5 results on '"van Raalte, Rutger"'
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2. Risk factors for adverse outcomes during mechanical ventilation of 1152 COVID-19 patients: a multicenter machine learning study with highly granular data from the Dutch Data Warehouse
- Author
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Fleuren, Lucas M., Tonutti, Michele, de Bruin, Daan P., Lalisang, Robbert C.A., Dam, Tariq A., Gommers, Diederik, Cremer, Olaf L., Bosman, Rob J., Vonk, Sebastiaan J.J., Fornasa, Mattia, Machado, Tomas, van der Meer, Nardo J.M., Rigter, Sander, Wils, Evert Jan, Frenzel, Tim, Dongelmans, Dave A., de Jong, Remko, Peters, Marco, Kamps, Marlijn J.A., Ramnarain, Dharmanand, Nowitzky, Ralph, Nooteboom, Fleur G.C.A., de Ruijter, Wouter, Urlings-Strop, Louise C., Smit, Ellen G.M., Mehagnoul-Schipper, D. Jannet, Dormans, Tom, de Jager, Cornelis P.C., Hendriks, Stefaan H.A., Oostdijk, Evelien, Reidinga, Auke C., Festen-Spanjer, Barbara, Brunnekreef, Gert, Cornet, Alexander D., van den Tempel, Walter, Boelens, Age D., Koetsier, Peter, Lens, Judith, Achterberg, Sefanja, Faber, Harald J., Karakus, A., Beukema, Menno, Entjes, Robert, de Jong, Paul, Houwert, Taco, Hovenkamp, Hidde, Noorduijn Londono, Roberto, Quintarelli, Davide, Scholtemeijer, Martijn G., de Beer, Aletta A., Cinà, Giovanni, Beudel, Martijn, de Keizer, Nicolet F., Hoogendoorn, Mark, Girbes, Armand R.J., Herter, Willem E., Elbers, Paul W.G., Thoral, Patrick J., Rettig, Thijs C.D., Reuland, M. C., van Manen, Laura, Montenij, Leon, van Bommel, Jasper, van den Berg, Roy, van Geest, Ellen, Hana, Anisa, Boersma, W. G., van den Bogaard, B., Pickkers, Peter, van der Heiden, Pim, van Gemeren, Claudia C.W., Meinders, Arend Jan, de Bruin, Martha, Rademaker, Emma, van Osch, Frits H.M., de Kruif, Martijn, Schroten, Nicolas, Arnold, Klaas Sierk, Fijen, J. W., van Koesveld, Jacomar J.M., Simons, Koen S., Labout, Joost, van de Gaauw, Bart, Kuiper, Michael, Beishuizen, Albertus, Geutjes, Dennis, Lutisan, Johan, Grady, Bart P.X., van den Akker, Remko, Simons, Bram, Rijkeboer, A. A., Arbous, Sesmu, Aries, Marcel, van den Oever, Niels C.Gritters, van Tellingen, Martijn, Dijkstra, Annemieke, van Raalte, Rutger, Roggeveen, Luca, van Diggelen, Fuda, Hassouni, Ali el, Guzman, David Romero, Bhulai, Sandjai, Ouweneel, Dagmar, Driessen, Ronald, Peppink, Jan, de Grooth, H. J., Zijlstra, G. J., van Tienhoven, A. J., van der Heiden, Evelien, Spijkstra, Jan Jaap, van der Spoel, Hans, de Man, Angelique, Klausch, Thomas, de Vries, Heder, de Neree tot Babberich, Michael, Thijssens, Olivier, Wagemakers, Lot, van der Pol, Hilde G.A., Hendriks, Tom, Berend, Julie, Silva, Virginia Ceni, Kullberg, Bob, Heunks, Leo, Juffermans, Nicole, Slooter, Arjan, Intensive care medicine, ACS - Diabetes & metabolism, ACS - Microcirculation, Amsterdam Cardiovascular Sciences, Neurology, AII - Infectious diseases, AII - Cancer immunology, CCA - Cancer biology and immunology, AII - Inflammatory diseases, Epidemiology and Data Science, APH - Methodology, ACS - Pulmonary hypertension & thrombosis, Intensive Care Medicine, APH - Quality of Care, Medical Informatics, Graduate School, Nephrology, Cardiology, Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, APH - Digital Health, Artificial intelligence, Network Institute, Computational Intelligence, Artificial Intelligence (section level), Mathematics, Intensive Care, Epidemiologie, RS: NUTRIM - R3 - Respiratory & Age-related Health, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: MA Medische Staf IC (9), and Internal medicine
- Subjects
Icu patients ,Coronavirus disease 2019 (COVID-19) ,Adverse outcomes ,medicine.medical_treatment ,Critical Care and Intensive Care Medicine ,Machine learning ,computer.software_genre ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,law ,SCORE ,medicine ,030212 general & internal medicine ,Risk factor ,Research Articles ,Mechanical ventilation ,business.industry ,RC86-88.9 ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,COVID-19 ,030208 emergency & critical care medicine ,Medical emergencies. Critical care. Intensive care. First aid ,Intensive care unit ,Data warehouse ,Data extraction ,Mortality prediction ,Risk factors ,Artificial intelligence ,business ,computer - Abstract
