Horn J.: Neurology on the Intensive Care Unit

Project Details


Two fields at the interface of intensive care medicine and neurology are my research topics: ICU acquired weakness (ICU-AW) and brain injury after cardiac arrest.
ICU-AW is a major problem which leads to increased mortality and disability. We investigated methods to establish the diagnosis early, autonomic nervous system problems and long-term disability. Despite the research of Luuk Wieske (PhD student), early diagnosis is still difficult. A model for a risk score was developed. This is currently validated in a new large cohort of ICU patients (by Esther Witteveen (PhD student)). She also investigates the use of ultrasound as a diagnostic test. As pathophysiology of ICU-AW is unclear we are developing an animal model in the LEICA laboratory. In this model we will investigate the inflammatory mechanisms involved in ICU-AW and the role of complement activation. Finally, the diaphragm seems to be especially sensitive to the harmful effects of mechanical ventilation. Ventilation induced diaphragm dysfunction is a recently recognized entity on the ICU. With the already available knowledge on ICU-AW we will further develop our research into this topic. Monitoring of the electrical activity of the diaphragm will become a major topic of research. Collaboration exists with the department of neurology and rehabilitation of the AMC and the department
of physiology of the VUMC (C. Ottenheim). A Doelmatigheidsgrant has been applied for.
In brain injury after cardiac arrest both treatment and optimal prognostication have been studied and will be the topics for the years to come. By optimizing treatment, brain injury can probably be diminished leading to an improved outcome. Both temperature strategies and neuroprotective drugs will be studied. In postanoxic coma, reliable tools to determine the prognosis of the patient have been developed. However, many questions remain. A large (intern)national collaboration exists for this research topic.
Effective start/end date1/01/2013 → …