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2. Phosphodiesterase 3 inhibitors do not influence lactate kinetics and clinical outcomes in patients with septic shock: A multicentre cohort study

Author

Tai-Passmann, Sharon, Slegers, Claire A.D., Hemelaar, Pleun, Waalders, Nicole, Koopmans, Matty, van den Bogaard, Bas, van Lookeren Campagne, Michiel, Goedegebuur, Jamilla, Kuindersma, Marnix, Schroten, Nicolas, van der Elsen, Fieke, Grady, Bart P.X., van den Beuken, Wisse M.F., Kiers, Dorien, Pickkers, Peter, and van den Oever, Huub L.A.

Published
2024
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3. Ventilation management and clinical outcomes in invasively ventilated patients with COVID-19 (PRoVENT-COVID): a national, multicentre, observational cohort study

Author

van Akkeren, Jesse P., Algera, Anna Geke, Algoe, Cheetel K., van Amstel, Rombout B., Baur, Onno L., van de Berg, Pablo, van den Berg, Alida E., Bergmans, Dennis C.J.J., van den Bersselaar, Dido I., Bertens, Freke A., Bindels, Alexander J.G.H., de Boer, Milou M., den Boer, Sylvia, Boers, Leonoor S., Bogerd, Margriet, Bos, Lieuwe D.J., Botta, Michela, Breel, Jennifer S., de Bruin, Hendrik, de Bruin, Sanne, Bruna, Caro L., Buiteman-Kruizinga, Laura A., Cremer, Olaf L., Determann, Rogier M., Dieperink, Willem, Dongelmans, Dave A., Franke, Hildegard S., Galek-Aldridge, Michal S., de Graaff, Mart J., Hagens, Laura A., Haringman, Jasper J., van der Heide, Sebastiaan T., van der Heiden, Pim L.J., Heijnen, Nanon F.L., Hiel, Stephan J.P., Hoeijmakers, Lotte L., Hol, Liselotte, Hollmann, Markus W., Hoogendoorn, Marga E., Horn, Janneke, van der Horst, Robrecht, Ie, Evy L.K., Ivanov, Dimitri P., Juffermans, Nicole, Kho, Eline, de Klerk, Eline S., Koopman-van Gemert, Ankie W.M.M., Koopmans, Matty, Kucukcelebi, Songul, Kuiper, Michael A., de Lange, Dylan W., van Mourik, Niels, Nijbroek, Sunny G.L.H., Onrust, Marisa, Oostdijk, Evelien A.N., Paulus, Frederique, Pennartz, Charlotte J., Pillay, Janesh, Pisani, Luigi, Purmer, Ilse M., Rettig, Thijs C.D., Roozeman, Jan-Paul, Schuijt, Michiel T.U., Schultz, Marcus J., Serpa Neto, Ary, Sleeswijk, Mengalvio E., Smit, Marry R., Spronk, Peter E., Stilma, Willemke, Strang, Aart C., Tsonas, Anissa M., Tuinman, Pieter R., Valk, Christel M.A., Veen-Schra, Felicia L., Veldhuis, Lars I., van Velzen, Patricia, van der Ven, Ward H., Vlaar, Alexander P.J., van Vliet, Peter, van der Voort, Peter H.J., van Welie, Louis, Wesselink, Henrico J.F.T., van der Wier-Lubbers, Hermien H., van Wijk, Bas, Winters, Tineke, Wong, Wing Yi, van Zanten, Arthur R.H., Tsonas, Anissa M, Boers, Leonoor S, Bos, Lieuwe D J, Dongelmans, Dave A, Hollmann, Marcus W, Vlaar, Alexander P J, Schultz, Marcus J, and Neto, Ary Serpa

Published
2021
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4. Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study

Author

Berger, Elke, Wils, Evert-Jan, Vos, Piet, van Santen, Susanne, Koets, Jeroen, Slooter, Arjen J.C., van der Woude, Meta, Koopmans, Matty, Rinket, Martin A., Hoiting, Oscar, Hoogendoorn, Emma E., Streefkerk, Jörn O., de Vreede, Els W., Riekerk, Bea, Simons, Koen S., Toscano, Eryk, Schoonderbeek, F Jeannette, Hofstra, Lieuwe S., van den Oever, Huub L.A., Raben, Adrienne M.T.J., Holman, Susanne, Nooteboom, Fleur, Bethlehem, Carina, ten Cate, Julia, Verkade, Martijn, Mijzen, Lisa, de Man-van Ginkel, Janneke M., Vermeulen, Hester, and van den Boogaard, Mark, RCCCNet

Published
2020
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13. Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensive care units from 16 countries (PRoVENT): an international, multicentre, prospective study

Author

Bell, Adam, Gecaj-Gashi, Agreta, Dilek, Ahmet, Denker, Ahmet Sukru, Aytulun, Akut, Kienbaum, Peter, Rose, Alastair, Bacuzzi, Alessandro, Cavalcanti, Alexandre Biasi, Chan, Alexandre, Molin, Alexandre, Ghosh, Alison, Roy, Alistair, Cowton, Amanda, Skinner, Amanda, Whileman, Amanda, McInerney, Amy, Peçanha, Ana Carolina, Cortegiani, Andrea, Sribar, Andrej, Bentley, Andrew, Corner, Andrew, Pinder, Angela, Hormis, Anil, Walker, Anna, Artigas-Raventós, Antonio, Neto, Ary Serpa, Dixon, Barry, Creagh-Brown, Ben, Volta, Carlo Alberto, Munhoz, Carlos, Brown, Carly, Barbas, Carmen S V, Scott, Carmen, Wreybrown, Caroline, Plowright, Catherine, Downes, Charlotte, Padilla-Harris, Cheryl, Hughes, Chloe, Frey, Christian, Putensen, Christian, Schlegel, Christian, Boyd, Christine, Ryan, Christine, Muench, Christoph, Smalley, Christopher, Zincircioglu, Çiler, Harris, Clair, Kaloo, Claire, Matthews, Claire, Miller, Claire, Pegg, Claire, Bullock, Clare, Mellis, Clare, Piras, Claudio, Seasman, Colette, Santos, Cristina, Beraldo, Daniel, Collins, Daniel, Hadfield, Daniel, Hull, Daniel, Prado, Daniel, Pogson, David, Rogerson, David, Shaw, David, D'Antini, Davide, Griffin, Dawn Trodd Denise, Weller, Debbie, Smith, Deborah, Wilson, Deborah, Aydin, Demet, Donaldson, Denise, Mestria, Donatella, Tschernko, Edda M, Lauro, Eduardo Di, Caser, Eliane Bernadete, Seghelini, Elisa, Cirstea, Emanuel, Young, Eoin, Alberts, Erna, Senturk, Evren, Simonis, Fabienne D, Brohi, Farooq, Ulger, Fatma, Kahveci, Feda, da Silva Ramos, Fernando José, Van Haren, Frank, Turan, Güldem, Sales, Gabriele, Mills, Gary H, Clifford, Gayle, Cinnella, Gilda, Mecatti, Giovana Colozza, Melchionda, Giuseppe, Hedenstierna, Goran, Hermans, Greet, Eren, Gulay, Crowther, Hannah, Spencer, Hazel, Blaylock, Heather, Green, Helen, Robertson, Helen, Rodgers, Helen, Talbot, Helen, Wong, Helen, Barcraft-Barnes, Helena, Ceunen, Helga, Reschreiter, Henrik, Wrigge, Hermann, Ulusoy, Hulya, Toman, Huseyin, McCullagh, Iain, White, Ian, Martin-Loeches, Ignacio, Welters, Ingeborg, van den Hul, Ingrid, Gava, Isabela Ambrósio, Reed, Isabelle, Kose, Isil, Maia, Israel, Limb, James, Máca, Jan, Adderly, Jane, Hunt, Jane, Martin, Jane, Montgomery, Jane, Snell, Jane, Canet, Jaume, Salgado, Jean, Ritzema, Jenny, Bewley, Jeremy, Howe, Joanne, Decruyenaere, Johan, Mouland, Johanna, Stickley, Johanna, Mellinghoff, Johannes, Criswell, John, Knighton, John, Cooper, Jonathan, Harrison, Jonathan, Paddle, Jonathan, Pellegrini, Jose Augusto Santos, Needleman, Joseph, Giles, Julian, Camsooksai, Julie, Furneval, Julie, Toms, Julie, Burt, Karen, Simeson, Karen, Williams, Karen, Blenk, Karl, Turner, Kate, Lynch, Katie, Sweet, Katie, Hugill, Keith, Matthews, Kelly, Ruas, Kessia, Clarkson, Kevin, Preller, Kobus, Joyce, Kristen, Ortiz-Ruiz, Laura, Youds, Laura, Tbaily, Lee, Barrell, Lisa, Grimmer, Lisa, Soyoral, Lokman, Peluso, Lorenzo, Murray, Lorna, Niska, Lotta, Tonks, Louise, Fasting, Lousie, DeCrop, Luc, Brazzi, Luca, Mirabella, Lucia, Cooper, Lucy, Falcão, Luis Fernando, Everett, Lynn, Watters, Malcolm, Carnahan, Mandy, Bourgeois, Marc, Abreu, Marcelo Gama de, Romano, Marcelo Luz Pereira, Botteri, Marco, Melo, Marcos F Vidal, Schultz, Marcus J, Faulkner, Maria, Krkusek, Marijana, Bahl, Marina, Holliday, Mark, Kol, Mark, Pulletz, Mark, Hollmann, Markus W, Kozlowski, Marta, Dvorscak, Matea Bogdanovic, Jurjevic, Matija, Koopmans, Matty, Morales, Mauricio, Schaefer, Maximilian, Brazier, Melinda, Harris, Meredith, Devile, Michael, Hiesmayr, Michael, Kuiper, Michael, Parris, Michael, Sharman, Michael, Kratochvil, Milan, Ramali, Mohamed, dos Santos, Moreno Calcagnotto, Bynorth, Natalie, Wilson, Natalie, Anquez, Nathalie, Huneke, Nathan, Dogan, Nazim, Karanovic, Nenad, Tarmey, Nicholas, Carreño, Nicolás, Fisher, Nicola, Lamb, Nicola, Venner, Nicola, Hollister, Nigel, Akgun, Nur, Ekinci, Osman, Boyd, Owen, Pelosi, Paolo, Severgnini, Paolo, Gill, Pardeep, Raimondo, Pasquale, Verrastro, Pasquale, Pulak, Paul, Fitzell, Pauline, Dark, Paulo, Alzugaray, Pedro, Özcan, Perihan Ergin, MacNaughton, Peter, Stourac, Petr, Hopkins, Phil, Tuinman, Pieter Roel, Pearson, Rachel, Walker, Rachel, Santos, Rafaella Souza dos, Caione, Raffaele, Matsa, Ramprasad, Oliver, Rebecca, Jacob, Reni, Howard-Griffin, Richard, Wilde, Robert BP de, Plant, Robert, Hollands, Robin, Biondi, Rodrigo, Smith, Roger, Determann, Rogier M, Jaafar, Rola, Avendaño, Rossana, Pearse, Rupert M, Salt, Ruth, Humphries, Ryan, Pinto, Sérgio Felix, Hemmes, Sabrine N T, Pearson, Sallyane, Hendry, Sam, Jaber, Samir, Lakhani, Sandeep, Beavis, Sarah, Moreton, Sarah, Prudden, Sarah, Thornthwaite, Sarah, Spadaro, Savino, Saylan, Sedat, Chenna, Shailaja, Gopal, Shammer, James, Shanaz, Suresh, Sheeba, Birch, Sian, Skilijic, Sonja, Aguirre, Stefania, Metherell, Stella, Bell, Stephanie, Janes, Stephanie, Wright, Stephen, Rose, Steve, Windebank, Steve, Glenn, Sue, Melbourne, Susan, Tyson, Susan, Leaver, Susannah, Treschan, Tanja A, Patel, Tasmin, Simurina, Tatjana, Sewell, Terri-Ann, Macruz, Tiago, Hatton, Tom, Evans, Tracey, Goktas, Ugur, Poultney, Una, Buyukkocak, Unase, Linnett, Vanessa, Oliveira, Vanessa, Russotto, Vincenzo, Klaric, Vlasta, Schmid, Werner, Orak, Yavuz, Demirtürk, Zerrin, Anstey, James, Melo, Marcos F V, and de Abreu, Marcelo Gama

Published
2016
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18. Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Author

