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  1. Article ; Online: The use of information technology to improve interdisciplinary communication during infectious diseases ward rounds on the paediatric intensive care unit.

    Willems, Jef / Heyndrickx, Adeline / Schelstraete, Petra / Gadeyne, Bram / De Cock, Pieter / Vandendriessche, Stien / Depuydt, Pieter

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 1657

    Abstract: Prospective audit with feedback during infectious diseases ward rounds (IDWR) is a common antimicrobial stewardship (AMS) practice on the Paediatric Intensive Care Unit (PICU). These interdisciplinary meetings rely on the quality of handover, with high ... ...

    Abstract Prospective audit with feedback during infectious diseases ward rounds (IDWR) is a common antimicrobial stewardship (AMS) practice on the Paediatric Intensive Care Unit (PICU). These interdisciplinary meetings rely on the quality of handover, with high risk of omission of information. We developed an electronic platform integrating infection-related patient data (COSARAPed). In the mixed PICU of a Belgian tertiary hospital we conducted an observational prospective cohort study comparing patient handovers during IDWRs using the COSARAPed-platform to those with access only to conventional resources. The quality of handover was investigated directly by assessment if the narrative was in accordance with Situation-Background-Assessment-Recommendation principles and if adequate demonstration of diagnostic information occurred, and also indirectly by registration if this was only achieved after intervention by the non-presenting AMS team members. We also recorded all AMS-recommendations. During a 6-month study period, 24 IDWRs and 82 patient presentations were assessed. We could only find a statistically significant advantage in favor of COSARAPed by indirect evaluation. We registered 92 AMS-recommendations, mainly resulting in reduced antibiotic pressure. We concluded that the IDWR is an appropriate platform for AMS on the PICU and that the utilisation of COSARAPed may enhance the quality of patient handover.
    MeSH term(s) Child ; Humans ; Information Technology ; Interdisciplinary Communication ; Prospective Studies ; Intensive Care Units, Pediatric ; Communicable Diseases ; Communication
    Language English
    Publishing date 2024-01-18
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-51986-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Anterior and posterior tracheopexy for severe tracheomalacia.

    Martens, Thomas / Schaballie, Heidi / Willekens, Julie / Schelstraete, Petra / Willems, Jef / Muthialu, Nagarajan / Desender, Liesbeth

    JTCVS techniques

    2022  Volume 17, Page(s) 159–163

    Abstract: Objectives: Congenital tracheomalacia can be the cause of respiratory failure in young children. Although the indication for surgical treatment has already been discussed vigorously, no clear guidelines about the modality are available.: Methods: ... ...

    Abstract Objectives: Congenital tracheomalacia can be the cause of respiratory failure in young children. Although the indication for surgical treatment has already been discussed vigorously, no clear guidelines about the modality are available.
    Methods: Through a sternotomy approach, a combination of posterior pexy and anterior tracheopexy using a tailored ringed polytetrafluoroethylene prosthesis is performed. Patient demographic characteristics, as well as operative details and postoperative outcomes, are included in the analysis.
    Results: Between 2018 and 2022, 9 children underwent the operation under review. All patients showed severe clinical symptoms of tracheomalacia, which was confirmed on bronchoscopy. The median age was 9 months. There was no operative mortality. Eight patients could be weaned from the ventilator. One patient died because of interstitial lung disease with bronchomalacia and concomitant severe cardiac disease. The longest follow-up now is 4 years, and shows overall excellent clinical results, without any reintervention.
    Conclusions: Surgical treatment of tracheomalacia through a combination of posterior and anterior pexy is feasible, with acceptable short- and midterm results.
    Language English
    Publishing date 2022-12-13
    Publishing country United States
    Document type Journal Article
    ISSN 2666-2507
    ISSN (online) 2666-2507
    DOI 10.1016/j.xjtc.2022.11.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Purpura fulminans: How varicella zoster can result in acquired protein S deficiency.

