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Volume 30 (3); August 2015
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Editorial
Cardiology/Hematology
Blood Transfusion Strategies in Patients Supported by Extracorporeal Membrane Oxygenation
Yoon Hee Kim
Korean J Crit Care Med. 2015;30(3):139-142.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.139
  • 5,007 View
  • 71 Download
PDF
Review
Neurosurgery
Therapeutic Hypothermia in Traumatic Brain injury; Review of History, Pathophysiology and Current Studies
Do-Keun Kim, Dong-Keun Hyun
Korean J Crit Care Med. 2015;30(3):143-150.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.143
  • 8,876 View
  • 235 Download
AbstractAbstract PDF
The fact that therapeutic hypothermia (TH) has lowered intracranial pressure and protected brain in severe traumatic brain injury (TBI) is well known throughout past sources and experimental data. In this paper, the result of TH in TBI needs to be confirmed. The result of North American Brain Injury Study; Hypothermia (NAVIS-H) 1 and 2, Eurotherm3235, Japan trauma society study was reviewed throughout randomized controlled study which performed recently. The prognosis was not confirmed throughout TH in NAVIS-H1; however, there was statistical significance among the group of 45 years or less and below 35 degree in celcius which checked when he or she visited initially. Hence, NAVIS-H2 study was preceded. In patient who had surgically removed hematoma, the effects of TH were proved compared to diffuse brain damage in NAVIS-H2 study. This was found in the result of Japan neurotrauma data bank. Eurotherm study has been doing, which leads to collect many data later on. The TBI of TH makes them better prognosis in patients who had surgically removed hematoma and lowered initial body temperature. Later on, it is considered further study is necessary.
Original Articles
Basic science and research
The Anti-Inflammatory Effect of Arginine-Vasopressin on Lipopolysaccharide-Induced IκBα/Nuclear Factor-κB Cascade
Jisoo Park, Eun Young Eo, Kyoung-Hee Lee, Jong Sun Park, Jae-Ho Lee, Chul-Gyu Yoo, Choon-Taek Lee, Young-Jae Cho
Korean J Crit Care Med. 2015;30(3):151-157.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.151
  • 6,493 View
  • 117 Download
  • 6 Crossref
AbstractAbstract PDFSupplementary Material
Background
Arginine vasopressin (AVP) is widely used as a vasopressor agent. Some recent studies have suggested that AVP may exert an immunomodulatory effect. However, the mechanism about the anti-inflammatory effect of AVP is not well known. We investigated the effect of AVP on the ihibitor of kappa B (IκBα)/nuclear factor-kappa B (NF-κB) pathway in RAW 264.7 cells.
Methods
Cultured RAW 264.7 cells were pretreated with AVP and stimulated with lipopolysaccharide (LPS). To evaluate the effect of AVP on inflammatory cytokines, the concentration of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were assessed by an enzyme-linked immunosorbent assay technique. The expression of IκBα and nuclear translocation of NF-κB p65 were measured by Western blotting, and IκB kinase (IKK) activity was analyzed by an in vitro immune complex kinase assay. To confirm the AVP effect on IκBα/NF-κB cascade and via V2 receptor, we added tolvaptan (V2 receptor antagonist) after AVP pretreatment.
Results
The increase of IL-6 and TNF-α in LPS-stimulated RAW 264.7 cells was suppressed by a treatment with AVP. Pretreatment of AVP inhibited increasing of IKK activity and IκBα degradation induced by LPS in RAW 264.7 cells. Furthermore, LPS induced and NF-κB transcription was inhibited by AVP pretreatment. The observed changes in IKK activity, IκBα degradation and NF-κB transcription by AVP was abolished by tolvaptan treatment.
Conclusions
Our results suggest that AVP showed anti-inflammatory effect on LPS-induced IκBα/NF-κB cascade in mouse macrophages via V2 receptors.

