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  1. Article ; Online: Helicopter-Based Search and Rescue Operations in the Dutch Caribbean: A Retrospective Analysis.

    Bensi, Elena Argia Bianca / Spijkerman, Roy / Brown, Philip A / Knights, Shaun / Nellensteijn, David R

    Wilderness & environmental medicine

    2022  Volume 34, Issue 1, Page(s) 31–37

    Abstract: Introduction: Search and rescue (SAR) operations in the Dutch Caribbean offer basic and advanced prehospital care and transport for definitive care. Helicopter-based SAR in this geographic area has not been previously studied. Data from the Dutch ... ...

    Abstract Introduction: Search and rescue (SAR) operations in the Dutch Caribbean offer basic and advanced prehospital care and transport for definitive care. Helicopter-based SAR in this geographic area has not been previously studied. Data from the Dutch Caribbean Coast Guard were analyzed with the aim of describing the current operational setting and optimizing SAR operations in the future.
    Methods: Data were collected retrospectively from March 2018 through April 2021. Epidemiologic data, patient demographics, details of flight operations, medical interventions, and outcomes were collected and analyzed for this period.
    Results: A total of 91 individuals were assisted through SAR, of whom 40 (44%) had a medical emergency. Most incidents occurred during high-tourism seasons. A yearly increase in helicopter tasking was observed. Boating was the most common activity (25%) requiring SAR. Injuries to the extremities were the most common injury (27%). The median time to reach the scene of SAR was 46 (interquartile range [IQR], 33-66) min. The most frequent reason for delay was the unavailability of a winch operator (15%). Of 16 fatalities, most (63%) were attributed to drowning. A total of 18 persons were transported to a hospital, with a median travel time of 63 (IQR, 47-79) min.
    Conclusions: The number of SAR missions in the Dutch Caribbean is increasing. The response times might be reduced by the inclusion of an on-call winch operator. A hospital helipad would likely decrease the time to definitive care. Stand-by physicians might improve the quality of medical care. Collection of data should be optimized in the future.
    MeSH term(s) Humans ; Emergency Medical Services ; Retrospective Studies ; Air Ambulances ; Rescue Work ; Aircraft ; Caribbean Region/epidemiology
    Language English
    Publishing date 2022-12-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1238909-2
    ISSN 1545-1534 ; 1080-6032
    ISSN (online) 1545-1534
    ISSN 1080-6032
    DOI 10.1016/j.wem.2022.09.007
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3025: Show issues Location:
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  2. Article ; Online: Identification of neutrophil phenotype categories in geriatric hip fracture patients aids in personalized medicine.

    Nijdam, Thomas M P / Jukema, Bernard N / de Fraiture, Emma J / Spijkerman, Roy / Schuijt, Henk Jan / Spoelder, Marcia / Bongers, Coen C W G / Hopman, Maria T E / Koenderman, Leo / Hietbrink, Falco / van der Velde, Detlef

    OTA international : the open access journal of orthopaedic trauma

    2023  Volume 6, Issue 5 Suppl, Page(s) e291

    Abstract: Objectives: The number of geriatric hip fracture patients is high and expected to rise in the coming years, and many are frail and at risk for adverse outcomes. Early identification of high-risk patients is crucial to balance treatment and optimize ... ...

