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1. Experience or perception: What healthcare providers need when using the Utrecht Symptom Diary—4 Dimensional, a mixed-methods study

Author

Tom Lormans, Everlien de Graaf, Carlo Leget, and Saskia Teunissen

Subjects
Medicine (General), R5-920
Abstract

Background: The Utrecht Symptom Diary—4 Dimensional (USD-4D), an adaptation of the Edmonton Symptom Assessment System, supports healthcare providers (HCPs) in identifying, monitoring, and exploring multidimensional symptoms and needs of patients in the palliative phase. For the USD-4D to be optimally implemented in clinical palliative care, it is essential to know and understand the needs of HCPs when using it. Objective: To identify and interpret the needs of HCPs when using the USD-4D in clinical palliative care, operationalized as perceived facilitators and barriers. Design: An explanatory mixed-methods study with a sequential design. Methods: Data were collected between October 2019 and September 2020. In phase I, quantitative data were collected through a survey targeting Dutch HCPs working in palliative care. Facilitators were identified as items answered positively by ⩾80% of participants, while barriers were identified as items answered negatively by ⩾20% of participants. In phase II, these identified facilitators and barriers were explored in depth through mixed composition focus groups. The Capability-Opportunity-Motivation-Behavior (COM-B) model was utilized to contextualize and interpret the perceived facilitators and barriers. Results: A total of 122 HCPs completed the survey, with 95% of the respondents being women with a mean age of 48 years and 72% being nurses. Additionally, 53% of the respondents had no prior experience with the USD-4D. In phase II, 21 HCPs participated in focus groups. 95% of the participants were women with a mean age of 49 years and 67% being nurses. HCPs pinpointed facilitators primarily related to the potential benefits of the USD-4D for daily patient care. Conversely, the identified barriers included issues related to HCPs’ behavior, knowledge gaps, uncertainty regarding their abilities and attitudes toward the USD-4D, and technical obstacles. Conclusion: Facilitators and barriers across all facets of the COM-B model were recognized, with a notable emphasis on motivational barriers. It should be acknowledged that facilitators and barriers can evolve throughout the implementation process, underscoring the importance of viewing implementation and integration as fluid and continuous endeavors. Facilitators and barriers are closely linked to HCPs’ reflective capacities, emphasizing the need for tailored intervention strategies that align with different stages of USD-4D implementation.

Published
2024
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2. ‘It is important to feel invited’: what patients require when using the Utrecht Symptom Diary – 4 Dimensional, a qualitative exploration

Author

Tom Lormans, Everlien de Graaf, Sita de Vries, Carlo Leget, and Saskia Teunissen

Subjects
Medicine (General), R5-920
Abstract

Background: In palliative care, the Utrecht Symptom Diary – 4 Dimensional (USD-4D), a Dutch-adapted and validated patient-reported outcome measure, supports multidimensional symptom management through identification and monitoring of, as well as dialogue on symptoms and needs. For the USD-4D to optimally support patients’ autonomy, it is essential to know what patients need to use it. Objective: This study aims to identify what patients need when using the USD-4D in clinical palliative care. Design: A generic qualitative design with primary and secondary analyses of semistructured interviews. Methods: Patients ⩾18 years with a life-limiting illness were purposefully recruited within hospice and home care settings if they were in their last year of life as identified by the surprise question. Patients had to be aware of their life-threatening condition. Patients were selected in two tranches. In the first tranche, patients had to have completed the USD-4D at least once. The second tranche consisted of patients who were not familiar with the USD-4D in clinical practice and were interviewed in a previous study on the content validity of the USD-4D. The interviews were transcribed verbatim and were subjected to thematic analysis. Results: Twenty-five patients were included (14 men, ages 44–87). Patients’ needs when using the USD-4D were summarized in three themes: (1) feeling invited, (2) being aware of the purpose and function of the USD-4D, and (3) experiencing a personal and nonjudgmental approach. Conclusion: For patients to optimally benefit from the USD-4D as a supportive measure of their autonomy in clinical palliative care, it is essential that they feel invited to use it. Healthcare providers are tasked with setting the right preconditions for patients to want and to be able to use the USD-4D. For patients, this means healthcare providers should always be attuned to their personal preferences when communicating the purpose and function of the USD-4D and when they enter into dialogue with them.

Published
2024
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3. Prognostic Impact of Bronchoalveolar Lavage Fluid Galactomannan and Aspergillus Culture Results on Survival in COVID-19 Intensive Care Unit Patients: a Post Hoc Analysis from the European Confederation of Medical Mycology (ECMM) COVID-19-Associated Pulmonary Aspergillosis Study

Author

Giacobbe, Daniele Roberto, Prattes, Juergen, Wauters, Joost, Dettori, Silvia, Signori, Alessio, Salmanton-García, Jon, Maertens, Johan, Bourgeois, Marc, Reynders, Marijke, Rutsaert, Lynn, Van Regenmortel, Niels, Lormans, Piet, Feys, Simon, Klimko, Nikolay, Shadrivova, Olga, Cornely, Oliver A, Rautemaa-Richardson, Riina, Koehler, Philipp, Lagrou, Katrien, Bassetti, Matteo, and Hoenigl, Martin

Subjects
Infectious Diseases, Rare Diseases, Lung, Good Health and Well Being, Aspergillus, Bronchoalveolar Lavage Fluid, COVID-19, Critical Illness, Galactose, Humans, Intensive Care Units, Invasive Pulmonary Aspergillosis, Mannans, Mycology, Prognosis, Pulmonary Aspergillosis, Sensitivity and Specificity, CAPA, GM, biomarker, galactomannan, BALF, ECMM-CAPA Study Group, Biological Sciences, Agricultural and Veterinary Sciences, Medical and Health Sciences, Microbiology
Abstract

Critically ill patients with coronavirus disease 2019 (COVID-19) may develop COVID-19-associated pulmonary aspergillosis (CAPA), which impacts their chances of survival. Whether positive bronchoalveolar lavage fluid (BALF) mycological tests can be used as a survival proxy remains unknown. We conducted a post hoc analysis of a previous multicenter, multinational observational study with the aim of assessing the differential prognostic impact of BALF mycological tests, namely, positive (optical density index of ≥1.0) BALF galactomannan (GM) and positive BALF Aspergillus culture alone or in combination for critically ill patients with COVID-19. Of the 592 critically ill patients with COVID-19 enrolled in the main study, 218 were included in this post hoc analysis, as they had both test results available. CAPA was diagnosed in 56/218 patients (26%). Most cases were probable CAPA (51/56 [91%]) and fewer were proven CAPA (5/56 [9%]). In the final multivariable model adjusted for between-center heterogeneity, an independent association with 90-day mortality was observed for the combination of positive BALF GM and positive BALF Aspergillus culture in comparison with both tests negative (hazard ratio, 2.53; 95% CI confidence interval [CI], 1.28 to 5.02; P = 0.008). The other independent predictors of 90-day mortality were increasing age and active malignant disease. In conclusion, the combination of positive BALF GM and positive BALF Aspergillus culture was associated with increased 90-day mortality in critically ill patients with COVID-19. Additional study is needed to explore the possible prognostic value of other BALF markers.

Published
2022

4. José Sanders

Author

Tom Lormans

Subjects
Practical Theology, BV1-5099
Published
2023

6. Acute kidney injury in critical COVID-19: a multicenter cohort analysis in seven large hospitals in Belgium

Author

Hannah Schaubroeck, Wim Vandenberghe, Willem Boer, Eva Boonen, Bram Dewulf, Camille Bourgeois, Jasperina Dubois, Alexander Dumoulin, Tom Fivez, Jan Gunst, Greet Hermans, Piet Lormans, Philippe Meersseman, Dieter Mesotten, Björn Stessel, Marc Vanhoof, Greet De Vlieger, and Eric Hoste

Subjects
Acute kidney injury, Kidney replacement therapy, Renal replacement therapy, COVID-19, Intensive care unit, Epidemiology, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Acute kidney injury (AKI) has been reported as a frequent complication of critical COVID-19. We aimed to evaluate the occurrence of AKI and use of kidney replacement therapy (KRT) in critical COVID-19, to assess patient and kidney outcomes and risk factors for AKI and differences in outcome when the diagnosis of AKI is based on urine output (UO) or on serum creatinine (sCr). Methods Multicenter, retrospective cohort analysis of patients with critical COVID-19 in seven large hospitals in Belgium. AKI was defined according to KDIGO within 21 days after ICU admission. Multivariable logistic regression analysis was used to explore the risk factors for developing AKI and to assess the association between AKI and ICU mortality. Results Of 1286 patients, 85.1% had AKI, and KRT was used in 9.8%. Older age, obesity, a higher APACHE II score and use of mechanical ventilation at day 1 of ICU stay were associated with an increased risk for AKI. After multivariable adjustment, all AKI stages were associated with ICU mortality. AKI was based on sCr in 40.1% and UO in 81.5% of patients. All AKI stages based on sCr and AKI stage 3 based on UO were associated with ICU mortality. Persistent AKI was present in 88.6% and acute kidney disease (AKD) in 87.6%. Rapid reversal of AKI yielded a better prognosis compared to persistent AKI and AKD. Kidney recovery was observed in 47.4% of surviving AKI patients. Conclusions Over 80% of critically ill COVID-19 patients had AKI. This was driven by the high occurrence rate of AKI defined by UO criteria. All AKI stages were associated with mortality (NCT04997915).

Published
2022
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8. Multinational Observational Cohort Study of COVID-19–Associated Pulmonary Aspergillosis

Author

Nico A.F. Janssen, Rémy Nyga, Lore Vanderbeke, Cato Jacobs, Mehmet Ergün, Jochem B. Buil, Karin van Dijk, Josje Altenburg, Catherine S.C. Bouman, Hans I. van der Spoel, Bart J.A. Rijnders, Albert Dunbar, Jeroen A. Schouten, Katrien Lagrou, Marc Bourgeois, Marijke Reynders, Niels van Regenmortel, Lynn Rutsaert, Piet Lormans, Simon Feys, Yves Debavaye, Fabienne Tamion, Damien Costa, Julien Maizel, Hervé Dupont, Taieb Chouaki, Saad Nseir, Boualem Sendid, Roger J.M. Brüggemann, Frank L. van de Veerdonk, Joost Wauters, and Paul E. Verweij

Subjects
respiratory infections, severe acute respiratory syndrome coronavirus 2, SARS-CoV-2, SARS, COVID-19, coronavirus disease, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

We performed an observational study to investigate intensive care unit incidence, risk factors, and outcomes of coronavirus disease–associated pulmonary aspergillosis (CAPA). We found 10%–15% CAPA incidence among 823 patients in 2 cohorts. Several factors were independently associated with CAPA in 1 cohort and mortality rates were 43%–52%.

