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Volume 31 (3); August 2016
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Editorial
Obstetric/Cardiology
Urgent Application of Extracorporeal Membrane Oxygenation in Amniotic Fluid Embolism
Moo Suk Park
Korean J Crit Care Med. 2016;31(3):179-180.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00745
  • 6,484 View
  • 146 Download
PDF
Review
Policy
The ABCDEF Implementation Bundle
Annachiara Marra, Kwame Frimpong, E. Wesley Ely
Korean J Crit Care Med. 2016;31(3):181-193.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00682
  • 33,914 View
  • 1,440 Download
  • 4 Crossref
AbstractAbstract PDF
Long-term morbidity, long-term cognitive impairment and hospitalization-associated disability are common occurrence in the survivors of critical illness, with significant consequences for patients and for the caregivers. The ABCDEF bundle represents an evidence-based guide for clinicians to approach the organizational changes needed for optimizing ICU patient recovery and outcomes. The ABCDEF bundle includes: Assess, Prevent, and Manage Pain, Both Spontaneous Awakening Trials (SAT) and Spontaneous Breathing Trials (SBT), Choice of analgesia and sedation, Delirium: Assess, Prevent, and Manage, Early mobility and Exercise, and Family engagement. The purpose of this review is to describe the core features of the ABCDEF bundle.

Citations

Citations to this article as recorded by  
  • Effect of using eye masks and earplugs in preventing delirium in intensive care patients: A single‐blinded, randomized, controlled trial
    Gülşen Kiliç, Sultan Kav
    Nursing in Critical Care.2023; 28(5): 698.     CrossRef
  • The impact of multidisciplinary huddle in decreasing time to extubation from mechanical ventilation
    Rana Al Tabee, AmalA Al Khalfan, KhaledA Al Awam
    Saudi Critical Care Journal.2020; 4(1): 15.     CrossRef
  • Patients´ experiences of pain in the intensive care – The delicate balance of control
    Mia Hylén, Eva Akerman, Ewa Idvall, Carin Alm‐Roijer
    Journal of Advanced Nursing.2020; 76(10): 2660.     CrossRef
  • Nursing Interventions to Prevent Delirium in Critically Ill Patients in the Intensive Care Unit during the COVID19 Pandemic—Narrative Overview
    Dorota Ozga, Sabina Krupa, Paweł Witt, Wioletta Mędrzycka-Dąbrowska
    Healthcare.2020; 8(4): 578.     CrossRef
Original Articles
Basic science and research
Flecainide Improve Sepsis Induced Acute Lung Injury by Controlling Inflammatory Response
Jia Song, Young joong Suh, Hyun jung Lee, Eun a Jang, Hong-beom Bae, Sang-Hyun Kwak
Korean J Crit Care Med. 2016;31(3):194-201.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00157
  • 7,739 View
  • 128 Download
AbstractAbstract PDF
Background
Flecainide is an antiarrhythmic agent that is used primarily in the treatment of cardiac arrhythmias. Some evidences also suggest that flecainide can participate in alveolar fluid clearance and inflammatory responses. This experiment was aimed to evaluate the effects of flecainide on sepsis induced acute lung injury in a rat model.
Methods
