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2. C30 24–HOUR PULMONARY ARTERY ELASTANCE IS THE STRONGEST HEMODYNAMIC PREDICTOR OF IN–HOSPITAL MORTALITY IN ACUTE DECOMPENSATED HEART FAILURE–RELATED CARDIOGENIC SHOCK

Author

Baldetti, L, primary, Den Uil, C, additional, Fiore, G, additional, Gallone, G, additional, Romagnolo, D, additional, De Ferrari, T, additional, Peveri, B, additional, Cianfanelli, L, additional, Calvo, F, additional, Gramegna, M, additional, Pazzanese, V, additional, Sacchi, S, additional, Frias, A, additional, Ajello, S, additional, and Scandroglio, A, additional

Published
2023
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3. Potential therapies for sodium azide intoxication

Author

Groeneveld, Nta, van Hoeven, L, van der Crabben, R S, den Uil, C A, Bethlehem, C, Alsma, J, Internal Medicine, Anesthesiology, Intensive Care, and Pharmacy

Subjects
Heart Failure, SDG 3 - Good Health and Well-being, Emergency Medicine, Internal Medicine, Humans, Suicide, Attempted, General Medicine, Critical Care and Intensive Care Medicine, Sodium Azide
Abstract

Intoxications with sodium azide are rare and in almost all cases lethal in doses above 700 mg or 10mg/kg. We report a case of a patient who ingested 2 grams of sodium azide as a suicide attempt. Sodium azide irreversible blocks cytochrome C oxidase by inhibiting oxidative phosphorylation leading to cell death. There is currently no antidote available. Our patient was treated with a range of therapies, on site, in the emergency department and in the intensive care unit, such as sodium thiosulphate, methylene blue, intralipid, extensive gastric lavage, whole bowel irrigation combined with pro-kinetics, hydroxocobalamin and exchange transfusion. During the clinical course the patient developed cardiac failure, for which veno-arterial ECMO and an intra-aortic balloon pump was placed. However, cardiac function did not recover, leading to discontinuation of treatment after 7 days. As literature on sodium azide intoxication is scarce, we conducted a review to present potential treatment options.

Published
2022

4. Age is the main determinant of COVID-19 related in-hospital mortality with minimal impact of pre-existing comorbidities, a retrospective cohort study

Author

Henkens, M. T. H. M., Raafs, A. G., Verdonschot, J. A. J., Linschoten, M., van Smeden, M., Wang, P., van der Hooft, B. H. M., Tieleman, R., Janssen, M. L. F., ter Bekke, R. M. A., Hazebroek, M. R., van der Horst, I. C. C., Asselbergs, F. W., Magdelijns, F. J. H., Heymans, S. R. B., Al-Ali, A. K., Al-Muhanna, F. A., Al-Windy, N. Y. Y., Almubarak, Y. A., Alnafie, A. N., Alshahrani, M., Alshehri, A. M., Anthonio, R. L., Aujayeb, A., ten Berg, J. M., van Boxem, A. J. M., Captur, G., Caputo, M., Charlotte, N., Dark, P., de Sutter, J., Delsing, C. E., Dorman, H. G. R., Drost, J. T., Emans, M. E., Ferreira, J. B., Gabriel, L., van Gilst, W. H., Groenemeijer, B. E., Haerkens-Arends, H. E., van der Harst, P., Hedayat, B., van der Heijden, D. J., Hellou, E., Hermanides, R. S., Hermans-van Ast, J. F., van Hessen, M. W. J., van Ierssel, S. H., Jewbali, L. S., Kearney, M. T., van Kesteren, H. A. M., Kietselaer, B. L. J. H., Koning, A. M. H., Kopylov, P. Y., Kuijper, A. F. M., Kwakkel-van Erp, J. M., van der Linden, M. M. J. M., Linssen, G. C. M., Macias Ruiz, R., Martens, F. M. A. C., McCann, G. P., van der Meer, P., Meijs, M. F. L., Messiaen, P., Monraats, P. S., Montagna, L., Moriarty, A., Mosterd, A., Nierop, P. R., van Ofwegen-Hanekamp, C. E. E., Pinto, Y. M., Poorhosseini, H., Prasad, S., Redón, J., Reidinga, A. C., Ribeiro, M. I. A., Ripley, D. P., Salah, R., Saneei, E., Saxena, M., Schaap, J., Schellings, D. A. A. M., Schut, A., Shafiee, A., Shore, A. C., Siebelink, H. J., Smits, P. C., Pisters, R., Tessitore, E., Tieleman, R. G., Timmermans, P., Tio, R. A., Tjong, F. V. Y., den Uil, C. A., van Craenenbroeck, E. M., van Veen, H. P. A. A., Veneman, T., Verschure, D. O., de Vries, J. K., van de Wal, R. M. A., van de Watering, D. J., Westendorp, I. C. D., Westendorp, P. H. M., Weytjens, C., Wierda, E., Williams, B., Woudstra, P., Wu, K. W., Zaal, R., Zaman, A. G., van der Zee, P. M., Cardiology, ACS - Heart failure & arrhythmias, CAPACITY-COVID collaborative consortium, Cardiologie, RS: Carim - H02 Cardiomyopathy, MUMC+: DA KG Lab Centraal Lab (9), Klinische Neurowetenschappen, MUMC+: HZC Med Staf Spec Klinische Neurofys (9), RS: MHeNs - R3 - Neuroscience, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H04 Arrhythmogenesis and cardiogenetics, MUMC+: MA Med Staf Artsass Cardiologie (9), RS: Carim - V04 Surgical intervention, Intensive Care, MUMC+: MA Medische Staf IC (9), MUMC+: MA Intensive Care (3), Interne Geneeskunde, and MUMC+: MA Alg Interne Geneeskunde (9)

Subjects
Male, SARS-CoV-2, COVID-19, Comorbidity, Hospitalization, Risk Factors, Humans, Mediation analysis, Female, Hospital Mortality, Human medicine, Geriatrics and Gerontology, Mortality, Aged, Retrospective Studies, Netherlands
Abstract

Background Age and comorbidities increase COVID-19 related in-hospital mortality risk, but the extent by which comorbidities mediate the impact of age remains unknown. Methods In this multicenter retrospective cohort study with data from 45 Dutch hospitals, 4806 proven COVID-19 patients hospitalized in Dutch hospitals (between February and July 2020) from the CAPACITY-COVID registry were included (age 69[58–77]years, 64% men). The primary outcome was defined as a combination of in-hospital mortality or discharge with palliative care. Logistic regression analysis was performed to analyze the associations between sex, age, and comorbidities with the primary outcome. The effect of comorbidities on the relation of age with the primary outcome was evaluated using mediation analysis. Results In-hospital COVID-19 related mortality occurred in 1108 (23%) patients, 836 (76%) were aged ≥70 years (70+). Both age 70+ and female sex were univariably associated with outcome (odds ratio [OR]4.68, 95%confidence interval [4.02–5.45], OR0.68[0.59–0.79], respectively;both pp Conclusions Age is the main determinant of COVID-19 related in-hospital mortality, with negligible mediation effect of pre-existing comorbidities. Trial registration CAPACITY-COVID (NCT04325412)

Published
2022
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5. Lupus anticoagulant associates with thrombosis in patients with COVID-19 admitted to intensive care units

Author

Noordermeer, Tessa, Schutgens, Roger E. G., Visser, Chantal, Rademaker, Emma, de Maat, Moniek P. M., Jansen, A. J. Gerard, Limper, Maarten, Cremer, Olaf L., Kruip, Marieke J. H. A., Endeman, Henrik, Maas, Coen, de Laat, Bas, Urbanus, Rolf T., van de Beek, D., Brouwer, M. C., de Bruin, S., Coppens, M., van Es, N., van Haaps, T. F., Juffermans, N. P., Muller, M. C. A., Vlaar, A. P. J., Hertogh, C. M. P. M., Heunks, L. M. A., Hugtenburg, J. G., van Kooten, J., Nossent, E. J., Smulders, Y., Tuinman, P. R., Noordegraaf, A. Vonk, Grootenboers, M. J. J. H., van Guldener, C., Kant, M., Lansbergen, A., Faber, J., Hajer, G., Stemerdink, A., van den Akker, J., Bierings, R., Endeman, H., Goeijenbier, M., Hunfeld, N. G. M., van Gorp, E. C. M., Gommers, D. A. M. P. J., Koopmans, M. P. G., Kruip, M. J. H. A., Kuiken, T., Langerak, T., Leebeek, Lauw, M. N., de Maat, M. P. M., Noack, D., Paats, M. S., Raadsen, M. P., Rockx, B., Rokx, C., Schurink, C. A. M., Tong-Minh, K., van den Toorn, L., den Uil, C. A., Visser, C., Boutkourt, F., Roest, T., Douma, R. A., de Haan, L. R., ten Wolde, M., Bemelmans, R. H. H., Festen, B., Stads, S., de Jager, C. P. C., Simons, K. S., Antoni, M. L., Bos, M. H., Burggraaf, J. L. I., Cannegieter, S. C., Eikenboom, H. C. J., den Exter, P. L., Geelhoed, J. J. M., Huisman, M. V., de Jonge, E., Kaptein, F. H. J., Klok, F. A., Kroft, L. J. M., Lijfering, W. M., Nab, L., Ninaber, M. K., Putter, H., Ramai, S. R. S., da Rocha Rondon, A. M., Roukens, A. H. E., Stals, M. A. M., Versteeg, H. H., Vliegen, H. W., van Vlijmen, B. J. M., van de Berg, T., Bruggemann, R., van Bussel, B. C. T., ten Cate, H., ten Cate-Hoek, A., Hackeng, T. M., Henskens, ir. Y., Hulshof, A., Mulder, M., Olie, R. H., Schurgers, L., Spaetgens, B., Spronk, H., Spruit, M. A., Winckers, K., Nieuwenhuizen, L., Franken, B., Schrover, I. M., de Waal, E. G. M., Beishuizen, A., Cornet, A., Krabbe, J., Kramers, K., Leentjens, J., de Mast, Q., Middeldorp, S., Brouwer, R. E., Ellerbroek, J. L. J., Tijmensen, J., Hovens, M. M. C., Oostdijk, E. A. N., Westerhof, B. D., Faber, L. M., van den Biggelaar, M., Meijers, J. C. M., Voorberg, J., Kevenaar, M. E., Soei, Y. L., Wils, E. J., Croles, F. N., de Laat, B., Kamphuisen, P. W., Vink, R., Lisman, T., Meijer, K., van Tichelaar, Y. I. G., Cremer, O. L., Geersing, G., Kaasjager, H. A. H., Kusadasi, N., Huisman, A., Maas, C., Nijkeuter, M., Schutgens, R. E. G., Creveldkliniek, Van, Urbanus, R. T., Westerink, J., Faber, H. J., Koster, S. C. E., van Montfort, P., van Twist, D. J. L., RS: Carim - B01 Blood proteins & engineering, Biochemie, Hematology, Intensive Care, Neurology, ANS - Neuroinfection & -inflammation, Intensive Care Medicine, ACS - Pulmonary hypertension & thrombosis, AII - Inflammatory diseases, Vascular Medicine, ACS - Amsterdam Cardiovascular Sciences, Graduate School, ACS - Microcirculation, Medical Microbiology and Infection Prevention, ARD - Amsterdam Reproduction and Development, Experimental Vascular Medicine, Landsteiner Laboratory, ACS - Atherosclerosis & ischemic syndromes, Elderly care medicine, APH - Aging & Later Life, Clinical pharmacology and pharmacy, APH - Health Behaviors & Chronic Diseases, Pulmonary medicine, Internal medicine, ACS - Diabetes & metabolism, Intensive care medicine, General practice, and Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], lupus anticoagulant, risk factor, critically ill, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], COVID-19, Hematology, thrombosis, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
Abstract

