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Volume 30 (4); November 2015
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Editorial
Infection
Sepsis in Immunocompromised Patients: Current Status in Korea
Kwangha Lee
Korean J Crit Care Med. 2015;30(4):239-240.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.239
  • 5,254 View
  • 114 Download
AbstractAbstract PDF
No abstract available.
Original Articles
Infection
Experience with Elizabethkingia meningoseptica Infection in Adult Patients at a Tertiary Hospital
Hyun Don Joo, Sun Young Ann, Sung Hyeok Ryou, Youn Seup Kim, Jong Wan Kim, Doh Hyung Kim
Korean J Crit Care Med. 2015;30(4):241-248.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.241
  • 9,612 View
  • 206 Download
  • 1 Crossref
AbstractAbstract PDF
Background
Few reports have documented the clinical characteristics and treatment outcomes of adult patients with Elizabethkingia meningoseptica infection.
Methods
Medical records of patients over 18 years of age and suspected of having an E. meningoseptica infection from March 1, 2006 to February 28, 2013 were reviewed retrospectively. Their clinical characteristics, antimicrobial susceptibility results, and treatment outcomes were analyzed.
Results
E. meningoseptica was isolated from 30 patients. Median age was 68.5 years, and infections were more frequent in males (17, 56.7%). The most common isolation source was sputum (23, 76.7%), and pneumonia was the most common condition (21, 70%) after excluding two cases of colonization. This bacterium was most susceptible to minocycline (27, 90%) and fluoroquinolones, including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%). The mortality rate due directly to E. meningoseptica infection was 20% (6/30), and uncontrolled pneumonia was the only cause of death. After isolating E. meningoseptica, the numbers of patients with pneumonia (9/9, 100% vs. 12/21, 57.1%), history of hemodialysis (5/9, 55.6% vs. 3/21, 14.3%), tracheostomy (8/9, 88.9 vs. 10/21, 47.6%), and median Charlson comorbidity index score (6 [range, 3–9] vs. 4 [range, 0–9]) were significantly higher in non-survivors than those in survivors (p < 0.05, for each). However, only 12 (40%) patients received appropriate antibiotics.
Conclusions
E. meningoseptica infection most commonly presented as pneumonia in adults with severe underlying diseases. Despite the high mortality rate, the rate of appropriate antibiotic use was notably low.

Citations

Citations to this article as recorded by  
  • Elizabethkingia meningosepticum Isolated from Pleural Fluid: A Diagnostic Dilemma
    Abha Sharma, Shweta Gupta, Tanisha Bharara, Shalini Dewan Duggal, Pragnya Paramita Jena, Renu Gur
    The Indian Journal of Chest Diseases and Allied Sciences.2022; 61(2): 91.     CrossRef
Infection
Sepsis in Patients Receiving Immunosuppressive Drugs in Korea: Analysis of the National Insurance Database from 2009 to 2013
Seung-Young Oh, Songhee Cho, Hannah Lee, Eun Jin Chang, Se Hee Min, Ho Geol Ryu
Korean J Crit Care Med. 2015;30(4):249-257.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.249
  • 7,819 View
  • 182 Download
  • 6 Crossref
AbstractAbstract PDF
Background
The aim of this study is to evaluate the influence of immunosuppressants on in-hospital mortality from sepsis.
Methods
Using data of the Health Insurance Review & Assessment Service, we collected data from patients who were admitted to the hospital due to sepsis from 2009 to 2013. Based on drugs commonly used for immunosuppression caused by various diseases, patients were divided into three groups; immunosuppressant group, steroid-only group, and control group. Patients with no history of immunosuppressants or steroids were assigned to the control group. To identify risk factors of in-hospital mortality in sepsis, we compared differences in patient characteristics, comorbidities, intensive care unit (ICU) care requirements, and immunodeficiency profiles. Subgroup analysis according to age was also performed.
Results
Of the 185,671 included patients, 13,935 (7.5%) were in the steroid-only group and 2,771 patients (1.5%) were in the immunosuppressant group. The overall in-hospital mortality was 38.9% and showed an increasing trend with age. The steroid-only group showed the lowest in-hospital mortality among the three groups except the patients younger than 30 years. The steroid-only group and immunosuppressant group received ICU treatment more frequently (p < 0.001), stayed longer in the hospital (p < 0.001), and showed higher medical expenditure (p < 0.001) compared to the normal group. Univariate and multivariate analyses revealed that age, male gender, comorbidities (especially malignancy), and ICU treatment had a significant effect on in-hospital mortality.
Conclusions
Despite longer hospital length of stay and more frequent need for ICU care, the in-hospital mortality was lower in patients taking immunosuppressive drugs than in patients not taking immunosuppressive drugs.

