Intensive Care Unit (ICU) is the most vulnerable area in the hospital premises. Hospital acquired infections in critically ill patients as well as of transmission of infections from a patient to another patient or to the health care workers or vice versa can occur in ICU. ICUs combine physicians, nurses and allied health professionals to manage patients with life threatening single or multiple organ system failure, including stabilization after surgical interventions. It is a continuous management including monitoring, diagnosis, and support of failing vital functions as well as the treatment of the underlying disease. Here we have to discuss the source of infection and their effective control measurement in intensive care unit. Ventilator associated pneumonia (VAP) as well with other sources is most common nosocomial infection having 33% mortality in ICU. Key words: Intensive care unit, Pneumonia, ventilator pneumonia DOI: http://dx.doi.org/10.3329/cardio.v1i1.8218 Cardiovasc. j. 2008; 1(1) : 78-80

Abstract:Background: The antifibrinolytic drug tranexamic acid (TA) decreases blood loss in Pediatric

DOI: http://dx.doi.org/10.3329/cardio.v1i2.8177 Cardiovasc. j. 2009; 1(2) : 229-230

Introduction:Over the past three decade myocardial perfusion single photon emission computed tomography (SPECT) has emerged as a robust tool for non invasive assessment of both myocardial perfusion and function. Since its inception in the 1970s, many advance have been made that have enhanced the diagnostic and prognostic strength of this modality, including the development of new Technetium 99m ( 99 mTc)-based on isotopes, implementation of SPECT, Multidetector cameras, computerized quantification, attenuation correction, and ECG gating for assessment of LV function. These advances allow for very high diagnostic sensitivity and specificity. In addition there is wealth of data supporting the strength of this technique as a prognostic tool, not only in general population, but also in many important patient subgroups, such as women, patient with diabetes mellitus, in post revascularization patients, and as a preoperative assessment prior to noncardiac surgery.In Bangladesh MPI is a newly introduced modem noninvasive test. In this study a total of 100 patients of both sex were evaluated by Myocardial Perfusion Imaging (MPI) in NICVD, Dhaka, Bangladesh. Full hemodynamic data, echo, ETT and in some cases CAG result were available. Even some patient has referred for MPI to see the post CABG or post PTCA status, so that prior diagnosis of coronary artery disease was established in those cases.Technetium tetrofosmin were used as a perfusion reagent. Gated SPECT procedure was done under dual head gamma camera in same day protocol. Treadmill stress instead of pharmacological stress was used in conjunction with MPI. The scanning has done in 64 slices both for stress and rest. Processing and reconstruction of image has done both in rest and stress slices of heart in SA, VLA and HLA views. Interpretation of the result has done by visual comparison of sequential images of Stress with rest in numerical parallel of SA, VLA and HLA. Diagnostic and Therapeutic Value of Cardiac Scan: First Experience of Utility and Prosfect of MPI in Bangladesh

Background: Cardiopulmonary bypass has been implicated in causing poor pulmonary gas exchange postoperatively in patients undergoing coronary artery bypass graft (CABG). This nonrandomized prospective study was conducted to determine whether patients undergoing off-pump CABG and thereby avoiding cardiopulmonary bypass will have improved pulmonary functions postoperatively.Method: Sixty patients undergoing elective CABG in the National Institute of Cardiovascular Diseases (NICVD), Dhaka between July 2005 and June 2006 were consecutively selected in the study. Sample was divided into two groups: Group A- off-pump CABG and Group-B on-pump CABG. The test statistics used to analyze the data were descriptive statistics as Chi-square (×2) and Student's t-test.Results: Preoperative arterial blood gas (ABG) analysis showed no significant difference. ABG immediately at ICU on FiO2 1 revealed significantly better gas exchange in off-pump group (PaO2: 296.5±32.4 torr vs 234.8±10.7 torr, p<0.001; D(A-a)O2: 378.5±27.3 torr vs 439.2±10.3 torr, p<0.001; PaCO2: 38.5±3.8 torr vs 40.1±1.8 torr, p=0.045). ABG on 3rd postoperative day revealed no significant difference between the two groups. Ventilation time in off-pump group was significantly less than in on-pump group (10.5±2.8 hours vs 14.8±3.7 hours, p<0.001). For ICU stay, there was no significant difference. Postoperative spirometry at 3 month and pulmonary complications within 3 months were not different between groups.Conclusion: off-pump CABG group yielded better gas exchange and earlier extubation than on-pump CABG group.KYAMC Journal Vol. 4, No.-1, July 2013, Page 341-347