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Volume 33 (4); November 2018
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Review Articles
Pulmonary
Critical Care before Lung Transplantation
Jin Gu Lee, Moo Suk Park, Su Jin Jeong, Song Yee Kim, Sungwon Na, Jeongmin Kim, Hyo Chae Paik
Acute Crit Care. 2018;33(4):197-205.   Published online November 30, 2018
DOI: https://doi.org/10.4266/acc.2018.00367
  • 8,157 View
  • 253 Download
  • 3 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Lung transplantation is widely accepted as the only viable treatment option for patients with end-stage lung disease. However, the imbalance between the number of suitable donor lungs available and the number of possible candidates often results in intensive care unit (ICU) admission for the latter. In the ICU setting, critical care is essential to keep these patients alive and to successfully bridge to lung transplantation. Proper management in the ICU is also one of the key factors supporting long-term success following transplantation. Critical care includes the provision of respiratory support such as mechanical ventilation (MV) and extracorporeal life support (ECLS). Accordingly, a working knowledge of the common critical care issues related to these unique patients and the early recognition and management of problems that arise before and after transplantation in the ICU setting are crucial for long-term success. In this review, we discuss the management and selection of candidates for lung transplantation as well as existing respiratory support strategies that involve MV and ECLS in the ICU setting.

Citations

Citations to this article as recorded by  
  • Optimizing the prelung transplant candidate
    John Pagteilan, Scott Atay
    Current Opinion in Organ Transplantation.2024; 29(1): 37.     CrossRef
  • Awakening in extracorporeal membrane oxygenation as a bridge to lung transplantation
    Su Hwan Lee
    Acute and Critical Care.2022; 37(1): 26.     CrossRef
  • Recipient Management before Lung Transplantation
    Hyoung Soo Kim, Sunghoon Park
    Journal of Chest Surgery.2022; 55(4): 265.     CrossRef
  • Outcomes of Patients on the Lung Transplantation Waitlist in Korea: A Korean Network for Organ Sharing Data Analysis
    Hye Ju Yeo, Dong Kyu Oh, Woo Sik Yu, Sun Mi Choi, Kyeongman Jeon, Mihyang Ha, Jin Gu Lee, Woo Hyun Cho, Young Tae Kim
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
    Nam Eun Kim, Ala Woo, Song Yee Kim, Ah Young Leem, Youngmok Park, Se Hyun Kwak, Seung Hyun Yong, Kyungsoo Chung, Moo Suk Park, Young Sam Kim, Ha Eun Kim, Jin Gu Lee, Hyo Chae Paik, Su Hwan Lee
    Respiratory Research.2021;[Epub]     CrossRef
Pulmonary
Critical Care after Lung Transplantation
Song Yee Kim, Su Jin Jeong, Jin Gu Lee, Moo Suk Park, Hyo Chae Paik, Sungwon Na, Jeongmin Kim
Acute Crit Care. 2018;33(4):206-215.   Published online November 30, 2018
DOI: https://doi.org/10.4266/acc.2018.00360
  • 16,836 View
  • 653 Download
  • 8 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Since the first successful lung transplantation in 1983, there have been many advances in the field. Nevertheless, the latest data from the International Society for Heart and Lung Transplantation revealed that the risk of death from transplantation is 9%. Various aspects of postoperative management, including mechanical ventilation, could affect intensive care unit stay, hospital stay, and immediate postoperative morbidity and mortality. Complications such as reperfusion injury, graft rejection, infection, and dehiscence of anastomosis increase fatal adverse side effects immediately after surgery. In this article, we review the possible immediate complications after lung transplantation and summarize current knowledge on prevention and treatment.

