Annual Report IC Kinderen 2012 Erasmus MC

Transcription

Annual Report IC Kinderen 2012
Erasmus MC-Sophia Children's Hospital
Rotterdam, The Netherlands
© 2013, Erasmus MC, IC Kinderen
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Table of contents
1 Introduction
3
2 Patient population
4
2.1 PICE
4
2.2 ExtraCorporeal Membrane Oxygenation (ECMO)
6
2.3 Cardiology
6
2.4 Centre for home-ventilation and respiratory disorders (CTB&A)
8
2.4.1 Home Ventilation
8
2.4.2 Home care for children with a tracheacanula
9
2.4.3 Polysomnography
9
2.5 Pallieterburght
10
2.6 Long term follow-up team (CHIL-team)
10
2.7 Evidence-based Pharmacotherapy - InMPhACT
12
3 Quality
13
3.1 Patient Safety Management System Activities
13
4 Education and training
17
4.1 A(N)IOS (residents)
17
4.2 Fellows
17
4.3 Nursing
18
5 Research
20
5.1 Peer reviewed manuscripts (international)
20
5.2 Other Publications
29
5.3 PhD Theses
29
5.4 Benchmark
31
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1 Introduction
In the year 2012, the staff of the Sophia Children’s Hospital, as a part of the Erasmus MC, invested a
lot in corporation and the creation of a vision and mission for the Sophia. Streamlining and optimizing
patient care throughout the Sophia’s Children’s Hospital including optimizing multidisciplinary
corporation as well as facing the future challenges in patient safety issues as well as financial. The IC
Kinderen of the Sophia is involved in many processes and leading in some parts. For example, the
position of the Admission Coordinator, who coordinates the number of admissions internally and
externally for the IC Kinderen, is introduced as a blue print in the Theme Sophia, to broaden this
coordination. Together they are responsible for the whole process of logistic and weekly meetings to
coordinate this process are scheduled. Another example is the bed capacity in Pallieterburght in
Capelle aan den IJssel; to make sure, this capacity is 80-90%. Together as a shared responsibility, we
make sure this capacity is achievable. At the Pallieterburght we started admitting children for MKR
during the week and in the weekend admitting children for ‘respijtzorg’. These initiatives will guarantee
admissions and therefore create space at the IC and MC. Another big advantage is that the children
are having the MKR in a much more pleasant environment. The ‘respijtzorg’ can be provided in the
weekend to reduce the burden of care for parents for a short period. The IC Kinderen also provided
agreements with the surgeons to ensure IC beds after surgery. In our continuous quality improvement
program involving patient care, education and research our aim remains to be within the top five of
pediatric intensive care units in Europe.
The scientific output remained of high standard bringing 77% of all peer review manuscripts in the
Q1 and the Q2 with a significant increase in mean numbers from 38 in the period 2008-2010 to
48 in 2012. Again major grant applications were rewarded both from ZonMW, NWO as well as
the Sophia Foundation. In total 7 PhD-students finalized their thesis.
We continue our scientific output at a high level mainly integrated in the top research schools of
the Erasmus MC. The attraction of future fellows and staff is aiming to enhance the number of
clinician-scientists combining state of the art care/cure and bringing the level of knowledge to a
higher level.
Inge van ‘t Wout
Dick Tibboel
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2 Patient population
2.1 PICE
Number of admissions: N = 1855
Girls: 823
(44.4%)
Boys: 1032
(52.5%)
Admission days between 1 and 301 days, median 2 days
Admission days 2012:
10014 days
Rejected admissions:
168
Age at admission between 0 and 26 years, median 1 year
Age groups
0-28 days:
253 (13.6%)
29 days-1 year:
560 (30.2%)
1-4 years:
386 (20.8%)
Older than 4 years: 656 (35.4%)
Deceased patients:
47
PICU/NICU transports 2012: 108
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Reason for admission:
1. respiratory
respiratory infections, trachaecanule, respiratory insufficiency, asthma,
starting non invasive ventilation
2. circulatory
sepsis, cor vitium, postop cardio surgery, cardiomyopathy, heart
transplant, shock, resuscitation, arrhythmias, CRS
3. gastrointestinal
(acquired intestinal problems) NEC, malrotation, volvulus, gastroenteritis,
ileus, abdominal trauma, mec plug, pyloric stenosis
4. neurology
neurological tumor, neurological trauma, coma, epilepsy, meningitis,
haemorrhages, AVM, near drowning, febrile convulsion
5. major congenital defects hernia, abdominal defects, atresia, renal abnormalities, MMC, anomalies,
CCAML
6. diagnostics/observation
MKR/ major survey, ICP reading, invasive RR reading, post-scope, post
MRI, post angiography, medication test, Schwann Ganz reading, ALTE
7. postop monitoring
hernia, cranium, scoliosis, renal transplantation, placement line/drain,
postop pain medication, ATE, minor interventions
8. other
diabetic ketoacidosis, hyperbilirubinaemie, hepatic failure, sickle cell crisis,
immune disorder, renal failure/HUS
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Ventilation days (invasive en non invasive)
Number of
% patients
patients
Minimum
Maximum
Median
Total
duration
duration
duration
number of
N = 1855
Ventilation
days
N = 499
26.9%
1
262
3
3152
N = 209
11.3%
1
341
2
1627
invasive
Ventilation
non invasive
2.2 ExtraCorporeal Membrane Oxygenation (ECMO)
Like in the previous years, the ICK expertise was intensively used. Apart from the common pediatric
intensive care the ICK has a clear quaternary IC function for particular interventions or fields of
expertise. One of these fields is ExtraCorporeal Membrane Oxygenation (ECMO), a technique that
provides respiratory and/or circulatory support. Treatment can be distinguished into neonatal and nonneonatal ECMO and into respiratory and circulatory support.
Internationally as well as locally a decrease in neonatal ECMO and an increase in pediatric ECMO is
observed. Neonates with high survival rates like meconium aspiration syndrome are less and less
presented for ECMO, possibly indicating better perincatal care, where experience in pediatric ECMO
results in successfully completing long-term difficult cases.
In 2012 close relations have been established with the manufacturer of the ECMO machines and
because of our large experience in neonatal and pediatric ECMO we have been designated as
reference centre. This contact keeps the ICK in the frontline of ECMO developments.
All ECMO data are registered in an international database run by ‘The Extracorporeal Life Support
Organization’ (ELSO). This database provides for international benchmarking, as shown in table 1.
This table contains the ICK data as well as the international survival rates for neonatal respiratory
ECMO patients. These data show that our unit, in accordance with international data, has a declining
rate of ECMO use over the last years.
In 2012 a total of 26 patients from all over the Netherlands suffering from respiratory or circulatory
failure received ECMO treatment in the ICK. Tabel 1 & 2 show the results the respiratory ECMO
patients . In the entire ECMO group thirteen patients were older than 28 days. Improved neonatal care
and more lung-protective ventilation in pediatric patients could explain this trend.
Neonatal Respiratory Runs per year in the Erasmus MC-Sophia Children’s Hospital
Runs per
Cumulative
Mean
Longest
No.
%
International
year
Runs
duration
duration
Survived
Survived
% Survived
2009
13
365
199
456
6
46%
68%
2010
18
383
187
462
12
67%
69%
2011
11
394
176
354
7
64%
65%
2012
9
403
144
388
4
44%
70%
Table 1. Mean duration in hours. Survived = survival until discharge or transfer
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Table 2 shows the ICK data and international survival rates for ECMO-treated respiratory insufficient
patients older than 1 month.
Pediatric Respiratory Runs per year in the Erasmus MC-Sophia Children’s Hospital
Runs per
Cumulative
Mean
Longest
No.
%
International
year
Runs
duration
duration
Survived Survived % Survived
2009
13
68
268
924
9
69%
56%
2010
7
75
231
636
3
43%
59%
2011
8
95
134
182
6
75%
58%
2012
9
104
258
574
7
78%
61%
Table 2. Mean duration in hours. Survived = survival until discharge or transfer
Apart from respiratory support, the ECMO expertise in 2012 was regularly applied patients suffering
from circulatory failure, either following on to/or directly after open-heart surgery or in patients in need
of mechanical cardiac support suffering from failing heart pump function. Internationally a small
