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9. The Nordic perioperative and intensive care registries—Collaboration and research possibilities

Author

Kvåle, Reidar, primary, Möller, Morten Hylander, additional, Porkkala, Timo, additional, Varpula, Tero, additional, Enlund, Gunnar, additional, Engerstrôm, Lars, additional, Sigurdsson, Martin Ingi, additional, Thormar, Katrin, additional, Garde, Kim, additional, Christensen, Steffen, additional, Buanes, Eirik Alnes, additional, and Sverrisson, Kristinn, additional

Published
2023
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10. The Nordic perioperative and intensive care registries-Collaboration and research possibilities

Author

Kvale, Reidar, Moller, Morten Hylander, Porkkala, Timo, Varpula, Tero, Enlund, Gunnar, Engerström, Lars, Sigurdsson, Martin Ingi, Thormar, Katrin, Garde, Kim, Christensen, Steffen, Buanes, Eirik Alnes, Sverrisson, Kristinn, Kvale, Reidar, Moller, Morten Hylander, Porkkala, Timo, Varpula, Tero, Enlund, Gunnar, Engerström, Lars, Sigurdsson, Martin Ingi, Thormar, Katrin, Garde, Kim, Christensen, Steffen, Buanes, Eirik Alnes, and Sverrisson, Kristinn

Abstract

Background: The Nordic perioperative and intensive care registries have been built up during the last 25 years to improve quality in intensive and perioperative care. We aimed to describe the Nordic perioperative and intensive care registries and to highlight possibilities and challenges in future research collaboration between these registries.Material and method: We present an overview of the following Nordic registries: Swedish Perioperative Registry (SPOR), the Danish Anesthesia Database (DAD), the Finnish Perioperative Database (FIN-AN), the Icelandic Anesthesia Database (IS-AN), the Danish Intensive Care Database (DID), the Swedish Intensive Care Registry (SIR), the Finnish Intensive Care Consortium, the Norwegian Intensive Care and Pandemic Registry (NIPaR), and the Icelandic Intensive Care Registry (IS-ICU).Results: Health care systems and patient populations are similar in the Nordic countries. Despite certain differences in data structure and clinical variables, the perioperative and intensive care registries have enough in common to enable research collaboration. In the future, even a common Nordic registry could be possible.Conclusion: Collaboration between the Nordic perioperative and intensive care registries is both possible and likely to produce research of high quality. Research collaboration between registries may have several add-on effects and stimulate international standardization regarding definitions, scoring systems, and benchmarks, thereby improving overall quality of care.

Published
2023
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13. Three-year mortality in 30-day survivors of critical care with acute kidney injury: data from the prospective observational FINNAKI study

Author

Mildh, Henriikka, Pettilä, Ville, Korhonen, Anna-Maija, Karlsson, Sari, Ala-Kokko, Tero, Reinikainen, Matti, Vaara, Suvi T., Laru-Sompa, Raili, Pulkkinen, Anni, Saarelainen, Minna, Reilama, Mikko, Tolmunen, Sinikka, Rantalainen, Ulla, Miettinen, Marja, Suvela, Markku, Pesola, Katrine, Saastamoinen, Pekka, Kauppinen, Sirpa, Pettilä, Ville, Kaukonen, Kirsi-Maija, Nisula, Sara, Vaara, Suvi, Suojaranta-Ylinen, Raili, Mildh, Leena, Haapio, Mikko, Nurminen, Laura, Sutinen, Sari, Pettilä, Leena, Laitinen, Helinä, Syrjä, Heidi, Henttonen, Kirsi, Lappi, Elina, Boman, Hillevi, Varpula, Tero, Porkka, Päivi, Sivula, Mirka, Rahkonen, Mira, Tsurkka, Anne, Nieminen, Taina, Pirttinen, Niina, Alaspää, Ari, Salanto, Ville, Juntunen, Hanna, Sanisalo, Teija, Parviainen, Ilkka, Uusaro, Ari, Ruokonen, Esko, Bendel, Stepani, Rissanen, Niina, Lång, Maarit, Rahikainen, Sari, Rissanen, Saija, Ahonen, Merja, Halonen, Elina, Vaskelainen, Eija, Poukkanen, Meri, Lintula, Esa, Suominen, Sirpa, Heikkinen, Jorma, Lavander, Timo, Heinonen, Kirsi, Juopperi, Anne-Mari, Kaminski, Tadeusz, Gäddnäs, Fiia, Kuusela, Tuija, Roiko, Jane, Karlsson, Sari, Reinikainen, Matti, Surakka, Tero, Jyrkönen, Helena, Eiserbeck, Tanja, Kallinen, Jaana, Ala-Kokko, Tero, Laurila, Jouko, Sälkiö, Sinikka, Lund, Vesa, Tuominen, Päivi, Perkola, Pauliina, Tuominen, Riikka, Hietaranta, Marika, Johansson, Satu, Hovilehto, Seppo, Kirsi, Anne, Tiainen, Pekka, Myllärinen, Tuija, Leino, Pirjo, Toropainen, Anne, Kuitunen, Anne, Tenhunen, Jyrki, Leppänen, Ilona, Levoranta, Markus, Hoppu, Sanna, Sauranen, Jukka, Kukkurainen, Atte, Kortelainen, Samuli, Varila, Simo, Inkinen, Outi, Koivuviita, Niina, Kotamäki, Jutta, Laine, Anu, Koivisto, Simo-Pekka, Hautamäki, Raku, Skinnar, Maria, and the FINNAKI Study Group

