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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
Journal of Cardiac Critical Care TSS
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2456-9224
Published by Thieme Publishing Group Homepage  [233 journals]
  • Nutrition Aggrandizement while on ECMO
    • Journal of Cardiac Critical Care TSS 2022; 06: 001-004
      DOI: 10.1055/s-0042-1750425

      Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     open access Volltext

      Journal of Cardiac Critical Care TSS 2022; 06: 001-0042022-06-01T07:14:56+01:00
      Issue No: Vol. 06, No. 01 (2022)
  • Nutrition in ICU Patients
    • Journal of Cardiac Critical Care TSS 2022; 06: 005-006
      DOI: 10.1055/s-0041-1739526

      Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     open access Volltext

      Journal of Cardiac Critical Care TSS 2022; 06: 005-0062022-06-01T07:14:56+01:00
      Issue No: Vol. 06, No. 01 (2022)
  • Risk of Developing Acute Kidney Injury on the VA ECLS Circuit in Patients
           with Acute Decompensated Heart Failure

    • Authors: Reaz; Shams, Loyaga-Rendon, Renzo, Dickinson, Michael G., Lee, Sangjin, Fitch, Stephen J., Marco, Greg, Boeve, Theodore, Langholz, David E., Kelty, Catherine, Shrestha, Nabin Manandhar, Leacche, Marzia, Jovinge, Stefan
      Pages: 007 - 011
      Abstract: Aims Venoarterial extracorporeal life support (VA ECLS) is a life-saving treatment with a high risk of mortality. Appropriate patient selection is critical for optimal patient outcomes. Acute kidney injury (AKI) is a common risk among VA ECLS patients, and more information is needed to understand how AKI affects the mortality risk of these patients. To do this, we examined acute decompensated heart failure (ADHF) patients supported by VA ECLS and compared their risk of developing AKI to a background population. VA ECLS has become an increasingly important tool to bridge or recover patients with severe ADHF as the primary indication of VA ECLS. Methods and Results All VA ECLS patients from a single center were included. ADHF patients supported by VA ECLS were compared with the remaining VA ECLS cohort. CATEGORICAL comparisons were made between groups using chi-squared and Fisher's exact tests. A survival analysis was conducted to determine freedom from AKI between the two groups. Predictor variables were tested by multiple logistic regression. Of the 255 patients included in this study, 110 had ADHF as their primary indication for VA ECLS and 145 patients had other VA ECLS indications. The survival analysis showed that patients with ADHF had a decreased risk of developing AKI on the VA ECLS circuit. Multiple logistic regression revealed no predictors in AKI development between groups and no difference in 30-day mortality was observed. Conclusion Patients supported by VA ECLS are at high risk of mortality and complications. This research demonstrated that medically complex ADHF patients had less chance of developing AKI when compared with other patients supported by VA ECLS. Future research is needed to investigate potential protective mechanisms of VA ECLS support.
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 007-011
      PubDate: 2022-06-01T07:14:56+01:00
      DOI: 10.1055/s-0042-1750191
      Issue No: Vol. 06, No. 01 (2022)
  • Postoperative Mortality in Surgically Treated Infective Endocarditis
           Patients and Its Correlation with EuroSCORE I

    • Authors: Anand; Amit, Singh, Sarvesh Pal, Sahu, Manoj, Hote, Milind Padmakar, Singh, Ummed, Reddy, Pradeep Ramakrishnan
      Pages: 012 - 016
      Abstract: Introduction Even after advances in medical and surgical treatment, infective endocarditis is associated with substantial morbidity and mortality. The aim of this study was to evaluate postoperative mortality in surgically treated infective endocarditis patients and its correlation with the European System for Cardiac Operative Risk Evaluation (EuroSCORE) I. Methods This retrospective observational study included 43 patients treated surgically for infective endocarditis, between 2014 and 2019, at a tertiary care center. Mortality in surgically treated infective endocarditis patients was determined in terms of frequency (%). Patients were divided into two groups—survivors and nonsurvivors (died within 30 days of surgery). Mean EuroSCORE I of survivors and nonsurvivors was compared using the unpaired t-test with equal variance. A correlation was sought between mortality and EuroSCORE I as well. The prediction ability of EuroSCORE I for mortality was determined by the area under receiver operating characteristic curve. Results Out of 43 patients who underwent surgery for infective endocarditis,11 patients (25.58%) died. Mean EuroSCORE I was 15.90 ± 2.02 in nonsurvivors and 7.84 ± 3.19 in survivors. EuroSCORE I was significantly higher in nonsurvivors (p 
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 012-016
      PubDate: 2022-06-01T07:14:56+01:00
      DOI: 10.1055/s-0042-1750194
      Issue No: Vol. 06, No. 01 (2022)
  • Malnutrition-Inflammation Liaison in Predicting AKI following OPCABG in
           Diabetics: Role of a Novel Monocyte/High-Density
           Lipoprotein × Albumin Ratio

