Acute and Critical Care

Shin Ok Koh

4 Articles

Hematology
Characteristics and Clinical Outcomes of Critically Ill Cancer Patients Admitted to Korean Intensive Care Units: Soo Jin Na, Tae Sun Ha, Younsuck Koh, Gee Young Suh, Shin Ok Koh, Chae-Man Lim, Won-Il Choi, Young-Joo Lee, Seok Chan Kim, Gyu Rak Chon, Je Hyeong Kim, Jae Yeol Kim, Jaemin Lim, Sunghoon Park, Ho Cheol Kim, Jin Hwa Lee, Ji Hyun Lee, Jisook Park, Juhee Cho, Kyeongman Jeon; Acute Crit Care. 2018;33(3):121-129. Published online August 31, 2018; DOI: https://doi.org/10.4266/acc.2018.00143

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Background
The objective of this study was to investigate the characteristics and clinical outcomes of critically ill cancer patients admitted to intensive care units (ICUs) in Korea.
Methods
This was a retrospective cohort study that analyzed prospective collected data from the Validation of Simplified Acute Physiology Score 3 (SAPS3) in Korean ICU (VSKI) study, which is a nationwide, multicenter, and prospective study that considered 5,063 patients from 22 ICUs in Korea over a period of 7 months. Among them, patients older than 18 years of age who were diagnosed with solid or hematologic malignancies prior to admission to the ICU were included in the present study.
Results
During the study period, a total of 1,762 cancer patients were admitted to the ICUs and 833 of them were deemed eligible for analysis. Six hundred fifty-eight (79%) had solid tumors and 175 (21%) had hematologic malignancies, respectively. Respiratory problems (30.1%) was the most common reason leading to ICU admission. Patients with hematologic malignancies had higher Sequential Organ Failure Assessment (12 vs. 8, P<0.001) and SAPS3 (71 vs. 69, P<0.001) values and were more likely to be associated with chemotherapy, steroid therapy, and immunocompromised status versus patients with solid tumors. The use of inotropes/ vasopressors, mechanical ventilation, and/or continuous renal replacement therapy was more frequently required in hematologic malignancy patients. Mortality rates in the ICU (41.7% vs. 24.6%, P<0.001) and hospital (53.1% vs. 38.6%, P=0.002) were higher in hematologic malignancy patients than in solid tumor patients.
Conclusions
Cancer patients accounted for one-third of all patients admitted to the studied ICUs in Korea. Clinical characteristics were different according to the type of malignancy. Patients with hematologic malignancies had a worse prognosis than did patients with solid tumor.

Citations

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Outcomes of Acute Respiratory Failure in Patients With Cancer in the United States
Kiyan Heybati, Jiawen Deng, Archis Bhandarkar, Fangwen Zhou, Cameron Zamanian, Namrata Arya, Mohamad Bydon, Philippe R. Bauer, Ognjen Gajic, Allan J. Walkey, Hemang Yadav
Mayo Clinic Proceedings.2024; 99(4): 578. CrossRef
Characteristics and outcomes of cancer patients admitted to intensive care units in cancer specialized hospitals in China
Wensheng Liu, Dongmin Zhou, Li Zhang, Mingguang Huang, Rongxi Quan, Rui Xia, Yong Ye, Guoxing Zhang, Zhuping Shen
Journal of Cancer Research and Clinical Oncology.2024;[Epub] CrossRef
Predictors of ICU mortality in patients with hemoblastosis and infectious complications
A.V. Lyanguzov, A.S. Luchinin, S.V. Ignatyev, I.V. Paramonov
Anesteziologiya i reanimatologiya.2023; (1): 33. CrossRef
Effect of the underlying malignancy on critically ill septic patient's outcome
Man‐Yee Man, Hoi‐Ping Shum, Sin‐Man Lam, Jacky Li, Wing‐Wa Yan, Mei‐Wan Yeung
Asia-Pacific Journal of Clinical Oncology.2022; 18(4): 473. CrossRef
Impacts of Corticosteroid Therapy at Acute Stage of Hospital-Onset Clostridioides difficile Infections
Ching-Chi Lee, Jen-Chieh Lee, Chun-Wei Chiu, Pei-Jane Tsai, Wen-Chien Ko, Yuan-Pin Hung
Infection and Drug Resistance.2022; Volume 15: 5387. CrossRef
Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy
Da Woon Kim, Geum Suk Jang, Kyoung Suk Jung, Hyuk Jae Jung, Hyo Jin Kim, Harin Rhee, Eun Young Seong, Sang Heon Song
Kidney Research and Clinical Practice.2022; 41(6): 717. CrossRef
A Systematic Review and Meta-Analysis Evaluating Geographical Variation in Outcomes of Cancer Patients Treated in ICUs
Lama H. Nazer, Maria A. Lopez-Olivo, Anne Rain Brown, John A. Cuenca, Michael Sirimaturos, Khader Habash, Nada AlQadheeb, Heather May, Victoria Milano, Amy Taylor, Joseph L. Nates
Critical Care Explorations.2022; 4(9): e0757. CrossRef
Clinico-demographic and Outcome Predictors in Solid Tumor Patients with Unplanned Intensive Care Unit Admissions: An Observational Study
Jigeeshu Divatia, Amit M Narkhede, Harish K Chaudhari, Ujwal Dhundi, Natesh Prabu Ravisankar, Satish Sarode
Indian Journal of Critical Care Medicine.2021; 25(12): 1421. CrossRef