Citations

Citations to this article as recorded by  
  • Aspergillus Galactomannan Titer as a Diagnostic Marker of Invasive Pulmonary Aspergillosis in Lung Transplant Recipients: A Single-Center Retrospective Cohort Study
    Eun-Young Kim, Seung-Hyun Yong, Min-Dong Sung, A-La Woo, Young-Mok Park, Ha-Eun Kim, Su-Jin Jung, Song-Yee Kim, Jin-Gu Lee, Young-Sam Kim, Hyo-Chae Paik, Moo-Suk Park
    Journal of Fungi.2023; 9(5): 527.     CrossRef
  • Nontuberculous mycobacterial infection after lung transplantation: A single-center experience in South Korea
    Youngmok Park, Nam Eun Kim, Se Hyun Kwak, Moo Suk Park, Su Jin Jeong, Jin Gu Lee, Hyo Chae Paik, Song Yee Kim, Young Ae Kang
    Journal of Microbiology, Immunology and Infection.2022; 55(1): 123.     CrossRef
  • Medical Complications of Lung Transplantation
    Moo Suk Park
    Journal of Chest Surgery.2022; 55(4): 338.     CrossRef
  • Roles of electrical impedance tomography in lung transplantation
    Hui Jiang, Yijiao Han, Xia Zheng, Qiang Fang
    Frontiers in Physiology.2022;[Epub]     CrossRef
  • Perioperative anidulafungin combined with triazole prophylaxis for the prevention of early invasive candidiasis in lung transplant recipients
    Emily Sartain, Kelly Schoeppler, Barrett Crowther, Joshua B. Smith, Maheen Z. Abidi, Todd J. Grazia, Mark Steele, Terri Gleason, Krista Porter, Alice Gray
    Transplant Infectious Disease.2021;[Epub]     CrossRef
  • The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea
    Yae-Jee Baek, Yun-Suk Cho, Moo-Hyun Kim, Jong-Hoon Hyun, Yu-Jin Sohn, Song-Yee Kim, Su-Jin Jeong, Moo-Suk Park, Jin-Gu Lee, Hyo-Chae Paik
    Journal of Fungi.2021; 7(8): 639.     CrossRef
  • Panel-Reactive and Donor-Specific Antibodies before Lung Transplantation can Affect Outcomes in Korean Patients Receiving Lung Transplantation
    Sung Woo Moon, Moo Suk Park, Jin Gu Lee, Hyo Chae Paik, Young Tae Kim, Hyun Joo Lee, Samina Park, Sun Mi Choi, Do Hyung Kim, Woo Hyun Cho, Hye Ju Yeo, Seung-il Park, Se Hoon Choi, Sang-Bum Hong, Tae Sun Shim, Kyung-Wook Jo, Kyeongman Jeon, Byeong-Ho Jeong
    Yonsei Medical Journal.2020; 61(7): 606.     CrossRef
  • A proof-of principal study using phase-contrast imaging for the detection of large airway pathologies after lung transplantation
    Stephan Umkehrer, Carmela Morrone, Julien Dinkel, Laura Aigner, Maximilian F. Reiser, Julia Herzen, Ali Ö. Yildirim, Franz Pfeiffer, Katharina Hellbach
    Scientific Reports.2020;[Epub]     CrossRef
Original Articles
Pulmonary
Performance of APACHE IV in Medical Intensive Care Unit Patients: Comparisons with APACHE II, SAPS 3, 216 and MPM0 III
Mihye Ko, Miyoung Shim, Sang-Min Lee, Yujin Kim, Soyoung Yoon
Acute Crit Care. 2018;33(4):216-221.   Published online November 21, 2018
DOI: https://doi.org/10.4266/acc.2018.00178
  • 8,231 View
  • 255 Download
  • 14 Web of Science
  • 15 Crossref
AbstractAbstract PDF
Background
In this study, we analyze the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE IV, Simplified Acute Physiology Score (SAPS) 3, and Mortality Probability Model (MPM)0 III in order to determine which system best implements data related to the severity of medical intensive care unit (ICU) patients.
Methods
The present study was a retrospective investigation analyzing the discrimination and calibration of APACHE II, APACHE IV, SAPS 3, and MPM0 III when used to evaluate medical ICU patients. Data were collected for 788 patients admitted to the ICU from January 1, 2015 to December 31, 2015. All patients were aged 18 years or older with ICU stays of at least 24 hours. The discrimination abilities of the three systems were evaluated using c-statistics, while calibration was evaluated by the Hosmer-Lemeshow test. A severity correction model was created using logistics regression analysis.
Results
For the APACHE IV, SAPS 3, MPM0 III, and APACHE II systems, the area under the receiver operating characteristic curves was 0.745 for APACHE IV, resulting in the highest discrimination among all four scoring systems. The value was 0.729 for APACHE II, 0.700 for SAP 3, and 0.670 for MPM0 III. All severity scoring systems showed good calibrations: APACHE II (chi-square, 12.540; P=0.129), APACHE IV (chi-square, 6.959; P=0.541), SAPS 3 (chi-square, 9.290; P=0.318), and MPM0 III (chi-square, 11.128; P=0.133).
Conclusions
APACHE IV provided the best discrimination and calibration abilities and was useful for quality assessment and predicting mortality in medical ICU patients.