Published
2016
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15. The predictive value of soluble urokinase plasminogen activator receptor (SuPAR) regarding 90-day mortality and 12-month neurological outcome in critically ill patients after out-of-hospital cardiac arrest. Data from the prospective FINNRESUSCI study

Author

Jalkanen, Ville, Vaahersalo, Jukka, Pettilä, Ville, Kurola, Jouni, Varpula, Tero, Tiainen, Marjaana, Huhtala, Heini, Alaspää, Ari, Hovilehto, Seppo, Kiviniemi, Outi, Kuitunen, Anne, and Tenhunen, Jyrki

Published
2014
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19. A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries

Author

Chew, Michelle S., Kattainen, Salla, Haase, Nicolai, Buanes, Eirik A., Kristinsdottir, Linda B., Hofsø, Kristin, Laake, Jon Henrik, Kvåle, Reidar, Hästbacka, Johanna, Reinikainen, Matti, Bendel, Stepani, Varpula, Tero, Walther, Sten, Perner, Anders, Flaatten, Hans K., Sigurdsson, Martin I., Chew, Michelle S., Kattainen, Salla, Haase, Nicolai, Buanes, Eirik A., Kristinsdottir, Linda B., Hofsø, Kristin, Laake, Jon Henrik, Kvåle, Reidar, Hästbacka, Johanna, Reinikainen, Matti, Bendel, Stepani, Varpula, Tero, Walther, Sten, Perner, Anders, Flaatten, Hans K., and Sigurdsson, Martin I.

Abstract

Background: We sought to provide a description of surge response strategies and characteristics, clinical management and outcomes of patients with severe COVID-19 in the intensive care unit (ICU) during the first wave of the pandemic in Denmark, Finland, Iceland, Norway and Sweden. Methods: Representatives from the national ICU registries for each of the five countries provided clinical data and a description of the strategies to allocate ICU resources and increase the ICU capacity during the pandemic. All adult patients admitted to the ICU for COVID-19 disease during the first wave of COVID-19 were included. The clinical characteristics, ICU management and outcomes of individual countries were described with descriptive statistics. Results: Most countries more than doubled their ICU capacity during the pandemic. For patients positive for SARS-CoV-2, the ratio of requiring ICU admission for COVID-19 varied substantially (1.6%–6.7%). Apart from age (proportion of patients aged 65 years or over between 29% and 62%), baseline characteristics, chronic comorbidity burden and acute presentations of COVID-19 disease were similar among the five countries. While utilization of invasive mechanical ventilation was high (59%–85%) in all countries, the proportion of patients receiving renal replacement therapy (7%–26%) and various experimental therapies for COVID-19 disease varied substantially (e.g. use of hydroxychloroquine 0%–85%). Crude ICU mortality ranged from 11% to 33%. Conclusion: There was substantial variability in the critical care response in Nordic ICUs to the first wave of COVID-19 pandemic, including usage of experimental medications. While ICU mortality was low in all countries, the observed variability warrants further attention.

