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A B I - M O N T H LY N E W S L E T T E R O F I N D I A N S O C I E T Y O F C R I T I C A L C A R E M E D I C I N E
www.isccm.org
C O M M U N I C A T I O N SCritical Care
Editorial officE
dr. Yatin Mehta272 Espace, Nirvana Country, Gurgaon 122001Mobile : +91 9971698149 emails : [email protected]
Published By :
IndIan SocIety of crItIcal care MedIcIneFor Free Circulation Amongst Medical ProfessionalsUnit 6, First Floor, Hind Service Industries Premises Co-operative Society, Near Chaitya Bhoomi, Off Veer Savarkar Marg, Dadar, Mumbai – 400028 Tel. 022-24444737 • Telefax :022-24460348 • email : [email protected]
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ISCCM News HeadlIneS ISCCM day – Multiple events across the country
Criticare 2018 agenda
ISCCM Go Green campaign
ISCCM MOVIe Return Gif t gets first prize at aarogya Film festival in Pune.
MCI has awarded 22 CMe hours to CRITICaRe 2018
Thematic conferences by various city branches
Volume 12.5 NoVemBeR-DeCemBeR 2017
1 ISCCM news Headlines
2 editorial
3 President's desk
3 editorial Board 2017-2018
4 General Secretary's desk
5 ISCCM day Celebration 2017
9 ISCCM Branch activities
10 Journal Scan
11 Battle of the Brains
11 Image Section
12 GUIdelIneS / PRaCTICe CORneR - newer Oral anticoagulants
15 Welcome new Members to the ISCCM family
16 new Office Bearers of ISCCM Branches
17 CRITICaRe 2018 Scientific Program
25 CRITICaRe 2018
C O N T E N T S
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine2
HAPPY NEW YEAR
HAPPY NEW YEAR
Editorial...
dr. yatin MehtaEditor in Chief, The Critical Care CommunicationsPresident-Elect, [email protected]
www.isccm.org
Dear Readers,
Season’s Greetings
The year is ending and we have had a very fruitful and academic
2017. The Varanasi Team under Dr. D. K. Singh has been burning
mid night Diyas (Oil) to make our Annual Conference a great success.
The Scientific programme under the guidance of the President
Dr. Zirpe has turned out very nice and we all are looking forward to it.
I would urge everyone to register and join the pilgrimage! Long Live
ISCCM and CCC! Happy New Year to you all and BIG THANK YOU to
my editorial team!
BeST WISHeS FOR all !
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine 3
HAPPY NEW YEAR
President's Desk...
Dear All,
2017 has been a great year for ISCCM. We had big achievements for the society. ISCCM Day was celebrated in full spirit across the country. I am happy to share that we (ISCCM) has won the 1st prize and Beat Short film award at the 7yh Aarogya film festival. The short movie “ Return Gift'' on organ donation was well appreciated at the festival in Pune.
ISCCM is dedicated to environment protection. We have launched a Go Green campaign. Most of our publications are already only in soft copy.
I am also happy to inform all members that Criticare 2018 has been credited with 20 CME hours by MCI. We received record number of abstracts for the conference.
The organising team is keen to welcome you all to Varanasi. In 2018 I wish that may you not only change the date of the calendar, but also your focus, commitments and actions for a more fruitful year ahead.
dr. Kapil ZirpePresident, [email protected]
Editorial Board 2017-2018
EdITor In ChIEfDr. Yatin Mehta, Delhi
dEPuTy EdITorS
Dr. Yash Javeri, Delhi Dr. Rajesh Mishra, AhmeDAbAD
[email protected] [email protected]
EdITorS
Dr. Samir Jog, Pune Dr. Sachin Gupta, Delhi Dr. Pradeep Bhatia, JoDhPur Dr. R. Senthil Kumar, ChennAi Dr. Suresh Ramasubban, KolKAtA
[email protected] [email protected] [email protected] [email protected] [email protected]
QuIz SECTIon
Dr. Yatin Mehta, Delhi Dr. Yash Javeri, Delhi
[email protected] [email protected]
Journal SCan
Dr. Srinivas Samavedan Dr. Prashant [email protected] [email protected]
IMagES SECTIon
Dr. Abhinav Gupta Dr. Tapas Kumar [email protected] [email protected]
www.isccm.org
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine4
dr. Subhal dixitgeneral Secretary, ISCCM
Greetings from ISCCM HQ
ISCCM is growing day by day and
increasing its pillars of strength as it
enters the silver jubilee year at the
strike of midnight on 31 december!
It has got a lot of new members and
branch to percolate in india !
Internationally Isccm is playing the role
of a big brother In SARCC region and
now has a very good prominence in
Europe, USA and the world federation!
Dr Kapil Zirpe was nominated by isccm
to represent isccm in world federation.
He was elected to world council during
its meeting in Rio 2017 November.
With education been its strength
always isccm has streamlined its
exams with its 2018 educational
calander out on its website !
Come January 2018 isccm is
going completely go green and all
application for students,institutions
and membership will be online
through the student and institute
management systems.
Members can now also download its
ID cards and membership certificates
online by login!
Many regional meetings, webinar’s
were held across india and are very
well appreciated! I congratulate and
thank all organisers for this !
Isccm day was celebrated with a high
success and lots of creative posters
were received on this theme ! I
sincerely thank all those who have put
in all their efforts in this !
webinar’s were held which got great
appreciation at international level!
General Secretary's Desk
‘‘Internationally
Isccm is playing
the role of a big
brother In sARcc
region and now
has a very good
prominence in
Europe, UsA
and the world
federation!
’’
The film on organ donation “THE
RETURN GIFT” was the show stopper
of the isccm day which has been
well appreciated and has been
nominated for award in the short film
category! Soon after the censorship
board approves this film isccm will
be showing this film across india in
theatres for public viewing.
Isccm is also taking care of its
members by joining hands with new
india insurance and secure safe by
implementing a professional indemnity
policy which will be available to all its
members at concessional rates.
The much awaited Criticare Varanasi
at the holy city is knocking its doors
and awaiting you all from 7-11
March 2018, and the preparation for
this is in full swing ! Many eminent
national and international faculty have
confirmed and the scientific program
is out on website.
Adhar card now has been made
mandatory by government and
hence forth all new applicants for
membership, students, teachers
will have to submit their adhar card
copy along with application! All old
members can update their adhar
card details at: http://www.isccm.org/
UpdateAadharDetails.aspx
Kindly update your adhar details by
31/3/2018!
Finally I welcome you all to the holy
city of Varanasi for Criticare 2018 and
wish you and your family a very happy
new year!
Cheers and thank you !!!
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine 5
ISCCM Day Celebration 2017Delhi
Raipur
ISCCM Day Celebration
13th October 2017
ISCCM Day Celebration was held on 13th October 2017 At Dharamshila Narayana Superspeciality Hospital. Chief Guest of the program was Dr. Anup Kumar was the, Nodal Officer-NOTTO and Professor & Head of the Department of Urology & Kidney Transplant, VMMC & Safdurjung Hospital. Dr. Deepak Govil and Dr. Anil Gurnani was the Guest of honor of the program.
