Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Jun 5, 2020; 9(2): 31-42
Published online Jun 5, 2020. doi: 10.5492/wjccm.v9.i2.31
Critical care practice in India: Results of the intensive care unit need assessment survey (ININ2018)
Rahul Kashyap, Kirtivardhan Vashistha, Chetan Saini, Taru Dutt, Dileep Raman, Vikas Bansal, Harpreet Singh, Geeta Bhandari, Nagarajan Ramakrishnan, Harshit Seth, Divya Sharma, Premkumar Seshadri, Mradul Kumar Daga, Mohan Gurjar, Yash Javeri, Salim Surani, Joseph Varon, ININ-2018 Investigators Team
Rahul Kashyap, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, United States
Kirtivardhan Vashistha, Department of Infectious Disease, Mayo Clinic, Rochester, MN 55905, United States
Kirtivardhan Vashistha, Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA 15212, United States
Chetan Saini, Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States
Chetan Saini, Department of Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY 14061, United States
Taru Dutt, Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States and Department of Psychiatry, Hennepin County Medical Center, Minneapolis, MN 55415, United States
Dileep Raman, Department of Medicine, Cloud Physician Healthcare, Bangalore 560038, India
Vikas Bansal, Department of Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
Harpreet Singh, Department of Internal Medicine, Maulana Azad Medical College & Associated Hospitals, New Delhi, Delhi 110002, India
Geeta Bhandari, Department of Anesthesiology, Government Medical College, Haldwani, Nainital 263129, India
Nagarajan Ramakrishnan, Department of Critical Care Medicine, Apollo Hospitals, Chennai 600006, India
Harshit Seth, Department of Hospitalist Medicine, Allegany Clinic, Allegany Health Network, Pittsburgh, PA 15222, United States
Divya Sharma, Premkumar Seshadri, Department of Medicine, MAAGF Healthcare, Chennai 600024, India
Mradul Kumar Daga, Department of Internal Medicine and Center for Occupational and Environment Health, Maulana Azad Medical College, New Delhi, Delhi 110002, India
Mohan Gurjar, Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
Yash Javeri, Department of Critical Care Medicine, Regency Super Speciality Hospital, Lucknow 208005, India
Yash Javeri, Nayati Healthcare, New Delhi, Delhi 110065, India
Salim Surani, Department of Pulmonary and Critical Care Medicine, Texas A&M University, College Station, TX 77843, United States
Joseph Varon, Department of Critical Care, United Memorial Medical Center, Houston, TX 77091, United States
Author contributions: All listed authors provided intellectual contribution and made critical revisions of this paper; Kashyap R, Ramakrishnan N, Daga MK, Seshadri P and Javeri Y contributed to study conception and design; All co-authors contributed to data acquisition; Vashistha K, Saini C and Kashyap R contributed to data analysis; Surani S and Varon J contributed to data interpretation and critical edits; all authors approved the final version of the manuscript.
Institutional review board statement: This study was deemed eligible for category-2 Institutional Review Board exempt status from Mayo Clinic IRB, Mayo Clinic, Rochester, MN, 55905, United States.
Informed consent statement: Informed consent was waived by IRB, as it being a survey and no human subject was involved.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
STROBE statement: We have read the Strobe statement and prepared checklist and the manuscript accordingly.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Rahul Kashyap, MBBS, MBA, Assistant Professor, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. kashyap.rahul@mayo.edu
Received: December 7, 2019
Peer-review started: December 7, 2019
First decision: January 28, 2020
Revised: April 27, 2020
Accepted: May 12, 2020
Article in press: May 12, 2020
Published online: June 5, 2020
Processing time: 180 Days and 14.3 Hours
ARTICLE HIGHLIGHTS
Research background

With the modernization of medicine and technology, the population is living longer. The patients presenting in hospital have several co-morbid factors and are critically ill on many instances. The developed countries have come with several protocol and best practices, based on the scientific facts and expert guideline. This has shown to save lives and improve the outcomes. When it comes to developing countries, though progress has been made but not much data or information is available.

Research motivation

There is not much data out there regarding standard of practice, variations in practice, clinical services available in the different region of intensive care unit (ICU). We believe that having that knowledge will help in decreasing the variation and improve henceforth help in improving the patient care.

Research objectives

Study was designed to understand the processes, adherence to the guidelines and clinical services available in ICU in different part of India.

Research methods

This study was cross-sectional pan-India based survey.

Research results

Responses were received from 134 adult/pediatric ICU were received. More than 80% of their ICU was either open or transitional. Digital infra-structure and technology was found to be marginal. More than 80% of them were utilizing sepsis care, ventilator-associated pneumonia bundle, deep venous thrombosis prophylaxis, stress ulcer prophylaxis and glycemic control. They have lower nurse to patient ratio. They also have fewer critical care specialist.

Research conclusions

There is definitely need for improvement in the digital infra-structure, nurse to patient ratio, critical care physician availability.

Research perspectives

Improving the practice gaps can help in improving the patient care, decreasing the hospital and ICU length of stay, decrease in mortality, and improvement in patient outcome.