- Pulmonary
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The Use of Lung Ultrasound in a Surgical Intensive Care Unit
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Hyung Koo Kang, Hyo Jin So, Deok Hee Kim, Hyeon-Kyoung Koo, Hye Kyeong Park, Sung-Soon Lee, Hoon Jung
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Korean J Crit Care Med. 2017;32(4):323-332. Published online November 30, 2017
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DOI: https://doi.org/10.4266/kjccm.2017.00318
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Abstract
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- Background
Pulmonary complications including pneumonia and pulmonary edema frequently develop in critically ill surgical patients. Lung ultrasound (LUS) is increasingly used as a powerful diagnostic tool for pulmonary complications. The purpose of this study was to report how LUS is used in a surgical intensive care unit (ICU).
Methods This study retrospectively reviewed the medical records of 67 patients who underwent LUS in surgical ICU between May 2016 and December 2016.
Results The indication for LUS included hypoxemia (n = 44, 65.7%), abnormal chest radiographs without hypoxemia (n = 17, 25.4%), fever without both hypoxemia and abnormal chest radiographs (n = 4, 6.0%), and difficult weaning (n = 2, 3.0%). Among 67 patients, 55 patients were diagnosed with pulmonary edema (n = 27, 41.8%), pneumonia (n = 20, 29.9%), diffuse interstitial pattern with anterior consolidation (n = 6, 10.9%), pneumothorax with effusion (n = 1, 1.5%), and diaphragm dysfunction (n = 1, 1.5%), respectively, via LUS. LUS results did not indicate lung complications for 12 patients. Based on the location of space opacification on the chest radiographs, among 45 patients with bilateral abnormality and normal findings, three (6.7%) and two (4.4%) patients were finally diagnosed with pneumonia and atelectasis, respectively. Furthermore, among 34 patients with unilateral abnormality and normal findings, two patients (5.9%) were finally diagnosed with pulmonary edema. There were 27 patients who were initially diagnosed with pulmonary edema via LUS. This diagnosis was later confirmed by other tests. There were 20 patients who were initially diagnosed with pneumonia via LUS. Among them, 16 and 4 patients were finally diagnosed with pneumonia and atelectasis, respectively.
Conclusions LUS is useful to detect pulmonary complications including pulmonary edema and pneumonia in surgically ill patients.
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Citations
Citations to this article as recorded by
- Lung Ultrasound in the Critically Ill
Jin Sun Cho The Korean Journal of Critical Care Medicine.2017; 32(4): 356. CrossRef
- Pulmonary
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Clinical Practice Guideline of Acute Respiratory Distress Syndrome
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Young-Jae Cho, Jae Young Moon, Ein-Soon Shin, Je Hyeong Kim, Hoon Jung, So Young Park, Ho Cheol Kim, Yun Su Sim, Chin Kook Rhee, Jaemin Lim, Seok Jeong Lee, Won-Yeon Lee, Hyun Jeong Lee, Sang Hyun Kwak, Eun Kyeong Kang, Kyung Soo Chung, Won-Il Choi, The Korean Society of Critical Care Medicine and the Korean Academy of Tuberculosis and Respiratory Diseases Consensus Group
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Korean J Crit Care Med. 2016;31(2):76-100. Published online May 31, 2016
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DOI: https://doi.org/10.4266/kjccm.2016.31.2.76
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16,876
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- There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.
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Citations
Citations to this article as recorded by
- 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 Acute and Critical Care.2024; 39(1): 91. CrossRef - Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19
Won Ho Han, Jae Hoon Lee, June Young Chun, Young Ju Choi, Youseok Kim, Mira Han, Jee Hee Kim Acute and Critical Care.2023; 38(1): 41. CrossRef - Treatment of acute respiratory failure: invasive mechanical ventilation
Young Sam Kim Journal of the Korean Medical Association.2022; 65(3): 151. CrossRef - Treatment of acute respiratory failure: extracorporeal membrane oxygenation
Jin-Young Kim, Sang-Bum Hong Journal of the Korean Medical Association.2022; 65(3): 157. CrossRef - Prolonged glucocorticoid treatment in acute respiratory distress syndrome – Authors' reply
Rob Mac Sweeney, Daniel F McAuley The Lancet.2017; 389(10078): 1516. CrossRef - Prolonged Glucocorticoid Treatment in ARDS: Impact on Intensive Care Unit-Acquired Weakness
Gianfranco Umberto Meduri, Andreas Schwingshackl, Greet Hermans Frontiers in Pediatrics.2016;[Epub] CrossRef
- Cardiology
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Catecholamine-Induced Cardiomyopathy associated with Neuroblastoma and Treated with Extracorporeal Membrane Oxygenation as a Bridge to Recovery
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Junggu Yi, Si Oh Kim, Jun-mo Park, Sung-hye Byun, Hoon Jung, Seong Wook Hong
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Korean J Crit Care Med. 2015;30(4):299-302. Published online November 30, 2015
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DOI: https://doi.org/10.4266/kjccm.2015.30.4.299
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5,176
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- Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
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Citations
Citations to this article as recorded by
- COVID-19 and cardiovascular disease: manifestations, pathophysiology, vaccination, and long-term implication
Adel Abdel Moneim, Marwa A. Radwan, Ahmed I. Yousef Current Medical Research and Opinion.2022; 38(7): 1071. CrossRef
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