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Article ; Online: Status Epilepticus Following Intrathecal Administration of Bupivacaine: A Case Report.

Vanmarcke, Arthur / Lormans, Piet / Vandewaeter, Catherine

Journal of investigative medicine high impact case reports

2022 Volume 10, Page(s) 23247096221090841

Abstract: Spinal anesthesia is common practice and rarely causes complications. Although extended experience is present, seldom side effects of this technique and the administration of intrathecal local anesthetics and/or opioids can occur. We present a case in ... ...

Abstract	Spinal anesthesia is common practice and rarely causes complications. Although extended experience is present, seldom side effects of this technique and the administration of intrathecal local anesthetics and/or opioids can occur. We present a case in which a 76-year old woman undergoing total hip arthroplasty received a low dose of intrathecal bupivacaine and sufentanil. One hour after administration, she developed myoclonic seizures of the lower extremities followed by generalized tonic-clonic seizures and status epilepticus. We conclude that status epilepticus is a rare and possible lethal side effect of intrathecal bupivacaine. Symptoms may be misleading, highlighting the importance of early recognition and adequate management.
MeSH term(s)	Aged ; Anesthesia, Spinal/adverse effects ; Anesthesia, Spinal/methods ; Bupivacaine/adverse effects ; Double-Blind Method ; Female ; Humans ; Injections, Spinal/adverse effects ; Status Epilepticus/chemically induced ; Status Epilepticus/drug therapy
Chemical Substances	Bupivacaine (Y8335394RO)
Language	English
Publishing date	2022-04-16
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2710326-2
ISSN	2324-7096 ; 2324-7096
ISSN (online)	2324-7096
ISSN	2324-7096
DOI	10.1177/23247096221090841
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Article: Balancing Cost and Efficiency in Screening Potential Organ Donors With Whole Body CT.

Lormans, Piet / Monbaliu, Diethard / Ferdinande, Patrick

Transplantation direct

2020 Volume 6, Issue 11, Page(s) e621

Language	English
Publishing date	2020-10-23
Publishing country	United States
Document type	Journal Article
ISSN	2373-8731
ISSN	2373-8731
DOI	10.1097/TXD.0000000000001069
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Article ; Online: COVID-19 acquisition risk among ICU nursing staff with patient-driven use of aerosol-generating respiratory procedures and optimal use of personal protective equipment.

Lormans, Piet / Blot, Stijn / Amerlinck, Saskia / Devriendt, Yves / Dumoulin, Alexander

Intensive & critical care nursing

2020 Volume 63, Page(s) 102993

MeSH term(s)	Adult ; Aerosols/adverse effects ; COVID-19/nursing ; COVID-19/prevention & control ; Female ; Humans ; Intensive Care Units/statistics & numerical data ; Male ; Middle Aged ; Nursing Staff, Hospital/statistics & numerical data ; Occupational Exposure/prevention & control ; Occupational Exposure/statistics & numerical data ; Personal Protective Equipment/statistics & numerical data ; Respiration Disorders/nursing ; Risk Assessment/statistics & numerical data ; SARS-CoV-2
Chemical Substances	Aerosols
Language	English
Publishing date	2020-12-04
Publishing country	Netherlands
Document type	Letter
ZDB-ID	1105892-4
ISSN	1532-4036 ; 0964-3397
ISSN (online)	1532-4036
ISSN	0964-3397
DOI	10.1016/j.iccn.2020.102993
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Zs.B 2818: Show issues

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Article ; Online: Exposure to intravenous posaconazole in critically ill patients with influenza: A pharmacokinetic analysis of the POSA-FLU study.

Van Daele, Ruth / Wauters, Joost / Dreesen, Erwin / Boelens, Jerina / Nulens, Eric / Lormans, Piet / Vanderbeke, Lore / Jacobs, Cato / Rijnders, Bart / Verweij, Paul E / Brüggemann, Roger J / Spriet, Isabel

Mycoses

2022 Volume 65, Issue 6, Page(s) 656–660

Abstract: Background: Data on posaconazole in the critically ill are scarce. In the POSA-FLU study, we examined the prevention of influenza-associated pulmonary aspergillosis with posaconazole in this population.: Methods: In this observational sub-study, we ... ...

