Suruchi Ambasta

Abstract

Introduction: Critically ill patients are prone to develop malnutrition which is a major contributory factor to the already existing burden of morbidity and mortality. Early nutrition support is an effective therapy to prevent malnutrition when patients are unable to take oral nutrition. Aim: To determine the effectiveness of a nutrition support protocol versus non-protocol management on initiating nutrition support in ICU patients. Materials and Methods: This randomized controlled study was conducted on fifty critically ill patients on mechanical ventilation with twenty five patients in each group. Nutrition protocols were followed in Group I patients and group II comprised of nonprotocolised patients. Results: Hospital stay for group I patients was 22.7 days while group II patients stayed for 31.9 days (p-value Conclusion: Patients in whom nutrition support protocols were followed received enteral nutrition earlier, had early weaning from ventilator, spent less time in ICU as well as hospital and had lesser complications with low mortality.  Keywords: Enteral nutrition, Nutrition protocol, Malnutrition, Mechanical ventilation, ICU.

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Abstract

Introduction: This was a prospective, randomized, double blind, comparative, clinical study to assess the efficacy of Esmolol and Labetalol, in low doses, for attenuation of sympathomimetic response to laryngoscopy and intubation. Materials and Methods: This study was conducted on 50 ASA 1 patients of either sex undergoing elective surgeries under general anaesthesia. Patients were randomized into two groups; group E who received intravenous Esmolol (0.5 mg/kg) or group L who received intravenous Labetalol (0.25 mg /kg) prior to induction and hemodynamic parameters were recorded as per designed protocol to assess stress response to laryngoscopy and intubation. Results: Both the study groups had similar demographic profile. Instat version 3.10 was used for statistical calculations. The study data were analyzed using statistical methods of mean, standard deviation. Esmolol (0.5 mg/kg), abetalol (0.25 mg/kg) significantly attenuated the rise in heart rate, systolic blood pressure, and RPP during laryngoscopy and intubation. However, the difference was not statistically significant among the values for DBP and MAP. Conclusion: From our clinical study it can be concluded that in lower doses, intravenous Labetalol (0.25 mg/kg) is a better agent than intravenous Esmolol (0.5 mg/kg) in attenuating the sympathomimetic response to laryngoscopy and intubation. Usual dose of esmolol used to obtund intubation response is 2-4mg/kg, while labetalol has been tried in all doses ranging from 0.25, 0.5, 0.75, and 1 mg/kg.17 Keywords: Esmolol, Labetalol, Stress response, Laryngoscopy and Intubation.

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