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Volume 32 (4); November 2017
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Review
Pulmonary
Patient-Ventilator Dyssynchrony
Elvira-Markela Antonogiannaki, Dimitris Georgopoulos, Evangelia Akoumianaki
Korean J Crit Care Med. 2017;32(4):307-322.   Published online November 30, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00535
  • 34,299 View
  • 2,098 Download
  • 13 Web of Science
  • 11 Crossref
AbstractAbstract PDF
In mechanically ventilated patients, assisted mechanical ventilation (MV) is employed early, following the acute phase of critical illness, in order to eliminate the detrimental effects of controlled MV, most notably the development of ventilator-induced diaphragmatic dysfunction. Nevertheless, the benefits of assisted MV are often counteracted by the development of patient-ventilator dyssynchrony. Patient-ventilator dyssynchrony occurs when either the initiation and/or termination of mechanical breath is not in time agreement with the initiation and termination of neural inspiration, respectively, or if the magnitude of mechanical assist does not respond to the patient’s respiratory demand. As patient-ventilator dyssynchrony has been associated with several adverse effects and can adversely influence patient outcome, every effort should be made to recognize and correct this occurrence at bedside. To detect patient-ventilator dyssynchronies, the physician should assess patient comfort and carefully inspect the pressure- and flow-time waveforms, available on the ventilator screen of all modern ventilators. Modern ventilators offer several modifiable settings to improve patient-ventilator interaction. New proportional modes of ventilation are also very helpful in improving patient-ventilator interaction.

