journal of Paramedicine     Open Access   (Followers: 2)
Journal Européen des Urgences et de Réanimation     Hybrid Journal   (Followers: 1)
Journal of Acute Care Physical Therapy     Hybrid Journal   (Followers: 3)
Journal of Cardiac Critical Care TSS     Open Access   (Followers: 1)
Journal Of Cardiovascular Emergencies     Open Access  
Journal of Concussion     Open Access  
Journal of Critical Care     Hybrid Journal   (Followers: 48)
Journal of Critical Care Medicine     Open Access   (Followers: 18)
Journal of Education and Teaching in Emergency Medicine     Open Access   (Followers: 1)
Journal of Emergencies, Trauma and Shock     Open Access   (Followers: 13)
Journal of Emergency Medical Services     Full-text available via subscription   (Followers: 12)
Journal of Emergency Medicine     Hybrid Journal   (Followers: 53)
Journal of Emergency Medicine, Trauma and Acute Care     Open Access   (Followers: 25)
Journal of Emergency Practice and Trauma     Open Access   (Followers: 6)
Journal of Intensive Care     Open Access   (Followers: 9)
Journal of Intensive Care Medicine     Hybrid Journal   (Followers: 22)
Journal of Intensive Medicine     Open Access  
Journal of Neuroanaesthesiology and Critical Care     Open Access   (Followers: 3)
Journal of Stroke Medicine     Hybrid Journal  
Journal of the American College of Emergency Physicians Open     Open Access   (Followers: 1)
Journal of the Intensive Care Society     Hybrid Journal   (Followers: 4)
Journal of the Royal Army Medical Corps     Hybrid Journal   (Followers: 6)
Journal of Thrombosis and Haemostasis     Hybrid Journal   (Followers: 81)
Journal of Translational Critical Care Medicine     Open Access   (Followers: 5)
Journal of Trauma and Acute Care Surgery, The     Hybrid Journal   (Followers: 34)
La Presse Médicale Open     Open Access  
Médecine de Catastrophe - Urgences Collectives     Hybrid Journal  
Medicina Intensiva     Open Access   (Followers: 3)
Medicina Intensiva (English Edition)     Hybrid Journal   (Followers: 1)
Mediterranean Journal of Emergency Medicine & Acute Care : MedJEM     Open Access  
Notfall + Rettungsmedizin     Hybrid Journal   (Followers: 3)
OA Critical Care     Open Access   (Followers: 3)
OA Emergency Medicine     Open Access   (Followers: 2)
Open Access Emergency Medicine     Open Access   (Followers: 6)
Open Journal of Emergency Medicine     Open Access   (Followers: 2)
Palliative Care : Research and Treatment     Open Access   (Followers: 19)
Palliative Medicine     Hybrid Journal   (Followers: 54)
Prehospital Emergency Care     Hybrid Journal   (Followers: 19)
Regulatory Toxicology and Pharmacology     Hybrid Journal   (Followers: 41)
Research and Opinion in Anesthesia and Intensive Care     Open Access   (Followers: 3)
Resuscitation     Hybrid Journal   (Followers: 54)
Resuscitation Plus     Open Access   (Followers: 2)
Saudi Critical Care Journal     Open Access   (Followers: 2)
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine     Open Access   (Followers: 11)
Seminars in Thrombosis and Hemostasis     Hybrid Journal   (Followers: 46)
Shock : Injury, Inflammation, and Sepsis : Laboratory and Clinical Approaches     Hybrid Journal   (Followers: 10)
Sklifosovsky Journal Emergency Medical Care     Open Access  
The Journal of Trauma Injury Infection and Critical Care     Full-text available via subscription   (Followers: 24)
Therapeutics and Clinical Risk Management     Open Access   (Followers: 2)
Transplant Research and Risk Management     Open Access  
Trauma Case Reports     Open Access   (Followers: 1)
Trauma Monthly     Open Access   (Followers: 3)
Visual Journal of Emergency Medicine     Full-text available via subscription   (Followers: 1)
Western Journal of Emergency Medicine     Open Access   (Followers: 11)
 AEM Education and Training : A Global Journal of Emergency Care     Open Access   (Followers: 1)

           