Dr Tarique presented on care of a brain dead patient.
The program was organized by Dr. Ashutosh Bhardwaj, Clinical lead & Senior consultant Department of Critical Care.
After the introduction and opening remarks by
Dr Deepak Govil, lamp lighting was done by all the dignitaries. Topics on Organ Donation Awareness, Brain Death testing, Brain Death donor maintenance were discussed. A short film on organ donation was also run during the program. After the program quiz for fellows & post Graduates on organ donation was also conducted by Dr Yash Javeri.
Program was well attended by more than 75 participants.
Organ Donation Camp
14th October 2017
Organ Donation Camp was organized at Dwarka for public to create awareness for donating organs. Program was well attended around 30 local resident of the society. The camp was organized by Dr Yash Javeri. Professor Alka Chandra,Head of Department,Anesthesia – Hindu Rao Hospital addressed the gathering on need of organ donation.
Society of critical care medicine, Raipur chapter celebrated ISCCM foundation day on 12th October and theme was “Organ Transplant”, on which society’s president Dr Mahesh Sinha and secretory Dr Surya Prakash Sahu spoke on importance of organ donation.
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine6
Raipur
Pune
Society for Critical Care Medicine, Raipur Chapter celebrate ISCCM Foundation day that was covered in city’s reputed Daily Hindi newspaper ‘Pioneer”
THEME : ‘‘RETURN GIFT’’ - ORGAN DONATION
Dates: 09th October 2017
Venue: 1st floor Auditorium Patrakar Bhavan, Ganjve Chowk, Pune
ISCCM Pune Branch is Organized the Program, awereness on organ donation, Well appriciated by media.
Very good Response from local public 190 people has attended the prgram. It is Celebrated to encourage People to donate organ.
PrOgraM
06:00 to 06:10 PMIntroduction of Topic & Role of ISCCMDr Subhal Dixit
06:10 to 06:25 PMOrgan Donation Film “Return Gift” release Felicitation of film production teamDr Marathe
06:25 to 07:05 PM Expert Panel Discussion/ interaction with Audience
Moderator: Dr. Kapil ZirpePanelist : Dr Shirish Prayag,Dr Kaynoosh Kadapatti,Dr Prasad Rajhanse, Dr Subhal DixitMrs Arati Ghokhale, Mr Rajesh Shetti
07:05 to 07:35 PM SKIT “ Sanjeevan : A Gift of life” Purva Shah & Team
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine 7
The Discussion Between public and experts
Lots of questions & Myths about organ dona-tion - Organs that can be donated are: Kidney, Eye, Lungs, Heart, Liver, Pancreas, Cornea, Small Intestine, Skin tissues, Bone tissues, Heart valves and Veins.
Organ donation has proved to be a miracle for the society. Organs such as kidneys, heart, eyes, liver, small intestine, bone tissues, skin tissues and veins are donated for the purpose of transplantation. The donor gives a new life to the recipient by the way of this noble act
Dr Kapil Zirpe has discussed the Gap between Demand and Supply The demand for organs is considerably higher than the number of donors around the world. Each year several patients die waiting for donors. Statistics re-veal that in India against an average annual demand for 200,000 kidneys, only 6,000 are received. Similarly, the average annual de-mand for hearts is 50,000 while as low as 15 of them are available.
Who pays for Surgery of an organ Donor??? Your family pays for your medical care and fu-neral costs, but not for organ donation. Costs related to donation are paid by the recipient, Hospitals.
Dr Kayanoosh Kadapatti has explained Or-gans that can be donated after death are the heart, liver, kidneys, lungs, pancreas and small intestines. Tissues include corneas, skin, veins, heart valves, tendons,ligaments and bones.
Organ and tissue donation involves removing organs and tissues from someone who has died (a donor) and transplanting them into someone who, in many cases, is very ill or dying (a recipient). Organs that can be trans-planted include the heart, lungs, liver, kid-neys, intestine and pancreas.
Dr Subhal Dixit has explained Organ and Tis-sue Donation after Cardiac Death. Typically when a person suffers a cardiac death, the heart stops beating. The vital organs quickly become unusable for transplantation. But their tissues – such as bone, skin, heart valves and corneas – can be donated within the first 24 hours of death.
Mrs. Arti Gokhale has explain the role of ZTCC on organ donation ,
Dr Balasaheb Bande has explained Individu-als in their 80s and 90s have successfully donated organs including liver and kidneys to save the lives of others. You must be 18 years of age to register through the state's Donate life Registry. People of any age wishing to be-come organ and tissue donors should inform their families that they wish to donate.
190 people had attended the program
Dance & Skit Represented by Purvi ShahAbout organ donation
SKIT “Sanjeevan : A Gift of life”Purva Shah & Team
TEAM BEHIND THE SUCCESSFUL PROGRAM ON ORGAN DONATION
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine8
Nagpur
Goa
Ahmedabad
As a part of SCCM annual day celebrations public awareness programme on organ donation was organised by SCCM Nagpur Branch chapter 2017-2019at city hotel centre point on Sunday 15 th october. This SCCM day was celebrated by all 67 branches of ISCCM across the country.
Programme was started with welcome address by Dr Nikhil Balankhe sir speaking on the importance of organ donation. He said "people need to realize that nothing more charitable and selfless than Organ donation can ever occurs in person’s life as you can save 8 live by doing so"
He welcomed with floral bouquet chief guest Dr Vibha Dani who is president of ZTCC followed by Dr Ravi Wankhede he is secretary of ZTCC.
After welcome address dr Ravi Wankhede gave talk on Organ donation. He said "lack of awareness and motivation, religious taboos are few reasons so as peoples are hesitant to donate organs" but people don't understand that every religion rightfully allowed organ
donation" he also said that "you get a great feeling because you brighten someone's life after yours life is over"
Following the talk two Skits were presented first by team of Dr Acharya sir on organ donation after demises of loved one to the unknown donor. Second skit was presented by Team SCCM DR Anant Rajput , Dr Sanjeev Bais, Dr Ajay, dr Shahnawaz Saddique, and dr Kaustub Upadhye, on how to manage burn patients, how Skin donation will help to improve outcomes of patients, and creating more awareness on skin donation. Programme was ended with panel discussion with the panelists Dr Vibha Dani, Dr Ravi Wankhede, Dr Nirmal Jaiswal, Dr Anand Dongare, Dr Bhuche,
dr Deepak Jeswani, Dr acharya, Dr Sameer Jahagirdar. The session was moderated by dr Nikhil balankhe who cleared the doubts on organ donation and successfully answered the question of audience.
The programme was ended with special thanks given to Mr N.K Garg who is chairman of DIFFUSION Engineers PVt. Ltd. Who donated some amount to SCCM for this noble cause.
