A5009616912- Hemodynamic Monitoring and Therapy
- Cardiac, Anesthesia and Surgical Outcomes
- Blood Pressure and Hypertension Studies
- Blood transfusion and management
- Traumatic Brain Injury and Neurovascular Disturbances
- Sepsis Diagnosis and Treatment
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Mechanical Circulatory Support Devices
- Venous Thromboembolism Diagnosis and Management
- Blood donation and transfusion practices
- Cardiac Arrest and Resuscitation
- Cardiac Valve Diseases and Treatments
- Intensive Care Unit Cognitive Disorders
- Optical Imaging and Spectroscopy Techniques
- Non-Invasive Vital Sign Monitoring
- Cardiovascular Function and Risk Factors
- Atrial Fibrillation Management and Outcomes
- Musculoskeletal pain and rehabilitation
- Stroke Rehabilitation and Recovery
- Hemoglobin structure and function
- Context-Aware Activity Recognition Systems
- Obstructive Sleep Apnea Research
- Cardiovascular Health and Disease Prevention
- Circadian rhythm and melatonin
- Dietary Effects on Health
University of Amsterdam
2019-2025
Amsterdam University Medical Centers
2019-2025
Public Health Service of Amsterdam
2022-2024
Amsterdam UMC Location University of Amsterdam
2019-2023
RELX Group (United States)
2023
American Nurses Credentialing Center
1999
<h3>Importance</h3> Intraoperative hypotension is associated with increased morbidity and mortality. A machine learning–derived early warning system to predict shortly before it occurs has been developed validated. <h3>Objective</h3> To test whether the clinical application of in combination a hemodynamic diagnostic guidance treatment protocol reduces intraoperative hypotension. <h3>Design, Setting, Participants</h3> Preliminary unblinded randomized trial performed tertiary center Amsterdam,...
Importance Red blood cell (RBC) transfusion is common among patients admitted to the intensive care unit (ICU). Despite multiple randomized clinical trials of hemoglobin (Hb) thresholds for transfusion, little known about how these are incorporated into current practice. Objective To evaluate and describe ICU RBC practices worldwide. Design, Setting, Participants International, prospective, cohort study that involved 3643 adult from 233 ICUs in 30 countries on 6 continents March 2019 October...
BACKGROUND The hypotension prediction index (HPI) predicts hypotension, with randomised trials showing a significant reduction in hypotension-related metrics. However, the reliability of previous validation studies is debated, and it's unclear if mean arterial pressure (MAP) can be used interchangeably HPI. OBJECTIVES This study compared effectiveness HPI versus MAP thresholds predicting intraoperative focusing on three clinically relevant metrics: time from alert to event, positive...
Intraoperative and postoperative hypotension are associated with morbidity mortality. The Hypotension Prediction (HYPE) trial showed that the Index (HPI) reduced depth duration of intraoperative (IOH), without excess use intravenous fluid, vasopressor, and/or inotropic therapies. We hypothesised HPI-guided haemodynamic care would reduce severity in PACU.This was a sub-study HYPE study, which 60 adults undergoing elective noncardiac surgery were allocated randomly to or standard care. Blood...
Although hypotension in ICU patients is associated with adverse outcome, currently used definitions are unknown and no universally accepted definition exists.We conducted an international, peer-reviewed survey among physicians nurses to provide insight definitions, estimations of incidence, duration hypotension.Out 1394 respondents (1055 (76%) 339 (24%)), 1207 (82%) completed the questionnaire. In all patient categories, were predominantly based on absolute MAP 65 mmHg, except for...
Cardiac surgery is associated with perioperative complications, some of which might be attributable to hypotension. The Hypotension Prediction Index (HPI), a machine-learning-derived early warning tool for hypotension, has only been evaluated in noncardiac surgery. We investigated whether using HPI diagnostic guidance reduced hypotension during cardiac and the ICU.
Background Vital signs measurements on the ward are performed intermittently. This could lead to failure rapidly detect patients with deteriorating vital and worsens long-term outcome. The aim of this study was test hypothesis that continuous wireless monitoring postsurgical improves patient Methods In prospective, multicenter, stepped-wedge cluster randomized study, in control group received standard monitoring. intervention heart rate, respiratory rate temperature top care. Automated...