    Verbeke, Frederick / De Wilde, Bram / Willems, Jef / Devreese, Katrien M J

    International journal of laboratory hematology

    2020  Volume 43, Issue 2, Page(s) 146–147

    MeSH term(s) Biomarkers ; Disease Susceptibility ; Herpesvirus 3, Human ; Humans ; Protein S Deficiency/diagnosis ; Protein S Deficiency/etiology ; Purpura Fulminans/diagnosis ; Purpura Fulminans/etiology ; Varicella Zoster Virus Infection/complications ; Varicella Zoster Virus Infection/virology
    Chemical Substances Biomarkers
    Language English
    Publishing date 2020-12-20
    Publishing country England
    Document type Case Reports
    ZDB-ID 2268590-X
    ISSN 1751-553X ; 1751-5521 ; 0141-9854
    ISSN (online) 1751-553X
    ISSN 1751-5521 ; 0141-9854
    DOI 10.1111/ijlh.13441
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Optimizing the Use of Antibiotic Agents in the Pediatric Intensive Care Unit: A Narrative Review.

    Willems, Jef / Hermans, Eline / Schelstraete, Petra / Depuydt, Pieter / De Cock, Pieter

    Paediatric drugs

    2020  Volume 23, Issue 1, Page(s) 39–53

    Abstract: Antibiotics are one of the most prescribed drug classes in the pediatric intensive care unit, yet the incidence of inappropriate antibiotic prescribing remains high in critically ill children. Optimizing the use of antibiotics in this population is ... ...

    Abstract Antibiotics are one of the most prescribed drug classes in the pediatric intensive care unit, yet the incidence of inappropriate antibiotic prescribing remains high in critically ill children. Optimizing the use of antibiotics in this population is imperative to guarantee adequate treatment, avoid toxicity and the occurrence of antibiotic resistance, both on a patient level and on a population level. Antibiotic stewardship encompasses all initiatives to promote responsible antibiotic usage and the PICU represents a major target environment for antibiotic stewardship programs. This narrative review provides a summary of the available knowledge on the optimal selection, duration, dosage, and route of administration of antibiotic treatment in critically ill children. Overall, more scientific evidence on how to optimize antibiotic treatment is warranted in this population. We also give our personal expert opinion on research priorities.
    MeSH term(s) Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Antimicrobial Stewardship/methods ; Child ; Humans ; Intensive Care Units, Pediatric
    Chemical Substances Anti-Bacterial Agents
    Keywords covid19
    Language English
    Publishing date 2020-11-10
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 1492748-2
    ISSN 1179-2019 ; 1174-5878
    ISSN (online) 1179-2019
    ISSN 1174-5878
    DOI 10.1007/s40272-020-00426-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Predictors of augmented renal clearance based on iohexol plasma clearance in critically ill children.

    Dhont, Evelyn / Van Der Heggen, Tatjana / Snauwaert, Evelien / Willems, Jef / Croubels, Siska / Delanghe, Joris / De Waele, Jan J / Colman, Roos / Vande Walle, Johan / De Paepe, Peter / De Cock, Pieter A

    Pediatric nephrology (Berlin, Germany)

    2023  Volume 39, Issue 5, Page(s) 1607–1616

    Abstract: Background: Augmented renal clearance (ARC) holds a risk of subtherapeutic drug concentrations. Knowledge of patient-, disease-, and therapy-related factors associated with ARC would allow predicting which patients would benefit from intensified dosing ... ...

