88 results on '"Hunfeld N"'
Search Results
2. Infusen
- Author
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Hunfeld, N. G. M., van den Brink, Geert, editor, Lindsen, Frans, editor, Dieperink, Willem, editor, and van Paassen-Remmerswaal, Chantal, editor
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- 2025
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3. Enterale en parenterale toediening van geneesmiddelen
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Hunfeld, N. G. M., van den Brink, Geert, editor, Lindsen, Frans, editor, Dieperink, Willem, editor, and van Paassen-Remmerswaal, Chantal, editor
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- 2025
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4. Farmacokinetiek
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Hunfeld, N. G. M., van den Brink, Geert, editor, Lindsen, Frans, editor, Dieperink, Willem, editor, and van Paassen-Remmerswaal, Chantal, editor
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- 2025
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5. Hypertensie
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Hunfeld, N. G. M., van den Brink, Geert, editor, Lindsen, Frans, editor, Dieperink, Willem, editor, and van Paassen-Remmerswaal, Chantal, editor
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- 2025
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6. Evaluation of medication-related problems in liver transplant recipients with and without an outpatient medication consultation by a clinical pharmacist: a cohort study
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Mulder, Midas B., Doga, B., Borgsteede, S. D., van den Burg, A. M., Metselaar, H. J., den Hoed, C. M., and Hunfeld, N. G.M.
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- 2022
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7. Voluntarily reported prescribing, monitoring and medication transfer errors in intensive care units in The Netherlands
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Bosma, B. E., Hunfeld, N. G. M., Roobol-Meuwese, E., Dijkstra, T., Coenradie, S. M., Blenke, A., Bult, W., Melief, P. H. G. J., Dixhoorn, M. Perenboom-Van, and van den Bemt, P. M. L. A.
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- 2021
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8. The effect of therapeutic drug monitoring of beta-lactam and fluoroquinolones on clinical outcome in critically ill patients: the DOLPHIN trial protocol of a multi-centre randomised controlled trial
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Abdulla, A., Ewoldt, T. M. J., Hunfeld, N. G. M., Muller, A. E., Rietdijk, W. J. R., Polinder, S., van Gelder, T., Endeman, H., and Koch, B. C. P.
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- 2020
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9. Circular material flow in the intensive care unit-environmental effects and identification of hotspots
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Hunfeld, N, Diehl, JC, Timmermann, M, van Exter, P, Bouwens, J, Browne-Wilkinson, S, de Planque, N, Gommers, D, Hunfeld, N, Diehl, JC, Timmermann, M, van Exter, P, Bouwens, J, Browne-Wilkinson, S, de Planque, N, and Gommers, D
- Abstract
Purpose The healthcare sector is responsible for 6–7% of CO2 emissions. The intensive care unit (ICU) contributes to these CO2 emissions and a shift from a linear system to a circular system is needed. The aim of our research was to perform a material flow analysis (MFA) in an academic ICU. Secondary aims were to obtain information and numbers on mass, carbon footprint, agricultural land occupation and water usage and to determine so-called “environmental hotspots” in the ICU. Methods A material flow analysis was performed over the year 2019, followed by an environmental footprint analysis of materials and environmental hotspot identification. Results 2839 patients were admitted to our ICU in 2019. The average length of stay was 4.6 days. Our MFA showed a material mass inflow of 247,000 kg in 2019 for intensive care, of which 50,000 kg is incinerated as (hazardous) hospital waste. The environmental impact per patient resulted in 17 kg of mass, 12 kg CO2 eq, 300 L of water usage and 4 m2 of agricultural land occupation per day. Five hotspots were identified: non-sterile gloves, isolation gowns, bed liners, surgical masks and syringes (including packaging). Conclusion This is the first material flow analysis that identified environmental risks and its magnitude in the intensive care unit.
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- 2023
10. Using Residual Blood from the Arterial Blood Gas Test to Perform Therapeutic Drug Monitoring of Vancomycin: An Example of Good Clinical Practice Moving towards a Sustainable Intensive Care Unit
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Smeets, T. J. L., primary, van de Velde, D., additional, Koch, B. C. P., additional, Endeman, H., additional, and Hunfeld, N. G. M., additional
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- 2022
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11. PP365 [Healthcare systems » Environmental sustainability in healthcare]: GOING GREEN: WASTE COLLECTION AND ANALYSES IN PEDIATRIC INTENSIVE CARE
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Cochius Den Otter, S., primary, Honkoop, M., additional, Van Den Berg, L., additional, Ville, A., additional, Hunfeld, N., additional, Diehl, J., additional, Kraemer, U., additional, and Verbruggen, S., additional
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- 2022
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12. Lupus anticoagulant associates with thrombosis in patients with COVID-19 admitted to intensive care units
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Noordermeer, Tessa, Schutgens, Roger E. G., Visser, Chantal, Rademaker, Emma, de Maat, Moniek P. M., Jansen, A. J. Gerard, Limper, Maarten, Cremer, Olaf L., Kruip, Marieke J. H. A., Endeman, Henrik, Maas, Coen, de Laat, Bas, Urbanus, Rolf T., van de Beek, D., Brouwer, M. C., de Bruin, S., Coppens, M., van Es, N., van Haaps, T. F., Juffermans, N. P., Muller, M. C. A., Vlaar, A. P. J., Hertogh, C. M. P. M., Heunks, L. M. A., Hugtenburg, J. G., van Kooten, J., Nossent, E. J., Smulders, Y., Tuinman, P. R., Noordegraaf, A. Vonk, Grootenboers, M. J. J. H., van Guldener, C., Kant, M., Lansbergen, A., Faber, J., Hajer, G., Stemerdink, A., van den Akker, J., Bierings, R., Endeman, H., Goeijenbier, M., Hunfeld, N. G. M., van Gorp, E. C. M., Gommers, D. A. M. P. J., Koopmans, M. P. G., Kruip, M. J. H. A., Kuiken, T., Langerak, T., Leebeek, Lauw, M. N., de Maat, M. P. M., Noack, D., Paats, M. S., Raadsen, M. P., Rockx, B., Rokx, C., Schurink, C. A. M., Tong-Minh, K., van den Toorn, L., den Uil, C. A., Visser, C., Boutkourt, F., Roest, T., Douma, R. A., de Haan, L. R., ten Wolde, M., Bemelmans, R. H. H., Festen, B., Stads, S., de Jager, C. P. C., Simons, K. S., Antoni, M. L., Bos, M. H., Burggraaf, J. L. I., Cannegieter, S. C., Eikenboom, H. C. J., den Exter, P. L., Geelhoed, J. J. M., Huisman, M. V., de Jonge, E., Kaptein, F. H. J., Klok, F. A., Kroft, L. J. M., Lijfering, W. M., Nab, L., Ninaber, M. K., Putter, H., Ramai, S. R. S., da Rocha Rondon, A. M., Roukens, A. H. E., Stals, M. A. M., Versteeg, H. H., Vliegen, H. W., van Vlijmen, B. J. M., van de Berg, T., Bruggemann, R., van Bussel, B. C. T., ten Cate, H., ten Cate-Hoek, A., Hackeng, T. M., Henskens, ir. Y., Hulshof, A., Mulder, M., Olie, R. H., Schurgers, L., Spaetgens, B., Spronk, H., Spruit, M. A., Winckers, K., Nieuwenhuizen, L., Franken, B., Schrover, I. M., de Waal, E. G. M., Beishuizen, A., Cornet, A., Krabbe, J., Kramers, K., Leentjens, J., de Mast, Q., Middeldorp, S., Brouwer, R. E., Ellerbroek, J. L. J., Tijmensen, J., Hovens, M. M. C., Oostdijk, E. A. N., Westerhof, B. D., Faber, L. M., van den Biggelaar, M., Meijers, J. C. M., Voorberg, J., Kevenaar, M. E., Soei, Y. L., Wils, E. J., Croles, F. N., de Laat, B., Kamphuisen, P. W., Vink, R., Lisman, T., Meijer, K., van Tichelaar, Y. I. G., Cremer, O. L., Geersing, G., Kaasjager, H. A. H., Kusadasi, N., Huisman, A., Maas, C., Nijkeuter, M., Schutgens, R. E. G., Creveldkliniek, Van, Urbanus, R. T., Westerink, J., Faber, H. J., Koster, S. C. E., van Montfort, P., van Twist, D. J. L., RS: Carim - B01 Blood proteins & engineering, Biochemie, Hematology, Intensive Care, Neurology, ANS - Neuroinfection & -inflammation, Intensive Care Medicine, ACS - Pulmonary hypertension & thrombosis, AII - Inflammatory diseases, Vascular Medicine, ACS - Amsterdam Cardiovascular Sciences, Graduate School, ACS - Microcirculation, Medical Microbiology and Infection Prevention, ARD - Amsterdam Reproduction and Development, Experimental Vascular Medicine, Landsteiner Laboratory, ACS - Atherosclerosis & ischemic syndromes, Elderly care medicine, APH - Aging & Later Life, Clinical pharmacology and pharmacy, APH - Health Behaviors & Chronic Diseases, Pulmonary medicine, Internal medicine, ACS - Diabetes & metabolism, Intensive care medicine, General practice, and Amsterdam Gastroenterology Endocrinology Metabolism
- Subjects
lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,lupus anticoagulant ,risk factor ,critically ill ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,COVID-19 ,Hematology ,thrombosis ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] - Abstract
Contains fulltext : 286889.pdf (Publisher’s version ) (Open Access) BACKGROUND: Thrombosis is a frequent and severe complication in patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU). Lupus anticoagulant (LA) is a strong acquired risk factor for thrombosis in various diseases and is frequently observed in patients with COVID-19. Whether LA is associated with thrombosis in patients with severe COVID-19 is currently unclear. OBJECTIVE: To investigate if LA is associated with thrombosis in critically ill patients with COVID-19. PATIENTS/METHODS: The presence of LA and other antiphospholipid antibodies was assessed in patients with COVID-19 admitted to the ICU. LA was determined with dilute Russell's viper venom time (dRVVT) and LA-sensitive activated partial thromboplastin time (aPTT) reagents. RESULTS: Of 169 patients with COVID-19, 116 (69%) tested positive for at least one antiphospholipid antibody upon admission to the ICU. Forty (24%) patients tested positive for LA; of whom 29 (17%) tested positive with a dRVVT, 19 (11%) tested positive with an LA-sensitive aPTT, and 8 (5%) tested positive on both tests. Fifty-eight (34%) patients developed thrombosis after ICU admission. The odds ratio (OR) for thrombosis in patients with LA based on a dRVVT was 2.5 (95% confidence interval [CI], 1.1-5.7), which increased to 4.5 (95% CI, 1.4-14.3) in patients at or below the median age in this study (64 years). LA positivity based on a dRVVT or LA-sensitive aPTT was only associated with thrombosis in patients aged less than 65 years (OR, 3.8; 95% CI, 1.3-11.4) and disappeared after adjustment for C-reactive protein. CONCLUSION: Lupus anticoagulant on admission is strongly associated with thrombosis in critically ill patients with COVID-19, especially in patients aged less than 65 years.
