213 results on '"van der Horst ICC"'
Search Results
2. Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries
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Linschoten, M, Uijl, A, Schut, A, Jakob, CEM, Romao, LR, Bell, RM, McFarlane, E, Stecher, M, Zondag, AGM, van Iperen, EPA, Hermans-van Ast, JF, Lea, NC, Schaap, J, Jewbali, LS, Smits, PC, Patel, RS, Aujayeb, A, van Smeden, M, Siebelink, HJ, Williams, S, Pilgram, L, Tieleman, RG, Williams, B, Asselbergs, FW, Al-Ali, AK, Al-Muhanna, FA, Al-Rubaish, AM, Al-Windy, NYY, Alkhalil, M, Almubarak, YA, Al Nafie, AN, Al Shahrani, M, Al Shehri, AM, Anning, C, Anthonio, RL, Badings, EA, Ball, C, Van Beek, EA, Ten Berg, JM, Von Bergwelt-Baildon, M, Bianco, M, Blagova, O, Bleijendaal, H, Bor, WL, Borgmann, S, van Boxem, AJM, van den Brink, FS, Bucciarelli-Ducci, C, Van Bussel, BCT, Byrom-Goulthorp, R, Captur, G, Caputo, M, Charlotte, N, vom Dahl, J, Dark, P, De Sutter, J, Degenhardt, C, Delsing, CE, Dolff, S, Dorman, HGR, Drost, JT, Eberwein, L, Emans, ME, Er, AG, Ferreira, JB, Forner, MJ, Friedrichs, A, Gabriel, L, Groenemeijer, BE, Groenendijk, AL, Gruener, B, Guggemos, W, Haerkens-Arends, HE, Hanses, F, Hedayat, B, Heigener, D, van der Heijden, DJ, Hellou, E, Hellwig, K, Henkens, MTHM, Hermanides, RS, Hermans, WRM, van Hessen, MWJ, Heymans, SRB, Hilt, AD, van der Horst, ICC, Hower, M, van Ierssel, SH, Isberner, N, Jensen, B, Kearney, MT, Kielstein, JT, Kietselaer, BLJH, Kochanek, M, Kolk, MZH, Koning, AMH, Kopylov, PY, Kuijper, AFM, Kwakkel-van, ERPJM, Lanznaster, J, van der Linden, MMJM, van der Lingen, ACJ, Linssen, GCM, Lomas, D, Maarse, M, Magdelijns, FJH, Magro, M, Markart, P, Martens, FMAC, Mazzilli, SG, McCann, GP, van der Meer, P, Meijs, MFL, Merle, U, Messiaen, P, Milovanovic, M, Monraats, PS, Montagna, L, Moriarty, A, Moss, AJ, Mosterd, A, Nadalin, S, Nattermann, J, Neufang, M, Nierop, PR, Offerhaus, JA, Van Ofwegen-Hanekamp, CEE, Parker, E, Persoon, AM, Piepel, C, Pinto, YM, Poorhosseini, H, Prasad, S, Raafs, AG, Raichle, C, Rauschning, D, Redon, J, Reidinga, AC, Ribeiro, MIA, Riedel, C, Rieg, S, Ripley, DP, Rommele, C, Rothfuss, K, Ruddel, J, Ruthrich, MM, Salah, R, Saneei, E, Saxena, M, Schellings, DAAM, Scholte, NTB, Schubert, J, Seelig, J, Shafiee, A, Shore, AC, Spinner, C, Stieglitz, S, Strauss, R, Sturkenboom, NH, Tessitore, E, Thomson, RJ, Timmermans, PJR, Tio, RA, Tjong, FVY, Tometten, L, Trauth, J, Van Craenenbroeck, EM, van Veen, HPAA, den Uil, CA, Vehreschild, MJGT, Veldhuis, L, Veneman, T, Verschure, DO, Voigt, I, Walter, L, vande Watering, DJ, de Vries, JK, vande Wal, RMA, Westendorp, ICD, Westendorp, PHM, Westhoff, T, Weytjens, C, Wierda, E, Wille, K, de With, K, Worm, M, Woudstra, P, Wu, KW, Zaal, R, Zaman, AG, van der Zee, PM, Zijlstra, LE, Alling, TE, Ahmed, R, Bayraktar-Verver, ECE, van Aken, K, Jimenes, Bermudez FJ, Biole, CA, Den Boer-Penning, P, Bontje, M, Bos, M, Bosch, L, Broekman, M, Broeyer, FJF, de Bruijn, EAW, Bruinsma, S, Cardoso, NM, Cosyns, B, Len, van Da DH, Dekimpe, E, Domange, J, van Doorn, JL, van DOorn, P, Dormal, F, Drost, IMJ, Dunnink, A, van Eck, JWM, Elshinawy, K, Gevers, RMM, Gognieva, DG, van der Graaf, M, Grangeon, S, Guclu, A, Habib, A, Haenen, NA, Hamilton, K, Handgraaf, S, Heidbuchel, H, Hendriks-van Woerden, M, Hessels-Linnemeijer, BM, Hosseini, K, Huisman, J, Jacobs, TC, Jansen, SE, Janssen, A, Jourdan, K, ten Kate, GL, van Kempen, MJ, Kievit, CM, Kleikers, P, Knufman, N, van der Kooi, SE, Koole, BAS, Koole, MAC, Kui, KK, Kuipers-Elferink, L, Lemoine, I, Lensink, E, van Marrewijk, V, Meijer, EJ, Melein, AJ, Mesitskaya, DF, van Nes, CPM, Paris, FMA, Perrelli, MG, Pieterse-Rots, A, Pisters, R, Polkerman, BC, van Poppel, A, Reinders, S, Reitsma, MJ, Ruiter, AH, Selder, JL, van der Sluis, A, Sousa, AIC, Tajdini, M, Sanchez, Tercedor L, Van de Heyning, CM, Vial, H, Vlieghe, E, Vonkeman, HE, Vreugdenhil, P, de Vries, TAC, Willems, AM, Wils, AM, Zoet-Nugteren, SK, Cardiovascular Centre (CVC), Restoring Organ Function by Means of Regenerative Medicine (REGENERATE), Cardiology, Intensive Care, RS: CAPHRI - R5 - Optimising Patient Care, MUMC+: MA Medische Staf IC (9), RS: Carim - H02 Cardiomyopathy, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - V04 Surgical intervention, MUMC+: MA Intensive Care (3), UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de cardiologie, CAPACITY-COVID Collaborative Consortium, LEOSS Study Group, Rheumatology, AII - Infectious diseases, AII - Inflammatory diseases, AMS - Musculoskeletal Health, AMS - Tissue Function & Regeneration, ACS - Heart failure & arrhythmias, General practice, Epidemiology and Data Science, Graduate School, Nuclear Medicine, and ACS - Atherosclerosis & ischemic syndromes
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Male ,Cardiac & Cardiovascular Systems ,Epidemiology ,education ,Medizin ,Comorbidity ,AMERICAN-COLLEGE ,GUIDELINES ,DIAGNOSIS ,Cohort Studies ,Risk Factors ,MANAGEMENT ,Humans ,AcademicSubjects/MED00200 ,Hospital Mortality ,Aged ,Heart Failure ,Science & Technology ,SARS-CoV-2 ,COVID-19 ,ASSOCIATION ,Cardiovascular disease ,EUROPEAN-SOCIETY ,Hospitalization ,surgical procedures, operative ,Editorial ,Cardiovascular System & Cardiology ,behavior and behavior mechanisms ,HEART-FAILURE ,Female ,Patient registry ,Human medicine ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,psychological phenomena and processes ,TASK-FORCE - Abstract
Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Methods and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66–75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n = 1545 vs. 15.9%; n = 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02–1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10–1.30; P Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization.
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- 2021
3. Breath octane and acetaldehyde as markers for acute respiratory distress syndrome in invasively ventilated patients suspected to have ventilator-associated pneumonia
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Heijnen, NFL, Hagens, LA, van Schooten, F-J, Bos, LDJ, van der Horst, ICC, Mommers, A, Schultz, MJ, Smit, MR, Bergmans, DCJJ, Smolinska, A, and Schnabel, RM
- Abstract
Rationale The concentration of octane and acetaldehyde in exhaled breath has good diagnostic accuracy for acute respiratory distress syndrome (ARDS). We aimed to determine whether breath octane and acetaldehyde are able to distinguish the presence and absence of ARDS in critically ill patients suspected to have ventilator-associated pneumonia (VAP). Methods This is a secondary analysis of a prospective observational study into exhaled breath analysis using gas chromatography–time-of-flight mass spectrometry. Difference in the relative abundance of octane and acetaldehyde in exhaled breath was compared between patients with and without ARDS using the Mann–Whitney U-test and the association was quantified using logistic regression. The discriminative accuracy of octane and acetaldehyde, alone or in combination, was calculated using the area under the receiver operating characteristic curve (AUROCC). Results We included 98 patients, of whom 32 had ARDS and 66 did not. The area under the acetaldehyde peak was higher in patients with ARDS (p=0.03), and associated with the presence of ARDS (OR 1.06 per 100 000 count change, 95% CI 1.02–1.13 per 100 000 count change; p=0.01). A combined model with octane and acetaldehyde showed a high specificity and low sensitivity (90% and 40.6%, respectively), with a low accuracy (AUROCC 0.65, 95% CI 0.53–0.78). Conclusion Patients suspected to have VAP with ARDS had a higher acetaldehyde concentration in exhaled breath than patients suspected to have VAP without ARDS. However, in this patient population, discrimination of these breath biomarkers for ARDS was poor, indicating the difficulty of translating diagnostic tests between clinical settings.
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- 2022
4. A new tool to assess Clinical Diversity In Meta-analyses (CDIM) of interventions
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Barbateskovic, M, Koster, TM, Eck, RJ, Maagaard, M, Afshari, A, Blokzijl, F, Cronhjort, M, Dieperink, W, Fabritius, ML, Feinberg, J, French, C, Gareb, B, Geisler, A, Granholm, A, Hiemstra, B, Hu, R, Imberger, G, Jensen, BT, Jonsson, AB, Karam, O, Kong, DZ, Korang, SK, Koster, G, Lai, B, Liang, N, Lundstrom, LH, Marker, S, Meyhoff, TS, Nielsen, EE, Norskov, AK, Munch, MW, Risom, EC, Rygard, SL, Safi, S, Sethi, N, Sjovall, F, Lauridsen, S, van Bakelen, N, Volbeda, M, van der Horst, ICC, Gluud, C, Perner, A, Moller, MH, Keus, E, Wetterslev, J, Barbateskovic, M, Koster, TM, Eck, RJ, Maagaard, M, Afshari, A, Blokzijl, F, Cronhjort, M, Dieperink, W, Fabritius, ML, Feinberg, J, French, C, Gareb, B, Geisler, A, Granholm, A, Hiemstra, B, Hu, R, Imberger, G, Jensen, BT, Jonsson, AB, Karam, O, Kong, DZ, Korang, SK, Koster, G, Lai, B, Liang, N, Lundstrom, LH, Marker, S, Meyhoff, TS, Nielsen, EE, Norskov, AK, Munch, MW, Risom, EC, Rygard, SL, Safi, S, Sethi, N, Sjovall, F, Lauridsen, S, van Bakelen, N, Volbeda, M, van der Horst, ICC, Gluud, C, Perner, A, Moller, MH, Keus, E, and Wetterslev, J
- Abstract
OBJECTIVE: To develop and validate Clinical Diversity In Meta-analyses (CDIM), a new tool for assessing clinical diversity between trials in meta-analyses of interventions. STUDY DESIGN AND SETTING: The development of CDIM was based on consensus work informed by empirical literature and expertise. We drafted the CDIM tool, refined it, and validated CDIM for interrater scale reliability and agreement in three groups. RESULTS: CDIM measures clinical diversity on a scale that includes four domains with 11 items overall: setting (time of conduct/country development status/units type); population (age, sex, patient inclusion criteria/baseline disease severity, comorbidities); interventions (intervention intensity/strength/duration of intervention, timing, control intervention, cointerventions); and outcome (definition of outcome, timing of outcome assessment). The CDIM is completed in two steps: first two authors independently assess clinical diversity in the four domains. Second, after agreeing upon scores of individual items a consensus score is achieved. Interrater scale reliability and agreement ranged from moderate to almost perfect depending on the type of raters. CONCLUSION: CDIM is the first tool developed for assessing clinical diversity in meta-analyses of interventions. We found CDIM to be a reliable tool for assessing clinical diversity among trials in meta-analysis.