Ethics
Evaluation of Informed Consent for Withholding and Withdrawal of Life Support in Korean Intensive Care Units: Jin Ha Park, Shin Ok Koh, Jin Sun Cho, Sungwon Na; Korean J Crit Care Med. 2015;30(2):73-81. Published online May 31, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.2.73

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Abstract PDF Supplementary Material

Background
The goal of this study was to analyze the process and characteristics of withholding or withdrawal of life support (WLS) in Korean intensive care units (ICUs). Methods: This was a single-centered retrospective analysis of patients who died in the ICUs of a tertiary hospital in Korea from January to December 2012. WLS informed consents and clinical data were analyzed. Results: Of 285 deaths during the study period, informed consents for WLS were obtained from 228 patients (80.0%). All WLS decisions were made by family members after the patient’s loss of decision-making capacity. Decisions were made most frequently by the patient’s son (50.6%). Patients in the WLS group were older than those in the non-WLS group, and older age was associated with the WLS decision. Thirty-seven patients (16.2%) died within one hour of WLS approval, and 182 patients (79.8%) died on the day of WLS approval. The most frequently withheld life support modality was chest compression (100%), followed by defibrillation (95.9%) and pacemaker insertion (63.3%). Conclusions: Aggressive and invasive life support measures were those most frequently withheld or withdrawn by decision-makers in Korean ICUs. The most common proxy was the son, rather than the spouse.

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Decision-making regarding withdrawal of life-sustaining treatment and the role of intensivists in the intensive care unit: a single-center study
Seo In Lee, Kyung Sook Hong, Jin Park, Young-Joo Lee
Acute and Critical Care.2020; 35(3): 179. CrossRef
Family-Clinician Communication About End-of-Life Care in Korea
Minjeong Jo, Yang-Sook Yoo, George Knafl, Marcia Van Riper, Linda Beeber, Mi-Kyung Song
Journal of Hospice & Palliative Nursing.2017; 19(6): 597. CrossRef

Hematology/Obstetric
Acute Myeloid Leukemia in Suspected Sepsis after Caesarean Section: Myoung Hwa Kim, Sung Won Na, Shin Ok Koh, Eun Jung Kim, Hye Jin Yoon, Yong Jae Lee, Hee Young Cho; Korean J Crit Care Med. 2014;29(2):99-104. Published online May 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.2.99

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Abstract PDF: The incidence of acute leukemia during pregnancy is extremely rare, and often it is not easy to differentiate it from other diseases associated with pregnancy such as sepsis or hemorrhage. Pregnancy itself is not known to affect the natural course of leukemia; however, complications of leukemia like anemia, infections, and coagulopathy can adversely influence both the fetus and the mother. In this case, a pregnant patient misdiagnosed with septic shock and severe leukocytosis was correctly diagnosed with acute myeloid leukemia after surgical delivery.

Cardiology/Pulmonary
One Hundred Seven Days of ECMO as a Bridge to Lung Transplantation: The Longest Duration Among Elderly Patients: Eun Jung Kim, Hyo Chae Paik, Moo Suk Park, Myung Hwa Kim, Shin Ok Koh, You Jin Lee, Sungwon Na; Korean J Crit Care Med. 2014;29(1):48-51. Published online February 28, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.1.48

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Abstract PDF

Extracorporeal membrane oxygenation (ECMO) is a means for supporting adequate gas exchange in patients with severe respiratory failure and is the only therapeutic option for ventilation-refractory patients awaiting lung transplantation. Moreover, defining the patients likely to benefit from ECMO as a bridge to transplantation has recently become a point of interest. Here, we report a case of prolonged ECMO support to a patient awaiting lung transplantation. A 66-year-old woman was diagnosed with acute interstitial pneumonia and was placed on veno-venous (VV) ECMO due to unsatisfactory gas exchange despite maximal ventilator care. She underwent bilateral lung transplantation after 99 days of ECMO and was successfully weaned from it on the 107th ECMO day. This is the longest period of ECMO support to be reported among elderly patients.

Citations

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Long-Term Venovenous Connection for Extracorporeal Carbon Dioxide Removal (ECCO2R)–Numerical Investigation of the Connection to the Common Iliac Veins
N. B. Steuer, K. Hugenroth, T. Beck, J. Spillner, R. Kopp, S. Reinartz, T. Schmitz-Rode, U. Steinseifer, G. Wagner, J. Arens
Cardiovascular Engineering and Technology.2020; 11(4): 362. CrossRef
One hundred forty six days on extracorporeal membrane oxygenation (ECMO): Our longest ECMO run
Ahmad Said Abdalmohsen Ali, Mohamed Yosri, Mohamed Abouelwafa, Mahmoud Saad, Kareem Zaki, Shady Mashhour, Husam Salah, Tarek Mohsen, Amaany Abozeid, Mohamed Khaled, Akram Abdelbary, Alia Abdelfattah
The Egyptian Journal of Critical Care Medicine.2018; 6(3): 113. CrossRef
Recovery from Acute Respiratory Distress Syndrome with Long-Run Extracorporeal Membrane Oxygenation
Jin Jeon, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Sang-Bum Hong
Korean Journal of Critical Care Medicine.2014; 29(3): 212. CrossRef

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