Abstract	Background: Data on posaconazole in the critically ill are scarce. In the POSA-FLU study, we examined the prevention of influenza-associated pulmonary aspergillosis with posaconazole in this population. Methods: In this observational sub-study, we performed a pharmacokinetic analysis, including protein binding and target attainment (TA). Blood samples were collected over a 24 h-dosing interval on both an early (Day 2 or 3) and a later (≥Day 4) treatment day. Results: Target attainment was shown for AUC Conclusions: Our analysis indicates that posaconazole may be a suitable drug to further investigate for prophylaxis, as TA for prophylaxis was reached. Exposure targets for treatment were insufficiently attained in this population.
MeSH term(s)	Administration, Intravenous ; Antifungal Agents ; Critical Illness/therapy ; Humans ; Influenza, Human/drug therapy ; Influenza, Human/prevention & control ; Triazoles
Chemical Substances	Antifungal Agents ; Triazoles ; posaconazole (6TK1G07BHZ)
Language	English
Publishing date	2022-04-28
Publishing country	Germany
Document type	Journal Article ; Observational Study
ZDB-ID	392487-7
ISSN	1439-0507 ; 0933-7407
ISSN (online)	1439-0507
ISSN	0933-7407
DOI	10.1111/myc.13446
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Ud II Zs.176: Show issues

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Article ; Online: Acute kidney injury in critical COVID-19: a multicenter cohort analysis in seven large hospitals in Belgium.

Schaubroeck, Hannah / Vandenberghe, Wim / Boer, Willem / Boonen, Eva / Dewulf, Bram / Bourgeois, Camille / Dubois, Jasperina / Dumoulin, Alexander / Fivez, Tom / Gunst, Jan / Hermans, Greet / Lormans, Piet / Meersseman, Philippe / Mesotten, Dieter / Stessel, Björn / Vanhoof, Marc / De Vlieger, Greet / Hoste, Eric

Critical care (London, England)

2022 Volume 26, Issue 1, Page(s) 225

Abstract: Background: Acute kidney injury (AKI) has been reported as a frequent complication of critical COVID-19. We aimed to evaluate the occurrence of AKI and use of kidney replacement therapy (KRT) in critical COVID-19, to assess patient and kidney outcomes ... ...

Abstract	Background: Acute kidney injury (AKI) has been reported as a frequent complication of critical COVID-19. We aimed to evaluate the occurrence of AKI and use of kidney replacement therapy (KRT) in critical COVID-19, to assess patient and kidney outcomes and risk factors for AKI and differences in outcome when the diagnosis of AKI is based on urine output (UO) or on serum creatinine (sCr). Methods: Multicenter, retrospective cohort analysis of patients with critical COVID-19 in seven large hospitals in Belgium. AKI was defined according to KDIGO within 21 days after ICU admission. Multivariable logistic regression analysis was used to explore the risk factors for developing AKI and to assess the association between AKI and ICU mortality. Results: Of 1286 patients, 85.1% had AKI, and KRT was used in 9.8%. Older age, obesity, a higher APACHE II score and use of mechanical ventilation at day 1 of ICU stay were associated with an increased risk for AKI. After multivariable adjustment, all AKI stages were associated with ICU mortality. AKI was based on sCr in 40.1% and UO in 81.5% of patients. All AKI stages based on sCr and AKI stage 3 based on UO were associated with ICU mortality. Persistent AKI was present in 88.6% and acute kidney disease (AKD) in 87.6%. Rapid reversal of AKI yielded a better prognosis compared to persistent AKI and AKD. Kidney recovery was observed in 47.4% of surviving AKI patients. Conclusions: Over 80% of critically ill COVID-19 patients had AKI. This was driven by the high occurrence rate of AKI defined by UO criteria. All AKI stages were associated with mortality (NCT04997915).
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Belgium/epidemiology ; COVID-19/complications ; Cohort Studies ; Critical Illness ; Hospitals ; Humans ; Intensive Care Units ; Retrospective Studies
Language	English
Publishing date	2022-07-25
Publishing country	England
Document type	Journal Article ; Multicenter Study
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-022-04086-x
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Zs.A 5517: Show issues

