Ain-Shams Journal of Anaesthesiology最新文献

{"title":"Perioperative medicine: a new concept for anesthetic care","authors":"K. Moris, A. Hilal","doi":"10.4103/1687-7934.238445","DOIUrl":"https://doi.org/10.4103/1687-7934.238445","url":null,"abstract":"Perioperative medicine is the future of our specialty, and it is defined as patient-centered multidisciplinary superior medical care from the time of taking the decision of surgery till the patient’s full recovery and discharge. Formerly most of the anesthetic practice focused on the index of the operation and the disease being treated by this procedure; however the appearance of postoperative related outcomes modulated by the type and quality of surgery had encouraged the development of that new concept.","PeriodicalId":7492,"journal":{"name":"Ain-Shams Journal of Anaesthesiology","volume":"1 1","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89265901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and outcome of GlideScope videolaryngoscope versus C-MAC videolaryngoscope in the management of obese patients with potentially difficult intubation","authors":"Abd-Elfattah Daboun, E. Ismail, Hassanain Hamzawy, A. Emara","doi":"10.4103/1687-7934.238446","DOIUrl":"https://doi.org/10.4103/1687-7934.238446","url":null,"abstract":"Background Difficult and failed tracheal intubation remains a leading cause of morbidity and mortality related to anesthesia practice. Videolaryngoscopes were introduced into practice to increase the success rate of intubation in obese patients with difficult airway. Aim The aim of this study was to compare GlideScope and C-MAC videolaryngoscopes in obese patients with anticipated difficult intubation as regards feasibility and outcome. Patients and methods The study was designed as a prospective comparative single-blind study, which was conducted at King Abdullah Hospital, Bisha, KSA, during the period from January 2013 to January 2015. It included 60 obese patients with anticipated difficult intubation. They were randomly divided into two equal groups: the GlideScope group and the C-MAC group. All patients were assessed for demographic characteristics, intubation parameters, and outcome. Results There were no significant differences between the two groups as regards general characteristics and hemodynamics. However, there was a significantly better glottic view in the GlideScope group compared with the C-MAC group. There was a significantly shorter total intubation time and first attempt intubation time in the GlideScope group compared with the C-MAC group (32.43±2.40 and 28.70±2.15 s vs. 40.40±5.07 and 34.80±2.92 s, respectively). The incidence of failure of the first intubation attempt was significantly higher in the C-MAC group compared with the GlideScope group (33.3 vs. 10.0%, respectively). Overall satisfaction was significantly better in the GlideScope group compared with the C-MAC group. Conclusion GlideScope had better glottic view, shorter total intubation and first attempt intubation times, and higher success rate of first intubation attempt compared with C-MAC. These results advocate the use of GlideScope in obese patients with potentially difficult intubation.","PeriodicalId":7492,"journal":{"name":"Ain-Shams Journal of Anaesthesiology","volume":"15 1","pages":"164 - 172"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88541307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the value of hypertonic saline as adjuvant treatment of severe ovarian hyperstimulation syndrome","authors":"A. Sobhy, H. Zaki, Doaa Kamal Eldin, W. Mohammed","doi":"10.4103/asja.asja_3_17","DOIUrl":"https://doi.org/10.4103/asja.asja_3_17","url":null,"abstract":"Background At present, ovarian hyperstimulation syndrome (OHSS) is an uncommon and potentially life-threatening complication of ovarian stimulation. The ideal colloid solution for the treatment of patients with severe OHSS is still unknown. Human albumin, however, is considered the most ‘physiologic’ solution for this purpose and commonly used. However, severe life-threatening anaphylaxis has been reported with albumin infusion. The purpose of this study was to compare the efficacy and safety of hypertonic saline 3% for the treatment of severe OHSS rather than albumin. Patients and methods Over a period of 2 years, this randomized prospective study was conducted on 60 patients diagnosed with severe or critical OHSS admitted to Obstetric ICU of Ain-Shams University Hospitals. Patients were randomly allocated into two groups, each containing 30 patients. Group A (n=30) received 100 ml of albumin 20% over 4 h every 12 h plus conventional treatment according to the Ain Shams obstetric ICU protocol. Group N (n=30) received 500 ml of hypertonic saline 3% over 24 h (20 ml/h) plus conventional treatment. The efficacy of the study medications was compared in this study between the two groups in terms of daily urine output, serum creatinitine, percentage of occurrence