Acute and Critical Care

Reviews

Pharmacology
Assessment and Treatment of Pain in Adult Intensive Care Unit Patients: Jun Mo Park, Ji Hyun Kim; Korean J Crit Care Med. 2014;29(3):147-159. Published online August 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.3.147

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In most cases, patients admitted to an intensive care unit (ICU) have suffered from severe trauma, undergone major surgery or been treated for a serious medical illness. Although they often experience more intense pain than general ward patients, they are frequently unable to communicate their experiences to health care providers, thus preventing accurate assessment and treatment of their pain. If appropriate measures are not taken to treat pain in critically ill patients, stress response or sympathetic overstimulation can lead to complications. The short-term consequences of untreated pain include higher energy expenditure and immunomodulation. Longer-term, untreated pain increases the risk of post-traumatic stress disorder. Because pain is quite subjective, the accurate assessment of pain is very difficult in the patients with impaired communication ability. The current most valid and reliable behavioral pain scales used to assess pain in adult ICU patients are the Behavioral Pain Scale and the Critical-Care Pain Observation Tool. Once pain has been accurately assessed using these methods, various pharmacologic and non-pharmacologic therapies should be performed by the multidisciplinary care team. Accurate assessment and proper treatment of pain in adult ICU patients will improve patients outcome, which reduces the stress response and decreases the risk of post-traumatic stress disorder.

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Nurses’ knowledge, practice, and associated factors of pain assessment in critically ill adult patients at public hospitals, Addis Ababa, Ethiopia
Temesgen Ayenew, Berhanu Melaku, Mihretie Gedfew, Haile Amha, Keralem Anteneh Bishaw
International Journal of Africa Nursing Sciences.2021; 15: 100361. CrossRef
Impact of Pain Management Algorithm on Pain Intensity of Patients with Loss of Consciousness Hospitalized in Intensive Care Unit: A Clinical Trial
Zahra Dehghani, Asadollah Keikhaei, Fariba Yaghoubinia, Aliakbar Keykha, Masoom Khoshfetrat
Medical - Surgical Nursing Journal.2019;[Epub] CrossRef
Ignorance may be Bliss (for Intensivists), but not for ICU Patients!
Atul P. Kulkarni, Sumitra G Bakshi
Indian Journal of Critical Care Medicine.2019; 23(4): 161. CrossRef

Hematology
Severe Fever with Thrombocytopenia Syndrome: Seung Jin Yoo, Sang Taek Heo, Keun Hwa Lee; Korean J Crit Care Med. 2014;29(2):59-63. Published online May 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.2.59

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Abstract PDF

Severe fever with thrombocytopenia syndrome (SFTS) is a newly emerging infectious disease, caused by a novel species of Phlebovirus of Bunyaviridae family, in China, South Korea, and Japan. SFTS is primarily known as a tick-borne disease, and human-to-human transmission is also possible in contact with infectious blood. Common clinical manifestations include fever, thrombocytopenia, and leukopenia as initial symptoms, and multiple organ dysfunction and failure manifest with disease progression. Whereas disease mortality is reported to be 12% to 30% in China, a recent report of cumulative SFTS cases indicated 47% in Korea. Risk factors associated with SFTS were age, presence of neurologic disturbance, serum enzyme levels, and elevated concentrations of certain cytokines. Diagnosis of SFTS is based on viral isolation, viral identification by polymerase chain reaction, and serologic identification of specific immunoglobulin G. Therapeutic guideline has not been formulated, but conservative management is the mainstream of treatment to prevent disease progression and fatal complications.

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The first discovery of severe fever with thrombocytopenia syndrome virus in Taiwan
Tsai-Lu Lin, Shan-Chia Ou, Ken Maeda, Hiroshi Shimoda, Jacky Peng-Wen Chan, Wu-Chun Tu, Wei-Li Hsu, Chi-Chung Chou
Emerging Microbes & Infections.2020; 9(1): 148. CrossRef
Epidemiology of severe fever and thrombocytopenia syndrome virus infection and the need for therapeutics for the prevention
Norbert John C. Robles, Hae Jung Han, Su-Jin Park, Young Ki Choi
Clinical and Experimental Vaccine Research.2018; 7(1): 43. CrossRef
Two Treatment Cases of Severe Fever and Thrombocytopenia Syndrome with Oral Ribavirin and Plasma Exchange
In Park, Hye In Kim, Ki Tae Kwon
Infection & Chemotherapy.2017; 49(1): 72. CrossRef

