Publications by authors named "Maarten de Haan"
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.
Background: Expected rise in the demand for healthcare and a dropping supply of healthcare professionals, has generated an increased interest in the most effective deployment of healthcare professionals. Consequently, task shifting has become a common strategy to redistribute tasks between established professional groups, however, little is known about the effects of shifting tasks to emerging professional groups. The aim of this study was to evaluate a legal amendment to facilitate task shifting to an emerging profession in Dutch healthcare: Clinical Technologists (CTs).
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- 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
Using mixed methods in health services research: A review of the literature and case study.
J Health Serv Res Policy
April 2021
Objective: To provide an overview of the challenges of conducting mixed methods research (MMR) in the context of health services research (HSR) and to discuss a case study example of the triangulation procedures used in a MMR study on task-shifting in the Netherlands.
Method: A narrative literature review of publications between January 2000 and February 2020 on the use of mixed methods in the context of HSR and a description of the triangulation procedures in an HSR study with a MMR design on task shifting in the Netherlands.
Results: The narrative review identified eight challenges.
Background/objectives: The increasing complexity of patients undergoing cardiac surgery requires extended myocardial ischaemic periods. Cardiac surgeons demand a cardioplegic solution with prolonged myocardial protection. Therefore, we introduced Custodiol in our centre in 2011.
View Article and Find Full Text PDFDespite recent studies confirming task shifting is both safe and effective, its implementation has proven difficult in practice. So too in the Netherlands, where legal barriers enforcing strict professional boundaries have historically limited task shifting. In recent years, Dutch policymakers have experimented with temporary expanded scopes of practice (ESP) for several professional groups, with the aim to facilitate task shifting in order to increase the overall effectiveness and efficiency of health care.
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