Acute and Critical Care

Yoon Kyung Lee

2 Articles

Acute Respiratory Distress Syndrome with Chemical Pneumonitis after Aspiration of Activated Charcoal: A Case Report: Suhyun Kim, Na Ree Kang, In Sohn, Heon Lee, Yoon Kyung Lee, Sook Hee Song; Korean J Crit Care Med. 2010;25(2):112-117.; DOI: https://doi.org/10.4266/kjccm.2010.25.2.112

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Charcoal has been commonly used for enteral detoxication although it causes few adverse effects. The major causes of morbidity and mortality secondary to activated charcoal therapy are pulmonary aspiration, gastrointestinal complication, and fluid and electrolyte abnormalities. Aspiration of charcoal is associated with pulmonary compromise due to increased microvascular permeability with concomitant lung edema, surfactant depletion, atelectasis, and obliterative bronchiolitis. Herein we report the case of a patient with acute respiratory distress syndrome with chemical pneumonitis after aspiration of activated charcoal in sorbitol with a review of the related literatures.

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Five Successful Experiences in the Treatment of Charcoal Aspiration with Bronchoscopic Toilet - A Case Report -
Young Il Kim, Jae-Seok Park, Jae Sung Choi, Sung-Shik Jou, Hyo-Wook Gil, Sae-Yong Hong
Korean Journal of Critical Care Medicine.2012; 27(3): 202. CrossRef
A Case of Activated Charcoal Aspiration Treated by Early and Repeated Bronchoalveolar Lavage
Han Min Lee, Jae-Seok Park, Jae Yun Kim, Ji Yeon Lee, Byung Kyu Ahn, Hyo-Wook Gil, Jae-Sung Choi
Tuberculosis and Respiratory Diseases.2012; 72(2): 177. CrossRef

The Usage Pattern of Neuromuscular Blocker at Intensive Care Unit: Jun Gol Song, Hwa Sung Jung, Jae Do Lee, Yoon Kyung Lee, Hong Seuk Yang; Korean J Crit Care Med. 2006;21(1):28-36.

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Abstract PDF: BACKGROUND
The neuromuscular blocker is helpful to intubate the patients and reduce the amount of anesthetic agent. It also used at intensive care unit (ICU) to maintain airway patency, to achieve proper ventilatory care, etc. This survey is to determine the neuromuscular blocker usage patterns in ICU settings.
METHODS
Three hundred general hospitals with ICU settings were chosen. We designed a 10 itemed questionnaire which has several subquestions with multiple choices and sent it to them. After three months, forty seven hospitals returned the questionnaire and we made careful analysis with it.
RESULTS
The most frequent indication of neuromuscular blocker was to facilitate the mechanical ventilation (80.9%). Vecuronium was the most common neuromuscular blocker used (97.9%). Only 6.4% of them used peripheral nerve stimulator and the rest of them (89.4%) used clinical information to determine the degree of neuromuscular blocker. The respondents reported that recovery from muscle relaxation was needed on a periodic basis for regular neurological examinations (59.6%) in ICU settings. All respondents used the sedatives or narcotics with neuromuscular blocker and only 6.4% used reversal agents.
CONCLUSIONS
Although the rate of reply was not much (15.7%), we could get the current usage pattern of neuromuscular blocker at ICU. We recommend using short to intermediate acting neuromuscular blocker than long acting agents. Continuous infusion with careful dosage titration by peripheral nerve stimulator would be helpful to achieve rapid recovery. Additional sedatives and narcotics are beneficial to reduce the amount of neuromuscular blocker and to make patients comfortable as well.

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