Acute and Critical Care

Volume 31 (4); November 2016

Reviews

Cardiology/Infection
How Do I Integrate Hemodynamic Variables When Managing Septic Shock?: Olfa Hamzaoui, Jean-Louis Teboul; Korean J Crit Care Med. 2016;31(4):265-275. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00927

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Hemodynamic management of sepsis-induced circulatory failure is complex since this pathological state includes multiple cardiovascular derangements that can vary from patient to patient according to the degree of hypovolemia, of vascular tone depression, of myocardial depression and of microvascular dysfunction. The treatment of the sepsis-induced circulatory failure is thus not univocal and should be adapted on an individual basis. As physical examination is insufficient to obtain a comprehensive picture of the hemodynamic status, numerous hemodynamic variables more or less invasively collected, have been proposed to well assess the severity of each component of the circulatory failure and to monitor the response to therapy. In this article, we first describe the hemodynamic variables, which are the most relevant to be used, emphasizing on their physiological meaning, their validation and their limitations in patients with septic shock. We then proposed a general approach for managing patients with septic shock by describing the logical steps that need to be followed in order to select and deliver the most appropriate therapies. This therapeutic approach is essentially based on knowledge of physiology, of pathophysiology of sepsis, and of published data from clinical studies that addressed the issue of hemodynamic management of septic shock.

Citations

Citations to this article as recorded by

Enhancement in Performance of Septic Shock Prediction Using National Early Warning Score, Initial Triage Information, and Machine Learning Analysis
Hyoungju Yun, Jeong Ho Park, Dong Hyun Choi, Sang Do Shin, Myoung-jin Jang, Hyoun-Joong Kong, Suk Wha Kim
The Journal of Emergency Medicine.2021; 61(1): 1. CrossRef

Cardiology/Surgery/Basic science and research
The Complexities of Intravenous Fluid Research: Questions of Scale, Volume, and Accumulation: Neil J Glassford, Rinaldo Bellomo; Korean J Crit Care Med. 2016;31(4):276-299. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00934

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Abstract PDF

Despite near ubiquity, information regarding fluids consumption at a health care systems level, and patient exposure at an individual level, is surprisingly limited in the medical literature. The epidemiology of the foundational medical intervention of intravenous fluid administration is incredibly complex, with millions of patients being exposed internationally every year. Fluid is being given for different reasons, to different targets, following different triggers, by different specialties in different countries, and any observations that can be made are thought to have limited external validity to other jurisdictions and patient groups. The independent effects of fluid administration and fluid accumulation are very hard to separate from other markers of illness severity and aspects of the process of care. Fluid accumulation can result in organ injury, even when the fluid is being given to purportedly ameliorate or prevent such injury, and if it were independently associated with mortality then would be an easily accessible and modifiable risk factor for subsequent morbidity or death. Despite their ubiquity, it is clear that we have limited understanding of the effects of the intravenous fluids we use daily in the most vulnerable of patient groups. The research agenda in this field is large and urgent.

Citations

Citations to this article as recorded by

Closed-Loop Control of Fluid Resuscitation Using Reinforcement Learning
Elham Estiri, Hossein Mirinejad
IEEE Access.2023; 11: 140569. CrossRef
Fluid Stewardship of Maintenance Intravenous Fluids
John R. Carr, W. Anthony Hawkins, Andrea Sikora Newsome, Susan E. Smith, Clemmons Amber B, Christopher M. Bland, Trisha N. Branan
Journal of Pharmacy Practice.2022; 35(5): 769. CrossRef
Clinician attitudes and concordance with self-assessed and actual intravenous fluid prescribing patterns: A single-institution evaluation of survey and electronic prescribing data
Michelle C. Spiegel, Annie N. Simpson, Nandita R. Nadig, Dee W. Ford, Andrew J. Goodwin
The American Journal of the Medical Sciences.2022; 364(1): 36. CrossRef
Acetate‐ versus lactate‐buffered crystalloid solutions: A systematic review with meta‐analysis and trial sequential analysis
Karen Louise Ellekjaer, Anders Perner, Praleene Sivapalan, Morten Hylander Møller
Acta Anaesthesiologica Scandinavica.2022; 66(7): 782. CrossRef
A fuzzy model for predicting burn patients’ intravenous fluid resuscitation rate
Sayma Alam Suha, M. Akhtaruzzaman, Tahsina Farah Sanam
Healthcare Analytics.2022; 2: 100070. CrossRef
Development and implementation of a clinical decision support-based initiative to drive intravenous fluid prescribing
Michelle C. Spiegel, Annie N. Simpson, Achsah Philip, Carolyn M. Bell, Nandita R. Nadig, Dee W. Ford, Andrew J. Goodwin
International Journal of Medical Informatics.2021; 156: 104619. CrossRef
Influence of acetate containing fluid versus lactate containing fluid on acid-base status, electrolyte level, and blood lactate level in dehydrated dogs
Annika Heitland, Ute Klein-Richers, Katrin Hartmann, René Dörfelt
Veterinary World.2021; : 2714. CrossRef
Infusion fluids: a clinical pharmacologist’s view
E.A. Ushkalova, S.K. Zyryanov, K.E. Zatolochina, O.I. Butranova
Anesteziologiya i reanimatologiya.2021; (6): 100. CrossRef
Pathophysiology of Volume Administration in Septic Shock and the Role of the Clinical Pharmacist
Brittany D. Bissell, Breanne Mefford
Annals of Pharmacotherapy.2020; 54(4): 388. CrossRef
Lactate versus acetate buffered intravenous crystalloid solutions: a scoping review
Karen L. Ellekjaer, Anders Perner, Martine M. Jensen, Morten H. Møller
British Journal of Anaesthesia.2020; 125(5): 693. CrossRef
Balanced Crystalloid Solutions
Matthew W. Semler, John A. Kellum
American Journal of Respiratory and Critical Care Medicine.2019; 199(8): 952. CrossRef
Does Fluid Type and Amount Affect Kidney Function in Critical Illness?
Neil J. Glassford, Rinaldo Bellomo
Critical Care Clinics.2018; 34(2): 279. CrossRef
Resuscitation fluids
Jonathan D. Casey, Ryan M. Brown, Matthew W. Semler
Current Opinion in Critical Care.2018; 24(6): 512. CrossRef
Utility of Volume Assessment Using Bioelectrical Impedance Analysis in Critically Ill Patients Receiving Continuous Renal Replacement Therapy: A Prospective Observational Study
Ki Hyun Park, Jung-ho Shin, Jin Ho Hwang, Su Hyun Kim
The Korean Journal of Critical Care Medicine.2017; 32(3): 256. CrossRef

Original Articles

Endocrinology
Prevalence and Related Factors of Vitamin D Deficiency in Critically Ill Patients: Hyun Jung Kim, Min Su Sohn, Eun Young Choi; Korean J Crit Care Med. 2016;31(4):300-307. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00276

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Abstract PDF

Background
To identify the prevalence and related factors for vitamin D deficiency in the patients who admitted to the medical intensive care unit (ICU) of a Korean tertiary care hospital.
Methods
We retrospectively analyzed the data from ICU patients requiring mechanical ventilation (MV) for a period of > 48 h to identify the prevalence and associated factors for vitamin D deficiency. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] level < 20 ng/mL.
Results
Among 570 patients admitted to the ICU, 221 were enrolled in the study, 194 in the vitamin D deficient group and 27 in the non-deficient group. Prevalence of vitamin D deficiency in critically ill patients was 87.8%. The patient age was lower in the vitamin D deficient group compared with the non-deficient group (64.4 ± 15.4 vs. 71.0 ± 9.6 years, p = 0.049). A higher acute physiology and chronic health evaluation II (APACHE II) score (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.10-1.37) and chronic illness (OR 3.12, 95% CI 1.08-9.01) were associated with vitamin D deficiency after adjusting for age and body mass index. Clinical outcomes of duration of MV, ICU stay, and 28- and 90-day mortality rates were not significantly different between the vitamin D deficient and nondeficient groups.
Conclusions
Vitamin D deficiency was common in critically ill patients, particularly among younger patients. Higher APACHE II score and chronic illness were associated with vitamin D deficiency.

