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Background. Early vasopressor utilization has been associated with improved outcomes of patients with spinal shock; however, there are difficulties in weaning off vasopressors, in which patients after recovery from spinal shock develop a state of persistent vasodilation, which may take a few days to resolve and delays the discharge in the intensive care unit (ICU). Therefore, we tested the hypothesis using two oral vasopressors (midodrine and minirin) to facilitate weaning off intravenous vasopressors, reducing the ICU length of stay, and compare them for more efficacy. Methods. A randomized controlled trial was conducted in the trauma ICU at the Assiut University Hospital in Egypt in patients with spinal shock who required intravenous vasopressor for ≥24 h. A convenience sample was classified into three groups, in which 30 patients were included for each group. The midodrine group received midodrine 10 mg per oral every 8 h with gradual weaning off intravenous (IV) vasopressor (noradrenaline) after receiving 4 doses, the minirin group received minirin 60 μg per oral every 8 h with gradual weaning off IV vasopressor after receiving 4 doses, whereas the control group received IV vasopressor (noradrenaline) with gradual weaning according to the routine hospital care without adding oral vasopressors. The primary outcome was shortening the duration of IV vasopressor requirements. The secondary outcome was reducing the ICU length of stay. Results. Our results showed that the duration of IV vasopressor requirements in the midodrine (3.3 ± 1.32) and minirin groups (4.8 ± 1.83) was significantly lower than in the control group (6.93 ± 2.32). Additionally, the ICU length of stay (days) in the midodrine (5.13 ± 1.83) and minirin groups (5.5 ± 1.91) was significantly lower than in the control group (9.03 ± 3.74). Conclusion. Midodrine and minirin accelerated liberation from intravenous noradrenaline and effective in reducing the ICU length of stay in patients with spinal shock.

Abstract.A quantitative physical model has been expressed in terms of features generic to electrical ageing.This has been used to simulate the evolution of damage structures during the electrical ageing of insulating polymers. During the main part of the ageing process isolated regions of damage were produced at a few extremely susceptible sites. However failure occurred via an accelerating filamentary damage path initiated in a region where a high energy concentration caused a number of adjoining sites to fail around the same time rather than through the connection of pre-existing damage regions.

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Background: Patients in intensive care units require comprehensive care.Hence, improving health care quality depends on accurate assessment and documentation.Aim: To develop and validate the content of an assessment sheet for critically ill patients.Study Design and Methods: A Delphi design study was conducted between January and March 2020. The content validity index (CVI) was used to calculate the degree of agreement among the experts to analyse the instrument and the entire set of items.Content validity was determined by seven experts (three critical care nursing professionals, two critical care doctors, and two anaesthesiologists) using a four-point Likert scale. They evaluated the items in terms of the following: 1 = "irrelevant," 2 = "somewhat relevant if the phrasing is profoundly adjusted," 3 = "relevant with some adjustment as to phrasing," and 4 = "very relevant." The CVI was applied, and the accepted value was ≥0.50.Results: Three rounds of evaluation were required to achieve the minimum index.The items were reviewed for content and face validity. The instrument was validated with 86 items with a total CVI of 0.90, a face validity of 1, and a scale-level content validity index/universal agreement calculation method (S-CVI/UA) value of 0.813. Conclusion:This instrument can help nurses, doctors, academics, and students assess patients in intensive care units.

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