increase in the use of ECMO in the cardiac setting can be observed.
Over the last few years an increase is observed in pediatric patients with primary cardiac out of
hospital cardiac arrest (OHCA). Selection of eligible patients for ECMO-CPR according the recent
literature in an improved survival compared to conventional CPR. This procedure is a high stress
multidisciplinary effort that gets more and more embedded in the process of caring for these CPR
cases.
In 2013 our ECMO system will be available for inter hospital transport even in small regular
ambulances. This opens the possibility to centralize ECMO care for pediatric patients in The
Netherlands. This will put a strain on resources and a financial compensation for this services needs to
be established.
2.3 Cardiology
After publication of the Ministry of Health, Welfare and Sport report on pediatric cardiac interventions in
2008 the minister declared that no more than three centers are needed and purposeful to provide
appropriate care to children with congenital heart defects in the Netherlands. Erasmus MC-Sophia was
one of the designated centers, next to Leiden and Groningen. On second thought, Utrecht was added
to these three. Since then we have further tried to fulfill the needed requirements. Erasmus MC-Sophia
is and has always been the national center for heart transplantations and assist devices in children.
Neonatal and pediatric ECMO are available at our department. We can offer treatment for the full
spectrum of heart defects in children in all age groups.
After changing the perioperative care (such as postoperative recovery) of children with congenital heart
disease in 2009 in the ICK we have further realized most of the started work from 2009. In the
meantime the new staff in the pediatric cardio-anesthesiology can guarantee 7x24 hour facilities to
perform surgery. After initial postoperative recovery in the thorax center where the children are
monitored from specially trained pediatric nurses in combination with the pediatric cardioanesthesiologist. They get transported under supervision of the pediatric intensivist. A special transport
unit, in order to reduce complication, has been customized and most of the children are transported on
it in the meantime.
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With the new staff for IC there are 1 pediatric intensivists and 1 pediatric intensivist-cardiologist in
charge for these patients. We have formed one part from the department into a special cardiac unit
where all children with heart disease and malformations are admitted and being nursed. In order to
fulfill the national requirements another cardiothoracic surgeon was employed. He is now being trained
in the subspecialty pediatric cardiothoracic surgery and is lately getting very involved with the pediatric
program. Every morning there is a round with the intensivist, cardiothoracic surgeon and pediatric
cardiologist. Furthermore, there is a weekly cardiothoracic conference where all the patients are
discussed and the future therapies get defined.
The number of patients treated in 2012 was slightly higher than in 2011 concerning operations with
CPB. In summary, 144 operations CPB and 88 without heart-lung machine were performed in children
beneath 18 years of age. The overall 30 day mortality was below 5%. One child received cardiac
ECMO treatment to counteract postoperative complications, which did not resolve and the patient died
some days after operation. One child with severe cardiac failure has been supported by a
leftventricular assist device (Berlin Heart, Levitronix). The patient could be successfully transplanted
after stabilization on the assist device.
Donor supply was and is scarce in the past years, but in 2011 and 2012 we have transplanted 5
children each year which is a considerable increase. None of the patients on the waiting list died. The
increase of transplantation within the last years is mainly due to the good results. Further more and
more children with end stage heart failure have been admitted over the last years in order to treat or
screen them for heart transplantation (CARS study, M. Dalinghaus, MD, PhD).
2.4 Centre for home-ventilation and respiratory disorders (CTB&A)
The centre for home-ventilation and respiratory disorders has 3 major fields of patient care; care of
children on home ventilation, care of children with a tracheacanula and screening of children with
respiratory disorders with polysomnography.
2.4.1
Home Ventilation
The Sophia Centre for Home Ventilations is one of the five centres for home mechanical ventilation in
The Netherlands. The others are run in Utrecht, Groningen, Maastricht and Rotterdam (Erasmus MC,
adult care). The Sophia centre is the only one dedicated to children.
A multidisciplinary program has been organized to manage the complex care of the children with home
ventilation, their parents and professionals. The aim of this program is to reduce multiple hospital visits
and to improve collaboration among various home care professionals.
Children with home ventilation and children in a preliminary phase for home ventilation are invited for
an annually hospital admission. During this hospital visit the required investigations are planned and
the various specialists visit the patient and parents. During the night a polysomnography takes place.
Patient numbers
At the end of 2012, 107 patients were seen for home ventilation; 72 patients were on home ventilation.
The other 35 patients were in preparation for home ventilation. The total number of patients increased
again in 2012. Especially, the number of young children (under the age of 6) is increasing. The home
ventilation team consists of a 1 paediatrician, 5 nurses, 1 technician, a secretary and a 1 social worker.
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number of patients Centre for Home Ventilation
2.4.2
Home care for children with a tracheacanula
Patients
Children with a tracheacanula are seen on a regular base in a multidisciplinary team with ENT
surgeon, pediatrician, specialized nurse and social worker. In 2012 two new ENT surgeons started to
participate in this multidisciplinary team. In 2012 a total of 35 children had a tracheacanula 5 of them
were new patients and 4 children were decanulated.One patient died, this was not related to the
tracheacanula. The table gives an overview of the number of children with a tracheacanula and
decannulations from 2000 to 2012.
2.4.3
Polysomnography
Measurements for the polysomnography program in 2012 were done partly on the PICU in Sophia
Children’s Hospital and partly in the high care facility Pallieterburght. In almost all children level 1
polysomnography was done due to a close collaboration with the department of neurophysiology. In
2012 in total 287 measurements were performed.
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2.5 Pallieterburght
Over the past years the Pallieter Foundation built Pallieterburght, a home for chronically and terminally
ill children. After years of fund raising, Prime Minister Balkenende eventually opened Pallieterburght as
a 24-hour care facility in June 2009. This was just after the Ministry of Health, Welfare and Sports had
approved the two-year financing of Pallieterburght as sub-unit of the ICK in the Erasmus MC-Sophia
Children’s Hospital as an extramural hospital function. On January 5th, 2010 the facility was ready for
24-hour care according to Erasmus-MC Sophia standards and was opened with 4 beds. This was
followed in September 2010 with an additional 2 beds. Electronic systems like PDMS and Elpado as
used on the ICU are in full operation.
ICK6-Pallieterburght now consists of a 6-bed 24-hour unit with six individual patient rooms and
rooming-in facilities for parents. One of the functions of the unit is serving as an interim location
between the ICU and home for children who will be discharged with many medical appliances whose
parents are in the process of learning the necessary nursing care so children can be discharged home.
Admission consist of for example, children with tracheal cannula’s, chronic home ventilation and
children with short-bowel syndrome receiving home TPN (Total Parenteral Nutrition). Palliative care is
offered when needed. The main difference with the common hospital situation is that efforts are
directed at emphasizing the child’s healthy sides, stimulating psychomotor and mental development
and creating a home-like atmosphere.
Physiotherapy and psychological follow-up is provided by the ChIL follow-up team members.
