Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Record number 497827
Title Slowing down of recovery as generic risk marker for acute severity transitions in chronic diseases
Author(s) Olde Rikkert, M.G.M.; Dakos, V.; Buchman, T.; Boer, R. de; Glass, L.; Cramer, A.O.J.; Levin, S.; Nes, E.H. van; Sugihara, G.; Ferrari, M.D.; Tolner, E.A.; Leemput, I.A. van de
Source Critical Care Medicine 44 (2016)3. - ISSN 0090-3493 - p. 601 - 606.
DOI https://doi.org/10.1097/CCM.0000000000001564
Department(s) Aquatic Ecology and Water Quality Management
WIMEK
Publication type Refereed Article in a scientific journal
Publication year 2016
Abstract OBJECTIVE:

We propose a novel paradigm to predict acute attacks and exacerbations in chronic episodic disorders such as asthma, cardiac arrhythmias, migraine, epilepsy, and depression. A better generic understanding of acute transitions in chronic dynamic diseases is increasingly important in critical care medicine because of the higher prevalence and incidence of these chronic diseases in our aging societies.

DATA SOURCES:

PubMed, Medline, and Web of Science.

STUDY SELECTION:

We selected studies from biology and medicine providing evidence of slowing down after a perturbation as a warning signal for critical transitions.

DATA EXTRACTION:

Recent work in ecology, climate, and systems biology has shown that slowing down of recovery upon perturbations can indicate loss of resilience across complex, nonlinear biologic systems that are approaching a tipping point. This observation is supported by the empiric studies in pathophysiology and controlled laboratory experiments with other living systems, which can flip from one state of clinical balance to a contrasting one. We discuss examples of such evidence in bodily functions such as blood pressure, heart rate, mood, and respiratory regulation when a tipping point for a transition is near.

CONCLUSIONS:

We hypothesize that in a range of chronic episodic diseases, indicators of critical slowing down, such as rising variance and temporal correlation, may be used to assess the risk of attacks, exacerbations, and even mortality. Identification of such early warning signals over a range of diseases will enhance the understanding of why, how, and when attacks and exacerbations will strike and may thus improve disease management in critical care medicine.
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