Volume 9.2

Volume 9 .2 mARCH-APRIl , 2014

Editorial officE

dr. atul P. KulkarniProfessor & Head, Division of Critical Care, Dept. of Anaesthesiology, Critical Care & Pain Tata Memorial Hospital, Parel, Mumbai 400012Phone : 022-24177049emails : [email protected]

Published By :

IndIan SocIety of crItIcal care MedIcIneFor Free Circulation Amongst Medical Professional

Unit 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]

C O N T E N T S ISCCM News Headlines ...........................1

Appeal to Members to Update their Contact Details ....................1

Editorial.....................................................2

Editorial Board 2014-2015 ........................2

President's Desk ........................................3

General Secretary's Desk ..........................4

New Office Bearers of ISCCM Branches .......................................4

Election of Office Bearers and Members of the Executive Committee for 2015-2016 .............................................5

College News .............................................6

Image Challenge........................................6

CRITICAL CARE UPDATE 2014 ..............6

CRITICARE 2014, Jaipur - A Report .....7-9

ISCCM Sub-Committees .........................10

Indian Colege of Critical Care Medicine - Board Members .................... 11

Advertisement .........................................11

Branch Activities ............................... 12-13

DCCS 2014 ............................................... 14

Gujarat Criticon 2014 .............................. 14

Calender of Events 2014.......................... 14

Welcome New Members to the ISCCM family ......................................................15

Journal Scan ....................................... 16-18

Career Corner ..........................................18

Best of Brussels 2014 ..............................19

CRITICARE 2015, Bengaluru .................20

ISCCM NewSHeadlINeS Criticare 2014 at Jaipur a Grand Success.

8 Comprehensive Critical Care Courses held to date. Welcomed by all Delegates.

elections to be held in the First Week of August 2014.

ISCCm joins hands with Indian Association of Palliative Care.

Both to issue a joint statement about end of life Care Policy for the Dying.

ISCCm to file impleadment motion in Supreme Court regarding end of life Care.

Dr. Sriram Sampath appointed Chairman Research Committee.

Nominations invited for Honorary Fellows of Indian College of Critical Care medicine.

We request our esteemed readers to send

their valued feedback, suggestions & views

at [email protected]

TM

ISCCM Elections 2014 AppealPlease update your Email ID and

Register your mobile phone no with ISCCM

Dear members

Free and fair elections are the foundation of any democratic society. ISCCm elections are now held online only. It is therefore, imperative that ISCCm has email ids and mobile phone nos. of all its members for registering them on the electoral rolls. You are therefore requested to please update your email ids and mobile numbers as soon as possible. election participation has been only 40% in ISCCm election 2013. Please visit our website www.isscm.org for downloading the membership update form. All branches have special duty for following this task. I will be in touch with all branch secretaries for continuing this important work for ISCCm election 2014.

Dr. Atul P. KulkarniChairperson Election Commission • [email protected]

Dr. Anand Dongre • Dr. Rajesh Pandemembers election Commission

Critical CareC O M M U N I C A T I O N S

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

TM

www.isccm.org

2 The CriTiCal Care CommuniCaTionsa Bi-monthly newsletter of indian society of Critical Care medicine

Editorial Board 2014-2015

eDItoR IN CHIeFDr. Atul P. Kulkarni, Mumbai

[email protected]

DePutY eDItoR

Dr. Vijaya Patil, MuMbai Dr. Jayashree M., Chandigarh

[email protected] [email protected]

memBeRS

NoRtH ZoNe WeSt ZoNe eASt ZoNe SoutH ZoNe CeNtRAl ZoNe

Dr. Vandana Agarwal, MuMbai Dr Avdhesh Bansal, delhi Dr. Manoj Singh, ahMedabad Dr. Susruta Bandyopadhyay, KolKata Dr. Pradeep Rangappa, bangalore Dr. Ranvir Singh Tyagi, agra

[email protected] [email protected] [email protected] [email protected] [email protected] [email protected]

edItorIaldr. atul P. Kulkarnieditor, the Critical Care CommunicationsPresident-elect, [email protected]

Dear Colleagues,

First of all my heartfelt thanks and gratitude for electing me to the august

office of the President Elect of Indian Society of

Critical Care Medicine. It is a great honour to

be entrusted with the responsibility of leading

such a vibrant and fast growing society. The

society is modern in every true sense of the word except the pitiful condition

of our contact data. Of nearly 7000 members we have contact data only for

about 4000 members. I urge all of you if your mobile nos. and e-mail IDs are

not updated, please update the same with us. The form can be downloaded

from our website isccm.org. This is important not only for elections but

also for communications from the office, since we are increasingly using

electronic forms communications rather than letters.

We are trying to regularise the branch elections process and will attempt to

hold them in the same week of August as central elections.

The '2nd Best of Brussels' is around the corner and similar to the first one,

I am sure; this too will prove to be a huge success. This is brainchild of

Dr. Shrish Prayag and as usual the Pune branch keeps coming up with

innovative ideas. Kudos to them!

Dr. Srinivasan has contributed the journal scan for this issue. Happy

reading.

TM

The CriTiCal Care CommuniCaTionsa Bi-monthly newsletter of indian society of Critical Care medicine 3

dr. Shivakumar IyerPresident, ISCCm • [email protected]

PreSIdeNt'S deSk

Dear ISCCM Members,I thank all of you for having elected me as your President for the next two years. I have several ideas for taking our

society forward and seek your wholehearted support. ISCCM is the third largest critical care society in the world with close to 7000 members. We have recently purchased a new office in Mumbai and I hope we now have enough space to have a world class ISCCM secretariat. It is imperative to put in place modern business processes in our ISCCM central office and have an integrated approach to data management in order to improve our communication with members and reach out to them more effectively. The website too needs to be revamped and integrated with our members and students database in order to meet our communication needs. Dr. Atul Kulkarni (President-elect), Dr. Dhruva Chaudhary (General Secretary), Dr. Vandana Agarwal and Dr. Shastri (Secretary), Dr. Jayant Shelgaonkar (Joint Secretary& Website Committee chair) and Dr. Vijaya Patil (Treasurer) are working closely with me for achieving this target as soon as possible.The members’ database has to be updated and made entirely compatible with our electronic election process so as to ensure free and fair elections. Dr. Atul Kulkarni as our president-elect and election commissioner along with his team Dr. Rajesh Pande and Dr. Anand Dongre are committed to this.Our constitution is in the process of being corrected and put in the right legal language in order to avoid any ambiguity by Dr. Rungta and Hon GS Hora. Dr. Atul Kulkarni as chair of the constitutional amendments committee along with Dr. Bande (ICCM College board member), Dr. Deepak Govil (ICCM accreditation secretary) and Dr. Kapil Zirpe (Vice President) will ensure that this process is completed and presented to the EC along with suggestions for further constitutional amendments.The rapid growth in our membership has resulted in the growth of no. ISCCM branches all over the country. In order to protect the interests of our members, branches need to have a clear understanding of their responsibilities to the members. Branches need to adhere to the ISCCM constitution, maintain proper accounts, have free and fair elections at the branch level, participate wholeheartedly in ISCCM activities like the ISCCM Foundation Day and organise regular academic activities. While branches of a particular region may get together to organise regional conferences, the ISCCM constitution does not recognise state or regional chapters at present. It will be my endeavor to work along with Dr. Vandana Agarwal (Secretary ISCCM), Dr Pradip Bhattacharya and our zonal representatives Dr. Avdesh Bansal (North), Dr. Ranvir Tyagi(Central), Dr. Pradeep Rangappa (South), Dr. Manoj Singh (West), Dr. Susruta Bandyopadhyay (East) to foster and promote close centre -branch relationships in order to maximise the benefit to ISCCM members.Pediatric Critical Care Fellowship and the basic pediatric critical care course represent our success with promoting pediatric critical care. Our new pediatric section chairperson, Dr. JayashreeMuralidharan along with her committee has promised to streamline the work of our pediatric section, establish a good liaison with the Indian Academy of Pediatrics and work to increase the membership of our pediatric section.Our national conferences are the showpiece of ISCCM. We are working closely with the Bengaluru and Agra organizing committees to ensure an impeccable scientific program, flawless organization and financial probity. Dr. Atul Kulkarni and I will act as central observers for the next two years.Education is the most important aspect of our society and the Indian College of Critical Care Medicine established three years back is doing a wonderful job. Our educational courses IDCCM

and IFCCM are now well established and are widely sought after by young postgraduates desirous of a career in Critical Care medicine. We hope to address the manpower shortage in our country with the help of our post MBBS course and Indian Diploma in Critical Care Nursing. We must take care to ensure adequate standards of training and certification in order to maintain the high standards of our society’s educational training. The '4 C' course is expanding rapidly and we hope to run it in all parts of India to enhance Critical Care education. We are already collaborating with WINFOCUS for ultrasound courses. BASIC is being run for entry level courses in Critical Care and resuscitation and I hope to take this forward during my presidency. We require to design standardised courses in hemodynamic monitoring, mechanical ventilation, neurocritical care, critical care nephrology. I hope to work along with Dr. Chawla (Chancellor ICCM), Dr. Ramakrishnan (Vice Chancellor) and the college board for attaining these educational objectives.The new Credentials Committee under Dr. Divatia has the important job of selecting fellows who have submitted their nominations in a fair and objective manner and also of selecting the research committee chairperson. I would also like to entrust the committee with the responsibility of framing an ethical framework for the society. We already have a conflict of interest form for office bearers of ISCCM and ICCCM. I plan to extend this to our teachers group, ISCCM branch secretaries and chairpersons and also faculty who speak at ISCCM regional and national conferences.The IDCCM and IFCCM alumni represent the society’s future and need to be encouraged to participate whole heartedly in ISCCM activities. Dr. Vijaya Patil and Dr. Ramakrishnan will head the alumni committee and we hope to organise the first alumni meet in the Bengaluru Criticare 2015 conference.ISCCM has made attempts to foster Critical Care research in our country with the important INDICAPS study spearheaded by Dr. Divatia and the ongoing tropical fever study by Dr. Singhi. A lot more needs to be achieved and I hope the new chairperson of the research committee will set an aggressive agenda. The important objectives will be to create a research network, ensure systematic and reliable data collection while ensuring confidentiality through a well designed central database and planning further multicentre Indian Studies. It would be nice if we could validate severity of illness scoring systems in India along with setting up a national system for critical care audit and research. I invite all ISCCM members who have contributed to Critical Care research in India to be part of the ISCCM research network. All the teaching centres of ISCCM should also contribute to the ISCCM research initiative in a big way. I assure all of you that ISCCM will take stringent steps to protect confidentiality of data and at the same time acknowledge everybody’s contribution appropriately.ISCCM has been at the forefront of setting national Critical Care guidelines and position statements. One guideline on Critical Care nephrology (Dr. ArindamKar) and one position statement on Critical Care nutrition (Dr. Ramakrishnan) are already planned. A joint position statement on palliative care and implementation of end of life guidelines along with the palliative care society of India is also being planned.Creating public awareness and reaching out to our patients is an activity we have successfully carried out on our ISCCM foundation day and this year too I hope to have an appropriate theme that will help empower our patients.I once again thank all members for having chosen me and welcome their suggestions for taking ISCCM to greater heights.Thank you.


dr. dhruva chaudhryGeneral Secretary, ISCCm

Dear Friends

It is an honour to take over as the Gen Secretary of the ISCCM. It is for the first time in the history of the society

when someone from outside Mumbai has taken over this huge responsibility & that too unanimously. It shows the maturity & statesmanship of leadership, esteemed members & vision of society.

The growth of the society over last decade reflects the story of growth of Critical Care in India. Credit for this goes to very large extent to the quality of leadership which we had in the past. ISCCM not only came out with various guidelines to improve quality of care of critically sick but also primarily initiated formal training in Critical Care in India by starting certificate courses & later upgrading to diploma & fellowship courses. Lately we have also initiated Post MBBS as well Indian Diploma of Nursing in Critical Care. To take care the need of the education ISCCM established Indian College of Critical Care Medicine & it gives me immense satisfaction that I have the privilege to be part of this process.