    Abstract Background: Augmented renal clearance (ARC) holds a risk of subtherapeutic drug concentrations. Knowledge of patient-, disease-, and therapy-related factors associated with ARC would allow predicting which patients would benefit from intensified dosing regimens. This study aimed to identify ARC predictors and to describe ARC time-course in critically ill children, using iohexol plasma clearance (CL
    Methods: This is a retrospective analysis of data from the "IOHEXOL" study which validated GFR estimating formulas (eGFR) against CL
    Results: Eighty-five patients were included; 57% were postoperative patients. Median CL
    Conclusions: Our findings raise PICU clinician awareness about increased risk for ARC after major surgery and in patients with eGFR above age-specific thresholds. This knowledge enables identification of patients with an ARC risk profile who would potentially benefit from a dose increase at initiation of treatment to avoid underexposure.
    Trial registration: ClinicalTrials.gov NCT05179564, registered retrospectively on January 5, 2022.
    MeSH term(s) Child ; Humans ; Creatinine ; Critical Illness/therapy ; Glomerular Filtration Rate ; Iohexol ; Kidney Function Tests ; Retrospective Studies
    Chemical Substances Creatinine (AYI8EX34EU) ; Iohexol (4419T9MX03)
    Language English
    Publishing date 2023-11-23
    Publishing country Germany
    Document type Clinical Study ; Journal Article
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-023-06221-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Suboptimal Beta-Lactam Therapy in Critically Ill Children: Risk Factors and Outcome.

    Van Der Heggen, Tatjana / Dhont, Evelyn / Willems, Jef / Herck, Ingrid / Delanghe, Joris R / Stove, Veronique / Verstraete, Alain G / Vanhaesebrouck, Sophie / De Paepe, Peter / De Cock, Pieter A J G

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2022  Volume 23, Issue 7, Page(s) e309–e318

    Abstract: Objectives: In critically ill children, severely altered pharmacokinetics may result in subtherapeutic β-lactam antibiotic concentrations when standard pediatric dosing regimens are applied. However, it remains unclear how to recognize patients most at ... ...

    Abstract Objectives: In critically ill children, severely altered pharmacokinetics may result in subtherapeutic β-lactam antibiotic concentrations when standard pediatric dosing regimens are applied. However, it remains unclear how to recognize patients most at risk for suboptimal exposure and their outcome. This study aimed to: 1) describe target attainment for β-lactam antibiotics in critically ill children, 2) identify risk factors for suboptimal exposure, and 3) study the association between target nonattainment and clinical outcome.
    Design: Post hoc analysis of the "Antibiotic Dosing in Pediatric Intensive Care" study (NCT02456974, 2012-2019). Steady-state trough plasma concentrations were classified as therapeutic if greater than or equal to the minimum inhibitory concentration of the (suspected) pathogen. Factors associated with subtherapeutic concentrations and clinical outcome were identified by logistic regression analysis.
    Setting: The pediatric and cardiac surgery ICU of a Belgian tertiary-care hospital.
    Patients: One hundred fifty-seven patients (aged 1 mo to 15 yr) treated intravenously with amoxicillin-clavulanic acid, piperacillin-tazobactam, or meropenem.
    Interventions: None.
    Measurements and main results: Three hundred eighty-two trough concentrations were obtained from 157 patients (median age, 1.25 yr; interquartile range, 0.4-4.2 yr). Subtherapeutic concentrations were measured in 39 of 60 (65%), 43 of 48 (90%), and 35 of 49 (71%) of patients treated with amoxicillin-clavulanic acid, piperacillin-tazobactam, and meropenem, respectively. Estimates of glomerular filtration rate (eGFR; 54% increase in odds for each sd increase in value, 95% CI, 0.287-0.736; p = 0.001) and the absence of vasopressor treatment (2.8-fold greater odds, 95% CI, 1.079-7.253; p = 0.034) were independently associated with target nonattainment. We failed to identify an association between antibiotic concentrations and clinical failure.
    Conclusions: Subtherapeutic β-lactam concentrations are common in critically ill children and correlate with renal function. eGFR equations may be helpful in identifying patients who may require higher dosing. Future studies should focus on the impact of subtherapeutic concentrations on clinical outcome.
    MeSH term(s) Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents/pharmacokinetics ; Child ; Critical Illness/therapy ; Humans ; Infant ; Meropenem ; Piperacillin, Tazobactam Drug Combination ; Risk Factors ; beta-Lactams/pharmacokinetics ; beta-Lactams/therapeutic use
    Chemical Substances Anti-Bacterial Agents ; beta-Lactams ; Piperacillin, Tazobactam Drug Combination (157044-21-8) ; Amoxicillin-Potassium Clavulanate Combination (74469-00-4) ; Meropenem (FV9J3JU8B1)
    Language English
    Publishing date 2022-04-15
    Publishing country United States
    Document type Clinical Trial ; Journal Article
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000002951
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Severe anaphylactic reaction following anti-thymocyte globulin administration in a pediatric stem cell transplantation patient.