Published
2022

20. A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries

Author

Chew, Michelle, Kattainen, Salla, Haase, Nicolai, Buanes, Eirik A., Kristinsdottir, Linda B., Hofso, Kristin, Laake, Jon Henrik, Kvale, Reidar, Hastbacka, Johanna, Reinikainen, Matti, Bendel, Stepani, Varpula, Tero, Walther, Sten, Perner, Anders, Flaatten, Hans K., Sigurdsson, Martin I, Chew, Michelle, Kattainen, Salla, Haase, Nicolai, Buanes, Eirik A., Kristinsdottir, Linda B., Hofso, Kristin, Laake, Jon Henrik, Kvale, Reidar, Hastbacka, Johanna, Reinikainen, Matti, Bendel, Stepani, Varpula, Tero, Walther, Sten, Perner, Anders, Flaatten, Hans K., and Sigurdsson, Martin I

Abstract

Background We sought to provide a description of surge response strategies and characteristics, clinical management and outcomes of patients with severe COVID-19 in the intensive care unit (ICU) during the first wave of the pandemic in Denmark, Finland, Iceland, Norway and Sweden. Methods Representatives from the national ICU registries for each of the five countries provided clinical data and a description of the strategies to allocate ICU resources and increase the ICU capacity during the pandemic. All adult patients admitted to the ICU for COVID-19 disease during the first wave of COVID-19 were included. The clinical characteristics, ICU management and outcomes of individual countries were described with descriptive statistics. Results Most countries more than doubled their ICU capacity during the pandemic. For patients positive for SARS-CoV-2, the ratio of requiring ICU admission for COVID-19 varied substantially (1.6%-6.7%). Apart from age (proportion of patients aged 65 years or over between 29% and 62%), baseline characteristics, chronic comorbidity burden and acute presentations of COVID-19 disease were similar among the five countries. While utilization of invasive mechanical ventilation was high (59%-85%) in all countries, the proportion of patients receiving renal replacement therapy (7%-26%) and various experimental therapies for COVID-19 disease varied substantially (e.g. use of hydroxychloroquine 0%-85%). Crude ICU mortality ranged from 11% to 33%. Conclusion There was substantial variability in the critical care response in Nordic ICUs to the first wave of COVID-19 pandemic, including usage of experimental medications. While ICU mortality was low in all countries, the observed variability warrants further attention., Funding Agencies|NordForsk (Nordic COVID-19 Activities); Finnish Society of Intensive Care

Published
2022
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21. Additional file 1 of Lung function and exercise capacity 6 months after hospital discharge for critical COVID-19

Author

Kattainen, Salla, Lindahl, Anna, Vasankari, Tuula, Ollila, Henriikka, Volmonen, Kirsi, Piirilä, Päivi, Kauppi, Paula, Paajanen, Juuso, Kreivi, Hanna-Riikka, Ulenius, Linda, Varpula, Tero, Aro, Miia, Reijula, Jere, and Hästbacka, Johanna

Abstract

Additional file 1: Figure S1. Grading of pulmonary abnormalities in patients with history of COVID-19 pneumonitis.

Published
2022
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23. A descriptive study of the surge response and outcomes of ICU patients with COVID‐19 during first wave in Nordic countries

Author

Chew, Michelle S., primary, Kattainen, Salla, additional, Haase, Nicolai, additional, Buanes, Eirik A., additional, Kristinsdottir, Linda B., additional, Hofsø, Kristin, additional, Laake, Jon Henrik, additional, Kvåle, Reidar, additional, Hästbacka, Johanna, additional, Reinikainen, Matti, additional, Bendel, Stepani, additional, Varpula, Tero, additional, Walther, Sten, additional, Perner, Anders, additional, Flaatten, Hans K., additional, and Sigurdsson, Martin I., additional

Published
2021
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24. Elevations of inflammatory markers PTX3 and sST2 after resuscitation from cardiac arrest are associated with multiple organ dysfunction syndrome and early death

Author

Ristagno, Giuseppe, Varpula, Tero, Masson, Serge, Greco, Marta, Bottazzi, Barbara, Milani, Valentina, Aleksova, Aneta, Sinagra, Gianfranco, Assandri, Roberto, Tiainen, Marjaana, Vaahersalo, Jukka, Kurola, Jouni, Barlera, Simona, Montanelli, Alessandro, Latini, Roberto, Pettilä, Ville, Bendel, Stepani, and Skrifvars, Markus B.