    Abstract Objectives: The number of geriatric hip fracture patients is high and expected to rise in the coming years, and many are frail and at risk for adverse outcomes. Early identification of high-risk patients is crucial to balance treatment and optimize outcome, but remains challenging. Previous research in patients with multitrauma suggested that neutrophil phenotype analysis could aid in early identification of high-risk patients. This pilot study investigated the feasibility and clinical value of neutrophil phenotype analysis in geriatric patients with a hip fracture.
    Methods: A prospective study was conducted in a regional teaching hospital in the Netherlands. At the emergency department, blood samples were collected from geriatric patients with a hip fracture and analyzed using automated flow cytometry. Flow cytometry data were processed using an automated clustering algorithm. Neutrophil activation data were compared with a healthy control cohort. Neutrophil phenotype categories were assessed based on two-dimensional visual assessment of CD16/CD62L expression.
    Results: Blood samples from 45 geriatric patients with a hip fracture were included. Neutrophils showed an increased activation profile and decreased responsiveness to formyl peptides when compared to healthy controls. The neutrophil phenotype of all patients was categorized. The incidence of severe adverse outcome was significantly different between the different categories (
    Conclusions: Using point-of-care fully automated flow cytometry to analyze the neutrophil compartment in geriatric hip fracture patients is feasible and holds clinical value in determining patients at risk for adverse outcome. This study is a first step toward immuno-based precision medicine for identifying geriatric hip fracture patients that are deemed fit for surgery.
    Language English
    Publishing date 2023-12-22
    Publishing country United States
    Document type Journal Article
    ISSN 2574-2167
    ISSN (online) 2574-2167
    DOI 10.1097/OI9.0000000000000291
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  3. Article: Predictors of surgical management of high grade blunt splenic injuries in adult trauma patients: a 5-year retrospective cohort study from an academic level I trauma center.

    Nijdam, Thomas M P / Spijkerman, Roy / Hesselink, Lilian / Leenen, Luke P H / Hietbrink, Falco

    Patient safety in surgery

    2020  Volume 14, Page(s) 32

    Abstract: Backgrounds: Splenic injury accounts for 40% of all injuries after blunt abdominal trauma. Blunt splenic injury in hemodynamically unstable patients is preferably treated by splenectomy. Nowadays hemodynamically stable patients with low grade splenic ... ...

    Abstract Backgrounds: Splenic injury accounts for 40% of all injuries after blunt abdominal trauma. Blunt splenic injury in hemodynamically unstable patients is preferably treated by splenectomy. Nowadays hemodynamically stable patients with low grade splenic injuries are mostly treated by non-operative management (NOM). However no consensus exists about the management of high grade splenic injuries in hemodynamically stable patients. Therefore the aim of this study was to analyze patients with high grade splenic injuries in our institution.
    Methods: We retrospectively included all patients with a splenic injury presented to our level I trauma center during the 5-year period from January 1, 2012, until December 31, 2017. Baseline characteristics, data regarding complications and mortality were collected from the electronic patient registry. Patients were grouped based on splenic injury and the treatment they received.
    Results: A total of 123 patients were included, of which 93 (75.6%) were male with a median age of 31 (24-52) and a median injury severity score of 27 (17-34). High grade injuries (
    Conclusion: Non-operative treatment in high grade splenic injuries is a safe treatment modality in hemodynamically stable patients. Hemodynamic status and peroperative bleeding, not injury severity or splenic injury grade were the drivers for surgical management by splenectomy. This selected cohort of patients must be closely monitored to prevent adverse outcomes from secondary delayed bleeding in case of non-operative management.
    Language English
    Publishing date 2020-08-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 2409244-7
    ISSN 1754-9493
    ISSN 1754-9493
    DOI 10.1186/s13037-020-00257-3
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  4. Article: Splenic injury severity, not admission hemodynamics, predicts need for surgery in pediatric blunt splenic trauma.

    Teuben, Michel / Spijkerman, Roy / Teuber, Henrik / Pfeifer, Roman / Pape, Hans-Christoph / Kramer, William / Leenen, Luke

    Patient safety in surgery

    2020  Volume 14, Page(s) 1

    Language English
    Publishing date 2020-01-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 2409244-7
    ISSN 1754-9493
    ISSN 1754-9493
    DOI 10.1186/s13037-019-0218-0
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  5. Article ; Online: Splenectomy is associated with altered leukocyte kinetics after severe trauma.

    Teuben, Michel Paul Johan / Hollman, Arne / Blokhuis, Taco / Pfeifer, Roman / Spijkerman, Roy / Teuber, Henrik / Pape, Hans-Christoph / Leenen, Luke Petrus Hendrikus

    European journal of medical research

    2021  Volume 26, Issue 1, Page(s) 26

    Abstract: Background: Inadequate activation of the innate immune system after trauma can lead to severe complications such as Acute Respiratory Distress Syndrome and Multiple Organ Dysfunction Syndrome. The spleen is thought to modulate the cellular immune system. ...