Rats were treated with subcutaneous infusion of saline or flecainide (0.1 or 0.2 mg/kg/hr) by a mini-osmotic pump. Subcutaneous infusion was started 3 hours before and continued until 8 hours after intraperitoneal injection of saline or endotoxin. Animals were sacrificed for analyses of severity of acute lung injury with wet to dry (W/D) ratio and lung injury score (LIS) in lung and inflammatory responses with level of leukocyte, polymorphonuclear neutrophils (PMNs) and inteleukin-8 (IL-8) in bronchoalveolar lavages fluid (BALF).
Results
Flecainide markedly improved dose dependently sepsis induced acute lung injury as analysed by W/D ratio (from 2.24 ± 0.11 to 1.76 ± 0.09, p < 0.05) and LIS (from 3 to 1, p < 0.05), and inflammatory response as determined by leukocyte (from 443 ± 127 to 229 ± 95, p < 0.05), PMNs (from 41.43 ± 17.63 to 2.43 ± 2.61, p < 0.05) and IL-8 (from 95.00 ± 15.28 to 40.00 ± 10.21, p < 0.05) in BALF.
Conclusions
Flecanide improve sepsis induced acute lung injury in rats by controlling inflammatory responses.
Pulmonary/Anesthesiology
A Pilot Survey of Difficult Intubation and Cannot Intubate, Cannot Ventilate Situations in Korea
Jung Soo Kim, Hyun Kyoung Lim, Jeong Yun Song, Hyun Keun Lim, Kyungchul Song, Jae Hwa Cho
Korean J Crit Care Med. 2016;31(3):202-207.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00297
  • 8,045 View
  • 142 Download
  • 2 Crossref
AbstractAbstract PDF
Background
There have been no studies of airway management strategies for difficult intubation and cannot intubate, cannot ventilate (CICV) situations in Korea. This study was intended to survey devices or methods that Korean anesthesiologists and intensivists prefer in difficult intubation and CICV situations.
Methods
A face-to-face questionnaire that consisted of a doctor’s preference, experience and comfort level for alternative airway management devices was presented to anesthesiologists and intensivists at study meetings and conferences from October 2014 to December 2014.
Results
We received 218 completed questionnaires. In regards to difficult intubation, the order of preferred alternative airway devices was a videolaryngoscope (51.8%), an optical stylet (22.9%), an intubating laryngeal mask airway (11.5%), and a fiber-optic bronchoscope (10.6%). One hundred forty-two (65.1%) respondents had encountered CICV situations, and most of the cases were identified during elective surgery. In CICV situations, the order of preferred methods of infraglottic airway management was cricothyroidotomy (CT) by intravenous (IV) catheter (57.3%), tracheostomy by a surgeon (18.8%), wire-guided CT (18.8%), CT using a bougie (2.8%), and open surgery CT using a scalpel (2.3%). Ninety-eight (45%) of the 218 respondents were familiar with the American Society of Anesthesiologists’ difficult airway algorithm or Difficult Airway Society algorithm, and only 43 (19.7%) had participated in airway workshops within the past five years.
Conclusion
The videolaryngoscope was the most preferred device for difficult airways. In CICV situations, the method of CT via an IV catheter was the most frequently used, followed by wire-guided CT method and tracheostomy by the attending surgeon.

