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37 "Gee Young Suh"
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Guideline
Pulmonary
Liberation from mechanical ventilation in critically ill patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines
Tae Sun Ha, Dong Kyu Oh, Hak-Jae Lee, Youjin Chang, In Seok Jeong, Yun Su Sim, Suk-Kyung Hong, Sunghoon Park, Gee Young Suh, So Young Park
Acute Crit Care. 2024;39(1):1-23.   Published online February 28, 2024
DOI: https://doi.org/10.4266/acc.2024.00052
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AbstractAbstract PDFSupplementary Material
Background
Successful liberation from mechanical ventilation is one of the most crucial processes in critical care because it is the first step by which a respiratory failure patient begins to transition out of the intensive care unit and return to their own life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider not only the individual experiences of healthcare professionals, but also scientific and systematic approaches. Recently, numerous studies have investigated methods and tools for identifying when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians about liberation from the ventilator. Methods: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. Those evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved recommendations. Results: Recommendations for nine PICO (population, intervention, comparator, and outcome) questions about ventilator liberation are presented in this document. This guideline includes seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. Conclusions: We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.
Original Articles
Pulmonary
Association between mechanical power and intensive care unit mortality in Korean patients under pressure-controlled ventilation
Jae Kyeom Sim, Sang-Min Lee, Hyung Koo Kang, Kyung Chan Kim, Young Sam Kim, Yun Seong Kim, Won-Yeon Lee, Sunghoon Park, So Young Park, Ju-Hee Park, Yun Su Sim, Kwangha Lee, Yeon Joo Lee, Jin Hwa Lee, Heung Bum Lee, Chae-Man Lim, Won-Il Choi, Ji Young Hong, Won Jun Song, Gee Young Suh
Acute Crit Care. 2024;39(1):91-99.   Published online January 26, 2024
DOI: https://doi.org/10.4266/acc.2023.00871
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AbstractAbstract PDFSupplementary Material
Background
Mechanical power (MP) has been reported to be associated with clinical outcomes. Because the original MP equation is derived from paralyzed patients under volume-controlled ventilation, its application in practice could be limited in patients receiving pressure-controlled ventilation (PCV). Recently, a simplified equation for patients under PCV was developed. We investigated the association between MP and intensive care unit (ICU) mortality. Methods: We conducted a retrospective analysis of Korean data from the Fourth International Study of Mechanical Ventilation. We extracted data of patients under PCV on day 1 and calculated MP using the following simplified equation: MPPCV = 0.098 ∙ respiratory rate ∙ tidal volume ∙ (ΔPinsp + positive end-expiratory pressure), where ΔPinsp is the change in airway pressure during inspiration. Patients were divided into survivors and non-survivors and then compared. Multivariable logistic regression was performed to determine association between MPPCV and ICU mortality. The interaction of MPPCV and use of neuromuscular blocking agent (NMBA) was also analyzed. Results: A total of 125 patients was eligible for final analysis, of whom 38 died in the ICU. MPPCV was higher in non-survivors (17.6 vs. 26.3 J/min, P<0.001). In logistic regression analysis, only MPPCV was significantly associated with ICU mortality (odds ratio, 1.090; 95% confidence interval, 1.029–1.155; P=0.003). There was no significant effect of the interaction between MPPCV and use of NMBA on ICU mortality (P=0.579). Conclusions: MPPCV is associated with ICU mortality in patients mechanically ventilated with PCV mode, regardless of NMBA use.
CPR/Resuscitation
Prognostic significance of respiratory quotient in patients undergoing extracorporeal cardiopulmonary resuscitation in Korea
Yun Im Lee, Ryoung-Eun Ko, Soo Jin Na, Jeong-Am Ryu, Yang Hyun Cho, Jeong Hoon Yang, Chi Ryang Chung, Gee Young Suh
Acute Crit Care. 2023;38(2):190-199.   Published online May 25, 2023
DOI: https://doi.org/10.4266/acc.2022.01438
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  • 3 Web of Science
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AbstractAbstract PDF
Background
Respiratory quotient (RQ) may be used as a tissue hypoxia marker in various clinical settings but its prognostic significance in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) is not known. Methods: Medical records of adult patients admitted to the intensive care units after ECPR in whom RQ could be calculated from May 2004 to April 2020 were retrospectively reviewed. Patients were divided into good neurologic outcome and poor neurologic outcome groups. Prognostic significance of RQ was compared to other clinical characteristics and markers of tissue hypoxia. Results: During the study period, 155 patients were eligible for analysis. Of them, 90 (58.1%) had a poor neurologic outcome. The group with poor neurologic outcome had a higher incidence of out-of-hospital cardiac arrest (25.6% vs. 9.2%, P=0.010) and longer cardiopulmonary resuscitation to pump-on time (33.0 vs. 25.2 minutes, P=0.001) than the group with good neurologic outcome. For tissue hypoxia markers, the group with poor neurologic outcome had higher RQ (2.2 vs. 1.7, P=0.021) and lactate levels (8.2 vs. 5.4 mmol/L, P=0.004) than the group with good neurologic outcome. On multivariable analysis, age, cardiopulmonary resuscitation to pump-on time, and lactate levels above 7.1 mmol/L were significant predictors for a poor neurologic outcome but not RQ. Conclusions: In patients who received ECPR, RQ was not independently associated with poor neurologic outcome.

