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Papers by Theodoros Aslanidis

Critical Care, 2024

Background There is currently no practice-based, multicenter database of poisoned patients admitt... more Background There is currently no practice-based, multicenter database of poisoned patients admitted to intensive care units (ICUs). The INTOXICATE study, endorsed by the ESICM and EAPCCT, aimed to determine the rate of eventful admissions among acutely intoxicated adult ICU patients. Methods Ethical approval was obtained for this multicenter, prospective observational study, and data-sharing agreements were signed with each participating center. An electronic case report form was used to collect data on patient demographics, exposure, clinical characteristics, investigations, treatment, and in-hospital mortality data. The primary outcome, 'eventful admission' , was a composite outcome defined as the rate of patients who received any of the following treatments in the first 24 h after the ICU admission: oxygen supplementation with a FiO2 > 40%, mechanical ventilation, vasopressors, renal replacement therapy (RRT), cardiopulmonary resuscitation, antidotes, active cooling, fluid resuscitation (> 1.5 L of intravenous fluid of any kind), sedation, or who died in the hospital. Results Seventy-eight ICUs, mainly from Europe, but also from Australia and the Eastern Mediterranean, participated. A total of 2,273 patients were enrolled between November 2020 and June 2023. The median age of the patients was 41 years, 72% were exposed to intoxicating drugs. The observed rate of patients with an eventful ICU admission was 68% (n = 1546/2273 patients). The hospital mortality was 4.5% (n = 103/2273). Conclusions The vast majority of patients survive, and approximately one third of patients do not receive any ICUspecific interventions after admission in an intensive care unit for acute intoxication. High-quality detailed clinical data have been collected from a large cohort of acutely intoxicated ICU patients, providing information on the pattern of severe acute poisoning requiring intensive care admission and the outcomes of these patients.

IntechOpen eBooks, Feb 7, 2024

Saudi journal of medicine, Sep 25, 2023

Clinical and experimental emergency medicine, Aug 24, 2023

IntechOpen eBooks, Dec 5, 2023

Anesthetic management of a patient with X-linked adrenoleukodystrophy and related Addison's disea... more Anesthetic management of a patient with X-linked adrenoleukodystrophy and related Addison's disease and Brugada syndrome. Aslanidis Th, Tsamaslidis G, Gkiauris E, Lazaridou EE X-linked adrenoleukodystrophy is rarely encountered in the operating room. The clinical presentation is highly variable and creates unique challenges for the anesthesiologist. Case: We hereby present a successful anesthetic management of patient with X-linked adrenoleukodystrophy and related Addison's disease and Brugada syndrome for an orthopedic surgery and review the available literature about the topic. Conclusion: The numerous phenotypes of the disease pose unique challenge to the anesthesiologists that must be handled from a multidisciplinary team and on an individual basis.

Case Study and Case Report, 2013

In the era of functional hemodynamic monitoring and computational modeling, the present book publ... more In the era of functional hemodynamic monitoring and computational modeling, the present book published by IntechOpen® highlights some interesting aspects in the field. Divided into two sections, it presents hemodynamic topics of special interest. Thus, the authors offer the readers not only a ""vigorous"" review of the current literature but also a research direction for further advancement