Citations

Citations to this article as recorded by

Vitamin D deficiency and mortality among critically ill surgical patients in an urban Korean hospital
Ji-hyun Lee, Seo-rin Doo, Dongha Kim, Yoo-kyoung Park, Eun-jeong Park, Jae-myeong Lee
International Journal for Vitamin and Nutrition Research.2022; 92(2): 101. CrossRef
Vitamin D Deficiency in Critically Ill Patients
Ji Hyun Lee, Jae-Myeong Lee
Surgical Metabolism and Nutrition.2017; 8(2): 17. CrossRef
Should We Measure Vitamin D Level?
Jae Hwa Cho
The Korean Journal of Critical Care Medicine.2016; 31(4): 369. CrossRef

Infection
High-dose Sulbactam Treatment for Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Acinetobacter Baumannii: In Beom Jeong, Moon Jun Na, Ji Woong Son, Do Yeon Jo, Sun Jung Kwon; Korean J Crit Care Med. 2016;31(4):308-316. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2015.00703

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Abstract PDF

Background
Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP.
Methods
Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed.
Results
Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality.
Conclusions
High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.

Citations

Citations to this article as recorded by

A Randomized Controlled Trial of Colistin Combined with Sulbactam: 9 g per Day versus 12 g per Day in the Treatment of Extensively Drug-Resistant Acinetobacter baumannii Pneumonia: An Interim Analysis
Chutchawan Ungthammakhun, Vasin Vasikasin, Dhitiwat Changpradub
Antibiotics.2022; 11(8): 1112. CrossRef
Meropenem/colistin versus meropenem/ampicillin–sulbactam in the treatment of carbapenem-resistant pneumonia
Hossein Khalili, Lida Shojaei, Mostafa Mohammadi, Mohammad-Taghi Beigmohammadi, Alireza Abdollahi, Mahsa Doomanlou
Journal of Comparative Effectiveness Research.2018; 7(9): 901. CrossRef

Infection
Surveillance of Extended-Spectrum β-Lactamase-producing Enterobacteriaceae Carriage in a Japanese Intensive Care Unit: a Retrospective Analysis: Yasumasa Kawano, Takeshi Nishida, Atsushi Togawa, Yuhei Irie, Kota Hoshino, Norihiko Matsumoto, Hiroyasu Ishikura; Korean J Crit Care Med. 2016;31(4):317-323. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00703

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Abstract PDF

Background
The effectiveness of surveillance to identify extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) carriers is controversial during a non-outbreak situation. We performed additional stool cultures for ESBL-E among intensive care unit (ICU) patients already under active surveillance by means of sputum and urine cultures. We aimed to assess the efficacy of stool cultures for screening for ESBL-E in a non-outbreak situation.
Methods
We conducted a retrospective cohort study in an ICU. Sputum and urine samples were cultured for ESBL-E surveillance purposes from January to September 2013 (phase 1). Stool cultures were routinely performed in addition from January to September 2014 (phase 2). Antimicrobial use density values and clinical outcomes were investigated and compared between phase 1 and 2.
Results
We identified 512 and 478 patients in phase 1 and phase 2, respectively. ESBL-E were found in the feces of 65 (13.6%) patients in phase 2. The antimicrobial use density values (expressed as defined daily doses per 1,000 bed-days) were not significantly different between the two phases for fluoroquinolones (7 vs. 10, p = 0.376), third-generation cephalosporins (24.2 vs. 29.5, p = 0.724), tazobactam/ piperacillin (44.6 vs. 57.3, p = 0.489), and carbapenems (73 vs. 55.5, p = 0.222). Moreover, there were no significant differences in ICU mortality and length of stay (11.5% vs. 9.8%, p = 0.412, and 9 vs. 10 days, p = 0.28, respectively).
Conclusions
Stool culture seemed ineffective in improving the antimicrobial use density of broad-spectrum antimicrobials, clinical outcomes, and ICU length of stay, and is not recommended for surveillance of ESBL-E in a non-outbreak situation.

