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2 "Athanasios Chalkias"
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Review Article
CPR/Resuscitation
Critical emergency medicine and the resuscitative care unit
Maria Mermiri, Georgios Mavrovounis, Dimitrios Chatzis, Ioannis Mpoutsikos, Aristea Tsaroucha, Maria Dova, Zacharoula Angelopoulou, Dimitrios Ragias, Athanasios Chalkias, Ioannis Pantazopoulos
Acute Crit Care. 2021;36(1):22-28.   Published online January 28, 2021
DOI: https://doi.org/10.4266/acc.2020.00521
  • 8,458 View
  • 290 Download
  • 9 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Critical emergency medicine is the medical field concerned with management of critically ill patients in the emergency department (ED). Increased ED stay due to intensive care unit (ICU) overcrowding has a negative impact on patient care and outcome. It has been proposed that implementation of critical care services in the ED can negate this effect. Two main Critical Emergency Medicine models have been proposed, the “resource intensivist” and “ED-ICU” models. The resource intensivist model is based on constant presence of an intensivist in the traditional ED setting, while the ED-ICU model encompasses the notion of a separate ED-based unit, with monitoring and therapeutic capabilities similar to those of an ICU. Critical emergency medicine has the potential to improve patient care and outcome; however, establishment of evidence-based protocols and a multidisciplinary approach in patient management are of major importance.

Citations

Citations to this article as recorded by  
  • Inhaled anaesthetic gas for severe bronchospasm at the emergency department
    Osman Adi, Farah Nuradhwa Apoo, Chan Pei Fong, Azma Haryaty Ahmad, Nurul Liana Roslan, Faheem Ahmed Khan, Shahridan Fathil
    The American Journal of Emergency Medicine.2024; 75: 179.     CrossRef
  • Patients’ Expectations in Emergency Department at King Abdulaziz University Hospital: A Cross-Sectional Survey-Based Study
    Ahmad H Bakhribah, Ghaida A. Eissa, Dania W Alsulami, Marah A Alotaibi, Htoun M Abdulmannan, Imad M Khojah
    Cureus.2024;[Epub]     CrossRef
  • CRP/Albumin Ratio and NLR in Recognizing Critically Ill Patients
    Abuzer Özkan
    Eurasian Journal of Critical Care.2024; 6(1): 38.     CrossRef
  • Rearranging the furniture: A blueprint for reappropriating fixed resources to create an emergency department resuscitative care unit
    Angela Barskaya, Liliya Abrukin, Christopher McStay
    Journal of the American College of Emergency Physicians Open.2024;[Epub]     CrossRef
  • The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study
    Ahmed Faidh Ramzee, Ayman El-Menyar, Mohammad Asim, Ahad Kanbar, Khalid Ahmed, Bahaa Daoud, Saji Mathradikkal, Ahmad Kloub, Hassan Al-Thani, Sandro Rizoli
    World Journal of Emergency Medicine.2023; 14(2): 96.     CrossRef
  • Value of Intensive Nursing Detail Management in Intensive Care Unit Nursing
    Yansong Li, Lehong Zhou, Qin Wei, Zhaoqi Dong
    Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1.     CrossRef
  • Effect of Early Low-Calorie Enteral Nutrition Support in Critically Ill Patients: A Systematic Review and Meta-analysis
    Qidong Jiang, Tao Xu, Dinesh Rokaya
    BioMed Research International.2022; 2022: 1.     CrossRef
  • Is the Critical Care Resuscitation Unit Sustainable: A 5-Year Experience of a Beneficial and Novel Model
    Elizabeth Powell, Iana Sahadzic, Daniel Najafali, Emilie Berman, Katie Andersen, Leenah Z. Afridi, Zoe Gasparotti, Erin Niles, Jeffrey Rea, Thomas Scalea, Daniel J. Haase, Quincy K. Tran, Edward A. Bittner
    Critical Care Research and Practice.2022; 2022: 1.     CrossRef
Original Article
CPR/Resuscitation
Measurement of mean systemic filling pressure after severe hemorrhagic shock in swine anesthetized with propofol-based total intravenous anesthesia: implications for vasopressor-free resuscitation
Athanasios Chalkias, Anastasios Koutsovasilis, Eleni Laou, Apostolos Papalois, Theodoros Xanthos
Acute Crit Care. 2020;35(2):93-101.   Published online April 20, 2020
DOI: https://doi.org/10.4266/acc.2019.00773
  • 7,175 View
  • 158 Download
  • 8 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Background
Mean systemic filling pressure (Pmsf) is a quantitative measurement of a patient’s volume status and represents the tone of the venous reservoir. The aim of this study was to estimate Pmsf after severe hemorrhagic shock and cardiac arrest in swine anesthetized with propofol-based total intravenous anesthesia, as well as to evaluate Pmsf’s association with vasopressor-free resuscitation.
Methods
Ten healthy Landrace/Large-White piglets aged 10–12 weeks with average weight 20±1 kg were used in this study. The protocol was divided into four distinct phases: stabilization, hemorrhagic, cardiac arrest, and resuscitation phases. We measured Pmsf at 5–7.5 seconds after the onset of cardiac arrest and then every 10 seconds until 1 minute postcardiac arrest. During resuscitation, lactated Ringers was infused at a rate that aimed for a mean right atrial pressure of ≤4 mm Hg. No vasopressors were used.
Results
The mean volume of blood removed was 860±20 ml (blood loss, ~61%) and the bleeding time was 43.2±2 minutes while all animals developed pulseless electrical activity. Mean Pmsf was 4.09±1.22 mm Hg, and no significant differences in Pmsf were found until 1 minute postcardiac arrest (4.20±0.22 mm Hg at 5–7.5 seconds and 3.72±0.23 mm Hg at 55– 57.5 seconds; P=0.102). All animals achieved return of spontaneous circulation (ROSC), with mean time to ROSC being 6.1±1.7 minutes and mean administered volume being 394±20 ml.
Conclusions
For the first time, Pmsf was estimated after severe hemorrhagic shock. In this study, Pmsf remained stable during the first minute post-arrest. All animals achieved ROSC with goal-directed fluid resuscitation and no vasopressors.

