Jan J De Waele

..Theories relating inter-relations between prone positioning and the abdominal condition are presented to aid in designing these studies...

..Surgical decompression through a midline laparotomy or decompressive laparotomy remains the sole definite therapy for ACS, but the effect of decompressive laparotomy has not been studied in large patient series...

..Better risk stratification methods should improve the design of future trials, so that only patients with a high probability of complications can be studied...

..To introduce a new scoring system based on signs of systemic inflammation on computed tomography (CT) [ExtraPancreatic Inflammation on CT (EPIC) score] and evaluate this score as an early prognostic tool...

..To compare intra-abdominal pressure (IAP) measurements obtained from an intragastric Compliance catheter with the pressure measured directly in the abdominal cavity...

..This study aimed to analyse the incidence of relative adrenal insufficiency (RAI) in these patients, to identify factors associated with RAI and to describe how adrenal responsiveness affects outcome...

..When infection occurs, source control using either surgical or percutaneous drainage techniques, is essential to avoid systemic complications...

..Three reference levels were studied: the symphysis pubis; the phlebostatic axis; and the midaxillary line at the level of the iliac crest...

..Blood stream infections (BSI) of abdominal origin are associated with a high mortality rate. We hypothesized that both patient and microbiological factors determine death in critically ill patients who develop such infections...

..The purpose of this review is to address the role of early source control in the management of patients with severe sepsis...

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..Fungal infections are often present, and antifungal coverage should be considered, especially if multiple risk factors for invasive candidiasis are present. Currently, no tools are available to guide antimicrobial treatment...

..Interpretation of the results and comparison of these studies is difficult, because of incomplete and inconsistent reporting of data and statistics...

..The objective was to determine the minimum volume of instillation fluid for intra-abdominal pressure (IAP) measurement, and to evaluate the effect of instillation volume on transvesically measured IAP...

..De-escalation of antimicrobial therapy is often advocated to reduce the use of broad-spectrum antibiotics in critically ill patients. However, little data are available on the application of this strategy in daily clinical practice...

..IAH prevention, most importantly during abdominal surgery but also during fluid resuscitation, may avoid ACS altogether. However, when ACS occurs and medical treatment fails, decompressive laparotomy is the only option...

..To analyze the incidence and outcome of bloodstream infections (BSIs) in patients operated on for severe acute pancreatitis to identify the source and associated risk factors...

..Overall, the use of antibiotics in the treatment of patients with severe acute pancreatitis has increased owing to the use of antibiotic prophylaxis...

..Currently, no tools are available to guide antimicrobial treatment. Antibiotic use is only effective if proper source control has been established...

..The clinical course was protracted, but the patient survived and was discharged from the hospital...

..Mesh-mediated vacuum-assisted wound closure is emerging as one of the most promising approaches for OAT. In the intensive care unit, continued attention to IAH/ACS and measures to prevent or treat these conditions is imperative...

..The aim of this study was to analyze the characteristics of patients requiring abdominal decompression, to describe the methods used for TAC, and to study the outcome of these patients...

..We describe three patients with severe acute pancreatitis who developed signs suggestive of adrenal insufficiency during the early phase of the disease. Clinical features and possible causes of adrenal insufficiency are discussed...

..We therefore studied patient factors associated with the development of intra-abdominal hypertension (IAH), the incidence of organ failure associated with IAH, and the effect on outcome in patients with severe acute pancreatitis (SAP)...

..Early treatment with fluconazole seems to prevent fungal infection in these high-risk patients...

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..We evaluate clinical and economic outcomes associated with nosocomial central venous catheter-related bloodstream infection (CR-BSI) in intensive care unit (ICU) patients...

..We found that infection with an antimicrobial-resistant organism did not adversely affect clinical outcome in this specific cohort, which already has a high mortality rate...

..Therefore, we investigated the occurrence of infection in a cohort of critically ill patients with ARF treated with renal replacement therapy (RRT). In addition, we assessed whether this infection worsened outcome...

..In general, antimicrobial therapy should be continued for 5-7 days. If sepsis is still present after 1 week, a diagnostic work up should be performed, and if necessary a surgical reintervention should be considered...

..The recent developed radiological scoring systems based on signs of systemic inflammatory response syndrome and organ dysfunction are promising in prediction of severity early after onset of AP...

..The review highlights current insights in the epidemiology, diagnosis and therapy of Candida peritonitis, focusing on complicated secondary and tertiary peritonitis...

..However, few data are available describing this effect and its relationship with outcomes in specific subgroups of ICU patients...

..To determine the minimal instillation volume at which an intra-abdominal pressure (IAP) curve can be obtained and to compare this with the IAP measured at 20 ml instilled volume...

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..The aim of this study was to compare the efficacy and adverse effects of a single dose of sodium bicarbonate and THAM in intensive care unit (ICU) patients with mild metabolic acidosis...

..Because of the significant morbidity associated with surgical decompression and the management of the ensuing open abdomen, more research is needed to define better the appropriate indications and techniques for surgical intervention...

..No intraabdominal abnormalities were found at operation. Both patients had a protracted clinical course, but they survived and were discharged from the hospital...

..The objective was to prospectively study the effect of neuromuscular blockers on intra-abdominal pressure (IAP) and a number of physiological variables in patients with increased IAP...

..Taking into account that our patients over the past 20 years have been progressively less extensively burned and hence have a lesser at risk for death, survival following severe burns has continued to improve...

..To report an unusual case of abdominal compartment syndrome (ACS) following endovascular repair of a ruptured abdominal aortic aneurysm (rAAA) that had been treated with a stent-graft 3 years prior...

..The aim of this study was to evaluate whether serum urea concentration or different serum urea concentration cutoffs as recommended in the literature were associated with in-hospital mortality at time of initiation of RRT for AKI...

..The aim of this study was to evaluate the use of sodium bicarbonate for prevention of CI-AKI...

..For patients in whom the source can be adequately controlled, antimicrobial therapy should be restricted to a short course (e.g. 3-7 days in peritonitis)...

..These factors contribute to a dysregulated inflammatory response and decreased immunity, and interfere with normal function of many organs. ACF may play an important role in the etiology of multiple organ dysfunction...