Biomedical subjects

Jan-Melle van Dantzig

Publications and source records attributed to Jan-Melle van Dantzig.

3 recordsLinked to original sources

PubMed2006

Peritoneal dialysis in patients with congestive heart failure.

BACKGROUND: Peritoneal dialysis (PD) may be a useful technique in the treatment of patients with congestive heart failure, both with and without primary end-stage renal disease (ESRD). METHODS: In the treatment of patients with ESRD and congestive heart failure (CHF), PD has theoretical advantages compared with haemodialysis (HD), such as the absence of an arteriovenous fistula and the more gradual fluid removal. In cohort studies, the incidence of heart failure was less as compared with HD, however, randomized studies on this aspect are lacking. RESULTS: As an acute rescue treatment of patients with treatment refractory heart failure, functional improvement has been observed with the use of PD. However, fluid removal is less predictable compared with continuous haemofiltration therapies. CONCLUSIONS: As a long-term option for patients with treatment refractory CHF without ESRD, various case series showed improved functional performance and a reduction in hospitalization with the use of PD. However, also with the use of PD, median survival is still limited in these patients. Randomized studies are needed to establish the potential role of PD for this indication.

Heart Failure↗

PubMed2006

Quantification in echocardiography.

Until recently, more than 2200 Swan Ganz catheters were used annually in the operating rooms (OR) and intensive care unit (ICU) of the Catharina Hospital in Eindhoven, The Netherlands. After cardiologists who were specialists in echocardiography (ECHO) trained anesthesiologists in ECHO, the need for these catheters in cardiac and noncardiac surgery was reduced. Initially intended as a local teaching project, an ECHO teaching compact disk (CD) was produced during the training and distributed later worldwide, thanks to a positive review in a major anesthesiology publication. By reducing the number of Swan Ganz catheters, the hospital could finance and acquire two echocardiography machines for the OR and ICU. The availability of these machines resulted in a further reduction of the number of Swan Ganz catheters. However, the need for quantification (eg, measurements of cardiac output) remained. During the creation of the ECHO teaching CD, the idea was born to apply indicator-dilution principles on injected echo contrast. This study was performed in cooperation with the Signal Processing Department of the Eindhoven University of Technology. Advanced signal processing and modelling were used to develop algorithms to enable quantification of intrapulmonary blood volume, ejection-fraction, and flow from the transesophageal echocardiography approach. These quantitative measurements, which can be performed on an outpatient basis, may become a real asset in cardiology, anesthesiology, and intensive care.

Algorithms↗

PubMed2004

Left ventricular pressure-volume measurements in mice: comparison of closed-chest versus open-chest approach.

OBJECTIVE: We investigated whether in vivo closed-chest left ventricular pressure-volume measurements would yield similar values for LV hemodynamics compared with open-chest PV measurements under several anesthetics. METHODS: The right common carotid of C57Bl/6 mice was cannulated with a combined pressure-conductance catheter and inserted retrogradely into the left ventricle in the closed-chest model. The open-chest model consisted of an abdominal approach involving the opening of the thoracic cavity by transverse opening of the diaphragm and ventricular catheterization by apical stab. Measurements were performed under urethane or pentobarbital intraperitoneal injection anesthesia. RESULTS: Cardiac function in the open-chest model was characterized by larger ejection fraction and stroke volume with a leftward shift in ventricular volume compared to the closed-chest model. Further observed characteristics include low end-systolic pressure and arterial-ventricular coupling mismatch in the open-chest model. Arrhythmias were not detected in either model. CONCLUSION: Murine cardiac function determination via open-chest or closed-chest protocols is sensitive, reproducible and comparable. The choice for open- or closed-chest pressure-volume measurements in mice depends on the aims of the study.

Animals↗