M Van de Velde

Universitair Ziekenhuis Leuven, Louvain, Flemish, Belgium

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Publications (111)195.52 Total impact

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    ABSTRACT: Background Off-pump coronary artery bypass (OPCAB) surgery carries a high risk for haemodynamic instability and perioperative organ injury. Favourable haemodynamic effects and organ-protective properties could render xenon an attractive anaesthetic for OPCAB surgery. The primary aim of this study was to assess whether xenon anaesthesia for OPCAB surgery is non-inferior to sevoflurane anaesthesia with regard to intraoperative vasopressor requirements. Methods Forty-two patients undergoing elective OPCAB surgery were enrolled in this prospective, single-blind, randomized controlled pilot trial. Patients were randomized to either xenon (50–60 vol%) or sevoflurane (1.1–1.4 vol%) anaesthesia. Primary outcome was intraoperative noradrenaline requirements necessary to achieve predefined haemodynamic goals. Secondary outcomes included safety variables such as the occurrence of adverse events (intraoperatively and during a 6-month follow-up after surgery) and the perioperative cardiorespiratory and inflammatory profile. Results Baseline and intraoperative data did not differ between groups. Xenon was non-inferior to sevoflurane, as xenon patients required significantly less noradrenaline intraoperatively to achieve the predefined haemodynamic goals {geometric mean 428 [95% confidence interval (CI) 312, 588] vs 1702 [1267, 2285] µg, P
    BJA British Journal of Anaesthesia 09/2015; 115(4):550-9. DOI:10.1093/bja/aev303 · 4.85 Impact Factor
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    ABSTRACT: We recruited patients scheduled for shoulder rotator cuff repair or subacromial decompression under general anaesthesia and interscalene brachial plexus blockade (30 ml ropivacaine 0.5%). We allocated 240 participants into four groups of 60 that were given pre-operative saline 0.9% or dexamethasone 1.25 mg, 2.5 mg or 10 mg, intravenously. We recorded outcomes for 48 h. The median (IQR [range]) time to first postoperative analgesic request after saline was 12.2 (11.0-14.1 [1.8-48]) h, which was extended by intravenous dexamethasone 2.5 mg and 10 mg to 17.4 (14.9-21.5 [7.2-48]) h, p < 0.0001, and 20.1 (17.2-24.3 [1.3-48]) h, p < 0.0001, respectively, but not by dexamethasone 1.25 mg, 14.0 (12.1-17.7 [2.1-48]) h, p = 0.05. Postoperative analgesia was given sooner after rotator cuff repair than subacromial decompression, hazard ratio (95% CI) 2.2 (1.6-3.0), p < 0.0001, but later in older participants, hazard ratio (95% CI) 0.98 (0.97-0.99) per year, p < 0.0001. © 2015 The Association of Anaesthetists of Great Britain and Ireland.
    Anaesthesia 06/2015; 70(10). DOI:10.1111/anae.13156 · 3.38 Impact Factor
  • S. Devroe · M. Van de Velde · P. Demaerel · K. Van Calsteren
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    ABSTRACT: We describe a case of subdural hematoma following accidental dural puncture (ADP) and epidural blood patching. Although the EBP is a frequently performed technique for PDPH, it can induce harm and vigilance is required. This accentuates once more the importance of follow-up of patients with PDPH and the responsibilities of the anaesthesiologist regarding post-EBP care.
    International Journal of Obstetric Anesthesia 06/2015; 24(3). DOI:10.1016/j.ijoa.2015.05.004 · 1.60 Impact Factor
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    ABSTRACT: It is often said that regional anesthesia is the practice of applied anatomy. Therefore, it is fitting that on the occasion of his 500th birthday, we celebrate the life and work of the brilliant Flemish anatomist, Andreas Vesalius (1514-1564), the founder of modern anatomy.
