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15 results on '"Hilkens, M."'

1. Long-Term Outcome of Patients With a Hematologic Malignancy and Multiple Organ Failure Admitted at the Intensive Care

Author

Vries, V.A. de, Muller, M.C.A., Arbous, M.S., Biemond, B.J., Blijlevens, N.M.A., Kusadasi, N., Span, L.R.F., Vlaar, A.P.J., Westerloo, D.J. van, Kluin-Nelemans, H.C., Bergh, W.M. van den, Tuinman, P.R., Spoelstra, A., Marijt, E., Blijlevens, N., Hilkens, M., Epker, J., Broers, A., Choi, G., Demandt, A., Mook, W. van, HEMA-ICU Study Grp, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Intensive Care Medicine, Clinical Haematology, CCA - Cancer Treatment and Quality of Life, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Emergency Medicine, Interne Geneeskunde, MUMC+: MA Hematologie (9), RS: SHE - R1 - Research (OvO), Intensive Care, MUMC+: MA Medische Staf IC (9), Intensive care medicine, and ACS - Diabetes & metabolism

Subjects
Male, IMPACT, Kaplan-Meier Estimate, Critical Care and Intensive Care Medicine, intensive care unit, law.invention, multiple organ failure/mortality, 0302 clinical medicine, PROGNOSTIC-FACTORS, law, Medicine, Netherlands, Mortality rate, Acute kidney injury, GROUPE, Online Clinical Investigations, CHEMOTHERAPY, Middle Aged, Intensive care unit, ADMISSION, Intensive Care Units, Treatment Outcome, Hematologic Neoplasms, SURVIVAL, Female, CRITICALLY-ILL PATIENTS, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9], medicine.medical_specialty, Multiple Organ Failure, CANCER-PATIENTS, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Intensive care, Internal medicine, Humans, organ failure, Survival rate, Survival analysis, Retrospective Studies, business.industry, 030208 emergency & critical care medicine, Retrospective cohort study, medicine.disease, Survival Analysis, SEVERITY, 030228 respiratory system, Respiratory failure, UNIT, hematologic malignancy, prognosis, business
Abstract

Objectives: Historically, patients with a hematologic malignancy have one of the highest mortality rates among cancer patients admitted to the ICU. Therefore, physicians are often reluctant to admit these patients to the ICU. The aim of our study was to examine the survival of patients who have a hematologic malignancy and multiple organ failure admitted to the ICU. Design: This retrospective cohort study, part of the HEMA-ICU study group, was designed to study the survival of patients with a hematologic malignancy and organ failure after admission to the ICU. Patients were followed for at least 1 year. Setting: Five university hospitals in the Netherlands. Patients: One-thousand ninety-seven patients with a hematologic malignancy who were admitted at the ICU. Interventions: None. Measurements and Main Results: Primary outcome was 1-year survival. Organ failure was categorized as acute kidney injury, respiratory failure, hepatic failure, and hemodynamic failure; multiple organ failure was defined as failure of two or more organs. The World Health Organization performance score measured 3 months after discharge from the ICU was used as a measure of functional outcome. The 1-year survival rate among these patients was 38%. Multiple organ failure was inversely associated with long-term survival, and an absence of respiratory failure was the strongest predictor of 1-year survival. The survival rate among patients with 2, 3, and 4 failing organs was 27%, 22%, and 8%, respectively. Among all surviving patients for which World Health Organization scores were available, 39% had a World Health Organization performance score of 0-1 3 months after ICU discharge. Functional outcome was not associated with the number of failing organs. Conclusions: Our results suggest that multiple organ failure should not be used as a criterion for excluding a patient with a hematologic malignancy from admission to the ICU.

Published
2019
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3. The management of critically ill patients with haematological malignancies

Author

Kusadasi, N., Muller, M.C., Westerloo, D.J. van, Broers, A.E., Hilkens, M., and Blijlevens, N.M.A.

Subjects
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Abstract

Item does not contain fulltext The management of critically ill patients with haematological malignancy (HM) still shows inter- and intra-regional differences. Our objective in this updated review was to address the evidence supporting the potential treatment options, based on multidisciplinary processes, of critically ill patients with HM. A stepwise approach to the critical care pathway of this patient population from the triage to ICU admission to ICU discharge was chosen to emphasise certain key findings. Our main focus relied on significant issues of decision-making in daily clinical routine. The plethora of studies shifted the pragmatic treatment policy into an evidence-based approach. The transfer of a patient with HM from the haematology ward to the ICU and vice versa should be based on a well-defined clinical care process in which the haematologists and intensivists are in close collaboration and direct communication. A protocolised clinical approach to treat a critically ill patient with HM seems helpful to optimise patient-oriented care and patient safety.