Moreover, speech therapists of the Erasmus MC-Sophia started consultations at the Pallieterburght.
Ongoing training was given to both medical and nursing personnel to better handle the multi-problem
families that are an important part of the patient population of Pallieterburght. Main aim was to reduce
length of stay of this group of patients.
Daily nursing care is provided by a dedicated team of ICU and HC nurses, for the majority rotating
between the ICU and Pallieterburght and by nurse assistants. Daily supervision of the Pallieterburght is
provided by Saskia Gischler, MD PhD.
During 2012, 37 different children were admitted, some repeatedly, resulting in a 63% occupancy of
bed capacity in the third year. Median length of stay (excluding polysomnography patients) was
reduced from 46 days to 20 days due to increased efficiency. Twenty-four-hour polysomnography
admissions were initiated in Pallieterburght starting December 2012. This increases bed occupancy
and diminishes pressure on ICU beds. Of the 37 admissions 7 were for polysomnography.
2.6 Long term follow-up team (CHIL-team)
In 1999 a prospective longitudinal follow-up program was started for children with major anatomical
congenital malformations. Initially, only patients from the Pediatric Surgical ICU were included. At
present, children with malformations such as Hirschsprung’s disease and anorectal malformations who
are initially admitted to the Medium Care ward are included as well. In 2001, a similar follow-up
program for ECMO-treated patients was introduced.
In 2008, children with anatomical congenital malformations aged 12-18 years were invited to join the
follow-up program: approximately 50% of children with colorectal malformations, Congenital
Diaphragmatic Hernia (CDH) and Esophageal Atresia (EA) entered the program. For those with
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congenital malformations who joined the program prospectively, the proportion of refusals to
participate ranged from 9-15%. In 2010, we also included pediatric patients with hypoxic-ischemic
trauma, e.g. near-drowning patients and admission following resuscitation. However, the majority died
or joined another follow-up program (e.g. in the oncology or cardiology department). In 2001 a
prospective longitudinal follow-up program was started for children with meningococcal septic shock
admitted to the PICU. A cohort of 94 pediatric patients was evaluated by one of the pediatric
intensivists (Corinne Buysse, MD, PhD). At present, 54 of them still join the follow-up program (see
Table).
Activities in 2012
In June 2012, we started a follow-up program for children who were treated in the ICU for hypoxic
ischemic events (e.g. cardiopulmonary resuscitation or near-drowning) and for severe neurotrauma
(Corinne Buysse, Karin Geleijns).
At the end of 2012, a total number of 1272 survivors participated in the follow-up program (an increase
of 193 patients). See Table.
Category
N in follow-
Colorectal malformations
326
Esophageal atresia
177
CDH and congenital lung malformation with resection
257
Congenital lung malformation without resection
62
Uncomplicated abdominal wall defects (AWD) and small intestinal atresias (SIA)
84
Complicated AWD and short bowel syndrome
18
up end 2012
Neonatal ECMO
197
Pediatric ECMO (age >28 days)
78
Meningococcal septic shock
54
Hypoxic Ischemic event
7
Neurotrauma (severe)
7
Miscellaneous
5
Staff
Hanneke IJsselstijn
pediatrician, genetic pediatrics (coordination CHIL-team)
Corinne Buysse, Saskia Gischler
pediatric intensivists
Karin Geleijns
pediatric neurologist
Ulrike Kraemer
pediatric cardiologist
Yolande van Bever
clinical geneticist
Marjolein Spoel
physician
Monique van der Cammen-van Zijp
pediatric physical therapist
Annabel van Gils-Frijters,
Anne Zirarpsychologists Daniel Hanauer Stuit social worker
all pediatric surgeons (except Sheila Terwisscha)
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2.7 Evidence-based Pharmacotherapy – InMPhACT
InMPhACT is the Center of Excellence for Pediatric Intensive Care Clinical Pharmacology at the
Erasmus MC Sophia Children's Hospital.
Research
2012 was a successful year for our Clinical Pharmacology research with € 500.000 million new grant
funding and over 30 peer-reviewed publications.
Our ongoing research program focuses on clinical trials and mechanistic studies. More specifically, our
clinical studies have largely focused on analgesics and sedatives. In 2012, the paracetamol IV –
morphine trial was accepted for publication in JAMA. Ongoing studies are the Daily Sedation
Interruption trial (DSI) and a ventolin PK-PD study. For the DSI study, two additional centers were
added to our multi-center study (LUMC, AMC) in the context of the PICU-Network of Excellence.
We initiated in vitro studies on the ontogeny of drug transporters in children, from biobank and surgical
tissues in collaboration with the University of Western Ontario, Canada and Children’s Mercy Hospital,
US and with our own Pediatrics Laboratory. Pediatric drug absorption simulation studies were
initiated, using the Pediatric TNO intestinal model in collaboration with TNO Zeist. In the context of a
TIPharma project and in collaboration with Leiden University, our group was involved in mechanistic
PK-PD studies to develop in vivo maturation models for main drug excretion pathways.
Teaching
We offer an accredited teaching program for (pediatric) clinical pharmacologists. One
PhDstudent/resident was accepted in the program. A case-based clinical teaching module for PICU
residents was implemented in 2012.
Our group actively participated in national and local teaching programs for fellows and residents
(pediatrics, anesthesiology, hospital pharmacists), undergraduate medical students and in continuous
medical education programs (pediatricians, obstetricians and pharmacists).Our research teaching
program in clinical pharmacology consists of weekly research rounds, where students and staff present
their research and/or pharmacokinetics teaching. In addition, more than 5 trainees successfully
followed the NIH Clinical Pharmacology program, which is offered as a distant learning program.
Clinical care
In 2011, monthly clinical ICU case presentations were launched in collaboration with our pediatric
hospital pharmacists. In these rounds, interesting clinical pharmacology cases from our unit were
presented and discussed. Clinical pharmacology consults were provided both in the ICU and outside to
support staff with clinical pharmacology-related questions. A main focus of these consults is sedation
withdrawal dosing advices.
Management
Dr de Wildt is member of the Erasmus MC research ethics board, as well as Treasurer for the
European Society of Developmental Pediatric and Perinatal Pharmacology and Board Member at large
for the American Society of Clinical Pharmacology and Therapeutics.
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3 Quality
3.1 Patient Safety Management System Activities
This document presents the Activities Report 2012 on the basis of the patient safety business plan and
follows the basic requirements laid down in the Dutch Technical Agreement (Nederlands Technische
Afspraak; NTA). First we report the current state as regards the central themes for 2012:
Prevention of central venous catheter-related sepsis
The developed care bundle protocols for catheter insertion and maintenance on the guidance of the
Zorggids Veilige Zorg voor Zieke Kinderen is introduced on the ICU. The registration of numbers of
days patients have lines inserted as well as the occurrences of catheter-related sepsis are counted
since then. Ongoing attention is required to enhance adherence to the new protocol. Especially new
rules like apllying a drying time of 30 seconds before start of the intervention appears to be hard to
follow.
Prevention of accidental extubation
The number of ventilator days and accidental extubations per 100 ventilator days are recorded. To
reduce the accidental extubations, a new method to fixate the tube was introduced. Together with
more control moments and control items in PDMS we expect that the accidental extubations will
decrease. Results of this intervention will be forthcoming next year.
Prevention of medication errors:
For the importance of the double check of medication administration was emphasized regularly this
year. In the Patient Safety week awareness created for this topic by using screensavers, interviews
and by demonstrating how the double check should be performed.
Barcoding of iv medication and the appliance of smart pump technology is still not possible.,
Other topics:

