Marina Tsoumpa’s research while affiliated with National and Kapodistrian University of Athens and other places

What role can renewable hydrogen play in achieving the ambitious decarbonization goals in the Nordic region? Linking to the FES/RIFS study "Building partnerships for an international hydrogen economy" (2023), the authors provide an overview of the countries' strategies, project landscape, and challenges concerning the infrastructure and economy of green hydrogen. Building upon the established expertise of the Nordics, hard-to-electrify sectors can be decarbonized, and infrastructure gaps closed within the frame of cross-border cooperation.

In diesem Grundsatzpapier werden die zentralen Fragen und Herausforderungen diskutiert, die sich im Aufbau von Kooperationen zwischen der EU und potenziellen internationalen Partnern in der entstehenden Wasserstoffwirtschaft stellen. Auf dieser Basis werden Ansatzpunkte für politisches Handeln auf diesem Gebiet benannt. Insbesondere werden sechs politische Bereiche umrissen, die europäische Entscheidungsträger_innen beim Aufbau internationaler Partnerschaften in der entstehenden Wasserstoffwirtschaft besonders beachten sollten: Klimaschutz, die Entwicklung grüner Industrien in Europa, Just Transitions (gerechte Übergänge) in Partnerländern, Geopolitik, Versorgungssicherheit und wirtschaftliche Machbarkeit. Ausgehend von diesen sechs Bereichen werden die folgenden neun Kernaussagen getroffen, wie sich eine internationale Wasserstoffwirtschaft als Bestandteil umfassenderer EU-Bemühungen zur Dekarbonisierung entwickeln lässt.

Intraoperative hypotension is common and has been associated with adverse events. Although association does not imply causation, predicting and preventing hypotension may improve postoperative outcomes. This review summarizes current evidence on the development and validation of an artificial intelligence predictive algorithm, the Hypotension Prediction (HPI) (formerly known as the Hypotension Probability Indicator). This machine learning model can arguably predict hypotension up to 15 min before its occurrence. Several validation studies, retrospective cohorts, as well as a few prospective randomized trials, have been published in the last years, reporting promising results. Larger trials are needed to definitively assess the usefulness of this algorithm in optimizing postoperative outcomes.

(1) Background: The Hypotension Prediction Index (HPI) is an algorithm that predicts hypotension, defined as mean arterial pressure (MAP) less than 65 mmHg for at least 1 min, based on arterial waveform features. We tested the hypothesis that the use of this index reduces the duration and severity of hypotension during noncardiac surgery. (2) Methods: We enrolled adults having moderate- or high-risk noncardiac surgery with invasive arterial pressure monitoring. Participating patients were randomized 1:1 to standard of care or hemodynamic management with HPI guidance with a goal directed hemodynamic treatment protocol. The trigger to initiate treatment (with fluids, vasopressors, or inotropes) was a value of HPI of 85 (range, 0–100) or higher in the intervention group. Primary outcome was the amount of hypotension, defined as time-weighted average (TWA) MAP less than 65 mmHg. Secondary outcomes were time spent in hypertension defined as MAP more than 100 mmHg for at least 1 min; medication and fluids administered and postoperative complications. (3) Results: We obtained data from 99 patients. The median (IQR) TWA of hypotension was 0.16 mmHg (IQR, 0.01–0.32 mmHg) in the intervention group versus 0.50 mmHg (IQR, 0.11–0.97 mmHg) in the control group, for a median difference of −0.28 (95% CI, −0.48 to −0.09 mmHg; p = 0.0003). We also observed an increase in hypertension in the intervention group as well as a higher weight-adjusted administration of phenylephrine in the intervention group. (4) Conclusions: In this single-center prospective study of patients undergoing elective noncardiac surgery, the use of this prediction model resulted in less intraoperative hypotension compared with standard care. An increase in the time spent in hypertension in the treatment group was also observed, probably as a result of overtreatment. This should provide an insight for refining the use of this prediction index in future studies to avoid excessive correction of blood pressure.

Pain is the most common complaint amongst trauma patients throughout the perioperative period. Multimodal analgesia is currently being regarded the mainstay, with regional anesthesia techniques constituting an integral part of it. Ultrasound imaging techniques display a plethora of advantages that have pervaded regional anesthesia practice. In this review, we set out to provide several examples of injuries, to elucidate the precise anatomy of fractured bones (osteotomes), and to elaborate on certain peripheral nerve blocks employed in pain management of trauma patients. Controversies/special considerations pertaining to peripheral nerve blocks also dictate thorough analysis: as such, acute compartment syndrome, acute peripheral nerve injuries, regional anesthesia in awake or anesthetized patients, continuous peripheral nerve blocks, positioning limitations and, finally, ultrasound imaging versus neurostimulation techniques are extensively reviewed.