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Article ; Online: Prognostic Impact of Bronchoalveolar Lavage Fluid Galactomannan and Aspergillus Culture Results on Survival in COVID-19 Intensive Care Unit Patients: a

Journal of clinical microbiology

2022 Volume 60, Issue 4, Page(s) e0229821

Abstract: Critically ill patients with coronavirus disease 2019 (COVID-19) may develop COVID-19-associated pulmonary aspergillosis (CAPA), which impacts their chances of survival. Whether positive bronchoalveolar lavage fluid (BALF) mycological tests can be used ... ...

Abstract	Critically ill patients with coronavirus disease 2019 (COVID-19) may develop COVID-19-associated pulmonary aspergillosis (CAPA), which impacts their chances of survival. Whether positive bronchoalveolar lavage fluid (BALF) mycological tests can be used as a survival proxy remains unknown. We conducted a
MeSH term(s)	Aspergillus ; Bronchoalveolar Lavage Fluid ; COVID-19/complications ; Critical Illness ; Galactose/analogs & derivatives ; Humans ; Intensive Care Units ; Invasive Pulmonary Aspergillosis/complications ; Invasive Pulmonary Aspergillosis/diagnosis ; Mannans ; Mycology ; Prognosis ; Pulmonary Aspergillosis ; Sensitivity and Specificity
Chemical Substances	Mannans ; galactomannan (11078-30-1) ; Galactose (X2RN3Q8DNE)
Language	English
Publishing date	2022-03-24
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	390499-4
ISSN	1098-660X ; 0095-1137
ISSN (online)	1098-660X
ISSN	0095-1137
DOI	10.1128/jcm.02298-21
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Zs.A 1188: Show issues

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Article ; Online: Risk factors and outcome of pulmonary aspergillosis in critically ill coronavirus disease 2019 patients-a multinational observational study by the European Confederation of Medical Mycology.

Prattes, Juergen / Wauters, Joost / Giacobbe, Daniele Roberto / Salmanton-García, Jon / Maertens, Johan / Bourgeois, Marc / Reynders, Marijke / Rutsaert, Lynn / Van Regenmortel, Niels / Lormans, Piet / Feys, Simon / Reisinger, Alexander Christian / Cornely, Oliver A / Lahmer, Tobias / Valerio, Maricela / Delhaes, Laurence / Jabeen, Kauser / Steinmann, Joerg / Chamula, Mathilde /

Bassetti, Matteo / Hatzl, Stefan / Rautemaa-Richardson, Riina / Koehler, Philipp / Lagrou, Katrien / Hoenigl, Martin

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2021 Volume 28, Issue 4, Page(s) 580–587

Abstract: Objectives: Coronavirus disease 2019 (COVID-19) -associated pulmonary aspergillosis (CAPA) has emerged as a complication in critically ill COVID-19 patients. The objectives of this multinational study were to determine the prevalence of CAPA in patients ...

