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Article ; Online: There Will be Blood-But Maybe Less with Prostaglandin E

Vlaar, Alexander P J / van den Bergh, Walter M

American journal of respiratory and critical care medicine

2022 Volume 206, Issue 2, Page(s) 134–135

MeSH term(s)	Alprostadil ; Double-Blind Method ; Extracorporeal Membrane Oxygenation ; Humans ; Pilot Projects ; Vasodilator Agents/therapeutic use
Chemical Substances	Vasodilator Agents ; Alprostadil (F5TD010360)
Language	English
Publishing date	2022-05-18
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.202204-0669ED
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Article ; Online: Fresh Frozen Plasma Versus Solvent Detergent Plasma for Cardiopulmonary Bypass Priming in Neonates and Infants Undergoing Cardiac Surgery: A Retrospective Cohort Study.

van Minnen, Olivier / van den Bergh, Walter M / Kneyber, Martin C J / Accord, Ryan E / Buys, Dedré / Meier, Sascha

Journal of cardiothoracic and vascular anesthesia

2024 Volume 38, Issue 5, Page(s) 1144–1149

Abstract: Objective: Compared with fresh frozen plasma (FFP), Omniplasma has been attributed to an increased coagulation potential and an increased fibrinolytic potential. This study aimed to compare Omniplasma and FFP used for cardiopulmonary bypass (CPB) ... ...

Abstract	Objective: Compared with fresh frozen plasma (FFP), Omniplasma has been attributed to an increased coagulation potential and an increased fibrinolytic potential. This study aimed to compare Omniplasma and FFP used for cardiopulmonary bypass (CPB) priming regarding the incidence of postoperative thrombotic or hemorrhagic complications and outcomes in pediatric patients undergoing cardiac surgery. Design: A retrospective observational cohort study SETTING: This single-center study was performed at the University Medical Center Groningen. Participant: All pediatric patients up to 10 kg undergoing cardiac surgery with CPB. Interventions: Procedures in which FFP was used for CPB priming were compared with those in which Omniplasma was used. Measurements and main results: The primary outcome parameter was a composite endpoint consisting of the following: (1) pediatric intensive care unit (PICU) mortality, (2) thromboembolic complications, and (3) hemorrhagic complications during PICU stay. The authors included 143 procedures in the analyses, 90 (63%) in the FFP group and 53 (37%) in the Omniplasma group. The occurrence of the combined primary endpoint (FFP 20% v Omniplasma 11%, p = 0.18) and its components did not differ between the used CPB priming agent). Omniplasma for CPB priming was associated with decreased unfractionated heparin administration per kg bodyweight (585 IU v 510 IU, p = 0.03), higher preoperative and postoperative activated clotting times (ACT) discrepancy (90% v 94%, p = 0.03), a lower postoperative ACT value (125 v 118 seconds, p = 0.01), and less red blood cell transfusion per kilogram bodyweight (78 v 55 mL, p = 0.02). However, none of the variables differed statistically significantly in the multivariate logistic regression analyses. Conclusions: The authors did not find an association between the plasma used for CPB priming and thromboembolic and hemorrhagic complications and death in neonates and infants undergoing cardiac surgery. Omniplasma seems to be safe to use in this population.
MeSH term(s)	Infant ; Infant, Newborn ; Humans ; Child ; Cardiopulmonary Bypass/adverse effects ; Cardiopulmonary Bypass/methods ; Retrospective Studies ; Detergents ; Heparin ; Cardiac Surgical Procedures/adverse effects ; Cardiac Surgical Procedures/methods ; Plasma ; Thromboembolism
Chemical Substances	Detergents ; Heparin (9005-49-6)
Language	English
Publishing date	2024-01-24
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	1067317-9
ISSN	1532-8422 ; 1053-0770
ISSN (online)	1532-8422
ISSN	1053-0770
DOI	10.1053/j.jvca.2024.01.021
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Zs.A 2203: 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 31: Show issues

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Article ; Online: Risk factors for elective and emergency oxygenator exchanges during veno-venous extracorporeal membrane oxygenation.

van Minnen, Olivier / Oude Lansink-Hartgring, Annemieke / Hoffmann, Roland F / van den Bergh, Walter M

Perfusion

2023 , Page(s) 2676591231168642

Abstract: Background: Despite systemic anticoagulation and antithrombotic surface coating, oxygenator dysfunction remains one of most common technical complications of Extracorporeal membrane oxygenation (ECMO). Several parameters have been associated with an ... ...