Citations

Citations to this article as recorded by  
  • Predicting Hospital Survival in Patients Admitted to ICU with Pulmonary Embolism
    Martin J. Ryll, Aurelia Zodl, Toby N. Weingarten, Alejandro A. Rabinstein, David O. Warner, Darrell R. Schroeder, Juraj Sprung
    Journal of Intensive Care Medicine.2024; 39(5): 455.     CrossRef
  • Relationship between Patient Classification System and APACHE II Scores, and Mortality Prediction in a Surgical Intensive Care Unit
    U Ri Go, Sung-Hyun Cho
    Journal of Korean Academy of Nursing Administration.2024; 30(1): 67.     CrossRef
  • Utilidad del uso del modelo MPM-II para predecir riesgo de mortalidad en comparación con SAPS-II en pacientes adultos en la unidad de cuidados intensivos
    Perla Marlene Guzmán Ramírez
    Acta Médica Grupo Ángeles.2023; 21(2): 115.     CrossRef
  • Plasma and Urinary Biomarkers Improve Prediction of Mortality through 1 Year in Intensive Care Patients: An Analysis from FROG-ICU
    Beth A. Davison, Christopher Edwards, Gad Cotter, Antoine Kimmoun, Étienne Gayat, Agnieszka Latosinska, Harald Mischak, Koji Takagi, Benjamin Deniau, Adrien Picod, Alexandre Mebazaa
    Journal of Clinical Medicine.2023; 12(9): 3311.     CrossRef
  • Effects of prior antiplatelet and/or nonsteroidal anti-inflammatory drug use on mortality in patients undergoing abdominal surgery for abdominal sepsis
    Se Hun Kim, Ki Hoon Kim
    Surgery.2023; 174(3): 611.     CrossRef
  • Extracorporeal blood purification is associated with improvement in biochemical and clinical variables in the critically‐ill COVID‐19 patients
    Vedran Premužić, Jakša Babel, Danilo Gardijan, Ivana Lapić, Rajka Gabelica, Zvonimir Ostojić, Marin Lozić, Gordana Pavliša, Maja Hrabak, Josip Knežević, Dunja Rogić, Slobodan Mihaljević
    Therapeutic Apheresis and Dialysis.2022; 26(2): 316.     CrossRef
  • Relation between red blood cell distribution width and acute kidney injury in patients with sepsis
    Marina Larissa Vettorello Ramires, Manoela Fidelis Batista Leite, Daniel Zu Yow Lo, Leonardo Bonilla da Silveira, Leonardo José Rolim Ferraz, Andreia Pardini, Araci Massami Sakashita, Andrea Tiemi Kondo, Guilherme Benfatti Olivato, Marcelino de Souza Durã
    Einstein (São Paulo).2022;[Epub]     CrossRef
  • Prediction of hospital mortality in intensive care unit patients from clinical and laboratory data: A machine learning approach
    Elena Caires Silveira, Soraya Mattos Pretti, Bruna Almeida Santos, Caio Fellipe Santos Corrêa, Leonardo Madureira Silva, Fabrício Freire de Melo
    World Journal of Critical Care Medicine.2022; 11(5): 317.     CrossRef
  • Reduction in the rate of mortality of moderate to severe COVID 19 infected patients with the use of remdesivir - A Tertiary Care Hospital-based retrospective observational study
    Mahima Lakhanpal, Debpriya Sarkar, Ritesh Kumar, Isha Yadav
    Anesthesia: Essays and Researches.2022; 16(3): 296.     CrossRef
  • Phase Angle and Frailty are Important Prognostic Factors in Critically Ill Medical Patients: A Prospective Cohort Study
    S.J. Ko, J. Cho, S.M. Choi, Y.S. Park, C.-H. Lee, S.-M. Lee, C.-G. Yoo, Y.W. Kim, Jinwoo Lee
    The Journal of nutrition, health and aging.2021; 25(2): 218.     CrossRef
  • The use of Chest Ultrasonography in Suspected Cases of COVID-19 in the Emergency Department
    Enrico Allegorico, Carlo Buonerba, Giorgio Bosso, Antonio Pagano, Giovanni Porta, Claudia Serra, Pasquale Dolce, Valentina Minerva, Ferdinando Dello Vicario, Concetta Altruda, Paola Arbo, Teresa Russo, Chiara De Sio, Nicoletta Franco, Gianluca Ruffa, Cinz
    Future Science OA.2021;[Epub]     CrossRef
  • Criticality: A New Concept of Severity of Illness for Hospitalized Children