Abstract	Objectives: Coronavirus disease 2019 (COVID-19) -associated pulmonary aspergillosis (CAPA) has emerged as a complication in critically ill COVID-19 patients. The objectives of this multinational study were to determine the prevalence of CAPA in patients with COVID-19 in intensive care units (ICU) and to investigate risk factors for CAPA as well as outcome. Methods: The European Confederation of Medical Mycology (ECMM) conducted a multinational study including 20 centres from nine countries to assess epidemiology, risk factors and outcome of CAPA. CAPA was defined according to the 2020 ECMM/ISHAM consensus definitions. Results: A total of 592 patients were included in this study, including 11 (1.9%) patients with histologically proven CAPA, 80 (13.5%) with probable CAPA, 18 (3%) with possible CAPA and 483 (81.6%) without CAPA. CAPA was diagnosed a median of 8 days (range 0-31 days) after ICU admission predominantly in older patients (adjusted hazard ratio (aHR) 1.04 per year; 95% CI 1.02-1.06) with any form of invasive respiratory support (HR 3.4; 95% CI 1.84-6.25) and receiving tocilizumab (HR 2.45; 95% CI 1.41-4.25). Median prevalence of CAPA per centre was 10.7% (range 1.7%-26.8%). CAPA was associated with significantly lower 90-day ICU survival rate (29% in patients with CAPA versus 57% in patients without CAPA; Mantel-Byar p < 0.001) and remained an independent negative prognostic variable after adjusting for other predictors of survival (HR 2.14; 95% CI 1.59-2.87, p ≤ 0.001). Conclusion: Prevalence of CAPA varied between centres. CAPA was significantly more prevalent among older patients, patients receiving invasive ventilation and patients receiving tocilizumab, and was an independent strong predictor of ICU mortality.
MeSH term(s)	Aged ; COVID-19/complications ; COVID-19/epidemiology ; COVID-19/therapy ; Critical Illness ; Humans ; Intensive Care Units ; Invasive Pulmonary Aspergillosis/diagnosis ; Invasive Pulmonary Aspergillosis/drug therapy ; Invasive Pulmonary Aspergillosis/epidemiology ; Mycology ; Pulmonary Aspergillosis/complications ; Pulmonary Aspergillosis/epidemiology ; Risk Factors ; SARS-CoV-2
Language	English
Publishing date	2021-08-26
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1470-9465 ; 1198-743X
ISSN (online)	1469-0691
ISSN	1470-9465 ; 1198-743X
DOI	10.1016/j.cmi.2021.08.014
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Zs.A 4541: 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)
Zs.MO 284: Show issues

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Article ; Online: Successful double-lung transplantation from a donor previously infected with SARS-CoV-2.

The Lancet. Respiratory medicine

2020 Volume 9, Issue 3, Page(s) 315–318

MeSH term(s)	Aged ; COVID-19 ; Female ; Humans ; Lung/virology ; Lung Transplantation/methods ; Middle Aged ; SARS-CoV-2 ; Tissue Donors/statistics & numerical data ; Transplants/virology
Language	English
Publishing date	2020-12-01
Publishing country	England
Document type	Case Reports ; Research Support, Non-U.S. Gov't
ZDB-ID	2686754-0
ISSN	2213-2619 ; 2213-2600
ISSN (online)	2213-2619
ISSN	2213-2600
DOI	10.1016/S2213-2600(20)30524-5
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Article ; Online: Multinational Observational Cohort Study of COVID-19-Associated Pulmonary Aspergillosis

Janssen, Nico A F / Nyga, Rémy / Vanderbeke, Lore / Jacobs, Cato / Ergün, Mehmet / Buil, Jochem B / van Dijk, Karin / Altenburg, Josje / Bouman, Catherine S C / van der Spoel, Hans I / Rijnders, Bart J A / Dunbar, Albert / Schouten, Jeroen A / Lagrou, Katrien / Bourgeois, Marc / Reynders, Marijke / van Regenmortel, Niels / Rutsaert, Lynn / Lormans, Piet /

Feys, Simon / Debavaye, Yves / Tamion, Fabienne / Costa, Damien / Maizel, Julien / Dupont, Hervé / Chouaki, Taieb / Nseir, Saad / Sendid, Boualem / Brüggemann, Roger J M / van de Veerdonk, Frank L / Wauters, Joost / Verweij, Paul E

Emerging infectious diseases

2021 Volume 27, Issue 11, Page(s) 2892–2898

Abstract: We performed an observational study to investigate intensive care unit incidence, risk factors, and outcomes of coronavirus disease-associated pulmonary aspergillosis (CAPA). We found 10%-15% CAPA incidence among 823 patients in 2 cohorts. Several ... ...

