Andreas A Theodorou

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Scholarly Contributions

Chapters

• Theodorou, A. (2021). Oxygen Delivery and Oxygen Consumption in Pediatric Critical Care. In Pediatric Critical Care: Text and Study Guide(pp 28-53). Springer. doi:https://doi.org/10.1007/978-3-030-53363-2
• Meyer, R. J., Theodorou, A. A., Theodorou, A. A., & Berg, R. A. (2014). Paediatric Considerations in Drowning. In Handbook on Drowning. Springer, Berlin, Heidelberg. doi:10.1007/978-3-642-04253-9_99
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  Drowning is one of the most common definable aetiologies of out-of-hospital paediatric cardiac arrest and constitutes a major cause of paediatric mortality and morbidity. For children of all ages, drowning was the cause of 5–8 % of out-of-hospital cardiac arrests in the USA and Canada [1], Japan [2] and the Netherlands [3]. For younger children, 1–12 years old, drowning was the cause of 9–13 % of out-of-hospital cardiac arrests [1, 2]. Importantly, children with out-of-hospital cardiac arrests from drowning are more likely to survive than those with arrests from other aetiologies [4].
• Gutierrez, J. A., Theodorou, A. A., & Theodorou, A. A. (2012). Oxygen Delivery and Oxygen Consumption in Pediatric Critical Care. In Pediatric Critical Care. Springer, London. doi:10.1007/978-0-85729-923-9_2
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  The maintenance of adequate oxygen delivery to meet the demands of tissues is the essence of critical care medicine. Inadequate oxygen delivery, which can occur on a global level as in cardiogenic shock, or on a regional level as in traumatic brain injury, must be recognized and treated in order to achieve a good clinical outcome. Therefore, an understanding of the determinants of oxygen delivery and oxygen consumption in the critically ill pediatric patient is essential for any pediatric critical care clinician.

Journals/Publications

• Theodorou, A. (2022). The All of Us research program: data quality, utility, and diversity. Patterns, 3(8).
• Ojo, T., Theodorou, A., Karnes, J. H., Vemulapalli, T., Ilori, T. O., Viera, E., Wilson, J., Moreno, F., Menon, U., Ehiri, J., Peterson, R., StimsonRiahi, S. C., Rosales, C., Calhoun, E., Sokan, A., Reiman, E., & Ojo, A. (2020). Approach to High Volume Enrollment in Clinical Research: Experiences from an All of Us Research Program Site. Clinical and Translational Science, 13(4), 685-692. doi:10.1111/cts.12759
• Theodorou, A. A., Patanwala, A. E., & Erstad, B. L. (2012). Comparison of methods for the detection of medication safety events in the critically ill.. Current drug safety, 7(3), 238-46. doi:10.2174/157488612803251270
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  To categorize and synthesize medication safety event detection methods in the critically ill in order to provide clinicians and administrators with approaches to event detection that are intended to expand and complement traditional voluntary reporting systems..A literature search of OvidMEDLINE was performed to identify articles related to medication safety involving critically ill patients in the intensive care unit setting. The inclusion of articles was restricted to comparative studies. The bibliographies of all retrieved articles were reviewed to obtain additional articles of relevance. The various event detection methods were compared by: evidence supporting their use; number, type and severity of events detected; phase of the medication use process in which events were detected; and ease and cost of implementation. Major limitations of each method were also collated..There are a number of methods that can be used to identify medication safety events in the critically ill. These can broadly be categorized as: 1) voluntary reporting, 2) record review, 3) rules/triggers and 4) direct observation and 5) interviews/surveys. Relatively few studies have directly compared these assessment methods in the ICU setting, although the limitations of the traditional voluntary reporting system as the sole method of event detection are well established. Although not truly dichotomous, these methods can be broken down into more proactive and reactive approaches. Rules/triggers and direct observation of the medication use process in the ICU are examples of proactive approaches to event detection, while the traditional unsolicited voluntary reporting is typically reactive. However, each of the event detection methods has advantages and disadvantages, so the methods should not be considered mutually exclusive with respect to obtaining information about medication safety..Given the limitations of traditional voluntary reporting systems, a multimodal approach used to identify medication safety events is most likely to capture the largest number and type of events. We would advise not trying to implement additional approaches beyond voluntary reporting systems all at once. This would be difficult and costly. Rather, we suggest a systematic implementation of additional event detection approaches that takes into account hospital-specific considerations.