Published
2021
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9. Interview met hoogleraar Cécile Boot

Author

Tom Lormans

Subjects
Practical Theology, BV1-5099
Abstract

Cécile (prof.dr. C.R.L.) Boot (1977) is gezondheidswetenschapper en houdt zich bezig met gezond werken. Ze is opgeleid in Nijmegen en behaalde in 2000 haar MSc Biomedische Gezondheidswetenschappen. Haar promotieonderzoek ging uit naar ziekteverzuim bij astma en COPD: welke rol spelen ziekte, werk, adaptatie, psychosociale factoren en kennis? Sinds 2013 is ze als ‘adjunct scientist’ verbonden aan het Institute for Work and Health in Toronto, Canada. Sinds oktober 2018 is Cécile Boot bijzonder hoogleraar Organisatie en kwaliteit van werk in de ouderenzorg aan de Radboud Universiteit Nijmegen. In september 2020 werd ze benoemd tot hoogleraar Maatschappelijke participatie en gezondheid bij Amsterdam Universitair Medisch Centrum/Vrije Universiteit.

Published
2022

11. Status Epilepticus Following Intrathecal Administration of Bupivacaine: A Case Report

Author

Arthur Vanmarcke, Piet Lormans, and Catherine Vandewaeter

Subjects
Medicine (General), R5-920, Pathology, RB1-214
Abstract

Spinal anesthesia is common practice and rarely causes complications. Although extended experience is present, seldom side effects of this technique and the administration of intrathecal local anesthetics and/or opioids can occur. We present a case in which a 76-year old woman undergoing total hip arthroplasty received a low dose of intrathecal bupivacaine and sufentanil. One hour after administration, she developed myoclonic seizures of the lower extremities followed by generalized tonic-clonic seizures and status epilepticus. We conclude that status epilepticus is a rare and possible lethal side effect of intrathecal bupivacaine. Symptoms may be misleading, highlighting the importance of early recognition and adequate management.

Published
2022
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12. Case report: an aortic aneurysm as cause of pseudoachalasia

Author

Marian Dejaeger, Maud Lormans, Eddy Dejaeger, and Katleen Fagard

Subjects
Ageing, Aortic aneurysm, Pseudoachalasia, Dysphagia aortica, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Abstract Background Pseudoachalasia is a rare disorder which has clinical, radiographic, and manometric findings that are often indistinguishable from primary achalasia. It is usually associated with malignancy. Few reports describe vascular compression as a cause of pseudoachalasia. Case presentation Here we present a case of a 84-year-old woman with anorexia, dysphagia and unintentional weight loss initially diagnosed as achalasia. Upon further investigation a rare cause of pseudoachalasia due to vascular compression of the esophagus was found. It could have been overlooked due to the fact that the initial work-out with a barium swallow, manometry and endoscopy was suggestive for primary achalasia. Conclusion Particularly in older patients with a manometric diagnosis of achalasia, additional investigation to rule out pseudoachalasia is warranted. Although malignant involvement of the esophagus is the most common cause of pseudoachalasia, benign origins have also been described.

Published
2020
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13. In-hospital and 6-month outcomes in patients with COVID-19 supported with extracorporeal membrane oxygenation (EuroECMO-COVID): a multicentre, prospective observational study