The digital incident reporting system was introduced . There was a slow start up due to many
system’s problems, which have almost all been solved.

The Safety Action Team had more time to conduct analyses like PRISMA, 21 PRISMA’s were
completed, the most frequent root causes were: organization and management issues, safety
culture, protocol errors and verification errors.
The following improvement strategies have been implemented:



Organization and management

the use of briefings and debriefings

coordination of admissions and discharges

Daily Goal Sheets
Culture

CRM base- and follow-up courses

implementation of RMS
Protocols

Critical Nursing Situation Index is "standard of care”
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

protocol development of Nitric Oxide administration via a new device
Verification

awareness of “the double check”, especially in critical situations
NTA basic requirements
1.
Board of Directors
One Safety Walk Round was held in 2012 joined by one of the members of the Board of Directors.
During Safety Rounds we ask representatives of various disciplines as well as patients and/or parents
about their experiences with matters of patient safety and staff safety.
2.
Leadership
Patient Safety is integrated in the ICU Children. Research and Education in this area is the next step
that needs to be developed more
3.
Communication
Once every 6 weeks a particular safety issue is extensively discussed in the Groot Regie Overleg
meeting. All initiatives regarding patient safety at the IC Kinderen are communicated to all team
members via the ICK newsletter, but also via the Safety First journal, news flashes, and screensavers.
Sophia-wide Patient Safety meetings were held every 6-8 weeks. Various Sophia-wide patient safety
issues have been discussed, as well as incident reports, analyses of these incidents, and possible
improvement actions.
4.
Staff
More PRISMA-analyses (21) have been performed with regard to accidental extubations, medication
errors and incident reports involving moderate or serious actual harm to the patient. One of the nursing
researchers has evaluated the feasibility of the CNSI, and has started implementing this as “standard
of care” in the ICU. The Sophia Simulation Team Training trainers have trained all nurses and
physicians at unitlevel. Satisfaction and safety was rated as high. There was also a CRM follow-up
team scenario done for the ICU for Children.
5.
Management by third parties
Safety aspects for externals are not worked out on unit level. There is a protocol search what the rules
are for trainees and “guests”
6.
Patient participation
One Safety Walk Rounds was held at the IC Kinderen in 2012. The parent satisfaction evaluation was
provided to the team through the News Letter with examples of how parents experienced their child’s
stay.
7.
Prospective risk assessment
No HFMEA analyses were done this year.
8.
Operational control measures
The Safety Action Teams are closely involved in the RMS and will help implement this early 2012. Until
the system is operational they will be responsible for entering and coding the Safety First reports.
Several PRISMA-analyses have been performed and improvement actions have been
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communicated/implemented to/by various working groups. Registration of complications by the
physicians remains a moot point and a more effective registration system is being considered. CNSI
observations have been well established and will be used as ‘standard of care ‘.
The use of the Pediatric Triggertool was started this year and provided indispesable information about
the actual adverse events on the ICU.
length of stay
No patients
% patiënts
No AE
% AE
0-2 days
3-7 days
8-30 days
> 30 days
Total
1115
472
226
42
1855
60.1%
25.4%
12.2%
2.3%
100%
94
238
422
190
944
10%
25.2%
44.7%
20.1%
100%
The Daily Goal Sheets are part of the catheter-related sepsis reduction implementation plan.
The CRM basic training course was offered once this year to new staff.
9.
Incident reporting and retrospective risk assessment
All staff is instructed individually on RMS reporting. There were one SIRE analyses, one Tripod
analyses and 21 PRISMA analyses done in the PICU..
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10. Monitoring of outcomes and reporting
A tailor-made database is in place that meets all PVMS requirements. Furthermore, the data manager
is involved in research meetings to discuss trends in incidents, patient outcomes, adverse events,
etcetera, and to study the effects of interventions.
11. Improving safety of care
Good instruction has resulted in safer use of the NO device. Safety First reports always necessitate ad
hoc improvement actions. The safety of the new enteral feeding system will be re evaluated after some
time. The use of the PICU Triggertool will make clear what interventions will be most effective.
12. Other activities
The Quality and Safety in Healthcare congress in Paris was attended by 2 Patient Safety officers and
the nursing staff from the IC Kinderen. There was a workshop given on CRM on the (IMSH)
International Meeting Society for Simulation in Healthcare in San Diego. On Bonaire there was
education given about patient safety and CRM. There was a lecture given on the Risky Business
Conference in London, Pediatrics Day. The Pediatric Psychiatric department was educated in Patient
Safety. During the Patient Safety Week, There was a Prisma Experience Day where the PSO’s
participated. The CRM workshop is also given on the conference “Samen Sterk”
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4 Education and training
4.1 A(N)IOS (residents)
Pediatricians/intensive care physicians Linda Corel and Corinne Buysse are accountable for the
scheduling and supervision of residents in the ICK. All A(N)IOS are assigned a mentor during their
traineeship. The ICK accommodates AIOS from the departments of Anesthesiology and Pediatrics and
ANIOS from the departments of Pediatric Surgery and Pediatrics. All A(N)IOS follow the same
educational program.
All A(N)IOS are offered an introductory program designed to get acquainted with the unit in general
and with the most used equipment. In addition all new A(N)IOS are instructed in mechanical ventilation
modes as well as sedation and pain management.
All A(N)IOS follow the obligatory pediatric training program. In addition, on the ICK the educational
structure is as follows:
1.
pediatric cardiology theoretical instruction every two weeks on Tuesday;
2.
Tuesday-morning meetings every two weeks, alternatingly protocols, presentations by A(N)IOS,
discussing questions from the MCCKAP board exam for fellows in pediatric ICU;3.weekly lectures
or instruction on pediatric ICU topics on Wednesday, alternatingly theoretical and bedside
teaching;
3.
Literature review on Thursday
4.
all AIOS give a presentation during their traineeship;
5.
mortality and morbidity round on Thursday;
6.
weekly clinic’s evaluation on Friday afternoon, aimed at discussing technical, organizational and
emotional aspects of the profession among A(N)IOS, fellows and staff;
7.
a weekly teaching round on Thursday afternoon, aimed at synchronizing policy and teaching for
fellows and A(N)IOS. Selected patients admitted to the ICU are discussed.;
8.
A(N)IOS participate in the APLS training as well as the interactive scenario training program for
nurses and medical staff;
9.
A(N)IOS perform a structured APLS scenario exam at the end of their PICU period.
4.2 Fellows
Matthijs de Hoog is the program director for fellows intensive care, Dick Tibboel is deputy director. The
training program was assessed in 2009 and the full program was accredited for 5 years. A training plan
has been prepared reflecting the structure and content of the training program in the ICK.
The training program for pediatric intensive care physicians includes the following activities:
1.
participation in ward rounds, lectures, bedside teaching, mortality and morbidity rounds and
scenario training as mentioned above;
2.
3.
participation in national PICU educational days;
