Zheng H, Wang W, Liu X
… +13 more, Wang X, Zhang S, Wang Z, Li L, Xing G, Lv Y, Jiang S, Xu S, Zheng Y, Yu J, Wen C, Tong Y, Liang P
Crit Care Med
· 2026 Jun · PMID 41879382
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OBJECTIVES: To assess critical care ultrasound (CCUS) utilization, training coverage, and barriers to implementation among ICU clinicians across economically diverse regions in China. DESIGN: An online cross-sectional su...OBJECTIVES: To assess critical care ultrasound (CCUS) utilization, training coverage, and barriers to implementation among ICU clinicians across economically diverse regions in China. DESIGN: An online cross-sectional survey with chi-square tests, Mann-Whitney U tests, multivariate logistic regression, and principal component analysis (PCA)-based clustering. SETTING: ICU clinicians from all 31 provincial-level regions in mainland China, classified into high- and low-gross domestic product (GDP) groups by per capita GDP relative to the national average. SUBJECTS: Six hundred fifty-five ICU clinicians who completed the survey. INTERVENTIONS: The survey included demographics, CCUS training experience, equipment availability, clinical usage frequency, and perceived implementation barriers. MEASUREMENTS AND MAIN RESULTS: A total of 61.4% of respondents reported receiving CCUS training, with similar coverage between high- and low-GDP regions (61.9% vs. 60.8%; p = 0.769). Clinicians from high-GDP areas reported significantly higher self-assessed ultrasound proficiency ( p = 0.008). Dedicated ultrasound equipment was unavailable in approximately one-third of ICUs, slightly more common in low-GDP regions (37.7% vs. 31.4%; p = 0.094). Major barriers included insufficient expert support (36.9%), lack of ultrasound consultants (31.3%), and difficulties in image interpretation (31.1%). Logistic regression analysis showed structured training significantly reduced the odds of encountering equipment-related barriers (odds ratio, 0.57; 95% CI, 0.34-0.97; p = 0.036). PCA-based clustering identified three clinician profiles: frequent users (high training and usage, predominantly from high-GDP areas), moderate users, and infrequent users (limited training and primarily from low-GDP regions). CONCLUSIONS: Structured CCUS training significantly enhances utilization and clinician expertise, irrespective of regional economic conditions. Policies promoting standardized training, equitable equipment distribution, and sustainable expert support are essential for broader CCUS integration in critical care settings across China.
Leone M, Myatra SN, Dugar S
… +62 more, Wieruszewski PM, Russell L, Evans L, Delamarre L, Sharif S, Chew MS, Gong MN, Hernández G, Schorr C, Lakbar I, Smith SE, Martin-Loeches I, Annane D, Balik M, Cecconi M, De Backer D, Donadello K, Dünser MW, Einav S, Ferrer R, Juffermans N, Hamzaoui O, Landoni G, Levy B, McKenzie C, Monnet X, Ostermann M, Spies C, Singer M, Theodorakopulou M, Topeli A, Barreto E, Bauer SR, Busse LW, Coopersmith CM, Deutschman C, Holder AL, Kamaleswaran R, Legrand M, Martin GS, Maves RC, Nazer L, Nunnally ME, Prescott HC, Rincon T, Sacha GL, Seymour CW, Arabi YM, Besen BA, Cavalcanti AB, Deane AM, Finfer S, Hammond N, Ibarra-Estrada M, Kattan E, Kotani Y, Machado FR, Ospina-Tascón GA, Mer M, Young PJ, Rochwerg B, Khanna AK
Crit Care Med
· 2026 May · PMID 41873857
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OBJECTIVE: A definition of refractory septic shock is necessary to guide diagnosis, management, prognostication, research, and future guidelines for this most severe form of the disease. We sought to achieve consensus on...OBJECTIVE: A definition of refractory septic shock is necessary to guide diagnosis, management, prognostication, research, and future guidelines for this most severe form of the disease. We sought to achieve consensus on clinical criteria that would be used to define refractory septic shock. DESIGN: Review of literature, expert panel position statements, and Delphi rounds with an international expert group. SETTING: Consensus was defined