- Surgery
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Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study
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Hye-Bin Kim, Sungwon Na, Hyo Chae Paik, Hyeji Joo, Jeongmin Kim
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Acute Crit Care. 2021;36(2):99-108. Published online April 5, 2021
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DOI: https://doi.org/10.4266/acc.2020.01144
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Abstract
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- Background
Lung transplantation (LT) is an accepted therapeutic modality for end-stage lung disease patients. Intensive care unit (ICU) readmission is a risk factor for mortality after LT, for which consistent risk factors have not been elucidated. Thus, we investigated the risk factors for ICU readmission during index hospitalization after LT, particularly regarding the posttransplant condition of LT patients.
Methods In this retrospective study, we investigated all adult patients undergoing LT between October 2012 and August 2017 at our institution. We collected perioperative data from electronic medical records such as demographics, comorbidities, laboratory findings, ICU readmission, and in-hospital mortality.
Results We analyzed data for 130 patients. Thirty-two patients (24.6%) were readmitted to the ICU 47 times during index hospitalization. At the initial ICU discharge, the Sequential Organ Failure Assessment (SOFA) score (odds ratio [OR], 1.464; 95% confidence interval [CI], 1.083−1.978; P=0.013) and pH (OR, 0.884; 95% CI, 0.813−0.962; P=0.004; when the pH value increases by 0.01) were related to ICU readmission using multivariable regression analysis and were still significant after adjusting for confounding factors. Thirteen patients (10%) died during the hospitalization period, and the number of ICU readmissions was a significant risk factor for in-hospital mortality. The most common causes of ICU readmission and in-hospital mortality were infection-related.
Conclusions The SOFA score and pH were associated with increased risk of ICU readmission. Early postoperative management of these factors and thorough posttransplantation infection control can reduce ICU readmission and improve the prognosis of LT patients.
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Citations
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- The association of the Sequential Organ Failure Assessment score at intensive care unit discharge with intensive care unit readmission in the cardiac intensive care unit
Yonghoon Shin, Ji Hoon Jang, Ryoung-Eun Ko, Soo Jin Na, Chi Ryang Chung, Ki Hong Choi, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang European Heart Journal: Acute Cardiovascular Care.2024; 13(4): 354. CrossRef - Cardiothoracic Transplant Anesthesia: Selected Highlights: Part I—Lung Transplantation
Andrew M. Courtwright, Jagan Devarajan, Ashley Virginia Fritz, Archer Kilbourne Martin, Barbara Wilkey, Sudhakar Subramani, Christopher M. Cassara, Justin N. Tawil, Andrea N. Miltiades, Michael L. Boisen, Brandi A. Bottiger, Angela Pollak, Theresa A. Gelz Journal of Cardiothoracic and Vascular Anesthesia.2023; 37(6): 884. CrossRef - Status and Risk Factors in Patients Requiring Unplanned Intensive Care Unit Readmission Within 48 Hours: A Retrospective Propensity-Matched Study in China
Yan-Ling Yin, Mei-Rong Sun, Kun Zhang, Yu-Hong Chen, Jie Zhang, Shao-Kun Zhang, Li-Li Zhou, Yan-Shuo Wu, Peng Gao, Kang-Kang Shen, Zhen-Jie Hu Risk Management and Healthcare Policy.2023; Volume 16: 383. CrossRef - Comment on “Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study”
Maida Qazi, Mahnoor Amin Acute and Critical Care.2023; 38(2): 234. CrossRef - Reply to comment on “Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study”
Hye-Bin Kim, Sungwon Na, Hyo Chae Paik, Hyeji Joo, Jeongmin Kim Acute and Critical Care.2023; 38(2): 236. CrossRef - Predicting outcomes, describing complications and optimising rehabilitation in patients undergoing lung transplantation
Massimiliano Polastri, Gian Maria Paganelli International Journal of Therapy and Rehabilitation.2023; 30(10): 1. CrossRef
- Pharmacology
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Inhalation sedation for postoperative patients in the intensive care unit: initial sevoflurane concentration and comparison of opioid use with propofol sedation
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Seungho Jung, Sungwon Na, Hye Bin Kim, Hye Ji Joo, Jeongmin Kim
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Acute Crit Care. 2020;35(3):197-204. Published online August 10, 2020
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DOI: https://doi.org/10.4266/acc.2020.00213
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Abstract
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- Background
Although the use of volatile sedatives in the intensive care unit (ICU) is increasing in Europe, it remains infrequent in Asia. Therefore, there are no clinical guidelines available. This study investigates the proper initial concentration of sevoflurane, a volatile sedative that induces a Richmond agitation-sedation scale (RASS) score of –2 to –3, in patients who underwent head and neck surgery with tracheostomy. We also compared the amount of postoperative opioid consumption between volatile and intravenous (IV) sedation.