    Regional anesthesia and pain medicine 11/2014; 39(6):450-5. DOI:10.1097/AAP.0000000000000173 · 3.09 Impact Factor
  • S. Verstraete · M.A. Walters · S. Devroe · E. Roofthooft · M. Van De Velde
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    ABSTRACT: Background Accidental dural puncture (ADP) and post-dural puncture headache (PDPH) are important complications of obstetric regional anesthesia. Inserting the catheter intrathecally after ADP to prevent PDPH has gained popularity. Nonetheless, data on the effect of an intrathecal catheter on PDPH and epidural blood patch (EBP) rates are mixed. Our primary objective was to examine if spinal catheterization reduces the incidence of PDPH after ADP in obstetric patients.Methods Anesthetic records of 29,749 regional blocks performed between January 1997 and July 2013 were analyzed retrospectively. In all blocks containing an epidural component, 18-gauge epidural needles were used. All patients who experienced a witnessed ADP or PDPH without ADP were identified. Data from patients with or without a prolonged spinal catheter were compared.ResultsThere were 128 events of witnessed ADP (0.43%). Following known ADP, 39 women had an epidural catheter placed at a different level and 89 had an intrathecal catheter (20-gauge) for at least 24 h. Sixty-one patients developed PDPH after observed ADP (48%). Prolonged intrathecal catheter placement significantly reduced the incidence of PDPH after ADP to 42% compared with 62% in those who have the catheter re-sited epidurally [odds ratio = 2.3 (95% confidence interval 1.04–4.86); P = 0.04].Conclusions The incidence of ADP, PDPH and blood patching is similar with previously published studies. After witnessed ADP, inserting the epidural catheter intrathecally significantly reduced the incidence of PDPH.
    Acta Anaesthesiologica Scandinavica 11/2014; 58(10). DOI:10.1111/aas.12394 · 2.32 Impact Factor
  • M Heesen · J Böhmer · S Klöhr · R Rossaint · M VAN DE Velde · J W Dudenhausen · S Straube
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    ABSTRACT: Tranexamic acid is effective in reducing blood loss during various types of surgery and after trauma. No compelling evidence has yet been presented for post-partum haemorrhage. A systematic literature search of relevant databases was performed to identify trials that assessed blood loss and transfusion incidence after tranexamic acid administration for post-partum haemorrhage. The random effects model was used for meta-analysis. Risk ratios (RRs) and weighted mean differences (WMDs) were calculated with 95% confidence intervals (CIs). Seven trials with a low risk of bias comparing tranexamic acid vs. placebo with a total of 1760 parturients were included in our systematic review and meta-analysis. Blood loss was significantly lower after tranexamic acid use (WMD -140.29 ml, 95% CI -189.64 to -90.93 ml; P < 0.00001). Tranexamic acid reduced the risk for blood transfusions (RR 0.34, 95% CI 0.20-0.60, P = 0.0001). The incidence of transfusions in the placebo group varied between 1.4% and 33%. When omitting the two trials with the highest incidence of transfusions, the RR was no longer significant. Additional uterotonics were necessary in the placebo groups; gastrointestinal adverse events were more common after tranexamic acid use. Only four cases of thrombosis were found, two each in the tranexamic acid and control groups. Tranexamic acid effectively reduced post-partum blood loss; the effect on the incidence of blood transfusions requires further studies. Only few trials observed adverse events including thromboembolic complications and seizures.
    Acta Anaesthesiologica Scandinavica 07/2014; 58(9). DOI:10.1111/aas.12341 · 2.32 Impact Factor
  • Y Peeters · M Van de Velde · A P Neyrinck · K Vermeylen
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    ABSTRACT: One lung ventilation (OLV) in children is a challenge and requires creative solutions. A case of OLV with bronchial placement of a fiberscope inspection-guided vascular embolectomy catheter in a three-year-old girl, scheduled for the resection of an intrathoracic tumor through thoracotomy is described. The availability of a broad range of vascular catheters as well as of fiberscope inspection material was decisive in managing the airway intra-operatively. Over the last 20 years, the need for OLV in children has increased, and various methods for performing it have been reported. Knowing all existing strategies in that domain is important to provide optimal perioperative care. In this paper, several methods of OLV in children will be discussed, such as selective endobronchial intubation, types of bronchial blockers, Univent tube, pediatric double lumen tubes, as well as the Marraro double lumen tube.
    Acta anaesthesiologica Belgica 07/2014; 65(1):45-9.