Similar Journals
Journal Cover
Research and Opinion in Anesthesia and Intensive Care
Number of Followers: 3  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2356-9115 - ISSN (Online) 2356-9123
Published by Medknow Publishers Homepage  [448 journals]
  • Efficacy of combined thoracic paravertebral block and intravenous
           dexmedetomidine in medical thoracoscopy: a randomized controlled trial

    • Authors: Ayman M Maaly, Ahmed M Abdelhady, Rehab A Abdelaziz
      Pages: 1 - 7
      Abstract: Ayman M Maaly, Ahmed M Abdelhady, Rehab A Abdelaziz
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):1-7
      Background Medical thoracoscopy has become the gold standard for evaluation of intrapleural space. Thoracic paravertebral block is instillation of local anesthetic drug in the thoracic paravertebral space and can be used in several procedures such as medical thoracoscopy. Dexmedetomidine is a potent α-2 agonist with a higher potency and short duration of action. It has a rapid onset and offset. It produces an ‘interactive’ form of sedation and does not induce respiratory depression. This study was conducted to evaluate the efficacy of paravertebral block with intravenous (i.v.) infusion of dexmedetomidine compared with standardized general anesthesia method in medical thoracoscopy.Patients and methods A randomized controlled trial was conducted in the Department of Chest Diseases at Alexandria Main University Hospital, on patients indicated for medical thoracoscopy.Patients were randomized into two groups (30 patients each). Group A received general anesthesia. Group B received paravertebral block at the level of medical thoracotomy covering three levels: at, above, and below thoracotomy level plus i.v. dexmedetomidine. Demographic data, hemodynamics, patient-rated procedural pain, and operator-rated overall procedure satisfaction scores were recorded.Results A significantly lower means of heart rate and blood pressure were found in group B after thoracotomy and immediately postoperative. Patient-rated procedural pain score in group A ranged from 2 to 5 with a mean of 3.90±0.85, while in group B, it ranged from 0 to 3 with a mean of 1.40±0.68. This difference was statistically significant (P<0.001). A significantly higher operator-rated overall procedure satisfaction score was found in group B (95.77±1.74) compared with group A (90.03±2.33) (P<0.001).Conclusion Use of thoracic paravertebral block plus use of i.v. dexmedetomidine in medical thoracoscopy is comparable to general anesthesia as it is comfortable to the patient and the operator without dealing with airway and its difficulties.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):1-7
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_78_20
      Issue No: Vol. 9, No. 1 (2022)
       
  • A comparative study of the effect of dexamethasone versus its use with
           clonidine on postoperative sore throat and hoarseness of voice