participation in the MCCKAPP (Multidisciplinary Critical Care Knowledge Assessment Program)
examination of the SCCM (since 2009);
4.
thematic evening meetings with selected PICU staff or other specialists. Topics are interactively
5.
participation at least once in:
discussed with fellows;
Page 17/32
a. European Postgraduate Course in Neonatal and Paediatric Intensive Care in Bern;
b. Pediatric Multiprofessional Critical Care Review of the SCCM (USA);
6.
participation in research activities, with a labelled period of 6 months for research.
In 2012,Jan Willem Kuiper and Valerie Sloofstarted their PICU fellowship. Erik Bokhorst and Caroline
vd Maarel participated as fellow from the Pediatric Anesthesia department. Nicoline Ran and Marijke
vd Meulen partook in the fellowship program for one year.
4.3 Nursing
We expect nurses in our IC Kinderen (ICK) to display an academic, proactive and inquisitive attitude.
This unconditionally requires that we should facilitate high-level knowledge development and
knowledge transfer. An additional requirement is establishing a positive, continually-learning and safe
learning climate.
The competence-based learning approach will be retained in an intensive collaboration between the
Erasmus MC Zorgacademie and the clinical trainers. This will ensure that the theoretical assignments
are geared to practice conditions. An educational plan will be prepared detailing the basic
requirements we expect each HC- and each IC-nurse to meet. This will form the basis for a description
of what is expected from the different expertise groups. Requirements will be formulated in close
consultation with all staff.
Every year the nursing education staff officer Carla Kops, together with education officer Gabrielle de
Vogel and scheduler Erik van Lenten, organizes many training sessions for permanent staff. This is
done in close collaboration with quality consultant Ada van den Bos who is functioning as contact for
the scenario trainers. An example of structural education is the unit training in groups of about ten
nurses. Sessions consist of several hours’ knowledge transfer followed by scenario training, which
provides the opportunity to integrate the knowledge in practice. This year we introduced knowledge
tests. Lessons are geared to gaps in knowledge. Testing is repeated the following year to assess
efficacy of the education. We also started brainstorming about the prof check. This will be further
elaborated in 2013, so that we can start testing elements such as the APLS and BLS in 2014.
Furthermore, e-learning programs are being developed by the nursing education team which is
composed of 7 senior education officers and 1 RVO. This team was established in 2012 and is
responsible, among other things, for a good learning culture and quality assurance. They have all been
instructed intensively about the art of coaching. Thus they are not only capable of coaching the
students, but also the permanent staff. Two senior education officers will take a practice supervisor
training course. The ICK department offers career perspectives in all fields. Apart from the education
team four Ventilation Practitioners are active.
Apart from the nurses’ own educational development, they will be expected to be able to transfer their
expertise to students, both in- and externally. In this way we contribute a great deal to our social
responsibility of transferring knowledge to society and to other healthcare institutions (regionally and
nationally). Methods to reach this goal include organizing symposia and participating in national and
international congresses. Improving our quality level will enhance our attractiveness to new students
and staff.
Page 18/32
The clinical trainer (RVO) is entrusted with the coordination and organization of this comprehensive
training and education program, supported by the nursing education staff officer. The program’s
execution is provided by the ICK in collaboration with the Erasmus MC Zorgacademie. The program
modules will be facilitated by nurses and physicians from the ICK. In this way the ICK training and
education program is retained in our own center.
The ICK nursing education follows national developments. Cutbacks have necessitated us to
streamline our system. It will be clear that education is essential to an IC department. Medical and
technical developments are advancing very fast. Also social trends are reason to intensify knowledge
transfer to parents and the patients themselves. More and more parents learn how they can manage
their child’s condition at home and we also see an increase in the number of parents who participate in
the care of their child. One element of our vision is perceiving the parents and their child as a close-knit
unit. Our education is in line with this view. Learning is a joint enterprise.
Page 19/32
5 Research
5.1 Peer reviewed manuscripts (international)
1.
Adverse drug reaction-related admissions in paediatrics, a prospective single-centre
study.Posthumus AA, Alingh CC, Zwaan CC, van Grootheest KK, Hanff LL, Witjes BB, 't Jong
GW, de Hoog M. BMJ Open. 2012 Aug 24;2(4).
IF 1.583
2.
5-year IF 1.583
medicine, general & internal 59/151 Q2
Hypereosinophilic syndrome in children. van Grotel M, de Hoog M, de Krijger RR, Beverloo HB,
van den Heuvel-Eibrink MM. Leuk Res. 2012 Oct;36(10):1249-54.
IF 2.764
5-year IF 2.587
hematology 31/67 Q2
oncology 90/196 Q2
3.
Maturation of the glomerular filtration rate in neonates, as reflected by amikacin clearance. De
Cock RF, Allegaert K, Schreuder MF, Sherwin CM, de Hoog M, van den Anker JN, Danhof M,
Knibbe CA. Clin Pharmacokinet. 2012 Feb 1;51(2):105-17. doi
IF 6.109
4.
5-year IF 5.486
pharmacology & pharmacy 13/260 Q1
Daily interruption of sedation in critically ill children. Risk factors for pediatric intensive care
admission in children with acute asthma. van den Bosch GE, Merkus PJ, Buysse CM, Boehmer
AL, Vaessen-Verberne AA, van Veen LN, Hop WC, de Hoog M. Respir Care. 2012
Sep;57(9):1391-7.
IF 2.030
5-year IF 1.978
critical care medicine 16/27 Q3
respiratory system 34/50 Q3
5.
Effect of hypothermia and extracorporeal life support on drug disposition in neonates. Wildschut
ED, de Wildt SN, Mâthot RA, Reiss IK, Tibboel D, Van den Anker J. Semin Fetal Neonatal Med.
2013 Feb;18(1):23-7.
IF 3.505
6.
5-year IF 3.579
pediatrics 7/121 Q1
Tacrolimus-induced nephrotoxicity and genetic variability: a review. Gijsen VM, Madadi P, Dube
MP, Hesselink DA, Koren G, de Wildt SN. Ann Transplant. 2012 Apr-Jun;17(2):111-21. Review.
IF 0.815
5-year IF 0.879
surgery 142/198 Q3
transplantation 23/26 Q4
7.
Ontogeny of oral drug absorption processes in children. Mooij MG, de Koning BA, Huijsman ML,
de Wildt SN. Expert Opin Drug Metab Toxicol. 2012 Oct;8(10):1293-303. Review.
IF 2.944
5-year IF 3.216
biochemistry & molecular biology 131/290 Q2
8.
Drug metabolism in pediatrics, pregnancy and lactation. de Wildt SN. Curr Drug Metab. 2012
Jul;13(6):693.
IF 4.405
5-year IF 4.508
biochemistry & molecular biology 68/290 Q1
Page 20/32
9.
Scaling of pharmacokinetics across paediatric populations: the lack of interpolative power of
allometric models. Cella M, Knibbe C, de Wildt SN, Van Gerven J, Danhof M, Della Pasqua O. Br
J Clin Pharmacol. 2012 Sep;74(3):525-35.
IF 5.067
5-year IF 4.898
10. Does a reduced glucose intake prevent hyperglycemia in children early after cardiac surgery? a
randomized controlled crossover study. de Betue CT, Verbruggen SC, Schierbeek H, Chacko SK,
Bogers AJ, van Goudoever JB, Joosten KF. Crit Care. 2012 Oct 2;16(5):R176.
IF 4.718
5-year IF 5.248
11. Nocturnal ultrasound measurements of optic nerve sheath diameter correlate with intracranial
pressure in children with craniosynostosis. Driessen C, van Veelen ML, Lequin M, Joosten KF,
Mathijssen IM. Plast Reconstr Surg. 2012 Sep;130(3):448e-51e.
IF 3.535
5-year IF 3.591
surgery 13/198 Q1
12. Obstructive sleep apnoea in Treacher Collins syndrome: prevalence, severity and cause. Plomp
RG, Bredero-Boelhouwer HH, Joosten KF, Wolvius EB, Hoeve HL, Poublon RM, Mathijssen IM.
Int J Oral Maxillofac Surg. 2012 Jun;41(6):696-701.
IF 1.521
5-year IF 1.823