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- 2022
13. ESICM LIVES 2016: part two: Milan, Italy. 1–5 October 2016
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Sivakumar, S., Taccone, F. S., Desai, K. A., Lazaridis, C., Skarzynski, M., Sekhon, M., Henderson, W., Griesdale, D., Chapple, L., Deane, A., Williams, L., Strickland, R., Lange, K., Heyland, D., Chapman, M., Rowland, M. J., Garry, P., Westbrook, J., Corkill, R., Antoniades, C. A., Pattinson, K. T., Fatania, G., Strong, A. J., Myers, R. B., Lazaridis, C., Jermaine, C. M., Robertson, C. S., Rusin, C. G., Hofmeijer, J., Sondag, L., Tjepkema-Cloostermans, M. C., Beishuizen, A., Bosch, F. H., van Putten, M. J. A. M., Carteron, L., Patet, C., Solari, D., Oddo, M., Ali, M. A., Dias, C., Almeida, R., Vaz-Ferreira, A., Silva, J., Monteiro, E., Cerejo, A., Rocha, A. P., Elsayed, A. A., Abougabal, A. M., Beshey, B. N., Alzahaby, K. M., Pozzebon, S., Ortiz, A. Blandino, Cristallini, S., Lheureux, O., Brasseur, A., Vincent, J. L., Creteur, J., Taccone, F. S., Hravnak, M., Yousef, K., Chang, Y., Crago, E., Friedlander, R. M., Abdelmonem, S. A., Tahon, S. A., Helmy, T. A., Meligy, H. S., Puig, F., Dunn-Siegrist, I., Pugin, J., Gupta, S., Govil, D., Srinivasan, S., Patel, S. J., N, J. K., Gupta, A., Tomar, D. S., Shafi, M., Harne, R., Arora, D. P., Talwar, N., Mazumdar, S., Papakrivou, E. E., Makris, D., Manoulakas, E., Tsolaki, B., Karadodas, B., Zakynthinos, E., Garcia, I. Palacios, Martin, A. Diaz, Encinares, V. Sanchez, Ibañez, M. Pachón, Montero, J. Garnacho, Labrador, G., Cangueiro, T. Cebrero, Poulose, V., Koh, J., Kam, J. W., Yeter, H., Kara, A., Aktepe, O., Topeli, A., Tsolakoglou, I., Intas, G., Stergiannis, P., Kolaros, A. A., Chalari, E., Athanasiadou, E., Martika, A., Fildisis, G., Faivre, V., Mengelle, C., Favier, B., Payen, D., Poppe, A., Winkler, M. S., Mudersbach, E., Schreiber, J., Wruck, M. L., Schwedhelm, E., Kluge, S., Zöllner, C., Tavladaki, T., Spanaki, A. M., Dimitriou, H., Kondili, E., Choulaki, C., Meleti, E., Kafetzopoulos, D., Georgopoulos, D., Briassoulis, G., la Torre, A. García-de, de la Torre-Prados, M. V., Tsvetanova-Spasova, T., Nuevo-Ortega, P., Rueda-Molina, C., Fernández-Porcel, A., Camara-Sola, E., Salido-Díaz, L., García-Alcántara, A., Tavladaki, T., Spanaki, A. M., Dimitriou, H., Kondili, E., Choulaki, C., Meleti, D. E., Kafetzopoulos, D., Georgopoulos, D., Briassoulis, G., Suberviola, B., Riera, J., Rellan, L., Sanchez, M., Robles, J. C., Lopez, E., Vicente, R., Miñambres, E., Santibañez, M., Le Guen, M., Moore, J., Mason, N., Windpassinger, M., Plattner, O., Mascha, E., Sessler, D. I., Research, Outcomes, Melia, U., Fontanet, J., van den Berg, J. P., Struys, M. M. R. F., Vereecke, H. E. M., Jensen, E. W., Rood, P. J. T., van de Schoor, F., van Tertholen, K., Pickkers, P., van den Boogaard, M., Beardow, Z. J., Redhead, H., Paramasivam, K., Numan, T., van den Boogaard, M., Kamper, A. M., Rood, P., Peelen, L. M., Zeman, P. M., Slooter, A. J., van Ewijk, C. E., Jacobs, G. E., Girbes, A. R. J., Myatra, S. N., Harish, M. M., Prabu, N. R., Siddiqui, S., Kulkarni, A. P., Divatia, J. V., Murbach, L. D., Leite, M. A., Osaku, E. F., Costa, C. R. L. M., Pelenz, M., Neitzke, N. M., Moraes, M. M., Jaskowiak, J. L., Silva, M. M. M., Zaponi, R. S., Abentroth, L. R. L., Ogasawara, S. M., Jorge, A. C., Duarte, P. A. D., Hernández-Sánchez, N., Sánchez-Hurtado, L. A., García-Guillen, F. J., Ñamendys-Silva, S. A., Maghsoudi, B., Emami, M., Khosravi, M. B., Zand, F., Tabatabaie, H. R., Masjedi, M., Sabetiyan, G., Mokri, A., Troubleyn, J., Diltoer, M., Jacobs, R., Nguyen, D. N., De Waele, E., De Regt, J., Honoré, P. M., Van Gorp, V., Spapen, H. D., Contreras, R. S., Toapanta, N. D., Moreno, G., Sabater, J., Torrado, H., Gonzalez, M., Marin, M., Farigola, E., Gonzalez, A., Fernandez, J., Vera, A., Gisbert, X., Juliá, C., Uya, J., Corral, L., Elias-Jones, I., Gemmell, L., MacKay, A., Randall, D., Adwaney, A., Blunden, M., Prowle, J. R., Kirwan, C. J., Thomas, N., Martin, A., Owen, H., Darwin, L., Conway, D., Atkinson, D., Sharman, M., Moore, J., Barbanti, C., Amour, J., Gaudard, P., Rozec, B., Mauriat, P., M’rini, M., Leger, P. L., Cambonie, G., Liet, J. M., Girard, C., Laroche, S., Damas, P., Assaf, Z., Loron, G., Lecourt, L., Pouard, P., Randall, D., Adwaney, A., Blunden, M., Prowle, J.R., Kirwan, C. J., Kim, S. H., Na, S., Kim, J., Oh, S. Y., Jung, C. W., Yoo, S. H., Min, S. H., Chung, E. J., Lee, H., Lee, N. J., Lee, K. W., Suh, K. S., Ryu, H. G., Marshall, D. C., Goodson, R. J., Salciccioli, J. D., Shalhoub, J., Potter, E. K., Kirk-Bayley, J., Karanjia, N. D., Forni, L. G., Creagh-Brown, B. C., Bossy, M., Nyman, M., Tailor, A., Creagh-Brown, B., D’Antini, D., Spadaro, S., Valentino, F., Sollitto, F., Cinnella, G., Mirabella, L., Calvo, F. J. Redondo, Bejarano, N., Padilla, D., Baladron, V., Villajero, P., Villazala, R., Redondo, J., Yuste, A. S., Liu, J., Shen, F., Teboul, J. L., Anguel, N., Beurton, A., Bezaz, N., Richard, C., Monnet, X., Fossali, T., Colombo, R., Ottolina, D., Rossetti, M., Mazzucco, C., Marchi, A., Porta, A., Catena, E., Tollisen, K. H., Andersen, G. Ø., Heyerdahl, F., Jacobsen, D., de Waard, M. C., Girbes, A. R. J., van IJzendoorn, M. C. O., Buter, H., Kingma, W. P., Navis, G. J., Boerma, E. C., Rulisek, J., Balik, M., Zacharov, S., Kim, H. S., Jeon, S. J., Namgung, H., Lee, E., Lee, E., Cho, Y. J., Lee, Y. J., Huang, A., Cioccari, L., Luethi, N., Mårtensson, J., Bellomo, R., Forsberg, M., Edman, G., Höjer, J., Forsberg, S., Freile, M. T. Chiquito, Hidalgo, F. N., Molina, J. A. Martinez, Lecumberri, R., Rosselló, A. Figuerola, Travieso, P. Medrano, Leon, G. Tuero, Sanchez, J. Gonzalez, Frias, L. Sahuquillo, Rosello, D. Balsells, Verdejo, J. A. Garcia, Serrano, J. A. Noria, Winterwerp, D., van Galen, T., Vazin, A., Karimzade, I., Zand, A., Ozen, E., Ekemen, S., Akcan, A., Sen, E., Yelken, B. Buyukkidan, Kureshi, N., Fenerty, L., Thibault-Halman, G., Erdogan, M., Walling, S., Green, R. S., Clarke, D. B., Briassoulis, P., Kalimeris, K., Ntzouvani, A., Nomikos, T., Papaparaskeva, K., Politi, E., Kostopanagiotou, G., Crewdson, K., Rehn, M., Weaver, A., Brohi, K., Lockey, D., Wright, S., Thomas, K., Baker, C., Mansfield, L., Stafford, V., Wade, C., Watson, G., Bryant, A., Chadwick, T., Shen, J., Wilkinson, J., Furneval, J., Henderson, A., Hugill, K., Howard, P., Roy, A., Bonner, S., Baudouin, S., Ramírez, C. Sánchez, Escalada, S. Hípola, Viera, M. A. Hernández, Santana, M. Cabrera, Balcázar, L. Caipe, Monroy, N. Sangil, Campelo, F. Artiles, Vázquez, C. F. Lübbe, Santana, P. Saavedra, Santana, S. Ruiz, Carteron, L., Patet, C., Quintard, H., Solari, D., Bouzat, P., Oddo, M., Wollersheim, T., Malleike, J., Haas, K., Carbon, N., Schneider, J., Birchmeier, C., Fielitz, J., Spuler, S., Weber-Carstens, S., Enseñat, L., Pérez-Madrigal, A., Saludes, P., Proença, L., Gruartmoner, G., Espinal, C., Mesquida, J., Huber, W., Eckmann, M., Elkmann, F., Gruber, A., Lahmer, T., Mayr, U., Herner, A., Schellnegger, R., Schneider, J., Schmid, R. M., Ayoub, W., Samy, W., Esmat, A., Battah, A., Mukhtar, S., Mongkolpun, W., Cortés, D. Orbegozo, Cordeiro, C. P. R., Vincent, J. L., Creteur, J., Funcke, S., Groesdonk, H., Saugel, B., Wagenpfeil, G., Wagenpfeil, S., Reuter, D. A., Fernandez, M. M., Fernandez, R., Magret, M., González-Castro, A., Bouza, M. T., Ibañez, M., García, C., Balerdi, B., Mas, A., Arauzo, V., Añón, J. M., Ruiz, F., Ferreres, J., Tomás, R., Alabert, M., Tizón, A. I., Altaba, S., Llamas, N., Goligher, E C., Fan, E., Herridge, M., Vorona, S., Sklar, M., Dres, M., Rittayamai, N., Lanys, A., Urrea, C., Tomlinson, G., Reid, W. D., Rubenfeld, G. D., Kavanagh, B. P., Brochard, L. J., Ferguson, N. D., Neto, A. Serpa, de Abreu, M. Gama, Pelosi, P., Schultz, M. J., Guérin, C., Papazian, L., Reignier, J., Ayzac, L., Loundou, A., Forel, J. M., Rolland-Debord, C., Bureau, C., Poitou, T., Clavel, M., Perbet, S., Terzi, N., Kouatchet, A., Similowski, T., Demoule, A., Hunfeld, N., Trogrlic, Z., Ladage, S., Osse, R. J., Koch, B., Rietdijk, W., Devlin, J., van der Jagt, M., Picetti, E., Ceccarelli, P., Mensi, F., Malchiodi, L., Risolo, S., Rossi, I., Antonini, M. V., Servadei, F., Caspani, M. L., Roquilly, A., Lasocki, S., Seguin, P., Geeraerts, T., Perrigault, P. F., Dahyot-Fizelier, C., Paugam-Burtz, C., Cook, F., Cinotti, R., dit Latte, D. Demeure, Mahe, P. 