    • Authors: Mohamed M.K Mohamed, Ragab Mohamed, Medhat Khali L Mohamed, Hamed M.D Khattab
      Pages: 8 - 12
      Abstract: Mohamed M.K Mohamed, Ragab Mohamed, Medhat Khali L Mohamed, Hamed M.D Khattab
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):8-12
      Regardless of some preventive measures, postoperative sore throat (POST) and hoarseness of voice are most undesirable and most frequent complication in the post-operative period [1,2]. Postoperatively it seems reasonable that most of the signs and symptoms are the result of mucosal injury which leads to inflammation caused by the process of air way instrumentation, also its postulated etiology has been associated with mucosal dehydration or edema, tracheal ischemia secondary to the pressure of endotracheal tube cuffs, aggressive oropharyngeal suctioning and mucosal erosion from friction between delicate tissues and the endotracheal tube (ETT) [4,5]. Aim, the primary outcome was to compare between the effects of Dexamethasone alone versus its use with Clonidine on post-operative sore throat. The secondary outcome was to compare between the effects of Dexamethasone alone versus its use with Clonidine on post-operative hoarseness of voice. Method, this prospective controlled randomized double- blind study was carried on 126 patients divided into two groups the Dexa group 63 and Dexaclonidine group 63. Randomization were done by using closed envelop technique opened immediately before induction by an anaesthetist who was unaware of the study protocol and responsible for preparing the study drugs. Patient in Dexaclonidine group received oral 150 microgram Clonidine tablet one hour before induction, whereas patients in the Dexa group received placebo which is multivitamin tablet with the same shape and size of Clonidine. Both Clonidine and placebo were covered with nontransparent paper. Patients in both groups were received 5 ml of normal saline containing Dexamethasone (8 mg) iv at 30 min before anaesthetic induction. Sedation with midazolam was given (0.05 mg/kg) IV 15 minutes before surgery for the two groups. On arrival to operating room patients were cannulated and monitored with electrocardiography, non-invasive blood pressure, pulse oximetry and capnography. Anaesthesia was induced with intravenous propofol (2 mg/kg) and fentanyl (1–1.5 micro g/kg) after approximately 5 min of preoxygenation and face mask ventilation. Rocuronium (0.6–0.8 mg/ kg) was administered to facilitate endotracheal intubation after using of nerve stimulator (train of four) to ensure complete muscle relaxation before intubation, an endotracheal tube were inserted (ETTs) after Cormack-Lehane scoring (13) of internal diameter 7.0 and 7.5 were used for females and males, respectively by Direct laryngoscopy with either a Macintosh blade size 3 or 4. The ETTs were inserted so that the vocal cords were located between the two indicator marks on the proximal part of the tube shaft. Intubations were confirmed by capnography and chest auscultation for equality of air entry on both sides. None of the patients received topical lidocaine or lidocaine jelly during the intubation procedure. The lungs were ventilated with 50% air 50% oxygen; ventilation was adjusted to maintain an end tidal carbon dioxide of 35–45 mmHg. Anaesthesia was maintained with isoflurane and intermittent bolus dose of rocuronium. Isoflurane concentration was adjusted to minimal alveolar concentration (MAC) 1–1,5% according to haemodynamics. After the end of surgery, residual neuromuscular relaxation was reversed by Neostigmine (0.03_0.07 mg/ kg) and Atropine (0,02–0,1 mg/kg). Oropharyngeal suction was gently performed under direct vision by soft suction catheter with sideway port to avoid trauma to the tissues before extubation, one end of the catheter was attached to an aspirator or collection canister and the unattached end was placed directly into a tube to extract secretions safely without injury to the mucous membranes. Conclusion From this study including that addition of clonidine to dexamethasone was more superior in reducing POST & hoarseness of voice than dexamethasone alone, resulted in more haemodynamic stability in both intra operative and early post-operative period. Result From this study, there was statistically significant difference between the two studied groups regarding the sore throat and hoarseness of voice incidence and grade (P value < 0.05). so, Addition of clonidine to dexamethasone was more superior in reducing POST & hoarseness of voice than dexamethasone alone.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):8-12
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_9_20
      Issue No: Vol. 9, No. 1 (2022)
       
  • Two versus five bilateral local anesthetic injections for submucosal
           resection: a randomized double-blind clinical trial

    • Authors: Zoher Naja, Saleh Kanawati, Ahmad S Naja, Fouad Ziade
      Pages: 13 - 18
      Abstract: Zoher Naja, Saleh Kanawati, Ahmad S Naja, Fouad Ziade
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):13-18
      Background Submucous resection (SMR) is performed under general anesthesia, local anesthesia, or a combination of both. The combination was associated with less postoperative pain and shorter hospital stay. The purpose of this clinical trial was to compare the effectiveness of two versus five bilateral local anesthetic injections in terms of postoperative pain relief at 24 h postoperatively.Patients and methods This was a prospective, randomized, double-blind clinical trial conducted at a tertiary care center between May 2015 and December 2016. Patients aged between 15 and 63 years scheduled for elective SMR of the nasal septum were included. Eligible patients received general anesthesia and were randomly assigned to receive either two or five bilateral local anesthetic injections. The primary outcome was pain assessed by the Numeric Rating Scale. Other outcomes were hemodynamic stability, analgesic consumption, nausea and vomiting, as well as patient’s and surgeon’s satisfaction.Results A total of 120 patients were included in the study and were divided equally into the two groups. Both groups were similar in terms of age, height, weight, surgery duration, and hemodynamic characteristics. There was no significant difference for both groups in pain scores at 24 h (1.53±1.25 vs. 2.07±1.82, P=0.069 for two vs. five injections, respectively) and over the 10 postoperative days. Similarly, the number of patients who consumed analgesics was similar between the two groups.Conclusion The present study revealed that two bilateral local anesthetic injections at the suprazygomatic and infraorbital areas could be an alternative to five injections in patients undergoing SMR.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):13-18
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_88_20
      Issue No: Vol. 9, No. 1 (2022)
       