General Secretary's desk

Over the years society has expanded very rapidly. We have more than 70 branches & large membership of young professionals who are there to mark their presence in the field. This has created both an opportunity as well as a challenge. Realising the change, as a society we have tried to march ahead with time.The old guard is crumbling & newer one is taking shape. Therefore the challenge is to make systems which are not only based on healthy conventions but are robust & transparent enough to withstand these dynamics. Those who are in leadership role have to do mentoring by leading by example.

Therefore my endeavour will be that over next year working actively as a team under the leadership of Dr Iyer to develop systems & processes where by we should not only consolidate the gains achieved over the years but to ensure that we continue with all round inclusive growth of the society.

Best wishes & warm regards.

New office Bearers of ISCCM BranchesAligarh Hubli Kolkata Ahmedabad Rajkot

CHAIRmAN

Dr. Sanjay Bhargawa

SeCRetARY

Dr. S Moeid Ahmad

tReASuReR

Dr. Pawan Varshney

exeCutIVe CommIttee memBeRS

Dr. Rajkumar

Dr. K. K. Varshney

Dr. S. Bano

Dr. Rakesh Bhargaw

Dr. Ajay Mittal

Dr. Vipin Gupta

CHAIRmAN

Dr. Manikant Lodaya

SeCRetARY

Dr. Nagaraj Tanksali

tReASuReR

Dr. Shrinivas Deshpande


Dr. Vajendr Joshi

Dr. Basavaraj Lakkundi

Dr. Rajesh Phatke

Dr. Pratima Mohite

Dr. Raghvendr Belgaonkar

Dr. Anilkumar Bembalgi

CHAIRmAN

Dr. Tapas Chakraborty

SeCRetARY

Dr. Dipankar Sarkar

tReASuReR

Dr. Rajarshi Roy


Dr. Amitabha Saha

Dr. Animesh Gupta

Dr. Ajoy Sarkar

Dr. Parthasarathi Goswami

Dr. Suresh Ramasubban

Dr. Mohit Kharbanda

CHAIRmAN

Dr. Manoj Singh

SeCRetARY

Dr. Jigar Mehta

tReASuReR

Dr. Bhavesh Patel


Dr. Anish JoshiDr. Bhagyesh ShahDr. Faruk MemonDr. Gopal Rawal

Dr. Harendra ThakkarDr. Harshal Thaker

Dr. Jay Kothari

CHAIRmAN

Dr. Jayeshkumar Dobariya

SeCRetARY

Dr. Tejas Karmata

tReASuReR

Dr. Archit Rathod


Dr. Bhumi Dave

Dr. Naresh Barasara

Dr. Hetal Vadera

Dr. Dharmendra Amritya

Dr. Ravi Nagrecha

Dr. Digvijaysinh Jadeja


Circular No. 1/2014Election of Office Bearers and Members of the Executive Committee for 2015-2016

Election of Office Bearers of the Executive Committee for 2015-2016. Members are hereby informed that the following persons will retire in AGM 2015.

• Three Vice Presidents Dr. Yatin Mehta Dr. Kapil Zirpe Dr. Praveen Khilnani

• One General Secretary Dr. Dhruva Chaudhry

• Two Secretaries Dr. Prakash Shastri Dr. Vandana Agarwal

• One Treasurer Dr. Vijaya Patil

• Four Executive Committee Members Dr. Yogendra Pal Singh Dr. Sudhir Khunteta Dr. Anand Nikhalje Dr. Anil Sachdev

Therefore election for the following Office Bearers and elected members of the Executive Committee for 2015-2016 will be held and nominations are hereby invited for them.

1. One Vice President (The elected VP should not be the same zone as the present vice president)

2. One General Secretary (open to anywhere in country)

3. One Treasurer (from Headquarters)

4. One Secretary (from Headquarters)

5. Four Executive Committee Elected Members (of which not more than 3 shall be from the same Zone)

4.1 Eligibility

4.1.1 For the post of Vice President and General Secretary, Treasurer the candidate should have been elected and not nominated for 4 (Four) years as follows; on the National Executive Committee for a minimum of 2 (two) terms i.e. total 4 (four) years in the National Executive Committee or 1 (one) term of 2 (two) years in the National Executive Committee and 2 (two) years as office bearer in the City Branch Executive Committee, the 2 terms not running concurrently.

4.1.2 For all other positions, membership of the society for at least 5 year is mandatory. For re-eligibility to contest election for any post on the National Executive Committee the candidate must have attended at least 2(two) out of the last 4 (four) Executive Committee meetings held in both years of his/her previous term. In case of such absence the member shall not be eligible to contest elections for one term (i.e. two years) and can contest after this term is over.

4.1.2.1 For re-eligibility to contest election for the post of Vice-Presidents, on the National Executive Committee the candidate must have attended at least 3 (three) Executive Committee Meetings out of the 4 (four) last Executive Committee Meetings held in the term that he/she had served on the National Executive Committee. (This will be applicable to members serving on the National executive committee on or after February 1, 2008).

4.1.3 No member shall be eligible to seek election for more than 2 tenures as Vice-President, Gen. Secretary, Treasurer, or Elected Member of the Executive Committee.

4.1.3.1 The Term for President, President-elect, Immediate Past President, General Secretary, Treasurer, Secretary is one year and for Vice President two years. The term for Executive Committee members is two years.

4.1.4 The President/President-Elect shall not seek election for any position in the Executive Committee after completing his / her tenure. However he / she can be nominated on the executive committee as may be decided by the Executive Committee provided his tenure in EC does not exceed 11 years.

4.1.5 A member shall not contest simultaneously for more than one office bearers post (i.e. of Vice President, General Secretary and Treasurer).

4.1.6 No member except the President shall be on the executive committee for more than eight years regardless of posts held in the EC. After completing 8 years in the EC, the member can contest only for the post of President. Thus the president shall remain on the EC for 11 years i. e. 8 years as EC member in any capacity and 1 year each as President elect, President and Immediate Past President.

4.2.6.1 Canvassing in any form will result the automatic disqualification from the election process. This includes emails, SMS etc.

The nomination paper which shall set out the candidate’s name, address and the office for which the candidate is nominated, shall be proposed by one valid member and duly signed by the candidate, signifying his/her willingness to stand for the election and to serve on the Executive Committee if elected. There shall be a separate nomination paper for each candidate, and for each post. These nominations must reach the General Secretary not later than 15th June by 5.00 P.M. For every post, the nomination paper must be accompanied by a sum of Rs.5000/- (Rupees five thousand only) from a candidate, in the form of a demand draft payable at Mumbai. A nomination paper not accompanied by a Bank Draft of Rs.5000/-, shall be deemed invalid. A short bio-data not exceeding 200 words, should accompany the nomination or it can also be sent as soft copy along with a photograph (compulsory).

The proceeding after this will be taken over by the election commissioner. The Election commission shall inform BY EMAIL the contesting candidate of all the nominations received for the post they are contesting, and if any one wishes to withdraw his/her nomination, he/she should inform election commissioner in writing or from the official e-mail address (i.e. registered with ISCCM headquarters previously) on or before the 30TH of June by 5.00 P.M. No member of ISCCM EC except those in Election Commission will in any manner interfere in the Election Process.

Dr. Dhruva Chaudhry, General Secretary, ISCCM

DEaD linES OF ElECTiOn PrOCEDurElast date to receive the nomination at iSCCM Office 15th June 2014 by 5.00 p.m.

last date for withdrawal 30th June 2014 by 5.00 p.m.

TM Indian Society of Critical Care MedicineSecretariat Address : Unit 6, First Floor, Hind Service Industries Premises Co-operative Society, Near Chaitya Bhoomi, Off Veer Savarkar Marg, Dadar, Mumbai - 400028


CollegeNewsdr. Palepu B. GopalSecretary, Indian College of Critical Care [email protected]

Dear Colleague Members of ISCCM and Indian College of Critical Care Medicine,

At the outset I am humbled and feel honoured to be given the responsibility of secretary of Indian College of Critical Care Medicine. I am grateful to all of you for trusting me with this vital position. Indian College of Critical Care Medicine is ever growing in its stature as the flagship academic institution of Critical Care medicine training and education in our country, under the able and mature leadership of ISCCM. The newly formatted College Board has taken charge during the Jaipur national congress. This board has Dr Rajesh Chawla as Chancellor, Dr N. Ramakrishnan as Vice-chancellor, Dr Palepu Gopal as College Secretary, Dr Deepak Govil as Accreditation Secretary, Dr Yatin Mehta as Controller of Examinations and Dr B D Bande and Dr P Rangappa as Joint Secretaries. Dr Prakash Shastri and Dr Khilnani will co-ordinate nursing education and pediatric programmes respectively. The board is also having the presence of Dr Narendra Rungta, Dr Shivakumar Iyer, Dr Atul Kulkarni and Dr Dhruva Chaudhry in their ex-officio capacity of ISCCM executive committee positions. This has been done to keep a dynamic liaison with and guidance from the parent organization, ie, ISCCM. It has been decided that from

next term the President of ISCCM will take the responsibility of Chancellor of the college.

This year the college has extended its training and educational courses by introducing the post MBBS certificate course and a Diploma course for Nursing in Critical Care Medicine (IDCCN). The number of centers accredited for IDCCM and IFCCM courses have also gone up in number. They currently stand at 128 centers for IDCCM course, 30 centers for IFCCM course and 128 centers for Post MBBS certificate course. All IDCCM accredited centers are permitted to conduct IDCCN courses as well.

The examination process for these courses is being streamlined further under the supervision of Controller of Examinations and an examination cell. The IDCCM examination was conducted successfully in four centers this year, including opening up of Kolkata as new center, apart from Delhi, Pune and Bengaluru. The IFCCM exam was held at three centers, namely, Delhi, Chennai and Pune. The chief examiners and examiners at each center has ensured

smooth conduct of this process, ably aided by our college and society staff. Process is underway to conduct the exam for Post-MBBS and IDCCN courses.

The popularity and attendance of 4C course has progressed impressively under the leadership of Dr Chawla and is set to become a platform course for periodic updating of Critical Care management in our country.

It is not without the guidance, co-ordination and hard work of all the members and office bearers of both the college and ISCCM that this progress was possible. The solid ground created by the outgoing team of Dr Divatia, Dr Chawla and Dr Ramakrishnan has raised the expectation of our stakeholders all around. On behalf of the current College Board, I respectfully thank the outgoing college board and ISCCM EC and all its leaders for their exemplary effort and leadership. We will continue to follow the path set by our beloved predecessors and try our best to take it to further lofty goals. I thank you one and all again.

With Regards.

TM

CRITICAL CARE UPDATE 201420, 21 & 22 June 2014, Hyderabad, India

VenueThe Fern, Chiran Fort Club, Begumpet, Hyderabad

Organised byDepartment of Critical Care Medicine,

Care Hospital, Banjara Hills, Hyderabad

endOrsed byIndian Society of Critical Care Medicine,

Hyderabad Chapter

registration Fee rs. 1500/- for all days.

Registration limited to first 125 delegates.

COnferenCe seCreTariaTdepartment of Critical Care, room no. 217, ii floor,

Care Hospital, road no. 1, banjara Hills, Hyderabad.

For Details Contact Mr. Vinod 9985612924

Image ChallengeA young male presented with increasing breathlessness, increasing red patches over body (sub cutaneous haemorrhage) & anaemia. He was on warferin 2.5mg OD. What Condition is most likely?