Published
2015
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29. SuPAR and PAI-1 in critically ill, mechanically ventilated patients

Author

Jalkanen, Ville, Yang, Runkuan, Linko, Rita, Huhtala, Heini, Okkonen, Marjatta, Varpula, Tero, and Pettilä, Ville

Subjects
Mortality -- United Kingdom -- Taiwan -- Finland, Infection -- Health aspects -- Analysis, Acute respiratory distress syndrome -- Health aspects -- Analysis, Health care industry
Abstract

Purpose SuPAR (soluble urokinase plasminogen activator receptor) and PAI-1 (plasminogen activator inhibitor 1) are active in the coagulation-fibrinolysis pathway. Both have been suggested as biomarkers for disease severity. We evaluated them in prediction of mortality, acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), sepsis and renal replacement therapy (RRT) in operative and non-operative ventilated patients. Methods We conducted a prospective, multicenter, observational study. Blood samples and data of intensive care were collected. Mechanically ventilated patients with baseline suPAR and PAI-1 measurements were included in the analysis, and healthy volunteers were analysed for comparison. Receiver operating characteristics (ROC), logistic regression, likelihood ratios and Kaplan-Meier analysis were performed. Results Baseline suPAR was 11.6 ng/ml (quartiles Q1-Q3, 9.6-14.0), compared to healthy volunteers with suPAR of 0.6 ng/ml (0.5-11.0). PAI-1 concentrations were 2.67 ng/ml (1.53-4.69) and 0.3 ng/ml (0.3-0.4), respectively. ROC analysis for suPAR 90-day mortality areas under receiver operating characteristic curves (AUC) 0.61 (95 % confidence interval (CI): 0.55-0.67), sepsis 0.68 (0.61-0.76), ALI/ARDS 0.64 (0.56-0.73) and RRT 0.65 (0.56-0.73). Patients with the highest quartile of suPAR concentrations had an odds ratio of 2.52 (1.37-4.64, p = 0.003) for 90-day mortality and 3.16 (1.19-8.41, p = 0.02) for ALI/ARDS. In non-operative patients, the AUC's for suPAR were 90-day mortality 0.61 (0.54-0.68), RRT 0.73 (0.64-0.83), sepsis 0.70 (0.60-0.80), ALI/ARDS 0.61 (0.51-0.71). Predictive value of PAI-1 was negligible. Conclusions In non-operative patients, low concentrations of suPAR were predictive for survival and high concentrations for RRT and mortality. SuPAR may be used for screening for patients with potentially good survival. The association with RRT may supply an early warning sign for acute renal failure., Author(s): Ville Jalkanen [sup.1], Runkuan Yang [sup.1], Rita Linko [sup.2], Heini Huhtala [sup.3], Marjatta Okkonen [sup.2], Tero Varpula [sup.2], Ville Pettilä [sup.2] [sup.4], Jyrki Tenhunen [sup.1] [sup.5] Author Affiliations: (1) [...]

Published
2013
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32. Koronaviruspandemiaan liittynyt tehohoidon tarve ja hoitotulokset Suomessa kevään ja kesän 2020 aikana

Author

Kattainen, Salla, Kiiski, Olli, Bendel, Stepani, Jokinen, Jukka, Reinikainen, Matti, Varpula, Tero, HUS Leikkaussalit, teho- ja kivunhoito, and Diagnostis-terapeuttinen osasto

Subjects
3126 Kirurgia, anestesiologia, tehohoito, radiologia
Abstract

Vertaisarvioitu. COVID-19-pandemia aiheutti merkittävää tehohoidon tarvetta keväällä 2020. Tilannekuvaa kokoamaan perustettiin tehohoidon koordinoiva toimisto, joka raportoi viranomaisille ajantasaista tietoa potilas- ja paikkamääristä koko maassa. Suurin tehohoidon kuormitus kohdistui HUS:n sairaaloihin. Teho-osastoilla hoidettiin yhteensä 227:ää COVID-19-potilasta, ja erillisiä tehohoitojaksoja kirjattiin 293. Suomessa COVID-19-potilaiden tehohoitokuolleisuus oli vähäistä, vain 15 %. Ikä ja krooniset sairaudet lisäsivät kuolleisuutta. Tehohoitojaksot olivat tavanomaisia tehohoitojaksoja pidempiä (14 vrk vs 3 vrk), ja 67 % potilaista tarvitsi hengityslaitehoitoa. Epidemian vaikeimmassa vaiheessa huhtikuun puolivälissä tehohoitokapasiteettia oli jo kasvatettu voimakkaasti, ja sen täyttöaste jäi alle puoleen.