    • Authors: Singh; Armaanjeet, Magoon, Rohan, Dey, Souvik, Bansal, Noopur, Shri, Iti, Kohli, Jasvinder Kaur, Kashav, Ramesh Chand
      Pages: 017 - 024
      Abstract: Background Monocyte/high-density lipoprotein ratio (MHR) has been recently proposed as a parsimonious inflammatory marker. Akin to MHR, hypoalbuminemia (a malnutrition marker) has a considerable proinflammatory potential and confers an accentuated risk of postcardiac surgery complications, like acute kidney injury (AKI). The present study evaluated the AKI-predictive value of the preoperative monocyte/high-density lipoprotein × albumin ratio (MHAR) in diabetic patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods The retrospective study conducted at our tertiary cardiac care center included 687 diabetic OPCABG patients. Forty-eight hours postoperative data was evaluated for the occurrence of AKI, as defined by the Acute Kidney Injury Network criteria. The perioperative attributes of the AKI and non-AKI groups were compared to evaluate the predictors of AKI, by employing a regression analysis. Results A total of 109 patients (15.87%) developed AKI postoperatively. On univariate analysis: age, EuroSCORE II, preoperative congestive heart failure, systemic hypertension, serum albumin, MHR, MHAR, intraoperative packed red blood cell transfusion, postoperative low cardiac output syndrome, and vasoactive-inotropic score (VIS) predicted AKI. AKI subsequent to multivariate analysis, age (odds ratio [OR]: 1.029), EuroSCORE II (OR: 1.264), MHAR (OR: 1.403), and VIS (OR: 1.07) were the independent predictors (p-values: 0.020, 
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 017-024
      PubDate: 2022-06-01T07:14:56+01:00
      DOI: 10.1055/s-0042-1750112
      Issue No: Vol. 06, No. 01 (2022)
  • Infections Acquired During Venoarterial Extracorporeal Membrane
           Oxygenation Postcardiac Surgery in Children: A Retrospective Observational

    • Authors: Yagani; Seshagiribabu, Singh, Sarvesh Pal, Sahu, Manoj Kumar, Choudhary, Shiv Kumar, Chowdhury, Ujjwal Kumar, Hote, Milind Padmakar, Singh, Ummed, Reddy, Pradeep Ramakrishna, Panday, Shivam
      Pages: 025 - 032
      Abstract: Introduction Extracorporeal membrane oxygenation (ECMO) is increasingly being used in refractory cardiac and pulmonary dysfunction as a rescue modality. The common indications for establishing venoarterial ECMO (VA-ECMO) support in children postcardiac surgery are failure to wean from cardiopulmonary bypass (CPB), postcardiotomy cardiogenic shock (PCCS), refractory pulmonary arterial hypertension, and as a bridge to recovery or transplant. The survival rate of children on VA-ECMO support is 45%. The most frequently encountered complications during VA-ECMO are bleeding, thrombosis, acute kidney injury, and infections. Among those, infections acquired during VA-ECMO lead to high morbidity and mortality. Hence, this study aimed to determine infection rates, causal microorganisms, and mortality risk factors in children developing an infection during VA-ECMO therapy. Methods This retrospective observational study was conducted on 106 children under 14 years of age who underwent elective or emergent cardiac surgery (between 2016 and 2020) and required VA-ECMO support. Medical records were reviewed to collect the targeted variables and analyzed. Results Out of 106 children, 49 (46.23%) acquired infections representing a prevalence of 46.23% and an infection rate of 186.4 episodes per 1,000 ECMO days. Prevalence and acquired infection rate/1,000 ECMO days were higher in the nonsurvivor group than in the survivor group (26.42 vs.19.81%) and (215.07 vs. 157.49), respectively. The bloodstream infection (BSI) and catheter-associated urinary tract infection (CAUTI) episodes were 53.04 and 68.19 per 1,000 ECMO days, and the ventilator-associated pneumonia (VAP) rate was 44.50 per 1,000 ventilator days. The mean preoperative admission duration, aortic cross-clamping duration, CPB duration (minutes), and vasoactive-inotropic score were higher in the nonsurviving children (p 
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 025-032
      PubDate: 2022-06-01T07:14:56+01:00
      DOI: 10.1055/s-0042-1750113
      Issue No: Vol. 06, No. 01 (2022)
  • Outcome of Ventilator-Associated Pneumonia in Children Post Cardiac
           Surgery: A Prospective Observational Study

    • Authors: Singh; Dharmraj, Sahu, Manoj Kumar, Singh, Sarvesh Pal, Singh, Ummed, Choudhary, Shiv, Pandey, Shivam
      Pages: 033 - 039
      Abstract: Background Ventilator-associated pneumonia (VAP) is a serious complication in post congenital cardiac repair in children leading to high morbidity and mortality. We conducted this study with an aim to determine incidence, risk factors, and mortality of VAP in pediatric cardiac surgical patients. Methodology This prospective observational study included 371 children aged less than 12 years who underwent elective cardiac surgery for congenital heart disease from March 2020 to September 2021. Patients were categorized into two groups: those with VAP and without VAP. Results Out of 371 patients, 67 patients (18%) developed VAP. The VAP incidence density was 36.3 episodes per 1,000 mechanical ventilation days. Age less than 1 year (p
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 033-039
      PubDate: 2022-06-01T07:14:55+01:00
      DOI: 10.1055/s-0042-1750196
      Issue No: Vol. 06, No. 01 (2022)
  • Dysglycemia in ICU Patients

    • Authors: Joshi; Anshu, Mehta, Yatin
      Pages: 040 - 042
      Abstract: Dysglycemia has emerged as a very common challenge in critically ill patients, especially with regard to current coronavirus disease 2019 pandemic. Prediabetes, poorly controlled diabetes, pharmaceutical intervention in intensive care unit (ICU) with glucocorticoids, catecholamines and other medicines, and stress response all contribute to dysglycemia in critically ill patients. Early identification and management are the key to prevent further complications. Patient prognosis in terms of clinical outcome, length of ICU stay, and in-hospital morbidity/mortality are adversely affected by patient's dysglycemic status. Apart from hyperglycemia, the other three important pillars of dysglycemia are discussed in this article. Synopsis of early intervention have been captured from India-specific practice guidelines. Important landmark trials have also been captured in this article to provide a clarity on certain aspects of managing dysglycemia in ICUs. Hence, this review article is an attempt to bring forth the salient aspects in diagnosing and managing dysglycemia in critical care settings.
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 040-042
      PubDate: 2022-06-01T07:14:55+01:00
      DOI: 10.1055/s-0042-1750116
      Issue No: Vol. 06, No. 01 (2022)
  • Critical Care Nutrition Support following Cardiac Surgery in the Pediatric
           and Adult Population—A Review Article

