Publications by authors named "Tom A Rijpstra"

Article Synopsis
  • In out-of-hospital cardiac arrest (OHCA) cases without ST-elevation, researchers investigated the usefulness of troponin-T (cTnT) levels in predicting the risk of acute coronary syndrome and patient survival.
  • The study analyzed data from 352 patients, revealing that higher cTnT values were independent predictors for 90-day mortality and the presence of acute unstable lesions and thrombotic occlusions.
  • However, cTnT levels did not show a significant correlation with left ventricular function, highlighting its role primarily in assessing mortality risk and acute coronary issues in these patients.
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Article Synopsis
  • * The multicenter randomized clinical trial involved 388 ICU patients and evaluated outcomes like ICU length of stay, mortality rates, and drug level attainment, revealing no significant differences between MIPD and standard dosing.
  • * The results suggest that MIPD did not provide any advantages in improving ICU stay or other health outcomes, indicating that alternative methods for optimizing antibiotic dosing should be explored.
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  • The study aimed to evaluate the prognostic value of ischaemic ECG patterns, specifically ST-depression and T-wave inversion, in patients who experienced out-of-hospital cardiac arrest.
  • Analysis of data from 510 patients revealed that 66.7% had ischaemic ECG patterns, which were linked to a significantly lower 90-day survival rate compared to those without such patterns.
  • While ischaemic ECG patterns correlated with worse survival and poorer heart function, these associations disappeared after adjusting for age and time to restore blood circulation.
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Background: Critically ill COVID-19 patients have proven to be at risk for developing invasive fungal infections. However, the incidence and impact of possible/probable COVID-19-associated pulmonary aspergillosis (CAPA) in severe COVID-19 patients varies between cohorts. We aimed to assess the incidence, risk factors, and clinical outcome of invasive pulmonary aspergillosis in a regional cohort of COVID-19 intensive care patients.

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Article Synopsis
  • A study comparing immediate versus delayed coronary angiography in patients with out-of-hospital cardiac arrest showed no significant difference in overall mean costs between the two strategies during the initial hospital stay.
  • Although immediate angiography resulted in higher procedural costs, expenses related to intensive care and ward stays were similar in both groups.
  • The findings suggest that a delayed approach, allowing for neurological recovery before invasive procedures, may be a more cost-effective strategy.
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Objectives: The optimal targeted temperature in patients with shockable rhythm is unclear, and current guidelines recommend targeted temperature management with a correspondingly wide range between 32°C and 36°C. Our aim was to study survival and neurologic outcome associated with targeted temperature management strategy in postarrest patients with initial shockable rhythm.

Design: Observational substudy of the Coronary Angiography after Cardiac Arrest without ST-segment Elevation trial.

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We describe four secondary fungal infections caused by Mucorales species in COVID-19 patients. Three COVID-19 associated mucormycosis (CAM) occurred in ICU, one outside ICU. All were men aged > 50 years, three died.

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Article Synopsis
  • A study was conducted on 552 patients who were resuscitated after cardiac arrest without STEMI, comparing immediate versus delayed coronary angiography and its impact on heart function.
  • Results showed no significant improvement in left ventricular function, with ejection fractions of 45.2% and 48.4% for immediate and delayed groups, respectively.
  • The conclusion indicates that immediate coronary angiography does not enhance heart dimensions or function compared to delaying the procedure after neurological recovery.
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Sex differences in out-of-hospital cardiac arrest (OHCA) patients are increasingly recognized. Although it has been found that post-resuscitated women are less likely to have significant coronary artery disease (CAD) than men, data on follow-up in these patients are limited. Data for this data in brief article was obtained as a part of the randomized controlled Coronary Angiography after Cardiac Arrest without ST-segment elevation (COACT) trial.

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Article Synopsis
  • The study investigates whether sex influences survival rates in patients who experience out-of-hospital cardiac arrest (OHCA) without ST-segment elevation myocardial infarction (STEMI).
  • Overall one-year survival rates were similar for men (63.4%) and women (59.6%), with no significant sex differences found.
  • Women had a lower occurrence of significant coronary artery disease (CAD), but when CAD was present, their survival was worse compared to women without CAD, while men did not show this discrepancy; immediate coronary angiography did not improve survival for either sex.
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Article Synopsis
  • * In a multicenter trial, 552 patients without STEMI were randomly assigned to receive immediate or delayed coronary angiography, with survival rates at 90 days as the primary focus.
  • * Results showed no significant difference in survival rates between the immediate angiography (64.5% alive) and delayed angiography (67.2% alive) groups after 90 days, suggesting that immediate intervention may not offer a survival advantage in these cases.
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Background: Ischemic heart disease is a major cause of out-of-hospital cardiac arrest. The role of immediate coronary angiography (CAG) and percutaneous coronary intervention (PCI) after restoration of spontaneous circulation following cardiac arrest in the absence of ST-segment elevation myocardial infarction (STEMI) remains debated.

Hypothesis: We hypothesize that immediate CAG and PCI, if indicated, will improve 90-day survival in post-cardiac arrest patients without signs of STEMI.

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The objective of this study was to describe the pharmacokinetics of cefotaxime (CTX) in critically ill patients with acute kidney injury (AKI) when treated with continuous renal replacement therapy (CRRT) in the intensive care unit (ICU). This single-center prospective observational pilot study was performed among ICU-patients with AKI receiving ≥48 h concomitant CRRT and CTX. CTX was administered intravenously 1,000 mg (bolus) every 6 h for 4 days.

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Objective: In the intensive-care unit (ICU), chest radiographs (CXRs) are frequently obtained routinely for postoperative cardiac surgery patients, despite the fact that the efficacy of routine CXRs is known to be low. We investigated the efficacy and safety of CXRs performed after cardiac surgery for specified indications only.

Methods: In this observational cohort study, we prospectively included all patients who underwent conventional major cardiac surgery by median sternotomy in the year 2012.

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Background: ICU patients frequently undergo chest radiographs (CXRs). The diagnostic and therapeutic efficacy of routine CXRs are now known to be low, but the discussion regarding specific indications for CXRs in critically ill patients and the safety of abandoning routine CXRs is still ongoing. We performed a survey of Dutch intensivists on the current practice of chest radiography in their departments.

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Objectives: Prediction of atrial fibrillation (AF) after coronary artery bypass grafting (CABG) may lead to preventive or early treatment and improved outcome. We investigated the association of serial perioperative cardiac troponin T (cTNT) measurements with postoperative AF in patients undergoing CABG.

Methods: In a retrospective analysis of prospectively collected data, 3148 patients undergoing elective CABG were evaluated.

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Background: Chest radiographs (CXRs) are obtained frequently in the intensive care unit (ICU). Whether these CXRs should be performed routinely or on clinical indication only is often debated. The aim of our study was to investigate the incidence and clinical significance of abnormalities found on routine postoperative CXRs in cardiac surgery patients and whether a restricted use of CXRs would influence the number of significant findings.

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