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  1. Article ; Online: Mediators, consequences and therapeutic considerations in patients with acute kidney injury.

    Pickkers, Peter

    Current opinion in critical care

    2023  Volume 29, Issue 6, Page(s) 527–528

    MeSH term(s) Humans ; Acute Kidney Injury/drug therapy ; Kidney
    Language English
    Publishing date 2023-11-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000001093
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The Obesity Paradox in Patients in Need of Extracorporeal Membrane Oxygenation.

    Pickkers, Peter

    American journal of respiratory and critical care medicine

    2023  Volume 208, Issue 6, Page(s) 649–650

    MeSH term(s) Humans ; Extracorporeal Membrane Oxygenation ; Obesity Paradox ; Obesity/complications ; Obesity/therapy ; Respiratory Distress Syndrome
    Language English
    Publishing date 2023-06-05
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202307-1261ED
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Scepsis over een Chinees kruidenmengsel voor sepsis.

    Pickkers, Peter

    Nederlands tijdschrift voor geneeskunde

    2023  Volume 167

    Abstract: While on the one hand the field yearns for an effective treatment for sepsis, on the other hand a there is a sceptical attitude towards positive results. The EXIT-SEP trial showed that treatment with Xuebijing (XBJ), a mixture of 5 Chinese herbs with 162 ...

    Title translation Scepticism about a Chinese herbal mixture for sepsis.
    Abstract While on the one hand the field yearns for an effective treatment for sepsis, on the other hand a there is a sceptical attitude towards positive results. The EXIT-SEP trial showed that treatment with Xuebijing (XBJ), a mixture of 5 Chinese herbs with 162 different components, significantly reduced mortality. This was a multicentric, double-blinded placebo-controlled, adequately powered trial. However, there were also relevant limitations: in view of the uncertainty about the mechanism of action of XBJ, it is disappointing that the secondary endpoints do not provide further insight into this. Also, it remains unclear if an organ-specific effect may be present, and to what extent the survival benefit may be explained from this. For registration in the Western world, an adequately powered positive confirmation trial would be necessary and for this botanical product, manufacturing and quality control issues might represent relevant hurdles for XBJ to become available outside of China.
    MeSH term(s) Humans ; Sepsis/drug therapy ; Treatment Outcome
    Language Dutch
    Publishing date 2023-09-28
    Publishing country Netherlands
    Document type English Abstract ; Journal Article
    ZDB-ID 82073-8
    ISSN 1876-8784 ; 0028-2162
    ISSN (online) 1876-8784
    ISSN 0028-2162
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  4. Article ; Online: Effect of CytoSorb on Interleukin-6.

    Waalders, Nicole J B / Jansen, Aron / Pickkers, Peter

    Critical care medicine

    2024  Volume 52, Issue 3, Page(s) e152–e153

    MeSH term(s) Interleukin-6
    Chemical Substances Interleukin-6
    Language English
    Publishing date 2024-02-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000006120
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Personalized medicine in COVID-19.

    Bakkerus, Lieke / Pickkers, Peter

    Intensive care medicine

    2022  Volume 48, Issue 11, Page(s) 1607–1610

    MeSH term(s) Humans ; Precision Medicine ; COVID-19
    Language English
    Publishing date 2022-10-10
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-022-06908-6
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  6. Article ; Online: Phenotype-specific therapeutic efficacy of ilofotase alfa in patients with sepsis-associated acute kidney injury.

    Bruse, Niklas / Pardali, Katerina / Kraan, Maarten / Kox, Matthijs / Pickkers, Peter

    Critical care (London, England)

    2024  Volume 28, Issue 1, Page(s) 50

    Abstract: Background: There is no effective treatment for sepsis-associated acute kidney injury (SA-AKI). Ilofotase alfa (human recombinant alkaline phosphatase) has been shown to exert reno-protective properties, although it remains unclear which patients might ... ...

    Abstract Background: There is no effective treatment for sepsis-associated acute kidney injury (SA-AKI). Ilofotase alfa (human recombinant alkaline phosphatase) has been shown to exert reno-protective properties, although it remains unclear which patients might be most likely to benefit. We aimed to identify a clinical phenotype associated with ilofotase alfa's therapeutic efficacy.
    Methods: Data from 570 out of 650 patients enrolled in the REVIVAL trial were used in a stepwise machine learning approach. First, clinical variables with increasing or decreasing risk ratios for ilofotase alfa treatment across quartiles for the main secondary endpoint, Major Adverse Kidney Events up to day 90 (MAKE90), were selected. Second, linear regression analysis was used to determine the therapeutic effect size. Finally, the top-15 variables were used in different clustering analyses with consensus assessment.
    Results: The optimal clustering model comprised two phenotypes. Phenotype 1 displayed relatively lower disease severity scores, and less pronounced renal and pulmonary dysfunction. Phenotype 2 exhibited higher severity scores and creatinine, with lower eGFR and bicarbonate levels. Compared with placebo treatment, ilofotase alfa significantly reduced MAKE90 events for phenotype 2 patients (54% vs. 68%, p = 0.013), but not for phenotype 1 patients (49% vs. 46%, p = 0.54).
    Conclusion: We identified a clinical phenotype comprising severely ill patients with underlying kidney disease who benefitted most from ilofotase alfa treatment. This yields insight into the therapeutic potential of this novel treatment in more homogeneous patient groups and could guide patient selection in future trials, showing promise for personalized medicine in SA-AKI and other complex conditions.
    MeSH term(s) Humans ; Acute Kidney Injury/etiology ; Acute Kidney Injury/complications ; Kidney ; Phenotype ; Sepsis/complications ; Sepsis/drug therapy ; Treatment Outcome
    Language English
    Publishing date 2024-02-19
    Publishing country England
    Document type Clinical Trial ; Journal Article
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-024-04837-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5517: Show issues Location:
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  7. Article ; Online: Simultaneously Mounted Pro- and Anti-inflammatory Host Response Relates to the Development of Secondary Infections in Patients with Sepsis.