• Typpo, K. V., Theodorou, A. A., Larmonier, C. B., Kiela, P. R., Ghishan, F. K., & Deschenes, J. (2012). 1058: INTESTINAL INJURY IN CHILDREN AFTER CARDIOPULMONARY BYPASS. Critical Care Medicine, 40, 1-328. doi:10.1097/01.ccm.0000425271.92762.5c
• Theodorou, A. A., Parrinello, K., O'keeffe, T., Hokula, C. A., Haas, C. E., & Erstad, B. L. (2011). Interdisciplinary patient care in the intensive care unit: focus on the pharmacist.. Pharmacotherapy, 31(2), 128-37. doi:10.1592/phco.31.2.128
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  The field of critical care medicine began to flourish only within the last 40 years, yet it provides some of the best examples of collaborative pharmacy practice models and evidence for the value of pharmacist involvement in interdisciplinary practice. This collaborative approach is fostered by critical care organizations that have elected pharmacists into leadership positions and recognized pharmacists through various honors. There is substantial literature to support the value of the critical care pharmacist as a member of an interdisciplinary intensive care unit (ICU) team, particularly in terms of patient safety. Furthermore, a number of economic investigations have demonstrated cost savings or cost avoidance with pharmacist involvement. As the published evidence supporting pharmacist involvement in patient care activities in the ICU setting has increased, surveys have demonstrated an increase in the percentage of pharmacists performing clinical activities. In addition, substantial support of pharmacists has been provided by other clinicians, safety officers, and administrative personnel who have been involved with the initiation and expansion of critical care pharmacy services in their own institutions. Although there is still room for improvement in the range of pharmacist involvement, particularly with respect to interdisciplinary activities related to education and scholarship, pharmacists have become essential members of interdisciplinary care teams in ICU settings.
• Theodorou, A. A., Romero, A., Hennings, S., Franke, H. A., & Erstad, B. L. (2010). A Comparison of Automated Infusion Device Technology to Prevent Medication Errors in Pediatric and Adult Intensive Care Unit Patients. Hospital Pharmacy, 45(6), 464-471. doi:10.1310/hpj4506-464
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  ObjectiveTo compare possible differences in the proportion of medication errors associated with high-risk medications that were avoided by the use of automated infusion device (AID) technology in p...
• Walter, F. G., Vazquez, H. L., Theodorou, A. A., Mcnally, J., Chase, P. B., Boyer-hassen, L. V., & Alagon, A. (2009). Serum levels and urine detection of Centruroides sculpturatus venom in significantly envenomated patients.. Clinical toxicology (Philadelphia, Pa.), 47(1), 24-8. doi:10.1080/15563650802039965
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  Envenomation by Centruroides sculpturatus can cause systemic signs and symptoms requiring treatment. The toxicokinetics of C. sculpturatus venom has not been described..Venom components were separated for cross-reactivity testing. Serum and urine collected from three patients envenomated by C. sculpturatus had venom levels determined by sandwich enzyme-linked immunosorbent assay (ELISA)..Western blot analysis indicated recognition of C. sculpturatus venom by Alacramyn, an equine F(ab')(2) antivenom developed against Centruroides scorpion venoms, including C. sculpturatus. Serum venom levels in ng/mL with post-envenomation times in minutes (min) were as follows: 85-year-old woman = 8.2 (approximately 150), 2.8 (515), 1.6 (1,200); 14-month-old girl = 29.7 (approximately 50), 5.0 (729); 3-year-old girl = 11.1 (approximately 313), urine venom level of 9.0 (approximately 490)..There is sufficient venom cross-antigenicity among different Centruroides species to allow this ELISA technique with Alacramyn to determine serum and urine C. sculpturatus venom concentrations in envenomated patients.
