Nynke Bruins - Academia.edu (original) (raw)
Papers by Nynke Bruins
Critical Care, Feb 1, 2012
PLOS ONE
Post-intensive care unit (ICU) sequelae, including physical and mental health problems, are relat... more Post-intensive care unit (ICU) sequelae, including physical and mental health problems, are relatively unexplored. Characteristics commonly used to predict outcome lack prognostic value when it comes to long-term physical recovery. Therefore, the objective of this study was to assess the incidence of non-recovery in long-stay ICU-patients. In this single-centre study, retrospective data of adults with an ICU stay >48 hours who visited the specialized post-ICU clinic, and completed the Dutch RAND 36-item Short Form questionnaire at 3 and 12 months post-ICU, were retrieved from electronic patient records. In cases where physical functioning scores at 12 months were below reference values, patients were allocated to the physical non-recovery (NR) group. Significantly different baseline and (post-)ICU-characteristics were assessed for correlations with physical recovery at 12 months post-ICU. Of 250 patients, 110 (44%) fulfilled the criteria for the NR-group. Neither the severity of ...
32nd Annual Congress of the European Society of Intensive Care Medicine (ESICM LIVES 2019), 2019
Critical Care Research and Practice, 2019
Introduction. Delirium during ICU stay is a widespread problem with complex aetiology. A premorbi... more Introduction. Delirium during ICU stay is a widespread problem with complex aetiology. A premorbid psychiatric disorder has been associated with an increased incidence of delirium in the general hospital population, but data on the impact of ICU delirium and consequences for morbidity and long-term mortality remain scarce. Methods. In this single-centre retrospective analysis, 472 patients with an ICU stay >48 hours were included during a 2-year period. Postresuscitation and neurosurgical patients were not included. The primary aim of the study was to establish the incidence and duration of delirium during ICU stay in patients with (PS group) and without (NPS group) a premorbid psychiatric disorder. Data were analysed with applicable nonparametric tests. In a secondary analysis, patients were compared according to the presence or absence of delirium. Finally, a binary logistic regression model was constructed to correct for potential confounders. Results. Of all patients, 19.7% w...
Intensive Care Medicine, 2016
Annals of intensive care, 2016
Before discharging a patient from the ICU, an adequate patient evaluation is needed to detect ind... more Before discharging a patient from the ICU, an adequate patient evaluation is needed to detect individuals as high risk for unfavorable outcome. A pro- or anti-inflammatory status is a potential risk factor for an adverse outcome, and elevated CRP concentrations have shown to correlate with organ failure. Several studies have been performed to evaluate the use of CRP as a marker of post-ICU prognosis. Results are seemingly conflicting, and it is worthwhile to investigate these markers further as CRP is an adequate marker of pro- and anti-inflammatory status of the patient. We aimed to test the hypothesis that elevated CRP levels at ICU discharge are associated with an increased risk of ICU readmission and in-hospital mortality in patients with a prolonged ICU stay. A retrospective cohort study was performed in a single-center hospital with an 18-bed mixed medical/surgical ICU. Patients discharged alive from the ICU with at least 48-h ICU length of stay were evaluated. Patients were d...
The Netherlands journal of medicine, 2007
Long-term treatment with minocycline is occasionally associated with the development of black thy... more Long-term treatment with minocycline is occasionally associated with the development of black thyroid syndrome in which thyroid cancer is frequently found. Here, we report a patient with cutaneous, pulmonary and thyroid sarcoidosis who developed papillary thyroid carcinoma in the presence of a black thyroid syndrome after being treated with minocycline for 2.5 years.