Methods We planned a prospective study to determine the proper initial sevoflurane concentration and a retrospective analysis to compare postoperative opioid consumption between volatile sedation and propofol sedation. Patients scheduled for head and neck surgery with tracheostomy and subsequent postoperative sedation in the ICU were enrolled.
Results In this prospective study, the effective dose 50 (ED50) of initial end-tidal sevoflurane concentration was 0.36% (95% confidence interval [CI], 0.20 to 0.60%), while the ED 95 was 0.69% (95% CI, 0.60 to 0.75%) based on isotonic regression methods. In this retrospective study, remifentanil consumption during postoperative sedation was significantly lower in the sevoflurane group (2.52±1.00 µg/kg/hr, P=0.001) than it was in the IV propofol group (3.66±1.30 µg/kg/hr).
Conclusions We determined the proper initial end-tidal concentration setting of sevoflurane for patients with tracheostomy who underwent head and neck surgery. Postoperative sedation with sevoflurane appears to be a valid and safe alternative to IV sedation with propofol.
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Citations
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Brian O’Gara, Christina Boncyk, Andreas Meiser, Angela Jerath, Martin Bellgardt, Matthieu Jabaudon, Jeremy R. Beitler, Christopher G. Hughes Anesthesiology.2024; 141(1): 163. CrossRef - Sedaconda ACD-S for Sedation with Volatile Anaesthetics in Intensive Care: A NICE Medical Technologies Guidance
Michal Pruski, Susan O’Connell, Laura Knight, Rhys Morris Applied Health Economics and Health Policy.2024; 22(6): 805. CrossRef - The sevoflurane concentration for light sedation in critically ill patients: A protocol for experimental study
Wilasinee Jitpakdee, Chawika Pisitsak, Sunthiti Morakul, Sahawat Thertchanakun, Tananchai Petnak Clinical Critical Care.2024;[Epub] CrossRef - Halogenated anesthetics vs intravenous hypnotics for short and long term sedation in the intensive care unit: A meta-analysis
V. Likhvantsev, G. Landoni, N. Ermokhina, M. Yadgarov, L. Berikashvili, K. Kadantseva, O. Grebenchikov, L. Okhinko, A. Kuzovlev Medicina Intensiva.2023; 47(5): 267. CrossRef - Halogenated anesthetics vs intravenous hypnotics for short and long term sedation in the intensive care unit: A meta-analysis
V. Likhvantsev, G. Landoni, N. Ermokhina, M. Yadgarov, L. Berikashvili, K. Kadantseva, O. Grebenchikov, L. Okhinko, A. Kuzovlev Medicina Intensiva (English Edition).2023; 47(5): 267. CrossRef - Inhaled Sedation with Volatile Anesthetics for Mechanically Ventilated Patients in Intensive Care Units: A Narrative Review
Khaled Ahmed Yassen, Matthieu Jabaudon, Hussah Abdullah Alsultan, Haya Almousa, Dur I Shahwar, Fatimah Yousef Alhejji, Zainab Yaseen Aljaziri Journal of Clinical Medicine.2023; 12(3): 1069. CrossRef - Sedation with Sevoflurane versus Propofol in COVID-19 Patients with Acute Respiratory Distress Syndrome: Results from a Randomized Clinical Trial
Sara Martínez-Castro, Berta Monleón, Jaume Puig, Carolina Ferrer Gomez, Marta Quesada, David Pestaña, Alberto Balvis, Emilio Maseda, Alejandro Suárez de la Rica, Ana Monero Feijoo, Rafael Badenes Journal of Personalized Medicine.2023; 13(6): 925. CrossRef - Effect of inhaled anaesthetics on cognitive and psychiatric outcomes in critically ill adults: a systematic review and meta-analysis