    Abstract Background: Inadequate activation of the innate immune system after trauma can lead to severe complications such as Acute Respiratory Distress Syndrome and Multiple Organ Dysfunction Syndrome. The spleen is thought to modulate the cellular immune system. Furthermore, splenectomy is associated with improved outcome in severely injured trauma patients. We hypothesized that a splenectomy alters the cellular immune response in polytrauma.
    Methods: All adult patients with an ISS ≥ 16 and suffering from splenic or hepatic injuries were selected from our prospective trauma database. Absolute leukocyte numbers in peripheral blood were measured. White blood cell kinetics during the first 14 days were compared between splenectomized patients, patients treated surgically for liver trauma and nonoperatively treated individuals.
    Results: A total of 129 patients with a mean ISS of 29 were included. Admission characteristics and leukocyte numbers were similar in all groups, except for slightly impaired hemodynamic status in patients with operatively treated liver injuries. On admission, leukocytosis occurred in all groups. During the first 24 h, leukopenia developed gradually, although significantly faster in the operatively treated patients. Thereafter, leukocyte levels normalized in all nonoperatively treated cases whereas leukocytosis persisted in operatively treated patients. This effect was significantly more prominent in splenectomized patients than all other conditions.
    Conclusions: This study demonstrates that surgery for intra-abdominal injuries is associated with an early drop in leucocyte numbers in peripheral blood. Moreover, splenectomy in severely injured patients is associated with an altered cellular immune response reflected by a persistent state of prominent leukocytosis after trauma.
    MeSH term(s) Abdominal Injuries/immunology ; Abdominal Injuries/metabolism ; Abdominal Injuries/surgery ; Adult ; Female ; Humans ; Immunity, Cellular ; Leukocyte Count ; Leukocytes/immunology ; Leukocytes/metabolism ; Male ; Middle Aged ; Prospective Studies ; Spleen/injuries ; Spleen/surgery ; Splenectomy/methods ; Wounds, Nonpenetrating/immunology ; Wounds, Nonpenetrating/metabolism ; Wounds, Nonpenetrating/surgery ; Young Adult
    Language English
    Publishing date 2021-03-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 1329381-3
    ISSN 2047-783X ; 0949-2321
    ISSN (online) 2047-783X
    ISSN 0949-2321
    DOI 10.1186/s40001-021-00497-8
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4636: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: Shift of Neutrophils From Blood to Bone Marrow Upon Extensive Experimental Trauma Surgery.

    Teuben, Michel P J / Heeres, Marjolein / Blokhuis, Taco / Spijkerman, Roy / Knot, Eric / Vrisekoop, Nienke / Pfeifer, Roman / Pape, Hans-Christoph / Koenderman, Leo / Leenen, Luke P H

    Frontiers in immunology

    2022  Volume 13, Page(s) 883863

    Abstract: Introduction: Extensive trauma surgery evokes an immediate cellular immune response including altered circulatory neutrophil numbers. The concurrent bone marrow (BM) response however is currently unclear. We hypothesize that these BM changes include (1) ...

    Abstract Introduction: Extensive trauma surgery evokes an immediate cellular immune response including altered circulatory neutrophil numbers. The concurrent bone marrow (BM) response however is currently unclear. We hypothesize that these BM changes include (1) a relative reduction of the bone marrow neutrophil fraction and (2) increasing heterogeneity of the bone marrow neutrophil pool due to (3) the appearance of aged/returning neutrophils from circulation into the BM-compartment.
    Materials and methods: Eight pigs were included in a standardized extensive trauma surgery model. Blood and bone marrow samples were collected at baseline and after 3 hours of ongoing trauma surgery. Leukocyte and subtype counts and cell surface receptor expression levels were studied by flow cytometry.
    Results: All animals survived the interventions. A significant drop in circulating neutrophil counts from 9.3 to 3.2x10
    Conclusion: The current study shows a shift in composition of the BM neutrophil pool during extensive trauma surgery that was associated with a relatively circulatory neutropenia. More specifically, under these conditions BM neutrophils were more mature than under homeostatic conditions and a CXCR4
    MeSH term(s) Animals ; Bone Marrow ; Bone Marrow Cells ; Flow Cytometry ; Homeostasis ; Neutrophils ; Swine
    Language English
    Publishing date 2022-05-17
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2022.883863
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  7. Article ; Online: Point-of-Care Analysis of Neutrophil Phenotypes: A First Step Toward Immuno-Based Precision Medicine in the Trauma ICU.