as having at least 75% of panellists in agreement or disagreement on the three highest or lowest levels of a 7-point Likert scale or based on responses to single- or multiple-choice questions, respectively. SUBJECTS: A panel of multinational, multiprofessional and multidisciplinary critical care experts assembled by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine (57 invitations and 56 participants). MEASUREMENTS AND MAIN RESULTS: A five-round Delphi process was conducted for consensus and stability. The steering committee proposed 34 statements, and five of them were rejected by panel experts after round 2. Among 29 statements selected from eight domains, consensus was reached for 13. The panel agreed on the need for a comprehensive consensus set of clinical criteria for refractory septic shock. Markers of organ dysfunction (75%, 2 rounds), tissue perfusion (91.1%, 2 rounds) including lactate (94.6%, 2 rounds) and capillary refill time (76.8%, 2 rounds), assessment of fluid-responsiveness after initial resuscitation (92.9%, 5 rounds), and use of vasoactive drugs at norepinephrine equivalents greater than 0.5 µg/kg/min (75.0%, 3 rounds), were selected as clinical criteria of refractory septic shock. The use of critical care ultrasound (CCUS) (92.9%, 3 rounds) was the single diagnostic modality that reached a consensus-based agreement. CONCLUSIONS: A consensus for 13 criteria to frame the definition of refractory septic shock was reached. Refractory septic shock is characterised by persistently elevated lactate concentrations and or prolonged capillary refill time in patients with septic shock who are fluid unresponsive, require a norepinephrine base equivalent dose greater than 0.5 micrograms per kilogram per minute, and undergo CCUS assessment when mixed shock is suspected.
Renet A, Ledorze M, Souppart V
… +3 more, Chubbère JJ, Denise T, Kentish-Barnes N
Crit Care Med
· 2026 Jun · PMID 41870237
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OBJECTIVES: Research on relatives' experiences with controlled donation after circulatory determination of death (cDCDD) is limited. This study aims to explore the challenges and experiences of relatives whose loved ones...OBJECTIVES: Research on relatives' experiences with controlled donation after circulatory determination of death (cDCDD) is limited. This study aims to explore the challenges and experiences of relatives whose loved ones die under cDCDD, focusing on how they navigate the process. DESIGN: A qualitative study using semi-structured, in-depth interviews conducted 6 months post-death. This research is part of a larger quantitative multicenter study on the psychologic burden in relatives of cDCDD patients. Relatives of patients in the cDCDD process were purposively sampled and invited to participate in qualitative interviews. Thematic analysis was used to explore the phenomenon from the participants' perspectives. SETTING: This study was conducted in France between November 2022 and November 2023. PATIENTS: Family members of ICU patients identified as potential cDCDD donors. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 23 family members approached, 19 (mean age 53 yr; 11 women) agreed to participate. The mean interview duration was 43 minutes. In three cases, organ retrieval was not possible. Thematic analysis revealed three key themes: 1) "Two decisions, two worlds"-discussing the decision to withdraw life-sustaining therapies and the organ donation request; 2) "Waiting for death"-the period between the decision and its implementation; and 3) "A controlled death"-dying and death in a monitored and technical environment. CONCLUSIONS: Relatives can be deeply engaged in cDCDD when well-prepared. However, additional support is needed during the waiting period, as families witness their loved one's decline. Proper preparation for dying is crucial to prevent perceptions of suffering, thereby reducing distress. Healthcare professionals must balance emotional, ethical, and medical considerations to facilitate informed choices in a highly regulated system.
