- Pulmonary
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Erratum to “Utilization of pain and sedation therapy on noninvasive mechanical ventilation in Korean intensive care units: a multi-center prospective observational study”
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Taehee Kim, Jung Soo Kim, Eun Young Choi, Youjin Chang, Won-Il Choi, Jae-Joon Hwang, Jae Young Moon, Kwangha Lee, Sei Won Kim, Hyung Koo Kang, Yun Su Sim, Tai Sun Park, Seung Yong Park, Sunghoon Park, Jae Hwa Cho
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Acute Crit Care. 2021;36(2):172-172. Published online May 28, 2021
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DOI: https://doi.org/10.4266/acc.2020.00164.e1
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Corrects: Acute Crit Care 2020;35(4):255
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- Pulmonary
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Utilization of pain and sedation therapy on noninvasive mechanical ventilation in Korean intensive care units: a multi-center prospective observational study
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Taehee Kim, Jung Soo Kim, Eun Young Choi, Youjin Chang, Won-Il Choi, Jae-Joon Hwang, Jae Young Moon, Kwangha Lee, Sei Won Kim, Hyung Koo Kang, Yun Su Sim, Tai Sun Park, Seung Yong Park, Sunghoon Park, Jae Hwa Cho
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Acute Crit Care. 2020;35(4):255-262. Published online November 9, 2020
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DOI: https://doi.org/10.4266/acc.2020.00164
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Correction in: Acute Crit Care 2021;36(2):172
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Abstract
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- Background
The use of sedative drugs may be an important therapeutic intervention during noninvasive ventilation (NIV) in intensive care units (ICUs). The purpose of this study was to assess the current application of analgosedation in NIV and its impact on clinical outcomes in Korean ICUs.
Methods Twenty Korean ICUs participated in the study, and data was collected on NIV use during the period between June 2017 and February 2018. Demographic data from all adult patients, NIV clinical parameters, and hospital mortality were included.
Results A total of 155 patients treated with NIV in the ICUs were included, of whom 26 received pain and sedation therapy (sedation group) and 129 did not (control group). The primary cause of ICU admission was due to acute exacerbation of obstructed lung disease (45.7%) in the control group and pneumonia treatment (53.8%) in the sedation group. In addition, causes of NIV application included acute hypercapnic respiratory failure in the control group (62.8%) and post-extubation respiratory failure in the sedation group (57.7%). Arterial partial pressure of carbon dioxide (PaCO2) levels before and after 2 hours of NIV treatment were significantly decreased in both groups: from 61.9±23.8 mm Hg to 54.9±17.6 mm Hg in the control group (P<0.001) and from 54.9±15.1 mm Hg to 51.1±15.1 mm Hg in the sedation group (P=0.048). No significant differences were observed in the success rate of NIV weaning, complications, length of ICU stay, ICU survival rate, or hospital survival rate between the groups.
Conclusions In NIV patients, analgosedation therapy may have no harmful effects on complications, NIV weaning success, and mortality compared to the control group. Therefore, sedation during NIV may not be unsafe and can be used in patients for pain control when indicated.
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Citations
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- Sedation and analgesia strategies for non-invasive mechanical ventilation: A systematic review and meta-analysis
Baolu Yang, Leyi Gao, Zhaohui Tong Heart & Lung.2024; 63: 42. CrossRef - Effect of Music Therapy and Sound Isolation on the Comfort of Mechanically Ventilated Patients
Sinem Çalışkan, Esra Akın, Mehmet Uyar Turkish Journal of Intensive Care.2024; 22(1): 83. CrossRef - 2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit
Yijun Seo, Hak-Jae Lee, Eun Jin Ha, Tae Sun Ha Acute and Critical Care.2022; 37(1): 1. CrossRef - Comfort During Non-invasive Ventilation
Gianmaria Cammarota, Rachele Simonte, Edoardo De Robertis Frontiers in Medicine.2022;[Epub] 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 - Treatment of acute respiratory failure: noninvasive mechanical ventilation
Sunghoon Park Journal of the Korean Medical Association.2022; 65(3): 144. CrossRef - Dexmedetomidine-Induced Aortic Contraction Involves Transactivation of the Epidermal Growth Factor Receptor in Rats
Soo Hee Lee, Seong-Chun Kwon, Seong-Ho Ok, Seung Hyun Ahn, Sung Il Bae, Ji-Yoon Kim, Yeran Hwang, Kyeong-Eon Park, Mingu Kim, Ju-Tae Sohn International Journal of Molecular Sciences.2022; 23(8): 4320. CrossRef
- Neurology
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Prevention and management of delirium in critically ill adult patients in the intensive care unit: a review based on the 2018 PADIS guidelines
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Seung Yong Park, Heung Bum Lee
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Acute Crit Care. 2019;34(2):117-125. Published online April 17, 2019
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DOI: https://doi.org/10.4266/acc.2019.00451
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21,416
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- Delirium is an acute, confusional state characterized by altered consciousness and a reduced ability to focus, sustain, or shift attention. It is associated with a number of complex underlying medical conditions and can be difficult to recognize. Many critically ill patients (e.g., up to 80% of patients in the intensive care unit [ICU]) experience delirium due to underlying medical or surgical health problems, recent surgical or other invasive procedures, medications, or various noxious stimuli (e.g., underlying psychological stressors, mechanical ventilation, noise, light, patient care interactions, and drug-induced sleep disruption or deprivation). Delirium is associated with a longer duration of mechanical ventilation and ICU admittance as well as an increased risk of death, disability, and long-term cognitive dysfunction. Therefore, the early recognition of delirium is important and ICU medical staff should devote careful attention to both watching for the occurrence of delirium and its prevention and management. This review presents a brief overview of delirium and an update of the literature with reference to the 2018 Society of Critical Care Medicine Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU.
