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003 EG-GiCUC
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008 191027s2019 ua d f m 000 0 eng d
040 _aEG-GiCUC
_beng
_cEG-GiCUC
041 0 _aeng
049 _aDeposite
097 _aM.Sc
099 _aCai01.11.09.M.Sc.2019.Ab.U
100 0 _aAbdulahad Mohammed Ali
245 1 0 _aUsing of oral midodrine in weaning of vasoactive infusions in patients admitted with septic shock /
_cAbdulahad Mohammed Ali ; Supervised Ahmed Hussien Alsherif , Karim Salem Mashhoor , Mohammed Amin Fakher
246 1 5 _aإستخدام عقار الميدودرين فى فطام الأدوية القابضة للأوعية الدموية فى مرضى الصدمة الإنتانية
260 _aCairo :
_bAbdulahad Mohammed Ali ,
_c2019
300 _a131 P. :
_bcharts ;
_c25cm
502 _aThesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine
520 _aBackground: Patients admitted to intensive care units (ICU) are often treated with intravenous (IV) vasopressors. Persistent hypotension and dependence on IV vasopressors in otherwise resuscitated patients lead to delay in discharge from ICU. Midodrine is an oral alpha-1 adrenergic agonist approved for treatment of symptomatic orthostatic hypotension. The use of midodrine as a vasopressor sparing agent has steadily increased in the ICU despite limited evidence for this off label use. Objectives: To evaluate the role of midodrine in weaning of vasopressor infusions in patient admitted to ICU with septic shock, and to evaluate of the effect of midodrine on outcome of septic patients regarding length of ICU stay and ICU mortality. Patients and Methods: This study was a randomized controlled intervention trial, being conducted in the critical care department, Kasr Elainy hospital, Cairo university, Cairo, Egypt. We targeted 60 patients. Adult patients aged {u2265}18 years, admitted to the ICU with diagnosis of septic shock and who were on IV vasopressors for at least 24 h were considered for recruitment. Participants were randomized to either receive midodrine, 10 mg three times a day, or not in addition to standard care. The primary outcome is the time (hours) from initiation to discontinuation of IV vasopressors and duration of weaning. Secondary outcomes include ICU LOS (days), ICU mortality rate. Results: The IV vasopressor duration (hours) and IV vasopressor weaning duration (hours) were lower in the midodrine group when compared to IV vasopressor only group but the difference is statistically insignificant (139.03±46.95 VS 141.90±79.77 and 62.37±14.94 VS 74.20±36.78 respectively). MAP was significantly improved in midodrine group from 84.50 mmHg at the time of midodrine initiation to 88.03 mmHg after 24hours of midodrine initiation (p=0.04) No differences in secondary outcomes, including ICU length of stay and ICU mortality, were observed
530 _aIssued also as CD
653 4 _aHypotension
653 4 _aIntensive care unit
653 4 _aSeptic shock
700 0 _aAhmed Hussien Alsherif ,
_eSupervisor
700 0 _aKarim Salem Mashhoor ,
_eSupervisor
700 0 _aMohammed Amin Fakher ,
_eSupervisor
856 _uhttp://172.23.153.220/th.pdf
905 _aNazla
_eRevisor
905 _aSamia
_eCataloger
942 _2ddc
_cTH
999 _c74812
_d74812