Abstract	We performed an observational study to investigate intensive care unit incidence, risk factors, and outcomes of coronavirus disease-associated pulmonary aspergillosis (CAPA). We found 10%-15% CAPA incidence among 823 patients in 2 cohorts. Several factors were independently associated with CAPA in 1 cohort and mortality rates were 43%-52%.
MeSH term(s)	COVID-19 ; Cohort Studies ; Humans ; Invasive Pulmonary Aspergillosis ; Pulmonary Aspergillosis ; SARS-CoV-2
Language	English
Publishing date	2021-09-14
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2711.211174
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Article ; Online: Posaconazole for prevention of invasive pulmonary aspergillosis in critically ill influenza patients (POSA-FLU): a randomised, open-label, proof-of-concept trial.

Vanderbeke, Lore / Janssen, Nico A F / Bergmans, Dennis C J J / Bourgeois, Marc / Buil, Jochem B / Debaveye, Yves / Depuydt, Pieter / Feys, Simon / Hermans, Greet / Hoiting, Oscar / van der Hoven, Ben / Jacobs, Cato / Lagrou, Katrien / Lemiale, Virginie / Lormans, Piet / Maertens, Johan / Meersseman, Philippe / Mégarbane, Bruno / Nseir, Saad /

van Oers, Jos A H / Reynders, Marijke / Rijnders, Bart J A / Schouten, Jeroen A / Spriet, Isabel / Thevissen, Karin / Thille, Arnaud W / Van Daele, Ruth / van de Veerdonk, Frank L / Verweij, Paul E / Wilmer, Alexander / Brüggemann, Roger J M / Wauters, Joost

Intensive care medicine

2021 Volume 47, Issue 6, Page(s) 674–686

Abstract: Purpose: Influenza-associated pulmonary aspergillosis (IAPA) is a frequent complication in critically ill influenza patients, associated with significant mortality. We investigated whether antifungal prophylaxis reduces the incidence of IAPA.: Methods! ...

Abstract	Purpose: Influenza-associated pulmonary aspergillosis (IAPA) is a frequent complication in critically ill influenza patients, associated with significant mortality. We investigated whether antifungal prophylaxis reduces the incidence of IAPA. Methods: We compared 7 days of intravenous posaconazole (POS) prophylaxis with no prophylaxis (standard-of-care only, SOC) in a randomised, open-label, proof-of-concept trial in patients admitted to an intensive care unit (ICU) with respiratory failure due to influenza (ClinicalTrials.gov, NCT03378479). Adult patients with PCR-confirmed influenza were block randomised (1:1) within 10 days of symptoms onset and 48 h of ICU admission. The primary endpoint was the incidence of IAPA during ICU stay in patients who did not have IAPA within 48 h of ICU admission (modified intention-to-treat (MITT) population). Results: Eighty-eight critically ill influenza patients were randomly allocated to POS or SOC. IAPA occurred in 21 cases (24%), the majority of which (71%, 15/21) were diagnosed within 48 h of ICU admission, excluding them from the MITT population. The incidence of IAPA was not significantly reduced in the POS arm (5.4%, 2/37) compared with SOC (11.1%, 4/36; between-group difference 5.7%; 95% CI - 10.8 to 21.7; p = 0.32). ICU mortality of early IAPA was high (53%), despite rapid antifungal treatment. Conclusion: The higher than expected incidence of early IAPA precludes any definite conclusion on POS prophylaxis. High mortality of early IAPA, despite timely antifungal therapy, indicates that alternative management strategies are required. After 48 h, still 11% of patients developed IAPA. As these could benefit from prophylaxis, differentiated strategies are likely needed to manage IAPA in the ICU.
MeSH term(s)	Adult ; Critical Illness ; Humans ; Influenza, Human/complications ; Influenza, Human/drug therapy ; Influenza, Human/prevention & control ; Intensive Care Units ; Invasive Pulmonary Aspergillosis/drug therapy ; Invasive Pulmonary Aspergillosis/prevention & control ; Triazoles
Chemical Substances	Triazoles ; posaconazole (6TK1G07BHZ)
Language	English
Publishing date	2021-05-29
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
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/s00134-021-06431-0
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