ISCCM Goa branch celebrated the 24th foundation day on 8 th October 2017 at hotel Double Tree Neptune, Panjim Goa, meeting was in association with ISA Goa branch.
Dr Seetaram Korgaonkar Chairman Goa branch welcomed the august gathering and told purpose of having foundation day celebration. ISCCM Goa is also completed one year since it was founded in Nov 2016.
Audience was given information about the aims of ISCCM and what it has achieved in last 24 years. The theme for this year was "Organ Donation the return Gift for Life". Dr Seetaram Korgaonkar Chairman, elaborated on the purpose of having this theme this year.
CME on Organ Donation started with screening of film "Organ Donation" developed by ISCCM headquarters.
Local TV channel prime TV has covered event and telecasted it in Goa which boosted the awareness program at general public level.(attaching link of telecast ).. Please find the link of the program - https://youtu.be/FvD6QKEMPiA
Photographs of meeting are also attached herewith.
Thanks
Dr. Seetaram KorgaonkarChairman, Goa Branch
Which was followed by talk on 'Organ Donation awareness' by Dr shital Lengde, Nephrologist.
Second talk was on 'brain death testing' given by Prof S ponraj, Head of department of Neurosurgery at Goa medical college. Doctors actively participated in discussion on Organ Donation. Meeting ended with vote of thanks by Secretary ISCCM Dr Hemchand Maenkar and Dr. Milind Naik which was followed by dinner.
Meeting was attended by many specialists and some general public.
ISCCM Foundation Day webinar
Monday, 9th October 2017, 7.00 to 9.30 pm Crowne Plaza, Ahmedabad
ISCCM Foundation Day webinar was organised on 9th October at Ahmedabad by Dr Rajesh Mishra. The topics covered were off day to day interest for intensivist. The webinar was attended by 900 plus world wide audience. The link is available for a month which can be accessed by ISCCM web site.
PrOgraM
7.00-7.15 pm ISCCM Organ Donation Video - Return Gift
7.15-7.35 pm Communication, Convincing and Social aspects of organ donation in India - Mrs. Sujata Ashtekar
7.35-7.55 pm Medicolegal aspects in organ donation in India - Mr. Mahendra Kumar Bajpai
7.55-8.15 pm Brain Death diagnosis Indian Perspective - Dr. Srinivas Samavedam
8.15-8.35 pm Before you ask for organ retrieval you need to know!! - Dr. Rahul Pandit
10 minutes Discussion and question answer
8.45-9.30 pm Managing brain death donor in ICU
Moderator: Dr. Rajesh Mishra
Panelist: Dr. Srinivas Samavedam, Dr. Rahul Pandit, Dr. Pratibha Dileep, Dr. Anuj Clark, Dr. Chirag Matrawadia
Weblink: http://estv.in/isccmday
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ISCCM Branch ActivitiesDelhi
Pondicherry
November 2017
International Speaker Program
advanced Mechanical Ventilation with Electrical Impedance Tomography (EIT)
Speaker: Dr Diederik Gommers, Professor Intensive Care Medicine at Erasmus MC, Rotterdam, The Netherlands
Cordinator: Dr Yash Javeri, Secretary - SCCM Delhi NCR, Director- Apex Healthcare Consortium
Panelist: Dr R K Mani, Group CEO, Chairman Critical Care and Pulmonology, Nayati Medicity
Dr J V Divatia, Professor and Head, Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Mumbai
Dr Sandeep Dewan, Director and HOD (Critical care) Fortis Memorial Research Institute, Gurugram
The meeting was organised under aegis of SCCM Delhi at Leela Ambience, Gurugram
December 2017
One Day Workshop on rational Use of Intravenous Fluid
10 December 2017, radisson Blu Hotel, Faridabad
Organized by Dr Supradip Ghosh
A workshop on Rational Use of Intravenous fluid was organized on 10th December 2017 at Hotel Radisson Blu, Faridabad. workshop program designed for audience intensivists, anesthesiologists, internsists and surgeons. Highlights of the workshop was critical appraisal of various commercially, available
fluids, bedside utilization of these principles, in various clinical scenarios and interactive session. Sessions on topics like ambasic concepts – physiology and more with the lectures includes on dynamics fluid and difference fluid were held. Various lectures were given by eminent local faculty and international faculty Dr Roop Kishen. At the last case based panel discussion was held for 2 hours. Workshop was thoroughly attended by more than 70 participants.
First State Level ISCCM Conference which held in October 7th & 8th 2017 at Indragandhi Government General Hospital, Pondicherry.
Dr G.Sreenivaasan ISCCM, Secretary, Pondicherry
Job opportunities Advertisement on isCCm Website
You can advertise Job opportunities in your Hospital/ Institute on ISCCM website and attract best talent. ISCCM has more than 9,500 members working in field of Critical Care in India.
Rates of Job Opportunities advertisement on ISCCM website are as follows:
Hospitals/ Institutes (India) Rs. 20,000 for 30 days
Hospitals/ Institutes (Foreign countries) US$ 500 for 30 days
For any further details required, please contact
Mr. Vimal Merchant
ISCCM Mumbai Office
Phone: 022-24444737/24460348 • Email: [email protected]
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine10
dr. Srinivas SamavedamMd, dnB, frCP, fnB, EdIC, fICCMdiploma in health Care Quality Management,diploma in Medical law and Ethics,head, Critical Care unit, Virinchi hospitals, hyderabadMobile: +919866343632e-mail: [email protected]
dr. Prashant KumarMd, IdCCM, fnB (Critical Care), EdIC, PgdPha, doaEditor 'Critical Care Waarticles'Senior Consultant Critical Care, Medanta The Medicity, global health Private ltd, Sector - 38, gurgaon 122001, haryana, IndiaMobile: +919899302959 e-mail: [email protected]
JOUR
NAL SCAN
The compilers would like to wish all members
an advance HAPPY NEW YEAR
Quite a few interesting publications came
out in the last quarter of the year. We look at
some of them
Tissue Doppler assessment of diastolic
function and relationship with mortality
in critically ill septic patients: a
systematic review and meta-analysis
San Filippo F et al ; British Journal of
Anaesthesia, 119 (4): 583–94 (2017)
Diastolic dysfunction is increasingly being
studied and reported in non-cardiac
conditions, especially those associated with a
SIRS response. San Filippo et al carried out a
systematic review of all data that evaluated the
role of tissue Doppler assessment in identifying
diastolic dysfunction among critically ill septic
patients. The primary analyses involved the
relationship o e’ and E/e’ ration with mortality
among critically ill septic patients. A total of 17
patients with about 1300 patients qualified
for the meta-analysis. A significant correlation
was found between lower e’ and higher E/e’
ratio with higher mortality. This implies that
LV diastolic dysfunction is an important cause
for mortality among septic patients. The e’
velocity does not seem to be correlate to the
pre-load status of the LV. This correlation was
more apparent among those patients who
were screened early in the course of sepsis.