Citations

Citations to this article as recorded by  
  • Acute Respiratory Failure in Severe Acute Brain Injury
    Zachary Robateau, Victor Lin, Sarah Wahlster
    Critical Care Clinics.2024; 40(2): 367.     CrossRef
  • Quantifiable identification of flow-limited ventilator dyssynchrony with the deformed lung ventilator model
    Deepak K. Agrawal, Bradford J. Smith, Peter D. Sottile, George Hripcsak, David J. Albers
    Computers in Biology and Medicine.2024; 173: 108349.     CrossRef
  • A novel application of spectrograms with machine learning can detect patient ventilator dyssynchrony
    Ishmael Obeso, Benjamin Yoon, David Ledbetter, Melissa Aczon, Eugene Laksana, Alice Zhou, R. Andrew Eckberg, Keith Mertan, Robinder G. Khemani, Randall Wetzel
    Biomedical Signal Processing and Control.2023; 86: 105251.     CrossRef
  • Effects of Neurally Adjusted Ventilation Assist (NAVA) and conventional modes of mechanical ventilation on diaphragm functions: A randomized controlled trial
    Vijay Hadda, Sourabh Pahuja, Saurabh Mittal, Karan Madan, Maroof A Khan, Anant Mohan, Randeep Guleria
    Heart & Lung.2022; 53: 36.     CrossRef
  • Reverse Triggering: An Introduction to Diagnosis, Management, and Pharmacologic Implications
    Brian Murray, Andrea Sikora, Jason R. Mock, Thomas Devlin, Kelli Keats, Rebecca Powell, Thomas Bice
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Attention-based convolutional long short-term memory neural network for detection of patient-ventilator asynchrony from mechanical ventilation
    Dingfu Chen, Kangwei Lin, Ziheng Deng, Dayu Li, Qingxu Deng
    Biomedical Signal Processing and Control.2022; 78: 103923.     CrossRef
  • Tracheotomy in ventilator-dependent patients with COVID-19: a cross-sectional study of analgesia and sedative requirements
    Brianne Wiemann, Jessica Mitchell, Preeyaporn Sarangarm, Richard Miskimins
    Journal of International Medical Research.2022; 50(11): 030006052211384.     CrossRef
  • An interpretable 1D convolutional neural network for detecting patient-ventilator asynchrony in mechanical ventilation
    Qing Pan, Lingwei Zhang, Mengzhe Jia, Jie Pan, Qiang Gong, Yunfei Lu, Zhongheng Zhang, Huiqing Ge, Luping Fang
    Computer Methods and Programs in Biomedicine.2021; 204: 106057.     CrossRef
  • Accuracy of Algorithms and Visual Inspection for Detection of Trigger Asynchrony in Critical Patients : A Systematic Review
    Monique Bandeira, Alícia Almeida, Lívia Melo, Pedro Henrique de Moura, Emanuelle Olympia Ribeiro Silva, Jakson Silva, Armèle Dornelas de Andrade, Daniella Brandão, Shirley Campos, Robert Boots
    Critical Care Research and Practice.2021; 2021: 1.     CrossRef
  • Patient–Ventilator Dyssynchrony in Critically Ill Patients
    Bruno De Oliveira, Nahla Aljaberi, Ahmed Taha, Baraa Abduljawad, Fadi Hamed, Nadeem Rahman, Jihad Mallat
    Journal of Clinical Medicine.2021; 10(19): 4550.     CrossRef
  • Patient–ventilator asynchrony in acute brain-injured patients: a prospective observational study
    Xu-Ying Luo, Xuan He, Yi-Min Zhou, Yu-Mei Wang, Jing-Ran Chen, Guang-Qiang Chen, Hong-Liang Li, Yan-Lin Yang, Linlin Zhang, Jian-Xin Zhou
    Annals of Intensive Care.2020;[Epub]     CrossRef
Original Articles
Pulmonary
The Use of Lung Ultrasound in a Surgical Intensive Care Unit
Hyung Koo Kang, Hyo Jin So, Deok Hee Kim, Hyeon-Kyoung Koo, Hye Kyeong Park, Sung-Soon Lee, Hoon Jung
Korean J Crit Care Med. 2017;32(4):323-332.   Published online November 30, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00318
  • 8,205 View
  • 254 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Pulmonary complications including pneumonia and pulmonary edema frequently develop in critically ill surgical patients. Lung ultrasound (LUS) is increasingly used as a powerful diagnostic tool for pulmonary complications. The purpose of this study was to report how LUS is used in a surgical intensive care unit (ICU).
Methods
This study retrospectively reviewed the medical records of 67 patients who underwent LUS in surgical ICU between May 2016 and December 2016.
Results
The indication for LUS included hypoxemia (n = 44, 65.7%), abnormal chest radiographs without hypoxemia (n = 17, 25.4%), fever without both hypoxemia and abnormal chest radiographs (n = 4, 6.0%), and difficult weaning (n = 2, 3.0%). Among 67 patients, 55 patients were diagnosed with pulmonary edema (n = 27, 41.8%), pneumonia (n = 20, 29.9%), diffuse interstitial pattern with anterior consolidation (n = 6, 10.9%), pneumothorax with effusion (n = 1, 1.5%), and diaphragm dysfunction (n = 1, 1.5%), respectively, via LUS. LUS results did not indicate lung complications for 12 patients. Based on the location of space opacification on the chest radiographs, among 45 patients with bilateral abnormality and normal findings, three (6.7%) and two (4.4%) patients were finally diagnosed with pneumonia and atelectasis, respectively. Furthermore, among 34 patients with unilateral abnormality and normal findings, two patients (5.9%) were finally diagnosed with pulmonary edema. There were 27 patients who were initially diagnosed with pulmonary edema via LUS. This diagnosis was later confirmed by other tests. There were 20 patients who were initially diagnosed with pneumonia via LUS. Among them, 16 and 4 patients were finally diagnosed with pneumonia and atelectasis, respectively.
Conclusions
LUS is useful to detect pulmonary complications including pulmonary edema and pneumonia in surgically ill patients.