  • E. Cools · J. Hendrickx · S. De Cooman · T. Deloof · M. Van de Velde · A. De Wolf
    European Journal of Anaesthesiology 06/2014; 31:29. DOI:10.1097/00003643-201406001-00081 · 2.94 Impact Factor
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    L. Al Tmimi · P. Sergeant · M. Van de Velde · B. Meyns · M. Coburn · S. Rex
    European Journal of Anaesthesiology 06/2014; 31:71. DOI:10.1097/00003643-201406001-00195 · 2.94 Impact Factor
  • J M Berghmans · M Poley · F Weber · M Van de Velde · P Adriaenssens · J Klein · D Himpe · E Utens
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    ABSTRACT: Background: preoperative anxiety at induction and postoperative emergence delirium (ED) in children are associated with postoperative behavioral changes and adjustment disorders. This study's aim is to assess the value of the Child Behavior Checklist (CBCL) score in order to predict anxiety during induction and emergence delirium after anesthesia in children undergoing elective day-care surgery. Methods: Anxiety at induction, assessed by the modified Yale Preoperative Anxiety Scale (mYPAS), was studied as outcome in 401 children (60.1% male, age range: 1.5-16 years). For 343 of these children (59.8% male, age range: 1.5-16 years) ED could be investigated postoperatively, as assessed by the Pediatric Anesthesia Emergence Delirium scale (PAED). Demographic data, healthcare contacts, anesthesia and surgical data were registered. Preoperative emotional/behavioral problems, during the 6 months prior to surgery, were assessed by the CBCL. Hierarchical, multiple regression was used to test whether anxiety and ED could be predicted by CBCL scores. Results: Children with a higher CBCL score on preoperative internalizing problems (e.g. anxious/depression) showed preoperative more anxiety at induction (P=0.003). A higher CBCL score on preoperative emotional/behavioral problems was not associated with ED. Conclusion: The CBCL predicted anxiety at induction but not ED.
    Minerva anestesiologica 05/2014; 81(2). · 2.13 Impact Factor
  • M. Heesen · S. Kloehr · R. Rossaint · M. Walters · S. Straube · M. van de Velde
    Obstetric Anesthesia Digest 03/2014; 34(1):4-5. DOI:10.1097/01.aoa.0000443338.55155.da
  • M. Heesen · S. Klöhr · T. Hofmann · R. Rossaint · S. Devroe · S. Straube · M. Van de Velde
    Obstetric Anesthesia Digest 03/2014; 34(1):59-60. DOI:10.1097/01.aoa.0000443406.77820.74
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    ABSTRACT: Because of the extensive variability in paracetamol clearance in young women, published data were pooled with newly collected observations in search of covariates of paracetamol pharmacokinetics (PK) within this specific population. PK estimates and clinical characteristics [pregnant, weight, exposure to oral contraceptives (OC)] in young women following IV loading dose (2 g paracetamol) were pooled, using a non-compartmental linear disposition model in individual time-concentration profiles. Data were reported by median and range. Rank correlation was used to link clearance (l/h) to weight, Mann Whitney U test to compare clearance (l/h.m-2) between subgroups (pregnant, OC exposure). Finally, a multiple regression model with clearance (l/h) in all women and all non-pregnant women was performed. Based on 73 paracetamol PK estimates, a 8-fold variability in clearance (range 7.1-62.2 l/h) was documented, in part explained by a correlation (r2=0.36) between clearance (l/h) and weight. Clearance (l/h and l/h.m-2) and distribution volume (l) at delivery (n=36) were higher compared to non-pregnant observations. In non-pregnant women, women on OC (n=20) had a higher paracetamol clearance (l/h.m-2) compared to women (n=17) not on OC (p = 0.023). Weight (p = 0.0043) and pregnancy (p = 0.02) were independent variables (r=0.56) of paracetamol clearance (l/h). In non-pregnant women, weight (p = 0.009) and OC exposure (p = 0.03) were independent variables (r=0.51). Weight, pregnancy and OC result in higher clearance of IV paracetamol in young women. Besides compound specific relevance, these findings also unveil covariates of drug metabolism in young women.
    European review for medical and pharmacological sciences 03/2014; 18(5):599-604. · 1.21 Impact Factor
  • M Van De Velde
    Acta anaesthesiologica Belgica 11/2013; 64(3):95-6.
  • Acta anaesthesiologica Belgica 11/2013; 64(3):97-104.