• Theodorou, A. A., & Berg, R. A. (2007). It's not easy to save a life.. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 8(5), 495-6. doi:10.1097/01.pcc.0000282162.31615.38
• Theodorou, A. A., Priestley, G., Kopp, B. J., Erstad, B. L., & Buckley, M. S. (2007). Direct observation approach for detecting medication errors and adverse drug events in a pediatric intensive care unit.. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 8(2), 145-52. doi:10.1097/01.pcc.0000257038.39434.04
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  To determine the incidence, type, and stage of occurrence of medication errors and potential and actual adverse drug events (ADEs) in a pediatric intensive care unit (ICU) using trained observers. The preventability and severity of ADEs and the system failures leading to medication error occurrence were also investigated..Prospective, direct observation study..A 16-bed pediatric medical/surgical ICU at a tertiary care academic medical center..One enrolled nurse caring for at least one pediatric ICU patient age
• Meyer, R. J., Theodorou, A. A., & Berg, R. A. (2006). Childhood drowning.. Pediatrics in review, 27(5), 163-8; quiz 169. doi:10.1542/pir.27-5-163
• Theodorou, A. A., Priestley, G., Kopp, B. J., Erstad, B. L., & Allen, M. E. (2006). Medication errors and adverse drug events in an intensive care unit: direct observation approach for detection.. Critical care medicine, 34(2), 415-25. doi:10.1097/01.ccm.0000198106.54306.d7
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  To determine the incidence and preventability of medication errors and potential/actual adverse drug events. To evaluate system failures leading to error occurrence..Prospective, direct observation study..Tertiary care academic medical center..Patients in a medical/surgical intensive care unit..Observers would intervene only in the event that the medication error would cause substantial patient harm or discomfort..The observers identified 185 incidents during a pilot period and four phases totaling 16.5 days (33 12-hr shifts). Two independent evaluators concluded that 13 of 35 (37%) actual adverse drug events were nonpreventable (i.e., not medication errors). An additional 40 of the remaining 172 medication errors were judged not to be clinically important. Of the 132 medication errors classified as clinically important, 110 (83%) led to potential adverse drug events and 22 (17%) led to actual, preventable adverse drug events. There was one error (i.e., resulting in a potential or actual, preventable adverse drug event) for every five doses of medication administered. The potential adverse drug events mostly occurred in the administration and dispensing stages of the medication use process (34% in each); all of the actual, preventable adverse drug events occurred in the prescribing (77%) and administration (23%) stages. Errors of omission accounted for the majority of potential and actual, preventable adverse drug events (23%), followed by errors due to wrong dose (20%), wrong drug (16%), wrong administration technique (15%), and drug-drug interaction (10%)..Using a direct observation approach, we found a higher incidence of potential and actual, preventable adverse drug events and an increased ratio of potential to actual, preventable adverse drug events compared with studies that used chart reviews and solicited incident reporting. All of the potential adverse drug events and approximately two thirds of the actual adverse drug events were judged to be preventable. There was one preventable error for every five doses of medication administered; most errors were due to dose omission, wrong dose, wrong drug, wrong technique, or interactions.
• Theodorou, A. A., Priestley, G., Kopp, B. J., Erstad, B. L., & Buckley, M. S. (2005). AN EVALUATION OF MEDICATION ERRORS AND ADVERSE DRUG EVENTS (ADES) IN A PEDIATRIC ICU.: 244-T. Critical Care Medicine, 33, A173. doi:10.1097/00003246-200512002-00612
• Theodorou, A. A., Gutierrez, J. A., & Berg, R. A. (2003). Fire attributable to a defibrillation attempt in a neonate.. Pediatrics, 112(3 Pt 1), 677-9. doi:10.1542/peds.112.3.677
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  A fire can occur during a defibrillation attempt because a spark can be generated in an oxygen-enriched atmosphere. Although the risk is small, a fire during patient care can have devastating effects. We describe a case of a fire attributable to a defibrillation attempt in a 10-day-old neonate following open-heart surgery. To our knowledge, this is the first published account of a fire during a defibrillation attempt in an infant or child. We review predisposing factors and preventive strategies, with special emphasis on the importance of removing oxygen from the immediate environment during defibrillation attempts. Fire is a rare but potentially devastating complication of defibrillation attempts.1–3 Despite the severe consequences of patient fires, this risk is not mentioned in standard critical care4,5 or cardiology textbooks,6,7 presumably because of the paucity of clinical reports.1,8,9 We present a case of a fire ignited by a defibrillation attempt in a 10-day-old infant, and discuss the contributing factors and recommended preventive measures. To our knowledge, this represents the first such report in an infant or child. The patient was a term newborn with a type II truncus arteriosus. Surgical correction on day 10 of life was complicated by myocardial ischemia attributable to an anomalous descending coronary artery that was severed during the surgery. Following the repair, the chest was left open and the median sternotomy was covered with a Gore-Tex tissue patch. She returned to the pediatric intensive care unit in an infant warmer and required high ventilator settings including fraction of inspired oxygen of 1.0, positive end-expiratory pressure of 12 cm H2O, tidal volume of 80 mL, and a respiratory rate of 20 breaths per minute. She was also provided with considerable inotropic support including epinephrine, dopamine, … Reprint requests to (A.A.T.) Department of Pediatrics, University of Arizona, 1501 N Campbell Ave, Room 3302, Box 245073, Tucson, AZ 85724-5073. E-mail: aat{at}peds.arizona.edu
• Theodorou, A. A., Gutierrez, J. A., & Berg, R. A. (2003). Incendio debido a un intento de desfibrilación en un neonato. Pediatrics, 56(3), 165-167.