Pisani, Luigi, Algera, Anna Geke, Neto, Ary Serpa, Azevedo, Luciano, Pham, Tài, Paulus, Frederique, de Abreu, Marcelo Gama, Pelosi, Paolo, Dondorp, Arjen M, Bellani, Giacomo, Laffey, John G, Schultz, Marcus J, Martinez, Amadeu, Leal, Livia, Jorge Pereira, Antonio, de Oliveira Maia, Marcelo, Neto, Josè Aires, Piras, Claudio, Caser, Eliana Bernadete, Moreira, Cora Lavigne, Braga Gusman, Pablo, Dalcomune, Dyanne Moysés, Ribeiro de Carvalho, Alexandre Guilherme, Gondim, Louise Aline Romão, Castelo Branco Reis, Lívia Mariane, da Cunha Ribeiro, Daniel, de Assis Simões, Leonardo, Campos, Rafaela Siqueira, Fernandez Versiani dos Anjos, José Carlos, Bruzzi Carvalho, Frederico, Alves, Rossine Ambrosio, Nunes, Lilian Batista, Réa-Neto, Álvaro, de Oliveira, Mirella Cristine, Tannous, Luana, Cardoso Gomes, Brenno, Rodriguez, Fernando Borges, Abelha, Priscila, Lugarinho, Marcelo E, Japiassu, Andre, de Melo, Hélder Konrad, Lopes, Elton Afonso, Varaschin, Pedro, de Souza Dantas, Vicente Cés, Freitas Knibel, Marcos, Ponte, Micheli, de Azambuja Rodrigues, Pedro Mendes, Costa Filho, Rubens Carmo, Saddy, Felipe, Wanderley Castellões, Théia Forny, Silva, Suzana Alves, Osorio, Luiz Antonio Gomes, Mannarino, Dora, Espinoza, Rodolfo, Righy, Cassia, Soares, Marcio, Salluh, Jorge, Tanaka, Lilian, Aragão, Daniel, Tavares, Maria Eduarda, Kehdi, Maura Goncalves Pereira, Rezende, Valéria Maria Campos, Carbonell, Roberto Carlos Cruz, Teixeira, Cassiano, de Oliveira, Roselaine Pinheiro, Maccari, Juçara Gasparetto, Castro, Priscylla Souza, Berto, Paula, Schwarz, Patricia, Torelly, André Peretti, Lisboa, Thiago, Moraes, Edison, Dal-Pizzol, Felipe, Tomasi Damiani, Cristiane, Ritter, Cristiane, Ferreira, Juliana Carvalho, Teixeira Costa, Ramon, Caruso, Pedro, Amendola, Cristina Prata, de Oliveira, Amanda Maria R R, Silva, Ulysses V A, Sanches, Luciana Coelho, Almeida, Rosana D S, Azevedo, Luciano Cesar, Park, Marcelo, Schettino, Guilherme, Assunção, Murillo Santucci, Silva, Eliezer, Barboza, Carlos Eduardo, Junior, Antonio Paulo Nassar, Marzocchi Tierno, Paulo Fernando G M, Malbouisson, Luis Marcelo, Oliveira, Lucas, Cristovao, Davi, Neto, Manoel Leitão, Rego, Ênio, Fernandes, Fernanda Eugênia, Romano, Marcelo Luz Pereira, Cavalcanti, Alexandre Biasi, de Souza Barros, Dalton, Suzumura, Érica Aranha, Meira, Karla Loureiro, de Oliveira, Gustavo Affonso, Luciano, Paula Menezes, Pacheco, Evelin Drociunas, Mazza, Bruno Franco, Machado, Flavia Ribeiro, Ferreira, Elaine, dos Santos, Ronaldo Batista, Colombo, Alexandra Siqueira, Nogueira, Antonio Carlos, Fernandes, Juliana Baroni, Nóbrega, Raquel Siqueira, do CS Martins, Barbara, Soriano, Francisco, Morsch, Rafaela Deczka, Nunes, Andre Luiz Baptiston, de Almeida, Juliano Pinheiro, Hajjar, Ludhmila, Moulin, Sílvia, Giannini, Fábio Poianas, Baptiston Nunes, Andre Luiz, Rios, Fernando, Van Haren, Frank, Sottiaux, T, Lora, Fredy S, Azevedo, Luciano C, Depuydt, P, Fan, Eddy, Bugedo, Guillermo, Qiu, Haibo, Gonzalez, Marcos, Silesky, Juan, Cerny, Vladimir, Nielsen, Jonas, Jibaja, Manuel, Wrigge, Hermann, Matamis, Dimitrios, Ranero, Jorge Luis, Hashemian, S M, Amin, Pravin, Clarkson, Kevin, Kurahashi, Kiyoyasu, Villagomez, Asisclo, Zeggwagh, Amine Ali, Heunks, Leo M, Laake, Jon Henrik, Palo, Jose Emmanuel, do Vale Fernandes, Antero, Sandesc, Dorel, Arabi, Yaasen, Bumbasierevic, Vesna, Lorente, Jose A, Larsson, Anders, Piquilloud, Lise, Abroug, Fekri, McAuley, Daniel F, McNamee, Lia, Hurtado, Javier, Bajwa, Ed, Démpaire, Gabriel, Francois, Guy M, Sula, Hektor, Nunci, Lordian, Cani, Alma, Zazu, Alan, Dellera, Christian, Insaurralde, Carolina S, Alejandro, Risso V, Daldin, Julio, Vinzio, Mauricio, Fernandez, Ruben O, Cardonnet, Luis P, Bettini, Lisandro R, Bisso, Mariano Carboni, Osman, Emilio M, Setten, Mariano G, Lovazzano, Pablo, Alvarez, Javier, Villar, Veronica, Milstein, Cesar, Pozo, Norberto C, Grubissich, Nicolas, Plotnikow, Gustavo A, Vasquez, Daniela N, Ilutovich, Santiago, Tiribelli, Norberto, Chena, Ariel, Pellegrini, Carlos A, Saenz, María G, Estenssoro, Elisa, Brizuela, Matias, Gianinetto, Hernan, Gomez, Pablo E, Cerrato, Valeria I, Bezzi, Marco G, Borello, Silvina A, Loiacono, Flavia A, Fernandez, Adriana M, Knowles, Serena, Reynolds, Claire, Inskip, Deborah M, Miller, Jennene J, Kong, Jing, Whitehead, Christina, Bihari, Shailesh, Seven, Aylin, Krstevski, Amanda, Rodgers, Helen J, Millar, Rebecca T, Mckenna, Toni E, Bailey, Irene M, Hanlon, Gabrielle C, Aneman, Anders, Lynch, Joan M, Azad, Raman, Neal, John, Woods, Paul W, Roberts, Brigit L, Kol, Mark R, Wong, Helen S, Riss, Katharina C, Staudinger, Thomas, Wittebole, Xavier, Berghe, Caroline, Bulpa, Pierre A, Dive, Alain M, Verstraete, Rik, Lebbinck, Herve, Depuydt, Pieter, Vermassen, Joris, Meersseman, Philippe, Ceunen, Helga, Rosa, Jonas I, Beraldo, Daniel O, Ampinelli, Adenilton M R, Nassar Jr, Antonio P, Mataloun, Sergio, Moock, Marcelo, Thompson, Marlus M, Gonçalves, Claudio H, Antônio, Ana Carolina P, Ascoli, Aline, Biondi, Rodrigo S, Fontenele, Danielle C, Nobrega, Danielle, Sales, Vanessa M, Shindhe, Suresh, Ismail, Dk Maizatul Aiman B Pg Hj, Laffey, John, Beloncle, Francois, Davies, Kyle G, Cirone, Rob, Manoharan, Venika, Ismail, Mehvish, Goligher, Ewan C, Jassal, Mandeep, Nishikawa, Erin, Javeed, Areej, Curley, Gerard, Rittayamai, Nuttapol, Parotto, Matteo, Ferguson, Niall D, Mehta, Sangeeta, Knoll, Jenny, Pronovost, Antoine, Canestrini, Sergio, Bruhn, Alejandro R, Garcia, Patricio H, Aliaga, Felipe A, Farías, Pamela A, Yumha, Jacob S, Ortiz, Claudia A, Salas, Javier E, Saez, Alejandro A, Vega, Luis D, Labarca, Eduardo F, Martinez, Felipe T, Carreño, Nicolás G, Lora, Pilar, Liu, Haitao, Liu, Ling, Tang, Rui, Luo, Xiaoming, An, Youzhong, Zhao, Huiying, Gao, Yan, Zhai, Zhe, Ye, Zheng L, Wang, Wei, Li, Wenwen, Li, Qingdong, Zheng, Ruiqiang, Yu, Wenkui, Shen, Juanhong, Li, Xinyu, Yu, Tao, Lu, Weihua, Wu, Ya Q, Huang, Xiao B, He, Zhenyang, Lu, Yuanhua, Han, Hui, Zhang, Fan, Sun, Renhua, Wang, Hua X, Qin, Shu H, Zhu, Bao H, Zhao, Jun, Liu, Jian, Li, Bin, Liu, Jing L, Zhou, Fa C, Li, Qiong J, Zhang, Xing Y, Li-Xin, Zhou, Xin-Hua, Qiang, Jiang, Liangyan, Gao, Yuan N, Zhao, Xian Y, Li, Yuan Y, Li, Xiao L, Wang, Chunting, Yao, Qingchun, Yu, Rongguo, Chen, Kai, Shao, Huanzhang, Qin, Bingyu, Huang, Qing Q, Zhu, Wei H, Hang, Ai Y, Hua, Ma X, Li, Yimin, Xu, Yonghao, Di, Yu D, Ling, Long L, Qin, Tie H, Wang, Shou H, Qin, Junping, Han, Yi, Zhou, Suming, Vargas, Monica P, Silesky Jimenez, Juan I, González Rojas, Manuel A, Solis-Quesada, Jaime E, Ramirez-Alfaro, Christian M, Máca, Jan, Sklienka, Peter, Gjedsted, Jakob, Christiansen, Aage, Villamagua, Boris G, Llano, Miguel, Burtin, Philippe, Buzancais, Gautier, Beuret, Pascal, Pelletier, Nicolas, Mortaza, Satar, Mercat, Alain, Chelly, Jonathan, Jochmans, Sébastien, Terzi, Nicolas, Daubin, Cédric, Carteaux, Guillaume, de Prost, Nicolas, Chiche, Jean-Daniel, Daviaud, Fabrice, Pham, Tai, Fartoukh, Muriel, Barberet, Guillaume, Biehler, Jerome, Dellamonica, Jean, Doyen, Denis, Arnal, Jean-Michel, Briquet, Anais, Hraiech, Sami, Papazian, Laurent, Follin, Arnaud, Roux, Damien, Messika, Jonathan, Kalaitzis, Evangelos, Dangers, Laurence, Combes, Alain, Au, Siu-Ming, Béduneau, Gaetan, Carpentier, Dorothée, Zogheib, Elie H, Dupont, Herve, Ricome, Sylvie, Santoli, Francesco L, Besset, Sebastien L, Michel, Philippe, Gelée, Bruno, Danin, Pierre-Eric, Goubaux, Bernard, Crova, Philippe J, Phan, Nga T, Berkelmans, Frantz, Badie, Julio C, Tapponnier, Romain, Gally, Josette, Khebbeb, Samy, Herbrecht, Jean-Etienne, Schneider, Francis, Declercq, Pierre-Louis M, Rigaud, Jean-Philippe, Duranteau, Jacques, Harrois, Anatole, Chabanne, Russell, Marin, Julien, Bigot, Charlene, Thibault, Sandrine, Ghazi, Mohammed, Boukhazna, Messabi, Ould Zein, Salem, Richecoeur, Jack R, Combaux, Daniele M, Grelon, Fabien, Le Moal, Charlene, Sauvadet, Elise P, Robine, Adrien, Lemiale, Virginie, Reuter, Danielle, Dres, Martin, Demoule, Alexandre, Goldgran-Toledano, Dany, Baboi, Loredana, Guérin, Claude, Lohner, Ralph, Kraßler, Jens, Schäfer, Susanne, Zacharowski, Kai D, Meybohm, Patrick, Reske, Andreas W, Simon, Philipp, Hopf, Hans-Bernd F, Schuetz, Michael, Baltus, Thomas, Papanikolaou, Metaxia N, Papavasilopoulou, Theonymfi G, Zacharas, Giannis A, Ourailogloy, Vasilis, Mouloudi, Eleni K, Massa, Eleni V, Nagy, Eva O, Stamou, Electra E, Kiourtzieva, Ellada V, Oikonomou, Marina A, Avila, Luis E, Cortez, Cesar A, Citalán, Johanna E, Jog, Sameer A, Sable, Safal D, Shah, Bhagyesh, Gurjar, Mohan, Baronia, Arvind K, Memon, Mohammedfaruk, Muthuchellappan, Radhakrishnan, Ramesh, Venkatapura J, Shenoy, Anitha, Unnikrishnan, Ramesh, Dixit, Subhal B, Rhayakar, Rachana V, Ramakrishnan, Nagarajan, Bhardwaj, Vallish K, Mahto, Heera L, Sagar, Sudha V, Palaniswamy, Vijayanand, Ganesan, Deeban, Mohammadreza Hashemian, Seyed, Jamaati, Hamidreza, Heidari, Farshad, Meaney, Edel A, Nichol, Alistair, Knapman, Karl M, O'Croinin, Donall, Dunne, Eimhin S, Breen, Dorothy M, Clarkson, Kevin P, Jaafar, Rola F, Dwyer, Rory, Amir, Fahd, Ajetunmobi, Olaitan O, O'Muircheartaigh, Aogan C, Black, Colin S, Treanor, Nuala, Collins, Daniel V, Altaf, Wahid, Zani, Gianluca, Fusari, Maurizio, Spadaro, Savino, Volta, Carlo A, Graziani, Romano, Brunettini, Barbara, Palmese, Salvatore, Formenti, Paolo, Umbrello, Michele, Lombardo, Andrea, Pecci, Elisabetta, Botteri, Marco, Savioli, Monica, Protti, Alessandro, Mattei, Alessia, Schiavoni, Lorenzo, Tinnirello, Andrea, Todeschini, Manuel, Giarratano, Antonino, Cortegiani, Andrea, Sher, Sara, Rossi, Anna, Antonelli, Massimo M, Montini, Luca M, Casalena, Paolo, Scafetti, Sergio, Panarello, Giovanna, Occhipinti, Giovanna, Patroniti, Nicolò, Pozzi, Matteo, Biscione, Roberto R, Poli, Michela M, Raimondi, Ferdinando, Albiero, Daniela, Crapelli, Giulia, Beck, Eduardo, Pota, Vincenzo, Schiavone, Vincenzo, Molin, Alexandre, Tarantino, Fabio, Monti, Giacomo, Frati, Elena, Mirabella, Lucia, Cinnella, Gilda, Fossali, Tommaso, Colombo, Riccardo, Terragni, Pierpaolo, Pattarino, Ilaria, Mojoli, Francesco, Braschi, Antonio, Borotto, Erika E, Cracchiolo, Andrea N, Palma, Daniela M, Raponi, Francesco, Foti, Giuseppe, Vascotto, Ettore R, Coppadoro, Andrea, Brazzi, Luca, Floris, Leda, Iotti, Giorgio A, Venti, Aaron, Yamaguchi, Osamu, Takagi, Shunsuke, Maeyama, Hiroki N, Watanabe, Eizo, Yamaji, Yoshihiro, Shimizu, Kazuyoshi, Shiozaki, Kyoko, Futami, Satoru, Ryosuke, Sekine, Saito, Koji, Kameyama, Yoshinobu, Ueno, Keiko, Izawa, Masayo, Okuda, Nao, Suzuki, Hiroyuki, Harasawa, Tomofumi, Nasu, Michitaka, Takada, Tadaaki, Ito, Fumihito, Nunomiya, Shin, Koyama, Kansuke, Abe, Toshikazu, Andoh, Kohkichi, Kusumoto, Kohei, Hirata, Akira, Takaba, Akihiro, Kimura, Hiroyasu, Matsumoto, Shuhei, Higashijima, Ushio, Honda, Hiroyuki, Aoki, Nobumasa, Imai, Hiroshi, Ogino, Yasuaki, Mizuguchi, Ichiko, Ichikado, Kazuya, Nitta, Kenichi, Mochizuki, Katsunori, Hashida, Tomoaki, Tanaka, Hiroyuki, Nakamura, Tomoyuki, Niimi, Daisuke, Ueda, Takeshi, Kashiwa, Yozo, Uchiyama, Akinori, Sabelnikovs, Olegs, Oss, Peteris, Haddad, Youssef, Liew, Kong Y, Ñamendys-Silva, Silvio A, Jarquin-Badiola, Yves D, Sanchez-Hurtado, Luis A, Gomez-Flores, Saira S, Marin, Maria C, Villagomez, Asisclo J, Lemus, Jordana S, Fierro, Jonathan M, Cervantes, Mavy Ramirez, Mejia, Francisco Javier Flores, Gonzalez, Daniel R, Dector, Dulce M, Estrella, Claudia R, Sanchez-Medina, Jorge R, Ramirez-Gutierrez, Alvaro, George, Fernando G, Aguirre, Janet S, Buensuseso, Juan A, Poblano, Manuel, Dendane, Tarek, Balkhi, Hicham, Elkhayari, Mina, Samkaoui, Nacer, Ezzouine, Hanane, Benslama, Abdellatif, Amor, Mourad, Maazouzi, Wajdi, Cimic, Nedim, Beck, Oliver, Bruns, Monique M, Schouten, Jeroen A, Rinia, Myra, Raaijmakers, Monique, Van Wezel, Hellen M, Heines, Serge J, Buise, Marc P, Simonis, Fabienne D, Goodson, Jennifer C, rowne, Troy S B, Navarra, Leanlove, Hunt, Anna, Hutchison, Robyn A, Bailey, Mathew B, Newby, Lynette, Mcarthur, Colin, Kalkoff, Michael, Mcleod, Alex, 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Tharwat M, Al Jabbary, Ahmed S, Tabhan, Edgardo, Arabi, Yaseen M, Trinidad, Olivia A, Al Dorzi, Hasan M, Tabhan, Edgardo E, Bolon, Stefan, Smith, Oliver, Mancebo, Jordi, Aguirre-Bermeo, Hernan, Lopez-Delgado, Juan C, Esteve, Francisco, Rialp, Gemma, Forteza, Catalina, De Haro, Candelaria, Artigas, Antonio, Albaiceta, Guillermo M, De Cima-Iglesias, Sara, Seoane-Quiroga, Leticia, Ceniceros-Barros, Alexandra, Ruiz-Aguilar, Antonio L, Claraco-Vega, Luis M, Soler, Juan Alfonso, Lorente, Maria del Carmen, Hermosa, Cecilia, Gordo, Federico, Prieto-González, Miryam, López-Messa, Juan B, Perez, Manuel P, Pere, Cesar P, Allue, Raquel Montoiro, Roche-Campo, Ferran, Ibañez-Santacruz, Marcos, Temprano, Susana, Pintado, Maria C, De Pablo, Raul, Gómez, Pilar Ricart Aroa, Ruiz, Silvia Rodriguez, Moles, Silvia Iglesias, Jurado, Mª Teresa, Arizmendi, Alfons, Piacentini, Enrique A, Franco, Nieves, Honrubia, Teresa, Perez Cheng, Meisy, Perez Losada, Elena, Blanco, Javier, Yuste, Luis J, Carbayo-Gorriz, 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Joanna, Persson, Linnea, Schiöler, Fredrik, Kedelv, Hans, Tibblin, Anna Oscarsson, Appelberg, Henrik, Hedlund, Lars, Helleberg, Johan, Eriksson, Karin E, Glietsch, Rita, Larsson, Niklas, Nygren, Ingela, Nunes, Silvia L, Morin, Anna-Karin, Kander, Thomas, Adolfsson, Anne, Zender, Hervé O, Leemann-Refondini, Corinne, Elatrous, Souheil, Bouchoucha, Slaheddine, Chouchene, Imed, Ouanes, Islem, Ben Souissi, Asma, Kamoun, Salma, Demirkiran, Oktay, Aker, Mustafa, Erbabacan, Emre, Ceylan, Ilkay, Girgin, Nermin Kelebek, Ozcelik, Menekse, Ünal, Necmettin, Meco, Basak Ceyda, Akyol, Onat O, Derman, Suleyman S, Kennedy, Barry, Parhar, Ken, Srinivasa, Latha, McAuley, Danny, Steinberg, Jack, Hopkins, Phil, Mellis, Clare, Stansil, Frank, Kakar, Vivek, Hadfield, Dan, Brown, Christine, Vercueil, Andre, Bhowmick, Kaushik, Humphreys, Sally K, Ferguson, Andrew, Mckee, Raymond, Raj, Ashok S, Fawkes, Danielle A, Watt, Philip, Twohey, Linda, Thomas, Rajeev R Jha Matthew, Morton, Alex, Kadaba, Varsha, Smith, 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Ryan, Christine, Mellinghoff, Johannes Mellinghoff, Prudden, Sarah Prudden, Green, Helen Green, Roy, Alistair Roy, Furneval, Julie Furneval, Bell, Adam Bell, Lakhani, Sandeep Lakhani, Fasting, Lousie Fasting, Murray, Lorna Murray, Preller, Kobu, McInerney, Amy, Beavis, Sarah, Whileman, Amanda, Toms, Julie, Glenn, Sue, Ramali, Mohamed, Ghosh, Alison, Bullock, Clare, Barrell, Lisa, Young, Eoin, Robertson, Helen, Faulkner, Maria, MacNaughton, Peter, Tyson, Susan, Pulak, Paul, Sewell, Terri-Ann, Smalley, Christopher, Jacob, Reni, Alzugaray, Pedro, Vidal Melo, Marcos F, Joyce, Kristen, Needleman, Joseph, Ahsan, Areef, Faiz, Abul, Alam, AKM Shamsul, Khatoon, Syeda Nafisa, Nath, Ranjan Kumer, Rahman Chowdhury, Mohammed Abdur, Banik, Debabrata, Mondol, Montosh Kumar, Bhuiyan, Sakibur Rahman, Nazneed, Suraiya, Sultana, Rozina, Hamid, Tarikul, Hossain, Mozaffer, Reza, Syed Tariq, Asaduzzaman, Muhammad, Salim, Mohammad, Mostafa Kamal, Abu Hena, Taher, Sheikh Mohammed, Taohid, Taohidul Majid, Karmaker, Pranab, Roy, Sabyasachi, Das, Shantanu, Sarkar, Sohel Ahmed, Dutta, Monju Lal, Roy, Poulomi, Iyer, Shivakumar, Krishna, Bhuvana, Sampath, Sriram, Pattnaik, Rajyabardhan, Kasi, Chinni Krishna, Shah, Jignesh, Dongre, Anand, Reza Hashemian, Seyed Mohammad, Nooraei, Navid, Raessi Estabragh, Reza, Malekmohammad, Majid, Khoundabi, Batoul, Mobasher, Maziar, Mohd Yunos, Nor'azim, Kassim, Mahazir, Voon, Chern Min, Das, Stanis Sutharsa, Azauddin, Siti Nur Suhaila, Dorasamy, Dharshinie, Tai, Li Ling, Mat Nor, Mohd Basri, Zarudin, Nurhafizah, Hasan, Mohd Shahnaz, Jamaluddin, Mohamad Fadhil Hadi, Othman Jailani, Mohamad Irfan, Kayashta, Gyan, Adhikari, Aaradhana, Pangeni, Raju, Hashmi, Madiha, Joseph, Sonia, Akhtar, Aftab, Qadeer, Aayesha, Memon, Iqbal, Ali, Syed Muneeb, Idrees, Farah, Kamal, Saima, Hanif, Sadaf, Rehman, Atta Ur, Taqi, Arshad, Hussain, Tanveer, Farooq, Ahmed, Khaskheli, Saleh, Hayat, Muhammad, Indraratna, Kanishka, Beane, Abigail, Haniffa, Rashan, Samaranayake, Upeka, Mathanalagan, Sathiyamoorthy, Gunaratne, Asoka, Mithraratne, Nimangee, Thilakasiri, Kaushila, Pilimatalawwe, Chamila, Dilhani, Y A Hasitha, Fernando, Marie, Ranatunge, Kumudini, Samarasinghe, Loranthi, Vaas, Manori, Edirisooriya, Manoj, Sigera, Chathurani, Arumoli, Janaki, De Silva, Kesharie, Kudavidanage, Bimal, Pinto, Visanthi, Dissanayake, Lakshman, Chittawatanarat, Kaweesak, Kongpolprom, Napplika, Silachamroon, Udomsak, Pornsuriyasak, Prapaporn, Petnak, Tananchai, Singhatas, Pongsasit, Tangsujaritvijit, Viratch, Rungruanghiranya, Suthat, Piriyapatsom, Annop, Juntaping, Kanokkarn, Trongtrakul, Konlawij, Thungtitigul, Poungrat, Tajarernmuang, Pattraporn, Chatmongkolchart, Sunisa, Bhurayanontachai, Rungsun, Akaraborworn, Osaree, Navasakulpong, Asma, Surasit, Karjbundid, Thwaites, Louise, Nadjm, Behzad, Vu Quoc, Dat, Nguyen Thi Thanh, Ha, Nguyen Van, Kinh, Duong Bich, Thuy, Lam Minh, Yen, Anesthesiology, Intensive care medicine, ACS - Pulmonary hypertension & thrombosis, ACS - Diabetes & metabolism, Graduate School, Intensive Care Medicine, AII - Inflammatory diseases, Nursing, and ACS - Microcirculation

Subjects
Male, Sociodemographic Factors, Respiration, Artificial/methods, ARDS, mechanical ventilation, Severity of Illness Index, NO, Settore MED/41 - ANESTESIOLOGIA, 80 and over, Tidal Volume, Humans, Hospital Mortality, Prospective Studies, ddc:610, Developing Countries, Aged, Hospital Mortality/trends, Aged, 80 and over, Developed Countries/statistics & numerical data, Developing Countries/statistics & numerical data, Respiration, Developed Countries, Articles, General Medicine, acute respiratory distress syndrome, Length of Stay, Middle Aged, Respiration, Artificial, Intensive Care Units, Observational Studies as Topic, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Length of Stay/statistics & numerical data, Artificial, Intensive Care Units/statistics & numerical data, Income, Female
Abstract

Contains fulltext : 252214.pdf (Publisher’s version ) (Open Access) BACKGROUND: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. METHODS: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. FINDINGS: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H(2)O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p

Published
2022
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20. Efficacy and safety of intravenous imatinib in COVID-19 ARDS: a randomized, double-blind, placebo-controlled clinical trial.

