Critical Care Update 2017 Atul Kulkarni, Subhash Todi, Kapil Zirpe
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FM1CRITICAL CARE UPDATE 2017FM2
FM3CRITICAL CARE UPDATE 2017
Editors Subhash Todi MD MRCP Director Department of Critical Care Advanced Medicare Research Institute Kolkata, West Bengal, India Atul P Kulkarni MD FISCCM PGDHHM FICCM Professor and Head Department of Anesthesiology, Critical Care Medicine and Pain Tata Memorial Hospital Mumbai, Maharashtra, India Kapil Zirpe MD FCCM FICCM Director Neuro Trauma Unit Ruby Hall Clinic Pune, Maharashtra, India
FM4
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Critical Care Update 2017 / Subhash Todi, Atul P Kulkarni, Kapil Zirpe
First Edition: 2017
9789386261151
FM5Contributors
EDITORS
  • Subhash Todi MD MRCP
    Director
    Department of Critical Care
    Advanced Medicare Research Institute
    Kolkata, West Bengal, India
  • Atul P Kulkarni MD FISCCM PGDHHM
    Professor and Head
    Department of Anesthesiology, Critical Care Medicine and Pain
    Tata Memorial Hospital
    Mumbai, Maharashtra, India
  • Kapil Zirpe MD FCCM FICCM
    Director
    Neuro Trauma Unit
    Ruby Hall Clinic
    Pune, Maharashtra, India
SECTION EDITORS
  • Arvind K Baronia MD
    Professor and Head
    Department of Critical Care Medicine
    Sanjay Gandhi Postgraduate Institute of Medical Sciences
    Lucknow, Uttar Pradesh, India
  • Rajesh Chawla MD FCCM FCCP
    Senior Consultant
    Department of Respiratory, Critical Care and Sleep Medicine
    Indraprastha Apollo Hospitals,
    New Delhi, India
  • Shivakumar S Iyer MD DNB EDIC
    Professor and Head
    Department of Critical Care Medicine
    Bharati Vidyapeeth Deemed University Medical College
    Pune, Maharashtra, India
  • Dilip R Karnad MD FACP FRCP
    Consultant
    Department of Critical Care
    Jupiter Hospital
    Thane, Maharashtra, India
  • Rahul A Pandit MD FJFICM FCICM EDIC FCCP DA
    Director, Department of Intensive Care
    Fortis Hospital and Healthcare
    Mumbai, Maharashtra, India
  • Vijaya P Patil MD
    Professor, Department of Anesthesiology, Critical Care and Pain
    Tata Memorial Hospital
    Mumbai, Maharashtra, India
  • Banani Poddar MD DNB
    Professor
    Department of Critical Care Medicine
    Sanjay Gandhi Postgraduate Institute of Medical Sciences
    Lucknow, Uttar Pradesh, India
  • Ramakrishnan N AB (Int Med) AB (Crit Care) AB (Sleep Med) MMM FACP FCCP FCCM FICCM
    Senior Consultant
    Department of Critical Care and Sleep Medicine, Apollo Hospitals
    Chennai, Tamil Nadu, India
  • Pradeep Rangappa DNB FJFICM EDIC FCICM, PGDipECHO MBA FICCM PGDMLE
    Senior Specialist
    Department of Intensive Care
    Columbiaasia Referral Hospital
    Bangalore, Karnataka, India
  • Jayant R Shelgaonkar DA MD FRCA FICCM
    Associate Director
    Department of Critical Care
    Aditya Birla Memorial Hospital
    Pune, Mahrashtra, India
  • Shrikanth Srinivasan MD DNB FNB EDIC
    Senior Consultant
    Department of Critical Care Medicine
    Medanta-The Medicity
    Gurgaon, Haryana, India
  • K Vinodan MD DA
    Head
    Department of Anesthesia and Critical Care
    Medical Trust Hospital
    Cochin, Kerala, IndiaFM6
CONTRIBUTING AUTHORS
  • Chu-Chu A MBBS
    Department of Anesthesia
    Kingston Hospital
    Kingston, United Kingdom
  • Ankur Agrawal MD DM
    DM Fellow
    Department of Pulmonary and Critical Care Medicine
    Post Graduate Institute of Medicine Sciences
    Rohtak, Haryana, India
  • Vandana Agarwal MD FRCA
    Professor
    Department of Anesthesia, Critical Care and Pain
    Tata Memorial Hospital
    Mumbai, Maharashtra, India