surgery 89/198 Q2
dentistry, oral surgery & medicine 32/82 Q2
13. Does central sleep apnea occur in children with syndromic craniosynostosis? Driessen C,
Mathijssen IM, De Groot MR, Joosten KF. Respir Physiol Neurobiol. 2012 May 31;181(3):321-5.
IF 2.051
5-year IF 2.279
physiology 45/73 Q3
14. Nocturnal oxygen saturation in children with stable cystic fibrosis. van der Giessen L, Bakker M,
Joosten K, Hop W, Tiddens H. Pediatr Pulmonol. 2012 Nov;47(11):1123-30.
IF 2.375
5-year IF 2.178
pediatrics 25/121 Q1
15. Screening for obstructive sleep apnea in Treacher-Collins syndrome. Plomp RG, Joosten KF,
Wolvius EB, Hoeve HL, Poublon RM, van Montfort KA, Bredero-Boelhouwer HH, Mathijssen IM.
Laryngoscope. 2012 Apr;122(4):930-4.
IF 1.979
5-year IF 2.269
medicine, research, experimental 72/121 Q3
otorhinolaryngology 7/43 Q1
16. Efficacy and safety of a tight glucose control protocol in critically ill term neonates. Verbruggen
SC, Landzaat LJ, Reiss IK, van Goudoever JB, Joosten KF. Neonatology. 2012;101(3):232-8.
IF 2.573
5-year IF 2.448
17. Circulating nucleosomes and severity of illness in children suffering from meningococcal sepsis
treated with protein C. Zeerleder S, Stephan F, Emonts M, de Kleijn ED, Esmon CT, Varadi K,
Hack CE, Hazelzet JA. Crit Care Med. 2012 Dec;40(12):3224-9.
IF 6.124
5-year IF 6.401
Page 21/32
18. Paediatric conferences: only a profit making enterprise? Koletzko B, Cochat P, de Groot R, Guys
JM, Hazelzet JA, Lagae L, Marlow N, Troncone R. Acta Paediatr. 2012 Dec;101(12):1194-5.
IF 1.974
5-year IF 2.064
19. Development and validation of a neonatal intensive care parent satisfaction instrument. Latour
JM, Duivenvoorden HJ, Hazelzet JA, van Goudoever JB. Pediatr Crit Care Med. 2012
Sep;13(5):554-9.
IF 2.354
5-year IF 2.659
20. Safety of routine early MRI in preterm infants. Plaisier A, Raets MM, van der Starre C, FeijenRoon M, Govaert P, Lequin MH, Heemskerk AM, Dudink J. Pediatr Radiol. 2012
Oct;42(10):1205-11.
IF 1.565
5-year IF 2.622
radiology, nuclear medicine & medical imaging 63/120 Q3
21. Eosinophilic myenteric ganglionitis as a cause of chronic intestinal pseudo-obstruction. Ooms AH,
Verheij J, Hulst JM, Vlot J, van der Starre C, de Ridder L, de Krijger RR. Virchows Arch. 2012
Jan;460(1):123-7.
IF 2.676
5-year IF 2.655
pathology 23/77 Q2
22. Pediatric influenza vaccination: understanding the T-cell response. Bodewes R, Fraaij PL,
Osterhaus AD, Rimmelzwaan GF. Expert Rev Vaccines. 2012 Aug;11(8):963-71. Review.
IF 4.219
5-year IF 3.665
immunology 33/135 Q1
23. Annual influenza vaccination affects the development of heterosubtypic immunity. Bodewes R,
Fraaij PL, Kreijtz JH, Geelhoed-Mieras MM, Fouchier RA, Osterhaus AD, Rimmelzwaan GF.
Vaccine. 2012 Dec 7;30(51):7407-10.
IF 3.492
5-year IF 3.458
immunology 48/135 Q1
medicine, research & experimental 33/121 Q2
24. Course of pandemic influenza A(H1N1) 2009 virus infection in Dutch patients. Friesema IH,
Meijer A, van Gageldonk-Lafeber AB, van der Lubben M, van Beek J, Donker GA, Prins JM, de
Jong MD, Boskamp S, Isken LD, Koopmans MP, van der Sande MA; Dutch ZonMw Influenza
A(H1N1) 2009 consortium. Influenza Other Respi Viruses. 2012 May;6(3):e16-20.
IF 1.471
5-year IF 2.083
virology 39/24 Q4
infectious diseases 58/69 Q4
25. Current and future applications of dried blood spots in viral disease management. Snijdewind IJ,
van Kampen JJ, Fraaij PL, van der Ende ME, Osterhaus AD, Gruters RA. Antiviral Res. 2012
Mar;93(3):309-21. Review.
IF 3.925
5-year IF 3.685
virology 8/34 Q1
Page 22/32
26. Morbidity and long-term follow-up in CDH patients. Chiu PP, IJsselstijn H. Eur J Pediatr Surg.
2012 Oct;22(5):384-92. Review.
IF 0.839
5-year IF 0.830
surgery 141/198 Q3
27. Efficacy of an intravenous bolus of morphine 2.5. versus morphine 7.5 mg for procedural pain
relief in postoperative cardiothoracic patients in the intensive care unit: a randomised doubleblind controlled trial. Ahlers SJ, Gulik L van, Dongen EP van, Bruins P, Garde EM van de, Boven
WJ van, Tibboel D, Knibbe CA. Anaesthesia and Intensive Care 2012;40:417-426.
IF 1.279
5-Year IF 1.288
Anesthesiology 19/28 Q3
28. Steam inhalation therapy: severe scalds as an adverse side effect. Baartmans M, Kerkhof E,
Vloemans J, Nijman S, Tibboel D, Nieuwenhuis M. British Journal of General Practice
2012;62:473-477.
If 1.831
5-Year IF 2.179
Medicine, General & Internal 52/153 Q2
29. Validation of the COMFORT Behavior Scale and the FLACC Scale for pain assessment in
Chinese children after cardiac surgery. Bai J, Hsu L, Tang Y, Dijk M van. Pain Management
Nursing 2012; 1: 18-26.
IF 1.039
5-Year IF none
Nursing 38/89 Q2
30. Biomarkers of the one-carbon pathway in association with congenital diaphragmatic hernia.
Beurskens LWJE, Jonge R de, Schoonderwalt EM, Tibboel D, Steegers-Theunissen RPM. Birth
Defects Research (Part A) 2012;94:557-560.
If 2.742
5-Year IF 2.738
Toxicology 33/83 Q2
31. The COMFORT behavior scale: is a shorter observation period feasible? (online brief report)
Boerlage AA, Ista E, de Jong M, Tibboel D, van Dijk M. Pediatric Critical Care Medicine
2012;13:e124-5.
IF 3.129
5-Year IF 2.973
Pediatrics 9/115 Q1
32. Biomarkers and clinical tools in critically ill children: are we heading toward tailored drug therapy?
Buijs E, Zwiers AJ, Ista E, Tibboel D, Wildt SN de. Biomarkers in Medicine 2012;6:239-257
If 2.630
5-Year IF 1.952
Medicine, Research & Experimental 43/111 Q2
33. Protocolized post-operative pain management in infants; do we stick to it? Ceelie I, de Wildt SN,
Jong M de, Ista E, Tibboel D, Dijk M van. Eur J Pain 2012;16:760-766.
IF 3.939
5-Year IF 4.267
34. Morbidity and long-term follow-up in CDH patients Chiu PPL, IJsselstijn H. European Journal of
Pediatric Surgery 2012;22:384-392
IF 0.808
5-Year IF 0.824
Surgery 99/152 Q4
35. Update on pain assessment in sick neonates and infants. Dijk M van, Tibboel D. Pediatric Clinics
of North America 2012; 59: 1167-1181
If 2.245
5-Year IF 2.171
Pediatrics 28/115 Q1
Page 23/32
36. Screening pediatric delirium with an adapted version of the Sophia Observation withdrawal
Symptoms scale (SOS). Dijk M van, Knoester H, van Beusekom BS, Ista E. Intensive Care
Medicine 2012;38:531-532.
IF 5.339
5-Year IF 4.971
Critical Care Medicine 3/26 Q1
37. Thermal detection thresholds in 5-year-old preterm born children; IQ does matter. Graaf J de,
Valkenburg AJ, Tibboel D, Dijk M van. Early Human Development 2012;88:487-491.
IF 2.046
5-Year IF 2.394
38. Remifentanil during cardiac surgery is associated with chronic thoracic pain 1 yr after sternotomy.
Gulik L van, Ahlers SJ, garde EM van de, Bruins P, Boven WJ van, Tibboel D, Dongen EP van,
Knibbe CA. British Journal of Anaesthia 2012;109:616-662.
IF 4.243
5-Year IF 3.848
39. Contribution of LPP copy number and sequence changes to esophageal atresia,
tracheoesophageal fistula, and VACTERL association. Hernandez-Garcia A, Brosens E, Zaveri
HP, Jong EM de, Yu Z, Nanwanje M, Mayle A, Fernandes CJ, Lee B, Blazo M, Lalani SR, Tibboel
D, Klein A de, Scott DA. American Journal of Medical Genetics part A 2012;158A:1785-1787.
IF 2.391
5-Year IF 2.549
Genetics & Heredity 91/158 Q3
40. Hypoxia-inducible factor 2α plays a critical role in the formation of alveoli and surfactant. Huang
Y, Buscop-van Kempen M, Boerema-de Munck A, Swagemakers S, Driegen S, Mahavadi P,
Meijer D, IJcken W van, Spek P van der, Grosveld F, Gunther A, Tibboel D, Rottier RJ. American
Journal of Respiratory Cell and Molecular Biology 2012;46:224-232
IF 5.125
5-Year IF 4.833
Respiratory System 5/48 Q1
41. Does postoperative ‘M’ technique massage with or without mandarin oil reduce infants’ distress
after major craniofacial surgery? Jong M de, Lucas C, Bredero H, Adrichem L van, Tibboel D, Dijk
M van. Journal of Advanced Nursing 2012;68:1348-1352.
IF 1.477
5-Year IF 2.304
Nursing 12 /97 Q1
42. Congenital diaphragmatic hernia: to repair on or off extracorporeal membrane oxygenation?
Keijzer R, Wilschut DE, Houmes RJ, Ven KP van de, Hout van den, Sluijter I, Rycus P, Bax KM,
Tibboel D. Journal of Pediatric Surgery 2012;47:631-636.
IF 1.450
5-Year IF 1.558
Surgery 92/199 Q2
43. Sex differences in inflammatory mechanical hypersensitivity in later life of rats exposed to