Intensive Care Medicine Experimental, 2015
Annals of Pharmacotherapy, 2011
To describe a case of a patient who became comatose after taking an overdose of duloxetine, a ser... more To describe a case of a patient who became comatose after taking an overdose of duloxetine, a serotonin-norepinephrine reuptake inhibitor. A 49-year-old male ingested an overdose of duloxetine approximately 2 hours before presentation to the emergency department. On arrival he was drowsy, but easily awakened and oriented, with Glasgow Coma Score 14 (eyes 3, motor 6, verbal 5). Immediately after admission, charcoal and magnesium sulfate were given to prevent further systemic absorption of medication through the gastrointestinal tract. No gastric lavage was performed. Six hours after drug intake the patient became unconscious (Glasgow Coma Score 7, eyes 2, motor 4, verbal 1). Full toxicologic screening showed a toxic duloxetine plasma concentration of 0.86 mg/L. The patient was admitted to the intensive care unit (ICU) and, on arrival, urinary retention was noted. During ICU admission the patient remained hemodynamically stable; approximately 12 hours after ingestion of duloxetine, he regained consciousness. Over the next 3 days the urinary output decreased to 60 mL/day. After 4 days patient was discharged without any remaining symptoms. Based on repeated plasma duloxetine serum concentration determinations, a plasma half-life of duloxetine was calculated to be 18 hours (reference range 9-19). The Naranjo probability scale suggested that duloxetine was the probable cause for the symptoms described. Overdose with duloxetine can induce coma several hours after intake, with a fast reversal in our case.
Annals of intensive care, 2016
Before discharging a patient from the ICU, an adequate patient evaluation is needed to detect ind... more Before discharging a patient from the ICU, an adequate patient evaluation is needed to detect individuals as high risk for unfavorable outcome. A pro- or anti-inflammatory status is a potential risk factor for an adverse outcome, and elevated CRP concentrations have shown to correlate with organ failure. Several studies have been performed to evaluate the use of CRP as a marker of post-ICU prognosis. Results are seemingly conflicting, and it is worthwhile to investigate these markers further as CRP is an adequate marker of pro- and anti-inflammatory status of the patient. We aimed to test the hypothesis that elevated CRP levels at ICU discharge are associated with an increased risk of ICU readmission and in-hospital mortality in patients with a prolonged ICU stay. A retrospective cohort study was performed in a single-center hospital with an 18-bed mixed medical/surgical ICU. Patients discharged alive from the ICU with at least 48-h ICU length of stay were evaluated. Patients were d...
Critical Care, Feb 1, 2012
PLOS ONE
Post-intensive care unit (ICU) sequelae, including physical and mental health problems, are relat... more Post-intensive care unit (ICU) sequelae, including physical and mental health problems, are relatively unexplored. Characteristics commonly used to predict outcome lack prognostic value when it comes to long-term physical recovery. Therefore, the objective of this study was to assess the incidence of non-recovery in long-stay ICU-patients. In this single-centre study, retrospective data of adults with an ICU stay >48 hours who visited the specialized post-ICU clinic, and completed the Dutch RAND 36-item Short Form questionnaire at 3 and 12 months post-ICU, were retrieved from electronic patient records. In cases where physical functioning scores at 12 months were below reference values, patients were allocated to the physical non-recovery (NR) group. Significantly different baseline and (post-)ICU-characteristics were assessed for correlations with physical recovery at 12 months post-ICU. Of 250 patients, 110 (44%) fulfilled the criteria for the NR-group. Neither the severity of ...
32nd Annual Congress of the European Society of Intensive Care Medicine (ESICM LIVES 2019), 2019
Critical Care Research and Practice, 2019
Introduction. Delirium during ICU stay is a widespread problem with complex aetiology. A premorbi... more Introduction. Delirium during ICU stay is a widespread problem with complex aetiology. A premorbid psychiatric disorder has been associated with an increased incidence of delirium in the general hospital population, but data on the impact of ICU delirium and consequences for morbidity and long-term mortality remain scarce. Methods. In this single-centre retrospective analysis, 472 patients with an ICU stay >48 hours were included during a 2-year period. Postresuscitation and neurosurgical patients were not included. The primary aim of the study was to establish the incidence and duration of delirium during ICU stay in patients with (PS group) and without (NPS group) a premorbid psychiatric disorder. Data were analysed with applicable nonparametric tests. In a secondary analysis, patients were compared according to the presence or absence of delirium. Finally, a binary logistic regression model was constructed to correct for potential confounders. Results. Of all patients, 19.7% w...