established renal impairment, need of paracentesis, occurrence of established acute respiratory distress syndrome, and ICU length of stay. Results Significant difference was found regarding daily urine output among the study groups, with a significantly higher value (3350±142.6) in group N compared with group A (2150±133.4) associated with significant reduction in occurrence of established renal impairment in three cases in group A rather than 1 in group N. This is reflected by significant reduction in the length of ICU stay (3.1±1.1) in group N rather than group A (3.7±1.2). Conclusion The use of hypertonic saline 3% as a small-volume resuscitation is comparable to and effective and superior to albumin for the treatment of severe OHSS with regard to urine output, and may have a protective effect against occurrence of acute respiratory distress syndrome in such patients, but further studies are needed to prove that.","PeriodicalId":7492,"journal":{"name":"Ain-Shams Journal of Anaesthesiology","volume":"8 1","pages":"41 - 45"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87216175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of adding dexamethasone to intra-articular morphine injection on postoperative pain after knee arthroscopy","authors":"Abd-Elazeem El Bakry, W. Sultan","doi":"10.4103/asja.asja_60_16","DOIUrl":"https://doi.org/10.4103/asja.asja_60_16","url":null,"abstract":"Background Postoperative analgesia after knee arthroscopy is mandatory for recovery and early rehabilitation. Medications were used intra-articularly to prolong postoperative analgesia and improve the quality of pain. The present study was scheduled to study the effects of dexamethasone addition to intra-articular morphine on postoperative pain after knee arthroscopy. Patients and methods This randomized double-blinded controlled study was carried out on 90 patients undergoing knee arthroscopy. The patients were randomly allocated into three equal groups. All medications were injected intra-articularly at the end of surgery. In the control group, the patients were administered 0.5% bupivacaine in normal saline. In M group, the patients were administered 5 mg morphine added to bupivacaine 0.5%. In MD group, the patients were administered 5 mg morphine and 8 mg dexamethasone added to bupivacaine 0.5%. Vital signs, visual analog score for pain at rest and movement, duration of analgesia, total analgesic consumption and adverse effects were recorded. Results MD Group showed lower visual analog score at rest and movement, prolonged postoperative analgesia, and decreased total analgesic consumption compared with the other groups (P<0.05). Conclusion The addition of dexamethasone to intra-articular morphine after knee arthroscopy prolongs the duration of analgesia, lowers pain scores, and decreases total analgesic consumption with minimal adverse effects.","PeriodicalId":7492,"journal":{"name":"Ain-Shams Journal of Anaesthesiology","volume":"31 1","pages":"253 - 257"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88647650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous glutamine supplementation improves gut mucosal function in burn patients: a randomized controlled trial","authors":"Yasser A Salem, Heba A. Labib, Mohammad A. Algendy","doi":"10.4103/1687-7934.238453","DOIUrl":"https://doi.org/10.4103/1687-7934.238453","url":null,"abstract":"Background Glutamine supplementation in burned adults was found to improve the overall immune functions and gut integrity, and shortens overall hospital stay after burn injury with better clinical outcome. Glutamine depletion jeopardizes the functional integrity of the gut and leads to immunosuppression. Enteral intolerance is a clinical sign of defective gut mucosal integrity and is considered as a major complication along the course of treatment of burned patients. It is associated with the development of sepsis and increased mortality. We aimed in this study to find out whether intravenous glutamine supplementation will improve tolerance to enteral feeding and eventually clinical outcome of burn patients. Patients and methods Sixty critically ill burn patients were included in this study. They were randomly allocated into two groups. Group A received intravenous glutamine, and group B received placebo. Both groups were assessed as regards inflammatory and nutritional markers. Tolerance to enteral nutrition was observed and compared between the two groups, in addition to development of bacteremia. Results Group A patients were found to be more tolerant to enteral feeding compared with group B patients, with a statistically significant drop in enteral feeding intolerance rate in group A (P=0.048). As regards nutritional markers, a drop in serum transferrin and serum prealbumin with statistical significance was noticed among group B patients compared with group A patients after day 7, whereas no difference of statistical significance was noticed in serum