Citations

Citations to this article as recorded by  
  • Lung Ultrasound in the Critically Ill
    Jin Sun Cho
    The Korean Journal of Critical Care Medicine.2017; 32(4): 356.     CrossRef
Hematology
Recombinant Activated Factor VII as a Second Line Treatment for Postpartum Hemorrhage
Soon Chang Park, Seok Ran Yeom, Sang Kyoon Han, Young Mo Jo, Hyung Bin Kim
Korean J Crit Care Med. 2017;32(4):333-339.   Published online November 30, 2017
DOI: https://doi.org/10.4266/kjccm.2016.00787
  • 9,906 View
  • 342 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
Severe or massive postpartum hemorrhage (PPH) has remained a leading cause of maternal mortality for decades across the world and it results in critical obstetric complications. Recombinant activated factor VII (rFVIIa) has emerged as a gold standard adjunctive hemostatic agent for the treatment of life-threatening PPH refractory to conventional therapies although it remains off-licensed for use in PPH. We studied the effects of rFVIIa on coagulopathy, transfusion volume, prognosis, severity change in Korean PPH patients.
Methods
A retrospective review of medical records between December 2008 and March 2011 indicating use of rFVIIa in severe PPH was performed. We compared age, rFVIIa treatment, transfusion volume, and Sequential Organ Failure Assessment (SOFA) score at the time of arrival in the emergency department and after 24 hours for patients whose SOFA score was 8 points or higher.
Results
Fifteen women with SOFA score of 8 and above participated in this study and eight received rFVIIa administration whereas seven did not. Patients’ mean age was 31.7 ± 7.5 years. There was no statistically significant difference in initial and post-24 hours SOFA scores between patients administered rFVIIa or not. The change in SOFA score between initial presentation and after 24 hours was significantly reduced after rFVIIa administration (P = 0.016).
Conclusions
This analysis aimed to support that the administration of rFVIIa can reduce the severity of life-threatening PPH in patients. A rapid decision regarding the administration of rFVIIa is needed for a more favorable outcome in severe PPH patients for whom there is no effective standard treatment.

Citations

Citations to this article as recorded by  
  • Role of recombinant factor VIIa in the clinical management of severe postpartum hemorrhage: consensus among European experts
    D. Surbek, J. Blatný, M. Wielgos, N. Acs, H. Edwards, O. Erez, J. L. Bartha, H. Madar, F. J. Mercier, D. Schlembach, G. C. Di Renzo
    The Journal of Maternal-Fetal & Neonatal Medicine.2024;[Epub]     CrossRef
  • Efficacy and Safety Analyses of Recombinant Factor VIIa in Severe Post-Partum Hemorrhage
    Camila Caram-Deelder, Hellen McKinnon Edwards, Jarmila A. Zdanowicz, Thomas van den Akker, Camilla Birkegård, Jan Blatný, Johanna G. van der Bom, Giuseppe Colucci, Derek van Duuren, Nan van Geloven, Dacia D. C. A. Henriquez, Marian Knight, Lars Korsholm,
    Journal of Clinical Medicine.2024; 13(9): 2656.     CrossRef
  • Coagulation management and transfusion in massive postpartum hemorrhage
    Christina Massoth, Manuel Wenk, Patrick Meybohm, Peter Kranke
    Current Opinion in Anaesthesiology.2023; 36(3): 281.     CrossRef
  • Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care
    Sibylle Kietaibl, Aamer Ahmed, Arash Afshari, Pierre Albaladejo, Cesar Aldecoa, Giedrius Barauskas, Edoardo De Robertis, David Faraoni, Daniela C. Filipescu, Dietmar Fries, Anne Godier, Thorsten Haas, Matthias Jacob, Marcus D. Lancé, Juan V. Llau, Jens Me
    European Journal of Anaesthesiology.2023; 40(4): 226.     CrossRef
Trauma
Acute Physiology and Chronic Health Evaluation II Score and Sequential Organ Failure Assessment Score as Predictors for Severe Trauma Patients in the Intensive Care Unit
Min A Lee, Kang Kook Choi, Byungchul Yu, Jae Jeong Park, Youngeun Park, Jihun Gwak, Jungnam Lee, Yang Bin Jeon, Dae Sung Ma, Gil Jae Lee
Korean J Crit Care Med. 2017;32(4):340-346.   Published online November 30, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00255
  • 7,924 View
  • 170 Download
  • 7 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU).
Methods
We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated.
Results
The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher.
Conclusions
In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.

