Anton van Kaam

Anton van Kaam
Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands · Neonatology

MD, PhD

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254
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Introduction

Publications

Publications (254)
Article
Full-text available
Introduction. Caffeine is the registered pharmacologic treatment for apnea of prematurity and is extensively used in the neonatal intensive care units (NICUs) based on evidence from randomized controlled trials. This study aimed to describe the clinical use of caffeine based on real-world data, hypothesizing a divergence from the registered dosing...
Article
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Background Physiological-based cord clamping (PBCC) in preterm infants is beneficial for cardiovascular transition at birth and may optimize placental transfusion. Whether PBCC can improve clinical outcomes is unknown. The aim of the Aeration, Breathing, Clamping (ABC3) trial was to test whether PBCC results in improved intact survival in very pret...
Conference Paper
Introduction Apnea of prematurity (AOP) is a clinical manifestation of an immature control of breathing in preterm infants. Caffeine therapy is the cornerstone of pharmacologic treatment for AOP, and is among the most frequently used medications in preterm infants. Although caffeine has been well studied in trials as well as in popPK studies, the d...
Article
Background: Bronchopulmonary dysplasia (BPD) remains an important complication of prematurity. Pulmonary inflammation plays a central role in the pathogenesis of BPD, explaining the rationale for investigating postnatal corticosteroids. Multiple systematic reviews (SRs) have summarised the evidence from numerous randomised controlled trials (RCTs)...
Article
Background and objectives: To provide support to parents of critically ill children, it is important that physicians adequately respond to parents' emotions. In this study, we investigated emotions expressed by parents, physicians' responses to these expressions, and parents' emotions after the physicians' responses in conversations in which cruci...
Article
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Amikacin is an aminoglycoside antibiotic that is frequently used for the treatment of neonatal late‐onset sepsis, for which therapeutic drug monitoring (TDM) is advised. In order to decrease the TDM associated burden of plasma sampling, a noninvasive TDM method using saliva samples was investigated. Methods This was a prospective single‐centre, ob...
Article
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Background and method Dutch obstetrics guideline suggest an initial maternal benzylpenicillin dose of 2,000,000 IU followed by 1,000,000 IU every 4 h for group-B-streptococci (GBS) prophylaxis. The objective of this study was to evaluate whether concentrations of benzylpenicillin reached concentrations above the minimal inhibitory concentrations (M...
Article
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Delay in the time-to-positivity of a peripheral blood culture (PBC), the gold standard for early onset neonatal sepsis (EOS) diagnosis, has resulted in excessive use of antibiotics. In this study, we evaluate the potential of the rapid Molecular Culture (MC) assay for quick EOS diagnosis. In the first part of this study, known positive and spiked b...
Article
Background: Systematic reviews showed that systemic postnatal corticosteroids reduce the risk of bronchopulmonary dysplasia (BPD) in preterm infants. However, corticosteroids have also been associated with an increased risk of neurodevelopmental impairment. It is unknown whether these beneficial and adverse effects are modulated by differences in...
Article
Background: Bronchopulmonary dysplasia (BPD), defined as oxygen dependence at 36 weeks' postmenstrual age (PMA), remains an important complication of prematurity. Pulmonary inflammation plays a central role in the pathogenesis of BPD. Attenuating pulmonary inflammation with postnatal systemic corticosteroids reduces the incidence of BPD in preterm...
Article
BACKGROUND Cyclooxygenase inhibitors are commonly used in infants with patent ductus arteriosus (PDA), but the benefit of these drugs is uncertain. METHODS In this multicenter, noninferiority trial, we randomly assigned infants with echocardiographically confirmed PDA (diameter, >1.5 mm, with left-to-right shunting) who were extremely preterm (<2...
Article
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The total uptake of prenatal aneuploidy screening for Down syndrome (DS) is increasing worldwide. As a result of increasing prenatal diagnosis of DS and subsequent termination of pregnancy, livebirth prevalence of DS is decreasing. The aim of this study is to explore the impact of an increasing uptake of prenatal aneuploidy screening on the neonata...
Article
Background Stress during treatment at the Neonatal Intensive Care Unit (NICU) has long-term negative consequences on preterm infants' development. Aims We developed an instrument suited to validly determine the cumulative stress exposure for preterm infants in a NICU. Study design This survey study made use of two consecutive questionnaires. Sub...
