References of "Kolh, Philippe"
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See detailPredictors of Mortality after Endovascular Repair of the Thoracic Descending Aorta - The Preliminary New Zealand Experience.
Kolh, Philippe ULiege

in European Journal of Vascular and Endovascular Surgery (2009), 37(2), 166-167

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See detailUnique parameter identification for model-based cardiac diagnosis in critical care
Hann, C. E.; Chase, J. G.; Desaive, Thomas ULiege et al

in IFAC Proceedings Volumes (IFAC-PapersOnline) (2009), 7(PART 1), 169-174

Lumped parameter approaches for modeling the cardiovascular system typically have many parameters of which many are not identifiable. The conventional approach is to only identify a small subset of ... [more ▼]

Lumped parameter approaches for modeling the cardiovascular system typically have many parameters of which many are not identifiable. The conventional approach is to only identify a small subset of parameters to match measured data, and to set the remaining parameters at population values. These values are often based on animal data or the "average human" response. The problem, is that setting many parameters at nominal fixed values, may introduce dynamics that are not present in a specific patient. As parameter numbers and model complexity increase, more clinical data is required for validation and the model limitations are harder to quantify. This paper considers the modeling and the parameter identification simultaneously, and creates models that are one to one with the measurements. That is, every input parameter into the model is uniquely optimized to capture the clinical data and no parameters are set at population values. The result is a geometrical characterization of a previously developed six chamber heart model, and a completely patient specific approach to cardiac diagnosis in critical care. In addition, simplified sub-structures of the six chamber model are created to provide very fast and accurate parameter identification from arbitrary starting points and with no prior knowledge on the parameters. Furthermore, by utilizing continuous information from the arterial/pulmonary pressure waveforms and the end-diastolic time, it is shown that only the stroke volumes of the ventricles are required for adequate cardiac diagnosis. This reduced data set is more practical for an intensive care unit as the maximum and minimum volumes are no longer needed, which was a requirement in prior work. The simplified models can also act as a bridge to identifying more sophisticated cardiac models, by providing a generating set of waveforms that the complex models can match to. Most importantly, this approach does not have any predefined assumptions on patient dynamics other than the basic model structure, and is thus suitable for improving cardiovascular management in critical care by optimizing therapy for individual patients. © 2009 IFAC. [less ▲]

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See detailRobust parameter identification for model-based cardiac diagnosis in critical care
Hann, C. E.; Chase, J. C.; Desaive, Thomas ULiege et al

in Proceedings of the 6th IFAC Symposium on Modeling and Control in Biomedical Systems (MCBMS09) (2009)

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See detailPatient specific model of the cardiovascular system during septic shock
Desaive, Thomas ULiege; Chase, J. G.; Lambermont, Bernard ULiege et al

in Intensive Care Medicine (2009), 35(suppl. 1), 80

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See detailModel-based therapeutics for the cardiovascular system - a clinical focus
Hann, C. E.; Chase, J. G.; Desaive, Thomas ULiege et al

in 6th IFAC Symposium on Modeling and Control in Biomedical Systems (MCBMS09) (2009)

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See detailGuideline for resuscitation in cardiac arrest after cardiac surgery.
Dunning, Joel; Fabbri, Alessandro; Kolh, Philippe ULiege et al

in European Journal of Cardio - Thoracic Surgery (2009), 36(1), 3-28

The Clinical Guidelines Committee of the European Association for Cardio-Thoracic Surgery provides this professional view on resuscitation in cardiac arrest after cardiac surgery. This document was ... [more ▼]

The Clinical Guidelines Committee of the European Association for Cardio-Thoracic Surgery provides this professional view on resuscitation in cardiac arrest after cardiac surgery. This document was created using a multimodal methodology for evidence generation including the extrapolation of existing guidelines from the International Liaison Committee on Resuscitation where possible, our own structured literature reviews on issues particular to cardiac surgery, an international survey on resuscitation hosted by CTSNet and manikin simulations of potential protocols. This protocol differs from existing generic guidelines in a number of areas, the most import of which are the following: successful treatment of cardiac arrest after cardiac surgery is a multi-practitioner activity with six key roles that should be allocated and rehearsed on a regular basis; in ventricular fibrillation, three sequential attempts at defibrillation (where immediately available) should precede external cardiac massage; in asystole or extreme bradycardia, pacing (where immediately available) should precede external cardiac massage; where the above measures fail, and in pulseless electrical activity, early resternotomy is advocated; adrenaline should not be routinely given; protocols for excluding reversible airway and breathing complications and for safe emergency resternotomy are given. This guideline is subject to continuous informal review, and when new evidence becomes available. [less ▲]