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- 2021
5. Metrology part 2: Procedures for the validation of major measurement quality criteria and measuring instrument properties
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Squara, P, Scheeren, TWL, Aya, HD, Bakker, Hanneke, Cecconi, M, Einav, S, Malbrain, MLNG, Monnet, X, Reuter, DA, van der Horst, ICC, Saugel, B, Squara, P, Scheeren, TWL, Aya, HD, Bakker, Hanneke, Cecconi, M, Einav, S, Malbrain, MLNG, Monnet, X, Reuter, DA, van der Horst, ICC, and Saugel, B
- Abstract
A measurement is always afflicted with some degree of uncertainty. A correct understanding of the different types of uncertainty, their naming, and their definition is of crucial importance for an appropriate use of the measuring instruments. However, in perioperative and intensive care medicine, the metrological requirements for measuring instruments are poorly defined and often used spuriously. The correct use of metrological terms is also of crucial importance in validation studies. The European Union published a new directive on medical devices, mentioning that in the case of devices with a measuring function, the notified body is involved in all aspects relating to the conformity of the device with the metrological requirements. It is therefore the task of scientific societies to establish the standards in their area of expertise. After adopting the same understandings and definitions (part 1), the different procedures for the validation of major quality criteria of measuring devices must be consensually established. In this metrologic review (part 2), we review the terms and definitions of validation, some basic processes leading to the display of an indication from a physiologic signal, and procedures for the validation of measuring instrument properties, with specific focus on perioperative and intensive care medicine including appropriate examples.
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- 2021
6. Current use of inotropes in circulatory shock
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Scheeren, TWL, Bakker, Hanneke, Kaufmann, T, Annane, D, Asfar, P, Boerma, EC, Cecconi, M, Chew, MS, Cholley, B, Cronhjort, M, De Backer, D, Dubin, A, Dunser, MW, Duranteau, J, Gordon, AC, Hajjar, LA, Hamzaoui, O, Hernandez, G, Edul, VK, Koster, G, Landoni, G, Leone, M, Levy, B, Martin, C, Mebazaa, A, Monnet, X, Morelli, A, Payen, D, Pearse, RM, Pinsky, MR, Radermacher, P, Reuter, DA, Sakr, Y, Sander, M, Saugel, B, Singer, M, Squara, P, Vieillard-Baron, A, Vignon, P, Vincent, JL, van der Horst, ICC, Vistisen, ST, Teboul, JL, Scheeren, TWL, Bakker, Hanneke, Kaufmann, T, Annane, D, Asfar, P, Boerma, EC, Cecconi, M, Chew, MS, Cholley, B, Cronhjort, M, De Backer, D, Dubin, A, Dunser, MW, Duranteau, J, Gordon, AC, Hajjar, LA, Hamzaoui, O, Hernandez, G, Edul, VK, Koster, G, Landoni, G, Leone, M, Levy, B, Martin, C, Mebazaa, A, Monnet, X, Morelli, A, Payen, D, Pearse, RM, Pinsky, MR, Radermacher, P, Reuter, DA, Sakr, Y, Sander, M, Saugel, B, Singer, M, Squara, P, Vieillard-Baron, A, Vignon, P, Vincent, JL, van der Horst, ICC, Vistisen, ST, and Teboul, JL
- Abstract
Background: Treatment decisions on critically ill patients with circulatory shock lack consensus. In an international survey, we aimed to evaluate the indications, current practice, and therapeutic goals of inotrope therapy in the treatment of patients with circulatory shock. Methods: From November 2016 to April 2017, an anonymous web-based survey on the use of cardiovascular drugs was accessible to members of the European Society of Intensive Care Medicine (ESICM). A total of 14 questions focused on the profile of respondents, the triggering factors, first-line choice, dosing, timing, targets, additional treatment strategy, and suggested effect of inotropes. In addition, a group of 42 international ESICM experts was asked to formulate recommendations for the use of inotropes based on 11 questions. Results: A total of 839 physicians from 82 countries responded. Dobutamine was the first-line inotrope in critically ill patients with acute heart failure for 84% of respondents. Two-thirds of respondents (66%) stated to use inotropes when there were persistent clinical signs of hypoperfusion or persistent hyperlactatemia despite a supposed adequate use of fluids and vasopressors, with (44%) or without (22%) the context of low left ventricular ejection fraction. Nearly half (44%) of respondents stated an adequate cardiac output as target for inotropic treatment. The experts agreed on 11 strong recommendations, all of which were based on excellent (> 90%) or good (81–90%) agreement. Recommendations include the indications for inotropes (septic and cardiogenic shock), the choice of drugs (dobutamine, not dopamine), the triggers (low cardiac output and clinical signs of hypoperfusion) and targets (adequate cardiac output) and stopping criteria (adverse effects and clinical improvement). Conclusion: Inotrope use in critically ill patients is quite heterogeneous as self-reported by individual caregivers. Eleven strong recommendations on the indications, choice, triggers
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- 2021
7. Meta-epidemiologic study of risk of bias assessed by Cochrane tool 2.0 and intervention effect estimates in intensive care randomised clinical trials. A protocol for the MERIT project
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Koster, TM, Gluud, C, Jakobsen, JC, Van Der Horst, ICC, and Keus, F
- Abstract
Introduction Meta-epidemiological analyses have demonstrated that reported trial design characteristics (e.g. randomisation method) are associated with intervention effect estimates in randomised clinical trials, but none have systematically assessed these aspects in intensive care trials. The objective of this meta-epidemiological study is to assess the associations between reported trial design characteristics and intervention effect estimates of randomised clinical trials included in meta-analyses on intensive care medicine. Methods and analysis We will search The Cochrane Library, MEDLINE, and EMBASE for systematic reviews and other reviews with meta-analyses of interventions in intensive care. We will extract data of pre-defined meta-analysed outcomes and the risk of bias assessments conducted by the authors of the reviews. We will reassess the risk of bias using the Cochrane risk of bias tool 2.0 (RoB 2.0). The primary analysis will evaluate the ratio of odds ratios (ROR) of the overall bias risk evaluation for the pre-defined outcomes. We will calculate the ROR by the OR of trials at overall some concerns on risk of bias or high risk of bias divided by the OR of trials at overall low risk of bias, so that a ROR < 1.0 indicates overestimation of beneficial intervention effects. Secondary analyses will evaluate the ROR of the individual bias risk domains. Tertiary analyses will compare the risk of bias assessments conducted by the review authors with RoB 1.0 with the one conducted by us employing RoB 2.0. Ethics and dissemination This will be a meta-epidemiological study and no patients will be involved in this study, accordingly no ethics approval is needed. Results of this study will be submitted for publication in an international peer-reviewed journal.
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- 2020
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8. Data on sex differences in one-year outcomes of out-of-hospital cardiac arrest patients without ST-segment elevation
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Spoormans, EM, Lemkes, JS, Janssens, GN, van der Hoeven, NW, Jewbali, Lucia, Dubois, Eric, van de Ven, PM, Meuwissen, M, Rijpstra, TA, Bosker, HA, Blans, MJ, Bleeker, GB, Baak, R, Vlachojannis, GJ, Eikemans, BJW, van der Harst, P, van der Horst, ICC, Voskuil, M, van der Heijden, JJ, Beishuizen, A, Stoel, M, Camaro, C, van der Hoeven, H, Henriques, JP, Vlaar, APJ, Vink, MA, van den Bogaard, B, Heestermans, T, de Ruijter, W, Delnoij, TSR, Crijns, H, Jessurun, G A J, Oemrawsingh, PV, Gosselink, MTM, Plomp, K, Magro, M, Elbers, PW, Appelman, Y, Royen, N, Spoormans, EM, Lemkes, JS, Janssens, GN, van der Hoeven, NW, Jewbali, Lucia, Dubois, Eric, van de Ven, PM, Meuwissen, M, Rijpstra, TA, Bosker, HA, Blans, MJ, Bleeker, GB, Baak, R, Vlachojannis, GJ, Eikemans, BJW, van der Harst, P, van der Horst, ICC, Voskuil, M, van der Heijden, JJ, Beishuizen, A, Stoel, M, Camaro, C, van der Hoeven, H, Henriques, JP, Vlaar, APJ, Vink, MA, van den Bogaard, B, Heestermans, T, de Ruijter, W, Delnoij, TSR, Crijns, H, Jessurun, G A J, Oemrawsingh, PV, Gosselink, MTM, Plomp, K, Magro, M, Elbers, PW, Appelman, Y, and Royen, N
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- 2020
9. Current use of vasopressors in septic shock
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Scheeren, TWL, Bakker, Hanneke, De Backer, D, Annane, D, Asfar, P, Boerma, EC, Cecconi, M, Dubin, A, Dunser, MW, Duranteau, J, Gordon, AC, Hamzaoui, O, Hernandez, G, Leone, M, Levy, B, Martin, C, Mebazaa, A, Monnet, X, Morelli, A, Payen, D, Pearse, R, Pinsky, MR, Radermacher, P, Reuter, D, Saugel, B, Sakr, Y, Singer, M, Squara, P, Vieillard-Baron, A, Vignon, P, Vistisen, ST, van der Horst, ICC, Vincent, JL, Teboul, JL, Scheeren, TWL, Bakker, Hanneke, De Backer, D, Annane, D, Asfar, P, Boerma, EC, Cecconi, M, Dubin, A, Dunser, MW, Duranteau, J, Gordon, AC, Hamzaoui, O, Hernandez, G, Leone, M, Levy, B, Martin, C, Mebazaa, A, Monnet, X, Morelli, A, Payen, D, Pearse, R, Pinsky, MR, Radermacher, P, Reuter, D, Saugel, B, Sakr, Y, Singer, M, Squara, P, Vieillard-Baron, A, Vignon, P, Vistisen, ST, van der Horst, ICC, Vincent, JL, and Teboul, JL
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- 2019
10. The relationship between terminal QRS distortion on initial ECG and final infarct size at 4 months in conventional ST- segment elevation myocardial infarct patients
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Hassell, MECJ, Delewi, R, Lexis, C P H, Smulders, M W, Hirsch, Alexander, Wagner, G, Bekkers, SCAM, van der Horst, ICC, Zijlstra, Felix, van Rossum, AC, Piek, JJ, van der Harst, P, Nijveldt, R, Hassell, MECJ, Delewi, R, Lexis, C P H, Smulders, M W, Hirsch, Alexander, Wagner, G, Bekkers, SCAM, van der Horst, ICC, Zijlstra, Felix, van Rossum, AC, Piek, JJ, van der Harst, P, and Nijveldt, R
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- 2016
11. Hyperglycemia has a stronger relation trauma patients than in other critically with outcome in ill patients
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Vogelzang, M, Nijboer, JMM, van der Horst, ICC, Zijlstra, F, ten Duis, HJ, Nijsten, MWN, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), and Cardiovascular Centre (CVC)
