A5072158047- Anesthesia and Sedative Agents
- Intensive Care Unit Cognitive Disorders
- Anesthesia and Neurotoxicity Research
- Pharmacological Effects and Toxicity Studies
- Antibiotics Pharmacokinetics and Efficacy
- Pharmacogenetics and Drug Metabolism
- Family and Patient Care in Intensive Care Units
- Pharmaceutical studies and practices
- Inhalation and Respiratory Drug Delivery
- Pharmacological Effects and Assays
- Sepsis Diagnosis and Treatment
- Pediatric Pain Management Techniques
- Asthma and respiratory diseases
- Cardiac Arrest and Resuscitation
- Renal function and acid-base balance
- Healthcare Decision-Making and Restraints
- Acute Kidney Injury Research
- Cardiac, Anesthesia and Surgical Outcomes
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Respiratory Support and Mechanisms
- Emergency and Acute Care Studies
- Traumatic Brain Injury and Neurovascular Disturbances
- Respiratory viral infections research
- Hemodynamic Monitoring and Therapy
- Health Systems, Economic Evaluations, Quality of Life
St. Antonius Ziekenhuis
2021-2023
Erasmus MC - Sophia Children’s Hospital
2009-2020
Boston Children's Hospital
2010-2013
Erasmus University Rotterdam
2010
Various in vitro, animal, and limited human adult studies suggest a profound inhibitory effect of inflammation disease on cytochrome P-450 3A (CYP3A)-mediated drug metabolism. Studies showing this relationship critically ill patients are lacking, whereas clearance many CYP3A substrates may be decreased, potentially leading to toxicity.To prospectively study the between inflammation, organ failure, midazolam as validated marker CYP3A-mediated metabolism children.From 83 children (median age,...
To compare daily sedation interruption plus protocolized (DSI + PS) to only (PS) in critically ill children.In this multicenter randomized controlled trial three pediatric intensive care units the Netherlands, mechanically ventilated children with need for sedative drugs were included. They randomly assigned either DSI PS or only. Children both study arms received adjusted on basis of validated scores. Provided a safety screen was passed, group blinded infusions saline; previous...
A drug is granted a license for use after thorough assessment of risks and benefits based on high-quality scientific proof its efficacy safety. Many drugs that are relevant to children not licensed in this population implying the pediatric has been made at all, negative risk-benefit balance children, or insufficient information establish balance. Use without positive exposes potential lack efficacy, unknown toxicity, harm. To aid guideline committees individual prescribers, we here present...
The imposition of lockdowns during the severe acute respiratory syndrome coronavirus-2 pandemic led to a significant decrease in pediatric care utilization 2020. After restrictions were loosened, surge disease was observed wards. aim this study quantify effect lockdown(s) on incidence disease.For multicenter retrospective study, emergency department (ED) visit and admission data between January 2017 September 2021 collected from eight general hospitals Netherlands. Clinical diagnoses...
Summary Aim To study the feasibility of daily interruption sedatives in critically ill children. Methods Prospective randomized controlled open‐label trial, performed a pediatric intensive care unit tertiary teaching and referring hospital. 30 children (0–12 years) receiving mechanically ventilation for >24 h were included. In intervention group, all stopped restarted when COMFORT‐behavior score ≥17. The control group received standard care. Primary end points amounts number bolus...
Aims Inflammation and organ failure have been reported to an impact on cytochrome P450 (CYP) 3A‐mediated clearance of midazolam in critically ill children. Our aim was evaluate a previously developed population pharmacokinetic model both children other populations, order allow the be used guide dosing clinical practice. Methods The evaluated externally 136 individuals, including (pre)term neonates, infants, adults (body weight 0.77–90 kg, C‐reactive protein level 0.1–341 mg l –1 0–4 failing...
To determine the effect of inflammation and disease severity on midazolam pharmacokinetics (as surrogate marker cytochrome 3A activity) pharmacodynamics in critically ill children.Analysis prospectively collected pharmacokinetic pharmacodynamic data from a study children.Pediatric intensive care unit university hospital.Twenty-one children who needed for sedation.None.We determined relationship between (using C-reactive protein leukocyte count as markers) (Pediatric Logistic Organ...
In most extracorporeal membrane oxygenation (ECMO) centers patients are heavily sedated to prevent accidental decannulation and bleeding complications. ventilated adults not on ECMO, daily sedation interruption protocols improve short- long-term outcome. This study aims evaluate safety feasibility of following cannulation in neonates ECMO.Prospective observational 20 (0.17-5.8 days age) admitted for ECMO treatment. Midazolam (n = 20) morphine 18) infusions were discontinued within 30 min...
To investigate whether analgesic and sedative drug use during PICU treatment is associated with long-term neurodevelopmental outcome in children who survived meningococcal septic shock.This study concerned a secondary analysis of data from medical psychological follow-up cross-sectional cohort all consecutive surviving patients shock purpura requiring intensive care between 1988 2001 at the Erasmus MC-Sophia Children's Hospital. At least 4 years after admission, these showed impairments on...
In adult patients who are critically ill and mechanically ventilated, daily interruption of sedation (DSI) is an effective method improving management, resulting in a decrease the duration mechanical ventilation, length stay intensive care unit (ICU) hospital. It safe approach common practice ICUs. For children it unknown if DSI feasible. The aim this multicenter randomized controlled trial to evaluate safety efficacy children. Children between 0 18 years age require with expected at least...
Intravenous salbutamol is used to treat children with refractory status asthmaticus, however insufficient pharmacokinetic data are available guide initial and subsequent dosing recommendations for its intravenous use. The pharmacologic activity of resides predominantly in the (R)-enantiomer, little or no even concerns adverse reactions attributed (S)-enantiomer. Our aim was develop a population model characterize profile asthmaticus admitted pediatric intensive care unit (PICU), use this...
Our earlier pediatric daily sedation interruption trial showed that in addition to protocolized critically ill children does not reduce duration of mechanical ventilation, length stay, or amounts sedative drugs administered when compared with only, but undersedation was more frequent the + group. We now report preplanned analysis comparing short-term health-related quality life and posttraumatic stress symptoms between two groups.Preplanned prospective part a randomized controlled trial.Two...
Objectives To develop a population pharmacokinetic model of R-albuterol and S-albuterol for children suffering from status asthmaticus following continuous intravenous administration. Methods At the pediatric ICU 19 severe were treated using albuterol in doses based on clinical symptoms (range 0.1–10 µg/kg/min). During therapy 111 blood samples collected analysed R- validated LC/MS-MS method. A analysis was conducted non-linear mixed effects modelling (NONMEM 7.2). Data logarithmically...
de Winter, Brenda C. M. PhD; Hoog, Matthijs MD; Vet, Nienke J. Dunk-Craaijo, Joke H.; Koch, Birgit P. Wildt, Saskia N. MD, PhD Author Information
Objectives To study the effect of organ failure and inflammation on midazolam clearance in critically ill children, using population pharmacokinetic modeling. Methods A total 83 children (median age 5 months (range 1 day-17 years), n=523 samples) receiving intravenous for continuous sedation during mechanical ventilation were included. Disease severity was described validated clinically used scores PELOD, PIM2 PRISM II. Cytokines (IL-1, IL-2, IL-6, TNF-a) C-reactive protein (CRP) as markers...