Ibrahim Abd Elbaser | Mansoura University (original) (raw)
Papers by Ibrahim Abd Elbaser
Anaesthesia & Surgery Open Access Journal
Viral infection, sepsis and multiple organ dysfunction are the most common causes of death in cri... more Viral infection, sepsis and multiple organ dysfunction are the most common causes of death in critically ill patients. Early diagnosis and early management are the key factor in improving outcome in sepsis due to viral infection, so, there is need to develop more rapid, sensitive, and specific diagnostic strategies that allow early intervention to improve patient outcome. Heart rate variability (HRV) has been documented to be both altered in the presence of systemic infection, and correlated with its severity. This aim of this article is to review the HRV analysis and its value in detection early diagnosis of viral infection including COVID-19 patients. The prognostic value of clinical bedside application of HRV in the management and treatment viral infection and sepsis are highlighted in this review. The overall HRV decreased with lower low frequency component has been shown to be consistently correlated with the presence and severity of viral infection. HRV monitoring may enhance the early diagnosis, prognosis and early initiation of treatment of viral infectionCOVID-19. Bedside wearable devices that are based on photoplethysmography such as watch-like devices and mobile phone apps may be used as a useful non-invasive tool for early diagnosis of COVID-19 by analyzing the HRV.
Anaesthesia and Surgery Open Access Journal, 2020
Viral infection, sepsis and multiple organ dysfunction are the most common causes of death in cri... more Viral infection, sepsis and multiple organ dysfunction are the most common causes of death in critically ill patients. Early diagnosis and early management are the key factor in improving outcome in sepsis due to viral infection, so, there is need to develop more rapid, sensitive, and specific diagnostic strategies that allow early intervention to improve patient outcome. Heart rate variability (HRV) has been documented to be both altered in the presence of systemic infection, and correlated with its severity. This aim of this article is to review the HRV analysis and its value in detection early diagnosis of viral infection including COVID-19 patients. The prognostic value of clinical bedside application of HRV in the management and treatment viral infection and sepsis are highlighted in this review. The overall HRV decreased with lower low frequency component has been shown to be consistently correlated with the presence and severity of viral infection. HRV monitoring may enhance ...
Anaesthesia & Surgery Open Access Journal, 2020
Sternum is the main source of pain after cardiac surgery. The use of high doses of opioid are ass... more Sternum is the main source of pain after cardiac surgery. The use of high doses of opioid are associated with prolonged mechanical ventilation.
Regional anesthetic techniques facilitate early recovery. Transversus thoracis plane (TTP) block is a newly developed analgesic technique that can
provide adequate analgesia for surgeries associated with sternotomy. In pediatric cardiac surgery, the dose of local anesthetics for TTP block is
not described in any of literature. In our hospital (Mansoura University Children Hospital), we perform bilateral TTP block for most of children
submitted for cardiac surgery via median sternotomy in a dose of 0.2-0.3mL/kg 0.2 to 0.25 % bupivacaine on each side of sternum. We found that,
the above dose provides effective perioperative analgesia without any signs of local anesthetic toxicity. The aim of this work is to highlight the
analgesic efficacy of TTP block and the dose of local anesthetic in children undergoing open heart surgery via median sternotomy.
Keywords: Transversus thoracis; Pediatric cardiac; Sternotomy; Block; Surgery
Turk J Anaesthesiol Reanim , 2019
Abstract Objective: The aim of the present study was to evaluate the efficy of inhaled milrinone ... more Abstract
Objective: The aim of the present study was to evaluate the efficy of inhaled milrinone in controlling pulmonary arterial hypertension (PAH)
in paediatric cardiac surgery and its effct on weaning from cardiopulmonary bypass (CPB).
Methods: A total of 40 patients with congenital heart diseases complicated by PAH submitted to cardiac surgery requiring CPB were included
in the present study and were randomly classifid into the control group (n=20) who received intravenous milrinone 0.5 μg kg-1 min-1 and the
inhaled group (n=20) who received inhaled milrinone 50 μg kg-1 before initiation and just before weaning of CPB. Mean pulmonary artery
pressure (mPAP), mean systemic arterial pressure (MAP), heart rate (HR), MAP/mPAP ratio, vasoactive drug requirements and time needed to
wean the patients from CPB were collected.