albumin values. Positivity of blood culture for gram-negative organisms was less frequent among patients in group A, with high statistical significance. Conclusion Early use of intravenous glutamine in severely burned patients might provide a gut mucosal protective value reflected on its function. This was evident with improvement in enteral feeding intolerance, in addition to improvement in the barrier function of the gut mucosa that limits bacterial translocation.","PeriodicalId":7492,"journal":{"name":"Ain-Shams Journal of Anaesthesiology","volume":"33 1","pages":"60 - 67"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80714284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of single versus repeated stepwise cycling recruitment maneuver during one-lung ventilation in patients with normal pulmonary function undergoing video-assisted thoracoscopic lung surgery: a randomized, controlled trial","authors":"E. A. Sherif, A. A. Rasha, Gamil Khaled","doi":"10.4103/1687-7934.238456","DOIUrl":"https://doi.org/10.4103/1687-7934.238456","url":null,"abstract":"Background One-lung ventilation (OLV)-associated hypoxemia is a major concern and a challenge for the anesthesiologist. Lung recruitment maneuvers (RMs) are ventilator strategies in which the main goal is to restore the functional residual capacity and improve arterial oxygenation. Hemodynamic side effects are mainly associated with ‘fast’ RM not with ‘slow’ cycling RM and their effects are self-limited; therefore, they must be performed repetitively. Aim The aim of this study was to evaluate the efficacy and safety of single versus repeated stepwise cycling RMs during OLV in patients with normal lung function. Settings and design The study design is a randomized, double-blinded, controlled one. Patients and methods Sixty adult patients of ASA I–II who were scheduled for elective thoracoscopic lung surgery were randomized into groups C, single recruitment maneuver (SRM), and repeated recruitment maneuver (RRM) comprising 20 patients each. Group C patients received standard ventilation protocol: volume-controlled ventilation mode, VT 6 ml/kg, I : E ratio 1 : 2, positive end expiratory pressure (PEEP) 5 cmH2O, and respiratory rate 10–12 breaths/min. SRM patients received standard ventilation protocol with one alveolar RM 10 min after initiation of OLV with a PEEP of 10 cmH2O until end of surgery. RRM patients received standard ventilation protocol with first RM 10 min after initiation of OLV and then repeated every 30 min during OLV and a PEEP of 10 cmH2O until end of surgery. The following were assessed: hemodynamic parameters – heart rate, mean arterial blood pressure, and central venous pressure; respiratory mechanical parameters – peak airway pressure (Paw-peak), plateau pressure (Paw-plat), and static lung compliance; and oxygenation parameters – partial arterial oxygen tension (PaO2), PaO2/FiO2, and oxygen saturation (SpO2). Results PaO2 and PaO2/FiO2 ratio increased in the SRM and RRM groups after RM from T2 (10 min after first RM) to T4 (45 min from first RM), with a significant difference compared with group C (P<0.05). Peak and plateau airway pressures declined in the SRM and RRM groups after RM from T2 to T4, with a significant difference when compared with group C (P<0.05). Static lung compliance increased in the SRM and RRM groups after RM, with a significant difference among the groups (P<0.05). Conclusion Single or repeated cycling RM was considered effective with high safety profile in patients with normal pulmonary function undergoing thoracoscopic lung surgery using OLV.","PeriodicalId":7492,"journal":{"name":"Ain-Shams Journal of Anaesthesiology","volume":"1 1","pages":"20 - 27"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90996677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of addition of hyaluronidase as an adjuvant to local anesthetics in ultrasound-guided supraclavicular brachial plexus block","authors":"K. Hakim, M. Ahmed","doi":"10.4103/1687-7934.238458","DOIUrl":"https://doi.org/10.4103/1687-7934.238458","url":null,"abstract":"Background This study was carried out to evaluate the efficacy of hyaluronidase as an adjuvant to the mixture of local anesthetics in ultrasound-guided supraclavicular brachial plexus block. Patients and methods Ninety patients received ultrasound-guided brachial plexus block through supraclavicular approach. They were then randomly divided into three groups: group C, group H1, and group H2. Group C patients received 2% (15 ml) lignocaine and 0.5% (15 ml) bupivacaine, making a total volume of 30 ml, by triple-injection technique. Group H1 patients received 2% (10 ml) lignocaine and 0.5% (10 ml) bupivacaine plus 0.9% (10 ml) normal saline containing 900 IU (90 IU/ml) hyaluronidase, making a total volume of 30 ml, by triple-injection technique. Group H2 patients received 2% (10 ml) lignocaine and 0.5% (10 ml) bupivacaine plus 0.9% (10 ml) normal saline containing 