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insulin ,BLOOD-GLUCOSE CONTROL ,MORTALITY ,craniocerebral trauma ,SEVERE HEAD-INJURY ,INTENSIVE-CARE ,ILLNESS ,SEVERITY ,outcome ,STRESS HYPERGLYCEMIA ,MANAGEMENT ,critical illness ,hyperglycemia ,ADMISSION HYPERGLYCEMIA - Abstract
Background. Acute hyperglycemia is associated with adverse outcome in critically ill patients. Glucose control with insulin improves outcome in surgical intensive care unit (SICU) patients, but the effect in trauma patients is unknown. We investigated hyperglycemia and outcome in SICU patients with and without trauma. Methods: A 12-year retrospective study,was performed at a 12-bed SICU. We collected the reason for admission, Injury Severity Scores (ISS), and 30-day mortality rates. Glucose measurements were used to calculate the hyperglycemic index (HGI), a measure indicative of overall hyperglycemia during the entire SICU stay. Results: In all, 5234 nontrauma and 865 trauma patients were studied. Trauma patients were younger, more frequently male, and had both lower median admission glucose (123 versus 133 mg/dL) and HGI levels (8.9 vs. 18.4 mg/dL) than nontrauma patients (p
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- 2006
12. The role of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention for ST elevation myocardial infarction
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Svilaas, T, van der Horst, ICC, Zijlstra, F, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), and Cardiovascular Centre (CVC)
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ABCIXIMAB ,TIROFIBAN ,PILOT TRIAL ,EPTIFIBATIDE ,ANGIOPLASTY ,METAANALYSIS - Published
- 2005
13. Sudden death in patients with myocardial infarction
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Zijlstra, F, van der Horst, ICC, Faculteit Medische Wetenschappen/UMCG, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), and Cardiovascular Centre (CVC)
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PRIMARY ANGIOPLASTY ,RANDOMIZED-TRIAL - Published
- 2005
14. The feasibility of repeated left ventricular ejection fraction analysis with sequential single-dose radionuclide ventriculography
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van der Vleuten, PA, Slart, RHJA, Tio, RA, van der Horst, ICC, van Veldhuisen, DJ, Dierckx, RA, Zijlstra, F, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC), Vascular Ageing Programme (VAP), and Translational Immunology Groningen (TRIGR)
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ACUTE MYOCARDIAL-INFARCTION ,SCINTIPHOTOGRAPHIC METHOD ,single dose ,planar radionuclide ventriculography ,CARDIOVASCULAR MAGNETIC-RESONANCE ,REPRODUCIBILITY ,VOLUME ,HEART-FAILURE ,SPIRAL-CT ,SOFTWARE ,sequential ,ECHOCARDIOGRAPHY ,DYSFUNCTION - Abstract
Objective Repeated left ventricular ejection fraction (LVEF) analyses with sequential single-dose radionuclide ventriculography might be an interesting technique for monitoring the effect of positive inotropic interventions. The aim of the study was to assess the reproducibility of LVEF measurement with planar radionuclide ventriculography within 3 h, using a standard single dose of radioactive tracer. Methods Sixteen patients underwent routine planar radionuclide ventriculography with a standard dose of 500 MBq of [[Tc-99m]pertechnetate and returned after 3 h for a repeat planar radionuclide ventriculography without administration of additional tracer. Results The average initial LVEF was 35.1 +/- 18.6%-point (range, 12%-point to 68%-point). The mean difference of the LVEF between the initial planar radionuclide ventriculography and the repeat planar radionuclide ventriculography was 2.8% +/- 6.3% (range, - 11.8% to 13.3%, P= NS). The correlation between both measurements was significant with a correlation coefficient of 0.995 (P Conclusion Repeated radionuclide ventriculography with a 3 h interval using a single standard dose of 500 MBq of [Tc-99m]pertechnetate is highly reproducible and will be useful for monitoring the effect of positive inotropic interventions.
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- 2005
15. Relationship of baseline glucose and mortality during medical critical illness?
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Ligtenberg, JJM, Meijering, S, Vogelzang, M, Nijsten, MWN, van der Horst, ICC, Tulleken, JE, Zijlstra, JG, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC), and Vascular Ageing Programme (VAP)
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- 2005
16. ST-segment elevation resolution and outcome in patients treated with primary angioplasty and glucose-insulin-potassium infusion
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van der Horst, ICC, De Luca, G, Ottervanger, JP, de Boer, MJ, Hoorntje, JCA, Suryapranata, H, Gosselink, ATM, Zijlstra, F, van 't Hof, AWJ, Dambrink, Jan Hendrik Everwijn, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), and Cardiovascular Centre (CVC)
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ACUTE MYOCARDIAL-INFARCTION ,INCREASED GLYCOLYTIC SUBSTRATE ,SUCCESSFUL REPERFUSION ,METABOLIC MODULATION ,BLOOD-FLOW ,CORONARY REPERFUSION ,FREE FATTY-ACIDS ,NONINVASIVE METHOD ,RANDOMIZED-TRIAL ,DIABETIC-PATIENTS - Abstract
Background To evaluate the impact of adjunctive high-dose glucose-insulin-potassium (GIK) on ST-segment elevation resolution in patients with ST-segment elevation myocardial infarction (MI). Methods As part of a randomized controlled trial of GIK versus no GIK in patients treated with primary percutaneous coronary intervention (PC[) for ST-elevation MI in a tertiary referral center, we analyzed ST-segment elevation resolution. Paired electrocardiographic recordings (baseline and 3 hours after primary PCI) were available in 612 (65%) of 940 patients. Results We analyzed paired electrocardiograms of 3 10 patients randomized to GIK and 302 control patients. Baseline characteristics of the groups were comparable. Combined complete (>70%) and partial (30%-70%) resolution was more commonly observed in the GIK group (87%) when compared with the control group (78%), odds ratio 1.92 (95% Cl 1.23-3.02, P =.004); 1-year mortality was lower in patients with combined complete and partial resolution compared with patients without resolution (3.8% vs 10.3%, P =.0 11). There was no difference in 1-year mortality between GIK and control patients (5.5% vs 4.3%, P =.58). Conclusions In patients with ST-elevation MI treated with primary PCI, addition of GIK is associated with improved ST-segment elevation resolution. ST-segment elevation resolution is related to improved 1-year survival. No benefit of GIK on 1-year outcome was observed. Future trials should investigate whether GIK-induced improvement of ST-segment elevation resolution results in more favorable clinical outcome.
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- 2005
17. Exogenous insulin and hypoglycemia as prognostic factors in critically ill patients
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van der Horst, ICC, Gans, ROB, Zijlstra, F, Ligtenberg, JJM, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC), Lifestyle Medicine (LM), and Groningen Kidney Center (GKC)
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- 2004
18. Beneficial effect of glucose-insulin-potassium infusion in noncritically ill patients has to be proven
- Author
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van der Horst, ICC, Gans, ROB, Nijsten, MWN, Ligtenberg, JJM, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC), Lifestyle Medicine (LM), and Groningen Kidney Center (GKC)
- Subjects
ACUTE MYOCARDIAL-INFARCTION ,RANDOMIZED-TRIAL ,DIABETIC-PATIENTS - Published
- 2003
19. Glucose-insulin-potassium infusion in patients treated with primary angioplasty for acute myocardial infarction - The glucose-insulin-potassium study: A Randomized trial
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van der Horst, ICC, Zijlstra, F, van't Hof, AWJ, Doggen, CJM, de Boer, MJ, Suryapranata, H, Hoorntje, JCA, Gans, ROB, Bilo, HJG, Dambrink, Jan Hendrik Everwijn, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC), Lifestyle Medicine (LM), and Groningen Kidney Center (GKC)
- Subjects
CRITICALLY ILL ,INCREASED GLYCOLYTIC SUBSTRATE ,THROMBOLYTIC THERAPY ,LEFT-VENTRICULAR FUNCTION ,MORTALITY ,REPERFUSION ,FATTY-ACIDS ,METABOLISM ,DIABETIC-PATIENTS ,ISCHEMIA - Abstract
OBJECTIVES In this study we considered the question of whether adjunction of glucose-insuhn-potassium (GIK) infusion to primary coronary transluminal angioplasty (PTCA) is effective in patients with an acute myocardial infarction (MI). BACKGROUND A combined treatment of early and sustained reperfusion of the infarct-related coronary artery and the metabolic modulation with GIK infusion has been proposed to protect the ischemic myocardium. METHODS From April 1998 to September 2001, 940 patients with an acute MI and eligible for PTCA were randomly assigned, by open-label, to either a continuous GIK infusion for 8 to 12 h or no infusion. RESULTS The 30-day mortality was 23 of 476 patients (4.8%) receiving GIK compared with 27 of 464 patients (5.8%) in the control group (relative risk [RR] 0.82, 95% confidence interval [CI] 0.46 to 1.46). In 856 patients (91.1%) without signs of heart failure (HF) (Killip class 1), 30-day mortality was 5 of 426 patients (1.2%) in the GIK group versus 18 of 430 patients (4.2%) in the control group (RR 0.28, 95% CI 0.1 to 0.75). In 84 patients (8.9%) with signs of HF (Killip class greater than or equal to 2), 30-day mortality was 18 of 50 patients (36%) in the GIK group versus 9 of 34 patients (26.5%) in the control group (RR 1.44, 95% CI 0.65 to 3.22). CONCLUSIONS Glucose-insulin-potassium infusion as adjunctive therapy to PTCA in acute MI did not result in a significant mortality reduction in all patients. In the subgroup of 856 patients without signs of HF, a significant reduction was seen. The effect of GIK infusion in patients with signs of HF (Killip class greater than or equal to 2) at admission is uncertain. (C) 2003 by the American College of Cardiology Foundation.
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- 2003
20. Fluid resuscitation during active hemorrhage: Need for a step forward
- Author
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Ligtenberg, JJM, van der Horst, ICC, Zijlstra, JG, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC), and Vascular Ageing Programme (VAP)
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IMMEDIATE - Published
- 2002
21. Glucose-insulin-potassium infusion inpatients treated with primary angioplasty for acute myocardial infarction: the glucose-insulin-potassium study: a randomized trial.
