A5065456365- Congenital Heart Disease Studies
- Respiratory Support and Mechanisms
- Healthcare Technology and Patient Monitoring
- Cardiac Arrest and Resuscitation
- Anesthesia and Neurotoxicity Research
- Neonatal Respiratory Health Research
- Mechanical Circulatory Support Devices
- Sepsis Diagnosis and Treatment
- Pediatric Pain Management Techniques
- Urinary Bladder and Prostate Research
- Airway Management and Intubation Techniques
- Phonocardiography and Auscultation Techniques
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Family and Patient Care in Intensive Care Units
- Urinary Tract Infections Management
- Congenital Diaphragmatic Hernia Studies
- Cardiovascular Issues in Pregnancy
- Craniofacial Disorders and Treatments
- ECG Monitoring and Analysis
- Sleep and related disorders
- Pulmonary Hypertension Research and Treatments
- Poisoning and overdose treatments
- Acute Myocardial Infarction Research
- Anesthesia and Sedative Agents
- COVID-19 diagnosis using AI
Wilhelmina Children's Hospital
2017-2024
Utrecht University
2024
University Medical Center Utrecht
2018-2024
Princess Máxima Center
2021
Boston Children's Hospital
2008
Maastricht University Medical Centre
2002-2006
In children undergoing heart surgery, nitric oxide administered into the gas flow of cardiopulmonary bypass oxygenator may reduce postoperative low cardiac output syndrome, leading to improved recovery and shorter duration respiratory support. It remains uncertain whether improves ventilator-free days (days alive free from mechanical ventilation).
Background Neonates with congenital heart disease are at risk for impaired brain development in utero, predisposing children to postnatal injury and adverse long‐term neurodevelopmental outcomes. Given the vital role of placenta fetal growth, we assessed incidence placental pathology explored its association total regional volumes, gyrification, after birth. Methods Results Placentas from 96 term singleton pregnancies severe were prospectively analyzed macroscopic microscopic pathology. We...
This Viewpoint describes a strategy for addressing major challenges in artificial intelligence pediatrics to maximize clinical impact.
Importance Children with congenital heart defects who undergo cardiopulmonary bypass (CPB) surgery are at risk for delayed or impaired neurodevelopmental outcomes. Nitric oxide (NO) added to the CPB oxygenator may reduce systemic inflammation due and improve recovery from surgery, including improved Objective To investigate neurodevelopment, health-related quality of life (HRQOL), factors associated neurodevelopment 12 months post in infants received NO standard CPB. Design, Setting,...
Abstract Background To determine whether intermittent intravenous (IV) paracetamol as primary analgesic would significantly reduce morphine consumption in children aged 0–3 years after cardiac surgery with cardiopulmonary bypass. Methods Multi-center, randomized, double-blinded, controlled trial four level-3 Pediatric Intensive Care Units (PICU) the Netherlands and Belgium. Inclusion period; March 2016–July 2020. Children years, undergoing bypass were eligible. Patients randomized to...
The intensive care unit (ICU) is one of the most technically advanced environments in healthcare, using a multitude medical devices for drug administration, mechanical ventilation and patient monitoring. However, these technologies currently come with disadvantages, namely noise pollution, information overload alarm fatigue—all caused by too many alarms. Individual generate alarms independently, without any coordination or prioritisation other devices, leading to cacophony where important...
Introduction Hospitalised paediatric oncology patients are at risk to develop acute complications. Early identification of clinical deterioration enabling adequate escalation care remains challenging. Various Paediatric Warning Systems (PEWSs) have been evaluated, also in but mostly retrospective or case–control study designs. This protocol encompasses the first prospective cohort with aim evaluating predictive performance a modified Bedside PEWS score for non-elective intensive unit (PICU)...
Critical congenital heart disease (cCHD)-requiring cardiac intervention in the first year of life for survival-occurs globally 2-3 every 1000 live births. In critical perioperative period, intensive multimodal monitoring at a pediatric care unit (PICU) is warranted, as their organs-especially brain-may be severely injured due to hemodynamic and respiratory events. These 24/7 clinical data streams yield large quantities high-frequency data, which are challenging terms interpretation varying...
Summary A 4‐month‐old ex‐premature infant with severe airway obstruction from subglottic cysts presented for surgical cyst removal. Laryngeal and tracheal procedures in children may present difficulties the anesthetist because is shared surgeon. We report use of high‐frequency jet ventilation (HFJV) to maintain provide adequate access. Anesthesia was induced using sevoflurane oxygen maintained intravenous infusions propofol 7.5 mg·kg −1 ·h remifentanil 0.4 μ g·kg ·min . The suction channel...