Citations

Citations to this article as recorded by  
  • Current practice pattern among anaesthesiologists for difficult airway management: A nationwide cross-sectional survey
    Balasaheb T Govardhane, Apurva D Shinde, Raghubirsingh P. Gehdoo, Sanya Arora
    Indian Journal of Anaesthesia.2023; 67(9): 809.     CrossRef
  • Difficult Airway and Cannot Intubate, Cannot Ventilate Situations in Korea: What Can We Do in the Future?
    Tak Kyu Oh
    The Korean Journal of Critical Care Medicine.2017; 32(2): 225.     CrossRef
Infection/Pharmacology
Clinical Effectiveness and Nephrotoxicity of Aerosolized Colistin Treatment in Multidrug-Resistant Gram-Negative Pneumonia
Seung Yong Park, Mi Seon Park, Chi Ryang Chung, Ju Sin Kim, Seoung Ju Park, Heung Bum Lee
Korean J Crit Care Med. 2016;31(3):208-220.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00129
  • 13,261 View
  • 287 Download
  • 3 Crossref
AbstractAbstract PDF
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.

Citations

Citations to this article as recorded by  
  • 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
    Yun Jung Jung, Eun Jin Kim, Young Hwa Choi
    The Korean Journal of Internal Medicine.2022; 37(1): 1.     CrossRef
  • Changes in Renal Function by Nebulized Colistimethate Treatment
    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
Trauma
The Best Prediction Model for Trauma Outcomes of the Current Korean Population: a Comparative Study of Three Injury Severity Scoring Systems
Kyoungwon Jung, John Cook-Jong Lee, Rae Woong Park, Dukyong Yoon, Sungjae Jung, Younghwan Kim, Jonghwan Moon, Yo Huh, Junsik Kwon
Korean J Crit Care Med. 2016;31(3):221-228.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00486
  • 9,573 View
  • 204 Download
  • 7 Crossref
AbstractAbstract PDF
Background
Injury severity scoring systems that quantify and predict trauma outcomes have not been established in Korea. This study was designed to determine the best system for use in the Korean trauma population.
Methods
We collected and analyzed the data from trauma patients admitted to our institution from January 2010 to December 2014. Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) were calculated based on the data from the enrolled patients. Area under the receiver operating characteristic (ROC) curve (AUC) for the prediction ability of each scoring system was obtained, and a pairwise comparison of ROC curves was performed. Additionally, the cut-off values were estimated to predict mortality, and the corresponding accuracy, positive predictive value, and negative predictive value were obtained.
Results
A total of 7,120 trauma patients (6,668 blunt and 452 penetrating injuries) were enrolled in this study. The AUCs of ISS, RTS, and TRISS were 0.866, 0.894, and 0.942, respectively, and the prediction ability of the TRISS was significantly better than the others (p < 0.001, respectively). The cut-off value of the TRISS was 0.9082, with a sensitivity of 81.9% and specificity of 92.0%; mortality was predicted with an accuracy of 91.2%; its positive predictive value was the highest at 46.8%.
Conclusions
The results of our study were based on the data from one institution and suggest that the TRISS is the best prediction model of trauma outcomes in the current Korean population. Further study is needed with more data from multiple centers in Korea.

Citations

Citations to this article as recorded by  
  • Outcomes in trauma patients undergoing veno-venous extracorporeal membrane oxygenation for acute respiratory distress syndrome
    Seon Hee Kim, Up Huh, Seunghwan Song, Min Su Kim, Il Jae Wang, Young Jin Tak
    Perfusion.2023; 38(5): 1037.     CrossRef
  • Prehospital Trauma Scoring Systems for Evaluation of Trauma Severity and Prediction of Outcomes
