Critical Care Center , Cairo University inaugurated in 1982 by the founder Dr Sherif Mokhtar

2. The story of Critical Care Medicine in Egypt started
more than 39 years ago with the inauguration of the
Critical Care Center On March 2, 1982 at Cairo University
Hospitals.
By then, there were neither clear concepts nor
established standards of this branch of Medicine. The
definition of critical illness itself was not clear in the mind
of most practitioners.

3. ‫أ‬ ‫الدعوة‬ ‫لبى‬ ‫وقد‬ ‫للمستشفى‬ ‫عيدا‬ ‫األفتتاح‬ ‫يوم‬ ‫كان‬
.
‫د‬
.
‫والدكتور‬ ‫الوزراء‬ ‫رئيس‬ ‫الدين‬ ‫محيى‬ ‫فؤاد‬
:
‫ص‬
‫زكى‬ ‫برى‬
‫والدكتور‬ ‫الصحة‬ ‫وزير‬
:
‫والدكتور‬ ‫العالى‬ ‫التعليم‬ ‫وزير‬ ‫حلمى‬ ‫كمال‬ ‫مصطفى‬
:
‫أكادي‬ ‫رئيس‬ ‫بدران‬ ‫أبراهيم‬
‫البحث‬ ‫مية‬
‫والدكتور‬ ‫القاهرة‬ ‫جامعة‬ ‫رئيس‬ ‫حمدى‬ ‫حسن‬ ‫والدكتور‬ ‫العلمى‬
:
‫القاهرة‬ ‫بجامعة‬ ‫الطب‬ ‫كلية‬ ‫عميد‬ ‫فؤاد‬ ‫هاشم‬

4. The center replaced the old emergency
department in a strategic central location,
facing the outpatient clinic and diagnostic
radiology, next to the causality section, and
in vertical connection with the two other
units of the Critical Care Department

5. The late Dr. Hashem Fouad Dean of medical school and Dr. Mokhtar.
Dr. Fouad was a great supporter of the newly emerging center and was very
proud of its unique high standard services

6. The late Dr. Hashem Fouad Dean of Cairo University
Medical School, in a visit to the center

7. The term Critical Care Medicine is now a popular
term in Egypt and increasing numbers of doctors are being
attracted to this subspecialty, I would say an
Independent Specialty.
It is no longer a mere ICU or recovery ward, but
rather a distinct entity of Critical Care Medicine
since 1992.

8. No one can ever deny the extremely important role
played by Critical Care Units in saving thousands of patients,
whose lives were usually harvested by cardiac crises,
respiratory failure and sepsis.
Tens of ICUs are now spread all over the nation not
only in University Hospitals & academic centers but in
ministry of public health hospitals.

9. Besides handling all medico surgical crises, our
practice of critical care medicine extended to new
horizons.
The Egyptian edition of Critical Care Medicine
now comprises diagnostic and interventional activities in
critically ill cardiac patients.

10. .
As a major reference center for pts with respiratory failure from every where, the center owns
the largest number of ventilator machines in any hospital in Egypt or Middle East Assisted &
controlled ventilation is performed by various models of ventilators mostly Bennet type, (MA1,
MA2, 7200, 840 and Bear 1000), Gallileo, Servo and Drager ventilators

11. From right to left Dr. Sanaa Abel Shafi, Dr. Hala El-Baradei, Dr. Magda El-Taweel,
Dr. Alia Abdel Fattah, and Dr. Sherif Mokhtar in discussion with Dr. Samir El-Badawi.

12. Advanced diagnostic tools for life-threatening situations
were essentially adopted and mastered. They included:
• Coronary angiography,
• Myocardial perfusion studies,
• Diagnostic and
• Interventional cardiac electrophysiology.

13. Follow up & Research Unit, November 1993
From left (Dr. Hossam Mowafi, Dr. Sherif Mokhtar & Dr. Alia Abdel Fattah).

14. A view of a 9 bed ward in the second unit. Only plastic curtains separate one pt from
another, allowing free access of the resuscitative equipment and fast movement of the
medical & nursing staff from one pt to another.