Abstract	Background: Despite systemic anticoagulation and antithrombotic surface coating, oxygenator dysfunction remains one of most common technical complications of Extracorporeal membrane oxygenation (ECMO). Several parameters have been associated with an oxygenator exchange, but no guidelines for when to perform an exchange are published. An exchange, especially an emergency exchange, has a risk of complications. Therefore, a delicate balance between oxygenator dysfunction and the exchange of the oxygenator exists. This study aimed to identify risk factors and predictors for elective and emergency oxygenator exchanges. Methods: This observational cohort study included all adult patients supported with veno-venous extracorporeal membrane oxygenation (V-V ECMO). We compared patients' characteristics and laboratory values of patients with and without an oxygenator exchange and between an elective and emergency exchange, defined as an exchange outside office hours. Risk factors for an oxygenator exchange were identified with cox regression analyses, and risk factors for an emergency exchange were identified with logistic regression analyses. Results: We included forty-five patients in the analyses. There were twenty-nine oxygenator exchanges in nineteen patients (42%). More than a third of the exchanges were emergency exchanges. Higher partial pressure of carbon dioxide (PaCO2), transmembrane pressure difference (ΔP), and hemoglobin (Hb) were associated with an oxygenator exchange. Lower lactate dehydrogenase (LDH) was the only risk factor for an emergency exchange. Conclusion: Oxygenator exchange is frequent during V-V ECMO support. PaCO2, ΔP and Hb were associated with an oxygenator exchange and lower LDH with the risk of an emergency exchange.
Language	English
Publishing date	2023-03-30
Publishing country	England
Document type	Journal Article
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/02676591231168642
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Zs.A 2424: Show issues

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Article ; Online: Near-infrared spectroscopy and processed electroencephalogram monitoring for predicting peri-operative stroke risk in cardiothoracic surgery: An observational cohort study.

Pierik, Ramon / Scheeren, Thomas W L / Erasmus, Michiel E / van den Bergh, Walter M

European journal of anaesthesiology

2023 Volume 40, Issue 6, Page(s) 425–435

Abstract: Background: Stroke is a feared complication after cardiothoracic surgery, with an incidence of around 2 to 3%. Anaesthesia and postoperative sedation may obscure clinical symptoms of stroke and thus delay diagnosis and timely intervention.: Objectives! ...

Abstract	Background: Stroke is a feared complication after cardiothoracic surgery, with an incidence of around 2 to 3%. Anaesthesia and postoperative sedation may obscure clinical symptoms of stroke and thus delay diagnosis and timely intervention. Objectives: The objective was to assess the value of intra-operative neuromonitoring and blood pressure monitoring for predicting the occurrence of peri-operative stroke within 3 days after cardiothoracic surgery. Design: Single-centre retrospective observational cohort study. Setting: Academic tertiary care medical centre. Patients: All consecutive patients with cardiothoracic surgery and intra-operative neuromonitoring admitted postoperatively to the Intensive Care Unit (ICU) between 2008 and 2017. Main outcome measures: The primary endpoint was the occurrence of any stroke confirmed by brain imaging within 3 days postcardiothoracic surgery. Areas under the curve (AUC) of intra-operative mean arterial pressure (MAP), cerebral oxygen saturation (ScO 2 ) and bispectral index (BIS) below predefined thresholds were calculated, and the association with early stroke was tested using logistic regression analyses. Results: A total of 2454 patients admitted to the ICU after cardiothoracic surgery had complete intra-operative data for ScO 2 , BIS and MAP and were included in the analysis. In 58 patients (2.4%), a stroke was confirmed. In univariate analysis, a larger AUC MAP<60 mmHg [odds ratio (OR) 1.43; 95% confidence interval (CI), 1.21 to 1.68) and larger AUC BIS<25 (OR 1.51; 95% CI, 1.24 to 1.83) were associated with the occurrence of postoperative stroke while ScO 2 less than 50% or greater than 20% reduction from individual baseline was not (OR 0.91; 95% CI, 0.50 to 1.67). After multivariable analysis, AUC BIS<25 (OR 1.45; 95% CI, 1.12 to 1.87) and longer duration of MAP less than 60 mmHg (OR 1.52; 95% CI, 1.02 to 2.27) remained independently associated with stroke occurrence. Conclusion: Cumulative intra-operative BIS values below 25 and longer duration of MAP below 60 mmHg were associated with the occurrence of peri-operative stroke within 3 days after cardiothoracic surgery. Prospective studies are warranted to evaluate a causal relationship between low BIS and stroke to establish whether avoiding intra-operative BIS values below 25 might reduce the incidence of peri-operative stroke.
MeSH term(s)	Humans ; Retrospective Studies ; Spectroscopy, Near-Infrared ; Cohort Studies ; Stroke/diagnosis ; Stroke/epidemiology ; Stroke/etiology ; Electroencephalography
Language	English
Publishing date	2023-04-18
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	605770-6
ISSN	1365-2346 ; 0265-0215
ISSN (online)	1365-2346
ISSN	0265-0215
DOI	10.1097/EJA.0000000000001836
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Zs.A 1955: Show issues

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Article ; Online: International Survey on Mechanical Ventilation During Extracorporeal Membrane Oxygenation.

van Minnen, Olivier / Jolink, Floris E J / van den Bergh, Walter M / Droogh, Joep M / Oude Lansink-Hartgring, Annemieke

ASAIO journal (American Society for Artificial Internal Organs : 1992)

2023 Volume 70, Issue 4, Page(s) 300–304

Abstract: The optimal ventilation strategy for patients on extracorporeal membrane oxygenation (ECMO) remains uncertain. This survey reports current mechanical ventilation strategies adopted by ECMO centers worldwide. An international, multicenter, cross-sectional ...

