A5053367841- Hemodynamic Monitoring and Therapy
- Cardiac, Anesthesia and Surgical Outcomes
- Non-Invasive Vital Sign Monitoring
- Respiratory Support and Mechanisms
- Cardiac Arrest and Resuscitation
- Cardiovascular Health and Disease Prevention
- Blood Pressure and Hypertension Studies
- Mechanical Circulatory Support Devices
- Intensive Care Unit Cognitive Disorders
- Cardiovascular Function and Risk Factors
- Blood Coagulation and Thrombosis Mechanisms
- Heart Rate Variability and Autonomic Control
- Traumatic Brain Injury and Neurovascular Disturbances
- Pulmonary Hypertension Research and Treatments
- Pneumonia and Respiratory Infections
- Ultrasound in Clinical Applications
- Nosocomial Infections in ICU
- Tracheal and airway disorders
- Sepsis Diagnosis and Treatment
- Heart Failure Treatment and Management
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Health and Medical Studies
- Medical and Health Sciences Research
- Respiratory viral infections research
- Pancreatic and Hepatic Oncology Research
Erasmus MC Transplant Institute
2024
Erasmus MC Cancer Institute
2024
Leiden University Medical Center
2013-2022
Catharina Ziekenhuis
2022
Radboud University Nijmegen
2022
The University of Texas Southwestern Medical Center
2022
Erasmus University Rotterdam
2022
Erasmus MC
2022
Amsterdam University Medical Centers
2022
University of Pittsburgh Medical Center
2022
It remains uncertain whether invasive ventilation should use low tidal volumes in critically ill patients without acute respiratory distress syndrome (ARDS).To determine a volume strategy is more effective than an intermediate strategy.A randomized clinical trial, conducted from September 1, 2014, through August 20, 2017, including ARDS expected to not be extubated within 24 hours after start of 6 intensive care units the Netherlands.Invasive using (n = 477) or 484).The primary outcome was...
Summary The bias, precision and tracking ability of five different pulse contour methods were evaluated by simultaneous comparison cardiac output values from the conventional thermodilution technique (COtd). included in this study were: Wesseling's method (cZ); Modelflow method; LiDCO system; PiCCO system a recently developed Hemac method. We studied 24 surgery patients undergoing uncomplicated coronary artery bypass grafting. In each patient, first series COtd was used to calibrate methods....
Objective: We studied the variable effects of norepinephrine infusion on cardiac output in postoperative surgical patients whom increased mean arterial pressure. hypothesized that directional change would be determined by baseline function, as quantified stroke volume variation, and subsequent changes systemic filling pressure vasomotor tone. Design: Intervention study. Setting: ICU a university hospital. Patients: Sixteen mechanically ventilated surgery patients. Interventions: Inspiratory...
To assess the level of agreement between different bedside estimates effective circulating blood volume—mean systemic filling pressure (Pmsf), arm equilibrium (Parm) and model analog (Pmsa)—in ICU patients. Eleven mechanically ventilated postoperative cardiac surgery patients were studied. Sequential measures made in supine position, rotating bed to a 30° head-up tilt after fluid loading (500 ml colloid). During each condition four inspiratory hold maneuvers done determine Pmsf; stop-flow...
Conservative oxygen therapy is aimed at the prevention of harm by iatrogenic hyperoxia while preserving adequate tissue oxygenation. Our aim was to study effectiveness and clinical outcomes a two-step implementation conservative oxygenation targets in ICU.This before after stepwise targets, between July 2011 2014. The primary endpoint proportion PaO2 values within target range. Secondary included ventilator-free days day 28, length stay, mortality.Three closed-format ICUs Netherlands.We...
Mean systemic filling pressure (Pmsf) can be determined at the bedside by measuring central venous (Pcv) and cardiac output (CO) during inspiratory hold maneuvers. Critical closing (Pcc) using same method arterial (Pa) CO. If Pcc > Pmsf, there is then a vascular waterfall. In this study, we assessed existence of waterfall its implications for calculation resistances determining Pmsf bedside.In 10 mechanically ventilated postcardiac surgery patients, maneuvers were performed, transiently...
The presence of respiratory viruses and the association with outcomes were assessed in invasively ventilated ICU patients, stratified by admission diagnosis.Prospective observational study.Five ICUs Netherlands.Between September 1, 2013, April 30, 2014, 1,407 acutely admitted patients included.None.Nasopharyngeal swabs tracheobronchial aspirates collected upon intubation tested for 14 viruses. Out 156 because a severe acute infection 1,251 other reasons (non-severe infection). Respiratory...
It is uncertain whether lung-protective mechanical ventilation using low tidal volumes should be used in all critically ill patients, irrespective of the presence acute respiratory distress syndrome (ARDS). A volume strategy includes use higher rates, which could associated with increased sedation needs, a incidence delirium, and an risk patient-ventilator asynchrony ICU-acquired weakness. Another alleged side-effect atelectasis. All these offset beneficial effects as found patients ARDS....