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F., Garcia, I. Palacios, Martin, A. Diaz, Marqués, M. Gil, Moreno, A. Puppo, Pizarraya, A. Gutierrez, Diaz, J. Pachón, Ibañez, M. Pachón, Smani, Y., Connell, M. Mc, Zhang, L. A., Parker, R. S., Banerjee, I., Clermont, G., Norberg, E., Oras, J., Cuisinier, A., Maufrais, C., Payen, J. F., Nottin, S., Walther, G., Bouzat, P., Arib, S., Bilotta, F., Badenes, R., Rubulotta, F., Mirek, S., Crippa, I. A., Monfort, B., Stazi, E., Roig, A. Lozano, Creteur, J., Taccone, F. S., Magnoni, S., Marando, M., Pifferi, S., Conte, V., Ortolano, F., Carbonara, M., Bertani, G., Scola, E., Cadioli, M., Triulzi, F., Colombo, A., Stocchetti, N., Rotzel, H. B., Lázaro, A. Serrano, Prada, D. Aguillón, Guimillo, M. Rodriguez, Piqueras, C. Sanchís, Guia, J. Romero, Simon, M. García, Arizmendi, A. Mesejo, Carratalá, A., El Maraghi, S., Yehia, A., Bakry, M., Shoman, A., Backes, F. N., Bianchin, M. M., Vieira, S. R. R., de Souza, A., Backes, A. N., Klein, C., Kalaiselvan, M. S., Renuka, M. K., Arunkumar, A. S., Lozano, A., Lheureux, O., Badenes, R., Vincent, J. L., Creteur, J., Taccone, F. S., Gallaher, C., Cattlin, S., Gordon, S., Picard, J., Fontana, V., Bond, O., Nobile, L., Vincent, J. L., Creteur, J., Taccone, F. S., Mrozek, S., Delamarre, L., Capilla, F., Al-Saati, T., Fourcade, O., Geeraerts, T., Dominguez-Berrot, A. M., Gonzalez-Vaquero, M., Vallejo-Pascual, M. E., Gupta, D., Ivory, B. D., Chopra, M., McCarthy, J., Felderhof, C. L., MacNeil, C., Rubulotta, F., Waldauf, P., Maggiorini, M., Duska, F., Fumis, R. R. L., Junior, J. M. Vieira, Amarante, G., Skorko, A., Sanders, S., Aron, J., Kroll, R. J., Redfearn, C., Krishnan, P., Khalil, J. E., Kovari, F., Kongpolprom, N., Gulia, V., Lourenço, E., Melão, L., Duro, C., Baptista, G., Alves, A., Arminda, B., Rodrigues, M., Marreiros, A., Granja, C., Hayward, J., Baldwin, F., Gray, R., Katinakis, P. A., Stijf, M., Ten Kleij, M., Jansen-Frederiks, M., Broek, R., de Bruijne, M., Spronk, P. E., Sinha, K., Luney, M., Palmer, K., Keating, L., Abu-Habsa, M., Bahl, R., Baskaralingam, N., Ahmad, A., Kanapeckaite, L., Bhatti, P., Glace, S., Jeyabraba, S., Lewis, H. F., Kostopoulos, A., Raja, M., West, A., Ely, A., Turkoglu, L. M., Zolfaghari, P., Baptista, J. P., Marques, M. P., Martins, P., Pimentel, J., Gupta, D., Su, Y. C., Villacres, S., Stone, M. E., Parsikia, A., Medar, S., O’Dea, K. P., Porter, J., Tirlapur, N., Jonathan, J. M., Singh, S., Takata, M., Abu-Habsa, M., Ahmad, A., McWhirter, E., Lyon, R., Hariz, M. L., Azmi, E., Alkhan, J., Honeybul, S., Movsisyan, V., Petrikov, S., Marutyan, Z., Aliev, I., Evdokimov, A., Antonucci, E., Merz, T., Hartmann, C., Pelosi, P., Calzia, E., Radermacher, P., Nußbaum, B., Hartmann, C., Huber-Lang, M., Gröger, M., Radermacher, P., Nußbaum, B., Nußbaum, B., Antonucci, E., Calzia, E., Pelosi, P., Radermacher, P., Hartmann, C., Svoren-Jabalera, E., Davenport, E. E., Humburg, P., Knight, J., Hinds, C. J., Jun, I. J., Kim, W. J., Lee, E. H., Besch, G., Perrotti, A., Puyraveau, M., Carteron, L., Baltres, M., Samain, E., Chocron, S., Pili-Floury, S., Plata-Menchaca, E. P., Sabater-Riera, J., Estruch, M., Boza, E., Sbraga, F., Toscana-Fernández, J., Bruguera-Pellicer, E., Ordoñez-Llanos, J., Pérez-Fernández, X. L., Cavaleiro, P., Tralhão, A., Arrigo, M., Lopes, J.-P., Lebrun, M., Cholley, B., PerezVela, J. L., MarinMateos, H., Rivera, J. J. Jimenez, Llorente, M. A. Alcala, De Marcos, B. Gonzalez, Fernandez, F. J. Gonzalez, Laborda, C. Garcia, Zamora, D. Fernandez, Delgado, J. C. Lopez, Imperiali, C., Berbel-Franco, D., Dastis, M., Moreno-Gonzalez, G., Perez-Sanchez, J., Romera-Peregrina, I., Abellan-Lencina, R., Martinez-Pascual, A., Fuentes-Mila, V., Gonzalez-Romero, M., Górka, J., Górka, K., Iwaniec, T., Frołow, M., Polok, K., Fronczek, J., Kózka, M., Musiał, J., Szczeklik, W., Pérez, A. González, Ordoñez, P. Florez, Giribet, A., Cuervo, M. A. Alonso, Cuervo, R. Alonso, Esteban, M. A. Rodriguez, Fraile, L. Iglesias, Mittelbrum, C. Ponte, Albaiceta, G. Muñiz, Ampatzidou, F., Sileli, M., Kehagioglou, G., Madesis, A., Karaiskos, T., Moursia, C., Maleoglou, H., Leleki, K., Drossos, G., Uz, Z., Ince, Y., Papatella, R., Bulent, E., Guerci, P., Ince, C., De Mol, B., Vicka, V., Gineityte, D., Ringaitiene, D., Norkiene, I., Sipylaite, J., Möller, C., Fleischmann, C., Thomas-Rueddel, D. O., Vlasakov, V., Rochwerg, B., Theurer, P., Gattinoni, L., Reinhart, K., Hartog, C. S., Pérez, A. González, Al Sibai, J. Zanabili, Camblor, P. Martinez, Fernandez, P. Alvarez, Gala, J. M. García, Guisasola, J. Silba, Albaiceta, G. Muñiz, Tamura, T., Yatabe, T., Miyajima, I., Yamashita, K., Yokoyama, M., Ampatzidou, F., Kehagioglou, G., Dalampini, E., Nastou, M., Baddour, A., Ignatiadis, A., Asteri, T., Drossos, G., Hathorn, K. E., Purtle, S. W., Horkan, C. M., Gibbons, F. K., Christopher, K. B., Viana, M. V., Tonietto, T. A., Gross, L. A., Costa, V. L., Tavares, A. L. J., Lisboa, B. O., Moraes, R. B., Vieira, S. R., Viana, L. V., Azevedo, M. J., Ceniccola, G. D., Pequeno, R. S. F., Holanda, T. P., Mendonça, V. S., Araújo, W. M. C., Carvalho, L. S. F., Segaran, E., Vickers, L., Brinchmann, K., Wignall, I., Rubulotta, F., De Brito-Ashurst, I., del Olmo, R., Esteban, M. J., Vaquerizo, C., Carreño, R., Gálvez, V., Kaminsky, G., Nieto, B., Fuentes, M., De la Torre, M. A., Torres, E., Alonso, A., Velayos, C., Saldaña, T., Escribá, A., GRIP, J., Kölegård, R., Sundblad, P., Rooyackers, O., Naser, Ben, Jaziri, F., Jazia, A. Ben, Barghouth, M., Hentati, O., Skouri, W., El Euch, M., Mahfoudhi, M., Turki, S., Abdelghni, K. Ben, Abdallah, Ben, Maha, B. N. M., Cánovas, J., Sotos, F., López, A., Lorente, M., Burruezo, A., Torres, D., Polok, K., Włudarczyk, A., Górka, J., Hałek, A., Musiał, J., Szczeklik, W., Jazia, A. Ben, Jaziri, F., Bargouth, M., Bennasr, M., Turki, S., Abdelghani, K. Ben, Abdallah, T. Ben, de Grooth, H. J., Geenen, I. L., Parienti, J. J., Straaten, H. M. Oudemans-van, Shum, H. P., King, H. S., Chan, K. C., Yan, W. W., Londoño, J. Gonzalez, Cardenas, C. Lorencio, Pedrosa, M. Morales, Gubianas, C. Murcia, Bertolin, C. Fuster, Batllori, N. Vila, Sirvent, J. M., Wykes, K., Jack, J., Morgan, P., Mukhopadhyay, A., Chan, H. Y., Kowitlawakul, Y., Remani, D., Leong, C. S. F., Henry, C. J., Puthucheary, Z. A., Mendsaikhan, N., Begzjav, T., Lundeg, G., Dünser, M., Espinoza, E. D. Valenzuela, Welsh, S. P., Motta, M. F., Guerra, E., Zerpa, M. C. l., Zechner, F., Furche, M., Berdaguer, F., Birri, P. N. Rubatto, Risso-Vazquez, A., Dubin, A., Masevicius, F. D., Greaney, D., Magee, A., Fitzpatrick, G., Lugo-Cob, R. G., Sánchez-Hurtado, L. A., Arvizu-Tachiquín, P. C., Tejeda-Huezo, B. C., Cano-Oviedo, A. A., Baltazar-Torres, J. A., Aydogan, M. S., Togal, T., Taha, A., Chai, H. Z., Kam, C., Razali, S. S. Yang, Sivasamy, V., Kuan, L. Y., Poulose, V., Morales, M. A. Lopez, Castro, S., Pires, T., Melão, L., Krystopchuk, A., Pereira, I., Granja, C., Taniguchi, L. U., Pires, E. M. C., Vieira, Jr, J. M., Azevedo, L. C. P., Nurses of the Central and General ICUs of Shiraz Namazi Hospital, Sedation an Delirium Group Hospital Universitari de Bellvitge, SPACeR group (Surrey Peri-operative, Anaesthesia and Critical Care Collaborative Research Group), for the PRoVENT investigators and the PROVE Network, SEMICYUC/GETGAG Working Group, TAVeM study group, POPC-CB investigators, DESIRE (DExmedetomidine for Sepsis in ICU Randomized Evaluation) Trial Investigators, GEMINI, Bioethics work group of SEMICYUC, The FINNAKI Study Group, Queen Square Neuroanaesthesia and Neurocritical Care Resreach Group, Renal Transplantation HUVR, GEMINI, EDISVAL Group, EDISVAL Group, PLUG Working group, TAVeM study Group, The FINNAKI Study Group, on behalf of Department of Professional Development, ESICM, Critical Care Research Group, SIRAKI group, and Grupo ESBAGA
- Published
- 2016
- Full Text
- View/download PDF
14. Using Residual Blood from the Arterial Blood Gas Test to Perform Therapeutic Drug Monitoring of Vancomycin:An Example of Good Clinical Practice Moving towards a Sustainable Intensive Care Unit
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Smeets, T. J.L., Van De Velde, D., Koch, B. C.P., Endeman, H., Hunfeld, N. G.M., Smeets, T. J.L., Van De Velde, D., Koch, B. C.P., Endeman, H., and Hunfeld, N. G.M.
