Publications by authors named "Diederik A M P J Gommers"

Article Synopsis
  • ECMO (Extracorporeal Membrane Oxygenation) has high complication rates, prompting the need for improved management strategies, which led to the development of the REMAP ECMO platform to investigate effective patient management techniques.* -
  • The REMAP ECMO platform allows for multiple adaptive randomized controlled trials, with the first focusing on the effects of early left ventricular unloading via intra-aortic balloon pumping compared to ECMO alone for cardiogenic shock patients in the ICU.* -
  • The primary outcome aims to determine successful weaning from ECMO at 30 days, while secondary outcomes include intervention needs, survival rates, and quality of life, all analyzed using a flexible Bayesian statistical framework.*
View Article and Find Full Text PDF
Article Synopsis
  • This study looks at how AI (artificial intelligence) can help doctors take care of very sick babies and kids, but it's not used much in real hospitals yet.
  • They reviewed a lot of research and found that most studies are still just testing ideas and have problems with bias, meaning they might not be very reliable.
  • The researchers say we need better plans to connect AI technology from labs to hospitals so it can really help improve patient care.
View Article and Find Full Text PDF
Article Synopsis
  • * Key facilitators identified include a user-friendly interface, easy login processes, thorough training, and feedback from users, while barriers consist of complicated access steps and resistance to contributing diary entries.
  • * Professionals’ participation in writing diary entries is valued by ICU survivors and their relatives, highlighting a disconnect between ICU staff's perspectives and patient/family experiences.
View Article and Find Full Text PDF

Background: Mechanical power (MP) is the energy delivered by the ventilator to the respiratory system and combines factors related to the development of ventilator-induced lung injury (VILI). Flow-controlled ventilation (FCV) is a new ventilation mode using a constant low flow during both inspiration and expiration, which is hypothesized to lower the MP and to improve ventilation homogeneity. Data demonstrating these effects are scarce, since previous studies comparing FCV with conventional controlled ventilation modes in ICU patients suffer from important methodological concerns.

View Article and Find Full Text PDF
Article Synopsis
  • Midazolam was commonly used for sedation in COVID-19 ICU patients, but its use raised concerns due to potential for delirium and longer mechanical ventilation times.
  • The study aimed to analyze how continuous renal replacement therapy (CRRT) affected the clearance of midazolam and its metabolites, as impaired renal function can lead to prolonged sedation.
  • Results from five patients showed varying concentrations of midazolam and its metabolites, highlighting the need to adjust dosages based on CRRT factors to minimize sedation duration.
View Article and Find Full Text PDF

Background: The role of haloperidol as treatment for ICU delirium and related symptoms remains controversial despite two recent large controlled trials evaluating its efficacy and safety. We sought to determine whether haloperidol when compared to placebo in critically ill adults with delirium reduces days with delirium and coma and improves delirium-related sequelae.

Methods: This multi-center double-blind, placebo-controlled randomized trial at eight mixed medical-surgical Dutch ICUs included critically ill adults with delirium (Intensive Care Delirium Screening Checklist ≥ 4 or a positive Confusion Assessment Method for the ICU) admitted between February 2018 and January 2020.

View Article and Find Full Text PDF

Background: Previous studies show positive effect of music on reducing anxiety, pain, and medication requirement. Anxiety has become a more pertinent issue in the intensive care unit (ICU) since wakefulness is preferred according to recent guidelines. Nevertheless, evidence on the effect of music in ICU patients is scarce.

View Article and Find Full Text PDF

Background: In hospitalized patients with COVID-19, the dosing and timing of corticosteroids vary widely. Low-dose dexamethasone therapy reduces mortality in patients requiring respiratory support, but it remains unclear how to treat patients when this therapy fails. In critically ill patients, high-dose corticosteroids are often administered as salvage late in the disease course, whereas earlier administration may be more beneficial in preventing disease progression.

View Article and Find Full Text PDF

Introduction: Quality improvement in prehospital emergency medical services (EMS) can only be achieved by high-quality research and critical appraisal of current practices. This study examines current opportunities and barriers in EMS research in the Netherlands.

Methods: This mixed-methods consensus study consisted of three phases.

View Article and Find Full Text PDF

Background: Timely identification of deteriorating COVID-19 patients is needed to guide changes in clinical management and admission to intensive care units (ICUs). There is significant concern that widely used Early warning scores (EWSs) underestimate illness severity in COVID-19 patients and therefore, we developed an early warning model specifically for COVID-19 patients.

Methods: We retrospectively collected electronic medical record data to extract predictors and used these to fit a random forest model.

View Article and Find Full Text PDF

Background And Objective: Many patients treated for COVID-19 related acute respiratory distress syndrome in the intensive care unit are sedated with the benzodiazepine midazolam. Midazolam undergoes extensive metabolism by CYP3A enzymes, which may be inhibited by hyperinflammation. Therefore, an exaggerated proinflammatory response, as often observed in COVID-19, may decrease midazolam clearance.

View Article and Find Full Text PDF

Background: First studies indicate that up to 6 months after hospital discharge, coronavirus disease 2019 (COVID-19) causes severe physical, cognitive, and psychological impairments, which may affect participation and health-related quality of life (HRQoL). After hospitalization for COVID-19, a number of patients are referred to medical rehabilitation centers or skilled nursing facilities for further treatment, while others go home with or without aftercare. The aftercare paths include 1] community-based rehabilitation; 2] in- and outpatient medical rehabilitation; 3] inpatient rehabilitation in skilled nursing facilities; and 4] sheltered care (inpatient).

View Article and Find Full Text PDF

Key questions in COVID-19 are the duration and determinants of infectious virus shedding. Here, we report that infectious virus shedding is detected by virus cultures in 23 of the 129 patients (17.8%) hospitalized with COVID-19.

View Article and Find Full Text PDF

A PHP Error was encountered

Severity: Notice

Message: fwrite(): Write of 34 bytes failed with errno=28 No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 272

Backtrace:

A PHP Error was encountered

Severity: Warning

Message: session_write_close(): Failed to write session data using user defined save handler. (session.save_path: /var/lib/php/sessions)

Filename: Unknown

Line Number: 0

Backtrace: