Acute and Critical Care

Suk-Kyung Hong

9 Articles

Pulmonary
Liberation from mechanical ventilation in critically ill patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines: Tae Sun Ha, Dong Kyu Oh, Hak-Jae Lee, Youjin Chang, In Seok Jeong, Yun Su Sim, Suk-Kyung Hong, Sunghoon Park, Gee Young Suh, So Young Park; Acute Crit Care. 2024;39(1):1-23. Published online February 28, 2024; DOI: https://doi.org/10.4266/acc.2024.00052

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Abstract PDF Supplementary Material: Background
Successful liberation from mechanical ventilation is one of the most crucial processes in critical care because it is the first step by which a respiratory failure patient begins to transition out of the intensive care unit and return to their own life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider not only the individual experiences of healthcare professionals, but also scientific and systematic approaches. Recently, numerous studies have investigated methods and tools for identifying when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians about liberation from the ventilator. Methods: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. Those evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved recommendations. Results: Recommendations for nine PICO (population, intervention, comparator, and outcome) questions about ventilator liberation are presented in this document. This guideline includes seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. Conclusions: We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

Nursing
The effects of environmental interventions for delirium in critically ill surgical patients: Hak-Jae Lee, Yoon-Joong Jung, Nak-Joon Choi, Suk-Kyung Hong; Acute Crit Care. 2023;38(4):479-487. Published online November 28, 2023; DOI: https://doi.org/10.4266/acc.2023.00990

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Abstract PDF: Background
Delirium occurs at high rates among patients in intensive care units and increases the risk of morbidity and mortality. The purpose of this study was to investigate the effects of environmental interventions on delirium.
Methods
This prospective cohort study enrolled 192 patients admitted to the surgical intensive care unit (SICU) during the pre-intervention (June 2013 to October 2013) and post-intervention (June 2014 to October 2014) periods. Environmental interventions involved a cognitive assessment, an orientation, and a comfortable environment including proper sleep conditions. The primary outcomes were the prevalence, duration, and onset of delirium.
Results
There were no statistically significant differences in incidence rate, time of delirium onset, general characteristics, and mortality between the pre-intervention and post-intervention groups. The durations of delirium were 14.4±19.1 and 7.7±7.3 days in the pre-intervention and post-intervention groups, respectively, a significant reduction (P=0.027). The lengths of SICU stay were 20.0±22.9 and 12.6±8.7 days for the pre-intervention and post-intervention groups, respectively, also a significant reduction (P=0.030).
Conclusions
The implementation of an environmental intervention program reduced the duration of delirium and length of stay in the SICU for critically ill surgical patients.

Intensivist/Policy
Experience of augmenting critical care capacity in Daegu during COVID-19 incident in South Korea: Je Hyeong Kim, Suk-Kyung Hong, Younghwan Kim, Ho Geol Ryu, Chi-Min Park, Young Seok Lee, Sung Jin Hong; Acute Crit Care. 2020;35(2):110-114. Published online May 31, 2020; DOI: https://doi.org/10.4266/acc.2020.00275

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Citations

Citations to this article as recorded by

The Activities and Roles of Trauma Surgeons in the Treatment of COVID-19 Patients
Younghwan Kim, Seok Hwa Youn
Journal of Acute Care Surgery.2023; 13(2): 43. CrossRef
Inhalation of Origanum majorana L. essential oil while working reduces perceived stress and anxiety levels of nurses in a COVID-19 intensive care unit: a randomized controlled trial
Sang Wook Lee, You Kyoung Shin, Jeong-Min Lee, Geun Hee Seol
Frontiers in Psychiatry.2023;[Epub] CrossRef
What happened during the period from senior medical students’ withdrawal of their applications to take the Korean Medical Licensing Examination in August 2020 to their taking the licensing examination in February 2021
Sun Huh
Journal of Educational Evaluation for Health Professions.2022; 19: 3. CrossRef
Comparison of clinical characteristics and hospital mortality in critically ill patients without COVID-19 before and during the COVID-19 pandemic: a multicenter, retrospective, propensity score-matched study
Sua Kim, Hangseok Choi, Jae Kyeom Sim, Won Jai Jung, Young Seok Lee, Je Hyeong Kim
Annals of Intensive Care.2022;[Epub] CrossRef
Correlation Between Third Dose of COVID-19 Vaccines and Regional Case Fatality Rates During the Omicron Wave in Korea
Youngook Jang, In Joong Kim, Sung-Sil Moon, Sun Bean Kim, Jacob Lee
Journal of Korean Medical Science.2022;[Epub] CrossRef
Socioeconomic disparity and the risk of contracting COVID-19 in South Korea: an NHIS-COVID-19 database cohort study
Tak Kyu Oh, Jae-Wook Choi, In-Ae Song
BMC Public Health.2021;[Epub] CrossRef
Association of Intensive Care Unit Patient Load and Demand With Mortality Rates in US Department of Veterans Affairs Hospitals During the COVID-19 Pandemic
Dawn M. Bravata, Anthony J. Perkins, Laura J. Myers, Greg Arling, Ying Zhang, Alan J. Zillich, Lindsey Reese, Andrew Dysangco, Rajiv Agarwal, Jennifer Myers, Charles Austin, Ali Sexson, Samuel J. Leonard, Sharmistha Dev, Salomeh Keyhani
JAMA Network Open.2021; 4(1): e2034266. CrossRef
Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
Sung Jun Ko, Jaeyoung Cho, Sun Mi Choi, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Jinwoo Lee, Sang-Min Lee, Robert Jeenchen Chen
PLOS ONE.2021; 16(10): e0259092. CrossRef