  • Nayana S Amin MD
    Professor
    Department of Anesthesiology, Critical Care and Pain
    Tata Memorial Hospital
    Mumbai, Maharashtra, India
  • Andrew C Argent MBBCh Mmed MD FCPeds DCH FRCPCH
    Professor and Medical Director PICU
    Department of Pediatric Intensive Care
    Red Cross War Memorial Children's Hospital and University of Cape Town
    Cape Town, South Africa
  • Madhur Arora MD IDCCM
    Attending Consultant
    Department of Critical Care Medicine
    Fortis Memorial Research Institute
    Gurgaon, Haryana, India
  • Gagan Brar MD FNB IDCC EDIC
    Consultant
    Department of Critical Care and Emergency Services
    Narayana Health
    Bangalore, Karnataka, India
  • Khusrav B Bajan MD EDIC
    Consultant
    Depatement of Critical Care
    PD Hinduja National Hospital and Medical Research Centre
    Mumbai, Maharashtra, India
  • Nikhil N Balankhe MD
    Director
    Department of Critical Care
    Orange City Hospital and Research Institute
    Nagpur, Maharashtra, India
  • Susruta Bandyopadhyay MD
    Director
    Department of Critical Care
    AMRI Hospitals
    Kolkata, West Bengal, India
  • Rajan Barokar MD EDIC
    Director and Consultant
    Aditya Hospital Critical Care and Emergency Centre
    Nagpur, Maharashtra, India
  • Rinaldo Bellomo MD FRACP FCICM PGDipEcho FAHMS
    Professor
    Department of Intensive Care Medicine
    University of Melbourne
    Parkville, Victoria, Australia
  • Vikas Bhagat MD DOMS
    Senior Registrar
    Department of Anesthesiology, Critical Care and Pain
    Tata Memorial Hospital
    Mumbai, Mahrashtra, India
  • Lata Bhattacharya MD
    Senior Consultant
    Department of Anesthesiology and Critical Care
    JLN Cancer Hospital
    Bhopal, Madhya Pradesh, India
  • Pradip K Bhattacharya MD FICCM FCCCM
    Director
    Emergency and Critical Care Services
    Chirayu Medical College and Hospital
    Bhopal, Madhya Pradesh, India
  • Neeta Bose MD
    Associate Professor
    Department of Anesthesia
    GMERS Medical College
    Vadodara, Gujarat, India
  • Devawrat R Buche MD FNB
    Clinical Associate
    Department of Centre for Critical Care
    BLK Superspeciality Hospital
    New Delhi, India
  • Vignesh C MD FNB EDIC
    Consultant
    Department of Critical Care
    Apollo Hospitals
    Chennai, Tamil Nadu, India
  • Chandrashish Chakravarty MD MNAMS EDIC
    Consultant
    Department of ICU
    Apollo Gleneagles Hospitals
    Kolkata, West Bengal, India
  • Matthew J Chan BMedSci
    Research Fellow
    Department of Intensive Care
    Austin Health
    Heidelberg, Victoria, Australia
  • Dhruva Chaudhry MD DNB DM FICCM FICP
    Senior Professor and Head
    Department of Pulmonary and Critical Care Medicine
    Post Graduate Institute of Medicine Sciences
    Rohtak, Haryana, India
  • Munish Chauhan MD FNB EDIC
    Consultant
    Department of Critical Care Medicine
    Fortis Memorial Research Institute
    Gurgaon, Haryana, India
  • Aakanksha Chawla MD FCCM FCCP
    Senior Resident
    Department of Respiratory, Critical Care and Sleep Medicine
    Indraprastha Apollo Hospitals
    New Delhi, India
  • Vipal Chawla MD IDCCM
    Associate Consultant
    Medanta Institute of Critical Care and Anesthesia
    Medanta-The Medicity
    Gurgaon, Haryana, IndiaFM7
  • Maurizio Cecconi MD FRCA FFICM MD
    Consultant and Reader
    Department of Anesthesia and Intensive Care Medicine
    St George's University Hospitals NHS Foundation Trust
    St George's University of London
    London, United Kingdom
  • Ravi Varma Durai Pandian MD FNB EDIC
    Associate Consultant
    Department of Intensive Care Medicine
    Apollo Hospital
