Acute and Critical Care

Hyuk Jun Yang

4 Articles

Cardiology
Erratum: Moderate to Severe Left Ventricular Ejection Fraction Related to Short-term Mortality of Patients with Post-cardiac Arrest Syndrome after Out-of-Hospital Cardiac Arrest: Kyoung Jeen Min, Jin Joo Kim, In Cheol Hwang, Jae Hyuk Woo, Yong Su Lim, Hyuk Jun Yang, Keun Lee; Korean J Crit Care Med. 2017;32(1):88-88. Published online February 28, 2017; DOI: https://doi.org/10.4266/kjccm.2016.00570.e01; Corrects: Acute Crit Care 2016;31(4):342

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Predictors of In-Hospital Mortality after Recovered Out-of-Hospital Cardiac Arrest in Patients with Proven Significant Coronary Artery Disease: A Retrospective Study
Maria Trepa, Samuel Bastos, Marta Fontes-Oliveira, Ricardo Costa, André Dias-Frias, André Luz, Vasco Dias, Mário Santos, Severo Torres
The Journal of Critical Care Medicine.2020; 6(1): 41. CrossRef

Cardiology/Emergency
Moderate to Severe Left Ventricular Ejection Fraction Related to Short-term Mortality of Patients with Post-cardiac Arrest Syndrome after Out-of-Hospital Cardiac Arrest: Kyoung Jeen Min, Jin Joo Kim, In Cheol Hwang, Jae Hyuk Woo, Yong Su Lim, Hyuk Jun Yang, Keun Lee; Korean J Crit Care Med. 2016;31(4):342-350. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00570; Correction in: Acute Crit Care 2017;32(1):88

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Background
The aim of this study was to investigate the relationships between left ventricular ejection fraction (LVEF) and mortality and neurologic outcomes with post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA).
Methods
Patients with PCAS after OHCA admitted to the intensive care unit between January 2014 and December 2015 were analyzed retrospectively.
Results
A total of 104 patients were enrolled in this study. The mean age was 54.4 ± 15.3 years, and 75 of the patients were male (72.1%). Arrest with a cardiac origin was found in 55 (52.9%). LVEF < 45%, 45-55%, and > 55% was measured in 39 (37.5%), 18 (17.3%), and 47 (45.2%) of patients, respectively. In multivariate analysis, severe LV dysfunction (LVEF < 45%) was significantly related to 7-day mortality (odds ratio 3.02, 95% Confidence Interval 1.01-9.0, p-value 0.047).
Conclusions
In this study, moderate to severe LVEF within 48 hours after return of spontaneous circulation was significantly related to 7-day short-term mortality in patients with PCAS after OHCA. Clinicians should actively treat myocardial dysfunction, and further studies are needed.

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Post cardiac arrest left ventricular ejection fraction associated with survival to discharge
Kanjit Leungsuwan, Kory R. Heier, Olivia Henderson, Karam Ayoub, Talal Alnabelsi, Emily Slade, Vedant A. Gupta
Resuscitation Plus.2024; 19: 100737. CrossRef

Emergency/Neurology
Brain Magnetic Resonance Imaging in Patients with Favorable Outcomes after Out-of-Hospital Cardiac Arrest: Many Have Encephalopathy Even with a Good Cerebral Performance Category Score: Woo Sung Choi, Jin Joo Kim, Hyuk Jun Yang; Korean J Crit Care Med. 2015;30(4):265-271. Published online November 30, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.4.265

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Abstract PDF: Background
The aim of this study was to retrospectively evaluate and analyze the brain magnetic resonance imaging (B-MRI) findings of patients with a favorable neurological outcome following cerebral performance category (CPC) after out-of-hospital cardiac arrest (OHCA) at single university hospital emergency center.
Methods
Patients with return of spontaneous circulation (> 24 h) after OHCA who were older than 16 years of age and who had been admitted to the emergency intensive care unit (EICU) for over a 57-month period between July 2007 and March 2012 and survived with a favorable neurological outcome were enrolled. B-MRI was taken after recovery of their mental status.
Results
Fifty-two patients among the 305 admitted patients had a good CPC, and 33 patients’ B-MRI were analyzed (CPC 1: 26 patients, CPC 2: 7 patients). Among these, 18 (54.5%) patients had a normal finding on B-MRI. On the other hand, ischemia/infarction/microangiopathy compatible with hypoxic-ischemic encephalopathy (HIE) were found on various brain areas including subcortical white matter (7/13), cerebral cortex, central semiovlae, basal ganglia, putamen, periventricular white matter, and cerebellum.
Conclusions
Survivors with a favorable neurological outcome from OHCA showed HIE on B-MRI, especially all of the patients with a CPC 2. More detail neurologic category including brain imaging would be needed to categorize patients with favorable outcome after OHCA.

Pulmonary
The Prognostic Factors of Pneumonia with Septic Shock in Patients Presenting to the Emergency Department: Jong Won Kim, Jin Joo Kim, Hyuk Jun Yang, Yong Su Lim, Jin Seong Cho, In Cheol Hwang, Sang Hyun Han; Korean J Crit Care Med. 2015;30(4):258-264. Published online November 30, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.4.258

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Background
Pneumonia is the most common cause of death among patients with infectious disease in Korea. However, studies of pneumonia with septic shock in patients presenting to the emergency department are limited. The aim of this study was to investigate the prognostic factors associated with pneumonia with septic shock in patients presenting to the emergency department.
Methods
From January 2008 to September 2014, patients with pneumonia with septic shock admitted through the emergency department were retrospectively examined.
Results
Of the 561,845 patients who visited the emergency department, 398 were admitted for pneumonia with septic shock. The 28-day mortality rate in these patients was 36.4%. The independent prognostic factors were old age (>70 yrs) (odds ratio [OR], 2.42; 95%, confidence interval [CI], 1.35–4.32), Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR, 1.04; 95% CI, 1.01–1.08), leukopenia (OR, 3.63; 95% CI, 1.48–8.94), prolonged PT-INR (OR, 2.53; 95% CI, 1.41–4.54), and hypoxemia (OR, 2.88; 95% CI, 1.30–6.38).
Conclusions
A poor prognosis of patients with pneumonia is associated with old age (>70 yrs), increased APACHE II score, leukopenia, prolonged PT-INR, and hypoxemia.

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