- Author
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van der Horst ICC, Zijlstra F, van't Hof AWJ, Doggen CJM, de Boer M, Suryapranata H, Hoorntje JCA, Dambrink JE, Gans ROB, Bilo HJG, Zwolle Infarct Study Group, van der Horst, Iwan C C, Zijlstra, Felix, van 't Hof, Arnoud W J, Doggen, Carine J M, de Boer, Menko-Jan, Suryapranata, Harry, Hoorntje, Jan C A, Dambrink, Jan-Henk E, and Gans, Rijk O B
- Abstract
Objectives: In this study we considered the question of whether adjunction of glucose-insulin-potassium (GIK) infusion to primary coronary transluminal angioplasty (PTCA) is effective in patients with an acute myocardial infarction (MI).Background: A combined treatment of early and sustained reperfusion of the infarct-related coronary artery and the metabolic modulation with GIK infusion has been proposed to protect the ischemic myocardium.Methods: From April 1998 to September 2001, 940 patients with an acute MI and eligible for PTCA were randomly assigned, by open-label, to either a continuous GIK infusion for 8 to 12 h or no infusion.Results: The 30-day mortality was 23 of 476 patients (4.8%) receiving GIK compared with 27 of 464 patients (5.8%) in the control group (relative risk [RR] 0.82, 95% confidence interval [CI] 0.46 to 1.46). In 856 patients (91.1%) without signs of heart failure (HF) (Killip class 1), 30-day mortality was 5 of 426 patients (1.2%) in the GIK group versus 18 of 430 patients (4.2%) in the control group (RR 0.28, 95% CI 0.1 to 0.75). In 84 patients (8.9%) with signs of HF (Killip class > or =2), 30-day mortality was 18 of 50 patients (36%) in the GIK group versus 9 of 34 patients (26.5%) in the control group (RR 1.44, 95% CI 0.65 to 3.22).Conclusions: Glucose-insulin-potassium infusion as adjunctive therapy to PTCA in acute MI did not result in a significant mortality reduction in all patients. In the subgroup of 856 patients without signs of HF, a significant reduction was seen. The effect of GIK infusion in patients with signs of HF (Killip class > or =2) at admission is uncertain. [ABSTRACT FROM AUTHOR]- Published
- 2003
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22. Corticosteroids for patients with septic shock.
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Brown JM, Schenarts CL, March JA, Millo J, Opal SM, Zijlstra JG, van der Horst ICC, Tulleken JE, van der Werf TS, Ligtenberg JJM, Williamson DR, Albert M, Charneux M, Mokhlesi B, Annane D, Sebille V, Bellissant E, and Mokhlesi, Babak
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- 2003
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23. Exogenous insulin and hypoglycemia as prognostic factors in critically ill patients.
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Moshenyat R, Kupfer YY, Tessler S, van der Horst ICC, Gans ROB, Zijlstra F, Ligtenberg JJM, Garg R, Chaudhuri A, Dandona P, Finney SJ, Evans TW, van der Horst, Iwan C C, Gans, Rijk O B, Zijlstra, Felix, and Ligtenberg, Jack J M
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- 2004
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24. Sudden death in patients with myocardial infarction.
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Pitt B, Zijlstra F, van der Horst ICC, Khera A, Levine BD, Jacobs AG, Solomon SD, Califf RM, Pfeffer MA, and Buxton AE
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- 2005
25. Monitoring of myocardial injury by serial measurements of QRS area and T area: The MaastrICCht cohort.
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Ghossein MA, de Kok JWTM, Eerenberg F, van Rosmalen F, Boereboom R, Duisberg F, Verharen K, Sels JEM, Delnoij T, Geyik Z, Mingels AMA, Meex SJR, van Kuijk SMJ, van Stipdonk AMW, Ghossein C, Prinzen FW, van der Horst ICC, Vernooy K, van Bussel BCT, and Driessen RGH
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- Humans, Male, Female, Middle Aged, Cohort Studies, Aged, Natriuretic Peptide, Brain blood, Respiration, Artificial methods, Biomarkers blood, Netherlands, SARS-CoV-2, COVID-19 complications, COVID-19 physiopathology, Electrocardiography methods, Peptide Fragments blood, Troponin T blood, Vectorcardiography methods
- Abstract
Background: Manually derived electrocardiographic (ECG) parameters were not associated with mortality in mechanically ventilated COVID-19 patients in earlier studies, while increased high-sensitivity cardiac troponin-T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were. To provide evidence for vectorcardiography (VCG) measures as potential cardiac monitoring tool, we investigated VCG trajectories during critical illness., Methods: All mechanically ventilated COVID-19 patients were included in the Maastricht Intensive Care Covid Cohort between March 2020 and October 2021. Serum hs-cTnT and NT-proBNP concentrations were measured daily. Conversion of daily 12-lead ECGs to VCGs by a MATLAB-based script provided QRS area, T area, maximal QRS amplitude, and QRS duration. Linear mixed-effect models investigated trajectories in serum and VCG markers over time between non-survivors and survivors, adjusted for confounders., Results: In 322 patients, 5461 hs-cTnT, 5435 NT-proBNP concentrations and 3280 ECGs and VCGs were analyzed. Non-survivors had higher hs-cTnT concentrations at intubation and both hs-cTnT and NT-proBNP significantly increased compared with survivors. In non-survivors, the following VCG parameters decreased more when compared to survivors: QRS area (-0.27 (95% CI) (-0.37 to -0.16, p < .01) μVs per day), T area (-0.39 (-0.62 to -0.16, p < .01) μVs per day), and maximal QRS amplitude (-0.01 (-0.01 to -0.01, p < .01) mV per day). QRS duration did not differ., Conclusion: VCG-derived QRS area and T area decreased in non-survivors compared with survivors, suggesting that an increase in myocardial damage and tissue loss play a role in the course of critical illness and may drive mortality. These VCG markers may be used to monitor critically ill patients., (© 2024 The Author(s). Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC.)
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- 2024
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26. Improved reporting of selection processes in clinical database research: author's reply.
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de Kok JWTM, van Bussel BCT, van der Horst ICC, and van Rosmalen F
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- Humans, Patient Selection, Research Design standards, Biomedical Research standards, Biomedical Research statistics & numerical data, Biomedical Research methods, Databases, Factual standards, Databases, Factual statistics & numerical data
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- 2024
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27. Reducing administrative burden by implementing a core set of quality indicators in the ICU: a multicentre longitudinal intervention study.
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Hesselink G, Verhage R, Westerhof B, Verweij E, Fuchs M, Janssen I, van der Meer C, van der Horst ICC, de Jong P, van der Hoeven JG, and Zegers M
- Abstract
Background: The number of quality indicators for which clinicians need to record data is increasing. For many indicators, there are concerns about their efficacy. This study aimed to determine whether working with only a consensus-based core set of quality indicators in the intensive care unit (ICU) reduces the time spent on documenting performance data and administrative burden of ICU professionals, and if this is associated with more joy in work without impacting the quality of ICU care., Methods: Between May 2021 and June 2023, ICU clinicians of seven hospitals in the Netherlands were instructed to only document data for a core set of quality indicators. Time spent on documentation, administrative burden and joy in work were collected at three time points with validated questionnaires. Longitudinal data on standardised mortality rates (SMR) and ICU readmission rates were gathered from the Dutch National Intensive Care registry. Longitudinal effects and differences in outcomes between ICUs and between nurses and physicians were statistically tested., Results: A total of 390 (60%), 291 (47%) and 236 (40%) questionnaires returned at T0, T1 and T2. At T2, the overall median time spent on documentation per day was halved by 30 min (p<0.01) and respondents reported fewer unnecessary and unreasonable administrative tasks (p<0.01). Almost one-third still experienced unnecessary administrative tasks. No significant changes over time were found in joy in work, SMR and ICU readmission., Conclusions: Implementing a core set of quality indicators reduces the time ICU clinicians spend on documentation and administrative burden without negatively affecting SMR or ICU readmission rates. Time savings can be invested in patient care and improving joy in work in the ICU., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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28. A novel positive end-expiratory pressure titration using electrical impedance tomography in spontaneously breathing acute respiratory distress syndrome patients on mechanical ventilation: an observational study from the MaastrICCht cohort.
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Heines SJH, de Jongh SAM, de Jongh FHC, Segers RPJ, Gilissen KMH, van der Horst ICC, van Bussel BCT, and Bergmans DCJJ
- Abstract
There is no universally accepted method for positive end expiratory pressure (PEEP) titration approach for patients on spontaneous mechanical ventilation (SMV). Electrical impedance tomography (EIT) guided PEEP-titration has shown promising results in controlled mechanical ventilation (CMV), current implemented algorithm for PEEP titration (based on regional compliance measurements) is not applicable in SMV. Regional peak flow (RPF, defined as the highest inspiratory flow rate based on EIT at a certain PEEP level) is a new method for quantifying regional lung mechanics designed for SMV. The objective is to study whether RPF by EIT is a feasible method for PEEP titration during SMV. Single EIT measurements were performed in COVID-19 ARDS patients on SMV. Clinical (i.e., tidal volume, airway occlusion pressure, end-tidal CO
2 ) and mechanical (cyclic alveolar recruitment, recruitment, cumulative overdistension (OD), cumulative collapse (CL), pendelluft, and PEEP) outcomes were determined by EIT at several pre-defined PEEP thresholds (1-10% CL and the intersection of the OD and CL curves) and outcomes at all thresholds were compared to the outcomes at baseline PEEP. In total, 25 patients were included. No significant and clinically relevant differences were found between thresholds for tidal volume, end-tidal CO2 , and P0.1 compared to baseline PEEP; cyclic alveolar recruitment rates changed by -3.9% to -37.9% across thresholds; recruitment rates ranged from - 49.4% to + 79.2%; cumulative overdistension changed from - 75.9% to + 373.4% across thresholds; cumulative collapse changed from 0% to -94.3%; PEEP levels from 10 up to 14 cmH2 O were observed across thresholds compared to baseline PEEP of 10 cmH2 O. A threshold of approximately 5% cumulative collapse yields the optimum compromise between all clinical and mechanical outcomes. EIT-guided PEEP titration by the RPF approach is feasible and is linked to improved overall lung mechanics) during SMV using a threshold of approximately 5% CL. However, the long-term clinical safety and effect of this approach remain to be determined., (© 2024. The Author(s).)- Published
- 2024
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29. Modeling creatine-kinase MB concentrations following coronary artery bypass grafting.
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Romeo JL, Vriesendorp PA, Gerritsen K, Nader M, Mahtab E, Maessen JG, Van't Hof AWJ, Gollmann-Tepeköylü C, van Rosmalen F, van der Horst ICC, Mingels AMA, and Heuts S
- Abstract
Background: An increase in cardiac biomarkers is a prerequisite for diagnosing periprocedural myocardial infarction (PMI) after coronary artery bypass grafting (CABG). Early-phase risk detection may be aided by modeling time-dependent serum creatine kinase-MB (CK-MB) concentrations. This study aimed to model the kinetics of CK-MB while identifying its influencing factors., Methods: Patients who underwent elective CABG and had CK-MB measurements within 72 hours postoperatively were included. The primary outcome was the modeled post hoc kinetics of CK-MB in patients without potential PMI. These patients were defined as having no potential PMI based on the absence of ischemic electrocardiographic abnormalities, imaging abnormalities, in-hospital cardiac arrest, mortality, or postoperative unplanned catheterization. A web-based application was created using mixed-effect modeling to provide an interactive and individualized result., Results: A total of 1589 CK-MB measurements from 635 patients who underwent elective isolated CABG were available for analysis. Of these, 609 patients (96%) had no potential PMI and 26 (4%) had potential PMI. Male sex, aortic cross-clamp time, and cardioplegia type significantly impacted CK-MB concentrations. The diagnostic accuracy of the model had an area under the receiver operating characteristic curve of 82.8% (95% confidence interval, 72.6%-90.2%). A threshold of 7 μg/L yielded a sensitivity of 94% and a specificity of 80% (positive predictive value, 17%; negative predictive value, 99%) for excluding potential PMI in our study population., Conclusions: CK-MB release after CABG depends on the timing of measurement, patient sex, aortic cross-clamp time, and cardioplegia type. The model (available at https://www.cardiomarker.com/ckmb) can be validated, reproduced, refined, and applied to other biomarkers., Competing Interests: Conflict of Interest Statement A.M.A.M. reports nonfinancial support from Abbott Diagnostics and Roche Diagnostics. A.W.J.V.H. reports unrestricted institutional grants from Abbott, Roche, Medtronic, Boehringer Ingelheim, and Astra Zeneca. All other authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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30. Association of fibrotic markers with diastolic function after STEMI.
