Skip Navigation
Skip to contents

ACC : Acute and Critical Care

OPEN ACCESS
SEARCH
Search

Previous issues

Page Path
HOME > Issue > Previous issues
11 Previous issues
Filter
Filter
Article category
Keywords
Authors
Volume 25 (1); March 2010
Prev issue Next issue
Reviews
Inflammation and Sepsis
Ji Young Yoon, Jae Young Kwon
Korean J Crit Care Med. 2010;25(1):1-8.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.1
  • 2,382 View
  • 78 Download
  • 4 Citations
AbstractAbstract PDF
Despite the development of modern intensive care and new antimicrobial agents, the mortality of the patients with severe sepsis and septic shock remains high. The poor outcome is considered to be a consequence of an overactive systemic inflammatory response. Sepsis is now defined as systemic inflammatory response syndrome (SIRS) in which there is an identifiable focus of infection. As a consequence of the overactive SIRS response, the function of various organ systems may be compromised, resulting in multiple organ dysfunction syndrome (MODS) and death. Systemic inflammation is a consequence of activation of the innate immune system. It is characterized by intravascular release of pro-inflammatory cytokines and other vasoactive mediators, and the concurrent activation of the innate immune cells. In addition to the pro-inflammatory reactions, the host's anti-inflammatory mechanisms are also activated and aimed at counteracting the inflammatory response. The balance between pro- and anti-inflammatory reactions is critical for the outcome of the patient. Understanding the mechanisms of acute inflammatory responses in critical ill patients is necessary for the development of urgently needed therapeutics. The aim of this review is to provide a description of the key components and mechanisms involved in the inflammatory response in patients with SIRS and sepsis.

Citations

Citations to this article as recorded by  
  • Risk Factors for Unawareness of Obstructive Airflow Limitation among Adults with Chronic Obstructive Pulmonary Disease
    Mirae Jo, Heeyoung Oh
    Journal of Korean Academy of Community Health Nursing.2018; 29(3): 290.     CrossRef
  • The Anti-Inflammatory Effect of Arginine-Vasopressin on Lipopolysaccharide-Induced IκBα/Nuclear Factor-κB Cascade
    Jisoo Park, Eun Young Eo, Kyoung-Hee Lee, Jong Sun Park, Jae-Ho Lee, Chul-Gyu Yoo, Choon-Taek Lee, Young-Jae Cho
    The Korean Journal of Critical Care Medicine.2015; 30(3): 151.     CrossRef
  • Splenic Hemorrhage with Hemoperitoneum Caused by a Snakebite
    Ji Young Yhi, Yoomi Yeo, Ji Yeoun Kim, Il Hwan Oh, Soon Woo Hwang, Sang Ki Lee, Dong Shin Kwak, Ji-Yoon Choi, Jeong Eun Kim, Joon-Sung Park
    Korean Journal of Critical Care Medicine.2013; 28(4): 336.     CrossRef
  • A Case of Systemic Inflammatory Response Syndrome Secondary to an Acute Polyarticular Gout
    Ji Hyun Cheon M.D., Ji Ung Kim M.D., Sun Kwang Kim M.D., Sung Hyun Ko M.D., Jun Ho Jo M.D., Geon Woo Park M.D., Jin Suk Lee M.D., Hyoung Yoel Park M.D.
    Journal of the Korean Geriatrics Society.2012; 16(3): 158.     CrossRef
Mechanisms of Muscle Wasting in Patients with Sepsis
Gi Dong Lee, Ho Cheol Kim
Korean J Crit Care Med. 2010;25(1):9-15.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.9
  • 3,336 View
  • 86 Download
  • 1 Citations
AbstractAbstract PDF
Muscle wasting is commonly seen in patients with sepsis as a consequence of the catabolic response in skeletal muscle. Muscle wasting can occur in cases that have an imbalance between degradation and synthesis of muscle proteins. Although decrements in the synthesis of muscle proteins may contribute to sepsis-induced muscle wasting, it has been recognized that increments in its degradation play a more essential role in muscle wasting. Muscle wasting in sepsis patients has some significant clinical consequences such as reduced ambulation and exercise tolerance, and an increased risk for pulmonary and thromboembolic complications. Several mechanisms have been proposed for sepsis-induced muscle wasting. Increased proteolysis via the ubiquitin-proteasome pathway and the calpains system is one of the principal mechanisms of muscle wasting induced by sepsis. Calpains are activated by calcium, which increases in patients with sepsis. The activation of the calpains system disrupts the sarcomere of the myofibrils, resulting in the release of myofilaments that are subsequently ubiquitinated and degraded by the 26S proteasome complex. Recent studies have suggested that transcriptional factors such as NF-kappaB and FoxO, and the apoptosis and autophagy-lysosome pathways may also be involved in sepsis-induced muscle wasting. This review briefly summarizes the contribution of these mechanisms of muscle wasting in patients with sepsis and the possible therapeutic agents to treat it.

