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3. Perioperative Brain Injury in Relation to Early Neurodevelopment Among Children with Severe Congenital Heart Disease: Results from a European Collaboration

Author

Neukomm, Astrid, Claessens, Nathalie H.P., Bonthrone, Alexandra F., Stegeman, Raymond, Feldmann, Maria, Nijman, Maaike, Jansen, Nicolaas J.G., Nijman, Joppe, Groenendaal, Floris, de Vries, Linda S., Benders, Manon J.N.L., Breur, Johannes M.P.J., Haas, Felix, Bekker, Mireille N., Logeswaran, Thushiha, Reich, Bettina, Kottke, Raimund, Dave, Hitendu, Simpson, John, Pushparajah, Kuberan, Kelly, Christopher J., Arulkumaran, Sophie, Rutherford, Mary A., Counsell, Serena J., Chew, Andrew, Knirsch, Walter, Sprong, Maaike C.A., van Schooneveld, Monique M., Hagmann, Cornelia, and Latal, Beatrice

Published
2024
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4. Prophylactic red blood cell transfusions in children and neonates with cancer: An evidence-based clinical practice guideline.

Author

Kruimer, Demi M., Stavleu, Debbie C., Mulder, Renée L., Kremer, Leontien C. M., Tissing, Wim J. E., Loeffen, Erik A. H., Bresters, Dorine, Evers, Janneke H. P., van Gestel, Sjef P. J., Hagleitner, Melanie M., Heitink-Pollé, Katja M. J., Huisman, Elise J., Janssens, Geert O. R., Kuijper, Philip H. M., Mensink, Maarten O., Nijman, Joppe, Noordzij, Jeroen G., Ophorst, Ida, Plieger, Willemijn, and Spijkerman, Judith

Abstract

Background: Red blood cell (RBC) transfusions play an important role in supportive care in children and neonates with cancer. However, in current clinical practice, evidence-based recommendations are lacking on when to administer prophylactic RBC transfusions. To address this gap, a clinical practice guideline (CPG) was developed to systematically review the available evidence and provide recommendations for clinicians. Methods: A systematic literature review in three databases was conducted. The GRADE methodology was used to assess, extract, and summarize the evidence. A multidisciplinary panel of 21 professionals was assembled to ensure comprehensive expertise. If there was insufficient evidence in children with cancer, additional evidence was gathered in general pediatric or adult oncology guidelines, or the panel utilized shared expert opinion to develop a comprehensive CPG. Multiple in-person meetings were conducted to discuss evidence, complete evidence-to-decision frameworks, and formulate recommendations. Results: Four studies including 203 children with all types of cancer, met the inclusion criteria. The expert panel assessed all evidence and translated it into recommendations. In total, 47 recommendations were formulated regarding RBC transfusions in children and neonates with cancer. For instance, specific thresholds for prophylactic RBC transfusions were recommended for children and neonates with cancer who have sepsis, are on ECMO, or are undergoing radiotherapy. Conclusion: This clinical practice guideline presents evidence-based recommendations regarding RBC transfusions in children and neonates with cancer. By providing these recommendations, we aim to guide clinicians and contribute to improving outcomes for children and neonates with cancer. [ABSTRACT FROM AUTHOR]

Published
2024
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5. CeRebrUm and CardIac Protection with ALlopurinol in Neonates with Critical Congenital Heart Disease Requiring Cardiac Surgery with Cardiopulmonary Bypass (CRUCIAL): study protocol of a phase III, randomized, quadruple-blinded, placebo-controlled, Dutch multicenter trial

Author

Stegeman, Raymond, Nijman, Maaike, Breur, Johannes M. P. J., Groenendaal, Floris, Haas, Felix, Derks, Jan B., Nijman, Joppe, van Beynum, Ingrid M., Taverne, Yannick J. H. J., Bogers, Ad J. J. C., Helbing, Willem A., de Boode, Willem P., Bos, Arend F., Berger, Rolf M. F., Accord, Ryan E., Roes, Kit C. B., de Wit, G. Ardine, Jansen, Nicolaas J. G., and Benders, Manon J. N. L.

Published
2022
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6. Population Pharmacokinetics and Target Attainment of Allopurinol and Oxypurinol Before, During, and After Cardiac Surgery with Cardiopulmonary Bypass in Neonates with Critical Congenital Heart Disease

Author

MS Neonatologie, Cardiologie onderzoek 1, Child Health, Circulatory Health, Medische staf Anesthesiologie, Intensive care patientenzorg, Brain, Apotheek O&O&O, Cancer, Chu, Wan-Yu, Nijman, Maaike, Stegeman, Raymond, Breur, Johannes M P J, Jansen, Nicolaas J G, Nijman, Joppe, van Loon, Kim, Koomen, Erik, Allegaert, Karel, Benders, Manon J N L, Dorlo, Thomas P C, Huitema, Alwin D R, CRUCIAL trial consortium, MS Neonatologie, Cardiologie onderzoek 1, Child Health, Circulatory Health, Medische staf Anesthesiologie, Intensive care patientenzorg, Brain, Apotheek O&O&O, Cancer, Chu, Wan-Yu, Nijman, Maaike, Stegeman, Raymond, Breur, Johannes M P J, Jansen, Nicolaas J G, Nijman, Joppe, van Loon, Kim, Koomen, Erik, Allegaert, Karel, Benders, Manon J N L, Dorlo, Thomas P C, Huitema, Alwin D R, and CRUCIAL trial consortium

Published
2024

7. Platelet reactivity in young children undergoing congenital heart disease surgery: a NITRIC randomized clinical trial substudy

Author

Circulatory Health, Medische staf Anesthesiologie, Intensive care patientenzorg, Child Health, Cardiopulmonale Chirurgie pat. zorg, Cardiologie onderzoek 1, van Loon, Kim, Koomen, Erik, Nijman, Joppe, van Wijk, Bram, Breur, Hans, Korporaal, Suzanne, Circulatory Health, Medische staf Anesthesiologie, Intensive care patientenzorg, Child Health, Cardiopulmonale Chirurgie pat. zorg, Cardiologie onderzoek 1, van Loon, Kim, Koomen, Erik, Nijman, Joppe, van Wijk, Bram, Breur, Hans, and Korporaal, Suzanne

Published
2024

8. Population Pharmacokinetics and Target Attainment of Allopurinol and Oxypurinol Before, During, and After Cardiac Surgery with Cardiopulmonary Bypass in Neonates with Critical Congenital Heart Disease

Author

Chu, Wan Yu, Nijman, Maaike, Stegeman, Raymond, Breur, Johannes M.P.J., Jansen, Nicolaas J.G., Nijman, Joppe, van Loon, Kim, Koomen, Erik, Allegaert, Karel, Benders, Manon J.N.L., Dorlo, Thomas P.C., Huitema, Alwin D.R., Chu, Wan Yu, Nijman, Maaike, Stegeman, Raymond, Breur, Johannes M.P.J., Jansen, Nicolaas J.G., Nijman, Joppe, van Loon, Kim, Koomen, Erik, Allegaert, Karel, Benders, Manon J.N.L., Dorlo, Thomas P.C., and Huitema, Alwin D.R.