Sean Cuninghame, Angela Jerath, Kevin Gorsky, Asaanth Sivajohan, Conall Francoeur, Davinia Withington, Lisa Burry, Brian H. Cuthbertson, Beverley A. Orser, Claudio Martin, Adrian M. Owen, Marat Slessarev, Martin Chapman, Damon Scales, Julie Nardi, Beth Li British Journal of Anaesthesia.2023; 131(2): 314. CrossRef - Experiencia y revisión de la literatura del uso del dispositivo Anesthetic Conserving Device (AnaConDa) durante la pandemia en pacientes con neumonía por COVID-19 en un hospital público
María Guadalupe Morales Hernández, Marcelo Díaz Conde, Ixchel Magaña Matienzo Medicina Crítica.2023; 37(4): 334. CrossRef - Sedation of patients in intensive care units. Guidelines
V.I. Potievskaya, I.B. Zabolotskikh, I.E. Gridchik, A.I. Gritsan, A.A. Eremenko, I.A. Kozlov, A.L. Levit, V.A. Mazurok, I.V. Molchanov Anesteziologiya i reanimatologiya.2023; (5): 6. CrossRef - Inhaled volatile anesthetics in the intensive care unit
Erin D Wieruszewski, Mariam ElSaban, Patrick M Wieruszewski, Nathan J Smischney World Journal of Critical Care Medicine.2023;[Epub] CrossRef - Prospects of inhalation sedation in intensive care
O.A. Grebenchikov, V.V. Kulabukhov, A.K. Shabanov, O.V. Ignatenko, V.V. Antonova, R.A. Cherpakov, I.V. Redkin, E.A. Boeva, A.N. Kuzovlev Anesteziologiya i reanimatologiya.2022; (3): 84. CrossRef - National analysis of applied sedation in critical care patients
Grace Pamela López Pérez , Melani Dayana Carrera Casa , Gissela Lizbeth Amancha Moyulema , Yadira Nathaly Chicaiza Quilligana , Ana Belén Guamán Tacuri , Joselyn Mireya Iza Arias Salud, Ciencia y Tecnología.2022; 2: 234. CrossRef
- Pulmonary
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Critical Care before Lung Transplantation
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Jin Gu Lee, Moo Suk Park, Su Jin Jeong, Song Yee Kim, Sungwon Na, Jeongmin Kim, Hyo Chae Paik
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Acute Crit Care. 2018;33(4):197-205. Published online November 30, 2018
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DOI: https://doi.org/10.4266/acc.2018.00367
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8,571
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Abstract
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- Lung transplantation is widely accepted as the only viable treatment option for patients with end-stage lung disease. However, the imbalance between the number of suitable donor lungs available and the number of possible candidates often results in intensive care unit (ICU) admission for the latter. In the ICU setting, critical care is essential to keep these patients alive and to successfully bridge to lung transplantation. Proper management in the ICU is also one of the key factors supporting long-term success following transplantation. Critical care includes the provision of respiratory support such as mechanical ventilation (MV) and extracorporeal life support (ECLS). Accordingly, a working knowledge of the common critical care issues related to these unique patients and the early recognition and management of problems that arise before and after transplantation in the ICU setting are crucial for long-term success. In this review, we discuss the management and selection of candidates for lung transplantation as well as existing respiratory support strategies that involve MV and ECLS in the ICU setting.
