Acute and Critical Care

Letter to the Editor

Ethics
The Authors Reply: Jeong Uk Lim, Jongmin Lee, Jick Hwan Ha, Hyeon Hui Kang, Sang Haak Lee, Hwa Sik Moon; Korean J Crit Care Med. 2017;32(4):377-379. Published online November 30, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00521.r1

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Original Article

Rapid response system
Demographic Changes in Intensive Care Units in Korea over the Last Decade and Outcomes of Elderly Patients: A Single-Center Retrospective Study: Jeong Uk Lim, Jongmin Lee, Jick Hwan Ha, Hyeon Hui Kang, Sang Haak Lee, Hwa Sik Moon; Korean J Crit Care Med. 2017;32(2):164-173. Published online May 31, 2017; DOI: https://doi.org/10.4266/kjccm.2016.00668

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Background
Aging is a significant issue worldwide, and Korea is one of the most rapidly aging countries. Along with the demographic transition, the age structure of intensive care unit (ICU) patients changes as well.
Methods
The aim of this study was to analyze the change in age distribution of the ICU patients over the last 10 years and its effect on clinical outcomes. Single-center, retrospective analysis of all patients aged ≥18 years admitted to either the medical or surgical ICU at St. Paul’s Hospital, The Catholic University of Korea, between January 2005 and December 2014 was conducted. For clinical outcome, in-hospital mortality, duration of ICU stay, and hospital stay were analyzed. Cost analysis was performed to show the economic burden of each age strata.
Results
A total of 10,366 ICU patients were admitted to the chosen ICUs during the study period. The proportion of elderly patients aged ≥65 years increased from 47.9% in 2005 to 63.7% in 2014, and the proportion of the very elderly patients aged ≥80 years increased from 12.8% to 20.7%. However, this increased proportion of elderly patients did not lead to increased in-hospital mortality. The percent of ICU treatment days attributable to elderly patients increased from 51.1% in year 2005 to 64.0% in 2014. The elderly ICU patients were associated with higher in-hospital mortality compared to younger age groups.
Conclusions
The proportion of elderly patients admitted to ICUs increased over the last decade. However, overall in-hospital mortality has not increased during the same period.

Citations

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Perfil de mortalidade de idosos jovens hospitalizados em uma unidade de terapia intensiva
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Ciência, Cuidado e Saúde.2023;[Epub] CrossRef
Characteristics and prognostic factors of very elderly patients admitted to the intensive care unit
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Retrospective Analysis of Long-Term Survival in Very Elderly (age ≥80) Critically Ill Patients of a Medical Intensive Care Unit at a Tertiary Care Hospital in Korea
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Erratum

Comparison of Morphine and Remifentanil on the Duration of Weaning from Mechanical Ventilation: Jae Myeong Lee, Seong Heon Lee, Sang Hyun Kwak, Hyeon Hui Kang, Sang Haak Lee, Jae Min Lim, Mi Ae Jeong, Young Joo Lee, Chae Man Lim; Korean J Crit Care Med. 2016;31(4):381-381. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2014.29.4.281.e01; Corrects: Acute Crit Care 2014;29(4):281

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Citations

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Early Sedation Depth and Clinical Outcomes in Mechanically Ventilated Patients in a Hospital: Retrospective Cohort Study
Jeong Mi Hwang, Su Jung Choi
Asian Nursing Research.2023; 17(1): 15. CrossRef

Randomized Controlled Trial

Pharmacology/Pulmonary
Comparison of Morphine and Remifentanil on the Duration of Weaning from Mechanical Ventilation: Jae Myeong Lee, Seong Heon Lee, Sang Hyun Kwak, Hyeon Hui Kang, Sang Haak Lee, Jae Min Lim, Mi Ae Jeong, Young Joo Lee, Chae Man Lim; Korean J Crit Care Med. 2014;29(4):281-287. Published online November 30, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.4.281; Correction in: Acute Crit Care 2016;31(4):381

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Abstract PDF

BACKGROUND
A randomized, multicenter, open-label, parallel group study was performed to compare the effects of remifentanil and morphine as analgesic drugs on the duration of weaning time from mechanical ventilation (MV).
METHODS
A total of 96 patients with MV in 6 medical and surgical intensive care units were randomly assigned to either, remifentanil (0.1-0.2 mcg/kg/min, n = 49) or morphine (0.8-35 mg/hr, n = 47) from the weaning start. The weaning time was defined as the total ventilation time minus the sum of controlled mode duration.
RESULTS
Compared with the morphine group, the remifentanil-based analgesic group showed a tendency of shorter weaning time (mean 143.9 hr, 89.7 hr, respectively: p = 0.069). Secondary outcomes such as total ventilation time, successful weaning rate at the 7th of MV day was similar in both groups. There was also no difference in the mortality rate at the 7th and 28th hospital day. Kaplan-Meyer curve for weaning was not different between the two groups.
CONCLUSIONS
Remifentanil usage during the weaning phase tended to decrease weaning time compared with morphine usage.

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Case Report

Pulmonary
Obstructive Fibrinous Tracheal Pseudomembrane Presented with Atelectasis: Jick Hwan Ha, Hyewon Lee, Young Jae Park, Hyeon Hui Kang, Hwa Sik Moon, Sang Haak Lee; Korean J Crit Care Med. 2014;29(2):110-113. Published online May 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.2.110

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Abstract PDF

Obstructive fibrinous tracheal pseudomembrane (OFTP) is a rare condition usually associated with endotracheal intubation. Airway obstruction caused by OFTP may occur after endotracheal tube extubation and can lead to severe respiratory distress. It is a rare but potentially fatal complication. In this report, we present a case of OFTP presented with atelectasis that caused dyspnea after extubation and was successfully treated by mechanical removal using a rigid bronchoscope.

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Obstructive Fibrinous Tracheal Pseudomembrane
Yoann Ammar, Juliette Vella-Boucaud, Claire Launois, Hervé Vallerand, Sandra Dury, François Lebargy, Gaëtan Deslee, Jeanne-Marie Perotin
Anesthesia & Analgesia.2017; 125(1): 172. CrossRef
Obstructive Fibrinous Tracheal Pseudomembrane: An Update
Alberto Manassero, Matteo Bossolasco
Korean Journal of Critical Care Medicine.2014; 29(3): 241. CrossRef

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