Citations

Citations to this article as recorded by

Risk Factors for Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Carriage in Patients Admitted to Intensive Care Unit in a Tertiary Care Hospital in Thailand
Anong Kiddee, Kanit Assawatheptawee, Anamai Na-udom, Pratya Boonsawang, Pornpit Treebupachatsakul, Timothy R. Walsh, Pannika R. Niumsup
Microbial Drug Resistance.2019; 25(8): 1182. CrossRef

Basic science and research
Changes in Insulin-like Growth Factor-1 Level in Patients with Sepsis and Septic Shock: Sang Hoon Lee, Byung Hoon Park, Joo Han Song, Song Yee Kim, Kyung Soo Chung, Eun Young Kim, Ji Ye Jung, Young Sam Kim, Se Kyu Kim, Joon Chang, Moo Suk Park; Korean J Crit Care Med. 2016;31(4):324-333. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00024

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Abstract PDF: Background
Despite many ongoing, prospective studies on the topic, sepsis still remains one of the main causes of death in hospital. The hormone insulin-like growth factor 1 (IGF-1) has a similar molecular structure to that of insulin. IGF-1 exerts anabolic effects and plays important roles in both normal physiology and pathologic processes. Previous studies have observed low serum IGF-1 level in patients with critical illnesses. Here, we evaluated changes in IGF-1 level based on survival of septic patients.
Methods
We evaluated 140 patients with sepsis and septic shock (21 with sepsis and 119 with septic shock) admitted to the intensive care unit of a university-affiliated hospital in Korea. Serum IGF-1 level was measured on days 0, 1, 3, and 7. Patients with liver disease were excluded from this study. All data were analyzed using SPSS version 20 (SPSS Inc., Chicago, IL, USA).
Results
Patients with septic shock had significantly lower serum IGF-1 level on days 1 and 3 than patients without septic shock (p = 0.002 and p = 0.007, respectively). Generally, there was a negative relationship between IGF-1 and serum cortisol levels; however, this relationship was only significant on day 3 (p = 0.029). Furthermore, renin showed significantly negative correlation with IGF-1 on day 3 (p = 0.038). IGF-1 level did not show significant difference between survivors and non-survivors.
Conclusions
Our results showed that IGF-1 was associated with septic shock, and that the IGF-1 axis is severely disrupted in septic patients. Additionally, serum cortisol and renin levels were associated with IGF-1 level.

Infection/Hematology
The Prevalence and Significance of Overt Disseminated Intravascular Coagulation in Patients with Septic Shock in the Emergency Department According to the Third International Consensus Definition: Byuk Sung Ko, Hyun Young Cho, Seung Mok Ryoo, Myung Chun Kim, Woong Jung, Sung Hyuk Park, Chang Min Lee, Won Young Kim; Korean J Crit Care Med. 2016;31(4):334-341. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00339

