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Leo Heunks

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https://www.readbyqxmd.com/read/28917004/critical-illness-associated-diaphragm-weakness
#1
REVIEW
Martin Dres, Ewan C Goligher, Leo M A Heunks, Laurent J Brochard
Diaphragm weakness is highly prevalent in critically ill patients. It may exist prior to ICU admission and may precipitate the need for mechanical ventilation but it also frequently develops during the ICU stay. Several risk factors for diaphragm weakness have been identified; among them sepsis and mechanical ventilation play central roles. We employ the term critical illness-associated diaphragm weakness to refer to the collective effects of all mechanisms of diaphragm injury and weakness occurring in critically ill patients...
September 15, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28624388/geo-economic-variations-in-epidemiology-patterns-of-care-and-outcomes-in-patients-with-acute-respiratory-distress-syndrome-insights-from-the-lung-safe-prospective-cohort-study
#2
John G Laffey, Fabiana Madotto, Giacomo Bellani, Tài Pham, Eddy Fan, Laurent Brochard, Pravin Amin, Yaseen Arabi, Ednan K Bajwa, Alejandro Bruhn, Vladimir Cerny, Kevin Clarkson, Leo Heunks, Kiyoyasu Kurahashi, Jon Henrik Laake, Jose A Lorente, Lia McNamee, Nicolas Nin, Jose Emmanuel Palo, Lise Piquilloud, Haibo Qiu, Juan Ignacio Silesky Jiménez, Andres Esteban, Daniel F McAuley, Frank van Haren, Marco Ranieri, Gordon Rubenfeld, Hermann Wrigge, Arthur S Slutsky, Antonio Pesenti
BACKGROUND: Little information is available about the geo-economic variations in demographics, management, and outcomes of patients with acute respiratory distress syndrome (ARDS). We aimed to characterise the effect of these geo-economic variations in patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE). METHODS: LUNG SAFE was done during 4 consecutive weeks in winter, 2014, in a convenience sample of 459 intensive-care units in 50 countries across six continents...
August 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28620438/assembly-2-respiratory-intensive%C3%A2-care
#3
Raffaele Scala, Leo Heunks, Cesare Gregoretti, Marcus J Schultz, Michael Dreher, João Winck
Meet @ERStalk Assembly 2: respiratory intensive care http://ow.ly/PnnB30b7nLU.
June 2017: Breathe
https://www.readbyqxmd.com/read/28530111/update-in-critical-care-2016
#4
Claudia Dos Santos, Leo Heunks, Hannah Wunsch
No abstract text is available yet for this article.
July 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28522757/functional-assessment-of-the-diaphragm-by-speckle-tracking-ultrasound-during-inspiratory-loading
#5
Eline Oppersma, Nima Hatam, Jonne Doorduin, Johannes G van der Hoeven, Gernot Marx, Andreas Goetzenich, Sebastian Fritsch, Leo M A Heunks, Christian S Bruells
BACKGROUND: Assessment of diaphragmatic effort is challenging especially in critically ill patients in the phase of weaning. Fractional thickening during inspiration assessed by ultrasound has been used to estimate diaphragm effort. It is unknown whether more sophisticated ultrasound techniques such as speckle tracking are superior in the quantification of inspiratory effort. This study evaluates the validity of speckle tracking ultrasound to quantify diaphragm contractility. METHODS: Thirteen healthy volunteers underwent a randomized stepwise threshold loading protocol of 0 to 50% of the maximal inspiratory pressure...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28361079/ultrasound-to-assess-diaphragmatic-function-in-the-critically-ill-a-critical-perspective
#6
EDITORIAL
Mark Haaksma, Pieter Roel Tuinman, Leo Heunks
Ultrasound of the diaphragm in critically ill patients has become a diagnostic technique of emerging interest among clinicians and scientists. The advantages include that it is widely available, non-invasive and examination can be performed after relatively short training and at low costs. It is used to estimate muscle mass by measurement of muscle thickness and diagnose weakness by the assessment of diaphragm movement during unassisted breathing. Thickening of the muscle during inspiration has been used to quantify force generation...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28320430/novel-insights-in-icu-acquired-respiratory-muscle-dysfunction-implications-for-clinical-care
#7
REVIEW
Annemijn H Jonkman, Diana Jansen, Leo M A Heunks
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2017. Other selected articles can be found online at http://ccforum.com/series/annualupdate2017 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901 .
March 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28290154/the-role-of-calpains-in-ventilator-induced-diaphragm-atrophy
#8
Xiaoping Zhu, Hieronymus W H van Hees, Leo Heunks, Feifei Wang, Lei Shao, Jiaru Huang, Lei Shi, Shaolin Ma
BACKGROUND: Controlled mechanical ventilation (CMV) is associated with diaphragm dysfunction. Dysfunction results from muscle atrophy and injury of diaphragm muscle fibers. Enhanced proteolysis and reduced protein synthesis play an important role in the development of atrophy. The current study is to evaluate the effects of the calpains inhibitor calpeptin on the development of diaphragm atrophy and activation of key enzymes of the ubiquitin-proteasome pathway in rats under CMV. METHODS: Three groups of rats were studied: control animals (CON, n = 8), rats subjected to 24 h of MV (CMV, n = 8), and rats subjected to 24 h of MV after administration of the calpain inhibitor calpeptin (CMVC, n = 8)...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27898224/recommended-reading-from-radboud-university-medical-centre-fellows
#9
Willem-Jan M Schellekens, Diana Jansen, Mirrin J Dorresteijn, Leo M A Heunks
No abstract text is available yet for this article.
