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Hasanin, A., A. Mukhtar, A. El-adawy, H. Nassar, D. Saad, S. Osman, A. Ahmed, A. Zaghlol, M. Sarhan, and M. Reda, "The Friday of Rage of the Egyptian Revolution: A Unique Role for Anesthesiologists", Anesthesia and Analgesia, vol. 114, issue 4, pp. 862-65, 2012.
Hasanin, A., A. Mukhtar, and A. Mokhtar, "Syrian revolution: A field hospital under attack", American Journal Of Disaster Medicine, vol. 8, issue 4, pp. 259-65, 2013.
Mukhtar, A., A. Hasanin, A. Abelaal, and G. Obayah, "Infection complications and pattern of bacterial resistance in living-donor liver transplantation: A multicenter epidemiologic study in Egypt", transplantation proceedings, vol. 46, issue 5, pp. 1444-7, 2014.
Ahmed Hasanin, Akram Eladawy, H. M. Y. S. I. A. L. H. M. D. G. A. M., "Prevalence of extensively drug-resistant gram negative bacilli in surgical intensive care in Egypt", Pan African Medical Journal, vol. 19, pp. 177, 2014.
Hasanin, A., N. Sherif, M. Elbarbary, and D. Mansor, "Providing medical care in unfamiliar settings; experience of an Egyptian campaign in Uganda", Pan African Medical Journal, vol. 17, pp. 111, 2014.
Mukhtar, A., I. Rasmy, hossam mohamed, and N. Nabil, "Evaluation of Perfusion Index as a Predictor of Vasopressor Requirement in Patients with Severe Sepsis", shock, vol. 44, issue 6, pp. 554-9, 2015.
Hasanin, A., "Fluid responsiveness in acute circulatory failure", Journal of Intensive Care, vol. 3, pp. 50, 2015.
Ahmed Mukhtar, Ahmed Hasanin, G. O. A. A., "Intraoperative Terlipressin Therapy Reduces the Incidence of Postoperative Acute Kidney Injury After Living Donor Liver Transplantation", Journal of cardiothoracic and vascular anesthesia, 2015.
Ghaith, D. M., R. M. Hassan, and A. Hasanin, "Rapid identification of nosocomial Acinetobacter baumannii isolated from a surgical intensive care unit in Egypt", Annals of Saudi Medicine, vol. 35, issue 6, pp. 440-4, 2015.
Habib, S., A. Mukhtar, H. Abdelreeem, M. Khorshied, R. E. Sayed, M. Hafez, H. Gouda, doaa ghaith, A. Hasanin, A. El-adawy, et al., "Diagnostic values of CD64, C-reactive protein and procalcitonin in ventilator-associated pneumonia in adult trauma patients: a pilot study", Clinical Chemistry and Laboratory Medicine, vol. 54, issue 5, pp. 889-95, 2016.
Abdulatif, M., M. Fawzy, H. Nassar, A. Hasanin, M. Ollaek, and H. Mohamed, "The effects of perineural dexmedetomidine on the pharmacodynamic profile of femoral nerve block: a dose-finding randomised, controlled, double-blind study", Anaesthesia, vol. 71, issue 10, pp. 1177-85, 2016.
Hasanin, A., A. Kamal, S. Amin, D. Zakaria, R. E. Sayed, kareem mahmoud, and A. Mukhtar, "Incidence and outcome of cardiac injury in patients with severe head trauma", Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, vol. 24, pp. 58, 2016.
Hasanin, A., S. A. R. Mohamed, and A. El-adawy, "Evaluation of perfusion index as a tool for pain assessment in critically ill patients", Journal of clinical monitoring and computing, vol. 31, issue 5, pp. 961-65, 2017.
Hasanin, A., A. Aiyad, A. Elsakka, M. OSMAN, A. Kamel, A. Mokhar, S. Refaat, R. Fouad, and Y. Hassabelnaby, "Leg elevation decreases the incidence of post-spinal hypotension in cesarean section: a randomized controlled trial", BMC Anesthesiology, vol. 17, issue 1, pp. 60, 2017.
Hasanin, A., A. Mukhtar, and H. Nassar, "Perfusion indices revisited", Journal of Intensive Care, vol. 5, pp. 24, 2017.
Abdelnasser, A., B. Abdelhamid, A. Elsonbaty, A. Hasanin, and A. Rady, "Predicting successful supraclavicular brachial plexus block using pulse oximeter perfusion index.", British journal of anaesthesia, vol. 119, issue 2, pp. 276-280, 2017 Aug 01. Abstract

Background: Supraclavicular nerve block is a popular approach for anaesthesia for upper limb surgeries. Conventional methods for evaluation of block success are time consuming and need patient cooperation. The aim of this study was to evaluate whether the perfusion index (PI) can be used to predict and provide a cut-off value for ultrasound-guided supraclavicular nerve block success.