    • Authors: Hote; Milind Padmakar, Kapoor, Poonam Malhotra, Malakar, Jaydeep
      Pages: 043 - 047
      Abstract: Cardiac surgical patients in the intensive care unit certainly develop complex nutritional issues. Nutrition support is indicated in these subsets of patients and the same may be customized depending on individual patient characteristics. This review article that aims to examine the American Society for Parenteral and Enteral Nutrition guidelines for the use of parenteral and enteral nutrition in pediatric and adult cardiac surgical patients in cardiac critical care/intensive care unit evaluates the evidence related to the use of nutritional screening and nutritional assessment. The goal of this review is to enrich the discussion contained in the clinical guidelines and simplify the guideline statements to provide a platform for cardiac care providers to implement into their daily practice related to nutrition support in postoperative cardiac surgery patients.
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 043-047
      PubDate: 2022-06-01T07:14:56+01:00
      DOI: 10.1055/s-0042-1750424
      Issue No: Vol. 06, No. 01 (2022)
  • Periprocedural Management during Therapeutic Cardiac Catheterization in
           Patients with Sleep Apnea Syndrome: Report of Three Cases and Review of

    • Authors: Choudhury; Minati, Sharma, Amita, Kapoor, Poonam Malhotra
      Pages: 048 - 053
      Abstract: Most of the patients with sleep apnea syndrome (SAS) also known as sleep disordered breathing are not diagnosed before undergoing any cardiac interventional procedure. Many of them can safely undergo outpatient procedure under sedation or anesthesia. Few of them with moderate to severe grade of SAS, who are not optimized medically, may create problem and need special consideration. We managed three such cases in cardiac catheterization laboratory; two of them were not diagnosed before. The periprocedural problems we faced in these patients are narrated in this article along with review of literature. Some suggestions for management of such patients undergoing therapeutic cardiac catheterization are also highlighted.
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 048-053
      PubDate: 2022-06-01T07:14:55+01:00
      DOI: 10.1055/s-0042-1750114
      Issue No: Vol. 06, No. 01 (2022)
  • Perfusion Strategies for Bivalirudin Anticoagulation: AIIMS Protocol

    • Authors: Sharma; Gaurav, Hasija, Suruchi, Kapoor, Poonam Malhotra
      Pages: 054 - 058
      Abstract: Anticoagulation strategies for cardiac surgery are witnessing a change with the identification of serious limitations of heparin, including development of resistance in 3 to 13% of patients undergoing cardiac surgery and heparin-induced thrombocytopenia/thrombosis syndrome in 1 to 5.5% of patients. Heparin alternatives have a potential role in these scenarios. Bivalirudin, a reversible direct thrombin inhibitor, has an onset time of 2 to 4 minutes and half-life of 25 minutes, is eliminated mainly by a proteolytic mechanism, does not require antithrombin III for effect, and is nonimmunogenic. The considerations for extracorporeal circulation are peculiar with its use, and this article outlines the aspects of initiating, maintaining, and terminating cardiopulmonary bypass and extracorporeal membrane oxygenation with bivalirudin as the anticoagulant.
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 054-058
      PubDate: 2022-06-01T07:14:56+01:00
      DOI: 10.1055/s-0042-1750011
      Issue No: Vol. 06, No. 01 (2022)
  • 24-Hour Blood Pressure Control with Amlodipine: A Review of the Current

    • Authors: Nair; Tiny, Kumar, A Sreenivas, Unni, T Govindan, Tiwaskar, Mangesh Harihar, Sharma, Shweta, Gaurav, Kumar
      Pages: 059 - 068
      Abstract: Introduction Hypertension is the leading cause of cardiovascular diseases and premature death worldwide. Antihypertensive therapy using calcium channel blockers (CCBs) is one of the preferred choices to treat blood pressure (BP) and control blood pressure variability (BPV). In contrast to clinic BP, 24-hour ambulatory BP monitoring (ABPM) has evolved into an accurate and reproducible tool for the assessment and management of hypertension. Amlodipine, a longer acting dihydropyridine CCB is effective for 24 hours BP control and also minimizing BPV. The present article is the comprehensive review highlighting the efficacy of amlodipine in controlling 24-hour BP and minimizing BPV from the review of recent studies. Materials and Methods The literature search was done using PubMed, Google Scholar, and MEDLINE databases. The studies to be included for review, were identified through the keywords: “amlodipine,” “ambulatory BP monitoring (ABPM),”“blood pressure variability (BPV),” “CCBs,” and filtering articles published in English language only. Results Pharmacological evidence suggests that amlodipine has the ability to block all the subtypes of CCBs such as L-, N-, P-, Q-, R-, and T-type. Various clinical studies reported that amlodipine is a powerful, well-tolerated, and safe antihypertensive agent which is widely used either alone or as a key component of combination therapy for control of 24 hours BP. Conclusion Overall, amlodipine is a proven and effective antihypertensive drug and helpful in controlling 24-hour BP, minimizing BP variability and hence reducing the risk of cardiovascular complications.
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 059-068
      PubDate: 2022-06-01T07:14:55+01:00
      DOI: 10.1055/s-0042-1750195
      Issue No: Vol. 06, No. 01 (2022)
  • Patient Prosthesis Mismatch

    • Authors: Singh; Rashmi, Kapoor, Poonam Malhotra, Prakash, Mohit
      Pages: 069 - 077
      Abstract: Concept of patient prosthesis mismatch came into existence from 1978 onward when Rahimtoola first defined it as “mismatch can be considered to be present when the effective prosthetic valve area, after insertion into the patient, is less than that of a normal human valve.” Patient prosthesis mismatch produces higher than expected pressure gradient through normally functioning valve. Since insertion of first ball caged mechanical valve in descending aorta by Dr. Charles Hufnagel in 1952, prosthetic valve had undergone tremendous improvement in terms of valve design, hemodynamics, durability, and thrombogenicity. Despite these marked changes in valve design, prosthetic valves are still subjected to inherent complications.
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 069-077
      PubDate: 2022-06-01T07:14:57+01:00
      DOI: 10.1055/s-0042-1750115
      Issue No: Vol. 06, No. 01 (2022)
  • Rare case of Left Ventricular Hemangioma

