A5046687117- Sepsis Diagnosis and Treatment
- Antibiotics Pharmacokinetics and Efficacy
- Intensive Care Unit Cognitive Disorders
- Respiratory Support and Mechanisms
- Hemodynamic Monitoring and Therapy
- COVID-19 Clinical Research Studies
- Emergency and Acute Care Studies
- Machine Learning in Healthcare
- Cardiac Arrest and Resuscitation
- Cardiac, Anesthesia and Surgical Outcomes
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Electronic Health Records Systems
- Diabetes Management and Research
- Healthcare Technology and Patient Monitoring
- Nosocomial Infections in ICU
- Renal function and acid-base balance
- Clinical Nutrition and Gastroenterology
- Pharmaceutical Practices and Patient Outcomes
- Antibiotic Use and Resistance
- Healthcare Operations and Scheduling Optimization
- Bacterial Identification and Susceptibility Testing
- Patient Safety and Medication Errors
- COVID-19 and healthcare impacts
- Antimicrobial Resistance in Staphylococcus
- Family and Patient Care in Intensive Care Units
OLVG
2015-2025
Amsterdam University Medical Centers
2019-2021
University of Amsterdam
2020-2021
Clinical Research Consortium
2021
GGZ Oost Brabant
2019-2020
Vrije Universiteit Amsterdam
2020
Keihin (Japan)
2020
Arthur B. McDonald-Canadian Astroparticle Physics Research Institute
2019
Tergooi
2014
Aarhus University
2008
Continuous venovenous hemofiltration (CVVH) is applied in critically ill patients with acute renal failure for replacement. Heparins used to prevent circuit clotting may cause bleeding. Regional anticoagulation citrate reduces bleeding, but has metabolic risks. The aim was compare the safety and efficacy of two.Randomized, nonblinded, controlled single-center trial.General intensive care unit a teaching hospital.Adult needing CVVH without an increased bleeding risk.Regional or systemic...
During resuscitation in severe sepsis and septic shock, several goals are set. However, usually not all equally met. The aim of this study is to determine the relative importance different goals, such as mean arterial pressure (MAP), lactate, central venous oxygen saturation (ScvO2) forefoot temperature (delta-T), how they relate intensive care unit (ICU) hospital mortality.In a retrospective cohort 20-bed mixed medical surgical ICU teaching we studied consecutive critically ill patients who...
Glucose measurement in intensive care medicine is performed intermittently with the risk of undetected hypoglycemia. The workload for ICU nursing staff substantial. Subcutaneous continuous glucose monitoring (CGM) systems are available and may be able to solve some these issues critically ill patients. In a randomized controlled design mixed teaching hospital we compared use subcutaneous CGM frequent point (POC) guide insulin treatment. Adult patients an expected stay more than 24 hours need...
Abstract Background To assess trends in the quality of care for COVID-19 patients at ICU over course time Netherlands. Methods Data from National Intensive Care Evaluation (NICE)-registry all admitted to an Netherlands were used. Patient characteristics and indicators during first two upsurges (N = 4215: October 5, 2020–January 31, 2021) final upsurge second wave, called ‘third wave’ 4602: February 1, 2021–June 30, compared with those wave 2733, February–May 24, 2020). Results During third...
Abstract Background Adequate antibiotic dosing may improve outcomes in critically ill patients but is challenging due to altered and variable pharmacokinetics. To address this challenge, AutoKinetics was developed, a decision support system for bedside, real-time, data-driven personalised dosing. This study evaluates the feasibility, safety efficacy of its clinical implementation. Methods In two-centre randomised trial, with sepsis or septic shock were standard four antibiotics: vancomycin,...
Abstract Background Previously, we reported a decreased mortality rate among patients with COVID-19 who were admitted at the ICU during final upsurge of second wave (February–June 2021) in Netherlands. We examined whether this decrease persisted third and phases decreasing incidence thereafter brought up to date information on patient characteristics. Methods Data from National Intensive Care Evaluation (NICE)-registry all an Netherlands used. Patient characteristics rates in-hospital (the...
Studies have shown contradicting results on the association of nursing workload and mortality. Most these studies expressed as patients per nurse ratios; however, this does not take into account that some require more time than others. Nursing can be quantified by tools like Activities Score. We investigated Score ratio, respectively, ratio with in-hospital mortality in ICUs.Retrospective analysis National Intensive Care Evaluation database.Fifteen Dutch ICUs.All ICU admitted to registered...