Εισαγωγή – Η μελέτη του στρες έχει αποκτήσει ιδιαίτερο ενδιαφέρον για την επιστημονική κοινότητα,... more Εισαγωγή – Η μελέτη του στρες έχει αποκτήσει ιδιαίτερο ενδιαφέρον για την επιστημονική κοινότητα, λόγω του ευρύ επιπολασμού που έχει το αναφερόμενο «αρνητικό στρες» στο γενικό πληθυσμό και των συνεπειών που έχει το τελευταίο σε συναισθηματικό, ψυχολογικό και σωματικό επίπεδο. Η μέτρηση της ηλεκτροδερματικής δραστηριότητας βασίζεται στην δραστηριότητα του αυτόνομου νευρικού συστήματος και έχει εφαρμοσθεί στο τομέα της ψυχοφυσιολογίας ήδη από πολύ νωρίς. Όμως, μόνο πρόσφατα άρχισε να εφαρμόζεται και στο πεδίο της περιεγχειρητικής ιατρικής. Σκοπός - Η παρούσα εργασία αναφέρεται σε ενήλικες κατασταλμένους ασθενείς Μονάδος Εντατικής Θεραπείας και καταγράφει τις μεταβολές που προκαλούνται από διάφορα ερεθίσματα στην ηλεκτροδερματική αγωγιμότητα, παράλληλα με άλλες παράμετρους. Έτσι, αξιολογείται η τελευταία ως δείκτης στρες στην κατηγορία αυτή των ασθενών. Υλικό- μέθοδοι - Η μελέτη διενεργήθηκε στην πολυδύναμη Μονάδα Εντατικής Θεραπείας του ΓΠΝ Θεσσαλονίκης Α.Χ.Ε.Π.Α από τον Οκτώβριο του 2012 έως τον Δεκέμβριο του 2013 και βασίστηκε στην παρατήρηση / καταγραφή για χρονική διάρκεια 4 ωρών όλων των παραμέτρων παρακολούθησης (αιμοδυναμικές, αναπνευστικές, μηχανικού αερισμού, ηλεκτροδερματικής αγωγιμότητας) καθώς και των μεταβολών τους σε διάφορα ερεθίσματα. Κριτήρια εισόδου στη μελέτη ήταν η ηλικία των ασθενών (>18 έτη), η εφαρμογή μηχανικού αερισμού >24 h,το σταθερό επίπεδο καταστολής μέσω της συνεχούς ενδοφλέβιας χορήγησης κατασταλτικών. Κάθε παράμετρος που θα μπορούσε να επηρεάσει τις μετρήσεις ορίσθηκε ως κριτήριο αποκλεισμού. Οι ασθενείς χωρίστηκαν σε 2 ομάδες, με βάση το βάθος καταστολής τους. Οι μεταβολές ομαδοποιήθηκαν ανα ερέθισμα και στη συνέχεια συγκρίθηκαν οι διαφορές μεταξύ των παραμέτρων και μεταξύ των 2 ομάδων. Αποτελέσματα - Συνολικά προγραμματίστηκαν 54 μετρήσεις, σε νοσηλευόμενους της ΜΕΘ. Στην περαιτέρω ανάλυση όμως συμπεριλήφθησαν δεδομένα μόνο από 25 μετρήσεις. Σε όλες τις μετρήσεις για όλα τα ερεθίσματα, η ηλεκτροδερματική αγωγιμότητα μεταβάλλεται σε πολύ μεγαλύτερο βαθμό από ό,τι οι άλλες παράμετροι. Το βάθος της καταστολής επηρεάζει την ένταση της μεταβολής. Συμπεράσματα – Η καταγραφή της ηλεκτροδερματικής αγωγιμότητας μπορεί να χρησιμοποιηθεί στην αξιολόγηση του στρες (= μη ειδικής αντίδρασης του οργανισμού σε ερεθίσματα) σε κατασταλμένους ασθενείς ΜΕΘ, υπό προϋποθέσεις. Περαιτέρω έρευνες χρειάζονται για να αποσαφηνιστεί όμως ακριβώς ο ρόλος και η σημασία της στην κλινική διαχείριση τέτοιων ασθενών.

Critical Care, Mar 19, 2013

Critical Care

BackgroundIt remains elusive how the characteristics, the course of disease, the clinical managem... more BackgroundIt remains elusive how the characteristics, the course of disease, the clinical management and the outcomes of critically ill COVID-19 patients admitted to intensive care units (ICU) worldwide have changed over the course of the pandemic.MethodsProspective, observational registry constituted by 90 ICUs across 22 countries worldwide including patients with a laboratory-confirmed, critical presentation of COVID-19 requiring advanced organ support. Hierarchical, generalized linear mixed-effect models accounting for hospital and country variability were employed to analyse the continuous evolution of the studied variables over the pandemic.ResultsFour thousand forty-one patients were included from March 2020 to September 2021. Over this period, the age of the admitted patients (62 [95% CI 60–63] years vs 64 [62–66] years,p < 0.001) and the severity of organ dysfunction at ICU admission decreased (Sequential Organ Failure Assessment 8.2 [7.6–9.0] vs 5.8 [5.3–6.4],p < 0.00...

