Publications by authors named "Hamid Reza Sharifnia"

2 Publications

  • Page 1 of 1

Nasogastric tube insertion in intubated patients with the guide of wire rope: A prospective randomised controlled study.

Int J Clin Pract 2021 Jun 12:e14508. Epub 2021 Jun 12.

Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Nasogastric tube (NGT) insertion is sometimes required in intubated patients. NGTs are prone to kink and coil during blind insertion. We hypothesised that wire rope guide-assisted NGT insertion with chin lift can significantly improve the first-attempt success rate over the conventional technique during its insertion in intubated patients.

Objective: Mean time to successful insertion of NGT, the failure rate of NGT insertion in the first attempt, the failure rate of NGT insertion in the second attempt and overall failure rate were assessed along with the incidence of any complications.

Method: This prospective clinical trial conducted 100 adult patients presenting for abdominal surgery under general anaesthesia. These patients were randomised to an experimental technique of Wire rope guide with chin lift (wire group) or a control technique of head flexion (control group) for insertion of the NGT.

Results: The first-attempt success rate was 98% in wire group compared with 74% in the control group (P = .001). Thus, the first-attempt failure rate was 2% in wire group compared with 26% in the control group (P = .001). The median time required to insert the NGT was significantly shorter in wire group (35.3 ± 4.8 vs 61.5 ± 6.2 seconds, P = .001). The incidences of kinking/coiling, bleeding, and moderate injuries were significantly lower in wire group.

Conclusion: The use of rope wire guide for correct positioning of the NGT in intubated patients is less time-consuming with the high first-attempt success rate and lower incidence of procedure-related injuries compared to the conventional method.
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June 2021

Evaluation of Amikacin Pharmacokinetics in Critically Ill Patients with Intra-abdominal Sepsis.

Adv Pharm Bull 2020 Jan 11;10(1):114-118. Epub 2019 Dec 11.

Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

Although the current widespread use of amikacin is in intra-abdominal sepsis treatment, its pharmacokinetic changes in the present setting are not yet well known. This study was aimed to evaluate the amikacin pharmacokinetic profile in critically ill patients with intraabdominal sepsis compared to pneumosepsis. Adult septic patients received amikacin therapy were studied. Patients with intraabdominal sepsis were enrolled in group 1 (n=16), and patients with pneumosepsis were enrolled in group 2 (n=13). The amikacin serum concentrations were evaluated in the first, second, fourth and sixth hours after initiating 30-minute infusion. The pharmacokinetic parameters were calculated for each patient. There was no significant difference in the volume of distribution between the two groups (0.33±0.08 vs. 0.28±0.10 L/kg, =0.193). The amikacin clearance was significantly lower in group 1 compared to group 2 (58.5±21.7 vs. 83.9±37.0 mL/min, =0.029). There was no significant correlation between amikacin clearance and creatinine clearance estimated by Cockcroft-Gault formula in all patients (=0.206). The half-life was significantly longer in group 1 compared to group 2 (5.3±2.8 vs. 3.4±3.2 hours, =0.015). Pathophysiologic changes following intra-abdominal sepsis can affect amikacin pharmacokinetics behavior. The clearance and half-life may change, but the alteration of the volume of distribution is not significantly different in comparison with pneumosepsis. Further studies are required to evaluate the pharmacokinetic variables of amikacin in critically ill patients with intra-abdominal sepsis.
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January 2020