Surgery
The Effect of Systematic Approach to Tracheostomy Care in Patients Transferred from the Surgical Intensive Care Unit to General Ward: Yooun-joong Jung, Younghwan Kim, Kyuhyouck Kyoung, Minae Keum, Taehyun Kim, Dae seong Ma, Suk-Kyung Hong; Acute Crit Care. 2019;34(1):99-99. Published online February 28, 2019; DOI: https://doi.org/10.4266/acc.2018.00248.e02; Corrects: Acute Crit Care 2018;33(4):252

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Nursing
The Effect of Systematic Approach to Tracheostomy Care in Patients Transferred from the Surgical Intensive Care Unit to General Ward: Yooun-joong Jung, Younghwan Kim, Kyuhyouck Kyoung, Minae Keum, Taehyun Kim, Dae seong Ma, Suk-Kyung Hong; Acute Crit Care. 2018;33(4):252-259. Published online November 30, 2018; DOI: https://doi.org/10.4266/acc.2018.00248; Correction in: Acute Crit Care 2019;34(1):99

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Abstract PDF

Background
The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward.
Methods
In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU.
Results
The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time (26.7±25.1 vs. 12.1±16.0 days, P=0.003), length of stay in the general ward (70.6±89.1 vs. 40.5±42.2 days, P=0.008), length of total hospital stay (107.5±95.6 vs. 74.7±51.2 days, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010).
Conclusions
Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct Tcannula.

Citations

Citations to this article as recorded by

Quality tracheotomy care can be maintained for non‐COVID patients during the COVID‐19 pandemic
Jacqueline Tucker, Nicole Ruszkay, Neerav Goyal, John P. Gniady, David Goldenberg
Laryngoscope Investigative Otolaryngology.2022; 7(5): 1337. CrossRef
Global Tracheostomy Collaborative: data-driven improvements in patient safety through multidisciplinary teamwork, standardisation, education, and patient partnership
Michael J. Brenner, Vinciya Pandian, Carly E. Milliren, Dionne A. Graham, Charissa Zaga, Linda L. Morris, Joshua R. Bedwell, Preety Das, Hannah Zhu, John Lee Y. Allen, Alon Peltz, Kimberly Chin, Bradley A. Schiff, Diane M. Randall, Chloe Swords, Darrin Fr
British Journal of Anaesthesia.2020; 125(1): e104. CrossRef

Surgery
Feasibility of Percutaneous Dilatational Tracheostomy with a Light Source in the Surgical Intensive Care Unit: Jong-Kwan Baek, Jung-Sun Lee, Minchang Kang, Nak-Jun Choi, Suk-Kyung Hong; Acute Crit Care. 2018;33(2):89-94. Published online April 26, 2018; DOI: https://doi.org/10.4266/acc.2017.00563

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Abstract PDF

Background
Although percutaneous dilatational tracheostomy (PDT) under bronchoscopic guidance is feasible in the intensive care unit (ICU), it requires extensive equipment and specialists. The present study evaluated the feasibility of performing PDT with a light source in the surgical ICU.
Methods
The study involved a retrospective review of the outcomes of patients who underwent PDT with a light source performed by a surgery resident under the supervision of a surgical intensivist in the surgical ICU from October 2015 through September 2016. During the procedure, a light wand was inserted into the endotracheal tube after skin incision. Then, the light wand and the endotracheal tube were pulled out slightly, the passage of light through the airway was confirmed, and the relevant point was punctured.
Results
Fifty patients underwent PDT with a light source. The average procedural duration was 14.0 ± 7.0 minutes. There were no procedure-associated deaths. Intraoperative complications included minor bleeding in three patients (6%) and paratracheal placement of the tracheostomy tube in one patient (2%); these were immediately resolved by the surgical intensivist. Two patients required conversion to surgical tracheostomy because of the difficulty in light wand insertion into the endotracheal tube and a very narrow trachea, respectively.
Conclusions
PDT with a light source can be performed without bronchoscopy and does not require expensive equipment and specialist intervention in the surgical ICU. It can be safely performed by a surgical intensivist with experience in surgical tracheostomy.

