Acute and Critical Care

Ah Reum Cho

3 Articles

Skin Necrosis after High Dose Vasopressor Infusion in Septic Shock: Two Case Reports: Ah Reum Cho, Jeung Il Kim, Eun Jung Kim, Seung Min Son; Korean J Crit Care Med. 2012;27(3):182-186.; DOI: https://doi.org/10.4266/kjccm.2012.27.3.182

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Survival sepsis campaign recommends that vasopressor therapy is required to maintain mean arterial pressure (MAP) > or = 65 mmHg. However, the absolute maximum dose of vasopressor is difficult to determine. Herein, we report 2 cases of severe skin necrosis after high dose vasopressor infusion to maintain the recommended MAP in septic shock. In our first case, norepinephrine 1.0-2.0 microg/kg/min and vasopressin 0.03-0.1 U/min were infused for 5 days; in the second case, dopamine 10-20 microg/kg/min and norepinephrine 0.25-2.5 microg/kg/min were infused for 7 days. Severe ischemic skin lesions, which required amputations, developed in both cases. The clinical appearance of the skin lesions in the 2 cases was different because of the unique distribution of target receptors for different vasopressors. Thus, when high dose vasopressors are required to achieve recommended MAP, extra vigilance is required. Further studies for dose adjustment are needed.

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BioMed Research International.2018; 2018: 1. CrossRef
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Ultrasound Guided Bronchoscopic Balloon Dilatation in the Management of Tracheal Stenosis: A Case Report: Jung Min Hong, Tae Kyun Kim, Ah Reum Cho, Do Won Lee, Yun Hee Han, Jae Young Kwon; Korean J Crit Care Med. 2012;27(2):139-142.; DOI: https://doi.org/10.4266/kjccm.2012.27.2.139

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Abstract PDF: We performed a balloon dilatation without a fluoroscopy monitoring by ultrasound. A 44 year old female patient was presented with subglottic stenosis, due to prolonged intubation. Although she had undergone tracheal resection and end-to-end anastomosis, the tracheal stenosis had recurred. She was scheduled for balloon dilatation. However, fluoroscopic guidance was not available, and thus, we used ultrasonographic monitoring as an alternative method. We performed a transverse scan, just cranial to the suprasternal notch, and we obtained a real time image of the trachea dilated by the balloon. We suggest that ultrasonographic monitoring is a useful adjunct to balloon dilatation in patients with tracheal stenosis.

Delayed Anaphylactic Shock to Intravenous Cefotetan in a Pregnant Woman: A Case Report: Ah Reum Cho, Hyeon Jeong Lee, Hye Kyung Park, Young Jae Oh; Korean J Crit Care Med. 2012;27(2):126-129.; DOI: https://doi.org/10.4266/kjccm.2012.27.2.126

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Abstract PDF

Anaphylactic reactions to agents administered intravenously usually occur within minutes. We present an unusual case of a delayed onset anaphylactic shock to intravenous cefotetan in a pregnant woman who underwent an epidural cesarean section. She sustained hypotension, tachycardia, bronchospasm, and rash 90 min after administering intravenous cefotetan. The possibilities of high epidural blocks or amnionic fluid embolisms were excluded by the height of sensory blocks or different presenting symptoms and signs, respectively. Allergic skin tests for exposed materials were performed 6 weeks after discharge and no immediate reactions occurred. However, delayed systemic allergic reactions, such as urticaria, rash, and edema on her face, neck, back, and abdomen, occurred 3 h after skin test to cefotetan.

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LC-MS/MS method for the quantitation of cefotetan in human plasma and its application to pharmacokinetic study
Meiyun Shi, Lei Yin, Lanlan Cai, Can Wang, Xidong Liu, Sen Zhao, Yantong Sun, Paul J. Fawcett, Limei Zhao, Yan Yang, Jingkai Gu
Chemical Research in Chinese Universities.2014; 30(6): 900. CrossRef

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