Research Staff Other
Biography
Special interest/expertise
Clinical pharmacology and clinical toxicology in intensive care patients. Maaike works at the intensive care and the Dutch Poisons Information Center of the University Medical Center of Utrecht in The Netherlands. Physiological changes in critically ill patients may have a large effect on pharmacokinetics. For instance, tacrolimus pharmacokinetics may change highly, especially bioavailability extremely varies directly after heart and lung transplantation. Tacrolimus is an immunosuppressant for which correct dosing is important. How to improve tacrolimus dosing in these critically ill patients is still unraveled.
Further, correct antibiotic treatment on the intensive care is of utmost importance. A lot of intensive care patients develop acute kidney injury or augmented renal clearance, which both may have an extreme effect on blood concentrations of e.g., betalactam antibiotics. Improving the intitial antibiotic dose may have a positive effect on outcomes of these vulnerable patients. Enhancing the establishment of renal function is needed to improve correct antibiotic treatment. The measured renal creatinine clearance maybe a practical approach and shows that a large part, approximately 33%, of critically ill patients may have augmented renal clearance. Nevertheless, the unrestraind escalation of antibiotics may lead to overdosing and caution should be taken. Research and training of doctors on these topics are important and often generates new questions and insights that help us further investigate and improve treatment of the critically ill.