Author

Atmowihardjo, Leila N., Schippers, Job R., Duijvelaar, Erik, Bartelink, Imke H., Bet, Pierre M., Swart, Noortje E. L., van Rein, Nienke, Purdy, Keith, Cavalla, David, McElroy, Andrew, Fritchley, Sarah, Vonk Noordegraaf, Anton, Endeman, Henrik, van Velzen, Patricia, Koopmans, Matty, Bogaard, Harm Jan, Heunks, Leo, Juffermans, Nicole, Schultz, Marcus J., and Tuinman, Pieter R.

Abstract

Purpose: A hallmark of acute respiratory distress syndrome (ARDS) is hypoxaemic respiratory failure due to pulmonary vascular hyperpermeability. The tyrosine kinase inhibitor imatinib reversed pulmonary capillary leak in preclinical studies and improved clinical outcomes in hospitalized COVID-19 patients. We investigated the effect of intravenous (IV) imatinib on pulmonary edema in COVID-19 ARDS. Methods: This was a multicenter, randomized, double-blind, placebo-controlled trial. Invasively ventilated patients with moderate-to-severe COVID-19 ARDS were randomized to 200 mg IV imatinib or placebo twice daily for a maximum of seven days. The primary outcome was the change in extravascular lung water index (∆EVLWi) between days 1 and 4. Secondary outcomes included safety, duration of invasive ventilation, ventilator-free days (VFD) and 28-day mortality. Posthoc analyses were performed in previously identified biological subphenotypes. Results: 66 patients were randomized to imatinib (n = 33) or placebo (n = 33). There was no difference in ∆EVLWi between the groups (0.19 ml/kg, 95% CI − 3.16 to 2.77, p = 0.89). Imatinib treatment did not affect duration of invasive ventilation (p = 0.29), VFD (p = 0.29) or 28-day mortality (p = 0.79). IV imatinib was well-tolerated and appeared safe. In a subgroup of patients characterized by high IL-6, TNFR1 and SP-D levels (n = 20), imatinib significantly decreased EVLWi per treatment day (− 1.17 ml/kg, 95% CI − 1.87 to − 0.44). Conclusions: IV imatinib did not reduce pulmonary edema or improve clinical outcomes in invasively ventilated COVID-19 patients. While this trial does not support the use of imatinib in the general COVID-19 ARDS population, imatinib reduced pulmonary edema in a subgroup of patients, underscoring the potential value of predictive enrichment in ARDS trials. Trial registrationNCT04794088, registered 11 March 2021. European Clinical Trials Database (EudraCT number: 2020-005447-23). [ABSTRACT FROM AUTHOR]

Published
2023
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22. Microcirculatory blood flow as a tool to select ICU patients eligible for fluid therapy

Author

Pranskunas, Andrius, Koopmans, Matty, Koetsier, Peter M., Pilvinis, Vidas, and Boerma, E. Christiaan

Subjects
Care and treatment, Blood flow, Hydroxyethyl starch
Abstract

Author(s): Andrius Pranskunas [sup.1], Matty Koopmans [sup.2], Peter M. Koetsier [sup.2], Vidas Pilvinis [sup.1], E. Christiaan Boerma [sup.2] [sup.3] Author Affiliations: (1) grid.45083.3a, 0000000404326841, Department of Intensive Care Medicine, Hospital [...], Purpose The aim of this study is to assess the incidence of sublingual microcirculatory flow alterations, according to a predefined arbitrary cutoff value, in patients with 'clinical signs of impaired organ perfusion'. Secondary endpoints were the changes in microvascular flow index (MFI), 'clinical signs of impaired organ perfusion', and stroke volume (SV) after fluid administration, and the differences between groups. Methods Prospective, single-center, observational study in a 22-bed mixed intensive care unit (ICU). Patients [greater than or equal to]18 years with invasive hemodynamic monitoring and 'clinical signs of impaired organ perfusion' as the principal reason for fluid administration were included. Before and after fluid challenge, systemic hemodynamics and direct in vivo observation of the sublingual microcirculation with sidestream dark-field imaging were obtained. Microvascular flow index (MFI) Results N = 50. At baseline, MFI Conclusions These data add to the understanding that noninvasive assessment of microvascular blood flow may help to identify patients eligible for fluid therapy, and to evaluate its effect.

Published
2013
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23. Severe abnormalities in microvascular perfused vessel density are associated to organ dysfunctions and mortality and can be predicted by hyperlactatemia and norepinephrine requirements in septic shock patients

Author

Hernandez, Glenn, Boerma, Christiaan E., Dubin, Arnaldo, Bruhn, Alejandro, Koopmans, Matty, Edul, Vanina Kanoore, Ruiz, Carolina, Castro, Ricardo, Pozo, Mario Omar, Pedreros, Cesar, Veas, Enrique, Fuentealba, Andrea, Kattan, Eduardo, Rovegno, Maximiliano, and Ince, Can

Published
2013
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25. Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest

Author

Nielsen, Niklas, Wetterslev, Jørn, Cronberg, Tobias, Erlinge, David, Gasche, Yvan, Hassager, Christian, Horn, Janneke, Hovdenes, Jan, Kjaergaard, Jesper, Kuiper, Michael, Pellis, Tommaso, Stammet, Pascal, Wanscher, Michael, Wise, Matt P., Åneman, Anders, Al-Subaie, Nawaf, Boesgaard, Søren, Bro-Jeppesen, John, Brunetti, Iole, Bugge, Jan Frederik, Hingston, Christopher D., Juffermans, Nicole P., Koopmans, Matty, Køber, Lars, Langørgen, Jørund, Lilja, Gisela, Møller, Jacob Eifer, Rundgren, Malin, Rylander, Christian, Smid, Ondrej, Werer, Christophe, Winkel, Per, and Friberg, Hans

Published
2013
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26. The Impact of Nursing Delirium Preventive Interventions in the ICU: A Multicenter Cluster-randomized Controlled Clinical Trial.

Author

Rood, Paul J. T., Zegers, Marieke, Ramnarain, Dharmanand, Koopmans, Matty, Klarenbeek, Toine, Ewalds, Esther, van der Steen, Marijke S., Oldenbeuving, Annemarie W., Kuiper, Michael A., Teerenstra, Steven, Adang, Eddy, van Loon, Lex M., Wassenaar, Annelies, Vermeulen, Hester, Pickkers, Peter, van den Boogaard, Mark, UNDERPIN-ICU Study Investigators, and Rood, Paul Jt

Subjects
CRITICAL care medicine, DELIRIUM, NURSING, CRITICALLY ill, INTENSIVE care units, RESEARCH, INTENSIVE care nursing, RESEARCH methodology, MEDICAL cooperation, EVALUATION research, TREATMENT effectiveness, COMPARATIVE studies, RANDOMIZED controlled trials, COMA, COMBINED modality therapy, STATISTICAL sampling, LONGITUDINAL method
Abstract

Rationale: Delirium is common in critically ill patients and is associated with deleterious outcomes. Nonpharmacological interventions are recommended in current delirium guidelines, but their effects have not been unequivocally established. Objectives: To determine the effects of a multicomponent nursing intervention program on delirium in the ICU. Methods: A stepped-wedge cluster-randomized controlled trial was conducted in ICUs of 10 centers. Adult critically ill surgical, medical, or trauma patients at high risk of developing delirium were included. A multicomponent nursing intervention program focusing on modifiable risk factors was implemented as standard of care. The primary outcome was the number of delirium-free and coma-free days alive in 28 days after ICU admission. Measurements and Main Results: A total of 1,749 patients were included. Time spent on interventions per 8-hour shift was median (interquartile range) 38 (14-116) minutes in the intervention period and median 32 (13-73) minutes in the control period (P = 0.44). Patients in the intervention period had a median of 23 (4-27) delirium-free and coma-free days alive compared with a median of 23 (5-27) days for patients in the control group (mean difference, -1.21 days; 95% confidence interval, -2.84 to 0.42 d; P = 0.15). In addition, the number of delirium days was similar: median 2 (1-4) days (ratio of medians, 0.90; 95% confidence interval, 0.75 to 1.09; P = 0.27). Conclusions: In this large randomized controlled trial in adult ICU patients, a limited increase in the use of nursing interventions was achieved, and no change in the number of delirium-free and coma-free days alive in 28 days could be determined. Clinical trial registered with www.clinicaltrials.gov (NCT03002701). [ABSTRACT FROM AUTHOR]

Published
2021
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27. Microcirculatory changes during open label magnesium sulphate infusion in patients with severe sepsis and septic shock

Author

Koopmans Matty, Pilvinis Vidas, Vellinga Namkje AR, Pranskunas Andrius, and Boerma E Christiaan

Subjects
Anesthesiology, RD78.3-87.3
Abstract

Abstract Background Microcirculatory alterations play a pivotal role in sepsis and persist despite correction of systemic hemodynamic parameters. Therefore it seems tempting to test specific pro-microcirculatory strategies, including vasodilators, to attenuate impaired organ perfusion. As opposed to nitric oxide donors, magnesium has both endothelium-dependent and non-endothelium-dependent vasodilatory pathways. Methods In a single-center open label study we evaluated the effects of magnesium sulphate (MgS) infusion on the sublingual microcirculation perfusion in fluid resuscitated patients with severe sepsis and septic shock within the first 48 hours after ICU admission. Directly prior to and after 1 hour of magnesium sulphate (MgS) infusion (2 gram) systemic hemodynamic variables, sublingual SDF images and standard laboratory tests, were obtained. Results Fourteen patients (12 septic shock, 2 severe sepsis) with a median APACHE II score of 20 were enrolled. No significant difference of the systemic hemodynamic variables was found between baseline and after MgS infusion. We did not observe any significant difference pre and post MgS infusion in the primary endpoint microvascular flow index (MFI) of small vessels: 2.25(1.98-2.69) vs. 2.33(1.96-2.62), p = 0.65. Other variables of microcirculatory perfusion were also unaltered. In the overall unchanged microvascular perfusion there was a non-significant trend to an inverse linear relationship between the changes of MFI and its baseline value (y = -0.7260 × + 1.629, r2 = 0.270, p = 0.057). The correlation between baseline Mg concentrations and the change in MFI pre- and post MgS infusion was non-significant (rs = -0.165, p = 0.67). Conclusions In the setting of severe sepsis and septic shock sublingual microcirculatory alterations were observed despite fulfillment of sepsis resuscitation guidelines. After infusion of a limited and fixed dose of MgS, microcirculatory perfusion did not improve over time. Trial registration ClinicalTrials.gov NTC01332734.

Published
2011
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28. Improvement of Sidestream Dark Field Imaging with an Image Acquisition Stabilizer

Author

Sjauw Krishan D, Yong Ze-Yie, Boerma E Christiaan, Bezemer Rick, Balestra Gianmarco M, Engstrom Annemarie E, Koopmans Matty, and Ince Can

Subjects
Medical technology, R855-855.5
Abstract

Abstract Background In the present study we developed, evaluated in volunteers, and clinically validated an image acquisition stabilizer (IAS) for Sidestream Dark Field (SDF) imaging. Methods The IAS is a stainless steel sterilizable ring which fits around the SDF probe tip. The IAS creates adhesion to the imaged tissue by application of negative pressure. The effects of the IAS on the sublingual microcirculatory flow velocities, the force required to induce pressure artifacts (PA), the time to acquire a stable image, and the duration of stable imaging were assessed in healthy volunteers. To demonstrate the clinical applicability of the SDF setup in combination with the IAS, simultaneous bilateral sublingual imaging of the microcirculation were performed during a lung recruitment maneuver (LRM) in mechanically ventilated critically ill patients. One SDF device was operated handheld; the second was fitted with the IAS and held in position by a mechanic arm. Lateral drift, number of losses of image stability and duration of stable imaging of the two methods were compared. Results Five healthy volunteers were studied. The IAS did not affect microcirculatory flow velocities. A significantly greater force had to applied onto the tissue to induced PA with compared to without IAS (0.25 ± 0.15 N without vs. 0.62 ± 0.05 N with the IAS, p < 0.001). The IAS ensured an increased duration of a stable image sequence (8 ± 2 s without vs. 42 ± 8 s with the IAS, p < 0.001). The time required to obtain a stable image sequence was similar with and without the IAS. In eight mechanically ventilated patients undergoing a LRM the use of the IAS resulted in a significantly reduced image drifting and enabled the acquisition of significantly longer stable image sequences (24 ± 5 s without vs. 67 ± 14 s with the IAS, p = 0.006). Conclusions The present study has validated the use of an IAS for improvement of SDF imaging by demonstrating that the IAS did not affect microcirculatory perfusion in the microscopic field of view. The IAS improved both axial and lateral SDF image stability and thereby increased the critical force required to induce pressure artifacts. The IAS ensured a significantly increased duration of maintaining a stable image sequence.

Published
2010
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29. Patient-reported physical functioning is limited in almost half of critical illness survivors 1-year after ICU-admission: A retrospective single-centre study.

Author

Beumeler, Lise F. E., van Wieren, Anja, Buter, Hanneke, van Zutphen, Tim, Bruins, Nynke A., de Jager, Corine M., Koopmans, Matty, Navis, Gerjan J., and Boerma, E. Christiaan

Subjects
PHYSICAL mobility, CRITICALLY ill, PROGNOSIS, MEDICAL records, COMORBIDITY, QUALITY of life
Abstract

Post-intensive care unit (ICU) sequelae, including physical and mental health problems, are relatively unexplored. Characteristics commonly used to predict outcome lack prognostic value when it comes to long-term physical recovery. Therefore, the objective of this study was to assess the incidence of non-recovery in long-stay ICU-patients. In this single-centre study, retrospective data of adults with an ICU stay >48 hours who visited the specialized post-ICU clinic, and completed the Dutch RAND 36-item Short Form questionnaire at 3 and 12 months post-ICU, were retrieved from electronic patient records. In cases where physical functioning scores at 12 months were below reference values, patients were allocated to the physical non-recovery (NR) group. Significantly different baseline and (post-)ICU-characteristics were assessed for correlations with physical recovery at 12 months post-ICU. Of 250 patients, 110 (44%) fulfilled the criteria for the NR-group. Neither the severity of illness, type of admission, nor presence of sepsis did not differ between groups. However, NR-patients had a higher age, were more often female, and had a higher incidence of co-morbidities. Shorter LOS ICU, lower incidence of medical comorbidities, and better physical performance at 3 months were significantly correlated with 1-year physical recovery. Comorbidities and reduced physical functioning at 3 months were identified as independent risk-factors for long-term physical non-recovery. In conclusion, a substantial proportion of long-stay ICU-patients who visited the standard care post-ICU clinic did not fulfil the criteria for full physical recovery at 12 months post-ICU. Commonly used ICU-characteristics, such as severity of illness, do not have sufficient prognostic value when it comes to long-term recovery of health-related quality of life. [ABSTRACT FROM AUTHOR]

Published
2020
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30. Targeted Temperature Management at 33 degrees C versus 36 degrees C after Cardiac Arrest

Author

Nielsen, Niklas, Wettersley, Jorn, Cronberg, Tobias, Erlinge, David, Gasche, Yvan, Hassager, Christian, Horn, Janneke, Hovdenes, Jan, Kjaergaard, Jesper, Kuiper, Michael, Pellis, Tommaso, Stammet, Pascal, Wanscher, Michael, Wise, Matt P., Aneman, Anders, Al-Subaie, Nawaf, Boesgaard, Soren, Bro-Jeppesen, John, Brunetti, Iole, Bugge, Jan Frederik, Hingston, Christopher D., Juffermans, Nicole P., Koopmans, Matty, Kober, Lars, Langorgen, Jorund, Lilja, Gisela, Moller, Jacob Eifer, Rundgren, Malin, Rylander, Christian, Smid, Ondrej, Werer, Christophe, Winkel, Per, Friberg, Hans, TTM-trial investigators, and HASH(0x55a75250fff0)

Subjects
Anesthesiology and Intensive Care, Neurology, Cardiac and Cardiovascular Systems
Abstract

BackgroundUnconscious survivors of out-of-hospital cardiac arrest have a high risk of death or poor neurologic function. Therapeutic hypothermia is recommended by international guidelines, but the supporting evidence is limited, and the target temperature associated with the best outcome is unknown. Our objective was to compare two target temperatures, both intended to prevent fever. MethodsIn an international trial, we randomly assigned 950 unconscious adults after out-of-hospital cardiac arrest of presumed cardiac cause to targeted temperature management at either 33 degrees C or 36 degrees C. The primary outcome was all-cause mortality through the end of the trial. Secondary outcomes included a composite of poor neurologic function or death at 180 days, as evaluated with the Cerebral Performance Category (CPC) scale and the modified Rankin scale. ResultsIn total, 939 patients were included in the primary analysis. At the end of the trial, 50% of the patients in the 33 degrees C group (235 of 473 patients) had died, as compared with 48% of the patients in the 36 degrees C group (225 of 466 patients) (hazard ratio with a temperature of 33 degrees C, 1.06; 95% confidence interval [CI], 0.89 to 1.28; P=0.51). At the 180-day follow-up, 54% of the patients in the 33 degrees C group had died or had poor neurologic function according to the CPC, as compared with 52% of patients in the 36 degrees C group (risk ratio, 1.02; 95% CI, 0.88 to 1.16; P=0.78). In the analysis using the modified Rankin scale, the comparable rate was 52% in both groups (risk ratio, 1.01; 95% CI, 0.89 to 1.14; P=0.87). The results of analyses adjusted for known prognostic factors were similar. ConclusionsIn unconscious survivors of out-of-hospital cardiac arrest of presumed cardiac cause, hypothermia at a targeted temperature of 33 degrees C did not confer a benefit as compared with a targeted temperature of 36 degrees C. (Funded by the Swedish Heart-Lung Foundation and others; TTM ClinicalTrials.gov number, NCT01020916.)

Published
2013

31. Mildly elevated lactate levels are associated with microcirculatory flow abnormalities and increased mortality: a microSOAP post hoc analysis.