Background The identification of risk factors for adverse outcomes and prolonged intensive care unit (ICU) stay in COVID-19 patients is essential for prognostication, determining treatment intensity, and resource allocation. Previous studies have determined risk factors on admission only, and included a limited number of predictors. Therefore, using data from the highly granular and multicenter Dutch Data Warehouse, we developed machine learning models to identify risk factors for ICU mortality, ventilator-free days and ICU-free days during the course of invasive mechanical ventilation (IMV) in COVID-19 patients. Methods The DDW is a growing electronic health record database of critically ill COVID-19 patients in the Netherlands. All adult ICU patients on IMV were eligible for inclusion. Transfers, patients admitted for less than 24 h, and patients still admitted at time of data extraction were excluded. Predictors were selected based on the literature, and included medication dosage and fluid balance. Multiple algorithms were trained and validated on up to three sets of observations per patient on day 1, 7, and 14 using fivefold nested cross-validation, keeping observations from an individual patient in the same split. Results A total of 1152 patients were included in the model. XGBoost models performed best for all outcomes and were used to calculate predictor importance. Using Shapley additive explanations (SHAP), age was the most important demographic risk factor for the outcomes upon start of IMV and throughout its course. The relative probability of death across age values is visualized in Partial Dependence Plots (PDPs), with an increase starting at 54 years. Besides age, acidaemia, low P/F-ratios and high driving pressures demonstrated a higher probability of death. The PDP for driving pressure showed a relative probability increase starting at 12 cmH2O. Conclusion Age is the most important demographic risk factor of ICU mortality, ICU-free days and ventilator-free days throughout the course of invasive mechanical ventilation in critically ill COVID-19 patients. pH, P/F ratio, and driving pressure should be monitored closely over the course of mechanical ventilation as risk factors predictive of these outcomes.
- Published
- 2021
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3. Some Patients Are More Equal Than Others: Variation in Ventilator Settings for Coronavirus Disease 2019 Acute Respiratory Distress Syndrome
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Dam, Tariq A, Dam, Tariq A, de Grooth, Harm-Jan, Klausch, Thomas, Fleuren, Lucas M, de Bruin, Daan P, Entjes, Robert, Rettig, Thijs C D, Dongelmans, Dave A, Boelens, Age D, Rigter, Sander, Hendriks, Stefaan H A, de Jong, Remko, Kamps, Marlijn J A, Peters, Marco, Karakus, A, Gommers, Diederik, Ramnarain, Dharmanand, Wils, Evert-Jan, Achterberg, Sefanja, Nowitzky, Ralph, van den Tempel, Walter, de Jager, Cornelis P C, Nooteboom, Fleur G C A, Oostdijk, Evelien, Koetsier, Peter, Cornet, Alexander D, Reidinga, Auke C, de Ruijter, Wouter, Bosman, Rob J, Frenzel, Tim, Urlings-Strop, Louise C, de Jong, Paul, Smit, Ellen G M, Cremer, Olaf L, Mehagnoul-Schipper, D Jannet, Faber, Harald J, Lens, Judith, Brunnekreef, Gert B, Festen-Spanjer, Barbara, Dormans, Tom, Dijkstra, Annemieke, Simons, Bram, Rijkeboer, A A, Arbous, Sesmu, Aries, Marcel, Beukema, Menno, Pretorius, Daniël, van Raalte, Rutger, van Tellingen, Martijn, Gritters van den Oever, Niels C, Lalisang, Robbert C A, Tonutti, Michele, Girbes, Armand R J, Hoogendoorn, Mark, Thoral, Patrick J, Elbers, Paul W G, Dam, Tariq A, Dam, Tariq A, de