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Citations
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- Optimizing the prelung transplant candidate
John Pagteilan, Scott Atay Current Opinion in Organ Transplantation.2024; 29(1): 37. CrossRef - Awakening in extracorporeal membrane oxygenation as a bridge to lung transplantation
Su Hwan Lee Acute and Critical Care.2022; 37(1): 26. CrossRef - Recipient Management before Lung Transplantation
Hyoung Soo Kim, Sunghoon Park Journal of Chest Surgery.2022; 55(4): 265. CrossRef - Outcomes of Patients on the Lung Transplantation Waitlist in Korea: A Korean Network for Organ Sharing Data Analysis
Hye Ju Yeo, Dong Kyu Oh, Woo Sik Yu, Sun Mi Choi, Kyeongman Jeon, Mihyang Ha, Jin Gu Lee, Woo Hyun Cho, Young Tae Kim Journal of Korean Medical Science.2022;[Epub] CrossRef - Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
Nam Eun Kim, Ala Woo, Song Yee Kim, Ah Young Leem, Youngmok Park, Se Hyun Kwak, Seung Hyun Yong, Kyungsoo Chung, Moo Suk Park, Young Sam Kim, Ha Eun Kim, Jin Gu Lee, Hyo Chae Paik, Su Hwan Lee Respiratory Research.2021;[Epub] CrossRef
- Pulmonary
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Critical Care after Lung Transplantation
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Song Yee Kim, Su Jin Jeong, Jin Gu Lee, Moo Suk Park, Hyo Chae Paik, Sungwon Na, Jeongmin Kim
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Acute Crit Care. 2018;33(4):206-215. Published online November 30, 2018
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DOI: https://doi.org/10.4266/acc.2018.00360
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17,550
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Abstract
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- Since the first successful lung transplantation in 1983, there have been many advances in the field. Nevertheless, the latest data from the International Society for Heart and Lung Transplantation revealed that the risk of death from transplantation is 9%. Various aspects of postoperative management, including mechanical ventilation, could affect intensive care unit stay, hospital stay, and immediate postoperative morbidity and mortality. Complications such as reperfusion injury, graft rejection, infection, and dehiscence of anastomosis increase fatal adverse side effects immediately after surgery. In this article, we review the possible immediate complications after lung transplantation and summarize current knowledge on prevention and treatment.
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- Aspergillus Galactomannan Titer as a Diagnostic Marker of Invasive Pulmonary Aspergillosis in Lung Transplant Recipients: A Single-Center Retrospective Cohort Study
Eun-Young Kim, Seung-Hyun Yong, Min-Dong Sung, A-La Woo, Young-Mok Park, Ha-Eun Kim, Su-Jin Jung, Song-Yee Kim, Jin-Gu Lee, Young-Sam Kim, Hyo-Chae Paik, Moo-Suk Park Journal of Fungi.2023; 9(5): 527. CrossRef - Nontuberculous mycobacterial infection after lung transplantation: A single-center experience in South Korea
Youngmok Park, Nam Eun Kim, Se Hyun Kwak, Moo Suk Park, Su Jin Jeong, Jin Gu Lee, Hyo Chae Paik, Song Yee Kim, Young Ae Kang Journal of Microbiology, Immunology and Infection.2022; 55(1): 123. CrossRef - Medical Complications of Lung Transplantation
Moo Suk Park Journal of Chest Surgery.2022; 55(4): 338. CrossRef - Roles of electrical impedance tomography in lung transplantation
Hui Jiang, Yijiao Han, Xia Zheng, Qiang Fang Frontiers in Physiology.2022;[Epub] CrossRef - Perioperative anidulafungin combined with triazole prophylaxis for the prevention of early invasive candidiasis in lung transplant recipients
Emily Sartain, Kelly Schoeppler, Barrett Crowther, Joshua B. Smith, Maheen Z. Abidi, Todd J. Grazia, Mark Steele, Terri Gleason, Krista Porter, Alice Gray Transplant Infectious Disease.2021;[Epub] CrossRef - The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea
Yae-Jee Baek, Yun-Suk Cho, Moo-Hyun Kim, Jong-Hoon Hyun, Yu-Jin Sohn, Song-Yee Kim, Su-Jin Jeong, Moo-Suk Park, Jin-Gu Lee, Hyo-Chae Paik Journal of Fungi.2021; 7(8): 639. CrossRef - Panel-Reactive and Donor-Specific Antibodies before Lung Transplantation can Affect Outcomes in Korean Patients Receiving Lung Transplantation
Sung Woo Moon, Moo Suk Park, Jin Gu Lee, Hyo Chae Paik, Young Tae Kim, Hyun Joo Lee, Samina Park, Sun Mi Choi, Do Hyung Kim, Woo Hyun Cho, Hye Ju Yeo, Seung-il Park, Se Hoon Choi, Sang-Bum Hong, Tae Sun Shim, Kyung-Wook Jo, Kyeongman Jeon, Byeong-Ho Jeong Yonsei Medical Journal.2020; 61(7): 606. CrossRef - A proof-of principal study using phase-contrast imaging for the detection of large airway pathologies after lung transplantation
Stephan Umkehrer, Carmela Morrone, Julien Dinkel, Laura Aigner, Maximilian F. Reiser, Julia Herzen, Ali Ö. Yildirim, Franz Pfeiffer, Katharina Hellbach Scientific Reports.2020;[Epub] CrossRef
- Neurology
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The Effect of Electrical Muscle Stimulation and In-bed Cycling on Muscle Strength and Mass of Mechanically Ventilated Patients: A Pilot Study
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Kyeongyoon Woo, Jeongmin Kim, Hye Bin Kim, Hyunwoo, Choi, Kibum Kim, Donghyung Lee, Sungwon Na
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Acute Crit Care. 2018;33(1):16-22. Published online February 14, 2017
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DOI: https://doi.org/10.4266/acc.2017.00542
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9,987
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Abstract
PDF
- Background
Critically ill patients experience muscle weakness, which leads to functional disability. Both functional electrical stimulation (FES) and in-bed cycling can be an alternative measure for intensive care unit (ICU) patients who are not feasible for active exercise. The aim of this study was to examine whether FES and in-bed cycling have a positive effect on muscle mass in ICU patients.