Abstract

Background: The CRUCIAL trial (NCT04217421) is investigating the effect of postnatal and perioperative administration of allopurinol on postoperative brain injury in neonates with critical congenital heart disease (CCHD) undergoing cardiac surgery with cardiopulmonary bypass (CPB) shortly after birth. Objective: This study aimed to characterize the pharmacokinetics (PK) of allopurinol and oxypurinol during the preoperative, intraoperative, and postoperative phases in this population, and to evaluate target attainment of the current dosing strategy. Methods: Nonlinear mixed-effects modeling was used to develop population PK models in 14 neonates from the CRUCIAL trial who received up to five intravenous allopurinol administrations throughout the postnatal and perioperative periods. Target attainment was defined as achieving an allopurinol concentration >2 mg/L in at least two-thirds of the patients during the first 24 h after birth and between the start and 36 h after cardiac surgery with CPB. Results: A two-compartment model for allopurinol was connected to a one-compartment model for oxypurinol with an auto-inhibition effect on the conversion, which best described the PK. In a typical neonate weighing 3.5 kg who underwent cardiac surgery at a postnatal age (PNA) of 5.6 days, the clearance (CL) of allopurinol and oxypurinol at birth was 0.95 L/h (95% confidence interval 0.75–1.2) and 0.21 L/h (0.17–0.27), respectively, which subsequently increased with PNA to 2.97 L/h and 0.41 L/h, respectively, before CPB. During CPB, allopurinol and oxypurinol CL decreased to 1.38 L/h (0.9–1.87) and 0.12 L/h (0.05–0.22), respectively. Post-CPB, allopurinol CL increased to 2.21 L/h (1.74–2.83), while oxypurinol CL dropped to 0.05 L/h (0.01–0.1). Target attainment was 100%, 53.8%, and 100% at 24 h postnatally, 24 h after the start of CPB, and 36 h after the end of cardiac surgery, respectively. The co

Published
2024

9. Morbidity and mortality in premature or low birth weight patients with congenital heart disease in three European pediatric heart centers between 2016 and 2020

Author

MS Neonatologie, De Silvestro, Alexandra, Reich, Bettina, Bless, Sarah, Sieker, Julia, Hollander, Willemijn, de Bijl-Marcus, Karen, Hagmann, Cornelia, Nijman, Joppe, Knirsch, Walter, MS Neonatologie, De Silvestro, Alexandra, Reich, Bettina, Bless, Sarah, Sieker, Julia, Hollander, Willemijn, de Bijl-Marcus, Karen, Hagmann, Cornelia, Nijman, Joppe, and Knirsch, Walter

Published
2024

11. Morbidity and mortality in premature or low birth weight patients with congenital heart disease in three European pediatric heart centers between 2016 and 2020

Author

De Silvestro, Alexandra A; https://orcid.org/0000-0003-3724-1038, Reich, Bettina, Bless, Sarah, Sieker, Julika, Hollander, Willemijn, de Bijl-Marcus, Karen, Hagmann, Cornelia; https://orcid.org/0000-0003-2647-9809, Nijman, Joppe; https://orcid.org/0000-0002-9843-0740, Knirsch, Walter; https://orcid.org/0000-0002-8741-3929, De Silvestro, Alexandra A; https://orcid.org/0000-0003-3724-1038, Reich, Bettina, Bless, Sarah, Sieker, Julika, Hollander, Willemijn, de Bijl-Marcus, Karen, Hagmann, Cornelia; https://orcid.org/0000-0003-2647-9809, Nijman, Joppe; https://orcid.org/0000-0002-9843-0740, and Knirsch, Walter; https://orcid.org/0000-0002-8741-3929

Abstract

Background: The treatment of preterm and low birth weight (LBW) neonates born with congenital heart disease (CHD) requiring early cardiac intervention remains challenging. We aimed to analyze morbidity and mortality in this combined high-risk patient group. Methods: A retrospective cohort study was conducted of preterm [<37 weeks gestational age (GA)] and/or LBW neonates (<2,500 g) born with a diagnosis of CHD, which requires invasive cardiac intervention (surgery or catheter) within their first year of life. Patients born between 2016 and 2020 and treated in three European pediatric heart centers were included.ResultsA total of 308 neonates (51% male) with CHD were included. Of those, 237 (77%) were born preterm, 259 (84%) were LBW, and 188 (61%) were both. The median GA was 35.4 weeks (interquartile range 33.3–36.9) and the mean birth weight was 2,016 ± 580 g. CHD was categorized as simple (12%), moderate (64%), or severe (24%). The overall complication rate was 45% and was highest in patients with severe CHD (p = 0.002). One-year mortality (19%) was associated with severe CHD, low relative birth weight in patients with genetic diagnoses, and low GA at birth, whereas GA at birth significantly impacted survival only after 3 months of life. Conclusions: The high morbidity and mortality in preterm and LBW neonates with CHD reflect their complexity and consequent limited treatment feasibility.