Objective. Postoperative urinary retention (PUR) is associated with overdistension of the bladder. The prevention PUR by routine catheterization may increase risk tract infection. monitoring bladder volume ultrasound to prevent reliable in adults, but has not been evaluated children. Material and methods. BladderScan® BVI 6200, an device specifically designed for children, was assessed. Forty patients who required catheter placement during surgery or intensive care unit stay were entered...
Morphine is worldwide the analgesic of first choice after cardiac surgery in children. has unwanted hemodynamic and respiratory side effects. Therefore, post–cardiac patients may potentially benefit from a non-opioid drug for pain relief. A previous study shown that intravenous (IV) paracetamol effective opioid-sparing children major non-cardiac surgery. The aim to test hypothesis intermittent IV administration will result reduction at least 30% cumulative morphine requirement. This...
Urinary retention occurring after caudal anaesthesia in children has a low incidence. Most will void within 12 h of surgery, although the incidence is higher hypospadias repair. However, overdistention causing bladder atony that temporary, or may become permanent, described adults. Long-term effects have not been described. Urine volume, used to describe overdistention, traditionally measured catheterization. We report two suffering from urine (bupivacaine 0.25%) was supplement general...
Abstract The aim of this brief communication is to provide a short overview cyanide intoxication following infusion sodium nitroprusside (SNP). SNP fast-acting antihypertensive drug frequently used in hypertensive emergencies. Although widely known as safe use drug, it can cause potentially lethal intoxication. difficulty diagnose and pharmacological principles will be discussed. Hereby, we like regain attention for severe complication. As result our experience, the Dutch national paediatric...
Cerebrotendinous xanthomatosis (CTX) is a rare genetic disorder, characterised by chronic diarrhoea, xanthomas, cataracts, and neurological deterioration. CTX caused CYP27A1 deficiency, which leads to abnormal cholesterol bile acid metabolism. Urinary profiling (increased m/z 627: glucuronide-5β-cholestane-pentol) serves as diagnostic screening for CTX. However, this led false positive diagnosis in two patients, who had received total intravenous anaesthesia (TIVA) with propofol.To determine...
<title>Abstract</title> <bold>Background</bold> To determine whether intermittent intravenous (IV) paracetamol as primary analgesic would significantly reduce morphine consumption in children aged 0–3 years after cardiac surgery with cardiopulmonary bypass.<bold>Methods</bold> Multi-center, randomized, double-blinded, controlled trial four level-3 Pediatric Intensive Care Units (PICU) the Netherlands and Belgium. Inclusion period; March 2016 - July 2020. Children years, undergoing bypass...
Abstract Introduction The international NITRIC trial studied the hypothesis that nitric oxide (NO) applied into cardiopulmonary bypass (CPB) oxygenator in infants would improve recovery after heart surgery. In a substudy, we evaluated effect of NO CPB on (re)activity platelets measured as fibrinogen binding (platelet aggregation) and P-selectin expression degranulation) young children. Methods Platelet activity (without agonist exposure) reactivity (after stimulation by an agonist) was...
The CRUCIAL trial (NCT04217421) is investigating the effect of postnatal and perioperative administration allopurinol on postoperative brain injury in neonates with critical congenital heart disease (CCHD) undergoing cardiac surgery cardiopulmonary bypass (CPB) shortly after birth. This study aimed to characterize pharmacokinetics (PK) oxypurinol during preoperative, intraoperative, phases this population, evaluate target attainment current dosing strategy. Nonlinear mixed-effects modeling...
Mechanical ventilators are increasingly evolving into computer-driven devices. These technical advancements have impact on clinical decisions in pediatric intensive care units (PICUs). A good understanding of the design mechanical can improve care. Tidal volume (TV) is one corner stones ventilation: multiple factors influence TV and, thus, decision making. Ventilator manufacturers make various choices regarding phase, site and conditions measurement as well algorithmic processing choices....
Abstract Purpose Optimal sleep helps parents and children cope with life-threatening disease. However, hospital-surroundings are noisy, negatively affecting quality quantity. We aimed to determine quantity; satisfaction; their relation infusionpump alarms in pediatric cancer patients parents; daytime impairment parents. Methods Patients (2–18 years), admitted for scheduled anti-cancer therapy were eligible, as inrooming Frequency duration of nightly infusion pump recorded. wore an...
Aims & Objectives: Respiratory support is a challenge in some children with congenital heart diseases, especially when increased pulmonary vascular resistance (PVR) plays an important role. Children Fontan circulation are vulnerable to PVR their passive drive of circulation. Down syndrome after AVSD surgery quite often have provoked by infection. We set up pilot study deliver NO using nCPAP or HFNC as mode spontaneous breathing reduce complications prolonged mechanical ventilation (MV) and...