Citations

Citations to this article as recorded by  
  • Predictive performance of NEWS and qSOFA in immunocompromised sepsis patients at the emergency department
    Lisanne Boekhoud, Helena M. E. A. Schaap, Rick L. Huizinga, Tycho J. Olgers, Jan C. ter Maaten, Douwe F. Postma, Hjalmar R. Bouma
    Infection.2024;[Epub]     CrossRef
  • Effects of Early Initiation of High-Dose Dexamethasone Therapy on Pro-Inflammatory Cytokines and Mortality in LPS-Challenged Mice
    Ji-young Son, Won Gun Kwack, Eun Kyoung Chung, Sooyoung Shin, Yeo Jin Choi
    Healthcare.2022; 10(7): 1247.     CrossRef
  • Alleviation of LPS-Induced Inflammation and Septic Shock by Lactiplantibacillus plantarum K8 Lysates
    Gayoung Kim, Kyeong-Hun Choi, Hangeun Kim, Dae-Kyun Chung
    International Journal of Molecular Sciences.2021; 22(11): 5921.     CrossRef
  • Critical Care Research Using “Big Data”: A Reality in the Near Future
    Kwangha Lee
    Acute and Critical Care.2018; 33(4): 269.     CrossRef
  • Should Very Old Patients Be Admitted to the Intensive Care Units?
    Jun Kwon Cha, In-Ae Song
    The Korean Journal of Critical Care Medicine.2017; 32(4): 376.     CrossRef
  • Sepsis in Immunocompromised Patients: Current Status in Korea
    Kwangha Lee
    The Korean Journal of Critical Care Medicine.2015; 30(4): 239.     CrossRef
Pulmonary
The Prognostic Factors of Pneumonia with Septic Shock in Patients Presenting to the Emergency Department
Jong Won Kim, Jin Joo Kim, Hyuk Jun Yang, Yong Su Lim, Jin Seong Cho, In Cheol Hwang, Sang Hyun Han
Korean J Crit Care Med. 2015;30(4):258-264.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.258
  • 8,692 View
  • 162 Download
  • 10 Crossref
AbstractAbstract PDF
Background
Pneumonia is the most common cause of death among patients with infectious disease in Korea. However, studies of pneumonia with septic shock in patients presenting to the emergency department are limited. The aim of this study was to investigate the prognostic factors associated with pneumonia with septic shock in patients presenting to the emergency department.
Methods
From January 2008 to September 2014, patients with pneumonia with septic shock admitted through the emergency department were retrospectively examined.
Results
Of the 561,845 patients who visited the emergency department, 398 were admitted for pneumonia with septic shock. The 28-day mortality rate in these patients was 36.4%. The independent prognostic factors were old age (>70 yrs) (odds ratio [OR], 2.42; 95%, confidence interval [CI], 1.35–4.32), Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR, 1.04; 95% CI, 1.01–1.08), leukopenia (OR, 3.63; 95% CI, 1.48–8.94), prolonged PT-INR (OR, 2.53; 95% CI, 1.41–4.54), and hypoxemia (OR, 2.88; 95% CI, 1.30–6.38).
Conclusions
A poor prognosis of patients with pneumonia is associated with old age (>70 yrs), increased APACHE II score, leukopenia, prolonged PT-INR, and hypoxemia.