Results: mPAP and HR were signifiantly lower, and MAP and MAP/mPAP ratio were signifiantly higher in the inhaled group than in the
control group. Vasoactive drug requirements were signifiantly lesser, and the time needed to wean the patients was signifiantly shorter in the
inhaled group than in the control group.
Conclusion: Milrinone inhalation facilitated the weaning from CPB as it signifiantly reduced mPAP and maintained MAP with subsequently
less needs for vasoactive drugs.
Keywords: Cardiopulmonary bypass, congenial heart diseases, milrinone inhalation, pulmonary hypertension, vasoactive drugs
Turk J Anaesthesiol Reanim, 2019
Abstract Objective: The aim of the present study was to evaluate the efficy of extrathoracic jugu... more Abstract
Objective: The aim of the present study was to evaluate the efficy of extrathoracic jugulo-femoral venous shunt (JFVS) in avoiding the need
for cardiopulmonary bypass (CPB) during the bi-directional Glenn shunt (BDGS) procedure.
Methods: A total of 40 patients aged between 9 and 36 months were enrolled in the present study. The patients were classifid into two groups,
group A (n=20) in which the patients had no veno-venous shunt and group B (n=20) in which the patients had extrathoracic JFVS. Patients
requiring CPB, arterial oxygen saturation (SaO2), heart rate, mean arterial pressure (MAP) and central venous pressure (CVP) were recorded
during surgery. Postoperative time of intubation, intensive care unit (ICU) and hospital length of stays and neurological complications were also
recorded.
Results: The number of patients who needed urgent CPB was greater in group A than in group B. Intraoperative MAP was signifiantly lower
in group A than in group B 10 min after clamping of the superior vena cava (SVC) and 30 min after declamping of the SVC. The CVP was
signifiantly lower, and arterial SaO2 was signifiantly higher in group B than in group A 10 min after clamping of the SVC. The duration of
postoperative intubation was signifiantly shorter in group B than in group A, and the ICU length of stay was shorter in group B than in group
A. The hospital length of stay was similar in both groups. Postoperative neurological defiits were comparable in both groups.
Conclusion: The use of extrathoracic JFVS during the BDGS procedure avoided the use of CPB, maintained MAP and prevented any significant increase in SVC pressure.
Keywords: Cardiopulmonary bypass, cyanotic congenial heart diseases, jugulo-femoral venous shunt, superior vena cava
The aim of the present study was to evaluate the efficacy of extrathoracic jugulo-femoral venous ... more The aim of the present study was to evaluate the efficacy of extrathoracic jugulo-femoral venous shunt (JFVS) in avoiding the need for cardiopulmonary bypass (CPB) during the bi-directional Glenn shunt (BDGS) procedure.
A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were rando... more A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were randomized into two groups. The control group (n = 35) received 0.4 ml/kg normal saline with fentanyl 2 μg/ml, whereas for the bupivacaine group (n = 35) 0.4 ml/kg bupivacaine 0.25% with fentanyl 2 μg/ml was injected down each side of the paravertebral space. Heart rate, mean arterial blood pressure, perioperative opioid requirements, operating room extubation, time to extubation, postextubation PaO 2 , PaCO 2 , postoperative objective pain discomfort score, ICU length of stay, and postoperative complications were recorded.
A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were rando... more A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were randomized into two groups. The control group (n = 35) received 0.4 ml/kg normal saline with fentanyl 2 μg/ml, whereas for the bupivacaine group (n = 35) 0.4 ml/kg bupivacaine 0.25% with fentanyl 2 μg/ml was injected down each side of the paravertebral space. Heart rate, mean arterial blood pressure, perioperative opioid requirements, operating room extubation, time to extubation, postextubation PaO 2 , PaCO 2 , postoperative objective pain discomfort score, ICU length of stay, and postoperative complications were recorded.
A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were rando... more A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were randomized into two groups. The control group (n = 35) received 0.4 ml/kg normal saline with fentanyl 2 μg/ml, whereas for the bupivacaine group (n = 35) 0.4 ml/kg bupivacaine 0.25% with fentanyl 2 μg/ml was injected down each side of the paravertebral space. Heart rate, mean arterial blood pressure, perioperative opioid requirements, operating room extubation, time to extubation, postextubation PaO 2 , PaCO 2 , postoperative objective pain discomfort score, ICU length of stay, and postoperative complications were recorded.