Citations

Citations to this article as recorded by  
  • Risk factors for neurological disability outcomes in patients under extracorporeal membrane oxygenation following cardiac arrest: An observational study
    Amir Vahedian-Azimi, Ibrahim Fawzy Hassan, Farshid Rahimi-Bashar, Hussam Elmelliti, Anzila Akbar, Ahmed Labib Shehata, Abdulsalam Saif Ibrahim, Ali Ait Hssain
    Intensive and Critical Care Nursing.2024; 83: 103674.     CrossRef
  • What factors are effective on the CPR duration of patients under extracorporeal cardiopulmonary resuscitation: a single-center retrospective study
    Amir Vahedian-Azimi, Ibrahim Fawzy Hassan, Farshid Rahimi-Bashar, Hussam Elmelliti, Anzila Akbar, Ahmed Labib Shehata, Abdulsalam Saif Ibrahim, Ali Ait Hssain
    International Journal of Emergency Medicine.2024;[Epub]     CrossRef
  • Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest and in-hospital cardiac arrest with return of spontaneous circulation: be careful when comparing apples to oranges
    Hwa Jin Cho, In Seok Jeong, Jan Bělohlávek
    Acute and Critical Care.2023; 38(2): 242.     CrossRef
Images in critical care
Pulmonary
Acute lung injury following occupational exposure to nitric acid
Ji Hoon Jang, Sung Yeon Hwang, Chi Ryang Chung, Gee Young Suh, Ryoung-Eun Ko
Acute Crit Care. 2021;36(4):395-396.   Published online November 26, 2021
DOI: https://doi.org/10.4266/acc.2021.01557
  • 2,969 View
  • 86 Download
  • 1 Web of Science
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Citations

