Tom A. Rijpstra
A5028561856- Cardiac Arrest and Resuscitation
- Antifungal resistance and susceptibility
- Sepsis Diagnosis and Treatment
- Acute Myocardial Infarction Research
- COVID-19 Clinical Research Studies
- Antibiotics Pharmacokinetics and Efficacy
- Ultrasound in Clinical Applications
- Respiratory Support and Mechanisms
- COVID-19 and healthcare impacts
- Pneumonia and Respiratory Infections
- Mechanical Circulatory Support Devices
- Intensive Care Unit Cognitive Disorders
- Cardiac, Anesthesia and Surgical Outcomes
- Antibiotic Resistance in Bacteria
- Cardiac Imaging and Diagnostics
- Hemodynamic Monitoring and Therapy
- Long-Term Effects of COVID-19
- Pleural and Pulmonary Diseases
- Non-Invasive Vital Sign Monitoring
- Mycotoxins in Agriculture and Food
- Fungal Infections and Studies
- Family and Patient Care in Intensive Care Units
- Cardiac Health and Mental Health
- Epilepsy research and treatment
- Antibiotic Use and Resistance
Amphia Ziekenhuis
2013-2025
Maastricht University
2024
Amsterdam University Medical Centers
2021-2024
Vrije Universiteit Amsterdam
2023-2024
University of Amsterdam
2021-2023
Intensive Care Society
2010
Ischemic heart disease is a major cause of out-of-hospital cardiac arrest. The role immediate coronary angiography and percutaneous intervention (PCI) in the treatment patients who have been successfully resuscitated after arrest absence ST-segment elevation myocardial infarction (STEMI) remains uncertain.
Individualising drug dosing using model-informed precision (MIPD) of beta-lactam antibiotics and ciprofloxacin has been proposed as an alternative to standard optimise antibiotic efficacy in critically ill patients. However, randomised clinical trials (RCT) on outcomes have lacking. This multicentre RCT, including patients admitted the intensive care unit (ICU) who were treated with antibiotics, was conducted eight hospitals Netherlands. Patients MIPD dose interval adjustments based...
We describe four secondary fungal infections caused by Mucorales species in COVID-19 patients. Three associated mucormycosis (CAM) occurred ICU, one outside ICU. All were men aged > 50 years, three died. Clinical presentations included pulmonary, rhino-orbital cerebral and disseminated infection. Infections patients with without diabetes mellitus. CAM is an emerging disease our observations underscore the need to be aware of invasive mucormycosis, including (poorly controlled) mellitus
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...
Abstract Background Sepsis and septic shock are significant global healthcare challenges with high mortality rates. Effective management requires timely adequate antimicrobial therapy. Beta-lactam antibiotics, commonly used in patients sepsis, crucial for treating these infections. However, standard dosing often leads to insufficient plasma levels due dynamic physiological changes critically ill patients. Previous randomized controlled trials highlighted the need dose adjustments improve...
The literature regarding COVID-19-associated pulmonary aspergillosis (CAPA) has shown conflicting observations, including survival of CAPA patients not receiving antifungal therapy and discrepancy between diagnosis autopsy findings. To gain insight into the pathophysiology CAPA, we performed a case-control study in which compared Aspergillus test profiles controls relation to intensive care unit (ICU) mortality. This was multinational results, use therapy, mortality were collected from...
Determining the optimal timing for extubation can be challenging in intensive care. In this study, we aim to identify predictors failure critically ill patients with COVID-19.We used highly granular data from 3464 adult COVID multicenter Dutch Data Warehouse, including demographics, clinical observations, medications, fluid balance, laboratory values, vital signs, and life support devices. All intubated at least one attempt were eligible analysis. Transferred patients, admitted less than 24...
Importance Several randomized clinical trials (RCTs) assessed the effect of immediate vs delayed coronary angiography in patients with out-of-hospital cardiac arrest (OHCA) without ST-segment elevations and found no difference short-term survival. However, association these strategies long-term outcomes identification patient subgroups that might benefit from tailored approaches remain unclear. Objective To compare or selective treatment for OHCA ST elevation on 1-year survival, identify may...
In Brief BACKGROUND: Chest radiographs (CXRs) are obtained frequently in the intensive care unit (ICU). Whether these CXRs should be performed routinely or on clinical indication only is often debated. The aim of our study was to investigate incidence and significance abnormalities found routine postoperative cardiac surgery patients whether a restricted use would influence number significant findings. METHODS: We prospectively included all consecutive who underwent during 2-month period....