- Abstract
Background. Regarding sustainability in the intensive care unit (ICU), there is increasing interest in reducing material waste and avoiding unnecessary procedures. Therapeutic drug monitoring (TDM) of vancomycin, using a dedicated tube, is standard clinical care during treatment with vancomycin. Furthermore, in the ICU, on a daily basis, arterial blood gas (ABG) tests are frequently performed throughout the day. After analysis, a variable volume of blood is discarded. Lithium heparin (LiHep) syringes for ABG tests differ from normally used dipotassium ethylenediaminetetraacetic acid (K2EDTA) tubes. The primary objective was to compare both containers and validate the use of LiHep syringes. Secondary objectives were to evaluate the potential impact on saving materials, nursing time, and costs when implementing vancomycin TDM via LiHep syringes. Methods. Vancomycin analysis from sampling in lithium heparin (LiHep) syringes for ABG tests was validated and compared with the concentrations from conventional sampling in K2EDTA tubes. For method comparison, a Bland-Altman plot and Deming regression analysis were performed. The method was validated for inter- and intra-day precision and accuracy. Vancomycin was analyzed by means of the validated method using a particle-enhanced turbidimetric inhibition immunoassay (PETINIA) autoanalyzer. Furthermore, an analysis was conducted to evaluate the potential impact of implementing vancomycin sampling via ABG tests on savings in materials, nursing time, and costs. Results. From 18 patients, 24 plasma samples in both K2EDTA tubes and LiHep syringes were obtained and compared. The mean relative difference between the two containers was -2.0% (-3.0 to -0.93%). Both the Deming regression analysis and the Bland-Altman plot met the acceptance criteria. Potentially, over 1000 blood draws and accompanying materials and packaging can be saved when vancomycin samples are obtained by means of scavenged LiHep syringe
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- 2022
15. Evaluation of medication-related problems in liver transplant recipients with and without an outpatient medication consultation by a clinical pharmacist:a cohort study
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Mulder, Midas B., Doga, B., Borgsteede, S. D., van den Burg, A. M., Metselaar, H. J., den Hoed, C. M., Hunfeld, N. G. M., Mulder, Midas B., Doga, B., Borgsteede, S. D., van den Burg, A. M., Metselaar, H. J., den Hoed, C. M., and Hunfeld, N. G. M.
- Abstract
Background: Transplant recipients undergo significant changes in their medication regimen during follow-up and are at an increased risk for medication-related problems (MRPs). Aim: This study aimed to compare the prevalence and types of MRPs and interventions in liver transplant recipients with and without an outpatient medication consultation by a clinical pharmacist as well as the satisfaction with information about medicines and medication adherence. Method: We performed a single-center, observational cohort study. A retro- and prospective cohort were used and subdivided in a group that did and did not receive a medication consultation. The prevalence and types of MRPs and interventions were identified and categorized. The satisfaction parameters were evaluated using validated questionnaires. Results: Included were 291 patients. In total, 368 MRPs were identified in 197 patients in the non-medication consultation cohort (median 1; range 1–3 per patient) and 248 MRPs in 94 patients in the medication consultation cohort (median 2; range 1–4 per patient). In the medication consultation cohort, significantly fewer MRPs as unnecessary drugs (17.3% versus 58.7%, p < 0.001), suboptimal therapy (2.4% versus 9.5%, p < 0.001), untreated indication (2.8% versus 6.8%, p = 0.040) and underdosed drugs (0.4% versus 6.3%, p < 0.001) were identified. In the non-medication consultation cohort significantly more patients used unnecessary drugs (72.1% versus 39.4%, p < 0.001) compared to the medication consultation cohort. Patients in both cohorts are satisfied with the information about medicines and reported a high medication adherence. Conclusion: Patients in the medication consultation cohort had significantly fewer MRPs and used significantly less unnecessary drugs. Including a clinical pharmacist to the post-transplant care has an added value.
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- 2022
16. Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study
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De Bus, L., Depuydt, P., Steen, J., Dhaese, S., De Smet, K., Tabah, A., Akova, M., Cotta, M. O., De Pascale, Gennaro, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J. -A., Schouten, J., Sjovall, F., Timsit, J. -F., Roberts, J. A., Zahar, J. -R., Zand, F., Zirpe, K., De Waele, J. J., Rios, F., Vazquez, A. R., Vidal, M. G., Zakalik, G., Attokaran, A. G., Banakh, I., Dey-Chatterjee, S., Ewan, J., Ferrier, J., Forbes, L., Fourie, C., Leditschke, A., Murray, L., Eller, P., Biston, P., Bracke, S., De Crop, L., De Schryver, N., Frans, E., Spapen, H., Van Malderen, C., Vansteelandt, S., Vermeiren, D., Arevalo, E. P., Crespo, M., Flores, R. Z., Piza, P., Tutillo, D. M., Elme, A., Kallaste, A., Starkopf, J., Bourenne, J., Calypso, M., Cohen, Y., Dahyot-Fizelier, C., Depret, F., Guillot, M., Imzi, N., Jochmans, S., Kouatchet, A., Lepape, A., Martin, O., Heim, M., Schaller, S. J., Arvaniti, K., Bekridelis, A., Ioannidis, P., Mitrakos, C., Papanikolaou, M. N., Pouriki, S., Vemvetsou, A., Abraham, B., Bhattacharya, P. K., Budugu, A., Dixit, S., Gurav, S., Kandanuri, P., Prabhu, D. A., Rathod, D., Savaru, K., Udupa, A. N., Varghese, S. B., Bakhodaei, H. H., Dabiri, G., Fallahi, M. J., Feiz, F., Firoozifar, M., Khaloo, V., Maghsudi, B., Masjedi, M., Nikandish, R., Sabetian, G., Marsh, B., Martin-Loeches, I., Steiner, J., Barbagallo, M., Caricato, Anselmo, Cortegiani, A., D'Andrea, R., Deana, C., Donati, A., Girardis, M., Mandala, G., Panarello, G., Pasero, D., Pelagalli, L., Soave, Paolo Maurizio, Spadaro, S., Fujita, Y., Fujiwara, S., Hara, Y., Hashi, H., Hashimoto, S., Hashimoto, H., Hayakawa, K., Inoue, M., Isokawa, S., Kameda, S., Kamohara, H., Kanamoto, M., Katayama, S., Kawagishi, T., Kawano, Y., Kida, Y., Kita, M., Kobayashi, A., Kuriyama, A., Naito, T., Nashiki, H., Nishiyama, K., Shindo, S., Suzuki, T., Takaba, A., Tanaka, C., Tetsuya, K., Tomioka, Y., Yanagawa, Y., Yoshida, H., Adnan, S., Hasan, M. S., Sulaiman, H., Gasca Lopez, G. A., Hernandez-Cardenas, C. M., Namendys-Silva, S. A., Bethlehem, C., de Lange, D., Hunfeld, N., Numan, S., van Leeuwen, H., Owens, D., Almeida, M., Fragoso, E., Leonor, T., Pereira, J. -M., Filipescu, D., Grigoras, I., Popescu, M., Tomescu, D., Alshahrani, M. S., Alvarez-Gonzalez, M., Barrero-Garcia, I., Blasco-Navalpotro, M. A., Claverias, L., Estella, A., Espina, L. F., Garmendia, J. L. G., Prieto, E. G., Gomez-Prieto, G., Conde, C. J., Sagasti, F. M., Cantero, A. M., Orejas-Gallego, A., Papiol, E., Perez-Civantos, D., Laderas, J. C. P., Alvarez, J. T., Vera-Artazcoz, P., Cortes, P. V., Oldner, A., Spangfors, M., Alp, E., Koksal, I., Korten, V., Ozveren, A., Hall, A., Hatton, K. W., Laudanski, K., De Pascale G. (ORCID:0000-0002-8255-0676), Caricato A. (ORCID:0000-0001-5929-120X), Soave P. M., De Bus, L., Depuydt, P., Steen, J., Dhaese, S., De Smet, K., Tabah, A., Akova, M., Cotta, M. O., De Pascale, Gennaro, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J. -A., Schouten, J., Sjovall, F., Timsit, J. -F., Roberts, J. A., Zahar, J. -R., Zand, F., Zirpe, K., De Waele, J. J., Rios, F., Vazquez, A. R., Vidal, M. G., Zakalik, G., Attokaran, A. G., Banakh, I., Dey-Chatterjee, S., Ewan, J., Ferrier, J., Forbes, L., Fourie, C., Leditschke, A., Murray, L., Eller, P., Biston, P., Bracke, S., De Crop, L., De Schryver, N., Frans, E., Spapen, H., Van Malderen, C., Vansteelandt, S., Vermeiren, D., Arevalo, E. P., Crespo, M., Flores, R. Z., Piza, P., Tutillo, D. M., Elme, A., Kallaste, A., Starkopf, J., Bourenne, J., Calypso, M., Cohen, Y., Dahyot-Fizelier, C., Depret, F., Guillot, M., Imzi, N., Jochmans, S., Kouatchet, A., Lepape, A., Martin, O., Heim, M., Schaller, S. J., Arvaniti, K., Bekridelis, A., Ioannidis, P., Mitrakos, C., Papanikolaou, M. N., Pouriki, S., Vemvetsou, A., Abraham, B., Bhattacharya, P. K., Budugu, A., Dixit, S., Gurav, S., Kandanuri, P., Prabhu, D. A., Rathod, D., Savaru, K., Udupa, A. N., Varghese, S. B., Bakhodaei, H. H., Dabiri, G., Fallahi, M. J., Feiz, F., Firoozifar, M., Khaloo, V., Maghsudi, B., Masjedi, M., Nikandish, R., Sabetian, G., Marsh, B., Martin-Loeches, I., Steiner, J., Barbagallo, M., Caricato, Anselmo, Cortegiani, A., D'Andrea, R., Deana, C., Donati, A., Girardis, M., Mandala, G., Panarello, G., Pasero, D., Pelagalli, L., Soave, Paolo Maurizio, Spadaro, S., Fujita, Y., Fujiwara, S., Hara, Y., Hashi, H., Hashimoto, S., Hashimoto, H., Hayakawa, K., Inoue, M., Isokawa, S., Kameda, S., Kamohara, H., Kanamoto, M., Katayama, S., Kawagishi, T., Kawano, Y., Kida, Y., Kita, M., Kobayashi, A., Kuriyama, A., Naito, T., Nashiki, H., Nishiyama, K., Shindo, S., Suzuki, T., Takaba, A., Tanaka, C., Tetsuya, K., Tomioka, Y., Yanagawa, Y., Yoshida, H., Adnan, S., Hasan, M. S., Sulaiman, H., Gasca Lopez, G. A., Hernandez-Cardenas, C. M., Namendys-Silva, S. A., Bethlehem, C., de Lange, D., Hunfeld, N., Numan, S., van Leeuwen, H., Owens, D., Almeida, M., Fragoso, E., Leonor, T., Pereira, J. -M., Filipescu, D., Grigoras, I., Popescu, M., Tomescu, D., Alshahrani, M. S., Alvarez-Gonzalez, M., Barrero-Garcia, I., Blasco-Navalpotro, M. A., Claverias, L., Estella, A., Espina, L. F., Garmendia, J. L. G., Prieto, E. G., Gomez-Prieto, G., Conde, C. J., Sagasti, F. M., Cantero, A. M., Orejas-Gallego, A., Papiol, E., Perez-Civantos, D., Laderas, J. C. P., Alvarez, J. T., Vera-Artazcoz, P., Cortes, P. V., Oldner, A., Spangfors, M., Alp, E., Koksal, I., Korten, V., Ozveren, A., Hall, A., Hatton, K. W., Laudanski, K., De Pascale G. (ORCID:0000-0002-8255-0676), Caricato A. (ORCID:0000-0001-5929-120X), and Soave P. M.