Citations

Citations to this article as recorded by  
  • Validity of mental and physical stress models
    Erin Hendry, Brady McCallister, Dan J. Elman, Roy Freeman, David Borsook, Igor Elman
    Neuroscience & Biobehavioral Reviews.2024; 158: 105566.     CrossRef
  • Osmoregulatory neurons clockwork is altered during metabolic disorder induced by high energy diet in the Sand rat Psammomys obesus
    Hanane Touati, Saliha Ouali-Hassenaoui, Aicha Dekar-Madoui, Nadir Benhafri, Lydia Boumansour, Etienne Challet, Paul Pévet, Patrick Vuillez
    Biological Rhythm Research.2023; 54(2): 153.     CrossRef
  • Microbial and Host Metabolites at the Backstage of Fever: Current Knowledge about the Co-Ordinate Action of Receptors and Molecules Underlying Pathophysiology and Clinical Implications
    Luigi Santacroce, Marica Colella, Ioannis Alexandros Charitos, Marina Di Domenico, Raffaele Palmirotta, Emilio Jirillo
    Metabolites.2023; 13(3): 461.     CrossRef
  • Birth triggers an inflammatory response in the neonatal periphery and brain
    Alexandra Castillo-Ruiz, Carla D. Cisternas, Hannah Sturgeon, Nancy G. Forger
    Brain, Behavior, and Immunity.2022; 104: 122.     CrossRef
  • Comprehensive biology of antipyretic pathways
    Prajitha N, Athira SS, Mohanan PV
    Cytokine.2019; 116: 120.     CrossRef
  • Oxytocin and Vasopressin Systems in Obesity and Metabolic Health: Mechanisms and Perspectives
    Cherlyn Ding, Faidon Magkos
    Current Obesity Reports.2019; 8(3): 301.     CrossRef
Cardiology
The Effect of the Valsalva Maneuver on the External Jugular Vein
Ho Sik Moon, Sung Hoon Jung, Sie Hyeon Yoo, Jae Young Ji, Hae Jin Lee
Korean J Crit Care Med. 2015;30(3):158-163.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.158
  • 10,400 View
  • 100 Download
AbstractAbstract PDF
Background
The external jugular vein (EJV) is a useful intravenous (IV) cannulation site for anesthesiologists, although it has a relatively high failure rate. Unlike other central veins, visualization of the EJV is important during IV cannulation, and the Valsalva maneuver distends the jugular venous system. However, the relationship between the maneuver and EJV visibility remains unknown. This study compared EJV visibility before and after the Valsalva maneuver.
Methods
This was a prospective observational study that included 200 participants. After the induction of anesthesia, EJV visibility grade, depth from the skin to the EJV superficial surface (EJV depth), and EJV cross-sectional area (CSA) before the Valsalva maneuver were measured. The same parameters were measured after the Valsalva maneuver was performed. The EJV visibility grade was defined as grade A: good appearance and good palpation, grade B: poor appearance and good palpation, and grade C: poor appearance and poor palpation.
Results
Patient body mass index and EJV depth affected the EJV visibility grade before the Valsalva maneuver (p < 0.05), although EJV CSA did not. The Valsalva maneuver distended EJV CSA and reduced EJV depth, although these changes were not correlated with EJV visibility grade. With regard to EJV visibility, 34.0% of grade B cases and 20.0% of grade C cases were improved by the Valsalva maneuver.
Conclusions
Although the Valsalva maneuver improved EJV CSA and EJV depth, it did not greatly affect EJV visibility grade.
Pulmonary
Factors Affecting Invasive Management after Unplanned Extubation in an Intensive Care Unit
A Lan Lee, Chi Ryang Chung, Jeong Hoon Yang, Kyeongman Jeon, Chi-Min Park, Gee Young Suh
Korean J Crit Care Med. 2015;30(3):164-170.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.164
  • 5,022 View
  • 104 Download
  • 1 Crossref
AbstractAbstract PDF
Background
Unplanned extubation (UE) of patients requiring mechanical ventilation in an intensive care unit (ICU) is associated with poor outcomes for patients and organizations. This study was conducted to assess the clinical features of patients who experienced UE and to determine the risk factors affecting reintubation after UE in an ICU.
Methods
Among all adult patients admitted to the ICU in our institution who required mechanical ventilation between January 2011 and December 2013, those in whom UE was noted were included in the study. Data were categorized according to noninvasive or invasive management after UE.
Results
The rate of UE was 0.78% (the number of UEs per 100 days of mechanical ventilation). The incidence of self-extubation was 97.2%, while extubation was accidental in the remaining patients. Two cases of cardiac arrest combined with respiratory arrest after UE were noted. Of the 214 incidents, 54.7% required invasive management after UE. Long duration of mechanical ventilation (odds ratio [OR] 1.52; 95% confidence interval [CI] 1.32-1.75; p = 0.000) and high ICU mortality (OR 4.39; 95% CI 1.33-14.50; p = 0.015) showed the most significant association with invasive management after UE. In multivariate analysis, younger age (OR 0.96; 95% CI 0.93-0.99; p = 0.005), medical patients (OR 4.36; 95% CI 1.95-9.75; p = 0.000), use of sedative medication (OR 4.95; 95% CI 1.97-12.41; p = 0.001), large amount of secretion (OR 2.66; 95% CI 1.01-7.02; p = 0.049), and low PaO2/FiO2 ratio (OR 0.99; 95% CI 0.98-0.99; p = 0.000) were independent risk factors of invasive management after UE.
Conclusions
To prevent unfavorable clinical outcomes, close attention and proper ventilatory support are required for patients with risk factors who require invasive management after UE.