• Theodorou, A. A., Samson, M. P., Gutierrez, J. A., Berg, R. A., & Bagatell, R. (2003). Femoral central venous catheter-associated deep venous thrombosis in children with diabetic ketoacidosis.. Critical care medicine, 31(1), 80-3. doi:10.1097/00003246-200301000-00012
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  To describe the incidence of clinical deep venous thrombosis associated with femoral central venous catheters (CVC-DVT) in children with diabetic ketoacidosis (DKA)..Retrospective case-matched control series..Pediatric intensive care units of two university-affiliated hospitals..All eight pediatric DKA patients with femoral central venous catheters between 1998 and 2001, and 16 age-matched control patients with femoral central venous catheters and circulatory shock..None..The records of all children with DKA and the control patients were reviewed. CVC-DVT was defined as persistent ipsilateral leg swelling after removal of a femoral central venous catheter. Control patients with coagulopathies, thrombocytopenia, cancer, and hyperglycemia were excluded. Four of eight patients with DKA developed CVC-DVT compared with none of the 16 control patients (p = .007, Fisher's exact test). All four patients with DKA and CVC-DVT were
• Yorgin, P. D., Theodorou, A. A., Scott, K. M., Rewari, M., Barton, L. L., & Al-uzri, A. Y. (2001). Coccidioidomycosis in adolescents with lupus nephritis.. Pediatric nephrology (Berlin, Germany), 16(1), 77-81. doi:10.1007/s004670000468
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  Coccidioidomycosis, a fungal infection endemic in the southwestern United States, can cause life-threatening infections in immunosuppressed patients. We report the contrasting cases of two adolescents with lupus nephritis, treated with intravenous pulse cyclophosphamide and daily oral corticosteroids, who developed pulmonary coccidioidomycosis. One patient developed a fatal form of fulminant disseminated coccidioidomycosis, while the other patient developed a solitary pulmonary Coccidioides immitis abscess which was responsive to intravenous liposomal amphotericin and fluconazole therapy. Because serologies and initial X-ray studies can be negative, definitive diagnostic studies including bronchoaveolar lavage and needle aspiration should be performed when there is clinical suspicion of coccidioidomycosis in an immunocompromised patient. Immunosuppressed patients with coccidioidomycosis should receive early intravenous amphotericin therapy and may benefit from long-term suppressive antifungal therapy to prevent relapse.
• Boyer, L. V., Boyer, L. V., Theodorou, A. A., & Binford, G. J. (2000). Spider on the headboard, child in the unit: severe Loxosceles arizonica envenomation confirmed by delayed spider identification and tissue antigen detection. Clinical Toxicology, 38.
