Recent predictive parameters for successful weaning from mechanical ventilation in critically Ill patients

Background: Removal of patients from mechanical ventilation (MV) has been termed liberation, discontinuation, withdrawal and most commonly weaning. Weaning covers the entire process of liberating the patient from mechanical support and from the endotracheal tube. Although weaning from MV is successful in most cases, the first attempt fails in 20% of patients. In addition, weaning accounts for over 40% of the total MV time, the proportion varying in function of the etiology of respiratory failure. Objective: The aim of this study was to evaluate the recent protocols of successful weaning from mechanical ventilation of critically ill patients, depending on central venous oxygen saturation, ultrasonographic assessment of diaphragmatic movement, and serial arterial blood gases to assess failure rate 48 hours after weaning. Patients and methods: This prospective randomized study included a total of 90 mechanically ventilated Egyptian patients of both sexes, ASA (I-II) attending at least for 48 hours at intensive care unit, AlAzhar University Hospitals. The included subjects were divided into three groups depending on method of monitoring; group A: serial arterial blood gases, group B: Central venous oxygen saturation and group C: Ultrasonographic assessment of diaphragmatic movement pre and post spontaneous breathing trial. All patients were subjected to daily monitoring of the following weaning parameters: static and dynamic compliances and inspiratory resistance, intrinsic positive end expiratory pressure (Auto PEEP) and Maximum inspiratory pressure (MIP). Results: There is highly statistically significant difference between patients as regard weaning outcome. As the group depended on normal ultrasonographic assessment of diaphragmatic movement, had the largest number of patients with successful weaning. Conclusion: Normal ultrasonographic assessment of diaphragmatic movement proved to be the most important criteria for successful weaning from mechanical ventilation

TSH, T3 and T4 serum levels in albino rats after intraperitoneal administration of khat extract for 5 days

The present study was conducted on normal adult albino rats of both sexes. Their body weight ranged between 200 and 250 gm the experimental animals received 0.2 ml Khat extract by intraperitoneal injection for 5 successive days. In the control male group the mean. Thyroid stimulating hormone [TSH] serum level was 0.766 +/- 0.273 micro IU/ml and was significantly increased to 1.66 +/- 0.81 micro IU/ml in the experimental group. In the control non-pregnant and pregnant female groups the mean TSH serum levels were 0.85 +/- 0.39 micro IU/ml and 1.11 +/- 0.41 micro IU/ml respectively and were significantly increased to 1.98 +/- 0.53 micro IU/ML and to 2.73 +/- 0.37 micro IU/ml in the corresponding experimental groups. In the control male group the mean Triiodothyronine [T3] serum levels was 46.17 +/- 4.81 ng/dl and was significantly increased to 61.17 +/- 649 ng/dl in the experimental group. In the control non-pregnant and pregnant female groups the mean T3 serum levels were 43.67 +/- 3.73 ng/dl and 53.83 +/- 3.53 ng/dl respectively and were significantly increased to 62.67 +/- 7.34 ng/dl and to 70.67 +/- 7.97 ng/dl in the corresponding experimental groups. In the control male group the mean. Thyroxine [T4] serum level was 3.32 +/- 0.38 micro gm/dl and was significantly increased to 4.22 +/- 0.49 micro mg/dl in the experimental group. In the control non-pregnant and pregnant female group the mean T4 serum level were 3.17 +/- 0.43 micro gm/dl and to 4.93 +/- 0.27 micro m/dl in the corresponding experimental groups

Effects of intraperitoneal administration of khat extract in albino rats on uterine, vas deferens and phrenic diaphragm

The present study was conducted on normal adult albino rats of both sexes. Their body weight ranged between 200 and 250 gm and the experimental animals received 0.2 ml khat extract by intraperitoneal injection for 5 successive days. The mean height of uterine contractions in the pregnant and non-pregnant control groups were 3.48 +/- 1.244 cm and 1 +/- 0.28 cm respectively and were significantly reduced in the experimental pregnant and non-pregnant groups to 2.2 +/- 0.5 m and 0.33 +/- 0.15 cm respectively. The mean height of vas deferens contractions in the control group was 4.3 +/- 0.836 cm and was significantly reduced in the experimental group to 1.5 +/- 0.547 cm. In the control male group, the mean height of phrenic diaphragm contractions produced by direct and indirect stimulation were 5.8 +/- 0.5 cm and 3.7 +/- 0.8 cm respectively and were reduced significantly in the experimental group to 3.5 +/- 1.2 cm and to 1.4 +/- 0.4 cm. In the control female non-pregnant group the phrenic diaphragm contractions produced by direct and indirect stimulation were 4.8 +/- 0.8 cm and 2.9 +/- 0.5 cm respectively, and were reduced significantly in the experimental group to 3 +/- 1.2 cm and to 1.2 +/- 0.2 cm. In the control pregnant group, the phrenic diaphragm contractions produced by direct and indirect stimulation were 4 +/- 0.6 cm and 2.4 +/- 0.4 cm respectively and were significantly reduced in the experimental group to 1.2 +/- 0.2 cm and to 0.8 +/- 0.3 cm. The results were discussed