Citations

Citations to this article as recorded by  
  • Re-Intubation Among Critical Care Patients: A Scoping Review
    Thandar Soe Sumaiyah Jamaludin, Mohd Said Nurumal, Nur Syila Syahida Syaziman, Syuhada Suhaimi, Muhammad Kamil Che Hasan
    INTERNATIONAL JOURNAL OF CARE SCHOLARS.2021; 4(Supp1): 93.     CrossRef
Case Reports
Infection
Polymyxin B Hemoperfusion in Pneumonic Septic Shock Caused by Gram-Negative Bacteria
Jung-Wan Yoo, Su Yeon Park, Jin Jeon, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Sang-Bum Hong
Korean J Crit Care Med. 2015;30(3):171-175.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.171
  • 4,880 View
  • 84 Download
AbstractAbstract PDF
Severe sepsis and septic shock are the main causes of death in critically ill patients. Early detection and appropriate treatment according to guidelines are crucial for achieving favorable outcomes. Endotoxin is considered to be a main element in the pathogenic induction of gram-negative bacterial sepsis. Polymyxin B hemoperfusion can remove endotoxin and is reported to improve clinical outcomes in patients with intra-abdominal septic shock, but its clinical efficacy for pneumonic septic shock remains unclear. Here, we report a case of a 51-year-old man with pneumonic septic shock caused by Pseudomonas aeruginosa, who recovered through polymyxin B hemoperfusion.
Infection/Surgery
Refractory Septic Shock Treated with Nephrectomy under the Support of Extracorporeal Membrane Oxygenation
Young Kun Lee, Jeong Am Ryu, Jeong Hoon Yang, Chi-Min Park, Gee Young Suh, Kyeongman Jeon, Chi Ryang Chung
Korean J Crit Care Med. 2015;30(3):176-179.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.176
  • 4,667 View
  • 69 Download
AbstractAbstract PDF
Conventional medical therapies have not been very successful in treating adults with refractory septic shock. The effects of direct hemoperfusion using polymyxin B and veno-arterial extracorporeal membrane oxygenation (ECMO) for refractory septic shock remain uncertain. A 66-year-old man was admitted to the emergency department and suffered from sepsis-induced hemodynamic collapse. For hemodynamic improvement, we performed direct hemoperfusion using polymyxin B. Computed tomography scan of this patient revealed emphysematous pyelonephritis (EPN), for which he underwent emergent nephrectomy with veno-arterial ECMO support. To the best of our knowledge, this is the first report of successful treatment of EPN with refractory septic shock using polymyxin B hemoperfusion and nephrectomy under the support of ECMO.
Infection
Septic Shock due to Unusual Pathogens, Comamonas testosteroni and Acinetobacter guillouiae in an Immune Competent Patient
Hyun Jung Kim, Yunkyoung Lee, Kyunghwan Oh, Sang-Ho Choi, Heungsup Sung, Jin Won Huh
Korean J Crit Care Med. 2015;30(3):180-183.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.180
  • 21,363 View
  • 85 Download
  • 6 Crossref
AbstractAbstract PDF
Comamonas testosteroni and Acinetobacter guillouiae are gram-negative bacilli of low virulence that are widely distributed in nature and normal flora. Despite their common occurrence in environments, they rarely cause infectious disease. We experienced a case of septic shock by C. testosterone and A. guillouiae, and isolated them by 16S ribosomal RNA sequencing method from the blood cultures of a previous healthy female during postoperative supportive care. This is the first case of septic shock required ventilator care and continuous renal replacement therapy due to these organisms in Korea.