Methods Critically ill patients who received mechanical ventilation for at least 24 hours were included. After passive range of motion exercise, in-bed cycling was applied for 20 minutes, and FES was applied for 20 minutes on the left leg. The right leg received in-bed cycling and the left leg received both FES and in-bed cycling. Thigh circumferences and rectus femoris cross-sectional area (CSA) were assessed with ultrasonography before and after the intervention. Muscle strength was assessed by Medical Research Council scale.
Results A total of 10 patients were enrolled in this study as a pilot study. Before and after the intervention, the CSA of right rectus femoris increased from 5.08 ± 1.51 cm2 to 6.01 ± 2.21 cm2 , which was statistically significant (P = 0.003). The thigh circumference was also increased and statistically significant (P = 0.006). There was no difference between left and right in regard to FES application. There is no significant change in muscle strength before and after the intervention (right and left, P = 0.317 and P = 0.368, respectively).
Conclusions In-bed cycling increased thigh circumferences rectus femoris CSA. Adding FES did not show differences.
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M. Polastri, F. Daniele, F. Tagariello Pulmonology.2024; 30(2): 152. CrossRef - Ultrasound for measurement of skeletal muscle mass quantity and muscle composition/architecture in critically ill patients: A scoping review on studies' aims, methods, and findings
Júlia Lima, Estéfani Foletto, Rafaella C.B. Cardoso, Charlles Garbelotto, Aline P. Frenzel, Juliana U. Carneiro, Larissa S. Carpes, Thiago G. Barbosa-Silva, Maria Cristina Gonzalez, Flávia M. Silva Clinical Nutrition.2024; 43(1): 95. CrossRef - Current Concepts in Early Mobilization of Critically Ill Patients Within the Context of Neurologic Pathology
Thaís Ferreira Lopes Diniz Maia, Paulo André Freire Magalhães, Dasdores Tatiana Silva Santos, Jorge Luiz de Brito Gomes, Paulo Adriano Schwingel, Aline de Freitas Brito Neurocritical Care.2024; 41(1): 272. CrossRef - Anabolic Strategies for ICU-Acquired Weakness. What Can We Learn from Bodybuilders?
Jakub Tarnawski, Maja Czub, Marta Dymecki, Medha Sunil, Marcin Folwarski Nutrients.2024; 16(13): 2011. CrossRef - Methodologies and clinical applications of lower limb muscle ultrasound in critically ill patients: a systematic review and meta-analysis
Roberto Venco, Alessandro Artale, Paolo Formenti, Cristian Deana, Giovanni Mistraletti, Michele Umbrello Annals of Intensive Care.2024;[Epub] CrossRef - Evaluating Muscle Mass Changes in Critically Ill Patients: Rehabilitation Outcomes Measured by Ultrasound and Bioelectrical Impedance
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Masatoshi Naruse, Scott Trappe, Todd A. Trappe Journal of Applied Physiology.2022; 132(5): 1267. CrossRef - Rehabilitation Therapy after the COVID-19 Era: Focused on
Cardiopulmonary Rehabilitation
Hyung Ik Shin Annals of CardioPulmonary Rehabilitation.2021; 1(1): 17. CrossRef - Rehabilitation Programs for Bedridden Patients with Prolonged Immobility: A Scoping Review Protocol
Vitor Parola, Hugo Neves, Filipa Margarida Duque, Rafael A. Bernardes, Remy Cardoso, Carla A. Mendes, Liliana B. Sousa, Paulo Santos-Costa, Cândida Malça, Rúben Durães, Pedro Parreira, João Apóstolo, Arménio Cruz International Journal of Environmental Research and Public Health.2021; 18(22): 12033. CrossRef - Non-paretic lower limb muscle wasting during acute phase is associated with dependent ambulation in patients with stroke
Masafumi Nozoe, Masashi Kanai, Hiroki Kubo, Miho Yamamoto, Shinichi Shimada, Kyoshi Mase Journal of Clinical Neuroscience.2020; 74: 141. CrossRef - Intensive Care Unit-Acquired Weakness: Not Just Another Muscle Atrophying Condition
Heta Lad, Tyler M. Saumur, Margaret S. Herridge, Claudia C. dos Santos, Sunita Mathur, Jane Batt, Penney M. Gilbert International Journal of Molecular Sciences.2020; 21(21): 7840. CrossRef - Problems with Rehabilitation for Critically ill Patients
Masaji Nishimura The Japanese Journal of Rehabilitation Medicine.2019; 56(1): 48. CrossRef - Exploring the Potential Effectiveness of Combining Optimal Nutrition With Electrical Stimulation to Maintain Muscle Health in Critical Illness: A Narrative Review
Selina M. Parry, Lee‐anne S. Chapple, Marina Mourtzakis Nutrition in Clinical Practice.2018; 33(6): 772. CrossRef
- Neurology/Obstetric