    Bauters, Tiene / Bordon, Victoria / Willems, Jef / De Wilde, Bram / Laureys, Geneviève

    Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

    2018  Volume 24, Issue 3, Page(s) 232–234

    Abstract: We present a case of a severe reaction after anti-thymocyte administration despite premedication and strict adherence to administration guidelines during the conditioning regimen. Due to the severity of the adverse drug reaction, we believe that this ... ...

    Abstract We present a case of a severe reaction after anti-thymocyte administration despite premedication and strict adherence to administration guidelines during the conditioning regimen. Due to the severity of the adverse drug reaction, we believe that this case should be reported.
    MeSH term(s) Anaphylaxis/chemically induced ; Anaphylaxis/diagnosis ; Animals ; Antilymphocyte Serum/administration & dosage ; Antilymphocyte Serum/adverse effects ; Child, Preschool ; Humans ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/adverse effects ; Male ; Premedication/adverse effects ; Premedication/trends ; Rabbits ; Severity of Illness Index ; Stem Cell Transplantation/trends ; Transplantation Conditioning/adverse effects
    Chemical Substances Antilymphocyte Serum ; Immunosuppressive Agents
    Language English
    Publishing date 2018-04
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1330764-2
    ISSN 1477-092X ; 1078-1552
    ISSN (online) 1477-092X
    ISSN 1078-1552
    DOI 10.1177/1078155217699989
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Research priorities in pediatric onco-critical care: an international Delphi consensus study.

    Soeteman, Marijn / Potratz, Jenny / Nielsen, Jeppe S Angaard / Willems, Jef / Valla, Frédéric V / Brierley, Joe / Wösten-van Asperen, Roelie M

    Intensive care medicine

    2019  Volume 45, Issue 11, Page(s) 1681–1683

    MeSH term(s) Consensus ; Critical Care/methods ; Delphi Technique ; Humans ; Internationality ; Medical Oncology/methods ; Pediatrics/methods ; Research/trends
    Language English
    Publishing date 2019-08-23
    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/s00134-019-05706-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Sensitivity and specificity of 14 SARS-CoV-2 serological assays and their diagnostic potential in RT-PCR negative COVID-19 infections.

    Van Honacker, Eveline / Coorevits, Liselotte / Boelens, Jerina / Verhasselt, Bruno / Van Braeckel, Eva / Bauters, Fré / De Bus, Liesbet / Schelstraete, Petra / Willems, Jef / Vandendriessche, Stien / Padalko, Elizaveta

    Acta clinica Belgica

    2020  Volume 77, Issue 2, Page(s) 315–320

    Abstract: Background: Molecular detection of SARS-CoV-2 in respiratory samples is the gold standard for COVID-19 diagnosis but it has a long turnaround time and struggles to detect low viral loads. Serology could help to diagnose suspected cases which lack ... ...

