- 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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Citations
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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
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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
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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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- 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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Ariadna Schuck, Minhee Kang, Yong-Sang Kim Journal of Electrical Engineering & Technology.2024; 19(5): 3309. CrossRef - Role of lactate level in predicting admission need to intensive care unit and short term outcomes in patients with acute gastrointestinal bleeding
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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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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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- 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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- 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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