Citations

Citations to this article as recorded by  
  • COMPARISON BETWEEN ACTIVE ABDOMINAL COMPRESSION-DECOMPRESSION CARDIOPULMONARY RESUSCITATION AND STANDARD CARDIOPULMONARY RESUSCITATION IN ASPHYCTIC CARDIAC ARREST RATS WITH MULTIPLE RIB FRACTURES
    Zhichu Dai, Sisen Zhang, Hongyu Wang, Liwei He, Jiankun Liao, Xuanyu Wu
    Shock.2024; 61(2): 266.     CrossRef
  • Effects of Vasopressin Receptor Agonists during the Resuscitation of Hemorrhagic Shock: A Systematic Review and Meta-Analysis of Experimental and Clinical Studies
    Eleni Laou, Nikolaos Papagiannakis, Androniki Papadopoulou, Theodora Choratta, Minas Sakellakis, Mariachiara Ippolito, Ioannis Pantazopoulos, Andrea Cortegiani, Athanasios Chalkias
    Journal of Personalized Medicine.2023; 13(7): 1143.     CrossRef
  • Hemodynamic Effects of Cardiovascular Medications in a Normovolemic and Hemorrhaged Yorkshire-cross Swine Model
    Jacob H Cole, Scott B Hughey, Phillip G Geiger, Kamala J Rapp-Santos, Gregory J Booth
    Comparative Medicine.2022; 72(1): 38.     CrossRef
  • Determinants of venous return in steady-state physiology and asphyxia-induced circulatory shock and arrest: an experimental study
    Athanasios Chalkias, Eleni Laou, Nikolaos Papagiannakis, Giolanda Varvarousi, Dimitrios Ragias, Anastasios Koutsovasilis, Demosthenes Makris, Dimitrios Varvarousis, Nicoletta Iacovidou, Ioannis Pantazopoulos, Theodoros Xanthos
    Intensive Care Medicine Experimental.2022;[Epub]     CrossRef
  • Assessment of Dynamic Changes in Stressed Volume and Venous Return during Hyperdynamic Septic Shock
    Athanasios Chalkias, Eleni Laou, Nikolaos Papagiannakis, Vaios Spyropoulos, Evaggelia Kouskouni, Kassiani Theodoraki, Theodoros Xanthos
    Journal of Personalized Medicine.2022; 12(5): 724.     CrossRef
  • A Critical Appraisal of the Effects of Anesthetics on Immune-system Modulation in Critically Ill Patients With COVID-19
    Athanasios Chalkias, Erin F. Barreto, Eleni Laou, Konstantina Kolonia, Marc H. Scheetz, Konstantinos Gourgoulianis, Ioannis Pantazopoulos, Theodoros Xanthos
    Clinical Therapeutics.2021; 43(3): e57.     CrossRef
  • Resuscitative Effect of Centhaquine (Lyfaquin®) in Hypovolemic Shock Patients: A Randomized, Multicentric, Controlled Trial
    Anil Gulati, Dinesh Jain, Nilesh Radheshyam Agrawal, Prashant Rahate, Rajat Choudhuri, Soumen Das, Deba Prasad Dhibar, Madhav Prabhu, Sameer Haveri, Rohit Agarwal, Manish S. Lavhale
    Advances in Therapy.2021; 38(6): 3223.     CrossRef
  • A Multicentric, Randomized, Controlled Phase III Study of Centhaquine (Lyfaquin®) as a Resuscitative Agent in Hypovolemic Shock Patients
    Anil Gulati, Rajat Choudhuri, Ajay Gupta, Saurabh Singh, S. K. Noushad Ali, Gursaran Kaur Sidhu, Parvez David Haque, Prashant Rahate, Aditya R. Bothra, Gyan P. Singh, Sanjiv Maheshwari, Deepak Jeswani, Sameer Haveri, Apurva Agarwal, Nilesh Radheshyam Agra
    Drugs.2021; 81(9): 1079.     CrossRef

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