Author

Lorusso, R, De Piero, M, Mariani, S, Di Mauro, M, Folliguet, T, Taccone, F, Camporota, L, Swol, J, Wiedemann, D, Belliato, M, Broman, L, Vuylsteke, A, Kassif, Y, Scandroglio, A, Fanelli, V, Gaudard, P, Ledot, S, Barker, J, Boeken, U, Maier, S, Kersten, A, Meyns, B, Pozzi, M, Pedersen, F, Schellongowski, P, Kirali, K, Barrett, N, Riera, J, Mueller, T, Belohlavek, J, Lo Coco, V, Van der Horst, I, Van Bussel, B, Schnabel, R, Delnoij, T, Bolotin, G, Lorini, L, Schmiady, M, Schibilsky, D, Kowalewski, M, Pinto, L, Silva, P, Kornilov, I, Blandino Ortiz, A, Vercaemst, L, Finney, S, Roeleveld, P, Di Nardo, M, Hennig, F, Antonini, M, Davidson, M, Jones, T, Staudinger, T, Mair, P, Kilo, J, Krapf, C, Erbert, K, Peer, A, Bonaros, N, Kotheletner, F, Krenner Mag, N, Shestakova, L, Hermans, G, Dauwe, D, Meersseman, P, Stockman, B, Nobile, L, Lhereux, O, Nrasseurs, A, Creuter, J, De Backer, D, Giglioli, S, Michiels, G, Foulon, P, Raes, M, Rodrigus, I, Allegaert, M, Jorens, P, Debeucklare, G, Piagnerelli, M, Biston, P, Peperstraete, H, Vandewiele, K, Germay, O, Vandeweghe, D, Havrin, S, Bourgeois, M, Lagny, M, Alois, G, Lavios, N, Misset, B, Courcelle, R, Timmermans, P, Yilmaz, A, Vantomout, M, Lehaen, J, Jassen, A, Guterman, H, Strauven, M, Lormans, P, Verhamme, B, Vandewaeter, C, Bonte, F, Vionne, D, Balik, M, Blaha, J, Lips, M, Othal, M, Bursa, F, Spacek, R, Christensen, S, Jorgensen, V, Sorensen, M, Madsen, S, Puss, S, Beljantsev, A, Saiydoun, G, Fiore, A, Colson, P, Bazalgette, F, Capdevila, X, Kollen, S, Muller, L, Obadia, J, Dubien, P, Ajrhourh, L, Guinot, P, Zarka, J, Besserve, P, Malfertheiner, M, Dreier, E, Heinze, B, Akhyari, P, Lichtenberg, A, Aubin, H, Assman, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Ruslan, N, Haverich, A, Thielmann, M, Brenner, T, Ruhpawar, A, Benk, C, Czerny, M, Staudacher, D, Beyersdorf, F, Kalbhenn, J, Henn, P, Popov, A, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Lotz, G, Sonntagbauer, M, Winkels, H, Fichte, J, Stohr, R, Kalverkamp, S, Karagiannidis, C, Schafer, S, Svetlitchny, A, Hopf, H, Jarczak, D, Groesdonk, H, Rommer, M, Hirsch, J, Kaehny, C, Soufleris, D, Gavriilidis, G, Pontikis, K, Kyriakopoulou, M, Kyriakoudi, A, O'Brien, S, Conrick-Martin, I, Carton, E, Makhoul, M, Ben-Ari, J, Hadash, A, Kogan, A, Kassif Lerner, R, Abu-Shakra, A, Matan, M, Balawona, A, Kachel, E, Altshuler, R, Galante, O, Fuchs, L, Almog, Y, Ishay, Y, Lichter, Y, Gal-oz, A, Carmi, U, Nini, A, Soroksky, A, Dekel, H, Rozman, Z, Tayem, E, Ilgiyaev, E, Hochman, Y, Miltau, D, Rapoport, A, Eden, A, Kompanietz, D, Yousif, M, Golos, M, Grazioli, L, Ghitti, D, Loforte, A, Di Luca, D, Baiocchi, M, Pacini, D, Cappai, A, Meani, P, Mondino, M, Russo, C, Ranucci, M, Fina, D, Cotza, M, Ballotta, A, Landoni, G, Nardelli, P, Fominski, E, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Livigni, S, Silengo, D, Arena, G, Sovatzis, S, Degani, A, Riccardi, M, Milanesi, E, Raffa, G, Martucci, G, Arcadipane, A, Panarello, G, Chiarini, G, Cattaneo, S, Puglia, C, Benussi, S, Foti, G, Giani, M, Bombino, M, Costa, M, Rona, R, Avalli, L, Donati, A, Carozza, R, Gasparri, F, Carsetti, A, Piciche, M, Marinello, A, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Russo, E, Agnoletti, V, Rociola, R, Milano, A, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Giordano, G, Carelli, S, Grieco, D, Dell'Anna, A, Antonelli, M, Ramoni, E, Zulueta, J, Del Giglio, M, Petracca, S, Bertini, P, Guarracino, F, De Simone, L, Angeletti, P, Forfori, F, Taraschi, F, Quintiliani, V, Samalavicius, R, Jankuviene, A, Scupakova, N, Urbonas, K, Kapturauskas, J, Soerensen, G, Suwalski, P, Linhares Santos, L, Marques, A, Miranda, M, Teixeira, S, Salgueiro, A, Pereira, F, Ketskalo, M, Tsarenko, S, Shilova, A, Afukov, I, Popugaev, K, Minin, S, Shelukhin, D, Malceva, O, Gleb, M, Skopets, A, Kornelyuk, R, Kulikov, A, Okhrimchuk, V, Turchaninov, A, Petrushin, M, Sheck, A, Mekulov, A, Ciryateva, S, Urusov, D, Gorjup, V, Golicnik, A, Goslar, T, Ferrer, R, Martinez-Martinez, M, Argudo, E, Palmer, N, De Pablo Sanchez, R, Juan Higuera, L, Arnau Blasco, L, Marquez, J, Sbraga, F, Fuset, M, De Gopegui, P, Claraco, L, De Ayala, J, Peiro, M, Ricart, P, Martinez, S, Chavez, F, Fabra, M, Sandoval, E, Toapanta, D, Carraminana, A, Tellez, A, Ososio, J, Milan, P, Rodriguez, J, Andoni, G, Gutierrez, C, Perez de la Sota, E, Eixeres-Esteve, A, Garcia-Maellas, M, Gutierrez-Gutierrez, J, Arboleda-Salazar, R, Santa Teresa, P, Jaspe, A, Garrido, A, Castaneda, G, Alcantara, S, Martinez, N, Perez, M, Villanueva, H, Vidal Gonzalez, A, Paez, J, Santon, A, Perez, C, Lopez, M, Rubio Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Munoz, J, Alcalde, I, Onieva, F, Gimeno Costa, R, Perez, F, Madrid, I, Gordon, M, Albacete Moreno, C, Perez, D, Lopez, N, Martinenz, D, Blanco-Schweizer, P, Diez, C, Prieto, A, Renedo, G, Bustamante, E, Cicuendez, R, Citores, R, Boado, V, Garcia, K, Voces, R, Domezain, M, Nunez Martinez, J, Vicente, R, Martin, D, Andreu, A, Gomez Casal, V, Chico, I, Menor, E, Vara, S, Gamacho, J, Perez-Chomon, H, Javier Gonzales, F, Barrero, I, Martin-Villen, L, Fernandez, E, Mendoza, M, Navarro, J, Colomina Climent, J, Gonzales-Perez, A, Muniz-Albaceita, G, Amado, L, Rodriguez, R, Ruiz, E, Eiras, M, Grins, E, Magnus, R, Kanetoft, M, Eidevald, M, Watson, P, Vogt, P, Steiger, P, Aigner, T, Weber, A, Grunefelder, J, Kunz, M, Grapow, M, Aymard, T, Reser, D, Agus, G, Consiglio, J, Haenggi, M, Hansjoerg, J, Iten, M, Doeble, T, Zenklusen, U, Bechtold, X, Faedda, G, Iafrate, M, Rohjer, A, Bergamaschi, L, Maessen, J, Reis Miranda, D, Endeman, H, Gommers, D, Meuwese, C, Maas, J, Van Gijlswijk, M, Van Berg, R, Candura, D, Van der Linden, M, Kant, M, Van der Heijden, J, Scholten, E, Van Belle-van Haren, N, Lagrand, W, Vlaar, A, De Jong, S, Cander, B, Sargin, M, Ugur, M, Kaygin, M, Daly, K, Agnew, N, Head, L, Kelly, L, Anoma, G, Russell, C, Aquino, V, Scott, I, Flemming, L, Gillon, S, Moore, O, Gelandt, E, Auzinger, G, Patel, S, Loveridge, R, Lorusso R., De Piero M. E., Mariani S., Di Mauro M., Folliguet T., Taccone F. S., Camporota L., Swol J., Wiedemann D., Belliato M., Broman L. M., Vuylsteke A., Kassif Y., Scandroglio A. M., Fanelli V., Gaudard P., Ledot S., Barker J., Boeken U., Maier S., Kersten A., Meyns B., Pozzi M., Pedersen F. M., Schellongowski P., Kirali K., Barrett N., Riera J., Mueller T., Belohlavek J., Lo Coco V., Van der Horst I. C. C., Van Bussel B. C. T., Schnabel R. M., Delnoij T., Bolotin G., Lorini L., Schmiady M. O., Schibilsky D., Kowalewski M., Pinto L. F., Silva P. E., Kornilov I., Blandino Ortiz A., Vercaemst L., Finney S., Roeleveld P. P., Di Nardo M., Hennig F., Antonini M. V., Davidson M., Jones T. J., Staudinger T., Mair P., Kilo J., Krapf C., Erbert K., Peer A., Bonaros N., Kotheletner F., Krenner Mag N., Shestakova L., Hermans G., Dauwe D., Meersseman P., Stockman B., Nobile L., Lhereux O., Nrasseurs A., Creuter J., De Backer D., Giglioli S., Michiels G., Foulon P., Raes M., Rodrigus I., Allegaert M., Jorens P., Debeucklare G., Piagnerelli M., Biston P., Peperstraete H., Vandewiele K., Germay O., Vandeweghe D., Havrin S., Bourgeois M., Lagny M. -G., Alois G., Lavios N., Misset B., Courcelle R., Timmermans P. J., Yilmaz A., Vantomout M., Lehaen J., Jassen A., Guterman H., Strauven M., Lormans P., Verhamme B., Vandewaeter C., Bonte F., Vionne D., Balik M., Blaha J., Lips M., Othal M., Bursa F., Spacek R., Christensen S., Jorgensen V., Sorensen M., Madsen S. A., Puss S., Beljantsev A., Saiydoun G., Fiore A., Colson P., Bazalgette F., Capdevila X., Kollen S., Muller L., Obadia J. -F., Dubien P. -Y., Ajrhourh L., Guinot P. G., Zarka J., Besserve P., Malfertheiner M. V., Dreier E., Heinze B., Akhyari P., Lichtenberg A., Aubin H., Assman A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Ruslan N., Haverich A., Thielmann M., Brenner T., Ruhpawar A., Benk C., Czerny M., Staudacher D. L., Beyersdorf F., Kalbhenn J., Henn P., Popov A. -F., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Lotz G., Sonntagbauer M., Winkels H., Fichte J., Stohr R., Kalverkamp S., Karagiannidis C., Schafer S., Svetlitchny A., Hopf H. -B., Jarczak D., Groesdonk H., Rommer M., Hirsch J., Kaehny C., Soufleris D., Gavriilidis G., Pontikis K., Kyriakopoulou M., Kyriakoudi A., O'Brien S., Conrick-Martin I., Carton E., Makhoul M., Ben-Ari J., Hadash A., Kogan A., Kassif Lerner R., Abu-Shakra A., Matan M., Balawona A., Kachel E., Altshuler R., Galante O., Fuchs L., Almog Y., Ishay Y. S., Lichter Y., Gal-oz A., Carmi U., Nini A., Soroksky A., Dekel H., Rozman Z., Tayem E., Ilgiyaev E., Hochman Y., Miltau D., Rapoport A., Eden A., Kompanietz D., Yousif M., Golos M., Grazioli L., Ghitti D., Loforte A., Di Luca D., Baiocchi M., Pacini D., Cappai A., Meani P., Mondino M., Russo C. F., Ranucci M., Fina D., Cotza M., Ballotta A., Landoni G., Nardelli P., Fominski E. V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Livigni S., Silengo D., Arena G., Sovatzis S. S., Degani A., Riccardi M., Milanesi E., Raffa G., Martucci G., Arcadipane A., Panarello G., Chiarini G., Cattaneo S., Puglia C., Benussi S., Foti G., Giani M., Bombino M., Costa M. C., Rona R., Avalli L., Donati A., Carozza R., Gasparri F., Carsetti A., Piciche M., Marinello A., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Russo E., Agnoletti V., Rociola R., Milano A. D., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Giordano G., Carelli S., Grieco D. L., Dell'Anna A. M., Antonelli M., Ramoni E., Zulueta J., Del Giglio M., Petracca S., Bertini P., Guarracino F., De Simone L., Angeletti P. M., Forfori F., Taraschi F., Quintiliani V. N., Samalavicius R., Jankuviene A., Scupakova N., Urbonas K., Kapturauskas J., Soerensen G., Suwalski P., Linhares Santos L., Marques A., Miranda M., Teixeira S., Salgueiro A., Pereira F., Ketskalo M., Tsarenko S., Shilova A., Afukov I., Popugaev K., Minin S., Shelukhin D., Malceva O., Gleb M., Skopets A., Kornelyuk R., Kulikov A., Okhrimchuk V., Turchaninov A., Petrushin M., Sheck A., Mekulov A., Ciryateva S., Urusov D., Gorjup V., Golicnik A., Goslar T., Ferrer R., Martinez-Martinez M., Argudo E., Palmer N., De Pablo Sanchez R., Juan Higuera L., Arnau Blasco L., Marquez J. A., Sbraga F., Fuset M. P., De Gopegui P. R., Claraco L. M., De Ayala J. A., Peiro M., Ricart P., Martinez S., Chavez F., Fabra M., Sandoval E., Toapanta D., Carraminana A., Tellez A., Ososio J., Milan P., Rodriguez J., Andoni G., Gutierrez C., Perez de la Sota E., Eixeres-Esteve A., Garcia-Maellas M. T., Gutierrez-Gutierrez J., Arboleda-Salazar R., Santa Teresa P., Jaspe A., Garrido A., Castaneda G., Alcantara S., Martinez N., Perez M., Villanueva H., Vidal Gonzalez A., Paez J., Santon A., Perez C., Lopez M., Rubio Lopez M. I., Gordillo A., Naranjo-Izurieta J., Munoz J., Alcalde I., Onieva F., Gimeno Costa R., Perez F., Madrid I., Gordon M., Albacete Moreno C. L., Perez D., Lopez N., Martinenz D., Blanco-Schweizer P., Diez C., Prieto A., Renedo G., Bustamante E., Cicuendez R., Citores R., Boado V., Garcia K., Voces R., Domezain M., Nunez Martinez J. M., Vicente R., Martin D., Andreu A., Gomez Casal V., Chico I., Menor E. M., Vara S., Gamacho J., Perez-Chomon H., Javier Gonzales F., Barrero I., Martin-Villen L., Fernandez E., Mendoza M., Navarro J., Colomina Climent J., Gonzales-Perez A., Muniz-Albaceita G., Amado L., Rodriguez R., Ruiz E., Eiras M., Grins E., Magnus R., Kanetoft M., Eidevald M., Watson P., Vogt P. R., Steiger P., Aigner T., Weber A., Grunefelder J., Kunz M., Grapow M., Aymard T., Reser D., Agus G., Consiglio J., Haenggi M., Hansjoerg J., Iten M., Doeble T., Zenklusen U., Bechtold X., Faedda G., Iafrate M., Rohjer A., Bergamaschi L., Maessen J., Reis Miranda D., Endeman H., Gommers D., Meuwese C., Maas J., Van Gijlswijk M. J., Van Berg R. N., Candura D., Van der Linden M., Kant M., Van der Heijden J. J., Scholten E., Van Belle-van Haren N., Lagrand W. K., Vlaar A. P., De Jong S., Cander B., Sargin M., Ugur M., Kaygin M. A., Daly K., Agnew N., Head L., Kelly L., Anoma G., Russell C., Aquino V., Scott I., Flemming L., Gillon S., Moore O., Gelandt E., Auzinger G., Patel S., Loveridge R., Lorusso, R, De Piero, M, Mariani, S, Di Mauro, M, Folliguet, T, Taccone, F, Camporota, L, Swol, J, Wiedemann, D, Belliato, M, Broman, L, Vuylsteke, A, Kassif, Y, Scandroglio, A, Fanelli, V, Gaudard, P, Ledot, S, Barker, J, Boeken, U, Maier, S, Kersten, A, Meyns, B, Pozzi, M, Pedersen, F, Schellongowski, P, Kirali, K, Barrett, N, Riera, J, Mueller, T, Belohlavek, J, Lo Coco, V, Van der Horst, I, Van Bussel, B, Schnabel, R, Delnoij, T, Bolotin, G, Lorini, L, Schmiady, M, Schibilsky, D, Kowalewski, M, Pinto, L, Silva, P, Kornilov, I, Blandino Ortiz, A, Vercaemst, L, Finney, S, Roeleveld, P, Di Nardo, M, Hennig, F, Antonini, M, Davidson, M, Jones, T, Staudinger, T, Mair, P, Kilo, J, Krapf, C, Erbert, K, Peer, A, Bonaros, N, Kotheletner, F, Krenner Mag, N, Shestakova, L, Hermans, G, Dauwe, D, Meersseman, P, Stockman, B, Nobile, L, Lhereux, O, Nrasseurs, A, Creuter, J, De Backer, D, Giglioli, S, Michiels, G, Foulon, P, Raes, M, Rodrigus, I, Allegaert, M, Jorens, P, Debeucklare, G, Piagnerelli, M, Biston, P, Peperstraete, H, Vandewiele, K, Germay, O, Vandeweghe, D, Havrin, S, Bourgeois, M, Lagny, M, Alois, G, Lavios, N, Misset, B, Courcelle, R, Timmermans, P, Yilmaz, A, Vantomout, M, Lehaen, J, Jassen, A, Guterman, H, Strauven, M, Lormans, P, Verhamme, B, Vandewaeter, C, Bonte, F, Vionne, D, Balik, M, Blaha, J, Lips, M, Othal, M, Bursa, F, Spacek, R, Christensen, S, Jorgensen, V, Sorensen, M, Madsen, S, Puss, S, Beljantsev, A, Saiydoun, G, Fiore, A, Colson, P, Bazalgette, F, Capdevila, X, Kollen, S, Muller, L, Obadia, J, Dubien, P, Ajrhourh, L, Guinot, P, Zarka, J, Besserve, P, Malfertheiner, M, Dreier, E, Heinze, B, Akhyari, P, Lichtenberg, A, Aubin, H, Assman, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Ruslan, N, Haverich, A, Thielmann, M, Brenner, T, Ruhpawar, A, Benk, C, Czerny, M, Staudacher, D, Beyersdorf, F, Kalbhenn, J, Henn, P, Popov, A, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Lotz, G, Sonntagbauer, M, Winkels, H, Fichte, J, Stohr, R, Kalverkamp, S, Karagiannidis, C, Schafer, S, Svetlitchny, A, Hopf, H, Jarczak, D, Groesdonk, H, Rommer, M, Hirsch, J, Kaehny, C, Soufleris, D, Gavriilidis, G, Pontikis, K, Kyriakopoulou, M, Kyriakoudi, A, O'Brien, S, Conrick-Martin, I, Carton, E, Makhoul, M, Ben-Ari, J, Hadash, A, Kogan, A, Kassif Lerner, R, Abu-Shakra, A, Matan, M, Balawona, A, Kachel, E, Altshuler, R, Galante, O, Fuchs, L, Almog, Y, Ishay, Y, Lichter, Y, Gal-oz, A, Carmi, U, Nini, A, Soroksky, A, Dekel, H, Rozman, Z, Tayem, E, Ilgiyaev, E, Hochman, Y, Miltau, D, Rapoport, A, Eden, A, Kompanietz, D, Yousif, M, Golos, M, Grazioli, L, Ghitti, D, Loforte, A, Di Luca, D, Baiocchi, M, Pacini, D, Cappai, A, Meani, P, Mondino, M, Russo, C, Ranucci, M, Fina, D, Cotza, M, Ballotta, A, Landoni, G, Nardelli, P, Fominski, E, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Livigni, S, Silengo, D, Arena, G, Sovatzis, S, Degani, A, Riccardi, M, Milanesi, E, Raffa, G, Martucci, G, Arcadipane, A, Panarello, G, Chiarini, G, Cattaneo, S, Puglia, C, Benussi, S, Foti, G, Giani, M, Bombino, M, Costa, M, Rona, R, Avalli, L, Donati, A, Carozza, R, Gasparri, F, Carsetti, A, Piciche, M, Marinello, A, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Russo, E, Agnoletti, V, Rociola, R, Milano, A, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Giordano, G, Carelli, S, Grieco, D, Dell'Anna, A, Antonelli, M, Ramoni, E, Zulueta, J, Del Giglio, M, Petracca, S, Bertini, P, Guarracino, F, De Simone, L, Angeletti, P, Forfori, F, Taraschi, F, Quintiliani, V, Samalavicius, R, Jankuviene, A, Scupakova, N, Urbonas, K, Kapturauskas, J, Soerensen, G, Suwalski, P, Linhares Santos, L, Marques, A, Miranda, M, Teixeira, S, Salgueiro, A, Pereira, F, Ketskalo, M, Tsarenko, S, Shilova, A, Afukov, I, Popugaev, K, Minin, S, Shelukhin, D, Malceva, O, Gleb, M, Skopets, A, Kornelyuk, R, Kulikov, A, Okhrimchuk, V, Turchaninov, A, Petrushin, M, Sheck, A, Mekulov, A, Ciryateva, S, Urusov, D, Gorjup, V, Golicnik, A, Goslar, T, Ferrer, R, Martinez-Martinez, M, Argudo, E, Palmer, N, De Pablo Sanchez, R, Juan Higuera, L, Arnau Blasco, L, Marquez, J, Sbraga, F, Fuset, M, De Gopegui, P, Claraco, L, De Ayala, J, Peiro, M, Ricart, P, Martinez, S, Chavez, F, Fabra, M, Sandoval, E, Toapanta, D, Carraminana, A, Tellez, A, Ososio, J, Milan, P, Rodriguez, J, Andoni, G, Gutierrez, C, Perez de la Sota, E, Eixeres-Esteve, A, Garcia-Maellas, M, Gutierrez-Gutierrez, J, Arboleda-Salazar, R, Santa Teresa, P, Jaspe, A, Garrido, A, Castaneda, G, Alcantara, S, Martinez, N, Perez, M, Villanueva, H, Vidal Gonzalez, A, Paez, J, Santon, A, Perez, C, Lopez, M, Rubio Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Munoz, J, Alcalde, I, Onieva, F, Gimeno Costa, R, Perez, F, Madrid, I, Gordon, M, Albacete Moreno, C, Perez, D, Lopez, N, Martinenz, D, Blanco-Schweizer, P, Diez, C, Prieto, A, Renedo, G, Bustamante, E, Cicuendez, R, Citores, R, Boado, V, Garcia, K, Voces, R, Domezain, M, Nunez Martinez, J, Vicente, R, Martin, D, Andreu, A, Gomez Casal, V, Chico, I, Menor, E, Vara, S, Gamacho, J, Perez-Chomon, H, Javier Gonzales, F, Barrero, I, Martin-Villen, L, Fernandez, E, Mendoza, M, Navarro, J, Colomina Climent, J, Gonzales-Perez, A, Muniz-Albaceita, G, Amado, L, Rodriguez, R, Ruiz, E, Eiras, M, Grins, E, Magnus, R, Kanetoft, M, Eidevald, M, Watson, P, Vogt, P, Steiger, P, Aigner, T, Weber, A, Grunefelder, J, Kunz, M, Grapow, M, Aymard, T, Reser, D, Agus, G, Consiglio, J, Haenggi, M, Hansjoerg, J, Iten, M, Doeble, T, Zenklusen, U, Bechtold, X, Faedda, G, Iafrate, M, Rohjer, A, Bergamaschi, L, Maessen, J, Reis Miranda, D, Endeman, H, Gommers, D, Meuwese, C, Maas, J, Van Gijlswijk, M, Van Berg, R, Candura, D, Van der Linden, M, Kant, M, Van der Heijden, J, Scholten, E, Van Belle-van Haren, N, Lagrand, W, Vlaar, A, De Jong, S, Cander, B, Sargin, M, Ugur, M, Kaygin, M, Daly, K, Agnew, N, Head, L, Kelly, L, Anoma, G, Russell, C, Aquino, V, Scott, I, Flemming, L, Gillon, S, Moore, O, Gelandt, E, Auzinger, G, Patel, S, Loveridge, R, Lorusso R., De Piero M. E., Mariani S., Di Mauro M., Folliguet T., Taccone F. S., Camporota L., Swol J., Wiedemann D., Belliato M., Broman L. M., Vuylsteke A., Kassif Y., Scandroglio A. M., Fanelli V., Gaudard P., Ledot S., Barker J., Boeken U., Maier S., Kersten A., Meyns B., Pozzi M., Pedersen F. M., Schellongowski P., Kirali K., Barrett N., Riera J., Mueller T., Belohlavek J., Lo Coco V., Van der Horst I. C. C., Van Bussel B. C. T., Schnabel R. M., Delnoij T., Bolotin G., Lorini L., Schmiady M. O., Schibilsky D., Kowalewski M., Pinto L. F., Silva P. E., Kornilov I., Blandino Ortiz A., Vercaemst L., Finney S., Roeleveld P. P., Di Nardo M., Hennig F., Antonini M. V., Davidson M., Jones T. J., Staudinger T., Mair P., Kilo J., Krapf C., Erbert K., Peer A., Bonaros N., Kotheletner F., Krenner Mag N., Shestakova L., Hermans G., Dauwe D., Meersseman P., Stockman B., Nobile L., Lhereux O., Nrasseurs A., Creuter J., De Backer D., Giglioli S., Michiels G., Foulon P., Raes M., Rodrigus I., Allegaert M., Jorens P., Debeucklare G., Piagnerelli M., Biston P., Peperstraete H., Vandewiele K., Germay O., Vandeweghe D., Havrin S., Bourgeois M., Lagny M. -G., Alois G., Lavios N., Misset B., Courcelle R., Timmermans P. J., Yilmaz A., Vantomout M., Lehaen J., Jassen A., Guterman H., Strauven M., Lormans P., Verhamme B., Vandewaeter C., Bonte F., Vionne D., Balik M., Blaha J., Lips M., Othal M., Bursa F., Spacek R., Christensen S., Jorgensen V., Sorensen M., Madsen S. A., Puss S., Beljantsev A., Saiydoun G., Fiore A., Colson P., Bazalgette F., Capdevila X., Kollen S., Muller L., Obadia J. -F., Dubien P. -Y., Ajrhourh L., Guinot P. G., Zarka J., Besserve P., Malfertheiner M. V., Dreier E., Heinze B., Akhyari P., Lichtenberg A., Aubin H., Assman A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Ruslan N., Haverich A., Thielmann M., Brenner T., Ruhpawar A., Benk C., Czerny M., Staudacher D. L., Beyersdorf F., Kalbhenn J., Henn P., Popov A. -F., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Lotz G., Sonntagbauer M., Winkels H., Fichte J., Stohr R., Kalverkamp S., Karagiannidis C., Schafer S., Svetlitchny A., Hopf H. -B., Jarczak D., Groesdonk H., Rommer M., Hirsch J., Kaehny C., Soufleris D., Gavriilidis G., Pontikis K., Kyriakopoulou M., Kyriakoudi A., O'Brien S., Conrick-Martin I., Carton E., Makhoul M., Ben-Ari J., Hadash A., Kogan A., Kassif Lerner R., Abu-Shakra A., Matan M., Balawona A., Kachel E., Altshuler R., Galante O., Fuchs L., Almog Y., Ishay Y. S., Lichter Y., Gal-oz A., Carmi U., Nini A., Soroksky A., Dekel H., Rozman Z., Tayem E., Ilgiyaev E., Hochman Y., Miltau D., Rapoport A., Eden A., Kompanietz D., Yousif M., Golos M., Grazioli L., Ghitti D., Loforte A., Di Luca D., Baiocchi M., Pacini D., Cappai A., Meani P., Mondino M., Russo C. F., Ranucci M., Fina D., Cotza M., Ballotta A., Landoni G., Nardelli P., Fominski E. V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Livigni S., Silengo D., Arena G., Sovatzis S. S., Degani A., Riccardi M., Milanesi E., Raffa G., Martucci G., Arcadipane A., Panarello G., Chiarini G., Cattaneo S., Puglia C., Benussi S., Foti G., Giani M., Bombino M., Costa M. C., Rona R., Avalli L., Donati A., Carozza R., Gasparri F., Carsetti A., Piciche M., Marinello A., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Russo E., Agnoletti V., Rociola R., Milano A. D., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Giordano G., Carelli S., Grieco D. L., Dell'Anna A. M., Antonelli M., Ramoni E., Zulueta J., Del Giglio M., Petracca S., Bertini P., Guarracino F., De Simone L., Angeletti P. M., Forfori F., Taraschi F., Quintiliani V. N., Samalavicius R., Jankuviene A., Scupakova N., Urbonas K., Kapturauskas J., Soerensen G., Suwalski P., Linhares Santos L., Marques A., Miranda M., Teixeira S., Salgueiro A., Pereira F., Ketskalo M., Tsarenko S., Shilova A., Afukov I., Popugaev K., Minin S., Shelukhin D., Malceva O., Gleb M., Skopets A., Kornelyuk R., Kulikov A., Okhrimchuk V., Turchaninov A., Petrushin M., Sheck A., Mekulov A., Ciryateva S., Urusov D., Gorjup V., Golicnik A., Goslar T., Ferrer R., Martinez-Martinez M., Argudo E., Palmer N., De Pablo Sanchez R., Juan Higuera L., Arnau Blasco L., Marquez J. A., Sbraga F., Fuset M. P., De Gopegui P. R., Claraco L. M., De Ayala J. A., Peiro M., Ricart P., Martinez S., Chavez F., Fabra M., Sandoval E., Toapanta D., Carraminana A., Tellez A., Ososio J., Milan P., Rodriguez J., Andoni G., Gutierrez C., Perez de la Sota E., Eixeres-Esteve A., Garcia-Maellas M. T., Gutierrez-Gutierrez J., Arboleda-Salazar R., Santa Teresa P., Jaspe A., Garrido A., Castaneda G., Alcantara S., Martinez N., Perez M., Villanueva H., Vidal Gonzalez A., Paez J., Santon A., Perez C., Lopez M., Rubio Lopez M. I., Gordillo A., Naranjo-Izurieta J., Munoz J., Alcalde I., Onieva F., Gimeno Costa R., Perez F., Madrid I., Gordon M., Albacete Moreno C. L., Perez D., Lopez N., Martinenz D., Blanco-Schweizer P., Diez C., Prieto A., Renedo G., Bustamante E., Cicuendez R., Citores R., Boado V., Garcia K., Voces R., Domezain M., Nunez Martinez J. M., Vicente R., Martin D., Andreu A., Gomez Casal V., Chico I., Menor E. M., Vara S., Gamacho J., Perez-Chomon H., Javier Gonzales F., Barrero I., Martin-Villen L., Fernandez E., Mendoza M., Navarro J., Colomina Climent J., Gonzales-Perez A., Muniz-Albaceita G., Amado L., Rodriguez R., Ruiz E., Eiras M., Grins E., Magnus R., Kanetoft M., Eidevald M., Watson P., Vogt P. R., Steiger P., Aigner T., Weber A., Grunefelder J., Kunz M., Grapow M., Aymard T., Reser D., Agus G., Consiglio J., Haenggi M., Hansjoerg J., Iten M., Doeble T., Zenklusen U., Bechtold X., Faedda G., Iafrate M., Rohjer A., Bergamaschi L., Maessen J., Reis Miranda D., Endeman H., Gommers D., Meuwese C., Maas J., Van Gijlswijk M. J., Van Berg R. N., Candura D., Van der Linden M., Kant M., Van der Heijden J. J., Scholten E., Van Belle-van Haren N., Lagrand W. K., Vlaar A. P., De Jong S., Cander B., Sargin M., Ugur M., Kaygin M. A., Daly K., Agnew N., Head L., Kelly L., Anoma G., Russell C., Aquino V., Scott I., Flemming L., Gillon S., Moore O., Gelandt E., Auzinger G., Patel S., and Loveridge R.