• Yorgin, P. D., Whitesell, L., Theodorou, A. A., Eklund, D. K., & Al-uzri, A. (2000). Concurrent centrifugation plasmapheresis and continuous venovenous hemodiafiltration.. Pediatric nephrology (Berlin, Germany), 14(1), 18-21. doi:10.1007/s004670050004
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  Continuous venovenous hemofiltration/hemodiafiltration (CVVH/D) is commonly used to provide renal replacement therapy for critically ill patients who are hemodynamically unstable. Occasionally, the addition of plasmapheresis therapy is necessary for some conditions, including immune-mediated acute renal failure, sepsis, fulminant hepatic failure, and thrombotic thrombocytopenic purpura/hemolytic uremic syndrome. Most tertiary care facilities provide centrifugation plasmapheresis instead of membrane plasmapheresis, because of the requirement for both therapeutic plasma exchange and pheresis of cellular blood products. We report a new technique where centrifugation plasmapheresis and CVVHD (P-CVVHD) are combined and used concurrently. Blood from the patient was concurrently filtered utilizing a Hospal BSM 22 machine with a Multiflow 60 hemofilter and a Cobe Spectra continuous cell separator in a parallel configuration. P-CVVHD is technically possible and can be used for long periods of time with limited risks. There may be advantages to P-CVVHD compared with discontinuous combined CVVH/D and plasmapheresis therapy.
• Bice, D., Weger, N., Theodorou, A. A., Rhee, K. H., Muggenberg, B., Lemen, R. J., Kunke, K., & Bice, D. E. (1997). Ragweed sensitization alters pulmonary vascular responses to bronchoprovocation in beagle dogs.. Journal of applied physiology (Bethesda, Md. : 1985), 83(3), 912-7. doi:10.1152/jappl.1997.83.3.912
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  In ragweed (RW)-sensitized beagle dogs, we tested the hypothesis that reactivity of the pulmonary vasculature was enhanced with aerosolized histamine (Hist) and RW. Seven dogs were neonatally sensitized with repeated intraperitoneal RW injections, and 12 dogs were controls (Con). The dogs were anesthetized with intravenous chloralose, mechanically ventilated, and instrumented with femoral arterial and pulmonary artery catheters. Specific lung compliance (CLsp), specific lung conductance (Gsp), systemic vascular resistance index, and pulmonary vascular resistance index (PVRI) were measured before and after bronchoprovocation with Hist and RW. After Hist inhalation (5 breaths of 30 mg/ml), both Con and RW dogs had significant (P < 0.05) decreases in CLsp (-51 +/- 4 and -53 +/- 5%, respectively) and Gsp (-65 +/- 5 and -69 +/- 3%, respectively), but only RW-sensitized dogs had a significant increase in PVRI (38 +/- 10%). After RW inhalation (60 breaths of 0.8 mg/ml), only RW-sensitized dogs had significant increases (62 +/- 20%) in PVRI and decreases in Gsp (-77 +/- 4%) and CLsp (-65 +/- 7%). We conclude that, compared with Con, RW-sensitized beagle dogs have increased pulmonary vasoconstrictive responses with Hist or RW inhalation.
• Yorgin, P. D., Theodorou, A. A., Johnson, M. I., Davenport, K. M., Boyer-hassen, L. V., & Al-uzri, A. (1997). Propylene glycol-induced proximal renal tubular cell injury.. American journal of kidney diseases : the official journal of the National Kidney Foundation, 30(1), 134-9. doi:10.1016/s0272-6386(97)90577-1
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  Propylene glycol is a solvent that is used in many oral, injectable, and topical medications. Although uncommon, acute renal failure has been attributed to propylene glycol. The mechanism of propylene glycol-mediated renal injury is unknown. We report a case of acute renal failure in a 16-year-old boy given large doses of pentobarbital and phenobarbital, both of which are solubilized with propylene glycol. A renal biopsy showed proximal renal tubular cell swelling and vacuole formation. The data from this case suggest that the reversible acute renal failure caused by propylene glycol is attributable to proximal renal tubular cell injury.