    • Authors: CH, Naga Sai Manjusha, V; Bharath, Hote, Milind Padmakar
      Pages: 078 - 081
      Abstract: Cardiac tumors are rare in occurrence. Among them, primary cardiac tumors that too hemangiomas are further rare. They usually are asymptomatic and are detected incidentally. Preoperative diagnosis may not correlate with histopathologic diagnosis. We report such a rare case of left ventricular hemangioma presented to us with vague chest discomfort, which preoperatively was suspected to be rhabdomyoma or fibroma.
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 078-081
      PubDate: 2022-06-01T11:21:02+01:00
      DOI: 10.1055/s-0042-1750393
      Issue No: Vol. 06, No. 01 (2022)
  • Truncus Arteriosus with Interrupted Aortic Arch: Aortic Arch
           Reconstruction Without Circulatory Arrest

    • Authors: V; Bharath, Hote, Milind Padmakar, Manjusha CH, Naga Sai
      Pages: 082 - 083
      Abstract: Truncus arteriosus (TA) with interrupted aortic arch (IAA) is a rare congenital cardiac anomaly. Traditionally, IAA would require period of deep hypothermic circulatory arrest (DHCA) for aortic arch reconstruction. DHCA may cause myocardial depression and neuro-developmental dysfunction. IAA repair is presently being performed with hypothermic low-flow selective cerebral perfusion and distal body circulatory arrest. Even though this prevents cerebral adverse effects of DHCA, there is still risk to the spinal cord and kidneys.Here, we describe the aortic arch reconstruction by maintaining the total body perfusion without any periods of circulatory arrest in a neonate with TA with IAA.
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 082-083
      PubDate: 2022-06-01T11:21:01+01:00
      DOI: 10.1055/s-0042-1750193
      Issue No: Vol. 06, No. 01 (2022)
  • Transesophageal Echocardiography of Mitral Valve Repair in a Case of Sinus
           of Valsalva Aneurysm: 2D versus 3D

    • Authors: Das; Devishree, Makhija, Neeti, Patra, Tarun
      Pages: 084 - 088
      Abstract: Mitral valve repair is a common and preferred technique over mitral valve replacement whenever it is feasible. Transesophageal echocardiography (TEE) not only reliably identify repairable mitral valve but also guide appropriate intervention. In addition to two-dimensional (2D) TEE, the three-dimensional (3D) technique clearly delineates size and shape of mitral valve apparatus, and determine the repairability and success of repair technique. We illustrate the 2D and 3D TEE techniques that guided the surgical intervention for Alfieri repair.
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 084-088
      PubDate: 2022-06-01T07:14:55+01:00
      DOI: 10.1055/s-0042-1750173
      Issue No: Vol. 06, No. 01 (2022)
  • Isolated Headache as a Symptom of the Acute Coronary Syndrome in a Case
           following Myocardial Revascularization

    • Authors: Nanda; Chinmaya, Mehta, Yatin
      Pages: 089 - 090
      Abstract: Retrosternal chest pain is the classical symptom of acute coronary syndrome (ACS). ACS sometimes presents with atypical symptoms and very rarely as headache as the only symptom. We present here a case where a patient who had undergone coronary artery bypass grafting presented with headache and on evaluation found to have complete occlusion of right coronary artery.
      Citation: Journal of Cardiac Critical Care TSS 2022; 06: 089-090
      PubDate: 2022-06-01T07:14:56+01:00
      DOI: 10.1055/s-0042-1749323
      Issue No: Vol. 06, No. 01 (2022)
  • What Remains at the Bottom of the PANDORA's Box'
    • Journal of Cardiac Critical Care TSS 2022; 06: 091-092
      DOI: 10.1055/s-0042-1750192

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      Journal of Cardiac Critical Care TSS 2022; 06: 091-0922022-06-01T07:14:55+01:00
      Issue No: Vol. 06, No. 01 (2022)
  • Hope Remains at the Bottom of the PANDORA's Box!
    • Journal of Cardiac Critical Care TSS 2022; 06: 092-092
      DOI: 10.1055/s-0042-1750111

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      Journal of Cardiac Critical Care TSS 2022; 06: 092-0922022-06-01T07:14:55+01:00
      Issue No: Vol. 06, No. 01 (2022)
  • Innovative Troubleshooting of Difficult TEE Probe Insertion: Letter To
           Editor Response
    • Journal of Cardiac Critical Care TSS 2022; 06: 093-096
      DOI: 10.1055/s-0042-1750210

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      Journal of Cardiac Critical Care TSS 2022; 06: 093-0962022-06-01T07:14:56+01:00
      Issue No: Vol. 06, No. 01 (2022)
  • Patient Blood Management in Cardiac Surgery and ECMO: The Indian Scenario
           in 2021
    • Journal of Cardiac Critical Care TSS 2021; 05: 181-183
      DOI: 10.1055/s-0042-1742451

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      Journal of Cardiac Critical Care TSS 2021; 05: 181-1832022-02-02T00:00:00+0100
      Issue No: Vol. 05, No. 03 (2022)
  • Role of Cardiac Magnetic Resonance in the Diagnosis of Cardiac Amyloidosis
    • Journal of Cardiac Critical Care TSS 2021; 05: 184-185
      DOI: 10.1055/s-0042-1743394