Citations

Citations to this article as recorded by  
  • Cell-free DNA as diagnostic and prognostic biomarkers for adult sepsis: a systematic review and meta-analysis
    Awirut Charoensappakit, Kritsanawan Sae-khow, Pongpera Rattanaliam, Nuntanuj Vutthikraivit, Monvasi Pecheenbuvan, Suwasin Udomkarnjananun, Asada leelahavanichkul
    Scientific Reports.2023;[Epub]     CrossRef
  • Evaluation of the sequential organ failure assessment score and newly introduced criteria – Traumasis - in traffic collision patients
    Sion Jo, Taeoh Jeong, Boyoung Park
    The American Journal of Emergency Medicine.2022; 51: 98.     CrossRef
  • Predictive value of Modified Early Warning Score (MEWS) and Revised Trauma Score (RTS) for the short-term prognosis of emergency trauma patients: a retrospective study
    Zhejun Yu, Feng Xu, Du Chen
    BMJ Open.2021; 11(3): e041882.     CrossRef
  • Risk factors for abdominal surgical site infection after exploratory laparotomy among combat casualties
    Joseph D. Bozzay, Patrick F. Walker, David W. Schechtman, Faraz Shaikh, Laveta Stewart, M. Leigh Carson, David R. Tribble, Carlos J. Rodriguez, Matthew J. Bradley
    Journal of Trauma and Acute Care Surgery.2021; 91(2S): S247.     CrossRef
Pediatric
Serum Albumin as a Biomarker of Poor Prognosis in the Pediatric Patients in Intensive Care Unit
Young Suh Kim, In Suk Sol, Min Jung Kim, Soo Yeon Kim, Jong Deok Kim, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Sohn, Kyu-Earn Kim
Korean J Crit Care Med. 2017;32(4):347-355.   Published online November 30, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00437
  • 8,567 View
  • 317 Download
  • 7 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary Material
Background
Serum albumin as an indicator of the disease severity and mortality is suggested in adult patients, but its role in pediatric patients has not been established. The objectives of this study are to investigate the albumin level as a biomarker of poor prognosis and to compare it with other mortality predictive indices in children in intensive care unit (ICU).
Methods
Medical records of 431 children admitted to the ICU at Severance Hospital from January 1, 2012 to December 31, 2015 were retrospectively analyzed. Children who expired within 24 hours after ICU admission, children with hepatic or renal failure, and those who received albumin replacement before ICU admission were excluded.
Results
The children with hypoalbuminemia had higher 28-day mortality rate (24.60% vs. 9.28%, P < 0.001), Pediatric Index of Mortality (PIM) 3 score (9.23 vs. 8.36, P < 0.001), Pediatric Risk of Mortality (PRISM) III score (7.0 vs. 5.0, P < 0.001), incidence of septic shock (12% vs. 3%, P < 0.001), C-reactive protein (33.0 mg/L vs. 5.8 mg/L, P < 0.001), delta neutrophil index (2.0% vs. 0.6%, P < 0.001), lactate level (1.6 mmol/L vs. 1.2 mmol/L, P < 0.001) and lower platelet level (206,000/μl vs. 341,000/μl, P < 0.001) compared to the children with normal albumin level. PIM 3 (r = 0.219, P < 0.001) and PRISM III (r = 0.375, P < 0.001) were negatively correlated with serum albumin level, respectively.
Conclusions
Our results highlight that hypoalbuminemia can be a biomarker of poor prognosis including mortality in the children in ICU.