Citations

Citations to this article as recorded by

Increasing the precision of simulated percutaneous dilatational tracheostomy—a pilot prototype device development study
Athia Haron, Lutong Li, Eryl A. Davies, Peter D.G. Alexander, Brendan A. McGrath, Glen Cooper, Andrew Weightman
iScience.2024; 27(3): 109098. CrossRef
The feasibility and safety of percutaneous dilatational tracheostomy without endotracheal guidance in the intensive care unit
Ji Eun Kim, Dong Hyun Lee
Acute and Critical Care.2022; 37(1): 101. CrossRef
Safety and feasibility of hybrid tracheostomy
Daeun Kang, In Beom Jeong, Sun Jung Kwon, Ji Woong Son, Gwan Woo Ku
Acute and Critical Care.2021; 36(4): 369. CrossRef

Thoracic Surgery
Aortic Dissection in a Survivor after Cardiopulmonary Resuscitation: Jeong-Sun Lee, Suk-Kyung Hong; Korean J Crit Care Med. 2017;32(2):218-222. Published online December 29, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00416

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Abstract PDF

We describe a case of traumatic aortic dissection associated with cardiac compression in a patient with anaphylactic cardiac arrest who underwent cardiopulmonary resuscitation (CPR). A 54-year-old man who was scheduled to undergo surgery for gastric cancer went into cardiac arrest caused by an anaphylactic reaction to prophylactic antibiotics in the operating room. Veno-arterial extracorporeal membrane oxygenation (ECMO) was performed. CPR, including chest compressions, was performed for 35 min, and the patient was transferred to the intensive care unit (ICU) after spontaneous circulation returned. The patient received ECMO for 9 hours until confirmation of normal cardiac function on transthoracic echocardiography (TTE). Twenty days after cardiac arrest, an aortic dissection and fractures in the left fourth and fifth ribs due to chest compression were detected by abdominal computed tomography. The DeBakey type III aortic dissection extended from the distal arch of the thoracic aorta to the proximal level of the renal artery, involving the celiac trunk. It was considered an uncomplicated type B aortic dissection with no sign of malperfusion of the major vessels. This case demonstrates the potential traumatic injuries that can occur after CPR and encourages proper management of mechanical complications in cardiac arrest survivors.

Citations

Citations to this article as recorded by

Blunt traumatic aortic dissection death by falling: an autopsy case report
Gentaro Yamasaki, Marie Sugimoto, Takeshi Kondo, Motonori Takahashi, Mai Morichika, Azumi Kuse, Kanako Nakagawa, Yasuhiro Ueno, Migiwa Asano
Forensic Science, Medicine and Pathology.2022; 19(3): 388. CrossRef
A Case of an Aortic Dissection After Mechanical Chest Compression by LUCAS
Karen Ho, David Kopriva, Payam Dehghani
JACC: Case Reports.2020; 2(12): 1984. CrossRef
Cardiac arrest after topical application of lidocaine during microneedling procedure: A rare case
Morteza Safi, Isa Khaheshi, Fatemeh Mottaghizadeh, Mohammadreza Tabary, Nasser Malekpour Alamdari
Dermatologic Therapy.2020;[Epub] CrossRef

Neurology
Posterior Reversible Encephalopathy Syndrome in a Critically Ill Postoperative Patient: Min Ae Keum, Hyo Keun No, Choong Wook Lee, Sang-Beom Jeon, Suk-Kyung Hong; Korean J Crit Care Med. 2015;30(1):46-51. Published online February 28, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.1.46

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Abstract PDF: Posterior reversible encephalopathy syndrome (PRES) is a transient condition characterized by altered mental status, seizure, headache, and visual disturbance with typical neuro-imaging findings in the bilateral parieto-occipital regions. Clinicians should be aware of this syndrome because delayed diagnosis and treatment result in irreversible neurologic deficits. We present the case of a 77-year-old male diagnosed with PRES in the setting of postoperative critical illness caused by small-bowel strangulation.

Cardiology/Allergy
Management of Cardiac Arrest following Anaphylactic Reaction to Cisatracurium Using Extracorporeal Membrane Oxygenation: Dae Sung Ma, Tae-Hyun Kim, Min Ae Keum, Dong Kwan Kim, Suk-Kyung Hong; Korean J Crit Care Med. 2015;30(1):42-45. Published online February 28, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.1.42

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Abstract PDF

Anaphylactic reaction during the perioperative period typically exhibits rapid onset, varying clinical manifestations, and an expected mortality rate of 1.5-9%. Neuromuscular blocking agents are the leading cause of perioperative anaphylaxis. Here, we report a severe case of anaphylaxis that developed in a 66-year-old man due to cisatracurium administration. And he was successfully managed by extracorporeal membrane oxygenation. Cardiopulmonary resuscitation was performed by extracorporeal membrane oxygenation, and the patient was successfully weaned off 24 hours later.

Citations

Citations to this article as recorded by

Case report: management of differential diagnosis and treatment of severe anaphylaxis in the setting of spinal anesthesia
Brian M. Osman, Joni M. Maga, Sebastian M. Baquero
Journal of Clinical Anesthesia.2016; 35: 145. CrossRef

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