Citations

Citations to this article as recorded by  
  • An investigation of clinical characteristics and antimicrobial agent susceptibility patterns in clinical Comamonas testosteroni isolates: An increasingly prevalent nosocomial pathogen
    Bahadır Orkun Ozbay, Adalet Aypak, Aliye Bastug, Ömer Aydos, İpek Mumcuoglu, Sevim Gayenur Büyükberber, Ayşe Müge Karcıoğlu, Hurrem Bodur
    Infectious Diseases Now.2023; 53(2): 104622.     CrossRef
  • Bullfrogs (Lithobates catesbeianus) as a Potential Source of Foodborne Disease
    Andrea P. Zepeda-Velazquez, Fabián-Ricardo Gómez-De-Anda, Luis F. Aguilar-Mendoza, Nayeli Shantal Castrejón-Jiménez, Juan Carlos Hernández-González, Jorge A. Varela-Guerrero, Jorge-Luis de-la-Rosa-Arana, Vicente Vega-Sánchez, Nydia E. Reyes-Rodríguez
    Journal of Food Protection.2023; 86(4): 100067.     CrossRef
  • The Emergence of the Genus Comamonas as Important Opportunistic Pathogens
    Michael P. Ryan, Ludmila Sevjahova, Rachel Gorman, Sandra White
    Pathogens.2022; 11(9): 1032.     CrossRef
  • A rare case of peritoneal dialysis‐associated peritonitis caused by Comamonas testosteroni
    Roman Kuźniewicz, Mirosław Śnit, Dariusz Szczyra
    Seminars in Dialysis.2022; 35(6): 556.     CrossRef
  • The complex pattern of codon usage evolution in the family Comamonadaceae
    Eugenio Jara, María A. Morel, Guillermo Lamolle, Susana Castro-Sowinski, Diego Simón, Andrés Iriarte, Héctor Musto
    Ecological Genetics and Genomics.2018; 6: 1.     CrossRef
  • First microbiota assessments of children's paddling pool waters evaluated using 16S rRNA gene-based metagenome analysis
    Toko Sawabe, Wataru Suda, Kenshiro Ohshima, Masahira Hattori, Tomoo Sawabe
    Journal of Infection and Public Health.2016; 9(3): 362.     CrossRef
Infection
Toxic Shock Syndrome following Tattooing
Ki Young Jeong, Kyung Su Kim, Gil Joon Suh, Woon Yong Kwon
Korean J Crit Care Med. 2015;30(3):184-190.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.184
  • 24,158 View
  • 115 Download
  • 5 Crossref
AbstractAbstract PDF
Toxic shock syndrome (TSS) is a rare but life-threatening illness that is mainly caused by toxigenic strains of Staphylococcus aureus. Although TSS is classically known to be associated with tampon use, the number of TSS cases with non-menstrual causes such as skin and soft tissue infection has been increasing. Tattooing can result in several complications such as localized and systemic infections, inflammatory skin eruptions and neoplasms. We recently experienced a 26-year-old man diagnosed with typical TSS following tattooing. He complained of fever, chills and erythematous rash at tattoo site. Subsequently, the patient developed sign of shock. The skin cultures on the tattoo site were positive for methicillin-sensitive Staphylococcus aureus. The patient was successfully treated with vasopressor infusion and intravenous antibiotics and was discharged without complications. On discharge from the hospital 7 days later, desquamations on the tattoo site, fingers and toes were observed.