Published
2017

4. Long-Term Outcome of Patients With a Hematologic Malignancy and Multiple Organ Failure Admitted at the Intensive Care

Author

de Vries, V.A., Muller, MCA, Arbous, M.S., Biemond, B.J. (Bart), Blijlevens, N.M. (Nicole ), Kusadasi, N. (Nuray), Span, LRF, Vlaar, A.P.J., van Westerloo, D.J., Kluin-Nelemans, J.C. (Hanneke), Bergh, W.M., Tuinman, S. (Sietske), Spoelstra, A., Marijt, E, Blijlevens, N., Hilkens, M., Epker, J, Broers, A., Choi, G. (Goda), Demandt, A., van Mook, W, de Vries, V.A., Muller, MCA, Arbous, M.S., Biemond, B.J. (Bart), Blijlevens, N.M. (Nicole ), Kusadasi, N. (Nuray), Span, LRF, Vlaar, A.P.J., van Westerloo, D.J., Kluin-Nelemans, J.C. (Hanneke), Bergh, W.M., Tuinman, S. (Sietske), Spoelstra, A., Marijt, E, Blijlevens, N., Hilkens, M., Epker, J, Broers, A., Choi, G. (Goda), Demandt, A., and van Mook, W

Abstract

Objectives: Historically, patients with a hematologic malignancy have one of the highest mortality rates among cancer patients admitted to the ICU. Therefore, physicians are often reluctant to admit these patients to the ICU. The aim of our study was to examine the survival of patients who have a hematologic malignancy and multiple organ failure admitted to the ICU. Design: This retrospective cohort study, part of the HEMA-ICU study group, was designed to study the survival of patients with a hematologic malignancy and organ failure after admission to the ICU. Patients were followed for at least 1 year. Setting: Five university hospitals in the Netherlands. Patients: One-thousand ninety-seven patients with a hematologic malignancy who were admitted at the ICU. Interventions: None. Measurements and Main Results: Primary outcome was 1-year survival. Organ failure was categorized as acute kidney injury, respiratory failure, hepatic failure, and hemodynamic failure; multiple organ failure was defined as failure of two or more organs. The World Health Organization performance score measured 3 months after discharge from the ICU was used as a measure of functional outcome. The 1-year survival rate among these patients was 38%. Multiple organ failure was inversely associated with long-term survival, and an absence of respiratory failure was the strongest predictor of 1-year survival. The survival rate among patients with 2, 3, and 4 failing organs was 27%, 22%, and 8%, respectively. Among all surviving patients for which World Health Organization scores were available, 39% had a World Health Organization performance score of 0–1 3 months after ICU discharge. Functional outcome was not associated with the number of failing organs. Conclusions: Our results suggest that multiple organ failure should not be used as a criterion for excluding a patient with a hematologic malignancy from admission to the ICU.

Published
2019
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5. Long-Term Outcome of Patients With a Hematologic Malignancy and Multiple Organ Failure Admitted at the Intensive Care

Author

de Vries, VA, Muller, MCA, Arbous, MS, Biemond, BJ, Blijlevens, NMA, Kusadasi, Nuray, Span, LRF, Vlaar, APJ, van Westerloo, DJ, Kluin-Nelemans, HC, Bergh, WM, Tuinman, PR, Spoelstra, A, Marijt, E, Blijlevens, N, Hilkens, M, Epker, J, Broers, A, Choi, G, Demandt, A, van Mook, W, de Vries, VA, Muller, MCA, Arbous, MS, Biemond, BJ, Blijlevens, NMA, Kusadasi, Nuray, Span, LRF, Vlaar, APJ, van Westerloo, DJ, Kluin-Nelemans, HC, Bergh, WM, Tuinman, PR, Spoelstra, A, Marijt, E, Blijlevens, N, Hilkens, M, Epker, J, Broers, A, Choi, G, Demandt, A, and van Mook, W

Published
2019

8. Guideline summary: Intensive care admission, treatment and discharge of critically ill haemato-oncological patients

Author

Schuitemaker, L.M., Muller, M. C. A., Kusadasi, N., Broers, A. E., Hilkens, M. G. E. C., Blijlevens, N., van Westerloo, D. J., Erasmus MC other, Other Research, Intensive Care Medicine, and ACS - Pulmonary hypertension & thrombosis

Subjects
quality of care, ICU outcome, haematology, guideline, haemato-oncology, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Abstract

Item does not contain fulltext

Published
2017

10. No elevation of glutathione S-transferase-a1-1 by amiodarone loading in intensive care unit patients with atrial fibrillation.