Summary We evaluated cardiac output (CO) using three new methods – the auto‐calibrated FloTrac–Vigileo (CO ed ), non‐calibrated Modelflow mf ) pulse contour method and ultra‐sound HemoSonic system hs with thermodilution td as reference. In 13 postoperative surgical patients, 104 paired CO values were assessed before, during after four interventions: (i) an increase of tidal volume by 50%; (ii) a 10 cm H 2 O in positive end‐expiratory pressure; (iii) passive leg raising (iv) head up position....
We conducted a retrospective cohort study in an academic tertiary care center to characterize ventilator-associated pneumonia (VAP) pediatric patients after cardiac surgery The Netherlands.All following and mechanically ventilated for ≥24 h were included. primary outcome was development of VAP. Secondary outcomes duration mechanical ventilation length ICU stay.A total 125 enrolled. Their mean age 16.5 months. rate VAP 17.1/1,000 days. Frequently found organisms Haemophilus influenzae,...
We compared the accuracy and precision of non-invasive Nexfin® device for determining systolic, diastolic, mean arterial pressure pulse variation, with blood values measured from a radial artery catheter in 19 patients following upper abdominal surgery. Measurements were taken at baseline fluid loading. Pooled data results pressures showed no difference between two measurement modalities. Bland–Altman analysis variation significant differences obtained Nexfin finger cuff technology (mean...
Blockade of cardiac sympathetic fibers by thoracic epidural anesthesia may affect right ventricular function and interfere with the coupling between afterload. Our main objectives were to study effects on ventricular-pulmonary coupling.In 10 patients scheduled for lung resection, its response increased afterload, induced temporary, unilateral clamping pulmonary artery, was tested before after induction using combined pressure-conductance catheters.Thoracic resulted in a significant decrease...
Cardiac output measurement with pulse contour analysis is a continuous, mini-invasive, operator-independent, widely used, and cost-effective technique, which could be helpful to assess changes in cardiac output. The 4-quadrant plot the polar have been described compare between 2 measurements performed under different conditions, direction of change by using methods measurements. However, present number limitations, risk misinterpretation routine clinical practice. We describe new trend...
Describing outcomes for children with hypoplastic left heart syndrome (HLHS) undergoing hybrid palliation (pulmonary artery band and stent placement in the patent ductus arteriosus) requiring extracorporeal membrane oxygenation (ECMO) support cardiorespiratory failure.We reviewed Extracorporeal Life Support Organization database all patients a diagnosis of an HLHS stage 1 supported ECMO those after comprehensive 2 palliation. Patients were identified using combination International...
Although oxygen is generally administered in a liberal manner the perioperative setting, effects of administration on dynamic cardiovascular parameters, filling status and cerebral perfusion have not been fully unraveled. Our aim was to study acute hemodynamic microcirculatory changes before, during after arterial hyperoxia mechanically ventilated patients coronary artery bypass grafting (CABG) surgery.This single-center physiological tertiary care ICU Netherlands. Twenty-two scheduled for...
Summary This study was performed to determine the interchangeability of femoral artery pressure and radial measurements as input for PiCCO system (Pulsion Medical Systems, Munich, Germany). We studied 15 intensive care patients following cardiac surgery. Five‐second averages output derived from (COfem) were compared 5‐s (COrad) . One patient excluded due problems in pattern recognition arterial signal. In remaining 14 patients, 734 comparative values analysed. The mean sample time 88 min,...
Summary The aim of this study was to compare the accuracy stroke volume variation (SVV) as measured by LiDCOplus system (SVVli) and FloTrac‐Vigileo (SVVed). We SVVli SVVed in 15 postoperative cardiac surgical patients following five interventions; a 50% increase tidal volume, an PEEP 10 cm H 2 O, passive leg raising, head‐up tilt procedure fluid loading. Between each intervention, baseline measurements were performed. 136 data pairs obtained. ranged from 1.4% 26.8% (mean (SD) 8.7 (4.6)%);...
Background and objective In pharmacological research, arm occlusion pressure is used to study haemodynamic effects of drugs. However, might be an indicator static filling the arm. We hypothesised that can predict fluid loading responsiveness. Methods Twenty-four patients who underwent cardiac surgery were studied during their first 2 h in ICU. The lungs ventilated mechanically left ventricular function was supported as necessary. Arm defined radial artery after occluding arterial flow for 35...
Background and aims: Cardiac function may differ after valvular (VS) coronary artery (CAS) surgery this affect assessment of fluid responsiveness. The aim the study was to compare VS CAS in value cardiac filling pressures volumes herein. Methods: There were eight consecutive patients CAS, with femoral pulmonary catheters place. In each patient, five sequential loading steps 250 ml colloid done. We measured central venous pressure (CVP), occlusion (PAOP) and, by transpulmonary thermodilution,...
The Bland-Altman (BA) and percentage error (PE) methods have been previously described to assess the agreement between 2 of medical or laboratory measurements. This type approach raises several problems: BA methodology constitutes a subjective interchangeability, whereas PE does not take into account distribution values over range. We describe new that defines an interchangeability rate measurement cutoff determine range interchangeable values. used simulated data published set demonstrate...