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See detailAppropriate myocardial revascularization: a joint viewpoint from an interventional cardiologist and a cardiac surgeon.
Wijns, William; Kolh, Philippe ULiege

in European Heart Journal (2009), 30(18), 2182-5

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See detailHaemodynamic properties of a distal Y-shaped arterial autograft bypass-flap in a porcine model: changes from elastic to viscoelastic mechanical behaviour?
Kolh, Philippe ULiege

in European Journal of Vascular and Endovascular Surgery (2009), 37(1), 85-6

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See detailRenal insufficiency after cardiac surgery: a challenging clinical problem.
Kolh, Philippe ULiege

in European Heart Journal (2009), 30(15), 1824-7

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See detailActualisation du Résumé Infirmier Minimum en Belgique, du concept à l’implémentation.
THONON, Olivier ULiege; VAN DEN HEEDE, Koen; GILLAIN, Daniel ULiege et al

in Actes de la 4ème conférence francophone en Gestion et Ingénierie des SystèmEs Hospitaliers - GISEH (2008, September)

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See detailEffective arterial elastance as an index of pulmonary vascular load.
Morimont, Philippe ULiege; Lambermont, Bernard ULiege; Ghuysen, Alexandre ULiege et al

in American Journal of Physiology - Heart and Circulatory Physiology (2008), 294(6), 2736-42

The aim of this study was to test whether the simple ratio of right ventricular (RV) end-systolic pressure (Pes) to stroke volume (SV), known as the effective arterial elastance (Ea), provides a valid ... [more ▼]

The aim of this study was to test whether the simple ratio of right ventricular (RV) end-systolic pressure (Pes) to stroke volume (SV), known as the effective arterial elastance (Ea), provides a valid assessment of pulmonary arterial load in case of pulmonary embolism- or endotoxin-induced pulmonary hypertension. Ventricular pressure-volume (PV) data (obtained with conductance catheters) and invasive pulmonary arterial pressure and flow waveforms were simultaneously recorded in two groups of six pure Pietran pigs, submitted either to pulmonary embolism (group A) or endotoxic shock (group B). Measurements were obtained at baseline and each 30 min after injection of autologous blood clots (0.3 g/kg) in the superior vena cava in group A and after endotoxin infusion in group B. Two methods of calculation of pulmonary arterial load were compared. On one hand, Ea provided by using three-element windkessel model (WK) of the pulmonary arterial system [Ea(WK)] was referred to as standard computation. On the other hand, similar to the systemic circulation, Ea was assessed as the ratio of RV Pes to SV [Ea(PV) = Pes/SV]. In both groups, although the correlation between Ea(PV) and Ea(WK) was excellent over a broad range of altered conditions, Ea(PV) systematically overestimated Ea(WK). This offset disappeared when left atrial pressure (Pla) was incorporated into Ea [Ea * (PV) = (Pes - Pla)/SV]. Thus Ea * (PV), defined as the ratio of RV Pes minus Pla to SV, provides a convenient, useful, and simple method to assess the pulmonary arterial load and its impact on the RV function. [less ▲]

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See detailSurgical correction of ischaemic mitral regurgitation - still a long way to go
Kolh, Philippe ULiege

in European Heart Journal (2008), 29

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See detailOpen surgery for abdominal aortic aneurysm or aorto-iliac occlusive disease--clinical and ultrasonographic long-term results.
Fontaine, Robert ULiege; Kolh, Philippe ULiege; Creemers, Etienne ULiege et al

in Acta Chirurgica Belgica (2008), 108(4), 393-9

OBJECTIVE: To determine postoperative and long-term outcome and assess the relevance of abdominal ultrasound (US) after surgery for abdominal aortic aneurysm (AAA) or aortoiliac occlusive disease (AIOD ... [more ▼]

OBJECTIVE: To determine postoperative and long-term outcome and assess the relevance of abdominal ultrasound (US) after surgery for abdominal aortic aneurysm (AAA) or aortoiliac occlusive disease (AIOD). METHODS: Records of 1704 consecutive patients having graft implantation from 1988 to 2000, either for AAA (n = 1144) or for AIOD (n = 560), were reviewed. In 2006, follow-up was 9180 patients-years for the AAA group and 5450 patients-years for the AIOD group. Among 1006 alive patients, 377 were invited randomly for US and clinical examination. RESULTS: Hospital death occurred in 99 patients (8.6%) of the AAA group (53% in ruptured and 2% in elective AAA), and in 18 patients of the AIOD group (3.2%). There were 581 late deaths, including eight due to prosthesis infection, one to pseudo-aneurysm rupture, and one to graft thrombosis (0.6% graft-related mortality). Prosthesis thrombosis occurred in 32 patients (26 in AIOD group, p < 0.001), and graft infection in 26 (17 in AAA group, p < 0.01). Pseudoaneurysms developed in 90 patients (68 in AIOD group, p < 0.001), including eight at the proximal aortic, one at the distal aortic, two at the iliac and 79 at the femoral anastomosis. In the AAA group only, surgery was required for a new thoraco-abdominal and pararenal aneurysm in eight and four patients, respectively, while US evidenced a 26-35 and a 36-50 mm supraanastomotic aortic dilatation in 65 (32%) and in 14 (7%) patients, at a mean follow-up of 10.5 and 9.3 years, respectively. CONCLUSION: Long-term results are good after open surgery for AAA or AIOD. Prosthesis infection and anastomotic pseudo-aneurysm are the main causes of graft-related mortality and morbidity, respectively. Because of high incidence of asymptomatic supraanastomotic aortic dilatation, all patients with a history of AAA repair should have regular abdominal US. [less ▲]

