Acute and Critical Care

Original Articles

Pulmonary
Effectiveness of online versus in-person structured training program on arterial blood gas, electrolytes, and ventilatory management of critically ill patients: Gaurav Jain, Bhavna Gupta, Priyanka Gupta, Sagarika Panda, Sameer Sharma, Shalinee Rao; Acute Crit Care. 2021;36(1):54-61. Published online February 2, 2021; DOI: https://doi.org/10.4266/acc.2020.00759

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Background
Due to the risk of viral transmission during in-person training, a shift toward online platforms is imperative in the current pandemic. Therefore, we compared the effectiveness of an in-person interactive course with a structurally similar online course designed to improve cognitive skills among clinical health professionals in arterial blood gas analysis, management of electrolyte imbalances, and approaches to mechanical ventilation in critically ill patients.
Methods
In an observational, outcome assessor-blinded, cohort trial, group A included participants enrolled prospectively in an online course, while group B included those who took part in an in-person course (retrospective arm). The primary objective was comparison of cognitive skills through a pre and post-test questionnaire. Statistical analysis was performed using Student t-test.
Results
In total, 435 participants were analyzed in group A, while 99 participants were evaluated in group B. The mean pre-test score was 9.48±2.75 and 10.76±2.42, while the mean post-test score was 11.94±1.90 (passing rate, 64.6%) and 12.53±1.63 (passing rate, 73.3%) in groups A and B, respectively. Group B scored significantly higher in both pre-test (P=0.001) and post-test evaluations (P=0.004). The improvement in post-test score was significantly greater (P=0.001) in group A (2.46±2.22) compared to group B (1.77±1.76). The medical specialties fared better in group B, while surgical specialties scored higher in group A. The pre-test vs. post-test scores exhibited a moderate correlation in both groups (P<0.001). The feedback survey showed a Likert score >3.5 for most points in both groups.
Conclusions
The online teaching module exhibited a significant benefit in terms of participant sensitization and knowledge sharing.

Citations

Citations to this article as recorded by

Health Care Simulation as a Training Tool for Epidemic Management
Marcia A. Corvetto, Fernando R. Altermatt, Francisca Belmar, Eliana Escudero
Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare.2023; 18(6): 382. CrossRef

Diagnosis of Acid-base Imbalance by Stewart's Physicochemical Approach and Mortality Prediction in Severe Burn Patients with Inhalation Injury: Sunghoon Park, Cheol Hong Kim, In Gyu Hyun, Ki Suck Jung; Korean J Crit Care Med. 2006;21(1):17-27.

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Abstract PDF: BACKGROUND
Acid-base derangement are commonly encountered in critically ill patients. This study is to investigate underlying mechanisms of acid-base imbalance and also to examine whether they can predict mortality in burn patients.
METHODS
We retrospectively reviewed 73 severely burned patients who had admitted to burn intensive care unit, from January to July in 2004. All the patients had inhalation injury, identified by bronchoscopic examination. We analyzed the type and nature of the acid-base imbalances from arterial blood gas analysis, electrolytes and other biological tests between survivors and non-survivors for 30 days after admission.
RESULTS
Acidosis was the most common disorder during the early and late hospital periods. Large fractions of those showed decreased strong ion difference (SID), increased anion gap corrected by albumin (AGc) and [Cl-]corrected. Mixed disorder and alkalosis emerged after the 7(th) hospital day. As time went by, albumin, PaO2/FiO2 ratio, pH and SID were more decreased in non-survivors (n=28) than in survivors (n=45) while [Cl-] corrected, alveolar-arterial oxygen tension gradients, peripheral WBC counts and CRP were more increased in non-survivors than in survivors. In the area under the receiver operating characteristic curves for mortality prediction, APACHE II score and % of total body surface area (%TBSA) burn were high: 0.866 (95% CI; 0.785~0.946) for APACHE II score, 0.817 (95% CI; 0.717~0.918) for %TBSA burn.
CONCLUSIONS
In burned patients with inhalation injury, various types of acid-base imbalances and electrolytes abnormalities emerged after resuscitation and so, more careful attentions pursued for correcting underlying acid-base derangement.

Comparison of Conventional Chiron 348 pH/blood Gas/electrolytes Analyzer and i-STAT Portable Clinical Analyzer: Dong Suk Chung, Jong Bun Kim, Sie Hyun You; Korean J Crit Care Med. 2000;15(1):35-40.

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Abstract PDF: BACKGROUND
The development of so-called "Point-of-care" (POC) devices for blood or urine analysis has resulted in many systems that are widely used at home or at the bedside. We evaluated the performance of the I-STAT portable clinical analyzer for measuring blood gases (pH, PCO2, PO2) and whole blood electrolytes (sodium, potassium and ionized calcium) with reference to a conventional blood gas analyzer (Chiron 348 pH/ blood gas/electrolytes).
METHODS
Thirty samples from the arterial blood were simultaneously analyzed with I-STAT system and with Chiron 348 pH/blood gas/ electrolytes analyzer. Differences between results of two methods were analyzed by paired t-test (p<0.05).
RESULTS
PO2, PCO2 and Na measured with I-STAT system and Chiron 348 PH/ blood gas/ electrolytes analyzer showed no significant differences. pH, calculated HCO3, K and Ca measured by two methods showed significant difference, but observed differences would not affect clinical decisions except ionized calcium.
CONCLUSIONS
This study shows that blood gas and electrolyte analysis using the I-STAT portable device is comparable with that performed by a conventional Chiron 348 pH/blood gas/ electrolytes analyzer except ionized calcium.

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