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1. Interferon-gamma driven elevation of CXCL9: a new sepsis endotype independently associated with mortalityResearch in context

Author: Evangelos J. Giamarellos-Bourboulis, Massimo Antonelli, Frank Bloos, Ioanna Kotsamidi, Christos Psarrakis, Konstantina Dakou, Daniel Thomas-Rüddel, Luca Montini, Josef Briegel, Georgia Damoraki, Panagiotis Koufargyris, Souzana Anisoglou, Eleni Antoniadou, Glykeria Vlachogianni, Christos Tsiantas, Matteo Masullo, Aikaterini Ioakeimidou, Eumorfia Kondili, Maria Ntaganou, Eleni Gkeka, Vassileios Papaioannou, Effie Polyzogopoulou, Armin J. Reininger, Gennaro De Pascale, Michael Kiehntopf, Eleni Mouloudi, and Michael Bauer
Subjects: Sepsis, Interferon-gamma, CXCL9, Macrophages, Outcome, Medicine, Medicine (General), R5-920
Abstract: Summary: Background: Endotype classification becomes the cornerstone of understanding sepsis pathogenesis. Macrophage activation-like syndrome (MALS) and immunoparalysis are the best recognized major endotypes, so far. Interferon-gamma (IFNγ) action on tissue macrophages stimulates the release of the cytotoxic chemokine CXCL9. It was investigated if this mechanism may be an independent sepsis endotype. Methods: In this cohort study, 14 patient cohorts from Greece, Germany and Italy were studied. The cohorts were 2:1 randomly split into discovery and validation sets. Sepsis was defined by the Sepsis-3 definitions and blood was sampled the first 24 h from meeting the Sepsis-3 definitions. Concentrations of IFNγ, CXCL9, IP-10 (IFNγ induced protein-10), soluble CD163 and ferritin were measured. The endotype of IFNγ-driven sepsis (IDS) was defined in the discovery set as the combination of a) blood IFNγ above a specified cut-off associated with the minimal risk for immunoparalysis (defined as ≥8000 HLA-DR receptors on CD45/CD14-monoytes); and b) increase of CXCL9. Results were compared to the validation set. Findings: 5503 patients were studied; 3670 in the discovery set and 1833 in the validation set. IDS was defined as IFNγ more than 3 pg/ml and CXCL9 more than 2200 pg/ml. The frequency of IDS in the discovery set was 19.9% (732 patients; 95% confidence intervals-CIs 18.7–21.3%) and in the validation set 20.0% (366 patients; 95% CIs 18.2–21.9%). Soluble CD163, a marker of macrophage activation, was greater in IDS and IDS had features distinct from MALS. The mortality in IDS patients was 43.0% (315 patients; 95% CIs 39.5–46.6%) in the discovery set and 40.4% in the validation set (148 patients; 95% CIs 35.5–45.5%) (p = 0.44 compared to patients of the discovery set). IDS was an independent risk factor for death in the presence of other endotypes, severity scores and organ dysfunctions of the multivariate model [hazard ratio 1.71 (95% CIs 1.45–2.01) in the discovery set and 1.70 (95% CIs 1.34–2.16) in the validation set]. Decreases of IFNγ and CXCL9 blood levels within the first 72 h were associated with better outcome. Interpretation: IDS is a new sepsis endotype independently associated with unfavorable outcome. Funding: Hellenic Institute for the Study of Sepsis; Horizon 2020 project ImmunoSep; Swedish Orphan BioVitrum AB (publ) and German Federal Ministry of Education and Research.
Published: 2024
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2. A combination of mild-moderate hypoxemia and low compliance is highly prevalent in persistent ARDS: a retrospective study

Author: Eleni Papoutsi, Ioannis Andrianopoulos, Vasiliki Mavrikaki, Maria Bolaki, Vagia Stamatopoulou, Eleni Toli, Georgios Papathanakos, Vasilios Koulouras, Eumorfia Kondili, Ilias I. Siempos, and Katerina Vaporidi
Subjects: Acute respiratory failure, Acute respiratory distress syndrome, COVID-19, Prolonged mechanical ventilation, Diseases of the respiratory system, RC705-779
Abstract: Abstract Background The Acute Respiratory Distress Syndrome (ARDS) is characterized by lung inflammation and edema, impairing both oxygenation and lung compliance. Recent studies reported a dissociation between oxygenation and compliance (severe hypoxemia with preserved compliance) in early ARDS and COVID-19-related-ARDS (CARDS). During the pandemic, in patients requiring prolonged mechanical ventilation, we observed the opposite combination (mild-moderate hypoxemia but significantly impaired compliance). The purpose of our study was to investigate the prevalence of this combination of mild-moderate hypoxemia and impaired compliance in persistent ARDS and CARDS. Methods For this retrospective study, we used individual patient-level data from two independent cohorts of ARDS patients. The ARDSNet cohort included patients from four ARDS Network randomized controlled trials. The CARDS cohort included patients with ARDS due to COVID-19 hospitalized in two intensive care units in Greece. We used a threshold of 150 for PaO2/FiO2 and 30 ml/cmH2O for compliance, estimated the prevalence of each of the four combinations of oxygenation and compliance at baseline, and examined the change in its prevalence from baseline to day 21 in the ARDSNet and CARDS cohorts. Results The ARDSNet cohort included 2909 patients and the CARDS cohort included 349 patients. The prevalence of the combination of mild-moderate hypoxemia and low compliance increased from baseline to day 21 both in the ARDSNet cohort (from 22.2 to 42.7%) and in the CARDS cohort (from 3.1 to 33.3%). Among surviving patients with low compliance, oxygenation improved over time. The 60-day mortality rate was higher for patients who had mild-moderate hypoxemia and low compliance on day 21 (28% and 56% in ARDSNet and CARDS), compared to those who had mild-moderate hypoxemia and high compliance (20% and 50%, respectively). Conclusions Among patients with ARDS who require prolonged controlled mechanical ventilation, regardless of ARDS etiology, a dissociation between oxygenation and compliance characterized by mild-moderate hypoxemia but low compliance becomes increasingly prevalent. The findings of this study highlight the importance of monitoring mechanics in patients with persistent ARDS.
Published: 2024
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3. Post-Traumatic Cerebral Venous Sinus Thrombosis (PtCVST) Resulting in Increased Intracranial Pressure during Early Post-Traumatic Brain Injury Period: Case Report and Narrative Literature Review

Author: Athanasios Theofanopoulos, Athanasia Proklou, Marianna Miliaraki, Ioannis Konstantinou, Konstantinos Ntotsikas, Nikolaos Moustakis, Sofia Lazarioti, Eleftherios Papadakis, George Kypraios, Georgios Angelidis, Georgia Vaki, Eumorfia Kondili, and Christos Tsitsipanis
Subjects: traumatic brain injury, cerebral venous thrombosis, post-traumatic, intracranial hypertension, clinical and imaging mismatch, Medicine
Abstract: Post-traumatic cerebral venous sinus thrombosis (ptCVST) often remains underdiagnosed due to the non-specific nature of clinical signs, commonly mimicking severe traumatic brain injury (TBI) manifestations. Early recognition of this rare and potentially life-threatening complication is crucial for the effective management of severe TBI patients in Intensive Care. The present study reports the case of a 66-year-old male who was transferred to the emergency department due to moderate TBI. Initial emergency brain computed tomography (CT) scans revealed certain traumatic lesions, not necessitating any urgent neurosurgical intervention. During his stay in an Intensive Care Unit (ICU), multiple transient episodes of intracranial pressure (ICP) values were managed conservatively, and through placement of an external ventricular drain. Following a series of CT scans, there was a continuous improvement of the initial traumatic hemorrhagic findings despite his worsening clinical condition. This paradox raised suspicion for ptCVST, and a brain CT venography (CTV) was carried out, which showed venous sinus thrombosis close to a concomitant skull fracture. Therapeutic anticoagulant treatment was administered. The patient was discharged with an excellent neurological status. To date, there are no clearly defined guidelines for medical and/or surgical management of patients presenting with ptCVST. Therapy is mainly based on intracranial hypertension control and the maintenance of normal cerebral perfusion pressure (CCP) in the ICU. The mismatch between clinical and imaging findings in patients with TBI and certain risk factors raises the suspicion of ptCVST.
Published: 2024
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4. Sleep Habits, Academic Performance and Health Behaviors of Adolescents in Southern Greece

Author: Christina Alexopoulou, Maria Fountoulaki, Antigone Papavasileiou, and Eumorfia Kondili
Subjects: sleep, sleep hygiene, adolescents, sleep habits, sleep deprivation, academic performance, Medicine
Abstract: Adolescents often experience insufficient sleep and have unhealthy sleep habits. Our aim was to investigate the sleep patterns of secondary education students in Heraklion, Crete, Greece and their association with school performance and health habits. We conducted a community-based cross-sectional study with 831 students aged 13–19 years who completed an online self-reported questionnaire related to sleep and health habits. The data are mostly numerical or categorical, and an analysis was performed using t-tests, chi-square tests and multiple logistic regression. During weekdays, the students slept for an average of 7 ± 1.1 h, which is significantly lower than the 7.8 ± 1.5 h average on weekends (p < 0.001). Nearly 79% reported difficulty waking up and having insufficient sleep time, while 73.8% felt sleepy at school at least once a week. Having sufficient sleep time ≥ 8 h) was positively correlated with better academic performance (OR: 1.48, CI: 1.06–2.07, p = 0.022) and frequent physical exercise (never/rarely: 13.5%, sometimes: 21.2%, often: 65.3%; p = 0.002). Conversely, there was a negative correlation between adequate sleep and both smoking (OR: 0.29, CI: 0.13–0.63) and alcohol consumption (OR: 0.51, CI: 0.36–0.71, p = 0.001). In conclusion, this study shows that students in Heraklion, Crete frequently experience sleep deprivation, which is associated with compromised academic performance, reduced physical activity and an increased likelihood of engaging in unhealthy behaviors like smoking and alcohol consumption.
Published: 2024
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5. A Fatal Case of Presumptive Diagnosis of Leptospirosis Involving the Central Nervous System

Author: Christina Alexopoulou, Athanasia Proklou, Sofia Kokkini, Maria Raissaki, Ioannis Konstantinou, and Eumorfia Kondili
Subjects: Leptospirosis, CNS, coma, Weil’s syndrome, case report, Medicine
Abstract: Leptospirosis is a reemerging zooanthroponosis with a worldwide distribution, though it has a higher incidence in areas with tropical climate. A characteristic finding of the disease is its wide spectrum of symptoms and organ involvement, as it can appear either with very mild flu-like manifestations or with multiorgan failure, affecting the central nervous system (CNS) with a concomitant hepatorenal dysfunction (Weil’s syndrome) and significant high mortality rate. We report herein a fatal case of a 25 years old female, previously healthy, with impaired neurological status. She had high fever and severe multiorgan failure. The clinical data and the epidemiological factors were not conclusive for the diagnosis, and the first serology test from the cerebrospinal fluid (CSF) and sera samples were negative. When the repetition of the blood test showed elevated IgM antibodies, Leptospirosis was the presumptive diagnosis. Although CNS involvement is rare, the diagnosis should be considered when there is an elevated risk of exposure. The diagnostic protocol should encompass direct evidence of the bacterium and indirect measurement of antibodies. Timely detection and management are imperative to forestall complications and fatality associated with the disease.
Published: 2024
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6. Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19

Author: Raphael Romano Bruno, Bernhard Wernly, Georg Wolff, Jesper Fjølner, Antonio Artigas, Bernardo Bollen Pinto, Joerg C. Schefold, Detlef Kindgen‐Milles, Philipp Heinrich Baldia, Malte Kelm, Michael Beil, Sigal Sviri, Peter Vernon vanHeerden, Wojciech Szczeklik, Arzu Topeli, Muhammed Elhadi, Michael Joannidis, Sandra Oeyen, Eumorfia Kondili, Brian Marsh, Finn H. Andersen, Rui Moreno, Susannah Leaver, Ariane Boumendil, Dylan W. De Lange, Bertrand Guidet, Hans Flaatten, Christian Jung, and COVIP study group
Subjects: COVID‐19, Heart failure, Elderly, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Aims Chronic heart failure (CHF) is a major risk factor for mortality in coronavirus disease 2019 (COVID‐19). This prospective international multicentre study investigates the role of pre‐existing CHF on clinical outcomes of critically ill old (≥70 years) intensive care patients with COVID‐19. Methods and results Patients with pre‐existing CHF were subclassified as having ischaemic or non‐ischaemic cardiac disease; patients with a documented ejection fraction (EF) were subclassified according to heart failure EF: reduced (HFrEF, n = 132), mild (HFmrEF, n = 91), or preserved (HFpEF, n = 103). Associations of heart failure characteristics with the 30 day mortality were analysed in univariate and multivariate logistic regression analyses. Pre‐existing CHF was reported in 566 of 3917 patients (14%). Patients with CHF were older, frailer, and had significantly higher SOFA scores on admission. CHF patients showed significantly higher crude 30 day mortality [60% vs. 48%, P
Published: 2022
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7. The association of the Activities of Daily Living and the outcome of old intensive care patients suffering from COVID-19

Author: Raphael Romano Bruno, Bernhard Wernly, Hans Flaatten, Jesper Fjølner, Antonio Artigas, Philipp Heinrich Baldia, Stephan Binneboessel, Bernardo Bollen Pinto, Joerg C. Schefold, Georg Wolff, Malte Kelm, Michael Beil, Sigal Sviri, Peter Vernon van Heerden, Wojciech Szczeklik, Muhammed Elhadi, Michael Joannidis, Sandra Oeyen, Eumorfia Kondili, Brian Marsh, Jakob Wollborn, Finn H. Andersen, Rui Moreno, Susannah Leaver, Ariane Boumendil, Dylan W. De Lange, Bertrand Guidet, Christian Jung, and COVIP study group
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Purpose Critically ill old intensive care unit (ICU) patients suffering from Sars-CoV-2 disease (COVID-19) are at increased risk for adverse outcomes. This post hoc analysis investigates the association of the Activities of Daily Living (ADL) with the outcome in this vulnerable patient group. Methods The COVIP study is a prospective international observational study that recruited ICU patients ≥ 70 years admitted with COVID-19 (NCT04321265). Several parameters including ADL (ADL; 0 = disability, 6 = no disability), Clinical Frailty Scale (CFS), SOFA score, intensive care treatment, ICU- and 3-month survival were recorded. A mixed-effects Weibull proportional hazard regression analyses for 3-month mortality adjusted for multiple confounders. Results This pre-specified analysis included 2359 patients with a documented ADL and CFS. Most patients evidenced independence in their daily living before hospital admission (80% with ADL = 6). Patients with no frailty and no disability showed the lowest, patients with frailty (CFS ≥ 5) and disability (ADL
Published: 2022
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8. Survivin and caspases serum protein levels and survivin variants mRNA expression in sepsis

Author: Marianna Miliaraki, Panagiotis Briassoulis, Stavroula Ilia, Aikaterini Polonifi, Marina Mantzourani, Efrossini Briassouli, Konstantinos Vardas, Serafim Nanas, Aikaterini Pistiki, Maria Theodorakopoulou, Theonymfi Tavladaki, Anna Maria Spanaki, Eumorfia Kondili, Helen Dimitriou, Sotirios Tsiodras, Dimitrios Georgopoulos, Apostolos Armaganidis, George Daikos, and George Briassoulis
Subjects: Medicine, Science
Abstract: Abstract Sepsis is a dysregulated host response to infection related to devastating outcomes. Recently, interest has been shifted towards apoptotic and antiapoptotic pathobiology. Apoptosis is executed through the activation of caspases regulated by a number of antiapoptotic proteins, such as survivin. The survivin and caspases’ responses to sepsis have not yet been elucidated. This is a multicenter prospective observational study concerning patients with sepsis (n = 107) compared to patients with traumatic systemic inflammatory response syndrome (SIRS) (n = 75) and to healthy controls (n = 89). The expression of survivin was quantified through real-time quantitative polymerase chain reaction for the different survivin splice variants (wild type-WT, ΔEx3, 2B, 3B) in peripheral blood leukocytes. The apoptotic or antiapoptotic tendency was specified by measuring survivin-WT, caspase-3, and -9 serum protein concentrations through enzyme-linked immunosorbent assay. The survivin-WT, -2B, -ΔΕx3 mRNA, survivin protein, and caspases showed an escalated increase in SIRS and sepsis, whereas survivin-3B was repressed in sepsis (p
Published: 2021
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9. Airway pressure morphology and respiratory muscle activity during end-inspiratory occlusions in pressure support ventilation

Author: Stella Soundoulounaki, Evangelia Akoumianaki, Eumorfia Kondili, Emmanouil Pediaditis, Georgios Prinianakis, Katerina Vaporidi, and Dimitris Georgopoulos
Subjects: Esophageal pressure, Gastric pressure, Driving pressure, Protective ventilation, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background The driving pressure of the respiratory system is a valuable indicator of global lung stress during passive mechanical ventilation. Monitoring lung stress in assisted ventilation is indispensable, but achieving passive conditions in spontaneously breathing patients to measure driving pressure is challenging. The accuracy of the morphology of airway pressure (Paw) during end-inspiratory occlusion to assure passive conditions during pressure support ventilation has not been examined. Methods Retrospective analysis of end-inspiratory occlusions obtained from critically ill patients during pressure support ventilation. Flow, airway, esophageal, gastric, and transdiaphragmatic pressures were analyzed. The rise of gastric pressure during occlusion with a constant/decreasing transdiaphragmatic pressure was used to identify and quantify the expiratory muscle activity. The Paw during occlusion was classified in three patterns, based on the differences at three pre-defined points after occlusion (0.3, 1, and 2 s): a “passive-like” decrease followed by plateau, a pattern with “clear plateau,” and an “irregular rise” pattern, which included all cases of late or continuous increase, with or without plateau. Results Data from 40 patients and 227 occlusions were analyzed. Expiratory muscle activity during occlusion was identified in 79% of occlusions, and at all levels of assist. After classifying occlusions according to Paw pattern, expiratory muscle activity was identified in 52%, 67%, and 100% of cases of Paw of passive-like, clear plateau, or irregular rise pattern, respectively. The driving pressure was evaluated in the 133 occlusions having a passive-like or clear plateau pattern in Paw. An increase in gastric pressure was present in 46%, 62%, and 64% of cases at 0.3, 1, and 2 s, respectively, and it was greater than 2 cmH2O, in 10%, 20%, and 15% of cases at 0.3, 1, and 2 s, respectively. Conclusions The pattern of Paw during an end-inspiratory occlusion in pressure support cannot assure the absence of expiratory muscle activity and accurate measurement of driving pressure. Yet, because driving pressure can only be overestimated due to expiratory muscle contraction, in everyday practice, a low driving pressure indicates an absence of global lung over-stretch. A measurement of high driving pressure should prompt further diagnostic workup, such as a measurement of esophageal pressure.
Published: 2020
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10. Effects of Sedatives on Sleep Architecture Measured With Odds Ratio Product in Critically Ill Patients