    Chennai, Tamil Nadu, India
  • Raymond D MD DM EDIC
    Consultant
    Department of Critical Care
    Apollo Hospitals
    Chennai, Tamil Nadu, India
  • Kanishka Davda DNB
    Fellow of National Board
    Department of Infectious Diseases
    PD Hinduja National Hospital and Medical Research Centre
    Mumbai, Maharashtra, India
  • Nimita Deora MSc
    Clinical Research Assistant
    Department of Anesthesiology and Critical Care
    Chirayu Medical College and Hospital
    Bhopal, Madhya Pradesh, India
  • Sandeep Dewan DA DNB IDCCM
    Director and Head
    Department of Critical Care Medicine
    Fortis Memorial Research Institute
    Gurgaon, Haryana, India
  • Jigeeshu V Divatia MD FCCM FISCCM
    Professor and Head
    Department of Anesthesiology, Critical Care and Pain
    Tata Memorial Hospital
    Mumbai, Maharashtra, India
  • Subhal B Dixit MD IDCCM FICCM FCCM
    Director
    Department of Intensive Care
    Sanjeevan Hospital and MJM Hospital
    Pune, Maharashtra, India
  • Supradip Ghosh Dip. Intensive Care
    Additional Director and Head
    Department of Critical Care medicine
    Fortis Escorts Hospital
    Faridabad, Haryana, India
  • Palepu B Gopal MD FRCA CCST FICCM FCCM
    Consultant and HOD
    Department of Critical Care Medicine
    Continental Hospitals
    Hyderabad, Telangana, India
  • Prabhas P Giri MD MRCPCH
    Assistant Professor and In-Charge PICU
    Department of Pediatrics
    Institute of Child Health
    Kolkata, West Bengal, India
  • Anish Gupta MD
    Fellow FNB
    Institute of Critical Care Medicine
    Max Super Speciality Hospital
    New Delhi, India
  • Rahul B Amte MD IDCCM EDIC
    Consultant
    Department of Critical Care Medicine
    Yashoda Hospitals
    Hyderabad, Telangana, India
  • Deepak Govil MD FCCM EDIC FICCM
    Director
    Department of Critical Care Medicine
    Medanta-The Medicity
    Gurgaon, Haryana, India
  • Navya Guwalani PG
    Clinical Reseacrh Officer
    Department of Anesthesiology and Critical Care
    Chirayu Medical College and Hospital
    Bhopal, Madhya Pradesh, India
  • Abhinav Gupta MD DNB FNB EDIC
    Additional Medical Superintendent and Head
    School of Medical Sciences and Research, Sharda Hospital
    Sharda University
    Greater Noida, Uttar Pradesh, India
  • Sachin Gupta MD IDCCM IFCCM EDIC
    Senior Consultant
    Department of Critical Care Medicine
    Medanta-The Medicity
    Gurgaon, Haryana, India
  • Sushma K Gurav DNB IDCCM
    Intensivist
    Neuro-trauma Unit
    Grant Medical Foundation Ruby Hall Clinic
    Pune, Maharashtra, India
  • James Hanison FRCA
    Consultant
    Department of Anesthesia and Intensive Care Medicine
    Manchester Royal Infirmary
    United Kingdom
  • Ashit V Hegde MD MRCP
    Consultant
    Department of Medicine and Critical Care
    PD Hinduja National Hospital
    Mumbai, Maharashtra, India
  • Javed Ismail MD DM
    Consultant
    Department of Pediatrics
    Post Graduate Institute of Medical Education and Research
    Chandigarh, India
  • Jose Chacko MD DA DNB EDIC
    Consultant and Head
    Department of Critical Care and Emergency Services
    Narayana Health
    Bangalore, Karnataka, India
  • Gaurav Jain MD PDCC
    Assistant Professor
    Department of Anesthesiology
    Institute of Medical Sciences
    Banaras Hindu University
    Varanasi, Uttar Pradesh, India
  • Yash Javeri DA IDCCM
    Director
    Department of Critical Care Medicine
    Apex Healthcare Consortium
    New Delhi, India
  • Sameer A Jog MD IDCCM EDIC
    Consultant Intensivist
    Department of Emergency Medicine and Critical Care
    Deenanath Mangeshkar Hospital