  • Comparison of nebulized fentanyl, midazolam, and dexmedetomidine as a
           sedative premedication in outpatient pediatric dental surgeries: a
           randomized double-blind study

    • Authors: Marwa M Medhat, Sara M Abd Elnaby
      Pages: 19 - 28
      Abstract: Marwa M Medhat, Sara M Abd Elnaby
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):19-28
      Background The preoperative time is traumatic for young children undergoing surgery. Parental separation and needle injection increase preoperative anxiety. Preoperative sedation in children is usually administered via the rectal, oral sublingual, and intranasal routes with different degrees of patient acceptance. Nebulized drug is an alternative method of sedation that is relatively easy to set up.Materials and Methods Thirty nine pediatric patients (2–6) years old scheduled for outpatient dental surgeries were randomly allocated in three groups (13 patients each); group (F) received nebulized fentanyl 2 μg/kg 30 min before surgery, group (M) received nebulized midazolam 0.2 mg/kg 30 min before surgery and group (D) received nebulized dexmedetomidine 2 μg/kg 30 min before surgery. The outcome measures included onset of sedation, parental separation, tolerance to mask induction, reaction to intravenous cannulation and preoperative hemodynamic changes (systolic blood pressure, diastolic blood pressure and heart rate).Results Children who received nebulized fentanyl and nebulized midazolam had early onset of sedation as compared to dexmedetomidine. In child-parent separation, quality of induction was better with fentanyl and dexmedetomidine as compared to midazolam. Intravenous cannulation score was best achieved with fentanyl as premedication.Conclusion Nebulized fentanyl in a dose of 2 μg/kg is better than nebulized midazolam 0.2 mg/kg and nebulized dexmedetomidine 2 μg/kg as far as premedication is concerned because of its early onset of action, deeper levels of sedation, easy child-parent separation and shorter duration of action.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):19-28
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_10_21
      Issue No: Vol. 9, No. 1 (2022)
       
  • A prospective randomized comparative study of dexmedetomidine versus
           clonidine as an adjunct to 0.75% ropivacaine in ultrasound-guided
           supraclavicular brachial plexus block

    • Authors: Gajanan Fultambkar, Pradeepa Chavla, Vijayanand Budi, Rammohan Gurram, Vinay Kukreja, Abhijit Nair
      Pages: 29 - 36
      Abstract: Gajanan Fultambkar, Pradeepa Chavla, Vijayanand Budi, Rammohan Gurram, Vinay Kukreja, Abhijit Nair
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):29-36
      Introduction Alpha-2 agonists are popular adjuvants used in neuraxial anesthesia like spinal, epidural, caudal anesthesia, and peripheral nerve blocks. The authors compared the efficacy of clonidine with dexmedetomidine as an adjuvant to ultrasound (US)-guided supraclavicular brachial plexus block in adult patients undergoing elective upper limb surgeries.Materials and methods After obtaining Ethics Committee approval, 60 American Society of Anesthesiologists’- physical status (ASA-PS) I/II patients were randomized into two groups. Group Clonidine-Ropivacaine (CR) received 1 μg/kg clonidine as an adjuvant and group Dexmedetomidine-Ropivacaine (DR) received 1 μg/kg dexmedetomidine. Patients received an ipsilateral US-guided supraclavicular brachial plexus block with 0.75% ropivacaine (total volume of 20 ml). Demographic data, hemodynamics, the onset of block (sensory, motor), the duration of block (sensory, motor), duration of analgesia and surgery, total number of rescue analgesics, numerical rating scores, and Ramsay sedation score were compared between both groups using appropriate statistical tests.Results Heart rates at 30 min, 60 min, 2 h, and 3 h were lower in group DR compared with group CR, which was statistically significant (P=0.0001, 0.0001, 0.021, and 0.026, respectively). The onset of sensory and motor block, duration of sensory and motor block, and duration of analgesia were better in group DR compared with CR, which was statistically significant (P=0.00). The number of rescue analgesics required in group CR in both groups was comparable (P=0.057). Numeric rating scale scores at 12, 18, and 24 h were significantly better in group DR compared with group CR (P=0.0001, 0.039, and 0.036, respectively).Conclusion When added as an adjuvant to 0.75% ropivacaine in the US-guided supraclavicular brachial plexus, dexmedetomidine block produced faster onset of sensory and motor blockade, prolonged the duration of sensory and motor blockade, and also prolonged the duration of analgesia, when compared with clonidine.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):29-36
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_11_21
      Issue No: Vol. 9, No. 1 (2022)
       
