- Liver
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Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study
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Seon Woo Yoo, Min-Jong Ki, Dal Kim, Seul Ki Kim, SeungYong Park, Hyo Jin Han, Heung Bum Lee
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Acute Crit Care. 2021;36(4):322-331. Published online November 16, 2021
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DOI: https://doi.org/10.4266/acc.2021.00276
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Abstract
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- Background
The molecular adsorbent recirculating system (MARS) is a hepatic replacement system that supports excretory liver function in patients with liver failure. However, since MARS has been employed in our hospital, bleeding complications have occurred in many patients during or after MARS. The objective of this study was to determine how MARS affects coagulopathy and identify specific factors associated with bleeding complications.
Methods We retrospectively analyzed data from 17 patients undergoing a total of 41 MARS sessions. Complete blood count, coagulation profiles, and blood chemistry values were compared before and after MARS. To identify pre-MARS factors associated with increased bleeding after MARS, we divided patients into bleeder and non-bleeder groups and compared their pre-MARS laboratory values.
Results MARS significantly reduced bilirubin and creatinine levels. MARS also increased prothrombin time and reduced platelet and fibrinogen, thus negatively impacting coagulation. Pre-MARS hemoglobin was significantly lower in the bleeder group than in the non-bleeder group (P=0.015). When comparing the upper and lower 33% of MARS sessions based on the hemoglobin reduction rate, hemoglobin reduction was significantly greater in MARS sessions involving patients with low pre-MARS international normalized ratio of prothrombin time (PT-INR) and factor V (P=0.038 and P=0.023, respectively).
Conclusions MARS could appears to alter coagulation-related factors such as factor V and increase the risk of bleeding complications particularly in patient with low hemoglobin. However, individual differences among patients were large, and various factors, such as low hemoglobin, PT-INR, and factor V levels, appear to be involved.
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Citations
Citations to this article as recorded by
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Jianhua Dong, Li Huang, Chuan Li, Bian Wu, Xi Yang, Yongchun Ge Journal of Clinical Apheresis.2024;[Epub] CrossRef - Crosslinked Bifunctional Particles for the Removal of Bilirubin in Hyperbilirubinemia Cases
María del Prado Garrido, Ana Maria Borreguero, Maria Jesús Ramos, Manuel Carmona, Francisco Javier Redondo Calvo, Juan Francisco Rodriguez Materials.2023; 16(8): 2999. CrossRef - The Effect of Molecular Adsorbent Recirculating System in Patients With Liver Failure: A Case Series of 44 Patients
Shahin Isha, Anna S. Jenkins, Abby J. Hanson, Parthkumar H. Satashia, Sai Abhishek Narra, Gunjan D. Mundhra, Mohammed Mustafa Hasan, Ashrita Donepudi, Abishek Giri, Patrick W. Johnson, Dolores Villar, Christan Santos, Juan Canabal, Philip Lowman, Pablo Mo Transplantation Proceedings.2023; 55(9): 2126. CrossRef - Extracorporeal organ support and the kidney
Maria-Jimena Muciño-Bermejo Frontiers in Nephrology.2022;[Epub] CrossRef
- Pulmonary
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Can the intensivists predict the outcomes of critically ill patients on the appropriateness of intensive care unit admission for limited intensive care unit resources ?
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SeungYong Park
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Acute Crit Care. 2021;36(4):388-389. Published online November 30, 2021
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DOI: https://doi.org/10.4266/acc.2021.01641
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2,958
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60
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Citations
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- Comparison of clinical characteristics and hospital mortality in critically ill patients without COVID-19 before and during the COVID-19 pandemic: a multicenter, retrospective, propensity score-matched study
Sua Kim, Hangseok Choi, Jae Kyeom Sim, Won Jai Jung, Young Seok Lee, Je Hyeong Kim Annals of Intensive Care.2022;[Epub] CrossRef
- Pulmonary
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High-flow nasal cannula for respiratory failure in adult patients
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SeungYong Park
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Acute Crit Care. 2021;36(4):275-285. Published online November 30, 2021
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DOI: https://doi.org/10.4266/acc.2021.01571
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18,109
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971
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Abstract
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- The high-flow nasal cannula (HFNC) has been recently used in several clinical settings for oxygenation in adults. In particular, the advantages of HFNC compared with low-flow oxygen systems or non-invasive ventilation include enhanced comfort, increased humidification of secretions to facilitate expectoration, washout of nasopharyngeal dead space to improve the efficiency of ventilation, provision of a small positive end-inspiratory pressure effect, and fixed and rapid delivery of an accurate fraction of inspired oxygen (FiO2) by minimizing the entrainment of room air. HFNC has been successfully used in critically ill patients with several conditions, such as hypoxemic respiratory failure, hypercapneic respiratory failure (exacerbation of chronic obstructive lung disease), post-extubation respiratory failure, pre-intubation oxygenation, and others. However, the indications are not absolute, and much of the proven benefit remains subjective and physiologic. This review discusses the practical application and clinical uses of HFNC in adults, including its unique respiratory physiologic effects, device settings, and clinical indications.
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Citations
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Annalisa Boscolo, Tommaso Pettenuzzo, Francesco Zarantonello, Nicolò Sella, Elisa Pistollato, Alessandro De Cassai, Sabrina Congedi, Irene Paiusco, Giacomo Bertoldo, Silvia Crociani, Francesca Toma, Giulia Mormando, Giulia Lorenzoni, Dario Gregori, Paolo BMC Pulmonary Medicine.2024;[Epub] CrossRef - Recommendations from The Medical Education Editor
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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 and Critical Care.2024; 39(1): 1. CrossRef - Clinical Practice of High-Flow Nasal Cannula Therapy in ARDS Patients: A Cross-Sectional Survey of Respiratory Therapists
Mohammed Alyami, Abdulelah Aldhahir, Abdullah Alqarni, Khalid Salwi, Abdullah Sarhan, Mohammed Almeshari, Nowaf Alobaidi, Jaber Alqahtani, Rayan Siraj, Abdullah Alsulayyim, Saeed Alghamdi, Ahmed Alasimi, Omar Alqarni, Mansour Majrshi, Hassan Alwafi Journal of Multidisciplinary Healthcare.2024; Volume 17: 1401. CrossRef - The Impact of High-Flow Nasal Cannula Therapy on Acute Respiratory Distress Syndrome Patients: A Systematic Review
Ahmed M Abdelbaky, Wael G Elmasry , Ahmed H. Awad, Sarrosh Khan, Maryam Jarrahi Cureus.2023;[Epub] CrossRef - High-Flow Oxygen Therapy in the Perioperative Setting and Procedural Sedation: A Review of Current Evidence
Lou’i Al-Husinat, Basil Jouryyeh, Ahlam Rawashdeh, Abdelrahman Alenaizat, Mohammad Abushehab, Mohammad Wasfi Amir, Zaid Al Modanat, Denise Battaglini, Gilda Cinnella Journal of Clinical Medicine.2023; 12(20): 6685. CrossRef - Current status of treatment of acute respiratory failure in Korea
Yong Jun Choi, Jae Hwa Cho Journal of the Korean Medical Association.2022; 65(3): 124. CrossRef - Transnasal High-Flow Oxygen Therapy versus Noninvasive Positive Pressure Ventilation in the Treatment of COPD with Type II Respiratory Failure: A Meta-Analysis
Wei Liu, Mingli Zhu, Liuqin Xia, Xiangying Yang, Pei Huang, Yanming Sun, Ye Shen, Jianping Ma, Gang Chen Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef - Association between timing of intubation and mortality in patients with idiopathic pulmonary fibrosis
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