    Eduardo A. Trujillo Rivera, Anita K. Patel, James M. Chamberlain, T. Elizabeth Workman, Julia A. Heneghan, Douglas Redd, Hiroki Morizono, Dongkyu Kim, James E. Bost, Murray M. Pollack
    Pediatric Critical Care Medicine.2021; 22(1): e33.     CrossRef
  • Validation of the Acute Physiology and Chronic Health Evaluation (APACHE) II and IV Score in COVID-19 Patients
    Jeroen Vandenbrande, Laurens Verbrugge, Liesbeth Bruckers, Laurien Geebelen, Ester Geerts, Ina Callebaut, Ine Gruyters, Liesbeth Heremans, Jasperina Dubois, Bjorn Stessel, Edward A Bittner
    Critical Care Research and Practice.2021; 2021: 1.     CrossRef
  • Relationship Between Mean Vancomycin Trough Concentration and Mortality in Critically Ill Patients: A Multicenter Retrospective Study
    Yanli Hou, Jiajia Ren, Jiamei Li, Xuting Jin, Ya Gao, Ruohan Li, Jingjing Zhang, Xiaochuang Wang, Xinyu Li, Gang Wang
    Frontiers in Pharmacology.2021;[Epub]     CrossRef
  • Blood purification therapy with a hemodiafilter featuring enhanced adsorptive properties for cytokine removal in patients presenting COVID-19: a pilot study
    Gianluca Villa, Stefano Romagnoli, Silvia De Rosa, Massimiliano Greco, Marco Resta, Diego Pomarè Montin, Federico Prato, Francesco Patera, Fiorenza Ferrari, Giuseppe Rotondo, Claudio Ronco
    Critical Care.2020;[Epub]     CrossRef
Pediatric
Oxygenation Index in the First 24 Hours after the Diagnosis of Acute Respiratory Distress Syndrome as a Surrogate Metric for Risk Stratification in Children
Soo Yeon Kim, Byuhree Kim, Sun Ha Choi, Jong Deok Kim, In Suk Sol, Min Jung Kim, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Sohn, Kyu-Earn Kim
Acute Crit Care. 2018;33(4):222-229.   Published online November 29, 2018
DOI: https://doi.org/10.4266/acc.2018.00136
  • 6,114 View
  • 182 Download
  • 3 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Background
The diagnosis of pediatric acute respiratory distress syndrome (PARDS) is a pragmatic decision based on the degree of hypoxia at the time of onset. We aimed to determine whether reclassification using oxygenation metrics 24 hours after diagnosis could provide prognostic ability for outcomes in PARDS.
Methods
Two hundred and eighty-eight pediatric patients admitted between January 1, 2010 and January 30, 2017, who met the inclusion criteria for PARDS were retrospectively analyzed. Reclassification based on data measured 24 hours after diagnosis was compared with the initial classification, and changes in pressure parameters and oxygenation were investigated for their prognostic value with respect to mortality.
Results
PARDS severity varied widely in the first 24 hours; 52.4% of patients showed an improvement, 35.4% showed no change, and 12.2% either showed progression of PARDS or died. Multivariate analysis revealed that mortality risk significantly increased for the severe group, based on classification using metrics collected 24 hours after diagnosis (adjusted odds ratio, 26.84; 95% confidence interval [CI], 3.43 to 209.89; P=0.002). Compared to changes in pressure variables (peak inspiratory pressure and driving pressure), changes in oxygenation (arterial partial pressure of oxygen to fraction of inspired oxygen) over the first 24 hours showed statistically better discriminative power for mortality (area under the receiver operating characteristic curve, 0.701; 95% CI, 0.636 to 0.766; P<0.001).
Conclusions
Implementation of reclassification based on oxygenation metrics 24 hours after diagnosis effectively stratified outcomes in PARDS. Progress within the first 24 hours was significantly associated with outcomes in PARDS, and oxygenation response was the most discernable surrogate metric for mortality.

