- Pulmonary
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Effects of high-flow nasal cannula in patients with mild to moderate hypercapnia: a prospective observational study
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Kyung Hun Nam, Hyung Koo Kang, Sung-Soon Lee, So-Hee Park, Sung Wook Kang, Jea Jun Hwang, So Young Park, Won Young Kim, Hee Jung Suh, Eun Young Kim, Ga Jin Seo, Younsuck Koh, Sang-Bum Hong, Jin Won Huh, Chae-Man Lim
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Acute Crit Care. 2021;36(3):249-255. Published online July 26, 2021
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DOI: https://doi.org/10.4266/acc.2020.01102
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Abstract
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- Background
Evidence for using high-flow nasal cannula (HFNC) in hypercapnia is still limited. Most of the clinical studies had been conducted retrospectively, and there had been conflicting reports for the effects of HFNC on hypercapnia correction in prospective studies. Therefore, more evidence is needed to understand the effect of the HFNC in hypercapnia.
Methods We conducted a multicenter prospective observational study after applying HFNC to 45 hospitalized subjects who had moderate hypercapnia (arterial partial pressure of carbon dioxide [PaCO2], 43–70 mm Hg) without severe respiratory acidosis (pH <7.30). The primary outcome was a change in PaCO2 level in the first 24 hours of HFNC use. The secondary outcomes were changes in other parameters of arterial blood gas analysis, changes in respiration rates, and clinical outcomes.
Results There was a significant decrease in PaCO2 in the first hour of HFNC application (-3.80 mm Hg; 95% confidence interval, -6.35 to -1.24; P<0.001). Reduction of PaCO2 was more prominent in subjects who did not have underlying obstructive lung disease. There was a correction in pH, but no significant changes in respiratory rate, bicarbonate, and arterial partial pressure of oxygen/fraction of inspired oxygen ratio. Mechanical ventilation was not required for 93.3% (42/45) of our study population.
Conclusions We suggest that HFNC could be a safe alternative for oxygen delivery in hypercapnia patients who do not need immediate mechanical ventilation. With HFNC oxygenation, correction of hypercapnia could be expected, especially in patients who do not have obstructive lung diseases.
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Citations
Citations to this article as recorded by
- Oxygénothérapie nasale à haut débit et insuffisance respiratoire aiguë hypercapnique
C. Girault, E. Artaud-Macari, G. Jolly, D. Carpentier, A. Cuvelier, G. Béduneau Revue des Maladies Respiratoires.2024;[Epub] CrossRef - Safety and efficacy of high flow nasal canula in patients with mild hypercapnia
Mohammed A. Ibrahim, Magdy Emara, Mohammed Shehta The Egyptian Journal of Bronchology.2023;[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 - High-flow nasal cannula: Evaluation of the perceptions of various performance aspects among Chinese clinical staff and establishment of a multidimensional clinical evaluation system
Ruoxuan Wen, Xingshuo Hu, Tengchen Wei, Kaifei Wang, Zhimei Duan, Zhanqi Zhao, Lixin Xie, Fei Xie Frontiers in Medicine.2022;[Epub] CrossRef - The Application Progress of HFNC in Respiratory Diseases
迪 吴 Advances in Clinical Medicine.2022; 12(11): 10617. CrossRef
- Cardiology
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Acute fulminant myocarditis following influenza vaccination requiring extracorporeal membrane oxygenation
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Youn-Jung Kim, Jun-Il Bae, Seung Mok Ryoo, Won Young Kim
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Acute Crit Care. 2019;34(2):165-169. Published online November 7, 2018
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DOI: https://doi.org/10.4266/acc.2017.00045
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Abstract
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- The inactivated influenza vaccination is generally safe with mostly mild side effects. We report a rare but fatal adverse event following influenza vaccination. A previously healthy 27-yearold woman who received the influenza vaccination 3 days before presenting to the emergency department had rapidly aggravating dyspnea and mental deterioration. She was diagnosed as having acute fulminant myocarditis with refractory cardiogenic shock, which was successfully managed with veno-arterial extracorporeal membrane oxygenation. The cardiac function of the patient recovered in 3 weeks.
