9 results on '"Pediaditis E"'
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2. Ortner’s Syndrome as First Clinical Presentation of Severe Pulmonar Arterial Hypertension
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Georgopoulos D, Fanaridis M, Bolaki M, Mitrouska I, and Pediaditis E
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medicine.medical_specialty ,Past medical history ,Aorta ,medicine.diagnostic_test ,business.industry ,Vascular disease ,Laryngoscopy ,Magnetic resonance imaging ,Vasoreactivity test ,medicine.disease ,Pulmonary function testing ,Surgery ,Internal medicine ,medicine.artery ,Pulmonary artery ,medicine ,Cardiology ,business - Abstract
A 40 year old female, non-smoker with a past medical history of urticaria and allergic rhinitis presented with hoarseness of voice of 3 months duration without any accompanying symptoms or limitation of daily activities. Direct laryngoscopy identified palsy of the left vocal cord. The magnetic resonance imaging of the chest indicated abnormal signal intensity in the left vocal cord. The thoracic computed tomography revealed only an enlargement of the pulmonary artery, while transthoracic echocardiography estimated systolic pulmonary artery pressure of 75 mmHg. Pulmonary function tests were compatible with pulmonary vascular disease and cardiopulmonary exercise test showed exercise limitation of cardiocirculatory origin (maximum O2 consumption 60% of pred.). Catheterization of the right heart showed precapillary pulmonary hypertension (mean pulmonary artery pressure 40 mmHg) with a positive response to vasoreactivity test. A diagnosis of idiopathic pulmonary arterial hypertension (IPAH) was made, with hoarseness of voice as the only manifestation of the disease. The hoarseness of voice is believed to be the result of the compression of the left recurrent laryngeal nerve between aorta and the dilated pulmonary artery. This is an unusual case of cardiovocal syndrome (or Ortner’s syndrome) in a patient with IPH who had no perception of dyspnea or limitation of daily activities.
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- 2017
- Full Text
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3. 37th International Symposium on Intensive Care and Emergency Medicine (part 3 of 3)
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Von Seth, M., Hillered, L., Otterbeck, A., Hanslin, K., Larsson, A., Sjölin, J., Lipcsey, M., Cove, ME, Chew, N. S., Vu, L. H., Lim, R. Z., Puthucheary, Z., Wilske, F., Skorup, P., Tano, E., Derese, I., Thiessen, S., Derde, S., Dufour, T., Pauwels, L., Bekhuis, Y., Van den Berghe, G., Vanhorebeek, I., Khan, M., Dwivedi, D., Zhou, J., Prat, A., Seidah, N. G., Liaw, P. C., Fox-Robichaud, A. E., Correa, T., Pereira, J, Takala, J, Jakob, S, Maudsdotter, L., Castegren, M., Sjölin, J, Xue, M., Xu, J. Y., Liu, L., Huang, Y. Z., Guo, F. M., Yang, Y., Qiu, H. B., Kuzovlev, A., Moroz, V., Goloubev, A., Myazin, A., Chumachenko, A., Pisarev, V., Takeyama, N., Tsuda, M., Kanou, H., Aoki, R., Kajita, Y., Hashiba, M., Terashima, T., Tomino, A., Davies, R., O’Dea, K. P., Soni, S., Ward, J. K., O’Callaghan, D. J., Takata, M., Gordon, A. C., Wilson, J., Zhao, Y., Singer, M., Spencer, J., Shankar-Hari, M., Genga, K. Roveran, Lo, C., Cirstea, M. S., Walley, K. R., Russell, J. A., Linder, A., Boyd, J. H., Sedlag, A., Riedel, C., Georgieff, M., Barth, E., Bracht, H., Essig, A., Henne-Bruns, D., Gebhard, F., Orend, K., Halatsch, M., Weiss, M., Chase, M., Freinkman, E., Uber, A., Liu, X., Cocchi, M. N., Donnino, M. W., Peetermans, M., Liesenborghs, L., Claes, J., Vanassche, T., Hoylaerts, M., Jacquemin, M., Vanhoorelbeke, K., De