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See detailDéfinition d'un système de financement de l'hôpital de jour gériatrique (Health Services Research)
Gillain, Daniel ULiege; Velghe, Anja; Boman, Xavier et al

Report (2008)

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See detailModel-based diagnosis of acute pulmonary embolism - results from a porcine model
Desaive, Thomas ULiege; Ghuysen, Alexandre ULiege; Kolh, Philippe ULiege et al

in Intensive Care Medicine (2008), 34(suppl. 1), 78

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See detailGuidelines for quality improvement in cardiac surgery. The College of Cardiac Surgery : results of the 2007 survey.
De Smet, J. M.; Kolh, Philippe ULiege; Van Kerrebroeck, Chr et al

in Acta Chirurgica Belgica (2008), 108(6), 638-44

Optimal delivery of health care is a common goal of individual physicians, professional organizations, hospital structures and governmental authorities. A growing concern has emerged from the public ... [more ▼]

Optimal delivery of health care is a common goal of individual physicians, professional organizations, hospital structures and governmental authorities. A growing concern has emerged from the public, media and third payer organizations concerning the quality of care and the amount of resources spending. In the United States, large databases, guidelines and performance evaluation have been elaborated by medical societies, particularly in the area of cardiac surgery. These tools are useful for improvement of patients' care, resources distribution, pay for performance and public and practitioners' awareness. The evaluation of quality is based on composite models combining structure, process and outcome indices. However, pitfalls such as patients' selection, and risk avoidance in order to improve results must been prevented by adjustment of the treated populations' risk factors by specific scores. The Belgian Health authorities have built a structure directed at delivery of care improvement based on "Care Programs", monitored by Colleges formed by delegates of professional organizations. The College of Cardiac Surgery has promoted several studies aimed at data collection and evaluation. In 2007, a survey was addressed to all the Belgian Cardiac surgeons to define their opinion as to the best indicators of care in their specialty. These results will serve to define further avenues of research. By maintaining the responsibility of care evaluation in the hands of the involved professionals, this kind of cooperation between governmental and physicians' organizations seems to serve the best interests of the public and the practitioners. [less ▲]

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See detailModel-based identification and diagnosis of a porcine model of induced endotoxic shock with hemofiltration
Starfinger, C.; Chase, J. G.; Hann, C. E. et al

in Mathematical Biosciences (2008), 216(2), 132-139

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See detailAlteration of Right Ventricular-Pulmonary Vascular Coupling in a Porcine Model of Progressive Pressure Overloading
Ghuysen, Alexandre ULiege; Lambermont, Bernard ULiege; Kolh, Philippe ULiege et al

in Shock (Augusta, Ga.) (2008), 29(2), 197-204

In acute pulmonary embolism, right ventricular (RV) failure may result from exceeding myocardial contractile resources with respect to the state of vascular afterload. We investigated the adaptation of RV ... [more ▼]

In acute pulmonary embolism, right ventricular (RV) failure may result from exceeding myocardial contractile resources with respect to the state of vascular afterload. We investigated the adaptation of RV performance in a porcine model of progressive pulmonary embolism. Twelve anesthetized pigs were randomly divided into two groups: gradual pulmonary arterial pressure increases by three injections of autologous blood clot (n = 6) or sham-operated controls (n = 6). Right ventricular pressure-volume (PV) loops were recorded using a conductance catheter. Right ventricular contractility was estimated by the slope of the end-systolic PV relationship (Ees). Afterload was referred to as pulmonary arterial elastance (Ea) and assessed using a four-element Windkessel model. Right ventricular-arterial coupling (Ees/Ea) and efficiency of energy transfer (from PV area to external mechanical work [stroke work]) were assessed at baseline and every 30 min for 4 h. Eaincreased progressively after embolization, from 0.26 +/- 0.04 to 2.2 +/- 0.7 mmHg mL (P < 0.05). Ees increased from 1.01 +/-0.07 to 2.35 +/- 0.27 mmHg mL (P < 0.05) after the first two injections but failed to increase any further. As a result, Ees/Ea initially decreased to values associated with optimal SW, but the last injection was responsible for Ees/Ea values less than 1, decreased stroke volume, and RV dilation. Stroke work/PV area consistently decreased with each injection from 79% +/- 3% to 39% +/- 11% (P < 0.05). In response to gradual increases in afterload, RV contractility reserve was recruited to a point of optimal coupling but submaximal efficiency. Further afterload increases led to RV-vascular uncoupling and failure. [less ▲]

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