Our research focuses on improving the care for patients with acute illnesses by addressing different aspects of their treatment. We aim to improve the early recognition of acute diseases through the analysis of demographic, nursing, and medical data, as well as the development of diagnostic tests and clinical decision support tools. In addition, we investigate individual factors that predict the response to therapy and aim to develop new treatments for acute diseases. We also identify risk factors for the development of acute illnesses and study their impact on the patient's quality of life and survival long after hospital discharge. Our goal is to develop preventive measures and minimize the long-term impact of acute illnesses on patients.
Our research mainly focuses on the following aspects of acute diseases in general and specifically on early sepsis, syncope, and the use of point-of-care-ultrasound (POCUS):
We develop personalized medicine for patients with sepsis by improving recognition, predicting individual response to treatment and developing novel treatments. The early sepsis research group performs translational and fundamental research to improve recognition of early sepsis, identify risk markers to predict response to treatment and develop novel treatment strategies to improve outcome for patients with sepsis. Risk markers associated with the clinical course in patients with early sepsis, will be exploited in pre-clinical models of sepsis (i.e. cells, mice, fruit flies) to identify novel therapeutic targets to feed drug discovery, with a specific focus on preservation of mitochondrial function, which is considered to be the culprit in the induction of organ failure in sepsis.
We aim to improve recognition and personalized management of syncope, specifically targeting orthostatic hypotension. By utilizing advanced haemodynamic profiling and continuous blood pressure monitoring, we examine the different subtypes and their diverse clinical manifestations. Through a comprehensive approach that includes patient history, physical examination, and blood pressure assessment, we will differentiate between neurogenic and non-neurogenic origins for tailored intervention strategies. We emphasize a systematic, individualized, approach, investigating the efficacy of non-pharmacological lifestyle modifications, counterpressure techniques and pharmacological therapy. The overarching objective is to enhance patient outcomes and promote early identification of underlying conditions for primary or secondary autonomic dysfunction, such as Parkinson's disease or associated synucleinopathies.
Point-of-care ultrasound is the use of ultrasonography by the treating physician to answer different clinical questions, in contrast to a more comprehensive ultrasound as performed by the radiologist. POCUS has several advantages compared to conventional diagnostics: it is fast, dynamic, it has no radiation, and results can be directly integrated in clinical decision making. For our research we focus on two important aspects of POCUS. First, POCUS is important in hemodynamic monitoring and fluid resuscitation for acute ill patients as it is non-invasive, fast and can be repeated in time to guide resuscitation. POCUS may be combined with other non-invasive devices to estimate changes in cardiac output or monitor changes in vital signs. Second, our research focus on the training program of POCUS, as the results are operator dependent and increasingly reliable with more experience. We need to optimize the ultrasound curriculum with assessment of proficiency, but also to integrate ultrasound/ POCUS sooner in the bachelor of medicine. The optimal way to assess proficiency or the minimal number of exams needed to obtain reliable results remain unknown. We investigate the effect of POCUS on clinical reasoning and decision making to improve acute patient care.
Our research aims to move beyond the "one size fits all" approach to acute care by developing personalized medicine for patients with an acute disease. We identify individual factors that predict response to therapy and use these to develop clinical decision support tools that enable clinicians to quickly and accurately determine the best course of treatment. We also investigate new treatments for acute illnesses by analysing patient data and biomarkers associated with disease outcomes. Our goal is to improve patient outcomes and quality of life by developing tailored approaches to acute care. The Acutelines data-biobank plays a key role in the discovery of individual factors predictive of response to therapy – such as vital parameters, electrophysiologic waveforms or biomarkers - and to use these to develop clinical decision support tools.
To reach our scientific aims and improve acute care, we have set up the data-biobank Acutelines. The collection of data and biomaterials in Acutelines follows the FAIR (Findable, Accessible, Interoperable and Reusable) principles for research: the metadata are described in the Groningen datacatalogus and are available for use by other researchers. In different research projects we aim te decipher the mechanisms of health and acute illness for the purpose of developing personalized treatments. The research projects are embedded within the following research themes within the Emergency Department:
Timely recognition of the correct diagnosis and expected course is essential for providing appropriate care and making the best decisions regarding treatment and patient well-being. However, early recognition of acute illnesses can be complex as symptoms may not be fully present and biomarkers are not yet indicative. Our research aims to improve early recognition of acute illnesses and predict their course through analysis of demographic, nursing, and medical data at the organ and molecular levels. The goal is to develop screening tools/diagnostic tests, improve patient triage, develop care pathways, and conduct research on the effects of early treatment with relevant partners.
Treatment based on the "one size fits all" principle is often applied (think of resuscitation care or sepsis), but does not necessarily result in the best treatment for all patients. In this research line, our aim is to a) identify individual factors that predict therapy response and b) develop new treatments for acute diseases. Individual factors predicting therapy response are used to develop clinical decision support tools that can help clinicians to establish the right treatment earlier. Analysis of patterns in demographic/medical data or (bio)markers associated with disease outcome in preclinical disease models can unravel disease mechanisms, allowing for the development of new treatments for acute diseases, including drug studies (phase II/III) within the Center for Acute Care.
An acute illness can have a significant impact on health and survival long after hospital discharge. In this research line, we identify risk factors for the development of acute illness and investigate the effect of acute illness (and treatment) on survival and quality of life after discharge. Our goal is to a) identify high-risk groups for the development of acute illnesses, b) develop preventive measures to reduce the chance of an acute illness (or recurrence), and c) minimize the long-term impact of acute illness and honour the quality of life. Patient-reported outcome and experience measures (PROMs/PREMs) are measured using validated instruments that are not specifically focused on acute care. The goal is to develop and validate specific instruments that efficiently measure relevant PROMs and PREMs after an acute illness.