Citations

Citations to this article as recorded by  
  • Look at the COVID-19 Pandemic with an Open Mind

    Archives of Health Science.2021; : 1.     CrossRef
  • The Myth of Septic Complications of Acute Pneumonia
    Igor Klepikov
    Journal of Biomedical Research & Environmental Sciences.2021; 2(8): 741.     CrossRef
  • Will the pill help defeat the coronavirus?
    Klepikov Igor
    Journal of Clinical Intensive Care and Medicine.2021; 6(1): 001.     CrossRef
  • Psychoanalysis of the doctrine of acute pneumonia
    Klepikov Igor
    International Journal of Clinical Microbiology and Biochemical Technology.2021; 4(1): 032.     CrossRef
  • COVID-19 Pandemic: The Causative Agent is New, The Problem is Old
    Igor Klepikov, Sasho Stoleski
    International Journal of Coronaviruses.2021; 3(1): 14.     CrossRef
  • Let’s evaluate the pandemic in terms of facts, not impressions
    Igor Klepikov
    Journal of Lung, Pulmonary & Respiratory Research.2021; 8(2): 62.     CrossRef
  • Non-bacteremic pneumococcal pneumonia: general characteristics and early predictive factors for poor outcome
    Leyre Serrano, Luis A. Ruiz, Lorea Martinez-Indart, Pedro P. España, Ainhoa Gómez, Ane Uranga, Marta García, Borja Santos, Amaia Artaraz, Rafael Zalacain
    Infectious Diseases.2020; 52(9): 603.     CrossRef
  • Acute Lung Inflammation: Old Illusions of the New Version
    Igor Klepikov
    International Journal of Research Studies in Medical and Health Sciences.2020; 5(7): 1.     CrossRef
  • As Evidenced by the Statistics of the Pandemic
    I. Klepikov, Jose Luis Turabian
    International Journal of Coronaviruses.2020; 2(2): 1.     CrossRef
  • Do you really want to improve the results of treatment for acute pneumonia?
    Igor* Klepikov
    Journal of Clinical Intensive Care and Medicine.2019; : 023.     CrossRef
Emergency/Neurology
Brain Magnetic Resonance Imaging in Patients with Favorable Outcomes after Out-of-Hospital Cardiac Arrest: Many Have Encephalopathy Even with a Good Cerebral Performance Category Score
Woo Sung Choi, Jin Joo Kim, Hyuk Jun Yang
Korean J Crit Care Med. 2015;30(4):265-271.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.265
  • 7,299 View
  • 101 Download
AbstractAbstract PDF
Background
The aim of this study was to retrospectively evaluate and analyze the brain magnetic resonance imaging (B-MRI) findings of patients with a favorable neurological outcome following cerebral performance category (CPC) after out-of-hospital cardiac arrest (OHCA) at single university hospital emergency center.
Methods
Patients with return of spontaneous circulation (> 24 h) after OHCA who were older than 16 years of age and who had been admitted to the emergency intensive care unit (EICU) for over a 57-month period between July 2007 and March 2012 and survived with a favorable neurological outcome were enrolled. B-MRI was taken after recovery of their mental status.
Results
Fifty-two patients among the 305 admitted patients had a good CPC, and 33 patients’ B-MRI were analyzed (CPC 1: 26 patients, CPC 2: 7 patients). Among these, 18 (54.5%) patients had a normal finding on B-MRI. On the other hand, ischemia/infarction/microangiopathy compatible with hypoxic-ischemic encephalopathy (HIE) were found on various brain areas including subcortical white matter (7/13), cerebral cortex, central semiovlae, basal ganglia, putamen, periventricular white matter, and cerebellum.
Conclusions
Survivors with a favorable neurological outcome from OHCA showed HIE on B-MRI, especially all of the patients with a CPC 2. More detail neurologic category including brain imaging would be needed to categorize patients with favorable outcome after OHCA.
Pharmacology
Dexmedetomidine Use in Patients with 33℃ Targeted Temperature Management: Focus on Bradycardia as an Adverse Effect
Hyo-yeon Seo, Byoung-joon Oh, Eun-jung Park, Young-gi Min, Sang-cheon Choi
Korean J Crit Care Med. 2015;30(4):272-279.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.272
  • 6,091 View
  • 80 Download
AbstractAbstract PDF
Background
This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33℃ target temperature management.
Methods
A retrospective study was conducted on patients who underwent 33℃ target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia.
Results
A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 ± 0.15 μg/kg/h. Decisions of charged doctor’s were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole.
Conclusions
Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33℃ target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33℃ targeted temperature management.
Vascular Surgery
Direction of the J-Tip of the Guidewire to Decrease the Malposition Rate of an Internal Jugular Vein Catheter
Byeong jun Ahn, Sung Uk Cho, Won Joon Jeong, Yeon Ho You, Seung Ryu, Jin Woong Lee, In Sool Yoo, Yong chul Cho
Korean J Crit Care Med. 2015;30(4):280-285.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.280
  • 5,866 View
  • 85 Download
  • 1 Crossref
AbstractAbstract PDF
Background
We hypothesized that the direction of the J-tip of the guidewire during insertion into the internal jugular vein (IJV) might determine its ultimate location. Methods: In this study, 300 patients between the ages of 18 and 99 years who required central venous catheterization via IJV in the emergency department enrolled for randomization. IVJ catheterization was successful in 285 of 300 patients. An independent operator randomly prefixed the direction of the J-tip of the guidewire to one of three directions. Based on the direction of the J-tip, patients were allocated into three groups: the J-tip medial-directed group (Group A), the lateral-directed group (Group B), or the downward-directed group (Group C). Postoperative chest radiography was performed on all patients in order to visualize the location of the catheter tip. A catheter is considered malpositioned if it is not located in the superior vena cava or right atrium. Results: Of the total malpositioned catheter tips (8 of 285; 2.8%), the majority (5 of 8; 62.5%) entered the contralateral subclavian vein, 2 (25.0%) were complicated by looping, and 1 (12.5%) entered the ipsilateral subclavian vein. According to the direction of the J-tip of the guidewire, the incidence of malpositioning of the catheter tip was 4 of 92 in Group A (4.3%), 4 of 96 in Group B (4.2%), and there were no malpositions in Group C. There were no significant differences among the three groups (p = 0.114). Conclusions: The direction of the J-tip of the guidewire had no statistically significant effect on incidence of malpositioned tips.