  • A propensity score matching analysis for CPAP versus conventional oxygen
           therapy as a ceiling of care in COVID-19-associated type 1 respiratory
           failure

    • Authors: Noeman-Ahmed Yasser, Roshdy Ashraf, Bedir Abdulla, El Sayed Iman, Noeman Maryam, Koduri Gouri, Warrier Vinod, Gokaraju Sriya, Ayuen Patrice, Abualela Nour, Sharma Shashank, Powrie Duncan J.
      Pages: 37 - 45
      Abstract: Noeman-Ahmed Yasser, Roshdy Ashraf, Bedir Abdulla, El Sayed Iman, Noeman Maryam, Koduri Gouri, Warrier Vinod, Gokaraju Sriya, Ayuen Patrice, Abualela Nour, Sharma Shashank, Powrie Duncan J.
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):37-45
      Background Continuous positive airway pressure (CPAP) is increasingly used as a ward ceiling of care. Nevertheless, little is known about its effectiveness.Objective A retrospective study to explore whether CPAP therapy as a ceiling of care improves outcome in coronavirus disease 2019 (COVID-19)-infected patients with acute respiratory failure.Methods A retrospective cohort study was conducted on adult COVID-19-infected patients admitted to two UK hospitals from the March 1 to June 30, 2020. All patients experienced type 1 respiratory failure and were not suitable for intubation. They were divided into two groups: patients for CPAP versus conventional oxygen therapy (COT).Results A total of 39 patients received CPAP, whereas 247 received COT. CPAP group patients were more hypoxic (mean SpO2 86.5% vs. 91%, P=0.003), younger (mean±SD: 71.8±8.8 vs. 80.7±9.8 years, P<0.001), and less frail than the COT group [median (interquartile range) clinical frailty score 4 (3–5) vs. 6 (4–7), P<0.001]. Overall, 35 patients died in the CPAP group (89.7%) compared with 185 patients in the COT group (74.9%) (P=0.041). Propensity score matching of the two groups showed that CPAP was still associated with higher mortality (90.3 vs. 67.7%, P=0.029). Length of hospital stay was similar in both groups (mean±SD 9.2±7.3 vs. 9.7±8.6 days, P=0.719).Conclusion In COVID-19-infected patients presenting with type 1 respiratory failure and deemed not suitable for escalation to intubation, the use of CPAP therapy does not carry extra benefit than COT. In such patients, COT appears to be the appropriate measure. Further studies are required to corroborate these findings.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):37-45
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_31_21
      Issue No: Vol. 9, No. 1 (2022)
       
  • Continuous positive airway pressure as a useful tool in coronavirus
           disease 2019-related acute hypoxemic respiratory failure: experience from
           three UK hospitals