    Radojka Jokšić-Mazinjanin, Nikolina Marić, Aleksandar Đuričin, Zoran Gojković, Velibor Vasović, Goran Rakić, Milena Jokšić-Zelić, Siniša Saravolac
    Medicina.2023; 59(5): 952.     CrossRef
  • Correlation between trauma and injury severity score and prognosis in patients with trauma
    Chusnul Chatimah, Indah D. Pratiwi, Chairul H. Al Husna
    Journal of Taibah University Medical Sciences.2021; 16(6): 807.     CrossRef
  • Trauma Volume and Performance of a regional Trauma Center in Korea: Initial 5-year analysis
    Byungchul Yu, Giljae Lee, Min A Lee, Kangkook Choi, Sungyoul Hyun, Yangbin Jeon, Yong-Cheol Yoon, Jungnam Lee
    Journal of Trauma and Injury.2020; 33(1): 31.     CrossRef
  • Inclusion of lactate level measured upon emergency room arrival in trauma outcome prediction models improves mortality prediction: a retrospective, single-center study
    Jonghwan Moon, Kyungjin Hwang, Dukyong Yoon, Kyoungwon Jung
    Acute and Critical Care.2020; 35(2): 102.     CrossRef
  • Trauma and Injury Severity Score modification for predicting survival of trauma in one regional emergency medical center in Korea: Construction of Trauma and Injury Severity Score coefficient model
    In Hye Kang, Kang Hyun Lee, Hyun Youk, Jeong Il Lee, Hee Young Lee, Keum Seok Bae
    Hong Kong Journal of Emergency Medicine.2019; 26(4): 225.     CrossRef
  • The thorax trauma severity score and the trauma and injury severity score
    Seong Ho Moon, Jong Woo Kim, Joung Hun Byun, Sung Hwan Kim, Jun Young Choi, In Seok Jang, Chung Eun Lee, Jun Ho Yang, Dong Hun Kang, Ki Nyun Kim, Hyun Oh Park
    Medicine.2017; 96(42): e8317.     CrossRef
Ethics
Effect of Timing of Do-Not-Resuscitate Orders on the Clinical Outcome of Critically Ill Patients
Moon Seong Baek, Younsuck Koh, Sang-Bum Hong, Chae-Man Lim, Jin Won Huh
Korean J Crit Care Med. 2016;31(3):229-235.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00178
  • 11,442 View
  • 152 Download
  • 11 Crossref
AbstractAbstract PDF
Background
Many physicians hesitate to discuss do-not-resuscitate (DNR) orders with patients or family members in critical situations. In the intensive care unit (ICU), delayed DNR decisions could cause unintentional cardiopulmonary resuscitation, patient distress, and substantial cost. We investigated whether the timing of DNR designation affects patient outcome in the medical ICU.
Methods
We enrolled retrospective patients with written DNR orders in a medical ICU (13 bed) from June 1, 2014 to May 31, 2015. The patients were divided into two groups: early DNR patients for whom DNR orders were implemented within 48 h of ICU admission, and late DNR patients for whom DNR orders were implemented more than 48 h after ICU admission.
Results
Herein, 354 patients were admitted to the medical ICU and among them, 80 (22.6%) patients had requested DNR orders. Of these patients, 37 (46.3%) had designated DNR orders within 48 hours of ICU admission and 43 (53.7%) patients had designated DNR orders more than 48 hours after ICU admission. Compared with early DNR patients, late DNR patients tended to withhold or withdraw life-sustaining management (18.9% vs. 37.2%, p = 0.072). DNR consent forms were signed by family members instead of the patients. Septic shock was the most common cause of medical ICU admission in both the early and late DNR patients (54.1% vs. 37.2%, p = 0.131). There was no difference in in-hospital mortality (83.8% vs. 81.4%, p = 0.779). Late DNR patients had longer ICU stays than early DNR patients (7.4 ± 8.1 vs. 19.7 ± 19.2, p < 0.001).
Conclusions
Clinical outcomes are not influenced by the time of DNR designation in the medical ICU. The late DNR group is associated with a longer length of ICU stay and a tendency of withholding or withdrawing life-sustaining treatment. However, further studies are needed to clarify the guideline for end-of-life care in critically ill patients.