(answer in the next issue.) - dr anand dongare


- a report

It is with great pleasure that we present the following report summarizing the activities and outcomes of first-ever Joint Meeting of the 20th Annual Conference of Indian Society of

Critical Care Medicine (ISCCM), 18th Asia-Pacific Congress of Critical Care Medicine (APACCM) & 2nd Annual Conference of Critical Care Nurses Society (CCNS) – CriTiCarE 2014 hosted at B.M. Birla Auditorium & Convention Center, Jaipur, India hosted by the Jaipur Branch of the Indian Society of Critical Care Medicine, from 14th to 16th February and workshops on 17th & 18th February, 2014.

CRITICARE 2014 was an overwhelming success, attracting over 3500 delegates, 303 speakers and many sponsors from India, SAARC countries, the Asia-Pacific Region & across the world. The conference provided great intellectual and social interaction for the participants with their fullest involvement in the scientific deliberations. It was the first ever Critical Care Medicine Conference of this scale at which we were able to actively engage with and reach out to a wider range of stakeholders across the Asia-Pacific Region. The outcome of this conference will help us strengthen Critical Care across the Asia-Pacific Region.

The conference had a comprehensive program and agenda, the discussions and sharing of experiences over the course of this conference was highly productive and useful with cutting-edge educational sessions, hands-on workshops and interactive debates. The delegates could preview the newest technologies, products, services and opportunities provided by exhibitors. New ideas and solutions to vexing problems came out of the scientific deliberations. The scientific program had over 40 Meet the Expert Sessions, over 60 Plenary Sessions, over 275 Thematic Sessions

and over 20 Panel Discussions & Debates. We also had a Grand Quiz, over 50 Free Paper Sessions & 181 poster presentations. The sessions in Adult, Pediatric, Nursing Critical Care and APACCM Sections reflected strong motivation for young and regional Indian talent to share their clinical experience in the field of Critical Care Medicine. The mammoth response which we received from the teachers, consultants, Intensivist fraternity, nurses and industry had overwhelmed us and with new ideas and enthuse young talents explored the new facets of the intriguing and important aspect of Critical Care Medicine.

Any vacuum left was filled with the mind-boggling demonstrations in workshops such as ACLS, Comprehensive Critical Care Course, ECMO, FCCS, PFCCS, Hemodynamic Monitoring, Mechanical Ventilation, Neuro-Critical Care, Nephro-Critical Care, Obstetrics Critical Care, Pediatric Ventilation & Simulation, Ultrasound, Trauma support course. The workshops c added the much needed practical tips in Critical Care Medicine. The conference presented attendees with the latest research and information on the science and treatment advances in Critical Care Medicine.

All the participants and delegates enjoyed the Rajasthani cuisines and cultural extravaganza including the ghazals & Light Satire on 13th February; Rajasthan Heritage Musical Dhamaka on 14th February, Western Musical Extravaganza by Euphoria Band on 15th February and Light Indian Musical Program on 16th February in the food courts respectively. We chose the best of the available programs to the suit the taste of Indians and foreign guests. The exhibition area was illuminated with the participation of more than 50 exhibitors from various fields including renowned pharmaceutical companies and medical book sellers.

Dr. H. Bagaria Organising Chairman

CRITICARE 2014

Dr. narendra rungta Chairman, Conference &

Chairman, Scientific Committee CRITICARE 2014

Dr. Manish Munjal Organising Secretary

CRITICARE 2014


Appreciations from All Around the Globe

Congratulations for memorable and wonderful conduction of Conference.

Dr Suresh Bhargava, Jaipur

Please convey my congratulations to the whole organizing team.

Farhad

Dear Dr. Munjal,

It was a pleasure meeting you at the conference-briefly though. Congrats on the success of criticare 2014. Also, thank you for visiting the simulation workshop and for all the media attention we got. Do let me know if I can be of help in future. Best Regards

Dr. Mahesh Joshi

A memorable conference. Kudos to the Organizing committee. Expect the next another 10 years from now.

Mohan Mathew

Congratulations on successfully organizing the mega event and thanks for inviting me as a faculty, regards.

Pradeep Bhatia, Prof. & Head, Dept of Anaesthesiology & Critical Care, AIIMS, Jodhpur

Dear Team Criticare 2014,

I would like to thank each one of you for your tireless efforts. It was such a massive event, but everything went smoothly. That really takes a great effort. I could personally meet some of your ‘torch bearers’ like Mr.

Pawan Bathla, Mr. Banna Ram and Mr. Rupesh and thank them. But please extend this thanks to all the others who worked silently behind the scenes. And thanks to you two, Sir, Dr. Rungta and Dr. Munjal. Regards,

Banani Poddar

Dear Manish,

On behalf of the SCCM, please accept our congratulations for a job well done. CRITICARE 2014 was wonderfully conceived and executed. This was a terrific congress. Awesome work!

Chris Farmer

Dear Sir,

It was an honour and privilege to be a part of Criticare 2014. Thank you for having me there. I sincerely hope that we achieve higher standards in Nursing practice. I had a very lovely time at Jaipur. Thank you very much for making the entire experience enriching and memorable. Best wishes

ruth

Dear Doctors,

Thank you for your hospitality and I will congratulate you and all members of the Indian Society on the amazing organization and great success of Criticare 2014. Best regards

nobuo Fuke, Teikyo University Chiba Medical Centre, Chiba, Japan

Dear Dr. Manish Munjal,

Thank you for organizing a wonderful conference and it was a pleasure to attend and participate in the Pediatric programme. With Best Wishes and Regards,

VVS Prasad

Dear Dr Rungta, Munjal & team,

Congratulations on a very successful conference. Well done indeed. Thank you very much for your warm hospitality too. We enjoyed the venue, food and most importantly the scientific sessions. So congrats once more and well done

Dr Sandhya Talekar, Pune

Dear All

Really enjoyed the congress. Hoping to meet you soon.

Sameer Jog

Dear Dr Munjal,

Thanks a lot for your hospitality. It was well organized academic feast with best of the content and faculties and I enjoyed it thoroughly. I am proud to be associated with this gala congress and will like to contribute in future too in whatever capacity. Pls send my deepest regards to Dr Rungta sir and other members of your team too. Regards

Dr Prashant nasa

Thank you, organizers.

You appear to have spared no effort in ensuring that we have a lively interaction and comfortable stay. The scientific fare as well as the catering & entertainment were varied and rich, the hospitality befitting the famed Rajasthani tradition! Kindly accept my sincere thanks. Warm regards,

rK Mani

Dear Manish and Narendra,

We are back in the U.S. and we want to thank you for the invitation and for an excellently run conference! It was a great experience and we are looking forward to working closely together!

Gene Sung, M.D., M.P.H. Immediate Past-President, Neurocritical Care Society Director, Neurocritical Care and Stroke Division, University of Southern California, Los Angeles, CA

Dear Dr Munjal and Rungta,

Let me congratulate all of you for a wonderful and well organized conference. It is a herculean task and all of you have put a lot of effort. Thank you for the wonderful hospitality. I enjoyed the changed and neat jaipur immensely with family too. Thanking you once again. Yours sincerely

Manimalarao

The CriTiCal Care CommuniCaTionsa Bi-monthly newsletter of indian society of Critical Care medicine 9Dear Professors Munjal, Rungta and Bagaria,

Congratulations on a wonderful conference which was most successful, state of the art and exciting. Your hospitality was beyond belief and the beautiful artistic historic picture most appreciated. Manish, I especially wish to thank you for going beyond what was necessary to make sure that I was well taken care of. The accommodations and transportation were superb and the evening venues were fantastic. When I showed my colleagues the pictures they were all envious and understand my excitement when I returned. If any of you are ever in the neighborhood please let me know so that I might reciprocate. Kind Regards

Marc J. Shapiro, M.S., M.D. Professor of Surgery and Anesthesiology, Stony Brook, New York

Respected Sir (Dr Rungta) and Dear Dr Munjal,

Trust this mail finds you and your family in best of health and spirit. Must be having a sigh of relief after a herculean task. Thank you so much for all that you have done for me and the whole critical care physician community. Though late but still accept my congratulations and hats off salute. Regards

S Moied

Sir

At the outset let me congratulate you on a fantastic Criticare 2014. I would also like to thank you for considering me as a faculty.

Ganshyam Jagathkar

Dear Dr. Munjal and Dr. Rungta,

It was indeed a pleasure to witness such a large congress of like-minded individuals for the 20th Critical Care conference at Jaipur. I was at the CCNS conference and workshop. Everything went very well for us too. Was indeed a privilege to be associated with stalwarts like yourselves. Regards

Dr. Shirley David, College of Nursing, CMC, Vellore

Dear Drs Munjal, Rungta and Bagaria,

Many thanks to you and all your colleagues at ISCCM for such excellent hospitality and a marvellous scientific and social program in Jaipur. Thankfully I did manage to get in a full day of sightseeing before my departure Tuesday evening and finally had an opportunity to see what an impressive city Jaipur is. Thanks again for the invitation. Kind Regards,

Michael. Michael J O’leary, Senior Staff Specialist, Intensive Care Service, RPAH Sydney & Clinical Associate Professor, Sydney Medical School, The University of Sydney

Congratulations for organizing such a big event. Unfortunate to miss the event. Thanks & Regards

Mukesh arora

Dear Sir,

Greetings. Please accept our hearty congratulations to you and your team for the successful conduct of the criticare 2014. It was a scientific great feast and we enjoyed our participation.

Dr.Sunil T Pandya, Hyderabad

To the Organizers

Congratulations for a high quality

conference! Best regards

Suchitra ranjit

Dear DR Munjal

Greetings. It was wonderful event and every one enjoyed . Almost all delegates were involved. It was not like other conference that people stay out. All session were full and properly attended by all. Faculty also put their best.

Kundan Mittal, Professor & Head of Unit, In-charge Pediatric Intensive Care and Respiratory Services, Department of Pediatrics, Pt. B D Sharma PGIMS, Rohtak

Dear Dr Munjal,

Jaipur conference was a life time memorable experience for me. I appreciate the organizer’s hospitality. The conference was a great and grand success. Congratulations go to you, Dr Bagaria and many others especially the leadership of Dr Rungta which made it a fantastic get together of the medical scientists across the globe. Regards

Prof. Mohammad Omar Faruq. MD, FACP, FACEP, FCPS, FCCM Professor of Critical Care Medicine, Birdem General Hospital & Ibrahim Medical College, Dhaka,Bangladesh. President, Bangladesh Society of Critical Care Medicine (BSCCM) Secretary General, Association of SAARC Critical Care Societies (ASAARCCS)

Dear Drs Rungta, Munjal and Bagaria,

Congratulations to the three of you for the overwhelming success of Criticare 2014, Jaipur. The Organizing Committee’s hard work, dedication and attention to detail was apparent throughout the conference and the sole reason for its success. I would personally like to thank the three of you from the bottom of my heart for giving me this opportunity to attend ISCCM conference, visit India for the first time and begin friendships that I hope will last a lifetime. I look forward to many such interactions with ISCCM at a professional level and with all of you at a personal level and sincerely hope and pray that. I will get an opportunity to return the hospitality at some stage! Best regards.

Madiha Hasmi, President, Pakistan Society of Critical Care Medicine (PSCCM)

Respected Dr Rungta and Dr Munjal,

It was a privilege and honour to participate in Jaipur criticare 2014 Thank You for a well organized congress with great scientific content, thank you also for a pleasant stay at Jaipur. Best Regards

anurag Kishore, Agra

Dear Manish,

Congratulations to the whole Jaipur team. Even though was there only on the last two days to do the workshop, the overall picture I got was that of a well conducted program. Regards

Babu abraham

Dear Dr Rungta and Dr Munjal sir,

It is really honour and privilege to attend and be the faculty in such a great event. I thank you from my heart for giving me this opportunity, I am obliged sir, Thanking you.

Dr. Deepak Jeswani, Nagpur

Hi Dr. Manish

I must congratulate you for the

excellent hospitality you provided to all of us during the Jaipur conference. You will not believe but I have actually gained weight during the days I was in Jaipur. Thank you from the bottom of my heart, and you deserve all the appreciation and good will for the success of the conference.

