References of "Kolh, Philippe"
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See detailAlteration of Right Ventricular-Pulmonary Vascular Coupling in a Porcine Model of Progressive Pressure Overloading
Ghuysen, Alexandre ULg; Lambermont, Bernard ULg; Kolh, Philippe ULg 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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See detailModel-based detection of pulmonary embolism using an extended physiologically relevant, cardiovascular model
Kok, K.; Starfinger, C.; Hann, C. E. et al

in Proceedings of Engineering & Physical Sciences in Medicine and Australian Biomedical Engineering Conference (EPSM ABEC 2008) (2008)

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See detailMaking sense of the Chaos: Model-based CVS monitoring and decision support in critical care
Shaw, G. M.; Chase, J. G.; Hann, C. E. et al

in Proceedings of the NZ Physiological Society 2008 Medical Science Congress (MedSci 2008) (2008)

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See detailModel-based analysis of induced endotoxic shock in pigs with and without hemofiltration,
Kok, K.; Starfinger, C.; Hann, C. E. et al

in Prodeedings of the Engineering & Physical Sciences in Medicine and Australian Biomedical Engineering Conference (EPSM ABEC 2008 (2008)

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See detailDetection of Adverse Events in Administrative Data
Gillet, Pierre ULg; Kolh, Philippe ULg; Sermeus, W. et al

Report (2008)

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See detailQuality of life after abdominal aortic aneurysm repair: similar long-term results with endovascular and open techniques.
Kolh, Philippe ULg

in European Journal of Vascular and Endovascular Surgery (2008), 36(3), 290-1

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See detailImproving model-based cardiac diagnosis with an ECG
Hann, C. E.; Chase, J. G.; Desaive, Thomas ULg et al

in Proceedings (CD) of the 4th European Congress for Medical and Biomedical Engineering (eMBEC 2008), Antwerp, Belgium, Nov 23-27, 2008 (2008)

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See detailModel-Based Assessment of Right Ventricular Arterial Coupling During Septic Shock – Results With a Porcine Model
Desaive, Thomas ULg; Lambermont, Bernard ULg; Janssen, N. et al

in Proceedings of the 21st European Society of Intensive Care Medicine (ESICM) Annual Congress, September 21-24, 2008, Lisbon, Portugal (2008)

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See detailGuideline on antiplatelet and anticoagulation management in cardiac surgery.
Dunning, Joel; Versteegh, Michel; Fabbri, Alessandro et al

in European Journal of Cardio - Thoracic Surgery (2008), 34(1), 73-92

This document presents a professional view of evidence-based recommendations around the issues of antiplatelet and anticoagulation management in cardiac surgery. It was prepared by the Audit and ... [more ▼]

This document presents a professional view of evidence-based recommendations around the issues of antiplatelet and anticoagulation management in cardiac surgery. It was prepared by the Audit and Guidelines Committee of the European Association for Cardio-Thoracic Surgery (EACTS). We review the following topics: evidence for aspirin, clopidogrel and warfarin cessation prior to cardiac surgery; perioperative interventions to reduce bleeding including the use of aprotinin and tranexamic acid; the use of thromboelastography to guide blood product usage; protamine reversal of heparin; the use of factor VIIa to control severe bleeding; anticoagulation after mechanical, tissue valve replacement and mitral valve repair; the use of antiplatelets and clopidogrel after cardiac surgery to improve graft patency and reduce thromboembolic complications and thromboprophylaxis in the postoperative period. This guideline is subject to continuous informal review, and when new evidence becomes available. The formal review date will be at 5 years from publication (September 2013). [less ▲]

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See detailAortic valve surgery in octogenarians: predictive factors for operative and long-term results
Kolh, Philippe ULg; Kerzmann, Arnaud ULg; Honoré, Charles ULg et al

in European Journal of Cardio - Thoracic Surgery (2007), 31(4), 600-605

Objective: To assess factors influencing operative and tong-term outcome in octogenarians undergoing aortic valve surgery (AVR). Methods: Records of 220 consecutive octogenarians having AVR between 1992 ... [more ▼]