Christiaanse PMR, van Zutphen T, Bolding HA
… +6 more, van der Werf RAM, Stellingwerf F, de Jager CM, Buter H, Boerma EC, Beumeler LFE
Crit Care Med
· 2026 Jun · PMID 41870216
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OBJECTIVES: Evidence supporting the benefits of combined nutrition and exercise programs in ICU survivors is limited. We assessed the impact of a combined lifestyle intervention on perceived physical functioning (PF) and...OBJECTIVES: Evidence supporting the benefits of combined nutrition and exercise programs in ICU survivors is limited. We assessed the impact of a combined lifestyle intervention on perceived physical functioning (PF) and health-related quality of life (HRQoL) post-ICU. DESIGN: Single-center randomized control trial. SETTING: Teaching hospital in the Netherlands (Frisius Medical Centre Leeuwarden). PATIENTS: Adult long stay ICU survivors (≥ 48 hr) with a PF score of less than 67% on the Dutch translation of the RAND-36 item Health Survey. INTERVENTIONS: The 12-week intervention included twice-weekly group exercise, dietary advice, and protein supplementation as needed. The control group received standard aftercare according to local protocol. MEASUREMENTS AND MAIN RESULTS: Primary outcome (PF score at 12 wk) and secondary outcomes were assessed during a clinic visit at baseline and after a 12-week period. 39 patients completed the study (control, n = 20; intervention, n = 19): 26% female, median age 61 years (46-72), median ICU stay 7 days (4-14), and patients were severely ill (Acute Physiology and Chronic Health Evaluation III: 67 [50-89]). Although there were imbalances in ICU characteristics, baseline characteristics and PF scores were similar. At 12 weeks, the intervention group showed a significant improvement ( p = 0.024) in PF-domain score. Daily protein intake in the intervention group increased from 82.3 (67.5-97.9) to 116.7 (107.3-138.7) g/kg ( p = 0.003), with 68% meeting the minimal intake target of 1.2 g/kg/d. CONCLUSIONS: The data of this small-sample size randomized controlled trial suggest that a combined lifestyle intervention program can significantly improve PF and protein intake in ICU survivors with a prolonged PF scores below reference.
Wetterberg H, Nilsson A, Linder A
… +4 more, Lengquist M, Frigyesi A, Sundén-Cullberg J, Inghammar M
Crit Care Med
· 2026 Jul · PMID 41870200
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OBJECTIVES: To quantify the risk of incident psychiatric morbidity after community-acquired sepsis and assess whether new chronic diseases mediate the association. DESIGN: Nationwide, population-based matched register co...OBJECTIVES: To quantify the risk of incident psychiatric morbidity after community-acquired sepsis and assess whether new chronic diseases mediate the association. DESIGN: Nationwide, population-based matched register cohort; hazards estimated with weighted Cox regression. SETTING: Sweden, linking the National Quality Sepsis Registry, National Patient Register, Prescribed Drug Register, and population registers. PATIENTS: Ten thousand three hundred eight adults (≥ 18 yr) treated in an ICU for sepsis (2008-2019), matched to 155,705 population controls by sex, age, region, and year. Individuals with a psychiatric diagnosis within 5 years or psychotropic medication within 1 year before index were excluded. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The primary outcome, psychiatric event, was first occurrence after index date of either initiation of a psychotropic medication (anatomic therapeutic chemical classification system code N05A, N05BA, N05C, N06A) in the Prescribed Drug Register (capturing prescriptions from primary and specialist care) or a new International Classification of Diseases , 10th Edition mood (F3) or anxiety (F4) diagnosis in specialist care. Weighted Cox models balanced baseline covariates. We used a Landmark approach with risk sets at 0-30, 31-90, 91-365 days; 1-3, 3-5, and greater than or equal to 5 years after the index date. Sepsis was associated with increased hazards of psychiatric events vs. matched controls, with the strongest associations in the first year (0-30 d: adjusted hazard ratio [aHR], 6.2 [5.0-7.7]; 31-90 d: aHR, 7.4 [6.5-8.6]; and 91-365 d: aHR, 2.3 [2.1-2.5]) attenuating over time but remaining elevated through 5 years (1-3 yr: aHR, 1.2 [1.1-1.5]; 3-5 yr: aHR, 1.3 [1.1-1.5]; and ≥ 5 yr: aHR, 1.1 [0.9-1.3]). In mediation analyses considering incident chronic diseases, estimates changed little, suggesting that these conditions did not mediate the association. CONCLUSIONS: Patients with sepsis had a higher subsequent incidence of psychiatric events compared with matched population controls, with a persistently elevated risk for at least 5 years. This increased risk suggests that sepsis may have a long-term impact on psychiatric health, warranting consideration of preventive strategies.