Citations

Citations to this article as recorded by  
  • Role of IL-15 in Sepsis-Induced Skeletal Muscle Atrophy and Proteolysis
    Ho Cheol Kim, Hee-Young Cho, Young-Sool Hah
    Tuberculosis and Respiratory Diseases.2012; 73(6): 312.     CrossRef
Original Articles
A Survey of Patients Who Were Admitted for Life-Sustaining Therapy in Nationwide Medical Institutions
Jong Myon Bae, Joo Young Gong, Jae Ran Lee, Dae Seog Heo, Younsuck Koh
Korean J Crit Care Med. 2010;25(1):16-20.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.16
  • 2,621 View
  • 54 Download
  • 16 Citations
AbstractAbstract PDF
BACKGROUND
The study focused on figuring out the present status and distribution of the underlying diseases of Korean terminally ill patients (TIP) who were on life-support care (LSC) by conducting a nationwide health care survey.
METHODS
The authors of this study requested that the 308 nationwide hospitals that operate intensive care units answer a questionnaire that asked about the number of admitted TIPs and their underlying diseases at 12 Am, 22 July, 2009. The proportion of TIPs among all the admitted patients and the percentages of the TIP's underlying diseases were calculated.
RESULTS
In a total of 83.1% of the eligible hospitals responded, the proportion of TIP was 1.6 of 100 admitted patients. Terminal cancer was the leading underlying disease in the TIPs (42.4%). Five % of the patients on LSC were brain dead. More TIPs were admitted in the national/public or university hospitals than in the private or non-university hospitals.
CONCLUSIONS
Futile treatment seems to be administered to the TIPs in Korean hospitals. The quality of terminal care in Korean hospitals should be improved by the application of socially acceptable LSC guidelines. Timely government health plans, including hospice care, to improve the quality of palliative care should be launched and maintained.