Published
2021

34. Acute respiratory failure in intensive care units. FINNALI: a prospective cohort study

Author

Linko, Rita, Okkonen, Marjatta, Pettila, Ville, Perttila, Juha, Parviainen, Ilkka, Ruokonen, Esko, Tenhunen, Jyrki, Ala-Kokko, Tero, and Varpula, Tero

Subjects
Acute respiratory distress syndrome -- Risk factors, Acute respiratory distress syndrome -- Diagnosis, Acute respiratory distress syndrome -- Care and treatment, Acute respiratory distress syndrome -- Research, Intensive care units -- Management, Artificial respiration -- Usage, Company business management, Health care industry
Abstract

Byline: Rita Linko (1), Marjatta Okkonen (1), Ville Pettila (2), Juha Perttila (3), Ilkka Parviainen (4), Esko Ruokonen (4), Jyrki Tenhunen (5), Tero Ala-Kokko (6), Tero Varpula (1) Keywords: Acute respiratory failure; Acute lung injury; Acute respiratory distress syndrome; Mechanical ventilation; Outcome Abstract: Objective To evaluate the incidence, treatment and mortality of acute respiratory failure (ARF) in Finnish intensive care units (ICUs). Study design Prospective multicentre cohort study. Methods All adult patients in 25 ICUs were screened for use of invasive or non-invasive ventilatory support during an 8-week period. Patients needing ventilatory support for more than 6 h were included and defined as ARF patients. Risk factors for ARF and details of prior chronic health status were assessed. Ventilatory and concomitant treatments were evaluated and recorded daily throughout the ICU stay. ICU and 90-day mortalities were assessed. Results A total of 958 (39%) from the 2,473 admitted patients were treated with ventilatory support for more than 6 h. Incidence of ARF, acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) was 149.5, 10.6 and 5.0/100,000 per year, respectively. Ventilatory support was started with non-invasive interfaces in 183 of 958 (19%) patients. Ventilatory modes allowing triggering of spontaneous breaths were preferred (81%). Median tidal volume/predicted body weight was 8.7 (7.6--9.9) ml/kg and plateau pressure 19 (16--23) cm[H.sub.2]O. The 90-day mortality of ARF was 31%. Conclusions While the incidence of ARF requiring ventilatory support is higher, the incidence of ALI and ARDS seems to be lower in Finland than previously reported in other countries. Tidal volumes are higher than recommended in the concept of lung protective strategy. However, restriction of peak airway pressure was used in the majority of ARF patients. Author Affiliation: (1) Intensive Care Units, Department of Anaesthesia and Intensive Care Medicine, Division of Surgery, Helsinki University Hospital, Helsinki, Finland (2) Department of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Center, Monash University, Melbourne, Australia (3) Department of Anesthesia and Intensive Care Medicine, Turku University Hospital, Turku, Finland (4) Division of Intensive Care, Kuopio University Hospital, Kuopio, Finland (5) Department of Intensive Care Medicine, Critical Care Medicine Research Group, Tampere University Hospital, Tampere, Finland (6) Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland Article History: Registration Date: 28/05/2009 Received Date: 14/01/2009 Accepted Date: 07/05/2009 Online Date: 13/06/2009 Article note: This article is discussed in the editorial available at: doi: 10.1007/s00134-009-1518-0. Electronic supplementary material The online version of this article (doi: 10.1007/s00134-009-1519-z) contains supplementary material, which is available to authorized users.

Published
2009

37. Tehohoidon kapasiteetti COVID-19-epidemiassa

Author

Ala-Kokko, Tero, Pettilä, Ville, Karlsson, Sari, Valtonen, Mika, Reinikainen, Matti, Bendel, Stepani, Varpula, Tero, HUS Leikkaussalit, teho- ja kivunhoito, Diagnostis-terapeuttinen osasto, and Helsingin yliopisto

Subjects
Ventilators, Mechanical, Critical Care, 3111 Biolääketieteet, Patient Selection, Health Status, 3126 Kirurgia, anestesiologia, tehohoito, radiologia, Surge Capacity, Respiratory Distress Syndrome, Adult, Age Factors, Disease Outbreaks, 3121 Yleislääketiede, sisätaudit ja muut kliiniset lääketieteet, Health Workforce, Coronavirus Infections, Needs Assessment, Aged
Abstract

Mitkä ovat käytössä olevat resurssit, miten ne saadaan riittämään ja kuinka hoito kohdennetaan mahdollisimman vaikuttavasti COVID-19-epidemian aikana? Tehohoitolääkärit vastaavat.