Citations

Citations to this article as recorded by  
  • A single‐center PICU present status survey of pediatric sepsis‐related acute respiratory distress syndrome
    Liang Zhou, Shaojun Li, Tian Tang, Xiu Yuan, Liping Tan
    Pediatric Pulmonology.2022; 57(9): 2003.     CrossRef
Pediatrics
Impact of Socioeconomic Status on 30-Day and 1-Year Mortalities after Intensive Care Unit Admission in South Korea: A Retrospective Cohort Study
Tak Kyu Oh, Jihoon Jo, Young-Tae Jeon, In-Ae Song
Acute Crit Care. 2018;33(4):230-237.   Published online November 13, 2018
DOI: https://doi.org/10.4266/acc.2018.00514
  • 6,684 View
  • 96 Download
  • 6 Web of Science
  • 6 Crossref
AbstractAbstract PDFSupplementary Material
Background
Socioeconomic status (SES) is closely associated with health outcomes, including mortality in critically ill patients admitted to intensive care unit (ICU). However, research regarding this issue is lacking, especially in countries where the National Health Insurance System is mainly responsible for health care. This study aimed to investigate how the SES of ICU patients in South Korea is associated with mortality.
Methods
This was a retrospective observational study of adult patients aged ≥20 years admitted to ICU. Associations between SES-related factors recorded at the time of ICU admission and 30-day and 1-year mortalities were analyzed using univariable and multivariable Cox regression analyses.
Results
A total of 6,008 patients were included. Of these, 394 (6.6%) died within 30 days of ICU admission, and 1,125 (18.7%) died within 1 year. Multivariable Cox regression analysis found no significant associations between 30-day mortality after ICU admission and SES factors (P>0.05). However, occupation was significantly associated with 1-year mortality after ICU admission.
Conclusions
Our study shows that 30-day mortality after ICU admission is not associated with SES in the National Health Insurance coverage setting. However, occupation was associated with 1-year mortality after ICU admission.

Citations

Citations to this article as recorded by  
  • Association Between Socioeconomic Status and Outcomes in Critical Care: A Systematic Review and Meta-Analysis
    Ryan D. McHenry, Christopher E. J. Moultrie, Tara Quasim, Daniel F. Mackay, Jill P. Pell
    Critical Care Medicine.2023; 51(3): 347.     CrossRef
  • The effect of socioeconomic status, insurance status, and insurance coverage benefits on mortality in critically ill patients admitted to the intensive care unit
    Moo Suk Park
    Acute and Critical Care.2022; 37(1): 118.     CrossRef
  • Association between off-hour admission of critically ill children to intensive care units and mortality in a Japanese registry
    Takahiro Kido, Masao Iwagami, Toshikazu Abe, Yuki Enomoto, Hidetoshi Takada, Nanako Tamiya
    Scientific Reports.2021;[Epub]     CrossRef
  • Associations Between Socioeconomic Status, Patient Risk, and Short-Term Intensive Care Outcomes
    Daniel V. Mullany, David V. Pilcher, Annette J. Dobson
    Critical Care Medicine.2021; 49(9): e849.     CrossRef
  • Association of Economic Status and Mortality in Patients with Acute Respiratory Distress Syndrome
    Tak Kyu Oh, In-Ae Song, Jae Ho Lee
    International Journal of Environmental Research and Public Health.2020; 17(6): 1815.     CrossRef
  • Critical Care Research Using “Big Data”: A Reality in the Near Future
    Kwangha Lee
    Acute and Critical Care.2018; 33(4): 269.     CrossRef
Infection
Intensive Care Unit Relocation and Its Effect on Multidrug-Resistant Respiratory Microorganisms
Hyung-Jun Kim, EuiSeok Jeong, Pyoeng Gyun Choe, Sang-Min Lee, Jinwoo Lee
Acute Crit Care. 2018;33(4):238-245.   Published online November 14, 2018
DOI: https://doi.org/10.4266/acc.2018.00220
  • 5,538 View
  • 100 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Background
Infection by multidrug-resistant (MDR) pathogens leads to poor patient outcomes in intensive care units (ICUs). Contact precautions are necessary to reduce the transmission of MDR pathogens. However, the importance of the surrounding environment is not well known. We studied the effects of ICU relocation on MDR respiratory pathogen detection rates and patient outcomes.
Methods
Patients admitted to the ICU before and after the relocation were retrospectively analyzed. Baseline patient characteristics, types of respiratory pathogens detected, antibiotics used, and patient outcomes were measured.
Results
A total of 463 adult patients admitted to the ICU, 4 months before and after the relocation, were included. Of them, 234 were admitted to the ICU before the relocation and 229 afterward. Baseline characteristics, including age, sex, and underlying comorbidities, did not differ between the two groups. After the relocation, the incidence rate of MDR respiratory pathogen detection decreased from 90.0 to 68.8 cases per 1,000 patient-days, but that difference was statistically insignificant. The use of colistin was significantly reduced from 53.5 days (95% confidence interval [CI], 20.3 to 86.7 days) to 18.7 days (95% CI, 5.6 to 31.7 days). Furthermore, the duration of hospital stay was significantly reduced from a median of 29 days (interquartile range [IQR], 14 to 50 days) to 21 days (IQR, 11 to 39 days).
Conclusions
Incidence rates of MDR respiratory pathogen detection were not significantly different before and after ICU relocation. However, ICU relocation could be helpful in reducing the use of antibiotics against MDR pathogens and improving patient outcomes.

