BACKGROUND There has been a growing interest in noninvasive ventilation(NIV)in comparison to invasive mechanical ventilation(IMV)as a standard of care for acute respiratory failure(ARF),especially in the post-covid er...BACKGROUND There has been a growing interest in noninvasive ventilation(NIV)in comparison to invasive mechanical ventilation(IMV)as a standard of care for acute respiratory failure(ARF),especially in the post-covid era,but direct head-to-head cost comparisons between the two modalities are not available in literature.AIM To compare the cost along with the clinical effectiveness of NIV in comparison to IMV in ARF.METHODS A prospective observational single-center case control study including adult patients with ARF(PaO2/FiO2 ratio<300)admitted from January 1,2024 to December 31,2024 in medical intensive care unit(ICU)of a tertiary care hospital requiring either NIV or invasive ventilation.NIV and IMV groups were compared based on average length of ICU and hospital stay,mortality,net cost of ICU treatment,need for intubation and tracheostomy.RESULTS A total of 319 patients were included in the study(197 in NIV,122 in IMV group).Statistically significant difference in length of ICU stay(NIV group:5±3.25 days,IMV group:9±2.6 days;P<0.05)and mortality rate was seen(11%NIV vs 34%IMV;P<0.01).On multivariate analyses,mortality showed a stronger association with IMV[odds ratio(OR)=7.73;95%CI:3.12-19.18]as compared to ICU stay(OR=2.73;95%CI:2.15-3.48).A total of 33 patients(17%)in NIV group required intubation of which 3 were tracheostomized,while 14 patients(11%)in IMV group needed tracheostomy.The net average cost of ICU stay was₹83902 in NIV group while in IMV group,the net ICU cost was₹476216.The average cost of ICU stay was five times higher with IMV.CONCLUSION NIV has potential economic and clinical benefits as compared to invasive ventilation in ARF.展开更多
BACKGROUND The proficiency of nursing professionals in the infection prevention and control(IPC)practices is a core component of the strategy to mitigate the challenge of healthcare associated infections.AIM To test k...BACKGROUND The proficiency of nursing professionals in the infection prevention and control(IPC)practices is a core component of the strategy to mitigate the challenge of healthcare associated infections.AIM To test knowledge of nurses working in intensive care units(ICU)in South Asia and Middle East countries on IPC practices.METHODS An online self-assessment questionnaire based on various aspects of IPC practices was conducted among nurses over three weeks.RESULTS A total of 1333 nurses from 13 countries completed the survey.The average score was 72.8%and 36%of nurses were proficient(mean score>80%).43%and 68.3%of respondents were from government and teaching hospitals,respectively.79.2%of respondents worked in<25 bedded ICUs and 46.5%in closed ICUs.Statistically,a significant association was found between the knowledge and expertise of nurses,the country’s per-capita income,type of hospitals,accreditation and teaching status of hospitals and type of ICUs.Working in high-and upper-middleincome countries(β=4.89,95%CI:3.55 to 6.22)was positively associated,and the teaching status of the hospital(β=-4.58,95%CI:-6.81 to-2.36)was negatively associated with the knowledge score among respondents.CONCLUSION There is considerable variation in knowledge among nurses working in ICU.Factors like income status of countries,public vs private and teaching status of hospitals and experience are independently associated with nurses’knowledge of IPC practices.展开更多
文摘BACKGROUND There has been a growing interest in noninvasive ventilation(NIV)in comparison to invasive mechanical ventilation(IMV)as a standard of care for acute respiratory failure(ARF),especially in the post-covid era,but direct head-to-head cost comparisons between the two modalities are not available in literature.AIM To compare the cost along with the clinical effectiveness of NIV in comparison to IMV in ARF.METHODS A prospective observational single-center case control study including adult patients with ARF(PaO2/FiO2 ratio<300)admitted from January 1,2024 to December 31,2024 in medical intensive care unit(ICU)of a tertiary care hospital requiring either NIV or invasive ventilation.NIV and IMV groups were compared based on average length of ICU and hospital stay,mortality,net cost of ICU treatment,need for intubation and tracheostomy.RESULTS A total of 319 patients were included in the study(197 in NIV,122 in IMV group).Statistically significant difference in length of ICU stay(NIV group:5±3.25 days,IMV group:9±2.6 days;P<0.05)and mortality rate was seen(11%NIV vs 34%IMV;P<0.01).On multivariate analyses,mortality showed a stronger association with IMV[odds ratio(OR)=7.73;95%CI:3.12-19.18]as compared to ICU stay(OR=2.73;95%CI:2.15-3.48).A total of 33 patients(17%)in NIV group required intubation of which 3 were tracheostomized,while 14 patients(11%)in IMV group needed tracheostomy.The net average cost of ICU stay was₹83902 in NIV group while in IMV group,the net ICU cost was₹476216.The average cost of ICU stay was five times higher with IMV.CONCLUSION NIV has potential economic and clinical benefits as compared to invasive ventilation in ARF.
文摘BACKGROUND The proficiency of nursing professionals in the infection prevention and control(IPC)practices is a core component of the strategy to mitigate the challenge of healthcare associated infections.AIM To test knowledge of nurses working in intensive care units(ICU)in South Asia and Middle East countries on IPC practices.METHODS An online self-assessment questionnaire based on various aspects of IPC practices was conducted among nurses over three weeks.RESULTS A total of 1333 nurses from 13 countries completed the survey.The average score was 72.8%and 36%of nurses were proficient(mean score>80%).43%and 68.3%of respondents were from government and teaching hospitals,respectively.79.2%of respondents worked in<25 bedded ICUs and 46.5%in closed ICUs.Statistically,a significant association was found between the knowledge and expertise of nurses,the country’s per-capita income,type of hospitals,accreditation and teaching status of hospitals and type of ICUs.Working in high-and upper-middleincome countries(β=4.89,95%CI:3.55 to 6.22)was positively associated,and the teaching status of the hospital(β=-4.58,95%CI:-6.81 to-2.36)was negatively associated with the knowledge score among respondents.CONCLUSION There is considerable variation in knowledge among nurses working in ICU.Factors like income status of countries,public vs private and teaching status of hospitals and experience are independently associated with nurses’knowledge of IPC practices.