Reviewer’s comments: This study emphasises
the role of assessment of diastolic function
while prognosticating a septic patient and
also reiterates the necessity of learning the
skills of echocardiography.
Continuous Versus Intermittent
Subglottic Secretion Drainage
to Prevent Ventilator-associated
Pneumonia: a Systematic review
Zunjia W et al; Critical Care Nurse. 2017;
37[5]:e10-e17)
Ventilator associated pneumonia is a problem
faced by most intensive care units. Ideas to
prevent the condition are constantly emerging.
One of the interventions which is considered
to be of some benefit is use of endotracheal
tubes with subglottic suction channels.
Manufacturers recommend continuous
suction through the channel for optimum
benefit. This however presents some logistic
difficulties. Zunjia et al carried out a systematic
review of studies comparing intermittent
subglottic suction with continuous suction.
They included studies which had VAP rates as
well as length of stay as indices of outcome.
After rigorous methodological screening eight
studies involving 1070 patients were selected
for the meta-analysis. The incidence of VAP as
well as the time to VAP onset was comparable
in the two types of subglottic suction. Mucosal
injury appeared to be more common with
continuous suction. No mortality difference
was found. The authors recommended a
larger RCT to elucidate this question.
Reviewer’s comments: It may not be a wrong
practice to use intermittent subglottic suction
to prevent VAP, till bigger RCTs come out with
more definite evidence
Lung recruitment Maneuvers for adult Patients with acute respiratory Distress Syndrome -a Systematic review and Meta-analysis
Goligher EC et al; Ann Am Thorac Soc Vol 14,
Supplement 4, pp S304–S311, Oct 2017
Lung recruitment maneuvers have been
in practice for more than a decade. As the
understanding of pathophysiology of ARDS
improves and consequences of mechanical
ventilation realised, alveolar recruitment
maneuvers have come under greater scrutiny.
Goligher et al carried out a systematic review
of mechanical ventilation strategies with and
without lung recruitment maneuvers. The
aim of the review was to evaluate whether
mechanical ventilation strategies with
recruitment measures, decrease the mortality
when compared to strategies not employing
lung recruitment. For the purpose of this review,
recruitment maneuvers were defined as any
type of transient elevation in mean airway
pressure undertaken to reduce atelectasis.
Six trials enrolling close to 1400 patients
qualified for the review. Significant benefit was
noted in 28 day mortality and oxygenation
when recruitment strategies were part of the
ventilator management. Similarly, incidence
of barotrauma was not higher with the use
of recruitment maneuvers. This study also did
not report increased hemodynamic instability
when recruitment maneuvers were applied.
The authors concluded that recruitment
maneuvers improve oxygenation, particularly
when combined with higher PEEP, and reduce
the requirement for rescue therapy. LRMs are
safe and well tolerated. LRMs may improve
survival in patients with ARDS, but further
research is required to definitively assess the
role of LRMs in the routine management of
mechanical ventilation in patients with ARDS
Reviewer’s comments: Recruitment
maneuvers, when applied in selected group of
moderate to severe ARDS patients probably
have some beneficial effects and are safe.
But selection of patient seems to be the
crucial issue
The influence of esmolol on septic
shock and sepsis: a meta-analysis of
randomized controlled studies
Liu P et al; Am J Emerg Med 2017 Nov 8
Sepsis and septic shock have a varied
outcome determined by a host of factors. One
of the implicated confounders is a myocardial
dysfunction which could be triggered by
a persistent tachycardia. Control of this
tachycardia with beta blockers is an attractive
hypothesis, which is always tempered by
concerns about the effect of the beta blockers
on hemodynamics. Liu et al carried out a
meta-analysis of RCTs evaluating the effect of
the betablocker, esmolol, on the outcomes of
patients with sepsis and septic shock. Only 5
RCTs withstood the methodological scrutiny.
Survival benefit appeared to be significant with
the use of esmolol. Cardiac injury markers
like troponin I were also favourably altered by
esmolol. However, there was no influence of
beta blockade on MAP, CVP or SCVO2. The
authors concluded that Esmolol treatment
may be able to improve survival rate, and
reduce heart rate and TnI.
Reviewer’s comments: In situations where
the SIRS response is severe and persistent,
this study reassures that beta-blockade with
esmolol may not be detrimental. It might have
a favourable effect on myocardial injury.
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine 11
Image Section
26 year old male presented to the ER with a history of difficulty breathing
Answer to lAst imAge section
Chest X-ray shows the implantable pulse generator with its leadsDeep brain stimulation is used in a variety of clinical settings, predominantly in patients with poorly controlled movement disorders.
Battle of the Brainsdr. yatin Mehta and dr. yash Javeri
Please mail the answers at the earliest to [email protected]
Correct answers with the name of first two correct entries will be published in next issue
Q1. What is Maastricht classification?
Q2. What is FeMg?
Q3. What is Nasogastric tube syndrome?
Q4. Expand OPSS
Q5. Fill in the blanks.
An outbreak called '......... .....' started in March 1990 and spread rapidly all over Bombay and adjoining area. A concomitant and steady increase in ..... ..... ...... ....... ....... isolation was observed.
answers of September-October 2017 Issue
1. For legal purposes death is: Cardio-pulmonary arrest
2. Consent for retrieval of organs or tissue from the deceased is not valid if obtained from: From the doctor attending the deceased at the time of death
3. Incorrect-It may be commercialised in necessary circumstances
4. 94%
5. 1954
6. 9
7. True
8. All of the options are correct
9. Organ Transplantation and Donation is permitted by law, and covered under the "Transplantation of Human Organs Act 1994", which has allowed organ donation by live & Brain-stem Dead donors. In 2011, amendment of the Act also brought in donation of human tissues, there by calling the Amended Act "Transplantation of Human Organs & Tissues Act 2011"
10. The police department has to be informed that a patient is brain dead if it is a medico- legal case, but the declaration of brain-stem death is only done by a panel of doctors.
Q6. What unit is used to measure EAA?
Q7. Which section of IPC deals with death caused by a negligent act.
Q8. Identify the drug
Q9. What is mechanism of action of Giapreza?
Q10. What is line listing?
Use of the Fluid Challenge in Critically Ill adult Patients: a Systematic review.
Messina et al Anesth Analg 2017; 125:1532–
43
Fluid therapy is one of the most common
interventions in hospital and ICU practice.
This is also the intervention with maximum
variability and individual preferences. Messina
et al carried out a systematic review to identify
the pattern and trends of fluid prescriptions.
The focus specifically was to look at the triggers,
targets and end points of fluid challenge. For
purposes of this study the authors defined
fluid challenge as the infusion of a definite
quantity of fluid of a specific quality in a fixed
time (expressed as either span or infusion
rate), and defined the outcome of the FC as
a change in a defined hemodynamic variable
for a predetermined threshold. A total of 71
studies enrolling 3617 patients were selected
for the review. The average amount of fluid
given was about 500 ml (7ml/kg). Colloids
were the most commonly used fluids while
starches were used in 6.7% of patients.