  • E Depuydt · M Van de Velde
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    ABSTRACT: Epidural analgesia is frequently used for labor. Several authors advocate its use when parturient women are at increased risk for emergency Cesarean delivery. Hereby, the time needed to achieve adequate surgical anesthesia may be shortened and general anesthesia may be avoided. Starting from epidural labor analgesia, the most predominant anesthetic technique for unplanned Cesarean surgery is to top-up the existing epidural catheter. Little consensus can be found in literature about the nature of local anesthetic solution to be used to provide rapid onset and high quality anesthesia for the entire duration of surgery. Women, whose epidural analgesia extension fails either receive a new neuraxial blockade, or receive general anesthesia. We reviewed the medical literature to better define the best methods and choice of products at providing a rapid and adequate surgical anesthesia in parturient women with an epidural catheter in-situ.
    Acta anaesthesiologica Belgica 11/2013; 64(2):61-74.
  • G Dewinter · K Allegaert · M van de Velde
    Minerva anestesiologica 10/2013; 80(3). · 2.13 Impact Factor
  • M Heesen · M Van de Velde · S Klöhr · J Lehberger · R Rossaint · S Straube
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    ABSTRACT: Observational studies suggest that combined spinal-epidural analgesia (CSE) is associated with more reliable positioning, lower epidural catheter replacement rates, and a lower incidence of unilateral block compared with epidural analgesia. However, evidence from high-quality trials still needs to be assessed systematically. We performed a systematic review that included 10 randomised controlled trials comparing CSE and epidural analgesia in 1722 labouring women in labour. The relative risk of unilateral block was significantly reduced after CSE vs epidural analgesia (0.48, 95% CI 0.24-0.97), but significant between-study heterogeneity was present (I(2) = 69%, p = 0.01). No differences were found for rates of epidural catheter replacement, epidural top-up, and epidural vein cannulation. On the basis of current best evidence, a consistent benefit of CSE over epidural analgesia cannot be demonstrated for the outcomes assessed in our review. A large randomised controlled trial with adequate power is required.
    Anaesthesia 10/2013; 69(1). DOI:10.1111/anae.12456 · 3.38 Impact Factor
  • C Vandepitte · M Latmore · E O'Murchu · A Hadzic · M Van de Velde · S Nijs
    International journal of obstetric anesthesia 10/2013; 23(2). DOI:10.1016/j.ijoa.2013.10.004 · 1.60 Impact Factor
  • M Heesen · S Klöhr · R Rossaint · M van de Velde · S Straube
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    ABSTRACT: Background: Accidental dural puncture (ADP) after epidural analgesia (EDA) for labor pain may cause severe postdural puncture headache (PDPH) and may prolong hospital stay. We aimed to identify techniques that reduce the incidence of ADP. Methods: A systematic literature search was performed. Data on the occurrence of ADP and PDPH were extracted and subjected to meta-analysis. The random effects model was applied. Risk ratios (RR) and 95% confidence intervals (CI) were calculated. Results: We identified 54 articles, 13 non-randomized controlled trials and 41 randomized controlled trials (RCTs), reporting on a total of 98,869 patients. In non-RCTs, the use of liquid for the identification of the epidural space was associated with a reduced risk of ADP compared to the use of air (RR 0.55, 95% CI 0.39 to 0.79, P=0.001). In our analysis of RCTs this comparison did not produce a significant difference. No effect was found for combined spinal-epidural analgesia, maternal position, type of the catheter, needle size, bevel direction, operator experience, or use of ultrasound. Conclusion: A reduction of the risk of ADP was found for liquid use for the loss of resistance, but only in lower quality studies. Based on current evidence, we cannot make a recommendation regarding any of the techniques under study. Therefore, clinicians should focus on measures to prevent or treat PDPH once ADP has occurred.
    Minerva anestesiologica 07/2013; 79(10). · 2.13 Impact Factor

Publication Stats

713 Citations
195.52 Total Impact Points


  • 2003–2015
    • Universitair Ziekenhuis Leuven
      • • Department of Gynaecology and obstetrics
      • • Department of Anesthesiology
      Louvain, Flemish, Belgium
  • 2003–2014
    • University of Leuven
      • Division of Anesthesiology and Algology
      Louvain, Flemish, Belgium
  • 2013
    • St. Luke's Hospital
      CID, Iowa, United States
  • 2010
    • Ghent University
      • Department of Organic Chemistry
      Gand, Flemish, Belgium
  • 2001
    • University of Antwerp
      Antwerpen, Flemish, Belgium
  • 2000
    • Universitair Ziekenhuis Ghent
      Gand, Flemish, Belgium
  • 1994
    • Catholic University of Louvain
      Лувен-ла-Нев, Walloon, Belgium