    • Authors: Yasser Noeman Ahmed, Niranjan Setty, Ashraf Roshdy, Duncan J Powrie, Dora A Amran, Alguili Elsheikh, Sriya Gokaraju, Anne Tear, Maryam Noeman, Maria Darda, Iman El Sayed, Vijayalakshmi Karunanithi, Aarani Mahalingam, Muhammad Shafiq, Iman Abdul-Khaliq, Johnson Samuel
      Pages: 46 - 51
      Abstract: Yasser Noeman Ahmed, Niranjan Setty, Ashraf Roshdy, Duncan J Powrie, Dora A Amran, Alguili Elsheikh, Sriya Gokaraju, Anne Tear, Maryam Noeman, Maria Darda, Iman El Sayed, Vijayalakshmi Karunanithi, Aarani Mahalingam, Muhammad Shafiq, Iman Abdul-Khaliq, Johnson Samuel
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):46-51
      Background Many coronavirus disease 2019 (COVID-19) patients suffering acute hypoxemic respiratory failure (AHRF), fail to respond to conventional oxygen therapy (COT). Subsequently, some centers escalate to continuous positive airway pressure (CPAP), while others resort directly to invasive mechanical ventilation (IMV). We conducted a study to compare the use of CPAP versus COT alone in COVID-19-related AHRF.Patients and methods It is a retrospective cohort study of laboratory-confirmed COVID-19 patients suffering AHRF and deemed eligible for IMV escalation at three university hospitals (United Kingdom) during a 3-month period. The primary endpoint was the need for intubation and the secondary endpoint was 60-day mortality.Results In total, 174 patients were included. In total, 84 patients received CPAP (group 1) and 90 received only COT (group 2). Both groups had comparable demographic criteria and disease severity. There was nonsignificant reduction in the need for IMV when using CPAP compared with COT alone (50 vs. 76.6%, P=0.866). Sixty-day mortality was significantly higher in group 2 (25 vs. 37.8%, P=0.02). COT as stand-alone therapy for COVID-19 patients (group 2) was associated with a significant increased relative risk of death (relative risk 2.14, 95% confidence interval 1.39–3.29) corresponding to a number needed to treat of 3.74 (95% confidence interval 2.47–7.73). Among patients who progressed to IMV, there was no difference in the risk of mortality between the two groups.Conclusion Introducing CPAP rather than escalating FiO2 or endotracheal intubation in COVID-19 cases refractory to COT is safe and associated with improved mortality. Clinical trials are needed to guide the optimum timing and selection of patients most likely to benefit.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):46-51
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_32_21
      Issue No: Vol. 9, No. 1 (2022)
       
  • Ultrasound-guided infraclavicular brachial plexus block using bupivacaine
           alone or combined with dexmedetomidine for hand and forearm surgeries

    • Authors: Yahya H Morsi, Ramadan A.E Ammar, Ahmed M.A Elshafie
      Pages: 52 - 61
      Abstract: Yahya H Morsi, Ramadan A.E Ammar, Ahmed M.A Elshafie
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):52-61
      Background Pain was identified by the International Association for the Study of Pain as an unpleasant sensory or emotional experience associated with actual or potential tissue damage. The incidence of inadequate pain management seems to be high, even in the developed countries. Traumatic upper limbs injuries are accountable for a considerable number of patients, who require care by medical facilities (5–10% of emergency department visits). Regional anesthesia [e.g. brachial plexus block (BPB)] is increasingly taking place in patients with upper limb injuries as it is a logical choice avoiding the side effects of muscle relaxants, narcotics, and potent volatile anesthetics used in general anesthesia. Different additives have been used as an adjuvant with local anaesthetics to achieve dense and prolonged block and adequate postoperative analgesia.Objective To evaluate the effects of adding dexmedetomidine to bupivacaine versus bupivacaine alone in infraclavicular BPB with ultrasound guidance for plastic and reconstructive surgeries of the hand and forearm as regards the duration of postoperative analgesia, onset, and the duration of sensory and motor block and postoperative analgesic requirements.Patients and methods This randomized double-blind study carried out in Alexandria Main University Hospital on 70 adult patients of both sexes aged from 20 to 40 years, who were evaluated as American Society of Anesthesiologists I or II physical status and were scheduled for plastic and reconstructive surgeries of the hand and forearm.Results The results of our study show that the duration of analgesia ranged from 450 to 690 min with a mean value of 588.90±73.15 min in group C ‘control,’ while the duration of analgesia ranged from 990 to 1440 min with a mean value of 1295.10±121.60 min in group D ‘dexmedetomidine.’ Comparing the two groups, there was significant statistical difference in the duration of analgesia between the two groups, showing prolonged duration of analgesia in group D more than in group C.Conclusion Administration of bupivacaine with dexmedetomidine in infraclavicular BPB provides prolonged postoperative analgesia without causing a significant hemodynamic instability. Also, coadministration of dexmedetomidine leads to significantly decreased total analgesic doses required postoperatively with minimal side effects.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):52-61
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_24_21
      Issue No: Vol. 9, No. 1 (2022)
       