Meyer, S., Verhamme, P., Vögeli, A., Ottiger, M., Meier, M., Steuer, C., Bernasconi, L., Huber, A., Christ-Crain, M., Henzen, C., Hoess, C., Thomann, R., Zimmerli, W., Müller, B., Schütz, P., Hoppensteadt, D., Walborn, A., Rondina, M., Tsuruta, K., Fareed, J., Tachyla, S., Ikeda, T., Ono, S., Ueno, T., Suda, S., Nagura, T., Damiani, E., Domizi, R., Scorcella, C., Tondi, S., Pierantozzi, S., Ciucani, S., Mininno, N., Adrario, E., Pelaia, P., Donati, A., Andersen, M. Schou, Lu, S., Lopez, G, Lassen, AT, Ghiran, I., Shapiro, N. I., Trahtemberg, U., Sviri, S., Beil, M., Agur, Z., Van Heerden, P., Jahaj, E., Vassiliou, A., Mastora, Z., Orfanos, S. E., Kotanidou, A., Wirz, Y., Sager, R., Amin, D., Amin, A., Haubitz, S., Hausfater, P., Kutz, A., Mueller, B., Schuetz, P., Sager, R. S., Wirz, Y. W., Amin, D. A., Amin, A. A., Hausfater, P. H., Huber, A. H., Mueller, B, Schuetz, P, Gottin, L., Dell’amore, C., Stringari, G., Cogo, G., Ceolagraziadei, M., Sommavilla, M., Soldani, F., Polati, E., Baumgartner, T., Zurauskaité, G., Gupta, S., Devendra, A., Mandaci, D., Eren, G., Ozturk, F., Emir, N., Hergunsel, O., Azaiez, S., Khedher, S., Maaoui, A., Salem, M., Chernevskaya, E., Beloborodova, N., Bedova, A., Sarshor, Y. U., Pautova, A., Gusarov, V., Öveges, N., László, I., Forgács, M., Kiss, T., Hankovszky, P., Palágyi, P., Bebes, A., Gubán, B., Földesi, I., Araczki, Á., Telkes, M., Ondrik, Z., Helyes, Z., Kemény, Á., Molnár, Z., Spanuth, E., Ebelt, H., Ivandic, B., Thomae, R., Werdan, K., El-Shafie, M., Taema, K., El-Hallag, M., Kandeel, A., Tayeh, O., Eldesouky, M., Omara, A., Winkler, M. S., Holzmann, M., Nierhaus, A., Mudersbach, E., Schwedhelm, E., Daum, G., Kluge, S., Zoellner, C., Greiwe, G., Sawari, H., Kubitz, J., Jung, R., Reichenspurner, H., Groznik, M., Ihan, A., Andersen, L. W., Holmberg, M. J., Wulff, A., Balci, C., Haliloglu, M., Bilgili, B., Bilgin, H., Kasapoglu, U., Sayan, I., Süzer, M., Mulazımoglu, L., Cinel, I., Patel, V., Shah, S., Parulekar, P., Minton, C., Patel, J., Ejimofo, C., Choi, H., Costa, R., Caruso, P., Nassar, P., Fu, J., Jin, J., Xu, Y., Kong, J., Wu, D., Yaguchi, A., Klonis, A., Ganguly, S., Kollef, M., Burnham, C., Fuller, B., Mavrommati, A., Chatzilia, D., Salla, E., Papadaki, E., Kamariotis, S., Christodoulatos, S., Stylianakis, A., Alamanos, G., Simoes, M., Trigo, E., Silva, N., Martins, P., Pimentel, J., Baily, D., Curran, L. A., Ahmadnia, E., Patel, B. V., Adukauskiene, D., Cyziute, J, Adukauskaite, A., Pentiokiniene, D., Righetti, F., Colombaroli, E., Castellano, G., Man, M., Shum, H. P., Chan, Y. H., Chan, K. C., Yan, W. W., Lee, R. A., Lau, S. K., Dilokpattanamongkol, P., Thirapakpoomanunt, P., Anakkamaetee, R., Montakantikul, P., Tangsujaritvijit, V., Sinha, S., Pati, J., Sahu, S., Valanciene, D., Dambrauskiene, A., Hernandez, K., Lopez, T., Saca, D., Bello, M., Mahmood, W., Hamed, K., Al Badi, N., AlThawadi, S., Al Hosaini, S., Salahuddin, N., Cilloniz, C. C., Ceccato, A. C., Bassi, G. L. Li, Ferrer, M. F., Gabarrus, A. G., Ranzani, O. R., Jose, A. S. San, Vidal, C. G. Garcia, de