Acute and Critical Care

Case Reports

Trauma/Vascular surgery
Resuscitative Endovascular Balloon Occlusion of the Aorta in a Trauma Patient with Hypovolemic Shock: Hong Kyung Shin, Ho-Seong Han, Taeseung Lee, Do-Joong Park, Kyuwhan Jung, Kyuseok Kim; Korean J Crit Care Med. 2015;30(2):115-118. Published online May 31, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.2.115

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Hemorrhagic shock is one of the most common causes of death in patients with multiple trauma and therefore rapid control of bleeding is the main strategy to save these patients. Resuscitative balloon occlusion of the aorta (REBOA) has been applied in several trauma cases and because of the effectiveness of this procedure it has been adopted in the trauma field. Herein, we report the first successful case of REBOA in Korea performed on a 46-year-old man with hemorrhagic shock after a fall from a height of 14-stories. The patient visited our hospital emergency room with hypovolemic shock, we performed Resuscitative Endovascular Balloon Occlusion of the Aorta under bed side blind technique. His vital sign was stabilized after procedure, then we could performed endovascular bleeding control. The patient was discharged on his 33rd in-hospital day without invasive procedure and major scar.

Citations

Citations to this article as recorded by

Nurses’ Knowledge Regarding Management of Hypovolemic Shock: A Cross-Sectional Study
Maher Atiyah
Academia Open.2024;[Epub] CrossRef
Implementation of resuscitative endovascular balloon occlusion of the aorta at the Korean Regional Trauma Center
Youngeun Park, Byungchul Yu, Giljae Lee, Jungnam Lee, Kangkook Choi, Ahram Han
Hong Kong Journal of Emergency Medicine.2021; 28(3): 129. CrossRef
Case Series of Zone III Resuscitative Endovascular Balloon Occlusion of the Aorta in Traumatic Shock Patients
Byungchul Yu, Gil Jae Lee, Kang Kook Choi, Min A Lee, Jihun Gwak, Youngeun Park, Jung Nam Lee
Journal of Trauma and Injury.2020; 33(3): 162. CrossRef

Surgical Management for Pulmonary Artieriole Rupture During Subclavian Vein Catheterization: A Case Report: Jiae Min, Hyun Koo Kim, Ho Kyung Sung, Hyun Joo Lee, Young Ho Choi; Korean J Crit Care Med. 2012;27(1):59-61.; DOI: https://doi.org/10.4266/kjccm.2012.27.1.59

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Abstract PDF: We experienced an extremely unusual case of a 37-year-old woman who suffered from hemothorax soon after subclavian vein catheterization. Many case reports of a hemothorax or hematoma after central vein catheterization through the great vessels, such as the subclavian vein and internal jugular vein, have been published. However, this rare case showed a pinpoint-sized active bleeding site from a pulmonary arteriole rupture. During an emergency operation using thoracoscopy-assisted minithoracotomy, this bleeding site was successfully managed by primary repair.

Hemothorax in an Uncontrolled Anticoagulated Patient: Fight or Flight?: A Case Report: Soon Ho Chon, Sung Ho Shinn, Chul Burm Lee; Korean J Crit Care Med. 2009;24(1):37-38.; DOI: https://doi.org/10.4266/kjccm.2009.24.1.37

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Abstract PDF: Hemothorax in a patient on anticoagulant therapy for atrial fibrillation after blunt trauma is not an uncommon event. However, massive hemothorax in such a patient with an extremely uncontrolled and high international normalized ratio (INR) may pose a serious dilemma. We report a case of a patient under anticoagulant therapy for atrial fibrillation who underwent an emergent thoracotomy for massive hemothorax with an INR of 9.57.

Randomized Controlled Trial

Post-thoracotomy Analgesia & ICU Length of Stay: Comparison of Thoracic Epidrual Morphine Infusion and Lumbar Epidural Plus Intravenous Morphine Infusion: Seok Hwa Yoon, Jung Hyun Lee, Hee Suk Yoon, Yoon Hee Kim, Myung Hoon Na, Seung Pyung Lim; Korean J Crit Care Med. 2007;22(2):77-82.

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Abstract PDF: BACKGROUND
Length of stay in ICU after thoracotomy is related to postoperative pulmonary function and complication which are affected by postoperative pain. For the post-thoracotomy pain control, epidural morphine is commonly used. Although total dose-requirement for analgesia of lumbar epidural morphine is more than the thoracic, lumbar epidural morphine could be substituted the thoracic. Our study compared the effect of patient controlled analgesia using thoracic epidural morphine (TEA group) and lumbar epidural analgesia with patient controlled intravenous analgesia using morphine (LEA+IV group).
METHODS
Sixty patients were randomly assigned into one of the two groups. The epidural taps were done before the induction. In all the patients morphine 0.2 mg/ml was administered via the epidural catheter at the end of surgery. In TEA group, basal infusion rate was 0.1 mg/hr and bolus dose was 0.02 mg. In LEA+IV group, basal infusion rate of epidural morphine was 0.1 mg/hr, patient controlled intravenous analgesia with morphine started when patients arrived at ICU, and basal infusion rate of intravenous morphine was 1.0 mg/hr and bolus dose was 0.8 mg. Pain score, side effect, postoperative length of stay in ICU and hospital were observed.
RESULTS
There were no significant differences between two groups in pain score, side effects, length of stay in ICU and hospital.
CONCLUSIONS
Lumbar epidural analgesia with patient controlled intravenous analgesia using morphine showed similar postoperative analgesia and length of stay in ICU and hospital compared to thoracic epidural analgesia with morphine, so that can substitute the thoracic epidural analgesia.

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