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Wen-Hwa Wang, Kai-Che Wei, Yu-Tung Huang, Kuang-Hua Huang, Tung-Han Tsai, Yu-Chia Chang Drugs & Aging.2023; 40(2): 145. CrossRef - Comparison of COVID-19 Vaccine-Associated Myocarditis and Viral Myocarditis Pathology
Kamron Reza Hamedi, Gannett Loftus, Lawson Traylor, Richard Goodwin, Sergio Arce Vaccines.2023; 11(2): 362. CrossRef - Myocarditis and autoimmunity
Akira Matsumori Expert Review of Cardiovascular Therapy.2023; 21(6): 437. CrossRef - Cardiovascular magnetic resonance (CMR) and positron emission tomography (PET) imaging in the diagnosis and follow-up of patients with acute myocarditis and chronic inflammatory cardiomyopathy
Federico Caobelli, Jordi Broncano Cabrero, Nicola Galea, Philip Haaf, Christian Loewe, Julian A. Luetkens, Giuseppe Muscogiuri, Marco Francone The International Journal of Cardiovascular Imaging.2023; 39(11): 2221. CrossRef - Clinical Syndromes Related to SARS-CoV-2 Infection and Vaccination in Pediatric Age: A Narrative Review
Maria Vincenza Mastrolia, Camilla De Cillia, Michela Orlandi, Sarah Abu-Rumeileh, Ilaria Maccora, Valerio Maniscalco, Edoardo Marrani, Ilaria Pagnini, Gabriele Simonini Medicina.2023; 59(11): 2027. CrossRef - Acute Lymphocyte Myocarditis Associated with Influenza Vaccination
Ryo Nakamura, Shin-ichi Ando, Seiya Kato, Toshiaki Kadokami Internal Medicine.2022; 61(15): 2307. CrossRef - Clinically Suspected Myocarditis Temporally Related to COVID-19 Vaccination in Adolescents and Young Adults: Suspected Myocarditis After COVID-19 Vaccination
Dongngan T. Truong, Audrey Dionne, Juan Carlos Muniz, Kimberly E. McHugh, Michael A. Portman, Linda M. Lambert, Deepika Thacker, Matthew D. Elias, Jennifer S. Li, Olga H. Toro-Salazar, Brett R. Anderson, Andrew M. Atz, C. Monique Bohun, M. Jay Campbell, M Circulation.2022; 145(5): 345. CrossRef - Myocarditis following rAd26 and rAd5 vector‐based COVID‐19 vaccine: case report
Farah Naghashzadeh, Shadi Shafaghi, Atosa Dorudinia, Seyed Alireza Naji, Majid Marjani, Ahmad Amin, Arezoo Mohamadifar, Sima Noorali, Babak Sharif Kashani ESC Heart Failure.2022; 9(2): 1483. CrossRef - Myocarditis following COVID-19 vaccination in adolescents and adults: a cumulative experience of 2021
Onyedika J. Ilonze, Maya E. Guglin Heart Failure Reviews.2022; 27(6): 2033. CrossRef - Chest Pain and Suspected Myocarditis Related to COVID-19 Vaccination in Adolescents—A Case Series
Da-Eun Roh, Hyejin Na, Jung-Eun Kwon, Insu Choi, Yeo-Hyang Kim, Hwa-Jin Cho Children.2022; 9(5): 693. CrossRef - Cardiac Adverse Events after Vaccination—A Systematic Review
Kanak Parmar, Sai Subramanyam, Gaspar Del Rio-Pertuz, Pooja Sethi, Erwin Argueta-Sosa Vaccines.2022; 10(5): 700. CrossRef - A case of myocarditis after COVID-19 vaccination: incidental or consequential?