Article
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Objective: To assess adverse perinatal outcomes and caesarean section of low-risk women receiving elective induction of labour at 41 weeks or expectant management until 42 weeks according to their preferred and actual management strategy. Design: Multicentre prospective cohort study alongside RCT. Setting: 90 midwifery practices and 12 hospitals in...
Article
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Objective To assess adverse perinatal outcomes and caesarean section of low-risk women receiving elective induction of labour at 41 weeks or expectant management until 42 weeks according to their preferred and actual management strategy Design Multicentre prospective cohort study alongside RCT. Setting 90 midwifery practices and 12 hospitals in t...
Article
BACKGROUND AND OBJECTIVES Physicians and parents of critically ill neonates and children receiving intensive care have to make decisions on the child’s behalf. Throughout the child’s illness and treatment trajectory, adequately discussing uncertainties with parents is pivotal because this enhances the quality of the decision-making process and may...
Chapter
Lung function is often compromised in preterm infants because of structural (lung parenchyma, airways, chest wall) and sometimes biochemical (surfactant deficiency) immaturity of the respiratory system. This can result in significant alterations in pulmonary mechanics, a low functional residual capacity (FRC), and an increased work of breathing (WO...
Article
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Background Controversy exists about the optimal management of a patent ductus arteriosus (PDA) in preterm infants. A persistent PDA is associated with neonatal mortality and morbidity, but causality remains unproven. Although both pharmacological and/or surgical treatment are effective in PDA closure, this has not resulted in an improved neonatal o...
Article
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Aims Therapeutic drug monitoring (TDM) of gentamicin in neonates is recommended for safe and effective dosing and is currently performed by plasma sampling, which is an invasive and painful procedure. In this study, feasibility of a non‐invasive gentamicin TDM strategy using saliva was investigated. Methods This was a multicentre, prospective, obs...
Article
Peripheral blood culture (PBC) is considered the gold standard for diagnosis of neonatal early-onset sepsis (EOS), but its diagnostic value can be questioned. We aimed to systematically asses the diagnostic test accuracy (DTA) of umbilical cord blood culture (UCBC) for EOS. A systematic literature search was performed in PubMed, Embase, Web of Scie...
Article
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Background Intensive care doctors have to find the right balance between sharing crucial decisions with families of patients on the one hand and not overburdening them on the other hand. This requires a tailored approach instead of a model based approach. Aim To explore how doctors involve families in the decision-making process regarding life-sus...
Article
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Objective: To evaluate if Non-Invasive Prenatal Testing (NIPT) affects livebirth (LB) prevalence of Down syndrome (DS) in the Netherlands. Method: Data from clinical genetics laboratories and the Working Party on Prenatal Diagnosis and Therapy (2014 - 2018) and previous published data (1991-2013) were used to assess trends for DS LB prevalence a...
Article
Full-text available
Objective of the current study was to assess whether game-formatted executive function (EF) training, is effective in improving attention, EF and academic performance in very preterm and/or extremely low birthweight children aged 8–12 years. A multi-center, double-blind, placebo- and waitlist controlled randomized trial (NTR5365) in two academic ho...
Article
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Evidence suggests that increased survival over the last decades of very preterm (VPT; gestational age < 32 weeks)– and very low birth weight (VLBW; birth weight < 1500 g)–born infants is not matched by improved outcomes. The objective of our study was to evaluate the reproductive rate, fertility, and pregnancy complications in 35-year-old VPT/VLBW...
Article
Background: The role of intestinal microbiota in the pathogenesis of late onset sepsis (LOS) in preterm infants is largely unexplored, but could provide opportunities for microbiota-targeted preventive and therapeutic strategies. We hypothesized that microbiota composition changes before the onset of sepsis with causative bacteria that are isolate...
Article
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Electrical impedance tomography (EIT) is a non-invasive imaging modality that can provide information about dynamic volume changes in the lung. This type of image does not represent structural lung information but provides changes in regions over time. EIT raw datasets or boundary voltages are comprised of two components, termed real and imaginary...
Article
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Necrotizing enterocolitis (NEC) is one of the most common and lethal gastrointestinal diseases in preterm infants. Early recognition of infants in need for surgical intervention might enable early intervention. In this multicenter case-control study, performed in nine neonatal intensive care units, preterm born infants (< 30 weeks of gestation) dia...
