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Your search keyword '"Heerden, P V van"' showing total 3 results
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3 results on '"Heerden, P V van"'

1. Behavioural responses of Intensivists to stressors in Intensive Care.

Author

Dennis, D, Heerden, P V van, Khanna, R, and Knott, C I

Subjects
*INTENSIVE care patients, *CRITICAL care medicine, *LIFE change events, *INTENSIVE care units, *MEDICAL personnel, *REFLECTIVE learning
Abstract

Background The hospital intensive care unit (ICU) environment encompasses sick patients who present for care in health crisis. Healthcare in this setting is complex, often involving the co-ordination of multiple professional teams, all under significant time pressures. The sequelae for staff interacting in this dynamic and often volatile setting are variable, depending upon their coping skillset and their familiarity with the stressors. Aims The primary aim of this study was to describe and in doing so, normalize the behavioural responses expressed by ICU doctors (Intensivists) in response to stressful workplace events. The secondary aim was to identify those responses that contributed to resilience. Methods A prospective qualitative study of senior Intensivists using a semi-scripted iterative interview. Data were transcribed and thematically analysed with verbatim quotations selected to support coding choices. Results Nineteen experienced Intensivists from three sites in Australia and Israel participated. Clinicians described conscious, physiological and professional responses to stressors, including sense-making and taking time to process information with appropriate support. Two of the most important mitigation processes revealed were the use of reflective learning and preventative practice changes to prevent future errors. These were overlaid with the importance of disclosure and transparency in clinical work. Conclusions Repeated exposure to stressful events potentiates burnout, wherein staff no longer experience satisfaction and enjoyment in what they do. This paper presents the behavioural responses that experienced Intensivists described in relation to stressful events in the ICU, including steps taken to mitigate the effects of these events on their personal well-being. [ABSTRACT FROM AUTHOR]

Published
2021
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2. The Role of Femoral Venous Pressure and Femoral Venous Oxygen Saturation in the Setting Of Intra-Abdominal Hypertension

Author

Regli, Adrian, Keulenaer, Bart L. De, Hockings, Lisen E., Musk, Gabrielle C., Roberts, Brigit, and Heerden, Peter V. van

Abstract

Femoral venous access is frequently used in critically ill patients. Because raised intra-abdominal pressure (IAP) is also frequently found in this group of patients, we examined the impact of IAP and positive end-expiratory pressure (PEEP) on femoral venous pressure (FVP) and femoral venous oxygen saturation (Sfvo2) in an animal model. Thirteen adult pigs received standardized anesthesia and ventilation. Randomized levels of IAP (3 baseline, 18, and 26 mmHg) were applied, with levels of PEEP (5, 8, 12, and 15 cmH2O) applied randomly at each IAP level. We measured bladder pressure (IAP), superior vena cava pressure, pulmonary artery pressure, pulmonary artery occlusion pressure, FVP, mixed venous oxygen saturation (Svo2), and Sfvo2. We found that FVP correlated well with IAP (FVP = 4.1 + 0.12 × PEEP + 1.00 × IAP; R2= 0.89, P< 0.001) with a moderate bias and precision of 5.0 and 3.8 mmHg, respectively. Because the level of agreement did not meet the recommendations of the World Society of Abdominal Compartment Syndrome, FVP cannot currently be recommended to measure IAP, and further clinical trials are warranted. However, a raised FVP should prompt the measurement of the bladder pressure. Femoral venous oxygen saturation did correlate neither with Svo2nor with abdominal perfusion pressure. Therefore, Sfvo2is of no clinical use in the setting of raised IAP.

Published
2011
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3. Inhaled diazeniumdiolates (NONOates) as selective pulmonary vasodilators

Author

Heerden, Peter V van, Sviri, Sigal, Ilett, Kenneth F, and Lam, Chen-Fuh

Abstract

Selective pulmonary vasodilators cause vasodilatation limited to the pulmonary vasculature, within well-ventilated lung regions. Selective pulmonary vasodilators ideally cause only a minimal effect on the systemic circulation and improve ventilation/perfusion matching. NONOates are a novel group of chemical compounds that spontaneously and continuously release nitric oxide under physiological conditions, over periods of up to 24 h. Inhaled NONOates retain the benefits of gaseous nitric oxide without many of its therapeutic disadvantages. This review focuses on the therapeutic potential of inhaled NONOates in pulmonary hypertension, other lung conditions associated with right ventricular dysfunction and in asthma. The potential toxicity of NONOates is also discussed.

Published
2002
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