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7 results on '"Brecht De Tavernier"'

1. Sniffing out safety: canine detection and identification of SARS-CoV-2 infection from armpit sweat

Author

Chris Callewaert, Maria Pezavant, Rony Vandaele, Bart Meeus, Ellen Vankrunkelsven, Phaedra Van Goethem, Alain Plumacker, Benoit Misset, Gilles Darcis, Sonia Piret, Lander De Vleeschouwer, Frank Staelens, Kristel Van Varenbergh, Sofie Tombeur, Anouck Ottevaere, Ilke Montag, Patricia Vandecandelaere, Stijn Jonckheere, Linos Vandekerckhove, Els Tobback, Gregoire Wieers, Jean-Christophe Marot, Kurt Anseeuw, Leen D’Hoore, Sebastiaan Tuyls, Brecht De Tavernier, Julie Catteeuw, Ali Lotfi, Alexey Melnik, Alexander Aksenov, Dominique Grandjean, Miguel Stevens, Frank Gasthuys, and Hugues Guyot

Subjects
COVID-19, detection dogs, GC/MS (gas chromatograph/mass spectrometry), acceptability analysis, odor, axilla, Medicine (General), R5-920
Abstract

Detection dogs were trained to detect SARS-CoV-2 infection based on armpit sweat odor. Sweat samples were collected using cotton pads under the armpits of negative and positive human patients, confirmed by qPCR, for periods of 15–30 min. Multiple hospitals and organizations throughout Belgium participated in this study. The sweat samples were stored at −20°C prior to being used for training purposes. Six dogs were trained under controlled atmosphere conditions for 2–3 months. After training, a 7-day validation period was conducted to assess the dogs’ performances. The detection dogs exhibited an overall sensitivity of 81%, specificity of 98%, and an accuracy of 95%. After validation, training continued for 3 months, during which the dogs’ performances remained the same. Gas chromatography/mass spectrometry (GC/MS) analysis revealed a unique sweat scent associated with SARS-CoV-2 positive sweat samples. This scent consisted of a wide variety of volatiles, including breakdown compounds of antiviral fatty acids, skin proteins and neurotransmitters/hormones. An acceptability survey conducted in Belgium demonstrated an overall high acceptability and enthusiasm toward the use of detection dogs for SARS-CoV-2 detection. Compared to qPCR and previous canine studies, the detection dogs have good performances in detecting SARS-CoV-2 infection in humans, using frozen sweat samples from the armpits. As a result, they can be used as an accurate pre-screening tool in various field settings alongside the PCR test.

Published
2023
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2. Modulation of thromboinflammation in hospitalized COVID‐19 patients with aprotinin, low molecular weight heparin, and anakinra: The DAWn‐Antico study

Author

Matthias M. Engelen, Quentin Van Thillo, Albrecht Betrains, Iwein Gyselinck, Caroline P. Martens, Valérie Spalart, Anna Ockerman, Caroline Devooght, Joost Wauters, Jan Gunst, Carine Wouters, Christophe Vandenbriele, Steffen Rex, Laurens Liesenborghs, Alexander Wilmer, Philippe Meersseman, Greet Van den Berghe, Dieter Dauwe, Ann Belmans, Michiel Thomeer, Tom Fivez, Dieter Mesotten, David Ruttens, Luc Heytens, Ilse Dapper, Sebastiaan Tuyls, Brecht De Tavernier, Peter Verhamme, Thomas Vanassche, and DAWn Consortium Members

Subjects
anakinra, aprotinin, COVID‐19, heparin, inflammation, low‐molecular‐weight, Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Abstract Background Thromboinflammation plays a central role in severe COVID‐19. The kallikrein pathway activates both inflammatory pathways and contact‐mediated coagulation. We investigated if modulation of the thromboinflammatory response improves outcomes in hospitalized COVID‐19 patients. Methods In this multicenter open‐label randomized clinical trial (EudraCT 2020‐001739‐28), patients hospitalized with COVID‐19 were 1:2 randomized to receive standard of care (SOC) or SOC plus study intervention. The intervention consisted of aprotinin (2,000,000 IE IV four times daily) combined with low molecular weight heparin (LMWH; SC 50 IU/kg twice daily on the ward, 75 IU/kg twice daily in intensive care). Additionally, patients with predefined hyperinflammation received the interleukin‐1 receptor antagonist anakinra (100 mg IV four times daily). The primary outcome was time to a sustained 2‐point improvement on the 7‐point World Health Organization ordinal scale for clinical status, or discharge. Findings Between 24 June 2020 and 1 February 2021, 105 patients were randomized, and 102 patients were included in the full analysis set (intervention N = 67 vs. SOC N = 35). Twenty‐five patients from the intervention group (37%) received anakinra. The intervention did not affect the primary outcome (HR 0.77 [CI 0.50‐1.19], p = 0.24) or mortality (intervention n = 3 [4.6%] vs. SOC n = 2 [5.7%], HR 0.82 [CI 0.14‐4.94], p = 0.83). There was one treatment‐related adverse event in the intervention group (hematuria, 1.49%). There was one thrombotic event in the intervention group (1.49%) and one in the SOC group (2.86%), but no major bleeding. Conclusions In hospitalized COVID‐19 patients, modulation of thromboinflammation with high‐dose aprotinin and LMWH with or without anakinra did not improve outcome in patients with moderate to severe COVID‐19.

