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Trauma in ICU
Trauma in the ICU presents unique challenges, requiring rapid assessment and multidisciplinary management to address life-threatening injuries. Patients admitted with trauma often have multiple injuries, including traumatic brain injury, fractures, and internal organ damage. The primary goal is to stabilize the airway, breathing, and circulation (the ABCs) while managing hemorrhage, ensuring adequate oxygenation, and preventing further injury. Early identification and treatment of potential complications such as sepsis, acute respiratory distress syndrome (ARDS), and multi-organ failure are critical. Continuous monitoring of vital signs, blood gases, and fluid balance is essential to guide interventions. Pain management and sedation are also key components, but they must be balanced to avoid oversedation, which can complicate recovery. A comprehensive approach, including rehabilitation and nutritional support, is necessary to optimize outcomes. Effective communication between the trauma, surgical, and ICU teams plays a pivotal role in managing complex trauma cases and improving patient survival.
About the Speaker
Dr. Aklesh Tandekar
Consultant Critical Care, Apollo Hospitals, Mumbai
Dr. B V A Rangareddy, Consultant, Apollo Hospitals, Hyderabad
Upcoming Case Discussions
Nutrition in Pregnancy
Nutrition in pregnancy is crucial for the health of both the mother and the developing baby. A well-balanced diet rich in essential nutrients like folic acid, iron, calcium, and protein supports fetal growth, reduces the risk of birth defects, and strengthens maternal health. Adequate intake of fruits, vegetables, whole grains, and healthy fats ensures a steady supply of vitamins and minerals. Staying hydrated and managing portion sizes helps avoid complications like gestational diabetes and excessive weight gain. Prenatal supplements may be recommended to meet specific nutritional needs. Proper nutrition fosters a healthy pregnancy and sets the foundation for the baby’s long-term well-being.
Treatment of Renal Disease in ANCA Vasculitis
The treatment of renal disease in ANCA-associated vasculitis (AAV) typically involves a combination of immunosuppressive therapies to control inflammation and prevent further kidney damage. First-line treatment often includes high-dose corticosteroids and cyclophosphamide or rituximab, both of which help to induce remission by targeting the underlying immune system dysfunction. In cases of kidney failure or rapidly progressive glomerulonephritis, plasmapheresis may be used to remove circulating autoantibodies. Once remission is achieved, maintenance therapy with lower doses of immunosuppressants, such as azathioprine or mycophenolate mofetil, is used to prevent relapses and preserve kidney function.
Management of Pulmonary Embolism
Management of pulmonary embolism (PE) involves rapid diagnosis through imaging techniques like CT pulmonary angiography and the administration of anticoagulant therapy to prevent further clot formation. In severe cases, thrombolytic therapy or surgical intervention may be necessary to remove the embolus and restore normal blood flow.
Pulmonary Tuberculosis: Challenges in Diagnosis
Diagnosing pulmonary tuberculosis (TB) poses significant challenges, particularly in resource-limited settings. The disease often mimics other respiratory conditions, leading to delayed or missed diagnoses. Traditional diagnostic methods like sputum smear microscopy have limited sensitivity, especially in HIV co-infected or low-bacterial-load patients. Advanced techniques such as GeneXpert and culture tests, though more accurate, are often unavailable in remote areas. Children and immunocompromised patients present additional hurdles due to atypical symptoms and difficulty obtaining diagnostic samples. Non-specific imaging findings further complicate diagnosis. Addressing these challenges requires expanded access to molecular diagnostics, improved point-of-care tools, and greater healthcare awareness.
NIV in Acute Respiratory Failure
Dr Viny Kantroo is a Chest, Critical Care & Sleep medicine specialist based in Delhi, boasting over more than 15 years of professional experience. She is currently practising as a full time Senior consultant in Indraprastha Apollo Hospitals New Delhi and Visiting Consultant Apollo Hospitals Noida in the department of Respiratory, Critical Care and Sleep Medicine. She is recognised for her expertise in various aspects of Chest medicine, which includes EBUS (Convex probe, Radial), Bronchoscopic procedures, pleural effusion management, interstitial lung disease, Covid-19, lung cancer, pneumonia, and intensive care patient management. Dr Kantroo is renowned not only for her medical proficiency but also for her empathy and positive attitude towards patient care. Patients consulting with Dr Viny can be assured of receiving an accurate diagnosis and effective treatment, thanks to her commitment to prompt and comprehensive care.