Browsing by Author "Ssemogerere, Lameck"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Assessment of the current capacity of intensive care units in Uganda; A descriptive study
    (Journal of Critical Care, 2020) Atumanya, Patience; Sendagire, Cornelius; Wabule, Agnes; Mukisa, John; Ssemogerere, Lameck; Kwizera, Arthur; Agaba, Peter K.
    Purpose: To describe the organizational characteristics of functional ICUs in Uganda. Methods: A descriptive survey of 12 ICUs in Uganda; ICU organisation, structure, staffing, and support facilities. A functional ICU was defined as one that admitted critically ill patients and had the ability to provide mechanical ventilation. ICUswere selected based on information of their existence. Direct structured interviewswere carried out with the ICU directors. Results: Of the fourteen ICUs reviewed, 12 were functional, and a majority were located in the central region. There were 55 ICU beds making up a ratio of 1.3 ICU beds per million population. The ICU beds comprised 1.5 % of the total bed capacity of studied hospitals. Most of the ICUs [11] were mixed (paediatric-adults), anaesthesia-led (nine) and five operated in a closed model. There were 171 ICU nurses, of whom 13 had formal training in critical care nursing. Themajority of the ICUs had a nurse to patient ratio ≥ 1.2; nine during the day and seven at night. Conclusions: This study shows limited accessibility to critical care services in Uganda.With a high variability in the ICU operational characteristics, there is a need for standardization of ICU care in the country.
  • Thumbnail Image
    Item
    Effect of low-dose ketamine on post-operative serum IL-6 production among elective surgical patients: a randomized clinical trial
    (African Health Sciences, 2017) Luggya, Tonny S.; Roche, Tony; Ssemogerere, Lameck; Kintu, Andrew; Kasumba, John M.; Kwizera, Arthur; Tindimwebwa, Jose V. B.
    Surgery and Anesthesia cause an excessive pro-inflammatory response. Mulago Hospital is faced with staff shortage making post-operative pain management difficult.Interleukin-6 (IL-6) drives inflammatory pain, endothelial cell dysfunction and fibrogenesis. Ketamine is cheap and, readily available. We hypothesized that its attenuation of serum IL-6 was a surrogate for clinical benefit. Materials and methods: Institutional Review Board’s approval was sought and RCT was registered at clinical trials.gov (identifier number: NCT01339065). Consenting patients were randomized to receive pre-incision intravenous ketamine - 0.5mg/kg or 0.9% saline placebo in weighted dosing. Blood samples were collected and laboratory analyzed at baseline, post-operatively in PACU, 24 and 48 hours respectively. Results: We recruited 39 patients of whom 18 were randomized to the ketamine arm and 21 in the placebo arm with follow up at 24 and 48 hours. Serum IL-6 and IL-1β levels were analyzed using ELIZA assay of pre-coated micro wells. Ketamine suppressed serum IL-6 at PACU with reduced increase at 24 hours. There was no reaction in 98% of IL-1β assayed. Conclusion: Low-dose ketamine attenuated early serum IL-6 levels due to surgical response with reduced 24 hour increase, but the difference was not statistically significant and we recommend more studies