Citations

Citations to this article as recorded by  
  • Systemic infections associated with tattoos or permanent makeup: A systematic review
    Jordi Rello, Sofia Tejada, Laura Campogiani, Adenike G. Adebanjo, Antonella Tammaro
    Medicina Clínica.2022; 158(4): 159.     CrossRef
  • Heterogenes Spektrum an dermatologischen Komplikationen
    Lynhda Nguyen, Jana Witte, Maria Christolouka, Stefan W. Schneider, Katharina Herberger
    ästhetische dermatologie & kosmetologie.2022; 14(1): 28.     CrossRef
  • Systemic infections associated with tattoos or permanent makeup: A systematic review
    Jordi Rello, Sofia Tejada, Laura Campogiani, Adenike G. Adebanjo, Antonella Tammaro
    Medicina Clínica (English Edition).2022; 158(4): 159.     CrossRef
  • Tattoo-associated complications and related topics: A comprehensive review
    JamesonM Petrochko, AndrewC Krakowski, Colin Donnelly, JohnB Wilson, JenniferBruno Irick, StanislawP Stawicki
    International Journal of Academic Medicine.2019; 5(1): 19.     CrossRef
  • The Risk of Bacterial Infection After Tattooing
    Ralf Dieckmann, Ides Boone, Stefan O. Brockmann, Jens A. Hammerl, Annette Kolb-Mäurer, Matthias Goebeler, Andreas Luch, Sascha Al Dahouk
    Deutsches Ärzteblatt international.2016;[Epub]     CrossRef
Neurology/Liver
Fixed Pupillary Light Reflex due to Peripheral Neuropathy after Liver Transplantation
Kwan Hyung Kim, Namo Kim, Sungwon Na, Jaewon Jang, Jeongmin Kim
Korean J Crit Care Med. 2015;30(3):191-195.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.191
  • 5,911 View
  • 88 Download
AbstractAbstract PDF
A 46- year-old female patient was admitted to the intensive care unit (ICU) after liver transplantation. About an hour later after the ICU admission, she had no pupillary light reflex. Both pupils were also fixed at 5 mm. Patients who undergo liver transplantation are susceptible to neurologic disorders including hepatic encephalopathy, thromboembolism and intracranial hemorrhage. Abnormal pupillary light reflex usually indicates a serious neurologic emergency in these patients; however, benign neurologic disorders such as peripheral autonomic neuropathy or Holmes-Adie syndrome should also be considered. We experienced a case of fixed pupillary light reflex after liver transplantation diagnosed as peripheral autonomic neuropathy.
Lung Transplantation in Acute Respiratory Distress Syndrome Caused by Influenza Pneumonia
Youjin Chang, Sang Oh Lee, Tae Sun Shim, Sae Hoon Choi, Hyung Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park, Sang-Bum Hong
Korean J Crit Care Med. 2015;30(3):196-201.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.196
  • 729 View
  • 0 Download
  • 2 Crossref
AbstractAbstract PDF
Severe acute respiratory distress syndrome (ARDS) is a life-threatening disease with a high mortality rate. Although many therapeutic trials have been performed for improving the mortality of severe ARDS, limited strategies have demonstrated better outcomes. Recently, advanced rescue therapies such as extracorporeal membrane oxygenation (ECMO) made it possible to consider lung transplantation (LTPL) in patients with ARDS, but data is insufficient. We report a 62-year-old man who underwent LTPL due to ARDS with no underlying lung disease. He was admitted to the hospital due to influenza A pneumonia-induced ARDS. Although he was supported by ECMO, he progressively deteriorated. We judged that his lungs were irreversibly damaged and decided he needed to undergo LTPL. Finally, bilateral sequential double-lung transplantation was successfully performed. He has since been alive for three years. Conclusively, we demonstrate that LTPL can be a therapeutic option in patients with severe ARDS refractory to conventional therapies.