Published
2020

38. Lower heart rate is associated with good one-year outcome in post-resuscitation patients

Author

FINNRESUSCI Study Grp, Oksanen, Tuomas, Tiainen, Marjaana, Vaahersalo, Jukka, Bendel, Stepani, Varpula, Tero, Skrifvars, Markus, Pettilä, Ville, Wilkman, Erika, Anestesiologian yksikkö, Clinicum, Department of Diagnostics and Therapeutics, University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine, Neurologian yksikkö, Department of Neurosciences, and HUS Neurocenter

Subjects
Male, Resuscitation, Time Factors, medicine.medical_treatment, Hemodynamics, Hypothermia, 030204 cardiovascular system & hematology, Emergency Nursing, Targeted temperature management, 0302 clinical medicine, Hypothermia, Induced, Outcome Assessment, Health Care, Single-Blind Method, Prospective Studies, Outcome, Therapeutic temperature management, RESUSCITATION, Middle Aged, 3. Good health, Intensive Care Units, Area Under Curve, SURVIVAL, Emergency Medicine, Female, FIBRILLATION, medicine.symptom, Cardiology and Cardiovascular Medicine, Bradycardia, medicine.medical_specialty, THERAPEUTIC HYPOTHERMIA, Heart rate, 03 medical and health sciences, Internal medicine, medicine, Humans, METAANALYSIS, Aged, Fibrillation, Haemodynamics, business.industry, BETA-BLOCKERS, ELEVATION MYOCARDIAL-INFARCTION, HOSPITAL CARDIAC-ARREST, 030208 emergency & critical care medicine, Recovery of Function, RATE-VARIABILITY, CARE, Postresuscitation, 3126 Surgery, anesthesiology, intensive care, radiology, Cardiopulmonary Resuscitation, Clinical trial, business, Out-of-Hospital Cardiac Arrest
Abstract

Background: Optimal hemodynamic goals in post-resuscitation patients are not clear. Previous studies have reported an association between lower heart rate and good outcome in patients receiving targeted temperature management (TTM) after out-of-hospital cardiac arrest. Methods: We analyzed heart rate (HR) and outcome data of 504 post-resuscitation patients from the prospectively collected database of the FINNRESUSCI study. One-year neurologic outcome was dichotomized by the Cerebral Performance Category (CPC) to good (1-2) or poor (3-5). Results: Of 504 patients, 40.1% (202/504) had good and 59.9% (302/504) had poor one-year neurologic outcome. Patients with good outcome had lower time-weighted mean HR during the first 48 h in the ICU (69.2 bpm [59.2-75.1] vs. 76.6 bpm [65.72-89.6], p

