Publications by authors named "Dieter Dauwe"
Article Synopsis
- Study Purpose
- : The research aimed to determine if using a hemoadsorption device during thoraco-abdominal normothermic regional perfusion (TA-NRP) in heart donation after circulatory death could reduce inflammation and improve heart function.
- Methodology
- : Involved 15 pigs undergoing induced circulatory arrest, followed by TA-NRP with and without a hemoadsorption device. Plasma cytokine levels were measured at various points, and cardiac function was evaluated using pressure-volume loop analysis.
- Findings
- : The hemoadsorption device did not significantly influence cytokine levels or cardiac function post-TA-NRP, indicating that inflammation levels and heart performance were not improved by this intervention
Successful clinical transplantation of hearts donated after circulatory death using direct procurement followed by hypothermic oxygenated perfusion: A report of the first 3 cases.
J Heart Lung Transplant
November 2024
Background: Extracorporeal life support (ECLS) is not routinely used at our center during sequential single-lung transplantation (LTx), but is restricted to anticipate and overcome hemodynamic and respiratory problems occurring peri-operatively. In this retrospective descriptive cohort study, we aim to describe our single-center experience with ECLS in LTx, analyzing ECLS-related complications.
Methods: All transplantations with peri-operative ECLS use [2010-2020] were retrospectively analyzed.
Background: Randomized, controlled trials have shown both benefit and harm from tight blood-glucose control in patients in the intensive care unit (ICU). Variation in the use of early parenteral nutrition and in insulin-induced severe hypoglycemia might explain this inconsistency.
Methods: We randomly assigned patients, on ICU admission, to liberal glucose control (insulin initiated only when the blood-glucose level was >215 mg per deciliter [>11.
Article Synopsis
- Existing research on RBC transfusion in VA ECMO patients is limited, mostly consisting of small-scale studies that hinder broader understanding.
- This study involved an international survey and retrospective data collection from 16 centers to assess transfusion practices and outcomes in VA ECMO patients.
- Results showed that a high percentage of patients (89%) received RBC transfusions, with factors like lower hemoglobin and longer ECMO duration influencing the need for transfusions, but overall survival did not significantly differ based on transfusion status.
Plasma Transfusion and Procoagulant Product Administration in Extracorporeal Membrane Oxygenation: A Secondary Analysis of an International Observational Study on Current Practices.
Crit Care Explor
August 2023
Article Synopsis
- The study examines the use of various blood products (plasma, fibrinogen concentrate, TXA, and PCC) in patients on extracorporeal membrane oxygenation (ECMO) to achieve better blood clotting balance.
- It analyzes data from a multicenter retrospective study involving adult patients on VA-ECMO and VV-ECMO, identifying complications related to bleeding and thrombosis.
- Results indicate a higher use of transfusions in patients with bleeding complications, revealing trends in treatment that suggest a need for reevaluation of current transfusion practices in ECMO patients.
The interaction of thrombocytopenia, hemorrhage, and platelet transfusion in venoarterial extracorporeal membrane oxygenation: a multicenter observational study.
Crit Care
August 2023
Article Synopsis
- Thrombocytopenia (low platelets) and bleeding are common problems for patients on a special machine called VA ECMO that helps with heart and lung issues.
- A study looked at 419 patients and found that almost all of them developed low platelets, with many having severe cases, and more than half needed platelet transfusions.
- The research showed that having severe low platelets makes it much more likely to need a platelet transfusion, especially if the patient is also bleeding.
Percutaneous ventricular assist devices (pVADs) are increasingly being used because of improved experience and availability. The Impella (Abiomed), a percutaneous microaxial, continuous-flow, short-term ventricular assist device, requires meticulous postimplantation management to avoid the 2 most frequent complications, namely, bleeding and hemolysis. A standardized approach to the prevention, detection, and treatment of these complications is mandatory to improve outcomes.
View Article and Find Full Text PDFThe ARC predictor is a prediction model for augmented renal clearance (ARC) on the next intensive care unit (ICU) day that showed good performance in a general ICU setting. In this study, we performed a retrospective external validation of the ARC predictor in critically ill coronavirus disease 19 (COVID-19) patients admitted to the ICU of the University Hospitals Leuven from February 2020 to January 2021. All patient-days that had serum creatinine levels available and measured creatinine clearance on the next ICU day were enrolled.