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation. Methods: EuroECMO-COVID is a prospective, multicentre, observational study developed by the European Extracorporeal Life Support Organization. This study was based on data from patients aged 16 years or older who received ECMO support for refractory COVID-19 during the first wave of the pandemic—from March 1 to Sept 13, 2020—at 133 centres in 21 countries. In-hospital mortality and mortality 6 months after ECMO initiation were the primary outcomes. Mixed-Cox proportional hazards models were used to investigate associations between patient and management-related variables (eg, patient demographics, comorbidities, pre-ECMO status, and ECMO characteristics and complications) and in-hospital deaths. Survival status at 6 months was established through patient contact or institutional charts review. This study is registered with ClinicalTrials.gov, NCT04366921, and is ongoing. Findings: Between March 1 and Sept 13, 2020, 1215 patients (942 [78%] men and 267 [22%] women; median age 53 years [IQR 46–60]) were included in the study. Median ECMO duration was 15 days (IQR 8–27). 602 (50%) of 1215 patients died in hospital, and 852 (74%) patients had at least one complication. Multiorgan failure was the leading cause of death (192 [36%] of 528 patients who died with available data). In mixed-Cox analyses, age of 60 years or older, use of inotropes and vasopressors before ECMO initiation, chronic renal failure, and time from intubation to ECMO initiation of 4 days or more were associated with higher in-hospital mortality. 613 patients