The End-of-Life Care in the Intensive Care Unit: Jae Young Moon, Yong Sup Shin; Korean J Crit Care Med. 2013;28(3):163-172.; DOI: https://doi.org/10.4266/kjccm.2013.28.3.163

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Abstract PDF

The intensive care units (ICUs) provide the best possible medical care to help critically ill patients survive acute threats to their lives. At the same time, the ICU is also the most common place to die. Thus the ICU clinicians should be competent in all aspects for end-of-life (EOL) care. The quality of EOL care in Korean ICUs do not ensure ICU patient's autonomy and dignity at their end-of-life. For examples, several studies present that do-not-resuscitate (DNR) orders are only initiated when the patient's death in imminent. To improve understanding EOL care of terminally ill patients, we summarize 'Recommendations for EOL care in the ICU by the American College of Critical Care Medicine' and 'Consensus guidelines to withdrawing life-sustaining therapies endorsed by Korean Academy of Medical Science'. EOL care will be emerging as a comprehensive area of expertise in Korean ICUs. The ICU clinicians must strive to find the barriers for EOL care in the ICU and develop their processes to improve the care of EOL.

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A Scoping Review of End-Of-Life Care Education Programs for Critical Care Nurses
Eugene HAN, Sumi CHOI, Ki Young YUN, Sung Ha KIM, Sanghee KIM, Hye Young YUN
Korean Journal of Medical Ethics.2023; 26(3): 185. CrossRef
Comparison of the Characteristics Among Deceased Do-Not-Attempt-Resuscitation (DNAR) Cancer Patients in Hospice and Oncology Wards
Nan Song, Ja Yun Choi
Asian Oncology Nursing.2020; 20(1): 10. CrossRef
Relationship of ICU Nurses' Difficulties in End-of-Life Care to Moral Distress, Burnout and Job Satisfaction
Kkot Bi Jeon, Mihyun Park
Journal of Korean Academy of Nursing Administration.2019; 25(1): 42. CrossRef
Difficulties in End-of-Life Care and Educational Needs of Intensive Care Unit Nurses: A Mixed Methods Study
Hyun Sook Kim, Eun Kyoung Choi, Tae Hee Kim, Hye Young Yun, Eun Ji Kim, Jin Ju Hong, Jeong A Hong, Geon Ah Kim, R.N. Sung Ha Kim
The Korean Journal of Hospice and Palliative Care.2019; 22(2): 87. CrossRef
Factors Influencing Performance of End-of-life Care by ICU Nurses
Mun Jung Ko, So-Hyun Moon
Journal of Korean Academy of Psychiatric and Mental Health Nursing.2016; 25(4): 327. CrossRef
Development of an Electronic Document for DNR Informed Consent based on the Electronic Medical Record System
Ji-Kyeong Park
The Korean Journal of Health Service Management.2016; 10(3): 99. CrossRef
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
The Korean Journal of Critical Care Medicine.2015; 30(2): 73. CrossRef
Application of Animation Mobile Electronic Informed Consent in Inpatient of Long-term Care Hospital: Focused on DNR Informed Consent
Ji-Kyeong Park, Ji-On Kim
Journal of Digital Convergence.2015; 13(11): 187. CrossRef

The Association of Nurse Staffing Levels and Patient Outcome in Intensive Care Units: Hyunjung Lee, Hongbeom Bae; Korean J Crit Care Med. 2013;28(2):75-79.; DOI: https://doi.org/10.4266/kjccm.2013.28.2.75

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Abstract PDF

Nurses play a crucial role in providing high-quality care in intensive care units (ICU). Previous studies have shown an association between nurse staffing levels and outcome of critically ill patients. Increasing nurse staffing levels in ICU has been recommended to improve the outcome of critically ill patients. However, nursing staff shortages associated with decreased budgets may prevent adequate nurse-to-patient ratios although there lies increasing needs for critical care. Several studies have suggested that higher nurse staffing level is associated with favorable patient outcome, including mortality, length of stay, and infections, but some of studies did not find an association between nurse staffing and patient outcome. Although there are some controversies in the associations between nurse staffing levels and patient outcome, it is difficult to apply such effect as compared with other developed countries in North American and Europe as the nurse-to-patient ratio in Korea's ICU is relatively low. By studying the nurse staffing effects for patient outcome from the Korea ICU, it is found that higher nurse staffing level is associated with improved patient mortality. This finding may suggest that a shortage of nursing staff is currently a serious issue for caring of critically ill patients in Korea.