Prescott HC, Antonelli M, Alhazzani W
… +66 more, Møller MH, Alshamsi F, Azevedo LCP, Belley-Cote E, De Waele J, Derde L, Dionne JC, Evans L, Gershengorn HB, Hodgson CL, Honarmand K, Kesecioglu J, McIntyre L, Mer M, Nunnally ME, Oczkowski SJW, Rochwerg B, Akinola OO, Akuamoah-Boateng KA, Alberto L, Angus DC, Arabi YM, Azoulay E, Cecconi M, Convocar PF, De Pascale G, Doi K, Du B, Egi M, Elie-Turenne MC, Ferrer R, Fox-Robichaud A, French C, Freund Y, Gong MN, Hale CP, Hammond NE, Hashmi M, Heunks L, Iwashyna TJ, Jacob ST, Klompas M, Kwizera A, Leeies M, Lejnieks JD, Levy MM, Machado FR, Maia MO, Masur H, Maves RC, McGloughlin S, McPeake J, Mohr NM, Myatra SN, Ostermann M, Peake SL, Pletz MW, Roberts JA, Rosa RG, Sawyer RG, Schorr CA, Simpson SQ, Weng L, Wiersinga WJ, Rhodes A, Coopersmith CM
Crit Care Med
· 2026 Apr · PMID 41869847
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Prescott HC, Antonelli M, Alhazzani W
… +66 more, Møller MH, Alshamsi F, Azevedo LCP, Belley-Cote E, De Waele J, Derde L, Dionne JC, Evans L, Gershengorn HB, Hodgson CL, Honarmand K, Kesecioglu J, McIntyre L, Mer M, Nunnally ME, Oczkowski SJW, Rochwerg B, Akinola OO, Akuamoah-Boateng KA, Alberto L, Angus DC, Arabi YM, Azoulay E, Cecconi M, Convocar PF, De Pascale G, Doi K, Du B, Egi M, Elie-Turenne MC, Ferrer R, Fox-Robichaud A, French C, Freund Y, Gong MN, Hale CP, Hammond NE, Hashmi M, Heunks L, Iwashyna TJ, Jacob ST, Klompas M, Kwizera A, Leeies M, Lejnieks JD, Levy MM, Machado FR, Maia MO, Masur H, Maves RC, McGloughlin S, McPeake J, Mohr NM, Myatra SN, Ostermann M, Peake SL, Pletz MW, Roberts JA, Rosa RG, Sawyer RG, Schorr CA, Simpson SQ, Weng L, Wiersinga WJ, Rhodes A, Coopersmith CM
Crit Care Med
· 2026 Apr · PMID 41869831
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Vijayasimha M, Srikanth M, Jayarajan D
… +2 more, Babu L, Malinidevi M
Indian J Crit Care Med
· 2026 Feb · PMID 41868085
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Vijayasimha M, Srikanth M, Jayarajan D, Babu L, Malinidevi M. Aminotransferase-to-platelet Ratio Index for Sepsis-associated Liver Dysfunction: Promising Triage Signal but Phenotype Confounding and Implementation Calibra...Vijayasimha M, Srikanth M, Jayarajan D, Babu L, Malinidevi M. Aminotransferase-to-platelet Ratio Index for Sepsis-associated Liver Dysfunction: Promising Triage Signal but Phenotype Confounding and Implementation Calibration must be Intensive Care Unit Ready. Indian J Crit Care Med 2026;30(2):177-178.
