Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4

Search results for: Abd El-Aziz Said

4 Role of Adaptive Support Ventilation in Weaning of COPD Patients

Authors: A. Kamel Abd Elaziz Mohamed, B. Sameh Kamal el Maraghi

Abstract:

Introduction: Adaptive support ventilation (ASV) is an improved closed-loop ventilation mode that provides both pressure-controlled ventilation and PSV according to the patient’s needs. Aim of the work: To compare the short-term effects of Adaptive support ventilation (ASV), with conventional Pressure support ventilation (PSV) in weaning of intubated COPD patients. Patients and methods: Fifty patients admitted in the intensive care with acute exacerbation of COPD and needing intubation were included in the study. All patients were initially ventilated with control/assist control mode, in a stepwise manner and were receiving standard medical therapy. Patients were randomized into two groups to receive either ASV or PSV. Results: Out of fifty patients included in the study forty one patients in both studied groups were weaned successfully according to their ABG data and weaning indices. APACHE II score showed no significant difference in both groups. There were statistically significant differences between the groups in term of, duration of mechanical ventilation, weaning hours and length of ICU stay being shorter in (group 1) weaned by ASV. Re-intubation and mortality rate were higher in (group 11) weaned by conventional PSV, however the differences were not significant. Conclusion: ASV can provide automated weaning and achieve shorter weaning time for COPD patients hence leading to reduction in the total duration of MV, length of stay, and hospital costs.

Keywords: COPD patients, ASV, PSV, mechanical ventilation (MV)

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3 Early versus Late Percutaneous Tracheostomy in Critically Ill Adult Mechanically Ventilated Patients

Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

Abstract:

Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

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2 Pattern of ICU Admission due to Drug Problems

Authors: Kamel Abd Elaziz Mohamed

Abstract:

Introduction: Drug related problems (DRPs) are of major concern, affecting patients of both sex. They impose considerable economic burden on the society and the health-care systems. Aim of the work: The aim of this work was to identify and categorize drug-related problems in adult intensive care unit. Patients and methods: The study was a prospective, observational study as eighty six patients were included. They were consecutively admitted to ICU through the emergency room or transferred from the general ward due to DRPs. Parameters included in the study as length of stay in ICU, need for cardiovascular support or mechanical ventilation, dialysis, as well as APACHE II score were recorded. Results: Drug related problems represent 3.6% of the total ICU admission. The median (range) of APACHE II score for 86 patients included in the study was 17 (10-23), and length of ICU stay was 2.4 (1.5-4.2) days. In 45 patients (52%), DRP was drug over dose (group 1), while other DRP was present in the other 41 patients (48%, group 11). Patients in group 1 were older (39 years versus 32 years in group 11), with significant impaired renal function. The need of inotropic drugs and mechanical ventilation as well as the length of stay (LOS) in ICU was significantly higher in group 1. There were no significant difference in GCS between both groups, however APACHE II score was significantly higher in group 1. Only four patients (4.6%) were admitted by suicidal attempt as well as three patients (3.4%) due to trauma drug-related admissions, all were in (group 1). Nineteen percent of the patients had drug related problem due to hypoglycaemic medication followed by tranquilizer (15%). Adverse drug effect followed by failure to receive medication were the most causes of drug problem in (group11).The total mortality rate was 4.6%, all of them were eventually non preventable. Conclusion: The critically ill patients admitted due to drug related problems represented a small proportion (3.6%) of admissions to the ICU. Hypoglycaemic medication was one of the most common causes of admission by drug related problems.

Keywords: drug related problems, ICU, cost, safety

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1 Wadi Halfa Oolitic Ironstone Formation, Wadi Halfa and Argein Areas, North Sudan

Authors: Mutwakil Nafi, Abed Elaziz El Amein, Muna El Dawi, Khalafala Salih, Osma Elbahi, Abed Elhalim Abou

Abstract:

Recently a large deposit of oolitic iron ore of Late Carboniferous-Permotriassic-Lower Jurassic age was discovered in Wadi Halfa and Argein areas, North Sudan. It seems that the iron ore mineralization exists in the west and east bank of the River Nile of the study area that are found on the Egyptian-Sudanese border. The Carboniferous-Lower Jurassic age strata were covered by 67 sections and each section has been examined and carefully described. The iron-ore in Wadi Halfa occurs as oolitic ironstone and contained two horizons: (A) horizon and (B) horizon. Only horizon (A) was observed in southern Argein area. The texture of the ore is variable depending on the volume of the component. In thin sections the average of the ooids were ranged between 90% - 80%. The matrix varies between 10%-20% by volume and detritus quartz in other component my reach up to 30% by volume in sandy massive ore. Ooids size ranges from 0.2mm-1.00 mm on average in very coarse ooids may attend up to 1 mm in size. The matrix around the ooids is dominated by iron hydroxide, carbonate, fine and amorphous silica. The probable ore reserve estimate of 1.234 billion at a head grade of 41.29% Fe for the Wadi Halfa Oolitic Ironstone Formation. The iron ore shows higher content of phosphorus ranges from 6.15% to 0.16%, with mean 1.45%. The new technology Hatch–Ironstone Chloride Segregation (HICS) can be used to produce commercial-quality of iron and reduce phosphorus and silica to acceptable levels for steel industry. The development of infra structures and presence huge quantity of iron ore would make exploitation of the iron ore economic.

Keywords: HICS, Late Carboniferous age, oolitic iron ore, phosphorus

Procedia PDF Downloads 524