The aim of the present study was to evaluate the efficacy of extrathoracic jugulo-femoral venous ... more The aim of the present study was to evaluate the efficacy of extrathoracic jugulo-femoral venous shunt (JFVS) in avoiding the need for cardiopulmonary bypass (CPB) during the bi-directional Glenn shunt (BDGS) procedure.
The aim of the present study was to evaluate the efficacy of inhaled milrinone in controlling pul... more The aim of the present study was to evaluate the efficacy of inhaled milrinone in controlling pulmonary arterial hypertension (PAH) in paediatric cardiac surgery and its effect on weaning from cardiopulmonary bypass (CPB).
The aim of our study was to evaluate the analgesic efficacy of the combination of pectoral nerve ... more The aim of our study was to evaluate the analgesic efficacy of the combination of pectoral nerve (Pecs II) block and transversus thoracic muscle plane (TTP) block in modified radical mastectomy.
Background: The aim of our study was to evaluate the analgesic efficacy of the combination of pec... more Background: The aim of our study was to evaluate the analgesic efficacy of the combination of pectoral nerve (Pecs II) block and transversus thoracic muscle plane (TTP) block in modified radical mastectomy.
Heart rate, mean arterial pressure, and FLACC score were significantly lower in the dexmedetomidi... more Heart rate, mean arterial pressure, and FLACC score were significantly lower in the dexmedetomidine group compared with the control group after 4 and 8 h in ICU. Duration of intubation and ICU stay were signifi cantly shorter in the dexmedetomidine group compared with the control group. Ramsay sedation score was lower in the dexmedetomidine group compared with the control group at 4 h in ICU. Bradycardia and hypotension incidence were higher in the dexmedetomidine group compared with that in the control group.
A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were rando... more A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were randomized into two groups. The control group (n = 35) received 0.4 ml/kg normal saline with fentanyl 2 μg/ml, whereas for the bupivacaine group (n = 35) 0.4 ml/kg bupivacaine 0.25% with fentanyl 2 μg/ml was injected down each side of the paravertebral space. Heart rate, mean arterial blood pressure, perioperative opioid requirements, operating room extubation, time to extubation, postextubation PaO 2 , PaCO 2 , postoperative objective pain discomfort score, ICU length of stay, and postoperative complications were recorded.
Anaesthesia & Surgery Open Access Journal
Viral infection, sepsis and multiple organ dysfunction are the most common causes of death in cri... more Viral infection, sepsis and multiple organ dysfunction are the most common causes of death in critically ill patients. Early diagnosis and early management are the key factor in improving outcome in sepsis due to viral infection, so, there is need to develop more rapid, sensitive, and specific diagnostic strategies that allow early intervention to improve patient outcome. Heart rate variability (HRV) has been documented to be both altered in the presence of systemic infection, and correlated with its severity. This aim of this article is to review the HRV analysis and its value in detection early diagnosis of viral infection including COVID-19 patients. The prognostic value of clinical bedside application of HRV in the management and treatment viral infection and sepsis are highlighted in this review. The overall HRV decreased with lower low frequency component has been shown to be consistently correlated with the presence and severity of viral infection. HRV monitoring may enhance the early diagnosis, prognosis and early initiation of treatment of viral infectionCOVID-19. Bedside wearable devices that are based on photoplethysmography such as watch-like devices and mobile phone apps may be used as a useful non-invasive tool for early diagnosis of COVID-19 by analyzing the HRV.
Anaesthesia and Surgery Open Access Journal, 2020
Viral infection, sepsis and multiple organ dysfunction are the most common causes of death in cri... more Viral infection, sepsis and multiple organ dysfunction are the most common causes of death in critically ill patients. Early diagnosis and early management are the key factor in improving outcome in sepsis due to viral infection, so, there is need to develop more rapid, sensitive, and specific diagnostic strategies that allow early intervention to improve patient outcome. Heart rate variability (HRV) has been documented to be both altered in the presence of systemic infection, and correlated with its severity. This aim of this article is to review the HRV analysis and its value in detection early diagnosis of viral infection including COVID-19 patients. The prognostic value of clinical bedside application of HRV in the management and treatment viral infection and sepsis are highlighted in this review. The overall HRV decreased with lower low frequency component has been shown to be consistently correlated with the presence and severity of viral infection. HRV monitoring may enhance ...