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A Study on Nurses' Communication Experiences with Intubation Patients
Ye Rim Kim, Hye Ree Park, Mee Kyung Shin
The Korean Journal of Rehabilitation Nursing.2023; 26(1): 28. CrossRef
The Nurse Staffing in Intensive Care Units based on Nursing Care Needs: A Multicenter Study
Miok Park, Eunjin Yang, Mimi Lee, Sung-Hyun Cho, Miyoung Shim, Soon Haeng Lee
Journal of Korean Critical Care Nursing.2021; 14(2): 1. CrossRef
The Relationship between the Work Environment and Person-centered Critical Care Nursing for Intensive Care Nurses
Jiyeon Kang, Yun Mi Lim
Journal of Korean Critical Care Nursing.2019; 12(2): 73. CrossRef

New Definition of Acute Respiratory Distress Syndrome: Je Hyeong Kim; Korean J Crit Care Med. 2013;28(1):10-16.; DOI: https://doi.org/10.4266/kjccm.2013.28.1.10

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Acute respiratory distress syndrome (ARDS) is a common disorder associated with significant mortality and morbidity. The American-European Consensus Conference (AECC) definition of ARDS, established in 1994, has advanced the knowledge of ARDS by allowing the acquisition of clinical and epidemiological data, which in turn have led to improvements in care for patients with ARDS. However, after 18 years of applied research, a number of issues regarding various criteria of AECC definition have emerged. For these reason, and because all disease definitions should be reviewed periodically, the European Society of Intensive Care Medicine convened an international expert panel to revise the ARDS definition from September 30 to October 2, 2011, Berlin, Germany, with endorsement from American Thoracic Society and the Society of Critical Care Medicine. This consensus discussion, following empirical evaluation and consensus revision, addressed some of the limitations of the AECC definition by incorporating current data, physiologic concepts, and clinical trials to develop a new definition of ARDS (Berlin definition). The Berlin definition should facilitate case recognition and better match treatment options to severity in both the research trials and clinical practice.

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Current status of treatment of acute respiratory failure in Korea
Yong Jun Choi, Jae Hwa Cho
Journal of the Korean Medical Association.2022; 65(3): 124. CrossRef
The Utility of Non-Invasive Nasal Positive Pressure Ventilation for Acute Respiratory Distress Syndrome in Near Drowning Patients
June Hyeong Kim, Kyung Hoon Sun, Yong Jin Park
Journal of Trauma and Injury.2019; 32(3): 136. CrossRef
Case Series of Transfusion-Related Acute Lung Injury in a Tertiary Hospital and a Practical Comparison with the New Diagnostic Criteria
Kwang Seob Lee, Sinyoung Kim, Juhye Roh, Seung Jun Choi, Hyun Ok Kim
The Korean Journal of Blood Transfusion.2019; 30(3): 219. CrossRef
Application of the Berlin definition in children with acute respiratory distress syndrome
Soo Yeon Kim, Yoon Hee Kim, In Suk Sol, Min Jung Kim, Seo Hee Yoon, Kyung Won Kim, Myung Hyun Sohn, Kyu-Earn Kim
Allergy, Asthma & Respiratory Disease.2016; 4(4): 257. CrossRef

Intensivist Physician Staffing in Intensive Care Units: Sunghoon Park, Gee Young Suh; Korean J Crit Care Med. 2013;28(1):1-9.; DOI: https://doi.org/10.4266/kjccm.2013.28.1.1