Methods: The study included 77 patients undergoing elective orthopaedic procedures under ultrasound-guided supraclavicular nerve block. After local anaesthetic injection, sensory block success was assessed every 3 min by pinprick, and motor block success was assessed every 5 min by the ability to flex the elbow and the hand against resistance. The PI was recorded at baseline and at 10, 20, and 30 min after anaesthetic injection in both blocked and non-blocked limbs. The PI ratio was calculated as the PI after 10 min divided by the PI at the baseline. Receiver operating characteristic curves were constructed for the accuracy of the PI in detection of block success.

Results: The PI was higher in the blocked limb at all time points, and this was paralleled by a higher PI ratio compared with the unblocked limb. Both the PI and the PI ratio at 10 min after injection showed a sensitivity and specificity of 100% for block success at cut-off values of 3.3 and 1.4, respectively.

Conclusions: The PI is a useful tool for evaluation of successful supraclavicular nerve block. A PI ratio of > 1.4 is a good predictor for block success.

Hasanin, A., "Reply to: Pulse oximeter perfusion index for assessment of brachial plexus block: a holy grail or a design fail?", British journal of anaesthesia, vol. 119, issue 6, pp. 1239, 2017 Dec 01.
Hasanin, A. M., A. M. Mokhtar, S. M. Amin, and A. A. Sayed, "Preprocedural ultrasound examination versus manual palpation for thoracic epidural catheter insertion.", Saudi journal of anaesthesia, vol. 11, issue 1, pp. 62-66, 2017 Jan-Mar. Abstract

BACKGROUND AND AIMS: Ultrasound imaging before neuraxial blocks was reported to improve the ease of insertion and minimize the traumatic trials. However, the data about the use of ultrasound in thoracic epidural block are scanty. In this study, pre-insertion ultrasound scanning was compared to traditional manual palpation technique for insertion of the thoracic epidural catheter in abdominal operations.

SUBJECTS AND METHODS: Forty-eight patients scheduled to midline laparotomy under combined general anesthesia with thoracic epidural analgesia were included in the study. Patients were divided into two groups with regard to technique of epidural catheter insertion; ultrasound group (done ultrasound screening to determine the needle insertion point, angle of insertion, and depth of epidural space) and manual palpation group (used the traditional manual palpation technique). Number of puncture attempts, number of puncture levels, and number of needle redirection attempts were reported. Time of catheter insertion and complications were also reported in both groups.

RESULTS: Ultrasound group showed lower number of puncture attempts (1 [1, 1.25] vs. 1.5 [1, 2.75],= 0.008), puncture levels (1 (1, 1) vs. 1 [1, 2],= 0.002), and needle redirection attempts (0 [0, 2.25] vs. 3.5 [2, 5],= 0.00). Ultrasound-guided group showed shorter time for catheter insertion compared to manual palpation group (140 ± 24 s vs. 213 ± 71 s= 0.00).

CONCLUSION: Preprocedural ultrasound imaging increased the incidence of first pass success in thoracic epidural catheter insertion and reduced the catheter insertion time compared to manual palpation method.

Hasanin, A., K. Taha, B. A. Elhamid, and S. M. Amin, "Evaluation of the effects of dexmedetomidine infusion on oxygenation and lung mechanics in morbidly obese patients with restrictive lung disease", BMC Anesthesiology, vol. 18, issue 1, pp. 104, 2018.
Hasanin, A., R. Soryal, T. Kaddah, S. A. E. Raouf, Y. Abdelwahab, K. Elshafaei, M. Elsayad, B. A. Elhamid, R. Fouad, D. Mahmoud, et al., "Hemodynamic effects of lateral tilt before and after spinal anesthesia during cesarean delivery: an observational study.", BMC anesthesiology, vol. 18, issue 1, pp. 8, 2018 01 15. Abstract

BACKGROUND: Post-spinal hypotension is a common maternal complication during cesarean delivery. Aortocaval compression by the gravid uterus has been assumed as a precipitating factor for post-spinal hypotension. The role of left lateral tilting position in improving maternal cardiac output after subarachnoid block (SAB) is unclear. The aim of this work is to investigate the effect of left lateral tilting on maternal hemodynamics after SAB.

METHODS: A prospective observational study was conducted including 105 full term pregnant women scheduled for cesarean delivery. Mean arterial pressure, heart rate, cardiac output (measured by electrical cardiometry), stroke volume, and systemic vascular resistance were recorded in three positions (supine, 15, and 30left lateral positions) before SAB, after SAB, and after delivery of the fetus.

RESULTS: Before SAB, no significant hemodynamic changes were reported with left lateral tilting. A significant decrease was reported in mean arterial pressure, cardiac output, stroke volume, and systemic vascular resistance after SAB (in supine position). When performing left lateral tilting, there was an increase in cardiac output, heart rate, and mean arterial pressure. No difference was reported between the two tilt angles (15and 30).

CONCLUSIONS: Changing position of full term pregnant woman after SAB from supine to left lateral tilted position results increased cardiac output and mean arterial pressure. There is no difference between the two tilt angles (15and 30).

TRIAL REGISTRATION: ( NCT02828176 ) retrospectively registered.