November 29, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27757516/potentially-modifiable-factors-contributing-to-outcome-from-acute-respiratory-distress-syndrome-the-lung-safe-study
#10
MULTICENTER STUDY
John G Laffey, Giacomo Bellani, Tài Pham, Eddy Fan, Fabiana Madotto, Ednan K Bajwa, Laurent Brochard, Kevin Clarkson, Andres Esteban, Luciano Gattinoni, Frank van Haren, Leo M Heunks, Kiyoyasu Kurahashi, Jon Henrik Laake, Anders Larsson, Daniel F McAuley, Lia McNamee, Nicolas Nin, Haibo Qiu, Marco Ranieri, Gordon D Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Antonio Pesenti
PURPOSE: To improve the outcome of the acute respiratory distress syndrome (ARDS), one needs to identify potentially modifiable factors associated with mortality. METHODS: The large observational study to understand the global impact of severe acute respiratory failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across five continents...
December 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27748627/partial-neuromuscular-blockade-during-partial-ventilatory-support-in-sedated-patients-with-high-tidal-volumes
#11
Jonne Doorduin, Joeke L Nollet, Lisanne H Roesthuis, Hieronymus W H van Hees, Laurent J Brochard, Christer A Sinderby, Johannes G van der Hoeven, Leo M A Heunks
RATIONALE: Controlled mechanical ventilation is used to deliver lung-protective ventilation in patients with acute respiratory distress syndrome. Despite recognized benefits, such as preserved diaphragm activity, partial support ventilation modes may be incompatible with lung-protective ventilation due to high Vt and high transpulmonary pressure. As an alternative to high-dose sedatives and controlled mechanical ventilation, pharmacologically induced neuromechanical uncoupling of the diaphragm should facilitate lung-protective ventilation under partial support modes...
April 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27498374/levosimendan-beyond-inotropy-and-acute-heart-failure-evidence-of-pleiotropic-effects-on-the-heart-and-other-organs-an-expert-panel-position-paper
#12
REVIEW
Dimitrios Farmakis, Julian Alvarez, Tuvia Ben Gal, Dulce Brito, Francesco Fedele, Candida Fonseca, Anthony C Gordon, Israel Gotsman, Elena Grossini, Fabio Guarracino, Veli-Pekka Harjola, Yaron Hellman, Leo Heunks, Visnja Ivancan, Apostolos Karavidas, Matti Kivikko, Vladimir Lomivorotov, Dan Longrois, Josep Masip, Marco Metra, Andrea Morelli, Maria Nikolaou, Zoltán Papp, Alexander Parkhomenko, Gerhard Poelzl, Piero Pollesello, Hanne Berg Ravn, Steffen Rex, Hynek Riha, Sven-Erik Ricksten, Robert H G Schwinger, Bojan Vrtovec, M Birhan Yilmaz, Marzenna Zielinska, John Parissis
Levosimendan is a positive inotrope with vasodilating properties (inodilator) indicated for decompensated heart failure (HF) patients with low cardiac output. Accumulated evidence supports several pleiotropic effects of levosimendan beyond inotropy, the heart and decompensated HF. Those effects are not readily explained by cardiac function enhancement and seem to be related to additional properties of the drug such as anti-inflammatory, anti-oxidative and anti-apoptotic ones. Mechanistic and proof-of-concept studies are still required to clarify the underlying mechanisms involved, while properly designed clinical trials are warranted to translate preclinical or early-phase clinical data into more robust clinical evidence...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27145818/assessment-of-dead-space-ventilation-in-patients-with-acute-respiratory-distress-syndrome-a-prospective-observational-study
#13
Jonne Doorduin, Joeke L Nollet, Manon P A J Vugts, Lisanne H Roesthuis, Ferdi Akankan, Johannes G van der Hoeven, Hieronymus W H van Hees, Leo M A Heunks
BACKGROUND: Physiological dead space (VD/VT) represents the fraction of ventilation not participating in gas exchange. In patients with acute respiratory distress syndrome (ARDS), VD/VT has prognostic value and can be used to guide ventilator settings. However, VD/VT is rarely calculated in clinical practice, because its measurement is perceived as challenging. Recently, a novel technique to calculate partial pressure of carbon dioxide in alveolar air (PACO2) using volumetric capnography (VCap) was validated...
