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| 1 | Respiratory mechanics in brain injury: A review显示文摘Several clinical and experimental studies have shown that lung injury occurs shortly after brain damage. The responsible mechanisms involve neurogenic pulmonary edema, inflammation, the harmful action of neurotransmitters, or autonomic system dysfunction. Mechanical ventilation, an essential component of life support in brain-damaged patients(BD), may be an additional traumatic factor to the already injured or susceptible to injury lungs of these patients thus worsening lung injury, in case that non lung protective ventilator settings are applied. Measurement of respiratory mechanics in BD patients, as well as assessment of their evolution during mechanical ventilation, may lead to preclinical lung injury detection early enough, allowing thus the selection of the appropriate ventilator settings to avoid ventilatorinduced lung injury. The aim of this review is to explore the mechanical properties of the respiratory system in BD patients along with the underlying mechanisms, and to translate the evidence of animal and clinical studies into therapeutic implications regarding the mechanical ventilation of these critically ill patients. | Antonia Koutsoukou Maria Katsiari Stylianos E Orfanos Anastasia Kotanidou Maria Daganou Magdalini Kyriakopoulou Nikolaos G Koulouris Nikoletta Rovina | 2016 | World Journal of Critical Care Medicine2016，5，1： | 7 |
| 2 | Expiratory flow-limitation in mechanically ventilated patients: A risk for ventilator-induced lung injury?显示文摘Expiratory flow limitation(EFL), that is the inability of expiratory flow to increase in spite of an increase of the driving pressure, is a common and unrecognized occurrence during mechanical ventilation in a variety of intensive care unit conditions. Recent evidence suggests that the presence of EFL is associated with an increase in mortality, at least in acute respiratory distress syndrome(ARDS) patients, and in pulmonary complications in patients undergoing surgery. EFL is a major cause of intrinsic positive end-expiratory pressure(PEEPi), which in ARDS patients is heterogeneously distributed, with a consequent increase of ventilation/perfusion mismatch and reduction of arterial oxygenation. Airway collapse is frequently concomitant to the presence of EFL.When airways close and reopen during tidal ventilation, abnormally high stresses are generated that can damage the bronchiolar epithelium and uncouple small airways from the alveolar septa, possibly generating the small airways abnormalities detected at autopsy in ARDS. Finally, the high stresses and airway distortion generated downstream the choke points may contribute to parenchymal injury, but this possibility is still unproven. PEEP application can abolish EFL, decrease PEEPi heterogeneity, and limit recruitment/derecruitment.Whether increasing PEEP up to EFL disappearance is a useful criterion for PEEP titration can only be determined by future studies. | Antonia Koutsoukou Matteo Pecchiari | 2019 | World Journal of Critical Care Medicine2019，8，1： | 5 |
| 3 | Effects of positive endexpiratory pressure on gas exchange and expiratory flow limitation in adult respiratory distress syndrome显示文摘 | Koutsoukou A Bekos B Sotiropoulou C | 2002 | Crit Care Med2002，30，： | 2 |
| 4 | Respiratory failure 显示文摘 | Roussos C Koutsoukou A | 2003 | Eur Respir J2003，，： | 1 |
| 5 | Plasma membrane dis- ruptions with different modes of injurious mechanical ventilation in normal rat lungs显示文摘 | Pecchiari M Monaco A Koutsoukou A | 2011 | Crit Care Med2011，40，3： | 1 |
| 6 | Osteonecrosis of the jaw in cancer after treatment with bisphosphonates:incidence and risk factors显示文摘 | Bamias A Kastritis E Bamia C Moulopoulos LA Melakopoulos I Bozas G Koutsoukou V Gika D Anagnostopoulos A Papadimi-triou C Terpos E Dimopoulos MA | | 0，，： | 1 |
| 7 | Inflammation and immune response in COPD: where do we stand? 显示文摘 | Rovina N Koutsoukou A Koulouris NG | 2013 | Mediators Inflamm2013，2013，： | 1 |
| 8 | Inflammation and immune response in COPD: where do we stand? 显示文摘 | Rovina N Koutsoukou A Koulouris NG | 2013 | Mediators Inflamm2013，9，15： | 1 |
| 9 | Dyspnea and respiratory muscle strength in end-stage liver disease显示文摘AIM:To investigate the prevalence of chronic dyspnea and its relationship to respiratory muscle function in end-stage liver disease.METHODS:Sixty-eight consecutive,ambulatory,Caucasian patients with end-stage liver disease,candidates for liver transplantation,were referred for preoperative respiratory function assessment.Forty of these(29 men) were included in this preliminary study after applying strict inclusion and exclusion criteria.Seventeen of 40 patients(42%) had ascites,but none of them was cachectic.Fifteen of 40 patients(38%)had a history of hepatic encephalopathy,though none of them was symptomatic at study time.All patients with a known history and/or presence of co-morbidities were excluded.Chronic dyspnea was rated according to the modified medical research council(mMRC) 6-point scale.Liver disease severity was assessed according to the Model for end-stage liver disease(MELD).Routine lung function tests,maximum static expiratory(Pemax) and