Clinical trials and validation studies demonstrate promising hypotension prediction capability by the Hypotension Prediction Index (HPI). Most that evaluate HPI derive it from invasive blood pressure readings, but a direct comparison with noninvasive alternative remains undetermined. Such could provide valuable insights for clinicians in deciding between monitoring strategies.
BACKGROUND: Rotational thromboelastometry (ROTEM) is widely used for point-of-care coagulation testing to reduce blood transfusions. Accurate interpretation of ROTEM data crucial and requires substantial training. This study investigates the inter- intrarater reliability among experts compares their interpretations with a ROTEM-guided algorithm. METHODS: was conducted at Amsterdam University Medical Center included 90 cardiac surgery patients. were collected 4 surgical stages: before...
Summary Introduction Rotational thromboelastometry (ROTEM ® ) is used widely in cardiac surgery. Reference ranges are derived from healthy volunteers but may not be interchangeable with those patients undergoing Furthermore, sex and age seem to influence rotational profiles. We performed a secondary analysis of two prospective observational study cohorts single centre the Netherlands, which establishes pre‐operative ROTEM sigma reference for adult surgery examines sex‐ age‐specific...
Abstract Background Intraoperative hypotension is associated with increased morbidity and mortality. Current treatment mostly reactive. The Hypotension Prediction Index (HPI) algorithm able to predict minutes before the blood pressure actually decreases. Internal external validation of this has shown good sensitivity specificity. We hypothesize that use in combination a personalized protocol will reduce time weighted average (TWA) during surgery spent intraoperatively. Methods/design aim...
Hypotension in the ICU is common, yet management challenging and variable. Insight by physicians nurses may improve patient care guide future hypotension treatment trials guidelines.We conducted an international survey among personnel to provide insight monitoring, management, perceived consequences of hypotension.Out 1464 respondents, 1197 (81.7%) were included (928 (77.5%) 269 (22.5%)). The majority indicated that underdiagnosed (55.4%) largely preventable (58.8%). Nurses are primarily...
Introduction Hypotension is common during cardiac surgery and often persists postoperatively in the intensive care unit (ICU). Still, treatment mainly reactive, causing a delay its management. The Prediction Index (HPI) can predict hypotension with high accuracy. Using HPI combined guidance protocol resulted significant reduction severity of four non-cardiac trials. This randomised trial aims to evaluate effectiveness combination diagnostic on reducing occurrence coronary artery bypass...
Thrombocytopenia, hemorrhage and platelet transfusion are common in patients supported with venoarterial extracorporeal membrane oxygenation (VA ECMO). However, current literature is limited to small single-center experiences high degrees of heterogeneity. Therefore, we aimed ascertain a multicenter study the course occurrence rate thrombocytopenia, assess association between during VA ECMO.This was sub-study (N = 16) on practices ECMO, which retrospective cohort (Jan-2018-Jul-2019) focusing...
Evidence-based recommendations for transfusion in patients with venoarterial extracorporeal membrane oxygenation (VA ECMO) are scarce. The current literature is limited to single-center studies small sample sizes, therefore complicating generalizability. This study aims create an overview of red blood cell (RBC) VA ECMO patients. international mixed-method combined a survey retrospective observational 16 centers. inventoried local guidelines. Additionally, data all adult run >24 h (January...
Delirium is a severe complication in critical care patients. Accurate prediction could facilitate determination of which patients are at risk. In the past decade, several delirium models have been developed.To compare prognostic accuracy PRE-DELIRIC, E-PRE-DELIRIC, and Lanzhou models, to investigate difference PRE-DELIRIC model between receiving not mechanical ventilation.This retrospective study involved adult admitted intensive unit during 2-year period. was assessed by using Confusion...
Classically, cerebral autoregulation (CA) entails blood flow (CBF) remaining constant by cerebrovascular tone adapting to fluctuations in mean arterial pressure (MAP) between ∼60 and ∼150 mmHg. However, this is not an on-off mechanism; previous work has suggested that vasomotor proportionally related CA function. During propofol-based anaesthesia, there vasoconstriction, static remains intact. Sevoflurane-based anaesthesia induces vasodilation attenuates dose-dependently. It unclear how...