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Abstract PDF

Despite a shortage of intensivists, there is an increased need for intensivist staffing in intensive care units (ICUs). Western studies showed that the survival rate of critically ill patients improved and the length of ICU stay decreased in "closed" or "high-intensity" ICU, where intensivists dedicated themselves to the ICU and were primary physicians. This system was also associated with an increased compliance of evidence-based medicine and a decreased medical error. The Leapfrog Group and American College of Critical Care Medicine recommend the implementation of intensivist staffing system in the ICU. Although there are still barriers to implement this system, such as the economic burden to hospitals and conflicts among medical staff, intensivist staffing in the ICU is important in terms of timely diagnosis and treatment and multidisciplinary team approach. The presence of intensivists may also increase the efficacy of ICU systems and save treatment cost. Although the "24 hours/7 days intensivist staffing" system may be ideal, recent data showed that high-intensity ICU system during daytime is not inferior to 24-hour intensivist staffing system in terms of hospital mortality. It is especially important to large-scale academic hospitals, where many severely ill patients are treated. However, few ICUs have intensivists who are committed to caring for ICU patients in Korea. Therefore, we have to try to expand this system throughout the whole country. Additionally, the definition of ICU standard, the role of intensivists, and the policy of financial reward also need to be clarified more clearly.

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Effects of the presence of a pediatric intensivist on treatment in the pediatric intensive care unit
Jung Eun Kwon, Da Eun Roh, Yeo Hyang Kim
Acute and Critical Care.2020; 35(2): 87. CrossRef
Intensivist as a Surgeon: The Role of a Surgeon in Critical Care Medicine
Kyung Sook Hong
The Ewha Medical Journal.2017; 40(2): 61. CrossRef

Muscle Relaxants in Critically Ill Patients with Renal Disease: Jin Young Chon; Korean J Crit Care Med. 2012;27(3):145-150.; DOI: https://doi.org/10.4266/kjccm.2012.27.3.145

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Abstract PDF: Critical illness often results in renal dysfunction. Renal disease includes acid base imbalance, electrolyte shift and neuromuscular disturbances in critically ill patients, who are influenced by the pharmacodynamics and pharmacokinetics of muscle relaxants, with kidney dependent metabolism and excretion. In terms of renal dysfunction, not only decreased circulating levels of normal cholinesterase, but also cholinesterase depletion after plasmapheresis and dialysis draw the attention of clinicians, when administering a muscle relaxant to critically ill patients who are compromised with renal function. These patients have a lower clearance of renal excreted drugs, changes of the volume of distribution, water retention, and pH changes that alter the protein bond and degree of ionization of the drugs. Immobilization of the limb and respiratory muscles, leading to muscle atrophy and the up-regulation of nicotinic acetylcholine receptors, associated with critical illness, is observed in many patients hospitalized in the intensive care unit with renal dysfunction. Disease related conditions or iatrogenically induced factors, including sedation, lead to immobilization of skeletal muscles. Aside from systemic inflammation, immobilization is a key contributing factor to the development of critical illness myopathy. Physicians who care for critically ill patients with renal dysfunction should pay attention to the adequate choice of muscle relaxants and their antagonists.

Transfusion-related Acute Lung Injury: Miok Kim; Korean J Crit Care Med. 2012;27(1):1-4.; DOI: https://doi.org/10.4266/kjccm.2012.27.1.1

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Transfusion-related acute lung injury (TRALI) is a significant cause of iatrogenic injuries in patients. It is also the major cause of transfusion-associated fatalities. Pathophysiologic mechanism is an implicated donor of HLA. Neutrophil antibodies and biologic response modifiers are accumulated in the stored blood products. Pulmonary endothelial activation of the host may be the response from these mediators. Treatment is supportive and will be subjected to other forms of ALL/ARDS. Diverting donors at high risk for alloimmunization may decrease the incidence of such cases.

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Transfusion-related acute lung injury in a parturient diagnosed with myelodysplastic syndrome - A case report -
Tae-Yun Sung, Young Seok Jee, Seok-jin Lee, Hwang Ju You, Ki Soon Jeong, Po-Soon Kang
Anesthesia and Pain Medicine.2019; 14(1): 35. CrossRef
Correlation between Allergic Rhinitis Prevalence and Immune Responses of Children in Ulsan: A Case-control Study
Jiho Lee, Inbo Oh, Ahra Kim, Minho Kim, Chang sun Sim, Yangho Kim
Korean Journal of Environmental Health Sciences.2015; 41(4): 249. CrossRef
Transfusion-Related Acute Lung Injury after Stored Packed Red Blood Cell Transfusion - A Case Report -
Ho-Hyun Kim, Dong-Kyu Lee, Chan-Yong Park, Jae-Kyoon Ju, Jung-Chul Kim
Korean Journal of Critical Care Medicine.2013; 28(2): 141. CrossRef