repetitive needle pricking as neonates. Knaepen L. Patijn J, Tibboel D, Joosten EA.
Neuroscience Letters 2012;2012;516:285-289.
IF 2.105
5-Year IF 2.168
Neuroscienc3es 170/244 Q3
44. Neonatal repetitive needle pricking: Plasticity of the spinal nociceptive circuit and extended
postoperative pain in later life. Knaepen L. Patijn J, Kleef M van, Mulder M, Tibboel D, Joosten
EA. Developmental Neurobiology 2013;73:85-97.
IF 3.551
5-Year IF 3.328
Developmental Biology 14/40 Q2
Page 24/32
45. Prediction of morphine clearance in the paediatric population. How accurate are the available
pharmacokinetic models? Krekels EH, Tibboel D, Danhof M, Knibbe CA. Clinical
Pharmacokinetics 2012;51:695-709.
IF 6.109
5-year IF 5.486
46. Ontogeny of hepatic glucoronidation: methods and results Krekels EH, Danhof M, Tibboel D,
Knibbe CA. Current Drug Metabolism 2012;13:728-743.
If 5.113
5-Year IF 4.879
Pharmacology & Pharmacy 18/261 Q1
47. A baby with meningococcemia and septic shock Leeuwenburgh-Pronk WG, Smith PJ, Vught AJ
van, Lantos JD, Tibboel D, Hoog M de, Buysse C. Pediatrics 2012;130: 134-138.
If 5.437
5-Year IF 5.785
Pediatrics 2/115 Q1
48. The pulmonary mesenchymal tissue layer is defective in an in vivo recombinant model of nitrofeninduced lung hypoplasia. Loenhout RB van, Tsu I, Fox EK, Huang Z, Tibboel D, Post M, Keijzer
R. Journal of Pathology 2012;180:48-60.
IF 6.318
5-Year IF 6.143
Pathology 3/78 Q1
49. Lumbar spine and total-body dual-energy X-ray absorptiometry in children with severe
neurological impairment and intellectual disability: a pilot study of artefacts and disrupting factors.
Mergler S, Rieken R, Tibboel D, Evenhuis HM, Rijn RR van, Penning C. Pediatric Radiology
2012;42:574-583.
IF 1.674
5-Year IF 1.604
50. Aromatherapy massage seems to enhance relaxation in children with burns: An observational
pilot study. O'Flaherty LA, van Dijk M, Albertyn R, Millar A, Rode H. Burns 2012;38:840-845.
IF 1.962
5-Year IF 1.978
Dermatology 22/58 Q2
51. Long-term impact of infantile short bowel syndrome on nutritional status and growth. Olieman JF,
Penning C, Spoel M, IJsselstijn H, Hoonaard TL van den, Escher JC, Bax NMA, Tibboel D. British
Journal of Nutrition 2012; 107: 1489-1497.
IF 3.013
5-Year IF 3.342
Nutrition & Dietetics 19/72 Q2
52. Impact of infantile short bowel syndrome on long-term health-related quality of life: a crosssectional study. Olieman JF, Penning C, Poley MJ, Utens EMWJ, Hop WCJ, Tibboel D. Journal of
Pediatric Surgery 2012; 47: 1309-1316.
IF 1.450
5-Year IF 1.558
Surgery 92/182 Q2
53. Discomfort and pain in newborns with myelomeningocele: A prospective evaluation, Ottenhoff
MJ, Dammers R, Kompanje EJO, Tibboel D, Jong RTHR de. Pediatrics 2012; 129: e741-e747.
If 5.437
5-Year IF 5.785
Pediatrics 2/115 Q1
54. Assessing health-related quality-of-life changes in informal caregivers: an evaluation in parents of
children with major congenital anomalies Poley MJ, Brouwer WB, Exel NJ van, Tibboel D. Quality
of Life Research 2012;21:849-861.
IF 2.300
5-Year IF 2.838
Health Care Sciences & Services 23/76 Q2
Page 25/32
55. SOX2 redirects the developmental fate of the intestinal epithelium toward a premature gastric
phenotype. Raghoebir L, Bakker ER, Mills JC, Swagemakers S, Kempen MB, Munck AB, Driegen
S, Meijer D, Grosveld F, Tibboel D, Smits R, Rottier RJ. Journal of Molecular Cell Biology
2012;4:377-385.
IF 7.667
5-Year IF 7.667
Cell Biology 28/181 Q1
56. Prediction of chronic lung disease, survival and need for ECMO therapy in infants with congenital
diaphragmatic hernia: additional value of fetal MRI measurements? Schaible, Büsing KA, Felix
JF, Hop WC, Zahn K, Wessel L, Siemer J, Neff KW, Tibboel D, Reiss I, Hout L van den. Europan
Journal of Radiology 2012;81:1076-1082.
IF 2.606
5-Year IF 2.617
Radiology, Nuclear Medicine & Medical Imaging 37/116 Q2
57. Reversal of pulmonary vascular remodeling in pulmonary hypertensive rats Sluiter I, Heijst A van,
Haasdijk R, Kempen MB, Boerema-de Munck A, Reiss I, Tibboel D, Rottier RJ. Experimental and
Molecular Pathology 2012;93:66-73.
IF 2.425
5-Year IF 2.474
Pathology 30/79 Q2
58. Etiological and pathogenic factors in congenital diaphragmatic hernia. Sluiter I, Veenma D,
Loenhout R van, Rottier R, Klein A de, Keijzer R, Post M, Tibboel D. European Journal of
Pediatric Surgery 2012;22:345-354.
IF 0.808
5-Year IF 0.824
Surgery 99/152 Q4
59. Clinical geneticists’ views of VACTERL/VATER association. Solomon BD, Bear KA, Kimonis V,
Klein A de, Scott DA, Shaw-Smith C, Tibboel D, Reutter H, Giampietro PF. American Journal of
Medical Genetics part A 2012;158A:3087-3100.
IF 2.391
5-Year IF 2.549
60. Diagnosis-related deterioration of lung function after extracorporeal membrane oxygenation.
Spoel M, Laas R, Gischler SJ, Hop WJC, Tibboel D, Jongste JC de, IJsselstijn H. European
Respiratory Journal 2012;40:1531-1537.
IF 5.895
5-Year IF 5.879
Respiratory System 3/48 Q1
61. Respiratory morbidity and growth after open thoracotomy or thoracoscopic repair of esophageal
atresia. Spoel M, Meeussen CJHM, Gischler SJ, Hop WJC, Bax NMA, Wijnen RMH, Tibboel D,
Jongste JC de, IJsselstijn H. Journal of Pediatric Surgery 2012;47:1975-1983.
IF 1.450
5-Year IF 1.558
Surgery 92/199 Q2
62. Prospective longitudinal evaluation of lung function during the first year of life after repair of
congenital diaphragmatic hernia. Spoel M, Hout L van den, Gischler SJ, Hop WJC, Reiss I,
Tibboel D, Jongste JC de, IJsselstijn H. Pediatric Critical Care Medicine 2012;13:e133-139.
IF 3.129
5-Year IF 2.973
Pediatrics 9/115 Q1
63. Real-time registration of adverse events in Dutch hospitalized children in general pediatric units:
first experiences. Starre C van der, Dijk M van, Tibboel D. European Journal of Pediatrics
2012;171:553-8.
If 1.879
5-Year IF 1.731
Page 26/32
64. Late vs early ostomy closure for necrotizing enterocolitis: analysis of adhesion formation,
resource consumption, and costs. Struijs MC, Poley MJ, Meeussen CJ, Madern GC, Tibboel D,
Keijzer R. Journal of Pediatric Surgery 2012;47:658-664.
IF 1.450
5-Year IF 1.558
Surgery 92/199 Q2
65. The timing of ostomy closure in infants with necrotizing enterocolitis: a systematic review. Struijs
MC, Sloots CE, Hop WC, Tibboel D, Wijnen RM. Pediatric Surgery International 2012;28:667672.
IF 1.253
5-Year IF 1.152
Surgery 109/199 Q2
66. The gap in referral criteria for pediatric intestinal transplantation. Struijs MC, Sloots CE, Tibboel
D, IJzermans JN. Transplantation 2012;94:92-98.
IF 4.003
5-Year IF 3.689
Surgery 11/199 Q1
67. Foreign bodies in a pediatric emergency department in South Africa. Timmers M, Snoek KG,
Gregori D, Felix JF, van Dijk M, van As SA. Pediatric Emergency Care 2012;28:1348-52.
IF 0.782
5-Year IF 1.002
Emergency Medicine 16/23 Q3
68. Pain management in intellectually disabled children: a survey of perceptions and current
practices among Dutch anesthesiologists. Valkenburg A, Kreeft SM van der, Leeuw TG de,
Stolker RJ, Tibboel D, Dijk M van. Pediatric Anesthesia 2012; 22: 682-689.
IF 2.100
5-Year IF 1.771
69. Skin conductance peaks could result from changes in vital parameters unrelated to pain.
Valkenburg A, Niehof SP, Dijk M van, Verhaar EJM, Tibboel D, Ince C. Pediatric Research
2012;71:375-379.
IF 2.700
5-Year IF 2.728
70. Anaesthesia and postoperative analgesia in surgical neonates with or without Down's syndrome:
is it really different? Valkenburg AJ, van Dijk M, de Leeuw TG, Meeussen CJ, Knibbe CA, Tibboel
D. British Journal of Anaesthia 2012;108:295-301.
IF 4.243
5-Year IF 3.848
71. Copy number detection in discordant monozygotic twins of congenital diaphragmatic hernia
(CDH) and esophageal atresia (EA) cohorts. Veenma D, Brosens E, Jong E de, Ven C van de,
Meeussen C, Cohen-Overbeek T, Boter M, Eussen H, Douben H, Tibboel D, Klein A de.
European Journal of Human Genetics 201;20:298-304.
IF 4.400
5-Year IF 3.997
72. Developmental and genetic aspects of congenital diaphragmatic hernia. Veenma D, Klein A de,
Tibboel D. Pediatric Pulmonology 2012;534-545.
IF 2.533
5-Year IF 2.058
73. The effect of critical illness and inflammation on midazolam therapy in children. Vet NJ, Hoog M