Author: Dimitris Georgopoulos, MD, PhD, Eumorfia Kondili, MD, PhD, Christina Alexopoulou, MD, PhD, and Magdy Younes, MD, PhD
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: OBJECTIVES:. Evaluation of sleep quality in critically ill patients is difficult using conventional scoring criteria. The aim of this study was to examine sleep in critically ill patients with and without light sedation using the odds ratio product, a validated continuous metric of sleep depth (0 = deep sleep; 2.5 = full wakefulness) that does not rely on the features needed for conventional staging. DESIGN:. Retrospective study. SETTINGS:. A 16-bed medical-surgical ICU. PATIENTS:. Twenty-three mechanically ventilated patients who had previously undergone two nocturnal sleep studies, one without and one with sedation (propofol, n = 12; dexmedetomidine, n = 11). INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Sleep architecture was evaluated with odds ratio product analysis by the distribution of 30-second epochs with different odds ratio product values. Electroencephalogram spectral patterns and frequency of wake intrusions (3-s odds ratio product > 1.75) were measured at different odds ratio product levels. Thirty-seven normal sleepers were used as controls. Compared with normal sleepers, unsedated critically ill patients spent little time in stable sleep (percent odds ratio product < 1.0: 31% vs 63%; p < 0.001), whereas most of the time were either in stage wake (odds ratio product > 1.75) or in a transitional state (odds ratio product 1.0–1.75), characterized by frequent wake intrusions. Propofol and dexmedetomidine had comparable effects on sleep. Sedation resulted in significant shift in odds ratio product distribution toward normal; percent odds ratio product less than 1.0 increased by 54% (p = 0.006), and percent odds ratio product greater than 1.75 decreased by 48% (p = 0.013). In six patients (26%), sedation failed to improve sleep. CONCLUSIONS:. In stable critically ill unsedated patients, sleep quality is poor with frequent wake intrusions and little stable sleep. Light sedation with propofol or dexmedetomidine resulted in a shift in sleep architecture toward normal in most, but not all, patients.
Published: 2021
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11. Non-invasive ventilation during surgery under neuraxial anaesthesia: a pathophysiological perspective on application and benefits and a systematic literature review

Author: Nadia Corcione, Habib Karim, Bushra Mina, Antonio Pisano, Yalim Dikmen, Eumorfia Kondili, Antonello Nicolini, Giuseppe Fiorentino, Vania Caldeira, Alejandro Ubeda, Peter Papadakos, Jakob Wittenstein, Subrata Singha, Milind Sovani, Chinmaya Panda, Corinne Tani, Mohamad Khatib, Andreas Perren, Kwok Ho, and Antonio Esquinas
Subjects: neuraxial anaesthesia, non-invasive ventilation, intra-operative respiratory failure, Anesthesiology, RD78.3-87.3, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Unlike general anaesthesia, neuraxial anaesthesia (NA) reduces the burden and risk of respiratory adverse events in the post-operative period. However, both patients affected by chronic obstructive pulmonary disease (COPD) and chest wall disorders and/or neuromuscular diseases may experience the development or the worsening of respiratory failure, even during surgery performed under NA; this latter negatively affects the function of accessory respiratory muscles, resulting in a blunted central response to hypercapnia and possibly in an exacerbation of cardiac dysfunction (NA-induced relative hypovolemia). According to European Respiratory Society (ERS) and American Thoracic Society (ATS) guidelines, non-invasive ventilation (NIV) is effective in the post-operative period for the treatment of both impaired pulmonary gas exchange and ventilation, while the intra-operative use of NIV in association with NA is just anecdotally reported in the literature. Whilst NIV does not assure a protected patent airway and requires the patient’s cooperation, it is a handy tool during surgery under NA: NIV is reported to be successful for treatment of acute respiratory failure; it may be delivered through the patient’s home ventilator, may reverse hypoventilation induced by sedatives or inadvertent spread of anaesthetic up to cervical dermatomes, and allow the avoidance of intubation in patients affected by chronic respiratory failure, prolonging the time of non-invasiveness of respiratory support (i.e., neuromuscular patients needing surgery). All these advantages could make NIV preferable to oxygen in carefully selected patients.
Published: 2019
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12. Driving pressure during proportional assist ventilation: an observational study

Author: Katerina Vaporidi, Charalambos Psarologakis, Athanasia Proklou, Emmanouil Pediaditis, Evangelia Akoumianaki, Elisavet Koutsiana, Achilleas Chytas, Ioanna Chouvarda, Eumorfia Kondili, and Dimitris Georgopoulos
Subjects: Protective ventilation, Compliance, Tidal volume, Monitoring, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background During passive mechanical ventilation, the driving pressure of the respiratory system is an important mediator of ventilator-induced lung injury. Monitoring of driving pressure during assisted ventilation, similar to controlled ventilation, could be a tool to identify patients at risk of ventilator-induced lung injury. The aim of this study was to describe driving pressure over time and to identify whether and when high driving pressure occurs in critically ill patients during assisted ventilation. Methods Sixty-two patients fulfilling criteria for assisted ventilation were prospectively studied. Patients were included when the treating physician selected proportional assist ventilation (PAV+), a mode that estimates respiratory system compliance. In these patients, continuous recordings of all ventilator parameters were obtained for up to 72 h. Driving pressure was calculated as tidal volume-to-respiratory system compliance ratio. The distribution of driving pressure and tidal volume values over time was examined, and periods of sustained high driving pressure (≥ 15 cmH2O) and of stable compliance were identified and analyzed. Results The analysis included 3200 h of ventilation, consisting of 8.8 million samples. For most (95%) of the time, driving pressure was
Published: 2019
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13. Oxidant/Antioxidant Status Is Impaired in Sepsis and Is Related to Anti-Apoptotic, Inflammatory, and Innate Immunity Alterations

Author: Marianna Miliaraki, Panagiotis Briassoulis, Stavroula Ilia, Kalliopi Michalakakou, Theodoros Karakonstantakis, Aikaterini Polonifi, Kalliopi Bastaki, Efrossini Briassouli, Konstantinos Vardas, Aikaterini Pistiki, Maria Theodorakopoulou, Theonymfi Tavladaki, Anna-Maria Spanaki, Eumorfia Kondili, Helen Dimitriou, Maria Venihaki, Sotirios Tsiodras, Dimitrios Georgopoulos, Marina Mantzourani, Serafeim Nanas, Apostolos Armaganidis, George L. Daikos, Ioannis Papassotiriou, and George Briassoulis
Subjects: oxidative stress, antioxidant status, apoptosis, interleukins, heat shock proteins, TOS, Therapeutics. Pharmacology, RM1-950
Abstract: Oxidative stress is considered pivotal in the pathophysiology of sepsis. Oxidants modulate heat shock proteins (Hsp), interleukins (IL), and cell death pathways, including apoptosis. This multicenter prospective observational study was designed to ascertain whether an oxidant/antioxidant imbalance is an independent sepsis discriminator and mortality predictor in intensive care unit (ICU) patients with sepsis (n = 145), compared to non-infectious critically ill patients (n = 112) and healthy individuals (n = 89). Serum total oxidative status (TOS) and total antioxidant capacity (TAC) were measured by photometric testing. IL-6, -8, -10, -27, Hsp72/90 (ELISA), and selected antioxidant biomolecules (Ζn, glutathione) were correlated with apoptotic mediators (caspase-3, capsase-9) and the central anti-apoptotic survivin protein (ELISA, real-time PCR). A wide scattering of TOS, TAC, and TOS/TAC in all three groups was demonstrated. Septic patients had an elevated TOS/TAC, compared to non-infectious critically ill patients and healthy individuals (p = 0.001). TOS/TAC was associated with severity scores, procalcitonin, IL-6, -10, -27, IFN-γ, Hsp72, Hsp90, survivin protein, and survivin isoforms -2B, -ΔΕx3, -WT (p < 0.001). In a propensity probability (age-sex-adjusted) logistic regression model, only sepsis was independently associated with TOS/TAC (Exp(B) 25.4, p < 0.001). The AUCTOS/TAC (0.96 (95% CI = 0.93–0.99)) was higher than AUCTAC (z = 20, p < 0.001) or AUCTOS (z = 3.1, p = 0.002) in distinguishing sepsis. TOS/TAC, TOS, survivin isoforms -WT and -2B, Hsp90, IL-6, survivin protein, and repressed TAC were strong predictors of mortality (p < 0.01). Oxidant/antioxidant status is impaired in septic compared to critically ill patients with trauma or surgery and is related to anti-apoptotic, inflammatory, and innate immunity alterations. The unpredicted TOS/TAC imbalance might be related to undefined phenotypes in patients and healthy individuals.
Published: 2022
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14. Invasive Aspergillus tracheobronchitis in a patient with hairy cell leukemia and previous Plasmodium falciparum infection

Author: Elvira-Markella Antonogiannaki, Athanasia Proklou, Dimitrios Tamiolakis, Evangelia Vassalou, and Eumorfia Kondili
Subjects: Invasive Aspergillus tracheobronchitis, malaria, Medicine
Abstract: Invasive Aspergillus tracheobronchitis is a relatively rare form of invasive pulmonary aspergillosis characterized by invasion of the tracheobronchial tree by Aspergillus spp. Invasive pulmonary aspergillosis is predominantly detected in severely immunocompromised patients. Notably however, pulmonary and tracheobronchial cases of invasive aspergillosis have also been reported, particularly in the context of severe malaria caused by Plasmodium falciparum. Herein, we present a case of invasive Aspergillus tracheobronchitis in a patient with hairy cell leukemia and previous Plasmodium falciparum infection.
Published: 2019
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15. Magnitude of Synchronous and Dyssynchronous Inspiratory Efforts during Mechanical Ventilation: A Novel Method

Author: Irene Telias, Matías Madorno, Tài Pham, Thomas Piraino, Rémi Coudroy, Michael C. Sklar, Eumorfia Kondili, Savino Spadaro, Tobias Becher, Chang-Wen Chen, Tommaso Mauri, Lise Piquilloud, Laurent Brochard, Felipe Damiani, Cesar Santis, Michael Sklar, Audery Kim, Megan Abbott, Elena Spinelli, Giacomo Grasselli, Nadia Corcione, Francesca Dalla Corte, Carlo Alberto Volta, Francesco Mojoli, Dimitris Georgopoulos, Stella Soundoulounaki, Norbert Weiler, Dirk Schaedler, Oriol Roca, Manel Santafe, Jordi Mancebo, Nuria Rodriguez, Leo Heunks, Heder de Vries, Chang Wen Chen, Jian-Xin Zhou, Guang-Qiang Chen, Nuttapol Rittayamai, Norberto Tiribelli, Sebastian Fredes, Ricard Artigas Mellado, Carlos Ferrando Ortolá, François Beloncle, Alain Mercat, Jean-Michel Arnal, Jean-Luc Diehl, Romy Younan, Alexandre Demoule, Martin Dres, Quentin Fossé, Sébastien Jochmans, Jonathan Chelly, Nicolas Terzi, Claude Guérin, Elias Baedorf Kassis, Jeremy Beitler, Davide Chiumello, Erica Ferrari Luca Bolgiaghi, Arnaud W. Thille, Laurent Papazian, C. Guervilly, Ewan C. Goligher, and Niall D. Ferguson
Subjects: Pulmonary and Respiratory Medicine, Correspondence, Critical Care and Intensive Care Medicine
Published: 2023

16. Neural Network-Enabled Identification of Weak Inspiratory Efforts during Pressure Support Ventilation Using Ventilator Waveforms

Author: Stella Soundoulounaki, Emmanouil Sylligardos, Evangelia Akoumianaki, Markos Sigalas, Eumorfia Kondili, Dimitrios Georgopoulos, Panos Trahanias, and Katerina Vaporidi
Subjects: Medicine (miscellaneous), machine learning, assisted ventilation, ventilator-induced diaphragmatic disfunction, flow waveform, monitoring
Abstract: During pressure support ventilation (PSV), excessive assist results in weak inspiratory efforts and promotes diaphragm atrophy and delayed weaning. The aim of this study was to develop a classifier using a neural network to identify weak inspiratory efforts during PSV, based on the ventilator waveforms. Recordings of flow, airway, esophageal and gastric pressures from critically ill patients were used to create an annotated dataset, using data from 37 patients at 2–5 different levels of support, computing the inspiratory time and effort for every breath. The complete dataset was randomly split, and data from 22 patients (45,650 breaths) were used to develop the model. Using a One-Dimensional Convolutional Neural Network, a predictive model was developed to characterize the inspiratory effort of each breath as weak or not, using a threshold of 50 cmH2O*s/min. The following results were produced by implementing the model on data from 15 different patients (31,343 breaths). The model predicted weak inspiratory efforts with a sensitivity of 88%, specificity of 72%, positive predictive value of 40%, and negative predictive value of 96%. These results provide a ‘proof-of-concept’ for the ability of such a neural-network based predictive model to facilitate the implementation of personalized assisted ventilation.
Published: 2023
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17. Respiratory Failure and Respiratory Support

Author: Eumorfia Kondili, Αthanasia Proklou, and Georgios Prinianakis
Published: 2023

18. Hypoxia and Ventilator Asynchronies

Author: Eumorfia Kondili and Maria Mpolaki
Published: 2023

19. Ventilatory Ratio Threshold for Unassisted Breathing: A Retrospective Exploratory Analysis

Author: Eleftherios Papadakis, Eugenia Triantafyllidou, Ioannis Konstantinou, Vlasios Karageorgos, Nikos Tserlikakis, Athanasia Proklou, Dimitrios Georgopoulos, Eumorfia Kondili, Maria Bolaki, and Katerina Vaporidi
Subjects: Male, Pulmonary and Respiratory Medicine, Dead space, medicine.medical_treatment, Discharged alive, Assisted ventilation, Critical Care and Intensive Care Medicine, Humans, Weaning, Medicine, Aged, Retrospective Studies, Original Research, Mechanical ventilation, Noninvasive Ventilation, business.industry, General Medicine, Exploratory analysis, Respiration, Artificial, Intensive Care Units, Respiratory failure, Anesthesia, Breathing, Female, business, Ventilator Weaning
Abstract: BACKGROUND: The ventilatory ratio (VR) is a simple index of ventilatory efficiency and dead space. Because increased dead space and high ventilatory demands impose a limitation to unassisted ventilation, and may predispose patients to injurious strong efforts during assisted ventilation, evaluation of the VR could provide helpful information during weaning. We hypothesize that there is a threshold of VR associated with tolerance of unassisted breathing. METHODS: In a retrospective analysis, we included subjects ventilated in a control mode for at least 24 h, who were successfully liberated from mechanical ventilation, without use of noninvasive ventilation, and discharged alive from the ICU. We focused on the successful weaning attempts (the last, if more than one was performed) and evaluated the VR at the beginning and at the end of the assisted ventilation period. RESULTS: We examined 2,000 medical records and included in our analysis 572 subjects (age: 68 y, R(5-95) = 25–85, 68% male) with main admission diagnosis of respiratory failure (23%), sepsis (11%), brain injury (34%), and postoperative (14%). The VR at the beginning and the end of the assisted ventilation period was 1.5 (R(5-95) = 1–2.1) and 1.4 (R(5-95) = 1–2), respectively. The median duration of assisted ventilation in subjects with a VR ≥ 2 at the beginning of the assisted ventilation period was 3 d (R(5-95) = 0–14 d), significantly longer than in those with a VR < 2, 0.5 d (R(5-95) = 0–8 d, P < .001). CONCLUSIONS: Successful liberation from assisted ventilation was associated with a VR < 2. A VR > 2 was associated with longer duration of weaning. The VR could be used as an additional tool to facilitate the decision-making process during weaning.
Published: 2021

20. Management of Inadvertent Arterial Catheterization during Central Venous Catheter Placement: A Case Series

Author: Georgios Papastratigakis, Diamantina Marouli, Athanasia Proklou, Nikolaos Nasis, Eumorfia Kondili, and Elias Kehagias
Subjects: Medicine (miscellaneous), inadvertent arterial catheterization, central venous catheter, ultrasound guidance
Abstract: Percutaneous central venous catheterization, although a widely used technique in ICU patients worldwide, is not devoid of complications even under real-time ultrasound guidance. Arterial puncture is a well-recognized complication, while unintended subclavian or carotid artery cannulations during attempted central venous catheterization are infrequent, but documented complications with potentially deleterious consequences. Recently, endovascular balloon tamponade has emerged as the preferred initial approach to repair inadvertent arterial cannulations. Herein, we present a case series of inadvertent arterial catheterization during an attempted ultrasound-guided access of the right internal jugular and the left subclavian vein that were successfully managed with endovascular balloon tamponade.
Published: 2022
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21. Survivin and caspases serum protein levels and survivin variants mRNA expression in sepsis

Author: Efrossini Briassouli, AM Spanaki, Serafim Nanas, George L. Daikos, Maria Theodorakopoulou, Marina Mantzourani, K. Vardas, T Tavladaki, Eumorfia Kondili, Aikaterini Pistiki, Sotirios Tsiodras, Apostolos Armaganidis, Aikaterini Polonifi, Marianna Miliaraki, Dimitrios Georgopoulos, Panagiotis Briassoulis, George Briassoulis, Stavroula Ilia, and Helen Dimitriou
Subjects: Male, Survivin, Science, Serum protein, Pathogenesis, Real-Time Polymerase Chain Reaction, Article, Sepsis, Medical research, Humans, Medicine, Prospective Studies, RNA, Messenger, Caspase, Messenger RNA, Multidisciplinary, biology, Caspase 3, business.industry, Middle Aged, medicine.disease, Caspase 9, Systemic Inflammatory Response Syndrome, Systemic inflammatory response syndrome, Real-time polymerase chain reaction, Apoptosis, Case-Control Studies, Caspases, Cancer research, biology.protein, Female, business, Biomarkers
Abstract: Sepsis is a dysregulated host response to infection related to devastating outcomes. Recently, interest has been shifted towards apoptotic and antiapoptotic pathobiology. Apoptosis is executed through the activation of caspases regulated by a number of antiapoptotic proteins, such as survivin. The survivin and caspases’ responses to sepsis have not yet been elucidated. This is a multicenter prospective observational study concerning patients with sepsis (n = 107) compared to patients with traumatic systemic inflammatory response syndrome (SIRS) (n = 75) and to healthy controls (n = 89). The expression of survivin was quantified through real-time quantitative polymerase chain reaction for the different survivin splice variants (wild type-WT, ΔEx3, 2B, 3B) in peripheral blood leukocytes. The apoptotic or antiapoptotic tendency was specified by measuring survivin-WT, caspase-3, and -9 serum protein concentrations through enzyme-linked immunosorbent assay. The survivin-WT, -2B, -ΔΕx3 mRNA, survivin protein, and caspases showed an escalated increase in SIRS and sepsis, whereas survivin-3B was repressed in sepsis (p p
Published: 2021

22. Proportional Assist Ventilation

Author: Eumorfia Kondili and Evangelia Akoumianaki
Published: 2022

23. Oxidant/Antioxidant Status Is Impaired in Sepsis and Is Related to Anti-Apoptotic, Inflammatory, and Innate Immunity Alterations