Citations

Citations to this article as recorded by  
  • A look at the past to draw lessons for the future: how the case of an urgent ICU transfer taught us to always be ready with a plan B
    Laura Brunelli, Edoardo Miotto, Massimo Del Pin, Daniele Celotto, Adriana Moccia, Gianni Borghi, Amato De Monte, Cristiana Macor, Roberto Cocconi, Luca Lattuada, Silvio Brusaferro, Luca Arnoldo
    Frontiers in Medicine.2023;[Epub]     CrossRef
CPR/Resuscitation
Comparison between Gel Pad Cooling Device and Water Blanket during Target Temperature Management in Cardiac Arrest Patients
Yoon Sun Jung, Kyung Su Kim, Gil Joon Suh, Jun-Hwi Cho
Acute Crit Care. 2018;33(4):246-251.   Published online November 30, 2018
DOI: https://doi.org/10.4266/acc.2018.00192
  • 6,087 View
  • 151 Download
  • 5 Web of Science
  • 6 Crossref
AbstractAbstract PDFSupplementary Material
Background
Target temperature management (TTM) improves neurological outcomes for comatose survivors of out-of-hospital cardiac arrest. We compared the efficacy and safety of a gel pad cooling device (GP) and a water blanket (WB) during TTM.
Methods
We performed a retrospective analysis in a single hospital, wherein we measured the time to target temperature (<34°C) after initiation of cooling to evaluate the effectiveness of the cooling method. The temperature farthest from 33°C was selected every hour during maintenance. Generalized estimation equation analysis was used to compare the absolute temperature differences from 33°C during the maintenance period. If the selected temperature was not between 32°C and 34°C, the hour was considered a deviation from the target. We compared the deviation rates during hypothermia maintenance to evaluate the safety of the different methods.
Results
A GP was used for 23 patients among of 53 patients, and a WB was used for the remaining. There was no difference in baseline temperature at the start of cooling between the two patient groups (GP, 35.7°C vs. WB, 35.6°C; P=0.741). The time to target temperature (134.2 minutes vs. 233.4 minutes, P=0.056) was shorter in the GP patient group. Deviation from maintenance temperature (2.0% vs. 23.7%, P<0.001) occurred significantly more frequently in the WB group. The mean absolute temperature difference from 33°C during the maintenance period was 0.19°C (95% confidence interval [CI], 0.17°C to 0.21°C) in the GP group and 0.76°C (95% CI, 0.71°C to 0.80°C) in the WB group. GP significantly decreased this difference by 0.59°C (95% CI, 0.44°C to 0.75°C; P<0.001).
Conclusions
The GP was superior to the WB for strict temperature control during TTM.