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Abstract PDF

Background
The prevalence and prognostic value of overt disseminated intravascular coagulation (DIC) in patients with septic shock presenting to emergency departments (EDs) is poorly understood, particularly following the release of a new definition of septic shock. The purpose of this study was to investigate the prevalence and prognostic value of DIC in septic shock.
Methods
We performed retrospective review of 391 consecutive patients with septic shock admitting to the ED of tertiary care, university-affiliated hospital during a 16-month. Septic shock was defined as fluid-unresponsive hypotension requiring vasopressor to maintain a mean arterial pressure of 65 mmHg or greater, and serum lactate level ≥ 2 mmol/L. Overt DIC was defined as an International Society on Thrombosis and Hemostasis (ISTH) score ≥ 5 points. The primary endpoint was 28-day mortality.
Results
Of 391 patients with septic shock, 290 were included in the present study. The mean age was 65.6 years, the 28-day mortality rate was 26.9%, and the prevalence of overt DIC was 17.6% (n = 51) according to the ISTH score. The median DIC score was higher in non-survivors than in survivors (5.0 vs. 2.0, p = 0.001). Significant higher risk of mortality was observed in overt DIC patients compared to those without (28.2% vs. 13.7%, p = 0.005). Multivariable logistic regression analysis identified DIC to be independently associated with 28-day mortality (odds ratio, 2.689 [95% confidence interval, 1.390-5.201]).
Conclusions
Using the ISTH criteria of DIC, overt DIC in septic shock was found to be common among patients admitting to the ED and to be associated with higher mortality when it is accompanied with septic shock. Efforts are required to identify presence of overt DIC during the initial treatment of septic shock in patients presenting the the ED.

Citations

Citations to this article as recorded by

Which Septic Shock Patients With Non-Overt DIC Progress to DIC After Admission? Point-of-Care Thromboelastography Testing
Sang-Min Kim, Sang-Il Kim, Gina Yu, Youn-Jung Kim, Won Young Kim
Shock.2022; 57(2): 168. CrossRef
Dysregulated haemostasis in thrombo-inflammatory disease
Paula A. Klavina, Gemma Leon, Annie M. Curtis, Roger J.S. Preston
Clinical Science.2022; 136(24): 1809. CrossRef
Disseminated Intravascular Coagulopathy in Critically Ill Patients in Amman, Jordan
Eman Mahmoud Qasim Emleek, Amani Anwar Khalil
Biological Research For Nursing.2021; 23(4): 689. CrossRef
Features of Development and Course of Disseminated Intravascular Coagulation Syndrome During Surgical Interventions in Children with Oncological Diseases
N. P. Leonov, V. V. Schukin, G. A. Novichkova, M. A. Maschan, F. I. Ataullakhanov, S. S. Yashin, A. M. Zeynalov, Е. A. Spiridonova
General Reanimatology.2020; 16(3): 54. CrossRef
Relationship between low hemoglobin levels and mortality in patients with septic shock
Sung Min Jung, Youn-Jung Kim, Seung Mok Ryoo, Won Young Kim
Acute and Critical Care.2019; 34(2): 141. CrossRef

Cardiology/Emergency
Moderate to Severe Left Ventricular Ejection Fraction Related to Short-term Mortality of Patients with Post-cardiac Arrest Syndrome after Out-of-Hospital Cardiac Arrest: Kyoung Jeen Min, Jin Joo Kim, In Cheol Hwang, Jae Hyuk Woo, Yong Su Lim, Hyuk Jun Yang, Keun Lee; Korean J Crit Care Med. 2016;31(4):342-350. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00570; Correction in: Acute Crit Care 2017;32(1):88

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Abstract PDF: Background
The aim of this study was to investigate the relationships between left ventricular ejection fraction (LVEF) and mortality and neurologic outcomes with post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA).
Methods
Patients with PCAS after OHCA admitted to the intensive care unit between January 2014 and December 2015 were analyzed retrospectively.
Results
A total of 104 patients were enrolled in this study. The mean age was 54.4 ± 15.3 years, and 75 of the patients were male (72.1%). Arrest with a cardiac origin was found in 55 (52.9%). LVEF < 45%, 45-55%, and > 55% was measured in 39 (37.5%), 18 (17.3%), and 47 (45.2%) of patients, respectively. In multivariate analysis, severe LV dysfunction (LVEF < 45%) was significantly related to 7-day mortality (odds ratio 3.02, 95% Confidence Interval 1.01-9.0, p-value 0.047).
Conclusions
In this study, moderate to severe LVEF within 48 hours after return of spontaneous circulation was significantly related to 7-day short-term mortality in patients with PCAS after OHCA. Clinicians should actively treat myocardial dysfunction, and further studies are needed.

