Publications by authors named "E D Wildschut"
Objectives: To determine if a priori standardization of outcome hemostatic definitions alone was adequate to enable useful comparison between two cohorts of pediatric extracorporeal membrane oxygenation (ECMO) patients, managed according to local practice and protocol.
Design: Comparison of two separate prospective cohort studies performed at different centers with standardized outcome definitions agreed upon a priori.
Setting: General and cardiac PICUs at the Royal Children's Hospital (RCH) in Melbourne, Australia, and the Sophia Children's Hospital (SCH) in Rotterdam, The Netherlands.
Article Synopsis
- Bleeding and thrombotic complications are prevalent in ECMO patients, impacting mortality and morbidity; this study compares complication rates before and after a change in anticoagulation monitoring protocol.
- A retrospective cohort study involved 250 adult ECMO patients, analyzing demographics, ECMO data, and coagulation tests to evaluate the effectiveness of the aPTT guided and multimodal protocols.
- Results showed that complication rates were similar between the two protocols, and surgical interventions significantly increased the risk of both bleeding and thrombotic issues.
Article Synopsis
- The study aimed to see if using intermittent intravenous paracetamol instead of continuous morphine would help kids aged 0-3 years feel less pain after heart surgery.
- It took place in special hospitals in the Netherlands and Belgium, and involved 208 children who had heart surgery, where they were split into two groups to compare pain relief methods.
- The results showed that kids who received paracetamol used much less morphine (79% less) for pain relief in the first 48 hours after surgery than those who got only morphine.
In critically ill adults, high plasma cortisol in face of low ACTH coincides with high pro-opiomelanocortin (POMC) levels. Glucocorticoids further lower ACTH without affecting POMC. We hypothesized that in pediatric cardiac surgery-induced critical illness, plasma POMC is elevated, plasma ACTH transiently rises intraoperatively but becomes suppressed post-operatively, and glucocorticoid administration amplifies this phenotype.
View Article and Find Full Text PDFFactors XI and XII in extracorporeal membrane oxygenation: longitudinal profile in children.
Res Pract Thromb Haemost
November 2023
Background: Extracorporeal membrane oxygenation (ECMO) is used in children with cardiopulmonary failure. While the majority of ECMO centers use unfractionated heparin, other anticoagulants, including factor XI and factor XII inhibitors are emerging, which may prove suitable for ECMO patients. However, before these anticoagulants can be applied in these patients, baseline data of FXI and FXII changes need to be acquired.
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