Grooth, Harm-Jan, Klausch, Thomas, Fleuren, Lucas M, de Bruin, Daan P, Entjes, Robert, Rettig, Thijs C D, Dongelmans, Dave A, Boelens, Age D, Rigter, Sander, Hendriks, Stefaan H A, de Jong, Remko, Kamps, Marlijn J A, Peters, Marco, Karakus, A, Gommers, Diederik, Ramnarain, Dharmanand, Wils, Evert-Jan, Achterberg, Sefanja, Nowitzky, Ralph, van den Tempel, Walter, de Jager, Cornelis P C, Nooteboom, Fleur G C A, Oostdijk, Evelien, Koetsier, Peter, Cornet, Alexander D, Reidinga, Auke C, de Ruijter, Wouter, Bosman, Rob J, Frenzel, Tim, Urlings-Strop, Louise C, de Jong, Paul, Smit, Ellen G M, Cremer, Olaf L, Mehagnoul-Schipper, D Jannet, Faber, Harald J, Lens, Judith, Brunnekreef, Gert B, Festen-Spanjer, Barbara, Dormans, Tom, Dijkstra, Annemieke, Simons, Bram, Rijkeboer, A A, Arbous, Sesmu, Aries, Marcel, Beukema, Menno, Pretorius, Daniël, van Raalte, Rutger, van Tellingen, Martijn, Gritters van den Oever, Niels C, Lalisang, Robbert C A, Tonutti, Michele, Girbes, Armand R J, Hoogendoorn, Mark, Thoral, Patrick J, and Elbers, Paul W G
- Abstract
OBJECTIVES: As coronavirus disease 2019 is a novel disease, treatment strategies continue to be debated. This provides the intensive care community with a unique opportunity as the population of coronavirus disease 2019 patients requiring invasive mechanical ventilation is relatively homogeneous compared with other ICU populations. We hypothesize that the novelty of coronavirus disease 2019 and the uncertainty over its similarity with noncoronavirus disease 2019 acute respiratory distress syndrome resulted in substantial practice variation between hospitals during the first and second waves of coronavirus disease 2019 patients.DESIGN: Multicenter retrospective cohort study.SETTING: Twenty-five hospitals in the Netherlands from February 2020 to July 2020, and 14 hospitals from August 2020 to December 2020.PATIENTS: One thousand two hundred ninety-four critically ill intubated adult ICU patients with coronavirus disease 2019 were selected from the Dutch Data Warehouse. Patients intubated for less than 24 hours, transferred patients, and patients still admitted at the time of data extraction were excluded.MEASUREMENTS AND MAIN RESULTS: We aimed to estimate between-ICU practice variation in selected ventilation parameters (positive end-expiratory pressure, Fio2, set respiratory rate, tidal volume, minute volume, and percentage of time spent in a prone position) on days 1, 2, 3, and 7 of intubation, adjusted for patient characteristics as well as severity of illness based on Pao2/Fio2 ratio, pH, ventilatory ratio, and dynamic respiratory system compliance during controlled ventilation. Using multilevel linear mixed-effects modeling, we found significant (p ≤ 0.001) variation between ICUs in all ventilation parameters on days 1, 2, 3, and 7 of intubation for both waves.CONCLUSIONS: This is the first study to clearly demonstrate significant practice variation between ICUs related to mechanical ventilation parameters that are under dire
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- 2021
4. Some Patients Are More Equal Than Others:Variation in Ventilator Settings for Coronavirus Disease 2019 Acute Respiratory Distress Syndrome
- Author
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Dam, Tariq A, de Grooth, Harm-Jan, Klausch, Thomas, Fleuren, Lucas M, de Bruin, Daan P, Entjes, Robert, Rettig, Thijs C D, Dongelmans, Dave A, Boelens, Age D, Rigter, Sander, Hendriks, Stefaan H A, de Jong, Remko, Kamps, Marlijn J A, Peters, Marco, Karakus, A, Gommers, Diederik, Ramnarain, Dharmanand, Wils, Evert-Jan, Achterberg, Sefanja, Nowitzky, Ralph, van den Tempel, Walter, de Jager, Cornelis P C, Nooteboom, Fleur G C A, Oostdijk, Evelien, Koetsier, Peter, Cornet, Alexander D, Reidinga, Auke C, de Ruijter, Wouter, Bosman, Rob J, Frenzel, Tim, Urlings-Strop, Louise C, de Jong, Paul, Smit, Ellen G M, Cremer, Olaf L, Mehagnoul-Schipper, D Jannet, Faber, Harald