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      Journal of Cardiac Critical Care TSS 2021; 05: 184-1852022-02-02T00:00:00+0100
      Issue No: Vol. 05, No. 03 (2022)
  • Platelet Function Test in Coronary Artery Bypass Grafting: Does It Predict
           Postoperative Bleeding'

    • Authors: Sharan; Sandeep, Kapoor, Poonam Malhotra, Choudhury, Minati, Prakash, Mohit, Chowdhury, Ujjwal K., Hote, Milind, Ravi, Vajala
      Pages: 186 - 195
      Abstract: Background Patients undergoing on-pump coronary artery bypass grafting (CABG) are at increased risk of perioperative bleeding and morbidity associated with transfusion as a result of acquired and pharmacologically induced impaired platelet function. Settings and Design In this a prospective observational study where 52 patients underwent on-pump CABG were analyzed with ROTEM platelet aggregometry. Materials and Methods Patients were assigned to the “nonexcessive” and “excessive” postoperative bleeding groups according to the postoperative chest tube drainage over 24 hours. Platelet function was assessed by ROTEM platelet using three different activators (arachidonic acid, adenosine diphosphate, and thrombin receptor-activating peptide), at two perioperative time points (T1, before heparinization and T2, 5–10 minutes after protamine administration). Results There were no differences regarding demographic, pre–cardiopulmonary bypass (CPB) platelet count and antiplatelet therapy. Platelet function was impaired over the time course in all parameters with three different activators. At T2 point, area under the curve (AUC) of all the three platelet indices, that is, TRAPTEM, ARATEM, and ADPTEM, showed significant difference between excessive and nonexcessive groups. At both T1 and T2 points, the amplitude after 6 minutes (A6) and maximum slope (MS) parameters of TRAPTEM, ARATEM, and ADPTEM tests were not significantly different in excessive and nonexcessive groups. At T1 point, AUC was also not significantly different in all three ROTEM platelet tests. Results after protamine administration showed correlation with postoperative chest tube drainage. Cut-off values, as determined by receiver operating characteristics (ROC) analyses, had a consistently weak positive predictive value for all tests at T2 time point, whereas negative predictive values were higher. Conclusion Platelet function analysis using ROTEM platelet can help to exclude platelet dysfunction as the reason for bleeding after cardiac surgery. Point-of-care platelet function analysis, particularly in combination with viscoelastic testing can reduce perioperative bleeding and transfusion requirements, as well as improve patient outcomes in cardiac surgery.
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 186-195
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0042-1742402
      Issue No: Vol. 05, No. 03 (2022)
  • Comparative Study of Effect of Continuous versus Intermittent Subglottic
           Suctioning by the Suction Above the Cuff Endotracheal Tube (SACETT) on
           Tracheal Mucosa and Incidence of VAP in Intensive Care Unit

    • Authors: Anand; Ravi, Singh, Siddhart, Prasoon, Anand, Kumar, Sanjeev, Singh, Ritu, Nayan, Santosh Kumar
      Pages: 196 - 200
      Abstract: Context Ventilator-associated pneumonia (VAP) is one of the important causes of morbidity and mortality in patients admitted to the intensive care unit (ICU) with ventilatory support. Subglottic secretion and their aspirations are primarily responsible for the occurrence of VAP and the risk of tracheal mucosa injury induced by subglottic suctioning and the risk of VAP inpatient on a ventilator has been raised. Aims Aim of this study is to compare the effect of continuous suctioning of subglottic secretions (CSSSs) versus intermittent suctioning of subglottic secretions (ISSS) on tracheal mucosa damage and incidence of VAP inpatient on a ventilator in both study groups. Settings and Design A prospective randomized study. Methods and Material A total of 140 patients requiring intubation or reintubation in the ICU with an expected ventilation duration > 24 hours were included in two groups: CSSS and ISSS. The effect on tracheal mucosa in front of the suction port was assessed after intubation (T0) and before extubation (T1) by bronchoscopy. VAP was compared in both groups on the basis of clinical suspicion and positive culture of bronchoalveolar lavage. Statistical Analysis Used The SAS statistical software version 9.4 (SAS Institute, Cary, North Carolina, United States) has been used for analysis. Chi-square of the Fisher's exact test and Student's t-test or the Wilcoxon rank-sum test were used for analysis. Results A total of 127 patients were included and 89 patients (CSSS, n = 44 and ISSS, n = 45) were evaluable on the primary endpoint. The occurrence or worsening of tracheal mucosal damages did not differ between the two groups (CSSS, n = 12 [27.3%] vs. ISSS, n = 8 [17.7%], p = 0.365). Daily average volume of suctioned secretion was higher with ISSS (72 ± 100 vs. 18 ± 25 mL, p 
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 196-200
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0041-1741524
      Issue No: Vol. 05, No. 03 (2022)
  • Comparison the Effect of Etomidate vs. Thiopentone on Left Ventricular
           Strain and Strain Rate at the Time of Anesthesia Induction in Patients
           Undergoing Elective Coronary Artery Bypass Surgery: A Randomized Double
           Blind Controlled Trial