Gamal, M., B. A. Elhamid, D. Zakaria, O. A. E. Dayem, A. Rady, M. Fawzy, and A. Hasanin, "Evaluation of Noninvasive Hemoglobin Monitoring in Trauma Patients with Low Hemoglobin Levels.", Shock (Augusta, Ga.), vol. 49, issue 2, pp. 150-153, 2018 Feb. Abstract

OBJECTIVE: Bleeding is a leading cause of death among trauma patients. Delayed assessment of blood hemoglobin level might result in either unnecessary blood transfusion in nonindicated patients or delayed blood transfusion in critically bleeding patients. In this study, we evaluate the precision of noninvasive hemoglobin monitoring in trauma patients with low hemoglobin levels.

METHODS: We included trauma patients with low hemoglobin levels (less than 8 g/dL) scheduled for surgical intervention. Blood samples were obtained on admission and after each blood unit with concomitant measurement of serum hemoglobin using radical-7 Masimo device. The change in blood hemoglobin after every transfused blood unit was also assessed by both methods (change in noninvasive Masimo hemoglobin [Delta-Sp-Hb] and change in laboratory hemoglobin [Delta-Lab-Hb]). The precision of Masimo hemoglobin level (Sp-Hb) compared with Laboratory hemoglobin level (Lab-Hb) was determined using both Bland-Altman and Pearson correlation analyses.

RESULTS: One hundred eighty-four time-matched samples were available for final analysis. Bland-Altman analysis showed excellent accuracy of Sp-Hb compared with Lab-Hb with mean bias of 0.12 g/dL and limits of agreement between -0.56 g/dL and 0.79 g/dL. Excellent correlation was reported between both measures with Pearson correlation coefficient of 0.872. Excellent agreement was also reported between both Delta-Sp-Hb and Delta-Lab-Hb with mean bias of -0.05 and limits of agreement from -0.62 to 0.51 CONCLUSIONS:: Sp-Hb showed accurate precision in both absolute values and trend values compared with Lab-Hb measurement in trauma patients with low hemoglobin levels.

Adel, A., W. Awada, B. A. Elhamid, H. Omar, O. A. E. Dayem, A. Hasanin, and A. Rady, "Accuracy and trending of non-invasive hemoglobin measurement during different volume and perfusion statuses.", Journal of clinical monitoring and computing, 2018 Jan 15. Abstract

The evolution of non-invasive hemoglobin measuring technology would save time and improve transfusion practice. The validity of pulse co-oximetry hemoglobin (SpHb) measurement in the perioperative setting was previously evaluated; however, the accuracy of SpHb in different volume statuses as well as in different perfusion states was not well investigated. The aim of this work is to evaluate the accuracy and trending of SpHb in comparison to laboratory hemoglobin (Lab-Hb) during acute bleeding and after resuscitation. Seventy patients scheduled for major orthopedic procedures with anticipated major blood loss were included. Radical-7 device was used for continuous assessment of SpHb, volume status [via pleth variability index (PVI)] and perfusion status [via perfusion index (PI)]. Lab-Hb and SpHb were measured at three time-points, a baseline reading, after major bleeding, and after resuscitation. Samples were divided into fluid-responsive and fluid non-responsive samples, and were also divided into high-PI and low-PI samples. Accuracy of SpHb was determined using Bland-Altman analysis. Trending of SpHb was evaluated using polar plot analysis. We obtained 210 time-matched readings. Fluid non-responsive samples were 106 (50.5%) whereas fluid responsive samples were 104 (49.5%). Excellent correlation was reported between Lab-Hb and SpHb (r = 0.938). Excellent accuracy with moderate levels of agreement was also reported between both measures among all samples, fluid non-responsive samples, fluid-responsive samples, high-PI samples, and low-PI samples [Mean bias (limits of agreement): 0.01 (- 1.33 and 1.34) g/dL, - 0.08 (- 1.27 and 1.11) g/dL, 0.09 (- 1.36 and 1.54) g/dL, 0.01 (- 1.34 to 1.31) g/dL, and 0.04 (- 1.31 to 1.39) g/dL respectively]. Polar plot analysis showed good trending ability for SpHb as a follow up monitor. In conclusion, SpHb showed excellent correlation with Lab-Hb in fluid responders, fluid non-responders, low-PI, and high PI states. Despite a favorable mean bias of 0.01 g/dL for SpHb, the relatively wide levels of agreement (- 1.3 to 1.3 g/dL) might limit its accuracy. SpHb showed good performance as a trend monitor.

Eltrabili, H. H., A. Hasanin, M. S. Soliman, A. M. Lotfy, W. I. Hamimy, and A. H. M. E. D. M. MUKHTAR, "Evaluation of Diaphragmatic Ultrasound Indices as Predictors of Successful Liberation From Mechanical Ventilation in Subjects With Abdominal Sepsis", Respiratory Care, vol. 64, issue 5, pp. 564-569, 2019.
Sabry, R., A. Hasanin, S. Refaat, S. A. E. Raouf, A. S. Abdallah, and N. Helmy, "Evaluation of Gastric Residual Volume in Fasting Diabetic Patients Using Gastric Ultrasound", Acta Anaesthesiologica Scandinavica, vol. 63, issue 5, pp. 615-619, 2019.