    Spijkerman, Roy / Hesselink, Lillian / Bongers, Suzanne / van Wessem, Karlijn J P / Vrisekoop, Nienke / Hietbrink, Falco / Koenderman, Leo / Leenen, Luke P H

    Critical care explorations

    2020  Volume 2, Issue 7, Page(s) e0158

    Abstract: Objectives: The amount of tissue damage and the amplitude of the immune response after trauma are related to the development of infectious complications later on. Changes in the neutrophil compartment can be used as read out of the amplitude of the ... ...

    Abstract Objectives: The amount of tissue damage and the amplitude of the immune response after trauma are related to the development of infectious complications later on. Changes in the neutrophil compartment can be used as read out of the amplitude of the immune response after trauma. The study aim was to test whether 24/7 point-of-care analysis of neutrophil marker expression by automated flow cytometry can be achieved after trauma.
    Design: A prospective cohort study was performed. Polytrauma patients who developed infectious complications were compared with polytrauma patients who did not develop infectious complications.
    Setting: The study was performed in a level 1 trauma center.
    Patients: All trauma patients presented in the trauma bay were included.
    Interventions: An extra blood tube was drawn from all patients. Thereafter, a member of the trauma team placed the blood tube in the fully automated flow cytometer, which was located in the corner of the trauma room. Next, a modified and tailored protocol for this study was automatically performed.
    Main results: The trauma team was able to successfully start the point-of-care automated flow cytometry analysis in 156 of 164 patients, resulting in a 95% success rate. Polytrauma patients who developed infectious complications had a significantly higher %CD16
    Conclusions: This study showed the feasibility of the implementation of a fully automated point-of-care flow cytometry system for the characterization of the cellular innate immune response in trauma patients. This study supports the concept that the assessment of CD16
    Language English
    Publishing date 2020-07-17
    Publishing country United States
    Document type Journal Article
    ISSN 2639-8028
    ISSN (online) 2639-8028
    DOI 10.1097/CCE.0000000000000158
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  8. Article ; Online: Management of pediatric blunt abdominal trauma in a Dutch level one trauma center.

    Spijkerman, Roy / Bulthuis, Lauren C M / Hesselink, Lillian / Nijdam, Thomas M P / Leenen, Luke P H / de Bruin, Ivar G J M

    European journal of trauma and emergency surgery : official publication of the European Trauma Society

    2020  Volume 47, Issue 5, Page(s) 1543–1551

    Abstract: Purpose: Most children with intra-abdominal injuries can be managed non-operatively. However, in Europe, there are many different healthcare systems for the treatment of pediatric trauma patients. Therefore, the aim of this study was to describe the ... ...

    Abstract Purpose: Most children with intra-abdominal injuries can be managed non-operatively. However, in Europe, there are many different healthcare systems for the treatment of pediatric trauma patients. Therefore, the aim of this study was to describe the management strategies and outcomes of all pediatric patients with blunt intra-abdominal injuries in our unique dedicated pediatric trauma center with a pediatric trauma surgeon.
    Methods: We performed a retrospective, single-center, cohort study to investigate the management of pediatric patients with blunt abdominal trauma. From the National Trauma Registration database, we retrospectively identified pediatric (≤ 18 years) patients with blunt abdominal injuries admitted to the UMCU from January 2012 till January 2018.
    Results: A total of 121 pediatric patients were included in the study. The median [interquartile range (IQR)] age of patients was 12 (8-16) years, and the median ISS was 16 (9-25). High-grade liver injuries were found in 12 patients. Three patients had a pancreas injury grade V. Furthermore, 2 (1.6%) patients had urethra injuries and 10 (8.2%) hollow viscus injuries were found. Eighteen (14.9%) patients required a laparotomy and 4 (3.3%) patients underwent angiographic embolization. In 6 (5.0%) patients, complications were found and in 4 (3.3%) children intervention was needed for their complication. No mortality was seen in patients treated non-operatively. One patient died in the operative management group.
    Conclusions: In conclusion, it is safe to treat most children with blunt abdominal injuries non-operatively if monitoring is adequate. These decisions should be made by the clinicians operating on these children, who should be an integral part of the entire group of treating physicians. Surgical interventions are only needed in case of hemodynamic instability or specific injuries such as bowel perforation.
    MeSH term(s) Abdominal Injuries/surgery ; Adolescent ; Child ; Cohort Studies ; Humans ; Retrospective Studies ; Trauma Centers ; Wounds, Nonpenetrating/surgery
    Language English
    Publishing date 2020-02-11
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2275480-5
    ISSN 1863-9941 ; 1863-9933
    ISSN (online) 1863-9941
    ISSN 1863-9933
    DOI 10.1007/s00068-020-01313-4
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    Zs.A 1221: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 607: Show issues