Author

Hilkens, M., Pickkers, P., Peters, W.H.M., Hoeven, J.G. van der, Hilkens, M., Pickkers, P., Peters, W.H.M., and Hoeven, J.G. van der

Abstract

Contains fulltext : 81242.pdf (publisher's version ) (Closed access), Hepatocellular toxicity is a putative side-effect of amiodarone. The hepatic detoxification enzyme glutathione S-transferase-A1-1 (GSTA1-1) is a sensitive indicator of hepatocellular damage. We investigated the occurrence of subclinical liver injury, as measured by plasma GSTA1-1 in intensive care unit patients with atrial fibrillation receiving amiodarone. Sixteen haemodynamically stable intensive care unit patients with atrial fibrillation were treated with amiodarone intravenously. Patients were given a loading dose of 150 mg followed by another 150 mg followed by a continuous infusion of 1200 mg/hour if atrial fibrillation persisted. Blood samples for GSTA1-1 (measured by an enzyme-linked immunosorbent assay) were taken at zero, one, three, six, 12 and 24 hours, transaminases and bilirubin at zero, six, 12 and 24 hours. Blood pressure and heart rate were continuously monitored. Effects were analysed for time-dependent changes (one-way analysis of variance for repeated measures). Blood pressure increased from 125 +/- 8/60 +/- 3 mmHg at t = 0 to 144 +/- 9/66 +/- 4 mmHg at t = 24 hours (P < 0.05), heart rate decreased from atrial fibrillation 124 +/- 5 to sinus rhythm 86 +/- 6 beats per minute (P < 0.05). There was no significant elevation of GSTA1-1, transaminases or bilirubin during the observation period of 24 hours. Amiodarone does not cause elevation of GSTA1-1 as a marker of subclinical liver injury in haemodynamically stable intensive care unit patients with atrial fibrillation.

Published
2009

14. Automated Measurement and Control of Germination Paper Water Content.

Author

Owino L, Hilkens M, Kögler F, and Söffker D

Abstract

Germination paper (GP) is used as a growth substrate in plant development studies. Current studies bear two limitations: (1) The actual GP water content and variations in GP water content are neglected. (2) Existing irrigation methods either maintain the GP water content at fully sufficient or at a constant deficit. Variation of the intensity of water deficit over time for plants grown on GP is not directly achievable using these methods. In this contribution, a new measurement and control approach was presented. As a first step, a more precise measurement of water content was realized by employing the discharging process of capacitors to determine the electrical resistance of GP, which is related to the water content. A Kalman filter using an evapotranspiration model in combination with experimental data was used to refine the measurements, serving as the input for a model predictive controller (MPC). The MPC was used to improve the dynamics of the irrigation amount to more precisely achieve the required water content for regulated water uptake in plant studies. This is important in studies involving deficit irrigation. The novel method described was capable of increasing the accuracy of GP water content control. As a first step, the measurement system achieved an improved accuracy of 0.22 g/g. The application of a MPC for water content control based on the improved measurement results in an overall control accuracy was 0.09 g/g. This method offers a new approach, allowing the use of GP for studies with varying water content. This addressed the limitations of existing plant growth studies and allowed the prospection of dependencies between dynamic water deficit and plant development using GP as a growth substrate for research studies.

Published
2019
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15. [Diagnostic image (95). A man with a greyish blue complexion].

Author

Hilkens MG and Netten PM

Subjects
Aged, Aged, 80 and over, Esophageal Neoplasms complications, Esophageal Neoplasms secondary, Fatal Outcome, Humans, Male, Melanoma complications, Melanoma secondary, Melanosis etiology, Esophageal Neoplasms diagnosis, Melanoma diagnosis, Melanosis diagnosis
Abstract

An 80-year-old man with anorexia and brown-coloured urine presented with a typical complexion due to diffuse melanosis caused by malignant melanoma.

Published
2002

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