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3 "Gaurav Jain"
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Original Articles
Pulmonary
Evaluating diaphragmatic dysfunction and predicting non-invasive ventilation failure in acute exacerbation of chronic obstructive pulmonary disease in India
Nupur B Patel, Gaurav Jain, Udit Chauhan, Ajeet Singh Bhadoria, Saurabh Chandrakar, Haritha Indulekha
Acute Crit Care. 2023;38(2):200-208.   Published online May 25, 2023
DOI: https://doi.org/10.4266/acc.2022.01060
  • 1,963 View
  • 87 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Baseline diaphragmatic dysfunction (DD) at the initiation of non-invasive ventilation (NIV) correlates positively with subsequent intubation. We investigated the utility of DD detected 2 hours after NIV initiation in estimating NIV failure in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients. Methods: In a prospective-cohort design, we enrolled 60 consecutive patients with AECOPD initiated on NIV at intensive care unit admission, and NIV failure events were noted. The DD was assessed at baseline (T1 timepoint) and 2 hours after initiating NIV (T2 timepoint). We defined DD as ultrasound-assessed change in diaphragmatic thickness (ΔTDI) <20% (predefined criteria [PC]) or its cut-off that predicts NIV failure (calculated criteria [CC]) at both timepoints. A predictive-regression analysis was reported. Results: In total, 32 patients developed NIV failure, nine within 2 hours of NIV and remaining in next 6 days. The ∆TDI cut-off that predicted NIV failure (DD-CC) at T1 was ≤19.04% (area under the curve [AUC], 0.73; sensitivity, 50%; specificity, 85.71%; accuracy; 66.67%), while that at T2 was ≤35.3% (AUC, 0.75; sensitivity, 95.65%; specificity, 57.14%; accuracy, 74.51%; hazard ratio, 19.55). The NIV failure rate was 35.1% in those with normal diaphragmatic function by PC (T2) versus 5.9% by CC (T2). The odds ratio for NIV failure with DD criteria ≤35.3 and <20 at T2 was 29.33 and 4.61, while that for ≤19.04 and <20 at T1 was 6, respectively. Conclusions: The DD criterion of ≤35.3 (T2) had a better diagnostic profile compared to baseline and PC in prediction of NIV failure.

Citations

Citations to this article as recorded by  
  • Advancing healthcare through thoracic ultrasound research in older patients
    Simone Scarlata, Chukwuma Okoye, Sonia Zotti, Fulvio Lauretani, Antonio Nouvenne, Nicoletta Cerundolo, Adriana Antonella Bruni, Monica Torrini, Alberto Finazzi, Tessa Mazzarone, Marco Lunian, Irene Zucchini, Lorenzo Maccioni, Daniela Guarino, Silvia Fabbr
    Aging Clinical and Experimental Research.2023; 35(12): 2887.     CrossRef
Pulmonary
Effectiveness of online versus in-person structured training program on arterial blood gas, electrolytes, and ventilatory management of critically ill patients
Gaurav Jain, Bhavna Gupta, Priyanka Gupta, Sagarika Panda, Sameer Sharma, Shalinee Rao
Acute Crit Care. 2021;36(1):54-61.   Published online February 2, 2021
DOI: https://doi.org/10.4266/acc.2020.00759
  • 4,260 View
  • 118 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Due to the risk of viral transmission during in-person training, a shift toward online platforms is imperative in the current pandemic. Therefore, we compared the effectiveness of an in-person interactive course with a structurally similar online course designed to improve cognitive skills among clinical health professionals in arterial blood gas analysis, management of electrolyte imbalances, and approaches to mechanical ventilation in critically ill patients.
Methods
In an observational, outcome assessor-blinded, cohort trial, group A included participants enrolled prospectively in an online course, while group B included those who took part in an in-person course (retrospective arm). The primary objective was comparison of cognitive skills through a pre and post-test questionnaire. Statistical analysis was performed using Student t-test.
Results
In total, 435 participants were analyzed in group A, while 99 participants were evaluated in group B. The mean pre-test score was 9.48±2.75 and 10.76±2.42, while the mean post-test score was 11.94±1.90 (passing rate, 64.6%) and 12.53±1.63 (passing rate, 73.3%) in groups A and B, respectively. Group B scored significantly higher in both pre-test (P=0.001) and post-test evaluations (P=0.004). The improvement in post-test score was significantly greater (P=0.001) in group A (2.46±2.22) compared to group B (1.77±1.76). The medical specialties fared better in group B, while surgical specialties scored higher in group A. The pre-test vs. post-test scores exhibited a moderate correlation in both groups (P<0.001). The feedback survey showed a Likert score >3.5 for most points in both groups.
Conclusions
The online teaching module exhibited a significant benefit in terms of participant sensitization and knowledge sharing.

Citations

Citations to this article as recorded by  
  • Health Care Simulation as a Training Tool for Epidemic Management
    Marcia A. Corvetto, Fernando R. Altermatt, Francisca Belmar, Eliana Escudero
    Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare.2023; 18(6): 382.     CrossRef
Letter to the editor
Pulmonary
Retrieval of a tracheobronchial blood clot with a Yankauer suction catheter in complete airway obstruction
Sharad Kaushik, Gaurav Jain, Namrata Gupta, Lokesh Kumar Saini, Girish Sindhwani
Acute Crit Care. 2021;36(1):78-80.   Published online January 13, 2021
DOI: https://doi.org/10.4266/acc.2020.00675
  • 4,592 View
  • 93 Download
  • 1 Web of Science
  • 1 Crossref
PDFSupplementary Material

Citations

Citations to this article as recorded by  
  • Determining Obstruction in Endotracheal Tubes Using Physical Respiratory Signals
    Hyunkyoo Kang, Jin-Kyung Park, Jinsu An, Jeong-Han Yi, Hyung-Sik Kim
    Applied Sciences.2023; 13(7): 4183.     CrossRef

ACC : Acute and Critical Care