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Rongrong Guo, Shan Zhang, Saiying Yu, Xiangyu Li, Xinju Liu, Yanling Shen, Jinling Wei, Ying Wu International Journal of Nursing Studies.2023; 147: 104582. CrossRef - Motion Detectors as Additional Monitoring Devices in the Intensive Care Unit—A Proof-of-Concept Study
Gülmisal Güder, Eva von Rein, Thomas Flohr, Dirk Weismann, Dominik Schmitt, Stefan Störk, Stefan Frantz, Vincent Kratzer, Christian Kendi Applied Sciences.2023; 13(16): 9319. CrossRef - Analytical Review of Unplanned Extubation in Intensive Care Units and Recommendation on Multidisciplinary Preventive Approaches
Antonious Anis, Ravi Patel, Maged A Tanios Journal of Intensive Care Medicine.2023;[Epub] CrossRef - The risk factors of postoperative cognitive dysfunction in patients undergoing carotid endarterectomy: an updated meta-analysis
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- Infection/Pharmacology
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Clinical Effectiveness and Nephrotoxicity of Aerosolized Colistin Treatment in Multidrug-Resistant Gram-Negative Pneumonia
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Seung Yong Park, Mi Seon Park, Chi Ryang Chung, Ju Sin Kim, Seoung Ju Park, Heung Bum Lee
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Korean J Crit Care Med. 2016;31(3):208-220. Published online August 30, 2016
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DOI: https://doi.org/10.4266/kjccm.2016.00129
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Abstract
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- Background
Colistin (polymyxin E) is active against multidrug-resistant Gram-negative bacteria (MDR-GNB). However, the effectiveness of inhaled colistin is unclear. This study was designed to assess the effectiveness and safety of aerosolized colistin for the treatment of ventilator-associated pneumonia (VAP) caused by MDR-GNB.
Methods In this retrospective longitudinal study, we evaluated the medical records of 63 patients who received aerosolized colistin treatment for VAP caused by MDR-GNB in the medical intensive care unit (MICU) from February 2012 to March 2014.
Results A total of 25 patients with VAP caused by MDR-GNB were included in this study. The negative conversion rate was 84.6% after treatment, and acute kidney injury (AKI) occurred in 11 patients (44%, AKI group). The average length of MICU stay and colistin treatment- related factors, such as daily and total cumulative doses and administration period, were not significantly different between groups. In-hospital mortality tended to be higher in the AKI group (p = 0.07). Multivariate analysis showed that a body mass index less than 18 was an independent risk factor of mortality (odds ratio [OR] = 21.95, 95% confidence interval [CI] 1.59-302.23; p = 0.02). Notably, AKI occurrence was closely related to the administration of more than two nephrotoxic drugs combined with aerosolized colistin (OR = 15.03, 95% CI 1.40-161.76; p = 0.025) and septic shock (OR = 8.10, 95% CI 1.40-161.76; p = 0.04).
Conclusions The use of adjunctive aerosolized colistin treatment appears to be a relatively safe and effective option for the treatment of VAP caused by MDR-GNB. However, more research on the concomitant use of nephrotoxic drugs with aerosolized colistin will be necessary, as this can be an important risk factor of development of AKI.
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Citations
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- Co-Administration of High-Dose Nebulized Colistin for Acinetobacter baumannii Bacteremic Ventilator-Associated Pneumonia: Impact on Outcomes
Ioannis Andrianopoulos, Nikolaos Kazakos, Nikolaos Lagos, Theodora Maniatopoulou, Athanasios Papathanasiou, Georgios Papathanakos, Despoina Koulenti, Eleni Toli, Konstantina Gartzonika, Vasilios Koulouras Antibiotics.2024; 13(2): 169. CrossRef - Aerosolized antibiotics in the treatment of hospital-acquired pneumonia/ventilator-associated pneumonia
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Hye Jin Ahn, Yoo Jin Jung, Jae Song Kim, Soo Hyun Kim, Eun Sun Son Korean Journal of Clinical Pharmacy.2017; 27(2): 92. CrossRef
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