Published
2024

12. Placental Pathology Contributes to Impaired Volumetric Brain Development in Neonates With Congenital Heart Disease

Author

Nijman, Maaike, primary, van der Meeren, Lotte E., additional, Nikkels, Peter G. J., additional, Stegeman, Raymond, additional, Breur, Johannes M. P. J., additional, Jansen, Nicolaas J. G., additional, ter Heide, Henriette, additional, Steenhuis, Trinette J., additional, de Heus, Roel, additional, Bekker, Mireille N., additional, Claessens, Nathalie H. P., additional, Benders, Manon J. N. L., additional, Nijman, Joppe, additional, Alderliesten, Thomas, additional, Bosch, Rian, additional, Wösten‐van Asperen, Roelie M., additional, Slieker, Martijn G., additional, van Iperen, Gabrielle G., additional, Grotenhuis, Heynric B., additional, van Loon, Kim, additional, Koomen, Erik, additional, van Wijk, Bram, additional, Schoof, Paul H., additional, Talacua, Hanna, additional, van Schooneveld, Monique M. J., additional, Sprong, Maaike C. A., additional, Haak, Monique C., additional, and Snoep, Maartje C., additional

Published
2024
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18. Risk factors and outcomes of NEC in preterm and low birth weight infants with a congenital heart defect

Author

Chin On, Sergei, Nijman, Joppe (Thesis Advisor), geen, Chin On, Sergei, Nijman, Joppe (Thesis Advisor), and geen

Abstract

In this study population of 64 preterm and LBW infants with CHD, the incidence of NEC was substantially higher than the general population. This incidence coincides with the experience that prematurity, LBW and CHD increase the risk for NEC up to 100- fold. This study population exclusively consisted of vulnerable preterm infants under 35 weeks of GA which explains the high incidence of NEC in this population. The predisposing conditions for NEC in this population of preterm and LBW infants with CHD were invasive ventilation, received CPR and sepsis preoperatively, and duration of 1st invasive ventilation, PHT and iNO treatment postoperatively. Factors with noticeable difference between the NEC and no-NEC group were gestational age, birth weight, type of feeding and surgical characteristics. These results should be carefully interpreted due to lack of power. As expected, NEC significantly increased the risk of mortality in the infants of this study population, the deaths directly or indirectly attributed to NEC or its complications. This study ads to the understanding of the ambiguity of many different variables. The results of this study will hopefully support future risk factor studies, act as a basis for prospective and multicenter studies and will hopefully add to future preventive strategies.

Published
2023

19. Paediatric Intensive Care at UMC Utrecht Improvement and testing of a Clinical Deterioration Model for the Continuous Data-Driven Monitoring in Critical Congenital Heart Disease

Author

Giacinto Villalobos, Alice, Nijman, Joppe (Thesis Advisor), Arno Siebes Erik Koomen Joppe Nijman Ruben S. Zoodsma, Giacinto Villalobos, Alice, Nijman, Joppe (Thesis Advisor), and Arno Siebes Erik Koomen Joppe Nijman Ruben S. Zoodsma

Abstract

[""Introduction: Continuous monitoring of vital signs is crucial in paediatric intensive care units (PICUs) to detect clinical deterioration. This study focuses on critically ill paediatric patients with congenital heart disease (CHD) who underwent cardiac interventions in the first year of life. To help medical practitioners with the big amount of monitoring data, a data-driven model for automated detection of clinical deterioration and instability was developed. This model used the Maahlanobis distance of 5 vital parameters combined and a one-class support vector machine model. The goal of this study is to improve the existing machine learning algorithm through a) broadening statistical foundation for data-based cutoff values, b) exploring an alternative method for splitting stable from unstable timepoints (lactate) and c) creating new baselines for the comparison of the Mahalanobis distance. Methods: For the broadening statistical foundation for the data-based cutoff values (80th percentile) a Local Outlier Factor methodology was used. The resulting outlier scores and k-distances were placed in density graphs to locate the start of the outliers. With the new percentile, a new SVM model was developed. The alternative method for splitting stable from unstable timepoints was lactate measurements. Lactate levels in blood are commonly used to determine if a patient is unstable. Thereafter measurements < 2 mmol/L were labeled as stable and fed into a new SVM model. The new baselines were created using the weighted moving average of the medians of the Mahalanobis measurements. The modified models were evaluated by a physician using visualizations that compared the models results with the vital parameters of new patients. Results: The modified models showed good evaluation metrics, except for specificity. They accurately identified stable periods but not unstable periods. The use of lactate measurements and smoothing the Mahalanobis baseline improved the model's performa

Published
2023

20. Detecting deterioration in patients with congenital heart diseases at the pediatric intensive care unit

Author

Mee Mendes, Daniel van der, Nijman, Joppe (Thesis Advisor), Mee Mendes, Daniel van der, and Nijman, Joppe (Thesis Advisor)

Abstract

Critical congenital heart disease (cCHD) is present in two to three of every 1,000 newborns. Children diagnosed with cCHD are admitted to the pediatric intensive care unit (PICU) and closely monitored to ensure the highest possible quality of healthcare. During this period large quantities of continuous data streams are collected. The aim of this study is to analyze these large quantities of data using machine learning techniques such as random forest and boosting to provide insights in detecting deterioration by classifying periods as stable and unstable. The data consisted of 86 patients with information on five vital signs: heart rate, respiratory rate, invasive mean blood pressure, oxygen saturation and regional cerebral oxygen saturation. Pre-processing steps were necessary to transform the data and generate artificial labels for model training. Using the pre-processed data, hyperparameter tuning was performed, and final models were created. Based on these models, classifications were made on a left-out dataset consisting of nine patients. These model classifications are compared with a clinical classification established by a medical expert. The findings revealed an accuracy range of 64.4% to 87.1%, a sensitivity range of 66.0% to 97.3%, and a specificity range of 23.1% to 94.3%. These numbers demonstrate generally favorable accuracy and sensitivity scores. However, some models had very low specificity scores, indicating large amounts of true unstable periods were not classified as unstable. Relying on such a model would result in missing many critical situations at the PICU. Nevertheless, some models showed great potential. This study highlights that machine learning techniques such as random forest and boosting can be used to provide insights in detecting deterioration in patients. Consequently, it is recommended to explore the best performing models further and assess if further improvements are possible. Additionally, it is important to analyze the reasons

Published
2023

21. Ultra-wideband radar for simultaneous and unobtrusive monitoring of respiratory and heart rates in early childhood: A Deep Transfer Learning Approach

Author

Arasteh, Emad, Veldhoen, Esther S., Long, Xi, van Poppel, Maartje, van der Linden, Marjolein N., Alderliesten, Thomas, Nijman, Joppe, de Goederen, Robbin, Dudink, Jeroen, Arasteh, Emad, Veldhoen, Esther S., Long, Xi, van Poppel, Maartje, van der Linden, Marjolein N., Alderliesten, Thomas, Nijman, Joppe, de Goederen, Robbin, and Dudink, Jeroen