Critically ill COVID-19 patients have proven to be at risk for developing invasive fungal infections. However, the incidence and impact of possible/probable COVID-19-associated pulmonary aspergillosis (CAPA) in severe varies between cohorts. We aimed assess incidence, factors, clinical outcome a regional cohort intensive care patients.We performed regional, multicentre, retrospective study units (ICUs) North Brabant, The Netherlands. included adult with rt-PCR-confirmed SARS-CoV-2 infection...
Introduction . Admission to the ICU is a significant event for patients and their families often accompanied by stress, anxiety depression. Literature shows that implementation of “unrestricted visiting policy” (UP) can potentially alleviate psychologically distressing elements admission. Methods A web-based questionnaire was sent all ICU’s concerning three main topics: general information, detailed policy rationale chosen policy. Results 87.1% retain “restricted policies” (RVP; ≤five hours...
ICU patients frequently undergo chest radiographs (CXRs). The diagnostic and therapeutic efficacy of routine CXRs are now known to be low, but the discussion regarding specific indications for in critically ill safety abandoning is still ongoing. We performed a survey Dutch intensivists on current practice radiography their departments. Web-based questionnaires, containing questions characteristics, patients, daily CXR strategies, radiologic evaluation, were sent medical directors all adult...
Describe the differences in characteristics and outcomes between COVID-19 other viral pneumonia patients admitted to Dutch ICUs.Data from National-Intensive-Care-Evaluation-registry of February 15th January 1th 2021 1st 2017 2020 were used. Patients' characteristics, unadjusted, adjusted in-hospital mortality compared.6343 2256 79 ICUs included. The included more male (71.3 vs 49.8%), had a higher Body-Mass-Index (28.1 25.5), less comorbidities (42.2 72.7%), prolonged hospital length stay...
Summary Non‐invasive cardiac output measurement by means of impedance cardiography has been evaluated before, and agreement with other methods variable. We decided to study a newly developed tracheal device, that is claimed be more accurate reliable. This incorporates new software mathematical formulae, are designed reduce signal noise from diathermy, leading improved accuracy. In 25 cardiothoracic surgery patients, simultaneous measurements were performed using both pulmonary artery...
For mechanically ventilated critically ill COVID-19 patients, prone positioning has quickly become an important treatment strategy, however, is labor intensive and comes with potential adverse effects. Therefore, identifying which intubated patients will benefit may help allocate resources. From the multi-center Dutch Data Warehouse of ICU from 25 hospitals, we selected all 3619 episodes in 1142 invasively patients. We excluded longer than 24 h. Berlin ARDS criteria were not formally...
Abstract Aims ST-depression and T-wave inversion are frequently present on the post-resuscitation electrocardiogram (ECG). However, prognostic value of ischaemic ECG patterns is unknown. Methods results In this post-hoc subgroup analysis Coronary Angiography after Cardiac arrest (COACT) trial, first in-hospital in out-of-hospital cardiac patients with a shockable rhythm was analysed for patterns. Ischaemia defined as ≥0.1 mV, ≥2 contiguous leads, or both. The primary endpoint 90-day...
Prediction of atrial fibrillation (AF) after coronary artery bypass grafting (CABG) may lead to preventive or early treatment and improved outcome. We investigated the association serial perioperative cardiac troponin T (cTNT) measurements with postoperative AF in patients undergoing CABG.In a retrospective analysis prospectively collected data, 3148 elective CABG were evaluated. cTNT values routinely determined before start surgery (cTNT0), at arrival on intensive care unit (cTNT1) 8-12 h...
BackgroundThe effect of immediate coronary angiography and percutaneous intervention (PCI) in patients who are successfully resuscitated after cardiac arrest the absence ST-segment elevation myocardial infarction (STEMI) on left ventricular function is currently unknown.MethodsThis prespecified sub-study a multicentre trial evaluated 552 patients, from out-of-hospital without signs STEMI. Patients were randomized to either undergo or delayed angiography, neurologic recovery. All underwent...
Objective prognostic information is essential for good clinical decision making. In case of unknown diseases, scarcity evidence and limited tacit knowledge prevent obtaining this information. Prediction models can be useful, but need to not only evaluated on how well they predict, also stable these are under fast changing circumstances with respect development the disease corresponding response. This study aims provide interpretable actionable insights, particularly clinicians. We developed...