Anaesthesia & Surgery Open Access Journal, 2020
Sternum is the main source of pain after cardiac surgery. The use of high doses of opioid are ass... more Sternum is the main source of pain after cardiac surgery. The use of high doses of opioid are associated with prolonged mechanical ventilation.
Regional anesthetic techniques facilitate early recovery. Transversus thoracis plane (TTP) block is a newly developed analgesic technique that can
provide adequate analgesia for surgeries associated with sternotomy. In pediatric cardiac surgery, the dose of local anesthetics for TTP block is
not described in any of literature. In our hospital (Mansoura University Children Hospital), we perform bilateral TTP block for most of children
submitted for cardiac surgery via median sternotomy in a dose of 0.2-0.3mL/kg 0.2 to 0.25 % bupivacaine on each side of sternum. We found that,
the above dose provides effective perioperative analgesia without any signs of local anesthetic toxicity. The aim of this work is to highlight the
analgesic efficacy of TTP block and the dose of local anesthetic in children undergoing open heart surgery via median sternotomy.
Keywords: Transversus thoracis; Pediatric cardiac; Sternotomy; Block; Surgery
Turk J Anaesthesiol Reanim , 2019
Abstract Objective: The aim of the present study was to evaluate the efficy of inhaled milrinone ... more Abstract
Objective: The aim of the present study was to evaluate the efficy of inhaled milrinone in controlling pulmonary arterial hypertension (PAH)
in paediatric cardiac surgery and its effct on weaning from cardiopulmonary bypass (CPB).
Methods: A total of 40 patients with congenital heart diseases complicated by PAH submitted to cardiac surgery requiring CPB were included
in the present study and were randomly classifid into the control group (n=20) who received intravenous milrinone 0.5 μg kg-1 min-1 and the
inhaled group (n=20) who received inhaled milrinone 50 μg kg-1 before initiation and just before weaning of CPB. Mean pulmonary artery
pressure (mPAP), mean systemic arterial pressure (MAP), heart rate (HR), MAP/mPAP ratio, vasoactive drug requirements and time needed to
wean the patients from CPB were collected.
Results: mPAP and HR were signifiantly lower, and MAP and MAP/mPAP ratio were signifiantly higher in the inhaled group than in the
control group. Vasoactive drug requirements were signifiantly lesser, and the time needed to wean the patients was signifiantly shorter in the
inhaled group than in the control group.
Conclusion: Milrinone inhalation facilitated the weaning from CPB as it signifiantly reduced mPAP and maintained MAP with subsequently
less needs for vasoactive drugs.
Keywords: Cardiopulmonary bypass, congenial heart diseases, milrinone inhalation, pulmonary hypertension, vasoactive drugs
Turk J Anaesthesiol Reanim, 2019
Abstract Objective: The aim of the present study was to evaluate the efficy of extrathoracic jugu... more Abstract
Objective: The aim of the present study was to evaluate the efficy of extrathoracic jugulo-femoral venous shunt (JFVS) in avoiding the need
for cardiopulmonary bypass (CPB) during the bi-directional Glenn shunt (BDGS) procedure.
Methods: A total of 40 patients aged between 9 and 36 months were enrolled in the present study. The patients were classifid into two groups,
group A (n=20) in which the patients had no veno-venous shunt and group B (n=20) in which the patients had extrathoracic JFVS. Patients
requiring CPB, arterial oxygen saturation (SaO2), heart rate, mean arterial pressure (MAP) and central venous pressure (CVP) were recorded
during surgery. Postoperative time of intubation, intensive care unit (ICU) and hospital length of stays and neurological complications were also
recorded.
Results: The number of patients who needed urgent CPB was greater in group A than in group B. Intraoperative MAP was signifiantly lower
in group A than in group B 10 min after clamping of the superior vena cava (SVC) and 30 min after declamping of the SVC. The CVP was
signifiantly lower, and arterial SaO2 was signifiantly higher in group B than in group A 10 min after clamping of the SVC. The duration of
postoperative intubation was signifiantly shorter in group B than in group A, and the ICU length of stay was shorter in group B than in group
A. The hospital length of stay was similar in both groups. Postoperative neurological defiits were comparable in both groups.
Conclusion: The use of extrathoracic JFVS during the BDGS procedure avoided the use of CPB, maintained MAP and prevented any significant increase in SVC pressure.