Abstract	The optimal ventilation strategy for patients on extracorporeal membrane oxygenation (ECMO) remains uncertain. This survey reports current mechanical ventilation strategies adopted by ECMO centers worldwide. An international, multicenter, cross-sectional survey was conducted anonymously through an internet-based tool. Participants from North America, Europe, Asia, and Oceania were recruited from the extracorporeal life support organization (ELSO) directory. Responses were received from 48 adult ECMO centers (response rate 10.6%). Half of these had dedicated ventilation protocols for ECMO support. Pressure-controlled ventilation was the preferred initial ventilation mode for both venovenous ECMO (VV-ECMO) (60%) and venoarterial ECMO (VA-ECMO) (34%). In VV-ECMO, the primary goal was lung rest (93%), with rescue therapies commonly employed, especially neuromuscular blockade (93%) and prone positioning (74%). Spontaneous ventilation was typically introduced after signs of pulmonary recovery, with few centers using it as the initial mode (7%). A quarter of centers stopped sedation within 3 days after ECMO initiation. Ventilation strategies during VA-ECMO focused less on lung-protective goals and transitioned to spontaneous ventilation earlier. Ventilation strategies during ECMO support differ considerably. Controlled ventilation is predominantly used initially to provide lung rest, often facilitated by sedation and neuromuscular blockade. Few centers apply "awake ECMO" early during ECMO support, some utilizing partial neuromuscular blockade.
MeSH term(s)	Adult ; Humans ; Respiration, Artificial/methods ; Extracorporeal Membrane Oxygenation/methods ; Cross-Sectional Studies ; Lung ; Surveys and Questionnaires
Language	English
Publishing date	2023-12-05
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	759982-1
ISSN	1538-943X ; 0162-1432 ; 1058-2916
ISSN (online)	1538-943X
ISSN	0162-1432 ; 1058-2916
DOI	10.1097/MAT.0000000000002101
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Uk I Zs.199: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.B 2435: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)

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Article: Correction: Slow recruitment in the HIMALAIA study: lessons for future clinical trials in patients with delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage based on feasibility data.

Gathier, Celine S / van der Jagt, Mathieu / van den Bergh, Walter M / Dankbaar, Jan Willem / Rinkel, Gabriel J E / Slooter, Arjen J C

Pilot and feasibility studies

2022 Volume 8, Issue 1, Page(s) 214

Language	English
Publishing date	2022-09-22
Publishing country	England
Document type	Published Erratum
ZDB-ID	2809935-7
ISSN	2055-5784
ISSN	2055-5784
DOI	10.1186/s40814-022-01172-3
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Article ; Online: You do something to me, something deep inside.

van den Bergh, Walter M / Droogh, Joep M / Damman, Kevin

European journal of heart failure

2018 Volume 20, Issue 4, Page(s) 801–802

MeSH term(s)	Heart Failure/therapy ; Heart-Assist Devices ; Humans ; Platelet Activation ; Risk Factors
Language	English
Publishing date	2018-01-31
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	1483672-5
ISSN	1879-0844 ; 1388-9842
ISSN (online)	1879-0844
ISSN	1388-9842
DOI	10.1002/ejhf.1151
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Zs.A 5299: Show issues

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Article ; Online: Hospital Costs of Extracorporeal Membrane Oxygenation in Adults: A Systematic Review.

Oude Lansink-Hartgring, Annemieke / van Minnen, Olivier / Vermeulen, Karin M / van den Bergh, Walter M

PharmacoEconomics - open

2021 Volume 5, Issue 4, Page(s) 613–623

Abstract: Background: Costs associated with extracorporeal membrane oxygenation (ECMO) are an important factor in establishing cost effectiveness. In this systematic review, we aimed to determine the total hospital costs of ECMO for adults.: Methods: The ... ...

