Acute and Critical Care

Moo Suk Park

4 Articles

Pulmonary
Predicting Delayed Ventilator Weaning after Lung Transplantation: The Role of Body Mass Index: Sarah Soh, Jin Ha Park, Jeong Min Kim, Min Jung Lee, Shin Ok Koh, Hyo Chae Paik, Moo Suk Park, Sungwon Na; Korean J Crit Care Med. 2014;29(4):273-280. Published online November 30, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.4.273

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Abstract PDF: BACKGROUND
Weaning from mechanical ventilation is difficult in the intensive care unit (ICU). Many controversial questions remain unanswered concerning the predictors of weaning failure. This study investigates patient characteristics and delayed weaning after lung transplantation.
METHODS
This study retrospectively reviewed the medical records of 17 lung transplantation patients from October 2012 to December 2013. Patients able to be weaned from mechanical ventilation within 8 days after surgery were assigned to an early group (n = 9), and the rest of the patients were assigned to the delayed group (n=8). Patients' intraoperative and postoperative characteristics were collected and analyzed, and conventional weaning predictors, including rapid shallow breathing index (RSBI), were also assessed.
RESULTS
The results of the early group showed a significantly shorter ICU stay in addition to a shorter hospitalization overall. Notably, the early group had a higher body mass index (BMI) than the delayed group (20.7 vs. 16.9, p = 0.004). In addition, reopening occurred more frequently in the delayed group (1/9 vs. 5/8, p = 0.05). During spontaneous breathing trials, tidal volume (TV) and arterial oxygen tension were significantly higher in the early group compared to the delayed weaning group, but differences in RSBI and respiratory rate (RR) between groups were not statistically significant.
CONCLUSIONS
Low BMI might be associated with delayed ventilator weaning in lung transplantation patients. In addition, instead of the traditional weaning predictors of RSBI and RR, TV might be a better predictor for ventilator weaning after lung transplantation.

A Case of Burkholderia cepacia Pneumonia after Lung Transplantation in a Recipient without Cystic Fibrosis: Jin Sun Cho, Sungwon Na, Moo Suk Park, Yun So, Bahn Lee, Shin Ok Koh, Hyo Chae Paik; Korean J Crit Care Med. 2013;28(3):187-191.; DOI: https://doi.org/10.4266/kjccm.2013.28.3.187

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Burkholderia cepacia is a highly virulent pathogen known to cause opportunistic infections in immunocompromised patients. It accelerates lung disease and causes necrotizing pneumonia with associated severe sepsis, known as cepacia syndrome. In particular, lung transplant recipients infected with Burkholderia cepacia show higher mortality after lung transplantation than those who are not infected with this organism. Due to broad-spectrum antibiotic resistance, a combination therapy should be used according to the results of the susceptibility test. This bacterial infection is rare in Korea, and no case was reported in lung transplant recipients. However, we report a case of pneumonia caused by Burkholderia cepacia after lung transplantation. As Burkholderia cepacia was grown from a sputum culture, the patient was treated initially with a combination of meropenem and trimethoprim/sulfamethoxazole and then ceftazidime and trimethoprim/sulfamethoxazole as a result of leukopenia. After antibiotics treatment for 20 days, sputum cultures became negative for Burkholderia cepacia and the patient successfully recovered.

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Current perspective of lung transplantation
Hyo Chae Paik
Journal of the Korean Medical Association.2016; 59(2): 119. CrossRef

Structure of Intensive Care Unit and Clinical Outcomes in Critically Ill Patients with Influenza A/H1N1 2009: Jaehwa Cho, Hun Jae Lee, Sang Bum Hong, Gee Young Suh, Moo Suk Park, Seok Chan Kim, Sang Hyun Kwak, Myung Goo Lee, Jae Min Lim, Huyn Kyung Lee, Younsuck Koh; Korean J Crit Care Med. 2012;27(2):65-69.; DOI: https://doi.org/10.4266/kjccm.2012.27.2.65

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Abstract PDF

BACKGROUND
During 2009 pandemic period, many Koreans were infected and admitted with Influenza A/H1N1. The primary aim of this study was to evaluate whether the structures of an intensive care unit (ICU) were associated with the outcomes of critically ill patients.
METHODS
This retrospective observational study examined critically ill adult patients with influenza A/H1N1, who were admitted to 24 hospitals in Korea, from September 2009 to February 2010. We collected data of ICU structure, patients and 90 days mortality. Univariate and multivariate logistic regression analysis, with backward elimination, were performed to determine the most significant risk factors.
RESULTS
Of the 239 patients, mortality of 90 days was 43%. Acute physiology and chronic health evaluation (APACHE) II score (p < 0.001), sequential organ failure assessment (SOFA) score (p < 0.0001), nurse to beds ratio (p = 0.039) and presence of intensivist (p = 0.024) were significant risk factors of 90 days mortality. Age (p = 0.123), gender (p = 0.304), hospital size (p = 0.260), and ICU type (p = 0.409) were insignificantly associated with mortality. In a multivariate logistic regression analysis, patients with less than 6 SOFA score had significantly lower mortality, compared with those with more than 10 SOFA score (odds ratio 0.156, p < 0.0001). The presence of intensivist had significantly lower mortality, compared with the absence (odds ratio 0.496, p = 0.026).
CONCLUSIONS
In critically ill patients with influenza A/H1N1, the severity of the illness and presence of intensivist might be associated with 90 days mortality.