Abstract

Unobtrusive monitoring of children’s heart rate (HR) and respiratory rate (RR) can be valuable for promoting the early detection of potential health issues, improving communication with healthcare providers and reducing unnecessary hospital visits. A promising solution for wireless vital sign monitoring is radar technology. This paper presents a novel approach for the simultaneous estimation of children’s RR and HR utilizing ultra-wideband (UWB) radar using a deep transfer learning algorithm in a cohort of 55 children. The HR and RR are calculated by processing radar signals via spectrogram from time epochs of 10 s (25 sample length of hamming window with 90% overlap) and then transforming the resultant representation into 2-dimensional images. These images were fed into a pre-trained Visual Geometry Group-16 (VGG-16) model (trained on ImageNet dataset), with weights of five added layers fine-tuned using the proposed data. The prediction on the test data achieved a mean absolute error (MAE) of 7.3 beats per minute (BPM < 6.5% of average HR) and 2.63 breaths per minute (BPM < 7% of average RR). We also achieved a significant Pearson’s correlation of 77% and 81% between true and extracted for HR and RR, respectively. HR and RR samples are extracted every 10 s.

Published
2023

22. Ultra-Wideband Radar for Simultaneous and Unobtrusive Monitoring of Respiratory and Heart Rates in Early Childhood: A Deep Transfer Learning Approach

Author

Intensive care patientenzorg, Child Health, MS Neonatologie, Circulatory Health, Arts-assistenten Kinderen, Brain, Developmental Disorders, Arasteh, Emad, Veldhoen, Esther S, Long, Xi, van Poppel, Maartje, van der Linden, Marjolein, Alderliesten, Thomas, Nijman, Joppe, de Goederen, Robbin, Dudink, Jeroen, Intensive care patientenzorg, Child Health, MS Neonatologie, Circulatory Health, Arts-assistenten Kinderen, Brain, Developmental Disorders, Arasteh, Emad, Veldhoen, Esther S, Long, Xi, van Poppel, Maartje, van der Linden, Marjolein, Alderliesten, Thomas, Nijman, Joppe, de Goederen, Robbin, and Dudink, Jeroen

Published
2023

23. Prognostic factors for multi-organ dysfunction in pediatric oncology patients admitted to the pediatric intensive care unit

Author

Arts-assistenten Kinderen, Intensive care patientenzorg, Child Health, Other research (not in main researchprogram), MDL onderzoek 1, Onderzoek, Infection & Immunity, Regenerative Medicine and Stem Cells, Medische staf Anesthesiologie, Cancer, Circulatory Health, PMC Medisch specialisten, Soeteman, Marijn, Fiocco, Marta F, Nijman, Joppe, Bollen, Casper W, Marcelis, Maartje M, Kilsdonk, Ellen, Nieuwenhuis, Edward E S, Kappen, Teus H, Tissing, Wim J E, Wösten-van Asperen, Roelie M, Arts-assistenten Kinderen, Intensive care patientenzorg, Child Health, Other research (not in main researchprogram), MDL onderzoek 1, Onderzoek, Infection & Immunity, Regenerative Medicine and Stem Cells, Medische staf Anesthesiologie, Cancer, Circulatory Health, PMC Medisch specialisten, Soeteman, Marijn, Fiocco, Marta F, Nijman, Joppe, Bollen, Casper W, Marcelis, Maartje M, Kilsdonk, Ellen, Nieuwenhuis, Edward E S, Kappen, Teus H, Tissing, Wim J E, and Wösten-van Asperen, Roelie M

Published
2023

24. Continuous Data-Driven Monitoring in Critical Congenital Heart Disease: Clinical Deterioration Model Development

Author

Intensive care patientenzorg, MS Intensive Care Onderzoek 2, MS Neonatologie, Child Health, Circulatory Health, Other research (not in main researchprogram), Medische staf Anesthesiologie, Cancer, Zoodsma, Ruben S., Bosch, Rian, Alderliesten, Thomas, Bollen, Casper W., Kappen, Teus H., Koomen, Erik, Siebes, Arno, Nijman, Joppe, Intensive care patientenzorg, MS Intensive Care Onderzoek 2, MS Neonatologie, Child Health, Circulatory Health, Other research (not in main researchprogram), Medische staf Anesthesiologie, Cancer, Zoodsma, Ruben S., Bosch, Rian, Alderliesten, Thomas, Bollen, Casper W., Kappen, Teus H., Koomen, Erik, Siebes, Arno, and Nijman, Joppe

Published
2023

25. Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity

Author

Van Reempts, Patrick, Martens, Evelyne, Martens, Guy, Pryds, Ole, Boerch, Klaus, Hasselager, Asbjoern, Huusom, Lene, Weber, Tom, Toome, Liis, Varendi, Heili, Truffert, Patrick, Jarreau, Pierre-Henri, Ancel, Pierre-Yves, Blondel, Beatrice, Burguet, Antoine, Schmidt, Stephan, Gortner, Ludwig, Cuttini, Marina, Croci, Ileana, Baronciani, Dante, Gargano, Giancarlo, Carnielli, Virgilio, Di Lallo, Domenico, Agostino, Rocco, Franco, Francesco, Koopman-Esseboom, Corine, Nijman, Joppe, van Heijst, Arno, Gadzinowski, Janusz, Mazela, Jan, Graça, Luis M., Ceu Machado, Maria, Carapato, Rui, Barros, Henrique, Rodrigues, Carina, Rodrigues, Teresa, Draper, Elizabeth, Boyle, Elaine M., Manktelow, Brad, Milligan, David W.A., Fenton, Alan, Wilson, Emilija, Maier, Rolf F., Norman, Mikael, Misselwitz, Bjoern, Howell, Elizabeth A., Zeitlin, Jennifer, and Bonamy, Anna-Karin

Published
2016
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26. Risk Factors for Perioperative Brain Lesions in Infants With Congenital Heart Disease: A European Collaboration.