- Abstract
Purpose: The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods: Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results: Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion: ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely.
- Published
- 2020
17. A comparison of the acid-inhibitory effects of esomeprazole and rabeprazole in relation to pharmacokinetics and CYP2C19 polymorphism
- Author
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Hunfeld, N. G., Touw, D. J., Mathot, R. A., van Schaik, R. H., and Kuipers, E. J.
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- 2012
- Full Text
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18. Avoiding crystallization of lorazepam during infusion
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Vellema, J., Hunfeld, N. G.M., Van den Akker, H. E.A., and ter Horst, J. H.
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- 2011
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19. Voluntarily reported prescribing, monitoring and medication transfer errors in intensive care units in The Netherlands
- Author
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Bosma, B. E., primary, Hunfeld, N. G. M., additional, Roobol-Meuwese, E., additional, Dijkstra, T., additional, Coenradie, S. M., additional, Blenke, A., additional, Bult, W., additional, Melief, P. H. G. J., additional, Dixhoorn, M. Perenboom-Van, additional, and van den Bemt, P. M. L. A., additional
- Published
- 2020
- Full Text
- View/download PDF
20. 4CPS-215 The impact of clinical pharmacist driven interventions on patient safety in hospitalised patients: preliminary results of a point prevalence study
- Author
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Wilkes, S, primary, Zaal, R, additional, Abdulla, A, additional, and Hunfeld, N, additional
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- 2020
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- View/download PDF
21. A comparison of the acid-inhibitory effects of esomeprazole and pantoprazole in relation to pharmacokinetics and CYP2C19 polymorphism
- Author
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HUNFELD, N. G., TOUW, D. J., MATHOT, R. A., MULDER, P. G. H., VAN SCHAIK, R. H., KUIPERS, E. J., KOOIMAN, J. C., and GEUS, W. P.
- Published
- 2010
- Full Text
- View/download PDF
22. Rebound acid hypersecretion: authorʼs reply
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HUNFELD, N. G. M., GEUS, W. P., and KUIPERS, E. J.
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- 2007
23. rebound acid hypersecretion after therapy with proton pump inhibitors
- Author
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HUNFELD, N. G. M., GEUS, W. P., and KUIPERS, E. J.
- Published
- 2007
24. Quetiapine overdosage: safe or life-threatening? Pharmacokinetics and clinical parameters
- Author
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Hunfeld, N. G. M., Westerman, E. M., Boswijk, D. J., de Haas, J. A. M., and Touw, D. J.
- Published
- 2005
25. Pharmacist interventions during patient rounds in two intensive care units: Clinical and financial impact
- Author
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Bosma, B E, van den Bemt, P M L A, Melief, P H G J, van Bommel, J, Tan, S S, Hunfeld, N G M, and Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)
- Subjects
Patient Care Team/standards ,Cost-Benefit Analysis ,Hospitals, University/standards ,Teaching Rounds/economics ,Quality Improvement ,Pharmacy Service, Hospital/economics ,Professional Role ,Models, Organizational ,Pharmacists/standards ,Medication Errors/prevention & control ,Hospitals, Teaching/standards ,Humans ,Intensive Care Units/economics ,Drug-Related Side Effects and Adverse Reactions/economics ,Netherlands - Abstract
INTRODUCTION: The risk of prescribing errors and related adverse drug events (ADE) on the intensive care unit (ICU) is high. Based on studies carried out in North America or the UK, a clinical pharmacy service can reduce ADEs and lower overall costs. This study looks into the clinical and financial impact of interventions made by pharmacists during patient rounds in two ICU settings in the Netherlands. MATERIALS AND METHODS: A quality improvement study was performed in a general teaching hospital (GTH) and a university hospital (UH) in the Netherlands. The improvement consisted of a review of medication orders and participation in patient rounds by an ICU-trained pharmacist. The main outcome measure was the proportion of accepted pharmacist interventions. Secondary outcome measures were the clinical relevance of the accepted interventions, the proportion of prevented potential ADEs (pADE) and a cost-benefit ratio. RESULTS: In the GTH 160 patients and in the UH 174 patients were included. A total of 332 and 280 interventions were analysed. Acceptance of the interventions was 67.3% in the GTH and 61.8% in the UH. The accepted interventions were mostly scored as clinically relevant, resulting in 0.16 and 0.11 prevented pADEs per patient. The cost benefit was €119 (GTH) and €136 (UH) per accepted intervention. CONCLUSION: This clinical pharmacy service in two ICUs resulted in high numbers of accepted and clinically relevant interventions. Our model appeared to be cost-effective in both ICU settings.
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- 2018
26. Intracerebral hemorrhage in ICU: is it worth treating?
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Sivakumar, S, Taccone, F, Desai, K, Lazaridis, C, Skarzynski, M, Sekhon, M, Henderson, W, Griesdale, D, Chapple, L, Deane, A, Williams, L, Strickland, R, Lange, K, Heyland, D, Chapman, M, Rowland, M, Garry, P, Westbrook, J, Corkill, R, Antoniades, C, Pattinson, K, Fatania, G, Strong, A, Myers, R, Jermaine, C, Robertson, C, Rusin, C, Hofmeijer, J, Sondag, L, Tjepkema Cloostermans, M, Beishuizen, A, Bosch, F, van Putten, M, Carteron, L, Patet, C, Solari, D, Oddo, M, Ali, M, Dias, C, Almeida, R, Vaz Ferreira, A, Silva, J, Monteiro, E, Cerejo, A, Rocha, A, Elsayed, A, Abougabal, A, Beshey, B, Alzahaby, K, Pozzebon, S, Ortiz, A, Cristallini, S, Lheureux, O, Brasseur, A, Vincent, J, Creteur, J, Hravnak, M, Yousef, K, Chang, Y, Crago, E, Friedlander, R, Abdelmonem, S, Tahon, S, Helmy, T, Meligy, H, Puig, F, Dunn Siegrist, I, Pugin, J, Gupta, S, Govil, D, Srinivasan, S, Patel, S, N, J, Gupta, A, Tomar, D, Shafi, M, Harne, R, Arora, D, Talwar, N, Mazumdar, S, Papakrivou, E, Makris, D, Manoulakas, E, Tsolaki, B, Karadodas, B, Zakynthinos, E, Garcia, I, Martin, A, Encinares, V, Ibañez, M, Montero, J, Labrador, G, Cangueiro, T, Poulose, V, Koh, J, Kam, J, Yeter, H, Kara, A, Aktepe, O, Topeli, A, Tsolakoglou, I, Intas, G, Stergiannis, P, Kolaros, A, Chalari, E, Athanasiadou, E, Martika, A, Fildisis, G, Faivre, V, Mengelle, C, Favier, B, Payen, D, Poppe, A, Winkler, M, Mudersbach, E, Schreiber, J, Wruck, M, Schwedhelm, E, Kluge, S, Zöllner, C, Tavladaki, T, Spanaki, A, Dimitriou, H, Kondili, E, Choulaki, C, Meleti, E, Kafetzopoulos, D, Georgopoulos, D, Briassoulis, G, la Torre, A, de la Torre Prados, M, Tsvetanova Spasova, T, Nuevo Ortega, P, Rueda Molina, C, Fernández Porcel, A, Camara Sola, E, Salido Díaz, L, García Alcántara, A, Meleti, D, Suberviola, B, Riera, J, Rellan, L, Sanchez, M, Robles, J, Lopez, E, Vicente, R, Miñambres, E, Santibañez, M, Le Guen, M, Moore, J, Mason, N, Windpassinger, M, Plattner, O, Mascha, E, Sessler, D, Research, O, Melia, U, Fontanet, J, van den Berg, J, Struys, M, Vereecke, H, Jensen, E, Rood, P, van de Schoor, F, van Tertholen, K, Pickkers, P, van den Boogaard, M, Beardow, Z, Redhead, H, Paramasivam, K, Numan, T, Kamper, A, Peelen, L, Zeman, P, Slooter, A, van Ewijk, C, Jacobs, G, Girbes, A, Myatra, S, Harish, M, Prabu, N, Siddiqui, S, Kulkarni, A, Divatia, J, Murbach, L, Leite, M, Osaku, E, Costa, C, Pelenz, M, Neitzke, N, Moraes, M, Jaskowiak, J, Silva, M, Zaponi, R, Abentroth, L, Ogasawara, S, Jorge, A, Duarte, P, Hernández Sánchez, N, Sánchez Hurtado, L, García Guillen, F, Ñamendys Silva, S, Maghsoudi, B, Emami, M, Khosravi, M, Zand, F, Tabatabaie, H, Masjedi, M, Sabetiyan, G, Mokri, A, Troubleyn, J, Diltoer, M, Jacobs, R, Nguyen, D, De Waele, E, De Regt, J, Honoré, P, Van Gorp, V, Spapen, H, Contreras, R, Toapanta, N, Moreno, G, Sabater, J, Torrado, H, Gonzalez, M, Marin, M, Farigola, E, Gonzalez, A, Fernandez, J, Vera, A, Gisbert, X, Juliá, C, Uya, J, Corral, L, Elias Jones, I, Gemmell, L, Mackay, A, Randall, D, Adwaney, A, Blunden, M, Prowle, J, Kirwan, C, Thomas, N, Owen, H, Darwin, L, Conway, D, Atkinson, D, Sharman, M, Barbanti, C, Amour, J, Gaudard, P, Rozec, B, Mauriat, P, M'Rini, M, Leger, P, Cambonie, G, Liet, J, Girard, C, Laroche, S, Damas, P, Assaf, Z, Loron, G, Lecourt, L, Pouard, P, Kim, S, Na, S, Kim, J, Oh, S, Jung, C, Yoo, S, Min, S, Chung, E, Lee, H, Lee, N, Lee, K, Suh, K, Ryu, H, Marshall, D, Goodson, R, Salciccioli, J, Shalhoub, J, Potter, E, Kirk Bayley, J, Karanjia, N, Forni, L, Creagh Brown, B, Bossy, M, Nyman, M, Tailor, A, D'Antini, D, Spadaro, S, Valentino, F, Sollitto, F, Cinnella, G, Mirabella, L, Calvo, F, Bejarano, N, Padilla, D, Baladron, V, Villajero, P, Villazala, R, Redondo, J, Yuste, A, Liu, J, Shen, F, Teboul, J, Anguel, N, Beurton, A, Bezaz, N, Richard, C, Monnet, X, Fossali, T, Colombo, R, Ottolina, D, Rossetti, M, Mazzucco, C, Marchi, A, Porta, A, Catena, E, Tollisen, K, Andersen, G, Heyerdahl, F, Jacobsen, D, de Waard, M, van IJzendoorn, M, Buter, H, Kingma, W, Navis, G, Boerma, E, Rulisek, J, Balik, M, Zacharov, S, Kim, H, Jeon, S, Namgung, H, Lee, E, Cho, Y, Lee, Y, Huang, A, Cioccari, L, Luethi, N, Mårtensson, J, Bellomo, R, Forsberg, M, Edman, G, Höjer, J, Forsberg, S, Freile, M, Hidalgo, F, Molina, J, Lecumberri, R, Rosselló, A, Travieso, P, Leon, G, Sanchez, J, Frias, L, Rosello, D, Verdejo, J, Serrano, J, Winterwerp, D, van