Keywords: Cardiopulmonary bypass, cyanotic congenial heart diseases, jugulo-femoral venous shunt, superior vena cava
The aim of the present study was to evaluate the efficacy of extrathoracic jugulo-femoral venous ... more The aim of the present study was to evaluate the efficacy of extrathoracic jugulo-femoral venous shunt (JFVS) in avoiding the need for cardiopulmonary bypass (CPB) during the bi-directional Glenn shunt (BDGS) procedure.
A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were rando... more A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were randomized into two groups. The control group (n = 35) received 0.4 ml/kg normal saline with fentanyl 2 μg/ml, whereas for the bupivacaine group (n = 35) 0.4 ml/kg bupivacaine 0.25% with fentanyl 2 μg/ml was injected down each side of the paravertebral space. Heart rate, mean arterial blood pressure, perioperative opioid requirements, operating room extubation, time to extubation, postextubation PaO 2 , PaCO 2 , postoperative objective pain discomfort score, ICU length of stay, and postoperative complications were recorded.
A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were rando... more A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were randomized into two groups. The control group (n = 35) received 0.4 ml/kg normal saline with fentanyl 2 μg/ml, whereas for the bupivacaine group (n = 35) 0.4 ml/kg bupivacaine 0.25% with fentanyl 2 μg/ml was injected down each side of the paravertebral space. Heart rate, mean arterial blood pressure, perioperative opioid requirements, operating room extubation, time to extubation, postextubation PaO 2 , PaCO 2 , postoperative objective pain discomfort score, ICU length of stay, and postoperative complications were recorded.
A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were rando... more A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were randomized into two groups. The control group (n = 35) received 0.4 ml/kg normal saline with fentanyl 2 μg/ml, whereas for the bupivacaine group (n = 35) 0.4 ml/kg bupivacaine 0.25% with fentanyl 2 μg/ml was injected down each side of the paravertebral space. Heart rate, mean arterial blood pressure, perioperative opioid requirements, operating room extubation, time to extubation, postextubation PaO 2 , PaCO 2 , postoperative objective pain discomfort score, ICU length of stay, and postoperative complications were recorded.
The aim of the present study was to evaluate the efficacy of extrathoracic jugulo-femoral venous ... more The aim of the present study was to evaluate the efficacy of extrathoracic jugulo-femoral venous shunt (JFVS) in avoiding the need for cardiopulmonary bypass (CPB) during the bi-directional Glenn shunt (BDGS) procedure.
The aim of the present study was to evaluate the efficacy of inhaled milrinone in controlling pul... more The aim of the present study was to evaluate the efficacy of inhaled milrinone in controlling pulmonary arterial hypertension (PAH) in paediatric cardiac surgery and its effect on weaning from cardiopulmonary bypass (CPB).
The aim of our study was to evaluate the analgesic efficacy of the combination of pectoral nerve ... more The aim of our study was to evaluate the analgesic efficacy of the combination of pectoral nerve (Pecs II) block and transversus thoracic muscle plane (TTP) block in modified radical mastectomy.
Background: The aim of our study was to evaluate the analgesic efficacy of the combination of pec... more Background: The aim of our study was to evaluate the analgesic efficacy of the combination of pectoral nerve (Pecs II) block and transversus thoracic muscle plane (TTP) block in modified radical mastectomy.
Heart rate, mean arterial pressure, and FLACC score were significantly lower in the dexmedetomidi... more Heart rate, mean arterial pressure, and FLACC score were significantly lower in the dexmedetomidine group compared with the control group after 4 and 8 h in ICU. Duration of intubation and ICU stay were signifi cantly shorter in the dexmedetomidine group compared with the control group. Ramsay sedation score was lower in the dexmedetomidine group compared with the control group at 4 h in ICU. Bradycardia and hypotension incidence were higher in the dexmedetomidine group compared with that in the control group.
A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were rando... more A total of 70 pediatric patients submitted for open heart surgery by median sternotomy were randomized into two groups. The control group (n = 35) received 0.4 ml/kg normal saline with fentanyl 2 μg/ml, whereas for the bupivacaine group (n = 35) 0.4 ml/kg bupivacaine 0.25% with fentanyl 2 μg/ml was injected down each side of the paravertebral space. Heart rate, mean arterial blood pressure, perioperative opioid requirements, operating room extubation, time to extubation, postextubation PaO 2 , PaCO 2 , postoperative objective pain discomfort score, ICU length of stay, and postoperative complications were recorded.