Sandeep Kantor

Dear Manish,

Thanks for organising the meeting it was a very successful scientific and social event and you should be very proud of what you have achieved . Thank you also for turning the heat down for those of us that are more used to cooler temperatures. Best wishes to you and your family.

ross Freebairn, MBChB, Dip Obst, FANZCA, FRCPE, FCICM President College of Intensive Care Medicine, ANZ, Consultant, Intensive Care Services, Hawke’s Bay Hospital, Hastings NZ

Dear Sir,

Firstly congratulations on hosting a spectacular conference. It was an academic feast. I also take this opportunity to thank you for having invited me as a faculty. Warm regards

Dr Hemant Hr

Dear Dr. Rungta, Dr. Manish and the entire CRITICARE 2014 team

Hello, Hearty congratulations on the grand success of CRITICARE 2014. Excellently organised and a great scientific feast. Social events were superb and very meticulously planned. Thank you for inviting me as faculty and for your kind hospitality. Regards

Sheila nainan Myatra MD, FICCM

Dear Dr Rungta

Congratulations for conducting a very successful conference. From event management, scientific content to hospitality, it was a highly successful performance. I have always been a fan of Jaipur. The weather was perfect. I will always look forward for the next conference in Jaipur. Thank You for inviting me.

Susruta

Dear Dr Munjal

This is to express our gratitude for the opportunity provided to CCNS to conduct conference along with ISCCM. The conference was of exemplarily standard . Thank you once again for your co-operation. Thanks & regards

Prof Jaya K, President CCNS

Dear sir,

Heartiest congratulations for conducting such a nice conference. Thanks a lot for great hospitality. I hope it will be remembered for long. Regards

Pradip Bhattacharya

Dear Dr. Rungta and Dr. Munjal,

Many many congratulations for the wonderful organization of the conference. I enjoyed the scientific contents immensely. The hospitality was great. Thanks,

aK Baronia, Professor & Head, Department of Critical Care Medicine, SGPGIMS, Lucknow 226014

Respected Sir,

Thanks very much for giving an opportunity to participate in the prestigious conference. The experience

shall be cherished for a long time. Kind regards,

abhinav Gupta

Sir,

I would like to wish you a hearty congratulations for the grand success of criticare 2014, Jaipur. Thanks for providing excellent hospitality and truly informative sessions.

Dr ranvir S Tyagi, M.D, Zonal member ISCCM

Thank you for having me as part of the programme. The RRT workshop was a learning experience. Me and my family enjoyed Jaipur city and staying at hotel Lalith was a nice experience

r.Chakravarthi

Well run meeting - thank you for the invitation.

neil Macintyre

Respected sir,

It was a great pleasure & honour to be a part of criticare 2014 at Jaipur, the arrangements were great & stay was comfortable. It was a fantastic scientific & academic feast with great scholars & speakers from all over the world coming on a single platform. Thanks a lot again sir,

Dr raman Chatrath

Dear Narendra and Manish,

Thank you very much for your very warm hospitality and excellent arrangements for my stay in Jaipur. I very much enjoyed the opportunity to participate in the conference which was a huge success. I look forward to opportunities to develop further collaborations with you and the ISCCM. Thank you again for a very memorable visit. Warmest regards, Ravi

ravindra l Mehta MD, FACP, FASN, FRCP, Professor of Clinical Medicine, Associate Chair for Clinical Research Department of Medicine, San Diego, CA

It was a pleasure participating in the congress. Congratulations for organizing a very successful congress. Regards

rajesh Pande

Thank u Dr Munjal

It was fantastic conference. Full of education topics and innovative workshops. My nursing staff was very much impressed. Thank u again for giving me the opportunity to become part of the conference.

Dr nirmal Jaiswal

Thank you, organizers,

You appear to have spared no effort in ensuring that we have a lively interaction and comfortable stay. The scientific fare as well as the catering & entertainment were varied and rich, the hospitality befitting the famed Rajasthani tradition! Kindly accept my sincere thanks. Warm regards,

rK Mani

To Dr Munjal and his team,

Thanks sir for organizing this great event, thanks for all the hospitality. Everything was perfect from the venue, to stay, to transportation. Thanks once again, especially to Dr Rungta Sir for me giving me this great opportunity to speak as a national faculty at such a young age.

Dr. Saurabh Saigal


President and General Secretary are ex officio members of all sub-committees. all sub-committee appointments are for one year

name Chairperson/Co-Chairperson Members Purpose

Credentials Committee Dr. Jigeeshu Divatia Dr. Arvind BaroniaDr. Sumit RayDr. Susruta BandyopadhyayDr. Babu Abraham

Selection of fellowsSelection of Research Committee ChairpersonSelection of EditorsSelection of New Speakers/ Talent Hunt

research Committee Nominations invited on websiteLast date 1st April 20141 nomination received from Dr. Sriram Sampath

Promote research by creating a framework for research projectsInvite proposals for research from ISCCM membersCreate a core group of Indian researchers

Election Committee Dr. Atul Kulkarni Dr. Rajesh PandeDr Anand Dongre

Carry out elections smoothly. Set criteria for elections of branches

Constitutional amendments Committee

Dr. Atul Kulkarni Dr. Bande Dr. Deepak GovilDr. Kapil Zirpe

Propose amendments for constitution. Scrutinise ISCCM constitution as corrected by Hon GS Hora & present it to the EC

iSCCM Day Committee Dr. Ramakrishnan/ Dr. Anand Nikalje

All Zonal Members To decide theme of ISCCM dayTo coordinate ISCCM day activities

Pediatric Section Committee

Dr. Jayashree Muralidharan Dr. Pravin KhilnaniDr. SachdevDr. Banani Poddar

To prepare pediatric members listTo prepare MOU for interaction with IAP pediatric intensive care sectionTo review pediatric ISCCM diploma courseTo review BPICC course

Finance Committee Dr. Atul KulkarniDr. Ramakrishnan

Dr. Narendra RungtaDr. Vijaya PatilDr. Kapil ZirpeDr. YP SinghDr. Yatin Mehta

Review accountant’s quarterly report & financial statusReview financial progress of previous national conferencesReview college financesReview use of funds by subcommitteesScrutinize research & other proposals for financial assistance

Office Committee Dr. Vandana AgarwalDr. Palepu Gopal

To review office processes regarding membership, college activities, staff, etc

Website Committee Dr. Jayant Shelgaonkar Dr. Sauren PanjaDr. Manoj SinghDr. Rajesh Mishra

To oversee website content on a weekly basisTo work with office committee for implementation of website changes for membership & college activitiesTo work with Newsletter editor for internet format of newsletter

Guidelines Committee Dr. Yatin Mehta Dr. Vijaya PatilDr. Arindam KarDr. Ramakrishnan

To complete current guidelinesTo review and see if any previous guidelines need any revisionTo explore new guidelines

Membership Committee Dr. Pradip Bhattacharya All zonal members To suggest methods to increase membership. Zonal members to represent ISCCM centre at regional conferences for

Branches liaison Committee

Dr. Vandana Agarwal Dr. Rajesh PandeDr. Sushruta BandopadhyayDr. Ranvir TyagiDr. YP Singh

alumni Committee Dr. Vijaya Patil Dr. Prakash Shastri Dr. Sauren PanjaDr. Manoj Singh

Create alumni group of ISCCM including all IDCCM and IFCCM awardees and plan alumni meeting at Criticare 2015

ISCCM Sub-CommitteesTM

The CriTiCal Care CommuniCaTionsa Bi-monthly newsletter of indian society of Critical Care medicine 11Indian Colege of Critical Care Medicine - Board Members

TIR ICC AF LO C E AG RE EL L M

O EDC ICN IA NI EDNI

CHANCELLORDr. rajesh Chawla

VICE CHANCELLORDr. n. ramakrishnan

IMMEDIATE PAST CHANCELLORDr. J. V. Divatia

SECRETARYDr. Palepu B. Gopal

ACCREDITATION SECRETARYDr. Deepak Govil

MEMBER – CONTROLLER OF ExAMINATIONSDr. Yatin Mehta

MEMBERDr. G. C. Khilnani

MEMBER - JOINT SECRETARIESDr. Pradeep rangappaDr. B. D. Bande

NURSING PROGRAMME CO-ORDINATORDr. Prakash Shastri

IMMEDIATE PAST PRESIDENT – ISCCMDr. narendra rungta

PRESIDENT, ISCCMDr. Shivakumar iyer

PRESIDENT–ELECT, ISCCMDr. atul Kulkarni

GENERAL SECRETARY, ISCCMDr. Dhruva Chaudhry

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BranchactivitiesraJkot BraNCH

Surat BraNCH

BHuBaNeSwar BraNCH

JanuarY 2014

After nearly 2 ½ years of hard work and persistence in tackling the government machinery, we have finally been able to register our ISCCM, Rajkot Branch with the Charity Commissioner Authority. Albeit we had to change the nomenclature of our branch as per existing government rules informed to us by the authorities, and now we are registered as “Critical Care Society of Rajkot” with the Charity Commissioner and the Registrar of Societies, Rajkot. We have also obtained our Income Tax PAN no. in this name. We have submitted the concerned papers, and our undertaking regarding the same, to the head office already by courier in Feb 2014.

a Family Get-Together for all ISCCM members was kept at the Doctor’s Club, Rajkot on 19th January, Sunday. A Special GBM was conducted during this gathering and it was attended by members. The Points that were discussed were...

1. Declaration of the new Nomenclature of the Society, as above

2. Declaration of forthcoming elections and the dates for filing nominations. Senior member Dr Asit Vaishnav was unanimously appointed as the Returning Officer for the elections during this meeting.

3. Discussion of the plan of action for Gujarat Criticon 2014 which wil be hosted by the ISCCM, Rajkot Branch.

Clinical Meeting and discussion on interesting cases was held on 30th

January, 2014 at the Imperial Palace. Speaker were Dr Milap Mashru & Dr Amit Patel.

FEBruarY 2014

We have had our Election process for electing our new Executive Committee for the 2-year term of 2014-2016, and we had appointed Dr Asit Vaishnav as our Election Presiding Officer/Returning Officer.

9 posts were vacant where the candidates were supposed to be elected. Nomination forms for these 9 posts were invited through 2 circulars, and also smses, during the designated period of 1st February to 28th February, 2014.

Clinical Meeting was held on 27th Feb. Speakers were Dr Sankalp Vanzara & Dr Samir Prajapati. Latest Advances discussed during Jaipur Criticare 2014, & Journal reading was done.

MarCH 2014

As one nomination was received for each of the 9 posts vacant, we did not have had to go through the voting process to elect our new office bearers. The following candidates were elected unopposed for the following posts for the next 2 year term beginning from 1st April 2014.

Chairman : Dr. Jayesh Dobariya

Hon. Secretary : Dr. Tejas Karmata

Treasurer : Dr. Archit Rathod

Executive Committee : Dr. Naresh Barasara, Dr. Hetal Vadera, Dr. Dharmendra Amritya, Dr. Digvijaysinh Jadeja, Dr. Bhumi Dave, Dr. Ravi Nagrecha

The Formal installation of the new team was done on 27th of March, 2014 after the Clinical Meeting at which the speaker, Dr Jayesh Dobariya made presentation on current status of Pulmonary Embolism.