Citations

Citations to this article as recorded by  
  • Perioperative Echocardiography to Confirm Correct Central Venous Catheter Placement: A Case Report
    Parag Gharde, Sourangshu Sarkar, Kalpana Irpachi, Amol Kumar Bhoje, Bhavdeep Kaur, Sandeep Chauhan
    A&A Practice.2020; 14(10): e01291.     CrossRef
Pulmonary/Cardiology
Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung Transplants
Ha Yeon Kim, Sungwon Na, Hyo Chae Paik, Jonglin Ha, Jeongmin Kim
Korean J Crit Care Med. 2015;30(4):286-294.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.286
  • 5,425 View
  • 55 Download
  • 1 Crossref
AbstractAbstract 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.

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
Case Reports
Cardiology/Thoracic Surgery
Extracorporeal Membrane Oxygenation for 67 Days as a Bridge to Heart Transplantation in a Postcardiotomy Patient with Failing Heart and Mediastinitis
Hyoung Woo Chang, Yang Hyun Cho, Suhyun Cho, Kiick Sung, Pyo Won Park
Korean J Crit Care Med. 2015;30(4):295-298.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.295
  • 4,500 View
  • 56 Download
AbstractAbstract PDF
We report a case of successful heart transplantation after 67 days of support with venoarterial extracorporeal membrane oxygenation (ECMO) in a patient who underwent surgery for type A aortic dissection and myocardial infarction complicated by irreversible myocardial damage and a deep sternal wound infection. During ECMO support, left heart vent and distal limb perfusion were performed. Mediastinitis was treated with mediastinal washout and irrigation. Multiple complications from peripheral ECMO were successfully managed.
Cardiology
Catecholamine-Induced Cardiomyopathy associated with Neuroblastoma and Treated with Extracorporeal Membrane Oxygenation as a Bridge to Recovery
Junggu Yi, Si Oh Kim, Jun-mo Park, Sung-hye Byun, Hoon Jung, Seong Wook Hong
Korean J Crit Care Med. 2015;30(4):299-302.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.299
  • 5,106 View
  • 89 Download
  • 1 Crossref
AbstractAbstract PDF
Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.