Article
[Heading level A] Bronchopulmonary dysplasia (BPD) is the most common morbidity of preterm infants, and its incidence has not responded to research and intervention efforts to the same degree as other major morbidities associated with prematurity. The complexity of neonatal respiratory care as well as persistent inter-institutional variability in B...
Article
This paper presents a new method for selecting a patient specific forward model to compensate for anatomical variations in electrical impedance tomography (EIT) monitoring of neonates. The method uses a combination of shape sensors and absolute reconstruction. It takes advantage of a probabilistic approach which automatically selects the best estim...
Article
To the Editor In the Maternal Omega-3 Supplementation to Reduce Bronchopulmonary Dysplasia in Very Preterm Infants (MOBYDIck) trial, Dr Marc and colleagues¹ reported no difference in bronchopulmonary dysplasia–free survival but higher rates for bronchopulmonary dysplasia in premature infants whose breastfeeding mothers received docosahexaenoic acid...
Article
Bronchopulmonary dysplasia (BPD) is the most common complication of pre-term birth with long lasting sequelae. Since its first description more than 50 years ago, many large randomized controlled trials have been conducted, aiming to improve evidence-based knowledge on the optimal strategies to prevent and treat BPD. However, most of these interven...
Article
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Background Individual contextual factors like gestational age (GA) or previous painful experiences have an influence on neonates' pain responses and may lead to inaccurate pain assessment when not appropriately considered. Objectives We set out to determine the influence of individual contextual factors on variability in pain response in neonates,...
Article
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Background The importance of lung recruitment before surfactant administration has been shown in animal studies. Well designed trials in preterm infants are absent. We aimed to examine whether the application of a recruitment manoeuvre just before surfactant administration, followed by rapid extubation (intubate-recruit-surfactant-extubate [IN-REC-...
Article
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Pneumothorax is a potentially life‐threatening complication of neonatal respiratory distress syndrome (RDS). We describe a case of a tension pneumothorax that occurred during neurally adjusted ventilatory assist (NAVA) in a preterm infant suffering from RDS. The infant was included in a multicenter study examining the role of electrical impedance t...
Article
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Fecal volatile organic compounds (VOC) reflect human and gut microbiota metabolic pathways and their interaction. VOC behold potential as non-invasive preclinical diagnostic biomarkers in various diseases, e.g., necrotizing enterocolitis and late onset sepsis. There is a need for standardization and assessment of the influence of clinical and envir...
Article
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Objectives The intestinal microbiota develops in early infancy and is essential for health status early and later in life. In this review we focus on the effect of prenatal and intrapartum maternally administered antibiotics on the infant intestinal microbiota. Methods A systematic literature search was conducted in PubMed and EMBASE. All studies...
Article
Objective: Non-adhesive textile electrode belts offer several advantages over adhesive electrodes and are increasingly used in neonatal patients during continuous electrical impedance tomography (EIT) lung monitoring. However, non-adhesive belts may rotate in unsedated patients and discrepancies between chest circumference and belt sizes may resul...
Article
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Background: Very preterm children often have difficulties in behavioral functioning, but there is large heterogeneity in the severity of these difficulties and in the combination of the difficulties observed. Few studies so far addressed this heterogeneity by examining whether more homogeneous subtypes of behavioral functioning can be identified....
Article
Importance Most preterm infants require respiratory support to establish lung aeration after birth. Intermittent positive pressure ventilation and continuous positive airway pressure are standard therapies. An initial sustained inflation (inflation time >5 seconds) is a widely practiced alternative strategy. Objective To conduct a systematic revie...
Article
Background: Late onset sepsis (LOS) in preterm infants is preceded by fecal volatile organic compound (VOC) alterations, suggesting an etiological role of gut microbiota in LOS rather than being primarily caused by central venous catheters (CVC). To increase our knowledge about the involvement of the gut microbiota in LOS, we analyzed fecal sample...
Article
This review summarizes the current knowledge on the physiological action of endogenous and exogenous pulmonary surfactant, the role of different types of animal-derived and synthetic surfactants for RDS therapy, different modes of administration, potential risks and strategies of ventilation, and highlights the most promising aims for future develo...