Author

Vellinga, Namkje A. R., Boerma, E. Christiaan, Koopmans, Matty, Donati, Abele, Dubin, Arnaldo, Shapiro, Nathan I., Pearse, Rupert M., van der Voort, Peter H. J., Dondorp, Arjen M., Bafi, Tony, Fries, Michael, Akarsu-Ayazoglu, Tulin, Pranskunas, Andrius, Hollenberg, Steven, Balestra, Gianmarco, Iterson, Mat van, Sadaka, Farid, Minto, Gary, Aypar, Ulku, and Hurtado, F. Javier

Abstract

Background: Mildly elevated lactate levels (i.e., 1-2 mmol/L) are increasingly recognized as a prognostic finding in critically ill patients. One of several possible underlying mechanisms, microcirculatory dysfunction, can be assessed at the bedside using sublingual direct in vivo microscopy. We aimed to evaluate the association between relative hyperlactatemia, microcirculatory flow, and outcome.Methods: This study was a predefined subanalysis of a multicenter international point prevalence study on microcirculatory flow abnormalities, the Microcirculatory Shock Occurrence in Acutely ill Patients (microSOAP). Microcirculatory flow abnormalities were assessed with sidestream dark-field imaging. Abnormal microcirculatory flow was defined as a microvascular flow index (MFI) < 2.6. MFI is a semiquantitative score ranging from 0 (no flow) to 3 (continuous flow). Associations between microcirculatory flow abnormalities, single-spot lactate measurements, and outcome were analyzed.Results: In 338 of 501 patients, lactate levels were available. For this substudy, all 257 patients with lactate levels ≤ 2 mmol/L (median [IQR] 1.04 [0.80-1.40] mmol/L) were included. Crude ICU mortality increased with each lactate quartile. In a multivariable analysis, a lactate level > 1.5 mmol/L was independently associated with a MFI < 2.6 (OR 2.5, 95% CI 1.1-5.7, P = 0.027).Conclusions: In a heterogeneous ICU population, a single-spot mildly elevated lactate level (even within the reference range) was independently associated with increased mortality and microvascular flow abnormalities. In vivo microscopy of the microcirculation may be helpful in discriminating between flow- and non-flow-related causes of mildly elevated lactate levels.Trial Registration: ClinicalTrials.gov, NCT01179243 . Registered on August 3, 2010. [ABSTRACT FROM AUTHOR]

Published
2017
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32. Plasma glutamine levels before cardiac surgery are related to post-surgery infections; an observational study.

Author

Buter, Hanneke, Koopmans, Matty, Kemperman, Ramses, Jekel, Lilian, and Boerma, Christiaan

Subjects
*BLOOD plasma, *GLUTAMINE, *CARDIAC surgery, *HEART transplantation, *SURGICAL complications
Abstract

Background: A low plasma glutamine level was found in 34% of patients after elective cardiothoracic surgery. This could be a result of the inflammation caused by surgical stress or the use of extracorporeal circulation (ECC). But it is also possible that plasma glutamine levels were already lowered before surgery and reflect an impaired metabolic state and a higher likelihood to develop complications. In the present study plasma glutamine levels were measured before and after cardiac surgery and we questioned whether there is a relation between plasma glutamine levels and duration of ECC and the occurrence of postoperative infections. Methods: We performed a single-centre prospective, observational study in a closed-format, 20-bed, mixed ICU in a tertiary teaching hospital. We included consecutive patients after elective cardiac surgery with use of extracorporeal circulation. Blood samples were collected on the day prior to surgery and at admission on the ICU. The study was approved by the local Medical Ethics Committee (Regional Review Committee Patient-related Research, Medical Centre Leeuwarden, nWMO 115, April 28th 2015). Results: Ninety patients were included. Pre-operative plasma glutamine level was 0.42 ± 0.10 mmol/l and post-operative 0.38 ± 0.09 mmol/l (p < 0.001). There was no relation between duration of extracorporeal circulation or aortic occlusion time and changes in plasma glutamine levels. A logistic regression analysis showed a significant correlation between the presence of a positive culture during the post-operative course and pre-operative plasma glutamine levels (p = 0.04). Conclusion: Plasma glutamine levels are significantly lower just after cardiac surgery compared to pre-operative levels. We did not find a relation between the decrease in plasma glutamine levels and the duration of extracorporeal circulation or aortic clamp time. There was a correlation between pre-operative plasma glutamine levels and the presence of a positive culture after cardiac surgery. [ABSTRACT FROM AUTHOR]

Published
2016
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33. Plasma glutamine levels in patients after non-elective or elective ICU admission: an observational study.

Author

Buter, Hanneke, Bakker, Andries J., Kingma, W. Peter, Koopmans, Matty, and Boerma, E. Christiaan

Subjects
CRITICALLY ill, GLUTAMINE, INTENSIVE care units, PATIENTS, PROBABILITY theory, REGRESSION analysis, ELECTIVE surgery
Abstract

Background: A low plasma glutamine level at the time of acute admission to the intensive care unit (ICU) is an independent predictor of an unfavourable outcome in critically ill patients. The primary objective of this study was to determine whether there are differences in plasma glutamine levels upon non-elective or elective ICU admission. The secondary objective was to compare glutamine levels over time, and to determine correlations between glutamine levels and the severity of illness and presence of infection in ICU patients. Methods: We performed a single-centre observational study in a closed-format, 22-bed, mixed ICU. Plasma glutamine levels were measured at admission and every morning at 6.00 a.m. during the ICU stay. We aimed to include at least 80 patients per group. The study was approved by the local Medical Ethics Committee. Results: In 88 patients after elective surgery, the median plasma glutamine level at admission was significantly higher compared with that in 90 non-elective patients (0.43 mmol/l [0.33-0.55 mmol/l] versus 0.25 mmol/l [0.09-0.37 mmol/l], P = 0.001). During the ICU stay, plasma glutamine levels remained significantly higher in elective patients than in non-elective patients. There was a significant correlation between the APACHE IV score and glutamine levels (R=0.52, P < 0.001). Moreover, backward linear regression analysis showed that this correlation was independently associated with the APACHE IV score and the presence of infection, but not with the type of admission. Conclusions: Plasma glutamine levels are significantly lower after non-elective admission compared with elective admission to the ICU. A considerable amount of elective and non-elective patients have decreased plasma glutamine levels, but this is not independently associated with the type of admission. In contrast to previous studies, we found that plasma glutamine levels were determined by the severity of illness and the presence of an infection. Trial registration: ClinicalTrials.gov, number NCT02310035. [ABSTRACT FROM AUTHOR]

Published
2016
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35. ‘Sepsis-related anemia’ is absent at hospital presentation; a retrospective cohort analysis.

Author

Jansma, Geertje, Lange, Fellery de, Kingma, W. Peter, Vellinga, Namkje AR, Koopmans, Matty, Kuiper, Michael A., and Boerma, E. Christiaan

Subjects
ANEMIA, CHI-squared test, HEMOGLOBINS, INTENSIVE care units, MULTIVARIATE analysis, SEPSIS, T-test (Statistics), WATER-electrolyte balance (Physiology), COMORBIDITY, RETROSPECTIVE studies, DATA analysis software, MANN Whitney U Test
Abstract

Background: Anemia is a common feature during sepsis that occurs due to iatrogenic blood loss, depression of serum iron levels and erythropoietin production, and a decreased lifespan of erythrocytes. However, these mechanisms are unlikely to play a role in anemia at the start of sepsis. Moreover, sequestration of fluids, renal failure and increase of intravascular space may additionally influence the change in hemoglobin concentration during intravenous fluid administration in the acute phase of sepsis. Methods: In this retrospective study, patients who were admitted acutely to the Intensive Care Unit (ICU) were included. Patients who fulfilled the international criteria for severe sepsis or septic shock were included in the sepsis group (S-group). The remaining patients were allocated to the control group (C-group). Laboratory data from blood samples taken at first presentation to the hospital and at admission to the ICU, the amount of intravenous fluid administration and length of stay in the emergency department were collected and tested for significant differences between groups. Results: The difference in hemoglobin concentration between the S-group (n = 296) and C-group (n = 320) at first presentation in hospital was not significant (8.8 ± 1.2 versus 8.9 ± 1.2 mmol/l, respectively, p = 0.07). The reduction in hemoglobin concentration from the first presentation at the emergency department to ICU admission was significantly greater in the S-group compared to the C-group (1 [0.5-1.7] versus 0.5 [0.1-1.1] mmol/l, (p < 0.001)). Spearman rho correlation coefficients between the reduction in hemoglobin concentration and the amount of intravenous fluids administered or the creatinine level in the emergency department were significant (0.3 and 0.4, respectively, p < 0.001). In a multivariate regression analysis, creatinine, the amount of fluid administration and the presence of sepsis remained independently associated. Conclusions: Prior to in-hospital intravenous fluid administration, there is no significant difference in hemoglobin concentration between acute septic patients and acutely ill controls. Within several hours after hospital admission, there is a significant reduction in hemoglobin concentration, not only associated with the amount of intravenous fluids administered and the creatinine level, but also independently with sepsis itself. [ABSTRACT FROM AUTHOR]

Published
2015
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36. International study on microcirculatory shock occurrence in acutely ill patients.

Author

Vellinga, Namkje A R, Boerma, E Christiaan, Koopmans, Matty, Donati, Abele, Dubin, Arnaldo, Shapiro, Nathan I, Pearse, Rupert M, Machado, Flavia R, Fries, Michael, Akarsu-Ayazoglu, Tulin, Pranskunas, Andrius, Hollenberg, Steven, Balestra, Gianmarco, van Iterson, Mat, van der Voort, Peter H J, Sadaka, Farid, Minto, Gary, Aypar, Ulku, Hurtado, F Javier, and Martinelli, Giampaolo

Published
2015
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37. Study Design of the Microcirculatory Shock Occurrence in Acutely Ill Patients (microSOAP): An International Multicenter Observational Study of Sublingual Microcirculatory Alterations in Intensive Care Patients.

Author

Vellinga, Namkje A. R., Boerma, E. Christiaan, Koopmans, Matty, Donati, Abele, Dubin, Arnaldo, Shapiro, Nathan I., Pearse, Rupert M., Bakker, Jan, and Ince, Can

Abstract

Objective. Sublingual microcirculatory alterations are associated with an adverse prognosis in several critical illness subgroups. Up to now, single-center studies have reported on sublingual microcirculatory alterations in ICU patient subgroups, but an extensive evaluation of the prevalence of these alterations is lacking. We present the study design of an international multicenter observational study to investigate the prevalence of microcirculatory alterations in critically ill: the Microcirculatory Shock Occurrence in Acutely ill Patients (microSOAP). Methods. 36 ICU's worldwide have participated in this study aiming for inclusion of over 500 evaluable patients. To enable communication and data collection, a website, an Open Clinica 3.0 database, and image uploading software have been designed. A one-session assessment of the sublingual microcirculation using Sidestream Dark Field imaging and data collection on patient characteristics has been performed in every ICU patient >18 years, regardless of underlying disease. Statistical analysis will provide insight in the prevalence and severity of sublingual alterations, its relation to systemic hemodynamic variables, disease, therapy, and outcome. Conclusion. This study will be the largest microcirculation study ever performed. It is expected that this study will also establish a basis for future studies related to the microcirculation in critically ill. [ABSTRACT FROM AUTHOR]

Published
2012
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38. Microcirculatory changes during open label magnesium sulphate infusion in patients with severe sepsis and septic shock.

Author

Pranskunas, Andrius, Vellinga, Namkje AR, Pilvinis, Vidas, Koopmans, Matty, and Boerma, E. Christiaan

Subjects
SEPSIS, BLOOD diseases, BACTERIAL disease complications, MAGNESIUM sulfate, SEPTIC shock
Abstract

Background: Microcirculatory alterations play a pivotal role in sepsis and persist despite correction of systemic hemodynamic parameters. Therefore it seems tempting to test specific pro-microcirculatory strategies, including vasodilators, to attenuate impaired organ perfusion. As opposed to nitric oxide donors, magnesium has both endothelium-dependent and non-endothelium-dependent vasodilatory pathways. Methods: In a single-center open label study we evaluated the effects of magnesium sulphate (MgS) infusion on the sublingual microcirculation perfusion in fluid resuscitated patients with severe sepsis and septic shock within the first 48 hours after ICU admission. Directly prior to and after 1 hour of magnesium sulphate (MgS) infusion (2 gram) systemic hemodynamic variables, sublingual SDF images and standard laboratory tests, were obtained. Results: Fourteen patients (12 septic shock, 2 severe sepsis) with a median APACHE II score of 20 were enrolled. No significant difference of the systemic hemodynamic variables was found between baseline and after MgS infusion. We did not observe any significant difference pre and post MgS infusion in the primary endpoint microvascular flow index (MFI) of small vessels: 2.25(1.98-2.69) vs. 2.33(1.96-2.62), p = 0.65. Other variables of microcirculatory perfusion were also unaltered. In the overall unchanged microvascular perfusion there was a nonsignificant trend to an inverse linear relationship between the changes of MFI and its baseline value (y = -0.7260 x + 1.629, r² = 0.270, p = 0.057). The correlation between baseline Mg concentrations and the change in MFI preand post MgS infusion was non-significant (rs = -0.165, p = 0.67). Conclusions: In the setting of severe sepsis and septic shock sublingual microcirculatory alterations were observed despite fulfillment of sepsis resuscitation guidelines. After infusion of a limited and fixed dose of MgS, microcirculatory perfusion did not improve over time. [ABSTRACT FROM AUTHOR]

Published
2011
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39. Effects of nitroglycerin on sublingual microcirculatory blood flow in patients with severe sepsis/septic shock after a strict resuscitation protocol: A double-blind randomized placebo controlled trial.

Author

Boerma, E. Christiaan, Koopmans, Matty, Konijn, Arjan, Kaiferova, Katerina, Bakker, Andries J., van Roon, Eric N., Buter, Hanneke, Bruins, Nienke, Egbers, Peter H., Gerritsen, Rik T., Koetsier, Peter M., Kingma, W. Peter, Kuiper, Michael A., and Ince, Can

Subjects
*BLOOD flow, *SEPTIC shock, *RANDOMIZED controlled trials, *PLACEBOS, *RESUSCITATION, THERAPEUTIC use of nitroglycerin
Abstract

The article presents a study that compares the effects of nitroglycerin on sublingual sidestream dark field and systemic hemodynamic guidelines in septic patients after a strict resuscitation protocol incorporated from a randomized placebo controlled trial. Patients were randomly assigned to receive nitroglycerin or placebo treatment after fulfillment of systemic hemodynamic end points. Results conclude that intravenous nitroglycerin does not promote sublingual microcirculatory blood flow.

Published
2010
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40. Improvement of Sidestream Dark Field Imagingwith an Image Acquisition Stabilizer.

Author

Balestra, Gianmarco M., Bezemer, Rick, Boerma, E. Christiaan, Ze-Yie Yong, Sjauw, Krishan D., Engstrom, Annemarie E., Koopmans, Matty, and Ince, Can

Subjects
MEDICAL imaging systems, CRITICALLY ill, STABILIZING agents, MICROCIRCULATION disorders, VOLUNTEERS
Abstract

Background: In the present study we developed, evaluated in volunteers, and clinically validated an image acquisition stabilizer (IAS) for Sidestream Dark Field (SDF) imaging. Methods: The IAS is a stainless steel sterilizable ring which fits around the SDF probe tip. The IAS creates adhesion to the imaged tissue by application of negative pressure. The effects of the IAS on the sublingual microcirculatory flow velocities, the force required to induce pressure artifacts (PA), the time to acquire a stable image, and the duration of stable imaging were assessed in healthy volunteers. To demonstrate the clinical applicability of the SDF setup in combination with the IAS, simultaneous bilateral sublingual imaging of the microcirculation were performed during a lung recruitment maneuver (LRM) in mechanically ventilated critically ill patients. One SDF device was operated handheld; the second was fitted with the IAS and held in position by a mechanic arm. Lateral drift, number of losses of image stability and duration of stable imaging of the two methods were compared. Results: Five healthy volunteers were studied. The IAS did not affect microcirculatory flow velocities. A significantly greater force had to applied onto the tissue to induced PA with compared to without IAS (0.25 ± 0.15 N without vs. 0.62 ± 0.05 N with the IAS, p < 0.001). The IAS ensured an increased duration of a stable image sequence (8 ± 2 s without vs. 42 ± 8 s with the IAS, p < 0.001). The time required to obtain a stable image sequence was similar with and without the IAS. In eight mechanically ventilated patients undergoing a LRM the use of the IAS resulted in a significantly reduced image drifting and enabled the acquisition of significantly longer stable image sequences (24 ± 5 s without vs. 67 ± 14 s with the IAS, p = 0.006). Conclusions: The present study has validated the use of an IAS for improvement of SDF imaging by demonstrating that the IAS did not affect microcirculatory perfusion in the microscopic field of view. The IAS improved both axial and lateral SDF image stability and thereby increased the critical force required to induce pressure artifacts. The IAS ensured a significantly increased duration of maintaining a stable image sequence. [ABSTRACT FROM AUTHOR]

Published
2010
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43. Enteral Vancomycin to Eliminate MRSA Carriership of the Digestive Tract in Critically Ill Patients.

Author

Buitinck, Sophie H., Koopmans, Matty, Determann, Rogier M., Jansen, Rogier R., and van der Voort, Peter H. J.

Subjects
ALIMENTARY canal, METHICILLIN-resistant staphylococcus aureus, ENTERAL feeding, CRITICALLY ill, VANCOMYCIN, TOPICAL drug administration, NASOENTERAL tubes
Abstract

Background: Carriership with methicillin resistant Staphylococcus aureus (MRSA) is a risk for the development of secondary infections in critically ill patients. Previous studies suggest that enteral vancomycin is able to eliminate enteral carriership with MRSA. Data on individual effects of this treatment are lacking. Methods: Retrospective analysis of a database containing 15 year data of consecutive patients from a mixed medical-(cardio)surgical 18 bedded intensive care unit was conducted. All consecutive critically ill patients with enteral MRSA carriership detected in throat and/or rectal samples were collected. We analyzed those with follow-up cultures to determine the success rate of enteral vancomycin. Topical application of 2% vancomycin in a sticky oral paste was performed combined with a vancomycin solution of 500 mg four times daily in the nasogastric tube. This treatment was added to a regimen of selective digestive tract decontamination (SDD) to prevent ICU acquired infection. Results: Thirteen patients were included. The mean age was 65 years and the median APACHE II score was 21. MRSA was present in the throat in 8 patients and in both throat and rectum in 5 patients. In all patients MRSA was successfully eliminated from both throat and rectum, which took 2–11 days with a median duration until decontamination of 4 days. Secondary infections with MRSA did not occur. Conclusions: Topical treatment with vancomycin in a 2% sticky oral paste four times daily in the nasogastric tube was effective in all patients in the elimination of MRSA and prevented secondary MRSA infections. [ABSTRACT FROM AUTHOR]

Published
2022
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44. Satisfaction with quality of ICU care for patients and families: the euroQ2 project.