Citations

Citations to this article as recorded by  
  • Prognostic factors and models to predict pediatric sepsis mortality: A scoping review
    Irene Yuniar, Cut Nurul Hafifah, Sharfina Fulki Adilla, Arifah Nur Shadrina, Anthony Christian Darmawan, Kholisah Nasution, Respati W. Ranakusuma, Eka Dian Safitri
    Frontiers in Pediatrics.2023;[Epub]     CrossRef
  • The association between serum albumin and long length of stay of patients with acute heart failure: A retrospective study based on the MIMIC-IV database
    Tao Liu, Haochen Xuan, Lili Wang, Xiaoqun Li, Zhihao Lu, Zhaoxuan Tian, Junhong Chen, Chaofan Wang, Dongye Li, Tongda Xu, Chiara Lazzeri
    PLOS ONE.2023; 18(2): e0282289.     CrossRef
  • Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 (PIMS-TS) and Serous Effusions in a Child With Severe Hypoalbuminemia: A Case Report
    Zohair El Haddar, Aziza Elouali, Ilham Belga, Maria Rkain, Abdeladim Babakhouya
    Cureus.2023;[Epub]     CrossRef
  • Inappropriate empirical antibiotic therapy was an independent risk factor of pediatric persistent S. aureus bloodstream infection
    Xingmei Wang, Ziyao Guo, Xi Zhang, Guangli Zhang, Qinyuan Li, Xiaoyin Tian, Dapeng Chen, Zhengxiu Luo
    European Journal of Pediatrics.2022; 182(2): 719.     CrossRef
  • Evaluation of models for predicting pediatric fraction unbound in plasma for human health risk assessment
    Yejin Esther Yun, Andrea N. Edginton
    Journal of Toxicology and Environmental Health, Part A.2021; 84(2): 67.     CrossRef
  • Diabetes Mellitus and Hypertension Increase Risk of Death in Novel Corona Virus Patients Irrespective of Age: a Prospective Observational Study of Co-morbidities and COVID-19 from India
    Anirban Gupta, Neelabh Nayan, Ranjith Nair, Krishna Kumar, Aditya Joshi, Shivangi Sharma, Jasdeep Singh, Rajan Kapoor
    SN Comprehensive Clinical Medicine.2021; 3(4): 937.     CrossRef
  • Overview of Albumin Physiology and its Role in Pediatric Diseases
    Charles B. Chen, Bilasan Hammo, Jessica Barry, Kadakkal Radhakrishnan
    Current Gastroenterology Reports.2021;[Epub]     CrossRef
  • The effect of nutritional status on post-operative outcomes in pediatric otolaryngology-head and neck surgery
    Jordan Luttrell, Matthew Spence, Hiba Al-Zubeidi, Michael J. Herr, Madhu Mamidala, Anthony Sheyn
    International Journal of Pediatric Otorhinolaryngology.2021; 150: 110875.     CrossRef
Editorial
Basic science and research
Lung Ultrasound in the Critically Ill
Jin Sun Cho
Korean J Crit Care Med. 2017;32(4):356-358.   Published online November 30, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00556
  • 5,487 View
  • 226 Download
PDF
Case Reports
Neurology
Malignant Syndrome in Parkinson Disease Similar to Severe Infection
Dong Hun Lee, Jeong Mi Moon, Yong Soo Cho
Korean J Crit Care Med. 2017;32(4):359-362.   Published online December 29, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00087
  • 16,710 View
  • 204 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
A 70-year-old woman with Parkinson disease was admitted to the emergency department with altered consciousness, fever and convulsive movements without experiencing withdrawal from antiparkinsonian medication. Six hours after the emergency department visit, the patient had a hyperpyrexia (>40°C) and a systolic blood pressure of 40 mmHg. There was no evidence of bacterial infection based on extensive workups. The patient was discharged without aggravation of Parkinson disease symptoms after treatment that included administration of dantrolene sodium, enforcement of continuous renal replacement therapy and cooling blankets. Malignant syndrome should be suspected if high fever occurs in Parkinson disease patients without evidence of a definitive infection.

