A5001355475- Sepsis Diagnosis and Treatment
- Respiratory Support and Mechanisms
- Advanced Chemical Sensor Technologies
- COVID-19 Clinical Research Studies
- Intensive Care Unit Cognitive Disorders
- Nosocomial Infections in ICU
- COVID-19 and healthcare impacts
- Hemodynamic Monitoring and Therapy
- Long-Term Effects of COVID-19
- Frailty in Older Adults
- Machine Learning in Healthcare
- Gas Sensing Nanomaterials and Sensors
- Neonatal Respiratory Health Research
- Clinical Reasoning and Diagnostic Skills
- Ultrasound in Clinical Applications
- Respiratory and Cough-Related Research
- Nutrition and Health in Aging
- Venous Thromboembolism Diagnosis and Management
- Inhalation and Respiratory Drug Delivery
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Mechanical Circulatory Support Devices
- Medical Coding and Health Information
- Pneumonia and Respiratory Infections
- Statistical Methods in Epidemiology
- Cardiac Arrest and Resuscitation
Maastricht University
2009-2025
Maastricht University Medical Centre
2014-2024
University of Amsterdam
2021-2024
Amsterdam University Medical Centers
2021-2024
University of Oxford
2020
BAM Nuttall (United Kingdom)
2016
Johannes Gutenberg University Mainz
2001
Texas A&M University
2001
Rationale: Lung ultrasound (LUS) is a promising tool for diagnosis of acute respiratory distress syndrome (ARDS), but adequately sized studies with external validation are lacking. Objectives: To develop and validate data-driven LUS score ARDS compare its performance that chest radiography (CXR). Methods: This multicenter prospective observational study included invasively ventilated ICU patients who were divided into derivation cohort cohort. Three raters scored according to the Berlin...
Ventilator-associated pneumonia (VAP) is a nosocomial infection occurring in the intensive care unit (ICU). The diagnostic standard based on clinical criteria and bronchoalveolar lavage (BAL). Exhaled breath analysis promising non-invasive method for rapid diagnosis of diseases contains volatile organic compounds (VOCs) that can differentiate diseased from healthy individuals. aim this study was to determine whether VOCs exhaled be used as monitoring tool VAP. One hundred critically ill...
Rationale: Recent studies showed that biological subphenotypes in acute respiratory distress syndrome (ARDS) provide prognostic enrichment and show potential for predictive enrichment. Objectives: To determine whether these their could be extended to other patients the ICU, irrespective of fulfilling definition ARDS. Methods: This is a secondary analysis prospective observational study adult admitted ICU. We tested both cluster-derived latent-class (LCA)-derived ARDS by evaluating...
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 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...
Flexible, fibreoptic bronchoscopy (FFB) and bronchoalveolar lavage (BAL) have been used for diagnostic purposes in critically ill ventilated patients. The additional value compared to tracheal aspirations ventilator-associated pneumonia (VAP) has questioned. Nevertheless, BAL can provide extra information the differential diagnosis of respiratory disease good antibiotic stewardship. These benefits should outweigh potential hazards caused by invasiveness this technique. focus present study...
Low skeletal muscle mass on intensive care unit admission is related to increased mortality. It however unknown whether this association influenced by co-morbidities that are associated with loss. The aim of study was investigate sarcopenia an independent risk factor for hospital mortality in critical illness the presence wasting. Data 155 patients abdominal sepsis were retrospectively analyzed. Skeletal area assessed using CT-scans at level vertebra L3. Demographic and clinical data...
The course of the disease in SARS-CoV-2 infection mechanically ventilated patients is unknown. To unravel clinical heterogeneity these patients, we designed prospective observational Maastricht Intensive Care COVID cohort (MaastrICCht). We incorporated serial measurements that harbour aetiological, diagnostic and predictive information. study aims to investigate natural critically ill with a infection.Mechanically admitted intensive care will be included. collect variables, vital parameters,...