Citations

Citations to this article as recorded by  
  • Characteristics and outcomes of patients with do-not-resuscitate and physician orders for life-sustaining treatment in a medical intensive care unit: a retrospective cohort study
    Song-I Lee, Ye-Rin Ju, Da Hyun Kang, Jeong Eun Lee
    BMC Palliative Care.2024;[Epub]     CrossRef
  • Prognostic models of in-hospital mortality of intensive care patients using neural representation of unstructured text: A systematic review and critical appraisal
    I. Vagliano, N. Dormosh, M. Rios, T.T. Luik, T.M. Buonocore, P.W.G. Elbers, D.A. Dongelmans, M.C. Schut, A. Abu-Hanna
    Journal of Biomedical Informatics.2023; 146: 104504.     CrossRef
  • The Impact of Do-Not-Resuscitate Order in the Emergency Department on Respiratory Failure after ICU Admission
    Ting-Yu Hsu, Pei-Ming Wang, Po-Chun Chuang, Yan-Ren Lin, Yuan-Jhen Syue, Tsung-Cheng Tsai, Chao-Jui Li
    Healthcare.2022; 10(3): 434.     CrossRef
  • Early DNR in Older Adults Hospitalized with SARS-CoV-2 Infection During Initial Pandemic Surge
    Shalin Shah, Alex Makhnevich, Jessica Cohen, Meng Zhang, Allison Marziliano, Michael Qiu, Yan Liu, Michael A. Diefenbach, Maria Carney, Edith Burns, Liron Sinvani
    American Journal of Hospice and Palliative Medicine®.2022; 39(12): 1491.     CrossRef
  • The Impact of Signing Do-Not-Resuscitate Orders on the Use of Non-Beneficial Life-Sustaining Treatments for Intensive Care Unit Patients: A Retrospective Study
    Shang-Sin Shiu, Ting-Ting Lee, Ming-Chen Yeh, Yu-Chi Chen, Shu-He Huang
    International Journal of Environmental Research and Public Health.2022; 19(15): 9521.     CrossRef
  • Early versus late DNR orders and its predictors in a Saudi Arabian ICU: A descriptive study
    WaleedTharwat Aletreby, AhmedF Mady, MohammedA Al-Odat, AhmedN Balshi, AnasA Mady, AdamM Al-Odat, AmiraM Elshayeb, AhmedF Mostafa, ShereenA Abd Elsalam, KrizL Odchigue
    Saudi Journal of Medicine and Medical Sciences.2022; 10(3): 192.     CrossRef
  • Decision-making regarding withdrawal of life-sustaining treatment and the role of intensivists in the intensive care unit: a single-center study
    Seo In Lee, Kyung Sook Hong, Jin Park, Young-Joo Lee
    Acute and Critical Care.2020; 35(3): 179.     CrossRef
  • Determination of the characteristics and outcomes of the palliative care patients admitted to the emergency department
    Gulcan Bakan, Mert Ozen, Arife Azak, Bulent Erdur
    International Emergency Nursing.2020; 53: 100934.     CrossRef
  • Do‐Not‐Resuscitate Orders in Older Adults During Hospitalization: A Propensity Score–Matched Analysis
    Karishma Patel, Liron Sinvani, Vidhi Patel, Andrzej Kozikowski, Christopher Smilios, Meredith Akerman, Kinga Kiszko, Sutapa Maiti, Negin Hajizadeh, Gisele Wolf‐Klein, Renee Pekmezaris
    Journal of the American Geriatrics Society.2018; 66(5): 924.     CrossRef
  • Changes in Life-sustaining Treatment in Terminally Ill Cancer Patients after Signing a Do-Not-Resuscitate Order
    Hyun A Kim, Jeong Yun Park
    The Korean Journal of Hospice and Palliative Care.2017; 20(2): 93.     CrossRef
  • The Authors Reply
    Jeong Uk Lim, Jongmin Lee, Jick Hwan Ha, Hyeon Hui Kang, Sang Haak Lee, Hwa Sik Moon
    The Korean Journal of Critical Care Medicine.2017; 32(4): 377.     CrossRef
Neurology
Predisposing Hemodynamic Factors Associated with a Failed Apnea Test during Brain Death Determination
Eun Young Kim, Ji Hyun Kim
Korean J Crit Care Med. 2016;31(3):236-242.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00332
  • 6,717 View
  • 123 Download
  • 2 Crossref
AbstractAbstract PDF
Background
The apnea test is an essential component in the clinical determination of brain death, however it may incur a significant risk of complications such as hypotension, hypoxia and even cardiac arrest. We analyzed the risk factors associated with a failed apnea test during brain death assessment in order to predict and avoid these adverse events.
Methods
Medical records on apnea tests performed for brain-dead donors at our institution between January 2009 and January 2016 were retrospectively reviewed. Age, gender, etiology of brain death, use of catecholamines and results of arterial blood gas analysis (ABGA), systolic/diastolic blood pressure (SBP/DBP), mean arterial pressure and central venous pressure prior to apnea test initiation were collected as variables. A-a gradient and PaO2/FiO2 were calculated for more precise assessment of the respiratory system. In total, 267 cases were divided into two groups based on those who completed the apnea test and those who failed the test.
Results
13 cases failed the apnea test. Among them, seven cases failed due to severe hypotension (SBP < 60 mmHg) and the others failed due to refractory hypoxia. In terms of hemodynamic state, SBP was significantly higher in the completed test group than the failed group (126.5 ± 23.9 vs. 103 ± 15.2, respectively; p = 0.001). In ABGA, the completed test group showed significantly higher PaO2/ FiO2 (313.6 ± 229.8 vs. 141.5 ± 131.0, respectively; p = 0.008) and a lower A-a gradient (278.2 ± 209.5 vs. 506.2 ± 173.1, respectively; p = 0.000). In multivariable analysis, low SBP (p = 0.003) and high A-a gradient (p = 0.044) were independent risk factors associated with a failed apnea test.
Conclusions
Although the unexpected adverse events during the apnea test for brain death determination do not occur frequently, they can be fatal. If a brain-dead patient has low SBP and a high A-a gradient, clinicians should pay more attention and prepare for potential complications prior to the apnea test.