ICU Acquired Weakness: Sung Won Na, Shin Ok Koh; Korean J Crit Care Med. 2011;26(4):203-207.; DOI: https://doi.org/10.4266/kjccm.2011.26.4.203

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Abstract PDF: Critical care has focused on recovery from acute organ failure and resuscitation. Neuromuscular abnormalities related to critical illness is not uncommon in critically ill patients, but they were relatively underestimated and unnoticed. Intensive care unit acquired weakness (ICUAW) leading to severe functional impairments in ICU survivors can be divided into two disease entities: critical illness polyneuropathy (CIP) and critical illness myopathy (CIM). Electrophysiologic study, muscle biopsy and physical examination are helpful to diagnose ICUAW. Several researches and reviews identified many risk factors including systemic inflammation, corticosteroids, hyperglycemia, and immobility. Additional research is needed to identify the pathogenesis of this disorder and to testify its preventive or therapeutic modalities.

Present and Future of ECMO in ICU: Hyung Gon Je, Sang Kwon Lee; Korean J Crit Care Med. 2011;26(2):51-56.; DOI: https://doi.org/10.4266/kjccm.2011.26.2.51

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Abstract PDF

Extracorporeal Membrane Oxygenation (ECMO) is a variation of cardiopulmonary bypass that temporarily supports tissue oxygenation in patients with life threatening respiratory or cardiac failure. As the ECLS technique becomes safer and simpler following technology advances, and as complications and survival have improved, indication of ECLS has widened. In 2009, a multicentre randomized controlled trial of conventional ventilator support versus extracorporeal life support for severe adult respiratory failure in 180 patients was published (the conventional ventilation or ECMO for severe adult respiratory failure (CESAR) trial). Of patients allocated to ECMO support, 63% survived for six months without disability compared to 47% allocated to conventional ventilation care. This represented the first positive randomized clinical trial on adult ECMO application in acute respiratory distress syndrome patients. In this review, we report on the common terminologies used with ECMO, the practical running mode of ECMO, indications of ECMO application in intensive care unit settings and results of recent clinical trials. In addition, management during ECMO support and common complications of ECMO is outlined. Finally, evolving technologies involved with the progress of ECMO are summarized.

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Successful Use of a Peripheral Extracorporeal Membrane Oxygenator in a Patient with Chronic Heart Failure and Pneumonia
Ji Hyun Lee, Yang Hyun Cho, Gee Young Suh, Jeong Hoon Yang
Korean Journal of Critical Care Medicine.2014; 29(1): 52. CrossRef
Fatal Left Ventricular Thrombosis in an Infant Receiving Extracorporeal Membrane Oxygenation Support - A Case Report -
Hwa Jin Cho, Byung Young Kim, Eun Song Song, Sang-Gi Oh, Bong-Suk Oh, In Seok Jeong
Korean Journal of Critical Care Medicine.2013; 28(2): 123. CrossRef

Hemodynamic Monitoring and Treatment Strategy of Acute Heart Failure: Chul Soo Park; Korean J Crit Care Med. 2011;26(1):1-5.; DOI: https://doi.org/10.4266/kjccm.2011.26.1.1

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Acute heart failure (AHF) has emerged as a major public health problem over the past 2 decades and AHF represents a period of high risk for patients, during which time the patients are more susceptible to have fatal outcomes or be re-hospitalized, compared to periods of chronic stable heart failure. The goals of AHF treatment are symptomatic relief and hemodynamic stabilization, which need accurate assessment of volume status and cardiac function of patients. Until now, there is a paucity of controlled clinical data to define optimal treatment for patients with AHF and most guidelines published by the American Heart Association or European Society of Cardiology have been generated by the consensus opinions of experts. In these guidelines, routine invasive hemodynamic monitoring of AHF patients is not recommended because there have not been any reports showing survival benefit in patients monitored with pulmonary artery catheters. At present, treatment strategies based on clinical characteristics such as pulmonary congestion and tissue hypoperfusion rather than invasive hemodynamic monitoring is widely accepted. In this article, we discuss an optimal management plan including appropriate assessment of the hemodynamic status of patients and treatment of AHF.

