Papers by Peter Van Der Voort
Critical Care Medicine, 2007
Objective: To study whether lactulose or polyethylene glycol is effective to promote defecation i... more Objective: To study whether lactulose or polyethylene glycol is effective to promote defecation in critically ill patients, whether either of the two is superior, and whether the use of enteral laxatives is related to clinical outcome.
Journal of diabetes science and technology, Jan 12, 2015
Hyperglycemia and hypoglycemia are associated with adverse clinical outcomes in intensive care pa... more Hyperglycemia and hypoglycemia are associated with adverse clinical outcomes in intensive care patients. In product development studies at 4 ICUs, the safety and performance of an intravascular continuous glucose monitoring (IV-CGM) system was evaluated in 70 postsurgical patients. The GluCath System (GluMetrics, Inc) used a quenched chemical fluorescence mechanism to optically measure blood glucose when deployed via a radial artery catheter or directly into a peripheral vein. Periodic ultrasound assessed blood flow and thrombus formation. Patient glucose levels were managed according to the standard of care and existing protocols at each site. Reference blood samples were acquired hourly and compared against prospectively calibrated sensor results. In all, 63 arterial sensors and 9 venous sensors were deployed in 70 patients. Arterial sensors did not interfere with invasive blood pressure monitoring, sampling or other aspects of patient care. A majority of venous sensors (66%) exhi...
Journal of Critical Care, 2012
Purpose: The aim of this study was to test the hypothesis that blood glucose amplitude variabilit... more Purpose: The aim of this study was to test the hypothesis that blood glucose amplitude variability (BGAV) is associated with mortality in critically ill patients. Method: A prospectively collected multicenter data set including all glucose measurements during intensive care unit (ICU) treatment and outcome was analyzed. We used logistic regression to assess the association between hospital mortality and standard deviation (SD), mean amplitude of glycemic excursions (MAGE), mean absolute glucose change per hour (MAG), and glycemic lability index (GLI). The analysis was adjusted for ICU, Acute Physiology And Chronic Health Evaluation IV-expected mortality, the presence of severe hypoglycemia, mean glucose, mean glucose measurement interval, and interaction between the latter 2. Results: There were 855 032 glucose measurements included of 20 375 patients admitted to 37 Dutch ICUs in 2008 and 2009. Median Acute Physiology And Chronic Health Evaluation IV-predicted mortality was 14%, and median glucose was 7.3 mmol/L. In all patients combined, adjusted hospital mortality was associated with SD and MAGE, but not with MAG and GLI. In surgical patients, adjusted hospital mortality was associated with SD, MAGE, and MAG, but not GLI. In medical patients, adjusted mortality was associated with SD but not with other BGAV measures. Conclusion: Not all BGAV measures were associated with mortality. Blood glucose amplitude variability as quantified by SD was consistently independently associated with hospital mortality.
Critical Care, 2008
Introduction The aim of this study was to investigate whether inhospital mortality was associated... more Introduction The aim of this study was to investigate whether inhospital mortality was associated with the administered fraction of oxygen in inspired air (FiO 2 ) and achieved arterial partial pressure of oxygen (PaO 2 ).
Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2008
Two women, aged 27, presented with different symptoms shortly after giving birth to their first c... more Two women, aged 27, presented with different symptoms shortly after giving birth to their first child. Peripartum cardiomyopathy (PPCM) was diagnosed. PPCM is a rare form of cardiac failure occurring late in pregnancy or in the postpartum period. Many women experience dyspnoea, fatigue, and pedal oedema in the last month of pregnancy or postpartum, symptoms which are identical to early congestive heart failure. Therefore, the diagnosis of PPCM requires vigilance. A high mortality rate and overall poor clinical outcome has been reported in a high percentage of these patients. Subsequent pregnancies remain controversial. (Neth Heart J 2008;16:415-8.).
Selective Digestive Tract Decontamination in Intensive Care Medicine: a Practical Guide to Controlling Infection, 2008
Page 168. Chapter 13 The Role of SDD in Liver Transplantation: a Meta-Analysis Peter HJ van der V... more Page 168. Chapter 13 The Role of SDD in Liver Transplantation: a Meta-Analysis Peter HJ van der Voort and Hendrick KF van Saene Introduction and rationale Wiesner et al. introduced SDD as infection prophylaxis in liver ...