la Bella Casa, J. P. Puig, Blasi, F. B., Torres, AT, Ciginskiene, A., Simoliuniene, R., Giuliano, G., Triunfio, D., Sozio, E., Taddei, E., Brogi, E., Sbrana, F., Ripoli, A., Bertolino, G., Tascini, C., Forfori, F., Fleischmann, C., Goldfarb, D., Schlattmann, P., Schlapbach, L., Kissoon, N., Baykara, N., Akalin, H., Arslantas, M. Kemal, Gavrilovic, S. G., Vukoja, M. V., Hache, M. H., Kashyap, R. K., Dong, Y. D., Gajic, O. G., Ranzani, O., Harrison, D., Rabello, L., Rowan, K., Salluh, J., Soares, M., Markota, A. M., Fluher, J. F., Kogler, D. K., Borovšak, Z. B., Sinkovic, A. S., Siddiqui, Z, Aggarwal, P., Iqbal, O., Lewis, M., Wasmund, R., Abro, S., Raghuvir, S., Barie, P. S., Fineberg, D., Radford, A., Casazza, A., Vilardo, A., Bellazzi, E., Boschi, R., Ciprandi, D., Gigliuto, C., Preda, R., Vanzino, R., Vetere, M., Carnevale, L., Kyriazopoulou, E., Pistiki, A., Routsi, C., Tsangaris, I., Giamarellos-Bourboulis, E., Pnevmatikos, I., Vlachogiannis, G., Antoniadou, E., Mandragos, K., Armaganidis, A., Allan, P., Oehmen, R., Luo, J., Ellis, C., Latham, P., Newman, J., Pritchett, C., Pandya, D., Cripps, A., Harris, S., Jadav, M., Langford, R., Ko, B., Park, H., Beumer, C. M., Koch, R., Beuningen, D. V., Oudelashof, A. M., Vd Veerdonk, F. L., Kolwijck, E., VanderHoeven, J. G., Bergmans, D. C., Hoedemaekers, C., Brandt, J. B., Golej, J., Burda, G., Mostafa, G., Schneider, A., Vargha, R., Hermon, M., Levin, P., Broyer, C, Assous, M., Wiener-Well, Y., Dahan, M., Benenson, S., Ben-Chetrit, E, Faux, A., Sherazi, R., Sethi, A., Saha, S., Kiselevskiy, M., Gromova, E., Loginov, S., Tchikileva, I., Dolzhikova, Y., Krotenko, N., Vlasenko, R., Anisimova, N., Spadaro, S., Fogagnolo, A., Remelli, F., Alvisi, V., Romanello, A., Marangoni, E., Volta, C., Degrassi, A., Mearelli, F., Casarsa, C., Fiotti, N., Biolo, G., Cariqueo, M., Luengo, C., Galvez, R., Romero, C., Cornejo, R., Llanos, O., Estuardo, N., Alarcon, P., Magazi, B., Khan, S., Pasipanodya, J., Eriksson, M., Strandberg, G., Lipsey, M., Rajput, Z., Hiscock, F., Karadag, T., Uwagwu, J., Jain, S., Molokhia, A., Barrasa, H., Soraluce, A., Uson, E., Rodriguez, A., Isla, A., Martin, A., Fernández, B., Fonseca, F., Sánchez-Izquierdo, J. A., Maynar, F. J., Kaffarnik, M., Alraish, R., Frey, O., Roehr, A., Stockmann, M., Wicha, S., Shortridge, D., Castanheira, M., Sader, H. S., Streit, J. M., Flamm, R. K., Falsetta, K., Lam, T., Reidt, S., Jancik, J., Kinoshita, T., Yoshimura, J., Yamakawa, K., Fujimi, S., Torres, A., Zakynthinos, S., Mandragos, C., Ramirez, P., De la Torre-Prados, M., Dale, G., Wach, A., Beni, L., Hooftman, L., Zwingelstein, C., François, B., Colin, G., Dequin, P. F., Laterre, P. F., Perez, A., Welte, R., Lorenz, I., Eller, P., Joannidis, M., Bellmann, R., Lim, S., Chana, S., Patel, S., Higuera, J., Cabestrero, D., Rey, L., Narváez, G., Blandino, A., Aroca, M., Saéz, S., De Pablo, R, Albert, C. Nadège, Langouche, L., Goossens, C., Peersman, N., Vermeersch, P., Vander Perre, S., Holst, J., Wouters, P., Uber, A. U., Holmberg, M., Konanki, V., McNaughton, M., Zhang, J., Demirkiran, O., Byelyalov, A., Guerrero, J., Cariqueo, M, Rossini, N., Falanga, U., Monaldi, V., Cole, O., Scawn, N., Balciunas, M., Blascovics, I., Vuylsteke, A., Salaunkey, K., Omar, A., Salama, A., Allam, M., Alkhulaifi, A., Verstraete, S., Van