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Thoracic aortic aneurysms exerting high extrinsic pressure on the airway
Hanna Jung, Young Woo Do, Sang Yub Lee, Youngok Lee, Tak Hyuk Oh, Gun Jik Kim
Journal of Cardiothoracic Surgery.2019;[Epub] CrossRef
Relationship of Temperature and Humidity with the Number of Daily Emergency Department Visits for Acute Heart Failure: Results from a Single Institute from 2008-2010
Sang Hyun Ha, Bong Gun Song, Na Kyoung Lee, Chang Shin Choi, Chong Kun Hong, Jun Ho Lee, Seong Youn Hwang
Korean Journal of Critical Care Medicine.2012; 27(3): 165. CrossRef

Current Insights into Sepsis Treatments: Chang Youl Lee; Korean J Crit Care Med. 2010;25(4):207-211.; DOI: https://doi.org/10.4266/kjccm.2010.25.4.207

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Abstract PDF

Sepsis is a common illness of intensive care unit patients that carries high morbidity and mortality, and increases hospital costs. Although mortality from sepsis remains high when compared with other critical illnesses, it has declined over the last few decades due to several adjunctive therapies and focused care programs or guidelines. In 2004, an international guideline was published that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock. Several landmark studies recently demonstrated that therapeutic strategies may substantially reduce mortality. The Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock: 2008 was updated using a new evidence-based methodology system for assessing the quality of evidence and the strengths of recommendations. Evidence-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. This article discusses the guidelines and current insights into sepsis treatment.

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Prevalence of Toxin Genes and Antibiotic Resistance Profiles of Vibrio vulnificus strains isolated from Jeju Island
Eunok Kang, Man Jae Cho, Ye-Seul Heo, Eun A Koh
Journal of Food Hygiene and Safety.2023; 38(5): 381. CrossRef
Association of Peripheral Lymphocyte Subset with the Severity and Prognosis of Septic Shock
Jin Kyeong Park, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Jin Won Huh
The Korean Journal of Critical Care Medicine.2011; 26(1): 13. CrossRef

Hormonal Changes in Critical Condition: Heung Bum Lee, Chi Ryang Chung; Korean J Crit Care Med. 2010;25(3):123-129.; DOI: https://doi.org/10.4266/kjccm.2010.25.3.123

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When disease or trauma progresses to a critical state, the reaction of the endocrine system in creating homeostasis is essential for survival. The association between the severity of hormonal changes and outcome in terms of morbidity and mortality has led to the challenge of development of several endocrine treatments. During sepsis, nitric oxide-mediated apoptosis is observed in the neurons and glial cells of the cerebrovascular centers of the autonomic nervous system. It is probably one of the components of the circulatory dysfunction of sepsis. The regulation of different organs was neither linear nor independent however organs were found to behave as biological oscillators coupled to each other through neurological or hormonal communication pathways. Sepsis, because of systemic inflammatory responsive syndrome, disrupts these communication pathways and leads to organ failures. Endocrine hormonal issues related to the intensive care setting are common challenges to ICU specialists. Disruptions of the endocrine system in sepsis are characterized by 1) an increase in cortisol plasma levels with a loss of the circadian rhythm of its secretion; 2) hyperglycemia due to insulin resistance and rise in hyperglycemic hormones secretion; 3) relative vasopressin deficiency; and 4) euthyroid sick syndrome or non-thyroidal illness syndrome. This article discusses the dynamic changes of four main endocrine axes: hypothalamic-pituitary-adrenal axis, insulin, vasopressin and thyroid during grave states of disease, when a patient is in critical condition.

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The Changing Pattern of Blood Glucose Levels and Its Association with In-hospital Mortality in the Out-of-hospital Cardiac Arrest Survivors Treated with Therapeutic Hypothermia
Ki Tae Kim, Byung Kook Lee, Hyoung Youn Lee, Geo Sung Lee, Yong Hun Jung, Kyung Woon Jeung, Hyun Ho Ryu, Byoeng Jo Chun, Jeong Mi Moon
Korean Journal of Critical Care Medicine.2012; 27(4): 255. CrossRef

Antioxidants in Sepsis: Jae Yeol Kim; Korean J Crit Care Med. 2010;25(2):57-60.; DOI: https://doi.org/10.4266/kjccm.2010.25.2.57