Contains fulltext : 286889.pdf (Publisher’s version ) (Open Access) BACKGROUND: Thrombosis is a frequent and severe complication in patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU). Lupus anticoagulant (LA) is a strong acquired risk factor for thrombosis in various diseases and is frequently observed in patients with COVID-19. Whether LA is associated with thrombosis in patients with severe COVID-19 is currently unclear. OBJECTIVE: To investigate if LA is associated with thrombosis in critically ill patients with COVID-19. PATIENTS/METHODS: The presence of LA and other antiphospholipid antibodies was assessed in patients with COVID-19 admitted to the ICU. LA was determined with dilute Russell's viper venom time (dRVVT) and LA-sensitive activated partial thromboplastin time (aPTT) reagents. RESULTS: Of 169 patients with COVID-19, 116 (69%) tested positive for at least one antiphospholipid antibody upon admission to the ICU. Forty (24%) patients tested positive for LA; of whom 29 (17%) tested positive with a dRVVT, 19 (11%) tested positive with an LA-sensitive aPTT, and 8 (5%) tested positive on both tests. Fifty-eight (34%) patients developed thrombosis after ICU admission. The odds ratio (OR) for thrombosis in patients with LA based on a dRVVT was 2.5 (95% confidence interval [CI], 1.1-5.7), which increased to 4.5 (95% CI, 1.4-14.3) in patients at or below the median age in this study (64 years). LA positivity based on a dRVVT or LA-sensitive aPTT was only associated with thrombosis in patients aged less than 65 years (OR, 3.8; 95% CI, 1.3-11.4) and disappeared after adjustment for C-reactive protein. CONCLUSION: Lupus anticoagulant on admission is strongly associated with thrombosis in critically ill patients with COVID-19, especially in patients aged less than 65 years.

Published
2022
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6. Potential therapies for sodium azide intoxication:a case report and review of the literature

Author

Groeneveld, Nta, van Hoeven, L, van der Crabben, R S, den Uil, C A, Bethlehem, C, Alsma, J, Groeneveld, Nta, van Hoeven, L, van der Crabben, R S, den Uil, C A, Bethlehem, C, and Alsma, J

Abstract

Intoxications with sodium azide are rare and in almost all cases lethal in doses above 700 mg or 10mg/kg. We report a case of a patient who ingested 2 grams of sodium azide as a suicide attempt. Sodium azide irreversible blocks cytochrome C oxidase by inhibiting oxidative phosphorylation leading to cell death. There is currently no antidote available. Our patient was treated with a range of therapies, on site, in the emergency department and in the intensive care unit, such as sodium thiosulphate, methylene blue, intralipid, extensive gastric lavage, whole bowel irrigation combined with pro-kinetics, hydroxocobalamin and exchange transfusion. During the clinical course the patient developed cardiac failure, for which veno-arterial ECMO and an intra-aortic balloon pump was placed. However, cardiac function did not recover, leading to discontinuation of treatment after 7 days. As literature on sodium azide intoxication is scarce, we conducted a review to present potential treatment options.

Published
2022

7. Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries

Author

Linschoten, M., Uijl, A., Schut, A., Jakob, C. E. M., Romao, L. R., Bell, R. M., McFarlane, E., Stecher, M., Zondag, A. G. M., van Iperen, E. P. A., Hermans-van Ast, J. F., Lea, N. C., Schaap, J., Jewbali, L. S., Smits, P. C., Patel, R. S., Aujayeb, A., van Smeden, M., Siebelink, H. J., Williams, S., Pilgram, L., Tieleman, R. G., Williams, B., Asselbergs, F. W., Al-Ali, A. K., Al-Muhanna, F. A., Al-Rubaish, A. M., Al-Windy, N. Y. Y., Alkhalil, M., Almubarak, Y. A., Al Nafie, A. N., Al Shahrani, M., Al Shehri, A. M., Anning, C., Anthonio, R. L., Badings, E. A., Ball, C., Van Beek, E. A., Ten Berg, J. M., Von Bergwelt-Baildon, M., Bianco, M., Blagova, O., V, Bleijendaal, H., Bor, W. L., Borgmann, S., van Boxem, A. J. M., van den Brink, F. S., Bucciarelli-Ducci, C., Van Bussel, B. C. T., Byrom-Goulthorp, R., Captur, G., Caputo, M., Charlotte, N., vom Dahl, J., Dark, P., De Sutter, J., Degenhardt, C., Delsing, C. E., Dolff, S., Dorman, H. G. R., Drost, J. T., Eberwein, L., Emans, M. E., Er, A. G., Ferreira, J. B., Forner, M. J., Friedrichs, A., Gabriel, L., Groenemeijer, B. E., Groenendijk, A. L., Gruener, B., Guggemos, W., Haerkens-Arends, H. E., Hanses, F., Hedayat, B., Heigener, D., van der Heijden, D. J., Hellou, E., Hellwig, K., Henkens, M. T. H. M., Hermanides, R. S., Hermans, W. R. M., van Hessen, M. W. J., Heymans, S. R. B., Hilt, A. D., van der Horst, I. C. C., Hower, M., van Ierssel, S. H., Isberner, N., Jensen, B., Kearney, M. T., Kielstein, J. T., Kietselaer, B. L. J. H., Kochanek, M., Kolk, M. Z. H., Koning, A. M. H., Kopylov, P. Y., Kuijper, A. F. M., Kwakkel-van, E. R. P. J. M., Lanznaster, J., van der Linden, M. M. J. M., van der Lingen, A. C. J., Linssen, G. C. M., Lomas, D., Maarse, M., Magdelijns, F. J. H., Magro, M., Markart, P., Martens, F. M. A. C., Mazzilli, S. G., McCann, G. P., van der Meer, P., Meijs, M. F. L., Merle, U., Messiaen, P., Milovanovic, M., Monraats, P. S., Montagna, L., Moriarty, A., Moss, A. J., Mosterd, A., Nadalin, S., Nattermann, J., Neufang, M., Nierop, P. R., Offerhaus, J. A., Van Ofwegen-Hanekamp, C. E. E., Parker, E., Persoon, A. M., Piepel, C., Pinto, Y. M., Poorhosseini, H., Prasad, S., Raafs, A. G., Raichle, C., Rauschning, D., Redon, J., Reidinga, A. C., Ribeiro, M. I. A., Riedel, C., Rieg, S., Ripley, D. P., Rommele, C., Rothfuss, K., Ruddel, J., Ruthrich, M. M., Salah, R., Saneei, E., Saxena, M., Schellings, D. A. A. M., Scholte, N. T. B., Schubert, J., Seelig, J., Shafiee, A., Shore, A. C., Spinner, C., Stieglitz, S., Strauss, R., Sturkenboom, N. H., Tessitore, E., Thomson, R. J., Timmermans, P. J. R., Tio, R. A., Tjong, F. V. Y., Tometten, L., Trauth, J., Van Craenenbroeck, E. M., van Veen, H. P. A. A., den Uil, C. A., Vehreschild, M. J. G. T., Veldhuis, L., I, Veneman, T., Verschure, D. O., Voigt, I, Walter, L., vande Watering, D. J., de Vries, J. K., vande Wal, R. M. A., Westendorp, I. C. D., Westendorp, P. H. M., Westhoff, T., Weytjens, C., Wierda, E., Wille, K., de With, K., Worm, M., Woudstra, P., Wu, K. W., Zaal, R., Zaman, A. G., van der Zee, P. M., Zijlstra, L. E., Alling, T. E., Ahmed, R., Bayraktar-Verver, E. C. E., van Aken, K., Jimenes, Bermudez F. J., Biole, C. A., Den Boer-Penning, P., Bontje, M., Bos, M., Bosch, L., Broekman, M., Broeyer, F. J. F., de Bruijn, E. A. W., Bruinsma, S., Cardoso, N. M., Cosyns, B., Len, van Da D. H., Dekimpe, E., Domange, J., van Doorn, J. L., van DOorn, P., Dormal, F., Drost, I. M. J., Dunnink, A., van Eck, J. W. M., Elshinawy, K., Gevers, R. M. M., Gognieva, D. G., van der Graaf, M., Grangeon, S., Guclu, A., Habib, A., Haenen, N. A., Hamilton, K., Handgraaf, S., Heidbuchel, H., Hendriks-van Woerden, M., Hessels-Linnemeijer, B. M., Hosseini, K., Huisman, J., Jacobs, T. C., Jansen, S. E., Janssen, A., Jourdan, K., ten Kate, G. L., van Kempen, M. J., Kievit, C. M., Kleikers, P., Knufman, N., van der Kooi, S. E., Koole, B. A. S., Koole, M. A. C., Kui, K. K., Kuipers-Elferink, L., Lemoine, I, Lensink, E., van Marrewijk, V, Meijer, E. J., Melein, A. J., Mesitskaya, D. F., van Nes, C. P. M., Paris, F. M. A., Perrelli, M. G., Pieterse-Rots, A., Pisters, R., Polkerman, B. C., van Poppel, A., Reinders, S., Reitsma, M. J., Ruiter, A. H., Selder, J. L., van der Sluis, A., Sousa, A. I. C., Tajdini, M., Sanchez, Tercedor L., Van de Heyning, C. M., Vial, H., Vlieghe, E., Vonkeman, H. E., Vreugdenhil, P., de Vries, T. A. C., Willems, A. M., Wils, A. M., Zoet-Nugteren, S. K., Linschoten, M., Uijl, A., Schut, A., Jakob, C. E. M., Romao, L. R., Bell, R. M., McFarlane, E., Stecher, M., Zondag, A. G. M., van Iperen, E. P. A., Hermans-van Ast, J. F., Lea, N. C., Schaap, J., Jewbali, L. S., Smits, P. C., Patel, R. S., Aujayeb, A., van Smeden, M., Siebelink, H. J., Williams, S., Pilgram, L., Tieleman, R. G., Williams, B., Asselbergs, F. W., Al-Ali, A. K., Al-Muhanna, F. A., Al-Rubaish, A. M., Al-Windy, N. Y. Y., Alkhalil, M., Almubarak, Y. A., Al Nafie, A. N., Al Shahrani, M., Al Shehri, A. M., Anning, C., Anthonio, R. L., Badings, E. A., Ball, C., Van Beek, E. A., Ten Berg, J. M., Von Bergwelt-Baildon, M., Bianco, M., Blagova, O., V, Bleijendaal, H., Bor, W. L., Borgmann, S., van Boxem, A. J. M., van den Brink, F. S., Bucciarelli-Ducci, C., Van Bussel, B. C. T., Byrom-Goulthorp, R., Captur, G., Caputo, M., Charlotte, N., vom Dahl, J., Dark, P., De Sutter, J., Degenhardt, C., Delsing, C. E., Dolff, S., Dorman, H. G. R., Drost, J. T., Eberwein, L., Emans, M. E., Er, A. G., Ferreira, J. B., Forner, M. J., Friedrichs, A., Gabriel, L., Groenemeijer, B. E., Groenendijk, A. L., Gruener, B., Guggemos, W., Haerkens-Arends, H. E., Hanses, F., Hedayat, B., Heigener, D., van der Heijden, D. J., Hellou, E., Hellwig, K., Henkens, M. T. H. M., Hermanides, R. S., Hermans, W. R. M., van Hessen, M. W. J., Heymans, S. R. B., Hilt, A. D., van der Horst, I. C. C., Hower, M., van Ierssel, S. H., Isberner, N., Jensen, B., Kearney, M. T., Kielstein, J. T., Kietselaer, B. L. J. H., Kochanek, M., Kolk, M. Z. H., Koning, A. M. H., Kopylov, P. Y., Kuijper, A. F. M., Kwakkel-van, E. R. P. J. M., Lanznaster, J., van der Linden, M. M. J. M., van der Lingen, A. C. J., Linssen, G. C. M., Lomas, D., Maarse, M., Magdelijns, F. J. H., Magro, M., Markart, P., Martens, F. M. A. C., Mazzilli, S. G., McCann, G. P., van der Meer, P., Meijs, M. F. L., Merle, U., Messiaen, P., Milovanovic, M., Monraats, P. S., Montagna, L., Moriarty, A., Moss, A. J., Mosterd, A., Nadalin, S., Nattermann, J., Neufang, M., Nierop, P. R., Offerhaus, J. A., Van Ofwegen-Hanekamp, C. E. E., Parker, E., Persoon, A. M., Piepel, C., Pinto, Y. M., Poorhosseini, H., Prasad, S., Raafs, A. G., Raichle, C., Rauschning, D., Redon, J., Reidinga, A. C., Ribeiro, M. I. A., Riedel, C., Rieg, S., Ripley, D. P., Rommele, C., Rothfuss, K., Ruddel, J., Ruthrich, M. M., Salah, R., Saneei, E., Saxena, M., Schellings, D. A. A. M., Scholte, N. T. B., Schubert, J., Seelig, J., Shafiee, A., Shore, A. C., Spinner, C., Stieglitz, S., Strauss, R., Sturkenboom, N. H., Tessitore, E., Thomson, R. J., Timmermans, P. J. R., Tio, R. A., Tjong, F. V. Y., Tometten, L., Trauth, J., Van Craenenbroeck, E. M., van Veen, H. P. A. A., den Uil, C. A., Vehreschild, M. J. G. T., Veldhuis, L., I, Veneman, T., Verschure, D. O., Voigt, I, Walter, L., vande Watering, D. J., de Vries, J. K., vande Wal, R. M. A., Westendorp, I. C. D., Westendorp, P. H. M., Westhoff, T., Weytjens, C., Wierda, E., Wille, K., de With, K., Worm, M., Woudstra, P., Wu, K. W., Zaal, R., Zaman, A. G., van der Zee, P. M., Zijlstra, L. E., Alling, T. E., Ahmed, R., Bayraktar-Verver, E. C. E., van Aken, K., Jimenes, Bermudez F. J., Biole, C. A., Den Boer-Penning, P., Bontje, M., Bos, M., Bosch, L., Broekman, M., Broeyer, F. J. F., de Bruijn, E. A. W., Bruinsma, S., Cardoso, N. M., Cosyns, B., Len, van Da D. H., Dekimpe, E., Domange, J., van Doorn, J. L., van DOorn, P., Dormal, F., Drost, I. M. J., Dunnink, A., van Eck, J. W. M., Elshinawy, K., Gevers, R. M. M., Gognieva, D. G., van der Graaf, M., Grangeon, S., Guclu, A., Habib, A., Haenen, N. A., Hamilton, K., Handgraaf, S., Heidbuchel, H., Hendriks-van Woerden, M., Hessels-Linnemeijer, B. M., Hosseini, K., Huisman, J., Jacobs, T. C., Jansen, S. E., Janssen, A., Jourdan, K., ten Kate, G. L., van Kempen, M. J., Kievit, C. M., Kleikers, P., Knufman, N., van der Kooi, S. E., Koole, B. A. S., Koole, M. A. C., Kui, K. K., Kuipers-Elferink, L., Lemoine, I, Lensink, E., van Marrewijk, V, Meijer, E. J., Melein, A. J., Mesitskaya, D. F., van Nes, C. P. M., Paris, F. M. A., Perrelli, M. G., Pieterse-Rots, A., Pisters, R., Polkerman, B. C., van Poppel, A., Reinders, S., Reitsma, M. J., Ruiter, A. H., Selder, J. L., van der Sluis, A., Sousa, A. I. C., Tajdini, M., Sanchez, Tercedor L., Van de Heyning, C. M., Vial, H., Vlieghe, E., Vonkeman, H. E., Vreugdenhil, P., de Vries, T. A. C., Willems, A. M., Wils, A. M., and Zoet-Nugteren, S. K.

