Dexmedetomedine versus standard sedatives in weaning from mechanical ventilation

Background: Sedation in the intensive care unit Patients is assumed to reduce discomfort from care interventions, increase tolerance of mechanical ventilation, prevent accidental removal of instrumentation, and reduce metabolic demands during cardiovascular and respiratory instability

Aim of the Work: The aim of the work was to evaluate the use of dexmedetomedine as a sedative to facilitate weaning from mechanical ventilation and extubation, so decrease the incidence of reintubation, ventilator complications and decrease the ICU cost and stay

Patients and Methods: This was a controlled randomized prospective clinical trial carried out at Ain-Shams University Hospitals. After approval of institutional ethical committee, the study included 90 adult postoperative patients and requiring postoperative mechanical ventilation in the surgical ICU for maximum duration of 48 hours postoperatively

Results: As regard to time to extubation, results of the current study showed a highly statistically significant difference between three groups regarding time to extubation [hr] when p-value was < 0.001

Conclusion: dexmedetomidine has clinically relevant benefits compared to midazolam and propofol in facilitating extubation because of its shorter time to extubation, more hemodynamic stability, easy arousability and lack of respiratory depression; hence, it can be used as an effective, and safe sedative agent to facilitate extubation in ICUs and decreasing ICU length of stay

Assessment of some MCH activities in Maghagha District, El Minia during the year 1997

The aim of this work was to assess some MCH activities using antenatal care, maternal health status and outcome of pregnancy as indicators and to discover the shortcomings in performances, process and outcome in some MCH services and suggest a plan for improvement to be applied on the light of this evaluation study. This study examined the data collected from 12 randomly selected out of 23 rural units and the two urban maternal and child health centers in Maghagha District, El-Minia Governorate from July 1997 to December 1997. Monthly reports of different MCH activities during this period were collected, revised, summarized and computarized for processing and analysis. A total of 416 and 1589 pregnant women were registered in urban and rural units, respectively, during the six-month study period