Fluid was administered over 30 minutes in
more than 40 % of the studies. Increase
in cardiac output or cardiac index were the
most common targets and a little more than
50% of patients were fluid responders. The
percentage change in CO or CI varied between
10-15%. The authors concluded that the Fluid
Challenge is not well standardized and lacks
of consistency among the published studies.
Reviewer’s comments: Despite lot of
published evidence and guidelines, one of
the most common and crucial interventions in
ICU has lot of variabilities and inconsistencies
in practice.
Continuous versus intermittent
neuromuscular blockade in patients
during targeted temperature
management
Mathias Stöckl et al; Resuscitation Volume
120, November 2017, Pages 14-19
Targeted temperature management is the
current standard of care for patients surviving
a cardiac arrest. Prevention of shivering is an
essential step to avoid hyperthermia. Stockl
et al carried out an RCT comparing continuous
infusion of rocuronium with intermittent doses
of the same drug. The primary outcomes of
interest were shivering episodes. Secondary
outcomes of interest were survival and one
year neurological outcome. The number of
shivering episodes were significantly less
in the continuous infusion group. Doses of
sedatives were also less in the continuous
infusion group. Patients who received
continuous infusion woke up earlier and for a
shorter time in the ICU. However, no difference
in ICU survival or one year neurological status
were noted.
Reviewer’s comments: Continuous
neuromuscular blockade seems to provide
a smoother course during TTM. However,
mortality and neurological status maybe
governed by several other factors and may not
be determined by one intervention alone. The
sample size is too small to make a statement,
but it does raise a valid hypothesis.
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine12
Newer Oral AnticoagulantsGUIDELINES / PRACTICE CORNER
NEWEr OraL aNTICOagULaNTS
Two classes are available: the oral direct thrombin inhibitors (DTIs; e.g. dabigatran) and oral direct factor Xa inhibitors (e.g. rivaroxaban, apixaban, and edoxaban {not vailable in India})
DABIGATRAN (Available as Pradaxa)
FDa aPPrOVED INDICaTIONS DOSagE rEgIMES
• Reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation
• For the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients who have been treated with a parenteral anticoagulant for 5-10 days
• To reduce the risk of recurrence of DVT and PE in patients who have been previously treated
Non-valvular Atrial Fibrillation
• 150 mg BID for CrCl >30mL/min
• 75 mg BID for CrCl 15-30mL/min
• If CrCl 30 to 50 mL/min and concomitant use of dronedarone or ketoconazole, consider 75 mg twice daily
• Contraindicated in patients with CrCl <15 mL/min
Treatment and Reduction in the Risk of
Recurrence of DVT and PE:
• For patients with CrCl >30 mL/min: 150 mg orally, twice daily after 5-10 days of parenteral anticoagulation
• No dosing recommendations available for patients with CrCl<30 mL/min or on dialysis
RIVAROXABAN (Available as Xarelto)
FDa aPPrOVED INDICaTIONS DOSagE rEgIMES
• To reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation
• For treatment of deep vein thrombosis (DVT), pulmonary embolism (PE), and for the reduction in the risk of recurrence of DVT and of PE
• For prophylaxis of DVT, which may lead to PE in patients undergoing knee or hip replacement surgery
Reduction in risk of stroke in nonvalvular atrial fibrillation
• 20 mg once daily with the evening meal for patients with CrCl >50 mL/min
• 15 mg once daily with the evening meal for patients with CrCl 15 to 50 mL/min
• Contraindicated in patients with CrCl<15 mL/min or moderate to severe hepatic impairment (ChildPugh B or C)
Treatment of DVT/PE
• 15 mg twice daily with food, for first 21 days.
• After 21 days, transition to 20 mg once daily with food, for remaining treatment
• Contraindicated in patients with CrCl<30 mL/min or moderate to severe hepatic impairment (ChildPugh B or C)
Prophylaxis of DVT following hip or knee
replacement surgery
• Hip replacement: 10 mg once daily for 35 days
• Knee replacement: 10 mg once daily for 12 days
APIXABAN (Available as Eliquis)
FDa aPPrOVED INDICaTIONS DOSagE rEgIMES
• To reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation
• For treatment of deep vein thrombosis (DVT), pulmonary embolism (PE), and for the reduction in the risk of recurrence of DVT and of PE
• For prophylaxis of DVT, which may lead to PE in patients undergoing knee or hip replacement surgery
Reduction in risk of stroke in nonvalvular
atrial fibrillation and prophylaxis of DVT
• 5 mg twice daily for patients with CrCl >50 mL/min
• 2.5 mg once daily for patients with CrCl 15 to 50 mL/min, age > 80 years, weight < 60kg
BaSIC CHaraCTErISTICS BETWEEN WarFarIN aND NOaC
WarFarIN NOaCOnset Slow Rapid Dosing Variable Fixed Food effect Yes Rivaroxaban should be taken with largest meal of the day,
otherwise no known food effects for OACsMedication interactions Many Few Monitoring required Yes No
Offset Long Shorter
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine 13
SAFETY, EFFICACY AND PHARMACOLOGY OF NOAC
Warfarin rivaroxaban apixaban DabigatranAdministration Once daily with or
without foodOnce or twicedaily with largestmeal of day3
Twice daily withor without food
- Twice daily with or without food- Must be kept in original packaging- Can’t be crushed
Safety in nonvalvularatrialfibrillation
Higher risk ofintracranialhemorrhagecompared toOACs
Higher risk of GIbleedingcompared towarfarin
Lower risk ofmajor bleedingcompared towarfarin
- Higher risk of GI bleeding compared to warfarin- Small increase in risk of MI compared to warfarin
Efficacy in non-valvularatrialfibrillation
Non-inferior towarfarin
Reduced all causemortality
- Lower risk of Ischemic stroke (150mg dose only)- Trend towards reduced all-cause mortality
Bio availability 100% 60-80% 60% 6%
Time to peakeffect
4-5 days 2-4 hours 1-2 hours 1-3 hours
Half-life 40 hours 7-11 hours 12 hours 8-15 hours
Renal clearance None 33% 25% 80%
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine14
INDIAN SOCIETY OF CRITICAL CARE MEDICINE
HAPPY NEW YEAR
BeST WISHeS FOR all !