  • Serum copeptin level as a prognostic marker for acute ischemic
           cerebrovascular stroke and cerebral hemorrhage

    • Authors: Sherif Sabry, Nael Samer, Khaled F Ibrahim, Mohammed Mahmoud
      Pages: 62 - 67
      Abstract: Sherif Sabry, Nael Samer, Khaled F Ibrahim, Mohammed Mahmoud
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):62-67
      Objective To assess the predictive utility of serum copeptin concerning the 30-day mortality among patients presenting with ischemic stroke (IS) or hemorrhagic stroke (HS) acute cerebrovascular stroke. Besides, we aimed to evaluate whether serum copeptin has a role in discriminating between HS and IS.Background Since its discovery in early 1970s, copeptin has emerged as an effective predictive marker with high potentials of wide clinical applications due to its stability and robust measure. Serum copeptin can reflect the vasopressogenics in a practical way.Patients and methods We performed this prospective study on patients with either IS or HS, as indicated by clinical signs and computed tomography. The serum copeptin level was assessed by sandwich immunoassay at admission. All patients were followed up for 30 days after admission.Results Nonsurvivors with acute cerebrovascular stroke exhibited a significantly higher copeptin level than the survivors’ group (P=0.038). Besides, patients with HS exhibited a significantly higher copeptin level than the patients with IS (P=0.042). Copeptin showed good sensitivity (70.6%) and specificity (56.5%) at a cutoff value of 48.8 pmol/l to predict mortality in the whole studied population.Conclusions Serum copeptin is a promising prognostic tool for the prediction of short-term mortality in patients with acute cerebrovascular stroke. Besides, the serum copeptin has a fair diagnostic accuracy for the differentiation of IS and HS.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):62-67
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_35_21
      Issue No: Vol. 9, No. 1 (2022)
       
  • Bupivacaine–lidocaine versus bupivacaine–lidocaine plus
           dexamethasone in supraclavicular brachial plexus block

    • Authors: Amr N Abdelrazik, Ashraf H.I Ali, Ibrahim A Youssef, Sohair A Megalla
      Pages: 68 - 76
      Abstract: Amr N Abdelrazik, Ashraf H.I Ali, Ibrahim A Youssef, Sohair A Megalla
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):68-76
      Background To evaluate whether dexamethasone as an adjuvant to bupivacaine–lidocaine mixture in supraclavicular brachial plexus block can enhance the block, prolong the duration of action, and improve postoperative analgesia than a mixture of bupivacaine–lidocaine only.Patients and methods In all, 60 patients were posted for elective and emergent upper limb orthopedic surgery (below shoulder joint), under supraclavicular brachial plexus block guided by a nerve stimulator. Patients were randomly divided into two equal groups: group C (the control group, n=30) received 40 ml solution containing local anesthetics only. Group D (the dexamethasone group, n=30) received a 40 ml solution containing local anesthetics plus 4 mg dexamethasone. Primary outcomes were onset time of sensory and motor block, and duration of sensory and motor block, which were assessed in minutes. Secondary outcomes were pain assessment using a scoring system based on the visual analog scale, time to first analgesic requirement, and total analgesic consumption.Results Duration of sensory and motor block in the dexamethasone group were significantly longer than the control group (753±68.04 vs. 565±30.85 min and 733.66±69.77 vs. 547.16±29.38 min, respectively). For visual analog scale, while comparing the two groups, the differences were significant at 9, 12, and 18 h after surgery in favor of the dexamethasone group. The time to first analgesic request was significantly longer in the dexamethasone group in comparison to the control group. The total analgesic requirement was also significantly lower in the dexamethasone group in comparison to the control group.Conclusion The use of dexamethasone at a dose of 4 mg as an adjuvant to local anesthetics provided effective prolongation in the duration of sensory and motor block, prolonged time to first analgesic request, and reduced the total analgesic consumption.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):68-76
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_50_21
      Issue No: Vol. 9, No. 1 (2022)
       
  • Ultrasound-guided rectus-sheath block compared with thoracic epidural
           analgesia for major abdominal cancer surgeries with a midline incision