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Al Ali L, Meijers WC, Beldhuis IE, Groot HE, Lipsic E, van Veldhuisen DJ, Voors AA, van der Horst ICC, de Boer RA, and van der Harst P
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- Humans, Male, Female, Middle Aged, Aged, Galectin 3 blood, Galectins blood, Prognosis, Echocardiography, Follow-Up Studies, Blood Proteins metabolism, ST Elevation Myocardial Infarction physiopathology, ST Elevation Myocardial Infarction blood, Biomarkers blood, Interleukin-1 Receptor-Like 1 Protein blood, Diastole, Fibrosis
- Abstract
Galectin-3 and Suppression of tumorigenicity-2 (ST2) are known markers of cardiac fibrosis. We investigated the prognostic value of fibrotic markers for the development of diastolic dysfunction and long-term outcome in patients suffering an ST-elevated myocardial infarction (STEMI). We analyzed 236 patients from the GIPS-III cohort with available echocardiographic studies and plasma measurements at hospitalization and after 4 months follow-up. Adjusted logistic mixed effects modelling revealed no association between the occurrence of diastolic dysfunction over time with abnormal plasma levels of galectin-3 and ST2. We observed no differences regarding survival outcome at follow-up of 5 years between patients with normal versus abnormal values in both galectin-3 (P = 0.75), and ST2 (P = 0.85). In conclusion, galectin-3 and sST2 were not associated with the development of diastolic dysfunction in non-diabetic patients that presented with a STEMI., (© 2024. The Author(s).)
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- 2024
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31. Effect of high versus standard protein provision on functional recovery in people with critical illness (PRECISe): an investigator-initiated, double-blinded, multicentre, parallel-group, randomised controlled trial in Belgium and the Netherlands.
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Bels JLM, Thiessen S, van Gassel RJJ, Beishuizen A, De Bie Dekker A, Fraipont V, Lamote S, Ledoux D, Scheeren C, De Waele E, van Zanten ARH, Bormans-Russell L, van Bussel BCT, Dictus MMJ, Fivez T, Harks I, van der Horst ICC, Jonckheer J, Marechal H, Massion PB, Meex I, Paulus MC, Rinket M, van Santen S, Tartaglia K, Deane AM, Demuydt F, Puthucheary Z, Vloet LCM, Weijs PJM, van Kuijk SMJ, van de Poll MCG, and Mesotten D
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- Humans, Male, Female, Belgium, Double-Blind Method, Middle Aged, Netherlands, Aged, Recovery of Function, Respiration, Artificial, Intensive Care Units, Critical Illness therapy, Quality of Life, Enteral Nutrition methods, Dietary Proteins administration & dosage
- Abstract
Background: Increased protein provision might ameliorate muscle wasting and improve long-term outcomes in critically ill patients. The aim of the PRECISe trial was to assess whether higher enteral protein provision (ie, 2·0 g/kg per day) would improve health-related quality of life and functional outcomes in critically ill patients who were mechanically ventilated compared with standard enteral protein provision (ie, 1·3 g/kg per day)., Methods: The PRECISe trial was an investigator-initiated, double-blinded, multicentre, parallel-group, randomised controlled trial in five Dutch hospitals and five Belgian hospitals. Inclusion criteria were initiation of invasive mechanical ventilation within 24 h of intensive care unit (ICU) admission and an expected duration of invasive ventilation of 3 days or longer. Exclusion criteria were contraindications for enteral nutrition, moribund condition, BMI less than 18 kg/m
2 , kidney failure with a no dialysis code, or hepatic encephalopathy. Patients were randomly assigned to one of four randomisation labels, corresponding with two study groups (ie, standard or high protein; two labels per group) in a 1:1:1:1 ratio through an interactive web-response system. Randomisation was done via random permuted-block randomisation in varying block sizes of eight and 12, stratified by centre. Participants, care providers, investigators, outcome assessors, data analysts, and the independent data safety monitoring board were all blinded to group allocation. Patients received isocaloric enteral feeds that contained 1·3 kcal/mL and 0·06 g of protein/mL (ie, standard protein) or 1·3 kcal/mL and 0·10 g of protein/mL (ie, high protein). The study-nutrition intervention was limited to the time period during the patient's ICU stay in which they required enteral feeding, with a maximum of 90 days. The primary outcome was EuroQoL 5-Dimension 5-level (EQ-5D-5L) health utility score at 30 days, 90 days, and 180 days after randomisation, adjusted for baseline EQ-5D-5L health utility score. This trial was registered with ClinicalTrials.gov (NCT04633421) and is closed to new participants., Findings: Between Nov 19, 2020, and April 14, 2023, 935 patients were randomly assigned. 335 (35·8%) of 935 patients were female and 600 (64·2%) were male. 465 (49·7%) of 935 were assigned to the standard protein group and 470 (50·3%) were assigned to the high protein group. 430 (92·5%) of 465 patients in the standard protein group and 419 (89·1%) of 470 patients in the high protein group were assessed for the primary outcome. The primary outcome, EQ-5D-5L health utility score during 180 days after randomisation (assessed at 30 days, 90 days, and 180 days), was lower in patients allocated to the high protein group than in those allocated to the standard protein group, with a mean difference of -0·05 (95% CI -0·10 to -0·01; p=0·031). Regarding safety outcomes, the probability of mortality during the entire follow-up was 0·38 (SE 0·02) in the standard protein group and 0·42 (0·02) in the high protein group (hazard ratio 1·14, 95% CI 0·92 to 1·40; p=0·22). There was a higher incidence of symptoms of gastrointestinal intolerance in patients in the high protein group (odds ratio 1·76, 95% CI 1·06 to 2·92; p=0·030). Incidence of other adverse events did not differ between groups., Interpretation: High enteral protein provision compared with standard enteral protein provision resulted in worse health-related quality of life in critically ill patients and did not improve functional outcomes during 180 days after ICU admission., Funding: Netherlands Organisation for Healthcare Research and Development and Belgian Health Care Knowledge Centre., Competing Interests: Declaration of interests EDW receives honoraria for scientific lectures from Baxter Healthcare, Nutricia–Danone, and Nestlé. ARHvZ receives grants from AOP Pharma, Nutricia–Danone, Fresenius Kabi, PAION, and Rousselot; receives consulting fees from AOP Pharma, Medcaptain, and PAION; receives honoraria for lectures from Abbott, AOP Pharma, Baxter, Nestlé, Nutricia–Danone, Fresenius Kabi, GE Healthcare, and Dutch Medical Food; receives support for travel from Nutricia–Danone and Dutch Medical Food; is a member of the adult intensive care unit patient nutrition guideline committee of the European Society for Clinical Nutrition and Metabolism, the executive team of SepsisNet Netherlands, and the executive team of the Netherlands Society for Parenteral and Enteral Nutrition; and is the European Society of Intensive Care Medicine Section Feeding, Rehabilitation Endocrinology and Metabolism chair. ZP receives grants from Fresenius Kabi, Nestlé, and Baxter; receives consulting fees from Fresenius Kabi, Nestlé, Baxter, Faraday Pharmaceuticals, and Bioage Pharmaceuticals; and receives honoraria for lectures from Baxter, Nestlé, Fresenius Kabi, and Nutricia. MCGvdP receives grants from the Netherlands Organisation of Health Research and Development and the Belgian Health Care Knowledge Centre; receives in-kind support from Nutricia; receives consulting fees from Nutricia and Nestlé; and receives honoraria for lectures and support for travel from Nutricia. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)- Published
- 2024
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32. The prognostic impact of unplanned invasive coronary angiography following coronary artery bypass grafting.
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Heuts S, Bova R, Romeo JLR, Vriesendorp PA, van der Horst ICC, Segers P, Maessen JG, Gollmann-Tepeköylü C, van 't Hof AWJ, Bidar E, and Lux A
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- Humans, Male, Female, Aged, Prognosis, Middle Aged, Retrospective Studies, Postoperative Complications epidemiology, Coronary Artery Disease surgery, Coronary Artery Disease mortality, Coronary Artery Disease diagnostic imaging, Risk Factors, Myocardial Ischemia surgery, Myocardial Ischemia mortality, Myocardial Ischemia diagnostic imaging, Coronary Artery Bypass adverse effects, Coronary Angiography statistics & numerical data
- Abstract
Objectives: Myocardial ischaemia following coronary artery bypass grafting (CABG) is a potentially devastating complication. Nevertheless, the incidence, aetiology and prognostic relevance of unplanned coronary angiography (uCAG) remain understudied. We aimed to investigate the prevalence and outcome of patients undergoing urgent, uCAG in the postoperative period following CABG., Methods: We screened all patients undergoing isolated elective CABG in an academic referral centre between 2016 and 2021 and identified patients undergoing uCAG within 30 days of surgery. For uCAG patients, a distinction was made between patients undergoing re-revascularization (REV) and patients receiving conservative management (CON). The primary outcomes were 30-day mortality and unadjusted and adjusted long-term survival. Secondary outcomes were the indication for and prevalence of uCAG and urgent revascularization., Results: Of the 1918 patients undergoing isolated CABG, 78 individuals needed uCAG (4.1%), of whom 45 underwent immediate revascularization (REV group; 2.3% overall, 57% within the uCAG group, median age 69.9 years) and 33 were treated conservatively (CONS group; 1.7% overall, 42% within the uCAG group, median age 69.1 years). Patients undergoing uCAG (n = 78) had a higher 30-day mortality than patients not undergoing uCAG (n = 1840, 30-day mortality: 9.0% vs 0.4%, P < 0.001). Long-term survival was significantly decreased in patients undergoing uCAG in both unadjusted (hazard ratio 2.20, 95% confidence interval 1.30-3.73) and EuroSCORE-, age- and sex-adjusted models (hazard ratio uCAG 2.03, 95% confidence interval 1.16-3.56)., Conclusions: Unplanned postoperative coronary angiography is performed in 4.1% of isolated CABG procedures, and patients in need of such urgent invasive evaluation are subjected to decreased short- and long-term survival., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
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- 2024
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33. Corrigendum to Table 0; documenting the steps to go from clinical database to research dataset Journal of Clinical Epidemiology Volume 170 (2024) 111342.
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de Kok JWTM, van Bussel BCT, Schnabel R, van Herpt TTW, Driessen RGH, Meijs DAM, Goossens JA, Mertens HJMM, van Kuijk SMJ, Wynants L, van der Horst ICC, and van Rosmalen F
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- 2024
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34. Serum Calcification Propensity Is Increased in Myocardial Infarction and Hints at a Pathophysiological Role Independent of Classical Cardiovascular Risk Factors.