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine 15
Welcome New Members to the ISCCM family1 Sanjeev Kumar, Palakkad LM-17/K-958
2 Balakrishna Palnati, Guntur LM-17/P-894
3 Rupali Lahoria, Chandigarh LM-17/L-103
4 Dhiraj Pol, Nipani LM-17/P-889
5 Abdul Parey, Jammu ALM-17/P-916
6 Megha Brahmavar, Bangalore ALM-17/B-699
7 Shilpa Autkar, Nagpur ALM-17/A-575
8 Sunil Krishnappa, Bangalore LM-17/K-953
9 Kamlesh Shekhawat, Udaipur LM-17/S-1562
10 Veereswara S K, Chennai LM-17/S-1557
11 Pawan Jain, Raipur LM-17/J-466
12 Pratik Jain, bhilai LM-17/J-464
13 Dewan Roshan Singh, Bangalore LM-17/S-1564
14 Faizur Rahman, Dehradun LM-17/R-570
15 Kushal Parikh, Nadiad ALM-17/P-910
16 Ravindran V, bellandur LM-17/V-330
17 Ravichandran R.P, Pudukkottai LM-17/R-576
18 Akash Shah, Ahmedabad LM-17/S-1552
19 Atiranjan Kumar, Ranchi ALM-17/K-963
20 Vamsi Anupa, Tirupathi LM-17/A-566
21 Prachee Makashir, Pune LM-17/M-855
22 Anil Gupta, Jaipur LM-17/G-719
23 Karthik Arigela, Nellore LM-17/A-572
24 Ankit Kumar, Kanpur nagar LM-17/K-961
25 Sandeep Gundu, godavarikhani LM-17/G-721
26 Karan Gagneja, Faridabad LM-17/G-708
27 Sudarshan Lakhe, Gulbarga LM-17/L-104
28 A Hari Prasad, Berhampur LM-17/P-883
29 Aditi Takale, Miraj LM-17/T-329
30 Geo John, Kuttappuzha LM-17/J-462
31 Sireesha Maddukuri, Hyderabad LM-17/M-839
32 Himanshu Jangid, Alwar LM-17/J-463
33 Deepthi Papineni, S.R.Nagar ALM-17/P-884
34 Manyam Sridhar, Somaikot LM-17/S-1549
35 Raju Ganesan, Chennai LM-17/G-706
36 Utpal Sarma, New Delhi LM-17/S-1550
37 Shivangi Mishra, Bangalore LM-17/M-840
38 Kunal Talreja, Jalgaon LM-17/T-330
39 Mahesh Patil, Osmanabad LM-17/P-885
40 Haider Abbas, Lucknow LM-17/A-560
41 Poonam Chaudhari, Chinchwad ALM-17/C-450
42 Vijaya Muthayala, Nellore LM-17/M-849
43 Jyothi Hattiholi, Belgaum LM-17/H-132
44 Gynendra Gautam, Kanpur LM-17/G-728
45 Santosh Boppidi, Hyderabad LM-17/B-703
46 Anitha Sanapala, Visakhapatnam LM-17/S-1567
47 Chinmaya Panda, Raipur LM-17/P-906
48 Vibhavari Naik, Hyderabad LM-17/N-288
49 Padma Priya Vemulapalli, Vijayawada LM-17/V-323
50 Neha Pareek, Jaipur LM-17/P-886
51 Poornachand Anne, Hyderabad LM-17/A-561
52 Nagaraju Munagala, Hyderabad LM-17/M-841
53 Harshilkumar Gandhi, Ahmedabad LM-17/G-707
54 Masood Mohammed, Hyderabad LM-17/M-842
55 Jithendra C, Bangalore LM-17/C-451
56 Shyam Prasad M S, Hyderabad LM-17/M-843
57 Praveen Kodisharapu, Kondapur LM-17/K-951
58 M.Asiel Christopher, Hyderabad LM-17/C-452
59 Priya Nayak, Hyderabad LM-17/N-289
60 Rajesh Baranwal, Gorakhpur LM-17/B-691
61 Shivam Puniyani, Nagpur LM-17/P-887
62 Prashant Mandilwar, Ranchi LM-17/M-844
63 Mitesh Patel, Gondiya LM-17/P-888
64 Sudhanshu Singhraul, Raipur LM-17/S-1551
65 Senthil Ramasamy, Dindigul LM-17/R-569
66 Ankit Mangla, New Delhi LM-17/M-845
67 Debatra Bose, Hooghly LM-17/B-692
68 Nisarg Oza, Vadodara LM-17/O-21
69 Nitesh Singh, Ghazipur LM-17/S-1553
70 MD Rehan Alam, Aligarh LM-17/A-562
71 Sudhakar Ghattamaneni, Vijayawada LM-17/G-709
72 Prashant Akulwar, Nanded LM-17/A-563
73 Deepak Chandra, Howrah LM-17/C-453
74 Shriswaroop Kulkarni, Kolhapur LM-17/K-952
75 Naresh V, Secunderabad LM-17/V-324
76 Sandeep Devulapally, Warangal LM-17/D-561
77 Mohan Narava, Visakhapatnam LM-17/N-290
78 Lokesh Gutta, Godavari LM-17/G-710
79 Sumanth M.V, Hyderabad LM-17/M-846
80 Mahender Voruganti, Karimnagar LM-17/V-325
81 Suman Nandi, Kamrup Rural LM-17/N-291
82 Shreyas Bhor, Ahmednagar LM-17/B-693
83 Chetan Mahajan, Jalgaon LM-17/M-847
84 Vivek Durai, Hosur LM-17/D-562
85 Aejaz Ahmad Ansari, Dhule ALM-17/A-564
86 Pavan Gautam, Raipur ALM-17/G-711
87 Sumita Sumita, Jaipur LM-17/S-1554
88 Shuvranu Ghosh, Tripura LM-17/G-712
89 Shailesh Gaikwad, Akluj LM-17/G-713
90 Jithin Jose, Shillong LM-17/J-465
91 Raju Shakya, Shillong LM-17/S-1555
92 Dhruva Sharma, Hathras LM-17/S-1556
93 Sony Vyas, New Delhi LM-17/V-326
94 Anwar Hassain, Thrikkakara LM-17/H-133
95 Madhur Joshi, Jaipur LM-17/J-467
96 Abhishek Kotalwar, Nanded LM-17/K-954
97 Pankaj Roy, Patna LM-17/R-571
98 Pavan Rahangdale, Bhopal LM-17/R-572
99 Sanjeev Yadav, Agra LM-17/Y-63
100 Tanmayee Tailam, Hyderabad LM-17/T-331
101 Supriya Pusapati, Hyderabad LM-17/P-890
102 Anurag Chavan, Miraj LM-17/C-454
103 Abhishek Singh, Nagpur LM-17/S-1558
104 Rakesh Mamilla, Hyderabad LM-17/M-848
105 Varun Gutti, Hyderabad LM-17/G-714
106 Kulesh Patir, Faridabad LM-17/P-891
107 Sanjay Kumar, Ranchi LM-17/K-955
108 Dheeraj Dumir, Panchkula LM-17/D-563
109 Deepa Agarwal, Kota LM-17/A-565
110 Manoj S, Chennai LM-17/S-1559
111 Usha N.C, Chennai LM-17/N-292
112 Samrat Verma, New Delhi LM-17/V-327
113 Krishan Thakur, Bhopal LM-17/T-332
114 Jais Sasidharan, Chennai LM-17/S-1560
115 Shilpee Kumari, New Delhi LM-17/K-956
116 Smit Bhongade, Yavatmal LM-17/B-694
117 Ankita Rajput, Nagpur LM-17/R-573
118 Sreeroop K.S, Thrissur LM-17/K-957
119 Naimish Chavada, Ahmedabad LM-17/C-455
120 Narasimha B C, Bangalore LM-17/B-695
121 Surendra Agarwala, Guwahati LM-17/A-567
122 Shivaraddi Bhandi, Hubli LM-17/B-696