Leona S. Alizadeh, Vitali Koch, Ibrahim Yel, Leon D. Grünewald, Daniel Mathies, Simon Martin, Thomas J. Vogl, Dominic Rauschning, Christian Booz Heliyon.2022; 8(6): e09537. CrossRef - COVID-19 Vaccination and the Rate of Immune and Autoimmune Adverse Events Following Immunization: Insights From a Narrative Literature Review
Naim Mahroum, Noy Lavine, Aviran Ohayon, Ravend Seida, Abdulkarim Alwani, Mahmoud Alrais, Magdi Zoubi, Nicola Luigi Bragazzi Frontiers in Immunology.2022;[Epub] CrossRef - COVID-19 vaccination and carditis in children and adolescents: a systematic review and meta-analysis
Oscar Hou In Chou, Jonathan Mui, Cheuk To Chung, Danny Radford, Simon Ranjithkumar, Endurance Evbayekha, Ronald Nam, Levent Pay, Danish Iltaf Satti, Sebastian Garcia-Zamora, George Bazoukis, Göksel Çinier, Sharen Lee, Vassilios S. Vassiliou, Tong Liu, Gar Clinical Research in Cardiology.2022; 111(10): 1161. CrossRef - Myopericarditis after vaccination, Vaccine Adverse Event Reporting System (VAERS), 1990–2018
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Melissa Y.Y. Moey, Rahim A. Jiwani, Kotaro Takeda, Karyn Prenshaw, R. Wayne Kreeger, John Inzerillo, Darla K. Liles, C. Bogdan Marcu, Bénédicte Lebrun‐Vignes, D. Lynn Morris, Sivakumar Ardhanari, Joe‐Elie Salem ESC Heart Failure.2021; 8(4): 3360. CrossRef - Myocarditis following COVID-19 vaccination
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- CPR/Resuscitation
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Utility of the early lactate area score as a prognostic marker for septic shock patients in the emergency department
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Gina Yu, Seung Joon Yoo, Sang-Hun Lee, June Sung Kim, Sungmin Jung, Youn-Jung Kim, Won Young Kim, Seung Mok Ryoo
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Acute Crit Care. 2019;34(2):126-132. Published online April 12, 2019
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DOI: https://doi.org/10.4266/acc.2018.00283
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Abstract
PDF
- Background
The current Surviving Sepsis Campaign guidelines recommend the remeasurement of lactate levels if the initial lactate level is elevated; however, the prognostic value of lactate kinetics is limited and inconsistent. We attempted to determine the efficacy of the lactate area score (calculated from repeated lactate measurements during initial resuscitation) as a prognostic marker of septic shock in the emergency department (ED).
Methods We performed a retrospective study of adult patients with septic shock in the ED of a single tertiary medical center. Serial lactate levels were measured five times within 12 hours. We also compared the initial lactate level, maximum lactate level, and lactate area score. The lactate area score was defined as the sum of the area under the curve measured at 2, 4, 6, and 12 hours following the initial measurement.
Results A total of 362 patients were enrolled in this study, and the overall 28-day mortality was 31.8%. The lactate area score of serial lactate levels as well as the initial (median [interquartile range], 4.9 [3.4 to 10.5]; P=0.003) and maximum (7.3 [4.2 to 13.2]; P<0.001) lactate levels were significantly higher in the non-survivor group. However, in multivariate analysis, only the lactate area score (odds ratio, 1.013; 95% confidence interval, 1.007 to 1.019) was significantly associated with 28-day mortality.
Conclusions The early lactate area score may be a possible prognostic marker for predicting the 28-day mortality of adult septic shock patients. Further prospective interventional studies should be conducted to validate our results.
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Yue Wu, Nannan Huang, Tienan Sun, Biyang Zhang, Shiyu Zhang, Pengyu Zhang, Chunxia Zhang International Journal of Cardiology.2023; : 131658. CrossRef - Increased normalized lactate load is associated with higher mortality in both sepsis and non-sepsis patients: an analysis of the MIMIC-IV database
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- Infection
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Relationship between low hemoglobin levels and mortality in patients with septic shock
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Sung Min Jung, Youn-Jung Kim, Seung Mok Ryoo, Won Young Kim
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Acute Crit Care. 2019;34(2):141-147. Published online May 31, 2019
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DOI: https://doi.org/10.4266/acc.2019.00465
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Abstract
PDFSupplementary Material
- Background
Hemoglobin levels are a critical parameter for oxygen delivery in patients with shock. On comparing target hemoglobin levels upon transfusion initiation, the correlation between the severity of decrease in hemoglobin levels and patient outcomes remains unclear. We evaluated the association between initial hemoglobin levels and mortality in patients with septic shock treated with protocol-driven resuscitation bundle therapy at an emergency department.