Puffelen, E., Ingels, C., Verbruggen, S., Joosten, K., Hanot, J., Guerra, G., Vlasselaers, D., Lin, J., Haines, R., Zolfaghari, P., Hewson, R., Offiah, C., Prowle, J., Buter, H., Veenstra, J. A., Koopmans, M., Boerma, E. C., Taha, A., Shafie, A., Hallaj, S., Gharaibeh, D., Hon, H., Bizrane, M., El Khattate, A. A., Madani, N., Abouqal, R., Belayachi, J., Kongpolprom, N., Sanguanwong, N., Sanaie, S., Mahmoodpoor, A., Hamishehkar, H., Biderman, P., Avitzur, Y., Solomon, S., Iakobishvili, Z., Carmi, U., Gorfil, D, Singer, P., Paisley, C., Patrick-Heselton, J., Mogk, M., Humphreys, J., Welters, I., Casarotta, E., Bolognini, S., Moskowitz, A., Patel, P., Grossestreuer, A., Malinverni, S., Goedeme, D., Mols, P., Langlois, P. L., Szwec, C., D’Aragon, F., Heyland, D. K., Manzanares, W., Langlois, P., Aramendi, I., Heyland, D., Stankovic, N., Nadler, J., Sanchez, L., Wolfe, R., Donnino, M., Cocchi, M., Atalan, H. K., Gucyetmez, B., Kavlak, M. E., Aslan, S., Kargi, A., Yazici, S., Donmez, R., Polat, K. Y., Piechota, M, Piechota, A., Misztal, M., Bernas, S., Pietraszek-Grzywaczewska, I., Saleh, M., Hamdy, A., Elhallag, M., Atar, F., Kundakci, A., Gedik, E., Sahinturk, H., Zeyneloglu, P., Pirat, A., Popescu, M., Tomescu, D., Van Gassel, R., Baggerman, M., Schaap, F., Bol, M., Nicolaes, G., Beurskens, D., Damink, S. Olde, Van de Poll, M., Horibe, M., Sasaki, M., Sanui, M., Iwasaki, E., Sawano, H., Goto, T., Ikeura, T., Hamada, T., Oda, T., Mayumi, T., Kanai, T., Kjøsen, G., Horneland, R., Rydenfelt, K., Aandahl, E., Tønnessen, T., Haugaa, H., Lockett, P., Evans, L., Somerset, L., Ker-Reid, F., Laver, S., Courtney, E., Dalton, S., Georgiou, A., Robinson, K., Haas, B., Bartlett, K., Bigwood, M., Hanley, R., Morgan, P., Marouli, D., Chatzimichali, A., Kolyvaki, S., Panteli, A., Diamantaki, E., Pediaditis, E., Sirogianni, P., Ginos, P., Kondili, E., Georgopoulos, D., Askitopoulou, H., Zampieri, F. G., Liborio, A. B., Besen, B. A., Cavalcanti, A. B., Dominedò, C., Dell’Anna, A. M., Monayer, A., Grieco, D. L., Barelli, R., Cutuli, S. L., Maddalena, A. Ionescu, Picconi, E., Sonnino, C., Sandroni, C., Antonelli, M., Tuzuner, F., Cakar, N., Jacob, M., Sahu, S, Singh, Y. P., Mehta, Y., Yang, K. Y., Kuo, S., Rai, V., Cheng, T., Ertmer, C., Czempik, P, Hutchings, S., Watts, S., Wilson, C., Burton, C., Kirkman, E., Drennan, D., O’Prey, A., MacKay, A., Forrest, R., Oglinda, A., Ciobanu, G., Casian, M., Oglinda, C., Lun, C. T., Yuen, H. J., Ng, G., Leung, A., So, S. O., Chan, H. S., Lai, K. Y., Sanguanwit, P., Charoensuk, W., Phakdeekitcharoen, B., Batres-Baires, G., Kammerzell, I., Lahmer, T., Mayr, U., Schmid, R., Huber, W., Bomberg, H., Klingele, M., Groesdonk, H., Piechota, M., Mirkiewicz, K., Pérez, A. González, Silva, J., Ramos, A., Acharta, F., Perezlindo, M., Lovesio, L., Antonelli, P. Gauna, Dogliotti, A., Lovesio, C., Baron, J., Schiefer, J., Baron, D. M., Faybik, P., Chan, T. M., Ginos, P, Vicka, V., Gineityte, D., Ringaitiene, D., Sipylaite, J., Pekarskiene, J., Beurskens, D. M., Van Smaalen, T. C., Hoogland, P., Winkens, B., Christiaans, M. H., Reutelingsperger, C. P., Van