Discipline: Anesthesie
Focus op perioperatieve neurocognitieve aandoeningen als bedreiging voor levenskwaliteit patiënt
Dr. Sarah Saxena die zich onlangs bij de dienst Anesthesie en kritische zorgen aansloot, verrichtte diepgaand onderzoek naar perioperatieve neurocognitieve…
Gepersonaliseerde anesthesie in het vizier
De anesthesioloog wordt steeds meer een perioperatieve arts, die zich focust op het comfort voor de patiënt tijdens de ingreep…
TIPS in de behandeling van de complicaties van portale hypertensie bij levercirrose
Bij patiënten met levercirrose met significante portale hypertensie kunnen complicaties zoals een varicesbloeding of refractaire ascitesvorming optreden, met een belangrijke…
Standaardaanpak locoregionale anesthesie
Om zeldzame complicaties tot een minimum te beperken, geldt voor locoregionale blocks een vaste werkmethode. Verschillende types lokaal anestheticum kunnen…
Locoregionale anesthesie: een bondgenoot in de strijd tegen pijn én de COVID-pandemie
De meest doeltreffende manier van pijnstilling is de onderbreking van het pijnsignaal op weg van het letsel naar de somatosensorische…
COVID-19 en obesitas
Tijdens de COVID-19-pandemie kwamen er geregeld alarmerende berichten dat naast oudere patiënten ook meer mannen met zwaarlijvigheid of obesitas ernstig…
REBOA: nieuwe therapie bij levensbedreigende bloedingen, zoals placenta percreta
Een nieuwe techniek, Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), geeft de mogelijkheid om tijd te winnen bij majeure…
Gevestigde TCI-technologie kan belangrijke bijdrage leveren tot optimalisatie anesthesie
Op de hoogte blijven van de steeds evoluerende kennis van zaken is een belangrijke focus binnen de dienst Anesthesie op…
Paradigmashift in de anesthesiologische praktijk: naar een opiaatvrije anesthesie?
De klassieke algehele anesthesie bestaat uit drie hoekstenen: hypnose of slaap, immobilisatie door curarisatie en analgesie of pijnstilling. Deze drie elementen vullen we doorgaans aan met een vierde pijler: controle van het sympathische zenuwstelsel. Twee generaties anesthesiologen hebben steeds op basis van dit stramien gewerkt, en dit sinds de introductie van intraveneuze barbituraten, curares en opiaten. Wordt dit paradigma nu verlaten?
Extracorporele membraanoxygenatie
Twintig jaar geleden startte ons ziekenhuis met extracorporele circulatie bij CPR-resistente gevallen van hartstilstand en ernstige gevallen van accidentele hypothermie.…
Volledige standaardisatie van de laparoscopische gastric bypass
Morbide obesitas is een chronische aandoening, geassocieerd met een verhoogd mortaliteitsrisico en met een groot aantal co-morbiditeiten (diabetes type 2, arteriële hypertensie, obstructief slaapapneu syndroom, hypercholesterolemie, gewrichtsproblematiek, …). De Wereldgezondheidsorganisatie (WHO) heeft obesitas uitgeroepen tot epidemie van de 21ste eeuw.
Therapeutische milde hypothermie bij reanimatie
Cardiovasculair lijden is nog steeds een van de belangrijkste doodsoorzaken in de Westerse Wereld. Zestig percent van deze mortaliteit doet zich voor na een plotse collaps van de patiënt. Ook al overleeft de patiënt de hartstilstand dankzij snelle reanimatie door omstaanders en professionele hulpverleners, dan nog is de kans op neurologische schade bijzonder groot. Drie tot vijf minuten na de hartstilstand worden de neuronen al onherstelbaar beschadigd. Zelfs na herstel van de eigen circulatie bij succesvolle reanimatie wordt de eerste uren en dagen verdere schade aangericht door veelvuldig ingezette cascades zoals calcium shifts, excitotoxiciteit, lipideperoxidatie en andere vrijradicaalreacties die leiden tot DNA-beschadiging en apoptose – beter bekend als het post-reanimatie syndroom. Deze agressors brengen eerst schade toe aan de meest kwetsbare delen van de hersenen (hippocampus, neocortex en cerebellum), wat leidt tot post-anoxische encephalopathie.