Methods Data of adult patients diagnosed with septic shock between June 2012 and December 2016 were extracted from a prospectively compiled septic shock registry at a single academic medical center. Patients were classified into four groups according to initial hemoglobin levels: ≥9.0 g/dl, 8.0−8.9 g/dl, 7.0−7.9 g/dl, and <7.0 g/dl. The primary endpoint was 90-day mortality.
Results In total, 2,265 patients (male, 58.3%; median age, 70.0 years [interquartile range, 60 to 78 years]) with septic shock were included. For the four groups, 90-day mortality rates were as follows: 29.1%, 43.0%, 46.5%, and 46.9% for ≥9.0 g/dl (n=1,808), 8.0−8.9 g/dl (n=217), 7.0−7.9 g/dl (n=135), and <7.0 g/dl (n=105), respectively (P<0.001). Multivariate logistic regression showed that initial hemoglobin levels were an independent factor associated with 90-day mortality and mortality proportionally increased with decreasing hemoglobin levels (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.36 to 2.61 for 8.0−8.9 g/dl; OR, 1.97; 95% CI, 1.31 to 2.95 for 7.0–7.9 g/dl; and OR, 2.35; 95% CI, 1.52 to 3.63 for <7.0 g/dl).
Conclusions Low hemoglobin levels (<9.0 g/dl) were observed in approximately 20% of patients with septic shock, and the severity of decrease in these levels correlated with mortality.
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- Basic science and research
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Anti-inflammatory Role of Mesenchymal Stem Cells in an Acute Lung Injury Mouse Model
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Jin Won Huh, Won Young Kim, Yun Young Park, Chae-Man Lim, Younsuck Koh, Mi-Jung Kim, Sang-Bum Hong
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Acute Crit Care. 2018;33(3):154-161. Published online August 31, 2018
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DOI: https://doi.org/10.4266/acc.2018.00619
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Abstract
PDFSupplementary Material
- Background
Mesenchymal stem cells (MSCs) attenuate injury in various lung injury models through paracrine effects. We hypothesized that intratracheal transplantation of allogenic MSCs could attenuate lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice, mediated by anti-inflammatory responses.
Methods Six-week-old male mice were randomized to either the control or the ALI group. ALI was induced by intratracheal LPS instillation. Four hours after LPS instillation, MSCs or phosphate-buffered saline was randomly intratracheally administered. Neutrophil count and protein concentration in bronchoalveolar lavage fluid (BALF); lung histology; levels of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and macrophage inflammatory protein-2; and the expression of proliferation cell nuclear antigen (PCNA), caspase-3, and caspase-9 were evaluated at 48 hours after injury.
Results Treatment with MSCs attenuated lung injury in ALI mice by decreasing protein level and neutrophil recruitment into the BALF and improving the histologic change. MSCs also decreased the protein levels of proinflammatory cytokines including IL-1β, IL-6, and TNF-α, but had little effect on the protein expression of PCNA, caspase-3, and caspase-9.
Conclusions Intratracheal injection of bone marrow-derived allogenic MSCs attenuates LPSinduced ALI via immunomodulatory effects.