Galen, T, Vazin, A, Karimzade, I, Zand, A, Ozen, E, Ekemen, S, Akcan, A, Sen, E, Yelken, B, Kureshi, N, Fenerty, L, Thibault Halman, G, Erdogan, M, Walling, S, Green, R, Clarke, D, Briassoulis, P, Kalimeris, K, Ntzouvani, A, Nomikos, T, Papaparaskeva, K, Politi, E, Kostopanagiotou, G, Crewdson, K, Rehn, M, Weaver, A, Brohi, K, Lockey, D, Wright, S, Thomas, K, Baker, C, Mansfield, L, Stafford, V, Wade, C, Watson, G, Bryant, A, Chadwick, T, Shen, J, Wilkinson, J, Furneval, J, Henderson, A, Hugill, K, Howard, P, Roy, A, Bonner, S, Baudouin, S, Ramírez, C, Escalada, S, Viera, M, Santana, M, Balcázar, L, Monroy, N, Campelo, F, Vázquez, C, Santana, P, Santana, S, Quintard, H, Bouzat, P, Wollersheim, T, Malleike, J, Haas, K, Carbon, N, Schneider, J, Birchmeier, C, Fielitz, J, Spuler, S, Weber Carstens, S, Enseñat, L, Pérez Madrigal, A, Saludes, P, Proença, L, Gruartmoner, G, Espinal, C, Mesquida, J, Huber, W, Eckmann, M, Elkmann, F, Gruber, A, Lahmer, T, Mayr, U, Herner, A, Schellnegger, R, Schmid, R, Ayoub, W, Samy, W, Esmat, A, Battah, A, Mukhtar, S, Mongkolpun, W, Cortés, D, Cordeiro, C, Funcke, S, Groesdonk, H, Saugel, B, Wagenpfeil, G, Wagenpfeil, S, Reuter, D, Fernandez, M, Fernandez, R, Magret, M, González Castro, A, Bouza, M, García, C, Balerdi, B, Mas, A, Arauzo, V, Añón, J, Ruiz, F, Ferreres, J, Tomás, R, Alabert, M, Tizón, A, Altaba, S, Llamas, N, Goligher, E, Fan, E, Herridge, M, Vorona, S, Sklar, M, Dres, M, Rittayamai, N, Lanys, A, Urrea, C, Tomlinson, G, Reid, W, Rubenfeld, G, Kavanagh, B, Brochard, L, Ferguson, N, Neto, A, de Abreu, M, Pelosi, P, Schultz, M, Guérin, C, 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- Subjects
intracerebral haemorrhage in intensive care - Published
- 2016
27. ESICM LIVES 2016: part two
- Author
-
Sivakumar, S., Taccone, F. S., Desai, K. A., Lazaridis, C., Skarzynski, M., Sekhon, M., Henderson, W., Griesdale, D., Chapple, L., Deane, A., Williams, L., Strickland, R., Lange, K., Heyland, D., Chapman, M., Rowland, M. J., Garry, P., Westbrook, J., Corkill, R., Antoniades, C. A., Pattinson, K. T., Fatania, G., Strong, A. J., Myers, R. B., Jermaine, C. M., Robertson, C. S., Rusin, C. G., Hofmeijer, J., Sondag, L., Tjepkema-Cloostermans, M. C., Beishuizen, A., Bosch, F. H., van Putten, M. J. A. M., Carteron, L., Patet, C., Solari, D., Oddo, M., Ali, M. A., Dias, C., Almeida, R., Vaz-Ferreira, A., Silva, J., Monteiro, E., Cerejo, A., Rocha, A. P., Elsayed, A. A., Abougabal, A. M., Beshey, B. N., Alzahaby, K. M., Pozzebon, S., Ortiz, A. Blandino, Cristallini, S., Lheureux, O., Brasseur, A., Vincent, J. L., Creteur, J., Hravnak, M., Yousef, K., Chang, Y., Crago, E., Friedlander, R. M., Abdelmonem, S. A., Tahon, S. A., Helmy, T. A., Meligy, H. 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F., Segaran, E., Vickers, L., Brinchmann, K., Wignall, I., De Brito-Ashurst, I., del Olmo, R., Esteban, M. J., Vaquerizo, C., Carreño, R., Gálvez, V., Kaminsky, G., Nieto, B., Fuentes, M., De la Torre, M. A., Torres, E., Alonso, A., Velayos, C., Saldaña, T., Escribá, A., GRIP, J., Kölegård, R., Sundblad, P., Rooyackers, O., Naser, Ben, Jaziri, F., Jazia, A. Ben, Barghouth, M., Hentati, O., Skouri, W., El Euch, M., Mahfoudhi, M., Turki, S., Abdelghni, K. Ben, Abdallah, Ben, Maha, B. N. M., Lorente, M., Włudarczyk, A., Hałek, A., Bargouth, M., Bennasr, M., Abdelghani, K. Ben, Abdallah, T. Ben, Geenen, I. L., Parienti, J. J., Straaten, H. M. Oudemans-van, Shum, H. P., King, H. S., Chan, K. C., Yan, W. W., Londoño, J. Gonzalez, Cardenas, C. Lorencio, Pedrosa, M. Morales, Gubianas, C. Murcia, Bertolin, C. Fuster, Batllori, N. Vila, Sirvent, J. M., Mukhopadhyay, A., Chan, H. Y., Kowitlawakul, Y., Remani, D., Leong, C. S. F., Henry, C. J., Puthucheary, Z. 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Meeting Abstracts - Abstract
Introduction In addition to systemic hemodynamics, the management\ud of neurocritically ill patients is often informed by neuromonitoring. In\ud the absence of high-level evidence clinicians are often guided by personal\ud and local expertise. Little is known about practices as they pertain\ud to the use of such monitoring in patients with acute brain injury (ABI).\ud Objectives To investigate practices in bedside monitoring for ABI patients.\ud Particularly interested in differences among “neurointensivists”\ud (NIs; defined here as intensivists whose clinical practice is comprised\ud > 1/3 by neurocritical care) and other intensivists (OIs). Also, to\ud explore patterns specific to traumatic brain injury (TBI) and subarachnoid\ud hemorrhage (SAH), as well as preferences and availability of\ud particular technologies/devices.\ud Methods Electronic survey of 22 items including two case-based scenarios;\ud endorsed by SCCM (9,000 recipients) and ESICM (on-line\ud newsletter) in 2013. A sample size of 370 was calculated based on a\ud population of 10,000 physician members, a 5 % margin error, and\ud 95 % confidence interval. We summarized results using descriptive\ud statistics (proportions with 95 % confidence intervals). A chi-square\ud test was used to compare proportions of responses between NIs and\ud OIs with a significance p < 0.05.\ud Results There were 655 responders (66 % completion rate); 422(65 %)\ud were classified as OIs and 226(35 %) as NIs. More NIs follow\ud hemodynamic protocols for neurocritically-ill patients (56 % vs. 43 %, p\ud 0.001), in TBI (44.5 % vs. 33.3 %, p 0.007), and in SAH (38.1 % vs. 21.3 %,\ud p < 000.1). For delayed cerebral ischemia (DCI), more NIs target cardiac\ud index (CI) (35 % vs. 21 %, p 0.0001), and fluid responsiveness (62 % vs.\ud 53 %, p 0.03), use more bedside ultrasound (BUS) (42 % vs. 29 %, p\ud 0.005) and arterial waveform analysis (40 % vs. 29 %, p 0.02). For DCI\ud neuromonitoring, NIs use more angiography (57 % vs. 43 %, p 0.004),\ud TCD (46 % vs. 38 %, p 0.0001), and CTP (32 % vs.16 %, p 0.0001). For\ud CPP optimization in TBI, NIs use more arterial waveform analysis (45 %\ud vs. 35 %, p 0.019), and BUS (37 % vs. 27.7 %, p 0.023), while more OIs\ud monitor mixed venous oxygen saturation (54.1 % vs. 45 %, p 0.045). For\ud TBI neuromonitoring, NIs use more PbtO2 (28 % vs. 10 %, p 0.0001). In\ud the case scenario of raised ICP/low PbtO2, most employ analgosedation\ud (47 %) and osmotherapy (38 %). Fewer make use of preserved pressure\ud reactivity, particularly OIs (vasopressor use 23 % vs. 34 %, p 0.014).\ud Conclusions There is large heterogeneity in the use of monitoring protocols,\ud variables, and technologies/devices. “Neurointensivists” not only\ud employ more neuromonitoring but also more hemodynamic monitoring\ud in patients with acute brain injury. ICP/CPP remain the most commonly\ud followed neuro-variables in TBI patients, with low use of other\ud brain-physiology parameters, sugg
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- 2016
28. Switching to different generic medicines: A checklist for safety issues
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Becker, M., primary, Al Hadithy, A. F. Y., additional, Van den Bemt, P. M. L. A., additional, and Hunfeld, N. G., additional
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- 2017
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29. GOING GREEN: WASTE COLLECTION AND ANALYSES IN PEDIATRIC INTENSIVE CARE.
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Den Otter, S. Cochius, Honkoop, M., Van Den Berg, L., Ville, A., Hunfeld, N., Diehl, J., Kraemer, U., and Verbruggen, S.
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- 2022
30. Therapeutic drug monitoring of free fraction valproic acid in patients with hypoalbuminaemia
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Jansen, A. J. G., Hunfeld, N. G. M., Bommel, J., birgit koch, Gelder, T., Hematology, Pharmacy, and Intensive Care
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- 2012
31. Vergelijking van de zuurremmende effecten van esomeprazol en pantoprazol in relatie tot farmacokinetiek en CYP2C19-polymorfisme
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Hunfeld, N. G. M., Touw, D. J., Mathot, R. A. A., Mulder, P. G. H., van Schaik, R. H. N., Kuipers, E. J., Kooiman, J. C., Geus, W. P., Amsterdam institute for Infection and Immunity, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, Other Research, and Pharmacy
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- 2012
32. Toxic tobramycin levels after Tobramycin intake via selective decontamination of the digestive tract (SDD)
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Wassenaar, S., primary, Brkic, Z., additional, Dos Reis Miranda, D., additional, Hunfeld, N., additional, and Koch, B.C.P., additional
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- 2015
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33. Systematic review: rebound acid hypersecretion after therapy with proton pump inhibitors
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HUNFELD, N. G. M., primary, GEUS, W. P., additional, and KUIPERS, E. J., additional
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- 2006
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34. Quetiapine in Overdosage
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Hunfeld, N. G. M., primary, Westerman, E. M., additional, Boswijk, D. J., additional, de Haas, J. A. M., additional, van Putten, M. J. A. M., additional, and Touw, D. J., additional
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- 2006
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35. A comparison of the acid-inhibitory effects of esomeprazole and rabeprazole in relation to pharmacokinetics and CYP2 C19 polymorphism.