Author

Jensen, Hanne Irene, Gerritsen, Rik T, Koopmans, Matty, Downey, Lois, Engelberg, Ruth A, Curtis, J Randall, Spronk, Peter E, Zijlstra, Jan G, and Ørding, Helle

Subjects
FAMILIES & psychology, COMMUNICATION, INTENSIVE care units, MEDICAL quality control, NURSE-patient relationships, PATIENT satisfaction, PSYCHOMETRICS, QUESTIONNAIRES, EQUIPMENT & supplies
Abstract

Background: Families' perspectives are of great importance in evaluating quality of care in the intensive care unit (ICU). This Danish-Dutch study tested a European adaptation of the "Family Satisfaction in the ICU" (euroFS-ICU). The aim of the study was to examine assessments of satisfaction with care in a large cohort of Danish and Dutch family members and to examine the measurement characteristics of the euroFS-ICU.Methods: Data were from 11 Danish and 10 Dutch ICUs and included family members of patients admitted to the ICU for 48 hours or more. Surveys were mailed 3 weeks after patient discharge from the ICU. Selected patient characteristics were retrieved from hospital records.Results: A total of 1077 family members of 920 ICU patients participated. The response rate among family members who were approached was 72%. "Excellent" or "Very good" ratings on all items ranged from 58% to 96%. Items with the highest ratings were concern toward patients, ICU atmosphere, opportunities to be present at the bedside, and ease of getting information. Items with room for improvement were management of patient agitation, emotional support of the family, consistency of information, and inclusion in and support during decision-making processes. Exploratory factor analysis suggested four underlying factors, but confirmatory factor analysis failed to yield a multi-factor model with between-country measurement invariance. A hypothesis that this failure was due to misspecification of causal indicators as reflective indicators was supported by analysis of a factor representing satisfaction with communication, measured with a combination of causal and reflective indicators.Conclusions: Most family members were moderately or very satisfied with patient care, family care, information and decision-making, but areas with room for improvement were also identified. Psychometric assessments suggest that composite scores constructed from these items as representations of either overall satisfaction or satisfaction with specific sub-domains do not meet rigorous measurement standards. The euroFS-ICU and other similar instruments may benefit from adding reflective indicators. [ABSTRACT FROM AUTHOR]

Published
2017
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45. Mortality after surgery in Europe: a 7 day cohort study

Author

Pearse, R, Moreno, R, Bauer, P, Pelosi, P, Metnitz, P, Spies, C, Vallet, B, Vincent, J, Hoeft, A, Rhodes, A, Fagnoul, D, van Obbergh, L, Al Subaie, N, Arif, F, Cashman, J, Cecconi, M, Edsell, M, Fossati, N, Hammond, S, Hamilton, M, Lonsdale, D, Moran, C, Siegmueller, C, Velzeboer, F, Wong, P, Awlakpui, E, Scheidemann, M, Wittmann, M, Damster, S, Golder, K, Hewson, R, Januszewska, M, Leva, B, Ramos, V, Hoste, E, Huyghens, L, Jacobs, R, Van Mossevelde, V, Opdenacker, G, Poelaert, J, Spapen, H, Leleu, K, Rijckaert, D, De Decker, K, Foubert, L, De Neve, N, Biston, P, Piagnerelli, M, Collin, V, den Blauwen, N, Clauwaert, C, De Crop, L, Verbeke, A, Derumeaux, P, Gardin, C, Kindt, S, Louage, S, Verhamme, B, Druwé, P, Lahaye, I, Rosseel, F, Rutsaert, R, Vanlinthout, L, De Kock, M, Forget, P, Georges, P, Grosu, I, Kahn, D, Lois, F, Momeni, M, Pospiech, A, Yemnga, B, Jadoul, J, Malbrain, M, Bosinceanu, D, Collard, E, Jorens, P, Reyntiens, D, Smitz, C, Vercauteren, M, Goranović, T, Mazul Sunko, B, Toplice, K, Oremuš, K, Bešlić, G, Duzel, V, Hauptman, A, Peremin, S, Šribar, A, Župčić, M, Brod, S, Mirković, I, Šarić Bauer, Z, Belavić, M, Blažanin, B, Katušin, M, Brozović Krijan, A, Mišković, P, Šimić Korać, N, Topić, J, Žilić, A, Žuni, J, Acan, I, Adanić, M, Ivanov, N, Pavičić Šarić, J, Tomulić, K, Visković, N, Bošnjak, S, Haršanji Drenjančevic, I, Kristek, G, Kvolik, S, Markić, S, Stojanovic Rakipovic, A, Katarina Tot, O, Venzera Azenic, D, Kalagac Fabris, L, Bačak Kocman, I, Balenović, I, Bandić, D, Judith Deutsch, P, Divjak, L, Filipović, I, Gužvinec, Z, Krznarić, Z, Lončarić, Y, Magaš, J, Mitrović, M, Okić, M, Pavlek, M, Ramov, E, Rezek, K, Sekulić, A, Tomasevic, B, Mirić, M, Tomašević, A, Tomić Mahečić, T, Vrbanović, V, Bobinac, M, Božić, A, Debelic, D, Frkovic, V, Batinica, I, Baranović, S, Gavranović, Ž, Kikec, M, Maldini, B, Marić, S, Agnić, I, Delić, N, Dropulić, N, Kljaković Gašpić, T, Ilić, D, Ivančev, B, Karanović, N, Kuščević, D, Marović, Z, Milić, M, Nevešćanin, A, Petković, T, Smoje, M, Brozović, G, Jelisavac, M, Matolić, M, Oberhofer, D, Marija Pavičić, A, Šakić, K, Delija Bozovic, M, Kotorac Krecek, Z, Krobot, R, Andabaka, T, Bratanić, M, Dzepina, O, Kraljev, M, Šeric, J, Šimurina, T, Grujić, R, Nacevski Bulaja, B, Barižon, M, Danira, V, Dražen, B, Dušanka, K, Bašić Halužan, M, Joško, Ž, Katica, R, Labor, M, Grgurević Marinković, T, Mihovilčević, D, Marija, B, Srečko, M, Vranković, S, Kyprianou, T, Neophytou, K, Cerny, V, Cvachovec, K, Belikova, B, Drab, M, Hudacek, K, Krikava, I, Stourac, P, Zadrazilova, K, Bicek, V, Brabcová, M, Klozová, R, Vajter, J, Vymazal, T, Toft, P, Blichfeldt, L, Dilling Hansen, B, Moller, K, Sylvest Nielsen, J, Frederiksen, J, Dohn Andersen, J, Peter Kühne, J, Leivdal, S, Stendell, L, Simonsen, M, Konrad Zoltowski, M, Salman Ali, Z, Freundlich, M, Pilypaite, J, Groes Clausen, N, Thorup, L, Hansen, F, Bestle, M, Steen Hansen, C, Afshari, A, Bastholm Bille, A, Lefort, M, Secher, E, Liboriussen, L, Herodes, V, Härma, E, Marvet, K, Pool, K, Kallas, P, Mägi, T, Sütt, J, Vijar, K, Visk, E, Vinnal, M, Ellermaa, J, Liibusk, L, Tikkerberi, A, Falk, I, Mällo, E, Talving, J, Pettilä, V, Hovilehto, S, Kirsi, A, Mustola, S, Tiainen, P, Toivonen, J, Dabnell, S, Kaminski, T, Sysimetsa, A, Kaukonen, M, Silvasti, P, Vainio, K, Lund, V, Sjövall, S, Saarinen, K, Viitanen, M, Ahonen, T, Alaspää, A, Zittling, R, Saarinen, A, Moisander, A, Wagner, B, Laru Sompa, R, Elomaa, E, Lavonen, L, Nevantaus, J, Geier, K, Kavasmaa, T, Koorits, U, Kubjas, M, Lauritsalo, S, Ottelin, L, Palve, M, Pynnönen, J, Rääbis, I, Saarelainen, M, Heikkilä, T, Kontula, T, Lehtimäki, M, Liimatainen, J, Moilanen Oikarinen, M, Pakarinen, M, Palanne, R, Seppänen, H, Pulkkinen, A, Vääräniemi, H, Koskenkari, J, Sälkiö, S, Vakkala, M, Koskue, T, Loisa, P, Laitio, R, Hautamäki, R, Koivisto, S, Futier, E, Lefrant, J, Leon, A, Bonnet, F, Marret, E, Spielvogel, C, Papageorgiou, C, Szymkiewicz, O, Tounou Akue, F, Aubrun, F, Bonnet, A, Gazon, M, Guiraud, M, Laurent, V, Tachon, G, Demars, N, Dumenil, A, Mercier, F, Landais, A, Mentec, H, Bazin, M, Gonnu, S, Petit, A, Albaladejo, P, Almeras, L, Bataillard, A, Rossi Blancher, M, Yves Lefrant, J, Barthel, F, Hallel, D, Sbai, H, Khalifeh, P, Lidzborski, L, Jully, M, Platon, E, Pottecher, J, Baumgarten, R, Schultz, C, Elmiloudi, F, Lefebvre, J, Waton, K, Sprunck, A, Steib, A, Thibaud, A, Thuet, V, Kieffer, V, Dubois Vallaud, D, Jacob, L, Becanne, X, Cherfaoui, S, Gauzit, R, Godier, A, Lakhdari, M, Samma, C, Bigeon, J, Burtin, P, Halchini, C, Lacroix, M, Pinna, F, Barbes, A, Just, B, Mateu, P, Benayoun, L, Berger, P, Granier, N, Francois Perrigault, P, Libert, N, De Rudnicki, S, Merat, S, Bourdet, B, Ferré, F, Minville, V, Piriou, V, Rague, P, Wallet, F, Lebuffe, G, Desbordes, J, Robin, E, Ichai, C, Orban, J, Marx, G, Sander, M, Gottschalk, A, Piontek, A, Unterberg, M, Hilpert, J, Kees, M, Triltsch, A, Wiegand Löhnert, C, Glöckner, C, Hohn, A, Rose, E, Schröder, S, Wiese, O, Ramminger, A, Dresden, C, de Abreu, M, Heller, A, Marx, C, Neidel, J, Goldmann, A, von Heymann, C, Laetsch, B, Maahs, E, Scholz, L, Frenzel, D, Massarat, K, Lenhart, F, Reichle, F, Rudlof, K, Borchers, F, Buettner, C, Schmutzler, M, Burgard, G, Lucht, A, Wagner, J, Pilge, S, Schneider, G, Untergehrer, G, Bis, B, Krassler, J, Dittmann, J, Haberkorn, J, Eberitsch, J, Eberitsch, K, Nippraschk, T, Wepler, U, Engelen, W, Nau, C, Scholler, A, Schüttler, J, Wintzheimer, S, Bloos, F, Braune, A, Fergen, D, Ludewig, K, Paxian, M, Reinhart, K, Graf, N, Schwarzkopf, K, Berger, K, Habicher, M, Kasperiunaite, R, Savelsberg, S, Krep, H, Reindl, M, Weber, M, Bauer, W, Bingold, F, Christ, S, Friederich, P, Kaviani, R, Auer, P, Bonnländer, G, Drescher, J, Braun, R, Eichenauer, T, Kerner, J, Bierbaum, K, Brünner, H, Grond, S, Perez Platz, U, Andresen, B, Linstedt, U, Stegmann, N, Erkens, U, Kopcke, J, Meyer, A, Brestrich, H, Ernst, S, Merkel, S, Krieger, L, Luers, F, Weyland, A, Noeldge Schomburg, G, Menckie, T, Wasmund, C, Bredtmann, R, Erler, I, Raufhake, C, Haumann, C, Möllemann, A, Oehmichen, U, Sergejewa, O, Lehning, B, Czeslick, E, Geyer, M, Malcharek, M, Sablotzki, A, Stier, M, Feld, F, Rossaint, R, Simon, V, Armaganidis, A, Koulenti, D, Kotanidou, A, Nanas, S, Papastylianou, A, Psevdi, A, Stathopoulos, A, Voulas, A, Kanna, E, Koutsikou, A, Moustaka, A, Chovas, A, Komnos, A, Zafiridis, T, Franses, J, Lavrentieva, A, Koraki, E, Katsenos, C, Flora Kasianidou, M, Nasopoulou, P, Spyropoulou, E, Gousia, C, Katsanoulas, C, Lathyris, D, Kyriazopoulos, G, Sfyras, D, Tsirogianni, A, Kostopanagiotou, G, Lignos, M, Matsota, P, Christopoulos, C, Mouratidou, A, Vrettou, E, Boufidis, S, Moka, E, Arnaoutoglou, E, Koulouras, V, Nakos, G, Papathanakos, G, Anthopoulos, G, Choutas, G, Karapanos, D, Tzani, V, Gkiokas, G, Nastos, K, Nikolakopoulos, F, Dragoumanis, C, Nikitidis, N, Pneumatikos, I, Theodorou, V, Zacharouli, D, Kandi, S, Tasopoulos, K, Arvaniti, K, Matamis, D, Mplougoura, E, Petropoulou, P, Soumpasis, I, Amaniti, E, Giannakou Peftoulidou, M, Gkeka, E, Soultati, I, Kokinou, M, Papatheodorou, L, Stafylaraki, M, Giasnetsova, T, Gritsi Gerogianni, N, Kydona, C, Kiskira, O, Koulentis, I, Apsokardos, A, Dimitropoulos, K, Soldatou, O, Nathanail, C, Papazotos, A, Tsakas, P, Clouva Molyvdas, P, Kolotoura, A, Sartzi, M, Papanikolaou, S, Polakis, P, Karatzas, S, Kyparissi, A, Papavasilopoulou, T, Koukoubani, T, Mastora, E, Spyropoulou Pagdatoglou, K, Nyktari, V, Malliotakis, P, Papaioannou, A, Bekos, V, Maragkou, E, Spring, A, Evagelatos, S, Ioakeimidou, A, Noulas, N, Molnár, Z, Csüllög, E, Elekes, E, Molnár, T, Katona, Z, Kremer, I, Miko, A, Csomos, A, Galambos, Z, Szucs, A, Nyikos, G, Szekeres, G, Szabo, E, Kranitz, K, Simon, M, Szigeti, J, Gaál, E, Havas, A, Ille, A, Bráz, K, Nagy, G, Sigurdsson, G, Sigurbjörnsson, F, Kárason, S, Edda Sigurdardottir, E, Blöndal, Á, Gunnarsson, B, Westbrook, A, Broderick, A, Hafeez, P, Hanumanthaiah, D, Brohan, J, O'Chroinin, D, Bailey, K, 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Maeyer, A, Pérez Marquez, M, López Mendoza, D, Milicua Muñoz, J, Arias Martínez, N, Santos Oviedo, A, Benavent Garrigues, P, Alonso Íñigo, J, Tormo Ferrandiz, S, Sanchez Morcillo, S, Lafuente Sánchez, M, Marqués Parra, A, Gomar Vidal, S, Montoiro Allué, R, Zalba Etayo, B, Bustamante Rodriguez, R, Martin Villen, L, Molla Jimenez, C, de Zayas, R, Dolera Moreno, C, SanJose Pacheco, F, Anton Pascual, J, Tejera Gude, F, Manteiga Riestra, E, Cota Delgado, F, de la Torre Prados, M, Barrios, J, Cervera Montes, M, García Sanz, M, García, V, Sanmiguel, G, López Álvaro, J, Bornay Barrachima, B, Romero Bermejo, F, Martinez Garcia, A, Navarro Ramírez, C, Gómez Ramos, J, Angel Samaniego, L, Belenguer Muncharaz, A, Ferrándiz Selles, A, Mateu Campos, M, Domínguez, D, Espinosa, E, León, T, Ojeda Betancor, N, Garcia Cortes, J, Díaz Díaz, J, Manzano Canalechevarria, A, Fores Novales, B, Garcia Peña, J, Rodriguez Delgado, T, Santamaria Roquerio, B, Gomez Sainz, J, Tebar Soto, T, Chew, M, Seeman Lodding, H, Dahm, P, Odenstedt Hergès, H, Lundborg, C, Söndergaard, S, Rylander, C, Sari, F, Oscarsson Tibblin, A, Adolfsson, A, Klarin, B, Schrey, S, Merisson, E, Rydén, J, Britt Divander, M, Hedin, A, Hedlund, D, Axelsson Lindkvist, M, Jawad, M, Layous, L, Wernerman, J, Björne, H, Brattström, O, Olheden, S, Oldner, A, Sellden, E, Walder, B, Wickboldt, N, Rossi, A, Steiner, L, Djurdjevic, M, Lussmann, R, Geisen, M, Hofer, C, Turina, M, Grocott, M, Goldhill, D, Everett, L, Harris, K, Wright, M, Adams, D, Alderson, L, Baker, J, Christie, I, Ferguson, C, Hill, M, Holmes, K, Hutton, A, Minto, G, Moor, P, Porter, A, Struthers, R, Akotia, N, Belhaj, A, Chang, S, Collantes, E, Eigener, K, Husband, M, Khan, A, Kong, M, Jane McAlees, E, Macdonald, N, Niebrzegowska, E, Parnell, W, Smith, A, Chhatwal, A, Jhingan, S, Muswell, R, Poon, Y, Singh, N, Stephens, R, Vasan, R, Waife, N, Weda, T, Clarke, A, Szakmany, T, Fletcher, S, Rosbergen, M, Blunt, M, Prince, L, Wong, K, Kumar, R, Stilwell, S, Couper, K, Crooks, N, Gao Smith, F, Melody, T, Snaith, C, Patel, J, Parekh, D, Yeung, J, Loughnan, B, Moosajee, V, Rope, T, Edger, L, Dawson, J, Hadfield, D, Hopkins, P, Mcdonald, L, Willars, C, Campbell, G, Craig, J, Ladipo, K, Lockwood, G, Moreno, J, Ballington, R, Hamandishe, S, Rogerson, D, Cowman, S, Hayden, P, Pinto, N, Sandhar, T, Arawwawala, D, Brotherston, L, Mitchell Inwang, C, Walsh, H, Alagarsamy, F, Goon, S, Karcheva, S, Krepska, A, Mckinney, B, Patil, V, Batchelor, N, Day, C, Finch, L, Gibson, C, Grayling, M, Hubble, S, Key, W, Knight, T, Loosley, A, Margetts, P, Stewart, H, Bewley, J, Hurley, K, Murphy, R, Philpott, C, Pollock, K, Sweet, K, Thomas, M, Tucker, K, Windsor, D, Conway, D, Gold, S, Quraishi, T, Cupitt, J, Baddeley, S, Brown, J, Foo, I, Mantle, D, Carvalho, P, Huddart, S, Kirk Bayley, J, Smith, R, Milligan, L, Poulose, S, Sarkar, S, Nolan, J, Pedley, E, Padkin, A, Pesian, S, Rajamanickam, S, Ramkumar, K, Crayford, A, Turner, A, Bottrill, F, Webb, S, Jhanji, S, Maccallum, N, Wessels, K, Wigmore, T, Meikle, A, Wilson, S, White, S, Bonnett, A, Rushton, A, Williams, C, Zuzan, O, Hall, A, Montgomery, J, Piggot, A, Read, R, Stocker, M, Tamm, T, Agarwal, B, Ward, S, Brown, L, Joy, M, Venkatesh, S, Hughes, T, Zsisku, L, Roy, A, Hooper, V, Mouland, J, Nightingale, J, Rose, S, Chiam, P, Chohan, H, Dickson, C, Gibb, S, Higham, C, Harvey, C, Janarthanan, C, Jones, L, Kapoor, A, Moll, M, Roberts, L, Saunders, D, Arnold, G, Gibbs, C, Jhurgursing, M, Pierro, D, Pritchard, F, Doyle, P, Templeton, M, Wilson, R, Zantua, K, Collyer, T, Featherstone, J, Worton, R, Bruce, J, Mcguigan, K, Price, G, Moreton, S, Pulletz, M, Anderson, H, Baxter, I, Beckingsale, A, Callaghan, M, Datta, A, Gollogly, J, Izod, C, Lobaz, S, Macfie, C, Patel, M, Payne, H, Singh, R, Timms, G, Mcleod, S, O'Brian, P, Horner, E, Joshi, V, Stuart Smith, K, Seale, T, Bolger, C, Collins, H, Ekins, E, Hawkins, L, Jonas, M, Linford, K, Wadams, B, Beach, M, Vizcaychipi, M, Jewsbury, W, Davies, S, Balaji, P, Kangaraj, M, Pissay, N, Smith, N, Gopalakrishnan, S, Mackinnon, J, Strandvik, G, Francis, R, Jennings, A, Keating, M, Kumar, S, Leese, S, Magee, C, Pilsbury, J, Ralph, J, Riddington, D, Sachdeva, R, Snelson, C, Vasanth, S, Wilde, J, Lavender, B, Lyons, R, Watters, M, Adams, T, Dyer, S, Tindall, L, Claxton, A, Netke, M, Akouds, E, Bates, D, Gallagher, H, Hatton, J, Holroyd, W, Mitra, A, Nurse, T, Reed, D, Desikan, S, Barber, R, Childs, S, O'Carroll Kuehn, B, Wyldbore, M, Al Abdaly, A, Amatya, S, Bhaskaran, S, Chandan, G, Chaudhry, S, Chikungwa, M, Earnshaw, G, Grewal, M, Haque, S, Hawkins, J, Javaid, A, Jackson, C, Kamel, M, Marla, R, Mculloch, D, Parker, T, Salib, Y, Saravanmuthu, R, Secker, C, Sockalingam, S, Taylor, A, Austine, P, Kanade, V, Paal, D, Sam Mok, M, Burtenshaw, A, Davis, L, Ellahee, P, Freeman, D, Pierson, R, Wollaston, J, Karmarkar, A, Ball, C, Calton, E, Maxwell, L, Walker, R, Bland, M, Bullock, L, Harrison Briggs, D, Hodge, P, Krige, A, Dempsey, G, Hammell, C, Loveridge, R, Parker, R, Snell, J, Wright, C, Baker, A, Barr, K, Belcher, A, Bonnington, S, Bougeard, A, Fitzgerald, E, Ford, R, Gillard, C, Griffiths, L, Greenberg, L, Huber, J, Mathieu, S, Richardson, N, Tompsett, L, White, N, Patel, S, Corner, V, Thomas, R, Trodd, D, Wilson, J, Copley, E, Flutter, L, Hulme, J, Susarla, J, Thwaites, A, Jayasundera, S, Mcafee, S, Chantler, J, Mckechnie, S, Neely, J, Mouton, R, Scarth, E, Soar, J, Buss, J, Currie, V, Sange, M, Kuttler, A, Power, F, Alexander, D, Dunne, K, Shinner, G, Black, E, Haldane, G, Kerr, J, Saran, T, Ward, G, Jefferies, F, Alexander, P, Royle, A, Nahla, F, Bowles, T, Gregory, M, Ahern, R, Cartlidge, D, Craker, L, Thompson, C, Bidd, H, Giles, J, Manser, A, Parry, G, Chan, P, Das, D, Fahmy, N, Higgins, D, Khader, A, Stone, A, Leonardi, S, Rose, O, Bright, E, Ercole, A, Amir Rafi, M, Ramasamy, R, Sheshgiri, B, Merrill, C, Page, V, Walker, E, Harris, S, Hughes, S, Morrison, A, Razouk, K, Ayman, M, Jakeman, A, Mowatt, C, Paananen, S, Translational Physiology, Other departments, ACS - Amsterdam Cardiovascular Sciences, AII - Amsterdam institute for Infection and Immunity, Anesthesiology, APH - Amsterdam Public Health, Pearse Rupert, Moreno Rui P., Bauer Peter, Pelosi Paolo, Metnitz Philipp, Spies Claudia, Vallet Benoit, Vincent Jean-Loui, Hoeft Andrea, Rhodes Andrew, Fagnoul David, van Obbergh Luc, Al-Subaie Nawaf, Arif Fuhazia, Cashman Jeremy, Cecconi Maurizio, Edsell Mark, Fossati Nicoletta, Hammond Sarah Jane, Hamilton Mark, Lonsdale Dagan, Moran Carl, Siegmueller Claa, Velzeboer Freya, Wong Patrick, Awlakpui Eli, Scheidemann Mona, Wittmann Maria, Damster Sandrine, Golder Kim, Hewson Russell, Januszewska Marta, Leva Brigitte, Ramos Vasco, Hoste Eric, Huyghens Luc, Jacobs Rita, Van Mossevelde Veerle, Opdenacker Godelieve, Poelaert Jan, Spapen Herbert, Leleu Kri, Rijckaert Dirk, De Decker Koen, Foubert Luc, De Neve Nikolaa, Biston Patrick, Piagnerelli Michael, Collin Vincent, den Blauwen Nadia, Clauwaert Charlotte, De Crop Luc, Verbeke An, Derumeaux Pieter, Gardin Christophe, Kindt Sebastiaan, Louage Sofie, Verhamme Bruno, Druwé Patrick, Lahaye Ingrid, Rosseel Franci, Rutsaert Robert, Vanlinthout Luc, De Kock Marc, Forget Patrice, Georges Pascal, Grosu Irina, Kahn David, Lois Fernande, Momeni Mona, Pospiech Audrey, Yemnga Bernadette, Jadoul Jean-Luc, Malbrain Manu, Bosinceanu Dana, Collard Edith, Jorens Philippe, Reyntiens Dirk, Smitz Carine, Vercauteren Marcel, Goranović Tatjana, Mazul-Sunko Branka, Toplice Krapinske, Oremuš Krešimir, Bešlić Gabrijela, Duzel Viktor, Hauptman Ada, Peremin Sanja, Šribar Andrej, Župčić Miroslav, Brod Slavonski, Mirković Ivan, Šarić Bauer Zlata, Belavić Matija, Blažanin Božidar, Katušin Mirjana Lončarić, Brozović Krijan Antonija, Mišković Petar, Šimić-Korać Nataša, Topić Jasna, Žilić Antonio, Žuni Josip, Acan Ivana, Adanić Mirta, Ivanov Nikola, Pavičić Šarić Jadranka, Tomulić Katarina, Visković Nataša, Bošnjak Silvana, Haršanji Drenjančevic Ivana, Kristek Gordana, Kvolik Slavica, Markić Stela, Stojanovic Rakipovic Andreja, Katarina Tot Ozana, Venzera-Azenic Darija, Kalagac Fabris Lada, Bačak-Kocman Iva, Balenović Igor, Bandić Daniela, Judith Deutsch Patricia Adrianne, Divjak Loredana, Filipović Ina Grčić, Gužvinec Zvonka, Krznarić Zrinka, Lončarić Yvonne, Magaš Jelena Vadlja, Mitrović Marek, Okić Marija, Pavlek Mario, Ramov Elza, Rezek Karolina, Sekulić Ante, Tomasevic Bori, Mirić Mirjana, Tomašević Anita, Tomić Mahečić Tina, Vrbanović Vilena, Bobinac Mirna, Božić Alfred, Debelic Danijela, Frkovic Vedran, Batinica Inga Mladić, Baranović Senka, Gavranović Željka, Kikec Mirna, Maldini Branka, Marić Stela, Agnić Ivan, Delić Nikola, Dropulić Nataša, Kljaković Gašpić Toni, Ilić Darko, Ivančev Božena, Karanović Nenad, Kuščević Dorjan, Marović Zlatko, Milić Matija, Nevešćanin Ana, Petković Tatjana, Smoje Mario, Brozović Gordana, Jelisavac Milana, Matolić Martina, Oberhofer Dagmar, Marija Pavičić Ana, Šakić Kata, Delija Bozovic Margarita, Kotorac Krecek Zvjezdana, Krobot Renata, Andabaka Tatjana, Bratanić Mislav, Dzepina Orjana, Kraljev Martina, Šeric Julija, Šimurina Tatjana, Grujić Rosa, Nacevski-Bulaja Biljana, Barižon Mirna, Danira Vrančić, Dražen Bulaja, Dušanka Kimer, Bašić Halužan Marijana, Joško Žaja, Katica Roca, Labor Magda, Grgurević Marinković Tea, Mihovilčević Danči, Marija Bego, Srečko Marinković, Vranković Srdan, Kyprianou Theodoro, Neophytou Kyriako, Cerny Vladimir, Cvachovec Karel, Belikova Barbora, Drab Michal, Hudacek Kamil, Krikava Ivo, Stourac Petr, Zadrazilova Katarina, Bicek Vladimír, Brabcová Milena, Klozová Radka, Vajter Jaromír, Vymazal Tomáš, Toft Palle, Blichfeldt Louise, Dilling Hansen Bo, Moller Kirsten, Sylvest Nielsen Jeppe, Frederiksen Joachim, Dohn Andersen Johnny, Peter Kühne Jan, Leivdal Siv, Stendell Line, Simonsen Martin, Konrad Zoltowski Marcin, Salman Ali Zahida, Freundlich Morten, Pilypaite Jurgita, Groes Clausen Nicola, Thorup Line, Hansen Frank, Bestle Morten, Steen Hansen Christian, Afshari Arash, Bastholm Bille Ander, Lefort Michele, Secher Erik L., Liboriussen Lisbeth, Herodes Veiko, Härma Eve, Marvet Kadri, Pool Kristiina, Kallas Pille, Mägi Triinu-Kreete, Sütt Jaan, Vijar Kerli, Visk Evelin, Vinnal Mare, Ellermaa Jaanu, Liibusk Liia, Tikkerberi Artur, Falk Ilme, Mällo Esta, Talving Jaak, Pettilä Ville, Hovilehto Seppo, Kirsi Anne, Mustola Seppo, Tiainen Pekka, Toivonen Juhani, Dabnell Sandra, Kaminski Tadeusz, Sysimetsa Anu, Kaukonen Maija, Silvasti Päivi, Vainio Kaisa, Lund Vesa, Sjövall Sari, Saarinen Kari, Viitanen Matti, Ahonen Tommi, Alaspää Ari, Zittling Ritva, Saarinen Aarne, Moisander Annette, Wagner Bodo, Laru-Sompa Raili, Elomaa Esa, Lavonen Leena, Nevantaus Juha, Geier Klau, Kavasmaa Tomi, Koorits Ursula, Kubjas Mare, Lauritsalo Seppo, Ottelin Lauri, Palve Markki, Pynnönen Jari, Rääbis Inga, Saarelainen Minna, Heikkilä Tapani, Kontula Timo, Lehtimäki Markku, Liimatainen Jari, Moilanen-Oikarinen Mari, Pakarinen Marika, Palanne Riku, Seppänen Hanna, Pulkkinen Anni, Vääräniemi Heikki, Koskenkari Juha, Sälkiö Sinikka, Vakkala Merja, Koskue Talvikki, Loisa Pekka, Laitio Ruut, Hautamäki Raku, Koivisto Simo-Pekka, Futier Emmanuel, Lefrant Jean-Yve, Leon Alain, Bonnet Franci, Marret Emmanuel, Spielvogel Catherine, Papageorgiou Chryssa, Szymkiewicz Olga, Tounou-Akue Felix, Aubrun Frederic, Bonnet Aurélie, Gazon Mathieu, Guiraud Michel, Laurent Virginie, Tachon Guillaume, Demars Nadège, Dumenil Anne-Sylvie, Mercier Frederic, Landais Alain, Mentec Herve, Bazin Marie, Gonnu Sophie, Petit Antoine, Albaladejo Pierre, Almeras Luc, Bataillard Amélie, Rossi-Blancher Marine, Yves Lefrant Jean, Barthel Florian, Hallel Dan, Sbai Hicham, Khalifeh Pamela, Lidzborski Lionel, Jully Marion, Platon Ecaterina, Pottecher Julien, Baumgarten Romain, Schultz Christel, Elmiloudi Fayçal, Lefebvre Julie, Waton Karen, Sprunck Adrien, Steib Annick, Thibaud Adrien, Thuet Vincent, Kieffer Vianney, Dubois-Vallaud Delphine, Jacob Laurent, Becanne Xavier, Cherfaoui Salim, Gauzit Remy, Godier Anne, Lakhdari Mourad, Samma Charle, Bigeon Jean-Yve, Burtin Philippe, Halchini Constantin, Lacroix Magali, Pinna Frederic, Barbes Aurélie, Just Bernard, Mateu Philippe, Benayoun Laurent, Berger Philippe, Granier Nathalie, Francois Perrigault Pierre, Libert Nicola, De Rudnicki Stephan, Merat Stéphane, Bourdet Benoit, Ferré Fabrice, Minville Vincent, Piriou Vincent, Rague Philippe, Wallet Florent, Lebuffe Gille, Desbordes Jacque, Robin Emmanuel, Ichai Carole, Orban Jean-Christophe, Marx Gernot, Sander Michael, Gottschalk André, Piontek André, Unterberg Matthia, Hilpert Justu, Kees Martin, Triltsch Andrea, Wiegand-Löhnert Carola, Glöckner Christiane, Hohn Andrea, Rose Elmar, Schröder Stefan, Wiese Oliver, Ramminger Axel, Dresden Caru, de Abreu Marcelo Gama, Heller Axel, Marx Christine, Neidel Julia, Goldmann Anton, von Heymann Christian, Laetsch Beatrix, Maahs Esther, Scholz Lar, Frenzel Dirk, Massarat Kyro, Lenhart Franz-Peter, Reichle Florian, Rudlof Kristina, Borchers Friedrich, Buettner Christoph, Schmutzler Martin, Burgard Gerald, Lucht Alexander, Wagner Jan, Pilge Stefanie, Schneider Gerhard, Untergehrer Gisela, Bis Beata, Krassler Jen, Dittmann Jan, Haberkorn Jörg, Eberitsch Jürgen, Eberitsch Karola, Nippraschk Thoma, Wepler Ulrich, Engelen Wolf-Christian, Nau Carla, Scholler Axel, Schüttler Jürgen, Wintzheimer Simone, Bloos Frank, Braune Anke, Fergen Daniela, Ludewig Katrin, Paxian Marku, Reinhart Konrad, Graf Nikolau, Schwarzkopf Konrad, Berger Katharina, Habicher Marit, Kasperiunaite Ruta, Savelsberg Sabine, Krep Henning, Reindl Michael, Weber Matthia, Bauer Wolfgang, Bingold Florian, Christ Saskia, Friederich Patrick, Kaviani Reza, Auer Patrick, Bonnländer Georg, Drescher Jürgen, Braun Roland, Eichenauer Tim, Kerner John, Bierbaum Kathrin, Brünner Horst, Grond Stefan, Perez-Platz Ursula, Andresen Bent, Linstedt Ulf, Stegmann Nil, Erkens Uwe, Kopcke Jen, Meyer Andrea, Brestrich Hartmut, Ernst Sandra, Merkel Stella, Krieger Lena, Luers Frank, Weyland Andrea, Noeldge-Schomburg Gabriele, Menckie Thoma, Wasmund Christina, Bredtmann Ralph-Dieter, Erler Ine, Raufhake Carsten, Haumann Christine, Möllemann Angela, Oehmichen Uwe, Sergejewa Olga, Lehning Brigitte, Czeslick Elke, Geyer Michaela, Malcharek Michael, Sablotzki Armin, Stier Marina, Feld Florian, Rossaint Rolf, Simon Verena, Armaganidis Apostolo, Koulenti Despoina, Kotanidou Anastasia, Nanas Serafim, Papastylianou Androula, Psevdi Aikaterini, Stathopoulos Anastasio, Voulas Asklepieion, Kanna Efthymia, Koutsikou Anastasia, Moustaka Alexandra, Chovas Achillea, Komnos Apostolo, Zafiridis Tilemacho, Franses Josef, Lavrentieva Athena, Koraki Eleni, Katsenos Chrysostomo, Flora Kasianidou Maria, Nasopoulou Pantelia, Spyropoulou Eleni, Gousia Chrysoula, Katsanoulas Constantine, Lathyris Dimitrio, Kyriazopoulos George, Sfyras Dimitrio, Tsirogianni Athanasia, Kostopanagiotou Georgia, Lignos Mihail, Matsota Paraskevi, Christopoulos Christo, Mouratidou Alexandra, Vrettou Efstratia, Boufidis Spyro, Moka Eleni, Arnaoutoglou Eleni, Koulouras Vasileio, Nakos George, Papathanakos Georgio, Anthopoulos Georgio, Choutas Georgio, Karapanos Dimitrio, Tzani Vaso, Gkiokas Georgio, Nastos Konstantino, Nikolakopoulos Fotio, Dragoumanis Christo, Nikitidis Niko, Pneumatikos Ioanni, Theodorou Vassiliki, Zacharouli Danai, Kandi Stella, Tasopoulos Konstantino, Arvaniti Kostoula, Matamis Dimitrio, Mplougoura Eva, Petropoulou Polixeni, Soumpasis Ioanni, Amaniti Ekaterini, Giannakou-Peftoulidou Maria, Gkeka Eleni, Soultati Ioanna, Kokinou Maria, Papatheodorou Lambrini, Stafylaraki Maria, Giasnetsova Tatiana, Gritsi-Gerogianni Nikoleta, Kydona Christina, Kiskira Olga, Koulentis Ioanni, Apsokardos Alexandro, Dimitropoulos Konstantino, Soldatou Ourania, Nathanail Christodoulo, Papazotos Alexio, Tsakas Pirro, Clouva-Molyvdas Phyllis-Maria, Kolotoura Athina, Sartzi Monika, Papanikolaou Spiro, Polakis Pavlo, Karatzas