Author: Marianna Miliaraki, Panagiotis Briassoulis, Stavroula Ilia, Kalliopi Michalakakou, Theodoros Karakonstantakis, Aikaterini Polonifi, Kalliopi Bastaki, Efrossini Briassouli, Konstantinos Vardas, Aikaterini Pistiki, Maria Theodorakopoulou, Theonymfi Tavladaki, Anna-Maria Spanaki, Eumorfia Kondili, Helen Dimitriou, Maria Venihaki, Sotirios Tsiodras, Dimitrios Georgopoulos, Marina Mantzourani, Serafeim Nanas, Apostolos Armaganidis, George L. Daikos, Ioannis Papassotiriou, and George Briassoulis
Subjects: oxidative stress, antioxidant status, apoptosis, interleukins, heat shock proteins, TOS, TAC, innate immunity, Physiology, Clinical Biochemistry, Cell Biology, Molecular Biology, Biochemistry
Abstract: Oxidative stress is considered pivotal in the pathophysiology of sepsis. Oxidants modulate heat shock proteins (Hsp), interleukins (IL), and cell death pathways, including apoptosis. This multicenter prospective observational study was designed to ascertain whether an oxidant/antioxidant imbalance is an independent sepsis discriminator and mortality predictor in intensive care unit (ICU) patients with sepsis (n = 145), compared to non-infectious critically ill patients (n = 112) and healthy individuals (n = 89). Serum total oxidative status (TOS) and total antioxidant capacity (TAC) were measured by photometric testing. IL-6, -8, -10, -27, Hsp72/90 (ELISA), and selected antioxidant biomolecules (Ζn, glutathione) were correlated with apoptotic mediators (caspase-3, capsase-9) and the central anti-apoptotic survivin protein (ELISA, real-time PCR). A wide scattering of TOS, TAC, and TOS/TAC in all three groups was demonstrated. Septic patients had an elevated TOS/TAC, compared to non-infectious critically ill patients and healthy individuals (p = 0.001). TOS/TAC was associated with severity scores, procalcitonin, IL-6, -10, -27, IFN-γ, Hsp72, Hsp90, survivin protein, and survivin isoforms -2B, -ΔΕx3, -WT (p < 0.001). In a propensity probability (age-sex-adjusted) logistic regression model, only sepsis was independently associated with TOS/TAC (Exp(B) 25.4, p < 0.001). The AUCTOS/TAC (0.96 (95% CI = 0.93–0.99)) was higher than AUCTAC (z = 20, p < 0.001) or AUCTOS (z = 3.1, p = 0.002) in distinguishing sepsis. TOS/TAC, TOS, survivin isoforms -WT and -2B, Hsp90, IL-6, survivin protein, and repressed TAC were strong predictors of mortality (p < 0.01). Oxidant/antioxidant status is impaired in septic compared to critically ill patients with trauma or surgery and is related to anti-apoptotic, inflammatory, and innate immunity alterations. The unpredicted TOS/TAC imbalance might be related to undefined phenotypes in patients and healthy individuals.
Published: 2021

24. COVID-19 ARDS: Points to Be Considered in Mechanical Ventilation and Weaning

Author: Antonia Koutsoukou, Demosthenes Makris, Dimitrios Georgopoulos, Anastasia Kotanidou, Eumorfia Kondili, and Nikoletta Rovina
Subjects: Mechanical ventilation, medicine.medical_specialty, ARDS, Coronavirus disease 2019 (COVID-19), business.industry, medicine.medical_treatment, weaning, Medicine (miscellaneous), COVID-19, Review, Hypoxia (medical), Lung injury, mechanical ventilation, medicine.disease, medicine, Extracorporeal membrane oxygenation, Weaning, Medicine, medicine.symptom, lung injury, Intensive care medicine, business, Conventional ventilation
Abstract: The COVID-19 disease can cause hypoxemic respiratory failure due to ARDS, requiring invasive mechanical ventilation. Although early studies reported that COVID-19-associated ARDS has distinctive features from ARDS of other causes, recent observational studies have demonstrated that ARDS related to COVID-19 shares common clinical characteristics and respiratory system mechanics with ARDS of other origins. Therefore, mechanical ventilation in these patients should be based on strategies aiming to mitigate ventilator-induced lung injury. Assisted mechanical ventilation should be applied early in the course of mechanical ventilation by considering evaluation and minimizing factors associated with patient-inflicted lung injury. Extracorporeal membrane oxygenation should be considered in selected patients with refractory hypoxia not responding to conventional ventilation strategies. This review highlights the current and evolving practice in managing mechanically ventilated patients with ARDS related to COVID-19.
Published: 2021

25. Sleep apnea patients report neglected care during COVID-19 pandemic

Author: Venetia Tsara, Georgia Varsou, Paschalis Steiropoulos, Dimitra Siopi, Eumorfia Kondili, Athanasios Voulgaris, Athanasia Pataka, Pantelis Natsiavas, Dimitra Tsakona, Dimitrios Kyrou, Athina Georgopoulou, Christina Alexopoulou, Anastasia Chasiotou, Christina Karamanidou, Georgia Trakada, and Anastasia Amfilochiou
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Emergency medicine, Pandemic, medicine, Sleep apnea, business, medicine.disease
Published: 2021

26. Prevalence of Cardiometabolic Disease in the Greek Sleep Apnea Patients Cohort

Author: Vlasios K. Dimitriadis, Anastasios Kallianos, Georgia Trakada, Athanasios Konstantinidis, Eumorfia Kondili, Venetia Tsara, Georgia Varsou, Anastasia Amfilochiou, Pantelis Natsiavas, Charikleia Tselepi, Paschalis Steiropoulos, Athanasios Gounidis, Athanasia Pataka, Dimitra Siopi, Michalis Agrafiotis, Christina Alexopoulou, Anastasia Chasiotou, Christos Karachristos, Konstantinos Porpodis, Maria Fountoulaki, and Vasiliki Paschidou
Subjects: Pediatrics, medicine.medical_specialty, business.industry, Cohort, medicine, Sleep apnea, Cardiometabolic disease, business, medicine.disease
Published: 2021

27. Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Author: Labeau, Sonia O, Afonso, Elsa, Benbenishty, Julie, Blackwood, Bronagh, Boulanger, Carole, Brett, Stephen J, Calvino-Gunther, Silvia, Chaboyer, Wendy, Coyer, Fiona, Deschepper, Mieke, François, Guy, Honore, Patrick M, Jankovic, Radmilo, Khanna, Ashish K, Llaurado-Serra, Mireia, Lin, Frances, Rose, Louise, Rubulotta, Francesca, Saager, Leif, Williams, Ged, Blot, Stijn I, Dritan, Muzha, Antoni Margarit Ribas, Fernando, Lipovesty, Cecilia, Loudet, Fiona, Coyer, Philipp, Eller, Nafseen, Mostafa, Patrick, M Honoré, Vanesa Mercado Telleria, Jasmina, Smajic, Paula Cristina Nogueira, Khalid Mahmood Khan Nafees, Romuald, Hentchoya, Louise, Rose, Javiera, Soledad, Frances, Lin, Yenny, Cardenas, Amylkar Garay Reyes, Alan, Sustic, Meropi, Mpouzika, Tamas, Vymazal, Hanne Irene Jensen, Hernan, Aguirre-Bermeo, Liivi, Maddison, Maija, Valta, Silvia, Calvino-Gunther, Frank, Bloos, Faustina Excel Adipa, Vasilios, Koulouras, Judy, Enamorado, Zsuzsann, Ágoston, Hrönn, Birgisdóttir, Amit, Gupta, Mohan, Gurjar, Bram, Kilapong, Seyed Mohammadreza Hashemian, Ignacio, Martin-Loeches, Julie, Benbenishty, Andrea, Cortegiani, Kelly, Fletcher, Yoshiro, Hayashi, Wangari, Waweru-Siika, Khalid, Abidi, Sang-Min, Lee, Burhan, Hadri, Mihails, Dolgusevs, Fayez François Abillama, Tomas, Jovaisa, Cyril, Thix, Muhammed, Elhadi, Basri Mat Nor, Shanti, Ratnam, Mohd Zulfakar Mazlan, Sundaresan, Maiyalagan, Luis, Sánchez-Hurtado, Adrian, Belii, Mendsaikhan, Naranpurev, Prabha, Gautam, Dylan De Lange, Rachael, Parke, Rose Ekama Ilesanmi, Mirjana, Shosholcheva, Antonija, Petosic, Ranveig, Lind, Madiha Hashmi Ffarcsi, Javier, Bogarin, Aaron Mark Hernandez, Malgorzata, Mikaszewska-Sokolewicz, Bruno, Sousa, Dana, Tomescu, Dorel, Sandesc, Theogene, Twagirumugabe, Vitaly, Gusarov, Maie, Ebaid, Radmilo, Jankovic, Gari, Slobodianiuk, Andrea, Martonova, Rihard, Knafelj, Mervyn, Mer, Emilio, Maseda, Bernardo, Panka, Joerg, C Schefold, Eva, Joelsson-Alm, Konlawij, Trongtrakul, Lorna, Merritt-Charles, Lamia Ouanes Besbes, Yalım, Dikmen, Lesia, Zgrzheblovska, Mark, Fielding, Francesca, Rubulotta, Ashish, K Khanna, Leif, Saager, Ingrid von der Osten, Alban, Greca, Alma, Cani, Nordian, Xhindi, Genci, Hyska, Antonio Margarit Ribas, Susana, Pinto, Paulo, Alves, Romina, Esposito, Emanuel, Valgolio, John Thomas Sanchez Minope, Antonio, Abdala, Maria, Ayala, Silvina, Bravo, Ana, Bantar, Patricia, Delgado, Gustavo, Badariotti, Fernando, Lipovestky, Ana, Diaz, Pablo, Saul, Mariano, Setten, Alejandra, Aucapina, Ysica, Acosta, Victor, Gonzalez, Luis, Camputaro, Fernando, Baccaro, Robert, Villa, Marcela, Mastantuono, Emiliano, Dean, Oscar Fernández Rostello, Patricia, Brizuela, Julio Ricardo Bartoli, Matias, Guereschi, Cristian, Quiroga, Sofia, Putruele, Paula, Villegas, Veronica, Curilen, Ruben, Fernandez, Mariangeles Gabriela Nocheretti, Rosana Gabriela Escalante, Cecilia Inés Loudet, Silvia, Fernandez, Ana Laura Gonzalez, Gustavo Andres Alvarez, Federico, Iglesias, Silvia, Chaparro, Graciela, Zakalik, Gonzalo, Pagella, Matías, Baini, Pierina Arias Campos, Ignacio, Sabbag, Armando, Schmukler, Imelda Perdomo Fonseca, Gonzalo Martín Alvarez, Mario, Ramirez, Fernando, Tapia, Carlos Alejandro Bascary, Graciela Del Valle Gimenez, Fernando Pablo Bertoletti, Esteban, Milioto, Pablo Julio Maldonaldo Bonsignore, Maria Alejandra Fernandez, Julie, Smith, Tim, Chimunda, Lorraine, Thompson, Teena, Maguire, Wendy, Chaboyer, Stacey, Watts, Marion, Mitchell, Madeleine, Powell, India, Lye, Leanne, Parsons, Nerilee, Baker, Claire, Reynolds, Amy, Thompson, Kristy, Masters, Kellie, Sosnowski, Lynette, Morrison, Gavin, D Leslie, Ramanathan, Lakshmanan, Alexis, Tabah, Wendy, Brown, Sharon, McDowell-Skaines, Andrea, Mclucas, Chris, Smith, Mandy, Tallot, Sarah, Jones, Michelle, Barakat-Johnson, Thomas, Leong, Rand, Butcher, Kerrie, Martin, Philipp, Douschan, Dirk von Lewinski, René, Schmutz, Uta, Kolussi, Fatema, Salman, Zainab, Ateya, Koen De Decker, Niels Van Regenmortel, Anita, Jans, Patricia, Wijnands, Stefano, Coremans, Patrick, M Honore, David De Bels, Tanja, Depuydt, Caroline, Paillet, Luc-Marie, Jacquet, Walter, Swinnen, Francis, Hannes, Matthia, Mergeay, Stijn Van de Velde, Silvie, Allaert, Pieter, Hoste, Christophe, Borin, Sandrine, Balon, Vincent, Fraipont, Patrick, Biston, Nicolas De Schryver, Thierry, Dugernier, Ilse Van Cotthem, Angelica Olivetto de Almeida, Silvia Angelica Jorge, Delmiro, Becker, Raysa Cristina Schmidt, Evellyn, Oliveira, Aline, Ramalho, Eliane, Mazocoli, Audrey, Fioretti, Elaine, Barros, Leticia, Serpa, Suzana, Bianchini, Ticiane, Campanili, Taís, Pantaleao, Paulo Carlos Garcia, Ana Lucia Vitti Ronchini, Rayanne, Santos, Nurulhuda Binti, A Manap, Sean, Bagshaw, Dominic, Carney, Jon, Davidow, Ella, Rokosh, Andréa Maria Laizner, Samantha, Smith, Megan, Mcquirter, Betty Star Kampayana, René, Favre, Martin, Sills, Julie, Dallaire, Cathy, Becker, Sherissa, Microys, Bonnie, Bowes, Jennifer, Lajeunesse, Rishi, Ghosh, Jacqueline, Baptiste-Savoie, Rose, Raizman, Gabriel, Suen, Noushin, Taghavi, Orla, Smith, Clare, Fielding, Julieta, Canales, Pia, Molina, Javiera, Chaparro, Maria Idalia Sepulveda, Matias Jesús Flamm Zamorano, Pamela, Rocha, Ximena, Villanueva, Paola, Araya, Meneses, Dayan, Fernando, Avalos, Xiaohan, Li, Liu, Yu, Xinxia, Li, Xiaoyan, Chen, Zhixia, Jiang, Jing, Yang, Jingfang, Chen, Lei, Yang, Kefang, Wang, Jie, Gao, Xiuhua, Fang, Ronghua, Zhao, Xinhua, Xia, Hongmei, Liu, Jing, Li, Haiyan, Wang, Gen, Meng, Yanhong, Di, Damei, Wang, Rong Hua Zhao, Li Ping Hu, Peipei, Xu, Qing Feng Jiao, Hai Yun Wang, Chun Jie Xia, Yan, Liu, Mei, Ye, Yan, Wan, Wenmei, Wang, Yajun, Ding, Aiua, Ren, Yan, Gao, Qi, Li, Guifang, Du, Yanling, Shen, Yanming, Ding, Ning, Li, Cui, Yuan, Lei, Tan, Qiang, Lin, Hailing, Guo, Howe, Yan, Xiao, Xu, Wei, Zhang, Jinxian, Liang, Libing, Zhang, Eryun, Tian, Qian, Zhao, Lin, Insu, Jingwen, Dong, Yanmei, Gu, Ying, Liu, Lina, Zhao, Wei, Wang, Hongmei, Qiao, Lili, Tuo, Mengmeng, Lv, Jin Yu Zhu, Jifen, Zhu, Ying, Wei, Man, Liu, Yin, He, Jiyin, Cheng, Jin, Liu, Jia, Na, Dongfang, Wei, Qing, Li, Xiaoying, Wu, Huan, Duan, Dongliang, Lin, Qiong, Liang, Xiaofang, Luo, Yunfeng, Xiong, Rong Fen Huang, Jing, Fu, Tao, Zan, Man, Ye, Zeya, Shi, Yanfei, Long, Yang, Lei, Xiaodi, Liu, Chen, Yumei, Lingling, Wang, Yali, Zhang, Yan, Xu, Cheng, Wang, Zhijuan, Chengxia, Sun, Jinhui, Song, Yingli, Wang, Xiumei, Liu, Yupeng, Liu, Yuxia, Yuan, Qingping, Huang, Fengling, Yang, Yun, Wu, Xianping, Luo, Xiaowu, Bai, Hong, Zheng, Min, Song, Yue, Sun, Zhangshuangzi, Li, Feifei, Luo, Miao, Liu, Li Chuntang Li, Xinjian, Li, Guiping, Zhang, Lina, Xiao, Tingting, Yu, Guangyuan, Gao, Wei, Wei, Fanglan, Wang, Ting, Han, Tingting, Li, Zeng, Qi, Jing Mei Zeng, Yan, Long, Fuqun, Pan, Jing, Wang, Guoxue, He, Haiyan, Chen, Feifei, Zhang, Chao, Yu, Gao, Chunhua, Xiuying, Yao, Dongmei, Bai, Liu, Lu, Xuelian, Xu, Yan, Wang, Xuejuan, Liang, Zhang, Na, Aizhi, Zhang, Xiaochun, Hu, Hui, Zhang, Ruixia, Wang, Poon Shing Tak, Sung Wai Ho, Qun Xia Jiang, Xinran, Ding, Liu, Hong, Limei, Miao, Zhaoxia, Feng, Liping, Huang, Juan, Wu, Yuping, Wang, Jiye, Guo, Baoke, Zhang, Chaoqun, Ma, Han, Yu, Congcong, Liu, Min, Ding, Linlin, Luan, Jing, Zheng, Shanshan, Lv, Shumin, Jiang, Wenzhen, Cao, Xiujuan, Xue, Guangyan, Liu, Xiyan, Wei, Youru, Jiang, Zhiru, Yao, Gao, Li, Jinhua, Li, Wenwen, Zhao, Mei, Jiang, Junping, Hao, Jing, Zhang, Caiju, Song, Feifei, Chen, Shuhui, Wang, Lili, Hu, Deyan, Cao, Jianhong, Wan, Xiaomin, Wang, Hongyan, Shao, Zhenxia, Zhang, Xia, Cui, Jingyu, Liu, Lijuan, Zhao, Xingguo, Li, Limei, Fan, Ling, Zhang, Min, Yu, Biyan, Li, Chunxia, Li, Ling, Liu, Xuelian, Liu, Wenmin, Chen, Yan, Li, Zhang, Zhigang, Yuchen, Wu, Chenghau, Mu, Guoyan, Zhu, Fan, Yang, Qi, Bo, Ling, Li, Meili, Chen, Jing Hua Jiang, Hai, Yin, Xuelian, Pang, Yue Ying Gong, Shunzhu, Yang, Xiaoli, Yan, Xianhong, Zheng, Dehong, Lei, Lei, Lei, Yinhua, Guo, Lihong, Liu, Jing, Yu, Wei, Sun, Aiping, Bi, Weiwei, Li, Yang, Wu, Ji, Li, Dongshu, Ni, Zijing, Wu, Bing, Song, Qin, Fei, Yang, Xiaoyan, Qiong, Ran, Xixi, Li, Xueping, Jiao, Hua, Ji, Sun, Zhiping, Hong, Ma, Jianhong, Mu, Yanhua, Hao, Yin, Li, Ying, Wang, Caihong, Hui, Wenjie, Ju, Yuxia, Huo, Yuxia, Wang, Lei, Chen, Yan, Yan, Qingli, Zhao, Hongjuan, Chen, Guijun, Bao, Ying, Cao, Hong, Li, Hong, Zhang, Ying, Zhang, Lina, Xu, Jia, Guixiang, Ying, Li, Hui Min Zhao, Xia, Huang, Zhaoxing, Dai, Yanman, Jian, Hongsu, Zhang, Zhixia, Tian, Zu Qing Cao, Miao, Li, Yang, Liu, Fei, Ouyang, Fuying, Ma, Wangyan, Jin, Liuyan, Ge, Shifen, Wu, Weilian, Yuan, Tianfei, Chen, Guanxiu, Shi, Zhihong, Chen, Kewei, Liu, Xue, Lin, Yuemen, Ly, Sun, Lijuan, Xiao Fang Tian, Shuo, Wang, Zhangxia, Feng, Xiaozhe, Liu, Yunchun, Dong, Jundi, Zhang, Nie, Bocui, Guoxian, Wang, Yingjuan, Zhao, Xiaojun, Wu, Qiao, Yang, Rongjun Ling Hu, Xue Qin Li, Zhu Jun Yu, Yanlan, Yao, Xiaoqiong, Deng, Yan, Xiao, Yan, Xie, Yanping, Yang, Huai, Yang, Yuming, Zhou, Zhuqing, Li, Min, Xiao, Yongxia, Yang, Yani, Tian, Luz Marina Silva Gama, Juan Sebastian Hernandez, Nestor, Caicedo, Jorge, Marin, Maria-Elena, Ochoa, Monica, Gomez, José, Rojas-Suarez, Jeniffer, Gonzalez, Amylkar José Garay Reyes, Edwin, Chapeta, Estefania, Orozco, Ina, Filipović-Grčić, Anita, Vuković, Suzana, Pečenković, Aleksandar, Šuput, Gordana, Zivanovic-Posilovic, Armanda, Bozena, Nikolina, Udiljak, Morena, Milic, Renata Curic Radivojevic, Slobodan, Mihaljevic, Marijana, Matas, Dinko, Tonkovic, Hemena, Čuljak, Ivana, Herceg, Gordana, Pavlisa, Milena, Dobric, Tatjana, Beker, Višnja Nesek Adam, Tanja, Goranovic, Chrysanthos, Markoulias, Mina, Mathaios, Maria, Mylordou, Eleni, Achilleos, Pavlina, Kleanthous, Veronika, Kotanidi, Maria, Foka, Iwy, Charalabous, Anna, Alexandrou, Marios, Georgiou, Artemis, Patsalos, Sofia, Zepoy, Constantina, Constantinou, Petr, Piza, Tomas, Vymazal, Elisabeth, Wiborg, Louise, Bruhn, Karin, Kaasby, Karin Rehnholt Pedersen, Sanne, Mikkelsen, Marie, Collet, Anne, Langvad, Hanne, Andresen, Susanne, Fischer, Inger Ebbesen Kjærgård, Britta, Jepsen, Birthe, Husted, Morten, Bestle, Anne Marie Kodal, Tina Charlotte Bitsch Hansen, Anne Sofie Bomholt Pedersen, Tina Damgaar Thomsen, Anisette, Hoegenhaven, Mette, From, Tine Melgaard Frandsen, Grit, Henning, Anja, Hansen, Inger Abildgaard Bliksted, Luis Mario Tamayo, Pedro, Mogrovejo, Carolina, Palaez, Diego Rolando Morocho Tutillo, Cintia Valencia Hurtado, Maria Fernanda García, Diana, Alvarez, Fausto, Guerrero, Alexandra, Vasquez, Martin, Kütimets, Kadri, Tamme, Eneli, Anvelt, Lomangisi, Dlamini-Sserumaga, Carita, Löfqvist, Virpi, Lusenius, Outi, Kauppi, Jenni-Katarina, Sakki, Tarja, Tervo-Heikkinen, Ulla, Kesti, Merja, Merilainen, Elina, Karjula, Minna, Peltomaa, Auli, Palmu, Maarit, Ahtiala, Maija Anniina Valta, Hervé, Mentec, Gaëtan, Plantefève, Guillaume, Besch, Sébastien, Pili-Floury, Stanislas, Ledochowski, Marc Danguy des Déserts, Christophe, Giacardi, Cédric, Daubin, Audrey, Massard, Yann Le Guen, Agnès, Blanc, Simon, Mandaroux, Silvia Calvino Günther, Prune, Avogadro, Anthony, Radavidson, Jean, Turc, Sébastien, Jochmans, Hervé, Quintard, Laetitia, Boyer, Cédric, Bruel, François, Philippart, Philippe, Montravers, Enora, Atchade, Nadine, Flessel, Benoît, Chinardet, Léa, Soulisse, Cindy, Pillard, Delphine, Ngo, Benjamin, Bongiorno, Nathalie, Heitzler, Virginie, Souppart, Nathalie, Gautheret, Jean-Francois, Timsit, Fatiha, Essardy, Muriel, Fartoukh, Daisy, Mehay, Fabienne, Etourneau, Jean-Christophe, Farkas, Pascal, Beuret, Gabriel, Preda, Etienne De Montmollin, Vincent, Castelain, Ulrich, Jaschinski, Monika, Rothenfusser, Detlef, Kindgen-Milles, Thomas, Dimski, Christine, Fiedler, Tobias, Heinicke, Patrick, Meybohm, Tobias, Schulze, Marc, Bota, Sabrina, Pelz, Tobias, Odenthal, Martin, Christ, Kathrin, Bösl, Achilleas, Chovas, Sebastian, Stehr, Philipp, Simon, Sarah, Grotheer, Sebastian, Schüppel, Stefan, Schaller, Lea, Albrecht, Andeas, Stübner, Stephan, Graeser, Nina, Kolbe, Martina, Lausch, Anja, Diers, Ulf, Guenther, Reimer, 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Styliani, Kourelea, Aikaterini, Efthimiou, Giannoula, Thoma, Apostolos, Bakas, Konstantinos, Psarulis, Souzana, Anisoglou, Eirini, Papageorgiou, Evangelia, Michailidou, Thomai, Tholioti, Athena, Lavrentieva, Evdokia, Sourla, Anastasia, Spyropoulou, Nikolaos, Pantelas, Kristina Mariana Matei Stalika, Ioannis, Georgakas, Antigoni, Karathanou, Syragoula, Tsikriki, Aikaterini, Dimoula, Sofia, Kanakaki, Aristeidis, Vakalos, Konstantinos, Pagioulas, Judy Enamorado Enamorado, Gabor, Nardai, Fatime, Hawchar, Asbjorn, Blondal, Brynja, Rygvadottir, Rannveig, J Jonasdottir, Hrönn, Birgisdottir, Bhagyesh, Shah, Shuchi, Kaushik, Swagata, Tripathy, Mukta, Singh, Sonika, Agarwal, Manish, Gupta, Meraj, Ahmad, Kishore, Mangal, Vaibhav, Bhargava, Vilas, Kushare, Simant, Jha, Lakshay, Bhakhtiani, Manoj, Kamal, Arvind, Baronia, Ade, Susanti, Mayang Indah Lestari, Zulkifli, Zulkifli, Windu, Baskoro, Farid, Zand, Fatemeh, Zarei, Ata, Mahmoodpoor, Farshad, Heidari, Fateme, Jafaraghaee, Aidan, O'Shea, Fiona, O'Shea, Caroline, O'Donnell, Geraldine, Craig, Gerry, Fitzpatrick, Lisa, Dunne, Jennifer, Hastings, Brian, Marsh, Caitriona, Cody, Elizabeth, Campbell, Deirdre, Doyle, Michelle, Pacturanan, Christine, Sheehan, Annette, Carey, Charlotte, Carter, Regina, Mulvey, Damien O'Connell Rosemary Finn, Catherine, Motherway, Amy, Walsh, Jennifer, Kehoe, Shella, Delossantos, Jennifer, Lalor, Siobhan, O'Nuallain, Helena, Behan, Sandra, Mcpherson, Ailesh, Corcoran, Patricia, Gordon, Glenda, Rooney, Dassy, Levy, Mazal, Azencot, Vladimir, Gurevich, Alinoy, Lavy, Valentina, Bendelari, Romina, Marconi, Antonio, Barone, Chiara, Gatti, Andrea, Giampaoletti, Cinzia, Borgognoni, Davide Massimo Ghioldi, Arena, Raimondo, Giacomo, Castiglione, Anna Vita Bruno, Giorgia, Rubulotta, Antonella, Mo, Amalia, Corso, Salvatore, Girianni, Andrea, Bruni, Eugenio, Garofalo, Salvatore Maurizio Maggiore, Alessandro Di Risio, Italo, Calamai, Rosario, Spina, Savino, Spadaro, Carlo Alberto Volta, Antonella, Cotoia, Lucia, 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Guillén, Josep Trenado Alvarez, Mercedes Del Cotillo, Jesus Emilio Barrueco-Francioni, Belen Burgos Conde, Maria Pilar Sogues Blanco, Maria Luisa Blasco, Ana Isabel Clement, Clara, Hurtado, Luz Coronado Sanz, David, Perez-Torres, Estefanía, Prol-Silva, Jorge, Pereira, Iván Areán González, Anastasio Espejo Cano, Cesar Rodriguez Nuñez, Inmaculada Lorenzo Fernadez, Alejandra Azahara Marguello Fernandez, Rosa Del Bosque Diez, Badiola, Hilario, Begoña, Zalba-Etayo, Ana, Pascual-Bielsa, Preveen, Banwarie, Dick, Nahar, Alisha van Axel, Naraindath, N Boedjawan, Erika Backlund Jansson, Ann-Sofie, Malvemyr, Lotta, Johansson, Ulla, Sandberg, Catarina, Tingsvik, Gunilla, Mattsson, Gun, Löf, Martin, Spångfors, Mona, Ringdal, Sebastian, Geijer, Lotti, Orvelius, Mia, Hylen, Caroline, Lagerhäll, Eva, Åkerman, Viveca Hamback Hellkvist, Ulrica, Mickelsson, Ewa, Wahlbom, Ing-Marie, Larsson, Ewa, Wallin, Filippo, Boroli, Solenne, Ory, Margaret Lynn Jong, Alexander, Dullenkopf, Martin, Lang, Yvan, Fleury, 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Rosie, Reece-Anthony, Luis, Mendes, Marcela, Vizcaychipi, Rhian, Bull, Grace, Lacaden, Eleanor, Santiago, Carlos Castro Delgado, Sarah, Farnell-Ward, Elaine, Thorpe, Justine, Somerville, Anne, Williams, Donna, Cummings, Helen, Derrick, Sarah, Brumwell, Claire, Randell, Nicola, Mccann, Emma, Aves, Gillian, Berry, Tamas, Szakmany, Una, Gunter, Paul, Pulak, Nikki, Sarkar, Kerry, Wright, Vitor, Gomes, Jones, Jo, Ruth, Palfrey, Julie, Camsooksai, Abby, Lewis, Antony, Eneas, Ascanio, Tridente, Louise, Barr, Beverley, Thomas, Emma, Parkin, Daniel, Horner, Christian, Frey, Suzanne, Bench, Rachel, Baumber, Phil, Broadhurst, Matthew, Jackson, Lynne, Williams, Michele, Clark, Jonathan, Paddle, Sarah, Bean, Sarah, Buckley, Christopher, Palfreeman, Sophie, Liu, Nicola, Allison, Ben, Attwood, Penny, Parsons, Victoria, Houghton, Sarah Jane Turner, David, Higgins, Egidija, Bielskute, Nicola, Horrigan, Reni, Jacob, Karen, Habgood, Ahmed, Zaki, Amy, Collins, Jenny, Lord, Charalice, Ramiro, Agnieszka, Kubisz-Pudelko, Michelle, Kotze, Helen, Williams, Ihor, Iovenko, Alexander, Tsarev, Arturo, Briva, Gabriela, Mendez, Lena, Napolitano, Magnus, Teig, Jarone, Lee, Gabriel Enrique Rodriguez, Talia, Ben-Jacob, Christopher, Potestio, Timothy, Eng, Dea, Mahanes, Ashish, Khanna, Abhijit, Duggal, Masakatsu, Nananmori, Manuel, Lois, Anna, Diaz, Kunal, Karamchandani, Cheryl, Bealer, Cindy, Barefield, Dorothy, Terry, Pauline, Fivecoat, Olakunle, Idowu, Juan, Cata, Tara, Clesi, Jessica, Peterson, Kevin, Hatton, Jasdeep, Dhaliwal, Dorothee, Mueller, Jing, Tao, Ashley Szabo Eltorai, Stephen, M Pastores, Natalie, Remor, Janel, Salazar, Diane, Barkas, Aaron, Joffe, Christopher, Barnes, Carrie, Sona, Marilyn, Schallom, Jack, Short, Javier, Lorenzo, Ingrid Von Der Osten, Marta, Borkowska, Mireia, Llaurado-Serra, Liesbet, Demarré, Vincianne, Pleitinckx, Cynthia, Xing, Anne-Sophie, Debue, Stefan, Goller, Elsa, Afonso, Gusarov, V, Eugeniya, Larina, Llaurado-Serra, M, Yalim, Dikmen, DecubICUs Study Team, European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators, Muzha, D., Ribas, A.M., Lipovesty, F., Loudet, C., Coyer, F., Eller, P., Mostafa, N., Honoré, P.M., Telleria, V.M., Smajic, J., Nogueira, P.C., Nafees, KMK, Hentchoya, R., Rose, L., Soledad, J., Lin, F., Cardenas, Y., Reyes, A.G., Sustic, A., Mpouzika, M., Vymazal, T., Jensen, H.I., Aguirre-Bermeo, H., Maddison, L., Valta, M., Calvino-Gunther, S., Bloos, F., Adipa, F.E., Koulouras, V., Enamorado, J., Ágoston, Z., Birgisdóttir, H., Gupta, A., Gurjar, M., Kilapong, B., Hashemian, S.M., Martin-Loeches, I., Benbenishty, J., Cortegiani, A., Fletcher, K., Hayashi, Y., Waweru-Siika, W., Abidi, K., Lee, S.M., Hadri, B., Dolgusevs, M., Abillama, F.F., Jovaisa, T., Thix, C., Elhadi, M., Nor, B.M., Ratnam, S., Mazlan, M.Z., Maiyalagan, S., Sánchez-Hurtado, L., Belii, A., Naranpurev, M., Gautam, P., De Lange, D., Parke, R., Ilesanmi, R.E., Shosholcheva, M., Petosic, A., Lind, R., Ffarcsi, M.H., Bogarin, J., Hernandez, A.M., Mikaszewska-Sokolewicz, M., Sousa, B., Tomescu, D., Sandesc, D., Twagirumugabe, T., Gusarov, V., Ebaid, M., Jankovic, R., Slobodianiuk, G., Martonova, A., Knafelj, R., Mer, M., Maseda, E., Panka, B., Schefold, J.C., Joelsson-Alm, E., Trongtrakul, K., Merritt-Charles, L., Besbes, L.O., Dikmen, Y., Zgrzheblovska, L., Fielding, M., Rubulotta, F., Khanna, A.K., Saager, L., von der Osten, I., Greca, A., Cani, A., Xhindi, N., Hyska, G., Pinto, S., Alves, P., Esposito, R., Valgolio, E., Minope, JTS, Abdala, A., Ayala, M., Bravo, S., Bantar, A., Delgado, P., Badariotti, G., Lipovestky, F., Diaz, A., Saul, P., Setten, M., Aucapina, A., Acosta, Y., Gonzalez, V., Camputaro, L., Baccaro, F., Villa, R., Mastantuono, M., Dean, E., Rostello, O.F., Brizuela, P., Bartoli, J.R., Guereschi, M., Quiroga, C., Putruele, S., Villegas, P., Curilen, V., Fernandez, R., Nocheretti, M.G., Escalante, R.G., Loudet, C.I., Fernandez, S., Gonzalez, A.L., Alvarez, G.A., Iglesias, F., Chaparro, S., Zakalik, G., Pagella, G., Baini, M., Campos, P.A., Sabbag, I., Schmukler, A., Fonseca, I.P., Alvarez, G.M., Ramirez, M., Tapia, F., Bascary, C.A., Del Valle Gimenez, G., Bertoletti, F.P., Milioto, E., Bonsignore, PJM, Fernandez, M.A., Smith, J., Chimunda, T., Thompson, L., Maguire, T., Chaboyer, W., Watts, S., Mitchell, M., Powell, M., Lye, I., Parsons, L., Baker, N., Reynolds, C., Thompson, A., Masters, K., Sosnowski, K., Morrison, L., Leslie, G.D., Lakshmanan, R., Tabah, A., Brown, W., McDowell-Skaines, S., McLucas, A., Smith, C., Tallot, M., Jones, S., Barakat-Johnson, M., Leong, T., Butcher, R., Martin, K., Douschan, P., von Lewinski, D., Schmutz, R., Kolussi, U., Salman, F., Ateya, Z., De Decker, K., Van Regenmortel, N., Jans, A., Wijnands, P., Coremans, S., Honore, P.M., De Bels, D., Depuydt, T., Paillet, C., Jacquet, L.M., Swinnen, W., Hannes, F., Mergeay, M., Van de Velde, S., Allaert, S., Hoste, P., Borin, C., Balon, S., Fraipont, V., Biston, P., De Schryver, N., Dugernier, T., Van Cotthem, I., de Almeida, A.O., Jorge, S.A., Becker, D., Schmidt, R.C., Oliveira, E., Ramalho, A., Mazocoli, E., Fioretti, A., Barros, E., Serpa, L., Bianchini, S., Campanili, T., Pantaleao, T., Garcia, P.C., Ronchini, ALV, Santos, R., Manap, NBA, Bagshaw, S., Carney, D., Davidow, J., Rokosh, E., Laizner, A.M., Smith, S., McQuirter, M., Kampayana, B.S., Favre, R., Sills, M., Dallaire, J., Becker, C., Microys, S., Bowes, B., Lajeunesse, J., Ghosh, R., Baptiste-Savoie, J., Raizman, R., Suen, G., Taghavi, N., Smith, O., Fielding, C., Canales, J., Molina, P., Chaparro, J., Sepulveda, M.I., Zamorano, MJF, Rocha, P., Villanueva, X., Araya, P., Dayan, M., Avalos, F., Li, X., Liu, Y., Chen, X., Jiang, Z., Yang, J., Chen, J., Yang, L., Wang, K., Gao, J., Fang, X., Zhao, R., Xia, X., Liu, H., Li, J., Wang, H., Meng, G., Di, Y., Wang, D., Zhao, R.H., Hu, L.P., Peipei, X., Jiao, Q.F., Wang, H.Y., Xia, C.J., Ye, M., Wan, Y., Wang, W., Ding, Y., Ren, A., Gao, Y., Li, Q., Du, G., Shen, Y., Li, N., Yuan, C., Tan, L., Lin, Q., Guo, H., Yan, H., Xu, X., Zhang, W., Liang, J., Zhang, L., Tian, E., Zhao, Q., InSu, L., Dong, J., Gu, Y., Zhao, L., Qiao, H., Tuo, L., Lv, M., Zhu, J.Y., Zhu, J., Wei, Y., Liu, M., He, Y., Cheng, J., Liu, J., Jia, N., Wei, D., Wu, X., Duan, H., Lin, D., Liang, Q., Luo, X., Xiong, Y., Huang, R.F., Fu, J., Zan, T., Shi, Z., Long, Y., Lei, Y., Liu, X., Yumei, C., Wang, L., Zhang, Y., Xu, Y., Cheng, X., Zhijuan, W., Sun, C., Song, J., Wang, Y., Yuan, Y., Huang, Q., Yang, F., Wu, Y., Bai, X., Zheng, H., Song, M., Sun, Y., Li, Z., Luo, F., Li, L.C., Zhang, G., Xiao, L., Yu, T., Gao, G., Wei, W., Wang, F., Han, T., Li, T., Zeng, Q., Zeng, J.M., Pan, F., Wang, J., He, G., Chen, H., Zhang, F., Chao, Y., Chunhua, G., Yao, X., Bai, D., Liu, L., Liang, X., Zhang, N., Zhang, A., Hu, X., Zhang, H., Wang, R., Tak, P.S., Ho, S.W., Jiang, Q.X., Ding, X., Hong, L., Miao, L., Feng, Z., Huang, L., Wu, J., Guo, J., Zhang, B., Ma, C., Han, Y., Liu, C., Ding, M., Luan, L., Zheng, J., Lv, S., Jiang, S., Cao, W., Xue, X., Liu, G., Wei, X., Jiang, Y., Yao, Z., Gao, L., Zhao, W., Jiang, M., Hao, J., Zhang, J., Song, C., Chen, F., Wang, S., Hu, L., Cao, D., Wan, J., Wang, X., Shao, H., Zhang, Z., Cui, X., Fan, L., Yu, M., Li, B., Li, C., Chen, W., Li, Y., Zhigang, Z., Yuchen, W., Mu, C., Zhu, G., Bo, Q., Li, L., Chen, M., Jiang, J.H., Yin, H., Pang, X., Gong, Y.Y., Yang, S., Yan, X., Zheng, X., Lei, D., Lei, L., Guo, Y., Yu, J., Sun, W., Bi, A., Li, W., Ni, D., Wu, Z., Song, B., Fei, Q., Xiaoyan, Y., Ran, Q., Xixi, L., Jiao, X., Ji, H., Zhiping, S., Hong, M., Jianhong, M., Hao, Y., Yin, L., Hui, C., Ju, W., Huo, Y., Chen, L., Yan, Y., Bao, G., Cao, Y., Xu, L., Guixiang, J., Zhao, H.M., Huang, X., Dai, Z., Jian, Y., Tian, Z., Cao, Z.Q., Li, M., Ouyang, F., Ma, F., Jin, W., Ge, L., Wu, S., Yuan, W., Chen, T., Shi, G., Chen, Z., Liu, K., Lin, X., Yuemen, L., Lijuan, S., Tian, X.F., Dong, Y., Bocui, N., Wang, G., Zhao, Y., Yang, Q., Hu, R.L., Li, X.Q., Yu, Z.J., Yao, Y., Deng, X., Xiao, Y., Xie, Y., Yang, Y., Yang, H., Zhou, Y., Xiao, M., Tian, Y., Gama, LMS, Hernandez, J.S., Caicedo, N., Marin, J., Ochoa, M.E., Gomez, M., Rojas-Suarez, J., Gonzalez, J., Reyes, AJG, Chapeta, E., Orozco, E., Filipović-Grčić, I., Vuković, A., Pečenković, S., Šuput, A., Zivanovic-Posilovic, G., Bozena, A., Udiljak, N., Milic, M., Radivojevic, R.C., Mihaljevic, S., Matas, M., Tonkovic, D., Čuljak, H., Herceg, I., Pavlisa, G., Dobric, M., Beker, T., Adam, V.N., Goranovic, T., Markoulias, C., Mathaios, M., Mylordou, M., Achilleos, E., Kleanthous, P., Kotanidi, V., Foka, M., Charalabous, I., Alexandrou, A., Georgiou, M., Patsalos, A., Zepoy, S., Constantinou, C., Piza, P., Wiborg, E., Bruhn, L., Kaasby, K., Pedersen, K.R., Mikkelsen, S., Collet, M., Langvad, A., Andresen, H., Fischer, S., Kjærgård, I.E., Jepsen, B., Husted, B., Bestle, M., Kodal, A.M., Hansen, TCB, Pedersen, ASB, Thomsen, T.D., Hoegenhaven, A., From, M., Frandsen, T.M., Henning, G., Hansen, A., Bliksted, I.A., Tamayo, L.M., Mogrovejo, P., Palaez, C., Tutillo, DRM, Hurtado, C.V., García, M.F., Alvarez, D., Guerrero, F., Vasquez, A., Kütimets, M., Tamme, K., Anvelt, E., Dlamini-Sserumaga, L., Löfqvist, C., Lusenius, V., Kauppi, O., Sakki, J.K., Tervo-Heikkinen, T., Kesti, U., Merilainen, M., Karjula, E., Peltomaa, M., Palmu, A., Ahtiala, M., Valta, M.A., Mentec, H., Plantefève, G., Besch, G., Pili-Floury, S., Ledochowski, S., Déserts, MDD, Giacardi, C., Daubin, C., Massard, A., Le Guen, Y., Blanc, A., Mandaroux, S., Günther, S.C., Avogadro, P., Radavidson, A., Turc, J., Jochmans, S., Quintard, H., Boyer, L., Bruel, C., Philippart, F., Montravers, P., Atchade, E., Flessel, N., Chinardet, B., Soulisse, L., Pillard, C., Ngo, D., Bongiorno, B., Heitzler, N., Souppart, V., Gautheret, N., Timsit, J.F., Essardy, F., Fartoukh, M., Mehay, D., Etourneau, F., Farkas, J.C., Beuret, P., Preda, G., De Montmollin, E., Castelain, V., Jaschinski, U., Rothenfusser, M., Kindgen-Milles, D., Dimski, T., Fiedler, C., Heinicke, T., Meybohm, P., Schulze, T., Bota, M., Pelz, S., Odenthal, T., Christ, M., Bösl, K., Chovas, A., Stehr, S., Simon, P., Grotheer, S., Schüppel, S., Schaller, S., Albrecht, L., Stübner, A., Graeser, S., Kolbe, N., Lausch, M., Diers, A., Guenther, U., Riessen, R., Roller, M., Osei, I.P., Kusi-Appiah, A.C., Yakubu, Y.H., Guadi-Gosh, B., Dragoumanis, C., Christofis, C., Kazakos, N., Bastani, S., Martinos, C., Bekos, V., Papanikolaou, M., Papavasilopoulou, T., Efthymiou, A., Chantziara, V., Kyriakoudi, A., Kakaras, N., Diakaki, C., Flevari, A., Nikolaou, C., Katerina, K., Avramopoulou, L., Tsikritsaki, K., Gkiokas, G., Pantiora, E., Katsenos, C., Patsiou, E.C., Alexandropoulou, P., Koutsodimitropoulos, I., Farmakis, E., Nestora, K., Chatzis, M., Kondili, E., Soundoulounaki, S., Mousafiri, O., Lepida, D., Liarmakopoulou, A., Papathanakos, G., Oikonomou, M., Ioannides, P., Papadopoulos, D., Staikos, I., Stafylaraki, M., Raitsiou, B., Mandis, K., Ravani, I., Kourelea, S., Efthimiou, A., Thoma, G., Bakas, A., Psarulis, K., Anisoglou, S., Papageorgiou, E., Michailidou, E., Tholioti, T., Lavrentieva, A., Sourla, E., Spyropoulou, A., Pantelas, N., Stalika, KMM, Georgakas, I., Karathanou, A., Tsikriki, S., Dimoula, A., Kanakaki, S., Vakalos, A., Pagioulas, K., Enamorado, J.E., Nardai, G., Hawchar, F., Blondal, A., Rygvadottir, B., Jonasdottir, R.J., Birgisdottir, H., Shah, B., Kaushik, S., Tripathy, S., Singh, M., Agarwal, S., Gupta, M., Ahmad, M., Mangal, K., Bhargava, V., Kushare, V., Jha, S., Bhakhtiani, L., Kamal, M., Baronia, A., Susanti, A., Lestari, M.I., Zulkifli, Z., Baskoro, W., Zand, F., Zarei, F., Mahmoodpoor, A., Heidari, F., Jafaraghaee, F., O'Shea, A., O'Shea, F., O'Donnell, C., Craig, G., Fitzpatrick, G., Dunne, L., Hastings, J., Marsh, B., Cody, C., Campbell, E., Doyle, D., Pacturanan, M., Sheehan, C., Carey, A., Carter, C., Mulvey, R., Finn, DOR, Motherway, C., Walsh, A., Kehoe, J., Delossantos, S., Lalor, J., O'Nuallain, S., Behan, H., McPherson, S., Corcoran, A., Gordon, P., Rooney, G., Levy, D., Azencot, M., Gurevich, V., Lavy, A., Bendelari, V., Marconi, R., Barone, A., Gatti, C., Giampaoletti, A., Borgognoni, C., Ghioldi, D.M., Raimondo, A., Castiglione, G., Bruno, A.V., Rubulotta, G., Mo, A., Corso, A., Girianni, S., Bruni, A., Garofalo, E., Maggiore, S.M., Di Risio, A., Calamai, I., Spina, R., Spadaro, S., Volta, C.A., Cotoia, A., Mirabella, L., Maulicino, L., Abregal, G., Donvito, M., D'Ambrosio, P., Binda, F., Adamina, I., Galazzi, A., Negro, A., Vaschetto, R., Capuzzi, F., Boschetto, M., Stivanello, L., Bonaccorso, L., Megna, C., Iozzo, P., Rizzo, A., Scire, G., Taibi, M.R., Tranello, F.P., Manzo, A., Traina, L., Pastore, B., Quaini, A., Giusti, G.D., Montaldi, G., Piergentili, F., Mancini, F., Casaioli, S., Uccelli, F., Guarracino, F., Onelli, A., Di Gravio, V., Cossu, M., Matrona, O., Rocco, M., Alampi, D., Dellafiore, F., Ranalli, F., Bossolasco, M., Brizio, E., Migliorino, P., Cortellazi, P., Rosati, M., D'Ambrosio, F., Quagliotto, C., Roman-Pognuz, E., Peratoner, A., De Rosa, S., Martin, M.A., De Sanctis, F., Ciorba, P., Toppin, P., Harding-Goldson, H., Taito, S., Shime, N., Yamamoto, R., Kanda, F., Hirao, A., Egi, M., Noguchi, A., Hashimoto, S., Aya, U., Sakuramoto, H., Ohuchi, A., Kataoka, J., Maruyama, K., Nakayama, I., Nishime, Y., Fujimoto, K., Takahashi, K., Tsujimoto, M., Shimizu, M., Tole, E., Correia, M.C., Kim, J.H., Park, S., Kim, K.C., Baek, J., Bae, J.M., Park, S.Y., Park, T.S., Lee, H.B., Park, J., Yeon-Joo, L., Young-Jae, C., Jeon, K., Kim, S.C., Lee, J., Chee, H.K., Huh, J.W., Sim, Y.S., Kim, J., Chang, Y., Ahn, J.J., Kang, B.J., Lee, W.Y., Lee, S.J., Baftiu, N., Krastins, I., Stiban, S., Feghaly, M.E., Gharios, E., Merheb, M., Benlamin, M., Khaled, A., Belkhair, W.A., Tabib, M., Ashour, F., Elhadi, A., Tababa, OWE, Khaled, T., Alkhumsi, SIR, Alshrif, A.I., Aboufray, A.A., Alabuzidi, A., Triki, A.R., Elgammudi, M., Zahra, H.B., Soula, E., Al-Alawi, MMS, Ahmed, H., Ghula, MAA, Vosylius, S., Mouton, L., Rastegar, T., Sertznig, C., Martin, G., Theisen, C., Ferretti, C., Gils, F., Gallion, M., Zainudin, A., Bahrin, LKK, Deva, S.R., Rahim, AHA, Wahab, S., Hassan, WNW, Ismail, WNW, Ali, M.N., Khoo, T.M., Samat, N.M., Tong, JMG, Adib, NAN, Nor, MBM, Ismail, N., Sulaiman, S.R., Foong, K.W., Alias, A., Hua, N.P., Zermeno, J.M., Blanco, D., Duran, K., Nava, CLL, Nandyelly, SJR, Sanchez-Hurtado, L.A., Tejeda-Huezo, B., Del Moral Armengol, M., Nava, LPA, Herrera, J.G., de Anda, GFV, Gallegos-Perez, H., Hernandez-Sanchez, N., Hernandez-Ponce, L., Gorordo-Delsol, L., Hernandez-Romero, M., Gomez, S., Molinar, F., Ñamendys-Silva, S.A., Romero-Gonzalez, J.P., Gonzalez, D., Landaverde, A., Sosa, M.Á., Navarro, B., de Molina Serrano, JIR, Iburrigarro, S.R., Ibarra, A., Aguirre, J., Martinez-Gonzalez, M., Padilla, NRC, Pineda, AAV, Villafuerte, MVE, Herrera, MOG, Baasanjav, B., Hachimi, A., Elkhayari, M., Dendane, T., Subedi, N.B., Pathak, S.D., Manandhar, M., Van Gulik, L., Van Den Brink, M., Van Vliet, P., Gerretsen, B., Van Den Berg, L., De Haan, M., Tuinstra, B., Kuijpers, P., Reijntjens, J., Vermeijden, J.W., Rinket, M., Vanroest, M., Reidinga, A., Loef, B., Dieperink, W., Onrust, M., Dormans, T., Bormans, L., Koopmans, M., Gerritsen, R.T., Van Den Elst, A., Evers, M., Oiting, O., Wilting, R., Ramaker, B., van der Kuil, M., Fijen, J.W., Haas, L., Haringman, J., Newby, L., Gilder, E., Hacking, D., Dagooc, R., Song, R., Waibel, H., Dawn, F., Rapley, J., Chadwick, L., Chapman, C., Crone, P., Albrett, J., Marko, P., Goodson, J., Browne, T., Whitticase, R., Davidson, C., Judd, H., Owens, D., Onyeka, T., Ugwu, I., Ilesanmi, R., Adejumo, P.O., Owojuyigbe, A., Adenekan, A., Uba, S., Chime, C., Jibrin, D., Sankey, B.J., Adekola, O., Olanipekun, S., Shosolcheva, M., Gievski, V., Kartalov, A., Naumovski, F., Kuzmanovska, B., Trposak, A., Bogoevska-Miteva, Z., Rosalia, R., Olsen, B.F., Sjobo, B., Jensen, K.D., Sykehus, D., Johansen, B.F., Straede, E., 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Gonzalez D., Landaverde A., Sosa M.A., Navarro B., de Molina Serrano J.I.R., Iburrigarro S.R., Ibarra A., Aguirre J., Martinez-Gonzalez M., Padilla N.R.C., Pineda A.A.V., Villafuerte M.V.E., Herrera M.O.G., Baasanjav B., Hachimi A., Elkhayari M., Dendane T., Subedi N.B., Pathak S.D., Manandhar M., Van Gulik L., Van Den Brink M., Van Vliet P., Gerretsen B., Van Den Berg L., De Haan M., Tuinstra B., Kuijpers P., Reijntjens J., Vermeijden J.W., Rinket M., Vanroest M., Reidinga A., Loef B., Dieperink W., Onrust M., Dormans T., Bormans L., Koopmans M., Gerritsen R.T., Van Den Elst A., Evers M., Oiting O., Wilting R., Ramaker B., van der Kuil M., Fijen J.-W., Haas L., De Lange D., Haringman J., Newby L., Gilder E., Hacking D., Dagooc R., Song R., Waibel H., Dawn F., Rapley J., Chadwick L., Chapman C., Crone P., Albrett J., Marko P., Goodson J., Browne T., Whitticase R., Davidson C., Judd H., Owens D., Onyeka T., Ugwu I., Ilesanmi R., Adejumo P.O., Owojuyigbe A., Adenekan A., Uba S., Chime C., Jibrin D., Sankey B.J., Adekola O., Olanipekun S., Shosolcheva M., Gievski V., Kartalov A., Naumovski F., Kuzmanovska B., Trposak A., Bogoevska-Miteva Z., Rosalia R., Olsen B.F., Sjobo B., Jensen K.D., Sykehus D., Johansen B.F., Straede E., Johansen E., Finnstrom I.J., Toellefsen A., Ostenjo H., Bjorgen H., Bratsberg B., Kristoffersen E., Skorstad E.M., Hansen S., Vullum S., Lunde G.A., Arntsen W., Lund M., Akselsen G.R., Monstad K.R., Stenset A., Haugom H., Monsen B., Hogvall L., Trudvang S., Galaaen B., Malmin S.K., Andersen M.H., Hargott R.F., Andersen Y., Steffenak E., Nyhus M., Meland B., Hashmi M., Rivas N., Maidana E., de Jesus Ortiz A., Cabral D.M.B., Simi M., Aponte C., Rivas J.C., Gill S., Garcia A., Alvarenga G., Cespedes L., Perez H., Moreira M.L., Canete F., Gonzalez R., Monges N., Coman M., Pederzani M., Franco N., Aganon F., Martinez R., Noblezada-Uy D., Ellazar C.G., Cerezo F.D., Palo J.E., Aperocho C.A.J., Isanan M., Tubacka M., Jasiewicz P., Czuczwar M., Borys M., Gutysz-Wojnicka A., Glinka L., Gawda R., Bilawicz J., Cabrita P., Vieira J., Figueiredo M.F., Pinheiro C.M., Antunes N., Pedro L., Ferreira F., Parente I., Varela M., Fernandes F., Martins C., Viveiros A., Cavaco R., Rita C.S., Dias S., Feranandes A.M., Silva P., Nunes C., Cabral J., Pires F., Ferreira H., Santos J., Pinto V.M.V., Bispo B.M., Ferreira A., Molinos E., Lafuente E., Gregorio R., Costa H., Lima A., Ferreira S., Seromenho V., Luis E., Valerio I., Cesar H., Tavares A., Alsheikhly A.S., Mahmood S., Guran C.T., Moise A., Filipescu D.C., Luchian M., Popescu M., Scutariu M.A., Petrisor C., Hagau N., Grigoras I., Patrichi T., Gusarev V., Pivkina A., Kulakov V., Ignatenko O., Kovaleva J., Zhivotneva T., Zhedaeva M., Matiushkov N., Ershova O., Egorova N., Khoronenko V., Baskakov D., Sergeev D., Piradov M., Grishina L., Magomedov M., Zuev E., Gorokhovatsky U., Leonova A., Fadeeva L., Belskiy V., Galishevskiy D., Zubareva N., Tribulev M., Zueva O., Kiselev A., Kamenshchikov N., Tokareva E., Petrushin M., Starchenko I., Nshimyumuremyi I., Muhizi J., Buregeya E., Nzarora J., Assiri A., Ebaid M.S., Almekhlafi G., Mandourah Y., Velickovic J., Velickovic D., Jovanovic B., Hadzibegovic A., Stefanovic B., Misic V., Bumbasirevic V., Rajkovic M., Stojanovic M., Gavrilovic S., Stanojevic M., Yaghi A., Turcan A., Firment P., Rabarova D., Lancaricova D., Vlaovic J., Groznik M., Lukic M., Perme J., Sostaric M., Umek N., Mirkovic T., Dolenc S., Fister M., Zorko N., Markota A., Yeni N.P., Jali P., Schmollgruber S., Syed M.R., Parag N., Wise R., Galiana M., Navarro J.A., De Pablo A.M., Albert P., Martinez P., Mendiara Y., Garcia B., Llinas A.A., Riveiro M., Gallart E., Riera A., Sanz M., Salo S., Lajara M.A.G., Nieto M.V., Garcia R., Pena J.M.G., Gorgolas M.C., Isasi M.A., Sierra R., Gordo F., Conejo I., Salva-Costa V., Garzon-Tovar C., Lospitao S., Gutierrez P., Girona M., Adamuz J., Olivares P.G., de Ceballos J.P.G., Tirado C., De Wit I., Polo A.B.C., del Mar Diaz Salcedo M., Ripolles-Melchor J., Martinez-Hurtado E., Alvarez J.D., Arcas M.L.B., Gonzalez J.I.T., de la Ventana A.B.S., Calleja P.L.-A., Alvarez R.G., Zamora P.S., Guerrero A.O., Cosano R., Perez-Vacas J., Campos-Perez M., Barreiro E.M., Sanchez L.C., Diaz M.G., Jimenez R., Del Rio Cabajo L., Muriel D.S., Alonso H.F., Fernandez A.W., Pinan I.S., Albaiceta G.M., Fernandez M.C.I., Abos F.J.S., Monedero P., Chueca R.M., Aguirre L.G., Manosa S.C., Luque C.P., Calpe N., Losilla M.R., Fores M.T., Farre O., Fernandez O., del Rosario Villar Redondo M., Arteta Arteta D.S., Sanchez M.A.H., Espinosa C.P., Reyes L.M., Domenech L.C., Guillen C.V., Alvarez J.T., del Cotillo M., Barrueco-Francioni J.E., Conde B.B., Blanco M.P.S., Blasco M.L., Clement A.I., Hurtado C., Sanz L.C., Perez-Torres D., Prol-Silva E., Pereira J., Gonzalez I.A., Cano A.E., Nunez C.R., Fernadez I.L., Fernandez A.A.M., Del Bosque Diez R., Hilario B., Zalba-Etayo B., Pascual-Bielsa A., Banwarie P., Nahar D., van Axel A., Boedjawan N.N., Jansson E.B., Malvemyr A.-S., Johansson L., Sandberg U., Tingsvik C., Mattsson G., Lof G., Spangfors M., Ringdal M., Geijer S., Orvelius L., Hylen M., Lagerhall C., Akerman E., Hellkvist V.H., Mickelsson U., Wahlbom E., Larsson I.-M., Wallin E., Boroli F., Ory S., Jong M.L., Dullenkopf A., Lang M., Fleury Y., Maus M., Ben-Hamouda N., Fishman A., Hsu M.Y., Chang S.C., Trongtratul K., Sawawiboon C., Morakul S., Khwannimit B., Singh K., Ventour D., Figaro-Barclay D., Sankar-Maharaj S., Mebazaa M.S., Kamoun S., Elatrous S., Besbes L., Abroug F., Naija W., Elhechmi Y.Z., Sellami W., Hajjej Z., Merhabene T., Talik I., Kuscu O.O., Dilek O., Zerman A., Dal H.C., Turan S., Aydemir S., Yilmaz H., Calili D.K., Izdes S., Cengiz M., Gumus A., Tasdemir B., Kagnici A., Ay M., Ay S.A., Caliskan G., Akbas T., Balbay A.O., Efe S., Inal V., Elay G., Karabacak P., Ozserezli B., Senturk E., Demirkiran O., Bozbay S., Erdogan E., Akker M., Peker N., Ozgultekin A., Serin S.O., Turan C., Karaoren G., Goksu S., Karakurt S., Arikan H., Gul F., Cinel I., Kara I., Undar H.N., Bayraktar Y.S., Celik J.B., Tokur M.E., Aydin D.T., Yildiz I., Ozcan B., Erdivanli B., Eroglu A., Akdag D., Unlu N., Dungca A., Ali A., Thankamma B., Reyes P.E., John S., Rajendran A., Ahmad F.K.E., Smiley K.A., Hojden S., Miller M.T., Das Sasidharan Nair V., Antonio M.G.S., Qawasmeh K.A., Shawish S.A., Twiggs H., Rosado I., Babych V., Morren F., Young C., Vaughan-Jones N., Harris S., Burns K., Georgiev C., Shayamano R., Kerslake I., Creber P., Vochin A., O'Brien C., Caddell P., Hagan S., Hughes M., Torlinski T., Sherwin J., Kannan S., Markham A., Lebon R., Cupitt J., Cranshaw J., White N., Marriott V., Milner W., Groba C.B., Azoia J., Polgarova P., George S., Kapoor R., Lynch C., Fox N., Cranmer K., Llewellym T., Matthews K., Maltby L., Ibao J., Boulton K., Jarman R., Baxter K., Raj A.S., Moghal A., White J., Barrowcliffe S., Pulletz M., Ganeshalingam V., Baruah R., Baker H., Woods J., Ei P.P., Ogbeide V., Hayden P., Hughes J., Balasubramanian M., Salberg A., Saha R., Holmquist D., Derbyshire C., Smith N., Stones E., Ademokun J., Legorburo M.S., North S., Brett C., Jaundoo H., Craig J., Whiteley S., Howcroft C., Wilby L., Delve P., Shaw D., Williams K., Welters I.D., McMullen J., Brett S., Flores L., Trueman-Dawkins T., Templeton M., Adams J., Prowle J., Byers H., McDonnell A., Rose B.O., Reece-Anthony R., Mendes L., Vizcaychipi M., Bull R., Lacaden G., Santiago E., Delgado C.C., Farnell-Ward S., Thorpe E., Somerville J., Williams A., Cummings D., Derrick H., Brumwell S., Randell C., McCann N., Aves E., Berry G., Szakmany T., Gunter U., Pulak P., Sarkar N., Wright K., Gomes V., Jones J., Palfrey R., Camsooksai J., Lewis A., Eneas A., Tridente A., Barr L., Thomas B., Parkin E., Horner D., Frey C., Bench S., Baumber R., Broadhurst P., Jackson M., Williams L., Clark M., Paddle J., Bean S., Buckley S., Palfreeman C., Liu S., Allison N., Attwood B., Parsons P., Houghton V., Turner S.J., Higgins D., Bielskute E., Horrigan N., Jacob R., Habgood K., Zaki A., Collins A., Lord J., Ramiro C., Kubisz-Pudelko A., Kotze M., Williams H., Iovenko I., Tsarev A., Briva A., Mendez G., Napolitano L., Teig M., Rodriguez G.E., Ben-Jacob T., Potestio C., Eng T., Mahanes D., Khanna A., Duggal A., Nananmori M., Lois M., Karamchandani K., Bealer C., Barefield C., Terry D., Fivecoat P., Idowu O., Cata J., Clesi T., Peterson J., Hatton K., Dhaliwal J., Mueller D., Tao J., Eltorai A.S., Pastores S.M., Remor N., Salazar J., Barkas D., Joffe A., Barnes C., Sona C., Schallom M., Short J., Lorenzo J., Von Der Osten I., Borkowska M., Demarre L., Pleitinckx V., Xing C., Debue A.-S., Goller S., Larina E., Labeau, S. O., Blackwood, B., Brett, S. J., Deschepper, M., Francois, G., Honore, P. M., Khanna, A. K., Williams, G., Blot, S. I., Ribas, A. M., Telleria, V. M., Nogueira, P. C., Nafees, K. M. K., Reyes, A. G., Jensen, H. I., Adipa, F. E., Agoston, Z., Hashemian, S. M., Lee, S. -M., Abillama, F. F., Nor, B. M., Mazlan, M. Z., Sanchez-Hurtado, L., De lange, D., Ilesanmi, R. E., Ffarcsi, M. H., Hernandez, A. M., Schefold, J. C., Besbes, L. O., Minope, J. T. S., Rostello, O. F., Bartoli, J. R., Nocheretti, M. G., Escalante, R. G., Loudet, C. I., Gonzalez, A. L., Alvarez, G. A., Campos, P. A., Fonseca, I. P., Alvarez, G. M., Bascary, C. A., del Valle Gimenez, G., Bertoletti, F. P., Bonsignore, P. J. M., Fernandez, M. A., Leslie, G. D., Mclucas, A., Jacquet, L. -M., de Almeida, A. O., Jorge, S. A., Schmidt, R. C., Garcia, P. C., Ronchini, A. L. V., Manap, N. B. A., Laizner, A. M., Mcquirter, M., Kampayana, B. S., Sepulveda, M. I., Zamorano, M. J. F., Zhao, R. H., Hu, L. P., Jiao, Q. F., Wang, H. Y., Xia, C. J., Insu, L., Zhu, J. Y., Zhu, J. F., Huang, R. F., Wang, L. L., Song, J. H., Liu, X. M., Li, Z. S., Li, L. C., Zeng, J. M., Hu, X. C., Wang, R. X., Tak, P. S., Ho, S. W., Jiang, Q. X., Huang, L. P., Liu, X. L., Jiang, J. H., Gong, Y. Y., Lei, D. H., Bi, A. P., Zhao, H. M., Cao, Z. Q., Wu, S. F., Tian, X. F., Feng, Z. X., Liu, X. Z., Jiang, Z. X., Wang, G. X., Hu, R. L., Li, X. Q., Yu, Z. J., Yang, Y. X., Gama, L. M. S., Hernandez, J. S., Ochoa, M. -E., Reyes, A. J. G., Filipovic-Grcic, I., Vukovic, A., Pecenkovic, S., Suput, A., Radivojevic, R. C., Culjak, H., Adam, V. N., Pedersen, K. R., Kjaergard, I. E., Kodal, A. M., Hansen, T. C. B., Pedersen, A. S. B., Thomsen, T. D., Frandsen, T. M., Bliksted, I. A., Tamayo, L. M., Tutillo, D. R. M., Hurtado, C. V., Garcia, M. F., Kutimets, M., Lofqvist, C., Sakki, J. -K., Valta, M. A., Plantefeve, G., Deserts, M. D., Gunther, S. C., Timsit, J. -F., Farkas, J. -C., Bosl, K., Schuppel, S., Stubner, A., Osei, I. 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V., Namendys-Silva, S. A., Romero-Gonzalez, J. P., Sosa, M. A., de Molina Serrano, J. I. R., Iburrigarro, S. R., Padilla, N. R. C., Pineda, A. A. V., Villafuerte, M. V. E., Herrera, M. O. G., Subedi, N. B., Pathak, S. D., Vermeijden, J. W., Gerritsen, R. T., Fijen, J. -W., Adejumo, P. O., Sankey, B. J., Olsen, B. F., Jensen, K. D., Johansen, B. F., Finnstrom, I. J., Skorstad, E. M., Lunde, G. A., Akselsen, G. R., Monstad, K. R., Hogvall, L., Malmin, S. K., Andersen, M. H., Hargott, R. F., de Jesus Ortiz, A., Cabral, D. M. B., Rivas, J. C., Moreira, M. L., Ellazar, C. G., Cerezo, F. D., Palo, J. E., Aperocho, C. A. J., Figueiredo, M. F., Pinheiro, C. M., Rita, C. S., Feranandes, A. M., Pinto, V. M. V., Bispo, B. M., Lima, A., Alsheikhly, A. S., Guran, C. T., Filipescu, D. C., Scutariu, M. A., Ebaid, M. S., Velickovic, D., Rajkovic, M., Stanojevic, M., Turcan, A., Lancaricova, D., Yeni, N. P., Syed, M. R., Navarro, J. A., De Pablo, A. M., Llinas, A. A., Lajara, M. A. G., Nieto, M. V., Pena, J. M. G., Gorgolas, M. C., Isasi, M. A., Salva-Costa, V., Garzon-Tovar, C., Olivares, P. G., de Ceballos, J. P. G., Polo, A. B. C., del Mar Diaz Salcedo, M., Alvarez, J. D., Arcas, M. L. B., Gonzalez, J. I. T., de la Ventana, A. B. S., Calleja, P. L. -A., Alvarez, R. G., Zamora, P. S., Guerrero, A. O., Barreiro, E. M., Sanchez, L. C., Diaz, M. G., Muriel, D. S., Alonso, H. F., Fernandez, A. W., Pinan, I. S., Albaiceta, G. M., Fernandez, M. C. I., Abos, F. J. S., Chueca, R. M., Aguirre, L. G., Manosa, S. C., Luque, C. P., Losilla, M. R., Fores, M. T., del Rosario Villar Redondo, M., Arteta Arteta, D. S., Sanchez, M. A. H., Espinosa, C. P., Reyes, L. M., Domenech, L. C., Guillen, C. V., Alvarez, J. T., del Cotillo, M., Barrueco-Francioni, J. E., Conde, B. B., Blanco, M. P. S., Blasco, M. L., Clement, A. I., Sanz, L. C., Gonzalez, I. A., Cano, A. E., Nunez, C. R., Fernadez, I. L., Fernandez, A. A. M., Boedjawan, N. N., Jansson, E. B., Malvemyr, A. -S., Lof, G., Spangfors, M., Lagerhall, C., Akerman, E., Hellkvist, V. H., Larsson, I. -M., Jong, M. L., Hsu, M. Y., Chang, S. C., Mebazaa, M. S., Elhechmi, Y. Z., Kuscu, O. O., Dal, H. C., Calili, D. K., Izdes, S., Gumus, A., Tasdemir, B., Kagnici, A., Ay, S. A., Balbay, A. O., Ozserezli, B., Senturk, E., Serin, S. O., Gul, F., Cinel, I., Undar, H. N., Bayraktar, Y. S., Celik, J. B., Tokur, M. E., Aydin, D. T., Yildiz, I., Ozcan, B., Akdag, D., Unlu, N., Reyes, P. E., Ahmad, F. K. E., Smiley, K. A., Miller, M. T., Antonio, M. G. S., Qawasmeh, K. A., Shawish, S. A., Groba, C. B., Raj, A. S., Ei, P. P., Legorburo, M. S., Welters, I. D., Mcmullen, J., Mcdonnell, A., Rose, B. O., Delgado, C. C., Mccann, N., Turner, S. J., Rodriguez, G. E., Eltorai, A. S., Pastores, S. M., Demarre, L., and Debue, A. -S.
Subjects: Male, Original, medicine.medical_treatment, artificial, Critical Care and Intensive Care Medicine, Medical and Health Sciences, Pressure ulcer, law.invention, Decubitus epidemiology, ICU, Morbidity, Mortality, Outcome, Pressure injury, Risk factors, Adult, Aged, Hospital Mortality, Humans, Patient Discharge, Prevalence, Risk Factors, Intensive Care Units, Respiration, Artificial, 0302 clinical medicine, decubitus epidemiology, pressure injury, pressure ulcer, outcome, risk factors, morbidity, mortality, law, Medicine and Health Sciences, adults, Medicine, Simplified Acute Physiology Score, icu, ziekenhuissterfte, Immunodeficiency, intensive care, European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators, mannen, volwassenen, COST, Intensive care unit, STATE, ULCERS, Underweight, medicine.symptom, Life Sciences & Biomedicine, Human, medicine.medical_specialty, risicofactoren, Decubitus epidemiology, ICU, Pressure injury, Pressure ulcer, Outcome, Risk factors, Morbidity, Mortality, pressure injuries, Intensive Care Unit, prevalentie, NO, 1117 Public Health and Health Services, DecubICUs Study Team, 03 medical and health sciences, Critical Care Medicine, Anesthesiology, General & Internal Medicine, Health Sciences, ouderen, Mechanical ventilation, Science & Technology, business.industry, decubitus, Risk Factor, 030208 emergency & critical care medicine, 1103 Clinical Sciences, Odds ratio, medicine.disease, Emergency & Critical Care Medicine, Confidence interval, 030228 respiratory system, Emergency medicine, kunstmatige ademhaling, RISK-FACTORS, business, respiration
Abstract: Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347, Funder: Flemish Society for Critical Care Nurses, Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score < 19, ICU stay > 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.
Published: 2021
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28. Effects of Sedatives on Sleep Architecture Measured With Odds Ratio Product in Critically Ill Patients