    • Authors: Singh; Ummed, Choudhury, Minati, Choudhury, Arindum, Hote, Milind P., Kapoor, Poonam Malhotra
      Pages: 201 - 207
      Abstract: Myocardial strain imaging with speckle tracking echocardiography (STE) is getting popularity because it does not depends on insonation angle and has shown good correlation with intraoperative and postoperative ventricular function in patients with coronary artery disease. The impact of thiopentone and etomidate induction on myocardial function was studied and compared on sixty patients undergoing elective coronary artery bypass grafting. Three loops for each views (apical 4 chamber, apical 2 chamber, and apical long axis ) were acquired at base line (T0) and 1 minute (T1) after induction for offline analysis. In Group T, significant increase in HR from the base line values (67.8 ± 13.8 vs 79.2 ± 15.6, p = 0.001) occurred post induction, where as in Group E it remain near to the base line (71.7 ± 8.3 vs 70.1± 8.9, p = 0.345). A reduction in mean arterial pressure (MAP) was noted in both the groups after the injection of the allocated drug. There was no significant difference in the index of contractility (ICON) (T0 vs T1: 48.7 ± 10.6 vs 47.0 ± 11.7, p = 0.120) in Group E where as in Group T there was a reduction in the ICON value (T0 vs T1: 45.0 ± 10.7 vs 41.0 ± 8.4, p = 0.005). A similar picture was also noted in systemic vascular resistance index. A significant decrease in cardiac index (CI) was seen in Group E (T0 vs T1: 2.7 ± 0.4 vs 2.5 ± 0.4, p = 0.027), however it remain near to the base line in Group T. There occurred no changes in stroke index (SI) in Group E (T0 vs T1: 38.7 ± 6 vs 37.0± 5.3, p = 0.134), where as a significant decrease was noted after injection of thiopental (T0 vs T1: 38.0 ± 6.2 vs 36.1± 4.9, p = 0.049). A significant decline in cardiac performance index (CPI) was also recorded in Group E (T0 vs T1: 0.57 ± 0.15 vs 0.52 ± 0.12, p = 0.032), and not in Group T. There was decrease in left ventricular ejection fraction (LVEF) after the injection of both the drugs (Group E, T0 vs T1: 57 ± 3.7 vs 54± 3.7, p= 0.001; and Group T, T0 vs T1: 57 ± 3.7 vs 54± 3.7, p = 0.001). In Group E, global longitudinal peak systolic strain (GLPSS) showed no change after the injection of the drug (T0 vs T1: −13.2 ± 2.2 vs −13.1± 2.3, p = 0.631). However, a significant decrease in GLPSS (T0 vs T1: −13.5 ± 1.5 vs – 10 ± 1.8, p = 0.001) after injection of thiopental. Longitudinal peak systolic strain rate (LPSSR) was significantly decreased in all echocardiographic views after the injection of respective drugs. However, the decrease in LPSSR was significantly less in Group E in comparison to Group T.To conclude, STE provides accurate and reliable real time quantitative regional and global LV assessment. Use of thiopentone for anesthesia induction is associated with more profound impairment of LV function in comparison to etomidate as assessed by a decreased longitudinal peak systolic strain rate and global longitudinal peak systolic strain. Further studies are warranted to understand the exact clinical impact, which may influence the choice of intravenous induction agent based upon preoperative patient characteristics.
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 201-207
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0042-1742618
      Issue No: Vol. 05, No. 03 (2022)
  • Feasibility of Opioid-Free Anesthesia for Cervical Rib Excision: A Case
           Series and Review of Literature

    • Authors: Dey; Souvik, Kohli, Jasvinder Kaur, Magoon, Rohan, ItiShri, ItiShri, Kashav, Ramesh Chand
      Pages: 208 - 213
      Abstract: Background Perioperative pain management following cervical rib excision can be compounded in the background of chronic pain disorder caused by the neurovascular compression. The former mandates an enhanced analgesic requirement wherein the perioperative opioid use, in particular, can be associated with a peculiar adverse-effect profile and abuse potential. Appropriate to the context, an opioid-free anesthesia (OFA) protocol can be instrumental in minimizing the incidence of the aforementioned. Case Series While two patients necessitated OFA owing to opioid contraindication, the formulated protocol was evaluated in another six consecutive patients posted for elective cervical rib excision. A combined paravertebral block and superficial cervical plexus block was employed alongside general anesthesia. Intravenous dexmedetomidine and lignocaine assisted the conduct of OFA, and paracetamol dosing was continued into the postoperative period. Intraoperative rescue analgesia was ensured by a ketofol bolus (1:1 mixture of ketamine and propofol) whereas intravenous diclofenac was used for postoperative rescue analgesia. Results OFA could be successfully contemplated in all eight patients. A single bolus rescue dose of ketofol had to be administered in two patients intraoperatively and diclofenac had to be administered as postoperative rescue analgesic in two patients. There was no incidence of postoperative nausea/vomiting or any block-related complications. The postoperative stay was uneventful with an acceptable patient satisfaction. Conclusion The index experience reiterates the fact that a prudent combination of nonopioid multimodal analgesics with case-based locoregional techniques can feature as a successful OFA protocol, albeit mandating future prospective studies in this novel area of clinical interest.
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 208-213
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0041-1741492
      Issue No: Vol. 05, No. 03 (2022)
  • Preoperative Combined Adiposity–Nutritional Index Predicts Major aDverse
           Cardiac and Cerebral Events following Off-pump coRonary Artery
           Revascularization (PANDORA): A Retrospective Single-Center Study

    • Authors: Bansal; Noopur, Magoon, Rohan, Dey, Souvik, ItiShri, ItiShri, Walian, Ashish, Kohli, Jasvinder Kaur, Kashav, Ramesh Chand
      Pages: 214 - 221
      Abstract: Background The metabolic–nutritional profile of coronary artery disease (CAD) patients can be an important outcome determinant. A high visceral adiposity index (VAI) and a low prognostic nutritional index (PNI) have been described to predict major adverse cardiac and cerebral events (MACCE) in nonoperative settings and poor cardiac-surgical outcomes, respectively. The present study evaluated the MACCE-predictive value of the two indices, in isolation and as a combined adiposity–nutritional index (CANI = VAI/PNI) in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods The retrospective study was conducted in 1207 OPCABG patients at a tertiary cardiac care center. Thirty-day postoperative data was evaluated for the development of MACCE, defined by any of the following: cardiac arrest, ST-segment elevation myocardial ischemia (STEMI), repeat coronary revascularization, or stroke. The perioperative characteristics of the MACCE and no-MACCE groups were analyzed for the predictors of postoperative MACCE. Results One-hundred thirty-two patients (10.93%) developed MACCE postoperatively. On univariate analysis, age, EuroSCORE II, ejection fraction, diabetes mellitus, asymptomatic carotid artery disease, left main (LM) disease, PNI, and VAI predicted MACCE. Subsequent to multivariate analysis, age, EuroSCORE II, and CANI were the independent predictors. The MACCE predictive cutoffs of VAI, PNI, and CANI were 3.2, 38.46, and 0.075 (area under the curve [AUC]; sensitivity; specificity: 0.64; 77%; 81.3%, 0.77; 92.6%, 65%, 0.78; 64.5%; 80.2%, respectively). CANI correlated positively with duration of mechanical ventilation, length of intensive care unit (ICU) stay, and mean postoperative vasoactive inotropic scores (VIS). CANI ≥ 0.075 was also associated with a higher incidence of postoperative atrial fibrillation, low cardiac output syndrome, and acute kidney injury. Conclusions CANI emerged as an independent predictor of MACCE following OPCABG.
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 214-221
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0041-1739530
      Issue No: Vol. 05, No. 03 (2022)
  • Noninvasive Bioreactance-Based Fluid Management Monitoring: A Review of