Abstract

Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Methods and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66-75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n= 1545 vs. 15.9%; n= 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02-1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10-1.30; P <0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20-1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization. [GRAPHICS] .

Published
2022

8. Routine reporting of grey-white matter differentiation in early brain computed tomography in comatose patients after cardiac arrest:A substudy of the COACT trial

Author

Adriaansens, K. O., Jewbali, L. S.D., Lemkes, J. S., Spoormans, E. M., Meuwissen, M., Blans, M. J., van der Harst, P., Eikemans, B. J.W., Bleeker, G. B., Beishuizen, A., Henriques, J. P., van der Lugt, A., van Royen, N., den Uil, C. A., Adriaansens, K. O., Jewbali, L. S.D., Lemkes, J. S., Spoormans, E. M., Meuwissen, M., Blans, M. J., van der Harst, P., Eikemans, B. J.W., Bleeker, G. B., Beishuizen, A., Henriques, J. P., van der Lugt, A., van Royen, N., and den Uil, C. A.

Abstract

Aim: A multimodal approach is advised for neurological prognostication in comatose patients after out-of-hospital cardiac arrest (OHCA). Grey-white matter differentiation (grey-white ratio, GWR) obtained from a brain CT scan performed < 24 hours after return of circulation can be part of this approach. The aims of this study were to investigate the frequency and method of reporting the GWR in brain CT scan reports and their association with outcome. Methods: This is a post-hoc descriptive analysis of the COACT trial. The primary endpoint was the reporting of GWR by the radiologist. Secondary endpoints were APACHE IV score, Cerebral Performance Categories at discharge and 90-day follow-up, Glasgow Coma Scale at discharge, GWR-stratified 1-year survival, and RAND-36 stratified by normal versus abnormal GWR. Associations were analysed using multivariable analysis. Results: A total of 427 OHCA patients were included in this study, 234 (55%) of whom underwent a brain CT scan within 24 hours after ROSC. Median time between arrest and initial CT scan was 12 hours. In 195 patients (83%), the GWR was described in the reports, but always expressed qualitatively. The GWR was deemed abnormal in 57 (29%) CT scans. No differences were found in secondary endpoints between the two groups. Conclusion: GWR was frequently described in CT scan reports. Early abnormal GWR, as assessed qualitatively by a radiologist within 24 hours after ROSC, was a poor predictor of neurological prognosis.

Published
2022

9. Safety of endomyocardial biopsy in new-onset acute heart failure requiring veno-arterial extracorporeal membrane oxygenation

Author

Van Der Boon, R M A, primary, Den Dekker, W K, additional, Meuwese, C L, additional, Lorusso, R, additional, Von Der Thusen, J H, additional, Constantinescu, A C, additional, Manintveld, O C, additional, Delnoij, T S R, additional, Van Der Heijden, J J, additional, Van Mieghem, N M D A, additional, and Den Uil, C A, additional

Published
2021
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16. P5122A novel method for early identification of cardiac tamponade in patients with continuous flow left ventricular assist devices by use of sublingual microcirculatory imaging

Author

Akin, S, primary, Ince, C, additional, Den Uil, C A, additional, Struijs, A, additional, Muslem, R, additional, Ocak, I, additional, Guven, G, additional, Constantinescu, A A, additional, Soliman, O I, additional, Zijlstra, F, additional, Bogers, A J J C, additional, and Caliskan, K, additional

Published
2018
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19. Abstracts