900 IU (90 IU/ml) hyaluronidase, making a total volume of 30 ml, by single-injection technique. Parameters such as needling time, onset of sensory block, onset of motor block, total dose of intraoperative rescue analgesics, rate of success of the block, duration of sensory block, duration of motor block, and possible side effects were measured. Results Time needed to perform the block was significantly shorter in the H2 group compared with the C and H1 groups. Onset of sensory block was statistically significantly lower in the two groups in which hyaluronidase was used compared with that in group C. Onset of motor block was statistically significantly lower in H1 and H2 groups compared with that in group C. The mean total intraoperative fentanyl administration was found to be nonsignificantly higher in group C compared with groups H1 and H2. The success of the ultrasound-guided block was 90% in group C versus 96.6% in groups H1 and H2. As regards the duration of sensory and motor block there were no statistically significant differences between the three studied groups. Comparison between the three groups revealed nonsignificant differences as regards the time of first analgesic dose. The total dose of morphine given during the first 24 h postoperatively was significantly lower in the control group compared with that in groups H1 and H2. Conclusion The use of hyaluronidase as an adjuvant to the local anesthetic reduces the time to reach complete sensory block of ultrasound-guided supraclavicular brachial plexus blocks and therefore shortens the total anesthetic time before operation. Although it also reduces the block duration, hyaluronidase had only a little effect on the total analgesic duration and on the consumption of postoperative analgesics. Also single-injection technique is sufficient for performing a successful block.","PeriodicalId":7492,"journal":{"name":"Ain-Shams Journal of Anaesthesiology","volume":"51 1","pages":"213 - 218"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90463643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subarachnoid anesthesia (with and without sedation) versus general anesthesia for ex-preterm neonates undergoing elective infraumbilical operations","authors":"M. Hussein, R. Mostafa","doi":"10.4103/asja.asja_50_16","DOIUrl":"https://doi.org/10.4103/asja.asja_50_16","url":null,"abstract":"Background Postoperative respiratory problems, especially apnea, is a common postoperative complication in ex-preterm neonates undergoing infraumbilical operations. So, most of these neonates require close postoperative monitoring for at least 12 h to avoid this hazard. Postoperative apnea is related more to the use of respiratory depressant drugs used during general anesthesia. Aim The aim was to evaluate safety and effectiveness of spinal anesthesia in ex-preterm infants undergoing infraumbilical operations and evaluate its role in elimination of routine postoperative hospital stay for apnea monitoring. Settings and design A prospective single-blinded randomized study was conducted. Materials and methods From March 2015 to March 2016, 105 ex-preterm neonates (gestational age <37 weeks), with postconceptual age at surgery less than 60 weeks, undergoing elective infraumbilical operations were studied prospectively. Patients were divided randomly into three groups (35 patients each). Group I received spinal anesthesia without sedation (only sugared pacifier), group II received spinal anesthesia with sedation in the form of ketamine/midazolam, and group III received general anesthesia with caudal analgesia. Postoperative apnea, bradycardia, and oxygen saturation were observed and compared for 12 h after operation. The primary outcome measures were postoperative apnea, postoperative bradycardia, and SpO2. The secondary outcome measures were postoperative complications (e.g. hypotension) and the need for postoperative respiratory support. Results No patients in group I developed any attacks of postoperative apnea, postoperative bradycardia, or hypoxia. On the contrary, 11 patients in group II and 16 patients in group III developed attacks of postoperative apnea and hypoxia and required postoperative respiratory support. Conclusion Spinal anesthesia without sedation is safe and effective for infraumbilical operations in ex-preterm neonates with short hospitalization.","PeriodicalId":7492,"journal":{"name":"Ain-Shams Journal of Anaesthesiology","volume":"237 1","pages":"237 - 241"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89035903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous ephedrine, phenylephrine, and ketamine for attenuation of hypotension associated with induction of general anesthesia with propofol","authors":"M. Hussein, R. Mostafa, Ibrahim T Ibrahim","doi":"10.4103/1687-7934.238454","DOIUrl":"https://doi.org/10.4103/1687-7934.238454","url":null,"abstract":"Background and objective Hypotension and bradycardia remain the major