Citations

Citations to this article as recorded by  
  • COVID-19 and cardiovascular disease: manifestations, pathophysiology, vaccination, and long-term implication
    Adel Abdel Moneim, Marwa A. Radwan, Ahmed I. Yousef
    Current Medical Research and Opinion.2022; 38(7): 1071.     CrossRef
Cardiology/Obstetric
Successful Application of Extracorporeal Membrane Oxygenation for a Patient with Clinical Amniotic Fluid Embolism
Hye Seon Kang, Hwa Young Lee, Hea Yon Lee, Seok Chan Kim
Korean J Crit Care Med. 2015;30(4):303-307.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.303
  • 5,684 View
  • 98 Download
  • 4 Crossref
AbstractAbstract PDF
Amniotic fluid embolism (AFE) is a rare but potentially fatal complication that occurs acutely during pregnancy or within 12 h of delivery. The management of AFE focuses initially on supportive measures for cardiopulmonary stabilization. Extracorporeal membrane oxygenation should be considered in patients who are unresponsive to medical treatment in order to prevent additional hypoxia and subsequent organ failure. We present a 41-year-old woman with clinical AFE who developed acute respiratory distress syndrome and was treated successfully with extracorporeal membrane oxygenation.

Citations

Citations to this article as recorded by  
  • Amniotic fluid embolism rescued using venoarterial extracorporeal membrane oxygenation without initial anticoagulation: A case report and literature review
    Hiroshi Araki, Motohiro Sekino, Yuri Hasegawa, Masaya Kurobe, Tetsufumi Motokawa, Akihiko Tanigawa, Takashi Egashira, Naoya Iwasaki, Miki Suzumura, Rintaro Yano, Sojiro Matsumoto, Taiga Ichinomiya, Ushio Higashijima, Naohiro Kanayama, Kiyonori Miura, Tets
    Medicine.2024; 103(20): e38176.     CrossRef
  • Extracorporeal Therapies for Amniotic Fluid Embolism
    Julien Viau-Lapointe, Niall Filewod
    Obstetrics & Gynecology.2019; 134(5): 989.     CrossRef
  • Venous Air Embolism Not Amniotic Fluid Embolism
    Charles Her
    Korean Journal of Critical Care Medicine.2016; 31(1): 68.     CrossRef
  • Urgent Application of Extracorporeal Membrane Oxygenation in Amniotic Fluid Embolism
    Moo Suk Park
    The Korean Journal of Critical Care Medicine.2016; 31(3): 179.     CrossRef
Pulmonary
Barotrauma after Manual Ventilation in a Patient with Life-Threatening Massive Hemoptysis
Hea Yon Lee, Yu Young Joo, Young Seung Oh, Yoo Rim Seo, Hyon Soo Joo, Seok Chan Kim, Chin Kook Rhee
Korean J Crit Care Med. 2015;30(4):308-312.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.308
  • 8,245 View
  • 112 Download
  • 2 Crossref
AbstractAbstract PDF
A 36-year-old female patient with aplastic anemia developed massive hemoptysis and was placed on ventilator support. However, airway obstruction by blood clots triggered desaturation and ventilator malfunction. Manual ventilation was initiated to improve oxygenation, and emergency flexible bronchoscopy was performed to clear the airway. Nevertheless, the patient developed extensive subcutaneous emphysema, pneumothorax, and pneumomediastinum.

Citations

Citations to this article as recorded by  
  • Clinical approach to massive hemoptysis - Perioperative focus on causes and management
    Timothy Weiquan TOH, Jacqueline Hui Fen GOH, Sui An LIE, Carrie Kah Lai LEONG, Nian Chih HWANG
    Journal of Cardiothoracic and Vascular Anesthesia.2024;[Epub]     CrossRef
  • Experimental validation of a portable tidal volume indicator for bag valve mask ventilation
    Benjamin S. Maxey, Luke A. White, Giovanni F. Solitro, Steven A. Conrad, J. Steven Alexander
    BMC Biomedical Engineering.2022;[Epub]     CrossRef
Anesthesiology/Pediatric
Aspiration Pneumonia in a Pediatric Patient under General Anesthesia despite Adequate Preoperative Fasting
Sang-Il Yoon, Jong-Man Kang
Korean J Crit Care Med. 2015;30(4):313-317.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.313
  • 65,535 View
  • 195 Download
  • 1 Crossref
AbstractAbstract PDF
Aspiration pneumonia rarely occurs during general anesthesia; however, it can result in fatal pulmonary complications. To reduce aspiration pneumonia, a preoperative fasting time of 8 hours is recommended. A 4-year-old boy with ankyloglossia was scheduled for frenotomy. He completed preoperative fasting time and had no digestive symptoms. Pulmonary aspiration due to unexpected massive vomiting occurred during anesthesia induction. The patient’s airway was immediately secured by endotracheal tube. The vomitus in the airway tract was removed by fiberoptic bronchoscopy. Abdomen radiograph taken after this event showed paralytic ileus which can cause aspiration of gastric contents. We describe a case of pneumonia caused by aspiration of gastric contents in a pediatric patient who followed fasting instructions and who was scheduled for outpatient surgery.