    Abstract Background: Molecular detection of SARS-CoV-2 in respiratory samples is the gold standard for COVID-19 diagnosis but it has a long turnaround time and struggles to detect low viral loads. Serology could help to diagnose suspected cases which lack molecular confirmation. Two case reports are presented as illustration.
    Objectives: The aim of this study was to evaluate the performance of several commercial assays for COVID-19 serology. We illustrated the added value of COVID-19 serology testing in suspect COVID-19 cases with negative molecular test.
    Study design: Twenty-three sera from 7 patients with a confirmed molecular diagnosis of SARS-CoV-2 were tested using 14 commercial assays. Additionally, 10 pre-pandemic sera and 9 potentially cross-reactive sera were selected. We calculated sensitivity and specificity. Furthermore, we discuss the diagnostic relevance of COVID-19 serology in a retrospective cohort of 145 COVID-19 cases in which repetitive molecular and serological SARS-CoV-2 tests were applied.
    Results: The interpretation of the pooled sensitivity of IgM/A and IgG resulted in the highest values (range 14-71% on day 2-7; 88-94% on day 8-18). Overall, the specificity of the assays was high (range 79-100%). Among 145 retrospective cases, 3 cases (2%) remained negative after sequential molecular testing but positive on final SARS-CoV-2 serology.
    Conclusion: Sensitivity of COVID-19 serological diagnosis was variable but consistently increased at >7 days after symptom onset. Specificity was high. Our data suggest that serology can complement molecular testing for diagnosis of COVID-19, especially for patients presenting the 2
    MeSH term(s) COVID-19/diagnosis ; COVID-19 Testing ; Humans ; Immunoglobulin M ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; SARS-CoV-2 ; Sensitivity and Specificity
    Chemical Substances Immunoglobulin M
    Language English
    Publishing date 2020-12-22
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 390201-8
    ISSN 2295-3337 ; 0001-5512 ; 1784-3286
    ISSN (online) 2295-3337
    ISSN 0001-5512 ; 1784-3286
    DOI 10.1080/17843286.2020.1861885
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Role of extracorporeal membrane oxygenation in pediatric cancer patients: a systematic review and meta-analysis of observational studies.

    Slooff, Valerie / Hoogendoorn, Rianne / Nielsen, Jeppe Sylvest Angaard / Pappachan, John / Amigoni, Angela / Caramelli, Fabio / Aziz, Omer / Wildschut, Enno / Verbruggen, Sascha / Crazzolara, Roman / Dohna-Schwake, Christian / Potratz, Jenny / Willems, Jef / Llevadias, Judit / Moscatelli, Andrea / Montaguti, Alessia / Bottari, Gabriella / Di Nardo, Matteo / Schlapbach, Luregn /
    Wösten-van Asperen, Roelie

    Annals of intensive care

    2022  Volume 12, Issue 1, Page(s) 8

    Abstract: Background: The use of extracorporeal membrane oxygenation (ECMO) in pediatric patients with underlying malignancies remains controversial. However, in an era in which the survival rates for children with malignancies have increased significantly and ... ...

    Abstract Background: The use of extracorporeal membrane oxygenation (ECMO) in pediatric patients with underlying malignancies remains controversial. However, in an era in which the survival rates for children with malignancies have increased significantly and several recent reports have demonstrated effective ECMO use in children with cancer, we aimed to estimate the outcome and complications of ECMO treatment in these children.
    Methods: We searched MEDLINE, Embase and CINAHL databases for studies on the use ECMO in pediatric patients with an underlying malignancy from inception to September 2020. This review was conducted in adherence to Preferred Reporting Items for Systematic Review and Meta-Analysis statement. Study eligibility was independently assessed by two authors and disagreements resolved by a third author. Included studies were evaluated for quality using the Newcastle-Ottawa Scale (NOS). Random effects meta-analyses (DerSimonian and Laird) were performed. The primary outcomes were mortality during ECMO or hospital mortality.
    Results: Thirteen retrospective, observational cohort studies were included, most of moderate quality (625 patients). The commonest indication for ECMO was severe respiratory failure (92%). Pooled mortality during ECMO was 55% (95% confidence interval [CI], 47-63%) and pooled hospital mortality was 60% (95% CI 54-67%). Although heterogeneity among the included studies was low, confidence intervals were large. In addition, the majority of the data were derived from registries with overlapping patients which were excluded for the meta-analyses to prevent resampling of the same participants across the included studies. Finally, there was a lack of consistent complications reporting among the studies.
    Conclusion: Significantly higher mortalities than in general PICU patients was reported with the use of ECMO in children with malignancies. Although these results need to be interpreted with caution due to the lack of granular data, they suggest that ECMO appears to represents a viable rescue option for selected patients with underlying malignancies. There is an urgent need for additional data to define patients for whom ECMO may provide benefit or harm.
    Language English
    Publishing date 2022-01-29
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-022-00983-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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