Langetermijneffecten van anesthesie
In oktober 2006 organiseerde de Dienst Anesthesiologie een symposium over de langetermijneffecten van anesthesie. Dit thema kan geneesheer noch patiënt onberoerd laten. Anesthesiologen hebben zich altijd bekommerd om de onmiddellijke peroperatieve morbiditeit en mortaliteit. Nu verruimen we echter de horizon.
Publicaties
Cardiac Postoperative Use of High-Flow Nasal Cannula: A Retrospective Single-Center Study.
Open Journal of Thoracic Surgery, 2022, 12, 11-20 - https://www.scirp.org/journal/ojts ISSN Online: 2164-3067 ISSN Print: 2164-3059
General purpose pharmacokinetic-dynamic models for target-controlled infusion of anaesthetic drugs.
A narrative review. J Clin Med. 2022 Apr 28;11(9):2487. doi: 10.3390/jcm11092487. PMID: 35566617; PMCID: PMC9101974.
Utility of the SmartPilot®View advisory screen to improve anaesthetic drug titration and postoperative outcomes in clinical practice: a two-centre prospective observational trial.
Br J Anaesth. 2022 Jun;128(6):959-970. doi: 10.1016/j.bja.2022.02.033. Epub 2022 Mar 28. PMID: 35361490.
Frontal Electroencephalogram based Drug, Sex, and Age Independent Sedation Level Prediction using Non-linear Machine Learning Algorithms.
Journal of Clinical Monitoring and Computing (2022) 36:121–130. https://doi.org/10.1007/s10877-020-00627-3
Standaardaanpak locoregionale anesthesie: Safety First.
AZ link 2021; 48: 14-17.
Locoregionale anesthesie: een bondgenoot in de strijd tegen pijn én de COVID-pandemie.
AZ Link 2021; 48: 10-13.
Catheter Port Reversal in Citrate CVVH.
Kidney International Reports (2021) 6, 2775-2781
Pain management after complex spine surgery: A systematic review and procedure-specific postoperative pain management recommendations
Eur J Anaesthesiol - 2021 Sep 1;38(9):985-994. doi: 10.1097/EJA.0000000000001448.
Motivation of overweight patients with atrial fibrillation to lose weight or to follow a weight loss management program: a cross-sectional study.
Acta Cardiol. 2021 Jul;76(5):494-503. doi: 10.1080/00015385.2020.1848274. Epub 2020 Nov 24.PMID: 33228467
Hematocrit as a predictor of preoperative transfusion-associated complications in spine surgery: A NSQIP study.
Clin Neurol Neurosurg. 2021 Jan;200:106322. doi: 10.1016/j.clineuro.2020.106322. Epub 2020 Oct 23.PMID: 33127163
Hospital-based epilepsy care in Uganda: A prospective study of three major public referral hospitals.
Epilepsy Behav. 2021 Jan;114(Pt B):107301. doi: 10.1016/j.yebeh.2020.107301. Epub 2020 Aug 27.PMID: 32861671
Comparison of haemodynamic- and electroencephalographic-monitored effects evoked by four combinations of effect-site concentrations of propofol and remifentanil, yielding a predicted tolerance to laryngoscopy of 90.
J Clin Monit Comput. 2020 Jun 3. doi: 10.1007/s10877-020-00540-9. Online ahead of print. PMID: 32488680
Determinants of Total/ionized Calcium in patients undergoing citrate CVVH: A retrospective observational study.
J Crit Care 2020 Oct;59:16-22. doi: 10.1016/j.jcrc.2020.05.005. Epub 2020 May 17.
A deadly capillary leak attack. Clarkson’s disease: a narrative review.
Acta Clinica Belgica, DOI: 10.1080/17843286.2020.1792685 - To link to this article: https://doi.org/10.1080/17843286.2020.1792685
Anaesthetic Factors Affecting Outcome After Bariatric Surgery, a Retrospective Levelled Regression Analysis.
Obesity surgery 29: 6. 1841-1850 Jun.
Is opioid-free general anesthesia for breast and gynecological surgery a viable option?
Current opinion in anaesthesiology 32: 3. 257-262 Jun.
Is the Balance in Anesthesia Right? Multitarget Approach and Alteration of Systemic Inflammation.
Anesthesia and analgesia 128: 6. Jun.