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Myotonic Dystrophy Confirmed after Cesarean Section
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Seung Hyun Kim, Jeongmin Kim, Taehoon Ha, Sungwon Na
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Korean J Crit Care Med. 2017;32(1):81-82. Published online February 17, 2017
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DOI: https://doi.org/10.4266/kjccm.2016.00864
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- Pharmacology
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Recurrent Desaturation Events due to Opioid-Induced Chest Wall Rigidity after Low Dose Fentanyl Administration
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Sung Yeon Ham, Bo Ra Lee, Taehoon Ha, Jeongmin Kim, Sungwon Na
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Korean J Crit Care Med. 2016;31(2):118-122. Published online May 31, 2016
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DOI: https://doi.org/10.4266/kjccm.2016.31.2.118
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25,034
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Abstract
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- Opioid-induced chest wall rigidity is an uncommon complication of opioids. Because of this, it is often difficult to make a differential diagnosis in a mechanically ventilated patient who experiences increased airway pressure and difficulty with ventilation. A 76-year-old female patient was admitted to the intensive care unit (ICU) after surgery for periprosthetic fracture of the femur neck. On completion of the surgery, airway pressure was increased, and oxygen saturation fell below 95% after a bolus dose of fentanyl. After ICU admission, the same event recurred. Manual ventilation was immediately started, and a muscle relaxant relieved the symptoms. There was no sign or symptom suggesting airway obstruction or asthma on physical examination. Early recognition and treatment should be made in a mechanically ventilated patient experiencing increased airway pressure in order to prevent further deterioration.
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Citations
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- Fentanyl-Induced Rigid Chest Syndrome in Critically Ill Patients
Alison J. Tammen, Donald Brescia, Dan Jonas, Jeremy L. Hodges, Philip Keith Journal of Intensive Care Medicine.2023; 38(2): 196. CrossRef - Effects of fentanyl overdose-induced muscle rigidity and dexmedetomidine on respiratory mechanics and pulmonary gas exchange in sedated rats
Philippe Haouzi, Nicole Tubbs Journal of Applied Physiology.2022; 132(6): 1407. CrossRef - Challenges in Sedation Management in Critically Ill Patients with COVID-19: a Brief Review
Kunal Karamchandani, Rajeev Dalal, Jina Patel, Puneet Modgil, Ashley Quintili Current Anesthesiology Reports.2021; 11(2): 107. CrossRef - A Case of Masseter Muscle Rigidity during Awake Intubation under Remifentanil Infusion
Tomoki YAMAGA, Takeshi NEGITA, Masayo SUGIURA, Nobuyuki KIMURA THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA.2019; 39(3): 274. CrossRef - Opioids and Chest Wall Rigidity During Mechanical Ventilation
Jeffrey P. Roan, Navin Bajaj, Field A. Davis, Natalie Kandinata Annals of Internal Medicine.2018; 168(9): 678. CrossRef
- Neurology/Liver
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Non-Convulsive Status Epilepticus following Liver Transplantation
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Bora Lee, Nar Hyun Min, Sung Yeon Ham, Sungwon Na, Jeongmin Kim
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Korean J Crit Care Med. 2016;31(1):49-53. Published online February 29, 2016
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DOI: https://doi.org/10.4266/kjccm.2016.31.1.49
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6,310
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Abstract
- Neurological complications following liver transplantation are more common than after other organ transplants. These complications include seizure in about 8% of cases, which is associated with morbidity and mortality. Seizure should be treated immediately, and the process of differential diagnosis has to be performed appropriately in order to avoid permanent neurologic deficit. We herein report a case of status epilepticus after liver transplantation. The status epilepticus was treated promptly and the cause of seizure was assessed. The patient was discharged without any complication.