Citations

Citations to this article as recorded by  
  • Parkinsonism-Hyperpyrexia Syndrome and Dyskinesia-Hyperpyrexia Syndrome in Parkinson’s Disease: Two Cases and Literature Review
    Jian-Yong Wang, Jie-Fan Huang, Shi-Guo Zhu, Shi-Shi Huang, Rong-Pei Liu, Bei-Lei Hu, Jian-Hong Zhu, Xiong Zhang
    Journal of Parkinson's Disease.2022; 12(6): 1727.     CrossRef
Toxicology
Methidathion Poisoning
Ki Hoon Kim, Se Hun Kim, Charles Her
Korean J Crit Care Med. 2017;32(4):363-369.   Published online January 17, 2017
DOI: https://doi.org/10.4266/kjccm.2016.00073
  • 5,899 View
  • 148 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Although methidathion is an organophosphate insecticide, it is different from the other organophosphates in terms of toxicity. Because of its relatively high fat solubility, the apparent volume of methidathion distribution throughout the body is very high, indicating that hemoperfusion is not effective in removing this organophosphate from the body. Redistribution of methidathion from fat to blood can also occur when plasma levels diminish. Additionally, acetylcholinesterase aging, which is the loss of an alkyl side chain that prevents reactivation by oximes, is very rapid so that the effective reactivation by oximes is thwarted. Thus, methidathion’s effect on acetylcholinesterase inhibition is long lasting, particularly with a high dose. In addition to its parasympatholytic effect and ability to induce muscle paralysis, methidathion poisoning is associated with a profound and long-lasting circulatory collapse due to sympathetic ganglion blockade. This report presents the case of a 55-year-old man who accidentally ingested a high dose of methidathion. He later developed enteroinvasive aspergillosis infection-induced multiple bowel perforations on two separate occasions while on mechanical ventilator support, resulting in a fatal outcome. The renin-angiotensin axis activated by sympathetic ganglion blockade may have reduced the patient’s splanchnic blood flow, contributing to translocation of endotoxin. Also, the effect of excessive acetylcholine on non-neuronal acetylcholine receptors may have contributed to the development of fatal enteroinvasive aspergillosis in this patient.

Citations

Citations to this article as recorded by  
  • A case report of acute kidney injury following organophosphate methidathion poisoning
    Bilel Chefirat, Anissa Zergui, Haciba Rezk-Kallah
    Toxicologie Analytique et Clinique.2022; 34(2): 121.     CrossRef
Image in Critical Care
Pulmonary
A Pleural Catheter Malposition through Diaphragm to Abdominal Cavity
Won Jai Jung, Sue In Choi, Eun Joo Lee, Sang Yeub Lee, Kwang Ho In
Korean J Crit Care Med. 2017;32(4):370-371.   Published online November 30, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00290
  • 5,725 View
  • 119 Download
  • 2 Web of Science
  • 1 Crossref
PDF

Citations

Citations to this article as recorded by  
  • The Malpositioned Tunneled Pleural Catheter
    Olaedo Abana, Uzair Ghori, Ammar Alqaid, Robert Holladay
    Journal of Bronchology & Interventional Pulmonology.2021; 28(4): e62.     CrossRef
Letters to the Editor
Cardiology
Spontaneous Echo Contrast Mistaken for Left Ventricular Thrombus during Venoarterial Extracorporeal Membrane Oxygenation
Seok In Lee, So Young Lee, Chang Hyu Choi, Kook Yang Park, Chul-Hyun Park
Korean J Crit Care Med. 2017;32(4):372-375.   Published online November 30, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00220
  • 11,442 View
  • 145 Download
PDF
Ethics
Should Very Old Patients Be Admitted to the Intensive Care Units?
Jun Kwon Cha, In-Ae Song
Korean J Crit Care Med. 2017;32(4):376-377.   Published online November 30, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00521
  • 5,358 View
  • 143 Download
PDF
Ethics
The Authors Reply
Jeong Uk Lim, Jongmin Lee, Jick Hwan Ha, Hyeon Hui Kang, Sang Haak Lee, Hwa Sik Moon
Korean J Crit Care Med. 2017;32(4):377-379.   Published online November 30, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00521.r1
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  • 110 Download
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ACC : Acute and Critical Care