Author: Christina Alexopoulou, Dimitris Georgopoulos, Magdy Younes, and Eumorfia Kondili
Subjects: Mechanical ventilation, propofol, business.industry, RC86-88.9, Sedation, medicine.medical_treatment, Methodology, dexmedetomidine, Retrospective cohort study, Medical emergencies. Critical care. Intensive care. First aid, sleep quality, General Medicine, Odds ratio, mechanical ventilation, Sleep in non-human animals, Anesthesia, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, medicine, medicine.symptom, Dexmedetomidine, Propofol, business, medicine.drug, Slow-wave sleep
Abstract: Supplemental Digital Content is available in the text., OBJECTIVES: Evaluation of sleep quality in critically ill patients is difficult using conventional scoring criteria. The aim of this study was to examine sleep in critically ill patients with and without light sedation using the odds ratio product, a validated continuous metric of sleep depth (0 = deep sleep; 2.5 = full wakefulness) that does not rely on the features needed for conventional staging. DESIGN: Retrospective study. SETTINGS: A 16-bed medical-surgical ICU. PATIENTS: Twenty-three mechanically ventilated patients who had previously undergone two nocturnal sleep studies, one without and one with sedation (propofol, n = 12; dexmedetomidine, n = 11). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Sleep architecture was evaluated with odds ratio product analysis by the distribution of 30-second epochs with different odds ratio product values. Electroencephalogram spectral patterns and frequency of wake intrusions (3-s odds ratio product > 1.75) were measured at different odds ratio product levels. Thirty-seven normal sleepers were used as controls. Compared with normal sleepers, unsedated critically ill patients spent little time in stable sleep (percent odds ratio product < 1.0: 31% vs 63%; p < 0.001), whereas most of the time were either in stage wake (odds ratio product > 1.75) or in a transitional state (odds ratio product 1.0–1.75), characterized by frequent wake intrusions. Propofol and dexmedetomidine had comparable effects on sleep. Sedation resulted in significant shift in odds ratio product distribution toward normal; percent odds ratio product less than 1.0 increased by 54% (p = 0.006), and percent odds ratio product greater than 1.75 decreased by 48% (p = 0.013). In six patients (26%), sedation failed to improve sleep. CONCLUSIONS: In stable critically ill unsedated patients, sleep quality is poor with frequent wake intrusions and little stable sleep. Light sedation with propofol or dexmedetomidine resulted in a shift in sleep architecture toward normal in most, but not all, patients.
Published: 2021