Citations

Citations to this article as recorded by  
  • Efficacy and safety of the Arctic Sun device for hypoxic-ischemic encephalopathy in adult patients following cardiopulmonary resuscitation: A systematic review and meta-analysis
    SaurabhC Sharda, MandipSingh Bhatia, RohitR Jakhotia, Ashish Behera, Atul Saroch, AshokKumar Pannu, HMohan Kumar
    Brain Circulation.2023; 9(3): 185.     CrossRef
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    Kanae Ochiai, Yasuhiro Otomo
    Open Heart.2023; 10(2): e002459.     CrossRef
  • Water Temperature Variability Is Associated with Neurologic Outcomes in Out-of-Hospital Cardiac Arrest Survivors Who Underwent Targeted Temperature Management at 33°C
    Seok Jin Ryu, Dong Hun Lee, Byung Kook Lee, Kyung Woon Jeung, Yong Hun Jung, Jung Soo Park, Jin Hong Min, Dong Ki Kim
    Therapeutic Hypothermia and Temperature Management.2022; 12(2): 74.     CrossRef
  • Comparison of hydrogel pad and water-circulating blanket cooling methods for targeted temperature management: A propensity score-matched analysis from a prospective multicentre registry
    Kyoung Tak Keum, Yong Hwan Kim, Jun Ho Lee, Seong Jun Ahn, Seong Youn Hwang, Joo Suk Oh, Su Jin Kim, Soo Hyun Kim, Kyung Woon Jeung
    Resuscitation.2021; 169: 78.     CrossRef
  • Use of a Servo-Controlled Cooling Gel Pad System to Regulate Body Temperature in Critically Ill Children
    Gema Pérez, Gema Manrique, Julia García, Sara de la Mata, Débora Sanz, Jesús López-Herce
    Pediatric Critical Care Medicine.2020; 21(12): e1094.     CrossRef
  • Management of post-cardiac arrest syndrome
    Youngjoon Kang
    Acute and Critical Care.2019; 34(3): 173.     CrossRef
Nursing
The Effect of Systematic Approach to Tracheostomy Care in Patients Transferred from the Surgical Intensive Care Unit to General Ward
Yooun-joong Jung, Younghwan Kim, Kyuhyouck Kyoung, Minae Keum, Taehyun Kim, Dae seong Ma, Suk-Kyung Hong
Acute Crit Care. 2018;33(4):252-259.   Published online November 30, 2018
DOI: https://doi.org/10.4266/acc.2018.00248
Correction in: Acute Crit Care 2019;34(1):99
  • 6,953 View
  • 300 Download
  • 4 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward.
Methods
In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU.
Results
The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time (26.7±25.1 vs. 12.1±16.0 days, P=0.003), length of stay in the general ward (70.6±89.1 vs. 40.5±42.2 days, P=0.008), length of total hospital stay (107.5±95.6 vs. 74.7±51.2 days, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010).
Conclusions
Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct Tcannula.

Citations

Citations to this article as recorded by  
  • Quality tracheotomy care can be maintained for non‐COVID patients during the COVID‐19 pandemic
    Jacqueline Tucker, Nicole Ruszkay, Neerav Goyal, John P. Gniady, David Goldenberg
    Laryngoscope Investigative Otolaryngology.2022; 7(5): 1337.     CrossRef
  • Global Tracheostomy Collaborative: data-driven improvements in patient safety through multidisciplinary teamwork, standardisation, education, and patient partnership
    Michael J. Brenner, Vinciya Pandian, Carly E. Milliren, Dionne A. Graham, Charissa Zaga, Linda L. Morris, Joshua R. Bedwell, Preety Das, Hannah Zhu, John Lee Y. Allen, Alon Peltz, Kimberly Chin, Bradley A. Schiff, Diane M. Randall, Chloe Swords, Darrin Fr
    British Journal of Anaesthesia.2020; 125(1): e104.     CrossRef
Pulmonary
Clinical Application of Modified Burns Wean Assessment Program Scores at First Spontaneous Breathing Trial in Weaning Patients from Mechanical Ventilation
Eun Suk Jeong, Kwangha Lee
Acute Crit Care. 2018;33(4):260-268.   Published online November 30, 2018
DOI: https://doi.org/10.4266/acc.2018.00276
  • 8,178 View
  • 263 Download
  • 6 Web of Science
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AbstractAbstract PDF
Background
The purpose of this study was to evaluate the clinical application of modified Burns Wean Assessment Program (m-BWAP) scoring at first spontaneous breathing trial (SBT) as a predictor of successful liberation from mechanical ventilation (MV) in patients with endotracheal intubation.
Methods
Patients requiring MV for more than 72 hours and undergoing more than one SBT in a medical intensive care unit (ICU) were prospectively enrolled over a 3-year period. The m-BWAP score at first SBT was obtained by a critical care nursing practitioner.
Results
A total of 103 subjects were included in this study. Their median age was 69 years (range, 22 to 87 years) and 72 subjects (69.9%) were male. The median duration from admission to first SBT was 5 days (range, 3 to 26 days), and the rate of final successful liberation from MV was 84.5% (n=87). In the total group of patients, the successful liberation from MV group at first SBT (n=65) had significantly higher m-BWAP scores than did the unsuccessful group (median, 60; range, 43 to 80 vs. median, 53; range, 33 to 70; P<0.001). Also, the area under the m-BWAP curve for predicting successful liberation of MV was 0.748 (95% confidence interval, 0.650 to 0.847), while the cutoff value based on Youden’s index was 53 (sensitivity, 76%; specificity, 64%).
Conclusions
The present data show that the m-BWAP score represents a good predictor of weaning success in patients with an endotracheal tube in place at first SBT.