    • Authors: Mona Gad, Mohamed Abdelkhalek, Khaled Gaballa, Saleh S Elbalka, Mohammed A Hegazy
      Pages: 77 - 86
      Abstract: Mona Gad, Mohamed Abdelkhalek, Khaled Gaballa, Saleh S Elbalka, Mohammed A Hegazy
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):77-86
      Background The thoracic epidural analgesia (TEA) is considered as a standard technique for postoperative pain relief in major abdominal surgeries, but sometimes, it is contraindicated or complicated. Rectus-sheath block (RSB) bilaterally has developed recently to offer analgesia in these operations. This study was designed to evaluate the promising RSB as a suitable alternative to TEA in major operations for abdominal cancers through a midline incision.Patients and methods The current clinical trial that had been performed on American Society of Anesthesiologists I, II, and III patients underwent major operations for abdominal cancers through a midline incision, and randomly allocated into either the TEA group: received TEA with bupivacaine+fentanyl or RSB group: received RSB with bupivacaine+fentanyl bilaterally. The primary outcome was the cumulative intravenous (IV) fentanyl doses consumed through the postoperative 24 h. The secondary outcomes were the patients’ number who needed analgesia, the duration spent till the first analgesic request, visual analog score with rest and cough, and any complications related to either the block techniques or drugs.Results Cumulative IV fentanyl consumed and the titration doses of IV fentanyl during the postoperative 24 h, the time to the first request of fentanyl, number of patients who needed analgesia, and visual analog score with rest and cough at the time points of the study, all did not show any statistical significant difference between both groups. The RSB group recorded significant shorter time to ambulation compared with the TEA group. Sedation scores were comparable in both groups at all time points of the trial. Both groups were comparable regarding the incidence of fentanyl-associated side effects, time to passing flatus, and patient-satisfaction score.Conclusion RSB could be used as an efficient alternative to TEA, especially whenever the latter is contraindicated in patients subjected to major abdominal surgeries with midline incision.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):77-86
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_87_21
      Issue No: Vol. 9, No. 1 (2022)
       
  • Diagnostic accuracy of lung ultrasound in acute heart failure

    • Authors: Mohamed Yahia, Mahmoud Soliman, Mohamed Fawzy, Hatem Sultan
      Pages: 87 - 93
      Abstract: Mohamed Yahia, Mahmoud Soliman, Mohamed Fawzy, Hatem Sultan
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):87-93
      Background and objective Although acute heart failure (AHF) is a common cause of dyspnea, its diagnosis still represents a challenge. Lung ultrasound is an emerging point-of-care diagnostic tool, but its diagnostic performance for AHF is still under evaluation. We evaluated the accuracy and clinical usefulness of combining lung ultrasound with clinical assessment compared with the use of chest radiography, echocardiography, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in conjunction with clinical evaluation for diagnosing AHF in the emergency department.Patients and methods A total of 47 patients presenting with dyspnea and symptoms suggestive of AHF were evaluated by NT-proBNP, echocardiography, and chest radiography. Lung ultrasound was done to look for the presence of diffuse B-lines.Results Lung ultrasound showed a sensitivity of 91.9% and a specificity of 100% in diagnosing AHF comparable to plasma NT-proBNP, which had a sensitivity of 100% and a specificity of 60%. It was also superior to other methods of diagnosing AHF namely chest radiograph. Lung ultrasound showed a significant correlation with the echocardiography findings (P=0.001).Conclusion The implementation of lung ultrasound with the clinical evaluation improves accuracy of diagnosis of AHF in the emergency department.
      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):87-93
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_54_21
      Issue No: Vol. 9, No. 1 (2022)
       
  • Anesthetic management of a patient with Gitelman syndrome for elective
           surgery

    • Authors: Varshini Ravindran, Sunil Rajan, Lakshmi Kumar
      Pages: 94 - 95
      Abstract: Varshini Ravindran, Sunil Rajan, Lakshmi Kumar
      Research and Opinion in Anesthesia and Intensive Care 2022 9(1):94-95

      Citation: Research and Opinion in Anesthesia and Intensive Care 2022 9(1):94-95
      PubDate: Fri,13 May 2022
      DOI: 10.4103/roaic.roaic_38_21
      Issue No: Vol. 9, No. 1 (2022)
       
 
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