J, Lens, Judith, Brunnekreef, Gert B, Festen-Spanjer, Barbara, Dormans, Tom, Dijkstra, Annemieke, Simons, Bram, Rijkeboer, A A, Arbous, Sesmu, Aries, Marcel, Beukema, Menno, Pretorius, Daniël, van Raalte, Rutger, van Tellingen, Martijn, Gritters van den Oever, Niels C, Lalisang, Robbert C A, Tonutti, Michele, Girbes, Armand R J, Hoogendoorn, Mark, Thoral, Patrick J, Elbers, Paul W G, Dam, Tariq A, de Grooth, Harm-Jan, Klausch, Thomas, Fleuren, Lucas M, de Bruin, Daan P, Entjes, Robert, Rettig, Thijs C D, Dongelmans, Dave A, Boelens, Age D, Rigter, Sander, Hendriks, Stefaan H A, de Jong, Remko, Kamps, Marlijn J A, Peters, Marco, Karakus, A, Gommers, Diederik, Ramnarain, Dharmanand, Wils, Evert-Jan, Achterberg, Sefanja, Nowitzky, Ralph, van den Tempel, Walter, de Jager, Cornelis P C, Nooteboom, Fleur G C A, Oostdijk, Evelien, Koetsier, Peter, Cornet, Alexander D, Reidinga, Auke C, de Ruijter, Wouter, Bosman, Rob J, Frenzel, Tim, Urlings-Strop, Louise C, de Jong, Paul, Smit, Ellen G M, Cremer, Olaf L, Mehagnoul-Schipper, D Jannet, Faber, Harald J, Lens, Judith, Brunnekreef, Gert B, Festen-Spanjer, Barbara, Dormans, Tom, Dijkstra, Annemieke, Simons, Bram, Rijkeboer, A A, Arbous, Sesmu, Aries, Marcel, Beukema, Menno, Pretorius, Daniël, van Raalte, Rutger, van Tellingen, Martijn, Gritters van den Oever, Niels C, Lalisang, Robbert C A, Tonutti, Michele, Girbes, Armand R J, Hoogendoorn, Mark, Thoral, Patrick J, and Elbers, Paul W G
- Abstract
OBJECTIVES: As coronavirus disease 2019 is a novel disease, treatment strategies continue to be debated. This provides the intensive care community with a unique opportunity as the population of coronavirus disease 2019 patients requiring invasive mechanical ventilation is relatively homogeneous compared with other ICU populations. We hypothesize that the novelty of coronavirus disease 2019 and the uncertainty over its similarity with noncoronavirus disease 2019 acute respiratory distress syndrome resulted in substantial practice variation between hospitals during the first and second waves of coronavirus disease 2019 patients.DESIGN: Multicenter retrospective cohort study.SETTING: Twenty-five hospitals in the Netherlands from February 2020 to July 2020, and 14 hospitals from August 2020 to December 2020.PATIENTS: One thousand two hundred ninety-four critically ill intubated adult ICU patients with coronavirus disease 2019 were selected from the Dutch Data Warehouse. Patients intubated for less than 24 hours, transferred patients, and patients still admitted at the time of data extraction were excluded.MEASUREMENTS AND MAIN RESULTS: We aimed to estimate between-ICU practice variation in selected ventilation parameters (positive end-expiratory pressure, Fio2, set respiratory rate, tidal volume, minute volume, and percentage of time spent in a prone position) on days 1, 2, 3, and 7 of intubation, adjusted for patient characteristics as well as severity of illness based on Pao2/Fio2 ratio, pH, ventilatory ratio, and dynamic respiratory system compliance during controlled ventilation. Using multilevel linear mixed-effects modeling, we found significant (p ≤ 0.001) variation between ICUs in all ventilation parameters on days 1, 2, 3, and 7 of intubation for both waves.CONCLUSIONS: This is the first study to clearly demonstrate significant practice variation between ICUs related to mechanical ventilation parameters that are under dire
- Published
- 2021
5. Testing a conceptual model on early opening of the microcirculation in severe sepsis and septic shock
- Author
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van der Voort, Peter H.J., primary, van Zanten, Mark, additional, Bosman, Rob J., additional, van Stijn, Ilse, additional, Wester, Jos P.J., additional, van Raalte, Rutger, additional, Oudemans-van Straaten, Heleen M., additional, and Zandstra, Durk F., additional
- Published
- 2015
- Full Text
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