Citations

Citations to this article as recorded by  
  • Attitudes, Perceptions, and Experiences toward End-of-Life Care Decision-Making among Intensive Care Unit Nurses in Korea : An Integrative Review
    JiYeon Choi, Youn-Jung Son, Kyounghoon Lee
    Journal of Korean Critical Care Nursing.2020; 13(1): 27.     CrossRef
  • Transcultural Adaptation and Validation of Quality of Dying and Death Questionnaire in Medical Intensive Care Units in South Korea
    Jun Yeun Cho, Jinwoo Lee, Sang-Min Lee, Ju-Hee Park, Junghyun Kim, Youlim Kim, Sang Hoon Lee, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Yeon Joo Lee
    Acute and Critical Care.2018; 33(2): 95.     CrossRef
  • A literature review on end-of-life care among Korean Americans
    Hye-young K Park, Cristina C Hendrix
    International Journal of Palliative Nursing.2018; 24(9): 452.     CrossRef
  • Attitude, Role Perception and Nursing Stress on Life Sustaining Treatment among Intensive Care Unit Nurses
    Su Jeong Lee, Hye Young Kim
    Korean Journal of Adult Nursing.2017; 29(2): 131.     CrossRef
  • End-of-life communication in Korean older adults: With focus on advance care planning and advance directives
    Dong Wook Shin, Ji Eun Lee, BeLong Cho, Sang Ho Yoo, SangYun Kim, Jun-Hyun Yoo
    Geriatrics & Gerontology International.2016; 16(4): 407.     CrossRef
  • The Current Status of End-of-Life Care in Korea and Legislation of Well-Dying Act
    Ji Eun Lee, Ae Jin Goo, Be Long Cho
    Journal of the Korean Geriatrics Society.2016; 20(2): 65.     CrossRef
  • The Current Status of Medical Decision-Making for Dying Patients in a Medical Intensive Care Unit: A Single-Center Study
    Kyunghwa Shin, Jeong Ha Mok, Sang Hee Lee, Eun Jung Kim, Na Ri Seok, Sun Suk Ryu, Myoung Nam Ha, Kwangha Lee
    Korean Journal of Critical Care Medicine.2014; 29(3): 160.     CrossRef
  • Comparing the Preference for Terminal Care in Nurses and Patients
    Dong Soon Kim, AeYoung So, Kyung-Sook Lee, Jung Sook Choi
    Journal of muscle and joint health.2013; 20(3): 214.     CrossRef
  • Life-Sustaining Medical Treatment for Terminal Patients in Korea
    Dae Seog Heo
    Journal of Korean Medical Science.2013; 28(1): 1.     CrossRef
  • The End-of-Life Care in the Intensive Care Unit
    Jae Young Moon, Yong Sup Shin
    Korean Journal of Critical Care Medicine.2013; 28(3): 163.     CrossRef
  • Factors Affecting Shared Decision Making at End of Life in Korean Adults
    Jo Kae-Hwa, An Gyeong-Ju
    Holistic Nursing Practice.2013; 27(6): 329.     CrossRef
  • On the life-sustaining treatment in Korea
    Yoon-seong Lee
    Journal of the Korean Medical Association.2012; 55(12): 1161.     CrossRef
  • Current status of end-of-life care in Korean hospitals
    Younsuck Koh
    Journal of the Korean Medical Association.2012; 55(12): 1171.     CrossRef
  • Medical Residents' Perception and Emotional Stress on Withdrawing Life-Sustaining Therapy
    Jae Young Moon, Hee Young Lee, Chae-Man Lim, Younsuck Koh
    Korean Journal of Critical Care Medicine.2012; 27(1): 16.     CrossRef
  • Predictive Factor s for City Dweller s’ Attitudes toward Death with Dignity
    Kae Hwa Jo, Gyeong Ju An, Gyun Moo Kim, Yeon Ja Kim
    The Korean Journal of Hospice and Palliative Care.2012; 15(4): 193.     CrossRef
  • Charactersitics and issues of guideline to withdrawal of a life-sustaining therapy
    Younsuck Koh, Dae-Seog Heo, Young Ho Yun, Jeong-Lim Moon, Hyoung Wook Park, Ji Tae Choung, Hyo Sung Jung, Bark Jang Byun, Yoon-Seong Lee
    Journal of the Korean Medical Association.2011; 54(7): 747.     CrossRef
Prognostic Factors and the Effect of Hemoperfusion for Patients with Paraquat Poisoning
Ae Jin Sung, Jae Young Jang
Korean J Crit Care Med. 2010;25(1):21-26.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.21
  • 2,065 View
  • 45 Download
  • 1 Citations
AbstractAbstract PDF
BACKGROUND
Paraquat has been widely used as a non-selective contact herbicide and it may induce damage to many organs. This study aimed to assess the factors that can predict the prognosis of paraquat poisoning and to determine the effect of hemoperfusion.
METHODS
We retrospectively reviewed 132 patients who were poisoned with paraquat from January 2005, to December 2008. The patients were divided into two groups: The first groups included the death and survived groups, and the second groups included the hemoperfusion and non-hemoperfusion groups. We investigated the mortality, the factors that can predictive the prognosis and the effect of hemoperfusion.
RESULTS
There were 79 males and 53 female (mean age: 56.1 +/- 15.1 years). The significant differences between the death and survival groups were the volume of paraquat ingested, the mental status, GCS (Glasgow coma scale), pH, base deficit, HCO3, serum Cr (creatinine), serum AST (aspartate transaminase), serum glucose, K (kalium), urine sodium dithionite test and hemoperfusion. The significant differences between the hemoperfusion and non-hemoperfusion groups were the mortality and the mean survival time. Multivariate regression analysis reveled four predictive factors and their's Odd ratio: 1) urine sodium dithionate test = strong 14.256, 2) hemoperfusion 0.493, 3) Cr > 0.95 mg/kg 31.603 and 4) an amount of ingested paraquat > 45 ml 16.945.
CONCLUSIONS
The predictive factors for mortality were the amount of paraquat ingested > 45 ml, a urine sodium dithionite test = strong and a serum Cr > 0.95 mg/dl. Hemoperfusion couldn't be used a predictive factor for mortality, but it increased the mean survival time.