Frontiers in Medicine, 2021

The continued digitalization of medicine has led to an increased availability of longitudinal pat... more The continued digitalization of medicine has led to an increased availability of longitudinal patient data that allows the investigation of novel and known diseases in unprecedented detail. However, to accurately describe any underlying pathophysiology and allow inter-patient comparisons, individual patient trajectories have to be synchronized based on temporal markers. In this pilot study, we use longitudinal data from critically ill ICU COVID-19 patients to compare the commonly used alignment markers “onset of symptoms,” “hospital admission,” and “ICU admission” with a novel objective method based on the peak value of the inflammatory marker C-reactive protein (CRP). By applying our CRP-based method to align the progression of neutrophils and lymphocytes, we were able to define a pathophysiological window that improved mortality risk stratification in our COVID-19 patient cohort. Our data highlights that proper synchronization of longitudinal patient data is crucial for accurate i...

Glucose is an essential carbohydrate for brain function. Even a short-lasted acute drop in its le... more Glucose is an essential carbohydrate for brain function. Even a short-lasted acute drop in its levels can result in cerebral dysfunction and even death. Early treatment of and decreasing duration of hypoglycemia episodes increases life expectancy and improves the level of consciousness. Furthermore, pharmacological symptoms' management should be continued for at least 2 weeks after hospital admission aiming to preserve the integrity of brain function and the wider well-being of patients.

Critical Care, 2024

Background There is currently no practice-based, multicenter database of poisoned patients admitt... more Background There is currently no practice-based, multicenter database of poisoned patients admitted to intensive care units (ICUs). The INTOXICATE study, endorsed by the ESICM and EAPCCT, aimed to determine the rate of eventful admissions among acutely intoxicated adult ICU patients. Methods Ethical approval was obtained for this multicenter, prospective observational study, and data-sharing agreements were signed with each participating center. An electronic case report form was used to collect data on patient demographics, exposure, clinical characteristics, investigations, treatment, and in-hospital mortality data. The primary outcome, 'eventful admission' , was a composite outcome defined as the rate of patients who received any of the following treatments in the first 24 h after the ICU admission: oxygen supplementation with a FiO2 > 40%, mechanical ventilation, vasopressors, renal replacement therapy (RRT), cardiopulmonary resuscitation, antidotes, active cooling, fluid resuscitation (> 1.5 L of intravenous fluid of any kind), sedation, or who died in the hospital. Results Seventy-eight ICUs, mainly from Europe, but also from Australia and the Eastern Mediterranean, participated. A total of 2,273 patients were enrolled between November 2020 and June 2023. The median age of the patients was 41 years, 72% were exposed to intoxicating drugs. The observed rate of patients with an eventful ICU admission was 68% (n = 1546/2273 patients). The hospital mortality was 4.5% (n = 103/2273). Conclusions The vast majority of patients survive, and approximately one third of patients do not receive any ICUspecific interventions after admission in an intensive care unit for acute intoxication. High-quality detailed clinical data have been collected from a large cohort of acutely intoxicated ICU patients, providing information on the pattern of severe acute poisoning requiring intensive care admission and the outcomes of these patients.

IntechOpen eBooks, Feb 7, 2024

Saudi journal of medicine, Sep 25, 2023

Clinical and experimental emergency medicine, Aug 24, 2023

IntechOpen eBooks, Dec 5, 2023

Anesthetic management of a patient with X-linked adrenoleukodystrophy and related Addison's disea... more Anesthetic management of a patient with X-linked adrenoleukodystrophy and related Addison's disease and Brugada syndrome. Aslanidis Th, Tsamaslidis G, Gkiauris E, Lazaridou EE X-linked adrenoleukodystrophy is rarely encountered in the operating room. The clinical presentation is highly variable and creates unique challenges for the anesthesiologist. Case: We hereby present a successful anesthetic management of patient with X-linked adrenoleukodystrophy and related Addison's disease and Brugada syndrome for an orthopedic surgery and review the available literature about the topic. Conclusion: The numerous phenotypes of the disease pose unique challenge to the anesthesiologists that must be handled from a multidisciplinary team and on an individual basis.