View Article and Find Full Text PDFBackground: To inform future research and practice, we aimed to investigate the outcomes of patients who received extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) due to different variants of SARS-CoV-2.
Methods: This retrospective study included consecutive adult patients with laboratory-confirmed SARS-CoV-2 infection who received ECMO for ARDS in 21 experienced ECMO centres in eight European countries (Austria, Belgium, England, France, Germany, Italy, Portugal, and Spain) between Jan 1, 2020, and Sept 30, 2021. We collected data on patient characteristics, clinical status, and management before and after the initiation of ECMO.
Background: Thromboinflammation plays a central role in severe COVID-19. The kallikrein pathway activates both inflammatory pathways and contact-mediated coagulation. We investigated if modulation of the thromboinflammatory response improves outcomes in hospitalized COVID-19 patients.
View Article and Find Full Text PDFUnlabelled: Although venovenous extracorporeal membrane oxygenation (VV ECMO) has been used in case of COVID-19 induced acute respiratory distress syndrome (ARDS), outcomes and criteria for its application should be evaluated.
Objectives: To describe patient characteristics and outcomes in patients receiving VV ECMO due to COVID-19-induced ARDS and to assess the possible impact of COVID-19 on mortality.
Design Setting And Participants: Multicenter retrospective study in 15 ICUs worldwide.
Background: Venous thromboembolism (VTE) frequently occurs in hospitalized patients with coronavirus disease 2019 (COVID-19). The optimal dose of anticoagulation for thromboprophylaxis in COVID-19 is unknown.
Aims: To report VTE incidence and bleeding before and after implementing a hospital-wide intensified thromboprophylactic protocol in patients with COVID-19.
Article Synopsis
- In the critical care setting, a restrictive blood transfusion strategy is generally safe, but patients on venovenous extracorporeal membrane oxygenation (ECMO) often receive more liberal transfusions, which prompts the need for better understanding of current practices.
- This study involved a mixed methods approach, including a retrospective analysis of patient data from 16 ICUs worldwide, focusing on those who underwent ECMO from January 2018 to July 2019.
- Results showed that a high percentage (88%) of patients received at least one red blood cell (RBC) transfusion, with average hemoglobin levels decreasing significantly during ECMO, and those with a threshold hemoglobin of over 9 g/dL received more transf
Article Synopsis
- Primary graft dysfunction (PGD) significantly impacts early recovery and survival rates after lung transplantation (LTx), with this study investigating the role of prolonged anastomosis time (AT) as a risk factor for PGD.
- Data from 427 patients who underwent double lung transplants between 2008 and 2016 revealed that 30.2% developed severe PGD3 within 72 hours, and longer AT was independently linked to increased risk of PGD3.
- The findings emphasize the importance of minimizing AT during LTx procedures and ensuring proper lung cooling to reduce the incidence of PGD and related complications.
Ventricular suction is a common adverse event in ventricular assist device (VAD) patients and can be due to multiple underlying causes. The aim of this study is to analyze the potential of different therapeutic interventions to mitigate suction events induced by different pathophysiological conditions. To do so, a suction module was embedded in a cardiovascular hybrid (hydraulic-computational) simulator reproducing the entire cardiovascular system.
View Article and Find Full Text PDFObjectives: To report a case of povidone-iodine (PVP-I, Iso-Betadine®) disinfection of lower leg fasciotomy wounds resulting in iodide absorption and possibly contributing to hypothyroidism and prolonged kidney injury.
Design: Case report. .
How the innate and adaptive host immune system miscommunicate to worsen COVID-19 immunopathology has not been fully elucidated. Here, we perform single-cell deep-immune profiling of bronchoalveolar lavage (BAL) samples from 5 patients with mild and 26 with critical COVID-19 in comparison to BALs from non-COVID-19 pneumonia and normal lung. We use pseudotime inference to build T-cell and monocyte-to-macrophage trajectories and model gene expression changes along them.
View Article and Find Full Text PDFBackground: Blood outgrowth endothelial cells (BOECs) mediate therapeutic neovascularization in experimental models, but outgrowth characteristics and functionality of BOECs from patients with ischemic cardiomyopathy (ICMP) are unknown. We compared outgrowth efficiency and in vitro and in vivo functionality of BOECs derived from ICMP with BOECs from age-matched (ACON) and healthy young (CON) controls.
Methods And Results: We isolated 3.