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Mencke R, Al Ali L, de Koning MLY, Pasch A, Minnion M, Feelisch M, van Veldhuisen DJ, van der Horst ICC, Gansevoort RT, Bakker SJL, de Borst MH, van Goor H, van der Harst P, Lipsic E, and Hillebrands JL
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- Humans, Male, Female, Middle Aged, Aged, Biomarkers blood, Heart Disease Risk Factors, Vascular Calcification blood, Vascular Calcification physiopathology, Risk Assessment, Risk Factors, Case-Control Studies, Time Factors, Ventricular Function, Left, Stroke Volume, ST Elevation Myocardial Infarction blood, ST Elevation Myocardial Infarction physiopathology
- Abstract
Background: Vascular calcification is associated with increased mortality in patients with cardiovascular disease. Secondary calciprotein particles are believed to play a causal role in the pathophysiology of vascular calcification. The maturation time (T
50 ) of calciprotein particles provides a measure of serum calcification propensity. We compared T50 between patients with ST-segment-elevated myocardial infarction and control subjects and studied the association of T50 with cardiovascular risk factors and outcome., Methods: T50 was measured by nephelometry in 347 patients from the GIPS-III trial (Metabolic Modulation With Metformin to Reduce Heart Failure After Acute Myocardial Infarction: Glycometabolic Intervention as Adjunct to Primary Coronary Intervention in ST Elevation Myocardial Infarction: a Randomized Controlled Trial) and in 254 matched general population controls from PREVEND (Prevention of Renal and Vascular End-Stage Disease). We also assessed the association between T50 and left ventricular ejection fraction, as well as infarct size, the incidence of ischemia-driven reintervention during 5 years of follow-up, and serum nitrite as a marker of endothelial dysfunction., Results: Patients with ST-segment-elevated myocardial infarction had a significantly lower T50 (ie, higher serum calcification propensity) compared with controls (T50 : 289±63 versus 338±56 minutes; P <0.001). In patients with ST-segment-elevated myocardial infarction, lower T50 was associated with female sex, lower systolic blood pressure, lower total cholesterol, lower LDL (low-density lipoprotein) cholesterol, lower triglycerides, and higher HDL (high-density lipoprotein) cholesterol but not with circulating nitrite or nitrate. Ischemia-driven reintervention was associated with higher LDL ( P =0.03) and had a significant interaction term for T50 and sex ( P =0.005), indicating a correlation between ischemia-driven reintervention and T50 above the median in men and below the median in women, between 150 days and 5 years of follow-up., Conclusions: Serum calcification propensity is increased in patients with ST-segment-elevated myocardial infarction compared with the general population, and its contribution is more pronounced in women than in men. Its lack of/inverse association with nitrite and blood pressure confirms T50 to be orthogonal to traditional cardiovascular disease risk factors. Lower T50 was associated with a more favorable serum lipid profile, suggesting the involvement of divergent pathways of calcification stress and lipid stress in the pathophysiology of myocardial infarction., Competing Interests: A. Pasch is a founder and employee of Calciscon AG, Switzerland, which commercializes the T50 test. The other authors report no conflicts.- Published
- 2024
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35. Extracorporeal cardiopulmonary resuscitation versus standard treatment for refractory out-of-hospital cardiac arrest: a Bayesian meta-analysis.
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Heuts S, Ubben JFH, Kawczynski MJ, Gabrio A, Suverein MM, Delnoij TSR, Kavalkova P, Rob D, Komárek A, van der Horst ICC, Maessen JG, Yannopoulos D, Bělohlávek J, Lorusso R, and van de Poll MCG
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- Humans, Extracorporeal Membrane Oxygenation methods, Randomized Controlled Trials as Topic methods, Treatment Outcome, Out-of-Hospital Cardiac Arrest therapy, Out-of-Hospital Cardiac Arrest mortality, Bayes Theorem, Cardiopulmonary Resuscitation methods, Cardiopulmonary Resuscitation standards
- Abstract
Background: The outcomes of several randomized trials on extracorporeal cardiopulmonary resuscitation (ECPR) in patients with refractory out-of-hospital cardiac arrest were examined using frequentist methods, resulting in a dichotomous interpretation of results based on p-values rather than in the probability of clinically relevant treatment effects. To determine such a probability of a clinically relevant ECPR-based treatment effect on neurological outcomes, the authors of these trials performed a Bayesian meta-analysis of the totality of randomized ECPR evidence., Methods: A systematic search was applied to three electronic databases. Randomized trials that compared ECPR-based treatment with conventional CPR for refractory out-of-hospital cardiac arrest were included. The study was preregistered in INPLASY (INPLASY2023120060). The primary Bayesian hierarchical meta-analysis estimated the difference in 6-month neurologically favorable survival in patients with all rhythms, and a secondary analysis assessed this difference in patients with shockable rhythms (Bayesian hierarchical random-effects model). Primary Bayesian analyses were performed under vague priors. Outcomes were formulated as estimated median relative risks, mean absolute risk differences, and numbers needed to treat with corresponding 95% credible intervals (CrIs). The posterior probabilities of various clinically relevant absolute risk difference thresholds were estimated., Results: Three randomized trials were included in the analysis (ECPR, n = 209 patients; conventional CPR, n = 211 patients). The estimated median relative risk of ECPR for 6-month neurologically favorable survival was 1.47 (95%CrI 0.73-3.32) with a mean absolute risk difference of 8.7% (- 5.0; 42.7%) in patients with all rhythms, and the median relative risk was 1.54 (95%CrI 0.79-3.71) with a mean absolute risk difference of 10.8% (95%CrI - 4.2; 73.9%) in patients with shockable rhythms. The posterior probabilities of an absolute risk difference > 0% and > 5% were 91.0% and 71.1% in patients with all rhythms and 92.4% and 75.8% in patients with shockable rhythms, respectively., Conclusion: The current Bayesian meta-analysis found a 71.1% and 75.8% posterior probability of a clinically relevant ECPR-based treatment effect on 6-month neurologically favorable survival in patients with all rhythms and shockable rhythms. These results must be interpreted within the context of the reported credible intervals and varying designs of the randomized trials., Registration: INPLASY (INPLASY2023120060, December 14th, 2023, https://doi.org/10.37766/inplasy2023.12.0060 )., (© 2024. The Author(s).)
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- 2024
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36. Cost-effectiveness of extracorporeal cardiopulmonary resuscitation vs. conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a pre-planned, trial-based economic evaluation.
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Delnoij TSR, Suverein MM, Essers BAB, Hermanides RC, Otterspoor L, Elzo Kraemer CV, Vlaar APJ, van der Heijden JJ, Scholten E, den Uil C, Akin S, de Metz J, van der Horst ICC, Maessen JG, Lorusso R, and van de Poll MCG
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- Aged, Female, Humans, Male, Middle Aged, Extracorporeal Membrane Oxygenation economics, Extracorporeal Membrane Oxygenation methods, Netherlands, Quality-Adjusted Life Years, Survival Rate trends, Cardiopulmonary Resuscitation economics, Cardiopulmonary Resuscitation methods, Cost-Benefit Analysis, Out-of-Hospital Cardiac Arrest therapy, Out-of-Hospital Cardiac Arrest economics, Quality of Life
- Abstract
Aims: When out-of-hospital cardiac arrest (OHCA) becomes refractory, extracorporeal cardiopulmonary resuscitation (ECPR) is a potential option to restore circulation and improve the patient's outcome. However, ECPR requires specific materials and highly skilled personnel, and it is unclear whether increased survival and health-related quality of life (HRQOL) justify these costs., Methods and Results: This cost-effectiveness study was part of the INCEPTION study, a multi-centre, pragmatic randomized trial comparing hospital-based ECPR to conventional CPR (CCPR) in patients with refractory OHCA in 10 cardiosurgical centres in the Netherlands. We analysed healthcare costs in the first year and measured HRQOL using the EQ-5D-5L at 1, 3, 6, and 12 months. Incremental cost-effectiveness ratios (ICERs), cost-effectiveness planes, and acceptability curves were calculated. Sensitivity analyses were performed for per-protocol and as-treated subgroups as well as imputed productivity loss in deceased patients. In total, 132 patients were enrolled: 62 in the CCPR and 70 in the ECPR group. The difference in mean costs after 1 year was €5109 (95% confidence interval -7264 to 15 764). Mean quality-adjusted life year (QALY) after 1 year was 0.15 in the ECPR group and 0.11 in the CCPR group, resulting in an ICER of €121 643 per additional QALY gained. The acceptability curve shows that at a willingness-to-pay threshold of €80.000, the probability of ECPR being cost-effective compared with CCPR is 36%. Sensitivity analysis showed increasing ICER in the per-protocol and as-treated groups and lower probabilities of acceptance., Conclusion: Hospital-based ECPR in refractory OHCA has a low probability of being cost-effective in a trial-based economic evaluation., Competing Interests: Conflict of interest: R.L. reports support from ABIOMED for consulting lecture work and consultancy on the Medical Advisory Board of Xenios., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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37. Table 0; documenting the steps to go from clinical database to research dataset.
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de Kok JWTM, van Bussel BCT, Schnabel R, van Herpt TTW, Driessen RGH, Meijs DAM, Goossens JA, Mertens HJMM, van Kuijk SMJ, Wynants L, van der Horst ICC, and van Rosmalen F
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- Humans, Netherlands, Documentation standards, Documentation statistics & numerical data, Documentation methods, Critical Care standards, Critical Care statistics & numerical data, Databases, Factual standards, Databases, Factual statistics & numerical data
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Objectives: Data-driven decision support tools have been increasingly recognized to transform health care. However, such tools are often developed on predefined research datasets without adequate knowledge of the origin of this data and how it was selected. How a dataset is extracted from a clinical database can profoundly impact the validity, interpretability and interoperability of the dataset, and downstream analyses, yet is rarely reported. Therefore, we present a case study illustrating how a definitive patient list was extracted from a clinical source database and how this can be reported., Study Design and Setting: A single-center observational study was performed at an academic hospital in the Netherlands to illustrate the impact of selecting a definitive patient list for research from a clinical source database, and the importance of documenting this process. All admissions from the critical care database admitted between January 1, 2013, and January 1, 2023, were used., Results: An interdisciplinary team collaborated to identify and address potential sources of data insufficiency and uncertainty. We demonstrate a stepwise data preparation process, reducing the clinical source database of 54,218 admissions to a definitive patient list of 21,553 admissions. Transparent documentation of the data preparation process improves the quality of the definitive patient list before analysis of the corresponding patient data. This study generated seven important recommendations for preparing observational health-care data for research purposes., Conclusion: Documenting data preparation is essential for understanding a research dataset originating from a clinical source database before analyzing health-care data. The findings contribute to establishing data standards and offer insights into the complexities of preparing health-care data for scientific investigation. Meticulous data preparation and documentation thereof will improve research validity and advance critical care., Competing Interests: Declaration of competing interest The authors declare that there are no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2024
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38. The incidence of neurological complications in mechanically ventilated COVID-19 ICU patients: An observational single-center cohort study in three COVID-19 periods.