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Hunfeld, N. G., Touw, D. J., Mathot, R. A., Schaik, R. H., and Kuipers, E. J.
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ESOMEPRAZOLE , *DRUG metabolism , *CHEMICAL kinetics , *GENETIC polymorphisms , *HELICOBACTER pylori - Abstract
Summary Background Esomeprazole and rabeprazole are metabolised in the liver by means of the CYP2 C19 enzyme, which has several functional genetic polymorphisms. Among Caucasians, 70% of the population has a fast metaboliser phenotype, 25-30% an intermediate and 2-5% a slow metaboliser phenotype. It is unknown whether different PPIs are affected to the same extent by these phenotypic differences. Aim To compare the acid-inhibitory effects of esomeprazole 40 mg and rabeprazole 20 mg in relation to CYP2 C19 genotype and pharmacokinetics. Methods Eighteen healthy Helicobacter pylori-negative Caucasian subjects with CYP2C19*2-*6 and *17 genotype were included in a randomised investigator-blinded crossover study with esomeprazole 40 mg and rabeprazole 20 mg. Intragastric 24-h pH-monitoring was performed on days 0, 1 and 5 of oral dosing. Results Onset of acid inhibition during the first 4 h after administration did not differ significantly between PPIs. During the upright period, the proportion of time with pH >4 was significantly higher with esomeprazole compared to rabeprazole (52.2 vs. 40.3%, P = 0.003). At day 1 and 5, acid inhibition was significantly greater with esomeprazole than with rabeprazole (median intragastric pH: day 1: 3.7 vs. 3.0, P = 0.008; day 5: 4.7 vs. 3.8, P < 0.001; percentage of time pH >4: day 1: 45 vs. 39%, P = 0.054; day 5: 65 vs. 48%, P < 0.001). Differences in acid inhibition between wt/wt and wt/*2 genotype were significant for both PPIs. Conclusions Once-daily dosing with esomeprazole 40 mg provides a more effective and faster acid-inhibitory effect than rabeprazole 20 mg. The acid-inhibitory effect of esomeprazole and rabeprazole are both influenced by CYP2 C19 polymorphism. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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36. Systematic review: rebound acid hypersecretion after therapy with proton pump inhibitors.
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HUNFELD, N. G. M., GEUS, W. P., and KUIPERS, E. J.
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THERAPEUTIC complications , *PROTON pump inhibitors , *GASTRIC diseases , *HELICOBACTER pylori , *ANTACIDS , *ENZYME inhibitors - Abstract
Background The occurrence and the clinical relevance of rebound acid hypersecretion after discontinuation of proton pump inhibitors is unclear. Aim To perform a systematic review of rebound acid hypersecretion after discontinuation of proton pump inhibitors. Methods PubMed, Embase and Central were searched up to October 2005 with indexed terms. Results Eight studies were included, sample size was 6–32. The studies used both basal and stimulated acid output as parameters to study rebound acid hypersecretion and assessed these at different time points and with variable methods. Five studies (including four randomized studies) did not find any evidence for rebound acid hypersecretion after proton pump inhibitor therapy. Of the remaining three studies, the duration of proton pump inhibitor therapy was the longest and two of these studies were the only to assess Helicobacter pylori status of their study subjects. These two studies suggested that rebound acid hypersecretion may occur in H. pylori-negatives after 8 weeks of proton pump inhibitors. Conclusions Studies that have investigated rebound acid hypersecretion after cessation of proton pump inhibitor treatment are heterogenic in design, methods and outcome. There is some evidence from uncontrolled trials for an increased capacity to secrete acid in H. pylori-negative subjects after 8 weeks of treatment. There is no strong evidence for a clinically relevant increased acid production after withdrawal of proton pump inhibitor therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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37. Environmental sustainability in intensive care: the path forward. An ESICM Green Paper.
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De Waele JJ, Hunfeld N, Baid H, Ferrer R, Iliopoulou K, Ioan AM, Leone M, Ostermann M, Scaramuzzo G, Theodorakopoulou M, Touw H, Citerio G, Derde LPG, Donadello K, Juffermans NP, Galarza L, Grasselli G, Maggiore SM, Martin-Loeches I, Alexandre J, Cecconi M, and Azoulay E
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- Humans, Conservation of Natural Resources methods, Sustainable Development, Europe, Climate Change, Intensive Care Units organization & administration, Critical Care methods, Critical Care standards, Critical Care trends
- Abstract
Purpose: The European Society of Intensive Care Medicine (ESICM) Green Paper aims to address the challenge of environmental sustainability in intensive care and proposes actionable strategies for integrating sustainability into intensive care unit (ICU) stakeholder actions., Methods: The ESICM Executive Committee appointed a task force of topic experts and ESICM committee representatives to develop the ESICM Green Paper. The task force convened biweekly from January to June 2024, identifying key domains for environmental sustainability and prioritizing actions. Drafts were iteratively refined and approved by the ESICM Executive Committee., Results: Climate change will impact activities in intensive care in many ways, but also the impact of ICU activities on the environment is considerable; drivers for this include extensive resource use and waste generation in ICUs from energy consumption, use of disposable items, and advanced therapies for critically ill patients. The ESICM Green Paper outlines a structured approach for ICUs to reduce their environmental impact, emphasizing energy efficiency, waste reduction, and sustainable procurement. Furthermore, it endorses the need for awareness and education among healthcare professionals, integration of sustainability into research, and sustainable policies within scientific societies., Conclusions: The ESICM Green Paper reviewed the relevance of climate change to intensive care and provided suggestions for clinical practice, research, education, and ESICM organizational domains. It underscores that reducing intensive care's ecological footprint can coexist with high-quality patient care. Promoting a resilient, responsible healthcare system is a joint responsibility of all ICU stakeholders., (© 2024. The Author(s).)
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- 2024
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38. The paracetamol challenge in intensive care: going green with paracetamol.
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Hunfeld N, Tibboel D, and Gommers D
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- 2024
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39. The carbon footprint of a Dutch academic hospital-using a hybrid assessment method to identify driving activities and departments.
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Lau I, Burdorf A, Hesseling S, Wijk L, Tauber M, and Hunfeld N
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- Netherlands, Humans, Greenhouse Gases, Academic Medical Centers statistics & numerical data, Carbon Footprint statistics & numerical data
- Abstract
Background: The healthcare sector is responsible for 7% of greenhouse gas (GHG) emissions in the Netherlands. However, this is not well understood on an organizational level. This research aimed to assess the carbon footprint of the Erasmus University Medical Center to identify the driving activities and sources., Methods: A hybrid approach was used, combining a life cycle impact assessment and expenditure-based method, to quantify the hospital's carbon footprint for 2021, according to scope 1 (direct emissions), 2 (indirect emissions from purchased energy), and 3 (rest of indirect emissions) of the GHG Protocol. Results were disaggregated by categories of purchased goods and services, medicines, specific product groups, and hospital departments., Results: The hospital emitted 209.5 kilotons of CO2-equivalent, with scope 3 (72.1%) as largest contributor, followed by scope 2 (23.1%) and scope 1 (4.8%). Scope 1 was primarily determined by stationary combustion and scope 2 by purchased electricity. Scope 3 was driven by purchased goods and services, of which medicines accounted for 41.6%. Other important categories were medical products, lab materials, prostheses and implants, and construction investment. Primary contributing departments were Pediatrics, Real Estate, Neurology, Hematology, and Information & Technology., Conclusion: This is the first hybrid analysis of the environmental impact of an academic hospital across all its activities and departments. It became evident that the footprint is mainly determined by the upstream effects in external supply chains. This research underlines the importance of carbon footprinting on an organizational level, to guide future sustainability strategies., Competing Interests: SH, LW and MT were employed by company Metabolic. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer CC declared a shared parent affiliation with the authors IL, AB, and NH to the handling editor at the time of review., (Copyright © 2024 Lau, Burdorf, Hesseling, Wijk, Tauber and Hunfeld.)
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- 2024
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40. Nudging intensive care unit personnel towards sustainable behaviour.
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Van Der Zee S, Verhoog T, Post T, Garcia-Gomez P, van Raaij EM, Diehl JC, and Hunfeld N
- Abstract
Background: The health care sector is among the most carbon-intensive sectors, contributing to societal problems like climate change. Previous research demonstrated that especially the use of personal protective equipment (e.g., aprons) in critical care contributes to this problem. To reduce personal protective equipment waste, new sustainable policies are needed., Aims: Policies are only effective if people comply. Our aim is to examine whether compliance with sustainable policies in critical care can be increased through behavioural influencing. Specifically, we examined the effectiveness of two sets of nudges (i.e., a Prime + Visual prompt nudge and a Social norm nudge) on decreasing apron usage in an intensive care unit (ICU)., Study Design: We conducted a field experiment with a pre- and post-intervention measurement. Upon the introduction of the new sustainable policy, apron usage data were collected for 9 days before (132 observations) and 9 days after (114 observations) the nudge interventions were implemented., Results: Neither the Prime + Visual prompt nudge, nor the Social norm nudge decreased apron usage., Conclusions: While previous studies have found that primes, visual nudges and social norm nudges can increase sustainable behaviour, we did not find evidence for this in our ICU field experiment. Future research is needed to determine whether this null finding reflects reality, or whether it was due to methodological decisions and limitations of the presented experiment., Relevance to Clinical Practice: The presented study highlights the importance of studying behavioural interventions that were previously proven successful in the lab and in other field contexts, in the complex setting of critical care. Results previously found in other contexts may not generalize directly to a critical care context. The unique characteristics of the critical care context also pose methodological challenges that may have affected the outcomes of this experiment., (© 2024 The Authors. Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of British Association of Critical Care Nurses.)
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- 2024
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41. Five sustainable tips about water in the ICU: reduction of water use and decrease of the amount of antibiotics in wastewater.
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Hunfeld N, Salinas Gabiña I, and Weinbren M
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- Humans, Anti-Bacterial Agents analysis, Water, Intensive Care Units, Wastewater, Water Pollutants, Chemical
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- 2024
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42. Ten reasons for the presence of pharmacy professionals in the intensive care unit.
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McKenzie C, Spriet I, and Hunfeld N
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- Humans, Intensive Care Units, Pharmacy
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- 2024
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43. Population pharmacokinetics of dexamethasone in critically ill COVID-19 patients: Does inflammation play a role?
