Patients' Family Satisfaction in Intensive Care Unit: A Leap Forward.

Garg SK. Patients' Family Satisfaction in Intensive Care Unit: A Leap Forward. Indian J Crit Care Med 2022;26(2):161-163.

Spontaneous hemothorax and implication of diagnostic evaluation: A case report.

The most critical intervention for large hemothorax is draining the blood out of the pleural cavity by placing a thoracostomy tube but it can be disastrous if done without due consideration. We report a rare case of spontaneous hemothorax due to posterior intercostal artery aneurysm and implication of diagnostic evaluation on its management.

Safety of prolonged prone ventilation in critically ill COVID-19 patients: A short report.

To share our observations regarding the safety of prolonged prone ventilation admitted to our intensive care unit with critical COVID-19 pneumonia and required prone ventilation because of severe ARDS. Since our observations were limited to assessing the safety of prolonged prone ventilation in critical COVID-19 patients and not to analyze any mortality benefit, we did not compare prolonged prone ventilation with standard invasive ventilation or standard duration of prone ventilation.

Management of mild to moderate COVID-19 during the second wave in India: A non-evidence-based approach.

The biggest public health catastrophe of this century-the SARS coronavirus-2, 2019 (COVID-19) pandemic has affected nearly all countries. Countries after countries were gripped by the intermittent waves of the infection. One of the most affected countries was India, wherein the second wave of the pandemic afflicted the vast swathe of the nation. The medical community was overwhelmed and stressed with the inordinate number of patients. Doctors were inundated with the task of managing all kinds of COVID-19 patients ranging from mildly symptomatic to critically ill, in addition to the non-COVID-19 patients. The life of most of the population was significantly disrupted due to the fear of infection and lockdowns in various places. Due to multiple reasons, physician access was limited for mild to moderately sick patients. During this time, online consultations were at their peak and many groups came forward to help Indian patients. These groups were supported largely by Indian doctors based overseas.

Anti-cytokine Therapy in Hospitalized Patients with COVID-19: The Jury is Out.

How to cite this article: Garg SK. Anti-cytokine Therapy in Hospitalized Patients with COVID-19: The Jury is Out. Indian J Crit Care Med 2022;26(10):1069-1071.

An Interesting Presentation of Pheochromocytoma.

Pheochromocytoma is a rare cause of hypertension, but it could have severe consequences if not recognized and treated appropriately. Pheochromocytoma classically presents with paroxysms of hypertension and adrenergic symptoms including classic triad of episodic headache, sweating, and tachycardia. The clinical presentation of pheochromocytoma can mimic a number of other medical conditions including migraine, cardiac arrhythmias, myocardial infarction, and stroke, thus making the diagnosis of pheochromocytoma difficult, and treatment is directed toward presenting issue rather than underlying problem in such patients. We present a case of a 41-year-old male patient who presented with cerebellar infarct and found to have aortic thrombi and later developed acute myocardial infaction during same hospitalization. To the best of our knowledge, this is the first reported case of this kind.

Iatrogenic Bilateral Simultaneous Pneumothorax: Call for Vigilance.

Iatrogenic pneumothorax refers to the pneumothorax generated after diagnostic or therapeutic procedure. We report the case of a 40-year-old male who had bilateral simultaneous iatrogenic pneumothorax with pneumomediastinum leading to cardiac arrest situation, due to wrong placement of nebulization kit in spontaneously breathing intubated patient. We report this case for its rarity, due to the critical importance of this cause as a etiology of bilateral simultaneous iatrogenic pneumothorax leading to cardiac arrest situation, and need to understand the importance of continuous training and stress of emergency environment.

How we managed a difficult to ventilate patient.

A 40-year-old female presented with respiratory difficulty, cough and sputum with blood streaking. Her right lung was destroyed, and trachea was shifted to the same side. On mechanical ventilation, she developed hypoxia and rise in blood pressure. Ventilator was not delivering set tidal volume. After looking into the cause, it was decided to reintubate the patient with new endotracheal tube after cutting bevel. Thereafter, there was successful ventilation.

Evolving paradigm of illnesses presented to medical Intensive Care Unit in body builders: Cases from tertiary care center.

Bodybuilding is the use of progressive resistance exercise to control and develop one's musculature. With the rise in number of persons adopting this activity, there is evolving paradigm of illnesses presented to intensive care in this population subset. Strict adherence to details of bodybuilding and avoidance of unsupervised medications are essential to prevent untoward effects.

Permissive hypercapnia: Is there any upper limit?

A 19-year-old male presented with history of massive hemoptysis. The patient was kept on mechanical ventilation because of severe hypoxia. Lung protective ventilation with low tidal volume was given in view of very poor pulmonary compliance. During the course of treatment, the patient developed a very high CO2 level of 373 mmHg. The patient was successfully weaned off on the 9(th) day without any obvious adverse consequences.

Hair dye poisoning: An unusual encounter.

A 19-year-old female patient presented with alleged history of hair dye "Super Vasmol 33" intake. She presented with cervicofacial edema with upper airway obstruction. Although patient was being managed for airway obstruction, she developed cardiac arrest. Cardiac resuscitation could not be started at that point of time because managing airway was the priority in a patient who in hypoxic cardiac arrest. As soon as the airway was secured by emergency tracheostomy, cardiac resuscitation was initiated and the patient was successfully revived.