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van der Knaap N, de Vreeze F, van Rosmalen F, Wintjens MSJN, van Santen S, Linden DEJ, Staals J, van Mook WNKA, Jansen JFA, van der Horst ICC, van Bussel BCT, and Ariës MJH
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- Humans, Male, Female, Middle Aged, Aged, Incidence, Cohort Studies, Netherlands epidemiology, Hospital Mortality, SARS-CoV-2, COVID-19 epidemiology, Intensive Care Units, Nervous System Diseases etiology, Nervous System Diseases epidemiology, Respiration, Artificial
- Abstract
Background: Neurological complications in COVID-19 patients admitted to an intensive care unit (ICU) have been previously reported. As the pandemic progressed, therapeutic strategies were tailored to new insights. This study describes the incidence, outcome, and types of reported neurological complications in invasively mechanically ventilated (IMV) COVID-19 patients in relation to three periods during the pandemic., Methods: IMV COVID-19 ICU patients from the Dutch Maastricht Intensive Care COVID (MaastrICCht) cohort were included in a single-center study (March 2020 - October 2021). Demographic, clinical, and follow-up data were collected. Electronic medical records were screened for neurological complications during hospitalization. Three distinct periods (P1, P2, P3) were defined, corresponding to periods with high hospitalization rates. ICU survivors with and without reported neurological complications were compared in an exploratory analysis., Results: IMV COVID-19 ICU patients (n=324; median age 64 [IQR 57-72] years; 238 males (73.5%)) were stratified into P1 (n=94), P2 (n=138), and P3 (n=92). ICU mortality did not significantly change over time (P1=38.3%; P2=41.3%; P3=37.0%; p=.787). The incidence of reported neurological complications during ICU admission gradually decreased over the periods (P1=29.8%; P2=24.6%; P3=18.5%; p=.028). Encephalopathy/delirium (48/324 (14.8%)) and ICU-acquired weakness (32/324 (9.9%)) were most frequently reported and associated with ICU treatment intensity. ICU survivors with neurological complications (n=53) were older (p=.025), predominantly male (p=.037), and had a longer duration of IMV (p<.001) and ICU stay (p<.001), compared to survivors without neurological complications (n=132). A multivariable analysis revealed that only age was independently associated with the occurrence of neurological complications (OR
adj =1.0541; 95% CI=1.0171-1.0925; p=.004). Health-related quality-of-life at follow-up was not significantly different between survivors with and without neurological complications (n = 82, p=.054)., Conclusions: A high but decreasing incidence of neurological complications was reported during three consecutive COVID-19 periods in IMV COVID-19 patients. Neurological complications were related to the intensity of ICU support and treatment, and associated with prolonged ICU stay, but did not lead to significantly worse reported health-related quality-of-life at follow-up., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)- Published
- 2024
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39. Health-related quality of life one year after refractory cardiac arrest treated with conventional or extracorporeal CPR; a secondary analysis of the INCEPTION-trial.
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van de Koolwijk AF, Delnoij TSR, Suverein MM, Essers BAB, Hermanides RC, Otterspoor LC, Elzo Kraemer CV, Vlaar APJ, van der Heijden JJ, Scholten E, den Uil CA, Dos Reis Miranda D, Akin S, de Metz J, van der Horst ICC, Winkens B, Maessen JG, Lorusso R, and van de Poll MCG
- Abstract
Background: Prospective, trial-based data comparing health-related quality of life (HRQoL) in patients surviving out-of-hospital cardiac arrest (OHCA) through extracorporeal cardiopulmonary resuscitation (ECPR) or conventional CPR (CCPR) are scarce. We aimed to determine HRQoL during 1-year after refractory OHCA in patients treated with ECPR and CCPR., Methods: We present a secondary analysis of the multicenter INCEPTION-trial, which studied the effectiveness of ECPR versus CCPR in patients with refractory OHCA. HRQoL was prospectively assessed using the EQ-5D-5L questionnaire. Poor HRQoL was pragmatically defined as an EQ-5D-5L health utility index (HUI) > 1 SD below the age-adjusted norm. We used mixed linear models to assess the difference in HRQoL over time and univariable analyses to assess factors potentially associated with poor HRQoL., Results: A total of 134 patients were enrolled, and hospital survival was 20% (27 patients). EQ-5D-5L data were available for 25 patients (5 ECPR and 20 CCPR). One year after OHCA, the estimated mean HUI was 0.73 (0.05) in all patients, 0.84 (0.12) in ECPR survivors, and 0.71 (0.05) in CCPR survivors (p-value 0.31). Eight (32%) survivors had a poor HRQoL. HRQoL was good in 17 (68%) patients, with 100% in ECPR survivors versus 60% in CCPR survivors (p-value 0.14)., Conclusion: One year after refractory OHCA, 68% of the survivors had a good HRQoL. We found no statistically significant difference in HRQoL one year after OHCA in patients treated with ECPR compared to CCPR. However, numerical differences may be clinically relevant in favor of ECPR., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)
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- 2024
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40. Favorable resuscitation characteristics in patients undergoing extracorporeal cardiopulmonary resuscitation: A secondary analysis of the INCEPTION-trial.
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Ubben JFH, Heuts S, Delnoij TSR, Suverein MM, Hermanides RC, Otterspoor LC, Kraemer CVE, Vlaar APJ, van der Heijden JJ, Scholten E, den Uil C, Dos Reis Miranda D, Akin S, de Metz J, van der Horst ICC, Winkens B, Maessen JG, Lorusso R, and van de Poll MCG
- Abstract
Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used as a supportive treatment for refractory out-of-hospital cardiac arrest (OHCA). Still, there is a paucity of data evaluating favorable and unfavorable prognostic characteristics in patients considered for ECPR., Methods: We performed a previously unplanned post-hoc analysis of the multicenter randomized controlled INCEPTION-trial. The study group consisted of patients receiving ECPR, irrespective of initial group randomization. The patients were divided into favorable survivors (cerebral performance category [CPC] 1-2) and unfavorable or non-survivors (CPC 3-5)., Results: In the initial INCEPTION-trial, 134 patients were randomized. ECPR treatment was started in 46 (66%) of 70 patients in the ECPR treatment arm and 3 (4%) of 74 patients in the conventional treatment arm. No statistically significant differences in baseline characteristics, medical history, or causes of arrest were observed between survivors ( n = 5) and non-survivors ( n = 44). More patients in the surviving group had a shockable rhythm at the time of cannulation (60% vs. 14%, p = 0.037), underwent more defibrillation attempts (13 vs. 6, p = 0.002), and received higher dosages of amiodarone (450 mg vs 375 mg, p = 0.047) despite similar durations of resuscitation maneuvers. Furthermore, non-survivors more frequently had post-ECPR implantation adverse events., Conclusion: The persistence of ventricular arrhythmia is a favorable prognostic factor in patients with refractory OHCA undergoing an ECPR-based treatment. Future studies are warranted to confirm this finding and to establish additional prognostic factors. Clinical trial Registration: clinicaltrials.gov registration number NCT03101787., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘Roberto Lorusso reports consulting fees from Medtronic, LivaNova, Getinge, and Abiomed and participates in an advisory board of Eurosets and Xenios, which are not related to this work. All other authors report no conflicts of interest.’., (© 2024 The Author(s).)
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- 2024
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41. Serial lactate measurements to guide resuscitation: more evidence not to?
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Legrand M, van der Horst ICC, and De Jong A
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- Humans, Biomarkers blood, Lactic Acid blood, Resuscitation methods, Resuscitation standards
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- 2024
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42. Pericardial Fat Is Associated With Less Severe Multiorgan Failure Over Time in Patients With Coronavirus Disease-19: The Maastricht Intensive Care COVID Cohort.
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Aydeniz E, Weberndorfer V, Brandts L, Smulders MW, van Herpt TTW, Martens B, Vernooy K, Linz D, van der Horst ICC, Wildberger JE, van Bussel BCT, Driessen RGH, and Mihl C
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- Male, Female, Humans, Adipose Tissue diagnostic imaging, Tomography, X-Ray Computed, Epicardial Adipose Tissue, Critical Care, Pericardium diagnostic imaging, COVID-19
- Abstract
Purpose: Pericardial fat (PF) and epicardial adipose tissue (EAT) may enhance the proinflammatory response in corona virus-19 (COVID-19) patients. Higher PF and EAT volumes might result in multiorgan failure and explain unfavorable trajectories.The aim of this study was to examine the association between the volume of PF and EAT and multiorgan failure over time., Materials and Methods: All mechanically ventilated COVID-19 patients with an available chest computed tomography were prospectively included (March-June 2020). PF and EAT volumes were quantified using chest computed tomography scans. Patients were categorized into sex-specific PF and EAT tertiles. Variables to calculate Sequential Organ Failure Assessment (SOFA) scores were collected daily to indicate multiorgan failure. Linear mixed-effects regression was used to investigate the association between tertiles for PF and EAT volumes separately and serial SOFA scores over time. All models were adjusted., Results: Sixty-three patients were divided into PF and EAT tertiles, with median PF volumes of 131.4 mL (IQR [interquartile range]: 115.7, 143.2 mL), 199.8 mL (IQR: 175.9, 221.6 mL), and 318.8 mL (IQR: 281.9, 376.8 mL) and median EAT volumes of 69.6 mL (IQR: 57.0, 79.4 mL), 107.9 mL (IQR: 104.6, 115.1 mL), and 163.8 mL (IQR: 146.5, 203.1 mL). Patients in the highest PF tertile had a statistically significantly lower SOFA score over time (1.3 [-2.5, -0.1], P =0.033) compared with the lowest PF tertile. EAT tertiles were not significantly associated with SOFA scores over time., Conclusion: A higher PF volume is associated with less multiorgan failure in mechanically ventilated COVID-19 patients. EAT volumes were not associated with multiorgan failure., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2024
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43. Facial appearance associates with longitudinal multi-organ failure: an ICU cohort study.
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Cox EGM, van Bussel BCT, Campillo Llamazares N, Sels JEM, Onrust M, van der Horst ICC, and Koeze J
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- Adult, Humans, Cohort Studies, Prospective Studies, Organ Dysfunction Scores, Prognosis, Retrospective Studies, Multiple Organ Failure, Intensive Care Units
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Background: Facial appearance, whether consciously or subconsciously assessed, may affect clinical assessment and treatment strategies in the Intensive Care Unit (ICU). Nevertheless, the association between objective clinical measurement of facial appearance and multi-organ failure is currently unknown. The objective of this study was to examine whether facial appearance at admission is associated with longitudinal evaluation of multi-organ failure., Methods: This was a sub-study of the Simple Intensive Care Studies-II, a prospective observational cohort study. All adult patients acutely admitted to the ICU between March 26, 2019, and July 10, 2019, were included. Facial appearance was assessed within three hours of ICU admission using predefined pictograms. The SOFA score was serially measured each day for the first seven days after ICU admission. The association between the extent of eye-opening and facial skin colour with longitudinal Sequential Organ Failure Assessment (SOFA) scores was investigated using generalized estimation equations., Results: SOFA scores were measured in 228 patients. Facial appearance scored by the extent of eye-opening was associated with a higher SOFA score at admission and follow-up (unadjusted 0.7 points per step (95%CI 0.5 to 0.9)). There was no association between facial skin colour and a worse SOFA score over time. However, patients with half-open or closed eyes along with flushed skin had a lower SOFA score than patients with a pale or normal facial skin colour (P-interaction < 0.1)., Conclusions: The scoring of patients' facial cues, primarily the extent of eye-opening and facial colour, provided valuable insights into the disease state and progression of the disease of critically ill patients. The utilization of advanced monitoring techniques that incorporate facial appearance holds promise for enhancing future intensive care support., (© 2024. The Author(s).)
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- 2024
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44. Serial electrical impedance tomography course in different treatment groups; The MaastrICCht cohort.