Citations

Citations to this article as recorded by  
  • Prediction of Mortality in Patients with Acute Paraquat Intoxication Using Simplified Acute Physiology Score II
    Young-yeol You, Younggi Min, Junghwan Ahn, Sang-Cheon Choi, Yeonho Shin, Yoonseok Jung, Eunjung Park
    The Korean Journal of Critical Care Medicine.2011; 26(4): 221.     CrossRef
Case Reports
Effective Management for Incidental Detachment of the Pilot Balloon on the Endotracheal Tube: A Case Report
Hyungsun Lim, Ji Seon Son, Hyun Ho Choi, Deokkyu Kim, Jeong Woo Lee, Seonghoon Ko
Korean J Crit Care Med. 2010;25(1):27-29.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.27
  • 2,022 View
  • 12 Download
AbstractAbstract PDF
A 57-year-old female with lumbar spinal stenosis at L4-S1 was scheduled to undergo posterolateral interbody fusion. Intubation with a 7.0 size ID cuffed reinforced tracheal tube (Mallinckrodt(TM), Mallinckrodt Medical Atholen, Ireland) was uncomplicated, and any air leakage was not detected at that time. Two hours after the start of operation, an air leak was apparent at the trachea during ventilation in the prone position. Closer inspection of the inflation tube and pilot balloon showed that the pilot balloon had become detached. Because she was being operated on in the prone position, and ventilation was only possible at a less than optimal state, we attempted to fix this without having to reintubate the patient's trachea. Our solution involved inserting a 21-gauge needle into the inflation tube and a handheld aneroid manometer was then connected to it. The tube cuff was thereafter inflated up to a pressure of 20 cmH2O. In conclusion, careful manipulation is recommended when performing intubation and a needle connector may help secure the airway if the pilot balloon becomes detached during the procedure.
Diffusion-weighted Imaging of a Patient in a Hypoglycemic Coma: A Case Report
Kwang Wook Jo, Hoon Kim
Korean J Crit Care Med. 2010;25(1):30-32.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.30
  • 1,980 View
  • 9 Download
  • 1 Citations
AbstractAbstract PDF
A 65-year-old woman with type 2 diabetes mellitus was found in an unresponsive state and she was admitted to our hospital. She was comatose on arrival. The bedside blood glucose level on admission was 15 mg/dl (normal range, 55-110 mg/dl). After emergency infusion with 50% dextrose, the blood glucose level rapidly normalized to 98 mg/dl, but there was no clinical improvement of her consciousness. Three days after admission, diffusion-weighted magnetic resonance imaging of the brain revealed bilateral temporal, occipital and frontal lobes lesions with high signal intensity. The patient's neurological condition did not change over the next 15 days. She died of pneumonia on the 30th day of hospitalization. DWI may be useful for detecting and making the differential diagnosis of hypoglycemic coma. Further, marked differences in the neuroimaging patterns of patients in a hypoglycemic coma are valuable prognostic predictors. We report here on a case of hypoglycemic coma with a poor outcome.

