Publications by authors named "Jos A H van Oers"
Article Synopsis
- Over 50% of ICU survivors experience "post-intensive care syndrome" (PICS) symptoms, which include physical, psychological, and cognitive impairments, especially amid the stress of COVID-19.
- A quality improvement study aimed to support patients and families transitioning home after ICU treatment by providing structured telephone support (STS) to identify and address PICS symptoms within four weeks of discharge.
- The study found that many patients reported physical symptoms like loss of strength and fatigue, while caregivers highlighted a desire for ongoing care, allowing healthcare providers to adjust follow-up plans based on individual needs.
Article Synopsis
- The study examined the impact of obesity on inflammatory biomarkers and clinical outcomes in critically ill patients with SARS-CoV-2 pneumonia.
- Among 105 patients, 42 were classified as obese, yet no significant differences in inflammatory markers (MR-proADM, CT-proET-1, etc.) were found between those with and without obesity over the first week of illness.
- The findings suggest that obesity does not affect the severity of inflammation or key clinical outcomes like ICU stay, ventilation time, or mortality in these cases.
Article Synopsis
- Aneurysmal subarachnoid hemorrhage (aSAH) is a serious condition that necessitates intensive care, and the study aimed to evaluate whether levels of C-terminal proarginine vasopressin (CT-proAVP) can predict poor outcomes, mortality, and delayed cerebral ischemia (DCI) in patients compared to existing scoring systems.
- The research examined CT-proAVP levels in 100 patients with aSAH and found that higher levels of CT-proAVP were significantly correlated with worse functional outcomes at one year, as well as with mortality within 30 days and one year.
- Though CT-proAVP showed high accuracy for predicting poor outcomes and mortality (with AUC values around 0.84
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a prothrombotic disorder, which has been described as a rare adverse effect of the adenoviral-vectored coronavirus disease 2019 (COVID-19) vaccines. The diagnosis is confirmed by the detection of anti-platelet factor 4 (PF4) antibodies by enzyme-linked immunosorbent assay (ELISA) or functional assay in individuals with the appropriate clinical history. Here, we report a case of a patient who presented with a severe intracerebral hemorrhage and thrombocytopenia 14 days after receiving the first dose of the Oxford-AstraZeneca COVID-19 vaccine, with negative PF4/heparin antibodies tested with ELISA, but positive heparin-induced platelet activation assay (HIPAA).
View Article and Find Full Text PDFPurpose: We assessed the ability of mid-regional proadrenomedullin (MR-proADM) and C-terminal proendothelin-1 (CT-proET-1) to predict 28-day mortality in critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia.
Methods: Biomarkers were collected during the first seven days in this prospective observational cohort study. We investigated the relationship between biomarkers and mortality in a multivariable Cox regression model adjusted for age and SOFA score.
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.
Background: Older patients have a less pronounced immune response to infection, which may also influence infection biomarkers. There is currently insufficient data regarding clinical effects of procalcitonin (PCT) to guide antibiotic treatment in older patients.
Objective And Design: We performed an individual patient data meta-analysis to investigate the association of age on effects of PCT-guided antibiotic stewardship regarding antibiotic use and outcome.
Objectives: Patients with impaired kidney function have a significantly slower decrease of procalcitonin (PCT) levels during infection. Our aim was to study PCT-guided antibiotic stewardship and clinical outcomes in patients with impairments of kidney function as assessed by creatinine levels measured upon hospital admission.
Methods: We pooled and analyzed individual data from 15 randomized controlled trials who were randomly assigned to receive antibiotic therapy based on a PCT-algorithms or based on standard of care.
Background: New Sepsis-3 definitions facilitate early recognition of patients with sepsis. In this study we investigated whether a single initial determination of procalcitonin (PCT) or C-reactive protein (CRP) in plasma can predict proven sepsis in Sepsis-3 criteria-positive critically ill patients. We also investigated whether a decline in serial PCT or CRP can predict outcome in 28-day mortality.
View Article and Find Full Text PDFAfter insertion of a nasal oxygen catheter, a 65-year-old man developed severe subcutaneous emphysema of the face and neck. The catheter damaged the mucosa of the left inferior nasal concha. Oxygen was blown into the subcutis.
View Article and Find Full Text PDFBackground: The clinical utility of serum procalcitonin levels in guiding antibiotic treatment decisions in patients with sepsis remains unclear. This patient-level meta-analysis based on 11 randomized trials investigates the impact of procalcitonin-guided antibiotic therapy on mortality in intensive care unit (ICU) patients with infection, both overall and stratified according to sepsis definition, severity, and type of infection.
Methods: For this meta-analysis focusing on procalcitonin-guided antibiotic management in critically ill patients with sepsis of any type, in February 2018 we updated the database of a previous individual patient data meta-analysis which was limited to patients with respiratory infections only.
Rationale, Aims, And Objectives: Since adequate staffing in intensive care units (ICUs) is an increasing problem worldwide, we investigated whether physician assistants (PAs) are able to substitute medical residents (MR) in ICUs with at least the same quality of clinical skills. In this study, we analysed the level of clinical skills of PAs in direct comparison with those who traditionally performed these tasks, ie, MR with 6 to 24 months of work experience in the ICU.
Method: Physician assistants and MRs in the ICUs were observed on their clinical skills by means of a simulated ICU comprising 2 scenarios on a human patient simulator with typical ICU cases.
Background: In February, 2017, the US Food and Drug Administration approved the blood infection marker procalcitonin for guiding antibiotic therapy in patients with acute respiratory infections. This meta-analysis of patient data from 26 randomised controlled trials was designed to assess safety of procalcitonin-guided treatment in patients with acute respiratory infections from different clinical settings.
Methods: Based on a prespecified Cochrane protocol, we did a systematic literature search on the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase, and pooled individual patient data from trials in which patients with respiratory infections were randomly assigned to receive antibiotics based on procalcitonin concentrations (procalcitonin-guided group) or control.