    Pickkers, Peter

    American journal of respiratory and critical care medicine

    2017  Volume 196, Issue 4, Page(s) 406–407

    Language English
    Publishing date 2017-08-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.201701-0253ED
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Modulation of Pain Sensitivity by a Hyperventilatory Breathing Exercise and Cold Exposure Training.

    Zwaag, Jelle / Timmerman, Hans / Pickkers, Peter / Kox, Matthijs

    Journal of pain research

    2023  Volume 16, Page(s) 1979–1991

    Abstract: Background: Evidence indicates that healthy individuals who follow a training program comprised hyperventilatory breathing exercises and cold exposure can voluntarily activate their sympathetic nervous system and attenuate their systemic inflammatory ... ...

    Abstract Background: Evidence indicates that healthy individuals who follow a training program comprised hyperventilatory breathing exercises and cold exposure can voluntarily activate their sympathetic nervous system and attenuate their systemic inflammatory response during experimental endotoxemia (intravenous administration of bacterial endotoxin). Furthermore, trained participants reported less endotoxemia-induced flu-like symptoms. However, it remained to be determined whether the effects on symptoms are due to the mitigated inflammatory response or involve direct analgesic effects of (elements of) the training program.
    Methods: In the present study, we used Nijmegen-Aalborg Screening Quantitative sensory testing (NASQ) to objectively map pain sensitivity using non-invasive stimuli to address this question. First, NASQ parameters were evaluated in 20 healthy volunteers before, during, and after the conduct of the hyperventilatory breathing exercise. Second, NASQ measurements were performed before and after 48 healthy volunteers followed different modalities of the training program: breathing exercise training, cold exposure training, the combination of both, or no training. Lastly, NASQ measurements were performed in these 48 subjects during experimental endotoxemia.
    Results: Electrical pain detection thresholds increased during the breathing exercise (p = 0.001) as well as four hours afterwards (p = 0.03). Furthermore, cold exposure training resulted in lower VAS scores during hand immersion in ice water (p < 0.001). Systemic inflammation induced by administration of endotoxin nullified the decreased pain perception during the ice water test in subjects trained in cold exposure.
    Conclusion: A hyperventilatory breathing exercise decreases pain perception induced by an electrical stimulus. Furthermore, cold exposure training may decrease pain perception induced by hand immersion in ice water.
    Language English
    Publishing date 2023-06-13
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2495284-9
    ISSN 1178-7090
    ISSN 1178-7090
    DOI 10.2147/JPR.S400408
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  9. Article ; Online: Circulating biomarkers to assess cardiovascular function in critically ill.

    van Lier, Dirk / Pickkers, Peter

    Current opinion in critical care

    2021  Volume 27, Issue 3, Page(s) 261–268

    Abstract: Purpose of review: Circulatory shock is one of the most common reasons for ICU admission. Mortality rates in excess of 40% necessitate the rapid identification of high-risk patients, as well as the early assessment of effects of initiated treatments. ... ...

    Abstract Purpose of review: Circulatory shock is one of the most common reasons for ICU admission. Mortality rates in excess of 40% necessitate the rapid identification of high-risk patients, as well as the early assessment of effects of initiated treatments. There is an unmet medical need for circulating biomarkers that may improve patient stratification, predict responses to treatment interventions and may even be a target for novel therapies, enabling a better biological rationale to personalize therapy.
    Recent findings: Apart from established biomarkers such as lactate, ScvO2 or NT-pro-BNP, novel biomarkers, including adrenomedullin, angiopoietins, angiotensin I/II ratios, renin and DPP3 show promise, as they are all associated with well defined, therapeutically addressable molecular pathways that are dysregulated during circulatory shock. Although some of the therapies related to these biomarkers are still in preclinical stages of development, they may represent personalized treatment opportunities for patients in circulatory shock.
    Summary: From a molecular perspective, shock represents a highly heterologous syndrome, in which multiple unique pathways are dysregulated. Assessment of the status of these pathways with circulating biomarkers may provide a unique opportunity to detect specific phenotypes and implement personalized medicine in the treatment of circulatory shock.
    MeSH term(s) Biomarkers ; Critical Illness ; Hospitalization ; Humans ; Prospective Studies ; Shock/diagnosis
    Chemical Substances Biomarkers
    Language English
    Publishing date 2021-04-26
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000000829
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  10. Article ; Online: Size does matter. Sustainable choice of intravenous bags.

    Touw, Hugo / Stobernack, Tim / Hunfeld, Nicole G M / Pickkers, Peter

    Intensive care medicine

    2023  Volume 49, Issue 12, Page(s) 1529–1530

    MeSH term(s) Humans ; Administration, Intravenous ; Infusions, Intravenous
    Language English
    Publishing date 2023-10-16
    Publishing country United States
    Document type Letter
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-023-07240-3
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