Citations

Citations to this article as recorded by  
  • Lung transplantation for acute respiratory distress syndrome: a retrospective European cohort study
    Jens Gottlieb, Philipp M. Lepper, Cristina Berastegui, Beatriz Montull, Alexandra Wald, Jasvir Parmar, Jesper M. Magnusson, Felix Schönrath, Tanel Laisaar, Sebastian Michel, Hillevi Larsson, Robin Vos, Assad Haneya, Tim Sandhaus, Erik Verschuuren, Jérôme
    European Respiratory Journal.2022; 59(6): 2102078.     CrossRef
  • Comment on “Lung Transplantation for Elderly Patients With End-Stage COVID-19 Pneumonia”
    Michael K. Hsin, See Ching Chan, Huiqing Lin
    Annals of Surgery.2021; 274(6): e829.     CrossRef
Cardiology/Pulmonary
Massive Hemoptysis due to Acute Mitral Regurgitation with Sporadic Primary Mitral Valve Prolapse
Won Young Chae, Sun Jin Park, Chi Woo Song, Byoung Hoon Lee, Sang Hoon Kim, Jae Hyung Lee
Korean J Crit Care Med. 2015;30(3):202-206.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.202
  • 15,149 View
  • 173 Download
  • 4 Crossref
AbstractAbstract PDF
The most common cardiac cause of massive hemoptysis is mitral stenosis. Mitral regurgitation is rarely complicated by massive hemoptysis. A 48-year-old man with no significant medical history was admitted to our hospital with hemoptysis and production of 500 mL of blood within 24 hours. A pan-systolic murmur was found on chest examination. A chest computed tomography showed airspace consolidation in the right upper and middle lobes, with faint bilateral ground glass opacity. Echocardiography revealed mitral valve prolapse and grade IV mitral regurgitation. The patient was diagnosed with sporadic primary mitral valve prolapse. After mitral valve repair surgery, the patient recovered fully.

Citations

Citations to this article as recorded by  
  • Hemoptysis and Unilateral Pulmonary Infiltrates due to Severe Acute Mitral Regurgitation from Papillary Muscle Rupture
    Joanna Wieckowska, Nicholas Diloreto, Shannon Hood, Isabella Chojnacki, Dalia Zakri, Antonio Corrado
    Case Reports in Pulmonology.2024; 2024: 1.     CrossRef
  • Surgically‐treated hemoptysis and alveolar hemorrhaging resulting from severe mitral regurgitation: A case report
    Daisuke Yamaguchi, Toshiya Tokui, Takahiro Narukawa, Masahiko Murakami, Tomotake Sekoguchi, Ryosai Inoue, Koji Hirano, Yasumi Maze, Hisato Ito
    Clinical Case Reports.2023;[Epub]     CrossRef
  • Acute mitral valve regurgitation causing severe alveolar hemorrhage
    Ayaka Sakamoto, Yuki Enomoto, Hiroaki Watabe, Yasuaki Koyama, Yukei Matsumoto, Nobutake Shimojo, Aiki Marushima, Satoru Kawano, Yoshiaki Inoue
    Acute Medicine & Surgery.2020;[Epub]     CrossRef
  • Man With Sudden Dyspnea and Hemoptysis
    Naoki Kawakami, Rina Kato, Chushu Liu, Kazuhiko Takahashi, Yoko Wakai, Kazuhito Saito
    Annals of Emergency Medicine.2020; 75(5): 668.     CrossRef
Toxicology
Acute Colchicine Poisoning Treated with Granulocyte Colony Stimulating Factor and Transfusion
Sung-Hwa Lee, Sung-Wook Park, Sang-Kyoon Han, Soon-Chang Park
Korean J Crit Care Med. 2015;30(3):207-211.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.207
  • 5,736 View
  • 96 Download
  • 1 Crossref
AbstractAbstract PDF
Colchicine poisoning is rare but can cause potentially life-threatening toxic complications such as hypovolemic shock, cardiovascular collapse and multiple organ failure. In this case report, we describe a case of a 20-year-old female who presented to the emergency department after suicidal ingestion of a toxic dose of colchicine. She developed thrombocytopenia, neutropenia and acute respiratory distress syndrome that required blood transfusion and administration of granulocyte colony stimulating factor for the prevention of infectious complications. With regard to the clinical manifestations of colchicine toxicity, we discussed suggested mechanisms.