123 Rahul Patne, Nanded LM-17/P-892
124 Prince Gupta, Gwalior LM-17/G-715
125 Aditi Prabhu, Chennai LM-17/P-893
126 Pallavi Rane, Jalgaon LM-17/R-574
127 Manisha Bhardwaj, Chandigarh LM-17/B-697
128 Jigar Dodiya, Rajkot LM-17/D-564
129 Rushyendra B, Nellore LM-17/B-698
130 Ramesh Agarwal, Faridabad ALM-17/A-568
131 Ginu Mathew, Palakkad LM-17/M-850
132 Naman Jain, New Delhi ALM-17/J-468
133 Nitin Kasana, Ghaziabad ALM-17/K-959
134 Gautam Parmar, Junagadh ALM-17/P-895
135 Tushar Charkha, Akola ALM-17/C-456
136 Anirban Bhattacharya, Haldia ALM-17/B-700
137 ShaikMohd Hidayathullah, Hyderabad ALM-17/H-134
138 Nipun Agrawal, Bareilly ALM-17/A-569
139 Tanu Shree, Bhopal LM-17/S-1561
140 Vashishth Patel, Sabarkantha LM-17/P-896
141 Anjana Gopinath, Kutch LM-17/G-716
142 Arun Bathena, Nellore LM-17/B-701
143 Siddhartha Hanjura, Jammu LM-17/H-135
144 Appu Jose, Idukki LM-17/J-469
145 Kunjesh Rupapara, Rajkot LM-17/R-575
146 Manas Bindra, Chhindwara LM-17/B-702
147 Dilpreet Kaur, Patiala LM-17/K-960
148 Deepti Thudamaladinne, Secunderabad LM-17/T-333
149 ManishKumar Variya, Surat LM-17/V-328
150 Sahil Sood, Faridabad LM-17/S-1563
151 Romi Prasad, Pune LM-17/P-897
152 Chirag Gilitwala, Surat LM-17/G-717
153 Gnaneshwar Arra Bhattu, Balapur LM-17/A-570
154 Thaha Hussain, Coimbatore LM-17/H-136
155 Harsha Makwaana, Ahmedabad LM-17/M-851
156 Apoorva Garhwal, Wani LM-17/G-718
157 Mohd Mustahsin, Pilibhit LM-17/M-857
158 Sanjoy George, Kottayam LM-17/G-720
159 Mohamed Arif S.A, Chennai LM-17/A-571
160 Amit Kothari, Pune LM-17/K-962
161 ArpitKumar Patel, Mehsana LM-17/P-898
162 Dhruv Upadhyay, Ahmedabad LM-17/U-58
163 Rajesh Patil, Jalgaon LM-17/P-900
164 Darshanbhai Satapara, Surendranagar LM-17/S-1565
165 Maharshi Pandya, Ahmedabad LM-17/P-901
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine16
New Office Bearers of ISCCM Branches
Delhi NCRChaIrMan
Dr. Yash JaveriSECrETary
Dr. Prashant KumarTrEaSurEr
Dr. Saurabh TanejaExECuTIVE CoMMITTEE MEMBErS
Dr. Ashutosh Bhardwaj
Dr. Deven Juneja
Dr. Himanshu Dewan
Dr. Rajat Gupta
Dr. Suneel Garg
Dr. Vishal Kumar
166 Guruprasad H S, Bangalore LM-17/H-137
167 Sonali Ghosh, Faridabad LM-17/G-722
168 Ghanshyam Chandak, Parbhani LM-17/C-457
169 Krishna Patil, Jalgaon LM-17/P-899
170 Ramu Mulampaka, Visakhapatnam LM-17/M-852
171 Rohini Gulhane, Nagpur LM-17/G-723
172 Sangeeta Basu, New Delhi LM-17/B-704
173 Vibin Vasudevan, New Delhi LM-17/V-329
174 Sandeep Gurugubelli, Srikakulam LM-17/G-724
175 Ankur Ohri, Noida LM-17/O-22
176 Sudipta Joy, New Delhi LM-17/J-470
177 Sourav Dhara, Howrah LM-17/D-565
178 Pankaj Mishra, New Delhi LM-17/M-853
179 Sonal Gajbhiye, Chennai LM-17/G-725
180 Arvind Prakash, New Delhi LM-17/P-902
181 Inderjeet Ahuja, Kanpur LM-17/A-573
182 Latheef P, Karuvissery LM-17/P-903
183 Bhattaram Gopalakrishna, Nellore LM-17/G-726
184 Banoth Naik, Chennai LM-17/N-293
185 Sriharika Chejerla, Nellore LM-17/C-458
186 Dhanraj P, Kannur LM-17/P-904
187 Hemansukumar Patel, Surat LM-17/P-905
188 Prem Gade, Hyderabad LM-17/G-727
189 Naresh Munot, Pune LM-17/M-854
190 Arun Saxena, Jaipur LM-17/S-1566
191 Shijukumar C, Trivandrum LM-17/C-459
192 Gaurav Acharya, bhopal LM-17/A-579
193 Radhika Dash, Chennai LM-17/D-569
194 Vandana Tyagi, Jaipur LM-17/T-334
195 Payal Saxena, Agra LM-17/S-1568
196 Kranthi Gedala, Bhadrachalam LM-17/G-729
197 Priyanka Patel, Surat ALM-17/P-907
198 Mirza Beg, New Delhi ALM-17/B-705
199 Jerestyn Khapoliwala, Mumbai ALM-17/K-964
200 Sana Abedin, Gurgaon ALM-17/A-574
201 R.Jagan Rao, Secunderabad ALM-17/R-577
202 Shamandeep Kaur, Kharar ALM-17/K-965
203 Seethiraju Bhargava, Guntur ALM-17/B-706
204 Vijay Gupta, Jaipur ALM-17/G-730
205 Preeti Chaudhary, Jaipur ALM-17/C-460
206 Anita Jangid, Bhilwara ALM-17/J-471
207 Hassan Khan, Mumbai ALM-17/K-966
208 Ajinkya Patil, Kolhapur ALM-17/P-908
209 Navinkumar Kore, Mumbai ALM-17/K-967
210 Sajida Sultana, Sixmile ALM-17/S-1569
211 Dhrumil Parekh, Navsari ALM-17/P-909
212 Pooja Arora, Jaipur ALM-17/A-576
213 Prahalad Kumawat, Nagaur ALM-17/K-968
214 Jaipratap Chouhan, Jaipur ALM-17/C-461
215 Siboprosad Bhattacharjee, ambari ALM-17/B-707
216 Jakir Mansuri, Sanganer ALM-17/M-856
217 Smridhi Gupta, Faridabad ALM-17/G-731
218 Rajesh Das, Kolkata ALM-17/D-566
219 Sravanthi Chaluvadi, Hyderabad ALM-17/C-462
220 Ritu Sen, Bhopal ALM-17/S-1570
221 Avinash Chaudhari, Amravati LM-17/C-464
222 Zehra Bagliwala, Mumbai ALM-17/B-708
223 Nikhilesh Pawaskar, Mumbai ALM-17/P-911
224 Parth Shah, Mumbai ALM-17/S-1571
225 Neha Srivastava, Bangalore LM-17/S-1572
226 Shivali Panwar, New Delhi LM-17/P-912
227 Vishalkumar Vaghani, Surat LM-17/V-331
228 Raj Deokule, Nagpur ALM-17/D-567
229 Sunil Sethi, Karnal LM-17/S-1573
230 Kamal Charaya, Karnal LM-17/C-463
231 Praveen Gupta, Karnal LM-17/G-732
232 Raghu Singh, Karnal LM-17/S-1574
233 Kaushal Gagan, Karnal LM-17/G-733
234 Bhoomika Patel, Surat LM-17/P-913
235 Parul Vadgama, Surat LM-17/V-332
236 Chandrapriya Khobragade, Chennai LM-17/K-969