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Aydeniz E, van Bussel BCT, de Jongh S, Schellens J, Heines SJH, van Kuijk SMJ, Tas J, van Rosmalen F, van der Horst ICC, and Bergmans DCJJ
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- Humans, Electric Impedance, Tomography methods, Dexamethasone therapeutic use, Positive-Pressure Respiration methods, Tomography, X-Ray Computed methods
- Abstract
Purpose: To describe the effect of dexamethasone and tocilizumab on regional lung mechanics over admission in all mechanically ventilated COVID-19 patients., Materials and Methods: Dynamic compliance, alveolar overdistension and collapse were serially determined using electric impedance tomography (EIT). Patients were categorized into three groups; no anti-inflammatory therapy, dexamethasone therapy, dexamethasone + tocilizumab therapy. The EIT variables were (I) visualized using polynomial regression, (II) evaluated throughout admission using linear mixed-effects models, and (III) average respiratory variables were compared., Results: Visual inspection of EIT variables showed a pattern of decreasing dynamic compliance. Overall, optimal set PEEP was lower in the dexamethasone group (-1.4 cmH
2 O, -2.6; -0.2). Clinically applied PEEP was lower in the dexamethasone and dexamethasone + tocilizumab group (-1.5 cmH2 O, -2.6; -0.2; -2.2 cmH2 O, -5.1; 0.6). Dynamic compliance, alveolar overdistension, and alveolar collapse at optimal set PEEP did not significantly differ between the three groups., Conclusion: Optimal and clinically applied PEEP were lower in the dexamethasone and dexamethasone + tocilizumab groups. The results suggest that the potential beneficial effects of these therapies do not affect lung mechanics favorably. However, this study cannot fully rule out any beneficial effect of anti-inflammatory treatment on pulmonary function due to its observational nature., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2023. Published by Elsevier Inc.)- Published
- 2024
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45. The association between coronary artery calcification and vectorcardiography in mechanically ventilated COVID-19 patients: the Maastricht Intensive Care COVID cohort.
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Aydeniz E, van Rosmalen F, de Kok J, Martens B, Mingels AMA, Canakci ME, Mihl C, Vernooy K, Prinzen FW, Wildberger JE, van der Horst ICC, van Bussel BCT, and Driessen RGH
- Abstract
Background: Coronary artery calcification (CAC) is associated with poor outcome in critically ill patients. A deterioration in cardiac conduction and loss of myocardial tissue could be an underlying cause. Vectorcardiography (VCG) and cardiac biomarkers provide insight into these underlying causes. The aim of this study was to investigate whether a high degree of CAC is associated with VCG-derived variables and biomarkers, including high-sensitivity troponin-T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)., Methods: Mechanically ventilated coronavirus-19 (COVID-19) patients with an available chest computed tomography (CT) and 12-lead electrocardiogram (ECG) were studied. CAC scores were determined using chest CT scans. Patients were categorized into 3 sex-specific tertiles: low, intermediate, and high CAC. Daily 12 leads-ECGs were converted to VCGs. Daily hs-cTnT and NT-proBNP levels were determined. Linear mixed-effects regression models examined the associations between CAC tertiles and VCG variables, and between CAC tertiles and hs-cTnT or NT-proBNP levels., Results: In this study, 205 patients (73.2% men, median age 65 years [IQR 57.0; 71.0]) were included. Compared to the lowest CAC tertile, the highest CAC tertile had a larger QRS area at baseline (6.65 µVs larger [1.50; 11.81], p = 0.012), which decreased during admission (- 0.27 µVs per day [- 0.43; - 0.11], p = 0.001). Patients with the highest CAC tertile also had a longer QRS duration (12.02 ms longer [4.74; 19.30], p = 0.001), higher levels of log hs-cTnT (0.79 ng/L higher [0.40; 1.19], p < 0.001) and log NT-proBNP (0.83 pmol/L higher [0.30; 1.37], p = 0.002)., Conclusion: Patients with a high degree of CAC had the largest QRS area and higher QRS amplitude, which decreased more over time when compared to patients with a low degree of CAC. These results suggest that CAC might contribute to loss of myocardial tissue during critical illness. These insights could improve risk stratification and prognostication of patients with critical illness., (© 2024. The Author(s).)
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- 2024
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46. Decision making in out-of-hospital cardiac arrest: what should come first?
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van 't Hof AWJ, Delnoij TSR, and van der Horst ICC
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- 2024
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47. Extracorporeal life support in cardiac arrest: a post hoc Bayesian re-analysis of the INCEPTION trial.
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Heuts S, van de Koolwijk AF, Gabrio A, Ubben JFH, van der Horst ICC, Delnoij TSR, Suverein MM, Maessen JG, Lorusso R, and van de Poll MCG
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- Humans, Bayes Theorem, Probability, Retrospective Studies, Extracorporeal Membrane Oxygenation methods, Cardiopulmonary Resuscitation methods, Out-of-Hospital Cardiac Arrest therapy
- Abstract
Aims: Previously, we performed the multicentre INCEPTION trial, randomizing patients with refractory out-of-hospital cardiac arrest (OHCA) to extracorporeal cardiopulmonary resuscitation (ECPR) or conventional cardiopulmonary resuscitation (CCPR). Frequentist analysis showed no statistically significant treatment effect for the primary outcome; 30-day survival with a favourable neurologic outcome (cerebral performance category score of 1-2). To facilitate a probabilistic interpretation of the results, we present a Bayesian re-analysis of the INCEPTION trial., Methods and Results: We analysed survival with a favourable neurologic outcome at 30 days and 6 months under a minimally informative prior in the intention-to-treat population. Effect sizes are presented as absolute risk differences (ARDs) and relative risks (RRs), with 95% credible intervals (CrIs). We estimated posterior probabilities at various thresholds, including the minimal clinically important difference (MCID) (5% ARD), based on expert consensus, and performed sensitivity analyses under sceptical and literature-based priors. The mean ARD for 30-day survival with a favourable neurologic outcome was 3.6% (95% CrI -9.5-16.7%), favouring ECPR, with a median RR of 1.22 (95% CrI 0.59-2.51). The posterior probability of an MCID was 42% at 30 days and 42% at 6 months, in favour of ECPR., Conclusion: Bayesian re-analysis of the INCEPTION trial estimated a 42% probability of an MCID between ECPR and CCPR in refractory OHCA in terms of 30-day survival with a favourable neurologic outcome., Trial Registration: Clinicaltrials.gov (NCT03101787, registered 5 April 2017)., Competing Interests: Conflict of interest: R.L. reports consulting fees from Abiomed and participates in an advisory board of Xenios not related to this work. All other authors report no conflicts of interest., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2024
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48. Consensus-based indicators for evaluating and improving the quality of regional collaborative networks of intensive care units: Results of a nationwide Delphi study.
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Hesselink G, Verhage R, van der Horst ICC, van der Hoeven H, and Zegers M
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- Humans, Consensus, Delphi Technique, Netherlands, Quality Indicators, Health Care, Intensive Care Units
- Abstract
Purpose: To select a consensus-based set of relevant and feasible indicators for monitoring and improving the quality of regional ICU network collaboratives., Methods: A three-round Delphi study was conducted in the Netherlands between April and July 2022. A multidisciplinary expert panel prioritized potentially relevant and feasible indicators in two questionnaire rounds with two consensus meetings between both rounds. The RAND/UCLA appropriateness method was used to categorize indicators and synthesize results. A core set of highest ranked indicators with consensus-based levels of relevance and feasibility were finally tested in two ICU networks to assess their measurability., Results: Twenty-four indicators were deemed as relevant and feasible. Seven indicators were selected for the core set measuring the standardized mortality rate in the region (n = 1) and evaluating the presence, content and/or follow-up of a formal plan describing network structures and policy agreements (n = 3), a long-term network vision statement (n = 1), and network meetings to reflect on and learn from outcome data (n = 2). The practice tests led to minor reformulations., Conclusions: This study generated relevant and feasible indicators for monitoring and improving the quality of ICU network collaboratives based on the collective opinion of various experts. The indicators may help to effectively govern such networks., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
- Full Text
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49. Deep embedded clustering generalisability and adaptation for integrating mixed datatypes: two critical care cohorts.
- Author
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de Kok JWTM, van Rosmalen F, Koeze J, Keus F, van Kuijk SMJ, Castela Forte J, Schnabel RM, Driessen RGH, van Herpt TTW, Sels JEM, Bergmans DCJJ, Lexis CPH, van Doorn WPTM, Meex SJR, Xu M, Borrat X, Cavill R, van der Horst ICC, and van Bussel BCT
- Subjects
- Humans, Cluster Analysis, Critical Care
- Abstract
We validated a Deep Embedded Clustering (DEC) model and its adaptation for integrating mixed datatypes (in this study, numerical and categorical variables). Deep Embedded Clustering (DEC) is a promising technique capable of managing extensive sets of variables and non-linear relationships. Nevertheless, DEC cannot adequately handle mixed datatypes. Therefore, we adapted DEC by replacing the autoencoder with an X-shaped variational autoencoder (XVAE) and optimising hyperparameters for cluster stability. We call this model "X-DEC". We compared DEC and X-DEC by reproducing a previous study that used DEC to identify clusters in a population of intensive care patients. We assessed internal validity based on cluster stability on the development dataset. Since generalisability of clustering models has insufficiently been validated on external populations, we assessed external validity by investigating cluster generalisability onto an external validation dataset. We concluded that both DEC and X-DEC resulted in clinically recognisable and generalisable clusters, but X-DEC produced much more stable clusters., (© 2024. The Author(s).)
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- 2024
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50. Long-Term Follow-Up of Critically Ill Patients With Traumatic Brain Injury: From Intensive Care Parameters to Patient and Caregiver-Reported Outcome.
- Author
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Domensino AF, Tas J, Donners B, Kooyman J, van der Horst ICC, Haeren R, Ariës MJH, and van Heugten C
- Subjects
- Humans, Follow-Up Studies, Caregivers psychology, Quality of Life psychology, Cross-Sectional Studies, Critical Illness, Critical Care, Patient Reported Outcome Measures, Brain Injuries, Traumatic therapy, Brain Injuries, Traumatic complications, Brain Injuries complications, Brain Concussion complications
- Abstract
Abstract Traumatic brain injury (TBI) is associated with a high social and financial burden due to persisting (severe) disabilities. The consequences of TBI after intensive care unit (ICU) admission are generally measured with global disability screeners such as the Glasgow Outcome Scale-Extended (GOSE), which may lack precision. To improve outcome measurement after brain injury, a comprehensive clinical outcome assessment tool called the Minimal Dataset for Acquired Brain Injury (MDS-ABI) was recently developed. The MDS-ABI covers 12 life domains (demographics, injury characteristics, comorbidity, cognitive functioning, emotional functioning, energy, mobility, self-care, communication, participation, social support, and quality of life), as well as informal caregiver capacity and strain. In this cross-sectional study, we used the MDS-ABI among formerly ICU admitted patients with TBI to explore the relationship between dichotomized severity of TBI and long-term outcome. Our objectives were to: 1) summarize demographics, clinical characteristics, and long-term outcomes of patients and their informal caregivers, and 2) compare differences between long-term outcomes in patients with mild-moderate TBI and severe TBI based on Glasgow Coma Scale (GCS) scores at admission. Participants were former patients of a Dutch university hospital (total n = 52; mild-moderate TBI n = 23; severe TBI n = 29) and their informal caregivers ( n = 45). Hospital records were evaluated, and the MDS-ABI was administered during a home visit. On average 3.2 years after their TBI, 62% of the patients were cognitively impaired, 62% reported elevated fatigue, and 69% experienced restrictions in ≥2 participation domains (most frequently work or education and going out). Informal caregivers generally felt competent to provide necessary care (81%), but 31% experienced a disproportionate caregiver burden. All but four patients lived at home independently, often together with their informal caregiver (81%). Although the mild-moderate TBI group and the severe TBI group had significantly different clinical trajectories, there were no persisting differences between the groups for patient or caregiver outcomes at follow-up. As a large proportion of the patients experienced long-lasting consequences beyond global disability or independent living, clinicians should implement a multi-domain outcome set such as the MDS-AB to follow up on their patients.
- Published
- 2024
- Full Text
- View/download PDF
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