Published
2018

44. Common Inflammation-Related Candidate Gene Variants and Acute Kidney Injury in 2647 Critically Ill Finnish Patients

Author

Vilander, Laura M., Vaara, Suvi T., Kaunisto, Mari A., Pettilä, Ville, FINNAKI Study Grp, Laru-Sompa, Raili, Pulkkinen, Anni, Saarelainen, Minna, Reilama, Mikko, Tolmunen, Sinikka, Rantalainen, Ulla, Miettinen, Marja, Suvela, Markku, Pesola, Katrine, Saastamoinen, Pekka, Kauppinen, Sirpa, Kaukonen, Kirsi-Maija, Korhonen, Anna-Maija, Nisula, Sara, Vaara, Suvi, Suojaranta-Ylinen, Raili, Mildh, Leena, Haapio, Mikko, Nurminen, Laura, Sutinen, Sari, Pettilä, Leena, Laitinen, Helinä, Syrja, Heidi, Henttonen, Kirsi, Lappi, Elina, Boman, Hillevi, Varpula, Tero, Porkka, Päivi, Sivula, Mirka, Rahkonen, Mira, Tsurkka, Anne, Prittinen, Niina, Alaspaa, Ari, Salanto, Ville, Juntunen, Hanna, Sanisalo, Teija, Parviainen, Ilkka, Uusaro, Ari, Ruokonen, Esko, Bendel, Stepani, Rissanen, Niina, Lång, Maarit, Rahikainen, Sari, Rissanen, Saija, Ahonen, Merja, Halonen, Elina, Vaskelainen, Eija, Poukkanen, Meri, Lintula, Esa, Suominen, Sirpa, Heikkinen, Jorma, Lavander, Timo, Heinonen, Kirsi, Juopperi, Anne-Mari, Kaminski, Tadeusz, Gäddnäs, Fiia, Kuusela, Tuija, Roiko, Jane, Karlsson, Sari, Reinikainen, Matti, Surakka, Tero, Jyrkönen, Helena, Eiserbeck, Tanja, Kallinen, Jaana, Lund, Vesa, Tuominen, Päivi, Perkola, Pauliina, Tuominen, Riikka, Hietaranta, Marika, Johansson, Satu, Hovilehto, Seppo, Kirsi, Anne, Tiainen, Pekka, Myllärinen, Tuija, Leino, Pirjo, Toropainen, Anne, Kuitunen, Anne, Leppänen, Ilona, Levoranta, Markus, Hoppu, Sanna, Sauranen, Jukka, Tenhunen, Jyrki, Kukkurainen, Atte, Kortelainen, Samuli, Varila, Simo, Inkinen, Outi, Koivuviita, Niina, Kotamäki, Jutta, Laine, Anu, Ala-Kokko, Tero, Laurila, Jouko J., Sälkiö, Sinikka, Koivisto, Simo-Pekka, Hautamäki, Raku, Skinnar, Maria, Anestesiologian yksikkö, Clinicum, Department of Diagnostics and Therapeutics, University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine, Institute for Molecular Medicine Finland, Helsinki Institute of Life Science HiLIFE, Nefrologian yksikkö, Department of Medicine, HUS Abdominal Center, and HYKS erva

Subjects
medicine.medical_specialty, Candidate gene, ADVERSE OUTCOMES, lcsh:Medicine, human genetics, Genome-wide association study, Article, PROMOTER POLYMORPHISM, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Genetic model, Genetic predisposition, medicine, GENOME-WIDE ASSOCIATION, PLASMA-LEVELS, 030304 developmental biology, 0303 health sciences, SEPSIS, business.industry, MORTALITY, lcsh:R, Acute kidney injury, 1184 Genetics, developmental biology, physiology, NECROSIS-FACTOR-ALPHA, General Medicine, Odds ratio, medicine.disease, INTERLEUKIN-10, 3. Good health, acute kidney injury, 030220 oncology & carcinogenesis, 3121 General medicine, internal medicine and other clinical medicine, Cohort, genetic variation, ENDOTHELIAL GROWTH-FACTOR, RISK-FACTORS, business, Kidney disease
Abstract

Acute kidney injury (AKI) is a syndrome with high incidence among the critically ill. Because the clinical variables and currently used biomarkers have failed to predict the individual susceptibility to AKI, candidate gene variants for the trait have been studied. Studies about genetic predisposition to AKI have been mainly underpowered and of moderate quality. We report the association study of 27 genetic variants in a cohort of Finnish critically ill patients, focusing on the replication of associations detected with variants in genes related to inflammation, cell survival, or circulation. In this prospective, observational Finnish Acute Kidney Injury (FINNAKI) study, 2647 patients without chronic kidney disease were genotyped. We defined AKI according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We compared severe AKI (Stages 2 and 3, n = 625) to controls (Stage 0, n = 1582). For genotyping we used iPLEXTM Assay (Agena Bioscience). We performed the association analyses with PLINK software, using an additive genetic model in logistic regression. Despite the numerous, although contradictory, studies about association between polymorphisms rs1800629 in TNFA and rs1800896 in IL10 and AKI, we found no association (odds ratios 1.06 (95% CI 0.89–1.28, p = 0.51) and 0.92 (95% CI 0.80–1.05, p = 0.20), respectively). Adjusting for confounders did not change the results. To conclude, we could not confirm the associations reported in previous studies in a cohort of critically ill patients.