Case Study and Case Report, 2013

In the era of functional hemodynamic monitoring and computational modeling, the present book publ... more In the era of functional hemodynamic monitoring and computational modeling, the present book published by IntechOpen® highlights some interesting aspects in the field. Divided into two sections, it presents hemodynamic topics of special interest. Thus, the authors offer the readers not only a ""vigorous"" review of the current literature but also a research direction for further advancement

Εισαγωγή – Η μελέτη του στρες έχει αποκτήσει ιδιαίτερο ενδιαφέρον για την επιστημονική κοινότητα,... more Εισαγωγή – Η μελέτη του στρες έχει αποκτήσει ιδιαίτερο ενδιαφέρον για την επιστημονική κοινότητα, λόγω του ευρύ επιπολασμού που έχει το αναφερόμενο «αρνητικό στρες» στο γενικό πληθυσμό και των συνεπειών που έχει το τελευταίο σε συναισθηματικό, ψυχολογικό και σωματικό επίπεδο. Η μέτρηση της ηλεκτροδερματικής δραστηριότητας βασίζεται στην δραστηριότητα του αυτόνομου νευρικού συστήματος και έχει εφαρμοσθεί στο τομέα της ψυχοφυσιολογίας ήδη από πολύ νωρίς. Όμως, μόνο πρόσφατα άρχισε να εφαρμόζεται και στο πεδίο της περιεγχειρητικής ιατρικής. Σκοπός - Η παρούσα εργασία αναφέρεται σε ενήλικες κατασταλμένους ασθενείς Μονάδος Εντατικής Θεραπείας και καταγράφει τις μεταβολές που προκαλούνται από διάφορα ερεθίσματα στην ηλεκτροδερματική αγωγιμότητα, παράλληλα με άλλες παράμετρους. Έτσι, αξιολογείται η τελευταία ως δείκτης στρες στην κατηγορία αυτή των ασθενών. Υλικό- μέθοδοι - Η μελέτη διενεργήθηκε στην πολυδύναμη Μονάδα Εντατικής Θεραπείας του ΓΠΝ Θεσσαλονίκης Α.Χ.Ε.Π.Α από τον Οκτώβριο του 2012 έως τον Δεκέμβριο του 2013 και βασίστηκε στην παρατήρηση / καταγραφή για χρονική διάρκεια 4 ωρών όλων των παραμέτρων παρακολούθησης (αιμοδυναμικές, αναπνευστικές, μηχανικού αερισμού, ηλεκτροδερματικής αγωγιμότητας) καθώς και των μεταβολών τους σε διάφορα ερεθίσματα. Κριτήρια εισόδου στη μελέτη ήταν η ηλικία των ασθενών (&amp;amp;gt;18 έτη), η εφαρμογή μηχανικού αερισμού &amp;amp;gt;24 h,το σταθερό επίπεδο καταστολής μέσω της συνεχούς ενδοφλέβιας χορήγησης κατασταλτικών. Κάθε παράμετρος που θα μπορούσε να επηρεάσει τις μετρήσεις ορίσθηκε ως κριτήριο αποκλεισμού. Οι ασθενείς χωρίστηκαν σε 2 ομάδες, με βάση το βάθος καταστολής τους. Οι μεταβολές ομαδοποιήθηκαν ανα ερέθισμα και στη συνέχεια συγκρίθηκαν οι διαφορές μεταξύ των παραμέτρων και μεταξύ των 2 ομάδων. Αποτελέσματα - Συνολικά προγραμματίστηκαν 54 μετρήσεις, σε νοσηλευόμενους της ΜΕΘ. Στην περαιτέρω ανάλυση όμως συμπεριλήφθησαν δεδομένα μόνο από 25 μετρήσεις. Σε όλες τις μετρήσεις για όλα τα ερεθίσματα, η ηλεκτροδερματική αγωγιμότητα μεταβάλλεται σε πολύ μεγαλύτερο βαθμό από ό,τι οι άλλες παράμετροι. Το βάθος της καταστολής επηρεάζει την ένταση της μεταβολής. Συμπεράσματα – Η καταγραφή της ηλεκτροδερματικής αγωγιμότητας μπορεί να χρησιμοποιηθεί στην αξιολόγηση του στρες (= μη ειδικής αντίδρασης του οργανισμού σε ερεθίσματα) σε κατασταλμένους ασθενείς ΜΕΘ, υπό προϋποθέσεις. Περαιτέρω έρευνες χρειάζονται για να αποσαφηνιστεί όμως ακριβώς ο ρόλος και η σημασία της στην κλινική διαχείριση τέτοιων ασθενών.