Twelve-Year Experience with Roux-en-Y Gastric Bypass as a Conversional Procedure for Vertical Banded Gastroplasty: Are We on the Right Track?
Obesity surgery Jun.
Perioperative Care of Patients With Obstructive Sleep Apnea Undergoing Upper Airway Surgery: A Review and Consensus Recommendations.
JAMA otolaryngology-- head & neck surgery Jun.
Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations.
British journal of anaesthesia Oct.
Administration of anesthetic drugs according to pharmacological principles: are we heading in the right direction?
E. M., Dec-2019, In : Journal of clinical monitoring and computing. 33, 6, p. 945-947 3 p.
Invited speaker for the Draeger technology user Symposium: The science behind “Smart Pilot View®”
Sweden
Administration of anesthetic drugs according to pharmacological principles: are we heading in the right direction?
E. M., Dec-2019, In : Journal of clinical monitoring and computing. 33, 6, p. 945-947
A Novel Machine Learning based Drug-Independent Sedation Level Estimation using Quantitative Features from Frontal Electroencephalogram.
Br J Anaesth. 2019 Oct;123(4):479-487. doi: 10.1016/j.bja.2019.06.004. Epub 2019 Jul 18.
Corrigendum to ‘Study of the time course of the clinical effect of propofol compared with the time course of the predicted effect-site concentration: performance of three pharmacokinetic-dynamic models’
Br J Anaesth. 2019 Feb;122(2):287. doi: 10.1016/j.bja.2018.11.017. Epub 2018 Dec 14.
Population Pharmacodynamics of Propofol and Sevoflurane in Healthy Volunteers Using a Clinical Score and the Patient State Index: A Crossover Study.
Anesthesiology. 2019 Dec;131(6):1223-1238. doi: 10.1097/ALN.0000000000002966.
Pharmacokinetic Pharmacodynamic Perspective on the Detection of Signs of Neural Inertia in Humans.
Anesthesiology. 2018 Aug;129(2):373-375. doi: 10.1097/ALN.0000000000002287.
Test of neural inertia in humans during general anaesthesia.
Br J Anaesth. 2018 Mar;120(3):525-536. doi: 10.1016/j.bja.2017.11.072. Epub 2017 Dec 1.
Ability of Bispectral Index, Autoregressive Modelling with Exogenous Input- derived Auditory Evoked Potentials and Predicted Propofol Concentrations to Measure Patient Responsiveness during Anesthesia with Propofol and Remifentanil.
Ability of Bispectral Index, Autoregressive Modelling with Exogenous Input- derived Auditory Evoked Potentials and Predicted Propofol Concentrations to Measure Patient Responsiveness during Anesthesia with Propofol and Remifentanil.
A Comparison of Bispectral Index and ARX-derived Auditory Evoked Potential Index in measuring the clinical interaction between ketamine and propofol anaesthesia.
A Comparison of Bispectral Index and ARX-derived Auditory Evoked Potential Index in measuring the clinical interaction between ketamine and propofol anaesthesia.
Perioperative opioids aggravate obstructive breathing in sleep apnea syndrome:mechanisms and alternative anesthesia strategies.
Current opinion in anaesthesiology 29: 1. 129-133 Feb. 2016
Optimal Surgical Conditions in Laparoscopic Surgery: Just Relax and Lower the Pressure.
Anesthesia and analgesia 122: 1. Jan. 2016
Pharmacokinetic and pharmacodynamic interactions in anaesthesia. A review of current knowledge and how it can be used to optimize anaesthetic drug administration.
British Journal of Anaesthesia, 118 (1): 44–57 (2017) doi: 10.1093/bja/aew312
The role of abdominal compliance, the neglected parameter in critically ill patients – a consensus review of 16. Part 2: measurement techniques and management recommendations.
Anaesthesiol Intensive Ther. 2014 Nov-Dec;46(5):406-32. doi: 10.5603/AIT.2014.0063. Review. PubMed PMID: 25432559.
Failure of sugammadex to reverse rocuronium-induced neuromuscular blockade: Simply an outlier or are we missing something?
Eur J Anaesthesiol. 2015 Oct;32(10):743-4. doi: 10.1097/EJA.0000000000000301. PubMed PMID: 26132985.
Factors determining the smooth flow and the non-operative time in a one-induction room to one-operating room setting.