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  • Treatment with sivelestat sodium of acute respiratory distress syndrome induced by chemical pneumonitis: A report of three cases
    Liang Jing, Xi Peng, Dayong Li, Yusen Qin, Yaqin Song, Wei Zhu
    Experimental and Therapeutic Medicine.2023;[Epub]     CrossRef
Erratum
Cardiology
Application of sepsis-3 criteria to Korean patients with critical illnesses
Jae Yeol Kim, Hwan Il Kim, Gee Young Suh, Sang Won Yoon, Tae-Yop Kim, Sang Haak Lee, Jae Young Moon, Jae-Young Kwon, Sungwon Na, Ho Geol Ryu, Jisook Park, Younsuck Koh
Acute Crit Care. 2019;34(2):172-172.   Published online April 2, 2019
DOI: https://doi.org/10.4266/acc.2018.00318.e1
Corrects: Acute Crit Care 2019;34(1):30
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Original Articles
Infection
Application of Sepsis-3 Criteria to Korean Patients with Critical Illnesses
Jae Yeol Kim, Hwan Il Kim, Gee Young Suh, Sang Won Yoon, Tae-Yop Kim, Sang Haak Lee, Jae Young Moon, Jae-Young Kwon, Sungwon Na, Ho Geol Ryu, Jisook Park, Younsuck Koh
Acute Crit Care. 2019;34(1):30-37.   Published online January 29, 2019
DOI: https://doi.org/10.4266/acc.2018.00318
Correction in: Acute Crit Care 2019;34(2):172
  • 8,040 View
  • 173 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
The 2016 Society of Critical Care Medicine (SCCM)/European Society of Intensive Care Medicine (ESICM) task force for Sepsis-3 devised new definitions for sepsis, sepsis with organ dysfunction and septic shock. Although Sepsis-3 was data-driven, evidence-based approach, East Asian descents comprised minor portions of the project population. Methods: We selected Korean participants from the fever and antipyretics in critically ill patients evaluation (FACE) study, a joint study between Korea and Japan. We calculated the concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria and evaluated mortality rates of sepsis, sepsis with organ dysfunction, and septic shock by Sepsis-3 criteria using the selected data. Results: Korean participants of the FACE study were 913 (383 with sepsis and 530 without sepsis by Sepsis-2 criteria). The concordance rate for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria was 55.4%. The intensive care unit (ICU) and 28-day mortality rates of sepsis, sepsis with organ dysfunction, and septic shock patients according to Sepsis-3 criteria were 26.2% and 31.0%, 27.5% and 32.5%, and 40.8% and 43.4%, respectively. The quick Sequential Organ Failure Assessment (qSOFA) was inferior not only to SOFA but also to systemic inflammatory response syndrome (SIRS) for predicting ICU and 28-day mortality. Conclusions: The concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria were low. Mortality rate for septic shock in Koreans was consistent with estimates made by the 2016 SCCM/ESICM task force. SOFA and SIRS were better than qSOFA for predicting ICU and 28-day mortality in Korean ICU patients.

Citations

Citations to this article as recorded by  
  • HYPOTENSION AT THE TIME OF SEPSIS RECOGNITION IS NOT ASSOCIATED WITH INCREASED MORTALITY IN SEPSIS PATIENTS WITH NORMAL LACTATE LEVELS
    Ji Hwan Kim, Yong Kyun Kim, Dong Kyu Oh, Kyeongman Jeon, Ryoung-Eun Ko, Gee Young Suh, Sung Yun Lim, Yeon Joo Lee, Young-Jae Cho, Mi-Hyeon Park, Sang-Bum Hong, Chae-Man Lim, Sunghoon Park
    Shock.2023; 59(3): 360.     CrossRef
  • The Surviving Sepsis Campaign: research priorities for the administration, epidemiology, scoring and identification of sepsis
    Mark E. Nunnally, Ricard Ferrer, Greg S. Martin, Ignacio Martin-Loeches, Flavia R. Machado, Daniel De Backer, Craig M. Coopersmith, Clifford S. Deutschman, Massimo Antonelli, Judith Hellman, Sameer Jog, Jozef Kesecioglu, Ishaq Lat, Mitchell M. Levy
    Intensive Care Medicine Experimental.2021;[Epub]     CrossRef
Hematology
Characteristics and Clinical Outcomes of Critically Ill Cancer Patients Admitted to Korean Intensive Care Units
Soo Jin Na, Tae Sun Ha, Younsuck Koh, Gee Young Suh, Shin Ok Koh, Chae-Man Lim, Won-Il Choi, Young-Joo Lee, Seok Chan Kim, Gyu Rak Chon, Je Hyeong Kim, Jae Yeol Kim, Jaemin Lim, Sunghoon Park, Ho Cheol Kim, Jin Hwa Lee, Ji Hyun Lee, Jisook Park, Juhee Cho, Kyeongman Jeon
Acute Crit Care. 2018;33(3):121-129.   Published online August 31, 2018
DOI: https://doi.org/10.4266/acc.2018.00143
  • 8,183 View
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  • 7 Web of Science
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AbstractAbstract PDF
Background
The objective of this study was to investigate the characteristics and clinical outcomes of critically ill cancer patients admitted to intensive care units (ICUs) in Korea.
Methods
This was a retrospective cohort study that analyzed prospective collected data from the Validation of Simplified Acute Physiology Score 3 (SAPS3) in Korean ICU (VSKI) study, which is a nationwide, multicenter, and prospective study that considered 5,063 patients from 22 ICUs in Korea over a period of 7 months. Among them, patients older than 18 years of age who were diagnosed with solid or hematologic malignancies prior to admission to the ICU were included in the present study.
Results
During the study period, a total of 1,762 cancer patients were admitted to the ICUs and 833 of them were deemed eligible for analysis. Six hundred fifty-eight (79%) had solid tumors and 175 (21%) had hematologic malignancies, respectively. Respiratory problems (30.1%) was the most common reason leading to ICU admission. Patients with hematologic malignancies had higher Sequential Organ Failure Assessment (12 vs. 8, P<0.001) and SAPS3 (71 vs. 69, P<0.001) values and were more likely to be associated with chemotherapy, steroid therapy, and immunocompromised status versus patients with solid tumors. The use of inotropes/ vasopressors, mechanical ventilation, and/or continuous renal replacement therapy was more frequently required in hematologic malignancy patients. Mortality rates in the ICU (41.7% vs. 24.6%, P<0.001) and hospital (53.1% vs. 38.6%, P=0.002) were higher in hematologic malignancy patients than in solid tumor patients.
Conclusions
Cancer patients accounted for one-third of all patients admitted to the studied ICUs in Korea. Clinical characteristics were different according to the type of malignancy. Patients with hematologic malignancies had a worse prognosis than did patients with solid tumor.