    • Authors: Mehta; Yatin, Kapoor, Poonam Malhotra, Maheswarappa, Harish Mallapura, Saxena, Gaurav
      Pages: 222 - 228
      Abstract: Body fluid balance is an independent predictor of mortality. For each liter of fluid over and above 5 L, risk-adjusted excess mortality is seen. Mortality increased by 2.3% for each 1 L of fluid and hospital costs increased by $999. Accordingly, most recent guidelines have endorsed dynamic modeling. Passive leg raising-induced increase of aortic blood flow ≥ 10% predicts fluid responsiveness with a sensitivity of 97% and a specificity of 94%. Thus, passive leg raising is often used as gold standard for validation of other procedures (though it's usefulness to assess respiratory variation in vena cava is not conclusive). STARLING, a device based on bioreactance, works on phase shift or time delay while bioimpedance works on the amplitude of the thoracic impedance. Unlike bioimpedance, bioreactance is not affected by the size of the patient, thoracic fluids, or position of sensors.STARLING is equipped with four sensor pads. Each pad contains two sensors, the outer sensor is a transmitting electrode and the inner sensor is a receiving electrode. The STARLING monitor induces a 75-KHz AC current. It then measures the time delay/phase shift.STARLING system, a bioreactance-based dynamic assessment system for fluid responsiveness, predicts it accurately, precisely, and noninvasively. It reduces invasive risks and is independently validated against pulmonary artery catheter. It is not affected by vasopressors or shock and has wide range of application.
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 222-228
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0041-1741491
      Issue No: Vol. 05, No. 03 (2022)
  • Anaesthesia Challenges during Sternal Wound Debridement

    • Authors: Kritika; K. G., Kapoor, Poonam Malhotra, Choudhury, Minati
      Pages: 238 - 241
      Abstract: A 50-year-old female weighing 80 kg is posted for a deep sternal wound debridement, post mitral valve replacement (MVR), and post-CABG (Coronary Artery Bypass Grafting) (left internal mammary artery (LIMA)→left anterior descending (LAD)). She had sternal osteomyelitis and had wound debridement thrice before. She had also history of cardiac injury repair during second wound debridement.Her initial three tissue cultures showed Acinetobacter positive. Her fourth tissue culture shows Staphylococcus haemolyticus positive. Histopathology shows necrotizing granuloma. Two-dimensional Echocardiography (ECHO) shows post-MVR, no Mitral regurgitation (MR), mild Tricuspid Regurgitation (TR) (right ventricular systolic pressure (RVSP)-24 + Retrograde autologous priming (RAP)), Inferior Vena Cava #x0028;IVC) 1.6 cm with respiratory collapse, no pericardial effusion, no Left atrium (LA) clot/veg, and normal biventricular function.
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 238-241
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0041-1742244
      Issue No: Vol. 05, No. 03 (2022)
  • Spinal Muscular Atrophy Type II: Anesthetic Challenges and Perioperative

    • Authors: Panda; Suvendu, Baby, S. K. Rojalin, Singh, Guriqbal
      Pages: 249 - 251
      Abstract: Spinal muscular atrophy (SMA) is a group of genetic diseases that cause weakness and wasting in voluntary muscles of infants and children and more rarely in adults. It is caused by inadequate production of a protein called survival motor neuron (SMN) protein coded by SMN1 gene on chromosome 5. Anesthetic challenges in patients of SMA include their sensitivity toward induction agents such as thiopental, opioids, muscle relaxants, and their incomplete reversal with anticholinesterases. They also have weakness of respiratory muscles and inadequate laryngeal reflexes, which make them prone to aspiration. Although spinal and epidural anesthesia have been described in adults with SMA, but general anesthesia in these patients is very challenging. In this case, successful perioperative management of such a patient scheduled for correction of dislocated hip has been described.
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 249-251
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0042-1742401
      Issue No: Vol. 05, No. 03 (2022)
  • Acute Rupture of Sinus of Valsalva into Right Atrium: An Echocardiographic

    • Authors: Makhija; Neeti, Das, Devishree, Agarwal, Sumit
      Pages: 252 - 256
      Abstract: A ruptured sinus of Valsalva is a rare and emergent cardiac abnormality, which can be acute and rapidly expanding to cause hemodynamic deterioration. Rupturing into right-sided heart chambers causes severe left-to-right shunt and sudden volume overload. Echocardiography especially transesophageal echocardiography (TEE) is the gold standard facility for early perioperative diagnosis and also to guide surgical technique. Medical stabilization followed by prompt surgical intervention is the treatment of choice.We hereby report a case of sinus of Valsalva rupturing into right atrium leading to severe left-to-right shunt and the role of TEE in its perioperative management.
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 252-256
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0041-1741493
      Issue No: Vol. 05, No. 03 (2022)
  • Transesophageal Echocardiography in Bentall Surgery: Hope or Hype'