• Theodorou, A. A., Konduri, G. G., & Gervasio, C. T. (1993). Role of adenosine triphosphate and adenosine in oxygen-induced pulmonary vasodilation in fetal lambs.. Pediatric research, 33(5), 533-9. doi:10.1203/00006450-199305000-00022
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  We investigated the hypothesis that purine nucleotides, ATP and adenosine, mediate the pulmonary vasodilation that occurs at birth in response to an increase in arterial O2 pressure (PaO2). We studied 20 fetal lambs 1 to 3 d after placement of intravascular catheters and a flow transducer around left pulmonary artery. In 16 lambs, we investigated the effects of 1) an increase in fetal PaO2 on ATP levels in pulmonary circulation and 2) 8-phenyl-theophylline (8-PT) and cibacron blue, antagonists of receptors for adenosine and ATP, on pulmonary vasodilation caused by increased PaO2. In four other lambs, we investigated the specificity of 8-PT and cibacron blue for purine receptors by investigating their effects on pulmonary vasodilation caused by acetylcholine, bradykinin, and nitroprusside. The fetal PaO2 increased by 7 +/- 2 during administration of 100% O2 to the pregnant ewe, resulting in a 3-fold decrease in PVR and increase in pulmonary blood flow. Blood and plasma concentrations of ATP in fetal pulmonary artery and left atrium increased significantly during the increase in fetal PaO2. 8-PT and cibacron blue caused increases in baseline pulmonary and systemic vascular pressures and pulmonary vascular resistance and inhibited the pulmonary vasodilation caused by O2. 8-PT and cibacron blue did not alter the pulmonary vascular effects of acetylcholine, bradykinin, and nitroprusside. An increase in baseline pulmonary vascular resistance caused by infusion of U46619 (in four lambs) did not alter the pulmonary vasodilation caused by O2. In summary, O2-induced pulmonary vasodilation is accompanied by increased ATP levels in pulmonary circulation and is attenuated by antagonists of purine receptors.(ABSTRACT TRUNCATED AT 250 WORDS)
• Sarnaik, A. P., Meert, K. L., Theodorou, A. A., Sarnaik, A. P., Moylan, P. M., Meert, K. L., Lieh-lai, M. W., & Canady, A. I. (1992). Limitations of the Glasgow Coma Scale in predicting outcome in children with traumatic brain injury.. The Journal of pediatrics, 120(2 Pt 1), 195-9. doi:10.1016/s0022-3476(05)80426-3
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  To study the hypothesis that, in the absence of an ischemic-hypoxic state, children with severe traumatic brain injury and with unfavorable Glasgow Coma Scale scores may have good recovery..Retrospective, observational, cross-sectional study with factorial design..Inpatient population in a university hospital..Seventy-nine children with traumatic brain injury admitted to the intensive care unit..All patients received close monitoring and strict control of intracranial pressure (less than 20 mm Hg) and cerebral perfusion pressure (greater than 60 mm Hg)..Admission Glasgow Coma Scale score, survival, need for cardiopulmonary resuscitation, presence of shock, peak intracranial pressure, duration of coma, Glasgow Outcome Scale score, and the results of neuropsychologic tests were analyzed. Of 79 children, 70 (89%) survived. Although the mortality rate was higher among patients with Glasgow Coma Scale scores of 3 to 5, 14 (64%) of 22 of these children survived. Nonsurvivors had a significantly higher incidence of shock and need for cardiopulmonary resuscitation. Except for two patients who had prolonged hypoxemia, all children, including those with Glasgow Coma Scale scores of 3 to 5, had a satisfactory outcome (Glasgow Outcome Scale scores of 4 or 5). Neuropsychologic outcome was not significantly different in the survivors with Glasgow Coma Scale scores of 3 to 5 and those with Glasgow Coma Scale scores of 6 or more..A low Glasgow Coma Scale score does not always accurately predict the outcome of severe traumatic brain injury; in the absence of hypoxic-ischemic injury, children with traumatic brain injury and Glasgow Coma Scale scores of 3 to 5 can recover independent function.