Citations

Citations to this article as recorded by  
  • Severe colchicine poisoning treated successfully with kidney replacement therapy and plasmapheresis: a case report
    D. H. Schaffer, D. L. Overbeek, T. B. Erickson, E. W. Boyer, C. Goldfine, S. A. Muhsin, P. R. Chai
    Toxicology Communications.2022; 6(1): 46.     CrossRef
Pulmonary
Successful Immunoglobulin Treatment in Severe Cryptogenic Organizing Pneumonia Caused by Dermatomyositis
Dong Hoon Lee, Jee Hyun Yeo, Young Il Kim, Seung Jun Gim, Jang Won Sohn, Ji Young Yhi
Korean J Crit Care Med. 2015;30(3):212-217.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.212
  • 7,616 View
  • 91 Download
  • 1 Crossref
AbstractAbstract PDF
In connective tissue diseases, autoantibodies cause pulmonary interstitial inflammation and fibrosis, and patients require treatment with an immunosuppressive agent such as a steroid. Dermatomyositis is an incurable, uncommon form of connective tissue disease that occasionally causes diffuse pulmonary inflammation leading to acute severe respiratory failure. In such cases, the prognosis is very poor despite treatment with high-dose steroid. In the present case, a 46-year-old man was admitted to our hospital with dyspnea. He was diagnosed with dermatomyositis combined with cryptogenic organizing pneumonia (COP) with respiratory failure and underwent treatment with steroid and an immunosuppressive agent, but the COP was not improved. However, the respiratory failure did improve after treatment with intravenous immunoglobulin, which therefore can be considered a treatment option in cases where steroids and immunosuppressive agents are ineffective.

Citations

Citations to this article as recorded by  
  • A Case Report of Steroid-Resistant Cryptogenic Organizing Pneumonia Managed with Intravenous Immunoglobulins
    Christian Akem Dimala, Urvi Patel, Benjamin Lloyd, Anthony Donato, William B. Kimmel, Robert Hallowell, Caitlyn Moss, Tun-Chieh Chen
    Case Reports in Pulmonology.2021; 2021: 1.     CrossRef
Toxicology
Management of Cyanide Intoxication with Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy
Jin Park, Seung-Yeob Lee, Hyun-Sik Choi, Yoon Hee Choi, Young-Joo Lee
Korean J Crit Care Med. 2015;30(3):218-221.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.218
  • 7,496 View
  • 88 Download
  • 1 Crossref
AbstractAbstract PDF
Cyanide intoxication results in severe metabolic acidosis and catastrophic prognosis with conventional treatment. Indications of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) are expanding to poisoning cases. A 50-year-old male patient arrived in the emergency room due to mental change after ingestion of cyanide as a suicide attempt 30 minutes prior. He was comatose, and brain stem reflexes were absent. Initial laboratory analysis demonstrated severe metabolic acidosis with increased lactic acid of 25 mM/L. Shock and acidosis were not corrected despite a large amount of fluid resuscitation with high-dose norepinephrine and continuous renal replacement therapy. We decided to apply ECMO and CRRT to allow time for stabilization of hemodynamic status. After administration of antidote infusion, although the patient had the potential to progress to brain death status, vital signs were improved with correction of acidosis. We considered the evaluation for organ donation. We report a male patient who showed typical cyanide intoxication as lethal metabolic acidosis and cardiac impairment, and the patient recovered after antidote administration during vital organ support through ECMO and CRRT.

Citations

Citations to this article as recorded by  
  • Cyanogenic glycoside amygdalin influences functions of human osteoblasts in vitro
    Radoslav Omelka, Veronika Kovacova, Vladimira Mondockova, Birgit Grosskopf, Adriana Kolesarova, Monika Martiniakova
    Journal of Environmental Science and Health, Part B.2021; 56(2): 109.     CrossRef

ACC : Acute and Critical Care