Walter Swinnen

az Sint Blasius · Department of Anesthesiology & Critical Care

Abstract : Background : Compliance with quality and patient safety guidelines for anesthesia is important but difficult to obtain. Many hospitals worldwide are preparing for or passing an accreditation process with Joint Commission International (JCI), with anesthesia teams endeavoring optimal conformity with these JCI guidelines. Requirements invo...

Background Noninvasive ventilation (NIV) is a promising alternative to invasive mechanical ventilation (IMV) with a particular importance amidst the shortage of intensive care unit (ICU) beds during the COVID-19 pandemic. We aimed to evaluate the use of NIV in Europe and factors associated with outcomes of patients treated with NIV. Methods This i...

Purpose: Critically ill old intensive care unit (ICU) patients suffering from Sars-CoV-2 disease (COVID-19) are at increased risk for adverse outcomes. This post hoc analysis investigates the association of the Activities of Daily Living (ADL) with the outcome in this vulnerable patient group. Methods: The COVIP study is a prospective internatio...

Purpose: The number of patients ≥ 80 years admitted into critical care is increasing. Coronavirus disease 2019 (COVID-19) added another challenge for clinical decisions for both admission and limitation of life-sustaining treatments (LLST). We aimed to compare the characteristics and mortality of very old critically ill patients with or without CO...

Background: health-related quality of life (HRQoL) is an important patient-centred outcome in patients surviving ICU admission for COVID-19. It is currently not clear which domains of the HRQoL are most affected. Objective: to quantify HRQoL in order to identify areas of interventions. Design: prospective observation study. Setting: admissions to E...

Background Intensive care unit (ICU) patients age 90 years or older represent a growing subgroup and place a huge financial burden on health care resources despite the benefit being unclear. This leads to ethical problems. The present investigation assessed the differences in outcome between nonagenarian and octogenarian ICU patients. Methods We i...

Background: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score...

Background Sepsis is one of the most frequent reasons for acute intensive care unit (ICU) admission of very old patients and mortality rates are high. However, the impact of pre-existing physical and cognitive function on long-term outcome of ICU patients ≥ 80 years old (very old intensive care patients (VIPs)) with sepsis is unclear. Objective To...

Purpose: Lactate is an established prognosticator in critical care. However, there still is insufficient evidence about its role in predicting outcome in COVID-19. This is of particular concern in older patients who have been mostly affected during the initial surge in 2020. Methods: This prospective international observation study (The COVIP study...

The COVID-19 pandemic created a heavy burden on hospitals worldwide. Hospitals had to switch rapidly from standard care to emergency care and faced multiple problems in reorganizing care. Belgian hospitals had to activate their existing Business Continuity Plan (BCP), often for the 1st time outside the exercise context, challenging the correctness...

Background: The point prevalence survey of healthcare-associated infections (HAIs) and antimicrobial use organized by the European Centre for Disease Prevention and Control (ECDC-PPS) and the Global Point Prevalence Survey of antimicrobial consumption (Global-PPS) were simultaneously performed in Belgian acute care hospitals in 2017. Methods: Be...

To measure effects of patient centered care, patient reported outcome measures (PROMS) have been defined. Few PROMS for anesthesia have been defined or tested. The Quality of Recovery-15 score (QoR-15) could be suitable for PROMS for anesthesia, as it is a comprehensive and validated score, covering most postoperative issues about recovery after an...

Seasonal flu increases the number of hospital admissions importantly when hospital activities already act at a high level. In absence of a business continuity plan (BCP) for influenza, the 2017-2018 flu season was chaotic, with a heavy burden on hospital structures: complete saturation of het hospital, unsafe premature discharge of patients and po...

Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prev...

Background Ketorolac has been associated with a lower risk of recurrence in retrospective studies, especially in patients with positive inflammatory markers. It is still unknown whether a single dose of pre-incisional ketorolac can prolong recurrence-free survival. Methods The KBC trial is a multicenter, placebo-controlled, randomized phase III tr...

OBJECTIVES To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs). DESIGN Prospective cohort study. SETTING A total of 306 ICUs from 24 European countries. PARTICIPANTS Older adults admitted to European ICUs (N = 3730; median age = 84 years [in...

Background and Goal of Study: Quality and Patient Safety (QPS) is becoming increasingly important in the organization of healthcare. QPS in anesthesia is guided by the ‘Safety First’ standards of the Belgian Society of Anesthesia-Resuscitation. However, compliance with the standards is not the synonym of a good culture of QPS. The goal was to asses...

Introduction: Perioperative events may affect the risk of breast cancer recurrence after surgery. Ketorolac, a non-steroidal anti-inflammatory drug routinely used to improve pain control postoperatively has been associated with better breast cancer outcome in retrospective studies. However, it is still unknown whether a single dose of pre-incisiona...