Author

Barthelemy, O., primary, Silvain, J., additional, Brieger, D., additional, Bellemain-Appaix, A., additional, Cayla, G., additional, Beygui, F., additional, Lancar, R., additional, Collet, J. P., additional, Mercadier, A., additional, Montalescot, G., additional, Cha, K. S., additional, Nam, Y. H., additional, Kim, J. H., additional, Park, S. Y., additional, Park, T. H., additional, Kim, M. H., additional, Kim, Y. D., additional, Lee, H. C., additional, Ahn, M. S., additional, Hong, T. J., additional, Blanco, R., additional, Blanco, F., additional, Szarfer, J., additional, Garcia Escudero, A., additional, Gigena, G., additional, Gagliardi, J., additional, Rodriguez, A., additional, Sarmiento, R., additional, Affatatto, S., additional, Riccitelli, M., additional, Petris, A., additional, Datcu, M. D., additional, Pop, C., additional, Radoi, M., additional, Arsenescu-Georgescu, C., additional, Petrescu, I., additional, Petrescu, L., additional, Serban, L., additional, Nechita, E., additional, Tatu-Chitoiu, G., additional, Dorobantu, M., additional, Benedek, I., additional, Craiu, E., additional, Sinescu, C., additional, Ionescu, D. D., additional, Ginghina, C., additional, Minescu, B., additional, Izzo, A., additional, Mantovani, P., additional, Tomasi, L., additional, Dall'oglio, L., additional, Bonatti, S., additional, Rosiello, R., additional, Romano, M., additional, Agostini, F., additional, Zanini, R., additional, Zhao, Z. Y., additional, Wu, Y. J., additional, Li, J. J., additional, Yany, Y. J., additional, Qian, H. Y., additional, Tang, Y. D., additional, Timoteo, A. T., additional, Toste, A., additional, Lousinha, A., additional, Ramos, R., additional, Oliveira, J. A., additional, Ferreira, M. L., additional, Ferreira, R. C., additional, Cabades, C., additional, Diez Gil, J. L., additional, Aguar, P., additional, Sanmiguel, D., additional, Lopez-March, A., additional, Marmol, R., additional, Guerra, L., additional, Girbes, V., additional, Ferrando, J., additional, Rincon De Arellano, A., additional, Patricio, L., additional, Blondal, M., additional, Ainla, T., additional, Marandi, T., additional, Eha, J., additional, Oliveira, M. M., additional, Silva, M. N., additional, Cunha, P. S., additional, Feliciano, J., additional, Silva, S., additional, Kanovsky, J., additional, Kala, P., additional, Parenica, J., additional, Poloczek, M., additional, Prymusova, K., additional, Kubkova, L., additional, Spinar, J., additional, Olinic, D., additional, Homorodean, C., additional, Ober, M., additional, Olinic, M., additional, Andrioaia, C., additional, Condac, A., additional, Masmoudi, M., additional, Berdaoui, B., additional, Labidi, S., additional, Tapia Ballesteros, C., additional, Hernandez Luis, C., additional, Sandin, M. G., additional, Vegas, J. M., additional, Andion, R., additional, Martinez, N., additional, Gonzalez, I. A., additional, Alvarado, M., additional, Amat, I. J., additional, San Roman, J. A., additional, Garcia Gonzalez, M. J., additional, Arroyo Ucar, E., additional, Hernandez Garcia, C., additional, Dorta Martin, M., additional, Marrero Rodriguez, F., additional, Dragu, R., additional, Kapeliovich, M., additional, Hammerman, H., additional, Silva, D., additional, Cortez-Dias, N., additional, Jorge, C., additional, Silva Marques, J., additional, Carilho Ferreira, P., additional, Robalo Martins, S., additional, Almeida Ribeiro, M., additional, Calisto, C., additional, Fiuza, M., additional, Lopes, M. G., additional, Milicevic, P., additional, Panic, M., additional, Stankovic, I., additional, Milicevic, D., additional, Kalezic, T., additional, Kafedzic, S., additional, Ilic, I., additional, Cerovic, M., additional, Putnikovic, B., additional, Neskovic, A., additional, Rott, D., additional, Leibowitz, D., additional, Monhart, Z., additional, Reissigova, J., additional, Grunfeldova, H., additional, Jansky, P., additional, Valente, B., additional, Villanueva Benito, I., additional, Solla, I., additional, Paredes, E., additional, Diaz Castro, O., additional, Calvo, F., additional, Baz, J. A., additional, Iniguez, A., additional, Aleksova, A., additional, Gerloni, R., additional, Belfiore, R., additional, Carriere, C., additional, Barbati, G., additional, Fabris, E., additional, Possa, F., additional, Nait, D., additional, Milo, M., additional, Sinagra, G., additional, Marques, N., additional, Mimoso, J., additional, Gomes, V., additional, Agra Bermejo, R. M., additional, Emad Abu Assi, E. A. A., additional, Sergio Raposeiras Roubin, S. R. R., additional, Pilar Cabanas Grandio, P. C. G., additional, Carlos Pena Gil, C. P. G., additional, Jose Maria Garcia Acuna, J. M. G. A., additional, Jose Ramon Gonzalez Juanatey, J. R. G. J., additional, Daly, M. J., additional, Scott, P., additional, Owens, C. G., additional, Tomlin, A., additional, Smith, B., additional, Adgey, A. A. J., additional, Alvarez-Contreras, L. R., additional, Juarez, U., additional, Altamirano, A., additional, Arias, A., additional, Alvarez-San Gabriel, A., additional, Gonzalez-Pacheco, H., additional, Martinez-Sanchez, C., additional, Rahnavardi, M., additional, Keshtkar-Jahromi, M., additional, Vakili, H., additional, Gholamin, S., additional, Razavi, S. M., additional, Gilis-Januszewski, T., additional, Mellwig, K.- P., additional, Wiemer, M., additional, Gilis-Januszewski, J., additional, Peterschroeder, A., additional, Koerfer, J., additional, Horstkotte, D., additional, Vrsalovic, M., additional, Getaldic, B., additional, Vrkic, N., additional, Pintaric, H., additional, Khan, S., additional, Wasan, B., additional, Moretti, L., additional, Grossi, P., additional, Silenzi, S., additional, Testa, M., additional, Candelori, L., additional, Clementi, L. N., additional, Forlini, M., additional, Lando, L., additional, Pezzuoli, M. L., additional, Corradetti, P., additional, Leurent, G., additional, Pennec, P. Y., additional, Filippi, E., additional, Moquet, B., additional, Hacot, J. P., additional, Druelles, P., additional, Rialan, A., additional, Rouault, G., additional, Coudert, I., additional, Le Breton, H., additional, Gevaert, S., additional, Tromp, F., additional, Vandecasteele, E., additional, De Somer, F., additional, Van Belleghem, Y., additional, Bouchez, S., additional, Martens, F., additional, Herck, I., additional, De Pauw, M., additional, Ludka, O., additional, Sepsi, M., additional, Miklik, R., additional, Dusek, L., additional, Tomcikova, D., additional, Garcia-Acuna, J. M., additional, Aguiar-Souto, P., additional, Raposeiras Roubin, S., additional, Agra-Bermejo, R., additional, Jacquet, M., additional, Abu-Assi, E., additional, Gonzalez-Juanatey, J. R., additional, Ibatov, A., additional, Labrova, R., additional, Karlik, R., additional, Lokaj, P., additional, She, Q., additional, Deng, S. B., additional, Huang, S. H., additional, Gu, L. J., additional, Rong, J. I. A. N., additional, Wu, Z. K., additional, Li, Y., additional, Zhang, J., additional, Parascan, L., additional, Campanile, A., additional, Spinelli, L., additional, Santulli, G., additional, Ciccarelli, M., additional, De Gennaro, S., additional, Assante Di Panzillo, E., additional, Trimarco, B., additional, Iaccarino, G., additional, Bobescu, E., additional, Datcu, G., additional, Dobreanu, D., additional, Doka, B., additional, Charniot, J.- C., additional, Cosson, C., additional, Albertini, J. P., additional, Bittar, R., additional, Giral, P., additional, Cherfils, C., additional, Guillerm, E., additional, Bonnefont-Rousselot, D., additional, Rusali, A., additional, Cojocaru, L., additional, Parepa, I., additional, Koizumi, T., additional, Iida, S., additional, Sato, J., additional, Kikutani, T., additional, Muramatsu, T., additional, Nishimura, S., additional, Komiyama, N., additional, Lee, W. P., additional, Ong, B. B., additional, Haralambos, K., additional, Townsend, D., additional, Rees, J. A. E., additional, Williams, E. J., additional, Halcox, J. P., additional, Mcdowell, I., additional, Damjanovic, M., additional, Koracevic, G., additional, Djordjevic-Radojkovic, D., additional, Pavlovic, M., additional, Krstic, N., additional, Ciric-Zdravkovic, S., additional, Stojkovic, A., additional, Perisic, Z., additional, Apostolovic, S., additional, Faustino, A., additional, Seca, L., additional, Barra, S., additional, Caetano, F., additional, Providencia, R., additional, Silva, J., additional, Gomes, P., additional, Costa, G., additional, Costa, M., additional, Leitao-Marques, A., additional, Volkova, A. L., additional, Arutyunov, G. P., additional, Bylova, N. A., additional, Dayter, I. I., additional, Jao, Y. T. F. N., additional, Fang, C. C., additional, Chen, Y., additional, Yu, C. L., additional, Wang, S. P., additional, Valencia, J., additional, Perez-Berbel, P., additional, Ruiz-Nodar, J. M., additional, Pineda, J., additional, Bordes, P., additional, Quintanilla, M., additional, Mainar, V., additional, Sogorb, F., additional, Santos, N., additional, Serrao, M., additional, Cafe, H., additional, Silva, B., additional, Oliveira, R., additional, Caires, G., additional, Drumond, A., additional, Araujo, J., additional, Providencia, R. A., additional, Gomes, P. L., additional, Pais, J. R., additional, Mota, P., additional, Leitao-Marques, A. M., additional, Farhan, S., additional, Jarai, R., additional, Tentzeris, I., additional, Vogel, B., additional, Freynhofer, M. K., additional, Wojta, J., additional, Huber, K., additional, Poli, M., additional, Trambaiolo, P., additional, Corsi, F., additional, De Luca, M., additional, Mustilli, M., additional, Lukic, V., additional, Simonetti, M., additional, Ferraiuolo, G., additional, Lettino, M., additional, Casella, G., additional, Conte, M. R., additional, De Luca, L., additional, Geraci, G., additional, Ceravolo, R., additional, Pani, A., additional, Fradella, G., additional, Schratter, A., additional, Thiele, H., additional, Klemm, T., additional, Demmin, K., additional, Lehmann, D., additional, Mende, M., additional, Schuler, G., additional, Pittl, U., additional, Chernova, A., additional, Nikulina, S. U., additional, Naruke, T., additional, Inomata, T., additional, Yanagisawa, T., additional, Maekawa, E., additional, Mizutani, T., additional, Shinagawa, H., additional, Nishii, M., additional, Takeuchi, I., additional, Takehana, H., additional, Izumi, T., additional, Paulo, C., additional, Mascarenhas, J., additional, Patacho, M., additional, Pimenta, J., additional, Bettencourt, P., additional, Nardai, S., additional, Szabo, G. Y., additional, Berta, B., additional, Edes, I., additional, Merkely, B., additional, Delgado Silva, J., additional, Baptista, R., additional, Faria, R., additional, Trigo, J., additional, Gago, P., additional, Gheorghe, G., additional, Nanea, I. T., additional, Cristea, A., additional, Almarichi, S., additional, Martins, H., additional, Saraiva, F., additional, Jorge, E., additional, Mendes, P. L., additional, Monteiro, P., additional, Costa, S., additional, Franco, F., additional, Providencia, L. A., additional, Nanea, T., additional, Gheorghe, G. S., additional, Visan, S., additional, Paun, N., additional, Gaber, R., additional, Delewi, R., additional, Nijveldt, R., additional, De Bruin, H. A., additional, Hirsch, A., additional, Van Der Laan, A., additional, Bouma, B. J., additional, Tijssen, J. P. G., additional, Van Rossum, A. C., additional, Zijlstra, F., additional, Piek, J. J., additional, Rus, H., additional, Donea, M., additional, Ciurea, C., additional, Ifteni, G., additional, Casolo, G., additional, Chioccioli, M., additional, Magnacca, M., additional, Del Meglio, J., additional, Comella, A., additional, Baratto, M., additional, Lera, J., additional, Salvadori, L., additional, Tessa, C., additional, Vignali, C., additional, Keca, Z., additional, Momcilov Popin, T., additional, Panic, G., additional, White, R., additional, Mateen, F., additional, Weaver, A., additional, Agmon, Y., additional, Okisheva, E., additional, Tsaregorodtsev, D., additional, Sulimov, V., additional, Amat Santos, I. J., additional, Hernandez, C., additional, Tapia, C., additional, Campo, A., additional, Fredman, D., additional, Svensson, L., additional, Rosenqvist, M., additional, Tadel-Kocjancic, S., additional, Radsel, P., additional, Knafelj, R., additional, Gorjup, V., additional, Noc, M., additional, Zima, E., additional, Jenei, Z. S., additional, Kovacs, E., additional, Osztheimer, I., additional, Molnar, L., additional, Horvath, A., additional, Becker, D., additional, Geller, L., additional, Maggi, R., additional, Furukawa, T., additional, Viscardi, V., additional, Brignole, M., additional, Leal, S. R. N., additional, Dores, H., additional, Rosario, I., additional, Monge, J., additional, Carvalho, M. J., additional, Arroja, I., additional, Leitao, A., additional, Fonseca, C., additional, Aleixo, A., additional, Silva, A., additional, Keuleers, S., additional, Herijgers, P., additional, Herregods, M. C., additional, Budts, W., additional, Dubois, C., additional, Meuris, B., additional, Verhamme, P., additional, Flameng, W., additional, Van De Werf, F., additional, Adriaenssens, T., additional, Badran, H., additional, Elnoamany, M., additional, Lolah, T., additional, Olariu, C., additional, Macarie, C., additional, Mollik, M. A. H., additional, Hassan, A. I., additional, Paul, T. K., additional, Haque, M. Z., additional, Jahan, R., additional, Rahmatullah, M., additional, Khatun, M. A., additional, Rahman, M. T., additional, Chowdhury, M. H., additional, Bustamante Munguira, J., additional, Tamayo, E., additional, Garcia-Cuenca, I., additional, Bustamante, E., additional, Gualis, J., additional, Gomez-Martinez, M. L., additional, Florez, S., additional, Gomez-Herreras, J. I., additional, Ramirez Rodriguez, R., additional, Ramirez Rodriguez, A. M., additional, Garcia-Bello, M. A., additional, Hernadez Ortega, E., additional, Caballero Dorta, E., additional, Garcia Quintana, A., additional, Piro Mastraccio, V., additional, Medina Fernandez Aceytuno, A., additional, Assanelli, E., additional, De Metrio, M., additional, Rubino, M., additional, Lauri, G., additional, Cabiati, A., additional, Campodonico, J., additional, Grazi, M., additional, Moltrasio, M., additional, Marana, I., additional, Marenzi, G., additional, Lovlien, M., additional, Schei, B., additional, Picon-Heras, R., additional, Acebal, C., additional, Garcia Rubira, J. C., additional, Vivas Balcones, D., additional, Nunez-Gil, I., additional, Ruiz-Mateos, B., additional, Ibanez, B., additional, Fernandez-Ortiz, A., additional, Vintila, V. D., additional, Enescu, O. A., additional, Stoicescu, C. I., additional, Udroiu, C., additional, Cinteza, M., additional, Tatu - Chitoiu, G., additional, Vinereanu, D., additional, Fresco, C., additional, De Biasio, M., additional, Muser, D., additional, Sappa, R., additional, Morocutti, G., additional, Bernardi, G., additional, Proclemer, A., additional, Fontanella, B., additional, Affatato, A., additional, Ciccarese, C., additional, Sacchini, M., additional, Volpini, M., additional, Bianchetti, F., additional, Verzura, G., additional, Dei Cas, L., additional, Pudil, R., additional, Blaha, V., additional, Vojacek, J., additional, Paraskevaidis, I., additional, Ikonomidis, I., additional, Parissis, J., additional, Papadopoulos, C., additional, Stasinos, V., additional, Bistola, V., additional, Anastasiou-Nana, M., additional, Shochat, M., additional, Shotan, A., additional, Kazatsker, M., additional, Gurovich, V., additional, Asif, A., additional, Noiman, E., additional, Levy, Y., additional, Blondhaim, D., additional, Rabinovich, P., additional, Meisel, S., additional, Petrovic, S., additional, Glasnovic, J., additional, Tomasevic, M., additional, Sakac, D., additional, Obradovic, S., additional, Londono Sanchez, O., additional, Pacreu, S., additional, Torres, L., additional, Mihaylov, G., additional, Shaban, G. M., additional, Trendafilova, E., additional, Krasteva, V., additional, Mudrov, T. S., additional, Didon, J. P., additional, Panageas, V., additional, Vlachos, N., additional, Pernat, A., additional, Radan, I., additional, Mozina, H., additional, Pepi, P., additional, Cionini, F., additional, Baccaglioni, N., additional, Viertel, A., additional, Havers, J., additional, Ballard, G., additional, Groenefeld, G., additional, Branco, L. M., additional, Ferreira, L., additional, Fiarresga, A., additional, Lettieri, L., additional, Reggiani, A., additional, Juarez Prera, R., additional, Blanco Palacios, G., additional, Martin, A.- C., additional, Manzo Silberman, S., additional, Chaib, A., additional, Varenne, O., additional, Allouch, P., additional, Salengro, E., additional, Jegou, A., additional, Margot, O., additional, Spaulding, C., additional, Diego, A., additional, De Miguel, A., additional, Cuellas, C., additional, Fraile, E., additional, Martin, J., additional, Vega, B., additional, Bangueses, R., additional, Fernandez-Vazquez, F., additional, Perez De Prado, A., additional, Leal, S., additional, Correia, M. J., additional, Monge, J. 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S., additional, Franci, B., additional, Nuti, R., additional, Maisel, A., additional, Negrini, M., additional, Minora, T., additional, Marino, P., additional, Seregni, R., additional, Tavlueva, E., additional, Barbarash, O., additional, Barbarash, L., additional, Janota, T., additional, Kudlicka, J., additional, Malik, K., additional, Wichterle, D., additional, Hradec, J., additional, Body, R., additional, Carley, S. D., additional, Mcdowell, G., additional, Nuttall, M., additional, Wibberley, C., additional, France, M., additional, Cruickshank, J. K., additional, Mackway-Jones, K., additional, Leon, M., additional, Cozma, C., additional, Mitu, F., additional, Almeida, D. R., additional, Dias, C. B., additional, Burazor, I., additional, Burazor, M., additional, Krstic, M., additional, Lazovic, M., additional, Vukmanovic, M., additional, Djordjevic, J., additional, Radovanovic, Z., additional, Ilic, D., additional, Bosnjakovic, P., additional, Ferreira, A. C., additional, Mateus, P. S., additional, Fontes, P., additional, Teixeira, T., additional, Conte, G., additional, Menozzi, A., additional, Solinas, E., additional, Bolognesi, M. G., additional, Tadonio, I., additional, Mantovani, F., additional, Cattabiani, A., additional, Vignali, L., additional, Ardissino, D., additional, Tautu, O., additional, Alexandrescu, A., additional, Niculescu, R., additional, Jankovic, R., additional, Bozinovic, N., additional, Santos, C., additional, Costa, F., additional, Cardoso, G., additional, Correia, I., additional, Fountoulaki, K., additional, Kastellanos, S., additional, Voltirakis, E., additional, Kokotos, A., additional, Michalakeas, C., additional, Kontsas, K., additional, Hasioti, K., additional, Iliodromitis, E. T., additional, Sandin Fuentes, M. G., additional, Zatarain Nicolas, E., additional, Martinez Uruena, N., additional, Alvarado Montes De Oca, M., additional, Dytrych, V., additional, Kovarnik, T., additional, Smid, O., additional, Kral, A., additional, Aroutunov, A. G., additional, Intwala, S., additional, Jegere, I., additional, Shaalan, H. S. H., additional, Pagava, Z., additional, Agladze, R., additional, Shakarishvili, R., additional, Sharashidze, N., additional, Gujejiani, L., additional, Saatashvili, G., additional, Katova, T. Z., additional, Kostova, V., additional, Simova, Y., additional, Vukotic, S., additional, Rafajlovski, S., additional, Romanovic, R., additional, Antonijevic, N., additional, Gligic, B., additional, Hutyra, M., additional, Skala, T., additional, Horak, D., additional, Vindis, D., additional, Taborsky, M., additional, Contine, A., additional, Del Pinto, M., additional, Angeli, F., additional, Verdecchia, P., additional, Borgognoni, F., additional, Grikstaite, E., additional, Pantano, P., additional, Ambrosio, G., additional, Cavallini, C., additional, Bonanad, C., additional, Sanchis, J., additional, Bodi, V., additional, Nunez, J., additional, Bosch, X., additional, Heras, M., additional, Pellicer, M., additional, Llacer, A., additional, Adao, L., additional, Oliveira, M., additional, Goncalves, H., additional, Primo, J., additional, Gama, V., additional, Lombardi, C., additional, Metra, M., additional, Bugatti, S., additional, Pasotti, E., additional, Quinzani, F., additional, Adamo, M., additional, Villa, C., additional, Rovetta, R., additional, Manerba, A., additional, Mariani, M., additional, Dushpanova, A., additional, Baroni, M., additional, Cerone, E., additional, Nardelli, A., additional, Gianetti, J., additional, Berti, S., additional, Feliciano, F., additional, Soares, R., additional, Santos, S., additional, Kruger, A., additional, Vondrakova, D., additional, Herget, J., additional, Navarro, C., additional, Cromie, N. A., additional, Adgey, J. A. A., additional, Caeiro Pereira, D., additional, Braga, P., additional, Fontes Carvalho, R., additional, Rodrigues, A., additional, Goncalves, M., additional, Simoes, L., additional, and Borisov, K. V., additional

