A5004317513- Pediatric Pain Management Techniques
- Infant Development and Preterm Care
- Anesthesia and Sedative Agents
- Intensive Care Unit Cognitive Disorders
- Respiratory Support and Mechanisms
- Cardiac, Anesthesia and Surgical Outcomes
- Pharmaceutical studies and practices
- Anesthesia and Neurotoxicity Research
- Cerebral Palsy and Movement Disorders
- Family and Disability Support Research
- Sepsis Diagnosis and Treatment
- Epilepsy research and treatment
- Infant Health and Development
- Thermal Regulation in Medicine
- Pharmacological Effects and Toxicity Studies
- Plant-based Medicinal Research
- Infrared Thermography in Medicine
- Anesthesia and Pain Management
- Pharmacovigilance and Adverse Drug Reactions
- Cardiac Ischemia and Reperfusion
- Healthcare Technology and Patient Monitoring
- Neuroscience of respiration and sleep
- Antibiotics Pharmacokinetics and Efficacy
- Frailty in Older Adults
- History of Medicine Studies
Erasmus MC
2011-2024
Isala
2021-2023
Erasmus University Rotterdam
2011-2021
Erasmus MC - Sophia Children’s Hospital
2011-2021
University of Florida
2019-2020
Columbus Oncology and Hematology Associates
2019-2020
Leiden University
2018
St. Antonius Ziekenhuis
2018
Boston Children's Hospital
2009
Summary Neonatal morphine infusion of 10 μg/kg/h does not affect general functioning 8 to 9 years later and may even have a positive effect on executive function skills. Morphine is widely used treat severe pain in neonatal intensive care unit patients. Animal studies suggest adverse long-term side effects morphine, but follow-up study 5-year-old children who participated morphine-placebo controlled trial as newborns found no such the child’s functioning. This indicated that negatively...
Many pediatric intensive care units use the COMFORT-Behavior scale (COMFORT-B) to assess pain in 0- 3-year-old children. The objective of this study was determine whether is also valid for assessment children with Down syndrome. These often undergo cardiac or intestinal surgery early life and therefore admission a unit. Seventy-six patients syndrome were included 466 without Pain regularly assessed COMFORT-B Numeric Rating Scale (NRS). For either group, confirmatory factor analyses revealed...
Aim The aim of this study was to compare thermal detection and pain thresholds in children with Down syndrome those their siblings. Method Sensory were assessed siblings using quantitative testing methods. Parental questionnaires addressing developmental age, coping, behaviour, chronic also utilized. Results Forty‐two (mean age 12y 10mo) 24 15y) participated observational study. different sensory tests proved feasible 13 29 (33–88%) the syndrome. These less sensitive cold warmth than...
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...
Very few data are available on the use of bispectral index (BIS) monitoring in children who intellectually disabled. Epileptiform electroencephalogram activity, underlying cerebral pathology, or anticonvulsant/spasmolytic therapy might influence BIS monitoring. Our aim this exploratory study was to first compare values at 4 different stages anesthesia between disabled and controls. second investigate discriminative properties consciousness unconsciousness for controls.Eighteen 35 control...
Objective: To compare the pharmacodynamics and pharmacokinetics of IV morphine after cardiac surgery in two groups children—those with without Down syndrome. Design: Prospective, single-center observational trial. Setting: PICU a university-affiliated pediatric teaching hospital. Patients: Twenty-one children syndrome 17 without, 3–36 months old, scheduled for cardiopulmonary bypass. Interventions: A loading dose (100 μg/kg) was administered coming off bypass; thereafter, infusion commenced...
Quantitative sensory testing (QST) is often used to measure children's and adults' detection- pain thresholds in a quantitative manner. In children especially the Thermal Sensory Analyzer (TSA-II) applied determine thermal detection thresholds. As comparisons between studies are hampered by different protocols used, we aimed present standard protocol reference values for children. Our includes reaction time dependent independent tests takes about 14–18 min complete. Reference were obtained...
Many patients treated for COVID-19 related acute respiratory distress syndrome in the intensive care unit are sedated with benzodiazepine midazolam. Midazolam undergoes extensive metabolism by CYP3A enzymes, which may be inhibited hyperinflammation. Therefore, an exaggerated proinflammatory response, as often observed COVID-19, decrease midazolam clearance. To develop a population pharmacokinetic model adult infected and to assess effect of inflammation, reflected IL-6, on pharmacokinetics...
This critical opinion article deals with the challenges of finding most effective pharmacotherapeutic options for management pain in intellectually disabled children and provides recommendations clinical practice research. Intellectual disability can be caused by a wide variety underlying diseases may associated congenital anomalies such as cardiac defects, small-bowel obstructions or limb abnormalities well comorbidities scoliosis, gastro-esophageal reflux disease, spasticity, epilepsy....
Abstract Children undergoing cardiac surgery often receive acetaminophen (paracetamol) as part of their postoperative pain treatment. To date, there is no information on the pharmacokinetics (PK) in this special population, even though differences, a result altered hemodynamics and/or use cardiopulmonary bypass, may be anticipated. Therefore, aim study was to investigate PK intravenous children after with bypass. In study, both and without Down syndrome were included. A population analysis,...
Summary Background: Intellectually disabled children are more likely to undergo surgical interventions and almost all have comorbidities that need be managed. Compared with controls, intellectually tend receive less intraoperative analgesia fewer of them assessed for postoperative pain. Aim: To evaluate perceptions practices anesthesiologists in the Netherlands concerning pain management children. Methods/Materials: We surveyed members Section on Pediatric Anesthesiology Society 2005 2009,...
In hospitalized patients with COVID-19, the dosing and timing of corticosteroids vary widely. Low-dose dexamethasone therapy reduces mortality in requiring respiratory support, but it remains unclear how to treat when this fails. critically ill patients, high-dose are often administered as salvage late disease course, whereas earlier administration may be more beneficial preventing progression. Previous research has revealed that increased levels various biomarkers associated mortality,...
<b><i>Introduction:</i></b> Midazolam-based continuous intravenous sedation in patients admitted to the intensive care unit (ICU) was a necessity during COVID-19 pandemic. However, benzodiazepine-based is associated with high incidence of benzodiazepine-related delirium and additional days on mechanical ventilation. Due requirement midazolam doses combination impaired renal clearance (CL) pharmacological active metabolite 1-OH-midazolam-glucuronide (10% compared...
The clinical relevance of the suggested hyperalgesic effects remifentanil is still unclear, especially in long term.The current study evaluated impact on thermal thresholds 3 days and 12 months after surgery, measured with Quantitative Sensory Testing.A single-blind, randomised controlled trial.A tertiary care teaching hospital Netherlands, from 2014 to 2016.A total 126 patients aged between 18 85 years, undergoing cardiothoracic surgery via sternotomy (coronary artery bypass grafts and/or...