Article
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Background: Infants are currently stabilized at birth with initial low FiO2 which increases the risk of hypoxia and suppression of breathing in the first minutes after birth. We hypothesized that initiating stabilization at birth with a high O2 concentration, followed by titration, would improve breathing effort when compared to a low O2 concentrat...
Article
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Background: Results from preclinical studies suggest that age-dependent differences in host defense and the pulmonary renin-angiotensin system (RAS) are responsible for observed differences in epidemiology of acute respiratory distress syndrome (ARDS) between children and adults. The present study compares biomarkers of host defense and RAS in bro...
Article
( BMJ . 2019;364:I344) Because of the fact that postterm pregnancy (defined as pregnancy extended to or beyond 42 weeks gestation) has been associated with increased perinatal morbidity and mortality, induction of labor is recommended after 42 weeks gestation. Although the probability of positive outcomes for neonates born between 40 and 42 weeks g...
Article
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Neonatal respiratory failure is a common and serious clinical problem which in a considerable proportion of infants requires invasive mechanical ventilation. The basic goal of mechanical ventilation is to restore lung function while limiting ventilator-induced lung injury, which is considered an important risk factor in the development of bronchopu...
Article
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Objective: To determine the effect of changing electrode positions on vital signs and respiratory effort parameters measured with transcutaneous electromyography of the diaphragm (dEMG) in preterm infants. Methods: In this observational study, simultaneous dEMG measurements were performed at the standard position and at one alternative electrode...
Article
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Aim: This study determined possible discrepancies between verbal IQ and performance IQ in eight-year-old very preterm (VPT) and extremely preterm (EPT) children, and examined associations between verbal IQ and performance IQ, and sociodemographic factors, perinatal factors, early cognitive outcomes and also with school achievement scores. Methods...
Article
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(Abstracted from Pediatrics 2019;143(6):e20183253) Guidelines on management of extreme prematurity differ regarding the lowest limits of gestation for which active support can or should be offered the recommendations for the role of parents in the decision making. In addition, the use of gestational age (GA) as a cutoff has been debated because oth...
Article
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Introduction Preterm birth complicates >15 million pregnancies annually worldwide. In many countries, women who present with signs of preterm labour are treated with tocolytics for 48 hours. Although this delays birth, it has never been shown to improve neonatal outcome. In 2015, the WHO stated that the use of tocolytics should be reconsidered and...
Article
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Objectives: To identify antenatal ultrasound markers and their predictive value in differentiating between simple and complex gastroschisis. Methods: Prospective nationwide study in which serial longitudinal ultrasound examinations were performed at regular specified intervals between 20 and 37 weeks in isolated fetal gastroschisis cases. The pr...
Article
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Objective: To determine whether complex gastroschisis (i.e. intestinal atresia, perforation, necrosis or volvulus) can prenatally be distinguished from simple gastroschisis by fetal stomach volume and stomach-bladder distance, using three-dimensional (3D) ultrasound. Methods: This multicenter prospective cohort study was conducted in the Netherl...
Article
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Objective Very preterm children have poorer attentional, behavioral and emotional functioning than term-born children. Problems on these domains have been linked to poorer executive function (EF). This study examined effects of a game-formatted, comprehensive EF training on attentional, behavioral and emotional functioning and self-perceived compet...
Poster
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Poster on our research investigating the use of transcutaneous electromyography of the diaphragm as a tool to monitor work of breathing in preterm infants.
Article
Background: Exogenous surfactant administration is an essential part of respiratory distress syndrome treatment in preterm infants. Current guidelines recommend the first dose to be given as early as possible, followed by an additional dose if symptoms persist. The effect of additional dosing on regional ventilation and lung volume has not been in...
Article
Transcutaneous electromyography (tc-EMG) has been used to measure the electrical activity of respiratory muscles during inspiration in various studies. Processing the raw tc-EMG signal of these inspiratory muscles has shown to be difficult as baseline noise, cardiac interference, cross-talk and motion artefacts can influence the signal quality. In...
Article
Probiotics are effective in reducing necrotising enterocolitis in preterm infants, but routine use is not generally adopted. We describe a safety issue concerning contamination by pathogenic bacteria and missing of labeled strains in a probiotic product widely used in neonatal care. We recommend all centers using probiotics in the care of vulnerabl...