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Development and validation of novel simple prognostic model for predicting mortality in Korean intensive care units using national insurance claims data
Ah Young Leem, Soyul Han, Kyung Soo Chung, Su Hwan Lee, Moo Suk Park, Bora Lee, Young Sam Kim
The Korean Journal of Internal Medicine.2024; 39(4): 625. CrossRef
A population-based observational study of patients with pulmonary disorders in intensive care unit
Hyun Woo Lee, Eunjeong Ji, Soyeon Ahn, Hye-Joo Yang, Seo-Young Yoon, Tae Yeon Park, Yeon Joo Lee, Jinwoo Lee, Sang-Min Lee, Seung-Hye Choi, Young-Jae Cho
The Korean Journal of Internal Medicine.2020; 35(6): 1411. CrossRef
Novel respiratory infectious diseases in Korea
Hyun Jung Kim
Yeungnam University Journal of Medicine.2020; 37(4): 286. CrossRef
Impact of the mother–nurse partnership programme on mother and infant outcomes in paediatric cardiac intensive care unit
Ju-Yeon Uhm, Hee Soon Kim
Intensive and Critical Care Nursing.2019; 50: 79. CrossRef
Major Obstacles to Implement a Full-Time Intensivist in Korean Adult ICUs: a Questionnaire Survey
Jun Wan Lee, Jae Young Moon, Seok Wha Youn, Yong Sup Shin, Sang Il Park, Dong Chan Kim, Younsuk Koh
Korean Journal of Critical Care Medicine.2016; 31(2): 111. CrossRef
Critical Care In Korea: Present and Future
Chae-Man Lim, Sang-Hyun Kwak, Gee Young Suh, Younsuck Koh
Journal of Korean Medical Science.2015; 30(11): 1540. CrossRef
Intensivist Physician Staffing in Intensive Care Units
Sunghoon Park, Gee Young Suh
Korean Journal of Critical Care Medicine.2013; 28(1): 1. CrossRef

A Case of Prolonged Extracorporeal Membrane Oxygenation Support for Severe Acute Respiratory Distress Syndrome: A Case Report: Byung Hoon Park, Joon Chang, Se Kyu Kim, Young Ae Kang, Ji Young Son, Kyung Jong Lee, Yoe Wun Yoon, Ji Ae Jung, Sak Lee, Moo Suk Park; Korean J Crit Care Med. 2010;25(1):37-42.; DOI: https://doi.org/10.4266/kjccm.2010.25.1.37

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Abstract PDF

When all the conventional treatments have failed for patients with acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) can offer these patients a chance to survive. We report here on a case of successful treatment with prolonged ECMO support for a patient with severe ARDS. A 41-year-old female patient with acute A-viral hepatitis developed pneumonia and progressive ARDS. After tracheostomy, her clinical condition deteriorated despite proper antibiotic administration and other conventional treatments, including the recruitment maneuver and steroid use. Venoarterial ECMO was given for the management of refractory hypoxemia that developed 14 days after the initiation of mechanical ventilation. The duration of ECMO support was 4 weeks, and she was successfully weaned off ECMO and mechanical ventilation.

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Early Extracorporeal Membrane Oxygenation for Massive Aspiration during Anesthesia Induction
Namo Kim, Kwan Hyung Kim, Jeong Min Kim, Su Youn Choi, Sungwon Na
The Korean Journal of Critical Care Medicine.2015; 30(2): 109. CrossRef
Massive Diffuse Alveolar Hemorrhage Caused by the Aspiration of Gastric Contents during Induction of Anesthesia in Patients with Adhesive Ileus - A Case Report -
Ji Seon Jeong, Jong Hun Jun, Hyo Jin Song, Hee Koo Yoo
Korean Journal of Critical Care Medicine.2012; 27(2): 115. CrossRef
Extracorporeal Membrane Oxygenation as a Bridge to Definitive Airway Security in 3 Severe Acute Extrinsic Airway Compression Patients - A Case Report -
Jiwon Lyu, Jin Won Huh, Chae Man Lim, Youn Suck Koh, Sang Bum Hong
The Korean Journal of Critical Care Medicine.2011; 26(1): 29. CrossRef

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