Hematology/Pediatric
Delta Neutrophil Index as a Prognostic Marker in the Pediatric Intensive Care Unit: In Suk Sol, Hyun Bin Park, Min Jung Kim, Seo Hee Yoon, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Sohn, Kyu-Earn Kim; Korean J Crit Care Med. 2016;31(4):351-358. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00171

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Abstract PDF

Background
The delta neutrophil index (DNI) is a useful marker for diagnosing and predicting the prognosis of sepsis. The purpose of this study was to investigate the usefulness of DNI as a prognostic marker in patients within the pediatric intensive care unit (PICU), as well as its association with other prognostic factors.
Methods
A total of 516 children admitted to Severance Children’s Hospital PICU from December 2009 to February 2015 were analyzed. DNI was measured on the day of PICU admission. Mortality was defined as death within 28 days following PICU admission.
Results
The median value of DNI was 1.2% (interquartile range [IQR] 0-4.3%) in the survivor group and 9.5% (IQR 2.3-20.8%) in the non-survivor group, and the difference was statistically significant (p < 0.001). DNI was significantly positively correlated with ICU scores such as Pediatric Index of Mortality 3 and Pediatric Risk of Mortality III, as well as with C-reactive protein and lactate levels. The area under the receiver operating characteristic curve of DNI for mortality was 0.748 (95% CI: 0.687-0.808) and the cut-off value was 4.95%.
Conclusions
The initial DNI level can be considered a useful indicator for predicting prognosis in PICU patients.

Citations

Citations to this article as recorded by

Performance Comparison of Procalcitonin, Delta Neutrophil Index, C-Reactive Protein, and Serum Amyloid A Levels in Patients with Hematologic Diseases
Jooyoung Cho, Jong-Han Lee, Dong Hyun Lee, Juwon Kim, Young Uh
Diagnostics.2023; 13(7): 1213. CrossRef
Potential and promising marker for serious bacterial infections in children: Delta neutrophil index
Metin Yigit, Aslinur Ozkaya‐Parlakay, Naci Yilmaz, Ozhan Akyol, Belgin Gulhan, Saliha Kanik Yuksek, Basak Yalcin Burhan, Enes K Kilic, Cuneyt Karagol
Journal of Paediatrics and Child Health.2022; 58(9): 1623. CrossRef
Delta Neutrophil Index as a Diagnostic Marker of Neonatal Sepsis
Nuriye Asli Melekoglu, Seyma Yasar, Mehmet Keskin
Journal of Pediatric Infectious Diseases.2021; 16(03): 099. CrossRef
Prognostic value of the delta neutrophil index in pediatric cardiac arrest
Seo Hee Yoon, Eun Ju Lee, Jinae Lee, Moon Kyu Kim, Jong Gyun Ahn
Scientific Reports.2020;[Epub] CrossRef

Case Reports

Obstetric/Emergency
Successful Hysterectomy and Therapeutic Hypothermia Following Cardiac Arrest due to Postpartum Hemorrhage: Kwang Ho Lee, Seong Jin Choi, Yeong Gwan Jeon, Raing Kyu Kim, Dae Ja Um; Korean J Crit Care Med. 2016;31(4):359-363. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00325

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Abstract PDF

Postpartum hemorrhage is a common cause of maternal mortality; its main cause is placenta accreta. Therapeutic hypothermia is a generally accepted means of improving clinical signs in postcardiopulmonary resuscitation patients. A 41-year-old pregnant woman underwent a cesarean section under general anesthesia at 37 weeks of gestation. After the cesarean section, the patient experienced massive postpartum bleeding, which led to cardiac arrest. Once spontaneous circulation returned, the patient underwent an emergency hysterectomy and was placed under therapeutic hypothermia management. The patient recovered without neurological complications.