15. 3871
4305
3831
3000
3400
3800
4200
4600
2017 2018 2019

16. Daily clinical rounds are an essential and integral part of the intensive
care teaching and pt caring as well (1985 picture).

17. Headed by the most senior staff, the daily rounds “by the same team” ensure continuity of
the same line of treatment and keep the whole staff and team on call informed of the new
and expected events. This unique policy is what distinguishes a major academic center
from a private facility.

18. The famous late novelist “Tawfik El-Hakeem” during his stay in the center
in 1985. Dr Hassan Khaled was the fellow in charge

19. Headed by Dr. Amal Rizk, the staff includes from (left to right)
chemists: Mohsen, Magdi, Sahar, Mohamed and Hossam.

20. In his last visit to Cairo, (October 2002) as an invited speaker to the second
international meeting in Critical Care Medicine, Mr. Yacoub was very keen to
visit the center, and was highly impressed by the Molecular biology lab. Shown
here also is Dr. Chachques from France.

21. Mr. Yacoub, Dr. Sanaa Abd El Shafee
(Director of the molecular biology lab.) and Dr. Sayed Akl, Cardiac Surgeons.

22. Electrophysiology lab. activities comprise the diagnosis and radiofrequency ablation
of supraventricular and ventricular tachycardias, as well as temporary and
permanent pacemaker implantations

23. 129
221
204
100
150
200
250
2017 2018 2019

24. Prior to RF ablation and in 1993, a Dutch team initiated the surgical technique of
cryoablation of accessory pathways. Dr. Olafpen is seen between Dr. Hammouda and
Dr. Magid Zekri, (a cardiac surgeon) Dr. Hassan Khaled, with Dutch
anaesthesiologist are shown at the right.

25. A modern monoplane Philips system is in active use with an average of 7-
10 cases of coronary angiographic studies & interventions daily 5-6 days/
week besides night calls and weekend emergencies

26. 2650
2840
2601
2450
2500
2550
2600
2650
2700
2750
2800
2850
2900
2017 2018 2019

27. Dr. Aly Ramzy Professor of Cardiology, Ain Shams University, Dr. Yehia
Saad Ex-Chief of Cardiology Department, Cairo University and
Dr. Mokhtar discussing MD thesis

28. Dr. Abdel Latif Osman, Professor of Neurology (Azhar University)
and Dr. Medhat El-Rafee Professor of Cardiology (Cairo University)
and Dr. Mokhtar Publicly discussing and MD thesis

29. First international meeting in cardiac electrophysiology )Jan. 1999)

30. Second international conference on critical care medicine, October,
2002 Dr. Mokhtar honoring Sir. Magdi Yacoub, one of the distinguished
faculty of the conference

31. Second international conference on critical care medicine, October 2002 the
conference hosted a public panel discussion titled "Brain Death and Organ
Donation". The panelists shown in the photograph are; professor Hamdy EL
Sayed President of Egyptian Medical Syndicate, Dr. Mokhtar, Dr.Ahmed El
Tayeb (Al Mufti of Egypt) and Professor Sayed Akl

32. ECCCP is a professional thought - leading
association of like-minded clinicians who have the common
goal to promote the science and practice of Critical Care
medicine.

33. A professional organization of critical care physicians
devoted to:
• Advancing the goals of academic critical care
medicine;
• Training and educating critical care physicians
and other physicians in critical care medicine;
and
• Expanding both our understanding of critical
illness and our ability to treat the critically ill.

34. The ECCCP is now running:
 Biannual FCCs courses,
 Biannual courses in comprehensive ICU training
 Biannual workshops on assisted ventilation, and
ECG reading
 Besides international meetings on Pulm.
And Care and ECMO.