Citations

Citations to this article as recorded by  
  • Outcomes of Acute Respiratory Failure in Patients With Cancer in the United States
    Kiyan Heybati, Jiawen Deng, Archis Bhandarkar, Fangwen Zhou, Cameron Zamanian, Namrata Arya, Mohamad Bydon, Philippe R. Bauer, Ognjen Gajic, Allan J. Walkey, Hemang Yadav
    Mayo Clinic Proceedings.2024; 99(4): 578.     CrossRef
  • Characteristics and outcomes of cancer patients admitted to intensive care units in cancer specialized hospitals in China
    Wensheng Liu, Dongmin Zhou, Li Zhang, Mingguang Huang, Rongxi Quan, Rui Xia, Yong Ye, Guoxing Zhang, Zhuping Shen
    Journal of Cancer Research and Clinical Oncology.2024;[Epub]     CrossRef
  • Predictors of ICU mortality in patients with hemoblastosis and infectious complications
    A.V. Lyanguzov, A.S. Luchinin, S.V. Ignatyev, I.V. Paramonov
    Anesteziologiya i reanimatologiya.2023; (1): 33.     CrossRef
  • Effect of the underlying malignancy on critically ill septic patient's outcome
    Man‐Yee Man, Hoi‐Ping Shum, Sin‐Man Lam, Jacky Li, Wing‐Wa Yan, Mei‐Wan Yeung
    Asia-Pacific Journal of Clinical Oncology.2022; 18(4): 473.     CrossRef
  • Impacts of Corticosteroid Therapy at Acute Stage of Hospital-Onset Clostridioides difficile Infections
    Ching-Chi Lee, Jen-Chieh Lee, Chun-Wei Chiu, Pei-Jane Tsai, Wen-Chien Ko, Yuan-Pin Hung
    Infection and Drug Resistance.2022; Volume 15: 5387.     CrossRef
  • Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy
    Da Woon Kim, Geum Suk Jang, Kyoung Suk Jung, Hyuk Jae Jung, Hyo Jin Kim, Harin Rhee, Eun Young Seong, Sang Heon Song
    Kidney Research and Clinical Practice.2022; 41(6): 717.     CrossRef
  • A Systematic Review and Meta-Analysis Evaluating Geographical Variation in Outcomes of Cancer Patients Treated in ICUs
    Lama H. Nazer, Maria A. Lopez-Olivo, Anne Rain Brown, John A. Cuenca, Michael Sirimaturos, Khader Habash, Nada AlQadheeb, Heather May, Victoria Milano, Amy Taylor, Joseph L. Nates
    Critical Care Explorations.2022; 4(9): e0757.     CrossRef
  • Clinico-demographic and Outcome Predictors in Solid Tumor Patients with Unplanned Intensive Care Unit Admissions: An Observational Study
    Jigeeshu Divatia, Amit M Narkhede, Harish K Chaudhari, Ujwal Dhundi, Natesh Prabu Ravisankar, Satish Sarode
    Indian Journal of Critical Care Medicine.2021; 25(12): 1421.     CrossRef
Letter to the Editor
CPR/Resuscitation
Refractory Ventricular Arrhythmia Induced by Aconite Intoxication and Its Treatment with Extracorporeal Cardiopulmonary Resuscitation
Mi Kyoung Hong, Jeong Hoon Yang, Chi-Ryang Chung, Jinkyeong Park, Gee Young Suh, Kiick Sung, Yang Hyun Cho
Korean J Crit Care Med. 2017;32(2):228-230.   Published online May 31, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00017
  • 5,360 View
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  • 3 Web of Science
  • 3 Crossref
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Citations