Citations

Citations to this article as recorded by  
  • Factors associated with bronchopulmonary aspiration: a national-based study
    Jaqueline Helena Tanner, Cristina Mara Zamarioli, Magda Machado de Miranda Costa, Heiko Thereza Santana, Ana Clara Ribeiro Bello dos Santos, Cleide Felicia de Mesquita Ribeiro, Fernanda Raphael Escobar Gimenes
    Revista Brasileira de Enfermagem.2022;[Epub]     CrossRef
Vascular Surgery/Nephrology
Spontaneous Lumbar Artery Bleeding and Retroperitoneal Hematoma in a Patient Treated with Continuous Renal Replacement Therapy
Jin Kyung Park, Sung Ho Kim, Hee Jin Kim, Duk Hyun Lee
Korean J Crit Care Med. 2015;30(4):318-322.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.318
Correction in: Acute Crit Care 2016;31(1):71
  • 7,183 View
  • 88 Download
  • 2 Crossref
AbstractAbstract PDF
Rupture of the lumbar artery is usually associated with trauma but rarely has been reported in association with anticoagulation. We present a 71-year-old man who developed spontaneous rupture of the lumbar artery leading to a retroperitoneal hematoma while receiving continuous renal replacement therapy (CRRT). The bleeding was confirmed by computed tomography and angiography and was controlled successfully using selective angiographic embolization. We suggest that spontaneous retroperitoneal bleeding should be considered in a case of sudden decrease in hemoglobin in a CRRT patient.

Citations

Citations to this article as recorded by  
  • Transcatheter Arterial Embolization of Spontaneous Soft Tissue Hematomas: A Systematic Review
    Lahoud Touma, Sarah Cohen, Christophe Cassinotto, Caroline Reinhold, Alan Barkun, Vi Thuy Tran, Olivier Banon, David Valenti, Benoit Gallix, Anthony Dohan
    CardioVascular and Interventional Radiology.2019; 42(3): 335.     CrossRef
  • Three cases of spontaneous lumbar artery rupture in hemodialysis patients
    Na Kyoung Hwang, Harin Rhee, Il Young Kim, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak, Chang Won Kim, Sang Heon Song
    Hemodialysis International.2017;[Epub]     CrossRef
Infection
Disseminated Gastrointestinal Mucormycosis in Immunocompromised Disease
Tae Sun Ha, Chi-Min Park, Jeong Hoon Yang, Yang Hyun Cho, Chi Ryang Chung, Kyeongman Jeon, Gee Young Suh
Korean J Crit Care Med. 2015;30(4):323-328.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.323
  • 5,638 View
  • 84 Download
  • 2 Crossref
AbstractAbstract PDF
Mucormycosis is an uncommon opportunistic fungal infection mostly affecting immunocompromised patients and gastrointestinal mucormycosis is a rare and life-threatening. We describe a 31-year-old man with a history of idiopathic cyclic neutropenia who developed perforations of the stomach and intestine and intra-abdominal bleeding due to disseminated gastrointestinal mucormycosis after the initial operation.

Citations

Citations to this article as recorded by  
  • A Fatal Case of Disseminated Intestinal Mucormycosis in a Patient with Vibrio Sepsis
    Seungwoo Chung, Hyun-Jung Sung, Jong Won Chang, Ile Hur, Ho Cheol Kim
    Journal of Acute Care Surgery.2021; 11(3): 133.     CrossRef
  • Gastric Mucormycosis Followed by Traumatic Cardiac Rupture in an Immunocompetent Patient
    Sang Won Lee, Hyun Seok Lee
    The Korean Journal of Gastroenterology.2016; 68(2): 99.     CrossRef

ACC : Acute and Critical Care