37. ‫ب‬‫ي‬‫ر‬‫د‬‫ت‬‫م‬‫ت‬
1200
‫ام‬‫ع‬‫لال‬‫خ‬‫ة‬‫ض‬‫ر‬‫م‬‫م‬
2017

39. 
‫ملء‬
‫بالمشروع‬ ‫الخاصة‬ ‫األستمارات‬
(
‫لكل‬
‫الحاالت‬
)

‫قلب‬ ‫رسم‬ ‫عمل‬
(
‫الحاالت‬ ‫لكل‬
)

‫الطبى‬ ‫الطاقم‬ ‫قبل‬ ‫من‬ ‫أكلينيكى‬ ‫فحص‬

43. • Overlap with Anaesthesiology ,
• Conflict with Critical Care Cardiology
• Inclusion of Critical Care Arrhythmology
• Overlap with Emergency an acute medicine and
• Need for Specialisation and Mutual Training

44. Historically, Anesthesiolgists ran the first
ICUs.
Today the majority of ICUs are run by
Critical Care Physicians certified in the
independent specialty of Critical Care Medicine
(or at least a subspecialty).

45. The perioperative Physicians
Anesthologists are now accepting the fact that
their role should be restricted to the perioperative
period and confined to the recovery room.
Even surgical ICUs are now run more by ICU
physicians rather than anesthesiologists.

46. Conflict with Critical Care Cardiology The
presence of Catheter Lab in ICUs.
For the first time in the history of Critical Care Catheter lab.
Facilities are now a central part of the activity of the Critical Care
Department, Cairo University.
This innovation exclusive to Cairo University hospitals has a
played a major role in saving lives of many pts with acute MI by
ensuring an optimally short door -to -needle time for primary PCI.
It has provided evidence that Critical Care Cardiology
should be part and parcel of the intensive care domain

47. Handling of critically ill cardiac pts by Intensive Care
Physicians proved to carry the advantage of covering all other
potential multiorgan problems starting from Basic Life Support
to Assisted Ventilation up to multiple organ failure syndrome.
But it raised the issue of qualification vs certification
and ignited the conflict of professional competition.

48. Scope of Critical Care in EGYPT has extended to
cover
• Diagnostic electrophysiology,
• Temporary and permanent PM implantation,
• Radiofrequency ablation of cardiac arrhythmias and
• Cardiac Resynchronization and ICD implantation
The rationale is that facing Life Threatening Arrhythmias
should not wait for cardiology consultation but should be an
integral part of the Critical Care Curriculum.

49. Emergency medical staff face a variety of problems
dominated by polytrauma, mass casualities environmental
disasters, burn injuries ….. etc., (the usual pt categories with
acute medical and surgical crises).
Emergency medicine represents strategically the front
line management of those pts.

50.  Locally confined physically to the Emergency Department,
 Aims at triage of pts for definitive referral and
 Overlaps with Intensive Care medicine in initiating
support & life saving therapies but
 Should not be concerned with pts on prolonged
ventilation or continued inotropic drug administration …
etc

51. • With the growth and progress of ICUs, came the
realization that caring for critically ill pts required the
expertise of specialized personnel.
• While some individuals debate Who Should Care for
Critically Ill Patients, studies support the necessity of
specialized training for intensivists.

52. • Furthermore, dedication and commitment to being
physically present in the ICU at all hours of the night and
day are vitally important.
• An intensivist should largely be responsible for all aspects
of patient care.

53.  Complexity and the multi system involvement in
different categories of pt. raised the question of
the need for mutual training of both cardiologists
and critical care specialists in both specialties.

54. CRITICAL CARE MEDICINE IN EGYPT HAS BECOME AN
INDEPENDENT SPECIALTY related to and overlapping with but
distinctly separate from Emergency Medicine And Recovery Or
Reanimation Practice.
Specific degrees are being granted by the
department "master and doctorate degrees" quite separate but
related to other displines of medicine and surgery.

55. By this concept of “Diagnose-and-Manage-Here-
and-Now”, we short circuited a long and time consuming
vicious circle spent in referring patients to diagnostic and
interventional departments.

56. We share with critical care specialties all over the
world their common problems, but we have our own
challenges based on the peculiarities dictated by the long
history, old traditions and religious background.