Citations to this article as recorded by  
  • A Narrative Review of Aconite Poisoning and Management
    Christine Lawson, Daniel J. McCabe, Ryan Feldman
    Journal of Intensive Care Medicine.2024;[Epub]     CrossRef
  • Extracorporeal cardio-pulmonary resuscitation in poisoning: A scoping review article
    Mingwei Ng, Zi Yang Wong, R. Ponampalam
    Resuscitation Plus.2023; 13: 100367.     CrossRef
  • Accidental poisoning with Aconitum: Case report and review of the literature
    Giuseppe Bonanno, Mariachiara Ippolito, Alessandra Moscarelli, Giovanni Misseri, Rosaria Caradonna, Giuseppe Accurso, Andrea Cortegiani, Antonino Giarratano
    Clinical Case Reports.2020; 8(4): 696.     CrossRef
Erratum
Primary Invasive Intestinal Aspergillosis in a Non-Severely Immunocompromised Patient
Eunmi Gil, Tae Sun Ha, Gee Young Suh, Chi Ryang Chung, Chi-Min Park
Korean J Crit Care Med. 2016;31(3):263-263.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.2.129.e01
Corrects: Acute Crit Care 2016;31(2):129
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Case Reports
Infection
Primary Invasive Intestinal Aspergillosis in a Non-Severely Immunocompromised Patient
Eunmi Gil, Tae Sun Ha, Gee Young Suh, Chi Ryang Chung, Chi-Min Park
Korean J Crit Care Med. 2016;31(2):129-133.   Published online May 31, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.2.129
Correction in: Acute Crit Care 2016;31(3):263
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AbstractAbstract PDF
Invasive aspergillosis (IA) is most commonly seen in patients with risk factors, such as cytotoxic chemotherapy, prolonged neutropenia, corticosteroids, transplantation and acquired immune deficiency syndrome. IA commonly occurs in the respiratory tract. Extrapulmonary aspergillosis is usually a part of a disseminated infection, and primary invasive intestinal aspergillosis is very rare. Herein, we report a case of an immunocompetent 53-year-old male who suffered recurrent septic shock in the intensive care unit (ICU) and was finally diagnosed as invasive intestinal aspergillosis without dissemination. IA is rarely considered for patients who do not have an immune disorder. Thus, when such cases do occur, the diagnosis is delayed and the clinical outcome is often poor. However, there is a growing literature reporting IA cases in patients without an immune disorder, mostly among ICU patients. Primary intestinal aspergillosis should be considered for critically ill patients, especially with severe disrupted gastrointestinal mucosal barrier.