Author

Bonthrone, Alexandra F., Stegeman, Raymond, Feldmann, Maria, Claessens, Nathalie H. P., Nijman, Maaike, Jansen, Nicolaas J. G., Nijman, Joppe, Groenendaal, Floris, de Vries, Linda S., Benders, Manon J. N. L., Haas, Felix, Bekker, Mirielle N., Logeswaran, Thushiha, Reich, Bettina, Kottke, Raimund, Hagmann, Cornelia, Latal, Beatrice, Dave, Hitendu, Simpson, John, and Pushparajah, Kuberan

Published
2023
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27. Risk Factors for Perioperative Brain Lesions in Infants With Congenital Heart Disease: A European Collaboration

Author

Bonthrone, Alexandra F, Stegeman, Raymond, Feldmann, Maria, Claessens, Nathalie H P, Nijman, Maaike, Jansen, Nicolaas J G, Nijman, Joppe, Groenendaal, Floris, de Vries, Linda S, Benders, Manon J N L, Haas, Felix, Bekker, Mirielle N, Logeswaran, Thushiha, Reich, Bettina, Kottke, Raimund, Hagmann, Cornelia, Latal, Beatrice, Dave, Hitendu, Simpson, John, Pushparajah, Kuberan, Austin, Conal, Kelly, Christopher J, Arulkumaran, Sophie, Rutherford, Mary A, Counsell, Serena J, Knirsch, Walter, Breur, Johannes M P J, and University of Zurich

Subjects
Advanced and Specialized Nursing, Heart Defects, Congenital, Venous Thrombosis, heart diseases, 10093 Institute of Psychology, Transposition of Great Vessels, Infant, Newborn, pedatrics, Infant, Brain, 610 Medicine & health, 10036 Medical Clinic, Risk Factors, Brain Injuries, magnetic resonance imaging, Humans, Female, 10220 Clinic for Surgery, Neurology (clinical), 150 Psychology, Cardiology and Cardiovascular Medicine, white matter, Ischemic Stroke
Abstract

Background: Infants with congenital heart disease are at risk of brain injury and impaired neurodevelopment. The aim was to investigate risk factors for perioperative brain lesions in infants with congenital heart disease. Methods: Infants with transposition of the great arteries, single ventricle physiology, and left ventricular outflow tract and/or aortic arch obstruction undergoing cardiac surgery Results: Preoperatively, induced vaginal delivery (odds ratio [OR], 2.23 [95% CI, 1.06–4.70]) was associated with white matter injury and balloon atrial septostomy increased the risk of white matter injury (OR, 2.51 [95% CI, 1.23–5.20]) and arterial ischemic stroke (OR, 4.49 [95% CI, 1.20–21.49]). Postoperatively, younger postnatal age at surgery (OR, 1.18 [95% CI, 1.05–1.33]) and selective cerebral perfusion, particularly at ≤20 °C (OR, 13.46 [95% CI, 3.58–67.10]), were associated with new arterial ischemic stroke. Single ventricle physiology was associated with new white matter injury (OR, 2.88 [95% CI, 1.20–6.95]) and transposition of the great arteries with new cerebral sinus venous thrombosis (OR, 13.47 [95% CI, 2.28–95.66]). Delayed sternal closure (OR, 3.47 [95% CI, 1.08–13.06]) and lower intraoperative temperatures (OR, 1.22 [95% CI, 1.07–1.36]) also increased the risk of new cerebral sinus venous thrombosis. Conclusions: Delivery planning and surgery timing may be modifiable risk factors that allow personalized treatment to minimize the risk of perioperative brain injury in severe congenital heart disease. Further research is needed to optimize cerebral perfusion techniques for neonatal surgery and to confirm the relationship between cerebral sinus venous thrombosis and perioperative risk factors.

Published
2022

29. Prognostic factors for multiorgan dysfunction in pediatric oncology patients admitted to the pediatric intensive care unit.

Author

Soeteman, Marijn, Fiocco, Marta F., Nijman, Joppe, Bollen, Casper W., Marcelis, Maartje M., Kilsdonk, Ellen, Nieuwenhuis, Edward E. S., Kappen, Teus H., Tissing, Wim J. E., and Wösten-van Asperen, Roelie M.

Subjects
PEDIATRIC oncology, INTENSIVE care units, PEDIATRIC intensive care, CANCER patients, PROGNOSIS
Abstract

Background: Pediatric oncology patients who require admission to the pediatric intensive care unit (PICU) have worse outcomes compared to their non-cancer peers. Although multi-organ dysfunction (MOD) plays a pivotal role in PICU mortality and morbidity, risk factors for MOD have not yet been identified. We aimed to identify risk factors at PICU admission for new or progressive MOD (NPMOD) during the first week of PICU stay. Methods: This retrospective cohort study included all pediatric oncology patients aged 0 to 18 years admitted to the PICU between June 2018 and June 2021. We used the recently published PODIUM criteria for defining multiorgan dysfunction and estimated the association between covariates at PICU baseline and the outcome NPMOD using a multivariable logistic regression model, with PICU admission as unit of study. To study the predictive performance, the model was internally validated by using bootstrap. Results: A total of 761 PICU admissions of 571 patients were included. NPMOD was present in 154 PICU admissions (20%). Patients with NPMOD had a high mortality compared to patients without NPMOD, 14% and 1.0% respectively. Hemato-oncological diagnosis, number of failing organs and unplanned admission were independent risk factors for NPMOD. The prognostic model had an overall good discrimination and calibration. Conclusion: The risk factors at PICU admission for NPMOD may help to identify patients who may benefit from closer monitoring and early interventions. When applying the PODIUM criteria, we found some opportunities for fine-tuning these criteria for pediatric oncology patients, that need to be validated in future studies. [ABSTRACT FROM AUTHOR]

Published
2023
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31. CeRebrUm and CardIac Protection with ALlopurinol in Neonates with Critical Congenital Heart Disease Requiring Cardiac Surgery with Cardiopulmonary Bypass (CRUCIAL):study protocol of a phase III, randomized, quadruple-blinded, placebo-controlled, Dutch multicenter trial

Author

Stegeman, Raymond, Nijman, Maaike, Breur, Johannes M.P.J., Groenendaal, Floris, Haas, Felix, Derks, Jan B., Nijman, Joppe, van Beynum, Ingrid M., Taverne, Yannick J.H.J., Bogers, Ad J.J.C., Helbing, Willem A., de Boode, Willem P., Bos, Arend F., Berger, Rolf M.F., Accord, Ryan E., Roes, Kit C.B., de Wit, G. Ardine, Jansen, Nicolaas J.G., Benders, Manon J.N.L., Stegeman, Raymond, Nijman, Maaike, Breur, Johannes M.P.J., Groenendaal, Floris, Haas, Felix, Derks, Jan B., Nijman, Joppe, van Beynum, Ingrid M., Taverne, Yannick J.H.J., Bogers, Ad J.J.C., Helbing, Willem A., de Boode, Willem P., Bos, Arend F., Berger, Rolf M.F., Accord, Ryan E., Roes, Kit C.B., de Wit, G. Ardine, Jansen, Nicolaas J.G., and Benders, Manon J.N.L.