President : Dr Mukur Petrolwala • Secretary : Dr Mitul Chavda

1. aClS workshop- in association with life Supporters , Mumbai

• March 8-10, 2013

• At BAPS Pramukh Swami Hospital, Surat

• Total no of participants-29

2. update on sepsis- Surviving Sepsis Campaign guideline 2013

• Local Speakers: Dr Mitul Chavda, Dr Karsan Nandaniya, Dr Alpesh Parmar, Dr Samir Gami, Dr Nikesh Davda, Dr Haresh Vastrapura, Dr Rajesh Prajapati

3. Workshop on “nutrition in critically ill patients”- 28th april 2013

• Dr Chirag Matrvadia ( Rajkot)- Basics of Nutrition in critically ill

• Dr Dipak Talwar (Delhi)- Immuno nutrition in ICU

• Dr Pravin Bhatia ( Delhi)– Nutrition in surgical patient

4. Basic life Support Training for Medical Students- 3rd MBBS –at SMiMEr Medical College, Surat

• Date : 19/04/2013

• Speakers: Dr Mitul Chavda, Dr Arul Shukla

5. iSCCM Day activity- 11/10/2013

• Theme- Tropical Fever in ICU

• Dr Ramesh Surati- “ Syndromic Approach in tropical fever”

• Dr Dipak Shukla- “ Recent advance in management of tropical fever”

6. Workshop for Critical Care nursing – Conducted by Surat iSCCM branch at TGB hotel, ahmadabad as part of Gujarat Criticon – Date- 25/10/2013

• Total numbers of delegate- 280

• Faculty: Dr Prakash Shashtri (Delhi), Dr Mitul Chavda, Dr Alpesh Parmar, Dr Rajesh Prajapati, Dr Samir Gami, Dr Chetan Mehta, Dr Arul Shukla

• 6 workshop stations:

i. Hemodynamic monitoring

ii. O2 therapy & airway management

iii. BLS

iv. Emergency Drugs & ABG

v. Mechanical Ventilation

vi. Tracheostomy care & suctioning

7. ISCCM Surat branch has started Critical Care Clinics last Friday of every month and it is being successfully conducted since March 2013.It is being supervised under guidance of senior physician Dr Ramesh Surati & Dr Amish Shah. Every time one interesting case presentation and recent study about Critical Care medicine was discussed.

1. The Bhubaneswar branch of Indian Society of Critical Care Medicine was formed on 17th March 2007. The branch got its registration on 15.11.2011. The registration no is BBS No.1784-57 of 2011-2012. It has been conducting academic meetings regularly every 3rd Friday in each month, along with an annual course or update every year.

2. On 22-23 June 2013 we conducted for the first time in Odisha a two days CME cum workshop on “Critical Care training for Nurses and Technicians” attended by around 100 nurses in and around Odisha.

3. The following Academic meetings were conducted:

4. 18.01.2013 – Assessment of Critically ill patient - Dr Saroj Pattnaik

5. 15.02.2013 - Post-resuscitation care - Dr Arata Kumar Swain

6. 15-03-2013 - A case of PUO ???? - Dr. Swayam Bikash Pattnaik

7. 19.04.2013 – Polymyxin -B Extracorporeal Hemo-perfusion Dr. Arindam Kar

8. Therapyin Sepsis management

9. 22-23 June 2013 - Critical Care training for Nurses and Technicians Dr Saroj Pattnaik

10. 16.08.2013 – “Traumatic Brain Injury – Dr. Sharmili Sinha

11. Evidence and Current practices in Critical Care”

12. 9-09-2013 - ISCCM Foundation Day Celebration - Dr Samir Sahu

13. Experience on Tropical Fevers in ICU patients)

14. 20.09.2013 – Adult Immunization and IPD - Dr. Ramasubramanium. V.


aGra BraNCH

NaGPur BraNCH

delHI BraNCH

PuNe BraNCH

1. 27 Oct.13 - Conducted BTC3 ICU course for Nurses 4th Annual Conference of UP & UK chapter at Kanpur

Faculty : Dr Vivek Badada, Dr Rakesh Kr Tyagi, Dr Ranvir S Tyagi, Dr Diptimala Agarwal

2. 10 Nov.13 - Panel Discussion on Sepsis at Rainbow Hospital Agra Panelists: Dr AK Gupta, Dr VN Kaushal, Dr Diptimala Agarwal, Dr Vandana Kalra

3. 30 Dec.13 - Role of Mocolytics in ICU Dr Yatin Mehta at Hotel Amar Agra

4. 30 Jan.14 - Celphos Poisoning: New Perspective Dr Diptimala Agarwal at Hotel Dazzle Agra

5. 6 Feb 14 - Change in ICU practises over last decade in our city Dr Diptimala Agarwal at Pushpanjali Hospital Agra

6. 2 March 14 - Role of steroids in Septic Shock, Dr Ranvir S Tyagi at Hotel Amar Agra

CME on severe sepsis. Date 29 Nov 2013

1. Management of severe sepsis- Where we are heading? and

2. Indian experience with safety and use of Ulinastatin

Speaker : Dr Ashit Hegde, ICU Director, PD Hinduja Hospital

Chairpersons were Dr Nirmal Jaiswal and Dr Anand Dongre

Venue: Hotel Tuli Imperial

Comprehensive Critical Care Course 10-11 May 2014

15. 15.11.2013 – “Newer Antibiotics & their usage in critical care cases” Dr. Amitav Mohanty

16. 20.12.2013 - Conception of Code blue team – Dr. Janmejayanayak

A step ahead in patient care

Dr. Saroj PattnaikSecretary, ISCCM, Bhubaneswar BranchConsultant, CCU, Apollo Hospitals, Bhubaneswar

September 2013Meeting : World Sepsis DayDate : 13th September 2013Venue : The Dome,

Hotel Vivanta by Taj Ambassador, Khan Market, New Delhi

Organized by : Dr Rajesh Pande, Secretary, SCCM Delhi

October 2013Meeting : iSCCM Foundation

Day (Fight against tropical Infections in ICU)Date : 9th October 2013Venue : Palwal (A district Town of Haryana) with IMA, PalwalOrganized by : Dr Supradip Ghosh, Fortis Faridabad Hospital

Meeting : Monthly CMEDate : 17th October June 2013Venue : Maple Hall at India Habitat World Organized by : Dr Vinod K Singh, Sir Ganga Ram Hospital, New Delhi

Agenda1. Case 1: A case of Multiple Drug Overdose. Speaker

- Dr Pradip Dalvi2. Case 2: A case of Refractory Hypoxemia. Speaker - Dr Rahul Kumar3. Journal Club Speaker - Dr S Taneja

97 Seconds for sepsis

97 Seconds for sepsis video“97 seconds for sepsis” is a short video that highlights the very personal impact sepsis has on those who experience it. it’s about loss and it’s about hope.The World Sepsis Day Awareness movie was partially recorded at Max Super Specialty Hospital, Saket-Delhi with inputs from Dr Yash Javeri.

november 2013Meeting : annual General BodyDate : 7th November 2013Venue : The Theaters Organized by : Dr Rajesh Pande, Secretary ISCCM Delhi

Agenda 1. Consensus for the new Executive Committee Members2. Executive committee Election process for the year 2014-2016:

Whether we should go for electronic voting or postal ballot or manual voting like last time?

3. Annual Conference DCCS 2013 - Accounts4. Branch Activities 2012 – 2013 (CME/Workshop/Annual Conference/

website etc)5. Any other issue with the permission of the Chairman

Meeting : Workshop on Management Of Fluids and Electrolytes Balance in Critical Care

Date : 17th November 2013Venue : Metropolitan Hotel, New Delhi. Organized by : Dr Supradip Ghosh, Fortis Faridabad Hospital

January 2014Meeting : Tropical Medicine update 2014Date : 18th January 2014Venue : Sri Balaji Action Medical Institute, Paschim Vihar,

New DelhiOrganized by : Dr Prashant Nasa/Dr Deven Juneja

Topics covered: • Approach to Tropical Fever• Diagnostic aspects of tropical fever.• What are red flag signs triggering intensive management?• Controversies in the management of Tropical Fever• Newer therapies and what is the evidence?

Meeting : Monthly CMEDate : 24th January 2014Venue : Willow Hall at India Habitat World Organized by : Dr Supradip Ghosh

Agenda :Case 1 : Osborne wave as the initial presenting manifestation of Stress cardiomyopathy.Case 2 : An unusual etiology of obstructive shock.Case 3 : Evaluation of a case of unexplained Cyanosis.

February 2014Meeting : Critical Care refresher

Course Date : 13-15 March 2014Venue : The Medicity, Sector

38. Gurgaon, Haryana.Organized by : Dr Deepak Govil

WSD 2014: 13 September 2014

EC members of Pune Branch in the New Office

TM


Calender of Events 2014May 201430, 31 May-1st June 2014 Comprehensive Critical Care Course, New Delhi Dr. Rajesh Chawla

9810033395 • [email protected]

30-31 May 2014 Winfocus USG Workshop, Gandhinagar Dr. Manoj Singh 9925179799 • [email protected]

June 201414-15 June 2014 Comprehensive Critical Care Course Dr. Pradeep Rangappa

9611700888 • [email protected]

20-22 June 2014 Critical Care Update 2014, Hyderabad Mr. Vinod • 9985612924July 20147-13 July 2014 Best of Brussels Symposium 2014, Pune Dr. Kapil Zirpe • 9822844212 • [email protected] July 2014 Comprehensive Critical Care Course, Ludhiana Dr. Rajesh Mahajan

9815620102 • [email protected] 20142-3 August 2014 Comprehensive Critical Care Course, Mumbai Dr. Amol Kothekar

9769633568 • [email protected] August 2014 Comprehensive Critical Care Course, Hyderabad Dr. Shyam Sunder

9849038265 • [email protected] 20144-6th September 2014 Delhi Critical Care Symposium – DCCS 2014

India Habitat Centre, New DelhiDr. Yash Javeri 9818716943 • [email protected]

6-9 September 2014 ESPEN Congress, Geneva, Switzerland www.espen.org/geneva-201418-21st September 2014 Maha Criticon 2014, Aurangabad, Maharashtra Dr. Anand Nikalje

09822496190 • [email protected] Sept.-1 Oct. 2014 ESICM Annual Congress, Centre de Convencions

Internacional de Barcelona, Spainwww.esicm.org

October 20149-11 October 2014 ANZICS/ACCCN Intensive Care ASM, Melbourne www.intensivecareasm.com.au/2014/11-12 October 2014 Comprehensive Critical Care Course, Bareilly Dr. Lalit Singh • 9415134949 • [email protected] 201414-16 November 2014 Mumbai Criticon 2014,

Hotel Trident, Nariman Point, MumbaiDr. Rahul Pandit • 9820595519 • [email protected]

21-23 November 2014 Gujarat Criticon 2014, Rajkot www.gujaratcriticon.com/

TM

Delhi Critical Care Symposium

12th Annual Conference of Society of Critical Care Medicine - Delhi

(A Delhi & NCR Branch of Indian Society of Critical Care Medicine)

Theme : Controversies in Critical Care Medicine

Pre-COnferenCe WOrksHOPs4th-5th September, 2014

Various Hospitals - NCr Delhi

Main COnferenCe6th-7th September, 2014

India Habitat Centre, New Delhi

HIGHLIGHTS Pre-Conference Workshop Hard Talk-PrO/COn debate Plenary sessions grand rounds acute Care Medicine session

Case based sessions buzzer rounds for trainees Quiz Post graduates & fellows dCCs Oration

aBSTraCTSContribute to Critical Care by submitting your original investigative

research and case reports. Last date 30 July 2014.

TarGeT auDIeNCe Critical Care Physicians &

Trainees emergency physicians

Critical Care nurses Post graduates students

Website : www.isccmdelhi.com

2nd Annual State Conference of GujaratOrganised jointly by all branches of ISCCM in Gujarat

21st-22nd and 23rd November, 2014 Rajkot

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SCIENTIFIC PROGRAM HIGHLIGHTS Latest Developments in Cri tical Care. Practice oriented clinically relevant topics. Interactive Sessions interspersed with

Informative Lectures. Plenary Session on Hot topics. Thematic sessions.

National and Internationally renowned faculties.