May 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27091359/strategies-to-optimize-respiratory-muscle-function-in-icu-patients
#14
REVIEW
Willem-Jan M Schellekens, Hieronymus W H van Hees, Jonne Doorduin, Lisanne H Roesthuis, Gert Jan Scheffer, Johannes G van der Hoeven, Leo M A Heunks
Respiratory muscle dysfunction may develop rapidly in critically ill ventilated patients and is associated with increased morbidity, length of intensive care unit stay, costs, and mortality. This review briefly discusses the pathophysiology of respiratory muscle dysfunction in intensive care unit patients and then focuses on strategies that prevent the development of muscle weakness or, if weakness has developed, how respiratory muscle function may be improved. We propose a simple strategy for how these can be implemented in clinical care...
April 19, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26854883/the-differential-diagnosis-for-failure-to-wean-from-mechanical-ventilation
#15
REVIEW
Jonne Doorduin, Johannes G van der Hoeven, Leo M A Heunks
PURPOSE OF REVIEW: In this review, we discuss the causes for a failed weaning trial and specific diagnostic tests that could be conducted to identify the cause for weaning failure. We briefly highlight treatment strategies that may enhance the chance of weaning success. RECENT FINDINGS: Impaired respiratory mechanics, respiratory muscle dysfunction, cardiac dysfunction, cognitive dysfunction, and metabolic disorders are recognized causes for weaning failure. In addition, iatrogenic factors may be at play...
April 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26850329/appropriate-positioning-of-the-nava-catheter
#16
LETTER
Willem-Jan M Schellekens, Leo M A Heunks
No abstract text is available yet for this article.
April 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/26540399/comparison-between-neurally-adjusted-ventilatory-assist-and-pressure-support-ventilation-levels-in-terms-of-respiratory-effort
#17
COMPARATIVE STUDY
Guillaume Carteaux, Ana Córdoba-Izquierdo, Aissam Lyazidi, Leo Heunks, Arnaud W Thille, Laurent Brochard
OBJECTIVES: To understand the potential equivalence between neurally adjusted ventilatory assist and pressure support ventilation levels in terms of respiratory muscle unloading. To compare the respiratory pattern, variability, synchronization, and neuromuscular coupling within comparable ranges of assistance. DESIGN: Prospective single-center physiologic study. SETTING: A 13-bed university medical ICU. PATIENTS: Eleven patients recovering from respiratory failure...
March 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26196838/effects-of-experimental-human-endotoxemia-on-diaphragm-function
#18
Jonne Doorduin, Jenneke Leentjens, Matthijs Kox, Hieronymus W H van Hees, Johannes G van der Hoeven, Peter Pickkers, Leo M A Heunks
INTRODUCTION: Systemic inflammation is a well-known risk factor for respiratory muscle weakness. Studies using animal models of inflammation have shown that endotoxin administration induces diaphragm dysfunction. However, the effects of in vivo endotoxin administration on diaphragm function in humans have not been studied. Our aim was to evaluate diaphragm function in a model of systemic inflammation in healthy subjects. METHODS: Two groups of 12 male volunteers received an intravenous bolus of 2 ng/kg of Escherichia coli lipopolysaccharide (LPS) and were monitored until 8 h after LPS administration...
October 2015: Shock
https://www.readbyqxmd.com/read/25955983/assisted-ventilation-in-patients-with-acute-respiratory-distress-syndrome-lung-distending-pressure-and-patient-ventilator-interaction
#19
Jonne Doorduin, Christer A Sinderby, Jennifer Beck, Johannes G van der Hoeven, Leo M A Heunks
BACKGROUND: In patients with acute respiratory distress syndrome (ARDS), the use of assisted mechanical ventilation is a subject of debate. Assisted ventilation has benefits over controlled ventilation, such as preserved diaphragm function and improved oxygenation. Therefore, higher level of "patient control" of ventilator assist may be preferable in ARDS. However, assisted modes may also increase the risk of high tidal volumes and lung-distending pressures. The current study aims to quantify how differences in freedom to control the ventilator affect lung-protective ventilation, breathing pattern variability, and patient-ventilator interaction...
July 2015: Anesthesiology
https://www.readbyqxmd.com/read/25888356/levosimendan-affects-oxidative-and-inflammatory-pathways-in-the-diaphragm-of-ventilated-endotoxemic-mice
#20
Willem-Jan M Schellekens, Hieronymus W H van Hees, Marianne Linkels, P N Richard Dekhuijzen, Gert Jan Scheffer, Johannes G van der Hoeven, Leo M A Heunks
INTRODUCTION: Controlled mechanical ventilation and endotoxemia are associated with diaphragm muscle atrophy and dysfunction. Oxidative stress and activation of inflammatory pathways are involved in the pathogenesis of diaphragmatic dysfunction. Levosimendan, a cardiac inotrope, has been reported to possess anti-oxidative and anti-inflammatory properties. The aim of the present study was to investigate the effects of levosimendan on markers for diaphragm nitrosative and oxidative stress, inflammation and proteolysis in a mouse model of endotoxemia and mechanical ventilation...
March 2, 2015: Critical Care: the Official Journal of the Critical Care Forum
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