    Pune, Maharashtra, IndiaFM8
  • Deven Juneja DNB FNB EDIC FCCM
    Principal Consultant
    Department of Critical Care Medicine
    Max Super Speciality Hospital
    New Delhi, India
  • Sunil Karanth MD FNB EDIC FCICM
    Chairman, Consultant, and Head
    Department of Critical care services
    Manipal Health Enterprise (P) Ltd
    Bangalore, Karnataka, India
  • Mohit Kharbanda MD IDCCM FNB
    Director
    Department of Critical Care
    Desun Hospital
    Kolkata, West Bengal, India
  • Ruchira W Khasne DA DNB IDCCM EDAIC EDIC
    Consultant
    Department of Critical Care
    Apollo Hospital
    Nashik, Maharashtra, India
  • Khalid I Khatib MD
    Professor
    Department of Medicine
    Shrimati Kashibai Navale Medical College
    Pune, Maharashtra, India
  • Jagadeesh KN MBBS
    Consultant, Medanta Institute of Critical Care and Anesthesia
    Medanta-The Medicity
    Gurgaon, Haryana, India
  • Niranjan Kissoon FRCPC FAAP FACPE MCCM CPE
    Professor
    Department of Pediatrics
    University of British Columbia and BC Children's Hospital
    British Columbia, Vancouver, Canada
  • Rohit V Kodagali MD
    Medical Advisor
    Medical Department
    Boehringer Ingelheim
    Mumbai, Maharashtra, India
  • Sadanand S Kulkarni MD
    Vice-President
    Department of Medical Affairs and Clinical Research
    Fresenius Kabi India Pvt. Ltd
    Pune, Maharashtra, India
  • Krishna P Mulavisala MD FRCA
    Consultant
    Department of Anesthesiology
    Global Hospitals
    Hyderabad, Telangana, India
  • Rajesh Pande MD PDCC FICCM FCCM
    Director
    BLK Center for Critical Care BLK Superspeciality Hospital
    New Delhi, India
  • Samidh B Patel MD
    In-Charge
    Department of Critical Care
    Manik Hospital and Research Center
    Aurangabad, Maharashtra, India
  • Kinjal Patel MD
    Clinical Assistant
    Department of Lab Medicine
    Hinduja Hospital and Medical Research Centre
    Mumbai, Maharashtra, India
  • Sweta Patel MD IDCCM
    Consultant, Medanta Institute of Critical Care and Anesthesia
    Medanta-The Medicity
    Gurgaon, Haryana, India
  • Harish M Maheshwarappa MD DNB IDCCM DM EDIC
    Consultant and Head
    Department of Critical Care Medicine
    Yashoda Hospitals
    Secunderabad, Telangana, India
  • Arghya Majumdar MD DNB MRCP
    Director and Head
    Department of Nephrology
    AMRI Hospitals
    Kolkata, West Bengal, India
  • Mohan A Mathew MD
    Director
    Department of Anesthesia and Critical Care
    Lakeshore Hospital
    Kochi, Kerala, India
  • Yatin Mehta MD MNAMS FRCA FAMS FIACTA FICCM FTEE
    Chairman
    Institute of Critical Care and Anesthesiology
    Medanta-The Medicity
    Gurgaon, Haryana, India
  • Saumen Meur DCH MRCPCH FRCPCH CCT
    Consultant Pediatric Intensivist
    Department of Pediatric Cardiology
    BM Birla Heart Research Centre
    Kolkata, West Bengal, India
  • Sheila N Myatra MD FCCM FICCM
    Professor
    Department of Anesthesiology, Critical Care and Pain
    Tata Memorial Hospital
    Mumbai, Maharashtra, Idia
  • Amit M Narkhede MD DNB
    Senior Resident
    Department of Anesthesiology, Critical Care and Pain
    Tata Memorial Hospital
    Mumbai, Maharashtra, India
  • Prashant Nasa MD FNB EDIC CIC FCCP FICCM
    Specialist and Head
    Department of Critical Care Medicine
    NMC Speciality Hospital
    Dubai, United Arab Emirates
  • Anand M Nikalje MD
    Medical Director and In-Charge
    Department of Medicine and Critical Care
    MIT Hospital and Research Institute
    Aurangabad, Maharashtra, India
  • Odiraa C Nwankwor MD MPH FAAP
    Consultant
    Department of Pediatrics