Indian J Crit Care Med
· 2026 Feb · PMID 41868084
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BACKGROUND AND AIMS: Family caregivers of intensive care unit (ICU) patients experience significant psychological distress; however, existing general caregiver measurement instruments fail to capture the unique stressors...BACKGROUND AND AIMS: Family caregivers of intensive care unit (ICU) patients experience significant psychological distress; however, existing general caregiver measurement instruments fail to capture the unique stressors inherent to intensive care settings. This study aimed to develop a self-report instrument to measure psychological distress specific to ICU family caregivers, explore its core dimensional structure, and evaluate its psychometric properties. PATIENTS AND METHODS: The ICU Caregiver Distress Scale (ICU-CDS) was developed and validated in multiple phases, including item generation, content validation, and pilot testing. A sample of 313 family caregivers of ICU patients participated in the study. Exploratory and confirmatory factor analyses were conducted to identify and confirm the scale's dimensional structure and psychometric properties. RESULTS: The ICU-CDS demonstrated a clear multidimensional structure with a Cronbach's coefficient of 0.72. Additionally, the scale showed satisfactory convergent validity through positive correlations with the Mishel Uncertainty in Illness Scale. CONCLUSION: The ICU-CDS provides a robust, contextually sensitive measure of psychological distress among ICU family caregivers. By capturing specific stressors unique to the ICU setting, this scale addresses critical limitations of existing general caregiver instruments and can be utilized to assess distress among ICU patient family caregivers. HOW TO CITE THIS ARTICLE: Chivukula U, Subhadarsani K. Development and Psychometric Validation of the Intensive Care Unit Caregiver Distress Scale. Indian J Crit Care Med 2026;30(2):128-133.
Indian J Crit Care Med
· 2026 Feb · PMID 41868083
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Rao S, Chaudhuri S. Author Response: Letter in Response to the Article: Utility of Extracellular Nicotinamide Phosphoribosyl Transferase as a Novel Biomarker in Predicting Early Severe Organ Dysfunction and Mortality in...Rao S, Chaudhuri S. Author Response: Letter in Response to the Article: Utility of Extracellular Nicotinamide Phosphoribosyl Transferase as a Novel Biomarker in Predicting Early Severe Organ Dysfunction and Mortality in Acute Respiratory Distress Syndrome: A Prospective Observational Study. Indian J Crit Care Med 2026;30(2):175-176.
Indian J Crit Care Med
· 2026 Feb · PMID 41868082
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Kumar N. Point-of-care Ultrasonography for Endotracheal Tube Confirmation: An Essential Adjunct in Airway Management. Indian J Crit Care Med 2026;30(2):92-94.Kumar N. Point-of-care Ultrasonography for Endotracheal Tube Confirmation: An Essential Adjunct in Airway Management. Indian J Crit Care Med 2026;30(2):92-94.
Indian J Crit Care Med
· 2026 Feb · PMID 41868081
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Panda CK, Karim HMR. C-reactive Protein/Albumin Ratio in Septic Polytrauma: Predictive Marker or Concurrent Indicator? Indian J Crit Care Med 2026;30(2):181.Panda CK, Karim HMR. C-reactive Protein/Albumin Ratio in Septic Polytrauma: Predictive Marker or Concurrent Indicator? Indian J Crit Care Med 2026;30(2):181.
Sarkar S, Sharma AK, Azim A
… +6 more, Chahar JS, Yadav S, Saran PS, Mishra P, Gurjar M, Poddar B
Indian J Crit Care Med
· 2026 Feb · PMID 41868080
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BACKGROUND: Diastolic shock index (DSI), the ratio of heart rate to diastolic arterial pressure, reflects vascular tone and sympathetic drive in septic shock. While baseline DSI correlates with mortality, its temporal ev...BACKGROUND: Diastolic shock index (DSI), the ratio of heart rate to diastolic arterial pressure, reflects vascular tone and sympathetic drive in septic shock. While baseline DSI correlates with mortality, its temporal evolution remains exploratory. PATIENTS AND METHODS: In this single-center prospective observational study, adult patients with septic shock (as per sepsis-3) were enrolled. Diastolic shock index, shock index (SI), and modified shock index (MSI) were recorded at 0, 6, 12, and 24 hours. Delta diastolic shock index (ΔDSI), lactate clearance, and vasoactive-inotropic score (VIS) were analyzed using repeated-measures ANOVA, receiver operating characteristic (ROC) analysis, Cox regression, and multivariable logistic regression (SPSS v23, MedCalc). RESULTS: Of 157 patients screened, 90 were included. Median age was 40 years (male 64.4%) with median SOFA and APACHE II scores of 9 and 18, respectively. Nonsurvivors had higher lactate (24 mg/dL, < 0.001) and lower platelet counts. Overall, 28-day mortality was 37.8%. Declining DSI, MSI, and SI over 24 hours were seen in the survivor group. Delta diastolic shock index correlated inversely with lactate clearance ( = -0.40, < 0.01) and vasopressor-free days ( = -0.33, = 0.001). Receiver operating characteristic analysis showed that ΔDSI (AUC = 0.684) outperformed baseline DSI (AUC = 0.402). A combined model (ΔDSI + VIS_0 + Lactate_0) improved discrimination (AUC = 0.781). In logistic regression, ΔDSI (OR 4.07, = 0.006), Lactate_0 (OR 1.04, = 0.012), and APACHE II (OR 1.14, = 0.002) independently predicted mortality. CONCLUSION: Temporal improvement in DSI (ΔDSI) independently predicts ICU mortality and correlates with vascular recovery. Integrating ΔDSI with VIS and lactate enhances risk stratification in septic shock. HOW TO CITE THIS ARTICLE: Sarkar S, Sharma AK, Azim A, Chahar JS, Yadav S, Sai Saran PV, . Temporal Analysis of Diastolic Shock Index in Patients with Septic Shock and Its Correlation with Clinical Outcomes in an Indian Setting: A Prospective Observational Study. Indian J Crit Care Med 2026;30(2):99-106.
