Acute and Critical Care

Sung Jin Nam

2 Articles

Neurosurgery
Therapeutic Hypothermia after Decompressive Craniectomy in Malignant Cerebral Infarction: Jun Young Chang, Jeong Ho Hong, Jin Heon Jeong, Sung Jin Nam, Ji Hwan Jang, Jae Seung Bang, Moon Ku Han; Korean J Crit Care Med. 2014;29(2):93-98. Published online May 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.2.93

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Decompressive hemicraniectomy followed by subsequent therapeutic hypothermia can reduce mortality in patients with malignant cerebral infarction without significantly increasing risk. We report three cases of malignant cerebral infarction treated with hemicraniectomy followed by hypothermia. Case 1 received elective decompressive surgery and hypothermia. Case 2 developed subsequent cerebral infarction with uncal herniation. Therefore, emergent decompressive surgery and hypothermia was performed in this case. Despite surgery and hyperosmolar therapy, case 3 received hypothermia treatment for refractory increased intracranial pressure. All patients survived with a score of 4 or 5 on the modified Rankin scale. Therefore, we suggest that application of hypothermia after hemicraniectomy is safe and feasible. Several possible modifications can be made to improve the management strategy in order to increase the benefits of hypothermia treatment.

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Dexmedetomidine Use in Patients with 33℃ Targeted Temperature Management: Focus on Bradycardia as an Adverse Effect
Hyo-yeon Seo, Byoung-joon Oh, Eun-jung Park, Young-gi Min, Sang-cheon Choi
The Korean Journal of Critical Care Medicine.2015; 30(4): 272. CrossRef

Thoracic Surgery
A Closed-Suction Catheter with a Pressure Valve Can Reduce Tracheal Mucosal Injury in Intubated Patients: Jin Heon Jeong, Sung Jin Nam, Young Jae Cho, Yeon Joo Lee, Se Joong Kim, In Ae Song, Sang Heon Park, Young Tae Jeon; Korean J Crit Care Med. 2014;29(1):7-12. Published online February 28, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.1.7

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Abstract PDF

Background
Endotracheal suctioning is associated with complications that include bleeding, infection, hypoxemia, cardiovascular instability, and tracheal mucosal injury. Recently, a closed-suction catheter with a pressure valve (Acetrachcare, AceMedical Co., Republic of Korea) was developed. We hypothesized that this new catheter might reduce tracheal mucosal injury compared to a conventional closed-suction catheter (Trachcare, Kimberly-balla RD, USA).
Methods
This prospective, randomized study enrolled medical and surgical patients who required mechanical ventilation for more than 48 hours. Patients were randomized into two groups: one group was suctioned with the conventional closed-suction catheter (CCC) and the other group was suctioned with the closed-suction catheter with pressure valve (CCPV). Bronchoscopy was performed 48 hours later, and the severity of tracheal mucosal injury was graded on a 5-point scale, as follows: 0 = normal; 1 = erythema or edema; 2 = erosion; 3 = hemorrhage; and 4 = ulceration or necrosis.
Results
A total of 76 patients (37 with CCPV and 39 with CCC) were included. There were no significant differences between the groups regarding demographic characteristics, changes in hemodynamic parameters during suction, incidence of pneumonia, length of intensive care unit (ICU) stay, or ICU mortality. On bronchoscopic evaluation, the use of the CCPV led to a significant decrease in tracheal mucosal injury (median tracheal mucosal injury grade 1 [IQR 0-1] vs. 2 [IQR 1-3], p = 0.001).
Conclusions
We conclude that the novel closed-suction catheter with pressure valve may reduce tracheal mucosal injury compared to conventional catheters.

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Citations to this article as recorded by

“Study on Device System to Reduce Tracheal Mucosal Injury in Intubation Patients” [ASME Journal of Medical Devices, 2022, 16(3), p. 031006; DOI: 10.1115/1.4054334]

Journal of Medical Devices.2022;[Epub] CrossRef
Efficacy of the Closed Suction Applied To Patients In Intensive Care Units with Different Techniques: A Nonrandomized Controlled Trial
Zuhal GÜLSOY, Şerife KARAGÖZOĞLU
Cumhuriyet Medical Journal.2020;[Epub] CrossRef

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