Styliano, Kyparissi Aikaterini, Papavasilopoulou Theonymfi, Koukoubani Triantafillia, Mastora Evangelia, Spyropoulou-Pagdatoglou Kyriaki, Nyktari Vasileia, Malliotakis Polychroni, Papaioannou Alexandra, Bekos Vasileio, Maragkou Elisavet, Spring Anna, Evagelatos Stavro, Ioakeimidou Aikaterini, Noulas Niko, Molnár Zsolt, Csüllög Emese, Elekes Eniko, Molnár Tamá, Katona Zsuzsana, Kremer Ildiko, Miko Angela, Csomos Ako, Galambos Zsuzsanna, Szucs Ako, Nyikos Gyorgy, Szekeres Gabor, Szabo Ervin, Kranitz Katalin, Simon Melinda, Szigeti Jano, Gaál Emánuel, Havas Attila, Ille Alexandru, Bráz Krisztina, Nagy Geza, Sigurdsson Gisli, Sigurbjörnsson Fridrik T., Sigurdsson Gisli H., Kárason Sigurbergur, Edda Sigurdardottir Elin, Blöndal Ásbjörn, Gunnarsson Björn, Westbrook Andrew, Broderick Alan, Hafeez Parvaiz, Hanumanthaiah Deepak, Brohan Janette, O'Chroinin Donal, Bailey Kevin, Ramamoorthy Karthik, Doyle Yvonne, Freir Noelle, O'Rourke Jame, Jonson Philip, Saeed Sabir, Hayes Ivan, Loughrey John, Frohlich Stephen, Mccauley Nuala, Ryan Donal, Fitzpatrick Gerry, Kevin Leo, Thomas Jubil, Warde Barry, Woolhead Alan, Duggan Michelle, Egan Cara, Crowley Seamu, Lebese Soloman, Bergin Anne, Page Rory, Collins Daniel, Mckenny Michael, Della Rocca Giorgio, Grasso Salvatore, Bresciani Anna, Carmino Livio, Ghelfi Silvia, Lorenzelli Laura, Teresa Novelli Maria, Pescarmona Chiara, Roasio Agostino, Gatta Alessandro, Nastasi Mauro, Sanseverino Manlio, Tinti Carla, Bianchin Andrea, Tormena Maria, Franco Antonio, Marini Federica, Di Mauro Piero, Rapido Francesca, Tommasino Concezione, Bellotti Ferdinando, Boninsegna Daniele, Castellani Gianluca, Sances Daniele, Spano Gianluca, Tredici Stefano, Vezzoli Dario, Fucecchio Igneo, Bacci Alessandro, Coppini Roberta, Dell'Unto Sandro, Mori Emanuele, Rosa Stanzani Maria, Tosi Monica, Collareta Michele, Forfori Francesco, Franchi Matteo, Mancino Giuseppe, Battistella Massimo, Baricocchi Elisa, Bona Francesco, Debernardi Felicino, Giacoletto Gianmarco, Iacobellis Antonio, Massucco Paolo, Moselli Nora, Muratore Andrea, Palomba Graziella, Sardo Elena, De Simone Michele, Suita Luisa, Zocca Edoardo, Bucci Barbara, Della Corte Francesco, Piciucco Tiziana, Viarengo Valeria, Bettelli Gabriella, Cantarini Eugenia, Giampieri Marina, Tanfani Alessandra, Recchia Eugenio, Bignami Elena, Bruno Giovanna, Costagliola Roberto, Gandolfi Azzurra, Greco Massimiliano, Lembo Rosalba, Monti Giacomo, Nicelli Elisa, Pasculli Nicola, Turi Stefano, Baroselli Antonio, Brazzoni Marcella, Buttazzoni Mattia, Buttera Stefania, Centonze Carlo, Serena Giovanni, Spagnesi Lorenzo, Toretti Ilaria, Vilardi Anna, Zearo Ester, Arpino Ine, Baraldi Sara, Guarnerio Chiara, Molene Vincenzo, Concetta Monea Maria, Vaccarisi Enrico, Vicari Luigi, Albante Alida, Aversano Marco, Loiacono Cinzia, Marandola Maurizio, Fusari Maurizio, Petrucci Nicola, Galla Amerigo, Mascia Antonio, Primieri Paolo, Di Noto Anna, Gratarola Angelo, Molin Alessandro, Spagnolo Luigi, Spena Claudio, Calligaro Plinio, Marchiotto Simonetta, Merlini Alberto, Pedrazzoli Eleonora, Perina Giulia, Visentin Renea, Fumagalli Roberto, Garbagnati Andrea, Manetti Bruna, Snaier Chiara, Somaini Marta, Farnia Antonio, Nani Roberto, Pierantonio Novello, De Michele Michele, Gazzanelli Sergio, Pugliese Francesco, Ruberto Franco, Bergamini Elena, Tassinati Tania, Capuzzo Maurizia, Cirillo Vera, Tufano Rosalba, Oggioni Roberto, Parrini Vieri, Brunori Emanuela, Capone Micaela, Carbone Luigi, Corradetti Francesco, Elisei Daniele, Fiorentino Stefano, Francesconi Maurizio, Gattari Diego, Gorgoglione Maria, Lacobone Emanuele, Minnucci Francesco, Montironi Claudio, Riccioni Gianrenato, Tappata Giuseppe, Zompanti Valeria, Verdenelli Paola, Cerutti Elisabetta, Ranieri Vito Marco, Golubovska Iveta, Grigorjevs Sergej, Rikmane Maija, Rozkalne Daina, Stepanovs Jevgenij, Suba Oleg, Kazune Sigita, Miscuk Aleksej, Nemme Jani, Oss Peteri, Sipylaite Jurate, Macas Andriu, Ragaisis Vytauta, Kontrimaviciute Egle, Tomkute Gabija, Boerma Christiaan, Fleur Kramer Irene, Poeze Martijn, Maria John, Pelzer Gerardu, Winsser Lex, Nijsten Maarten, Schoorl Michiel, Spanjersberg Rob, Buhre Wolfgang, Dieleman Stefan, van Klei Wilton, Bouw Martijn, Pickkers Peter, van der Marieke A., Schreiner Frodo, Zandvliet Ria, van den Berg Roy, De Wit Esther, Keijzer Christaan, Hollmann Marku, Preckel Benedikt, van Acker Gij, Dennesen Paul, Veld Ba, Kuijpers-Visser Agne, Inan T., Koopman-van Gemert A., Ponssen Huibert, Brouwer Tammo, Koopmans Matty, van Bommel Jasper, van Duijn Ditty, van der Hoven Ben, Ormskerk Patricia, Beck Oliver, Schiere Sjouke, Reidinga Auke, Venema Allart, Hoogendoorn Marga, Olthof Kee, Flaatten Han, Jammer Ib, Dokka Vegard, Arne Monsen Svein, Marius Ytrebo Lar, Noursadeghi Mostafa, Shahzad Ahmed, Dagfinn Boksasp Ola, Roiss Christoph, Frank Strietzel Han, Gina Anne, Berntsen Schie, Haugland Helge, Ove Vingsnes Svein, Axelsson Patric, Risom Olsen Thoma, Katre Sanjay, Aakeroey Kristin, Mikstacki Adam, Tamowicz Barbara, Boziłow Dominika, Goch Robert, Grabowski Piotr, Kupisiak Jacek, Małłek Małgorzata, Szyca Robert, Kostyrka Włodzimierz, Choma Robert, Jankowski Grzegorz, Kościelniak Władysław, Pietraszek Paweł, Szarowar Bartosz, Matos Ricardo, França Carlo, Pais Lacerda António, Ormonde Lucindo, Rosa Rosário, Pereira Inê, Vitor Paula, Completo Bento Henrique, Raquel Lopes Maria, Carvalho Marque, Faria Manuela, Cláudia de Sousa Ana, de Freitas Pereira, Almeida Eduardo, Mealha Rui, Vicente Rachel, Monte Raquel, Rua Fernando, Barros Nelson, Esteves Francisco, Gouveia Pinheiro Célia Maria, Real Vila, Miguel Oliveira Vítor, Fátima Oliveira Maria, Martins Isabel, Pedro Saraiva José, Pedro Assunção José, Bártolo Anabela, Carvalho Anabela, Correia Carlo, Martins Salomé, Milheiro Ruth, Diaz Alejandro, Imelda Gonçalves Maria, Ribeiro Rosa, Estilita Joana, Glória Carlo, de Almeida José, Barros Filipa, Ramos Armindo, Camara Margarida, Richard Maul Edward, Nobrega Julio, Langner Anuscka, Faria Maia Dionísio, Afonso Ofélia, Faria Filomena, Serra Sofia, Manuela Botelho Maria, Ferreira Pedro, Mourão Luí, Vintém Oliveira Ana, Resende Margarida, Aleman Miguel, Fonseca Jorge, Isidoro Marta, de Meneses Helena, Pêgas António, Pereira José, Pereira Lui, Ramos Bárbara, Matos Francisco, Gonçalves Castro Maria de Lurde, Martins Ana, Ramos Cristina, de Sousa Manuel, Bento Luí, Botas Conceição, Lopes Vitor, Mendes Rosa, Grigoras Ioana, Blaj Mihaela, Damian Mihaela, Lupusoru Andreea, Ristescu Irina, Codreanu Monica, Diaconescu Ciresica, Nistor Alina, Stanescu Stelian Dorin, Streanga Livia, Berneanu Maria, Bordeianu Cristina, Florenta Calarasu, Iacob Alina, Nicoleta Lupu Mary, Mocanu Iulian, Moraru Coca, Meran Carleta, Nicolae Bacalbasa, Sandu Madalina, Turcanu Roxana, Epure Florina, Grigore Monica, Hotaranu Cristina, Popescu Nicoleta, Baban Oleg, Baciu Manuela, Ciobanu Aurica, Ioan Denciu Catalin, Gurau Vitalie, Maftei Ion, Moldovan Ion, Ungureanu Liviu, Bogdan Prodan, Corneci Dan, Dinu Melania, Madalina Dutu, Rely Manolescu, Silvius Negoita, Tomescu Dana, Gabriela Droc, Adrian Dinescu Stelian, Calin Mitre, Ionescu Daniela, Margarit Simona, Vasian Horatiu, Albu Corina, Balasa Carmen, Cadrigati Alina, Dragulescu Dorian, Gavra Loredana, Hentia Ciprian, Macarie Claudiu, Manescu Mihaela, Nediglea Ioan, Ocica Dana, Ovidiu Bedreag, Papurica Mariu, Plavat Cosmin, Popa Claudia, Ramneantu Mihaela, Sandesc Dorel, Sandici Zoran, Sarandan Mihaela, Belciu Ioana, Tincu Eugen, Ursu Irina, Aignatoaie Mariana, Huzuneanu Mariana, Cocu Simona, Hagau Natalia, Ciubotaru Roxana, Copotoiu Sanda-Maria, Copotoiu Ruxandra, Ioana Ghitescu, Kovacs Judit, Leonard Azamfirei, Szederjesi Iano, Genoveva Vanvu, Mosnegutu Simona, Surbatovic Maja, Djordjevic Dragan, Djordjevic Biljana, Grujic Krasimirka, Jovanovic Dusko, Krstic-Lecic Ivana, Obradovic Jovana, Zeba Snjezana, Jevdjic Jasna, Miletic Milo, Zunic Filip, Bulasevic Aleksandra, Brko Radoslava, Gazibegovic Narcisa, Kendrisic Mirjana, Vojinovic Radisa, Firment Jozef, Zahorec Roman, Capková Judita, Grochova Monika, Trenkler Stefan, Griger Martin, Bakosova Erika, Kvasnica Martin, Saniova Beata, Sulaj Miroslav, Zacharovska Andrea, Simkova Alexandra, Číková Andrea, Gebhardtova Andrea, Hanuljaková Slávka, Koutun Juraj, Martonová Andrea, Žilinčárová Veronika, Galkova Katarína, Krbila Stefan, Sobona Viliam, Ocenasova Marieta, Novak-Jankovic Vesna, Stecher Adela, Stivan Feri, Grynyuk Andriy, Damjanovska Marija, Kostadinov Ivan, Knezevic Mile, Malivojevic Marko, Borovsak Zvonko, Kamenik Mirt, Mekiš Dušan, Osojnik Irena, Kosec Lučka, Ostojič Kapš Silva, Aleksic Dragoslav, Gerjevič Božena, Kalan Katja, Ursic Tomaz, Aldecoa Cesar, Montejo González Juan, Artigas Anna, Garcia Andre, Lisi Alberto, Perez Isabel, Perez Gisela, Poch Nuria, Vaquer Sergi, Balciscueta Goiatz, Barrasa Helena, Cabanes Sara, Maynar Javier, Poveda Yolanda, Quintano Rodero Amaia, Vallejo Ana, Duque Patrícia, Garcia-Bunger Beatriz, Adoracion Elvira Maria, María Lajara Ana, Palencia María, Ramos Rafael, Saez Fernandez Ana, Tirapu León Juan, Iza López Jaione, Yoldi Murillo Francisco, Turumbay Ramirez Eva, Unzué Rico Patricia, Patricia Marta, Vizcaíno Martín, Bernat Álvarez Maria José, Planas Real Kenneth, Mas Serra Arantxa, Aracil Norma, Menendez Bodega Begoña, Fernández García Raquel, Álvarez García Marivi, Gordon Borja de la Quintana, Gutiérrez Jodrá Alicia, De Santos López Angela, Llavador Ros Juan José, Ayala Soto Rocío, Sepúlveda Isabel, Pascual Díez Esperanza, Fernández Fernández Luisa, Soria Gulina Carlo, Pérez Arviza Laura, Fernandez Lorena Mouriz, Río Gómez Antía, Alonso Martínez Concepción, Rodríguez Rodríguez Ana Belén, Lopez Soto Carmen, Garcia Clara, Lorenzo Mario, Pinilla Elena, Rico Jesu, Ruperez Irene, Saiz Alonso Eduardo, Leira Fernando, Emilio Maseda David Pestaña, Royo Concepcion, Villagran Jose, Murillo Candi Giralt, Eduardo Esteva Garcia, Mansilla Folgado Raquel, Joan Fornaguera Nadal, Calonge Montse Pijoan, Sape Prat Anna, Sintes Dolore, Arteta Arteta Donaldo, García Delgado Horacio, Fajardo López-Cuervo Juan, López Mikel Celaya, Ramírez Alejandro, José Saldaña Francisco, Aliste Pilar, Hermira Anchuelo Ana, García Campos Ascensión, Catalán Mercede, García Gómez Mónica, Gonzalez Gonzalaez Olga, López López Eloísa, Real Navacerrada Isabel, de Quevedo Sara Arlanzón, Gonzalez Serrano Matilde, Silvestre Francisco Perez-Cerdá, Martinez Torrente Francisco, Arocas Blanca, Pastor Martinez Ernesto, Soro Marina, Maroto Fernando, Robledo Algarra Ruth, Silla Aleixandre Iné, Argente Gemma Rodriguez, Lleó Ana Broseta, Rubio Antonio Vela, Vicente Sánchez José Lui, Enríquez Valcárcel Irene, Balust Clara, Balust Jaume, Borrat Xavier, Jose Carretero Maria, Gracia Isabel, Matute Purificacion, Mercadal Jordi, Pujol Roger, Tena Beatriz, Ubre Marta, Dorda Albalad Dolore, Muñoz Alcaide Concepción, Caballero Jesu, Camps Cervantes Angel, de Nadal Clanchet Miriam, Montferrer Estruch Nuria, Ballvé Ferrer Mercè, Lacasta Fornells Albert, Terrer Galera Eduard, Garcia Martinez Irene, Manrique Muñoz Susana, Pelavski Andre, Tormos Perez Pilar, Gonzalez Posada Miguel Angel, de Prat Ivette Chocron, Rello Jordi, García Serrano Llum, Naya Sieiro José Manuel, Silva Lorena, Colomina Sole Maria Jose, Biarnes Suñé Alfon, Rochera Villach Isabel, Gómez Herreras José Ignacio, Poves Rodrigo, Martinez Rafael Beatriz, Martinez Almeida Icier, Fernandez Collates Angel, Jose Bartolomé Maria, Cimadevilla Bonifacio, González González Antonio Manuel, Rabanal Llevot Jose Manuel, de Terán Mira Juan Carlos Diaz, González Molina Begoña, Pardo Sara, López Sánchez Carlo, Williams Monica, Zaldibar Estibaliz, Muñoz Corsini Lourde, Rodríguez Fraile José Ramón, de la Lastra Maria, Kabiri Sacramento Monir, López Saña Francisco Javier, Trenado Ålvarez Josep, Cantón Bulnes Maria Luisa, Gándara Carrasco Violeta, Crespo Ma del Rocío Míguez, Narváez Cubillos Diana, Laza Laza Enrique, Pérez Ma del Pino Heredia, Arenzana Seisdedos Ángel, Fernández Torres Bartolomé, Santos Ampuero Marian, Chicot Llano Marta, Mata Esperanza, Munoz Manuel, Orts Mar, Planas Antonio, Ramasco Fernando, Roman Carlo, Varela Durán Marina, Fernandez Sabela del Río, Sanduende Otero Yolanda, Lopez Pineiro Susana, Barreiro Pardal Cristina, Fernández Alcantud Jesú, Ayuso Antolinos Mercede, Barrios Francisco, Collantes Casanova Ana, Ruiz Castro Manuel, Infantes Crespo Beatriz, Lancha Felipe Uzuri, Liceras Fuster Marta, Sanz García Máximo, Herrero Garrote Begoña, Moreno Gonzalez Ricardo, Montes Granero Maria José, de la Guía Carlos Lloreda, Chaves López Raquel, de Frutos López Santiago, Marco Martinez Jose Javier, Garcia Mostaza Angel, Jiménez Moreno Antonio, Riquelme Osado Irene, Bardina Pastor Ana, Peña Rosa, Rustarazo Pérez Mónica, Aliaño Piña María, Aranda Romero Carlo, Rodríguez Elena Rodríguez, Pedroviejo Sáez Vicente, Safatle Fernando, Hernández Salvan Javier, Galán Sampedro Mar, de la Torre Patricia Alfaro, Pérez Toro Jonatan, Lasa Unzúe Crsitina, José Vargas Maria, Garcia Bernal David, Echevarria Mercede, Ubeda Iglesias Alejandro, Loza Ana, Rodriguez Morillo Araceli, Diaz Serrano Pedro, Barrientos Sevilla Fernando Caba, Cacho Elena, Calderón Ricardo, Dufur Mercede, Marginet Carolina, Monedero Pablo, José Yepes Maria, Rellán Alvarez Luzdivina, Fernández Carballal Francisca, Pensado Castiñeiras Alberto, Dieguez García Paula, Ramos López Lorena, Rama Maceiras Pablo, Martínez Puente María Socorro, Rey Rilo Maria Teresa, Trujillo Alonso Ana Esther, Rodríguez Fernández Sonia, Omaña García Rafael, Pérez García Aníbal, Bello Puentes Rafael, Nunez Aguado Domingo, Lopez Carballo Carlo, Fernandez Fernandez Ricardo, Toledo Presedo Amadeo, de Rabago Ricardo Bermejo Diaz, Rodriguez Velasco Ana, Jiménez Capel Yolanda, Fernández Cortés Ana, Martínez García Esther, Martinez Gimeno Laura, Klamburg Jordi, Castillo Omedas Rosa, González Núñez Miriam, Llubià Maristany Clara, Moret Ruiz Enrique, Artigas Xavier, Castrillón Sebastian, Espinosa Nieve, Gomez-Caro Ana M., Illa Susana, India Inmaculada, Martín-Huerta Beatriz, Moral Victoria, Moreno Marisa, Iglesias Fernández Cristina, Fernández García Violeta, Picatto Hernández Pedro, Honrubia Checa Angel Alberto, Salvatierra Diaz David, Linero Noguera Manuel, Pujol Varela Ignacio, González Gallego Miguel, Martínez García Oscar, Ariño Irujo José Javier, González Perrino Carlo, Rey Picazo Julio, López Timoneda Francisco, Manzanero Arroyo María, Albalá Blanco Isabel, Martínez Borja Marco, Martín Burcio Sara, Martinez Castro Nilda, Puente Cerdeiriña Aránzazu, de la Torre Concostrina Marta, Viñas Cristina Medrano, Dorado Díaz Trinidad, Avellanosa Esteruelas Juan, Ingelmo Ingelmo Ildefonso, Duran Insuga Paco, Claros Llamas Elisabeth, Martín Lopez Jose Juan, Beltran Martín María, Elías Martín Elena, Ureta Mesa Eva, Loren Monterde Manuela, Alonso Montoiro Paloma, Gonzalez Móstoles Maria Luisa, Velasco Olarte Eva, Martínez Pérez Adolfo, Domínguez Perez Fernando, Serrano Romero Ana, Parise Rous Diego, Mané Ruiz Nuria, Palomo Ruiz Jose Angel, Ruigomez Saiz Alvaro, Terol Alvaro de la Vega, Candela Toha Angel, Alvarez Utrera Fernando, Alberdi Fermín, Elósegui Itxaso, García Javier, Marco Garde Pilar, Itziar Mintegui Escudero, García Sáez Iker, Salas Estibaliz, Zabarte Mercede, Diaz-Boladeras Rosa-Maria, Mora-Guevara Emilio, Ferreras Zamora Julia, Bonet Alfon, Salo Lidia, Salinas Unai, Zaballos Juan, Abella Alvarez Ana, Jimenez Garrido Carlo, Hita Roa Juan Ramón, Gordo Vidal Federico, Garcia-Egea Jorge, Zamora Elson Monica, Seron-Arbeloa Carlo, Mendiola Asensio Miguel Angel, Gastaldo Simeón Rosa, Muñoz Alameda Luis Enrique, Oeding Angulo Guillermo, Aranzubia Monserrat, Juan Arcas Jose, Arevalo Julian, Quesada Belvert Belén, Pérez Calvo César, Cremades Marta, Crespo Pascual, Cuarental Ana, Del Olmo Mercede, Turrión Fernández Pablo, Garcia Vega José Luis Franqueza García Isabel, Herrera Elena, Alcala Llorente Miguel Angel, Martin Rabes Cecilia, de Maeyer Ana Gamo, Pérez Marquez Manuel, López Mendoza Diego, Milicua Muñoz José María, Arias Martínez Natividad, Santos Oviedo Arnoldo, Benavent Garrigues Pau, Alonso Íñigo José, Tormo Ferrandiz Sergi, Sanchez-Morcillo Silvia, Lafuente Sánchez Matilde, Marqués Parra Asunción, Gomar Vidal Sonia, Montoiro Allué Raquel, Zalba Etayo Begoña, Bustamante Rodriguez Raquel, Martin Villen Lui, Molla Jimenez Cristina, de Zayas Ricardo Sala, Dolera Moreno Cristina, SanJose Pacheco Fernando, Anton Pascual Jose Lui, Tejera Gude Fernando, Manteiga Riestra Eva, Cota Delgado Francisco, de la Torre Prados Maria Victoria, Barrios Javier, Cervera-Montes Manuel, García-Sanz Mercede, García Vicente, Sanmiguel Guillermo, López Álvaro Julian, Bornay Barrachima Beatriz, Romero Bermejo Francisco Jose, Martinez Garcia Alberto Garcia Fernandez Pilar, Navarro Ramírez Carolina, Gómez Ramos Jorge, Angel Samaniego Lui, Belenguer-Muncharaz Alberto, Ferrándiz-Selles Amparo, Mateu-Campos Maria-Lidon, Domínguez David, Espinosa Elena, León Teresa, Ojeda Betancor Nazario, Garcia Cortes Javier, Díaz Díaz Juan José, Manzano Canalechevarria Ana, Fores Novales Beatriz, Garcia Peña Jose Manuel, Rodriguez Delgado Toma, Santamaria Roquerio Beatriz, Gomez Sainz Juan Jose, Tebar Soto Teresa, Chew Michelle, Seeman-Lodding Heléne, Dahm Peter, Odenstedt Hergès Helena, Lundborg Christoffer, Söndergaard Sören, Rylander Christian, Sari Ferenc, Oscarsson Tibblin Anna, Adolfsson Anne, Klarin Bengt, Schrey Susann, Merisson Edyta, Rydén Jörgen, Britt Divander Mona, Hedin Annika, Hedlund Daniel, Axelsson Lindkvist Mikael, Jawad Monir, Layous Lona, Wernerman Jan, Björne Håkan, Brattström Olof, Olheden Staffan, Oldner Ander, Sellden Eva, Walder Bernhard, Wickboldt Nadine, Rossi Ariane, Steiner Luziu, Djurdjevic Mirjana, Lussmann Roger, Geisen Martin, Hofer Christoph, Turina Matthia, Grocott Mike, Goldhill David, Everett Lynn, Harris Katy, Wright Maggie, Adams David, Alderson Lorraine, Baker Julie, Christie Iain, Ferguson Colin, Hill Matthew, Holmes Kate, Hutton Andrew, Minto Gary, Moor Paul, Porter Andrew, Struthers Richard, Akotia Niven, Belhaj Alaa, Chang Serene, Collantes Enrique, Eigener Katrin, Husband Michael, Khan Ahsun, Kong Ming-Li, Jane McAlees Eleanor, Macdonald Neil, Niebrzegowska Edyta, Parnell Wendy, Smith Amanda, Chhatwal Ally, Jhingan Smriti, Muswell Richard, Poon Yoyo, Singh Nidhita, Stephens Robert, Vasan Robin, Waife Nicola, Weda Tahmina, Clarke Adrian, Szakmany Tama, Fletcher Simon, Rosbergen Melissa, Blunt Mark, Prince Liz, Wong Kate, Kumar Ram, Stilwell Sarah, Couper Keith, Crooks Neil, Gao-Smith Fang, Melody Teresa, Snaith Catherine, Patel Jaimin, Parekh Dhruv, Yeung Joyce, Loughnan Bernadette, Moosajee Va, Rope Tamsin, Edger Lliam, Dawson Julie, Hadfield Daniel, Hopkins Phil, Mcdonald Lisa, Willars Chri, Campbell Gillian, Craig Jayne, Smith Andrew, Ladipo Karleen, Lockwood Geoff, Moreno Juan, Ballington Ruth, Hamandishe Sibongilele, Rogerson David, Cowman Sarah, Hayden Paul, Pinto Nuno, Sandhar Taj, Arawwawala Dilshan, Brotherston Lauren, Mitchell-Inwang Christine, Walsh Helena, Alagarsamy Famila, Goon Serena, Karcheva Sylvia, Krepska Amy, Mckinney Brian, Patil Vishal, Batchelor Nichola, Day Christopher, Finch Louise, Gibson Charlie, Grayling Matthew, Hubble Sheena, Key William, Knight Thoma, Loosley Alexander, Margetts Paul, Stewart Hannah, Bewley Jeremy, Hurley Katrina, Murphy Ruth, Philpott Catherine, Pollock Kathryn, Sweet Katie, Thomas Matthew, Tucker Katy, Windsor David, Conway Daniel, Gold Steve, Quraishi Tanviha, Cupitt Jason, Baddeley Sally, Brown John David, Foo Irwin, Mantle Damien, Carvalho Peter, Huddart Sam, Kirk-Bayley Justin, Smith Rebecca, Milligan Lisa, Poulose Sonia, Sarkar Som, Nolan Jerry, Pedley Emma, Padkin Andrew, Pesian Siamak, Rajamanickam Satish, Ramkumar Konnur, Thomas Jerry, Crayford Alison, Turner Angu, Bottrill Fiona, Webb Stephen, Jhanji Shaman, Maccallum Niall, Wessels Kate, Wigmore Tim, Meikle Alistair, Wilson Stephen, White Stuart, Bonnett Andrew, Rushton Andrew, Williams Colin, Zuzan Oliver, Hall Andrew, Montgomery Jane, Piggot Ailie, Read Richard, Stocker Mary, Tamm Tiina, Agarwal Banwari, Ward Stephen, Brown Lucy, Joy Manju, Venkatesh Suresh, Hughes Thoma, Zsisku Lajo, Roy Alistair, Hooper Victoria, Mouland Johanna, Nightingale Jeremy, Rose Steve, Chiam Patrick, Chohan Harnita, Dickson Chri, Gibb Sarah, Higham Charley, Harvey Caroline, Janarthanan Chandra, Jones Laura, Kapoor Avinash, Moll Mark, Roberts Louise, Saunders David, Arnold Glenn, Gibbs Claire, Jhurgursing Mhairi, Pierro Dena, Pritchard France, Doyle Patrick, Templeton Maie, Wilson Robert, Zantua Kim, Collyer Thoma, Featherstone Jame, Worton Rachael, Bruce Jean, Mcguigan Kate, Price Grant, Moreton Sarah, Pulletz Mark, Anderson Helen, Baxter Ian, Beckingsale Alex, Callaghan Mark, Datta Ansu, Dawson Jo, Gollogly Jackit, Izod Chri, Lobaz Steve, Macfie Caroline, Patel Manju, Payne Heather, Singh Raj, Timms Gemma, Mcleod Shaun, O'Brian Peter, Horner Elspeth, Joshi Vivekananda, Stuart-Smith Karen, Seale Tania, Bolger Clare, Collins Hannah, Ekins Emma, Hawkins Lesley, Jonas Max, Linford Karen, Wadams Beverley, Beach Madeleine, Vizcaychipi Marcela, Jewsbury William, Davies Simon, Balaji Packianathaswamy, Kangaraj Muthuraj, Pissay Nagesh, Smith Neil, Gopalakrishnan Senthilkumar, Mackinnon John, Strandvik Gustav, Francis Ruth, Jennings Adrian, Keating Matthew, Kumar Sajith, Leese Sarah, Magee Cliona, Pilsbury Jane, Ralph Jame, Riddington David, Sachdeva Rajneesh, Snelson Catherine, Vasanth Suresh, Wilde Judith, Lavender Beth, Lyons Rachel, Watters Malcolm, Adams Tim, Dyer Simon, Tindall Lucy, Claxton Andrew, Netke Meenu, Akouds Esam, Bates Debrah, Gallagher Heather, Hatton Jonathan, Holroyd William, Mitra Atideb, Nurse Trudy, Reed Deborah, Desikan Somi, Barber Russell, Childs Sophie, O'Carroll-Kuehn Britta, Wyldbore Mark, Al-Abdaly Ayad, Amatya Suman, Bhaskaran Sherly, Chandan Garud, Chaudhry Suman, Chikungwa Mose, Earnshaw Greg, Grewal Moni, Haque Shamimul, Hawkins John, Javaid Ahmed, Jackson Clare, Kamel Miriam, Marla Ruchira, Mculloch Dori-Ann, Parker Tom, Salib Yussof, Saravanmuthu Ramesh, Secker Chri, Sockalingam Siva, Taylor Anne, Austine Pauline, Kanade Vrushali, Paal Dora, Sam Mok May Un, Burtenshaw Andrew, Davis Laura, Ellahee Parvez, Freeman David, Pierson Richard, Wollaston Julie, Karmarkar Amara, Ball Clare, Calton Emily, Maxwell Louise, Walker Rachel, Bland Martin, Bullock Lynne, Harrison-Briggs Donna, Hodge Paul, Krige Anton, Dempsey Ged, Hammell Claire, Loveridge Robert, Parker Robert, Snell Jane, Wright Carl, Baker Andy, Barr Katharine, Belcher Alex, Bonnington Sam, Bougeard Anne-Marie, Fitzgerald Emma, Ford Rachael, Gillard Chantal, Griffiths Liz, Greenberg Lizzie, Huber Jonathan, Mathieu Steve, Richardson Neil, Tompsett Laura, White Nigel, Patel Santosh, Corner Victoria, Thomas Richard, Trodd Dawn, Wilson Jennifer, Copley Ed, Flutter Laura, Hulme Jonathan, Susarla Jay, Thwaites Alison, Jayasundera Suraj, Mcafee Sean, Chantler Jonathan, Mckechnie Stuart, Neely Julia, Mouton Ronelle, Scarth Edward, Soar Jasmeet, Buss Joanne, Currie Vicki, Sange Mansoor, Kuttler Anja, Power Fiona, Alexander David, Dunne Kevin, Shinner Guy, Black Euan, Haldane Grant, Kerr Jennie, Saran Taj, Ward Geraldine, Jefferies Fiona, Alexander Peter, Royle Alison, Nahla Farid, Bowles Tim, Gregory Maggie, Ahern Rebecca, Cartlidge David, Craker Lloyd, Thompson Christopher, Bidd Heena, Giles Julian, Manser Amanda, Parry Gareth, Chan Peter, Das Dinesh, Fahmy Nisreen, Higgins David, Khader Ahmed, Stone Alex, Leonardi Silvia, Rose Oliver, Bright Elizabeth, Ercole Ari, Amir Rafi Muhammed, Ramasamy Radhika, Sheshgiri Bengeri, Merrill Colin, Page Valerie, Walker Elaine, Harris Stephen, Hughes Sarah, Morrison Alan, Razouk Khaled, Ayman Mustafa, Jakeman Alicia, Mowatt Chri, Paananen Sami, Supporting clinical sciences, Intensive Care, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service d'anesthésiologie, Surgery, and RS: NUTRIM - R2 - Gut-liver homeostasis