Sert H, Gurcay B, Koc F
… +3 more, Eren MG, Acar BA, Toprak Y
Indian J Crit Care Med
· 2026 Feb · PMID 41868079
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BACKGROUND AND AIMS: Hand massage is a nonpharmacological nursing intervention that reduces pain, anxiety, and discomfort. This study aimed to evaluate the effects of hand massage on pain, anxiety, and comfort levels in...BACKGROUND AND AIMS: Hand massage is a nonpharmacological nursing intervention that reduces pain, anxiety, and discomfort. This study aimed to evaluate the effects of hand massage on pain, anxiety, and comfort levels in neurological intensive care unit (ICU) patients, contributing to evidence-based nursing practice. PATIENTS AND METHODS: This randomized controlled trial was conducted in a neurology ICU in Turkey. A total of 66 patients were randomly assigned to intervention and control groups. The intervention group received 12 hand massage sessions over six consecutive days (twice daily). Pain, anxiety, and comfort were assessed using the visual analog scale (VAS), the Spielberger state-trait anxiety inventory (STAI), and the general comfort scale-short form (GCS-SF). The control group received standard care. Data were analyzed using one-way ANOVA, the Kruskal-Wallis test, and the Bonferroni analysis. RESULTS: Patients in the intervention group demonstrated significantly reduced pain and anxiety levels and increased comfort at both 15 and 60 minutes postintervention compared with the control group ( < 0.05). CONCLUSION: Hand massage based on Kolcaba's comfort theory is a safe, low-cost, and effective intervention that reduces pain and anxiety while enhancing comfort in neurological ICU patients. Integrating hand massage into routine care may support holistic symptom management in critical care settings. HOW TO CITE THIS ARTICLE: Sert H, Gurcay B, Koc F, Eren MG, Acar BA, Toprak Y. The Effect of Hand Massage on Pain, Anxiety, and Comfort Levels of Intensive Care Patients: A Randomized Controlled Trial. Indian J Crit Care Med 2026;30(2):140-147.