de, Tibboel D, Wildt SN de. Pediatric Critical Care Medicine 2012;1:e48-50.
IF 3.129
5-Year IF 2.973
Pediatrics 9/115 Q1
Page 27/32
74. Daily interruption of sedation in critically ill children, Letter to the editor. Vet NJ, Verlaat CW, Wildt
SN de, Tibboel D, Hoog M de. Pediatric Critical Care Medicine 2012;13:122.
IF 3.129
5-Year IF 2.973
Pediatrics 9/115 Q1
75. Management of pulmonary hypertension in neonates with congenital diaphragmatic hernia.
Vijfhuize S, Schaible T, Kramer U, Cohen-Overbeek TE, Tibboel D, Reiss I. European Journal of
Pediatric Surgery 2012;22:374-388.
IF 0.808
5-Year IF 0.824
Surgery 99/152 Q4
76. A bodyweight –dependent allometric exponent for scaling clearance across the human life-span.
Wang C, peeter MY, Allegaert K, Oud-Alblas HJ van, Krekels EH, Tibboel D, Danhof M, Knibbe
CA. Pharmaceutical Research 2012;26:1570-1581.
IF 4.093
5-Year IF 4.668
77. Mouse model reveals the role of SOX7 in the development of congenital diaphragmatic hernia
associated with recurrent deletions of 8p23.1. Wat MJ, Beck TF, Hernandez-Garcia A, Yu Z,
Veenma D, Garcia M, Holder AM, Wat JJ, Chen Y, Mohila CA, Lally KP, Dickinson M, Tibboel D,
Klein A de, Lee B, Scott DA. Human Molecular Genetics 2012;21:4115-4125 .
IF 7.636
5-Year IF 7.510
78. CLMP is required for intestinal development, and loss-of-function mutations cause congenital
short-bowel syndrome. Werf CS van der, Wabbersen TD, Hsiao N-H, Paredes J, Etchervers HC,
Kroisel PM, Tibboel D et. al. Gastroenterology 2012;142:453-462.
If 11.675 5-Year IF 12.455
Gastroenterology & Hepatology 1/74 Q1
79. Pharmacotherapy in neonatal and pediatric extracorporeal membrane oxygenation (ECMO).
Wildschut ED, Ahsman MJ, HGoumes RJ, Pokorna P, Wildt SN de, Mathot RA, Tibboel D.
Current Drug Metabolism 2012;13:767-777
If 5.113
5-Year IF 4.879
80. The impact of extracorporeal life support and hypothermia on drug disposition in critically ill
infants and children. Wildschut ED, Saet A van, Pokorna P, Ahsman MJ, Anker JN van den,
Tibboel D. Pediatric Clinics of North America 2012;59:1183-1204.
IF 2.2.45 5-Year IF 2.171
81. Congenital diaphragmatic hernia. Wijnen R, Tibboel D. European Journal of Pediatric Surgery
2012;22:343.
IF 0.808
5-Year IF 0.824
Surgery 99/152 Q4
82. Accuracy of burn size assessment prior to arrival in Dutch Burn centres and its consequences in
children: a nationwide evaluation. Baartmans MG, Baar ME van, Boxma H, Dokter J, Tibboel D,
Nieuwenhuis MK
Injury 2012;43:1451-1456.
Page 28/32
83. How health professionals rate painfulness of childhood injuries and illnesses: a survey study. Dijk
van M, Timmers M, Snoek K, Scholten WK, Albertyn R. Journal of Pain and Palliative Care
Pharmacotherapy 2012;26:105-10.
IF 2.311
5-Year IF 2.348
84. Challenges in non-neonatal extracorporeal membrane oxygenation. Houmes RJ, Wildschut E,
Pokorna P, Vobruva V, Kraemer U, Reiss I, Tibboel D. Minerva Pediatrics 2012;64:439-445.
IF 5.119
5-Year IF 5.930
Pediatrics 2/121 Q1
85. VACTERL association etiology: the impact of de novo and rare copy number variations. Brosens
E, Eussen H, Bever Y van, Helm RM van der, IJsselstijn H, Zaveri HP, Wijnen R, Scott DA,
Tibboel D, Klein A de. Mol Syndromol. 2013 Feb;4(1-2):20-6.
86. Critical illness is a major determinant of midazolam clearance in children aged 1 month to 17
years. Ince I, Wildt SN de, Peeters MY, Murry DJ, Tibboel D, Danhof M, Knibbe CA. Therapeutic
Drug Monitoring 2012;34:381-389
IF 2.491
5-Year IF 2.605
87. The status of paediatric medicines initiatives around the world—What has happened and what
has not? Hoppu K, Anabwani G, Garcia-Bournissen F, Gazarian M, Kearns GL, Nakamura H,
Peterson RG, Sri Ranganathan S, Wildt SN de. European Journal of Clinical Pharmacology
2012;68:1-10.
IF 2.845
5-Year IF 2.663
88. HSP: Bystander Antigen in Atopic Diseases? Aalberse JA, Prakken BJ, Kapitein B. Front
Immunol. 2012;3:139.
5.2 Other Publications
[Syncope in childhood: not always vasovagal in origin].
Heinerman BC, van Beynum IM, Buysse CM. Ned Tijdschr Geneeskd. 2012;156(1):A4024.
5.3 PhD Theses
Congenital diaphragmatic hernia: a vascular disease.
Thesis: Ilona Sluiter
Promotors: prof. dr. D. Tibboel, prof. dr. I.K.M. Reiss
Co-promotor: dr. R.J. Rottier
February 23, 2012
The pathogenesis of pulmonary hypoplasia in congenital diaphragmatic hernia.
A continuing quest.
Thesis: Rhiannon B. van Loenhout
Promotor: prof. dr. D. Tibboel, prof. dr. M. Post
Co-promotor: dr. R. Keijzer
May 30, 2012
Page 29/32
Intestinal crises in the newborn.
Thesis: Marie-Chantal Struijs
Promotors: prof. dr. D. Tibboel, prof. dr. J.B. van Goudoever
Co-promotor: dr. R. Keijzer
June 1, 2012
Genetiv and Epigentic Interplay in Congenital Diaphragmatic Hernia
Thesis: Danielle Veenma
Promotor: prof. dr. D. Tibboel
Co-promotor: dr. J.E.M.M. de Klein
June 6,2012
Pain still hurts. Pain assessment and pain management in intensive care patients.
Thesis: Sabine J.G.M. Ahlers
Promotors: prof. dr. D. Tibboel, prof. dr. C.A.J. Knibbe
Co-promotor: dr. E.P.A. van Dongen
June 8, 2012
The air that we breath. Respiratory morbidity in children with congenital pulmonary
Malformations.
Thesis: Marjolein Spoel
Promotors: prof. dr. D. Tibboel, prof. dr. J.C. de Jongste
Co-promotor: dr. H. Meijers-IJsselstijn
June 15, 2012
The paediatric skin at risk.
Thesis: Martin G.A. Baartmans
Co-promotor: dr. M.K. Nieuwenhuis
June 20, 2012
Dyring for Oxygen. Roles of Hypoxia Indiced Factor 2-alpha and 3-alpha during lung development.
Thesis: Yadi Huang
Promotors: prof. dr. D. Tibboel,
June 29, 2012
Protein Anabolism in Critically Ill Children
Thesis: Carlijn de Betue
Promotors: prof. dr. D. Tibboel, prof. dr. N.E.P. Deutz
September 6, 2012
Size Does Matter; Drug Glucuronidation in Children.
Thesis: Elke H.J. Krekels
Promotors: prof. dr. C.A.J. Knibbe, prof. dr. D. Tibboel
October 10, 2012
Page 30/32
Balancing on Sox. Involvement of Sox2 in determination and maintenance of organ identity of the
gastrointestinal tract.
Thesis: Lalini Jasoda Raghoebir
October 17, 2012
Without Uttering a Word
Thesis: Bram Valkenburg (cum laude)
Co-promotor: dr. M. van Dijk
November 30, 2012
5.4 Benchmark
2008
2009
2010
2011
2012
Q1
41 (47.1%)
42 (56.0%)
30 (47.6%)
51 (53.7%)
44 (44.4%)
Q2
26 (26.9%)
19 (25.3%)
27 (42.9%)
31 (32.6%)
33 (33.3%)
Q3
16 (18.4%)
14 (18.7%)
6 (9.5%)
9 (9.5%)
14 (14.1%)
Q4
4 (4.6%)
0 (0%)
0 (0%)
4 (4.2%)
8 (8.1%)*
*all from one special issue
Total
87
75
63
95
99
FIVE MANUSCRIPS WITH THE HIGHEST IMPACT FACTOR
1.
CLMP is required for intestinal development, and loss-of-function mutations cause congenital
short-bowel syndrome. Werf CS van der, Wabbersen TD, Hsiao N-H, Paredes J, Etchervers HC,
Kroisel PM, Tibboel D et. al. Gastroenterology 2012;142:453-462.
If 11.675 5-Year IF 12.455
2.
Gastroenterology & Hepatology 1/74 Q1
SOX2 redirects the developmental fate of the intestinal epithelium toward a premature gastric
phenotype. Raghoebir L, Bakker ER, Mills JC, Swagemakers S, Kempen MB, Munck AB, Driegen
S, Meijer D, Grosveld F, Tibboel D, Smits R, Rottier RJ. Journal of Molecular Cell Biology
2012;4:377-385.
IF 7.667
3.
5-Year IF 7.667
Cell Biology 28/181 Q1
Mouse model reveals the role of SOX7 in the development of congenital diaphragmatic hernia
associated with recurrent deletions of 8p23.1. Wat MJ, Beck TF, Hernandez-Garcia A, Yu Z,
Veenma D, Garcia M, Holder AM, Wat JJ, Chen Y, Mohila CA, Lally KP, Dickinson M, Tibboel D,
Klein A de, Lee B, Scott DA. Human Molecular Genetics 2012;21:4115-4125 .
IF 7.636
5-Year IF 7.510
Page 31/32
4.
Maturation of the glomerular filtration rate in neonates, as reflected by amikacin clearance. De
Cock RF, Allegaert K, Schreuder MF, Sherwin CM, de Hoog M, van den Anker JN, Danhof M,
Knibbe CA. Clin Pharmacokinet. 2012 Feb 1;51(2):105-17. doi
IF 6.109
5.
5-year IF 5.486
Prediction of morphine clearance in the paediatric population. How accurate are the available
pharmacokinetic models? Krekels EH, Tibboel D, Danhof M, Knibbe CA. Clinical
Pharmacokinetics 2012;51:695-709.
IF 6.109
5-year IF 5.486
Page 32/32

Annual Report IC Kinderen 2012 Erasmus MC

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