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Oxidant byproducts, such as superoxide anion (O2-) and hydrogen peroxide are produced as a consequence of normal aerobic metabolism. Because they are highly reactive with other biologic molecules, such as protein, DNA, and lipids, they are called as reactive oxygen species (ROS). Fortunately, our body is equipped with numerous potent endogenous antioxidants. Oxidative stress is caused by an imbalance between the production of ROS and the biologic scavenger system, antioxidants. Oxidative-induced damage has been considered to be one of the underlying mechanisms that contribute to multiple organ failure in sepsis. Both enzymatic and nonenzymatic antioxidants have been widely tested in human and animals with sepsis. However, the disappointing results of N-acetylcysteine (NAC), which is the most extensively tested antioxidant may reflect the inability to reestablish a redox balance in the setting of sepsis in patients. Still, three antioxidants demonstrated clinical benefits and reached level A evidence; selenium improves clinical outcome (infections, organ failure); glutamine reduces infectious complication in large-sized trials; and omega-3-fatty acids have significant anti-inflammatory effects. Other antioxidants are still on the clinical benchmark level, awaiting well-designed clinical trial.

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The Crucial Role of Xanthine Oxidase in CKD Progression Associated with Hypercholesterolemia
You-Jin Kim, Se-Hyun Oh, Ji-Sun Ahn, Ju-Min Yook, Chan-Duck Kim, Sun-Hee Park, Jang-Hee Cho, Yong-Lim Kim
International Journal of Molecular Sciences.2020; 21(20): 7444. CrossRef
Design of an accelerator-driven subcritical dual fluid reactor for transmutation of actinides
Sang-in Bak, Seung-Woo Hong, Yacine Kadi
The European Physical Journal Plus.2019;[Epub] CrossRef
Effect of Intravenous High-Dose Selenium Supplementation in Patients with Systemic Inflammatory Response Syndrome: A Pilot Study
Mi-Jeoung Kim, Ki-Jong Lee, In-Myung Oh, Dong-Hyun Oh, Kyoung-Hwa Yoo, Ju-Sang Park, Eun-Jeong Jang, Sang-Jong Park, Sang-Woon Park, Sang-Jung Kim, Hyun Wook Baik
Korean Journal of Medicine.2013; 84(4): 531. CrossRef
Effects of Atractylodis Rhizoma Pharmacopuncture on an Acute Gastric Mucosal Lesion Induced by Compound 48/80 in Rats
Yun-Kyu Lee, Jae-Soo Kim, Seong-Chul Lim
Journal of Pharmacopuncture.2012; 15(1): 12. CrossRef
Association of Peripheral Lymphocyte Subset with the Severity and Prognosis of Septic Shock
Jin Kyeong Park, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Jin Won Huh
The Korean Journal of Critical Care Medicine.2011; 26(1): 13. CrossRef

Mechanisms of Muscle Wasting in Patients with Sepsis: Gi Dong Lee, Ho Cheol Kim; Korean J Crit Care Med. 2010;25(1):9-15.; DOI: https://doi.org/10.4266/kjccm.2010.25.1.9

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Abstract PDF

Muscle wasting is commonly seen in patients with sepsis as a consequence of the catabolic response in skeletal muscle. Muscle wasting can occur in cases that have an imbalance between degradation and synthesis of muscle proteins. Although decrements in the synthesis of muscle proteins may contribute to sepsis-induced muscle wasting, it has been recognized that increments in its degradation play a more essential role in muscle wasting. Muscle wasting in sepsis patients has some significant clinical consequences such as reduced ambulation and exercise tolerance, and an increased risk for pulmonary and thromboembolic complications. Several mechanisms have been proposed for sepsis-induced muscle wasting. Increased proteolysis via the ubiquitin-proteasome pathway and the calpains system is one of the principal mechanisms of muscle wasting induced by sepsis. Calpains are activated by calcium, which increases in patients with sepsis. The activation of the calpains system disrupts the sarcomere of the myofibrils, resulting in the release of myofilaments that are subsequently ubiquitinated and degraded by the 26S proteasome complex. Recent studies have suggested that transcriptional factors such as NF-kappaB and FoxO, and the apoptosis and autophagy-lysosome pathways may also be involved in sepsis-induced muscle wasting. This review briefly summarizes the contribution of these mechanisms of muscle wasting in patients with sepsis and the possible therapeutic agents to treat it.

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Role of IL-15 in Sepsis-Induced Skeletal Muscle Atrophy and Proteolysis
Ho Cheol Kim, Hee-Young Cho, Young-Sool Hah
Tuberculosis and Respiratory Diseases.2012; 73(6): 312. CrossRef

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