Paul W. G. Elbers

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Over 30 years ago Weil and Shubin proposed a re-classification of shock states and identified hypovolemic, cardiogenic, obstructive and distributive shock. The first three categories have in common that they are associated with a fall in cardiac output. Distributive shock, such as occurs during sepsis and septic shock, however, is associated with an(More)
The purpose of this study was to develop a rapid and fully automatic method for the assessment of microvascular density and perfusion in sidestream dark field (SDF) images. We modified algorithms previously developed by our group for microvascular density assessment and introduced a new method for microvascular perfusion assessment. To validate the new(More)
n engl j med 370;12 nejm.org march 20, 2014 1172 These findings have implications from both regulatory and safety perspectives. First, it is clear that many approvals for the addition of phenylephrine to any number of analgesic agents were based on assumptions that were incorrect for acetaminophen. Second, the plasma exposure of phenylephrine combined with(More)
INTRODUCTION Measurement of energy expenditure (EE) is recommended to guide nutrition in critically ill patients. Availability of a gold standard indirect calorimetry is limited, and continuous measurement is unfeasible. Equations used to predict EE are inaccurate. The purpose of this study was to provide proof of concept that EE can be accurately assessed(More)
INTRODUCTION Tight glycemic control (TGC) after ischemic stroke may improve clinical outcome but previous studies failed to establish TGC, principally because of postprandial glucose surges. The aim of the present study was to investigate if safe, effective and feasible TGC can be achieved with continuous tube feeding and a computerized treatment protocol.(More)
When we first considered creating a second edition of Stewart’s classic “How to Understand Acid-Base” our motivation was solely to improve its accessibility to a growing number of readers. However, as we began to plan for this edition we became increasingly interested in what made the original text so popular and at the same time why it produced such(More)
OBJECTIVES It has become possible to image the human microcirculation at the bedside using sidestream dark field (SDF) imaging. This may help the clinician when correlation between global and microvascular hemodynamics may not be straightforward. Ketanserin, a serotonin and alpha-1 adrenoceptor antagonist, is used in some countries to treat elevated blood(More)
n engl j med 360;7 nejm.org february 12, 2009 e9 A 51-year-old woman presented with a 3-month history of fatigue and a 2-week history of a nonproductive cough and night sweats. Chronic myeloid leukemia was diagnosed, with a leukocyte count of 398,000 per cubic millimeter. On the basis of suspected leukostasis, sidestream dark-field (SDF) imaging was(More)
Dear Editor, Ventilator-dependent patients in the intensive care unit (ICU) experience difficulties with communication, mainly due to intubation. Tube placement between the vocal cords induces loss of speech and concomitant communication problems, creating severe negative emotional reactions [1]. The magnitude of the problem is increasing as there is a(More)
INTRODUCTION The Intra-Aortic Balloon Pump (IABP) is frequently used to mechanically support the heart. There is evidence that IABP improves microvascular flow during cardiogenic shock but its influence on the human microcirculation in patients deemed ready for discontinuing IABP support has not yet been studied. Therefore we used sidestream dark field(More)