Abstract

Background: Neonates with critical congenital heart disease (CCHD) undergoing cardiac surgery with cardiopulmonary bypass (CPB) are at risk of brain injury that may result in adverse neurodevelopment. To date, no therapy is available to improve long-term neurodevelopmental outcomes of CCHD neonates. Allopurinol, a xanthine oxidase inhibitor, prevents the formation of reactive oxygen and nitrogen species, thereby limiting cell damage during reperfusion and reoxygenation to the brain and heart. Animal and neonatal studies suggest that allopurinol reduces hypoxic-ischemic brain injury and is cardioprotective and safe. This trial aims to test the hypothesis that allopurinol administration in CCHD neonates will result in a 20% reduction in moderate to severe ischemic and hemorrhagic brain injury. Methods: This is a phase III, randomized, quadruple-blinded, placebo-controlled, multicenter trial. Neonates with a prenatal or postnatal CCHD diagnosis requiring cardiac surgery with CPB in the first 4 weeks after birth are eligible to participate. Allopurinol or mannitol-placebo will be administered intravenously in 2 doses early postnatally in neonates diagnosed antenatally and 3 doses perioperatively of 20 mg/kg each in all neonates. The primary outcome is a composite endpoint of moderate/severe ischemic or hemorrhagic brain injury on early postoperative MRI, being too unstable for postoperative MRI, or mortality within 1 month following CPB. A total of 236 patients (n = 188 with prenatal diagnosis) is required to demonstrate a reduction of the primary outcome incidence by 20% in the prenatal group and by 9% in the postnatal group (power 80%; overall type 1 error controlled at 5%, two-sided), including 1 interim analysis at n = 118 (n = 94 with prenatal diagnosis) with the option to stop early for efficacy. Secondary outcomes include preoperative and postoperative brain injury severity, white matter injury volume (MRI), and cardiac function (echocardiography); postnatal a

Published
2022

32. Risk Factors for Perioperative Brain Lesions in Infants With Congenital Heart Disease: A European Collaboration

Author

Cardiologie onderzoek 1, Child Health, Arts-assistenten Kinderen, Brain, MS Neonatologie, Intensive care patientenzorg, Regenerative Medicine and Stem Cells, Circulatory Health, Bonthrone, Alexandra F, Stegeman, Raymond, Feldmann, Maria, Claessens, Nathalie H P, Nijman, Maaike, Jansen, Nicolaas J G, Nijman, Joppe, Groenendaal, Floris, de Vries, Linda S, Benders, Manon J N L, Haas, Felix, Bekker, Mirielle N, Logeswaran, Thushiha, Reich, Bettina, Kottke, Raimund, Hagmann, Cornelia, Latal, Beatrice, Dave, Hitendu, Simpson, John, Pushparajah, Kuberan, Austin, Conal, Kelly, Christopher J, Arulkumaran, Sophie, Rutherford, Mary A, Counsell, Serena J, Knirsch, Walter, Breur, Johannes M P J, Cardiologie onderzoek 1, Child Health, Arts-assistenten Kinderen, Brain, MS Neonatologie, Intensive care patientenzorg, Regenerative Medicine and Stem Cells, Circulatory Health, Bonthrone, Alexandra F, Stegeman, Raymond, Feldmann, Maria, Claessens, Nathalie H P, Nijman, Maaike, Jansen, Nicolaas J G, Nijman, Joppe, Groenendaal, Floris, de Vries, Linda S, Benders, Manon J N L, Haas, Felix, Bekker, Mirielle N, Logeswaran, Thushiha, Reich, Bettina, Kottke, Raimund, Hagmann, Cornelia, Latal, Beatrice, Dave, Hitendu, Simpson, John, Pushparajah, Kuberan, Austin, Conal, Kelly, Christopher J, Arulkumaran, Sophie, Rutherford, Mary A, Counsell, Serena J, Knirsch, Walter, and Breur, Johannes M P J

Published
2022

33. Early Determinants of Adverse Motor Outcomes in Preschool Children with a Critical Congenital Heart Defect

Author

Kinderbewegingszorg patientenzorg, Child Health, MS Neonatologie, Cardiopulmonale Chirurgie pat. zorg, Medische staf Anesthesiologie, Brain, Intensive care patientenzorg, Cardiologie onderzoek 1, Circulatory Health, Regenerative Medicine and Stem Cells, Activity&Health sectie exercise, Cardiologie patientenzorg, Sprong, Maaike C A, Huijgen, Barbara C H, de Vries, Linda S, Talacua, Hanna, van Loon, Kim, Eijsermans, Rian M J C, Nijman, Joppe, Breur, Johannes M P J, van Brussel, Marco, Slieker, Martijn G, Kinderbewegingszorg patientenzorg, Child Health, MS Neonatologie, Cardiopulmonale Chirurgie pat. zorg, Medische staf Anesthesiologie, Brain, Intensive care patientenzorg, Cardiologie onderzoek 1, Circulatory Health, Regenerative Medicine and Stem Cells, Activity&Health sectie exercise, Cardiologie patientenzorg, Sprong, Maaike C A, Huijgen, Barbara C H, de Vries, Linda S, Talacua, Hanna, van Loon, Kim, Eijsermans, Rian M J C, Nijman, Joppe, Breur, Johannes M P J, van Brussel, Marco, and Slieker, Martijn G

Published
2022

34. Mind the gap: Mapping variation between national and local clinical practice guidelines for acute paediatric asthma from the United Kingdom and the Netherlands