Nimbal A, Bahulikar A, Phalgune D
… +1 more, Tambolkar A
Indian J Crit Care Med
· 2026 Feb · PMID 41868078
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BACKGROUND AND AIMS: Presepsin is hypothesized to be more specific for the diagnosis of sepsis, as it is directly involved in the pathogenesis of the syndrome. Several studies have investigated the clinical validity of p...BACKGROUND AND AIMS: Presepsin is hypothesized to be more specific for the diagnosis of sepsis, as it is directly involved in the pathogenesis of the syndrome. Several studies have investigated the clinical validity of presepsin; however, the results have shown considerable variability. The present study aimed to determine the diagnostic accuracy of presepsin as a biomarker for the diagnosis of sepsis. PATIENTS AND METHODS: This prospective observational study included 140 patients, aged 18 years and older, who presented with suspected sepsis, a quick sequential organ failure assessment (qSOFA) score ≥2, and radiological or microbiological evidence of infection. The study was conducted from April 2024 to February 2025 at a tertiary care hospital in Western India. The SOFA score and presepsin levels were measured at the time of presentation. Receiver-operating characteristic (ROC) curve analysis was performed to determine the optimal presepsin cutoff value for predicting sepsis and mortality. RESULTS: Presepsin levels were significantly higher in patients with sepsis and in those who died. They showed a strong correlation with the SOFA score ( = 0.45; = 0.01). Receiver-operating characteristic analysis demonstrated that presepsin is a strong predictor of sepsis [area under the curve (AUC) = 0.926 (95% CI: 0.881-0.971; cutoff > 195 pg/mL; sensitivity, 87.2%; specificity, 88.9%]. For mortality, ROC analysis showed good predictive value [AUC = 0.843 (95% CI: 0.755-0.931); cutoff > 1,364 pg/mL; sensitivity, 78.0%; specificity, 80.0%]. CONCLUSION: Presepsin is a reliable biomarker for the diagnosis and prognosis of sepsis. HOW TO CITE THIS ARTICLE: Nimbal A, Bahulikar A, Phalgune D, Tambolkar A. Diagnostic and Prognostic Value of Presepsin in Sepsis: A Prospective Observational Study. Indian J Crit Care Med 2026;30(2):117-121.
Indian J Crit Care Med
· 2026 Feb · PMID 41868077
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BACKGROUND AND AIMS: Sexual harassment in intensive care units (ICUs) is a critical yet underreported issue affecting staff and patients alike. This review examines the prevalence, typologies, risk factors, legal framewo...BACKGROUND AND AIMS: Sexual harassment in intensive care units (ICUs) is a critical yet underreported issue affecting staff and patients alike. This review examines the prevalence, typologies, risk factors, legal frameworks, and barriers to reporting within ICU environments. DATA SOURCES: Peer-reviewed literature from PubMed, Scopus, and Google Scholar, along with verified media reports and legal documents, were reviewed. STUDY SELECTION: Included sources focused on ICU-specific sexual harassment involving healthcare workers and patients. Studies and sources addressing legal responses, institutional mechanisms, and vulnerable populations were prioritized. DATA SYNTHESIS: Intensive care unit harassment stems from peers, superiors, patients, and attendants, manifesting across verbal, physical, and digital forms. Female, LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, and Queer+), and junior staff, as well as sedated patients, face heightened risk. Barriers to reporting include fear of retaliation, cultural stigma, and ineffective institutional redressal. Legal mandates like India's POSH Act remain poorly enforced. CONCLUSION: Harassment in ICUs threatens staff safety and patient dignity. Addressing it demands ICU-specific policy, trauma-informed reporting systems, and cultural change toward accountability and protection. HOW TO CITE THIS ARTICLE: Gondode P, Dass C, Singh R, Khanna P. Sexual Harassment in Intensive Care Unit Settings. Indian J Crit Care Med 2026;30(2):165-172.
Indian J Crit Care Med
· 2026 Feb · PMID 41868076
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Pannu AK, Bhalla A. Paraquat Poisoning: When Intensive Care Meets the Limits of Medicine. Indian J Crit Care Med 2026;30(2):88-89.Pannu AK, Bhalla A. Paraquat Poisoning: When Intensive Care Meets the Limits of Medicine. Indian J Crit Care Med 2026;30(2):88-89.