Abstract	Background: Costs associated with extracorporeal membrane oxygenation (ECMO) are an important factor in establishing cost effectiveness. In this systematic review, we aimed to determine the total hospital costs of ECMO for adults. Methods: The literature was retrieved from the PubMed/MEDLINE, EMBASE, and Web of Science databases from inception to 4 March 2020 using the search terms 'extracorporeal membrane oxygenation' combined with 'costs'; similar terms or phrases were then added to the search, i.e. 'Extracorporeal Life Support' or 'ECMO' or 'ECLS' combined with 'costs'. We included any type of study (e.g. randomized trial or observational cohort) evaluating hospital costs of ECMO in adults (age ≥18 years). Results: A total of 1768 unique articles were retrieved during our search. We assessed 74 full-text articles for eligibility, of which 14 articles were selected for inclusion in this review; six papers were from the US, five were from Europe, and one each from Japan, Australia, and Taiwan. The sample sizes ranged from 16 to 18,684 patients. One paper exclusively used prospective cost data collection, while all other papers used retrospective data collection. Five papers reported charges instead of costs. There was large variation in hospital costs, ranging from US$22,305 to US$334,608 (2019 values), largely depending on the indication for ECMO support and location. The highest reported costs were for lung transplant recipients who were receiving ECMO support in the US, and the lowest reported costs were for extracorporeal cardiopulmonary resuscitation patients presenting with non-shockable rhythm in Japan. The additional costs of ECMO patients compared with non-ECMO patients varied between US$2518 and US$200,658. Personnel costs varied between 11 and 52% of the total amount. Conclusions: ECMO therapy is an advanced and expensive technology, although reported costs differ considerably depending on ECMO indication and whether charges or costs are measured. Combined with the ongoing gathering of outcome data, cost effectiveness per ECMO indication could be determined in the future.
Language	English
Publishing date	2021-05-31
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	2874287-4
ISSN	2509-4254 ; 2509-4262
ISSN (online)	2509-4254
ISSN	2509-4262
DOI	10.1007/s41669-021-00272-9
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Article: Slow recruitment in the HIMALAIA study: lessons for future clinical trials in patients with delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage based on feasibility data.

Gathier, Celine S / van der Jagt, Mathieu / van den Bergh, Walter M / Dankbaar, Jan Willem / Rinkel, Gabriel J E / Slooter, Arjen J C

Pilot and feasibility studies

2022 Volume 8, Issue 1, Page(s) 193

Abstract: Background: Our randomized clinical trial on induced hypertension in patients with delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) was halted prematurely due to unexpected slow recruitment rates. This raised new questions ...

Abstract	Background: Our randomized clinical trial on induced hypertension in patients with delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) was halted prematurely due to unexpected slow recruitment rates. This raised new questions regarding recruitment feasibility. As our trial can therefore be seen as a feasibility trial, we assessed the reasons for the slow recruitment, aiming to facilitate the design of future randomized trials in aSAH patients with DCI or other critically ill patient categories. Methods: Efficiency of recruitment and factors influencing recruitment were evaluated, based on the patient flow in the two centers that admitted most patients during the study period. We collected numbers of patients who were screened for eligibility, provided informed consent, and developed DCI and who eventually were randomized. Results: Of the 862 aSAH patients admitted in the two centers during the course of the trial, 479 (56%) were eligible for trial participation of whom 404 (84%) were asked for informed consent. Of these, 188 (47%) provided informed consent, of whom 50 (27%) developed DCI. Of these 50 patients, 12 (24%) could not be randomized due to a logistic problem or a contraindication for induced hypertension emerging at the time of randomization, and four (8%) were missed for randomization. Eventually, 34 patients were randomized and received intervention or control treatment. Conclusions: Enrolling patients in a randomized trial on a treatment strategy for DCI proved unfeasible: only 1 out of 25 admitted and 1 out of 14 eligible patients could eventually be randomized. These rates, caused by a large proportion of ineligible patients, a small proportion of patients providing informed consent, and a large proportion of patients with contraindications for treatment, can be used to make sample size calculations for future randomized trials in DCI or otherwise critically ill patients. Facilitating informed consent through improved provision of information on risks, possible benefits, and study procedures may result in improved enrolment. Trial registration: The original trial was prospectively registered with ClinicalTrials.gov (NCT01613235), date of registration 07-06-2012.
Language	English
Publishing date	2022-08-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2809935-7
ISSN	2055-5784
ISSN	2055-5784
DOI	10.1186/s40814-022-01155-4
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Article ; Online: The Big Difference Between Direct and Nonstop Flights Is the Intermediate Stop Along the Way to the Final Destination.

van den Bergh, Walter M

Critical care medicine

2015 Volume 43, Issue 12, Page(s) 2685–2686

MeSH term(s)	Anti-Bacterial Agents/administration & dosage ; Emergency Service, Hospital/statistics & numerical data ; Female ; Humans ; Intensive Care Units/statistics & numerical data ; Male ; Patient Transfer/statistics & numerical data ; Sepsis/drug therapy
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2015-12
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000001343
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