J Eval Clin Pract. 2015 Apr;21(2):205-14. doi: 10.1111/jep.12288. Epub 2014 Dec 11. PubMed PMID: 25496600; PubMed Central PMCID:PMC4406160.
Sedation options for the morbidly obese intensive care unit patient: a concise survey and an agenda for development.
Multidiscip Respir Med. 2015 Mar 7;10(1):8. doi: 10.1186/s40248-015-0007-2. eCollection 2015. PubMed PMID: 25883785; PubMed Central PMCID: PMC4399437. d
Factors determining the smooth flow and the non-operative time in a one-induction room to one-operating room setting.
Journal of evaluation in clinical practice 21: 2. 205-214 Apr.
Sedation options for the morbidly obese intensive care unit patient: a concise survey and an agenda for development.
Multidisciplinary respiratory medicine 10: 1. 03.
The role of abdominal compliance, the neglected parameter in critically ill patients – a consensus review of 16. Part 1: definitions and pathophysiology.
Anaesthesiol Intensive Ther. 2014 Nov-Dec;46(5):392-405. doi: 10.5603/AIT.2014.0062. Review. PubMed PMID: 25432558.
The role of abdominal compliance, the neglected parameter in critically ill patients – a consensus review of 16. Part 2: measurement techniques and management recommendations.
Anaesthesiology intensive therapy 46: 5. 406-432 Nov/Dec.
High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial.
Lancet. 2014 Aug 9;384(9942):495-503. doi: 10.1016/S0140-6736(14)60416-5. Epub 2014 Jun 2. PubMed PMID: 24894577.
A COMPREHENSIVE GUIDE TO ORTHOFACIAL SURGERY vol 1 planning and operative techniques chapter: Anaesthesia for facial surgeons by J Mulier.
isbn:9789080776500.
A review of the interest of sugammadex for deep neuromuscular blockade management in Belgium.
Acta anaesthesiologica Belgica 64: 2. 49-60.
Controversies in the Anesthetic Management of the Obese Surgical Patient Springer.
Book chapters
Presentaties
New TCI models and drugs: A new perspective in Clinical Applications.
New Therapeutic Strategies in Anesthetic Pharmacology.
General Anesthesiology eBoard 1.
Webinar ESAIC: How to use your drugs in a better way – Webinar on Anaesthetic Pharmacology.
Bispectral index, state and response entropy, quantification of consciousness, patient state index: different or more of the same?
“Perioperative Neurocognitive Disorder; nomenclature, research guidelines and best practices”.
Monitoring the risk for a “valley of inadequate anesthesia” using bispectral index and the noxious stimulation response index during different inflow speeds of sevoflurane.
Meeting organizing committee co-chair for the 29th annual meeting of the ISAP meeting 2020.
Practical Concepts of Anesthetic Pharmacology for The Benefit of Your Patient. A practical course that will improve your skills for anesthetic drug administration.
A scientific approach to optimal titration of anaesthetic drugs: Using Smart Pilot View as my GPS-system.
The advantages of TCI.
Impact of OFA versus opioids on diepflap perfusion and recovery.
“The Science behind PKPD models for TIVA”.
Chair of the advisory board for BD medical on the new target controlled infusion models.
“Measuring nociception-antinociception balance. Do we know what to expect?”
“Liver” and “general anaesthesia”
Lead coordination for recording a Medasense® sponsored educational video on the use of NOL monitoring during clinical practice.
https://www.youtube.com/watch?v=Wab3QXMUeQA. AND https://www.youtube.com/watch?v=dCD56Rcqtzc.
Chair of the international seminar on new target-controlled infusion models. One week of lectures and live sessions with patient cases.
Invited speaker for workshop on advanced PKPD modeling at the SIVA UK 2018.
“Critical care Issues” – Post-Influenza Aspergillosis, do not under estimate Influenza B.
From single-drug pharmacokinetics and pharmacodynamics to multi-drug interaction modeling: using population-based modeling to increase accuracy of anesthetic drug titration.
The effect of volatile anaesthetics on QT prolongation: new insights.
“The use of intravenous anesthetics for induction and maintenance of children.”
Measuring intraoperative nociception.
Does the SAD have any place in Obese patients?
“Anesthesievoering bij elektroconvulsietherapie”
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“Chiraliteit in anesthesie: relevantie”
Pro-Con debate: Opioid free general anesthesia?
