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Case series: two cases of life threatening dynamic airway obstruction from thyroid mass

Authors: Yeeshay Lee, Haozheng Wong, Sing Chee Tan, Rana Muhammad Habibullah, Yoke Yeow Yap, Faheem Khan, Chee Keat Tan

Abstract We present 2 cases of dynamic airway obstruction with respiratory failure leading to cardiac arrest. Both have significant aetiology of cystic thyroid mass with sudden haemorrhagic changes leading to airway obstruction. We discuss the plausible pathophysiology leading to cardiopulmonary compromise where tracheobronchomalacia (TBM) and excessive dynamic airway collapse (EDAC) play a significant role. We […]

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Barriers to effective in-hospital resuscitation: lessons learned during implementation of a hospital-wide code system

Authors: Sharon Einav, Nechama Kaufman, Joseph Varon

Abstract Aims and objectives: To understand the barriers involved in effecting a hospital-wide code system and overcoming them during implementation. Background: Improving survival after in-hospital cardiac arrest involves standardization of both defibrillation equipment and staff’s abilities during codes. Design: Observational descriptive study. Methods: Observational study of the situation existing before implementation of an effective in-hospital […]

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Medication incompatibility in intravenous lines in a Paediatric Intensive Care Unit (PICU) of Indonesian hospital

Authors: Suci Hanifah, Patrick Ball, Ross Kennedy

Abstract Objectives: Currently, little is documented concerning the patterns of multiple concurrent medication use utilising single intravenous line. The in-line compatibility issues in Paediatric Intensive Care Units (PICUs) are not as well documented as in adult patients either. This study closely examined the combination of medications used concurrently in a PICU, recorded how medications were […]

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Association of vitamin D plasma concentration with the severity of illness among children with sepsis treated in Pediatric Intensive Care Unit

Authors: Dyah Kanya Wati, Putu Mas Vina Paramitha Cempaka, I Nyoman Budi Hartawan, Ida Bagus Suparyatha

Abstract Objective: To investigate whether vitamin D plasma concentration correlated with the severity of illness in sepsis children treated in a Pediatric Intensive Care Unit (PICU). Design: This was a cross sectional study. Settings: Pediatric Intensive Care Unit of Sanglah Hospital Denpasar, Bali, in May to November 2016. Patients and participants: Samples were patients aged […]

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SARS 15 years on – My reflection on how to motivate your team to overcome the crisis?

Authors: Dessmon YH Tai

Severe acute respiratory syndrome (SARS) was a new infectious disease that emerged in mid-November 2003 in Guangdong, southern China. By the time this global pandemic was declared contained on 5 July 2003 by WHO, it had afflicted 8090 patients in 29 countries. No other disease had such a phenomenal impact on healthcare workers (HCWs), as […]

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Cardiac tamponade in acute necrotising pancreatitis

Authors: Christopher Thong, Jolene Loi, Bryan Chong, Lu Hern Goh

Abstract Objective: This case report highlights cardiac tamponade as a potentially significant complication of severe acute pancreatitis. Settings: This patient was admitted to the Ng Teng Fong general hospital emergency department. He was subsequently admitted to the Intensive Care Unit (ICU) in the same hospital. Patients: A 58-year-old male presented with severe acute gallstone pancreatitis […]

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Respiratory arrest following CT guided selective cervical nerve root injection

Authors: Arran Keir, Umesh C. Pandey, Thomas Cheri, Ross Freebairn

CT guided cervical nerve root injection is performed for diagnostic purposes or to reduce inflammation and pain in cervical radiculopathy. Steroid and local anaesthetic are injected under CT guidance around the nerve root. This is performed as an outpatient procedure with most patients being able to be discharged 15-30 mins after the procedure. CT guidance […]

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Resuscitation after cardiac surgery in Australia: a survey of practice and the implementation of a training course

Authors: David John Melia, Richard Pieter Ruberti, Kimberley Smith, Sarah Emily Owen

Abstract Objective: To characterise the out-of-hours cover of Cardiac-Surgical Intensive Care Units in Australia, the experience of covering physicians in the training, and management of, cardiac arrest after cardiac surgery, and to describe a novel educational course. Design: Nighttime phone survey with doctors on public cardiac intensive care units across Australia. Members of nursing, intensive […]

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Colistin resistance in organisms causing ventilator-associated pneumonia – Are we going into pre-antibiotic era?

Authors: Sonika Agarwal, Barnali Kakati, Nand Kishore, Sushant Khanduri, Mukta Singh

Abstract Introduction: Ventilator-associated pneumonia (VAP) is one of the most common infections in mechanically ventilated patients. VAP is usually caused by multidrug resistant bacteria. The beta-lactam antibiotics, which were once considered the backbone of antibiotic therapy is under strain due to a variety of bacterial antibiotic resistance. Recent evidence suggests that colistin is the only […]

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Vitamin D deficiency and outcome of patients with sepsis in pediatric intensive care unit: a prospective observational study

Authors: Nurnaningsih, Desy Rusmawatiningtyas

Abstract Background: Vitamin D is important in immunomodulation, regulation of inflammation and cytokines, cell proliferation, cell differentiation, apoptosis, angiogenesis, muscle strength, and muscle contraction. Patients with sepsis have high mortality rate and high deficiency in vitamin D. (1) Vitamin D is increasingly recognized as an important mediator of immune function and may have a preventive […]

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Electrocardiography Holter monitoring abnormalities in acute intracerebral hemorrhages

Authors: Marjan Asadollahi, Mahtab Ramezani, Fatemeh Sharif, Ehsan Karimialavijeh

Abstract Objective: To avoid the misinterpretation of electrocardiogram (ECG) abnormalities in acute intracerebral hemorrhage (ICH), it is important to recognize ECG abnormalities in such patients. Previous studies have reported ECG disorders in ICH patients based on a single ECG tracing. In this study, we used ECG Holter monitoring to determine ECG abnormalities in acute ICH […]

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Initial caloric administration as a risk factor for mortality in critically ill children

Authors: Melia Yunita, Titis Widowati, Nurnaningsih, Desy Rusmawatiningtyas

Abstract Background: The mortality rate of critically ill children with multiple organ dysfunction syndrome (MODS) in Indonesia is approximately 51.85%. Various studies suggested malnutrition as a risk factor for mortality; therefore, nutrition therapy in the form of initial caloric administration became imperative. Objective: To determine the relationship between initial caloric administration (initial route, initial time […]

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The case of the malpositioned feeding tube… while in plain sight

Authors: Thomas Lynch V, Brian T. Wessman

Patient WS is a 63-year-old male who presented to the Emergency Department (ED) with a chief complaint of progressive shortness of breath (SOB) over the past two weeks. Associated symptoms at time of presentation included acute bilateral lower extremity edema, orthopnea, and paroxysmal nocturnal dyspnea. His past medical history was significant for diabetes mellitus type […]

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Difference in serum procalcitonin levels between decompensated liver cirrhosis patients with and without bacterial infection

Authors: Rino Alvani Gani, Oska Mesanti, Marcellus Simadibrata, Suhendro, Irsan Hasan, Andri Sanityoso, C. Rinaldi A. Lesmana

Abstract Background: Decompensated liver cirrhosis may increase procalcitonin (PCT) levels in patients without bacterial infection. Previous studies have not provided conclusive results about the difference in serum PCT levels caused by specific liver decompensation and bacterial infection. Objective: To examine the role of PCT in assisting the diagnosis of bacterial infection in decompensated liver cirrhosis […]

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