Budding Young Clinicians and Old Warhorses. Poster Presentations for Registrars and Post

Graduates. Applying for Credit Hours from Gujarat

Medical Council.WORKSHOP HIGHLIGHTS Pre Conference Program on 21st November,

2014. Comfor table timings of 10 am 6 pm. Limited Seats only.

WORKSHOP TOPICS ABC of Cri tical Care. Vascular Access and Basic Hemodynamic

Monitoring. Mechanical Ventilation.

Do's & Dont's in ICU Cri tical Care Nursing (for Nurses and

Paramedics)

CONfeReNCe HOSTSISCCM, Rajkot Branch

Ahmedabad Branch Baroda Branch Bhavnagar Branch Karamsad Branch Surat Branch Valsad BranchfOR COMMUNICATION WITH ISCCM, RAjKOT BRANCH

Dr. Sankalp Vanzara : +91 98244 59695 Dr. jayesh Dobariya : +91 98250 43590302, Lifeline Building, 13, Manhar Plot, Vidyanagar Main Road, Rajkot 360001.

[email protected] www.gujaratcri ticon.com


welcome New Members to the ISCCM family1 Babji Kalapati, Dist. Chittoor LM-14/K-6722 Kiran V Todkari, Latur LM-14/T-2343 Vishal Pawar, Latur LM-14/P-6054 Ashok Kumar Baidya, Ranchi LM-14/B-5035 Bharat Patodiya, Jaipur LM-14/P-6066 Janarthanan S, Mumbai LM-14/S-10787 Hemanth K Jayanna, Shimoga LM-14/J-3288 Milind Sangle, Ahmednagar ALM-14/S-10799 Greeshma Goyal, Jaipur ALM-14/G-50510 Niyaz Ashraf, Calicut LM-14/A-40411 Naveen Kumar Prabhudev, Bangalore LM-14/P-60712 Sayeduz Zaman, Bongaigaon LM-14/Z-1213 V.Krishna Murti, Terunelveli Dist LM-14/M-57114 Anup Jyoti Dutta, Dispur - Guwahati LM-14/D-41615 Debasish Paul, P.O Pandu LM-14/P-60816 Mohd Argawan Bashir, Kashmir ALM-14/B-50417 Rajeev Navaria, Jaipur LM-14/N-21118 Sudha Subhana Desai, Mumbai LM-14/D-41719 Janak M Patel, Ahmedabad LM-14/P-60920 Shashidhar Manchegowda, Mandya LM-14/M-57221 Saravanan Subburaj, Coimbatore LM-14/S-108022 Sukhen Samanta, New Delhi LM-14/S-108123 Priteema Chanana, Rajasthan LM-14/C-31424 Sujay Samanta, Lucknow LM-14/S-108225 Manoj Kumar Karabathula, Secunderabad ALM-14/K-67326 Jannamreddy Ashwin, Hyderabad ALM-14/A-40527 Ram Gurumukhdas Tejwani, Dist – Amravati ALM-14/T-23528 Sunil Kumar Raskaran, Jaipur LM-14/R-41829 Virendra R Modi, Bhillai LM-14/M-57330 Kumara Swamy Koutam, Secunderabad LM-14/K-67431 Sheela Swaraj, Aligarh LM-14/S-108332 Swaraj Bhartiya, Aligarh LM-14/B-50533 Anil Gadodia, Aligarh LM-14/G-50634 Sampath Kumar Nidhra , Hyderabad LM-14/N-21235 Rajesh Holalu Chikkalinge Gowda, Bangalore LM-14/C-31536 Shipra Gulati, New Delhi LM-14/G-50737 Vinayanand Balijepalli, Hyderabad ALM-14/B-50638 Vidya Sagar Ongole, Hyderabad ALM-14/O-1439 Vivekanand V Varasarajan, Chennai LM-14/V-22340 Indrajit Suresh, Mysore LM-14/S-108441 Vikrant Tamrakar, Dist - Durg ALM-14/T-23642 Hukmi Chand Soni, Rajsamand LM-14/S-108543 Ram Vikrambhai Odedara, Porbandar LM-14/O-1544 Atul Nagare, Pune LM-14/N-21345 Monika Sinha, Gurgaon ALM-14/S-108646 Sandip Mandal, Kolkata LM-14/M-57447 Hari Govind Prasad, Distt - Begusarai LM-14/P-61048 Jasmeet Singh, Chandigarh LM-14/S-108749 Abhijit Roy Choudhury, Bahadurgarh LM-14/C-31650 Shilpa Sharda, Udaipur LM-14/S-108851 Bipin Sinha, Dhanbad LM-14/S-108952 Atanu Pal, 24 Paraganas LM-14/P-61153 Rajesh Menon, Kottyam LM-14/M-57554 S.K Asif Iqbal, Warangal LM-14/I-3855 Munni Singhania, Port Blair LM-14/S-109056 Adiveppa R Devaraddi, TQ Jamkhandi LM-14/D-41857 Arnab Banerjee, Rohtak ALM-14/B-50758 Arun Kumar Sethuraman, Tiruchirapalli LM-14/S-109159 Riteshkumar Maradia, Mumbai LM-14/M-57660 Rudradatt C Parmar, Mumbai LM-14/P-61261 Ajay Khobragade, Mumbai LM-14/K-67562 Amit Botre, Dt : Satara LM-14/B-50863 Mayur Hendre, Dist - Pune ALM-14/H-9064 Imliwati Aier, New Delhi LM-14/A-40665 Irfan Ali, New Delhi ALM-14/A-40766 Sushma Parihar, Chattisgarh ALM-14/P-61367 Saumil B Sanghvi, Ahmedabad LM-14/S-109268 Prince Bashir Jan, New Delhi ALM-14/J-32969 Mohan Ranganathan, Chennai LM-14/R-41970 Al Shadili S, Trivandrum ALM-14/S-109371 Sudheer Dorairaj, Trivandrum ALM-14/D-41972 Rani Lakhe, Nagpur LM-14/L-7373 Shabeer Fakrudeen, Kannur LM-14/F-2174 Rahulan Damodharan, Trivandrum ALM-14/D-42075 Yogesh Talekar, Mumbai LM-14/T-23776 Sumona Paul, Hyderabad LM-14/P-61477 Hameeda Begum, Hyderabad ALM-14/B-50978 Prabir Kumar Roy, Hyderabad LM-14/R-42079 Saravin Nallaiyan, Erode LM-14/N-21480 Bababhai H Munji, Palanpur LM-14/M-57781 Ambrish Nerlikar, Mumbai LM-14/N-215

82 Tejas Hemant Mehta, Mumbai LM-14/M-57883 Garima Sinha, Raipur ALM-14/S-109484 Shivam Bipin Parekh, Vadodara LM-14/P-61585 Sidhesh Wagh, Nashik LM-14/W-4986 Gaurav Agarwal, Delhi LM-14/A-40887 Narendra Fiske, Dist - Buldhana LM-14/F-2288 Surekha C, Bangalore LM-14/C-31789 Anuradha Bheri, Bhubaneswar LM-14/B-51090 Aniket Kataria, Ahmednagar ALM-14/K-67691 Rakesh Agrawal, Hyderabad LM-14/A-40992 Vijay Kumar Motwani, Raipur ALM-14/M-57993 Subhendu Behera, Raipur ALM-14/B-51194 Ankit Kirankumar Gajjar, Surat LM-14/G-50895 Neha Arora, Bhiwani LM-14/A-41096 Ramesh P, Dist - Medak LM-14/P-61697 Nagarakanti Chaitanya, Hyderabad LM-14/C-31898 Gaurav Pratap Singh, Ghaziabad LM-14/S-109599 Ranjit Singh Thakur, Bhopal LM-14/T-238100 Shoeab Ahmed K.M, New Delhi ALM-14/M-580101 Surinder Pal Singh, Dist - Ropar LM-14/S-1096102 P.V Sai Saran, Chandigarh LM-14/S-1097103 Nimisha Mrinal, Mohali LM-14/M-581104 Tahir Ali Khan, Bhopal LM-14/K-677105 Girish Chandra, Lucknow LM-14/C-319106 Madhusmita Mohanty, Bhubaneswar LM-14/M-582107 Pankaj Shankar Gujar, Pune LM-14/G-509108 Sweta Chodavarapu, Hyderabad LM-14/C-320109 Vineet Milind Ranveer, Mumbai LM-14/R-421110 Harshal Parekh, Mumbai LM-14/P-617111 Dev Lakshmesesh, Kodagu LM-14/L-74112 Abhijit Roy, Kolkata ALM-14/R-422113 Laxman S Jambagi, Dist Belgaum LM-14/J-330114 Manuja Aggarwal, Gurgaon LM-14/A-411115 Anil Jadhav, Pune LM-14/J-331116 Amit H Vasani, Rajkot LM-14/V-224117 Ashpak Bangi, Pune LM-14/B-512118 Arjun Jay Deshmukh, Mumbai LM-14/D-421119 Nibedita Pani, Bhubaneswar LM-14/P-618120 Ghasiram Agrawal, Raipur LM-14/A-412121 Vijay Kumar, Ghaziabad LM-14/K-678122 Lakshman Thimmegowda, Bangalore ALM-14/T-239123 Venkatagiri Sreekanth, Tirupathi LM-14/S-1098124 Naveen Kanth Reddy, Tirupathi LM-14/R-423125 Anitha Varghese, Bangalore LM-14/V-225126 Jerry Thomas, Kottayam LM-14/T-240127 Samrat Joshi, Jaipur LM-14/J-332128 Sourabh Phadtare, Thane (W) LM-14/P-619129 Shakya Majumder, Kolkata LM-14/M-583130 Vikas Bhagat LM-14/B-513131 Mohammed Zakiyoodin, Gurgaon ALM-14/Z-13132 Ashish Mishra, Mumbai ALM-14/M-584133 Shashi Sinha, Patna LM-14/S-1099134 Gaurav Aggarwal, Yamuna Nagar LM-14/A-413135 Sajana Salam, Trivandrum ALM-14/S-1100136 Nishi Sood, Mansa LM-14/S-1101137 Vikas Sudan, Coimbatore LM-14/S-1102138 Kamal Deep Yadav, Delhi ALM-14/Y-43139 Meghena, Chennai LM-14/M-585140 Raja Basu, Kolkata LM-14/B-520141 Sandeep Anehosur, Mumbai LM-14/A-414142 Garima Ahrawal, New Delhi LM-14/A-415143 Sudhakar M Ranpise, Pune LM-14/R-424144 IPE K Jacob, Bangalore ALM-14/J-333145 Anshul Jain, Gurgaon ALM-14/J-334146 Gagandeep Singh, Ludhiana ALM-14/S-1103147 Debjani Goswami, Dist - Burdwan LM-14/G-510148 Amitkumar Prajapati, Ahemdabad LM-14/P-620149 Deepak Sharma, Gandhinagar LM-14/S-1104150 Viren Hindocha, Dist - Jamnagar LM-14/H-91151 Jigar R Padalia, Rajkot ALM-14/P-621152 Darshan Sanjeev Jani, Rajkot ALM-14/J-335153 Snehil Kumar, Bhagalpur ALM-14/K-679154 Rajiv Sabnani, Ahemdabad LM-14/S-1105155 Rahul Roy, Ranchi LM-14/R-425156 Jayanti Singh, Vellore LM-14/S-1106157 Rishikesh M Awode, Bhopal LM-14/A-416158 Rajakumar P.S, Thundalam LM-14/S-1107159 Sandeep Kumar, New Delhi LM-14/K-680160 Veeranna Lokapur, Dist - Bagalkot LM-14/L-75161 Amol Lichade, Dist - Chandrapur ALM-14/L-76162 Manpreet Singh Gill, Mohali LM-14/G-511