Hoe OFA implementeren in de derde wereld?
Der obese patient.
What extra ERAS recommendations do we need for obese patients.
Opioid free anesthesia in bariatric surgery and beyond ASA.
Sedaties in de anesthesiologie.
New anti atelectasis strategies for optimizing ventilation in the morbidly obese.
Opioid reduction to the max.
Impact of anesthesia on inflammation. do we need further research?
Efficiency in Bariatric Anesthesiology
Post operative ventilation in obese patients
Anaesthesia (opioid free) in Bariatric Surgery.
Optimizing deep Muscle paralysis and insufflation pressure during abdominal laparoscopic surgery.
Anesthetic technique in laparoscopic surgery and ventilation setting for morbidly obese patients.
iologic and anaesthetic considerations in optimizing clinical outcome in high risk patients. Do we need Sevoflurane?
Anaesthetic considerations in optimizing clinical outcome.
Efficiency in Anesthesiology.
Improve total outcome in obese patients by adapting anesthesia.
Improving surgical outcome in bariatric patients.
Pourquoi et comment éviter les opioids?
Sedaties in de anesthesiologische praktijk: visie vanuit Vlaanderen.
Enhanced recovery after bariatric surgery.
Enquete peri operatieve activiteit in Belgie.
Key points for bariatric anesthesia.
Anesthesie bij risico patienten.
A randomized double blind study evaluating the effect of opioid free versus opioid anesthesia on postoperative pain and discomfort in 50 laparoscopic bariatric surgery patients.
Opioid free (OFA) versus opioid (OA) and low opioid anesthesia (LOA) for the laparoscopic gastric bypass surgery. Immediate post operative morbidity and mortality in a single center study on 5061 consecutive patients from March 2011 till June 2015.
Deep neuromuscular blockade versus remifentanyl or sevoflurane to augment measurable laparoscopic workspace during bariatric surgery.
623 answers for World Survey on opioid free anaesthesia (OFA) today.
Comparison of opioid free anaesthesia with opioid anesthesia on postoperative shivering in morbidly obese patients scheduled for bariatric surgery.
Live anesthesia demonstraties in Az Sint Jan voor bariatrische anesthesia. (CAPE: Clinical Anesthesia Programme)
Anesthesie voor risico patienten.
Optimized concepts for NMB management.
Zorginspectie Vlaanderen en Safety First.
Dexdor het ultieme sedatiemiddel bij opiaat vrije bariatrische anesthesie.
OFA Roeselare.
ERAS and obesity pan arabic.
How to improve surgical outcome PAN arabic.
Low vs Standard Pneumoperitoneum Pressure during Abdominal Laparoscopic Surgery.
Optimierte Konzepte für das NMB-Management.
Sedation of obese patients in remote locations.
What you should know as an anaesthesiologist to help improve the bariatric surgical outcome.
Anaesthesia without opioids might reduce obstructive breathing, silent aspiration and post-operative pain in morbidly obese patients.
Best Practices in the OR: Anaesthesia-Surgery cooperation during RNY gastric bypass surgery.
Anesthesiologist ́s view on metabolic syndrome.
OFA Mogelijk? Voordelen, Nadelen en Moeilijkheden?
Why and how using protective lung ventilation in anaesthesia for morbid obese patients.
Pourquoi et comment éviter les opioïdes en anesthésie ambulatoire?
Le syndrome du compartiment abdominal durant la laparoscopie.
Safe sedation in morbid obese patients.
Anesthesia for the high risk patient.
Ventilation of morbid obese patients Networks in anesthesia.
Opioid vrije anesthesie. Voordelen, Nadelen en Moeilijkheden.
The place of Nicardipine in the opioid free anaesthesia and the Peri operative hypertension treatment.
Assessing Abdominal Compliance and the Impact on Intra-abdominal Volume.
Case Studies in Patients with Different Abdominal Elastance Patterns.
Keypoints that are important for morbidly obese patients.
Best Practice Video lecture.
Opioid free anaesthesia.
OFA Why and How.
OFA ASA
Controlled hypotension during opioid free anaesthesia.
When is deep NMB needed TARK.
Anaesthesia for endoscopic nasal surgery.
Bleeding and leak prevention.
ERAS and Obesity.
Opioid free anaesthesia.
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