Selective Digestive Tract Decontamination in Intensive Care Medicine: a Practical Guide to Controlling Infection, 2008
ABSTRACT Infection in intensive care patients may be the reason for their admission or it may be ... more ABSTRACT Infection in intensive care patients may be the reason for their admission or it may be acquired in the intensive care unit (ICU). Infection in the ICU is common and causes morbidity and hospital mortality [1]. The aim of SDD is to prevent newly acquired infection and associated mortality in the ICU. This chapter describes the magnitude of the infectious problem according to the current literature. If we accept the hypothesis that SDD can prevent ICU acquired infection, it follows that the incidence of infection will show the possible impact of SDD in preventing these infections. However, SDD is designed to prevent infections caused by potentially pathogenic microorganisms (Chapter 2) and will therefore not prevent infections caused by low level pathogens, including coagulase-negative staphylococci and enterococci.
Some decades ago, yeasts were not recognized as pathogens [1, 2]. Since the 1980s the pathogenici... more Some decades ago, yeasts were not recognized as pathogens [1, 2]. Since the 1980s the pathogenicity of fungi has gained more and more attention, first in immunocompromised patients and later on in critically ill patients as well [3]. Critically ill patients are frequently colonized with yeasts. Amongst other reasons, extensive use of broad spectrum antibiotics in critically ill patients lead to overgrowth in the digestive tract and other organs. Overgrowth is the most important factor in the development of fungal infection. This sequence of events is amplified by decreased motility of the digestive tract during critical illness. In addition, contributing to yeast infection is the fact that critically ill patients are immunodeficient, especially in the cellular immune functions.
Kwaliteit van medische zorg wordt in grote mate be-paald door individuele expertise van zorgverle... more Kwaliteit van medische zorg wordt in grote mate be-paald door individuele expertise van zorgverleners. Daarom is er veel aandacht voor een gedegen opleiding en het behoud van expertise door nascholing en herregi-stratie. Voor bepaalde (orgaan)specialismen is de pro- ...
Netherlands Journal of Critical Care, Feb 1, 2011
ABSTRACT Telemedicine is medicine practiced from a distance. In the United States tele-ICU, a for... more ABSTRACT Telemedicine is medicine practiced from a distance. In the United States tele-ICU, a form of telemedicine has been instituted as a solution for the shortage of intensivists. Intensivists provide daily ICU care from a distance. Tele-ICU seems most effective for rural and/or small ICUs that do not have round–the-clock intensivist staffing. In this situation, the implementation of tele-ICU can lead to a decrease in Length Of Stay and ICU mortality. Another benefit of tele-ICU is enhanced adherence to guidelines. Telemedicine in the Netherlands is currently only used in the form of teleconsulting.
Intensive Care Medicine, Sep 25, 2014
Journal of Electrocardiology, 2015
Prolongation of the corrected QT interval (QTc) can lead to torsades de pointes. This study is de... more Prolongation of the corrected QT interval (QTc) can lead to torsades de pointes. This study is designed to determine the validity of the continuous QTc (cQTc) measurement in critically ill patients. In a retrospective cohort study, QTc analysis was performed with manual measurements on a single selected lead from a 12-lead ECG and cQTc measurement obtained at the same time. In addition, automated QTc measurement from the 12-lead ECG was also included in the study. Validation was performed by calculating intraclass correlation coefficient (ICC), Pearson's correlation and Bland-Altman plot. 119 patients with QRS<120ms were included with a mean cQTc of 468ms (standard deviation (SD) 37) and mean manually measured QTc of 449ms (SD 41) (p<0.001). Pearson's correlation was 0.65 (p<0.01), ICC was 0.65 (95% CI: 0.53-0.74). Bland-Altman plot shows a mean difference of 19.5ms (limits of agreement (LOA) -44.6 to 83.7). For cQTc compared to automated QTc from the 12-lead ECG the intraclass correlation coefficient was 0.77 (95% CI: 0.68-0.83, p<0.001) and the Bland-Altman plot shows a mean difference of 7.8ms (LOA -40.2 to 55.8). cQTc measurement in critically ill patients with a QRS duration shorter than 120ms shows an acceptable accuracy to be used in routine care.
Swiss medical weekly, 2014
Critical Care, 2010
Kwaliteit van medische zorg wordt in grote mate be-paald door individuele expertise van zorgverle... more Kwaliteit van medische zorg wordt in grote mate be-paald door individuele expertise van zorgverleners. Daarom is er veel aandacht voor een gedegen opleiding en het behoud van expertise door nascholing en herregi-stratie. Voor bepaalde (orgaan)specialismen is de pro- ...
The Lancet, 1995
125 20 mg omeprazole daily for 2 weeks. Blood ammonia was slightly decreased at first but again i... more 125 20 mg omeprazole daily for 2 weeks. Blood ammonia was slightly decreased at first but again increased within a week of antibiotic treatment.
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Papers by Peter Van Der Voort