Author

Intensive care patientenzorg, Child Health, Koldeweij, Charlotte, Appelbaum, Nicholas, Rodriguez Gonzalvez, Carmen, Nijman, Joppe, Nijman, Ruud, Sinha, Ruchi, Maconochie, Ian, Clarke, Jonathan, Intensive care patientenzorg, Child Health, Koldeweij, Charlotte, Appelbaum, Nicholas, Rodriguez Gonzalvez, Carmen, Nijman, Joppe, Nijman, Ruud, Sinha, Ruchi, Maconochie, Ian, and Clarke, Jonathan

Published
2022

35. Longitudinal Motor-Developmental Outcomes in Infants with a Critical Congenital Heart Defect

Author

Kinderbewegingszorg patientenzorg, Child Health, Activity&Health sectie exercise, MS Neonatologie, KGW-algemeen, Intensive care patientenzorg, Cardiologie onderzoek 1, Circulatory Health, Regenerative Medicine and Stem Cells, Cardiologie patientenzorg, Sprong, Maaike C A, van Brussel, Marco, de Vries, Linda S, van der Net, Janjaap, Nijman, Joppe, Breur, Johannes M P J, Slieker, Martijn G, Kinderbewegingszorg patientenzorg, Child Health, Activity&Health sectie exercise, MS Neonatologie, KGW-algemeen, Intensive care patientenzorg, Cardiologie onderzoek 1, Circulatory Health, Regenerative Medicine and Stem Cells, Cardiologie patientenzorg, Sprong, Maaike C A, van Brussel, Marco, de Vries, Linda S, van der Net, Janjaap, Nijman, Joppe, Breur, Johannes M P J, and Slieker, Martijn G

Published
2022

36. Risk Factors for Perioperative Brain Lesions in Infants With Congenital Heart Disease: A European Collaboration

Author

Bonthrone, Alexandra F; https://orcid.org/0000-0001-5487-5564, Stegeman, Raymond; https://orcid.org/0000-0001-9874-5470, Feldmann, Maria; https://orcid.org/0000-0002-6616-3510, Claessens, Nathalie H P; https://orcid.org/0000-0002-4221-2779, Nijman, Maaike; https://orcid.org/0000-0001-9665-0291, Jansen, Nicolaas J G; https://orcid.org/0000-0003-3106-3824, Nijman, Joppe; https://orcid.org/0000-0002-9843-0740, Groenendaal, Floris, de Vries, Linda S; https://orcid.org/0000-0002-7282-8304, Benders, Manon J N L; https://orcid.org/0000-0001-5491-9168, Haas, Felix, Bekker, Mirielle N; https://orcid.org/0000-0002-7372-4291, Logeswaran, Thushiha, Reich, Bettina, Kottke, Raimund; https://orcid.org/0000-0003-0166-2770, Hagmann, Cornelia, Latal, Beatrice; https://orcid.org/0000-0003-1309-4790, Dave, Hitendu, Simpson, John; https://orcid.org/0000-0002-9773-7441, Pushparajah, Kuberan; https://orcid.org/0000-0003-1541-1155, Austin, Conal, Kelly, Christopher J; https://orcid.org/0000-0002-1246-844X, Arulkumaran, Sophie; https://orcid.org/0000-0002-4510-1767, Rutherford, Mary A, Counsell, Serena J; https://orcid.org/0000-0002-8033-5673, Knirsch, Walter; https://orcid.org/0000-0002-8741-3929, Breur, Johannes M P J; https://orcid.org/0000-0001-8009-8869, Bonthrone, Alexandra F; https://orcid.org/0000-0001-5487-5564, Stegeman, Raymond; https://orcid.org/0000-0001-9874-5470, Feldmann, Maria; https://orcid.org/0000-0002-6616-3510, Claessens, Nathalie H P; https://orcid.org/0000-0002-4221-2779, Nijman, Maaike; https://orcid.org/0000-0001-9665-0291, Jansen, Nicolaas J G; https://orcid.org/0000-0003-3106-3824, Nijman, Joppe; https://orcid.org/0000-0002-9843-0740, Groenendaal, Floris, de Vries, Linda S; https://orcid.org/0000-0002-7282-8304, Benders, Manon J N L; https://orcid.org/0000-0001-5491-9168, Haas, Felix, Bekker, Mirielle N; https://orcid.org/0000-0002-7372-4291, Logeswaran, Thushiha, Reich, Bettina, Kottke, Raimund; https://orcid.org/0000-0003-0166-2770, Hagmann, Cornelia, Latal, Beatrice; https://orcid.org/0000-0003-1309-4790, Dave, Hitendu, Simpson, John; https://orcid.org/0000-0002-9773-7441, Pushparajah, Kuberan; https://orcid.org/0000-0003-1541-1155, Austin, Conal, Kelly, Christopher J; https://orcid.org/0000-0002-1246-844X, Arulkumaran, Sophie; https://orcid.org/0000-0002-4510-1767, Rutherford, Mary A, Counsell, Serena J; https://orcid.org/0000-0002-8033-5673, Knirsch, Walter; https://orcid.org/0000-0002-8741-3929, and Breur, Johannes M P J; https://orcid.org/0000-0001-8009-8869

Abstract

Background: Infants with congenital heart disease are at risk of brain injury and impaired neurodevelopment. The aim was to investigate risk factors for perioperative brain lesions in infants with congenital heart disease. Methods: Infants with transposition of the great arteries, single ventricle physiology, and left ventricular outflow tract and/or aortic arch obstruction undergoing cardiac surgery <6 weeks after birth from 3 European cohorts (Utrecht, Zurich, and London) were combined. Brain lesions were scored on preoperative (transposition of the great arteries N=104; single ventricle physiology N=35; and left ventricular outflow tract and/or aortic arch obstruction N=41) and postoperative (transposition of the great arteries N=88; single ventricle physiology N=28; and left ventricular outflow tract and/or aortic arch obstruction N=30) magnetic resonance imaging for risk factor analysis of arterial ischemic stroke, cerebral sinus venous thrombosis, and white matter injury. Results: Preoperatively, induced vaginal delivery (odds ratio [OR], 2.23 [95% CI, 1.06-4.70]) was associated with white matter injury and balloon atrial septostomy increased the risk of white matter injury (OR, 2.51 [95% CI, 1.23-5.20]) and arterial ischemic stroke (OR, 4.49 [95% CI, 1.20-21.49]). Postoperatively, younger postnatal age at surgery (OR, 1.18 [95% CI, 1.05-1.33]) and selective cerebral perfusion, particularly at ≤20 °C (OR, 13.46 [95% CI, 3.58-67.10]), were associated with new arterial ischemic stroke. Single ventricle physiology was associated with new white matter injury (OR, 2.88 [95% CI, 1.20-6.95]) and transposition of the great arteries with new cerebral sinus venous thrombosis (OR, 13.47 [95% CI, 2.28-95.66]). Delayed sternal closure (OR, 3.47 [95% CI, 1.08-13.06]) and lower intraoperative temperatures (OR, 1.22 [95% CI, 1.07-1.36]) also increased the risk of new cerebral sinus venous thrombosis. Conclusions: Delivery planning and surgery timing may be modifiable risk fac