Subjects
Male, The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients, Hospital admission, Hospital discharge, Intensive care, Length of stay, Surgical mortality, Epidemiology, Iron metabolism Pathogenesis and modulation of inflammation [IGMD 7], surgery, Cohort Studies, Clinical endpoint, Medicine, Hospital Mortality, Hospital discharge, education.field_of_study, Mortality rate, Medicine (all), Confounding, General Medicine, Middle Aged, Surgical mortality, Operative, Europe, Hospitalization, Treatment Outcome, Surgical Procedures, Operative, outcomes, surgery, mortality, Female, mortality, cohort study, Cohort study, Human, Adult, medicine.medical_specialty, Critical Care, Population, MEDLINE, Settore MED/41 - ANESTESIOLOGIA, Humans, ddc:610, Mortality, education, surgery, mortality, Europe, Aged, Postoperative Care, Surgical Procedures, business.industry, Length of Stay, Hospital admission, Surgery, Clinical outcomes, Intensive care, Mann–Whitney U test, Cohort Studie, business
Abstract

Item does not contain fulltext BACKGROUND: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe. METHODS: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used chi(2) and Fisher's exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p

Published
2012
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46. Influence of Two Colloidal Extracorporeal Primes on Coagulation of Cardiac Surgical Patients: A Prospectively Randomized Open-Label Pilot Trial.

Author

Bethlehem I, Wierda K, Visser C, Jekel L, Koopmans M, and Kuiper MA

Subjects
Aged, Female, Humans, Male, Middle Aged, Pilot Projects, Prospective Studies, Thrombelastography, Blood Coagulation drug effects, Cardiopulmonary Bypass methods, Colloids therapeutic use, Gelatin therapeutic use, Hydroxyethyl Starch Derivatives therapeutic use, Plasma Substitutes therapeutic use
Abstract

The search for the ideal priming fluid continues as more evidence is discovered about side effects of volume expanders. With the availability of modern, balanced hydroxyethyl starch (HES) solutions with less side effects than former HES solutions, we considered to replace our gelatin- (modified gelatin) based extracorporeal circuit prime for a HES (130/.42) prime. Therefore, we studied the influence of two colloidal priming fluids on postoperative coagulation in patients undergoing cardiac surgery. The primary endpoint was to compare clot formation time between the HES group and the gelatin group with rotational thromboelastometry (ROTEM). Additionally we compared colloid osmotic pressure and fluid balance of both groups. Forty patients, undergoing elective first time coronary artery bypass grafting or single-valve surgery, were included in this prospectively randomized open-label pilot study. Laboratory data and ROTEM data were collected and analyzed for differences between the two groups. ROTEM data show significantly more prolongation in Extem clot formation time and significant more decrease in Extem alpha in the HES group. Fibtem maximum clot firmness was significantly smaller in the HES group; this was consistent with fibrinogen concentration measurement, which decreased more in the HES group than in the gelatin group and recovered more over time in the gelatin group. We found no significant difference in colloid. osmotic pressure between the groups. In this trial, HES (130/.42) impairs coagulation significantly more compared with gelatin. These differences in influence on coagulation did not lead to a difference in blood loss or fluid balance, so clinical relevance could not be proven.

Published
2014

47. No agreement of mixed venous and central venous saturation in sepsis, independent of sepsis origin.

Author

van Beest PA, van Ingen J, Boerma EC, Holman ND, Groen H, Koopmans M, Spronk PE, and Kuiper MA

Subjects
Aged, Catheterization, Central Venous methods, Female, Humans, Intensive Care Units standards, Male, Middle Aged, Oximetry methods, Oximetry standards, Predictive Value of Tests, Prospective Studies, Catheterization, Central Venous standards, Oxygen Consumption physiology, Sepsis diagnosis, Sepsis physiopathology
Abstract

Introduction: Controversy remains regarding the relationship between central venous saturation (ScvO(2)) and mixed venous saturation (SvO(2)) and their use and interchangeability in patients with sepsis or septic shock. We tested the hypothesis that ScvO(2) does not reliably predict SvO(2) in sepsis. Additionally we looked at the influence of the source (splanchnic or non-splanchnic) of sepsis on this relationship., Methods: In this prospective observational two-center study we concurrently determined ScvO(2) and SvO(2) in a group of 53 patients with severe sepsis during the first 24 hours after admission to the intensive care units in 2 Dutch hospitals. We assessed correlation and agreement of ScvO(2) and SvO(2), including the difference, i.e. the gradient, between ScvO(2) and SvO(2) (ScvO(2) - SvO(2)). Additionally, we compared the mean differences between ScvO(2) and SvO(2) of both splanchnic and non-splanchnic group., Results: A total of 265 paired blood samples were obtained. ScvO(2) overestimated SvO(2) by less than 5% with wide limits of agreement. For changes in ScvO(2) and SvO(2) results were similar. The distribution of the (ScvO(2) - SvO(2)) (< 0 or ≥ 0) was similar in survivors and nonsurvivors. The mean (ScvO(2) - SvO(2)) in the splanchnic group was similar to the mean (ScvO(2) - SvO(2)) in the non-splanchnic group (0.8 ± 3.9% vs. 2.5 ± 6.2%; P = 0.30). O(2)ER (P = 0.23) and its predictive value for outcome (P = 0.20) were similar in both groups., Conclusions: ScvO(2) does not reliably predict SvO(2) in patients with severe sepsis. The trend of ScvO(2) is not superior to the absolute value in this context. A positive difference (ScvO(2) - SvO(2)) is not associated with improved outcome.

Published
2010
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48. Determinants of tidal volumes with adaptive support ventilation: a multicenter observational study.

Author

Dongelmans DA, Veelo DP, Bindels A, Binnekade JM, Koppenol K, Koopmans M, Korevaar JC, Kuiper MA, and Schultz MJ

Subjects
Aged, Anesthesiology methods, Critical Care, Female, Hemodynamics, Humans, Male, Microcomputers, Middle Aged, Prospective Studies, Pulmonary Gas Exchange, Thoracic Surgery methods, Treatment Outcome, Respiration, Artificial, Tidal Volume
Abstract

Introduction: In the present study, we investigated the behavior of adaptive support ventilation (ASV) in patients after cardiothoracic surgery. We determined tidal volumes (Vt) and factors that influence Vt with this mode of microprocessor-controlled mechanical ventilation (MV)., Methods: This was a prospective, multicenter, observational study in three Dutch intensive care units over a 5-mo period. MV data were collected during steady-state after arrival in the intensive care unit., Results: Data were collected for 346 consecutive patients after cardiothoracic surgery: 262 patients weaned with ASV, and 84 patients weaned with pressure-controlled/pressure-support MV. With ASV the mean (+/- sd) Vt expressed per kilogram actual body weight was 7.1 +/- 1.6 mL. Expressed per kilogram ideal body weight (IBW), Vt was 8.3 +/- 1.5 mL. In patients with a correctly set body weight (SBW) (i.e., the IBW), Vt was 8.1 +/- 1.4 mL/kg. With pressure-controlled/pressure-support-MV Vt was 7.3 +/- 1.4 mL/kg IBW (P < 0.001 vs ASV). Multivariate logistic regression analysis showed Vt with ASV to be dependent on only two parameters: respiratory rate and the correctness of SBW., Conclusions: Vt with ASV seems to be dependent on two parameters: respiratory rate and the correctness of SBW. The first factor is not clinically important because respiratory rate is automatically chosen by the microprocessor. The second factor is clinically important because it is the only factor that can be influenced by the operator. Our data show the importance of setting the correct weight with ASV. With ASV, Vt are >8 mL/kg IBW in a substantial number of patients. Randomized clinical trials should be performed to compare ASV with other ventilation modes.

Published
2008
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