Heurn, E., Nicolaes, G. A., Schmitt, F. S., Salgado, E. S., Friebe, J. F., Fleming, T. F., Zemva, J. Z., Schmoch, T. S., Uhle, F. U., Kihm, L. K., Morath, C. M., Nusshag, C. N., Zeier, M. Z., Bruckner, T. B., Mehrabi, A. M., Nawroth, P. N., Weigand, M. W., Hofer, S. H., Brenner, T. B., Fotopoulou, G., Poularas, I., Kokkoris, S., Brountzos, E., Elghonemi, M., Nilsson, K. F., Sandin, J., Gustafsson, L., Frithiof, R., Skorniakov, I., Varaksin, A., Vikulova, D., Shaikh, O., Whiteley, C., Ostermann, M., Di Lascio, G., Anicetti, L., Bonizzoli, M., Fulceri, G., Migliaccio, M. L., Sentina, P., Cozzolino, M., Peris, A., Khadzhynov, D., Halleck, F., Staeck, O., Lehner, L., Budde, K., Slowinski, T., Kindgen-Milles, D., Huysmans, N., Laenen, M. Vander, Helmschrodt, A., Boer, W., Debain, A., Jonckheer, J., Moeyersons, W., Van zwam, K., Puis, L., Staessens, K., Honoré, P. M., Spapen, H. D., De Waele, E., de Garibay, A. Perez Ruiz, Ende-Schneider, B., Schreiber, C., Kreymann, B., Bini, A., Votino, E., Steinberg, I., Vetrugno, L., Trunfio, D., Sidoti, A., Conroy, M., Marsh, B., and O’Flynn, J
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Critical Care and Intensive Care Medicine ,Meeting Abstracts - Full Text
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4. Intensive Care Unit Mortality Trends during the First Two Years of the COVID-19 Pandemic in Greece: A Multi-Center Retrospective Study.
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Fragkou PC, Karagiannis SP, Dimopoulou D, Kefala S, Fligou F, Gallos P, Jahaj E, Bellou A, Koukaki E, Magira E, Orfanos P, Papathanakos G, Papathanasiou A, Pediaditis E, Pontikis K, Rovina N, Vaporidi K, Xenikakis M, Theodorakopoulou M, and Kotanidou A
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- Humans, Greece epidemiology, Male, Female, Middle Aged, Retrospective Studies, Aged, SARS-CoV-2, Risk Factors, Aged, 80 and over, Pandemics, Adult, COVID-19 mortality, COVID-19 epidemiology, Intensive Care Units statistics & numerical data, Hospital Mortality trends, Critical Illness mortality
- Abstract
Data on COVID-19 mortality among patients in intensive care units (ICUs) from Eastern and/or Southern European countries, including Greece, are limited. The purpose of this study was to evaluate the ICU mortality trends among critically ill COVID-19 patients during the first two years of the pandemic in Greece and to further investigate if certain patients' clinical characteristics contributed to this outcome. We conducted a multi-center retrospective observational study among five large university hospitals in Greece, between February 2020 and January 2022. All adult critically ill patients with confirmed COVID-19 disease who required ICU admission for at least 24 h were eligible. In total, 1462 patients (66.35% males) were included in this study. The mean age of this cohort was 64.9 (±13.27) years old. The 28-day mortality rate was 35.99% ( n = 528), while the overall in-hospital mortality was 50.96% ( n = 745). Cox regression analysis demonstrated that older age (≥65 years old), a body mass index within the normal range, and a delay in ICU admission from symptom onset, as well as worse baseline clinical severity scores upon ICU admission, were associated with a greater risk of death. Mortality of critically ill COVID-19 patients was high during the first two years of the pandemic in Greece but comparable to other countries. Risk factors for death presented in this study are not different from those that have already been described for COVID-19 in other studies.