Published
2023

16. ‘Het is een soort stap-voorstapmeditatie: je blijft oefenen’

Author

Tom Lormans

Subjects
Practical Theology, BV1-5099
Abstract

Dian Marie Hosking is hoogleraar Relation Process aan Utrecht School of Governance en als associate verbonden aan Taos Institute. Ze heeft haar carrière gewijd aan ‘relationeel constructionisme’ en aanverwante methodologieën van onderzoek en transformatie. Samen met Sheila McNamee schreef ze Research and Social Change: A Relational Constructionist Approach (2012). Hierin overbruggen ze wetenschappelijke vormen van onderzoek en de dagelijkse activiteiten van beoefenaars. Ze introduceren onderzoek als een proces van relationele constructie en bieden hulpmiddelen aan beoefenaars die willen nadenken over hoe hun werk praktische effecten genereert.

Published
2021
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23. ‘Verbaal repertoire meegeven in kwalitatief onderzoek’

Author

Tom Lormans

Subjects
Practical Theology, BV1-5099
Abstract

Prof.dr. Fred Wester is emeritus hoogleraar Communicatiewetenschap aan de Radboud Universiteit Nijmegen. Hij doet onderzoek naar de rol van media en mediaboodschappen: televisieprogramma’s, krantenberichten, websites, tijdschriftartikelen en reclameborden, en in het bijzonder naar de kenmerken en tendenties in de uitingen en de sociaal-culturele boodschappen die zij bevatten. Publicaties van zijn hand als Strategieën voor kwalitatief onderzoek (1996) en Inhoudsanalyse: theorie en praktijk (2013) helpen (toekomstige) onderzoekers nog altijd bij het opzetten, verhelderen en beschrijven van hun onderzoek. Ook is hij voorzitter van KWALON, een onafhankelijke organisatie van onderzoekers en docenten aan universiteiten, hogescholen, onderzoeksbureaus en andere organisaties die zich bezighouden met reflectie op de methodologie van kwalitatief sociaalwetenschappelijk onderzoek. Zijn kennis van en ervaring met het verrichten van kwalitatief onderzoek maken hem een expert van wie veel geleerd kan worden op het gebied van case studies.

Published
2019
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24. An industrial case study in reconstructing requirements views

Author

Lormans, Marco, van Deursen, Arie, and Gross, Hans-Gerhard

Abstract

Abstract: Requirements views, such as coverage and status views, are an important asset for monitoring and managing software development projects. We have developed a method that automates the process of reconstructing these views, and we have built a tool, ReqAnalyst, that supports this method. This paper presents an investigation as to which extent requirements views can be automatically generated in order to monitor requirements in industrial practice. The paper focuses on monitoring the requirements in test categories and test cases. In order to retrieve the necessary data, an information retrieval technique, called Latent Semantic Indexing, was used. The method was applied in an industrial study. A number of requirements views were defined and experiments were carried out with different reconstruction settings for generating these views. Finally, we explored how these views can help the developers during the software development process.

Published
2024
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25. Exposure to intravenous posaconazole in critically ill patients with influenza: A pharmacokinetic analysis of the POSA-FLU study

Author

Daele, R. Van, Wauters, J., Dreesen, E., Boelens, J. Jan, Nulens, E., Lormans, P., Vanderbeke, L., Jacobs, Cato, Rijnders, B., Verweij, P.E., Bruggemann, R.J.M., Spriet, I., Daele, R. Van, Wauters, J., Dreesen, E., Boelens, J. Jan, Nulens, E., Lormans, P., Vanderbeke, L., Jacobs, Cato, Rijnders, B., Verweij, P.E., Bruggemann, R.J.M., and Spriet, I.

Abstract

Item does not contain fulltext, BACKGROUND: Data on posaconazole in the critically ill are scarce. In the POSA-FLU study, we examined the prevention of influenza-associated pulmonary aspergillosis with posaconazole in this population. METHODS: In this observational sub-study, we performed a pharmacokinetic analysis, including protein binding and target attainment (TA). Blood samples were collected over a 24 h-dosing interval on both an early (Day 2 or 3) and a later (≥Day 4) treatment day. RESULTS: Target attainment was shown for AUC(0-24) and C(min) prophylaxis but not for C(min) treatment. Moreover, a saturable protein binding with a significant, positive relationship between albumin concentrations and the maximum binding capacity was observed. CONCLUSIONS: Our analysis indicates that posaconazole may be a suitable drug to further investigate for prophylaxis, as TA for prophylaxis was reached. Exposure targets for treatment were insufficiently attained in this population.