Published
2019

46. Mean arterial pressure and vasopressor load after out-of-hospital cardiac arrest: Associations with one-year neurologic outcome

Author

Reinikainen, Matti, Varpula, Tero, Kurola, Jouni, Tallgren, Minna, Pettilä, Ville Yrjö Olavi, Hoppu, Sanna, Ala-Kokko, Tero, Tiainen, Marjaana, Laurikkala, Johanna, Skrifvars, Markus B, Vaahersalo, Jukka, and Wilkman, Erika

Subjects
610 Medicine & health
Abstract

THE AIM OF THE STUDY There are limited data on blood pressure targets and vasopressor use following cardiac arrest. We hypothesized that hypotension and high vasopressor load are associated with poor neurological outcome following out-of-hospital cardiac arrest (OHCA). METHODS We included 412 patients with OHCA included in FINNRESUSCI study conducted between 2010 and 2011. Hemodynamic data and vasopressor doses were collected electronically in one, two or five minute intervals. We evaluated thresholds for time-weighted (TW) mean arterial pressure (MAP) and outcome by receiver operating characteristic (ROC) curve analysis, and used multivariable analysis adjusting for co-morbidities, factors at resuscitation, an illness severity score, TW MAP and total vasopressor load (VL) to test associations with one-year neurologic outcome, dichotomized into either good (1-2) or poor (3-5) according to the cerebral performance category scale. RESULTS Of 412 patients, 169 patients had good and 243 patients had poor one-year outcomes. The lowest MAP during the first six hours was 58 (inter-quartile range [IQR] 56-61) mmHg in those with a poor outcome and 61 (59-63) mmHg in those with a good outcome (p

Published
2016
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47. Additional file 1: of Elevated plasma heparin-binding protein is associated with early death after resuscitation from cardiac arrest

Author

Ristagno, Giuseppe, Masson, Serge, Tiainen, Marjaana, Stepani Bendel, Bernasconi, Roberto, Varpula, Tero, Milani, Valentina, Vaahersalo, Jukka, Magnoli, Michela, Spanuth, Eberhard, Barlera, Simona, Latini, Roberto, Hoppu, Sanna, Pettilä, Ville, and Skrifvars, Markus

Abstract

Baseline characteristics and clinical factors in all FINNRESUSCI patients and in patients with blood samples. Description of data: a table reporting the main clinical characteristics of the patients included in the overall FINNRESUSCI trial and the patients included in the present biomarker substudy. (DOCX 14 kb)

Published
2016
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48. Additional file 2: of Elevated plasma heparin-binding protein is associated with early death after resuscitation from cardiac arrest

Author

Ristagno, Giuseppe, Masson, Serge, Tiainen, Marjaana, Stepani Bendel, Bernasconi, Roberto, Varpula, Tero, Milani, Valentina, Vaahersalo, Jukka, Magnoli, Michela, Spanuth, Eberhard, Barlera, Simona, Latini, Roberto, Hoppu, Sanna, Pettilä, Ville, and Skrifvars, Markus

Subjects
health services administration, health care facilities, manpower, and services, respiratory tract diseases
Abstract

Plasma levels of heparin-binding protein (HBP) at ICU admission in relationship to the 24-hour SOFA score and 24-hour cardiovascular SOFA score. Description of data: at ICU admission, plasma levels of HBP were significantly higher in patients with higher 24Â h SOFA scores. Moreover, HBP levels were significantly higher in patients who developed cardiovascular failure. (DOCX 19 kb)

Published
2016
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49. Osasto U2 : suunnitelmista tiloiksi ja toiminnaksi

Author

Varpula, Tero, Diagnostis-terapeuttinen osasto, and Clinicum

Subjects
Intensive Care Units, Burn Units, 3126 Kirurgia, anestesiologia, tehohoito, radiologia, Health Facilities
Published
2016

50. NT-proBNP in patients with out-of-hospital cardiac arrest: Results from the FINNRESUSCI Study

Author

Røsjø, Helge, Vaahersalo, Jukka, Hagve, Tor-Arne, Myhre, Peder L, Tiainen, Marjaana, Varpula, Tero, Pettilä, Ville Yrjö Olavi, Omland, Torbjørn, and Kurola, Jouni

Subjects
cardiovascular diseases, 610 Medicine & health, hormones, hormone substitutes, and hormone antagonists
Abstract

AIM To assess whether the established cardiovascular biomarker N-terminal pro-B-type natriuretic peptide (NT-proBNP) provides prognostic information in patients with out-of-hospital cardiac arrest due to ventricular tachycardia or fibrillation (OHCA-VT/VF). METHODS We measured NT-proBNP levels in 155 patients with OHCA-VT/VF enrolled into a prospective multicenter observational study in 21 ICUs in Finland. Blood samples were drawn

Published
2016
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