Abstract We validated a Deep Embedded Clustering (DEC) model and its adaptation for integrating mixed datatypes (in this study, numerical categorical variables). is promising technique capable of managing extensive sets variables non-linear relationships. Nevertheless, DEC cannot adequately handle datatypes. Therefore, we adapted by replacing the autoencoder with an X-shaped variational (XVAE) optimising hyperparameters cluster stability. call “X-DEC”. compared X-DEC reproducing previous...
Background: Clear definitions for septic shock assist clinicians regarding recognition, treatment and standardized reporting of characteristics outcome this entity. Sepsis-3 definition incorporates a new criterion, lactate level >2 mmol/L. Differences in epidemiology based upon both were studied an intensive care (ICU) population patients.Methods: We analyzed prospectively collected cohort data the ICU Maastricht University Medical Centre. 632 patients included. mortality was compared...
The majority of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are admitted to the Intensive Care Unit (ICU) for mechanical ventilation. role multi-organ failure during ICU admission as driver outcome remains be investigated yet. Prospective cohort mechanically ventilated critically ill SARS-CoV-2 infection. 94 participants MaastrICCht (21% women) had a median length stay 16 days (maximum 77). After division into survivors (n = 59) and non-survivors 35),...
Biological subphenotypes have been identified in acute respiratory distress syndrome (ARDS) based on two parsimonious models: the "uninflamed" and "reactive" subphenotype (cluster-model) "hypo-inflammatory" "hyper-inflammatory" (latent class analysis (LCA) model). The distinction between is mainly driven by inflammatory coagulation markers plasma. However, systemic inflammation not specific for ARDS it unknown whether these also reflect differences alveolar compartment. Alveolar dysbiosis of...
It has been questioned if Candida pneumonia exists as a clinical entity. Only histopathology can establish the definite diagnosis. Less invasive diagnostic strategies lack specificity and have insufficiently validated. Scarcity of this pathomechanism nonspecific presentation make validation development algorithm difficult. In present study, we analyze whether in our critical care population. We used bronchoalveolar lavage (BAL) specimen database that built structural approach to...
Abstract Background The incidence of pulmonary thromboembolism is high in SARS-CoV-2 patients admitted to the Intensive Care. Elevated biomarkers coagulation (fibrinogen and D-dimer) inflammation (c-reactive protein (CRP) ferritin) are associated with poor outcome SARS-CoV-2. Whether time-course fibrinogen, D-dimer, CRP ferritin occurrence unknown. We hypothesise that on mechanical ventilation infection clinical have lower concentrations fibrinogen higher CRP, over time compared without a...
Background Sepsis is a global health care problem with high mortality. Early death seems common; however, data are sparse. The objective of the present study was to report causes and influencing factors early in sepsis septic shock.Methods All ICU patients were included from 2012 2017. predefined as occurring within 48 h. Causes leading up reported by panel four intensivists, independently reviewing medical files. Following assessed: (1) delay admission; (2) futile treatment; (3) missed...
• The assessment of muscle loss during critical illness using computed tomography scans is hampered by the formation edema. Edema in leads to overestimation area measurements. and decreased quality were associated with a higher disease severity. Muscle radiation attenuation cannot be used as an indicator for In illness, researchers must careful interpretation Changes mass are important targets nutritional intervention illness. Effects such interventions may assessed sequential (CT) scans....
To investigate national mortality trends over a 12-year period for patients with severe acute pancreatitis (SAP) admitted to Dutch ICUs. Additionally, an assessment of outcome in SAP was undertaken differentiate between early (< 14 d ICU admission) and late (> mortality.Data from the National Intensive Care Evaluation health insurance companies' databases were extracted. Outcomes included 14-day, ICU, hospital, 1-year mortality. Mortality before after 2010 compared using mixed logistic...
Pulmonary edema is a central hallmark of acute respiratory distress syndrome (ARDS). Endothelial dysfunction and epithelial injury contribute to alveolar-capillary permeability but their differential contribution pulmonary development remains understudied. Plasma levels surfactant protein-D (SP-D), soluble receptor for advanced glycation end products (sRAGE), angiopoietin-2 (Ang-2) were measured in prospective, multicenter cohort invasively ventilated patients. was quantified using the...