Published
2022

39. Additional file 1 of CeRebrUm and CardIac Protection with ALlopurinol in Neonates with Critical Congenital Heart Disease Requiring Cardiac Surgery with Cardiopulmonary Bypass (CRUCIAL): study protocol of a phase III, randomized, quadruple-blinded, placebo-controlled, Dutch multicenter trial

Author

Stegeman, Raymond, Nijman, Maaike, Breur, Johannes M. P. J., Groenendaal, Floris, Haas, Felix, Derks, Jan B., Nijman, Joppe, van Beynum, Ingrid M., Taverne, Yannick J. H. J., Bogers, Ad J. J. C., Helbing, Willem A., de Boode, Willem P., Bos, Arend F., Berger, Rolf M. F., Accord, Ryan E., Roes, Kit C. B., de Wit, G. Ardine, Jansen, Nicolaas J. G., and Benders, Manon J. N. L.

Abstract

Additional file 1. SPIRIT Checklist.

Published
2022
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40. Additional file 2 of CeRebrUm and CardIac Protection with ALlopurinol in Neonates with Critical Congenital Heart Disease Requiring Cardiac Surgery with Cardiopulmonary Bypass (CRUCIAL): study protocol of a phase III, randomized, quadruple-blinded, placebo-controlled, Dutch multicenter trial

Author

Stegeman, Raymond, Nijman, Maaike, Breur, Johannes M. P. J., Groenendaal, Floris, Haas, Felix, Derks, Jan B., Nijman, Joppe, van Beynum, Ingrid M., Taverne, Yannick J. H. J., Bogers, Ad J. J. C., Helbing, Willem A., de Boode, Willem P., Bos, Arend F., Berger, Rolf M. F., Accord, Ryan E., Roes, Kit C. B., de Wit, G. Ardine, Jansen, Nicolaas J. G., and Benders, Manon J. N. L.

Abstract

Additional file 2. List of expected disease-related adverse events.

Published
2022
Full Text
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41. Additional file 3 of CeRebrUm and CardIac Protection with ALlopurinol in Neonates with Critical Congenital Heart Disease Requiring Cardiac Surgery with Cardiopulmonary Bypass (CRUCIAL): study protocol of a phase III, randomized, quadruple-blinded, placebo-controlled, Dutch multicenter trial

Author

Stegeman, Raymond, Nijman, Maaike, Breur, Johannes M. P. J., Groenendaal, Floris, Haas, Felix, Derks, Jan B., Nijman, Joppe, van Beynum, Ingrid M., Taverne, Yannick J. H. J., Bogers, Ad J. J. C., Helbing, Willem A., de Boode, Willem P., Bos, Arend F., Berger, Rolf M. F., Accord, Ryan E., Roes, Kit C. B., de Wit, G. Ardine, Jansen, Nicolaas J. G., and Benders, Manon J. N. L.

Abstract

Additional file 3. Information letter and consent form.

Published
2022
Full Text
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47. Tidal Volume in Pediatric Ventilation: Do You Get What You See?

Author

Intensive care patientenzorg, Child Health, Medische staf Anesthesiologie, Cancer, Circulatory Health, Koomen, Erik, Nijman, Joppe, Nieuwenstein, B., Kappen, Teus, Intensive care patientenzorg, Child Health, Medische staf Anesthesiologie, Cancer, Circulatory Health, Koomen, Erik, Nijman, Joppe, Nieuwenstein, B., and Kappen, Teus

Published
2021

49. Effect of mechanical insufflation-exsufflation in children with neuromuscular weakness

Author

Intensive care patientenzorg, Child Health, Ambulante zorg CTB, Activity&Health sectie exercise, AIOS Anesthesiologie, Speerpunt Child Health, Longziekten patientenzorg, Infection & Immunity, Veldhoen, Esther S., Verweij-van den Oudenrijn, Laura P., Ros, Leandra A., Hulzebos, Erik H., Papazova, Diana A., van der Ent, Cornelis K., van der Pol, Ludo W., Nijman, Joppe, Wösten-van Asperen, Roelie M., Intensive care patientenzorg, Child Health, Ambulante zorg CTB, Activity&Health sectie exercise, AIOS Anesthesiologie, Speerpunt Child Health, Longziekten patientenzorg, Infection & Immunity, Veldhoen, Esther S., Verweij-van den Oudenrijn, Laura P., Ros, Leandra A., Hulzebos, Erik H., Papazova, Diana A., van der Ent, Cornelis K., van der Pol, Ludo W., Nijman, Joppe, and Wösten-van Asperen, Roelie M.

Published
2020

50. PICU Admission Rates in Pediatric Cancer and Hematopoietic Stem Cell Transplant Patients Receiving High-flow Nasal Cannula Oxygen Therapy on the General Ward

Author

Intensive care patientenzorg, Other research (not in main researchprogram), PMC Medisch specialisten, SCT patientenzorg, Child Health, Speerpunt, Zorg en O&O, Van Dorst, Mila, Van Gestel, Josephus P.J., Van Grotel, Martine, Versluijs, Birgitta, Van Den Heuvel-Eibrink, Marry M., Nijman, Joppe, Wösten-Van Asperen, Roelie M., Intensive care patientenzorg, Other research (not in main researchprogram), PMC Medisch specialisten, SCT patientenzorg, Child Health, Speerpunt, Zorg en O&O, Van Dorst, Mila, Van Gestel, Josephus P.J., Van Grotel, Martine, Versluijs, Birgitta, Van Den Heuvel-Eibrink, Marry M., Nijman, Joppe, and Wösten-Van Asperen, Roelie M.

Published
2020

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