    Children's Regional Hospital at Cooper University Hospital
    Camden, New Jersey, USA
    Consultant
    Department of Pediatrics
    Alfred I. DuPont Hospital for Children
    Wilmington, Delaware, USA
  • Divya Pal MD IDCCM
    Fellow (FNB) Critical Care
    Institute of Critical Care and Anesthesiology
    Medanta-The Medicity
    Gurgaon, Haryana, India
  • JV Peter MD DNB MAMS FRACP FJFICM FCICM FICCM
    Professor and Head
    Medical Intensive Care Unit
    Christian Medical College
    Vellore, Tamil Nadu, IndiaFM9
  • Natesh R Prabu MD DNB DM EDIC
    Specialist Registrar
    Department of Anesthesiology, Critical Care and Pain
    Tata Memorial Hospital
    Mumbai, Maharashtra, India
  • Ramesh Venkataraman AB (IM) AB (CCM)
    Senior Consultant
    Department of Critical Care Medicine
    Apollo Hospitals
    Chennai, Tamil Nadu, India
  • Suresh Ramasubban FACP FCCP AB
    Senior Consultant
    Department of Pulmonary and Critical Care Medicine
    Apollo Gleneagles Hospital
    Kolkata, West Bengal, India
  • Banambar Ray MD FICCM
    Chief Consultant
    Department of Critical Care and Anaesthesia
    Apollo Hospitals
    Bhubaneswar, Odisha, India
  • Sumit Ray MD FICCM
    Senior Consultant and Vice-Chairperson
    Department of Critical Care and Emergency Medicine
    Sir Gangaram Hospital
    New Delhi, India
  • Camilla Rodrigues MD
    Consultant
    Department of Lab Medicine
    Hinduja Hospital and Medical Research Centre
    Mumbai, Maharashtra, India
  • Samir Sahu MD FICCM
    Director
    Department of Critical Care and Pulmonology
    AMRI Hospitals
    Bhubaneswar, Odisha, India
  • Arijit Samanta DA MD FNB
    FNB trainee
    Department of Critical Care and Emergency Medicine
    Sir Gangaram Hospital
    New Delhi, India
  • Sriram Sampath MD
    Professor and Director
    Department of Critical Care Medicine
    St John's Medical College and Hospital
    Bangalore, Karnataka, India
  • Gauri Saroj MD IDCCM EDIC
    Consultant
    Department of Critical Care
    Jupiter Hospital
    Thane, Maharashtra, India
  • Sanjith Saseedharan IDCCM EDIC FNNCC DA FIMSA
    Head
    Department of Critical Care
    SL Raheja Hospital – A Fortis Associate
    Mumbai, Maharashtra, India
  • Pratik Savaj DNB
    Fellow of National Board
    Department of Infectious Diseases
    PD Hinduja National Hospital and Medical Research Centre
    Mumbai, Maharashtra, India
  • Mozammil Shafi MD FNB
    Associate Consultant
    Institute of Critical Care and Anesthesiology
    Medanta-The Medicity
    Gurgaon, Haryana, India
  • Prakash Shastri MD FRCA FICCM
    Senior Consultant and Vice-Chairman
    Department of Critical Care and Emergency Medicine
    Sir Gangaram Hospital
    New Delhi, India
  • Suhail S Siddiqui MD FCCM DM
    Specialist Senior Resident
    Department of Anesthesiology, Critical Care and Pain
    Tata Memorial Hospital
    Mumbai, Mahrashtra, India
  • Dinesh K Singh MD FICCM
    Professor
    Department of Anesthesiology
    Institute of Medical Sciences
    Banaras Hindu University
    Varanasi, Uttar Pradesh, India
  • Manoj K Singh MD DNB FNB
    Consultant
    Department of Critical Care
    Apollo Hospital International Ltd
    Ahmedabad, Gujarat, India
  • Omender Singh MD FCCM
    Director
    Institute of Critical Care Medicine
    Max Super Speciality Hospital
    New Delhi, India
  • Saswati Sinha MD IDCCM EDIC
    Consultant
    Department of Critical Care
    AMRI Hospitals
    Kolkata, West Bengal, India
  • Mehul K Solanki MD FNB
    Consultant
    Department of Critical Care
    BAPS Yogiji Maharaj Hospital
    Ahmedabad, Gujarat, India
  • Rajeev Soman MD
    Consultant
