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Background Inability to communicate is very distressing for patients in the intensive care unit (ICU). Most communication exchanges in ICU are initiated by healthcare workers (HCWs). Touch screen apps may enable patients to initiate communication and improve their interactions. Objectives This study aimed to evaluate the pertinent features of iPad-based apps designed for communication in ICU. Methods Apple “App Store” and Google “Play Store” were searched for keywords “communication” and “intensive care.” Related app suggestions were screened. Two independent assessors evaluated iPad-based apps that were deemed useful. The assessors resolved the discrepancies by re-evaluating the apps and reaching a consensus. Results Nine apps met the inclusion criteria. Of these six apps were free. There were seven apps specific to intensive care. Most apps had preloaded phrases for the patient to request to see someone (e.g., family), personal hygiene (e.g., bowel care), seek help with symptoms (e.g., pain), or a comfort item (e.g., blanket). CALD Assist, Patient Communicator, VidaTalk, and YoDoc were available in more than eight languages. VidaTalk and YoDoc allowed the user to write. Four apps were deemed not suitable for routine ICU use, while the remaining five had several attractive features. Conclusion Several high-quality apps are available to assist with patient-initiated communication exchange in ICU. This study provides a guide for readers to choose the app most suited to their needs. In the opinion of the authors, YoDoc is the most suitable app for routine use in ICU. Among free apps, CommuniCare appears to be the most user-friendly. How to cite this article Dind AJ, Starr JS, Arora S. iPad-based Apps to Facilitate Communication in Critically Ill Patients with Impaired Ability to Communicate: A Preclinical Analysis. Indian J Crit Care Med 2021;25(11):1232–1240.

Aim and objective Fogging of eyeglasses while wearing N95 respirators is common. It is commonly held that the N95 respirator has a poor fit if there is fogging of eyeglasses. We conducted this prospective, pilot study to determine if fogging of eyeglasses predicts poor fit of N95 respirator. Materials and methods Seventy volunteer healthcare workers from a tertiary intensive care unit in Sydney, Australia participated. The participants donned one of the following N95 respirators: three-panel flat-fold respirator (3M 1870), cup-shaped respirator (3M 1860), or a duckbill respirator. After a satisfactory “user seal check” as recommended by the manufacturer, the participants donned eyeglasses and checked for fogging. A quantitative fit test (QnFT) of the respirator was then performed (using PortaCount Respirator Fit Tester 8048, TSI Inc., Minnesota, USA). A fit factor of

N95 respirators and safety goggles are important components of personal protective equipment to reduce the spread of airborne infections, such as COVID-19, among healthcare workers. Poor N95 respirator seal may reduce its protective effect, thereby increasing transmission. Quantitative fit testing is an established way of assessing the N95 respirator fit, which provides a quantitative measure for seal, called the fit factor. Duckbill N95 respirators frequently fail the fit test. We hypothesized that using safety goggles with a wraparound elastic headband will increase their fit-factor by reinforcing the seal between the face and the upper margin of the respirator. We studied the effect of safety goggles with a wraparound elastic headband (3M™ Chemical Splash Resistant Goggles, ID 70006982741) on the fit factor of two types of Duckbill N95 respirators (Halyard FLUIDSHIELD*3, Model 99SA070M, and ProShield® N95 Model TN01-11) in 63 healthy volunteers in a nonrandomized, before-and-after intervention study design. The mean fit factor increased from 69.4 to 169.1 increased from 17/63 (27%) to 46/63 (73%) after the intervention (p

Transport of oxygen is one of the most important functions of blood. How oxygen moves from the air, where its partial pressure is about 150 mm Hg to mitochondria, where it drops down to a single digit is an evolutionary marvel. In this article, we discuss the physiology of oxygen transport from the alveoli to the tissue, the alveolar gas equation and the oxyhemoglobin dissociation curve. In the applied physiology section, we discuss the impact of high altitude, hyperbaric conditions, carbon monoxide poisoning on the transport of oxygen. Some common pitfalls in the interpretation of pulse oximetry and arterial blood gas are also discussed. Finally, we talk about the methods of increasing oxygen delivery, the compensation for hypoxia and some indications of venous oxygen saturation measurement. How to cite this article Arora S, Tantia P. Physiology of Oxygen Transport and its Determinants in Intenstive Care Unit. Indian J Crit Care Med 2019;23(Suppl 3):S172–S177.

This paper explores the emergence of biotechnology centers in Shanghai and Bangalore by comparing their development to best practices in the literature for biotechnology cluster growth and development. Interviews with over fifty biotech companies and related institutions in China and India indicate that these regions are developing alternate models of low cost manufacturing and services that build on the current local base of knowledge and expertise. The ability to convert research into successful commercial activity was identified in both regions. The strong research capacity, private sector funding, and entrepreneurial environment deemed critical best practices were limited. New growth theory is used to explain these alternate approaches to technological and social change.

Respiratory complications following cervical spinal cord injury are common and are the leading cause of morbidity and mortality after this type of injury. Impaired mechanics of ventilation, poor cough, increased secretions and bronchospasm predispose to atelectasis, pneumonia and exacerbations of respiratory failure. Prolonged mechanical ventilation and tracheostomy are often required. This review discusses the relevant pathophysiology, various ventilatory strategies and timing of tracheostomy, and examines the evidence surrounding physiotherapeutic and pharmacological treatment options.

This case report compares three types of renal replacement therapy for acute severe lithium toxicity and is the first to use prolonged intermittent renal replacement therapy (PIRRT). A peak lithium level of 13.2mmol/L was recorded after a 51- year-old man attempted suicide. He was treated with intermittent haemodialysis (IHD), PIRRT and continuous venovenous haemofiltration (CVVH) over 55 hours. Lithium clearance was shown to be comparable between IHD and PIRRT, both of which were superior to CVVH. Expected efficacy of treatment with a single daily session of PIRRT was higher than IHD or CVVH. PIRRT is a useful strategy for dialysis among patients with acute lithium intoxication.