Background: Glucose variability is an indicator and independent predictors of mortality and severity of sepsis in critically septic patients of intensive care unit. Objectives: This study evaluated the relationship of glucose variability in critically ill septic patients in relation with serum lactate. Method: It is a prospective observational study was conducted in the Intensive Care Unit (ICU) in Department of Anesthesia, Pain, Palliative Care and Intensive Care, Dhaka Medical College hospital, Dhaka over a period of one year in between 1st January- 31st December, 2015. Total 51 septic adult patients were included in the study according to the selection criteria. In this study, 8 consecutive capillary blood samples were taken with a periodic interval of 3 hours starting from admission. Mean and standard deviation (SD) blood glucose were computed to see the glucose variability and agreement done with serum lactate and severity of sepsis. All collected data were registered documented and analyzed in the statistical program Statistical Package for Social Science (SPSS) version 20.0. Result: Among total 51 patients, 52.9% study cases were of 4th decade with a mean age of 46±12 years had a mild female predominance. Glycemic variability was taken as >2SD. High glycemic variability observed in 70.6% cases. Good agreement observed in glucose variability with serum lactate by Kappa Statistics. Conclusion: Glucose variability shows the prediction of sepsis and it could be used as a useful alternative tool to predict sepsis and severity of sepsis. Bangladesh Crit Care J March 2022; 10 (1): 10-14

Background: Acute respiratory distress syndrome (ARDS) necessitates rapid recognition for early intervention and favourable outcomes. The Berlin Definition may not be always helpful for ARDS diagnosis in critically ill patients, because of the inability to acquire adequate information from bedside chest X-rays. Lung ultrasound may be a reasonable alternative to chest X-ray for the identification of ARDS, but the effectiveness of lung ultrasound in ARDS diagnosis remains uncertain. Objective: To explore the efficacy of lung ultrasound (LUS) for the diagnosis of ARDS in ICU. Methods: This observational, cross-sectional study was conducted in the ICU, DMCH at the Department of Anaesthesia, Analgesia, Palliative, and Intensive Care Medicine from March 2017 to June 2019. Lung ultrasound was performed on acute hypoxic respiratory failure patients requiring mechanical ventilation. chest X-ray, arterial blood gas analysis, and echocardiography were done to fulfill the Berlin Definition. ARDS was diagnosed by the ‘CXR-based Berlin Definition’ and ‘LUS-based Berlin Definition’. Results: A total of 141 patients were assessed. Their median age was 35 years. Primary diagnoses were sepsis, pulmonary oedema, pneumonia, and trauma. A total of 62 (43.97%) patients fulfilled ‘CXR-based Berlin Definition’ and a total of 69 (48.93%) patients were diagnosed as ARDS by ‘LUS-based Berlin Definition’. Considering the ‘CXR-based Berlin Definition’ as the reference standard, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ‘LUS-based Berlin Definition’ were 90.3%, 83.5%, 81.2%, 91.7%, and 86.5% respectively. Conclusion: Lung ultrasound can be an effective tool for the diagnosis of ARDS in the intensive care unit. Bangladesh Crit Care J September 2022; 10(2): 104-109

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