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- 2024
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5. Airway pressure morphology and respiratory muscle activity during end-inspiratory occlusions in pressure support ventilation.
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Soundoulounaki S, Akoumianaki E, Kondili E, Pediaditis E, Prinianakis G, Vaporidi K, and Georgopoulos D
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- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Positive-Pressure Respiration methods, Positive-Pressure Respiration statistics & numerical data, Respiration, Artificial instrumentation, Respiration, Artificial methods, Respiratory Physiological Phenomena immunology, Retrospective Studies, Positive-Pressure Respiration standards, Respiration, Artificial standards, Respiratory Muscles physiopathology
- 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 cmH
2 O, 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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6. Age, Comorbidities and Fear of Fall: mortality predictors associated with fall-related fractures.
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Velegraki M, Ioannou P, Tsioutis C, Persynaki GS, Pediaditis E, Koutserimpas C, Kontakis G, Alpantaki K, Samonis G, and Panagiotakis SH
- Abstract
Objectives: To determine mortality predictors following fall related fractures in older patients. Materials and methods: Patients aged ≥ 70 years hospitalized for fall related fractures were prospectively evaluated. Mortality was the main outcome. Age, functional-cognitive function, medications, comorbidities, fall history, fear of falls were also assessed. Outcomes: A total of 100 patients were enrolled. Ninety-one out of 100 (91%) suffered a hip fracture; 92 (92%) had surgery. The one-year post-discharge mortality was 20%. Univariate analysis revealed that older age, increased Charlson comorbidity index, low abbreviated mental test on admission, low modified Barthel index (MBI), fear of falls and delirium were significantly correlated with one-year post discharge mortality (p=.03, p=.003, p=.04, p=.005, p=.004, p=.015, respectively). Conclusion: Age, fear of falls and Charlson comorbidity index are predictors of one-year mortality after hospitalization for fracture. It is of utmost importance to identify older patients suffering from fracture at risk of dying that may benefit from patient-centered care.
- Published
- 2020
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7. Validation of a Proposed Algorithm for Assistance Titration During Proportional Assist Ventilation With Load-Adjustable Gain Factors.
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Amargiannitakis V, Gialamas I, Pediaditis E, Soundoulounaki S, Prinianakis G, Vaporidi K, Akoumianaki E, Proklou A, Alexopoulou C, Georgopoulos D, and Kondili E
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- Algorithms, Humans, Respiration, Artificial, Respiratory Muscles, Retrospective Studies, Tidal Volume, Interactive Ventilatory Support methods, Respiratory Insufficiency therapy
- 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 P
mus ) 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 H2 O) and effort (-82 to 125 cm H2 O × 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., Competing Interests: Drs Amargiannitakis and Gialamas contributed equally to this work. Drs Kondili, Vaporidi, and Georgopoulos have received lecture fees (honoraria) from Covidien., (Copyright © 2020 by Daedalus Enterprises.)- Published
- 2020
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8. Driving pressure during proportional assist ventilation: an observational study.
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Vaporidi K, Psarologakis C, Proklou A, Pediaditis E, Akoumianaki E, Koutsiana E, Chytas A, Chouvarda I, Kondili E, and Georgopoulos D
- 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 cmH
2 O) 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 < 15 cmH2 O and tidal volume < 11 mL/kg (of ideal body weight). In most patients, high driving pressure was observed for short periods of time (median 2.5 min). Prolonged periods of high driving pressure were observed in five patients (8%). During the 661 periods of stable compliance, high driving pressure combined with a tidal volume ≥ 8 mL/kg was observed only in 11 cases (1.6%) pertaining to four patients. High driving pressure occurred almost exclusively when respiratory system compliance was low, and compliance above 30 mL/cmH2 O excluded the presence of high driving pressure with 90% sensitivity and specificity., Conclusions: In critically ill patients fulfilling criteria for assisted ventilation, and ventilated in PAV+ mode, sustained high driving pressure occurred in a small, yet not negligible number of patients. The presence of sustained high driving pressure was not associated with high tidal volume, but occurred almost exclusively when compliance was below 30 mL/cmH2 O.- Published
- 2019
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9. Gastrointestinal dysmotility in critically ill patients.
- Author
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Ladopoulos T, Giannaki M, Alexopoulou C, Proklou A, Pediaditis E, and Kondili E
- 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., Competing Interests: Conflict of interest: None
- Published
- 2018
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