Published
2010
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25. Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest.

Author

Suverein, M. M., Delnoij, T. S. R., Lorusso, R., Bravo Bruinsma, G. J. Brandon, Otterspoor, L., Kraemer, C. V. Elzo, Vlaar, A. P. J., van der Heijden, J. J., Scholten, E., den Uil, C., Jansen, T., van den Bogaard, B., Kuijpers, M., Lam, K. Y., Cabezas, J. M. Montero, Driessen, A. H. G., Rittersma, S. Z. H., Heijnen, B. G., Miranda, D. Dos Reis, and Bleeker, G.

Subjects
*CARDIAC arrest, *RETURN of spontaneous circulation, *ADVANCED cardiac life support, *VENTRICULAR arrhythmia, *BYSTANDER CPR
Abstract

BACKGROUND Extracorporeal cardiopulmonary resuscitation (CPR) restores perfusion and oxygenation in a patient who does not have spontaneous circulation. The evidence with regard to the effect of extracorporeal CPR on survival with a favorable neurologic outcome in refractory out-of-hospital cardiac arrest is inconclusive. METHODS In this multicenter, randomized, controlled trial conducted in the Netherlands, we assigned patients with an out-of-hospital cardiac arrest to receive extracorporeal CPR or conventional CPR (standard advanced cardiac life support). Eligible patients were between 18 and 70 years of age, had received bystander CPR, had an initial ventricular arrhythmia, and did not have a return of spontaneous circulation within 15 minutes after CPR had been initiated. The primary outcome was survival with a favorable neurologic outcome, defined as a Cerebral Performance Category score of 1 or 2 (range, 1 to 5, with higher scores indicating more severe disability) at 30 days. Analyses were performed on an intention-to-treat basis. RESULTS Of the 160 patients who underwent randomization, 70 were assigned to receive extracorporeal CPR and 64 to receive conventional CPR; 26 patients who did not meet the inclusion criteria at hospital admission were excluded. At 30 days, 14 patients (20%) in the extracorporeal-CPR group were alive with a favorable neurologic outcome, as compared with 10 patients (16%) in the conventional-CPR group (odds ratio, 1.4; 95% confidence interval, 0.5 to 3.5; P=0.52). The number of serious adverse events per patient was similar in the two groups. CONCLUSIONS In patients with refractory out-of-hospital cardiac arrest, extracorporeal CPR and conventional CPR had similar effects on survival with a favorable neurologic outcome. (Funded by the Netherlands Organization for Health Research and Development and Maquet Cardiopulmonary [Getinge]; INCEPTION ClinicalTrials.gov number, NCT03101787.) [ABSTRACT FROM AUTHOR]

Published
2023
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26. Routine reporting of grey-white matter differentiation in early brain computed tomography in comatose patients after cardiac arrest: A substudy of the COACT trial.