29. Ventilatory support in the intensive care unit

Author: Eumorfia Kondili, Athanasia Proklou, and Aikaterini Vaporidi
Subjects: Mechanical ventilation, medicine.medical_specialty, business.industry, medicine.medical_treatment, Functional features, Critical Care and Intensive Care Medicine, Intensive care unit, law.invention, Anesthesiology and Pain Medicine, law, medicine, Ventilator settings, Intensive care medicine, business
Abstract: This article focuses on the functional features of positive-pressure ventilators, the modes of invasive and non-invasive mechanical ventilation, and the main ventilator settings. It also highlights the potential complications of mechanical ventilation, the basic principles of weaning, and the pathophysiological basis of patient-ventilator dyssynchrony.
Published: 2019

30. Non-invasive ventilation during surgery under neuraxial anaesthesia: a pathophysiological perspective on application and benefits and a systematic literature review

Author: Eumorfia Kondili, Antonio M. Esquinas, Andreas Perren, Jakob Wittenstein, Giuseppe Fiorentino, Alejandro Ubeda, Habib Md Reazaul Karim, Kwok M. Ho, Milind Sovani, Peter J. Papadakos, Yalım Dikmen, Subrata Kumar Singha, Bushra Mina, Corinne Tani, Chinmaya Kumar Panda, Nadia Corcione, Antonio Pisano, Antonello Nicolini, Mohamad Khatib, and Vania Caldeira
Subjects: Anesthesia, Epidural, medicine.medical_specialty, Exacerbation, Critical Care and Intensive Care Medicine, neuraxial anaesthesia, Anesthesia, Spinal, Pulmonary Disease, Chronic Obstructive, Thoracic Diseases, Anesthesiology, medicine, Humans, RD78.3-87.3, General anaesthesia, Respiratory system, COPD, Noninvasive Ventilation, RC86-88.9, business.industry, non-invasive ventilation, Patient Selection, Medical emergencies. Critical care. Intensive care. First aid, Neuromuscular Diseases, General Medicine, medicine.disease, Surgery, Hypoventilation, Anesthesiology and Pain Medicine, Respiratory failure, Anesthesia, Breathing, intra-operative respiratory failure, medicine.symptom, Respiratory Insufficiency, business, Hypercapnia
Abstract: Unlike general anaesthesia, neuraxial anaesthesia (NA) reduces the burden and risk of respiratory adverse events in the post-operative period. However, both patients affected by chronic obstructive pulmonary disease (COPD) and chest wall disorders and/or neuromuscular diseases may experience the development or the worsening of respiratory failure, even during surgery performed under NA; this latter negatively affects the function of accessory respiratory muscles, resulting in a blunted central response to hypercapnia and possibly in an exacerbation of cardiac dysfunction (NA-induced relative hypovolemia). According to European Respiratory Society (ERS) and American Thoracic Society (ATS) guidelines, non-invasive ventilation (NIV) is effective in the post-operative period for the treatment of both impaired pulmonary gas exchange and ventilation, while the intra-operative use of NIV in association with NA is just anecdotally reported in the literature. Whilst NIV does not assure a protected patent airway and requires the patient’s cooperation, it is a handy tool during surgery under NA: NIV is reported to be successful for treatment of acute respiratory failure; it may be delivered through the patient’s home ventilator, may reverse hypoventilation induced by sedatives or inadvertent spread of anaesthetic up to cervical dermatomes, and allow the avoidance of intubation in patients affected by chronic respiratory failure, prolonging the time of non-invasiveness of respiratory support (i.e., neuromuscular patients needing surgery). All these advantages could make NIV preferable to oxygen in carefully selected patients.
Published: 2019

