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Extracorporeal Membrane Oxygenation (ECMO) and Iliac Vein Injury
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Sang Ook Ha, Jae Seok Park, So Hee Park, Chae Man Lim, Younsuck Koh, Sang Bum Hong
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Korean J Crit Care Med. 2013;28(3):197-200.
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DOI: https://doi.org/10.4266/kjccm.2013.28.3.197
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- The use of extracorporeal membrane oxygenation (ECMO) has increased after the 2009 pandemic H1N1 infections, and the ECMO-related complications have also increased.
Specifically, the mechanical vessel injury due to catheter cannulation seems to be less frequent than other complications, but there is a risk of hemorrhagic shock which requires special attention. We experienced a case of successful management with graft stenting during ECMO operation for iliac vein injury. A 56-year-old female patient with non-small cell lung cancer developed endobronchial obstruction, and ECMO was applied for the ECMO-assisted rigid bronchoscopy. During catheter cannulation, hypovolemic shock was developed due to her right external iliac vein injury. We detected the hemorrhage with bedside ultrasound at an early stage and the hemorrhage was effectively managed with graft stenting on ECMO.
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A Case of Pumpless Interventional Lung Assist Application in a Tuberculosis Destroyed Lung Patient with Severe Hypercapnic Respiratory Failure
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So Hee Park, Sang Ook Ha, Jae Seok Park, Sang Bum Hong, Tae Sun Shim, Chae Man Lim, Younsuck Koh
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Korean J Crit Care Med. 2013;28(3):192-196.
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DOI: https://doi.org/10.4266/kjccm.2013.28.3.192
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- Pumpless extracorporeal interventional lung assist (iLA) is a rescue therapy allowing effective carbon dioxide removals and lung protective ventilator settings. Herein, we report the use of a pumpless extracorporeal iLA in a tuberculosis destroyed lung (TDL) patient with severe hypercapnic respiratory failures. A 35-year-old male patient with TDL was intubated due to CO2 retention and altered mentality.
After 11 days, Ventilator Associated Pneumonia (VAP) had developed. Despite the maximal mechanical ventilator support, his severe respiratory acidosis was not corrected.
We applied the iLA for the management of refractory hypercapnia with respiratory acidosis. This case suggests that the iLA is an effective rescue therapy for TDL patients with ventilator refractory hypercapnia.
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Usefulness of Screening Criteria System Used by Medical Alert Team in a General Hospital
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Hyejin Joo, So Hee Park, Sang Bum Hong, Chae Man Lim, Younsuck Koh, Young Seok Lee, Jin Won Huh
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Korean J Crit Care Med. 2012;27(3):151-156.
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DOI: https://doi.org/10.4266/kjccm.2012.27.3.151
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Abstract
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- BACKGROUND
Rapid response team (RRT) is becoming an essential part of patient safety by the early recognition and management of patients on general hospital wards. In this study, we analyzed the usefulness of screening criteria of RRT used at Asan Medical Center.
METHODS
On a retrospective basis, we reviewed the records of 675 cases in 543 patients that were managed by RRT (called medical alert team in the Asan Medical Center), from July 2011 to December 2011. The medical alert team was acted by requests of attending doctors or nurses or the medical alert system (MAS) criteria composed of abnormal vital sign, neurology, laboratory data and increasing oxygen demand. We investigated the patterns of MAS criteria for targeting the patients who were managed by the medical alert team.
RESULTS
Respiratory distress (RR > 25/min) was the most common item for identifying patients whose condition had worsened. The criteria consist with respiratory distress and abnormal blood pressure (mean BP < 60 mmHg or systolic BP < 90 mmHg) found 70.0% of patients with deteriorated conditions. Vital sign (RR > 25/min, mean BP < 60 mmHg or systolic BP < 90 mmHg, pulse rate, PR > 130/min or < 50/min) and oxygen demand found 79.2% of them. Vital signs, arterial blood gas analysis (ABGA) with lactate level (pH, pO2, pCO2, and lactate) and O2 demand found 98.6% of patient conditions had worsened.
CONCLUSIONS
Vital signs, especially RR > 25/min is useful criteria for detecting patients whose conditions have deteriorated. The addition of ABGA data with lactate levels leads to a more powerful screening tool.
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Citations
Citations to this article as recorded by  - Influence of the Rapid Response Team Activation via Screening by Nurses on Unplanned Intensive Care Unit Admissions
Ye-Ji Huh, Seongmi Moon, Eun Kyeung Song, Minyoung Kim
Korean Journal of Adult Nursing.2020; 32(5): 539. CrossRef - Early Experience of Medical Alert System in a Rural Training Hospital: a Pilot Study
Maru Kim
The Korean Journal of Critical Care Medicine.2017; 32(1): 47. CrossRef - Temporal patterns of change in vital signs and Cardiac Arrest Risk Triage scores over the 48 hours preceding fatal in‐hospital cardiac arrest
HyunSoo Oh, KangIm Lee, WhaSook Seo
Journal of Advanced Nursing.2016; 72(5): 1122. CrossRef - A combination of early warning score and lactate to predict intensive care unit transfer of inpatients with severe sepsis/septic shock
Jung-Wan Yoo, Ju Ry Lee, Youn Kyung Jung, Sun Hui Choi, Jeong Suk Son, Byung Ju Kang, Tai Sun Park, Jin-Won Huh, Chae-Man Lim, Younsuck Koh, Sang Bum Hong
The Korean Journal of Internal Medicine.2015; 30(4): 471. CrossRef
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