Diagnostic, prognostic and therapeutic strategies in critically ill COVID–19 patients

Research output: PhD ThesisPhd-Thesis - Research and graduation internal


This thesis is a collection of investigations focusing on classification and prognostication, and strategies to improve oxygenation in patients with COVID-19.
In Chapter 2 we report the results of an observational study including 109 critically ill COVID-19 patients and suggest that an adjusted definition Berlin definition, in which PEEP is replaced by a minimum level of air flow in patients under HFNO results in comparable groups. Chapter 3 contains the results of an international multicenter observational study in 139 COVID-19 ARDS patients. We concluded that the baseline RALE score has no prognostic value, but that an increase of the RALE score does.
In Chapter 4 we report the results of a multicenter observational study in 82 COVID-19 ARDS patients. We concluded that the CTSS was associated with mortality, while the RALE score did not. In Chapter 5 we present the findings of an observational study in 28 COVID-19 ARDS patients with a lung CT scan at low and high PEEP. We concluded that these frequently have collapsed lung tissue that can be reaerated.
Chapter 6 shows the results of an analysis in 933 COVID-19 ARDS patients that were categorized as having received higher or lower PEEP. We concluded that higher PEEP does not confer clinical benefit in invasively ventilated COVID-19 ARDS patients.
In Chapter 7 of the 734 COVID-19 ARDS patients, 438 patients received early prone positioning. We concluded that there was no difference in mortality at day 28.
In Chapter 8 we describe the rational of the ‘Practice of Adjunctive Treatments in Intensive Care Unit Patients with Coronavirus Disease 2019’ (PRoAcT-COVID) study.
In Chapter 9 we investigated the practice of awake prone positioning in 946 patients. We concluded that awake prone positioning was used in one in every six patients.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • University of Amsterdam
  • Schultz, Marcus, Supervisor
  • Paulus, Frederique, Co-supervisor
Award date7 Jun 2022
Print ISBNs9789464582277
Publication statusPublished - 2022

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