237 Deepak Dhummansure, Bidar LM-17/D-568
238 Khyati Shamaliya, Surat LM-17/S-1575
239 Gousuddin Arif, Gulbarga LM-17/A-577
240 Kaja Sriramamurthy, Kalaburagi LM-17/S-1576
241 Pratima Patil, Kalaburgi LM-17/P-914
242 Manjunath Patil, Kalaburagi LM-17/P-915
243 Manjula Bapugol, Kalaburgi LM-17/B-709
244 Mohammed Inamdar, Kalaburgi LM-17/I-46
245 Mallikarjuna Holakunde, Kalaburagi LM-17/H-138
246 Paary T.T.S, Hosur LM-17/T-335
247 Kaushal Kumar, Ranchi LM-17/K-970
248 Liyakhath Ali, Gulbarga LM-17/A-578
249 Payal Patel, Valsad LM-17/P-917
250 Jayram Navade, Thane LM-17/N-294
251 Vishnu Gautam, Tonk ALM-17/G-734
252 Greeshma Issac, Kottayam LM-17/I-47
253 Lal Prasad, Noida LM-17/P-918
254 Pratik Tantia, Udaipur LM-17/T-336
255 Surmila Khoirom, Imphal LM-17/K-971
256 Seni Potsangbam, Imphal LM-17/P-919
257 Monika Thokchom, Imphal LM-17/T-337
258 Kangabam Devi, Imphal LM-17/D-570
259 Thuibahenba Singh, Imphal LM-17/S-1577
260 Soibam Meitei, Imphal LM-17/M-858
261 Potsangbam Singh, Imphal LM-17/S-1578
262 Maharabam Binarani, Imphal LM-17/B-710
263 Longjam Eshori, Imphal LM-17/E-23
264 Sinam Devi, Imphal LM-17/D-571
265 Smita Smita, Durg ALM-17/S-1579
266 Shailesh Kalamkar, Navi Mumbai LM-17/K-972
267 Mandar Jamdar, Nagpur LM-17/J-472
268 Rajesh Shah, Mumbai LM-17/S-1580
269 Sadhana Srivastava, Varanasi LM-17/S-1581
270 Pragathesh Palaniappan, Vellore ALM-17/P-920
271 Rinu Kashyap, Saharanpur ALM-17/K-973
272 Jaison Sunny, Kottayam LM-17/S-1582
273 Ajay Kumar, Chittoor LM-17/K-974
274 Loveleen Mangla, Lucknow LM-17/M-859
275 Munesh Maheswari, Jaipur ALM-17/M-860
276 Rishab Priyadarshi, Bangalore ALM-17/P-921
277 Ajay Kumar, New Delhi LM-17/K-975
278 Sathisha Sathisha, Bangalore LM-17/S-1583
279 Rameshkumar Malam, Junagadh LM-17/M-861
280 Arvinder Singh, Amritsar LM-17/S-1584
281 Sirshendu Pal, Siliguri LM-17/P-922
282 Srinivasa M, Mysore LM-17/M-862
283 Baidya Rajak, Ramgarh ALM-17/R-578
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CRITICARE 2018 SCIENTIFIC PROGRAM
Wednesday, 7th March 2018
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Wednesday, 7th March 2018
The CriTiCal Care CommuniCaTions a Bi-monThly newsleTTer of indian soCieTy of CriTiCal Care mediCine 19
Wednesday, 7th March 2018
CRITICARE2018
7-11 March, 2018 Varanasi
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Thursday, 8th March 2018
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Thursday, 8th March 2018
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Thursday, 8th March 2018
CRITICARE2018
7-11 March, 2018 Varanasi
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Friday, 9th March 2018
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Friday, 9th March 2018
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CRITICARE 2018 7-11 March, 2018 • Varanasi
SWaGatHaM!
Friends,
I am honoured and privileged to assume the role of Chairperson of the 24th Annual Congress at Varanasi.
Situated on the bank of River Ganga. Varanasi is the oldest living city & considered as the holiest and most sacred place on this planet. Mark Twain once said, "Varanasi is older than history, older than tradition, older even than legend & looks twice as old as all of them put together." It is also an important industrial center, famous for its carpet, silk fabrics, perfumes, ivory works & sculptures.
Banaras Hindu University is an internationally reputed temple of learning. It was founded by the great nationalist leader, Pt. Madan Mohan Malviya, in 1916. It played a stellar role in the independence
dr. Kapil ZirpenaTIonal PrESIdEnT, ISCCM &
ChaIrMan SCIEnTIfIC CoMMITTEE
movement & has developed into one of the greatest center of learning. It has produced many a great freedom fighters, renowned scholars, artists, scientists & technologist all contributing immensely towards the
progress of modern India. We also proud to be associated with six Bharat Ratna Award.
I am confident that we will be steadfast in addressing the pressing challenges. On behalf of all of us, I am most pleased to welcome Prof. D K Singh who is organizing secretary of 24 TH Annual Congress of ISCCM. Over his years of service in BHU, he has distinguished himself as a person with dedication, integrity, and professionalism. We are confident that he and his team will continue to make outstanding contributions to ISCCM.
Thus, on the behalf of Organizing Committee, Varanasi City Branch & BHU, I invite you all to join this excellent scientific feast at Varanasi in 2018. The city is eager to greet with you with spiritual music to enlighten your soul with learning & knowledge.
Dr. Michael S Niederman Dr. Michale Oleary Dr. Rupert Pearse Dr. Vito Marco Ranieri Dr. Claudio Ronco
Prof. Alain Combes Prof. Dr. Med. Tobias Welte Prof. Giuseppe Citerio Prof. Jean-Louis Teboul Prof. Paul Wischmeyer
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7-11 March, 2018 • Varanasi
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