Citations

Citations to this article as recorded by  
  • Consideration of Prognostic Factors in Hypoglycemic Encephalopathy
    Ik-Kwon Seo, Woo-Ik Choi, Sang-Chan Jin, Hyuk-Won Chang
    Korean Journal of Critical Care Medicine.2012; 27(4): 209.     CrossRef
Multiple Organ Dysfunction Syndrome and Quadriplegia due to Acute Methamphetamine Intoxication: A Case Report
Oh Young Kwon, Jong Seok Lee, Han Sung Choi, Hoon Pyo Hong, Young Gwan Ko
Korean J Crit Care Med. 2010;25(1):33-36.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.33
  • 2,120 View
  • 16 Download
AbstractAbstract PDF
Methamphetamine (MA) is an extremely addictive central nervous system stimulant. MA abuse has increased during the past three decades in Korea because it is cheap relatively and easily produced. Acute toxicity can occur via nasal insufflation, intravenous administration and ingestion of liquid formulations. The clinical manifestations include hypertension, tachycardia, hyperthermia, an altered mentality and seizure. Severe complications can occur such as pulmonary edema, rhabdomyolysis, disseminated intravascular coagulation and multiple organ dysfunction syndrome. This case report describes a previously healthy 40-year-old woman who presented to an emergency department with complaints of hyperthermia, an altered mentality and vomiting. This patient was diagnosed as acute MA intoxication by urine toxicology screening, and she showed a variety of clinical manifestations and complications. Physicians should suspect MA intoxication if a patient shows an unknown fever, an altered mentality and hypertension, and they should carefully manage these patients in the ICU.
A Case of Prolonged Extracorporeal Membrane Oxygenation Support for Severe Acute Respiratory Distress Syndrome: A Case Report
Byung Hoon Park, Joon Chang, Se Kyu Kim, Young Ae Kang, Ji Young Son, Kyung Jong Lee, Yoe Wun Yoon, Ji Ae Jung, Sak Lee, Moo Suk Park
Korean J Crit Care Med. 2010;25(1):37-42.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.37
  • 2,668 View
  • 25 Download
  • 3 Citations
AbstractAbstract PDF
When all the conventional treatments have failed for patients with acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) can offer these patients a chance to survive. We report here on a case of successful treatment with prolonged ECMO support for a patient with severe ARDS. A 41-year-old female patient with acute A-viral hepatitis developed pneumonia and progressive ARDS. After tracheostomy, her clinical condition deteriorated despite proper antibiotic administration and other conventional treatments, including the recruitment maneuver and steroid use. Venoarterial ECMO was given for the management of refractory hypoxemia that developed 14 days after the initiation of mechanical ventilation. The duration of ECMO support was 4 weeks, and she was successfully weaned off ECMO and mechanical ventilation.