Critical Care, Mar 19, 2013

Critical Care

BackgroundIt remains elusive how the characteristics, the course of disease, the clinical managem... more BackgroundIt remains elusive how the characteristics, the course of disease, the clinical management and the outcomes of critically ill COVID-19 patients admitted to intensive care units (ICU) worldwide have changed over the course of the pandemic.MethodsProspective, observational registry constituted by 90 ICUs across 22 countries worldwide including patients with a laboratory-confirmed, critical presentation of COVID-19 requiring advanced organ support. Hierarchical, generalized linear mixed-effect models accounting for hospital and country variability were employed to analyse the continuous evolution of the studied variables over the pandemic.ResultsFour thousand forty-one patients were included from March 2020 to September 2021. Over this period, the age of the admitted patients (62 [95% CI 60–63] years vs 64 [62–66] years,p < 0.001) and the severity of organ dysfunction at ICU admission decreased (Sequential Organ Failure Assessment 8.2 [7.6–9.0] vs 5.8 [5.3–6.4],p < 0.00...

Frontiers in Medicine, 2021

The continued digitalization of medicine has led to an increased availability of longitudinal pat... more The continued digitalization of medicine has led to an increased availability of longitudinal patient data that allows the investigation of novel and known diseases in unprecedented detail. However, to accurately describe any underlying pathophysiology and allow inter-patient comparisons, individual patient trajectories have to be synchronized based on temporal markers. In this pilot study, we use longitudinal data from critically ill ICU COVID-19 patients to compare the commonly used alignment markers “onset of symptoms,” “hospital admission,” and “ICU admission” with a novel objective method based on the peak value of the inflammatory marker C-reactive protein (CRP). By applying our CRP-based method to align the progression of neutrophils and lymphocytes, we were able to define a pathophysiological window that improved mortality risk stratification in our COVID-19 patient cohort. Our data highlights that proper synchronization of longitudinal patient data is crucial for accurate i...

Glucose is an essential carbohydrate for brain function. Even a short-lasted acute drop in its le... more Glucose is an essential carbohydrate for brain function. Even a short-lasted acute drop in its levels can result in cerebral dysfunction and even death. Early treatment of and decreasing duration of hypoglycemia episodes increases life expectancy and improves the level of consciousness. Furthermore, pharmacological symptoms' management should be continued for at least 2 weeks after hospital admission aiming to preserve the integrity of brain function and the wider well-being of patients.

The Greek E-Journal of Perioperative Medicine 2020;19(b): XX- XX (ISSN 1109-6888, 2020

Cardiopulmonary resuscitation in prone position in critically ill patients with SARS-CoV-2 infect... more Cardiopulmonary resuscitation in prone position in critically ill patients with SARS-CoV-2 infection. Bersot C.D.A, Pereira J.E.G, Aslanidis Th. Coronaviruses are a large family of viruses that cause illnesses ranging from the common cold to more severe diseases. SARS-CoV-2 is a new virus that has not been previously identified in humans. Patients with SARS-CoV-2 commonly develop acute respiratory distress syndrome (ARDS), myocardial injury, ventricular arrhythmias, and shock, all of which increase their risk of cardiac arrest. The main objective of this brief review is to raise the discussion on the possible indication of cardiopulmonary resuscitation in a patient with SARS-CoV-2 in prone position as a way to save time, since the entire process of decubitus change is complex and often slow, due to the number of devices used in these patients, such as catheters, infusion pumps and monitors. In addition to a price of high demand for stressed human resources.