Published
2022

28. Posaconazole for prevention of invasive pulmonary aspergillosis in critically ill influenza patients (POSA-FLU): a randomised, open-label, proof-of-concept trial

Author

Vanderbeke, L., Vanderbeke, L., Janssen, N.A.F., Bergmans, D.C.J.J., Bourgeois, M., Buil, J.B., Debaveye, Y., Depuydt, P., Feys, S., Hermans, G., Hoiting, O., van der Hoven, B., Jacobs, C., Lagrou, K., Lemiale, V., Lormans, P., Maertens, J., Meersseman, P., Megarbane, B., Nseir, S., van Oers, J.A.H., Reynders, M., Rijnders, B.J.A., Schouten, J.A., Spriet, I., Thevissen, K., Thille, A.W., Van Daele, R., van de Veerdonk, F.L., Verweij, P.E., Wilmer, A., Bruggemann, R.J.M., Wauters, J., Dutch Belgian Mycosis Study Grp, Vanderbeke, L., Vanderbeke, L., Janssen, N.A.F., Bergmans, D.C.J.J., Bourgeois, M., Buil, J.B., Debaveye, Y., Depuydt, P., Feys, S., Hermans, G., Hoiting, O., van der Hoven, B., Jacobs, C., Lagrou, K., Lemiale, V., Lormans, P., Maertens, J., Meersseman, P., Megarbane, B., Nseir, S., van Oers, J.A.H., Reynders, M., Rijnders, B.J.A., Schouten, J.A., Spriet, I., Thevissen, K., Thille, A.W., Van Daele, R., van de Veerdonk, F.L., Verweij, P.E., Wilmer, A., Bruggemann, R.J.M., Wauters, J., and Dutch Belgian Mycosis Study Grp

Abstract

Purpose Influenza-associated pulmonary aspergillosis (IAPA) is a frequent complication in critically ill influenza patients, associated with significant mortality. We investigated whether antifungal prophylaxis reduces the incidence of IAPA. Methods We compared 7 days of intravenous posaconazole (POS) prophylaxis with no prophylaxis (standard-of-care only, SOC) in a randomised, open-label, proof-of-concept trial in patients admitted to an intensive care unit (ICU) with respiratory failure due to influenza (ClinicalTrials.gov, NCT03378479). Adult patients with PCR-confirmed influenza were block randomised (1:1) within 10 days of symptoms onset and 48 h of ICU admission. The primary endpoint was the incidence of IAPA during ICU stay in patients who did not have IAPA within 48 h of ICU admission (modified intention-to-treat (MITT) population). Results Eighty-eight critically ill influenza patients were randomly allocated to POS or SOC. IAPA occurred in 21 cases (24%), the majority of which (71%, 15/21) were diagnosed within 48 h of ICU admission, excluding them from the MITT population. The incidence of IAPA was not significantly reduced in the POS arm (5.4%, 2/37) compared with SOC (11.1%, 4/36; between-group difference 5.7%; 95% CI - 10.8 to 21.7; p = 0.32). ICU mortality of early IAPA was high (53%), despite rapid antifungal treatment. Conclusion The higher than expected incidence of early IAPA precludes any definite conclusion on POS prophylaxis. High mortality of early IAPA, despite timely antifungal therapy, indicates that alternative management strategies are required. After 48 h, still 11% of patients developed IAPA. As these could benefit from prophylaxis, differentiated strategies are likely needed to manage IAPA in the ICU.

Published
2021

29. In-hospital and 6-month outcomes in patients with COVID-19 supported with extracorporeal membrane oxygenation (EuroECMO-COVID): a multicentre, prospective observational study

Author

Lorusso, Roberto, De Piero, Maria Elena, Mariani, Silvia, Di Mauro, Michele, Folliguet, Thierry, Taccone, Fabio Silvio, Camporota, Luigi, Swol, Justyna, Wiedemann, Dominik, Belliato, Mirko, Broman, Lars Mikael, Vuylsteke, Alain, Kassif, Yigal, Scandroglio, Anna Mara, Fanelli, Vito, Gaudard, Philippe, Ledot, Stephane, Barker, Julian, Boeken, Udo, Maier, Sven, Kersten, Alexander, Meyns, Bart, Pozzi, Matteo, Pedersen, Finn M, Schellongowski, Peter, Kirali, Kaan, Barrett, Nicholas, Riera, Jordi, Mueller, Thomas, Belohlavek, Jan, Lorusso, Roberto, De Piero, Maria Elena, Mariani, Silvia, Di Mauro, Michele, Folliguet, Thierry, Taccone, Fabio Silvio, Camporota, Luigi, Swol, Justyna, Wiedemann, Dominik, Belliato, Mirko, Broman, Lars Mikael, Vuylsteke, Alain, Kassif, Yigal, Scandroglio, Anna Mara, Fanelli, Vito, Gaudard, Philippe, Ledot, Stephane, Barker, Julian, Boeken, Udo, Maier, Sven, Kersten, Alexander, Meyns, Bart, Pozzi, Matteo, Pedersen, Finn M, Schellongowski, Peter, Kirali, Kaan, Barrett, Nicholas, Riera, Jordi, Mueller, Thomas, Belohlavek, Jan, Lo Coco, Valeria, Van der Horst, Iwan C C, Van Bussel, Bas C T, Schnabel, Ronny M, Delnoij, Thijs, Bolotin, Gil, Lorini, Luca, Schmiady, Martin O, Schibilsky, David, Kowalewski, Mariusz, Pinto, Luis F, Silva, Pedro E, Kornilov, Igor, Blandino Ortiz, Aaron, Vercaemst, Leen, Finney, Simon, Roeleveld, Peter P, Di Nardo, Matteo, Hennig, Felix, Antonini, Marta Velia, Davidson, Mark, Jones, Tim J, Staudinger, Thomas, Mair, Peter, Kilo, Juliane, Krapf, Christoph, Erbert, Kathrin, Peer, Andreas, Bonaros, Nikolaos, Kotheletner, Florian, Krenner Mag, Niklas, Shestakova, Liana, Hermans, Greet, Dauwe, Dieter, Meersseman, Philippe, Stockman, Bernard, Nobile, Leda, Lhereux, Olivier, Nrasseurs, Alexandre, Creuter, Jacques, De Backer, Daniel, Giglioli, Simone, Michiels, Gregoire, Foulon, Pierre, Raes, Matthias, Rodrigus, Inez, Allegaert, Matthias, Jorens, Philippe, Debeucklare, Gerd, Piagnerelli, Michael, Biston, Patrick, Peperstraete, Harlinde, Vandewiele, Komeel, Germay, Olivier, Vandeweghe, Dimitri, Havrin, Sven, Bourgeois, Marc, Lagny, Marc-Gilbert, Alois, Genette, Lavios, Nathalie, Misset, Benoit, Courcelle, Romain, Timmermans, Philippe J, Yilmaz, Alaaddin, Vantomout, Michiel, Lehaen, Jerone, Jassen, Ame, Guterman, Herbert, Strauven, Maarten, Lormans, Piet, Verhamme, Bruno, Vandewaeter, catherine, Bonte, Frederik, Vionne, Dominique, Balik, Martin, Blàha, Jan, Lips, Michal, Othal, Michal, Bursa, Filip, Spacek, Radim, Christensen, Steffen, Jorgensen, Vibeke, Sorensen, Marc, Madsen, Soren A, Puss, Severin, Beljantsev, Aleksandr, Saiydoun, gabriel, Fiore, Antonio, Colson, Pascal, Bazalgette, Florian, Capdevila, Xavier, Kollen, Sebastien, Muller, Laurent, Obadia, Jean-Francois, Dubien, Pierre-Yves, Ajrhourh, Lucrezia, Guinot, Pierre G, Zarka, Jonathan, Besserve, Patricia, Malfertheiner, Maximilian V, Dreier, Esther, Heinze, Birgit, Akhyari, Payam, Lichtenberg, Artur, Aubin, Hug, Assman, Alexander, Saeed, Diyar, Thiele, Holger, Baumgaertel, Matthias, Schmitto, Jan D, Ruslan, Natanov, Haverich, Axel, Thielmann, Matthias, Brenner, Thorsten, Ruhpawar, Arjang, Benk, Christoph, Czerny, Martin, Staudacher, Dawid L, Beyersdorf, Fridhelm, Kalbhenn, Johannes, Henn, Philipp, Popov, Aron-Frederik, Iuliu, Torje, Muellenbach, Ralf, Reyher, Christian, Rolfes, Caroline, Lotz, Gosta, Sonntagbauer, Michael, Winkels, Helen, Fichte, Julia, Stohr, Robert, Kalverkamp, Sebastian, Karagiannidis, Christian, Schafer, Simone, Svetlitchny, Alexei, Fichte, Julia, Hopf, Hans-Bernd, Jarczak, Dominik, Groesdonk, Heinirich, Rommer, Magdalena, Hirsch, Jan, Kaehny, Christian, Soufleris, Dimitros, Gavriilidis, Georgios, Pontikis, Kostantinos, Kyriakopoulou, Magdalini, Kyriakoudi, Anna, O'Brien, Serena, Conrick-Martin, Ian, Carton, Edmund, Makhoul, Maged, Ben-Ari, Josef, Hadash, Amir, Kogan, Alexander, Kassif Lerner, Reut, Abu-Shakra, Anas, Matan, Moshe, Balawona, Ahmad, Kachel, Erez, Altshuler, Roman, Galante, Ori, Fuchs, Lior, Almog, Yaniv, Ishay, Yaron S, Lichter, Yael, Gal-oz, Amir, Carmi, Uri, Nini, Asaph, Soroksky, Arie, Dekel, Hagi, Rozman, Ziv, Tayem, Emad, Ilgiyaev, Eduard, Hochman, Yuval, Miltau, daniel, Rapoport, Avigal, Eden, Arieh, Kompanietz, Dmitry, Yousif, Michael, Golos, Miri, Grazioli, Lorenzo, Ghitti, Davide, Loforte, Antonio, Di Luca, Daniela, Baiocchi, Massimo, Pacini, Davide, Cappai, Antioco, Meani, Paolo, Mondino, Michele, Russo, Claudio F, Ranucci, Marco, Fina, Dario, Cotza, Marco, Ballotta, Andrea, Landoni, Giovanni, Nardelli, Pasquale, Fominski, Eygeny V, Brazzi, Luca, Montrucchio, Giorgia, Sales, Gabriele, Simonetti, Umberto, Livigni, Sergio, Silengo, Daniela, Arena, Giulia, Sovatzis, Stefania S, Degani, Antonella, Riccardi, Mariachiara, Milanesi, Elisa, Raffa, Giuseppe, Martucci, Gennaro, Arcadipane, Antonio, Panarello, Giovanna, Chiarini, Giovanni, Cattaneo, Sergio, Puglia, Carmine, Benussi, Stefano, Foti, Giuseppe, Giani, Marco, Bombino, Michela, Costa, Maria Cristina, Rona, Roberto, Avalli, Leonello, Donati, Abele, Carozza, Roberto, Gasparri, Francesco, Carsetti, Andrea, Picichè, Marco, Marinello, Anna, Danzi, Vinicio, Zanin, Anita, Condello, Ignazio, Fiore, Flavio, Moscarelli, Marco, Nasso, Giuseppe, Speziale, Giuseppe, Sandrelli, Luca, Montalto, Andrea, Musumeci, Francesco, Circelli, Alessandro, Russo, Emanuele, Agnoletti, Vanni, Rociola, Ruggero, Milano, Aldo D, Pilato, Emanuele, Comentale, Giuseppe, Montisci, Andrea, Alessandri, Francesco, Tosi, Antonella, Pugliese, Francesco, Giordano, Giovanni, Carelli, Simone, Grieco, Domenico L, Dell'Anna, Antonio M, Antonelli, Massimo, Ramoni, Enrico, Zulueta, Josè, Del Giglio, Mauro, Petracca, Sebastiano, Bertini, Pietro, Guarracino, Fabio, De Simone, Luigi, Angeletti, Paolo M, Forfori, Francesco, Taraschi, Francesco, Quintiliani, Veronica N, Samalavicius, Robertas, Jankuviene, Agne, Scupakova, Nadezda, Urbonas, Karolis, Kapturauskas, Juozas, Soerensen, Gro, Suwalski, Piotr, Linhares Santos, Luis, Marques, Ana, Miranda, Marisa, Teixeira, Sonia, Salgueiro, Andrea, Pereira, Filipe, Ketskalo, Michail, Tsarenko, Sergey, Shilova, Alexandra, Afukov, Ivan, Popugaev, Konstantin, Minin, Sergei, Shelukhin, Daniil, Malceva, Olga, Gleb, Moroz, Skopets, Alexander, Kornelyuk, Roman, Kulikov, Alexandr, Okhrimchuk, Vadim, Turchaninov, Alexandr, Shelukhin, Daniil, Petrushin, Maxim, Sheck, Anastasia, Mekulov, Akhmed, Ciryateva, Svetlana, Urusov, Dmitry, Gorjup, Vojka, Golicnik, Alenka, Goslar, Tomaz, Ferrer, Ricard, Martinez-Martinez, Maria, Argudo, Eduard, Palmer, Neiser, De Pablo Sanchez, Raul, Juan Higuera, Lucas, Arnau Blasco, Lucas, Marquez, Josè A, Sbraga, Fabrizio, Fuset, Mari Paz, De Gopegui, Pablo Ruiz, Claraco, Luis M, De Ayala, Josè A, Peiro, Maranta, Ricart, Pilar, Martinez, Sergio, Chavez, Fernando, Fabra, Marc, Sandoval, elena, Toapanta, David, Carraminana, Albert, Tellez, Adrian, Ososio, Jeysson, Milan, Pablo, Rodriguez, Jorge, Andoni, Garcia, Gutierrez, Carola, Perez de la Sota, Enrique, Eixeres-Esteve, Andrea, Garcia-Maellas, Maria Teresa, Gutierrez-Gutierrez, Judit, Arboleda-Salazar, Rafael, Santa Teresa, Patricia, Jaspe, Alexis, Garrido, Alberto, Castaneda, Galo, Alcantara, Sara, Martinez, Nuria, Perez, Marina, Villanueva, Hector, Vidal Gonzalez, Anxela, Paez, Juan, Santon, Arnoldo, Perez, Cesar, Lopez, Marta, Rubio Lopez, Maria Isabel, Gordillo, Antonio, Naranjo-Izurieta, Jose, Munoz, Javier, Alcalde, Immaculada, Onieva, Fernando, Gimeno Costa, Ricardo, Perez, Francisco, Madrid, Isabel, Gordon, Monica, Albacete Moreno, Carlos L, Perez, Daniel, Lopez, Nayara, Martinenz, Domingo, Blanco-Schweizer, Pablo, Diez, Cristina, Perez, David, Prieto, Ana, Renedo, Gloria, Bustamante, Elena, Cicuendez, Ramon, Citores, Rafael, Boado, Victoria, Garcia, Katherine, Voces, Roberto, Domezain, Monica, Nunez Martinez, Jose Maria, Vicente, Raimundo, Martin, David, Andreu, Antonio, Gomez Casal, Vanesa, Chico, Ignacio, Menor, Eva Maria, Vara, Sabela, Gamacho, Jose, Perez-Chomon, Helen, Javier Gonzales, Francisco, Barrero, Irene, Martin-Villen, Luis, Fernandez, Esperanza, Mendoza, Maria, Navarro, Joaquin, Colomina Climent, Joaquin, Gonzales-Perez, Alfredo, Muniz-Albaceita, Guillermo, Amado, Laura, Rodriguez, Raquel, Ruiz, Emilio, Eiras, Maria, Grins, Edgars, Magnus, Rosen, Kanetoft, Mikael, Eidevald, Marcus, Watson, Pia, Vogt, Paul R, Steiger, Peter, Aigner, Tobias, Weber, Alberto, Grunefelder, Jurg, Kunz, Martin, Grapow, Martin, Aymard, Thierry, Reser, Diana, Agus, Gianluca, Consiglio, Jolanda, Haenggi, Matthias, Hansjoerg, Jenni, Iten, Manuela, Doeble, Thomas, Zenklusen, Urs, Bechtold, Xavier, Faedda, Giovanni, Iafrate, Manuel, Rohjer, Amanda, Bergamaschi, Layla, Maessen, Jos, Reis Miranda, Dinis, Endeman, H, Gommers, D, Meuwese, C, Maas, Jacinta, Van Gijlswijk, MJ, Van Berg, RN, Candura, Dario, Van der Linden, Marcel, Kant, Merijin, Van der Heijden, JJ, Scholten, Eric, Van Belle-van Haren, Nicole, Lagrand, WK, Vlaar, Alexander P, De Jong, Syste, Cander, Basar, Sargin, Murat, Ugur, Murat, Kaygin, Mehmet A, Daly, Kathleen, Agnew, Nicola, Head, Laura, Kelly, Laura, Anoma, Gunawardena, Russell, Clare, Aquino, Verna, Scott, Ian, Flemming, Lucy, Gillon, Stuart, Moore, Olivia, Gelandt, Elton, Auzinger, George, Patel, Sameer, and Loveridge, Robert