Citations

Citations to this article as recorded by  
  • Identification of Hemodynamic Risk Factors for Apnea Test Failure During Brain Death Determination
    Jin Joo Kim, Eun Young Kim
    Transplantation Proceedings.2019; 51(6): 1655.     CrossRef
  • Reduction of Apnea Test Time in an Extracorporeal Membrane Oxygenation-Dependent Potential Donor
    Hyeon Sook Jee, Sora Cha, Gaab Soo Kim
    Korean Journal of Transplantation.2017; 31(1): 49.     CrossRef
Hematology/Cardiology
Extracorporeal Membrane Oxygenation Support in Adult Patients with Hematologic Malignancies and Severe Acute Respiratory Failure
Tai Sun Park, You Na Oh, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Je-Hwan Lee, Jung-Hee Lee, Kyoo-Hyung Lee, Jin Won Huh
Korean J Crit Care Med. 2016;31(3):243-250.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00318
  • 8,860 View
  • 143 Download
  • 3 Crossref
AbstractAbstract PDF
Background
Administering extracorporeal membrane oxygenation (ECMO) to critically ill patients with acute respiratory distress syndrome has substantially increased over the last decade, however administering ECMO to patients with hematologic malignancies may carry a particularly high risk. Here, we report the clinical outcomes of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO.
Methods
We performed a retrospective review of the medical records of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO at the medical intensive care unit of a tertiary referral hospital between March 2010 and April 2015.
Results
A total of 15 patients (9 men; median age 45 years) with hematologic malignancies and severe acute respiratory failure received ECMO therapy during the study period. The median values of the Acute Physiology and Chronic Health Evaluation II score, Murray Lung Injury Score, and Respiratory Extracorporeal Membrane Oxygenation Survival Prediction Score were 29, 3.3, and -2, respectively. Seven patients received venovenous ECMO, whereas 8 patients received venoarterial ECMO. The median ECMO duration was 2 days. Successful weaning of ECMO was achieved in 3 patients. Hemorrhage complications developed in 4 patients (1 pulmonary hemorrhage, 1 intracranial hemorrhage, and 2 cases of gastrointestinal bleeding). The longest period of patient survival was 59 days after ECMO initiation. No significant differences in survival were noted between venovenous and venoarterial ECMO groups (10.0 vs. 10.5 days; p = 0.56).
Conclusions
Patients with hematologic malignancies and severe acute respiratory failure demonstrate poor outcomes after ECMO treatment. Careful and appropriate selection of candidates for ECMO in these patients is necessary.

Citations

Citations to this article as recorded by  
  • Extracorporeal membrane oxygenation in patients with hematologic malignancies: a systematic review and meta-analysis
    Jackie Jia Lin Sim, Saikat Mitra, Ryan Ruiyang Ling, Chuen Seng Tan, Bingwen Eugene Fan, Graeme MacLaren, Kollengode Ramanathan
    Annals of Hematology.2022; 101(7): 1395.     CrossRef
  • Extracorporeal Membrane Oxygenation with rituximab‐combined chemotherapy in AIDS‐associated primary cardiac lymphoma: A case report
    Hoyuri Fuseya, Takuro Yoshimura, Minako Tsutsumi, Yosuke Nakaya, Mirei Horiuchi, Masahiro Yoshida, Yoshiki Hayashi, Takafumi Nakao, Takeshi Inoue, Takahisa Yamane
    Clinical Case Reports.2021;[Epub]     CrossRef
  • Extracorporeal Life Support in Adult Patients with Hematologic Malignancies and Acute Circulatory and/or Respiratory Failure
    Sungbin Cho, Won Chul Cho, Ju Yong Lim, Pil Je Kang
    The Korean Journal of Thoracic and Cardiovascular Surgery.2019; 52(1): 25.     CrossRef
Case Reports
Liver
Brain Oxygen Monitoring via Jugular Venous Oxygen Saturation in a Patient with Fulminant Hepatic Failure
Yerim Kim, Chi Kyung Kim, Seunguk Jung, Sang-Bae Ko
Korean J Crit Care Med. 2016;31(3):251-255.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00143
  • 9,899 View
  • 221 Download
  • 2 Crossref
AbstractAbstract PDF
Fulminant hepatic failure (FHF) is often accompanied by a myriad of neurologic complications, which are associated with high morbidity and mortality. Although appropriate neuromonitoring is recommended for early diagnosis and to minimize secondary brain injury, individuals with FHF usually have a high chance of coagulopathy, which limits the ability to use invasive neuromonitoring. Jugular bulb venous oxygen saturation (JvO2) monitoring is well known as a surrogate direct measures of global brain oxygen use. We report the case of a patient with increased intracranial pressure due to FHF, in which JvO2 was used for appropriate brain oxygen monitoring.