Author

Adriaansens, K O, Jewbali, L S D, Lemkes, J S, Spoormans, E M, Meuwissen, M, Blans, M J, van der Harst, P, Eikemans, B J W, Bleeker, G B, Beishuizen, A, Henriques, J P, van der Lugt, A, van Royen, N, and den Uil, C A

Subjects
*BRAIN, *RETROSPECTIVE studies, *PROGNOSIS, *COMA, *COMPUTED tomography
Abstract

Aim: A multimodal approach is advised for neurological prognostication in comatose patients after out-of-hospital cardiac arrest (OHCA). Grey-white matter differentiation (grey-white ratio, GWR) obtained from a brain CT scan performed < 24 hours after return of circulation can be part of this approach. The aims of this study were to investigate the frequency and method of reporting the GWR in brain CT scan reports and their association with outcome.Methods: This is a post-hoc descriptive analysis of the COACT trial. The primary endpoint was the reporting of GWR by the radiologist. Secondary endpoints were APACHE IV score, Cerebral Performance Categories at discharge and 90-day follow-up, Glasgow Coma Scale at discharge, GWR-stratified 1-year survival, and RAND-36 stratified by normal versus abnormal GWR. Associations were analysed using multivariable analysis.Results: A total of 427 OHCA patients were included in this study, 234 (55%) of whom underwent a brain CT scan within 24 hours after ROSC. Median time between arrest and initial CT scan was 12 hours. In 195 patients (83%), the GWR was described in the reports, but always expressed qualitatively. The GWR was deemed abnormal in 57 (29%) CT scans. No differences were found in secondary endpoints between the two groups.Conclusion: GWR was frequently described in CT scan reports. Early abnormal GWR, as assessed qualitatively by a radiologist within 24 hours after ROSC, was a poor predictor of neurological prognosis. [ABSTRACT FROM AUTHOR]

Published
2022
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27. Disease characteristics of MCT8 deficiency: an international, retrospective, multicentre cohort study

Author

Anina Enderli, Krishna Chatterjee, David A. Koolen, Jana Malikova, Paul Dimitri, Roelineke J. Lunsing, Patricia Crock, Charles Marques Lourenço, Corstiaan A. den Uil, Ferdy S van Geest, Jan Lebl, Christine M. Armour, Michaela Linder-Lucht, Tony Huynh, Annette Hackenberg, Zita Halász, Jan Fairchild, Francesco Porta, Adri van der Walt, Verónica Mericq, Gautem P. Ambegaonkar, Nitash Zwaveling-Soonawala, Daniel Konrad, D Barca, Barbara Castellotti, Cláudia Fernandes Lorea, Anna Dolcetta-Capuzzo, Peter J Simm, Heiko Krude, Evelien F. Gevers, Ayhan Abaci, Claudia Castiglioni, Jet van der Spek, Jolante Wierzba, Carla Moran, Serap Turan, Isabelle Oliver-Petit, Felipe Monti Lora, Amnon Zung, Klara Rozenkova, Nicola Brunetti-Pierri, Fabiano de Oliveira Poswar, W. Edward Visser, Gopinath M. Subramanian, Bianka Heinrich, Irenaeus F.M. de Coo, Milou A.M. Stals, Belinda George, Michael Wurm, Alice Dica, Amy Lawson-Yuen, Rachana Dubey, Christina Reinauer, Athanasia Stoupa, Stefan Groeneweg, Joel Vanderniet, Marjolein H G Dremmen, Marie Claire Y. de Wit, Marjo S. van der Knaap, Edna E. Mancilla, Dana Craiu, Korcan Demir, Greta Lyons, Gerarda Cappuccio, Jean Louis Wémeau, Yogen Singh, Anne McGowan, Alberto Alcantud, Praveen G. Paul, Enrico Bertini, Laura Paone, Marco Spada, Régis Coutant, Marco Cappa, Ingrid M. van Beynum, Jonathan Gallichan, Nicole I. Wolf, Michel Polak, Marieke M. van der Knoop, Christian DeGoede, Davide Tonduti, Federica Zibordi, Tuba Seven Menevse, Katalin Eszter Müller, Anna Simon, Marianna Bugiani, Priyanka Bakhtiani, Anna Kłosowska, Internal Medicine, Pediatrics, Neurology, Radiology & Nuclear Medicine, Cardiology, Intensive Care, Amsterdam Neuroscience - Cellular & Molecular Mechanisms, Pathology, Pediatric surgery, Paediatric Endocrinology, ANS - Cellular & Molecular Mechanisms, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Functional Genomics, Groeneweg, S., van Geest, F. S., Abaci, A., Alcantud, A., Ambegaonkar, G. P., Armour, C. M., Bakhtiani, P., Barca, D., Bertini, E. S., van Beynum, I. M., Brunetti-Pierri, Nicola, Bugiani, M., Cappa, M., Cappuccio, G., Castellotti, B., Castiglioni, C., Chatterjee, K., de Coo, I. F. M., Coutant, R., Craiu, D., Crock, P., Degoede, C., Demir, K., Dica, A., Dimitri, P., Dolcetta-Capuzzo, A., Dremmen, M. H. G., Dubey, R., Enderli, A., Fairchild, J., Gallichan, J., George, B., Gevers, E. F., Hackenberg, A., Halasz, Z., Heinrich, B., Huynh, T., Klosowska, A., van der Knaap, M. S., van der Knoop, M. M., Konrad, D., Koolen, D. A., Krude, H., Lawson-Yuen, A., Lebl, J., Linder-Lucht, M., Lorea, C. F., Lourenco, C. M., Lunsing, R. J., Lyons, G., Malikova, J., Mancilla, E. E., Mcgowan, A., Mericq, V., Lora, F. M., Moran, C., Muller, K. E., Oliver-Petit, I., Paone, L., Paul, P. G., Polak, M., Porta, F., Poswar, F. O., Reinauer, C., Rozenkova, K., Menevse, T. S., Simm, P., Simon, A., Singh, Y., Spada, M., van der Spek, J., Stals, M. A. M., Stoupa, A., Subramanian, G. M., Tonduti, D., Turan, S., den Uil, C. A., Vanderniet, J., van der Walt, A., Wemeau, J. -L., Wierzba, J., de Wit, M. -C. Y., Wolf, N. I., Wurm, M., Zibordi, F., Zung, A., Zwaveling-Soonawala, N., and Visser, W. E.

Subjects
Male, Pediatrics, Endocrinology, Diabetes and Metabolism, Bayley Scales of Infant Development, Monocarboxylic Acid Transporter, 0302 clinical medicine, Endocrinology, Retrospective Studie, Neurodevelopmental Disorder, Medicine, 030212 general & internal medicine, Child, Thyroid hormone transport, Symporters, Mental Disorders, Hazard ratio, SDG 10 - Reduced Inequalities, Middle Aged, Prognosis, Survival Rate, International Agencie, Child, Preschool, Cohort, Mental Disorder, Female, Disease characteristics, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5], Human, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9], Cohort study, Adult, Monocarboxylic Acid Transporters, medicine.medical_specialty, Adolescent, Prognosi, HEART-RATE, 030209 endocrinology & metabolism, Sudden death, Follow-Up Studie, MONOCARBOXYLATE TRANSPORTER-8, Young Adult, 03 medical and health sciences, HORMONE, Muscular Diseases, Internal Medicine, Humans, PSYCHOMOTOR RETARDATION, Survival rate, Aged, Retrospective Studies, Muscular Disease, business.industry, MUTATIONS, Symporter, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Infant, International Agencies, Retrospective cohort study, Biomarker, Neurodevelopmental Disorders, Mutation, business, Biomarkers, Follow-Up Studies
Abstract

Contains fulltext : 220431.pdf (Publisher’s version ) (Closed access) BACKGROUND: Disordered thyroid hormone transport, due to mutations in the SLC16A2 gene encoding monocarboxylate transporter 8 (MCT8), is characterised by intellectual and motor disability resulting from cerebral hypothyroidism and chronic peripheral thyrotoxicosis. We sought to systematically assess the phenotypic characteristics and natural history of patients with MCT8 deficiency. METHODS: We did an international, multicentre, cohort study, analysing retrospective data from Jan 1, 2003, to Dec 31, 2019, from patients with MCT8 deficiency followed up in 47 hospitals in 22 countries globally. The key inclusion criterion was genetically confirmed MCT8 deficiency. There were no exclusion criteria. Our primary objective was to analyse the overall survival of patients with MCT8 deficiency and document causes of death. We also compared survival between patients who did or did not attain full head control by age 1.5 years and between patients who were or were not underweight by age 1-3 years (defined as a bodyweight-for-age Z score

Published
2020
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28. Cost-effectiveness of extracorporeal cardiopulmonary resuscitation vs. conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a pre-planned, trial-based economic evaluation.

Author

Delnoij TSR, Suverein MM, Essers BAB, Hermanides RC, Otterspoor L, Elzo Kraemer CV, Vlaar APJ, van der Heijden JJ, Scholten E, den Uil C, Akin S, de Metz J, van der Horst ICC, Maessen JG, Lorusso R, and van de Poll MCG

Subjects
Aged, Female, Humans, Male, Middle Aged, Extracorporeal Membrane Oxygenation economics, Extracorporeal Membrane Oxygenation methods, Netherlands, Quality-Adjusted Life Years, Survival Rate trends, Cardiopulmonary Resuscitation economics, Cardiopulmonary Resuscitation methods, Cost-Benefit Analysis, Out-of-Hospital Cardiac Arrest therapy, Out-of-Hospital Cardiac Arrest economics, Quality of Life
Abstract

Aims: When out-of-hospital cardiac arrest (OHCA) becomes refractory, extracorporeal cardiopulmonary resuscitation (ECPR) is a potential option to restore circulation and improve the patient's outcome. However, ECPR requires specific materials and highly skilled personnel, and it is unclear whether increased survival and health-related quality of life (HRQOL) justify these costs., Methods and Results: This cost-effectiveness study was part of the INCEPTION study, a multi-centre, pragmatic randomized trial comparing hospital-based ECPR to conventional CPR (CCPR) in patients with refractory OHCA in 10 cardiosurgical centres in the Netherlands. We analysed healthcare costs in the first year and measured HRQOL using the EQ-5D-5L at 1, 3, 6, and 12 months. Incremental cost-effectiveness ratios (ICERs), cost-effectiveness planes, and acceptability curves were calculated. Sensitivity analyses were performed for per-protocol and as-treated subgroups as well as imputed productivity loss in deceased patients. In total, 132 patients were enrolled: 62 in the CCPR and 70 in the ECPR group. The difference in mean costs after 1 year was €5109 (95% confidence interval -7264 to 15 764). Mean quality-adjusted life year (QALY) after 1 year was 0.15 in the ECPR group and 0.11 in the CCPR group, resulting in an ICER of €121 643 per additional QALY gained. The acceptability curve shows that at a willingness-to-pay threshold of €80.000, the probability of ECPR being cost-effective compared with CCPR is 36%. Sensitivity analysis showed increasing ICER in the per-protocol and as-treated groups and lower probabilities of acceptance., Conclusion: Hospital-based ECPR in refractory OHCA has a low probability of being cost-effective in a trial-based economic evaluation., Competing Interests: Conflict of interest: R.L. reports support from ABIOMED for consulting lecture work and consultancy on the Medical Advisory Board of Xenios., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Published
2024
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29. Favorable resuscitation characteristics in patients undergoing extracorporeal cardiopulmonary resuscitation: A secondary analysis of the INCEPTION-trial.