inspiratory(Pimax) mouth pressures were measured.Respiratory muscle strength(RMS) was calculated from Pimax and Pemax values.In addition,arterial blood gases and pattern of breathing(VE:minute ventilation;VT:tidal volume;VT/TI:mean inspiratory flow;TI:duration of inspiration) were measured.RESULTS:Thirty-five(88%) of 40 patients aged(mean ± SD) 52 ± 10 years reported various degrees of chronic dyspnea(mMRC),ranging from 0 to 4,with a mean value of 2.0 ± 1.2.MELD score was 14 ± 6.Pemax,percent of predicted(%pred) was 105 ± 35,Pimax,%pred was 90 ± 29,and RMS,%pred was 97 ± 30.These pressures were below the normal limits in 12(30%),15(38%),and 14(35%) patients,respectively.Furthermore,comparing the subgroups of ascites to non-ascites patients,all respiratory muscle indices measured were found significantly decreased in ascites patients.Patients with ascites also had a significantly worse MELD score compared to non-ascites ones(P = 0.006).Significant correlations were found between chronic dyspnea and respiratory muscle function indices in all patients.Specifically,mMRC score was significantly correlated with Pemax,Pimax,and RMS(r =-0.53,P < 0.001;r =-0.42,P < 0.01;r =-0.51,P < 0.001,respectively).These correlations were substantially closer in the non-ascites subgroup(r =-0.82,P < 0.0001;r =-0.61,P < 0.01;r =-0.79,P < 0.0001,respectively) compared to all patients.Similar results were found for the relationship between mMRC vs MELD score,and MELD score vs respiratory muscle strength indices.In all patients the sole predictor of mMRC score was RMS(r =-0.51,P < 0.001).In the subgroup of patients without ascites this relationship becomes closer(r =-0.79,P < 0.001),whilst this relationship breaks down in the subgroup of patients with ascites.The disappearance of such a correlation may be due to the fact that ascites acts as a 'confounding' factor.PaCO2(4.4 ± 0.5 kPa) was increased,whereas pH(7.49 ± 0.04) was decreased in 26(65%) and 34(85%) patients,respectively.PaO2(12.3 ± 0.04 kPa) was within normal limits.VE(11.5 ± 3.5 L/min),VT(0.735 ± 0.287 L),and VT/TI(0.449±0.129 L/s) were increased signifying hyperventilation in both subgroups of patients.VT/TI was significantly higher in patients with ascites than without ascites.Significant correlations,albeit weak,were found for PaCO2 with VE and VT/TI(r =-0.44,P < 0.01;r =-0.41,P < 0.01,respectively).CONCLUSION:The prevalence of chronic dyspnea is 88% in end-stage liver disease.The mMRC score closely correlates with respiratory muscle strength. | Georgios Kaltsakas Efstathios Antoniou Anastasios F Palamidas Sofia-Antiopi Gennimata Panorea Paraskeva Anastasios Smyrnis Antonia Koutsoukou Joseph Milic-Emili Nickolaos G Koulouris | 2013 | World Journal of Hepatology2013，5，2： | 1 |
| 10 | Effect of surface roughness of hydroxyapatite on human bone marrow cell adhesion, proliferation, differentiation and detachment strength显示文摘 | Deligaianni DD Katsala rqD Koutsoukes PG | 2001 | Biomaterial2001，22，1： | 1 |
| 11 | Respiratory mechanics in brain-damaged patients显示文摘 | Koutsoukou A Perraki H Raftopoulou A | 2006 | Intensive Care Med2006，32，12： | 1 |
| 12 | Cytokine release, small airway injury, and parenchymal damage during mechanical ventilation in normal open-chest rats 显示文摘 | D'Angelo E Koutsoukou A Della-Valle P | 2008 | J Appl Physiol2008，104，1： | 1 |
| 13 | Correlation of NK T-like CD3+CD56+ cells and CD4+CD25+(hi) regulatory T cells with VEGF and TNFα in ascites from advanced ovarian cancer: Association with platinum resistance and prognosis in patients receiving first-line, platinum-based chemotherapy显示文摘 | Aristotelis Bamias Vasiliki Koutsoukou Evangelos Terpos Marinos L. Tsiatas Christina Liakos Ourania Tsitsilonis Alexandros Rodolakis Zannis Voulgaris G. Vlahos Theocharis Papageorgiou G. Papatheodoridis A. Archimandritis A. Antsaklis M.A. Dimopoulos | 2007 | Gynecologic Oncology2007，，2： | 1 |
| 14 | Biweekly gemcitabine and cisplatin in platinumresistant/refractory,paclitaxel-pretreated,ovarian and peritoneal carcinoma显示文摘 | Bozas G Bamias A Koutsoukou V | | 0，，03： | 1 |
| 15 | Cytokine release,small airway injury,and parenchymal damage during mechanical ventilation in normal open-chest rats显示文摘 | Angelo ED Koutsoukou A Valle PD | 2008 | J Appl Physiol2008，104，1： | 1 |
| 16 | Septic arthritis caused by Erysipelothrix rhusiopathiae infection after arthroscopically assisted anterior cruciate ligament reconstruction显示文摘 | Panagiotis G.V allianatos Anastasia C. Tilentzoglou Alexander D. Koutsoukou | 2003 | Arthroscopy: The Journal of Arthroscopic and Related Surgery2003，，3： | 1 |
| 17 | Spontaneous precipitation of struvite from aqueous solutions 显示文摘 | Bouropoulos N C Koutsoukous P G | 2000 | Journal of Crystal Growth2000，，213： | 1 |
| 18 | Biweekly gemcitabine and cisplatin in platinum-rusistant/rofractory,paclitaxel-pretreated,ovarian and peritoneal carcinoma显示文摘 | Bamias A Koutsoukou V | 2007 | Gynecol Oncol2007，104，3： | 1 |
| 19 | Respiratory failure 显示文摘 | Roussos C Koutsoukou A | 2003 | Eur Respir J2003，，： | 1 |
| 20 | Inflammation and Im- mune Response in COPD: Where Do We Stand? 显示文摘 | Rovina N Koutsoukou A Koulouris NG | 2013 | Mediators Inflamm2013，2013，41： | 1 |
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