Jose S, Cyriac MC, Dhandapani M
… +1 more, Gayathri PV
Indian J Crit Care Med
· 2026 Feb · PMID 41868075
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BACKGROUND AND AIMS: Deceased organ donation is a vital but underutilized solution to the global organ shortage. As frontline responders, emergency nurses are pivotal to the donation process; however, their involvement m...BACKGROUND AND AIMS: Deceased organ donation is a vital but underutilized solution to the global organ shortage. As frontline responders, emergency nurses are pivotal to the donation process; however, their involvement may be limited by their death work competence or their ability to manage the complexities of end-of-life care. This study explores the relationship between death work competence and emergency nurses' perspectives on organ donation, specifically focusing on their knowledge, attitudes, and communication readiness. PATIENTS AND METHODS: A descriptive cross-sectional study was conducted among 107 emergency nurses in a North Indian teaching hospital. Data were collected using a structured self-administered questionnaire and the Self-Competence in Death Work Scale (SC-DWS). Descriptive and correlational analyses were performed to examine associations between knowledge, attitudes, and self-competence. RESULTS: Most participants supported organ donation (97.4%), and 69.2% had considered donor registration. Nurses demonstrated moderate knowledge (mean 8.41 ± 1.53) and attitudes (mean 6.21 ± 1.36), with overall moderate death work competence (mean 55.21 ± 9.13). A significant positive correlation was observed between knowledge and death work competence ( = 0.296, = 0.009), suggesting that higher competence enhances understanding and positive perspectives toward organ donation. CONCLUSION: Death work competence seems to influence emergency nurses' perspectives and readiness to engage in organ donation discussions. HOW TO CITE THIS ARTICLE: Jose S, Cyriac MC, Dhandapani M, Gayathri PV. Impact of Death Work Competence on Emergency Nurses' Perspectives in the Organ Donation Process. Indian J Crit Care Med 2026;30(2):134-139.
Indian J Crit Care Med
· 2026 Feb · PMID 41868074
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Singh AP, Govil D. Beyond the Mean: The Dynamic Fingerprint of Vasoplegia in Septic Shock. Indian J Crit Care Med 2026;30(2):85-87.Singh AP, Govil D. Beyond the Mean: The Dynamic Fingerprint of Vasoplegia in Septic Shock. Indian J Crit Care Med 2026;30(2):85-87.
Neeraj GP, Philip AJ, Prakash G
… +12 more, Praneeth CS, Chandiraseharan VK, Zachariah A, Rajan SJ, Nellickal AJ, Iyyadurai R, Pichamuthu KK, Hansdak SG, Gunasekaran K, Abhilash KP, Peter JV, Yadav B
Indian J Crit Care Med
· 2026 Feb · PMID 41868073
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BACKGROUND AND AIM: Paraquat (PQ) dichloride is a commonly used herbicide across agricultural sectors worldwide. Despite being banned in over 70 countries, PQ is still frequently misused in India for suicidal and homicid...BACKGROUND AND AIM: Paraquat (PQ) dichloride is a commonly used herbicide across agricultural sectors worldwide. Despite being banned in over 70 countries, PQ is still frequently misused in India for suicidal and homicidal poisoning. The study aims to evaluate the clinical and laboratory predictors of survival and to estimate time-to-event outcomes of patients admitted to a quaternary care center in South India with a history of PQ poisoning. PATIENTS AND METHODS: This retrospective study included patients aged 16 and above who presented with PQ poisoning over 10 years (January 2015 to October 2024). Data were collected from the emergency department (ED) triage registry and hospital electronic database. Statistical analyses were conducted to identify factors predicting survival. RESULTS: During the study period, 166 patients with PQ poisoning were included. The majority were young males, with 79.5% experiencing poor outcomes. Acute kidney injury (AKI) (92.2%) and lung injury (57.6%) were common complications. The overall survival rate was 20.5%, with a median survival time of 5 days. Multivariate Cox regression analysis identified N-acetylcysteine, ascorbic acid, cyclophosphamide, and steroids (NACS) combination therapy, a low acute physiology and chronic health evaluation (APACHE) II score, and activated charcoal as independent predictors of survival. A meta-analysis of 15 Indian studies revealed a pooled bad outcome rate of 79%. CONCLUSION: High morbidity and mortality associated with PQ poisoning in India have been highlighted in our study. The authors suggest that a combination therapy using NACS may improve survival; however, this needs to be explored further. Despite these interventions, delayed presentation with multiorgan system involvement points toward a poor prognosis. Further research is needed to standardize treatment protocols and guide policy interventions to limit PQ use and enhance outcomes. HOW TO CITE THIS ARTICLE: Neeraj GPP, Philip AJ, Prakash G, Praneeth CS, Chandiraseharan VK, Zachariah A, . Paraquat Peril: A Retrospective Study from the Frontlines of a Quaternary Care Hospital in South India. Indian J Crit Care Med 2026;30(2):107-116.