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Li L, Sassen S, Hunfeld N, Smeets T, Ewoldt T, van den Berg SAA, Koch BCP, and Endeman H
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- Humans, Retrospective Studies, Pilot Projects, COVID-19 Drug Treatment, Inflammation drug therapy, Dexamethasone therapeutic use, Anti-Bacterial Agents, Critical Illness, COVID-19
- Abstract
Purpose: The aim of this study is to design a population pharmacokinetic study to gain a deeper understanding of the pharmacokinetics of dexamethasone in critically ill COVID-19 patients in order to identify relevant covariates that can be used to personalize dosing regimens., Methods: Blood samples from critically ill patients receiving fixed-dose intravenous dexamethasone (6 mg/day) for the treatment of COVID-19 were sampled in a retrospective pilot study. The data were analyzed using Nonlinear Mixed Effects Modeling (NONMEM) software for population pharmacokinetic analysis and clinically relevant covariates were selected and evaluated., Results: A total of 51 dexamethasone samples from 18 patients were analyzed and a two-compartment model fit the data best. The mean population estimates were 2.85 L/h (inter-individual-variability 62.9%) for clearance, 15.4 L for the central volume of distribution, 12.3 L for the peripheral volume of distribution and 2.1 L/h for the inter-compartmental distribution clearance. The covariate analysis showed a significant negative correlation between dexamethasone clearance and CRP., Conclusions: Dexamethasone PK parameters in ICU COVID patients were substantially different from those from non-ICU non-COVID patients, and inflammation may play an important role in dexamethasone exposure. This finding suggests that fixed-dose dexamethasone over several days may not be appropriate for ICU COVID patients., Competing Interests: Declaration of Competing Interest The authors declared no competing interests for this work., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2023
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44. Which patients benefit from model-informed precision dosing of beta-lactam antibiotics and ciprofloxacin at the ICU?
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Ewoldt TMJ, Abdulla A, Rietdijk WJR, Hunfeld N, Muller AE, Endeman H, and Koch BCP
- Abstract
Objectives: Antibiotic dosing is not optimal in the ICU. Our recent trial investigated the effect of model-informed precision dosing (MIPD) of beta-lactam antibiotics and ciprofloxacin and showed no significant differences in clinical outcomes in all patients. This study aimed to identify subgroups of patients in which the MIPD of these antibiotics could be beneficial for clinical outcomes., Methods: We analysed data from the DOLPHIN randomized controlled trial, which compared MIPD to standard dosing of beta-lactam antibiotics and ciprofloxacin in 388 ICU patients. We divided patients into subgroups based on baseline characteristics and assessed the effect of MIPD on 28-day mortality, 6-month mortality, change in sequential organ failure assessment (delta-SOFA), and ICU length of stay (LOS)., Results: We found a lower 28-day mortality in patients with a SOFA below 8 randomized to MIPD (OR 0.40; 95% CI 0.17-0.88). However, patients with a higher SOFA show an increased 28-day mortality (OR 1.94; 95% CI 1.07-3.59) in the MIPD group. ICU LOS was increased in patients receiving MIPD with a SOFA below 8 (IRR 1.36; 95% CI 1.01-1.83) and those receiving MIPD for ceftriaxone (IRR 1.76; 95% CI 1.24-2.51). Patients receiving a dose recommendation within 24 hours show a trend towards decreased ICU LOS (IRR 0.77; 95% CI 0.52-1.16) and higher delta-SOFA (estimate -1.19; 95% CI -2.98-0.60)., Conclusions: ICU patients with a SOFA below 8 using MIPD had an increased ICU LOS but a lower 28-day mortality. Fast dose recommendations using MIPD of beta-lactam antibiotics and ciprofloxacin needs to be investigated in ICU patients., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2023
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45. Sense and sensibility.
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Hunfeld N and Skrobik Y
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- 2023
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46. A comparison of the effectiveness of different doses of tocilizumab and sarilumab in the treatment of severe COVID-19: a natural experiment due to drug shortages.
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Swets MC, Moss RJ, Kor F, Hilarius D, Moes DJAR, Berkhout WE, van den Toorn LM, van den Oever NCG, de Valk R, Rosendaal FR, Hunfeld N, Groeneveld GH, and de Boer MGJ
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- Humans, SARS-CoV-2, Treatment Outcome, COVID-19 Drug Treatment, COVID-19
- Abstract
Objectives: Interleukin (IL)-6 inhibitors are administered to treat patients hospitalized with COVID-19. In 2021, due to shortages, different dosing regimens of tocilizumab, and a switch to sarilumab, were consecutively implemented. Using real-world data, we compare the effectiveness of these IL-6 inhibitors., Methods: Hospitalized patients with COVID-19, treated with IL-6 inhibitors, were included in this natural experiment study. Sixty-day survival, hospital- and intensive care unit (ICU) length of stay, and progression to ICU or death were compared between 8 mg/kg tocilizumab, fixed-dose tocilizumab, low-dose tocilizumab, and fixed-dose sarilumab treatment groups., Results: A total of 5485 patients from 49 hospitals were included. After correction for confounding, increased hazard ratios (HRs) for 60-day mortality were observed for fixed-dose tocilizumab (HR 1.20, 95% confidence interval [CI] 1.04-1.39), low-dose tocilizumab (HR 1.12, 95% CI 0.97-1.31), and sarilumab (HR 1.24, 95% CI 1.08-1.42), all relative to 8 mg/kg. The 8 mg/kg dosing regimen had lower odds of progression to ICU or death. Both hospital- and ICU length of stay were shorter for low-dose tocilizumab than for the 8 mg/kg group., Conclusion: We found differences in the probability of 60-day survival and the incidence of the combined outcome of mortality or ICU admission, mostly favoring 8 mg/kg tocilizumab. Because of potential time-associated residual confounding, further clinical studies are warranted., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2023
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47. Circular material flow in the intensive care unit-environmental effects and identification of hotspots.
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Hunfeld N, Diehl JC, Timmermann M, van Exter P, Bouwens J, Browne-Wilkinson S, de Planque N, and Gommers D
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- Humans, Intensive Care Units, Carbon Dioxide, Carbon Footprint
- Abstract
Purpose: The healthcare sector is responsible for 6-7% of CO
2 emissions. The intensive care unit (ICU) contributes to these CO2 emissions and a shift from a linear system to a circular system is needed. The aim of our research was to perform a material flow analysis (MFA) in an academic ICU. Secondary aims were to obtain information and numbers on mass, carbon footprint, agricultural land occupation and water usage and to determine so-called "environmental hotspots" in the ICU., Methods: A material flow analysis was performed over the year 2019, followed by an environmental footprint analysis of materials and environmental hotspot identification., Results: 2839 patients were admitted to our ICU in 2019. The average length of stay was 4.6 days. Our MFA showed a material mass inflow of 247,000 kg in 2019 for intensive care, of which 50,000 kg is incinerated as (hazardous) hospital waste. The environmental impact per patient resulted in 17 kg of mass, 12 kg CO2 eq, 300 L of water usage and 4 m2 of agricultural land occupation per day. Five hotspots were identified: non-sterile gloves, isolation gowns, bed liners, surgical masks and syringes (including packaging)., Conclusion: This is the first material flow analysis that identified environmental risks and its magnitude in the intensive care unit., (© 2022. The Author(s).)- Published
- 2023
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48. Towards sustainability for medical devices and consumables: The radical and incremental challenges in the technology ecosystem.
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Hinrichs-Krapels S, Diehl JC, Hunfeld N, and van Raaij E
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- Humans, Ecosystem, Technology
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- 2022
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49. Barriers and facilitators for therapeutic drug monitoring of beta-lactams and ciprofloxacin in the ICU: a nationwide cross-sectional study.
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Ewoldt TMJ, Abdulla A, van den Broek P, Hunfeld N, Bahmany S, Muller AE, Gommers D, Polinder S, Endeman H, Spronk I, and Koch BCP
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- Anti-Bacterial Agents therapeutic use, Ciprofloxacin therapeutic use, Cross-Sectional Studies, Humans, Intensive Care Units, Drug Monitoring, beta-Lactams therapeutic use
- Abstract
Background: Recent studies demonstrated that failure of achieving pharmacodynamic targets of commonly used antibiotics is common in critically ill patients. Therapeutic drug monitoring (TDM) can contribute to optimize the exposure of beta-lactams and ciprofloxacin. While evidence for TDM of these antibiotics is growing, translation into clinical implementation remains limited. Therefore, perceived barriers and facilitators are important for implementing TDM in this population. The primary aim of this study was to identify healthcare professionals' barriers and facilitators for the implementation of TDM of beta-lactams and ciprofloxacin in Dutch intensive care units (ICU)., Methods: We conducted a nationwide cross-sectional online survey among healthcare professionals (HCPs) involved in antibiotic treatment of ICU patients. An adapted version of the Measurement Instrument for Determinants of Innovations was sent out. Items were considered barriers when ≥ 20% of participants responded with a negative answer. If ≥ 80% of the participants responded with a positive answer, the item was considered a facilitator., Results: Sixty-four HCPs completed the survey, of which 14 were from academic hospitals, 25 from general hospitals, and 25 from teaching hospitals. Most participants were hospital pharmacists (59%) or medical specialists (23%). Eleven barriers and four facilitators for implementation of TDM of beta-lactams were identified; 17 barriers for TDM of ciprofloxacin and no facilitators. The most important barriers were a lack of conclusive evidence, organizational support, and low availability of assays. Additional barriers were a lack of consensus on which specific patients to apply TDM and which pharmacodynamic targets to use. Identified facilitators for beta-lactam TDM implementation are low complexity and high task perception, combined with the perception that TDM is important to prevent side effects and to adequately treat infections. Twenty-eight percent of participants reported that flucloxacillin could be analyzed in their hospital. Assay availability of other beta-lactams and ciprofloxacin was lower (3-17%)., Conclusion: Several barriers were identified that could obstruct the implementation of TDM of beta-lactams and ciprofloxacin in the ICU. In particular, education, clear guidelines, and organizational support should be considered when creating tailored implementation strategies. Finally, evidence of beneficial clinical outcomes on TDM of beta-lactams and ciprofloxacin can enhance further implementation., (© 2022. The Author(s).)
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- 2022
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50. The impact of sepsis on hepatic drug metabolism in critically ill patients: a narrative review.
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Ewoldt TM, Abdulla A, Hunfeld N, Li L, Smeets TJL, Gommers D, Koch BCP, and Endeman H
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- Humans, Liver metabolism, Critical Illness, Sepsis drug therapy
- Abstract
Introduction: Hepatic drug metabolism is important in improving drug dosing strategies in sepsis. Pharmacokinetics in the critically ill population are severely altered due to changes in absorption, distribution, excretion and metabolization. Hepatic drug metabolism might be altered due to changes in hepatic blood flow, drug metabolizing protein availability, and protein binding. The purpose of this review is to examine evidence on whether hepatic drug metabolism is significantly affected in septic patients, and to provide insights in the need for future research., Areas Covered: This review describes the effect of sepsis on hepatic drug metabolism in humans. Clinical trials, pathophysiological background information and example drug groups are further discussed. The literature search has been conducted in Embase, Medline ALL Ovid, and Cochrane CENTRAL register of trials., Expert Opinion: Limited research has been conducted on drug metabolism in the sepsis population, with some trials having researched healthy individuals using endotoxin injections. Notwithstanding this limitation, hepatic drug metabolism seems to be decreased for certain drugs in sepsis. More research on the pharmacokinetic behavior of hepatic metabolized drugs in sepsis is warranted, using inflammatory biomarkers, hemodynamic changes, mechanical ventilation, organ support, and catecholamine infusion as possible confounders.
- Published
- 2022
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