Objective: To assess factors influencing operative and tong-term outcome in octogenarians undergoing aortic valve surgery (AVR). Methods: Records of 220 consecutive octogenarians having AVR between 1992 and 2004 were reviewed, and follow-up obtained (99% complete). Of the group (mean age: 82.8 years; 174 females), 142 patients (65%) were in New York Heart Association (NYHA) class III-IV, 22 (10%) had previous myocardial infarction, 11 (5%) had previous coronary artery bypass grafting (CABG), and 8 (4%) had percutaneous aortic valvuloplasty. There were 44 urgent procedures (20%), and additional CABG was performed in 58 patients (26%). Results: Operative mortality was 13% (9% for AVR, 24% for AVR + CABG). Among the 29 patients who died, 14 (48%) were operated on urgently (32% mortality for urgent procedures). Causes of hospital death were respiratory insufficiency or infection in 16 patients (16/29 = 55%), myocardial, infarction in 8 (28%), stroke in 2 (7%), sepsis in 2 (7%), and renal failure in 1 (3%). Significant postoperative complications were atrial fibrillation in 48 patients (22%), respiratory insufficiency in 46 (21%), permanent atrio-ventricular bloc in 12 (5%), myocardial infarction in 10 (5%), hemodialysis in 4 (2%), and stroke in 4 (2%). Mean hospital and intensive care unit (ICU) stays were 17.6 +/- 5.2 and 6.9 +/- 3.4 days, respectively. Multivariate predictors (p < 0.05) of hospital death were urgent procedure, associated CABG, NYHA class IV, and percutaneous aortic valvuloplasty. Age, associated CABG, and urgent procedure were predictors of prolonged ICU stay. Mean follow-up was 58.2 months and actuarial 5-year survival was 73.2 +/- 6.9%. Age, preoperative myocardial infarction, urgent procedure, and duration of ICU stay were independent predictors of late death. Among 130 patients alive at follow-up, 91% were angina free and 81% in class I-II. Conclusions: AVR in octogenarians can be performed with acceptable mortality, although significant morbidity. These results stress the importance of early operation on elderly patients with aortic valve disease, avoiding urgent procedures. Associated coronary artery disease is a harbinger of poor operative outcome. Long-term survival and functional recovery are excellent. (c) 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved. [less ▲]

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See detailCardiovascular haemodynamics and ventriculo-arterial coupling in an acute pig model of coronary ischaemia-reperfusion
Lanoye, Lieve; Segers, Patrick; Tchana-Sato, Vincent ULg et al

in Experimental Physiology (2007), 92(1), 127-137

Although reperfusion after coronary occlusion is mandatory for myocardial salvage, reperfusion may trigger a cascade of harmful events (reperfusion injury) adding to myocardial injury. We investigated ... [more ▼]

Although reperfusion after coronary occlusion is mandatory for myocardial salvage, reperfusion may trigger a cascade of harmful events (reperfusion injury) adding to myocardial injury. We investigated effects of reperfusion on left ventricular (LV) haemodynamics and ventriculo-arterial (VA) coupling in pigs following acute myocardial ischaemia induced by coronary artery occlusion. Experiments were performed in six animals, with measurements of cardiac and arterial function at baseline, after 60 min of ischaemia (T60) and after 2 (T180) and 4 h of reperfusion (T300). Ventriculo-arterial coupling was assessed using the ventriculo-arterial elastance ratio of paper, as well as using a 'stiffness coupling' and 'temporal coupling' index. Reperfusion following ischaemia (T180 versus T60) induced a progressive decline in cardiovascular function, evidenced by a decrease in mean arterial blood pressure, cardiac output and ejection fraction which was not restored at T300. Although reperfusion also induced an increase in slope of the end-systolic pressure-volume relationship (ESPVR), the ESPVR curve shifted to the right, associated with a depression of contractile function. Histology demonstrated irreversible myocardial damage at T300. The ventriculo-arterial elastance ratio and the 'stiffness coupling' index were unaffected throughout the protocol, but the 'temporal coupling' parameter indicated a relative shift between heart period and the time constant of the arterial system. It is unlikely that these alterations are attributable to ischaemic injury alone. The combination of both the stiffness and temporal coupling index may provide more information when studying ventriculo-arterial coupling than the more commonly used ventricular end-systolic stiffness/effection arterial elastance (E-es/E-a) ratio. [less ▲]

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See detailFunctional residual capacity measurement as a guide during Peep titration in ARDS
Lambermont, Bernard ULg; Ghuysen, Alexandre ULg; MOMMENS, Véronique et al

in ESICM (2007)

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See detailDiagnosis and treatment of peripheral arterial disease: recommendations for the medical practice in Belgium.
Clement, Denis; Kolh, Philippe ULg; Motte, Serge et al

in Acta Chirurgica Belgica (2007), 107(6), 595-604

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See detailStudy of ventricular interaction during pulmonary embolism using clinical identification in a minimum cardiovascular system model.
Desaive, Thomas ULg; Ghuysen, Alexandre ULg; Lambermont, Bernard ULg et al

in Proceedings of the IEEE (2007)

Cardiovascular disturbances are difficult to diagnose and treat because of the large range of possible underlying dysfunctions combined with regulatory reflex mechanisms that can result in conflicting ... [more ▼]

Cardiovascular disturbances are difficult to diagnose and treat because of the large range of possible underlying dysfunctions combined with regulatory reflex mechanisms that can result in conflicting clinical data. Thus, medical professionals often rely on experience and intuition to optimize hemodynamics in the critically ill. This paper combines an existing minimal cardiovascular system model with an extended integral based parameter identification method to track the evolution of induced pulmonary embolism in porcine data. The model accounts for ventricular interaction dynamics and is shown to predict an increase in the right ventricle expansion index and a decrease in septum volume consistent with known physiological response to pulmonary embolism. The full range of hemodynamic responses was captured with mean prediction errors of 4.1% in the pressures and 3.1% in the volumes for 6 sets of clinical data. Pulmonary resistance increased significantly with the onset of embolism in all cases, as expected, with the percentage increase ranging from 89.98% to 261.44% of the initial state. These results are an important first step towards model-based cardiac diagnosis in the Intensive Care Unit. [less ▲]

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

in European Journal of Heart Failure, Supplements (2007), 6

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