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Editorial
Basic science and research
Critical Care Research Using “Big Data”: A Reality in the Near Future
Kwangha Lee
Acute Crit Care. 2018;33(4):269-270.   Published online November 30, 2018
DOI: https://doi.org/10.4266/acc.2018.00346
  • 4,359 View
  • 99 Download
PDF
Case Reports
Nephrology
Sudden Intraoperative Hyperkalemia during Laparoscopic Radical Nephrectomy in a Patient with Underlying Renal Insufficiency
Sung Hoon Jung, Yun-Joung Han, Sang Ho Shin, Hyo Seon Lee, Ji Young Lee
Acute Crit Care. 2017;33(4):271-275.   Published online November 21, 2018
DOI: https://doi.org/10.4266/acc.2016.00696
  • 6,058 View
  • 111 Download
  • 1 Web of Science
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AbstractAbstract PDF
We experienced a case of severe intraoperative hyperkalemia during laparoscopic radical nephrectomy in a 60-year-old male patient with renal insufficiency, whose hypertension had been managed by preoperative angiotensin II receptor blocker (ARB) and adrenergic beta-antagonist. After renal vessel ligation, his intraoperative potassium concentration suddenly increased to 7.0 mEq/L, but his electrocardiography (ECG) did not show any significant change. While preoperative ARB therapy has been regarded as a contributing factor for further aggravation of underlying renal insufficiency, we assumed that nephrectomy itself and rhabdomyolysis caused by surgical trauma also aggravated the underlying renal dysfunction and resulted in sudden hyperkalemia. Hyperkalemia was managed successfully with calcium gluconate, insulin, furosemide and crystalloid loading during the intraoperative and immediate postoperative periods, and potassium concentration decreased to 5.0 mEq/L at 8 hours after the operation. The patient’s hospital course was uncomplicated, but his renal function deteriorated further.

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Surgery
Iatrogenic Intramural Dissection of the Esophagus after Insertion of a Laryngeal Mask Airway
Hee Young Kim, Seung-Hoon Baek, Yong Hoon Cho, Joo-Yun Kim, Yun Mi Choi, Eun Ji Choi, Jung Pil Yoon, Jung Hyun Park
Acute Crit Care. 2018;33(4):276-279.   Published online June 30, 2017
DOI: https://doi.org/10.4266/acc.2016.00829
  • 6,439 View
  • 121 Download
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AbstractAbstract PDF
In pediatric patients, a laryngeal mask airway (LMA) is usually used during minor surgeries that require general anesthesia. No esophageal injury has been reported after insertion of an LMA. We report a case of an esophageal injury with intramural dissection after an i-gel® (size, 1.5; Intersurgical Ltd.) insertion in a pediatric patient. A 2-month-old male infant was hospitalized for left inguinal herniorrhaphy. After induction of anesthesia, a trained resident tried to insert an i-gel® . However, it was only successful after three attempts. Dysphagia was sustained until postoperative day 10, and the pediatrician observed duplication of the esophagus on gastroendoscopy. However, a whitish mucosal lesion, which looked like a scar, was observed, and previous lesions suggestive of esophageal duplication were almost healed on postdischarge day 11. His condition was diagnosed as dysphagia and esophagitis due to an esophageal laceration, not esophageal duplication. He was scheduled for symptomatic treatment with a proton pump inhibitor. In conclusion, although an esophageal injury or perforation in pediatric patients is rare, an LMA insertion or a procedure such as aspiration or nasogastric tube insertion should be performed gently to avoid a possible injury to the esophagus in pediatric patients.

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DOI: https://doi.org/10.4266/acc.2017.00598
  • 18,054 View
  • 187 Download
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Posterior Reversible Encephalopathy Syndrome after Hypovolemic Shock Which Is Required Differential Diagnosis with Delirium in the Intensive Care Unit
Seo In Lee, Gyeong Seon Choi, Jin Park, Young-Joo Lee, Kyung Sook Hong
Acute Crit Care. 2018;33(4):282-285.   Published online November 30, 2018
DOI: https://doi.org/10.4266/acc.2018.00262
  • 5,831 View
  • 131 Download
  • 2 Web of Science
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ACC : Acute and Critical Care