adverse effects of propofol during induction of general anesthesia. Several drugs were studied to prevent these adverse effects. In our study, we compare the effect of mixing ephedrine, phenylephrine, or ketamine with propofol to attenuate its hypotensive effect during induction of general anesthesia. Materials and methods A total of 120 patients of both sexes between 20 and 50 years of age and ASA I–II physical status undergoing elective ambulatory surgeries under general anesthesia were included in our study. Patients were randomly allocated into four groups (30 patients each): group C (the control group), which received plain propofol; group E (the ephedrine group), which received 15 mg of ephedrine premixed with propofol; group Ph (the phenylephrine group), which received 100 μg of phenylephrine premixed with propofol; and group K (the ketamine group), which received 30 mg of ketamine premixed with propofol. In all groups, mean arterial blood pressure (MABP) and heart rate (HR) were recorded at baseline (before induction) and then every 1 min until 6 min after induction. Results Addition of ephedrine, phenylephrine, or ketamine to propofol during general anesthesia induction can significantly attenuate hypotension and bradycardia. In the control group, the MABP dropped from 91.96±3 mmHg just before induction to 75.6±8.7 mmHg at 6 min after induction. HR in the control group dropped from 83.76±7.29/min just before induction to 75.3±12/min at 6 min after induction. The drop in MABP and HR were nonsignificant in the other three groups. Conclusion Mixing propofol with ketamine, ephedrine, or phenylephrine before induction can attenuate its hypotensive and bradycardic effects.","PeriodicalId":7492,"journal":{"name":"Ain-Shams Journal of Anaesthesiology","volume":"9 1","pages":"182 - 187"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79183738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the value of early use of norepinephrine infusion in the improvement of renal function in patients with severe sepsis with early renal impairment using cystatin C, a sensitive renal marker","authors":"A. Sobhy, A. Tharwat, A. Nabil, Akthm Adel","doi":"10.4103/1687-7934.238464","DOIUrl":"https://doi.org/10.4103/1687-7934.238464","url":null,"abstract":"Introduction Acute renal failure occurs in ∼23% of patients with severe sepsis. The combination of acute renal failure and severe sepsis may carry a mortality of up to 70%. Several studies have demonstrated that serum cystatin C level is a better marker of glomerular filtration rate (GFR) compared with serum creatinine, particularly for individuals with small-to-moderate decreases in GFR. To maintain organ perfusion in sepsis, a mean arterial pressure of 65 mmHg should be maintained with fluid therapy and vasopressors. Marked delays in initiation are associated with increase in mortality risk in patients with septic shock. Patients and methods Sixty patients enrolled in the study proved to have severe sepsis with early renal impairment. Patients were randomly allocated into one of two groups (30 patients each): the norepinephrine infusion group (the N group) and the control group (the C group). The N group received norepinephrine infusion + conventional treatment for severe sepsis, whereas the C group was treated with conventional treatment for severe sepsis according to the latest Surviving Sepsis Campaign. For each patient, the following data were collected: age, body weight, hemodynamic changes, urine output, renal function as detected from levels of the sensitive renal marker cystatin C and from serum creatinine levels, blood urea nitrogen, and estimated GFR (eGFR). Results There was a statistically significant increase in blood pressure and urine output in the N group at 10 min and 2 h, respectively, after norepinephrine infusion and on comparing subsequent measures with baseline values (T0) and also when compared with corresponding values in the C group. In addition, patients in the N group showed a statistically signifi cant decrease in serum cystatin C levels and an increase in eGFR based on cystatin C levels after 2 h of norepinephrine infusion, compared with baseline values and values in the C group, denoting marked improvement in GFR. Serum creatinine levels, blood urea nitrogen levels, and eGFR based on serum creatinine levels showed no significant difference in either group whether compared with baseline of the same group or when comparing both groups together. Conclusion The results this study demonstrate that early continuous infusion of norepinephrine at 0.5–1 μg/ kg/min may have a renoprotective role in septic patients with early renal impairment detected by levels of the sensitive renal marker cystatin C.","PeriodicalId":7492,"journal":{"name":"Ain-Shams Journal of Anaesthesiology","volume":"71 1","pages":"46 - 53"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89392769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}