Author

Ubben JFH, Heuts S, Delnoij TSR, Suverein MM, Hermanides RC, Otterspoor LC, Kraemer CVE, Vlaar APJ, van der Heijden JJ, Scholten E, den Uil C, Dos Reis Miranda D, Akin S, de Metz J, van der Horst ICC, Winkens B, Maessen JG, Lorusso R, and van de Poll MCG

Abstract

Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used as a supportive treatment for refractory out-of-hospital cardiac arrest (OHCA). Still, there is a paucity of data evaluating favorable and unfavorable prognostic characteristics in patients considered for ECPR., Methods: We performed a previously unplanned post-hoc analysis of the multicenter randomized controlled INCEPTION-trial. The study group consisted of patients receiving ECPR, irrespective of initial group randomization. The patients were divided into favorable survivors (cerebral performance category [CPC] 1-2) and unfavorable or non-survivors (CPC 3-5)., Results: In the initial INCEPTION-trial, 134 patients were randomized. ECPR treatment was started in 46 (66%) of 70 patients in the ECPR treatment arm and 3 (4%) of 74 patients in the conventional treatment arm. No statistically significant differences in baseline characteristics, medical history, or causes of arrest were observed between survivors ( n  = 5) and non-survivors ( n  = 44). More patients in the surviving group had a shockable rhythm at the time of cannulation (60% vs. 14%, p  = 0.037), underwent more defibrillation attempts (13 vs. 6, p  = 0.002), and received higher dosages of amiodarone (450 mg vs 375 mg, p  = 0.047) despite similar durations of resuscitation maneuvers. Furthermore, non-survivors more frequently had post-ECPR implantation adverse events., Conclusion: The persistence of ventricular arrhythmia is a favorable prognostic factor in patients with refractory OHCA undergoing an ECPR-based treatment. Future studies are warranted to confirm this finding and to establish additional prognostic factors. Clinical trial Registration: clinicaltrials.gov registration number NCT03101787., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘Roberto Lorusso reports consulting fees from Medtronic, LivaNova, Getinge, and Abiomed and participates in an advisory board of Eurosets and Xenios, which are not related to this work. All other authors report no conflicts of interest.’., (© 2024 The Author(s).)

Published
2024
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30. Effect of Next Generation Pulsatile Mechanical Circulatory Support on Cardiac Mechanics: The PULSE Trial.

Author

Bastos MB, McConkey H, Malkin O, den Uil C, Daemen J, Patterson T, Wolff Q, Kardys I, Schreuder J, Lenzen M, Zijlstra F, Redwood S, and Van Mieghem NM

Subjects
Aged, Hemodynamics, Humans, Prospective Studies, Stroke Volume, Heart-Assist Devices, Percutaneous Coronary Intervention adverse effects
Abstract

Objectives: To describe hemodynamic effects of iVAC2L mechanical circulatory support (MCS)., Background: MCS is increasingly used in the context of high-risk percutaneous coronary intervention (PCI). The effect of the pulsatile iVAC2L MCS on left ventricular loading conditions and myocardial oxygen consumption (MVO 2 ) is unknown., Methods: This prospective single-arm two-center study included 29 patients who underwent high-risk PCI with iVAC2L MCS using simultaneous invasive pulmonary pressure monitoring and left ventricular pressure-volume analysis. Hemodynamic recordings were performed during steady state conditions with MCS off and on before and after PCI. Pressure-volume variations were analyzed to denote responders and non-responders., Results: The mean age was 74 (IQR: 70-81) years and the mean SYNTAX score was 31 ± 8.3. Left ventricular unloading with iVAC2L MCS was demonstrated in 22 out of 27 patients with complete PV studies. Patients with moderate or severe mitral regurgitation or presenting with acute coronary syndrome (ACS) had higher filling pressures and volumes and were most responsive to iVAC2L unloading (9/10 patients with moderate or severe MR and 11/11 patients with ACS). Pulsatile MCS activation reduced MAP (-4%), SBP (-9%), ESP (-11%), ESV (-15%) and EDV (-4%) among responders but not among non-responders. Responders experienced significant reductions in afterload (Ea: -19%) with increases in stroke volume (+11%) and cardiac output (+11%)., Conclusions: Pulsatile iVAC2L MCS in patients with advanced coronary artery disease at high to prohibitive operative risk resulted in LV unloading and reduced myocardial oxygen consumption particularly in patients with ACS or significant MR with higher filling pressures at baseline., Clinical Trial Registration: NCT03200990., Competing Interests: Declaration of competing interest Dr Van Mieghem is advisor and received research grant support from PulseCath B.V. He received institutional research grant support from Abbott Vascular, Boston Scientific, Medtronic, Edwards Lifesciences, Daiichi Sankyo. Dr Bastos received personal fees from PulseCath BV. Dr Daemen received institutional grant/research support from Astra Zeneca, Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, and ReCor medical, and consultancy and speaker fees from Abiomed, ACIST medical, Boston Scientific, ReCor Medical, PulseCath, Pie Medical, Siemens Health Care and Medtronic. Dr Schreuder is an employee of CD Leycom. Mr Malkin is an employee of PulseCath BV. The other authors report no conflicts., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2022
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31. Managing Patients With Short-Term Mechanical Circulatory Support: JACC Review Topic of the Week.

Author

Balthazar T, Vandenbriele C, Verbrugge FH, Den Uil C, Engström A, Janssens S, Rex S, Meyns B, Van Mieghem N, Price S, and Adriaenssens T

Subjects
Heart Failure diagnostic imaging, Heart Failure physiopathology, Heart-Assist Devices adverse effects, Humans, Intensive Care Units trends, Retrospective Studies, Shock, Cardiogenic diagnostic imaging, Shock, Cardiogenic physiopathology, Time Factors, Treatment Outcome, Disease Management, Heart Failure therapy, Heart-Assist Devices trends, Shock, Cardiogenic therapy
Abstract

The use of mechanical circulatory support for patients presenting with cardiogenic shock is rapidly increasing. Currently, there is only limited and conflicting evidence available regarding the role of the Impella (a microaxial, continuous-flow, short-term, left or right ventricular assist device) in cardiogenic shock; further randomized trials are needed. Patient selection, timing of implantation, and post-implantation management in the cardiac intensive care unit are crucial elements for success. Particular challenges at the bedside include the practical management of anticoagulation, evaluation of correct device position, and the approach to use in a patient with signs of insufficient hemodynamic support. Profound knowledge of these issues is required to enable the maximal potential of the device. This review provides a comprehensive overview of the short-term assist device and describes a practical approach to optimize care for patients supported with the device., Competing Interests: Funding Support and Author Disclosures Drs. Balthazar, Vandenbriele, Engström, Meyns, Van Mieghem, and Price have reported receiving research and/or travel funding, as well as speaker fees, from Abiomed. Dr. Balthazar was supported by a grant from the Van De Werf fund for clinical research. Dr. Vandenbriele has reported being supported by a grant from University Hospitals Leuven (Klinische onderzoeks-en opleidingsraad). Dr. Verbrugge has reported being supported by a Fellowship of the Belgian American Educational Foundation and by the Special Research Fund of Hasselt University (BOF19PD04). Dr. Adriaenssens has received speaker fees from Abiomed. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2021 American College of Cardiology Foundation. All rights reserved.)

Published
2021
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32. Prognostic implications of microcirculatory perfusion versus macrocirculatory perfusion in cardiogenic shock: a CULPRIT-SHOCK substudy.

Author

Wijntjens GW, Fengler K, Fuernau G, Jung C, den Uil C, Akin S, van de Hoef TP, Šerpytis R, Diletti R, Henriques JP, Šerpytis P, Thiele H, and Piek JJ

Subjects
Aged, Female, Follow-Up Studies, Hemodynamics, Humans, Male, Microscopy, Video methods, Middle Aged, Mouth Floor blood supply, Mouth Floor diagnostic imaging, Myocardial Infarction complications, Myocardial Infarction surgery, Percutaneous Coronary Intervention methods, Percutaneous Coronary Intervention statistics & numerical data, Prognosis, Renal Replacement Therapy statistics & numerical data, Shock, Cardiogenic etiology, Shock, Cardiogenic mortality, Time Factors, Microcirculation physiology, Myocardial Infarction physiopathology, Perfusion Index statistics & numerical data, Shock, Cardiogenic physiopathology
Abstract

Background: After early revascularisation, restoration of macrocirculatory perfusion parameters is the primary objective in the management of cardiogenic shock complicated acute myocardial infarction. Nevertheless, vital organ perfusion may be compromised at the systemic microcirculatory level, even in patients with preserved macrohaemodynamics. Microvascular perfusion was shown to have independent prognostic value for early mortality. The present study aims to compare the prognostic value of microcirculatory versus macrocirculatory perfusion parameters., Methods: This substudy of the culprit lesion-only percutaneous coronary intervention versus multivessel percutaneous coronary intervention in cardiogenic shock (CULPRIT-SHOCK) trial examined the sublingual capillary network using videomicroscopy post-percutaneous coronary intervention to determine the proportion of perfused capillaries (<20 µm) and perfused capillary density. Thirty-day follow-up was performed to obtain the occurrence of a combined clinical endpoint of all-cause death and renal replacement therapy., Results: Videomicroscopy measurements were performed in 66 patients. There was a significant adjusted association between microcirculatory perfusion parameters and the combined clinical endpoint (proportion of perfused capillaries: P =0.020; perfused capillary density: P =0.035), whereas there was no significant adjusted association between macrocirculatory perfusion parameters and the combined clinical endpoint (systolic blood pressure: P =0.205). Normotensive patients with compromised microcirculatory perfusion parameters had a higher risk of the combined clinical endpoint than normotensive patients with preserved microcirculatory perfusion parameters (proportion of perfused capillaries: Breslow P =0.014; perfused capillary density: Breslow P =0.076)., Conclusions: There is a significant and independent association between microcirculatory perfusion parameters perfused capillary density and proportion of perfused capillaries and the combined clinical endpoint of all-cause death and renal replacement therapy at 30 days follow-up. In patients with loss of haemodynamic coherence between microcirculatory and macrocirculatory perfusion parameters, microcirculatory perfusion parameters confer dominant prognostic value.

Published
2020
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33. Acute calcium channel blocker withdrawal-induced cardiac arrest.

Author

Peeters LEJ, den Uil CA, Feyz L, van den Bemt PMLA, Daemen J, and Versmissen J

Subjects
Angina Pectoris drug therapy, Coronary Vasospasm drug therapy, Diagnosis, Differential, Female, Humans, Middle Aged, Treatment Outcome, Calcium Channel Blockers administration & dosage, Calcium Channel Blockers adverse effects, Heart Arrest, Induced methods, Substance Withdrawal Syndrome drug therapy, Verapamil administration & dosage, Verapamil adverse effects
Abstract

Acute withdrawal of calcium channel blockers can lead to the so-called calcium channel blocker withdrawal phenomenon, in particular, when high dosages are used. In the case presented, inadequate drug substitution led to this phenomenon which resulted in a serious course of events. Careful monitoring the process of drug substitution with respect to equal therapeutic dosages is therefore a necessity, especially in vulnerable patients.