Article
Pneumothoraces are common in preterm infants and are a major cause of morbidity. Early detection and treatment of pneumothoraces is vital to minimize further respiratory compromise. Electrical Impedance Tomography (EIT) has been suggested as a method of rapidly detecting pneumothoraces at the bedside. Our objective was to define the EIT-derived reg...
Article
(Abstracted from BMJ 2019;364:l344) Postterm pregnancy, defined as a pregnancy extended to or beyond 42 weeks, is associated with increased perinatal morbidity and mortality. The risk of adverse perinatal outcome increases gradually after 40 weeks, even though favorable perinatal outcomes between 40 and 42 weeks are good in high-resource settings.
Article
Objectives: To develop a nationwide, evidence-based framework to support prenatal counseling in extreme prematurity, focusing on organization, decision-making, content, and style aspects. Methods: A nationwide multicenter RAND-modified Delphi method study was performed between November 2016 and December 2017 in the Netherlands. Firstly, recommen...
Article
Background: Compared to their term-born peers, children born very preterm are at risk for poorer cognitive, academic and behavioral outcomes, however this finding may have been confounded by lower parental education level in the very preterm children. Studies that compare very preterm and term-born children with comparable (high) parental educatio...
Article
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Most preterm infants breathe at birth, but need additional respiratory support due to immaturity of the lung and respiratory control mechanisms. To avoid lung injury, the focus of respiratory support has shifted from invasive towards non-invasive ventilation. However, applying effective non-invasive ventilation is difficult due to mask leak and air...
Article
Improving the quality of care delivered to neonates who require support at birth saves lives and improves long-term outcomes. However, conducting studies in the delivery room can be ethically difficult. To manage the challenge of obtaining prospective consent for delivery room studies, guidelines on deferring the consent process have been establish...
Article
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Background: Although most preterm infants breathe at birth, their respiratory drive is weak and supplemental oxygen is often needed to overcome hypoxia. This could in turn lead to hyperoxia. To reduce the risk of hyperoxia, currently an initial low oxygen concentration (21–30%) is recommended during stabilization at birth, accepting the risk of a h...
Article
Objective To evaluate incidence of minimally invasive surfactant therapy (MIST) failure, identify risk factors and assess the impact of MIST failure on neonatal outcome. Design Retrospective cohort study. MIST failure was defined as need for early mechanical ventilation (<72 hours of life). Multivariate logistic regression analysis was performed t...
Article
Full-text available
Background: Most preterm infants fail to aerate their immature lungs at birth and need respiratory support for cardiopulmonary stabilization. Cord clamping before lung aeration compromises cardiovascular function. Delaying cord clamping until the lung has aerated may be beneficial for preterm infants by optimizing hemodynamic transition and placent...
Article
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Background: Late-onset sepsis (LOS) in preterm infants is a leading cause of mortality and morbidity. Timely recognition and initiation of antibiotics are important factors for improved outcomes. Identification of risk factors could allow selection of infants at an increased risk for LOS. Objectives: The aim was to identify risk factors for LOS....
Article
Full-text available
Aim To investigate the magnitude of executive function deficits and their dependency on gestational age, sex, age at assessment, and year of birth for children born preterm and/or at low birthweight. Method PubMed, PsychINFO, Web of Science, and ERIC were searched for studies reporting on executive functions in children born preterm/low birthweigh...
Article
Importance Preterm infants must establish regular respirations at delivery. Sustained inflations may establish lung volume faster than short inflations. Objective To determine whether a ventilation strategy including sustained inflations, compared with standard intermittent positive pressure ventilation, reduces bronchopulmonary dysplasia (BPD) or...
Article
Objective To investigate the association between invasive mechanical ventilation (IMV) duration and long-term neurodevelopmental outcomes in preterm infants in an era of restricted IMV. Design Retrospective cohort study. Setting Single neonatal intensive care unit in Amsterdam. Patients All ventilated patients with a gestational age between 24 a...
Article
Full-text available
Objective: Continuous functional thorax monitoring using EIT has been extensively researched. A limiting factor in high temporal resolution, three dimensional, and fast EIT is the handling of the volume of raw impedance data produced for transmission and storage. Owing to the periodicity of breathing that may be reflected in EIT boundary measureme...