Citations

Citations to this article as recorded by  
  • Aspergillus fumigatus cholangitis in a patient with cholangiocarcinoma: case report and review of the literature
    Kathrin Rothe, Sebastian Rasch, Nina Wantia, Alexander Poszler, Joerg Ulrich, Christoph Schlag, Wolfgang Huber, Roland M. Schmid, Dirk H. Busch, Tobias Lahmer
    Infection.2021; 49(1): 159.     CrossRef
Cardiology
Use of Polymyxin B Hemoperfusion in a Patient with Septic Shock and Septic Cardiomyopathy Who Was Placed on Extracorporeal Membrane Oxygen Support
Sun Hye Shin, Hyun Lee, Aeng Ja Choi, Kylie Hae Jin Chang, Gee Young Suh, Chi Ryang Chung
Korean J Crit Care Med. 2016;31(2):123-128.   Published online May 31, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.2.123
  • 19,898 View
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AbstractAbstract PDF
Although shock in sepsis is usually managed successfully by conventional medical treatment, a subset of cases do not respond and may require salvage therapies such as veno-arterial extracorporeal membrane oxygenation (VA ECMO) support as well as an attempt to remove endotoxins. However, there are limited reports of attempts to remove endotoxins in patients with septic shock on VA ECMO support. We recently experienced a case of septic shock with severe myocardial injury whose hemodynamic improvement was unsatisfactory despite extracorporeal membrane oxygenation (ECMO) support. Since the cause of sepsis was acute pyelonephritis and blood cultures grew gram-negative bacilli, we additionally applied polymyxin B direct hemoperfusion (PMX-DHP) to the ECMO circuit and were able to successfully taper off vasopressors and wean off ECMO support. To the best of our knowledge, this is the first adult case in which PMX-DHP in addition to ECMO support was successfully utilized in a patient with septic shock. This case indicates that additional PMX-DHP therapy may be beneficial and technically feasible in patients with septic shock with severe myocardial injury refractory to ECMO support.
Pulmonary
Successful Treatment with Empirical Erlotinib in a Patient with Respiratory Failure Caused by Extensive Lung Adenocarcinoma
Suk Hyeon Jeong, Sang-Won Um, Hyun Lee, Kyeongman Jeon, Kyung Jong Lee, Gee Young Suh, Man Pyo Chung, Hojoong Kim, O Jung Kwon, Yoon La Choi
Korean J Crit Care Med. 2016;31(1):44-48.   Published online February 29, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.1.44
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AbstractAbstract PDF
We herein describe a 70-year-old woman who presented with respiratory failure due to extensive lung adenocarcinoma. Despite advanced disease, care in the intensive care unit with ventilator support was performed because she was a newly diagnosed patient and was considered to have the potential to recover after cancer treatment. Because prompt control of the cancer was needed to treat the respiratory failure, empirical treatment with an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor was initiated before confirmation of EGFR-mutant adenocarcinoma, and the patient was successfully treated. Later, EGFR-mutant adenocarcinoma was confirmed.

Citations

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  • Lazarus effect in a patient initially empirically treated with osimertinib for EGFR L858R mutant non-small cell lung cancer with leptomeningeal disease: a case report
    Shreya Bhatia, Manuel G. Cortez, Spencer Lessans, Wade T. Iams
    Oncotarget.2024; 15(1): 27.     CrossRef
  • Lung cancer with superior vena cava syndrome diagnosed by intravascular biopsy using EBUS-TBNA
    Daegeun Lee, Seong Mi Moon, Dongwuk Kim, Juwon Kim, Haseong Chang, Bumhee Yang, Suk Hyeon Jeong, Kyung Jong Lee
    Respiratory Medicine Case Reports.2016; 19: 177.     CrossRef
Infection
Disseminated Gastrointestinal Mucormycosis in Immunocompromised Disease
Tae Sun Ha, Chi-Min Park, Jeong Hoon Yang, Yang Hyun Cho, Chi Ryang Chung, Kyeongman Jeon, Gee Young Suh
Korean J Crit Care Med. 2015;30(4):323-328.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.323
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AbstractAbstract PDF
Mucormycosis is an uncommon opportunistic fungal infection mostly affecting immunocompromised patients and gastrointestinal mucormycosis is a rare and life-threatening. We describe a 31-year-old man with a history of idiopathic cyclic neutropenia who developed perforations of the stomach and intestine and intra-abdominal bleeding due to disseminated gastrointestinal mucormycosis after the initial operation.

Citations

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  • A Fatal Case of Disseminated Intestinal Mucormycosis in a Patient with Vibrio Sepsis
    Seungwoo Chung, Hyun-Jung Sung, Jong Won Chang, Ile Hur, Ho Cheol Kim
    Journal of Acute Care Surgery.2021; 11(3): 133.     CrossRef
  • Gastric Mucormycosis Followed by Traumatic Cardiac Rupture in an Immunocompetent Patient
    Sang Won Lee, Hyun Seok Lee
    The Korean Journal of Gastroenterology.2016; 68(2): 99.     CrossRef
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
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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.
Original Article
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
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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

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  • 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

ACC : Acute and Critical Care