    Department of Internal Medicine and Infectious Diseases
    PD Hinduja National Hospital and Medical Research Centre
    Mumbai, Maharashtra, India
  • Peter E Spronk MD PhD EDIC FCCP
    Director
    Department of Intensive Care Medicine
    Gelre Hospitals Apeldoorn
    Apeldoorn, The Netherlands
  • T Shyam Sunder MD PDCC FICCM
    Medical Director
    Thumbay Hospital
    Hyderabad, Telangana, India
  • Nisha Tipparaju MBBS
    ICU Medical Officer
    Thumbay Hospital
    Hyderabad, Telangana, India
  • Deeksha S Tomar DA IDCCM IFCCM
    Associate Consultant
    Department of Critical Care Medicine
    Medanta-The Medicity
    Gurgaon, Haryana, IndiaFM10
  • Younsuck Koh MD PhD FCCM
    Professor
    Department of Pulmonary and Critical Care Medicine Asan Medical Center
    University of Ulsan College of Medicine
    Songpa-gu, Seoul, Korea
  • Mahesh Nirmalan MD FRCA PhD FFICM
    Faculty of Biology, Medicine and Health
    Consultant, Intensive Care Medicine
    Manchester Royal Infirmary
    University of Manchester and Central Manchester Foundation Trust
    Manchester, United Kingdom
  • Swapnil R Patharekar MD IDCCM IFCCM EDIC
    Consultant Intensivist
    Department of Emergency Medicine and Critical Care
    Deenanath Mangeshkar Hospital
    Pune, Maharashtra, India
  • Sushma Patil MD
    Consultant In-Charge
    Neuro Trauma Unit, Ruby Hall Clinic
    Pune, Maharashtra, India
  • Saroj K Pattnaik DNB IDCCM
    Consultant, Department of Critical Care Medicine, Apollo Hospitals
    Bhubaneswar, Odisha, India
  • Srinivas Samavedam MD FNB EDIC FRCP DNB DMLE
    Head, Department of Critical Care
    Virinchi Hospitals
    Hyderabad, Telangana, India
  • Sunit C Singhi MD FIAP FAMS FISCCM FICCM FCCM
    Director-Principal
    Maharishi Markandeshwar Institute of Medical Sciences and Research
    Ambala, Haryana, India
  • Sharmili Sinha MD DNB EDIC
    Senior Consultant
    Department of Critical Care Medicine
    Apollo Hospitals
    Bhubaneswar, Odisha, India
  • Sunitha B Varghese DNB IDCCM EDIC
    Head
    Department of Critical Care
    Niramaya Hospital
    Pune, Maharashtra, India
  • Ximena Watson MbCHb
    Department of Anesthesia
    Kingston Hospital
    Kingston, United Kingdom
FM11Preface
Dear Friends
It is indeed a proud moment for Indian Society of Critical Care Medicine (ISCCM) to launch the first Critical Care Update 2017 book during its annual congress in Kochi. Over the years, attendance at ISCCM congress has been increasing exponentially and a scientific congress book highlighting the key topics discussed in the congress was long overdue. This book has around 80 chapters authored by national and international faculty covering all the major topics which will be discussed during the congress. This update will highlight the recent advances made in the field of critical care with special reference to its relevance and application in resource limited settings. A special section on “Economics of ICU” is worth mentioning. We sincerely hope this book will be useful both for young intensivists to promote analytical thinking, post graduates to keep abreast of recent advances, and also to senior clinicians. The publication of this book was possible only through a joint effort from the members of the editorial board, authors, and the publisher. We hope this book will continue to be published in the future congresses.
Subhash Todi
Atul P Kulkarni
Kapil ZirpeFM12
FM13Acknowledgment
The Indian Society of Critical Care Medicine (ISCCM) acknowledges the enthusiastic support of all the members of the society and is ever grateful to them for it. This book is dedicated to all these members.