31. Early Evaluation of Organ Failure Using MELD-XI in Critically Ill Elderly COVID-19 Patients

Author: Johanna Hornemann, Christian Jung, Malte Kelm, Sandra Oeyen, Dylan W. de Lange, Michael Joannidis, Brian Marsh, Wojciech Szczeklik, Bernardo Bollen Pinto, Stephan Binneboessel, Finn H. Andersen, Bernhard Wernly, Michael Beil, Philipp Heinrich Baldia, Muhammed Elhadi, Hans Flaatten, Peter Vernon van Heerden, Raphael Romano Bruno, Eumorfia Kondili, Georg Wolff, Ariane Boumendil, Rui Moreno, Jesper Fjølner, Susannah Leaver, Bertrand Guidet, Joerg C. Schefold, Sigal Sviri, Antonio Artigas, Jakob Wollborn, Gestionnaire, Hal Sorbonne Université, Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf], Paracelsus Medizinische Privatuniversität = Paracelsus Medical University (PMU), University of Bergen (UiB), Aarhus University Hospital, CIBER de Epidemiología y Salud Pública (CIBERESP), Geneva University Hospitals and Geneva University, Hadassah Hebrew University Medical Center [Jerusalem], The Hebrew University of Jerusalem (HUJ), Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), Ghent University Hospital, Mater Misericordiae University Hospital (The Mater Hospital), NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), St George’s University Hospitals, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Réanimation Médicale [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Physiology, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Critical Illness, [SDV]Life Sciences [q-bio], Disease, Logistic regression, Severity of Illness Index, chemistry.chemical_compound, Physiology (medical), Intensive care, Internal medicine, medicine, Humans, 610 Medicine & health, Aged, Creatinine, business.industry, Critically ill, SARS-CoV-2, Confounding, COVID-19, Hematology, Prognosis, body regions, [SDV] Life Sciences [q-bio], chemistry, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; PURPOSE Critically ill elderly patients who suffer from Sars-CoV-2 disease are at high risk for organ failure. The modified MELD-XI score has not been evaluated for outcome prediction in these most vulnerable patients. METHODS The Corona Virus disease (COVID19) in Very Elderly Intensive Care Patients study (COVIP, NCT04321265) prospectively recruited patients on intensive care units (ICU), who were = 70 years. Data were collected from March 2020 to February 2021. The MELD-XI score was calculated using the highest serum bilirubin and creatinine on ICU admission. Univariate and multivariable logistic regression analyses were performed to assess associations between the MELD-XI score and mortality. The primary outcome was 30-day-mortality, the secondary outcomes were ICU- and 3-month-mortality. RESULTS In total, data from 2,993 patients were analyzed. Most patients had a MELD-XI
Published: 2021

32. Personalized prophylactic anticoagulation in hospitalized patients with Covid-19 – The role of anti-Xa monitoring

Author: Petros Ioannou, Diamantis P. Kofteridis, Georgios Chamilos, Eumorfia Kondili, and Theodosios D Filippatos
Subjects: Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Tailored approach, Coronavirus disease 2019 (COVID-19), Hospitalized patients, 030106 microbiology, law.invention, Anticoagulation, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Dose adjustment, law, Internal medicine, medicine, Humans, 030212 general & internal medicine, Thromboprophylaxis, Letter to the Editor, Aged, Monitoring, Physiologic, Retrospective Studies, Antithrombotic prophylaxis, SARS-CoV-2, business.industry, Anticoagulants, COVID-19, Thrombosis, General Medicine, Heparin, Middle Aged, COVID-19 Drug Treatment, Hospitalization, Regimen, Infectious Diseases, Female, Once daily, business, Factor Xa Inhibitors, Venous thromboembolism, medicine.drug
Abstract: Due to the strong association between severe COVID-19 and a prothrombotic state, most experts suggest an intensified anticoagulation regimen, mostly including an intermediate dose of low-molecular heparin, even though there is no clear clinical evidence supporting the efficacy of this strategy. In our hospital, among 16 patients admitted due to COVID-19, initially treated with enoxaparin 40mg/daily, 81.3% needed dose adjustment due to lower than 0.4IU/ml anti-Xa levels. Based on this approach, a median enoxaparin dose of 60mg (IQR 50-80mg) once daily was needed to successfully tailor prophylaxis with an anti-Xa between 0.4-0.5IU/ml. A future randomized study comparing patients treated with prophylactic enoxaparin to patients treated with a tailored approach based on anti-Xa monitoring could be performed.
Published: 2021

33. Hemophagocytic lymphohistiocytosis syndrome associated with Epstein-Barr infection in an immunocompetent patient. A case study

Author: Konstantinos Alexakis, Diamantis P. Kofteridis, Petros Ioannou, Evangelia Akoumianaki, Athanasia Proklou, Eumorfia Kondili, Efthimis Stamatopoulos, Maria Psyllaki, and Mairi Koulentaki
Subjects: Microbiology (medical), medicine.medical_specialty, Hemophagocytic lymphohistiocytosis, General Immunology and Microbiology, Respiratory distress, medicine.diagnostic_test, Epidemiology, business.industry, Public Health, Environmental and Occupational Health, Case Report, medicine.disease, Malignancy, Gastroenterology, Infectious Diseases, medicine.anatomical_structure, Internal medicine, Macrophage activation syndrome, hemic and lymphatic diseases, Biopsy, medicine, Bone marrow, Hemophagocytosis, business, Rare disease
Abstract: Introduction Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening rare disease resulting from the uncontrolled activation of the immune system, leading to unrestrained cytokine release and macrophage activation. It can be either hereditary or acquired due to infections, hematological disease or malignancy. Case report We present the case of a 19-year old woman that presented with high fever and acute cholestatic hepatitis. She was initially admitted to the Gastroenterology department and the following days she developed respiratory distress and multiorgan insufficiency that necessitated intubation and support in the Intensive Care Unit. Fever, splenomegaly, hypertriglyceridemia, increased ferritin levels and hemophagocytosis in the bone marrow were found, thus, fulfilling the criteria of hemophagocytic lymphohistiocytosis. Laboratory examination was notable for positive serology (IgM and IgG) and PCR for EBV in the serum. An extensive workup including virology and immunologic workup, blood cultures, a CT of the thorax and the abdomen and a bone marrow biopsy did not reveal any cause of secondary HLH other than the EBV infection. The patient was treated with high dose corticosteroids and intravenous immunoglobulins with slow resolution of her symptoms. Conclusions In patients with EBV infection who exhibit persistent high fever and unresponsiveness to antibiotics, the possibility of HLH should be considered. Early diagnosis and rapid initiation of appropriate treatment may avert an unfavorable outcome.
Published: 2020

34. Inspiratory effort and breathing pattern change in response to varying the assist level: a physiological study

Author: Elvira-Markela Antonogiannaki, Eumorfia Kondili, Dimitrios Georgopoulos, Emmanouil Lilitsis, Adamantia Petraki, Vaia Stamatopoulou, Katerina Vaporidi, and Eleftherios Andrianakis
Subjects: Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Maximal Respiratory Pressures, Respiratory rate, Physiology, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Critical Illness, inspiratory effort breathing pattern assist level, Article, 03 medical and health sciences, Level of Effort, 0302 clinical medicine, Proportional Assist Ventilation, Breathing pattern, Respiratory Rate, Internal medicine, Respiratory muscle, Tidal Volume, Medicine, Humans, Respiratory system, Interactive Ventilatory Support, skin and connective tissue diseases, Lung Compliance, Aged, Work of Breathing, Aged, 80 and over, business.industry, General Neuroscience, Airway Resistance, Middle Aged, 030228 respiratory system, Inhalation, Cardiology, Female, sense organs, business, 030217 neurology & neurosurgery
Abstract: Highlights • In mechanically ventilated patients on the recovery phase of acute illness, changing the assist level results in changes of inspiratory effort in more patients and to a greater magnitude, than of respiratory rate, though both effort and rate change almost always in the same tendency (either increase or decrease) • Neither the magnitude of change nor the absolute value of respiratory rate can be used to quantitatively estimate the resulting respiratory effort after a change in the level of assist, Aim To describe the response of breathing pattern and inspiratory effort upon changes in assist level and to assesss if changes in respiratory rate may indicate changes in respiratory muscle effort. Methods Prospective study of 82 patients ventilated on proportional assist ventilation (PAV+). At three levels of assist (20%-50%-80%), patients’ inspiratory effort and breathing pattern were evaluated using a validated prototype monitor. Results Independent of the assist level, a wide range of respiratory rates (16-35br/min) was observed when patients’ effort was within the accepted range. Changing the assist level resulted in paired changes in inspiratory effort and rate of the same tendency (increase or decrease) in all but four patients. Increasing the level in assist resulted in a 31% (8-44%) decrease in inspiratory effort and a 10% (0-18%) decrease in respiratory rate. The change in respiratory rate upon the change in assist correlated modestly with the change in the effort (R = 0.5). Conclusion Changing assist level results in changes in both respiratory rate and effort in the same direction, with change in effort being greater than that of respiratory rate. Yet, neither the magnitude of respiratory rate change nor the resulting absolute value may reliably predict the level of effort after a change in assist.
Published: 2020

35. Airway pressure morphology and respiratory muscle activity during end-inspiratory occlusions in pressure support ventilation

Author: Dimitris Georgopoulos, Eumorfia Kondili, Stella Soundoulounaki, Evangelia Akoumianaki, Katerina Vaporidi, G. Prinianakis, and Emmanouil Pediaditis
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Gastric pressure, Pressure support ventilation, Critical Care and Intensive Care Medicine, Esophageal pressure, Positive-Pressure Respiration, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Occlusion, medicine, Respiratory muscle, Humans, 030212 general & internal medicine, Respiratory system, Aged, Retrospective Studies, Mechanical ventilation, Aged, 80 and over, Lung, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Middle Aged, Respiration, Artificial, Respiratory Muscles, medicine.anatomical_structure, Driving pressure, Cardiology, Respiratory Physiological Phenomena, Female, business, Airway, Protective ventilation
Abstract: Background The driving pressure of the respiratory system is a valuable indicator of global lung stress during passive mechanical ventilation. Monitoring lung stress in assisted ventilation is indispensable, but achieving passive conditions in spontaneously breathing patients to measure driving pressure is challenging. The accuracy of the morphology of airway pressure (Paw) during end-inspiratory occlusion to assure passive conditions during pressure support ventilation has not been examined. Methods Retrospective analysis of end-inspiratory occlusions obtained from critically ill patients during pressure support ventilation. Flow, airway, esophageal, gastric, and transdiaphragmatic pressures were analyzed. The rise of gastric pressure during occlusion with a constant/decreasing transdiaphragmatic pressure was used to identify and quantify the expiratory muscle activity. The Paw during occlusion was classified in three patterns, based on the differences at three pre-defined points after occlusion (0.3, 1, and 2 s): a “passive-like” decrease followed by plateau, a pattern with “clear plateau,” and an “irregular rise” pattern, which included all cases of late or continuous increase, with or without plateau. Results Data from 40 patients and 227 occlusions were analyzed. Expiratory muscle activity during occlusion was identified in 79% of occlusions, and at all levels of assist. After classifying occlusions according to Paw pattern, expiratory muscle activity was identified in 52%, 67%, and 100% of cases of Paw of passive-like, clear plateau, or irregular rise pattern, respectively. The driving pressure was evaluated in the 133 occlusions having a passive-like or clear plateau pattern in Paw. An increase in gastric pressure was present in 46%, 62%, and 64% of cases at 0.3, 1, and 2 s, respectively, and it was greater than 2 cmH2O, in 10%, 20%, and 15% of cases at 0.3, 1, and 2 s, respectively. Conclusions The pattern of Paw during an end-inspiratory occlusion in pressure support cannot assure the absence of expiratory muscle activity and accurate measurement of driving pressure. Yet, because driving pressure can only be overestimated due to expiratory muscle contraction, in everyday practice, a low driving pressure indicates an absence of global lung over-stretch. A measurement of high driving pressure should prompt further diagnostic workup, such as a measurement of esophageal pressure.
Published: 2020

36. Additional file 1 of Airway pressure morphology and respiratory muscle activity during end-inspiratory occlusions in pressure support ventilation

Author: Soundoulounaki, Stella, Akoumianaki, Evangelia, Eumorfia Kondili, Pediaditis, Emmanouil, Prinianakis, Georgios, Vaporidi, Katerina, and Georgopoulos, Dimitris
Abstract: Additional file 1: Table S1. Timing of expiratory muscle contraction during end-inspiratory occlusion. Figure A1. Patterns of expiratory muscle activity during end-inspiratory occlusion. Figure A2. Respiratory rate and drive in the presence or absence of expiratory muscle activity during occlusion.
Published: 2020
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37. Gastrointestinal dysmotility in critically ill patients

Author: Eumorfia Kondili, Theodoros Ladopoulos, Emmanuel Pediaditis, Christina Alexopoulou, Maria Giannaki, and Athanasia Proklou
Subjects: medicine.medical_specialty, Gastrointestinal motility, Critically ill, business.industry, critically ill, Gastroenterology, Psychological intervention, 030208 emergency & critical care medicine, Review Article, Intensive care unit, law.invention, 03 medical and health sciences, 0302 clinical medicine, Underlying disease, law, Intervention (counseling), Critical illness, medicine, 030211 gastroenterology & hepatology, Intensive care medicine, business, gastrointestinal dysmotility, Gastrointestinal dysmotility
Abstract: Gastrointestinal (GI) motility disorders are commonly present in critical illness. Up to 60% of critically ill patients have been reported to experience GI dysmotility of some form necessitating therapeutic intervention. It has been attributed to various factors, related to both the underlying disease and the therapeutic interventions undertaken. The assessment of motility disturbances can be challenging in critically ill patients, as the available tests used to detect abnormal motility have major limitations in the setting of an Intensive Care Unit. Critically ill patients with GI dysmotility require a multifaceted treatment approach that addresses multiple causes and utilizes multiple pharmacological pathways. In this review, we discuss the pathophysiology, assessment and management of GI dysmotility in critically ill patients.
Published: 2018

38. Validation of a Proposed Algorithm for Assistance Titration During Proportional Assist Ventilation With Load-Adjustable Gain Factors

Author: Christina Alexopoulou, Emmanouil Pediaditis, Eumorfia Kondili, Katerina Vaporidi, Vasilios Amargiannitakis, Ioannis Gialamas, Evangelia Akoumianaki, Athanasia Proklou, Stella Soundoulounaki, G. Prinianakis, and Dimitrios Georgopoulos
Subjects: Pulmonary and Respiratory Medicine, Maximum inspiratory pressure, business.industry, Transdiaphragmatic pressure, Inspiratory muscle, General Medicine, Critical Care and Intensive Care Medicine, Respiration, Artificial, Respiratory Muscles, 03 medical and health sciences, 0302 clinical medicine, Proportional Assist Ventilation, 030228 respiratory system, Retrospective analysis, Tidal Volume, Medicine, Humans, Sensitivity (control systems), business, Interactive Ventilatory Support, Respiratory Insufficiency, Algorithm, Algorithms, Retrospective Studies
Abstract: BACKGROUND: The present study aimed to validate a recently proposed algorithm for assistance titration during proportional assist ventilation with load-adjustable gain factors, based on a noninvasive estimation of maximum inspiratory pressure (peak Pmus) and inspiratory effort (pressure-time product [PTP] peak Pmus). METHODS: Retrospective analysis of the recordings obtained from 26 subjects ventilated on proportional assist ventilation with load-adjustable gain factors under different conditions, each considered as an experimental case. The estimated inspiratory output (peak Pmus) and effort (PTP-peak Pmus) were compared with the actual-determined by the measurement of transdiaphragmatic pressure- and the derived PTP. Validation of the algorithm was performed by assessing the accuracy of peak Pmus in predicting the actual inspiratory muscle effort and indicating the appropriate level of assist. RESULTS: In the 63 experimental cases analyzed, a limited agreement was observed between the estimated and the actual inspiratory muscle pressure (−11 to 10 cm H2O) and effort (−82 to 125 cm H2O × s/min). The sensitivity and specificity of peak Pmus to predict the range of the actual inspiratory effort was 81.2% and 58.1%, respectively. In 49% of experimental cases, the level of assist indicated by the algorithm differed from that indicated by the transdiaphragmatic pressure and PTP. CONCLUSIONS: The proposed algorithm had limited accuracy in estimating inspiratory muscle effort and with indicating the appropriate level of assist.
Published: 2019

39. Invasive Aspergillus tracheobronchitis in a patient with hairy cell leukemia and previous Plasmodium falciparum infection

Author: Eumorfia Kondili, Evangelia E. Vassalou, Elvira-Markella Antonogiannaki, Athanasia Proklou, and Dimitrios Tamiolakis
Subjects: Pulmonary and Respiratory Medicine, Male, malaria, lcsh:Medicine, Context (language use), Plasmodium falciparum infection, Aspergillosis, Microbiology, Fatal Outcome, parasitic diseases, medicine, Invasive Aspergillus tracheobronchitis, Humans, Hairy cell leukemia, Malaria, Falciparum, Bronchitis, Invasive Pulmonary Aspergillosis, Aspergillus, Leukemia, Hairy Cell, biology, business.industry, lcsh:R, Plasmodium falciparum, Middle Aged, medicine.disease, biology.organism_classification, Leukemia, Tracheitis, Cardiology and Cardiovascular Medicine, business, Malaria
Abstract: Invasive Aspergillus tracheobronchitis is a relatively rare form of invasive pulmonary aspergillosis characterized by invasion of the tracheobronchial tree by Aspergillus spp. Invasive pulmonary aspergillosis is predominantly detected in severely immunocompromised patients. Notably however, pulmonary and tracheobronchial cases of invasive aspergillosis have also been reported, particularly in the context of severe malaria caused by Plasmodium falciparum. Herein, we present a case of invasive Aspergillus tracheobronchitis in a patient with hairy cell leukemia and previous Plasmodium falciparum infection.
Published: 2019

40. MOESM1 of Driving pressure during proportional assist ventilation: an observational study

Author: Vaporidi, Katerina, Psarologakis, Charalambos, Proklou, Athanasia, Pediaditis, Emmanouil, Akoumianaki, Evangelia, Koutsiana, Elisavet, Chytas, Achilleas, Chouvarda, Ioanna, Eumorfia Kondili, and Georgopoulos, Dimitris
Subjects: Data_FILES
Abstract: Additional file 1. Methods.
Published: 2019
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41. Driving pressure during proportional assist ventilation: an observational study

Author: Dimitris Georgopoulos, Eumorfia Kondili, Evangelia Akoumianaki, Achilleas Chytas, Elisavet Koutsiana, Katerina Vaporidi, Ioanna Chouvarda, Athanasia Proklou, Charalambos Psarologakis, and Emmanouil Pediaditis
Subjects: Monitoring, medicine.medical_treatment, Lung injury, Critical Care and Intensive Care Medicine, law.invention, Tidal volume, 03 medical and health sciences, 0302 clinical medicine, Proportional Assist Ventilation, law, medicine, Respiratory system, Mechanical ventilation, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, 3. Good health, Compliance (physiology), 030228 respiratory system, Anesthesia, Ventilation (architecture), Observational study, business, Protective ventilation, Compliance
Abstract: Background During passive mechanical ventilation, the driving pressure of the respiratory system is an important mediator of ventilator-induced lung injury. Monitoring of driving pressure during assisted ventilation, similar to controlled ventilation, could be a tool to identify patients at risk of ventilator-induced lung injury. The aim of this study was to describe driving pressure over time and to identify whether and when high driving pressure occurs in critically ill patients during assisted ventilation. Methods Sixty-two patients fulfilling criteria for assisted ventilation were prospectively studied. Patients were included when the treating physician selected proportional assist ventilation (PAV+), a mode that estimates respiratory system compliance. In these patients, continuous recordings of all ventilator parameters were obtained for up to 72 h. Driving pressure was calculated as tidal volume-to-respiratory system compliance ratio. The distribution of driving pressure and tidal volume values over time was examined, and periods of sustained high driving pressure (≥ 15 cmH2O) and of stable compliance were identified and analyzed. Results The analysis included 3200 h of ventilation, consisting of 8.8 million samples. For most (95%) of the time, driving pressure was
Published: 2019