The Top 10 Quality Indicators For Anesthesia Selected By Belgian Anesthesiologists Proposal Number: P-9085 Proposal Type: Poster Author: Tom Vansteenkiste AZ Sint-Blasius Co-Author(s): Walter Swinnen az Sint-Blasius Bart Van Damme AZ Sint-Blasius Marc Van de Velde UZ Leuven Introduction: Quality and Patient Safety (QPS) is becoming...

Introduction: Perioperative events may affect the risk of breast cancer recurrence after surgery. Ketorolac, a non-steroidal anti-inflammatory drug routinely used to improve pain control postoperatively has been associated with better breast cancer outcome in retrospective studies. But whether a single dose of pre-incisional ketorolac may be suffic...

PURPOSE: To evaluate differences in the characteristics and outcomes of intensive care unit (ICU) patients over time. METHODS: We reviewed all epidemiological data, including comorbidities, types and severity of organ failure, interventions, lengths of stay and outcome, for patients from the Sepsis Occurrence in Acutely ill Patients (SOAP) study,...

Depuis 2009, l’Organisation Mondiale de la Santé (OMS) promeut l’utilisation de la check-list sécurité du patient (CL) dans tous les blocs opératoires, afin de réduire les événements indésirables et de sauver des vies.L’usage de la CL fait partie des directives internationales en matière de sécurité des patients et est requis par les autorités de s...

We explored opinions of OR professionals on the appropriateness of the items in the original WHO SSC.

5 years after the introduction of the SSC in Flemish hospitals, we explored the presence of feelings of pressure among OR professionals, when using the SSC.

We observed the process improving compliance with JCI standards for anesthesia around an accreditation audit and assessed durability of improvement 1 year later

Presentation about the reasons why earlier national programs for data collection in Belgian ICU’s failed.

Hoewel deze studie veel verbeterpotentieel aantoont bij het gebruik van SSC, toont ze ook dat de SSC universeel geac-cepteerd is in de Vlaamse Operatiezalen. De positieve impact van de SSC weegt zeker op tegen de klassieke negatieve opinies.

Perceptie van druk voor of tegen het gebruik van de SSC blijft al bij al beperkt. Hierbij worden de traditionele schei-dingslijnen tussen de verschillende professionele groepen bevestigd. Artsen lijken minder betrokken om het gebruik van de SSC te stimuleren.

In Vlaamse Operatiezalen worden niet alle items van de WHO SSC even noodzakelijk gevonden. In het bijzonder ver-wacht bloedverlies, team voorstelling en verwachte operatieduur worden minder geapprecieerd. De opinies worden duidelijk gestuurd door direct professioneel belang.

A SurveyMonkey survey was open for all surgeons, anesthesiologists, and OR nurses in 55 hospitals in Flanders (Belgium), between February 15th and March 29th 2016. This part of the survey searched for knowledge and opinions about the SSC. Although this study shows important room for improvement in the use of the SSC, Flemish HCP universally have ad...

Deze presentatie vertelt de vereisten, hindernissen, de aankoopprocedure en de technologische implementatie van EWS in az Sint-Blasius (Dendermonde) en az Groeninge (Kortrijk)

This continuous quality improvement program shows that the sys- tematic use of evidence based and PDCA-cycle driven process im- provements may contribute to reduce VAP-rate.

This continuous quality improvement program shows that the systematic use of evidence based and PDCA-cycle driven process improvements may contribute to reduce VAP-incidence.

Introduction: It's becoming more and more important for hospitals not only to deliver quality medical care, but also to show proof of this quality. The Joint Commission International defined standards to do this. The goal of this study was to compare adherence of these standards in an outpatient versus an inpatient operation theatre in a Belgian ge...

This study provides a view on the preparatory process and increasing compliance to JCI standards in the months prior to audit. The streamlining of procedures, communication to the professionals involved in the perioperative process and close follow-up demonstrate the strong potential of improvement in hospitals preparing for JCI-accreditation.

Is het mogelijk om op Intensieve Zorgen tot benchmarking te komen? Problemen en mogelijke oplossingen.

In order to avoid microaspiration and tracheal injury, the target for endotracheal tube cuff pressure is 20 to 30 cm H2O. Objective: To assess the effect of changes in body position on cuff pressure in adult patients. Methods: Twelve orally intubated and sedated patients received neuromuscular blockers and were positioned in a neutral starting po...

In order to avoid either microaspiration ( 30 cmH2O), the target for endotracheal tube (ETT) cuff pressure (CP) is between 20 and 30 cmH2O. Our objective was to assess the effect of patient positioning changes on CP in adult patients.

Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial. Prospective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry. Two hundred twenty patients admit...