Abstract

Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation.

Published
2023
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36. Successful double-lung transplantation from a donor previously infected with SARS-CoV-2.

Author

Ceulemans, Laurens J, Van Slambrouck, Jan, De Leyn, Paul, Decaluwé, Herbert, Van Veer, Hans, Depypere, Lieven, Ceuterick, Vincent, Verleden, Stijn E, Vanstapel, Arno, Desmet, Stefanie, Maes, Piet, Van Ranst, Marc, Lormans, Piet, Meyfroidt, Geert, Neyrinck, Arne P, Vanaudenaerde, Bart M, Van Wijngaerden, Eric, Bos, Saskia, Godinas, Laurent, and Carmeliet, Peter

Subjects
SARS-CoV-2, LUNG transplantation
Abstract

Lung transplantation from a donor previously infected with SARS-CoV-2 [ABSTRACT FROM AUTHOR]

Published
2021
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40. Towards Software Component Procurement Automation with Latent Semantic Analysis.

Author

Gross, Hans-Gerhard, Lormans, Marco, and Zhou, Jun

Subjects
SEMANTICS, COMPARATIVE linguistics, SEMANTIC networks (Information theory), COMPUTER science, INFORMATION science
Abstract

Abstract: One of the first steps of component procurement is the identification of required component features in large repositories of existing components. On the highest level of abstraction, component requirements as well as component descriptions are usually written in natural language. Therefore, we can reformulate component procurement as a text analysis problem and apply latent semantic analysis for automatically identifying suitable existing components in large repositories, based on the descriptions of required component features. In this article, we motivate our choice of this technique for feature identification, describe how it can be applied to feature tracing problems, and discuss the results that we achieved with the application of this technique in a number of case studies. [Copyright &y& Elsevier]

Published
2007
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42. Transcortical Sensory Aphasia in a Right-Handed Patient Following Watershed Infarcts in the Right Cerebral Hemisphere: A 15-Month Evaluation of Another Case of Crossed Aphasia

Author

Roebroek, R.M.J.A., Promes, M.M., Korten, J.J., Lormans, A.C.M., and van der Laan, R.T.

Abstract

Well-documented cases of crossed (transcortical sensory) aphasia, especially those with longitudinal evaluation, are rare. We report a case of crossed transcortical sensory aphasia following watershed infarcts in the right hemisphere, from the moment of the accident until 15 months afterward. The aphasia type, and the course of recovery, is a “mirror” representation of that seen in cases of uncrossed aphasia. Unfortunately, the data do not permit strong conclusions regarding the lateralization of language in association with praxis and visuospatial abilities. This underlines the need for more well-documented (case) studies to come to a better understanding of the mechanisms through which lateralization occurs.

Published
1999
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44. Spontaneous pneumomediastinum in Covid-19 : a case of complete resolution despite invasive positive pressure ventilation

Author

Martha Wolfskeil, Devriendt, Y., Dumoulin, A., and Lormans, P.

Subjects
Anesthesiology and Pain Medicine, covid-19, patient self-inflicted lung injury, Medicine and Health Sciences, lung protective ventilation, case report, General Medicine, Spontaneous pneumomediastinum
Abstract

We present the case of a 65-year-old patient who was admitted to the intensive care unit (ICU) due to Covid-19 respiratory failure. During his hospital stay, he developed a spontaneous pneumomediastinum (SP). To date, there have been few reports of SP associated with Covid-19 and even less is known about the impact of positive pressure ventilation on these patients. Our patient was first treated with high-flow nasal cannula oxygen therapy (HFNC). Because of further respiratory deterioration, he was supported with non-invasive ventilation (NIV). Later, he required intubation and ventilation with invasive positive pressure ventilation. Despite this, a complete spontaneous resolution of the pneumomediastinum was observed 13 days after the initial diagnosis.

45. Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury: The TRAIN Randomized Clinical Trial.

