This work was done in hope to clarify the role of breast milk as a vehicle foraflatoxin and ochratoxin in the infants and impact’of them in lactating infants.50 exclusively healthy lactating mothers and their healthy exclusively lactatinginfants, for at least 4 months, were included in this study. Full physicalexamination was done for both infants and mothers. Samples of blood and breastmilk were collected from mothers and their infants and level of aflatoxin andochratoxin were detected. Serum creatinine, urea, uric acid, liver tests (ALT,AST, serum albumin and prothrombine time) were determined. Infants’ urinarymicroalbumin and B2-microglobulin levels were also determined.The results of this study showed that:-1- The mycotoxin detection rate was higher among mothers’ serum,mothers’ milk and serum of their exclusive breast feed infants.2- The contamination rate of ochratoxin was higher (72% for mothers’serum and milk) than that for aflatoxin (48% and 50% for mothersserum and mothers milk respectively) with higher positivecontamination rate in urban areas than in rural areas.3- The levels (mean ± S.D ug/rnl) of aflatoxin and ochratoxin were4.1715 ± 5.517 and 3.987 ± 4.0105 respectively in mothers’ serum,0.957 ± 1.036 and 1.1505 ± 1.003 respectively in mothers milk and0.858 ± 1.154 and 1.379 ± 1.92 in serums of their exculsive breast fedinfants, for aflatoxin and ochratoxin respectively.4- There was no statistically significant difference between urban andrural areas as regard to positive detection rate and levels of aflatoxinand ochratoxin for mothers’ serum, mothers’ milk and infants’ serum.85Summary,:. ’”’, . ’.._.’ .5- Mothers milk aflatoxin showed a significant positive correlation withinfants serum aflatoxin (P=0.008) and with mothers’ serum aflatoxin I\.(P=O,003),6- A significant positive correlation was noted between mothers’ milkochratoxin and mothers serum ochratoxin (P < 0.001), while there wasno statistical significant correlation between mothers’ milk ochratoxinand infants serum ochratoxin.7- There was a significant negative correlation (P=0.023) between infantsserum aflatoxin and the residual of regression of length/age.8- Both unne microalbumin and p2-microglobulin levels weresignificantly higher in infants positive for ochratoxin or for ochratoxinand aflatoxin than negative.9- For infants’ serum positive for aflatoxin, there was no significantalternation in their liver function findings.10- No statistical significant differences in kidney function tests amongThe arterial blood gases and the hematocrit level were evaluated every 10 minutes till the end resuscitation point, then every day for 15 days. Liver function, kidney function, cardiac enzymes and coagulation profiles were evaluated every two days for 15 days. The resuscitative fluid mixture was blood/Ringer lactate, it was given as rapid as we can according to the advanced trauma life support course guidelines, till each of CI and pHi reached the intended normal value in randomly half number of selected patients.For patients who need mechanical ventilation post-operatively in ICU, they were kept on fentanyl 0.1 mg/h, midazolam 3 mg/1/2 h and atracurium 10 mg/h intravenously.According to the resuscitation end point, the selected patients were divided into two equal groups.Group I (Global group):In this group, the resuscitation was ended when cardiac index (CI) became equal or just above 4 L/min/m2.Group II (Regional group):In this group, the resuscitation was stopped when pHi became equal or just above 7.32.If the intended resuscitation end point was still below the desired values in spite of administration of adequate volume of resuscitative fluid mixture, dopamine 5 mg/kg/min was given in case of low blood pressure and normal CVP and dobutamine 3 mg/kg/min was administered in case of low blood pressure and high CVP.When the intended resuscitation end point was reached, the rate of fluid administration and the blood/Ringer lactate ratio was readjusted to maintain the reached end point constant and to keep haematocrite value above 30.During resuscitation and during the first 24 hours after resuscitation we monitored the various global and regional tissue oxygenation, arterial blood gases and haematocrit level.After reaching the corresponding end point of resuscitation the following were detected and recorded in each group:· Success rate to reach the corresponding resuscitation end point within 12 hours.· Optimizing time of CI and pHi.· The values of the various global and regional tissue oxygenation indices at each resuscitation end point of both groups.· The percent of the resulting corrective changes of various global and regional tissue oxygenation indices values from the pre resuscitation values at each resuscitation end point of both groups.· The incidence of patient with persistent low pHi:· Incidence and severity of MODS.· Mortality rate.· Correlation between global and regional tissue oxygenation indices.From this study, it was found no significant difference among the corresponding various demographic data, surgical and anesthesia time, distribution of various surgical procedure and pre-resuscitation value of global and regional tissue oxygenation indices of both groups. The success rate to reach the corresponding resuscitation end point was similar in both group. The time needed to optimize pHi was significantly longer than the time needed to optimize CI. At the resuscitation end point the values of CI, BE, pHi, PrCO2 and Pr-PaCO2 in group II were more better than the corresponding values in group I and the other tissue oxygenation indices values (HCO3 and lactate) were statistically similar.Although the incidence of MODS in group II was numerically less than that of group I but statistically it was found no significant difference between them. The severity score values of MODS in group I was significantly more higher than in group II patients.Also, the mortality rate was numerically higher in group I than in group II patients, but statistically, there was no significant difference between them. Moreover, there was negative correlation between serum lactate level and pHi value, positive correlation between serum lactate level and PrCO2 and Pr-PaCO2, positive correlation between HCO3- level and pHi value but there were no correlation among the values of BE, CI and regional tissue oxygenation indices.In conclusion, normalization of pHi was superior to normalization of CI as resuscitation end point in traumatic shocked patients because normalization of pHi was associated with more corrective changes to global and regional tissue oxygenation indices and hence less morbidity and mortality.For these reasons we recommended normalization of pHi as resuscitation end point for traumatic shocked patients especially tonocap is available in our hospital and in some other hospitals. Also we recommend training of junior anesthetist to use tonocap. If the tonocap is not available we can depends on the usage of normalization of each of lactate and HCO3 as a safe resuscitation end point in mechanical trauma shocked patients.