    • Authors: Krishnan; V., Prakash, Mohit, Kumar, Sanjeev, Malhotra, Rohit, Kapoor, Poonam Malhotra
      Pages: 257 - 262
      Abstract: A 57-year-old male patient who is a known case of hypertension well controlled on ramipril presented with a history of shortness of breath and palpitation of 3 months duration. The symptoms were insidious in onset; however, it progressed rapidly over the period of 3 months, wherein at present the patient feels breathless in performing normal daily activities of living making him New York Heart Association class III patient. Palpitations are regular in nature and present throughout the time and are exacerbated on performing even light activities within his house. There was associated swelling of bilateral lower limbs that usually improved after a night's rest; however, it was not completely resolved. The individual did not give any history of chest pain, presyncope, syncope, or any other symptoms that pointed toward a cardiac condition.
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 257-262
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0042-1742715
      Issue No: Vol. 05, No. 03 (2022)
  • From Propped up to Prone: A Paradigm Shift in the Management of Severe
           COVID Pneumonia!

    • Authors: Choudhury; Arindam, Senathipati, Deva
      Pages: 265 - 267
      Abstract: Coronavirus disease (COVID) pneumonia in the recent times has shown us the importance of prone positioning during the management of moderate to severe hypoxia. In fact, we have rediscovered the benefits of this positional maneuver in coping with the “oxygen crisis” during the second wave of this dreaded pandemic. While we (the clinicians) derive benefits of this postural therapy for treating our patients, it is imperative for us to know the underlying mechanisms behind improvement in oxygenation in mild to moderate cases of COVID pneumonia. In this brief communication, we try to decipher the miracles of this great “life-saver.”
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 265-267
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0041-1741494
      Issue No: Vol. 05, No. 03 (2022)
  • Shock Index in COVID Era

    • Authors: Dey; Souvik, Magoon, Rohan, Kohli, Jasvinder Kaur, Kashav, Ramesh Chand, ItiShri, ItiShri, Walian, Ashish
      Pages: 268 - 272
      Abstract: The health care burden and risks to health care workers imposed by novel coronavirus disease 2019 (COVID-19) mandated the need for a simple, noninvasive, objective, and parsimonious risk stratification system predicting the level of care, need for definitive airway, and titration of the ongoing patient care. Shock index (SI = heart rate/systolic blood pressure) has been evaluated in emergency triage, sepsis, and trauma settings including different age group of patients. The ever accumulating girth of evidences demonstrated a superior predictive value of SI over other hemodynamic parameters. Inclusion of respiratory and/or neurological parameters and adjustment of the cutoffs appropriate to patient age increase the predictability in the trauma and sepsis scenario. Being reproducible, dynamic, and simple, SI can be a valuable patient risk stratification tool in this ongoing era of COVID-19 pandemic.
      Citation: Journal of Cardiac Critical Care TSS 2021; 05: 268-272
      PubDate: 2022-02-02T00:00:00+0100
      DOI: 10.1055/s-0041-1739499
      Issue No: Vol. 05, No. 03 (2022)
  • Pulmonary Thromboendarterectomy in a Known Case of Antiphospholipid
    • Journal of Cardiac Critical Care TSS
      DOI: 10.1055/s-0042-1753495

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      Journal of Cardiac Critical Care TSS ; : -2022-07-31T18:25:05+01:00
  • A Randomized Controlled Trial to Evaluate the Use of Probiotics in
           Prevention of Ventilator-Associated Pneumonia in Critically Ill ICU

    • Authors: Prasoon; Anand, Singh, Ritu, Anand, Ravi, Kumar, Sanjeev, Singh, Siddharth, Singh, Akrity
      Abstract: Context Ventilator-associated pneumonia (VAP) is one of the most common causes of morbidity and mortality in mechanically ventilated patients. Curing and preventing effects of probiotics in promoting the growth of Bifidobacterium in the digestive system and the central role of bacteria colonization in the pathogenesis of VAP are evident. Aims The purpose of this study was to evaluate the effects of administration of commercially available probiotics, that is, orodispersible probiotic sachets on VAP prevention and clinical outcomes in critically ill patients. Settings and Design Randomized control trials. Methods and Materials In this study, 120 mechanically ventilated patients were randomly divided into two groups (n = 60 per group). Group 1 was given orodispersible probiotic sachets by gavage, twice a day in addition to routine care, while group 2 received only routine care. Demographic and clinical data were analyzed and clinical outcomes to the primary component (prevalence of VAP) and secondary component (other clinical factors) were interpreted. Statistical Analysis Used In this study, data were analyzed via SAS statistical software version 9.4, using Student's t-test, chi-squared test, repeated measure analysis of variance, and Wilcoxon test. Results There was a significant reduction in VAP diagnosed patients, as well as Clostridium difficile-associated diarrhea and some complications of mechanical ventilation, in group 1 in comparison to group 2. The improvement in VAP was significantly greater for group 1 as compared with group 2. However, the mortality rate was similar between two groups. Conclusions This study demonstrated that a daily diet with orodispersible probiotic sachets can be used as add-on therapy with other medications in the prevention of VAP. As a result, the use of orodispersible probiotic sachets in the treatment plan of patients undergoing long-term intubation is recommended.
      Citation: Journal of Cardiac Critical Care TSS ; : -
      PubDate: 2022-07-02T08:59:00+01:00
      DOI: 10.1055/s-0042-1754161
  • Evolution of a Parsimonious Prognostic Index in COVID-19
    • Journal of Cardiac Critical Care TSS
      DOI: 10.1055/s-0042-1750197

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      Journal of Cardiac Critical Care TSS ; : -2022-06-29T06:54:09+01:00
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