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Citations
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- Early postoperative seizures in liver and kidney recipients
O. M. Tsirulnikova, A. V. Syrkina, I. A. Miloserdov, I. E. Pashkova, S. Yu. Oleshkevich, I. B. Komarova Russian Journal of Transplantology and Artificial Organs.2021; 23(2): 158. CrossRef
- Pulmonary/Cardiology
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Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung Transplants
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Ha Yeon Kim, Sungwon Na, Hyo Chae Paik, Jonglin Ha, Jeongmin Kim
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Korean J Crit Care Med. 2015;30(4):286-294. Published online November 30, 2015
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DOI: https://doi.org/10.4266/kjccm.2015.30.4.286
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5,716
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Abstract
PDF
- Background
Extracorporeal membrane oxygenation (ECMO) is administered for a few days after lung transplantation (LTx) in recipients who are expected to have early graft dysfunction. Despite its life-saving potential, immediate postoperative ECMO has life-threatening complications such as postoperative bleeding. We investigated the risk factors related to the use of immediate postoperative ECMO.
Methods We retrospectively reviewed the records of 60 LTx patients who were at our institution from October 2012 to May 2015. Perioperative variables associated with postoperative ECMO were compared between the two groups.
Results There were 26 patients who received postoperative ECMO (ECMO group) and 34 patients who did not (control group). Multivariate regression analysis revealed preoperative ECMO (odds ratio [OR] 12.55, 95% confidence intervals [CI] 1.34 – 117.24, p = 0.027) and lower peripheral pulse oxymetry saturation (SpO2) at the end of surgery (OR 0.71, 95% CI 0.54 – 0.95, p = 0.019) were independent risk factors for postoperative ECMO in LTx patients. The incidences of complications, such as re-operation, tracheostomy, renal failure and postoperative atrial fibrillation, were higher in the ECMO group. There was no difference in the duration of postoperative intensive care unit stay or postoperative 30-day mortality between the two groups.
Conclusions The preoperative ECMO and lower SpO2 at the end of surgery were associated with postoperative ECMO. Further, postoperative adverse events were higher in the ECMO group compared with the control group. This study suggests that determination of postoperative ECMO requires careful consideration because of the risks of postoperative ECMO in LTx patients.
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Citations
Citations to this article as recorded by
- The Future of Research on Extracorporeal Membrane Oxygenation (ECMO)
Ji Young Lee Korean Journal of Critical Care Medicine.2016; 31(2): 73. CrossRef
- Neurology/Liver
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Fixed Pupillary Light Reflex due to Peripheral Neuropathy after Liver Transplantation
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Kwan Hyung Kim, Namo Kim, Sungwon Na, Jaewon Jang, Jeongmin Kim
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Korean J Crit Care Med. 2015;30(3):191-195. Published online August 31, 2015
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DOI: https://doi.org/10.4266/kjccm.2015.30.3.191
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Abstract
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- A 46- year-old female patient was admitted to the intensive care unit (ICU) after liver transplantation. About an hour later after the ICU admission, she had no pupillary light reflex. Both pupils were also fixed at 5 mm. Patients who undergo liver transplantation are susceptible to neurologic disorders including hepatic encephalopathy, thromboembolism and intracranial hemorrhage. Abnormal pupillary light reflex usually indicates a serious neurologic emergency in these patients; however, benign neurologic disorders such as peripheral autonomic neuropathy or Holmes-Adie syndrome should also be considered. We experienced a case of fixed pupillary light reflex after liver transplantation diagnosed as peripheral autonomic neuropathy.
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