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  9. Article ; Online: Correction to: Selective non-operative management for penetrating splenic trauma: a systematic review.

    Teuben, Michel / Spijkerman, Roy / Pfeifer, Roman / Blokhuis, Taco / Huige, Josephine / Pape, Hans-Christoph / Leenen, Luke

    European journal of trauma and emergency surgery : official publication of the European Trauma Society

    2019  Volume 45, Issue 6, Page(s) 987

    Abstract: The original article has been corrected. ...

    Abstract The original article has been corrected.
    Language English
    Publishing date 2019-05-20
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 2275480-5
    ISSN 1863-9941 ; 1863-9933
    ISSN (online) 1863-9941
    ISSN 1863-9933
    DOI 10.1007/s00068-019-01136-y
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1221: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
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  10. Article: A cohort study to evaluate infection prevention protocol in pediatric trauma patients with blunt splenic injury in a Dutch level 1 trauma center.

    Spijkerman, Roy / Teuben, Michel Pj / Hietbrink, Falco / Kramer, William Lm / Leenen, Luke Ph

    Patient preference and adherence

    2018  Volume 12, Page(s) 1607–1617

    Abstract: Purpose: Asplenic patients are at increased risk for the development of overwhelming postsplenectomy infection (OPSI) syndrome. It is believed that adequate immunization, antimicrobial prophylaxis, as well as appropriate education concerning risks on ... ...

    Abstract Purpose: Asplenic patients are at increased risk for the development of overwhelming postsplenectomy infection (OPSI) syndrome. It is believed that adequate immunization, antimicrobial prophylaxis, as well as appropriate education concerning risks on severe infection lead to the decreased incidence of OPSI. The aim of this study was to analyze the methods used to prevent OPSI in trauma patients splenectomized before the age of 18.
    Patients and methods: A retrospective, single-center study of all pediatric patients sustaining blunt splenic injury (BSI) managed at our level 1 trauma center from January 1979 to March 2012 was performed. A questionnaire was sent to all the included patients to determine the level of knowledge concerning infection risks, the use of antibiotics, and compliance to vaccination recommendations. Furthermore, we investigated whether the implementation of guidelines in 2003 and 2011 resulted in higher vaccination rates.
    Results: We included 116 children with BSI. A total of 93 completed interviews were eligible for analysis, resulting in a total response rate of 80% and 1,116 patient years. Twenty-seven patients were splenectomized, and 66 patients were treated by a spleen preserving therapy (including embolization). Only two out of 27 splenectomized patients were adequately vaccinated, five patients without a spleen used prophylactic antibiotics, and about half of the asplenic patients had adequate knowledge of the risk that asplenia entails. A total of 22/27 splenectomized patients were neither adequately vaccinated nor received prophylactic antibiotics. There was no OPSI seen in our study population during the 1,116 follow-up years.
    Conclusion: The vaccination status, the level of knowledge concerning prevention of an OPSI, and the use of prophylactic antibiotics are suboptimal in pediatric patients treated for BSI. Therefore, we created a new follow-up treatment guideline to have adequate preventive coverage to current standards for these patients.
    Language English
    Publishing date 2018-08-28
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2455848-5
    ISSN 1177-889X
    ISSN 1177-889X
    DOI 10.2147/PPA.S169072
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