Published
2022
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3. Principles of fluid management and stewardship in septic shock: it is time to consider the four D’s and the four phases of fluid therapy

Author

Manu L. N. G. Malbrain, Niels Van Regenmortel, Bernd Saugel, Brecht De Tavernier, Pieter-Jan Van Gaal, Olivier Joannes-Boyau, Jean-Louis Teboul, Todd W. Rice, Monty Mythen, and Xavier Monnet

Subjects
Fluids, Fluid therapy, Fluid management, Fluid stewardship, Four D’s, Four indications, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition. In this paradigm-shifting review, we discuss different fluid management strategies including early adequate goal-directed fluid management, late conservative fluid management and late goal-directed fluid removal. In addition, we expand on the concept of the “four D’s” of fluid therapy, namely drug, dosing, duration and de-escalation. During the treatment of patients with septic shock, four phases of fluid therapy should be considered in order to provide answers to four basic questions. These four phases are the resuscitation phase, the optimization phase, the stabilization phase and the evacuation phase. The four questions are “When to start intravenous fluids?”, “When to stop intravenous fluids?”, “When to start de-resuscitation or active fluid removal?” and finally “When to stop de-resuscitation?” In analogy to the way we handle antibiotics in critically ill patients, it is time for fluid stewardship.

Published
2018
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4. Effect of the First Wave of the Belgian COVID-19 Pandemic on Physician-Provided Prehospital Critical Care in the City of Antwerp (Belgium)

Author

Jan Christiaen, Brecht De Tavernier, Wouter De Tavernier, Ives Hubloue, Niels Van Regenmortel, Tina Lavigne, Kurt Anseeuw, Emergency Medicine, and Supporting clinical sciences

Subjects
medicine.medical_specialty, Critical Care, Coronavirus disease 2019 (COVID-19), Psychological intervention, Emergency Nursing, infectious diseases, State Medicine, Cohort Studies, Belgium, Disease severity, Physicians, Pandemic, Emergency medical services, medicine, physician-led prehospital care, Humans, Illness severity, Pandemics, Original Research, Retrospective Studies, SARS-CoV-2, business.industry, COVID-19, Early warning score, Emergency medicine, business, Cohort study
Abstract

Introduction:There is evidence to suggest that patients delayed seeking urgent medical care during the first wave of the coronavirus disease 2019 (COVID-19) pandemic. A delay in health-seeking behavior could increase the disease severity of patients in the prehospital setting. The combination of COVID-19-related missions and augmented disease severity in the prehospital environment could result in an increase in the number and severity of physician-staffed prehospital interventions, potentially putting a strain on this highly specialized service.Study Objective:The aim was to investigate if the COVID-19 pandemic influences the frequency of physician-staffed prehospital interventions, prehospital mortality, illness severity during prehospital interventions, and the distribution in the prehospital diagnoses.Methods:A retrospective, multicenter cohort study was conducted on prehospital charts from March 14, 2020 through April 30, 2020, compared to the same period in 2019, in an urban area. Recorded data included demographics, prehospital diagnosis, physiological parameters, mortality, and COVID-status. A modified National Health Service (NHS) National Early Warning Score (NEWS) was calculated for each intervention to assess for disease severity. Data were analyzed with univariate and descriptive statistics.Results:There was a 31% decrease in physician-staffed prehospital interventions during the period under investigation in 2020 as compared to 2019 (2019: 644 missions and 2020: 446 missions), with an increase in prehospital mortality (OR = 0.646; 95% CI, 0.435 – 0.959). During the study period, there was a marked decrease in the low and medium NEWS groups, respectively, with an OR of 1.366 (95% CI, 1.036 – 1.802) and 1.376 (0.987 – 1.920). A small increase was seen in the high NEWS group, with an OR of 0.804 (95% CI, 0.566 – 1.140); 2019: 80 (13.67%) and 2020: 69 (16.46%). With an overall decrease in cases in all diagnostic categories, a significant increase was observed for respiratory illness (31%; P = .004) and cardiac arrest (54%; P < .001), combined with a significant decrease for intoxications (-58%; P = .007). Due to the national test strategy at that time, a COVID-19 polymerase chain reaction (PCR) result was available in only 125 (30%) patients, of which 20 (16%) were positive.Conclusion:The frequency of physician-staffed prehospital interventions decreased significantly. There was a marked reduction in interventions for lower illness severity and an increase in higher illness severity and mortality. Further investigation is needed to fully understand the reasons for these changes.