163 Siddhartha Banerjee, Narendrapur LM-14/B-514164 Monalisa Singh, Kolkata LM-14/S-1108165 Manamita Mandal, Kolkata ALM-14/M-586166 Piya Ghose, Howrah ALM-14/G-512167 Sweety Das, Cuttack ALM-14/D-422168 Payel Bose, Kolkata LM-14/B-515169 Samir Malik, New Delhi LM-14/M-587170 Garima Mishra, New Delhi LM-14/M-588171 Shankar Datt Joshi, Dehradoon LM-14/J-336172 Renuka Agarwal, Ghaziabad LM-14/A-417173 Sheeshpal Thalor, Jodhpur ALM-14/T-241174 Madan Gopal Goswami, Jodhpur ALM-14/G-513175 Suneesh Thilak, Trivandrum LM-14/T-242176 Arun Jain, Dist Buldhana ALM-14/J-337177 Deepika Tayade, Pune LM-14/T-243178 Sahil Doshi, Ahemdabad ALM-14/D-423179 Chinmay Godbole, Mumbai LM-14/G-514180 Rakesh Periwal, Guwahati LM-14/P-622181 Rakesh Choudhary, Dist Alwar LM-14/C-321182 Preeti Sharma, Chadigarh LM-14/S-1109183 Vijay Singh Bhandari, Dehradun LM-14/B-516184 Aditya Jindal, Chadigarh LM-14/J-338185 Rajjan Prasad, Faridabad ALM-14/P-623186 Tejas Chaudhari, Rajkot LM-14/C-322187 Valay Harshkumar Zaveri, Dahod ALM-14/Z-14188 Nityanand Rao Patil, Bangalore LM-14/P-624189 Rajasekara Madarasu, Hyderabad LM-14/M-589190 Sachin Chidrawar, Hyderabad LM-14/C-323191 Alok Ahlawat, Faridabad ALM-14/A-418192 Govardhan Gupta, Mumbai ALM-14/G-515193 Vijaykumar Chaini, Athani LM-14/C-324194 Govind Nathu Pawar, Panvel LM-14/P-625195 Moho Abdulsalam H.S Tamboli, Parbhani LM-14/T-244196 Jayashankar C A, Bangalore LM-14/A-419197 Lalit Kumar Rajbanshi, Vellore LM-14/R-426198 Anita Surana, Udaipur LM-14/S-1110199 Mahesh Shetty, Navi Mumbai LM-14/S-1111200 Narendra Kumar Tyagi, Muzzaffarnagar LM-14/T-245201 Sunita Pandey, Hoshngabad LM-14/P-626202 Narendra Kumar Pandey, Hoshngabad LM-14/P-627203 Adhi Ganesh C.S , Puducherry LM-14/S-1112204 Tulasi Ram Kolukula, Vijaywada LM-14/K-681205 Manjula Sinha, Ranchi LM-14/S-1113206 Sweetha Mohan LM-14/M-590207 Florence Almeida, Pitampura LM-14/A-420208 Nilesh Patel, Patan LM-14/P-628209 Tapas Bandopadhyay, Kolkata LM-14/B-517210 Daipayan Bhowmick, Guwahati ALM-14/B-518211 Satish Joshi, Kolhapur LM-14/J-339212 Kavyashree S.P, Bangalore LM-14/P-629213 Rajesh Kumar Mussani, New Delhi LM-14/M-591214 Sumedh Jajoo, Dist - Wardha LM-14/J-340215 Soumar Dutta, Guwahati ALM-14/D-424216 Nitin Wadaskar, Nagpur LM-14/W-50217 Krishnakumar E.V, Thrissur LM-14/V-226218 Praveen Valsalan K, Cochin LM-14/K-682219 Amit Garg, Meerut LM-14/G-516220 Shivakumar Shamrao, Bangalore LM-14/S-1114221 Shuba S, Chennai LM-14/S-1115222 Gautam Kheria, Johrat ALM-14/K-683223 Ravi Ranjan Rakesh, Patna ALM-14/R-427224 Manojkumar Patil, Pune LM-14/P-630225 SaiGayatri Penumaka, Guntur ALM-14/P-631226 Amit Mishra, Lucknow LM-14/M-592227 Siddharth Trivedi, Vadodara LM-14/T-246228 Navdeep Dhaliwal, Chandigarh LM-14/D-425229 Amit Mohan, Ranchi LM-14/M-593230 Nirav M Visavadia, Ahemedabad LM-14/V-227231 Rashmi Iyengar, Bangalore ALM-14/I-39232 Anish Gupta, Mumbai LM-14/G-517233 Arvind Kasaragod, Bangalore LM-14/K-684234 Rajeev Kumar Bhatia, Jalandhar LM-14/B-519235 Raghavendra K.P, Tumkur (Dist) LM-14/P-632236 Rajni Kant Prasad, New Delhi LM-14/P-633237 Rameshkumar Virani, Junagadh LM-14/V-228238 Nikhil Jivanbhai Prajapati, Mehsana LM-14/P-634239 Hardik Maheshbhai Soni, Mehsana LM-14/S-1116240 Praveshkumar Bhikhabhai Patel, Mehsana LM-14/P-635241 Elizabeth Jacob Mekkunel, Ahemdabad LM-14/M-594242 Muraleedharan Raman, Trivandrum LM-14/R-428


JOUR

NAL SCAN

dr. Srinivas SamvedanChief Intensivist, CARe Hospitals, Hyderabad

The effect of intravenous interferon-beta-1a (FP-

1201) on lung CD73 expression and on acute

respiratory distress syndrome mortality: an

open-label study.

Macrolides and Mortality in Critically Ill Patients

With Community-Acquired Pneumonia: A Systematic Review and

Meta-Analysis

Fluid Management in the Intensive Care Unit: Bioelectrical Impedance Vector Analysis as a Tool

to Assess Hydration Status and Optimal Fluid

Balance in Critically Ill Patients.

Delirium in the ICU and Subsequent Long-Term Disability Among Survivors of Mechanical

Ventilation

Bellingan et al

The Lancet Respiratory M edicine, Volume 2, Issue 2, Pages 98 - 107, February 2014

ARDS is a fairly common condition in intensive care. mechanical ventilation is the mainstay of therapy with extra corporeal support used as a rescue. mortality is also high in refractory ARDS. However, ventilator and extra corporeal supports address the consequence of the process rather than the patho-physiological basis of the syndrome. Several therapies including corticosteroids have been used with varying results. Bellingan and colleagues initially demonstrated the beneficial effect of IFN-beta-1a induced CD73 upregulation on lung tissue samples. Subsequently they identified optimal therapeutic dose of IFN-beta-1a. they then compared 28 day mortality of patients with ARDS who received the drug as compared to those who did not. the optimum dose was identified at 10µgm per day and was given for 6 days. the authors report a 81% reduction in odds of 28 day mortality (odds ratio 0.19 [95% CI 0.03—0.72]; p=0.01). the authors suggest that this could be the first effective, mechanistically targeted disease specific pharmacotherapy for ARDS.

Reviewers comments: this certainly seems to be an interesting hypothesis. However, several such therapies have appeared and disappeared. Whether these results can be replicated by others and withstand the rigorous course of an RCt and inevitable meta analysis remains to be seen. Nevertheless a ray of hope….watch this space

Wendy Sligl

Crit Care Med 2014; 42:420–432

Community acquired pneumonia is one of the most common diagnosis for patients needing ICu admission. Several guidelines recommend a combination of cephalosporins and macrolides as an empirical choice. of late there has been some concern about the cardiac effects of macrolides particulary related to their effect on

volume and total body water. Bio-impedance is a measure of the body’s conductivity and is directly proportional to its fluid composition. Bioelectric impedance vector analysis (BIVA) combines measures of capacity with the standard bio-impedance. BIVA is already implemented for the determination and monitoring of weight in the chronic kidney patient in both extracorporeal and peritoneal dialysis. this method is well validated in this subset of patients. However, its application in ICU and relevance of fluid overload as assessed by BIVA in ICu has not been studied. Basso et al sought to study the hydration status of ICu patients and its variation during ICu stay, hydration status among ICu patients needing RRt and the relationship between hydration status and mortality with or without RRt. this was a single centre observational study. Primary outcome measured was ICu mortality. BIVA measurements were taken for a minimum of 72 hours upto a maximum of 120 hours. Patients were classified as dehydrated, normally hydrated and hyperhydrated with the first and last groups being subdivided into mild, moderate and severe. this study found that more than 70% of patients were admitted to the ICu in a state of hyperhydration. Patients receiving CRRt had higher prevalence of hyperhydration. Non survivors had higher mean and maximum hydration values. Sixty day mortality also appeared to be influenced by mean and maximum hydration values.

Reviewers comments: this study is a observational study, thus scoring less on strength of evidence. However, it comes from Ronco’s group known for its work on AKI. BIVA might take some more time to enter the ICu. But the study draws attention to the fact that fluid balance needs to be regulated more meticulously in critically ill patients since it has a direct bearing on survival in critically ill patients. CRRT is not an insurance against fluid overload.

Nathan E. Brummel

Crit Care Med 2014; 42:369–377

Delirium is a well recognized but somehow underdiagnosed phenomenon in patients being ventilated mechanically. Delerium is recognized as a determinant of outcomes while the patient is in ICu. the effect of delirium after ICu discharge is less appreciated. Brummel et al hypothesized that duration of delirium while being ventilated in the ICu is associated with disability and worse health status after discharge. they performed a single centre prospective cohort study nested

within a randomized controlled trial of a paired sedation and ventilator weaning strategy. they evaluated 126 survivors of critical illness using a logistic regression analysis model. Confusion Assessment method for the ICu, Katz activities of daily living, Functional Activities Questionnaire (measuring instrumental activities of daily living), medical outcomes Study 36-item Short Form General Health Survey Physical Components Score, and Awareness Questionnaire were used. they had a 81% followup at 3 months and 72% follow up at 12 months. Duration of delirium was given more importance rather than simple occurrence on non-occurrence. Follow up occurred at the patients home and questionnaires were applied by an independent blinded neuro-psychologist. Their main findings suggest that the duration of delirium in the ICu was independently associated with disability in Activities of Daily living in the year following critical illness after adjusting for covariates, including baseline ADl function, and the longer a patient was delirious in the ICu, the more likely he or she was to report worse motor-sensory function during follow up compared with his or her pre-illness state. However physical disability and health status was not significantly affected.

Reviewers comments: this is a very well designed and executed study. However, the results do not substantiate the initial hypothesis. Nevertheless this study brings into focus the issue of minimizing the duration of delirium in order to improve overall quality of Post ICu life of critically ill patients. maybe Indian ICus can collaborate and conduct a similar survey.

Flavio Basso

Blood Purif 2013;36:192–199

Fluid management in ICu is always a tricky, difficult and sometimes emotional issue. Positive fluid balance has been shown to have an adverse effect on outcome in certain subsets of patients. None of the currently available tools of assessment of hydration status have proven infallible. Basso et al from Vicenza (Ronco’s group) have chosen to use Bioelectrical Impedance to answer this question.