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Youngheon Park, Jimin Jang, Jooyeon Lee, Hyosin Baek, Jaehyun Park, Sang-Ryul Cha, Se Bi Lee, Sunghun Na, Jae-Woo Kwon, Seok-Ho Hong, Se-Ran Yang International Journal of Stem Cells.2023; 16(2): 191. CrossRef - Mesenchymal stem cells and their derived exosomes to combat Covid–19
Maryam Yousefi Dehbidi, Nima Goodarzi, Mohammad H. Azhdari, Mohammad Doroudian Reviews in Medical Virology.2022;[Epub] CrossRef - Stem Cell‐based therapies for COVID‐19‐related acute respiratory distress syndrome
Hoi Wa Ngai, Dae Hong Kim, Mohamed Hammad, Margarita Gutova, Karen Aboody, Christopher D. Cox Journal of Cellular and Molecular Medicine.2022; 26(9): 2483. CrossRef - Development of a physiomimetic model of acute respiratory distress syndrome by using ECM hydrogels and organ-on-a-chip devices
Esther Marhuenda, Alvaro Villarino, Maria Narciso, Linda Elowsson, Isaac Almendros, Gunilla Westergren-Thorsson, Ramon Farré, Núria Gavara, Jorge Otero Frontiers in Pharmacology.2022;[Epub] CrossRef - Advances in mesenchymal stromal cell therapy for acute lung injury/acute respiratory distress syndrome
Chang Liu, Kun Xiao, Lixin Xie Frontiers in Cell and Developmental Biology.2022;[Epub] CrossRef - Auxiliary role of mesenchymal stem cells as regenerative medicine soldiers to attenuate inflammatory processes of severe acute respiratory infections caused by COVID-19
Peyvand Parhizkar Roudsari, Sepideh Alavi-Moghadam, Moloud Payab, Forough Azam Sayahpour, Hamid Reza Aghayan, Parisa Goodarzi, Fereshteh Mohamadi-jahani, Bagher Larijani, Babak Arjmand Cell and Tissue Banking.2020; 21(3): 405. CrossRef - The Role of MSC Therapy in Attenuating the Damaging Effects of the Cytokine Storm Induced by COVID-19 on the Heart and Cardiovascular System
Georgina M. Ellison-Hughes, Liam Colley, Katie A. O'Brien, Kirsty A. Roberts, Thomas A. Agbaedeng, Mark D. Ross Frontiers in Cardiovascular Medicine.2020;[Epub] CrossRef
- CPR/Resuscitation
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APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management
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Sang-Il Kim, Youn-Jung Kim, You-Jin Lee, Seung Mok Ryoo, Chang Hwan Sohn, Dong Woo Seo, Yoon-Seon Lee, Jae Ho Lee, Kyoung Soo Lim, Won Young Kim
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Acute Crit Care. 2018;33(2):83-88. Published online May 31, 2018
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DOI: https://doi.org/10.4266/acc.2017.00514
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Abstract
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- Background
This study assessed the association between the initial Acute Physiology and Chronic Health Evaluation (APACHE) II score and good neurological outcome in comatose survivors of out-of-hospital cardiac arrest who received targeted temperature management (TTM).
Methods Data from survivors of cardiac arrest who received TTM between January 2011 and June 2016 were retrospectively analyzed. The initial APACHE II score was determined using the data immediately collected after return of spontaneous circulation rather than within 24 hours after being admitted to the intensive care unit. Good neurological outcome, defined as Cerebral Performance Category 1 or 2 on day 28, was the primary outcome of this study.
Results Among 143 survivors of cardiac arrest who received TTM, 62 (43.4%) survived, and 34 (23.8%) exhibited good neurological outcome on day 28. The initial APACHE II score was significantly lower in the patients with good neurological outcome than in those with poor neurological outcome (23.71 ± 4.39 vs. 27.62 ± 6.16, P = 0.001). The predictive ability of the initial APACHE II score for good neurological outcome, assessed using the area under the receiver operating characteristic curve, was 0.697 (95% confidence interval [CI], 0.599 to 0.795; P = 0.001). The initial APACHE II score was associated with good neurological outcome after adjusting for confounders (odds ratio, 0.878; 95% CI, 0.792 to 0.974; P = 0.014).
Conclusions In the present study, the APACHE II score calculated in the immediate post-cardiac arrest period was associated with good neurological outcome. The initial APACHE II score might be useful for early identification of good neurological outcome.