42. Noninvasive ventilation: Education and training. A narrative analysis and an international consensus document

Author: Habib Karim, Karen Burns, Laura Ciobanu, Mohamad El-Khatib, Antonello Nicolini, Nicola Vargas, Thierry Hernández-Gilsoul, Szymon Skoczyński, Vito Falcone, Jean-Michel Arnal, John Bach, Luca De Santo, Alberto Lucchini, Joerg Steier, Andrea Purro, Angelo Petroianni, Catherine Sassoon, Stefano Bambi, Margarida Aguiar, Ayman Soubani, Corinne Taniguchi, Corrado Mollica, David Berlin, Edoardo Piervincenzi, Fabrizio Rao, Ferini-Strambi Luigi, Rodolfo Ferrari, Giancarlo Garuti, Gerhard Laier-Groeneveld, Giuseppe Fiorentino, Kwok Ho, Jaber Alqahtani, Manuel Luján, Onnen Moerer, Onofrio Resta, Paola Pierucci, Peter Papadakos, Stephan Steiner, Sven Stieglitz, Yalim Dikmen, Jun Duan, Pradipta Bhakta, Alejandro Iglesias, Nadia Corcione, Vânia Caldeira, Zuhal Karakurt, Gabriele Valli, Eumorfia Kondili, Maria Ruggieri, Margarida Raposo, Fabrizio Bottino, Rafael Soler-González, Mohan Gurjar, José Sandoval-Gutierrez, Behrouz Jafari, Marta Arroyo-Cozar, Ana Noval, Igor Barjaktarevic, Irena Sarc, Bushra Mina, Zbigniew Szkulmowski, Antonio Esquinas, Reazaul Karim, H. M., Burns, K. E. A., Ciobanu, L. D., El-Khatib, M., Nicolini, A., Vargas, N., Hernandez-Gilsoul, T., Skoczynski, S., Falcone, V. A., Arnal, J. -M., Bach, J., De Santo, L. S., Lucchini, A., Steier, J., Purro, A., Petroianni, A., Sassoon, C. S., Bambi, S., Aguiar, M., Soubani, A. O., Taniguchi, C., Mollica, C., Berlin, D. A., Piervincenzi, E., Rao, F., Luigi, F. -S., Ferrari, R., Garuti, G., Laier-Groeneveld, G., Fiorentino, G., Ho, K. M., Alqahtani, J. S., Lujan, M., Moerer, O., Resta, O., Pierucci, P., Papadakos, P., Steiner, S., Stieglitz, S., Dikmen, Y., Duan, J., Bhakta, P., Iglesias, A. U., Corcione, N., Caldeira, V., Karakurt, Z., Valli, G., Kondili, E., Ruggieri, M. P., Raposo, M. S., Bottino, F., Soler-Gonzalez, R., Gurjar, M., Sandoval-Gutierrez, J. L., Jafari, B., Arroyo-Cozar, M., Noval, A. R., Barjaktarevic, I., Sarc, I., Mina, B., Szkulmowski, Z., Esquinas, A. M., Karim, H, Burns, K, Ciobanu, L, El-Khatib, M, Nicolini, A, Vargas, N, Hernández-Gilsoul, T, Skoczyński, S, Falcone, V, Arnal, J, Bach, J, De Santo, L, Lucchini, A, Steier, J, Purro, A, Petroianni, A, Sassoon, C, Bambi, S, Aguiar, M, Soubani, A, Taniguchi, C, Mollica, C, Berlin, D, Piervincenzi, E, Rao, F, Luigi, F, Ferrari, R, Garuti, G, Laier-Groeneveld, G, Fiorentino, G, Ho, K, Alqahtani, J, Luján, M, Moerer, O, Resta, O, Pierucci, P, Papadakos, P, Steiner, S, Stieglitz, S, Dikmen, Y, Duan, J, Bhakta, P, Iglesias, A, Corcione, N, Caldeira, V, Karakurt, Z, Valli, G, Kondili, E, Ruggieri, M, Raposo, M, Bottino, F, Soler-González, R, Gurjar, M, Sandoval-Gutierrez, J, Jafari, B, Arroyo-Cozar, M, Noval, A, and Esquinas, A
Subjects: Pulmonary and Respiratory Medicine, osebje, usposabljanje, Attitude of Health Personnel, education, MEDLINE, Developing country, HSM PNEU, Narrative inquiry, staff, zdravstveno osebje -- izobraževanje, Education, noninvasive ventilation -- education, Medical Staff, Hospital, Humans, Training, Narrative, health personnel -- education, udc:616.2, Respiratory Distress Syndrome, Medical education, Noninvasive Ventilation, training, Program, Staff, neinvazivna ventilacija -- izobraževanje, Pneumonia, Ventilator-Associated, 3. Good health, Clinical trial, Systematic review, Life support, Programs, Clinical Competence, Respiratory Insufficiency, Psychology, Developed country, Noninvasive ventilation
Abstract: Noninvasive ventilation (NIV) is an increasingly used method of respiratory support. The use of NIV is expanding over the time and if properly applied, it can save patients' lives and improve long-term prognosis. However, both knowledge and skills of its proper use as life support are paramount. This systematic review aimed to assess the importance of NIV education and training. Literature search was conducted (MEDLINE: 1990 to June, 2018) to identify randomized controlled studies and systematic reviews with the results analyzed by a team of experts across the world through e-mail based communications. Clinical trials examining the impact of education and training in NIV as the primary objective was not found. A few studies with indirect evidence, a simulation-based training study, and narrative reviews were identified. Currently organized training in NIV is implemented only in a few developed countries. Due to a lack of high-grade experimental evidence, an international consensus on NIV education and training based on opinions from 64 experts across the twenty-one different countries of the world was formulated. Education and training have the potential to increase knowledge and skills of the clinical staff who deliver medical care using NIV. There is a genuine need to develop structured, organized NIV education and training programs, especially for the developing countries. info:eu-repo/semantics/publishedVersion
Published: 2019

43. Esophageal and transdiaphragmatic pressure swings as indices of inspiratory effort

Author: Katerina Vaporidi, Stella Soundoulounaki, Dimitris Georgopoulos, Evangelia Akoumianaki, Eumorfia Kondili, and Eleftherios Papadakis
Subjects: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Physiology, Diaphragm, Diagnostic accuracy, Esophagus, Internal medicine, Retrospective analysis, medicine, Humans, Aged, Retrospective Studies, Receiver operating characteristic, business.industry, General Neuroscience, Transdiaphragmatic pressure, Middle Aged, Swing, Respiratory Function Tests, Diaphragm (structural system), Protective ventilation, Inhalation, Cardiology, Female, business, Pressure time product
Abstract: Aim To describe the correlation between the inspiratory esophageal and transdiaphragmatic pressure swings (ΔPes and ΔPdi), easily measured indices of inspiratory effort, with the gold-standard, the transdiaphragmatic pressure time product (PTPPdi/min), and assess the accuracy of swing pressures in predicting very high or low effort. Method Retrospective analysis of data from patients enrolled in four previous studies. ROC curves of ΔPes and ΔPdi values for specific PTPPdi/min thresholds (50, 150, 200 cmH2O × sec/min) were constructed, and the diagnostic accuracy of different thresholds of swing values were computed. Results A threshold of inspiratory ΔP 14–18cmH2O can be used to identify patients with very high inspiratory effort (PTPPdi/min> 200 cmH2O × sec/min). Conclusions The results of this study can help clinicians better select and interpret thresholds of ΔP to evaluate inspiratory effort.
Published: 2021

44. Radiation Therapy: Impact on Lung Function and Acute Respiratory Failure

Author: Eumorfia Kondili, Emmanouil Pediaditis, Athanasia Proklou, and Eleni Diamantaki
Subjects: Mechanical ventilation, medicine.medical_specialty, Lung, Pulmonary toxicity, medicine.drug_class, business.industry, medicine.medical_treatment, Antibiotics, Lung injury, medicine.disease, Gastroenterology, Radiation therapy, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030228 respiratory system, 030220 oncology & carcinogenesis, Internal medicine, Pulmonary fibrosis, medicine, Respiratory system, business
Abstract: Chest wall radiotherapy is widely used as part of therapeutic management in patients with breast, neck, and lung malignancies. It has been associated with the development of lung toxicity in two different forms of lung injury: the radiation pneumonitis which appears within 6 months after exposure and radiation pulmonary fibrosis which is a delayed reaction developed from about 6 months to years after exposure. The extent of lung injury depends on both physical and biological factors including the radiation dose, its quality, and whether the exposure is single, fractionated, or protracted and most importantly on the endogenous ability of lung tissue to repopulate after radiation damage. Dyspnea, cough, and progressive respiratory insufficiency represent the most common clinical manifestations. The treatment of both radiation fibrosis and radiation pneumonitis remains empiric and mainly supportive and is escalated depending on the severity of the symptoms. Serious pulmonary toxicity (grades 3 and 4) always requires hospitalization with oxygen supplementation or mechanical ventilation if needed, fluids, empirical antibiotics, and a high dose of intravenous steroids.
Published: 2018

45. Acute Respiratory Failure Before ICU Admission: A Practical Approach

Author: Emmanouil Pediaditis, Eleni Diamantaki, Eumorfia Kondili, Athanasia Proklou, and Vasilis Amargianitakis
Subjects: medicine.medical_specialty, Chemotherapy, business.industry, medicine.medical_treatment, Cancer, 030204 cardiovascular system & hematology, Malignancy, medicine.disease, Pulmonary edema, Pulmonary embolism, Icu admission, 03 medical and health sciences, 0302 clinical medicine, medicine, Acute respiratory failure, 030212 general & internal medicine, Intensive care medicine, business
Abstract: Acute respiratory failure (ARF) is a common and life-threatening event in cancer patients. It is the leading cause of admission to ICU among the patients with hematologic and solid malignancies and is often associated with poor outcome. Timely identification of the cause of ARF and the initiation of the appropriate therapy may improve the survival. Pulmonary infections represent the leading cause of ARF in those patients, and unless proven otherwise, ARF must be considered as an infectious emergency. Noninfectious causes of ARF include cardiogenic and noncardiogenic pulmonary edema, acute pulmonary embolism, and complications related both to the underlying malignancy and the toxic effects of chemotherapy.
Published: 2018

46. Effects of Dexmedetomidine on Sleep Quality in Critically Ill Patients

Author: Eleni Diamantaki, Charalambos Psarologakis, Sofia Kokkini, Maria Bolaki, Christina Alexopoulou, Dimitris Georgopoulos, and Eumorfia Kondili
Subjects: Sleep quality, medicine.diagnostic_test, business.industry, medicine.drug_class, Sedation, Polysomnography, Richmond Agitation-Sedation Scale, Sleep in non-human animals, Anesthesiology and Pain Medicine, Interquartile range, Anesthesia, Sedative, medicine, Dexmedetomidine, medicine.symptom, business, medicine.drug
Abstract: Background: Dexmedetomidine, a potent α-2-adrenergic agonist, is widely used as sedative in critically ill patients. This pilot study was designed to assess the effect of dexmedetomidine administration on sleep quality in critically ill patients. Methods: Polysomnography was performed on hemodynamically stable critically ill patients for 57 consecutive hours, divided into three night-time (9:00 pm to 6:00 am) and two daytime (6:00 am to 9:00 pm) periods. On the second night, dexmedetomidine was given by a continuous infusion targeting a sedation level −1 to −2 on the Richmond Agitation Sedation Scale. Other sedatives were not permitted. Results: Thirteen patients were studied. Dexmedetomidine was given in a dose of 0.6 μg kg−1 h−1 (0.4 to 0.7) (median [interquartile range]). Compared to first and third nights (without dexmedetomidine), sleep efficiency was significantly higher during the second night (first: 9.7% [1.6 to 45.1], second: 64.8% [51.4 to 79.9], third: 6.9% [0.0 to 17.1], P < 0.002). Without dexmedetomidine, night-time sleep fragmentation index (7.6 events per hour [4.8 to 14.2]) and stage 1 of sleep (48.0% [30.1 to 66.4]) were significantly higher (P = 0.023 and P = 0.006, respectively), and stage 2 (47.0% [27.5 to 61.2]) showed values lower (P = 0.006) than the corresponding values (2.7 events per hour [1.6 to 4.9], 13.1% [6.2 to 23.6], 80.2% [68.9 to 92.8]) observed with dexmedetomidine. Without sedation, sleep was equally distributed between day and night, a pattern that was modified significantly (P = 0.032) by night-time dexmedetomidine infusion, with more than three quarters of sleep occurring during the night (79% [66 to 87]). Conclusion: In highly selected critically ill patients, dexmedetomidine infusion during the night to achieve light sedation improves sleep by increasing sleep efficiency and stage 2 and modifies the 24-h sleep pattern by shifting sleep mainly to the night.
Published: 2014

47. Akt2 Deficiency Protects from Acute Lung Injury via Alternative Macrophage Activation and miR-146a Induction in Mice

Author: Eumorfia Kondili, Andrew N. Margioris, Birte Soennichsen, Eleni Vergadi, Katerina Vaporidi, Vassilia Ismini Alexaki, Dimitrios Georgopoulos, Efstathios N. Stathopoulos, Eleni Lagoudaki, Christos Tsatsanis, Mike Helms, Christina Doxaki, Eleftheria Ieronymaki, and Emmanuel E. Theodorakis
Subjects: ARDS, Lung, medicine.diagnostic_test, medicine.medical_treatment, Immunology, respiratory system, Lung injury, Biology, medicine.disease, M2 Macrophage, 3. Good health, Pathogenesis, Bronchoalveolar lavage, Cytokine, medicine.anatomical_structure, medicine, Immunology and Allergy, Macrophage
Abstract: Acute respiratory distress syndrome (ARDS) is a major cause of respiratory failure, with limited effective treatments available. Alveolar macrophages participate in the pathogenesis of ARDS. To investigate the role of macrophage activation in aseptic lung injury and identify molecular mediators with therapeutic potential, lung injury was induced in wild-type (WT) and Akt2−/− mice by hydrochloric acid aspiration. Acid-induced lung injury in WT mice was characterized by decreased lung compliance and increased protein and cytokine concentration in bronchoalveolar lavage fluid. Alveolar macrophages acquired a classical activation (M1) phenotype. Acid-induced lung injury was less severe in Akt2−/− mice compared with WT mice. Alveolar macrophages from acid-injured Akt2−/− mice demonstrated the alternative activation phenotype (M2). Although M2 polarization suppressed aseptic lung injury, it resulted in increased lung bacterial load when Akt2−/− mice were infected with Pseudomonas aeruginosa. miR-146a, an anti-inflammatory microRNA targeting TLR4 signaling, was induced during the late phase of lung injury in WT mice, whereas it was increased early in Akt2−/− mice. Indeed, miR-146a overexpression in WT macrophages suppressed LPS-induced inducible NO synthase (iNOS) and promoted M2 polarization, whereas miR-146a inhibition in Akt2−/− macrophages restored iNOS expression. Furthermore, miR-146a delivery or Akt2 silencing in WT mice exposed to acid resulted in suppression of iNOS in alveolar macrophages. In conclusion, Akt2 suppression and miR-146a induction promote the M2 macrophage phenotype, resulting in amelioration of acid-induced lung injury. In vivo modulation of macrophage phenotype through Akt2 or miR-146a could provide a potential therapeutic approach for aseptic ARDS; however, it may be deleterious in septic ARDS because of impaired bacterial clearance.
Published: 2014

48. Patient–ventilator synchrony and sleep quality with proportional assist and pressure support ventilation

Author: Christina Alexopoulou, Dimitris Georgopoulos, Eumorfia Kondili, and Maria Plataki
Subjects: Adult, Male, Sleep Wake Disorders, medicine.medical_specialty, genetic structures, Critical Illness, Polysomnography, Pain medicine, Pressure support ventilation, Critical Care and Intensive Care Medicine, Pulmonary Disease, Chronic Obstructive, Proportional Assist Ventilation, Anesthesiology, Humans, Medicine, Intensive care medicine, Aged, Work of Breathing, Patient ventilator asynchrony, Sleep quality, Critically ill, business.industry, Middle Aged, Respiration, Artificial, Asynchrony (computer programming), Intensive Care Units, Cross-Sectional Studies, Female, business
Abstract: To examine patient-ventilator asynchrony and sleep quality in non-sedated critically ill patients ventilated with proportional assist ventilation with load adjustable gain factors (PAV+) and pressure support (PSV).This was a randomized crossover physiological study conducted in an adult ICU at a tertiary hospital. Patients who exhibited patient-ventilator asynchrony on PSV were selected. Polysomnography was performed in these patients over 24 h, during which respiratory variables were continuously recorded. During the study period, each patient was randomized to receive alternating 4-h periods of PSV and PAV+ equally distributed during the day and night. Sleep architecture was analyzed manually using predetermined criteria. Patient-ventilator asynchrony was evaluated breath by breath using the flow-time and airway pressure-time waveforms.Fourteen patients were studied. The majority (85.7 %) had either acute exacerbation of COPD as admission diagnosis or COPD as comorbidity. During sleep, compared to PSV, PAV+ significantly reduced the patient-ventilator asynchrony events per hour of sleep [5 (1-17) vs. 40 (4-443), p = 0.02, median (25-75th interquartile range)]. Compared to PSV, PAV+ was associated with slightly but significantly greater sleep fragmentation [18.8 (13.1-33.1) versus 18.1 (7.0-22.8) events/h, p = 0.01] and less REM sleep [0.0 % (0.0-8.4) vs. 5.8 % (0.0-21.9), p = 0.02).PAV+ failed to improve sleep in mechanically ventilated patients despite the fact that this mode was associated with better synchrony between the patient and ventilator. These results do not support the hypothesis that patient-ventilator synchrony plays a central role in determining sleep quality in this group of patients.
Published: 2013

49. Iron Deficiency and Raised Hepcidin in Idiopathic Pulmonary Arterial Hypertension

Author: Martin R. Wilkins, J. Simon R. Gibbs, Christopher J. Rhodes, Luke Howard, Mark Busbridge, John Wharton, Damien Ashby, and Eumorfia Kondili
Subjects: medicine.medical_specialty, biology, business.industry, Respiratory disease, medicine.disease, Pulmonary hypertension, Gastroenterology, Endocrinology, medicine.anatomical_structure, Iron-deficiency anemia, Hepcidin, Internal medicine, Epidemiology, biology.protein, Medicine, Clinical significance, business, Cardiology and Cardiovascular Medicine, Artery, Soluble transferrin receptor
Abstract: Objectives: This study sought to understand the prevalence and clinical relevance of iron deficiency in patients with idiopathic pulmonary arterial hypertension (IPAH).Background: Iron availability...
Published: 2011
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50. Effect of propofol on breathing stability in adult ICU patients with brain damage

Author: Christina Alexopoulou, Dimitris Georgopoulos, George Prinianakis, Eumorfia Kondili, and Maria Klimathianaki
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, Adolescent, Physiology, Polysomnography, Brain damage, Young Adult, Proportional Assist Ventilation, Humans, Hypnotics and Sedatives, Medicine, Respiratory system, Propofol, Tidal volume, Aged, Ventilators, Mechanical, business.industry, Respiration, General Neuroscience, Middle Aged, Intensive Care Units, Control of respiration, Brain Injuries, Periodic breathing, Anesthesia, Breathing, Brain Damage, Chronic, Female, medicine.symptom, business, medicine.drug
Abstract: The aim of the study was to investigate Propofol's effect on breathing stability in brain damage patients, as quantified by the Loop Gain (LG) of the respiratory system (breathing stability increases with decreasing LG). In 11 stable brain damage patients full polysomnography was performed before, during and after propofol sedation, titrated to achieve stage 2 or slow wave sleep. During each period, patients were ventilated with proportional assist ventilation and the % assist was increased in steps, until either periodic breathing (PB) occurred or the highest assist (95%) was achieved. The tidal volume amplification factor (VT(AF)) at the highest assist level reached just before PB occurred was used to calculate LG (LG=1/VT(AF)). In all but one patient, PB was observed. With propofol, the assist level at which PB occurred (73 + or - 19%) was significantly higher, than that before (43 + or - 35%) and after propofol sedation (49 + or - 29%). As a result, with propofol LG (0.49 + or - 0.2) was significantly lower than that before (0.74 + or - 0.2) and after propofol sedation (0.69 + or - 0.2) (p
Published: 2010

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