Bioelectrical impedance analysis has been used for decades to measure resistivity of tissues, as well as to determine extracellular fluid


Therapeutic Hypothermia (TH) and the Risk of Infection: A Systematic Review and

Meta-Analysis

Long-Term Survival and Dialysis Dependency

Following Acute Kidney Injury in Intensive Care: Extended Followup of a Randomized Controlled

Trial

Selenium supplementation in

critically ill patients: A systematic review and

meta-analysis

Francesco Landucci

Journal of Critical Care 29 (2014) 150–156

oxidative stress is one of the metabolic derangements that accompany sepsis. mitochondrial dysfunction and SIRS are believed to be linked to oxidative stress. the antioxidant systems include enzymatic proteins like superoxide dismutase, glutathione peroxidase, and catalase. Selenium, a trace mineral, is an integral part of glutathione peroxidase. the role of selenium deficiency in contributing to infections in ICu and in hospital mortality has been shown in quite a few studies. The beneficial effect of antioxidants on outcomes among critically ill patients has also been studied. landucci and colleagues attempted to review the role of selenium as a monotherapy. the primary outcome analysed was 28 day mortality. Secondary outcomes analysed included 6 month mortality, ICu length of stay, incidence of nosocomial infections and renal insufficiency and need for RRt. the duration of selenium therapy, the route of administration and the dose were analysed as predetermined subgroups. Nine studies withstood methodological scrutiny and were analysed. there seemed to be a benefit in 28 day mortality but not much benefit for in hospital mortality. The dose of selenium (<500 vs 500 µgm /day) did not seem to make a difference. the duration of selenium therapy did not show any impact either. only two trials evaluated 6 month mortality and no difference could be identified on analysis. None of the secondary outcomes changed with dose, duration and route of selenium administration. In fact selenium administration seemed to

Marjolein Geurts

Crit Care Med 2014; 42:231–242

therapeutic hypothermia is increasingly being used for neuro protection in a expanding set of investigations. Patients in whom tH is generally considered are intrinsically at risk for nosocomial infections. While observational studies have reiterated this fact, RCts have not shown the same association. But most RCts have evaluated the association between tH and Infection for a single indication for tH. Geurts et al have attempted to pool all the data and arrive at a broader conclusion. Subgroup analysis was defined apriori. Twenty three studies involving 2820 patients were found eligible for meta analysis. this data set evaluated 1398 patients undergoing tH. majority of the studies used tH as part of traumatic Brain Injury management. only one study relating tH to post cardiac arrest care measured infectious complications as an outcome measure. A very high proportion of studies used surface cooling to achieve target temperatures. A total of 579 infectious events were reported, of which

316 occurred in patients treated with hypothermia and 263 in controls (rate ratio, 1.21 [95% CI, 0.95–1.54]). A moderate heterogeneity was noted in the data analyzed.

Martin Gallagher for the POSTRENAL Study Investigators

PLOS Medicine. February 2014 Volume 11 Issue 2

the incidence of AKI is high in an ICu cohort. Development of AKI is considered as a marker of poorer outcomes among critically ill patient. this study aims to present the results of a four year follow up of patients diagnosed with AKI and undergoing various forms of renal replacement therapy. this is a continuation of a randomized-controlled trial comparing higher and lower intensities of continuous RRt in ICu patients with AKI published by the same authors in NeJm 2009.

this study was a multicentre open label RCt involving 1500 patients across Australia and New Zealand. the current study evaluated all cause mortality at 3.5 years as primary outcome measure. Need for maintenance dialysis was the secondary outcome measure. Quantification of renal function, proteinuria, hypertension and quality of life were the tertiary end points. the investigators found that patients with AKI treated with RRt in the ICu were at high risk of dying during the 3.5-year follow-up period; overall 31.9% of those surviving to 90 days died during the extended follow-up period.

the risk of dying was much greater than the risk of entering a maintenance dialysis program, with neither outcome being influenced by the use of a higher intensity of RRt.

the rate of albuminuria in survivors was substantial, despite relative preservation of renal function. Quality of life however was similar to that in patients with other life style diseases.

Reviewers comments: this study emphasizes the relevance of AKI in ICu patients. Since the mortality seems to be a significant factor at 3.5 years, a more aggressive approach to identify patients at risk of AKI and steps to prevent AKI seem to be in order.

Qt interval. Sligl et al carried out a systematic review and analysed available data. twenty eight studies involving 9850 patients were analysed. All studies were methodologically high quality studies. macrolide therapy was used in 41% of patients studied. macrolide use was associated with a statistically significant lower risk of mortality compared with non macrolide use (21% [846 of 4,036 patients] vs 24% [1,369 of 5,814]; RR, 0.82; 95% CI, 0.70–0.97; p = 0.02). Some other conclusions were drawn after sub group analysis. they found that an antibiotic combination that includes macrolides had marginally better survival benefit. Combination including fluoro-quinolones was marginally inferior to a combination that included macrolides. However, this benefit did not seem to be significant when only prospective studies were evaluated. macrolides did not show a beneficial effect on shock reversal.

Reviewers comments: this meta analysis primarily establishes the safety of macrolides. The beneficial effect on survival seems to be obvious in non ventilated patients and in those who were hemodynamically stable. this is not the bread and butter ICu patient. therefore extrapolation into tertiary critical care looks a little distance away. However, safety concerns should not prevent the use of these agents if the clinical situation warrants.

Pneumonia seemed to be the most common subset. Infections did not seem to be significantly higher when TH was done as part of a procedure for less than 12 hours or as part of Ischemic stroke or tBI management. the only study involving post cardiac arrest patients did not show a higher risk of infection. the risk ratio for developing infection was higher in patients cooled by endovascular means. mechanical ventilation did not increase the risk of infections. the overall increase in the risk of infections was not matched by an increased prevalence of sepsis. ICu mortality and neurological outcomes were not evaluated as part of this meta-analysis.

Reviewer’s comments: this meta-analysis draws attention to the issue of risk of infections while tH is used in ICu. Studies evaluating the outcome of tH should include this as one of the end points. more attention needs to be paid to infection control practices while using tH protocols.

increase the overall length of ICu stay. the incidence of kidney injury and the need for RRt also differ significantly between the selenium and non selenium groups.

Reviewers comments: this meta analysis establishes the fact that anti oxidants have a role to play in the management of septic patients. Selenium might be an attractive anti-oxidant. However, more data needs to be built up before selenium supplementation becomes standard of care.


Career CorNerrEQuirED inTEnSiViSTS

FNB / IFCCM / IDCCM For Multispecialty hospital in Erode, Tamilnadu Willing to work in a Team Kindly send your resume to [email protected]

Division of Critical Care, Bharati Vidyapeeth University Medical College, a rapidly growing ICU with excellent case mix and state-of-the-art equipmentInvites applications from candidates interested in a career in intensive care for the following posts

JuniOr COnSulTanT iCu - 2 POSTSQualification : IDCCM/IFCCM after MD/DNB Medicine, Anesthesia or Chest Medicine

iDCCM COurSE - 2 SEaTS(I year for MD, DNB, 2 years for diploma candidates)

Qualification : MD/DNB Medicine, Anaesthesia, or Chest Medicine, DA, DTCD (MCI recognized) may also apply

CONTACT

Mrs. ashwini Bapat, Secretary, Medical Directors Office Tel.: 020-24375541 (9 am to 4 pm) [email protected]

Dr. Shivakumar iyer, Professor & HOD, Division of Critical Care, [email protected]

Inotropic agents and vasodilator strategies for acute myocardial

infarction complicated by cardiogenic shock or low cardiac output syndrome.

Continuous Ultrafiltration for

Congestive Heart Failure: The CUORE Trial

Bedside Selection of Positive End-Expiratory

Pressure in Mild, Moderate, and Severe

Acute Respiratory Distress Syndrome

Luciano Gattinoni

Crit Care Med 2014; 42:252–264

Acute Respiratory Distress Syndrome (ARDS) is one of the common indications for initiation of ventilator support in ICu. the ARDS Net studies have streamlined the strategies for ventilating these patients. However, a common bed side dilemma is to determine the optimal PeeP for individual patients. Gattinoni et al attempted to evaluate three well described methods to identify optimal PeeP – stress index ( described in the exPress study; JAmA 2008; 299:646–655), esophageal pressure and oxygenation. the patients were stratified into mild, moderate and severe ARDS as per the Berlin definition. this study found that PeeP selected by exPress stress index and oesophageal pressure resulted in higher PeeP unrelated to recruitability of the lung. the oxygenation based determination resulted in lower PeeP and correlated with recruitability of the lung. the recruitability of the lung was judged on the basis of Ct imaging at the end of the maneuver. Recruitability was measured according to the following equation: Recruitabilty = (not aerated lung tissue peep 5 cm H2 o – not aerated

tissue PEEP 45cm H2 O) / (total lung tissue PeeP 5cm H2o). the increment of PeeP showed a progressive trend from mild to severe ARDS, while other methods did not show such progress. this study concludes that oxygenation based upscaling of PeeP appears to be the most effective and safer technique.

Reviewers comments: this study emphasizes the value of clinical assessment of oxygenation to decide on optimum PeeP. It also reiterates the value of identifying recruitable lung prior to manipulating PeeP.

GIANCARLO MARENZI J

Cardiac Fail 2014;20:9-17

Fluid overload is a common problem associated with severe congestive heart failure. the presence of oedema is a negative predictor among patients with CCF. Diuretics are generally considered as the mainstay of therapy. Ultrafiltration is generally reserved for refractory fluid overload. Of late some concerns have emerged about the use of diuretics with reference to renal function compromise. Several recent studies have pointed out about the beneficial role of ultrafiltration on achieving net negative balance. marenzi et al attempted to analyze the efficacy of ultrafiltration versus conventional pharmacologic therapy in patients with severe systolic HF who were hospitalized for HF worsening and significant weight gain due to overt fluid overload. The study randomized 56 patients with CHF into two groups – one

The Cochrane Library 2014, Issue 1

this study attempted to determine the effects in terms of efficacy, efficiency and safety of cardiac care with inotropic agents and vasodilator strategies versus placebo or against each other for haemodynamic stabilisation following surgical treatment, interventional therapy (angioplasty, stent implantation) and conservative treatment (that is no revascularization) on mortality and morbidity in patients with acute myocardial infarction (AmI) complicated by CS or low cardiac output syndrome (lCoS). the reviewers selected only RCts involving patients with AmI complicated

Other studies: Two meta analyses were published on the method of administration of diuretics in heart failure comparing bolus doses versus infusion. (Journal of Critical Care 29 (2014) 2–9; Journal of Critical Care 29 (2014) 10–17). Both the studies came out with conflicting findings. Interestingly both studies analysed nearly the same original studies. The reviewer could therefore not make any concrete decision.

The rationale of applying routine nicotine supplementation in ICU patients was also addressed in another study. (Journal of Intensive Care Medicine 2014, Vol 29(1) 22-30). This meta analysis concluded that nicotine replacement should be used in a highly selected group of patients and not ad lib. More studies seem warranted on this issue.

by CS or LCOS. Very few studies were identified which satisfied the screening criteria. Data from a total of 63 patients was available. three trials compared levosimendan with Dobutamine or other vasodilators. levosimendan showed a trend towards better outcomes but numbers were insignificant. The reviewers commented that there are no robust and convincing data to support a distinct inotropic or vasodilator drug based therapy as a superior solution to reduce mortality in haemodynamically unstable patients with CS or low cardiac output complicating AmI.

Reviewer’s comments: this Cochrane analysis came as a surprise. First was the paucity of data on a problem which seems very common. Second, accepted modalities of “improving lV function” were not actually backed by evidence. there is probably a need for a well designed multi centre RCt on this topic.

receiving standard therapy and the other to ultrafiltration with targeted cumulative removal of > 2 litres. A specific UF device was used. the primary end point was re-hospitalisation for heart failure. Secondary end points included: all cause mortality, a combined end point of death and rehospitalizations for congestive HF, changes in diuretic dose, renal function, and BNP values during the follow-up. Despite similar body weight reduction at hospital discharge in the 2 groups respectively; a lower incidence of rehospitalizations for HF was observed in the ultrafiltration-treated patients during the following year. Ultrafiltration-induced benefit was associated with a more stable renal function, unchanged furosemide dose, and lower B-type natriuretic peptide levels. However, there did not seem to be a mortality benefit.

Reviewer’s comment: Ultrafiltration seems to have a beneficial effect on major morbidity associated with CHF. However, this study did not include patients in cardiogenic shock. Ultimate survival benefit did not emerge from this small study.


Editorial officEdr. atul P. Kulkarni

Professor & Head, Division of Critical Care, Dept. of Anaesthesiology, Critical Care & Pain, Tata Memorial Hospital, Parel, Mumbai 400012 • Phone : 022-24177049

[email protected]

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