• Theodorou, A. A., Mukhopadhyay, A., Konduri, G. G., & Deshmukh, D. R. (1992). Adenosine triphosphate and adenosine increase the pulmonary blood flow to postnatal levels in fetal lambs.. Pediatric research, 31(5), 451-7. doi:10.1203/00006450-199205000-00007
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  We investigated the hypothesis that purine nucleotides may mediate the pulmonary vasodilation that occurs at birth in fetal lambs. We studied nine fetal lambs 3 d after placement of intravascular catheters, a flow transducer around the left pulmonary artery, and an inflatable vascular occluder around the ductus arteriosus. The pressure-flow relationship of left lung during a brief occlusion of the ductus arteriosus was studied as an index of pulmonary vascular resistance. We investigated the pulmonary vascular effects of adenosine, ATP, or saline (control) in doses of 0.01-2.50 mumol/kg/min infused into the right atrial line, and measured blood adenosine and ATP levels in samples from the pulmonary artery and left atrium. We also investigated the mechanism of pulmonary vascular effects of adenosine and ATP. Adenosine and ATP caused significant decreases in pulmonary vascular resistance and increases in pulmonary blood flow in doses of 0.08-2.5 mumol/kg/min. The pulmonary blood flow increased to levels seen in postnatal lambs at doses of 1.2 and 2.5 mumol/kg/min of adenosine and ATP. The baseline blood adenosine and ATP levels in fetus were 8 and 70% of levels in postnatal lambs. ATP concentrations increased to postnatal levels and adenosine levels increased to 20% of postnatal levels at infusion rates of 1.2 and 2.5 mumol/kg/min. The pulmonary vasodilation caused by adenosine and ATP was attenuated by 8-phenyltheophylline and cibacron blue, respectively, but not by indomethacin. We conclude that adenosine and ATP are pulmonary vasodilators and increase the fetal pulmonary flow to postnatal levels in doses that increase their blood concentrations to less than or equal to postnatal levels.(ABSTRACT TRUNCATED AT 250 WORDS)
• Sarnaik, A. P., Wade, D. D., Theodorou, A. A., Shayevitz, J. R., Sarnaik, A. P., Sanfilippo, D., & Alvarez, D. M. (1987). CHANGES IN BODY COMPOSITION IN PEDIATRIC INTENSIVE CARE UNIT (PICU) VS WARD (W) PATIENTS. Pediatric Research, 21(4), 206-206. doi:10.1203/00006450-198704010-00242
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  We performed a prospective survey of PICU and W patients to compare changes in body composition over time. On admission and hospital day 3, we recorded weight (WT), midarm circumference (MAC), triceps skinfold thickness (TST), and therapeutic intervention score (TIS). Anthropometries were normalized as a percentage of the value for day 1 to minimize size and age effects. We compared WT, MAC, TST, and TIS score on day 1 with day 3 by 2-way ANOVA. P≤0.05 was considered significant. Values are expressed as mean ± SD. By Least Significant Difference (P ≤0.05), day 3 PICU TST is less than both day 1 PICU and day 3 W TST. These results suggest that a rapid loss of fat stores occurs in PICU but not in W patients over time (P=0.04). TIS scores were higher in PICU vs W patients on both days (P=0.045). Decline in fat stores may be related to severity of illness or to deficient provision of supplemental nutrition. We can make no conclusions about differences in premorbid nutritional state between PICU and W patients.

Presentations

• Theodorou, A. (2023).  Healthcare Culture of Safety. . Med 101 UA BS in Medicine Undergraduate Curriculum.
• Theodorou, A. (2023, Spring). Healthcare Culture of Safety. Med 101 UA BS in Medicine Undergraduate Curriculum. University of Arizona, Main Campus: U of A.

Poster Presentations

• Theodorou, A. A., Amerongen, H. M., Larson, W. J., Cooley, J. H., LeGros, T. A., LeGros, T. A., Cooley, J. H., Larson, W. J., Amerongen, H. M., & Theodorou, A. A. (2016, April 2016). A Constructivist Tool for Teaching Role Knowledge and Respect in Early Interprofessional Education. Western Group on Educational Affairs. Tucson, AZ: Western Group on Educational Affairs.

Other Teaching Materials

• Theodorou, A., Thienhaus, O. J., Winegar, B., Desoky, S. M., Ebert, V., Plitt, J., Combs, D. A., Matika, R. W., Pritchard, G., Thajudeen, B., Sam, A., & Kutob, R. M. (2021. Professionalism: Communicating with the Health Care Team. Virtual Lecture Hall.
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  Collaborated with University of Arizona College of Medicine Continuing Medical Education committee on development of this online, case-based, interactive course accredited for 1.5 CME credits, available to physicians nationwide on Virtual Lecture HallAvailable from: https://www.vlh.com/shared/courses/course_info.cfm?courseno=1807 (accessed September 16, 2021).