Citations

Citations to this article as recorded by

Persephin as a diagnostic marker of acute brain injury in critically ill newborns: a clinical trial
A. A. Zadvornov, E. V. Grigoriev
Fundamental and Clinical Medicine.2021; 6(3): 15. CrossRef

Pulmonary/Cardiology
Successful Use of Extracorporeal Membrane Oxygenation in Diffuse Alveolar Hemorrhage Secondary to Systemic Lupus Erythematosus: Gyu Ho Choi, Mi Il Kang; Korean J Crit Care Med. 2016;31(4):364-368. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00451

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Abstract PDF: Diffuse alveolar hemorrhage (DAH) is an uncommon complication in patients with systemic lupus erythematosus (SLE), and mortality remains high. In recent years, cases of DAH due to SLE treated with extracorporeal membrane oxygenation (ECMO) have rarely been reported. The authors present a case of a 43-year-old woman with SLE who had rapidly aggravating dyspnea and hemoptysis. She was diagnosed as having DAH with refractory respiratory failure and was successfully managed with veno-venous ECMO. We propose ECMO as a useful salvage therapy in patients with alveolar hemorrhage secondary to SLE who are failing conventional ventilatory support.

Editorial

Endocrinology
Should We Measure Vitamin D Level?: Jae Hwa Cho; Korean J Crit Care Med. 2016;31(4):369-370. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00948

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PDF

Letters to the Editor

Cardiology/Liver
Successful Extracorporeal Membrane Oxygenation Support for Acute Pulmonary Thromboembolism during Adult Liver Transplantation: Ju Yong Lim, Pil Je Kang, Doo Hwan Kim; Korean J Crit Care Med. 2016;31(4):371-374. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00269

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PDF

Citations

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The applications of ECMO in liver transplant recipients
Yue Qiu, Ibtesam Hilmi
Transplantation Reviews.2024; 38(1): 100816. CrossRef
Applications and Outcomes of Extracorporeal Life Support Use in Adult Liver Transplantation: A Case Series and Review of Literature
Jeieung Park, Michael Y. Lin, Christopher L. Wray, Fady M. Kaldas, Peyman Benharash, Vadim Gudzenko
ASAIO Journal.2022; 68(5): 683. CrossRef

Vascular Surgery
Radial Artery Pseudoaneurysm Treated with a Compression Bandage after Invasive Blood Pressure Monitoring in a Patient with a Traumatic Injury: Seong Pyo Mun, Yoo Seok Kim, Nam Kyu Choi, Sung Soo Kim, Young Sun Yoo; Korean J Crit Care Med. 2016;31(4):375-380. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00430

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Citations

Citations to this article as recorded by

Update on complications and their management during transradial cardiac catheterization
Joe Aoun, Laith Hattar, Khabib Dgayli, Gordon Wong, Tariq Bhat
Expert Review of Cardiovascular Therapy.2019; 17(10): 741. CrossRef

Erratum

Comparison of Morphine and Remifentanil on the Duration of Weaning from Mechanical Ventilation: Jae Myeong Lee, Seong Heon Lee, Sang Hyun Kwak, Hyeon Hui Kang, Sang Haak Lee, Jae Min Lim, Mi Ae Jeong, Young Joo Lee, Chae Man Lim; Korean J Crit Care Med. 2016;31(4):381-381. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2014.29.4.281.e01; Corrects: Acute Crit Care 2014;29(4):281

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Citations

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Early Sedation Depth and Clinical Outcomes in Mechanically Ventilated Patients in a Hospital: Retrospective Cohort Study
Jeong Mi Hwang, Su Jung Choi
Asian Nursing Research.2023; 17(1): 15. CrossRef

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