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Citations
Citations to this article as recorded by
- Prediction performance of scoring systems after out-of-hospital cardiac arrest: A systematic review and meta-analysis
Boldizsár Kiss, Rita Nagy, Tamás Kói, Andrea Harnos, István Ferenc Édes, Pál Ábrahám, Henriette Mészáros, Péter Hegyi, Endre Zima, Jignesh K. Patel PLOS ONE.2024; 19(2): e0293704. CrossRef - Predicting the survivals and favorable neurologic outcomes after targeted temperature management by artificial neural networks
Wei-Ting Chiu, Chen-Chih Chung, Chien-Hua Huang, Yu-san Chien, Chih-Hsin Hsu, Cheng-Hsueh Wu, Chen-Hsu Wang, Hung-Wen Chiu, Lung Chan Journal of the Formosan Medical Association.2022; 121(2): 490. CrossRef - Artificial neural network-boosted Cardiac Arrest Survival Post-Resuscitation In-hospital (CASPRI) score accurately predicts outcome in cardiac arrest patients treated with targeted temperature management
Szu-Yi Chou, Oluwaseun Adebayo Bamodu, Wei-Ting Chiu, Chien-Tai Hong, Lung Chan, Chen-Chih Chung Scientific Reports.2022;[Epub] CrossRef - Novel Approaches to Risk Stratification of In-Hospital Cardiac Arrest
Jason J. Yang, Xiao Hu, Noel G. Boyle, Duc H. Do Current Cardiovascular Risk Reports.2021;[Epub] CrossRef
- Infection/Hematology
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The Prevalence and Significance of Overt Disseminated Intravascular Coagulation in Patients with Septic Shock in the Emergency Department According to the Third International Consensus Definition
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Byuk Sung Ko, Hyun Young Cho, Seung Mok Ryoo, Myung Chun Kim, Woong Jung, Sung Hyuk Park, Chang Min Lee, Won Young Kim
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Korean J Crit Care Med. 2016;31(4):334-341. Published online November 30, 2016
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DOI: https://doi.org/10.4266/kjccm.2016.00339
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9,657
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- Background
The prevalence and prognostic value of overt disseminated intravascular coagulation (DIC) in patients with septic shock presenting to emergency departments (EDs) is poorly understood, particularly following the release of a new definition of septic shock. The purpose of this study was to investigate the prevalence and prognostic value of DIC in septic shock.
Methods We performed retrospective review of 391 consecutive patients with septic shock admitting to the ED of tertiary care, university-affiliated hospital during a 16-month. Septic shock was defined as fluid-unresponsive hypotension requiring vasopressor to maintain a mean arterial pressure of 65 mmHg or greater, and serum lactate level ≥ 2 mmol/L. Overt DIC was defined as an International Society on Thrombosis and Hemostasis (ISTH) score ≥ 5 points. The primary endpoint was 28-day mortality.
Results Of 391 patients with septic shock, 290 were included in the present study. The mean age was 65.6 years, the 28-day mortality rate was 26.9%, and the prevalence of overt DIC was 17.6% (n = 51) according to the ISTH score. The median DIC score was higher in non-survivors than in survivors (5.0 vs. 2.0, p = 0.001). Significant higher risk of mortality was observed in overt DIC patients compared to those without (28.2% vs. 13.7%, p = 0.005). Multivariable logistic regression analysis identified DIC to be independently associated with 28-day mortality (odds ratio, 2.689 [95% confidence interval, 1.390-5.201]).
Conclusions Using the ISTH criteria of DIC, overt DIC in septic shock was found to be common among patients admitting to the ED and to be associated with higher mortality when it is accompanied with septic shock. Efforts are required to identify presence of overt DIC during the initial treatment of septic shock in patients presenting the the ED.
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Sang-Min Kim, Sang-Il Kim, Gina Yu, Youn-Jung Kim, Won Young Kim Shock.2022; 57(2): 168. CrossRef - Dysregulated haemostasis in thrombo-inflammatory disease
Paula A. Klavina, Gemma Leon, Annie M. Curtis, Roger J.S. Preston Clinical Science.2022; 136(24): 1809. CrossRef - Disseminated Intravascular Coagulopathy in Critically Ill Patients in Amman, Jordan
Eman Mahmoud Qasim Emleek, Amani Anwar Khalil Biological Research For Nursing.2021; 23(4): 689. CrossRef - Features of Development and Course of Disseminated Intravascular Coagulation Syndrome During Surgical Interventions in Children with Oncological Diseases
N. P. Leonov, V. V. Schukin, G. A. Novichkova, M. A. Maschan, F. I. Ataullakhanov, S. S. Yashin, A. M. Zeynalov, Е. A. Spiridonova General Reanimatology.2020; 16(3): 54. CrossRef - Relationship between low hemoglobin levels and mortality in patients with septic shock
Sung Min Jung, Youn-Jung Kim, Seung Mok Ryoo, Won Young Kim Acute and Critical Care.2019; 34(2): 141. CrossRef
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