Author

Taccone FS, Rynkowski Bittencourt C, Møller K, Lormans P, Quintana-Díaz M, Caricato A, Cardoso Ferreira MA, Badenes R, Kurtz P, Søndergaard CB, Colpaert K, Petterson L, Quintard H, Cinotti R, Gouvêa Bogossian E, Righy C, Silva S, Roman-Pognuz E, Vandewaeter C, Lemke D, Huet O, Mahmoodpoor A, Blandino Ortiz A, van der Jagt M, Chabanne R, Videtta W, Bouzat P, and Vincent JL

Abstract

Importance: Blood transfusions are commonly administered to patients with acute brain injury. The optimal hemoglobin transfusion threshold is uncertain in this patient population., Objective: To assess the impact on neurological outcome of 2 different hemoglobin thresholds to guide red blood cell transfusions in patients with acute brain injury., Design, Setting, and Participants: Multicenter, phase 3, parallel-group, investigator-initiated, pragmatic, open-label randomized clinical trial conducted in 72 intensive care units across 22 countries. Eligible patients had traumatic brain injury, aneurysmal subarachnoid hemorrhage, or intracerebral hemorrhage; hemoglobin values below 9 g/dL within the first 10 days after injury; and an expected intensive care unit stay of at least 72 hours. Enrollment occurred between September 1, 2017, and December 31, 2022. The last day of follow-up was June 30, 2023., Interventions: Eight hundred fifty patients were randomly assigned to undergo a liberal (transfusion triggered by hemoglobin <9 g/dL; n = 408) or a restrictive (transfusion triggered by hemoglobin <7 g/dL; n = 442) transfusion strategy over a 28-day period., Main Outcomes and Measures: The primary outcome was occurrence of an unfavorable neurological outcome, defined as a Glasgow Outcome Scale Extended score between 1 and 5, at 180 days following randomization. There were 14 prespecified serious adverse events, including occurrence of cerebral ischemia after randomization., Results: Among 820 patients who completed the trial (mean age, 51 years; 376 [45.9%] women), 806 had available data on the primary outcome, 393 in the liberal strategy group and 413 in the restrictive strategy group. The liberal strategy group received a median of 2 (IQR, 1-3) units of blood, and the restrictive strategy group received a median of 0 (IQR, 0-1) units of blood, with an absolute mean difference of 1.0 unit (95% CI, 0.87-1.12 units). At 180 days after randomization, 246 patients (62.6%) in the liberal strategy group had an unfavorable neurological outcome compared with 300 patients (72.6%) in the restrictive strategy group (absolute difference, -10.0% [95% CI, -16.5% to -3.6%]; adjusted relative risk, 0.86 [95% CI, 0.79-0.94]; P = .002). The effect of the transfusion thresholds on neurological outcome at 180 days was consistent across prespecified subgroups. In the liberal strategy group, 35 (8.8%) of 397 patients had at least 1 cerebral ischemic event compared with 57 (13.5%) of 423 in the restrictive strategy group (relative risk, 0.65 [95% CI, 0.44-0.97])., Conclusions and Relevance: Patients with acute brain injury and anemia randomized to a liberal transfusion strategy were less likely to have an unfavorable neurological outcome than those randomized to a restrictive strategy., Trial Registration: ClinicalTrials.gov Identifier: NCT02968654.

Published
2024
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46. Hip Fracture in the Sportive Adult: Case Report of Complete Functional Recovery After Removal of Hardware.

Author

Lormans P, Loos PJ, Vanbrabant S, Quetin P, Huybrechts X, and Ghekiere O

Abstract

Context: Pertrochanteric hip fractures in sportive young adults are mainly caused by a high-energy trauma and treated in the same way as in the older population, using an osteosynthesis immediately followed by a rehabilitation program for several months. The current standard is not to remove osteosynthesis material, similar to the case of older patients., Case Presentation: A 45-year-old male cyclist experienced a right pertrochanteric femoral fracture, treated with cephalomedullary nails. After 9 months of adequate rehabilitation, weakness of the quadriceps musculature and functional complaints persisted, objectified through an isokinetic strength test and a significantly reduced score on the Hip Disability and Osteoarthritis Outcome Score questionnaire. The patient was unable to return to his previous level of cycling performance., Management and Outcome: After exclusion of structural bone complications, nerve injury, and central sensitization, the functional complaints and strength deficiency were hypothesized to be related to the osteosynthesis material. Therefore, the hardware was removed 9 months after the first surgery, and the rehabilitation was continued for another 20 weeks. Very soon after the removal of the hardware, the functional complaints disappeared with a remarkable improvement of the Hip Disability and Osteoarthritis Outcome Score. The isokinetic strength test showed complete recovery of muscle strength 20 weeks after osteosynthesis removal, and preinjury cycling performance values were obtained 9 months posthardware removal., Conclusion: Despite an adequate rehabilitation following a hip fracture, sporty young adults may fail to reach their previous level of functioning. Osteosynthesis removal may be indicated in this sportive population to reach complete muscle strength and functional recovery. The management of hip fractures in the sportive young adult and the identification of patients who may benefit from removal of the hardware require more research.

Published
2024
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47. Exposure to intravenous posaconazole in critically ill patients with influenza: A pharmacokinetic analysis of the POSA-FLU study.

Author

Van Daele R, Wauters J, Dreesen E, Boelens J, Nulens E, Lormans P, Vanderbeke L, Jacobs C, Rijnders B, Verweij PE, Brüggemann RJ, and Spriet I

Subjects
Administration, Intravenous, Antifungal Agents, Humans, Triazoles, Critical Illness therapy, Influenza, Human drug therapy, Influenza, Human prevention & control
Abstract

Background: Data on posaconazole in the critically ill are scarce. In the POSA-FLU study, we examined the prevention of influenza-associated pulmonary aspergillosis with posaconazole in this population., Methods: In this observational sub-study, we performed a pharmacokinetic analysis, including protein binding and target attainment (TA). Blood samples were collected over a 24 h-dosing interval on both an early (Day 2 or 3) and a later (≥Day 4) treatment day., Results: Target attainment was shown for AUC 0-24 and C min prophylaxis but not for C min treatment. Moreover, a saturable protein binding with a significant, positive relationship between albumin concentrations and the maximum binding capacity was observed., Conclusions: Our analysis indicates that posaconazole may be a suitable drug to further investigate for prophylaxis, as TA for prophylaxis was reached. Exposure targets for treatment were insufficiently attained in this population., (© 2022 Wiley-VCH GmbH.)

Published
2022
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48. Risk factors and outcome of pulmonary aspergillosis in critically ill coronavirus disease 2019 patients-a multinational observational study by the European Confederation of Medical Mycology.

Author

Prattes J, Wauters J, Giacobbe DR, Salmanton-García J, Maertens J, Bourgeois M, Reynders M, Rutsaert L, Van Regenmortel N, Lormans P, Feys S, Reisinger AC, Cornely OA, Lahmer T, Valerio M, Delhaes L, Jabeen K, Steinmann J, Chamula M, Bassetti M, Hatzl S, Rautemaa-Richardson R, Koehler P, Lagrou K, and Hoenigl M

Subjects
Aged, Critical Illness, Humans, Intensive Care Units, Mycology, Risk Factors, SARS-CoV-2, COVID-19 complications, COVID-19 epidemiology, COVID-19 therapy, Invasive Pulmonary Aspergillosis diagnosis, Invasive Pulmonary Aspergillosis drug therapy, Invasive Pulmonary Aspergillosis epidemiology, Pulmonary Aspergillosis complications, Pulmonary Aspergillosis epidemiology
Abstract

Objectives: Coronavirus disease 2019 (COVID-19) -associated pulmonary aspergillosis (CAPA) has emerged as a complication in critically ill COVID-19 patients. The objectives of this multinational study were to determine the prevalence of CAPA in patients with COVID-19 in intensive care units (ICU) and to investigate risk factors for CAPA as well as outcome., Methods: The European Confederation of Medical Mycology (ECMM) conducted a multinational study including 20 centres from nine countries to assess epidemiology, risk factors and outcome of CAPA. CAPA was defined according to the 2020 ECMM/ISHAM consensus definitions., Results: A total of 592 patients were included in this study, including 11 (1.9%) patients with histologically proven CAPA, 80 (13.5%) with probable CAPA, 18 (3%) with possible CAPA and 483 (81.6%) without CAPA. CAPA was diagnosed a median of 8 days (range 0-31 days) after ICU admission predominantly in older patients (adjusted hazard ratio (aHR) 1.04 per year; 95% CI 1.02-1.06) with any form of invasive respiratory support (HR 3.4; 95% CI 1.84-6.25) and receiving tocilizumab (HR 2.45; 95% CI 1.41-4.25). Median prevalence of CAPA per centre was 10.7% (range 1.7%-26.8%). CAPA was associated with significantly lower 90-day ICU survival rate (29% in patients with CAPA versus 57% in patients without CAPA; Mantel-Byar p < 0.001) and remained an independent negative prognostic variable after adjusting for other predictors of survival (HR 2.14; 95% CI 1.59-2.87, p ≤ 0.001)., Conclusion: Prevalence of CAPA varied between centres. CAPA was significantly more prevalent among older patients, patients receiving invasive ventilation and patients receiving tocilizumab, and was an independent strong predictor of ICU mortality., (Copyright © 2021 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2022
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49. Status Epilepticus Following Intrathecal Administration of Bupivacaine: A Case Report.

Author

Vanmarcke A, Lormans P, and Vandewaeter C

Subjects
Aged, Bupivacaine adverse effects, Double-Blind Method, Female, Humans, Injections, Spinal adverse effects, Anesthesia, Spinal adverse effects, Anesthesia, Spinal methods, Status Epilepticus chemically induced, Status Epilepticus drug therapy
Abstract

Spinal anesthesia is common practice and rarely causes complications. Although extended experience is present, seldom side effects of this technique and the administration of intrathecal local anesthetics and/or opioids can occur. We present a case in which a 76-year old woman undergoing total hip arthroplasty received a low dose of intrathecal bupivacaine and sufentanil. One hour after administration, she developed myoclonic seizures of the lower extremities followed by generalized tonic-clonic seizures and status epilepticus. We conclude that status epilepticus is a rare and possible lethal side effect of intrathecal bupivacaine. Symptoms may be misleading, highlighting the importance of early recognition and adequate management.

Published
2022
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50. Multinational Observational Cohort Study of COVID-19-Associated Pulmonary Aspergillosis 1 .

Author

Janssen NAF, Nyga R, Vanderbeke L, Jacobs C, Ergün M, Buil JB, van Dijk K, Altenburg J, Bouman CSC, van der Spoel HI, Rijnders BJA, Dunbar A, Schouten JA, Lagrou K, Bourgeois M, Reynders M, van Regenmortel N, Rutsaert L, Lormans P, Feys S, Debavaye Y, Tamion F, Costa D, Maizel J, Dupont H, Chouaki T, Nseir S, Sendid B, Brüggemann RJM, van de Veerdonk FL, Wauters J, and Verweij PE

Subjects
Cohort Studies, Humans, SARS-CoV-2, COVID-19, Invasive Pulmonary Aspergillosis, Pulmonary Aspergillosis
Abstract

We performed an observational study to investigate intensive care unit incidence, risk factors, and outcomes of coronavirus disease-associated pulmonary aspergillosis (CAPA). We found 10%-15% CAPA incidence among 823 patients in 2 cohorts. Several factors were independently associated with CAPA in 1 cohort and mortality rates were 43%-52%.

Published
2021
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