Intensive Care Medicine, 2016
Annals of intensive care, 2016
Before discharging a patient from the ICU, an adequate patient evaluation is needed to detect ind... more Before discharging a patient from the ICU, an adequate patient evaluation is needed to detect individuals as high risk for unfavorable outcome. A pro- or anti-inflammatory status is a potential risk factor for an adverse outcome, and elevated CRP concentrations have shown to correlate with organ failure. Several studies have been performed to evaluate the use of CRP as a marker of post-ICU prognosis. Results are seemingly conflicting, and it is worthwhile to investigate these markers further as CRP is an adequate marker of pro- and anti-inflammatory status of the patient. We aimed to test the hypothesis that elevated CRP levels at ICU discharge are associated with an increased risk of ICU readmission and in-hospital mortality in patients with a prolonged ICU stay. A retrospective cohort study was performed in a single-center hospital with an 18-bed mixed medical/surgical ICU. Patients discharged alive from the ICU with at least 48-h ICU length of stay were evaluated. Patients were d...
The Netherlands journal of medicine, 2007
Long-term treatment with minocycline is occasionally associated with the development of black thy... more Long-term treatment with minocycline is occasionally associated with the development of black thyroid syndrome in which thyroid cancer is frequently found. Here, we report a patient with cutaneous, pulmonary and thyroid sarcoidosis who developed papillary thyroid carcinoma in the presence of a black thyroid syndrome after being treated with minocycline for 2.5 years.
Intensive Care Medicine Experimental, 2015
Annals of Pharmacotherapy, 2011
To describe a case of a patient who became comatose after taking an overdose of duloxetine, a ser... more To describe a case of a patient who became comatose after taking an overdose of duloxetine, a serotonin-norepinephrine reuptake inhibitor. A 49-year-old male ingested an overdose of duloxetine approximately 2 hours before presentation to the emergency department. On arrival he was drowsy, but easily awakened and oriented, with Glasgow Coma Score 14 (eyes 3, motor 6, verbal 5). Immediately after admission, charcoal and magnesium sulfate were given to prevent further systemic absorption of medication through the gastrointestinal tract. No gastric lavage was performed. Six hours after drug intake the patient became unconscious (Glasgow Coma Score 7, eyes 2, motor 4, verbal 1). Full toxicologic screening showed a toxic duloxetine plasma concentration of 0.86 mg/L. The patient was admitted to the intensive care unit (ICU) and, on arrival, urinary retention was noted. During ICU admission the patient remained hemodynamically stable; approximately 12 hours after ingestion of duloxetine, he regained consciousness. Over the next 3 days the urinary output decreased to 60 mL/day. After 4 days patient was discharged without any remaining symptoms. Based on repeated plasma duloxetine serum concentration determinations, a plasma half-life of duloxetine was calculated to be 18 hours (reference range 9-19). The Naranjo probability scale suggested that duloxetine was the probable cause for the symptoms described. Overdose with duloxetine can induce coma several hours after intake, with a fast reversal in our case.
Annals of intensive care, 2016
Before discharging a patient from the ICU, an adequate patient evaluation is needed to detect ind... more Before discharging a patient from the ICU, an adequate patient evaluation is needed to detect individuals as high risk for unfavorable outcome. A pro- or anti-inflammatory status is a potential risk factor for an adverse outcome, and elevated CRP concentrations have shown to correlate with organ failure. Several studies have been performed to evaluate the use of CRP as a marker of post-ICU prognosis. Results are seemingly conflicting, and it is worthwhile to investigate these markers further as CRP is an adequate marker of pro- and anti-inflammatory status of the patient. We aimed to test the hypothesis that elevated CRP levels at ICU discharge are associated with an increased risk of ICU readmission and in-hospital mortality in patients with a prolonged ICU stay. A retrospective cohort study was performed in a single-center hospital with an 18-bed mixed medical/surgical ICU. Patients discharged alive from the ICU with at least 48-h ICU length of stay were evaluated. Patients were d...