Previous studies have shown that patients admitted to the intensive care unit (ICU) after "office hours" are more likely die. However these results been challenged by numerous other studies. We therefore analysed this possible relationship between ICU admission time and in-hospital mortality in The Netherlands.This article relates of hospital for all who were included Dutch national registry (National Intensive Care Evaluation, NICE) from 2002 2008. defined office hours as 08:00-22:00 during...
The prognostic value of biochemical tests in critically ill patients with multiple organ failure and suspected bowel ischemia is unknown. In a prospective observational cohort study intensive care were included when the attending intensivist considered intestinal diagnostic workup at any time during stay. Patients only once. When enrolment was ended each patient classified as ‘proven ischemia’, ‘ischemia likely’, unlikely’ or ‘no ischemia’. Proven defined gross disturbance blood flow bowel,...
Dosing of vancomycin is often guided by therapeutic drug monitoring and population pharmacokinetic models in the intensive care unit (ICU). The validity these crucial, as ICU patients have marked variability. Therefore, we set out to evaluate predictive performance published patients. PubMed database was used search for adult identified were evaluated two independent data sets which collected from large hospitals Netherlands (Amsterdam UMC, Location VUmc, OLVG Oost). We also tested a...
Background/Objectives: Aciclovir is a widely used antiviral agent. Since aciclovir primarily eliminated through the kidneys, maintaining renal function crucial to avoid toxicity. Although mitigating strategies are introduced in standard of care, nephrotoxicity still major concern during treatment, especially for critically ill intensive care unit (ICU) patients. Therefore, risk factors development therapy should be addressed. This study aimed evaluate if combination with therapeutic drug...
Abstract Introduction Caring for the critically ill is a 24-hour-a-day responsibility, but not all resources and staff are available during off hours. We evaluated whether intensive care unit (ICU) admission hours affects hospital mortality. Methods This retrospective multicentre cohort study was carried out in three non-academic teaching hospitals Netherlands. All consecutive patients admitted to ICUs between 2004 2007 were included study, except who did fulfil APACHE II criteria...
The long-term ecological effects on the emergence of antimicrobial resistance at ICU level during selective decontamination digestive tract (SDD) are unknown. We determined incidence newly acquired aerobic gram-negative potentially pathogenic bacteria (AGNB) SDD. In a single-centre observational cohort study over 21-year period, all consecutive patients, treated with or without SDD, admitted to were included. antibiotic regime was unchanged period. Incidence rates for ICU-acquired AGNB's...
The Coronavirus disease 2019 (COVID-19) pandemic has underlined the urgent need for reliable, multicenter, and full-admission intensive care data to advance our understanding of course investigate potential treatment strategies. In this study, we present Dutch Data Warehouse (DDW), first multicenter electronic health record (EHR) database with from critically ill COVID-19 patients.
Determining the optimal timing for extubation can be challenging in intensive care. In this study, we aim to identify predictors failure critically ill patients with COVID-19.We used highly granular data from 3464 adult COVID multicenter Dutch Data Warehouse, including demographics, clinical observations, medications, fluid balance, laboratory values, vital signs, and life support devices. All intubated at least one attempt were eligible analysis. Transferred patients, admitted less than 24...
Abstract Background Antibiotic exposure is often inadequate in critically ill patients with severe sepsis or septic shock and this associated worse outcomes. Despite markedly altered rapidly changing pharmacokinetics these patients, guidelines clinicians continue to rely on standard dosing schemes. To address challenge, we developed AutoKinetics, a clinical decision support system for antibiotic dosing. By feeding large amounts of electronic health record patient data into pharmacokinetic...
Potential drug-drug interactions (pDDIs) may harm patients admitted to the Intensive Care Unit (ICU). Due patient's critical condition and continuous monitoring on ICU, not all pDDIs are clinically relevant. Clinical decision support systems (CDSSs) warning for irrelevant could result in alert fatigue overlooking important signals. Therefore, our aim was describe frequency of relevant (crpDDIs) enable tailoring CDSSs ICU setting. In this multicenter retrospective observational study, we used...
Antibiotic dosing in critically ill patients is challenging because their pharmacokinetics (PK) are altered and may change rapidly with disease progression. Standard frequently leads to inadequate PK exposure. Therapeutic drug monitoring (TDM) offers a potential solution but requires sampling knowledge, which delays decision support. It our philosophy that antibiotic support should be directly available at the bedside through deep integration into electronic health record (EHR) system....