Published
2019

34. Risk indicators for acute kidney injury in cardiogenic shock.

Author

van den Akker JPC, Bakker J, Groeneveld ABJ, and den Uil CA

Subjects
Acute Kidney Injury etiology, Adult, Aged, Female, Humans, Male, Microcirculation physiology, Middle Aged, Retrospective Studies, Risk Factors, Shock, Cardiogenic complications, Acute Kidney Injury physiopathology, Central Venous Pressure physiology, Shock, Cardiogenic physiopathology
Abstract

Purpose: In critical illness, the relation between the macrocirculation, microcirculation and organ dysfunction, such as acute kidney injury (AKI), is complex. This study aimed at identifying predictors for AKI in patients with cardiogenic shock., Materials and Methods: Thirty-nine adult cardiogenic shock patients, with an admission creatinine <200 μmol l -1 , and whose microcirculation was measured within 48 h were enrolled. Patient data were analyzed if AKI stage ≥1 developed according to the Kidney Disease/Improving Outcomes classification within 48 h after admission. Variables with a p < .05 in the univariate analysis were considered for analysis with logistic regression., Results: Twenty-four patients (61.5%) developed AKI within 48 h. The group that developed AKI had higher central venous pressures (CVP), lower diastolic arterial blood pressures and mean perfusion pressures, higher maximum ventilator pressures as well as positive end expiratory pressures and were treated with higher dosages of dobutamine. There was no difference of the microcirculation. In the multivariate logistic regression analysis, CVP was the only independent predictor for AKI (OR 1.241; 95% CI 1.030-1.495; p = .023)., Conclusions: In this population of patients with cardiogenic shock, CVP was associated with the development of AKI., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Published
2019
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35. Excessive Extracellular ATP Desensitizes P2Y2 and P2X4 ATP Receptors Provoking Surfactant Impairment Ending in Ventilation-Induced Lung Injury.

Author

Hasan D, Satalin J, van der Zee P, Kollisch-Singule M, Blankman P, Shono A, Somhorst P, den Uil C, Meeder H, Kotani T, and Nieman GF

Subjects
Animals, Humans, Lung Injury metabolism, Lung Injury pathology, Pulmonary Surfactant-Associated Proteins metabolism, Receptors, Purinergic P2X4 metabolism, Receptors, Purinergic P2Y2 metabolism, Signal Transduction, Adenosine Triphosphate metabolism, Lung Injury etiology, Respiration, Artificial adverse effects
Abstract

Stretching the alveolar epithelial type I (AT I) cells controls the intercellular signaling for the exocytosis of surfactant by the AT II cells through the extracellular release of adenosine triphosphate (ATP) (purinergic signaling). Extracellular ATP is cleared by extracellular ATPases, maintaining its homeostasis and enabling the lung to adapt the exocytosis of surfactant to the demand. Vigorous deformation of the AT I cells by high mechanical power ventilation causes a massive release of extracellular ATP beyond the clearance capacity of the extracellular ATPases. When extracellular ATP reaches levels >100 &mu;M, the ATP receptors of the AT II cells become desensitized and surfactant impairment is initiated. The resulting alteration in viscoelastic properties and in alveolar opening and collapse time-constants leads to alveolar collapse and the redistribution of inspired air from the alveoli to the alveolar ducts, which become pathologically dilated. The collapsed alveoli connected to these dilated alveolar ducts are subject to a massive strain, exacerbating the ATP release. After reaching concentrations >300 &mu;M extracellular ATP acts as a danger-associated molecular pattern, causing capillary leakage, alveolar space edema, and further deactivation of surfactant by serum proteins. Decreasing the tidal volume to 6 mL/kg or less at this stage cannot prevent further lung injury.

Published
2018
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36. Design and principle of operation of the HeartMate PHP (percutaneous heart pump).

Author

Van Mieghem NM, Daemen J, den Uil C, Dur O, Joziasse L, Maugenest AM, Fitzgerald K, Parker C, Muller P, and van Geuns RJ

Subjects
Aged, Aged, 80 and over, Female, Hemodynamics, Humans, Male, Equipment Design, Heart-Assist Devices
Abstract

The HeartMate PHP (percutaneous heart pump) is a second-generation transcatheter axial flow circulatory support system. The collapsible catheter pump is inserted through a 14 Fr sheath, deployed across the aortic valve expanding to 24 Fr and able to deliver up to 5 L/min blood flow at minimum haemolytic risk. As such, this device may be a valuable adjunct to percutaneous coronary intervention (PCI) of challenging lesions in high-risk patients or treatment of cardiogenic shock. This technical report discusses: (i) the HeartMate PHP concept, (ii) the implantation technique, (iii) the haemodynamic performance in an in vitro cardiovascular flow testing set-up, and (iv) preliminary clinical experience. An update on the device, produced by St. Jude Medical/Abbott Laboratories, can be found in the Appendix.

Published
2018
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37. Timing of coronary angiography in survivors of out-of-hospital cardiac arrest without obvious extracardiac causes.

Author

Staudacher II, den Uil C, Jewbali L, van Zandvoort L, Zijlstra F, Van Mieghem N, Boersma E, and Daemen J

Subjects
Aged, Case-Control Studies, Coronary Angiography methods, Female, Humans, Male, Middle Aged, Proportional Hazards Models, Retrospective Studies, Time-to-Treatment, Cardiopulmonary Resuscitation methods, Coronary Angiography statistics & numerical data, Out-of-Hospital Cardiac Arrest mortality, Out-of-Hospital Cardiac Arrest therapy
Abstract

Background: Indications and timing of coronary angiography in patients surviving out-of-hospital cardiac arrest (OHCA) remain controversial. The aim of the present study was to assess the impact of an early invasive strategy in patients presenting with an OHCA and no obvious extracardiac cause., Methods: Between January 1st 2009 and December 31st 2014 a total 612 survivors of OHCA were admitted to our institution. Patients with no obvious extracardiac cause (n=507) were stratified into two groups: patients that underwent cardiac catheterization ≤3h (early invasive; n=291) and patients not undergoing cardiac catheterization within 3h (non-early invasive; n=216). Primary endpoint was all-cause mortality at 30days., Results: All-cause 30-day mortality was 28.9% in the early invasive group vs. 36.6% in the non-early invasive group (log-rank p=0.071). After propensity analyses, an early invasive strategy, as compared to a non-early strategy, was not associated with 30-day mortality (adjusted Hazard ratio [HR] 0.69; 95% CI 0.35-1.37; p=0.029). Cox multivariable regression analyses demonstrated age (HR 1.04/year; 95% CI 1.02-1.07) and presentation with cardiogenic shock (HR 5.1; 95% CI 1.8-14.0) to be the sole independent predictors of 30-day mortality., Conclusions: In this retrospective study, early coronary angiography (<3h), as compared to a non-early invasive strategy, was not associated with reduced 30-day mortality in patients hospitalized after OHCA, irrespective of the presence of ST segment elevation or cardiogenic shock at presentation., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Published
2018
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38. [Extracorporeal life support in calcium antagonist intoxication].

Author

Groot MW, Grewal S, Meeder HJ, van Thiel RJ, and den Uil CA

Subjects
Female, Heart Failure etiology, Humans, Male, Middle Aged, Retrospective Studies, Shock etiology, Suicide, Attempted, Treatment Outcome, Calcium Channel Blockers poisoning, Drug Overdose therapy, Extracorporeal Membrane Oxygenation, Heart Failure therapy, Shock therapy
Abstract

Background: Intoxication with calcium antagonists is associated with poor outcome. Even mild calcium antagonist overdose may be fatal., Case Description: A 51-year-old woman and a 51-year-old man came to the Accident and Emergency Department in severe shock after they had taken a calcium antagonist overdose. After extensive medicinal therapy had failed, they both needed extracorporeal life support (ECLS) as a bridge to recovery., Conclusion: In severe calcium antagonist overdose, the combination of vasoplegia and cardiac failure leads to refractory shock. ECLS temporarily supports the circulation and maintains organ perfusion. In this way ECLS functions as a bridge to recovery and may possibly save lives. Timely consultation with and referral to an ECLS centre is recommended in patients with calcium antagonist overdose.

Published
2017

39. Perioperative blood glucose monitoring and control in major vascular surgery patients.

Author

van Kuijk JP, Schouten O, Flu WJ, den Uil CA, Bax JJ, and Poldermans D

Subjects
Aged, Blood Glucose drug effects, Critical Care, Diabetes Mellitus blood, Diabetes Mellitus drug therapy, Diabetes Mellitus mortality, Drug Monitoring, Evidence-Based Medicine, Fasting blood, Humans, Hyperglycemia blood, Hyperglycemia drug therapy, Hyperglycemia etiology, Hyperglycemia mortality, Hypoglycemic Agents adverse effects, Middle Aged, Perioperative Care, Practice Guidelines as Topic, Prediabetic State blood, Prediabetic State drug therapy, Prediabetic State mortality, Predictive Value of Tests, Preoperative Care, Risk Assessment, Blood Glucose metabolism, Diabetes Mellitus diagnosis, Glucose Tolerance Test, Hyperglycemia diagnosis, Prediabetic State diagnosis, Vascular Surgical Procedures adverse effects, Vascular Surgical Procedures mortality
Abstract

Diabetes mellitus (DM) is an independent predictor for morbidity and mortality in the general population, which is even more apparent in patients with concomitant cardiovascular risk factors. As the prevalence of DM is increasing, with an ageing general population, it is expected that the number of diabetic patients requiring surgical interventions will increase. Perioperative hyperglycaemia, without known DM, has been identified as a predictor for morbidity and mortality in patients undergoing surgery. Moreover, early studies showed that intensive blood-glucose-lowering therapy reduced both morbidity and mortality among patients admitted to the postoperative intensive care unit (ICU). However, later studies have doubted the benefit of intensive glucose control in medical-surgical ICU patients. This article aims to comprehensively review the evidence on the use of perioperative intensive glucose control, and to provide recommendations for current clinical practice. A systematic review was performed of the literature on perioperative intensive glucose control. Based on this literature review, we observed that intensive glucose control in the perioperative period has no clear benefit on short-term mortality. Intensive glucose control may even have a net harmful effect in selected patients. In addition, concerns on the external validity of some studies are important barriers for widespread recommendation of intensive glucose control in the perioperative setting. We propose that guidelines recommending intensive glucose control should be re-evaluated. In addition, moderate tight glucose control should currently be regarded as the safest and most efficient approach to patients undergoing major vascular surgery.

Published
2009
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40. The heterogeneity of the microcirculation in critical illness.

Author

Klijn E, Den Uil CA, Bakker J, and Ince C

Subjects
Brain blood supply, Conjunctiva blood supply, Critical Illness, Eye blood supply, Hemodynamics physiology, Humans, Intestines blood supply, Mouth Floor blood supply, Multiple Organ Failure physiopathology, Prognosis, Regional Blood Flow physiology, Resuscitation, Shock, Septic physiopathology, Skin blood supply, Microcirculation physiology, Sepsis physiopathology
Abstract

Microcirculation, a complex and specialized facet of organ architecture, has characteristics that vary according to the function of the tissue it supplies. Bedside technology that can directly observe microcirculation in patients, such as orthogonal polarization spectral imaging and sidestream dark field imaging, has opened the way to investigating this network and its components, especially in critical illness and surgery. These investigations have underscored the central role of microcirculation in perioperative disease states. They have also highlighted variations in the nature of microcirculation, both among organ systems and within specific organs. Supported by experimental studies, current investigations are better defining the nature of microcirculatory alterations in critical illness and how these alterations respond to therapy. This review focuses on studies conducted to date on the microcirculatory beds of critically ill patients. The functional anatomy of microcirculation networks and the role of these networks in the pathogenesis of critical illness are discussed. The morphology of microvascular beds that have been visualized during surgery and intensive care at the bedside are also described, including those of the brain, sublingual region, skin, intestine, and eyes.

Published
2008
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