Published
2022

5. A case of multisystem inflammatory syndrome (MIS-A) in an adult woman 18 days after COVID-19 vaccination

Author

Britt Ceuleers, Anke Verlinden, Daan Van Brusselen, Brecht de Tavernier, Philippe Willems, and Sofie Stappers

Subjects
Adult, 2019-20 coronavirus outbreak, Pediatrics, medicine.medical_specialty, COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), business.industry, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Vaccination, COVID-19, food and beverages, General Medicine, Systemic Inflammatory Response Syndrome, Intravenous Immunoglobulins, Medicine, Humans, Female, Human medicine, business
Abstract

We discuss a case of a young woman, presenting a constellation of clinical and biochemical features meeting the current case definition of multisystem inflammatory syndrome in adults (MIS-A), 18 days after receiving her first dose of the Oxford/AstraZeneca vaccine. Therapy by means of intravenous immunoglobulins was initiated, leading to clinical and biochemical recovery. Although a relationship between MIS-A and the preceding vaccination cannot be confirmed, it can also not be excluded, given the temporal association and the fact that there were no indicators of a preceding SARS-CoV-2 infection.

Published
2022

6. Anatomy and Physiology of the Abdominal Compartment

Author

Manu L N G Malbrain, Pieter-Jan Van Gaal, and Brecht De Tavernier

Subjects
medicine.medical_specialty, Abdominal compartment syndrome, business.industry, medicine.disease, Abdominal compartment, Pathophysiology, IAP measurement, Internal medicine, Epidemiology, Etiology, medicine, Cardiology, Respiratory system, business, Organ system
Abstract

Increasing attention has been paid to understanding the etiology, pathophysiology, prognosis, and treatment of increased intra-abdominal pressure (IAP) in surgical, trauma, and medical patients. Intra-abdominal hypertension (IAH) is a graded phenomenon; however, abdominal compartment syndrome (ACS) is an all-or-none condition resulting in dysfunction of neurological, respiratory, cardiovascular, renal, and hepatic organ systems. This chapter provides a detailed overview of the historical background, definitions, classification, epidemiology, and pathophysiology related to IAH and ACS, including different IAP measurement techniques.

Published
2018
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7. Executive summary on the use of ultrasound in the critically ill: consensus report from the 3rd Course on Acute Care Ultrasound (CACU)

Author

Daniel Lichtenstein, Manu L N G Malbrain, Antoine Vieillard-Baron, Jan Poelaert, Willem Stockman, Brecht De Tavernier, Paul W. G. Elbers, Michel Slama, Adrian Wong, Sandrine Haverals, Xavier Monnet, Ziekenhuis Netwerk Antwerpen (ZNA), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Service de réanimation medico-chirurgicale [CHU Raymond-Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Ambroise Paré [AP-HP], Supporting clinical sciences, Intensive Care, Anesthesiology research group, Anesthesiology, and Hospital Ambroise Paré

Subjects
medicine.medical_specialty, Consensus, Critical Care, Monitoring, Critical Illness, [SDV]Life Sciences [q-bio], resuscitation, education, Vascular access, transthoracic, Critical Care and Intensive Care Medicine, law.invention, lung, 03 medical and health sciences, 0302 clinical medicine, Fluid therapy, law, Acute care, Vascular, Ultrasound, medicine, fluid responsiveness, Humans, 030212 general & internal medicine, point-of-care ultrasound, Intensive care medicine, critical care ultrasound, Ultrasonography, Modalities, Executive summary, training, POCUS, business.industry, Critically ill, 030208 emergency & critical care medicine, General Medicine, Intensive care unit, Intensive Care Units, Anesthesiology and Pain Medicine, Echocardiography, CCUS, abdominal, Professional association, transesophageal, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Over the past decades, ultrasound (US) has gained its place in the armamentarium of monitoring tools in the intensive care unit (ICU). Critical care ultrasonography (CCUS) is the combination of general CCUS (lung and pleural, abdominal, vascular) and CC echocardiography, allowing prompt assessment and diagnosis in combination with vascular access and therapeutic intervention. This review summarises the findings, challenges lessons from the 3rd Course on Acute Care Ultrasound (CACU) held in November 2015, Antwerp, Belgium. It covers the different modalities of CCUS; touching on the various aspects of training, clinical benefits and potential benefits. Despite the benefits of CCUS, numerous challenges remain, including the delivery of CCUS training to future intensivists. Some of these are discussed along with potential solutions from a number of national European professional societies. There is a need for an international agreed consensus on what modalities are necessary and how best to deliver training in CCUS.

Published
2017
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