Citations

Citations to this article as recorded by  
  • Early Extracorporeal Membrane Oxygenation for Massive Aspiration during Anesthesia Induction
    Namo Kim, Kwan Hyung Kim, Jeong Min Kim, Su Youn Choi, Sungwon Na
    The Korean Journal of Critical Care Medicine.2015; 30(2): 109.     CrossRef
  • Massive Diffuse Alveolar Hemorrhage Caused by the Aspiration of Gastric Contents during Induction of Anesthesia in Patients with Adhesive Ileus - A Case Report -
    Ji Seon Jeong, Jong Hun Jun, Hyo Jin Song, Hee Koo Yoo
    Korean Journal of Critical Care Medicine.2012; 27(2): 115.     CrossRef
  • Extracorporeal Membrane Oxygenation as a Bridge to Definitive Airway Security in 3 Severe Acute Extrinsic Airway Compression Patients - A Case Report -
    Jiwon Lyu, Jin Won Huh, Chae Man Lim, Youn Suck Koh, Sang Bum Hong
    The Korean Journal of Critical Care Medicine.2011; 26(1): 29.     CrossRef
A Case of Peripheral T Cell Lymphoma Presenting as Severe Hypoxic Respiratory Failure: A Case Report
Joon Seok Choi, Hong Joon Shin, Eun Young Kim, In Jae Oh, Kyu Sik Kim, Yu Il Kim, Sung Chul Lim, Young Chul Kim, Yoo Duk Choi, Hyun Ju Seon, Yong Soo Kwon
Korean J Crit Care Med. 2010;25(1):43-47.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.43
  • 2,165 View
  • 29 Download
AbstractAbstract PDF
We describe here the first known case in Korea of pulmonary involvement with peripheral T cell lymphoma and the patient presented with severe hypoxic respiratory failure. A 57-yr-old man was admitted to our hospital with rapid progression of dyspnea and bilateral diffuse infiltration on a chest radiograph. He received mechanical ventilation and low dose corticosteroid treatment under the suspicion of critical illness-related corticosteroid insufficiency. Transbronchial lung biopsy revealed large atypical lymphoid cells with positivity for CD3+. We diagnosed this patient as having a peripheral T cell lymphoma and we treated him with high dose corticosteroid. His clinical and radiologic findings rapidly improved and then he received a full dose of chemotherapy for the peripheral T cell lymphoma.
Bronchospasm during Minimally Invasive Cardiac Surgery in a Patient with a Mosaic Attenuation Pattern on Lung Computed Tomography: A Case Report
Eun Soo Kim, Hyeon Jeong Lee, Sung Chun Park, Hee Young Kim, Hyung Gon Je, Jung Min Hong
Korean J Crit Care Med. 2010;25(1):48-51.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.48
  • 1,950 View
  • 11 Download
  • 1 Citations
AbstractAbstract PDF
Severe bronchospasm during cardiac surgery is an uncommon, but serious problem. A 52-year-old woman with a mosaic attenuation pattern on the whole lung field was scheduled for repair of an atrial septal defect under minimally invasive cardiac surgery. Bronchospasm developed intraoperatively, but the underlying ventilatory impairment, poor performance of one-lung ventilation and initiation of cardiopulmonary bypass delayed diagnosing and treating the bronchospasm. The bronchospasm induced severe pulmonary edema that required postoperative ventilatory care.

Citations

Citations to this article as recorded by  
  • Pulmonary Edema in Severe Bronchospasm
    Charles Her
    The Korean Journal of Critical Care Medicine.2010; 25(3): 203.     CrossRef
The Care of a Jehovah's Witness with Life-threatening Anemia Refusing Ventilator Care: A Case Report
Ji Hyeon Lee, So Ron Choi, Young Jhoon Chin, Soo Il Lee, Chan Jong Chung, Jong Hwan Lee, Seung Cheol Lee
Korean J Crit Care Med. 2010;25(1):52-55.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.52
  • 2,192 View
  • 24 Download
AbstractAbstract PDF
Jehovah's Witnesses refuse the transfusion of blood and blood products, even when it can be lifesaving. Their religious conviction against receiving blood can create a difficult clinical dilemma, particularly in the life threatening situations. We report a case of a 42-year-old female Jehovah's Witness patient who had life-threatening anemia after postpartum hemorrhage. Despite severe anemia, she had a good postoperative recovery without complications.

ACC : Acute and Critical Care