Citations

Citations to this article as recorded by  
  • Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study
    Seon Woo Yoo, Min-Jong Ki, Dal Kim, Seul Ki Kim, SeungYong Park, Hyo Jin Han, Heung Bum Lee
    Acute and Critical Care.2021; 36(4): 322.     CrossRef
  • Neurological Monitoring in Acute Liver Failure
    Alexandra S. Reynolds, Benjamin Brush, Thomas D. Schiano, Kaitlin J. Reilly, Neha S. Dangayach
    Hepatology.2019; 70(5): 1830.     CrossRef
Obstetric/Cardiology
Use of Extracorporeal Membrane Oxygenation in a Fulminant Course of Amniotic Fluid Embolism Syndrome Immediately after Cesarean Delivery
Jae Ha Lee, Hang Jea Jang, Jin Han Park, Yong Kyun Kim, Ho Ki Min, Sun Young Kim, Hyun-kuk Kim
Korean J Crit Care Med. 2016;31(3):256-261.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00213
  • 8,541 View
  • 149 Download
  • 2 Crossref
AbstractAbstract PDF
Amniotic fluid embolism is rare but is one of the most catastrophic complications in the peripartum period. This syndrome is caused by a maternal anaphylactic reaction to the introduction of fetal material into the pulmonary circulation. When amniotic fluid embolism is suspected, the immediate application of extracorporeal mechanical circulatory support such as veno-arterial extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass should be considered. Without the application of extracorporeal mechanical circulatory support, medical supportive care might not be sufficient to maintain cardiopulmonary stabilization in severe cases of amniotic fluid embolism. In this report, we present the case of a 36-year-old pregnant woman who developed an amniotic fluid embolism immediately after a cesarean section. Her catastrophic event started with the sudden onset of severe hypoxia, followed by circulatory collapse within 8 minutes. The veno-arterial mode of extracorporeal membrane oxygenation was initiated immediately. She was successfully resuscitated but with impaired cognitive function. Thus, urgent ECMO should be considered when amniotic fluid embolism syndrome is suspected in patients presenting acute cardiopulmonary collapse.

Citations

Citations to this article as recorded by  
  • Venoarterial Extracorporeal Membrane Oxygenation as Supportive Therapy After Cardiac Arrest After Amniotic Fluid Embolism: A Case Report
    Claire Depondt, Darko Arnaudovski, Audrey Voulgaropoulos, Olivier Milleron, Walid Ghodbane, Alexy Tran Dinh, Philippe Montravers, Elie Kantor
    A&A Practice.2019; 13(2): 74.     CrossRef
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Erratums
Major Obstacles to Implement a Full-Time Intensivist in Korean Adult ICUs: a Questionnaire Survey
Jun Wan Lee, Jae Young Moon, Seok Wha Youn, Yong Sup Shin, Sang Il Park, Dong Chan Kim, Younsuk Koh
Korean J Crit Care Med. 2016;31(3):262-262.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.2.111.e01
Corrects: Acute Crit Care 2016;31(2):111
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Citations

Citations to this article as recorded by  
  • Challenges experienced by health care professionals working in resource-poor intensive care settings in the Limpopo province of South Africa
    Hulisani Malelelo-Ndou, Dorah U. Ramathuba, Khathutshelo G. Netshisaulu
    Curationis.2019;[Epub]     CrossRef
Primary Invasive Intestinal Aspergillosis in a Non-Severely Immunocompromised Patient
Eunmi Gil, Tae Sun Ha, Gee Young Suh, Chi Ryang Chung, Chi-Min Park
Korean J Crit Care Med. 2016;31(3):263-263.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.2.129.e01
Corrects: Acute Crit Care 2016;31(2):129
  • 4,827 View
  • 65 Download
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ACC : Acute and Critical Care