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Volume 34 (1); February 2019
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Review Articles
Pulmonary
Pulmonary and Physical Rehabilitation in Critically Ill Patients
Myung Hun Jang, Myung-Jun Shin, Yong Beom Shin
Acute Crit Care. 2019;34(1):1-13.   Published online February 28, 2019
DOI: https://doi.org/10.4266/acc.2019.00444
  • 20,239 View
  • 1,214 Download
  • 35 Web of Science
  • 35 Crossref
AbstractAbstract PDF
Some patients admitted to the intensive care unit (ICU) because of an acute illness, complicated surgery, or multiple traumas develop muscle weakness affecting the limbs and respiratory muscles during acute care in the ICU. This condition is referred to as ICU-acquired weakness (ICUAW), and can be evoked by critical illness polyneuropathy (CIP), critical illness myopathy (CIM), or critical illness polyneuromyopathy (CIPNM). ICUAW is diagnosed using the Medical Research Council (MRC) sum score based on bedside manual muscle testing in cooperative patients. The MRC sum score is the sum of the strengths of the 12 regions on both sides of the upper and lower limbs. ICUAW is diagnosed when the MRC score is less than 48 points. However, some patients require electrodiagnostic studies, such as a nerve conduction study, electromyography, and direct muscle stimulation, to differentiate between CIP and CIM. Pulmonary rehabilitation in the ICU can be divided into modalities intended to remove retained airway secretions and exercise therapies intended to improve respiratory function. Physical rehabilitation, including early mobilization, positioning, and limb exercises, attenuates the weakness that occurs during critical care. To perform mobilization in mechanically ventilated patients, pretreatment by removing secretions is necessary. It is also important to increase the strength of respiratory muscles and to perform lung recruitment to improve mobilization in patients who are weaned from the ventilator. For these reasons, pulmonary rehabilitation is important in addition to physical therapy. Early recognition of CIP, CIM, and CIPNM and early rehabilitation in the ICU might improve patients’ functional recovery and outcomes.

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  • Efficacy of Physiotherapy Interventions on Weaning in Mechanically Ventilated Critically Ill Patients: A Systematic Review and Meta-Analysis
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  • Muscle weakness assessment in older intensive care unit patients
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Ethics
Medical Management of Brain-Dead Organ Donors
A.S.M. Tanim Anwar, Jae-myeong Lee
Acute Crit Care. 2019;34(1):14-29.   Published online February 28, 2019
DOI: https://doi.org/10.4266/acc.2019.00430
  • 23,778 View
  • 1,450 Download
  • 29 Web of Science
  • 36 Crossref
AbstractAbstract PDF
With improving healthcare services, the demand for organ transplants has been increasing daily worldwide. Deceased organ donors serve as a good alternative option to meet this demand. The first step in this process is identifying potential organ donors. Specifically, braindead patients require aggressive and intensive care from the declaration of brain death until organ retrieval. Currently, there are no specific protocols in place for this, and there are notable variations in the management strategies implemented across different transplant centers. Some transplant centers follow their own treatment protocols, whereas other countries, such as Bangladesh, do not have any protocols for potential organ donor care. In this review, we discuss how to identify brain-dead donors and describe the physiological changes that occur following brain death. We then summarize the management of brain-dead organ donors and, on the basis of a review of the literature, we propose recommendations for a treatment protocol to be developed in the future.

Citations

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Original Articles
Infection
Application of Sepsis-3 Criteria to Korean Patients with Critical Illnesses
Jae Yeol Kim, Hwan Il Kim, Gee Young Suh, Sang Won Yoon, Tae-Yop Kim, Sang Haak Lee, Jae Young Moon, Jae-Young Kwon, Sungwon Na, Ho Geol Ryu, Jisook Park, Younsuck Koh
Acute Crit Care. 2019;34(1):30-37.   Published online January 29, 2019
DOI: https://doi.org/10.4266/acc.2018.00318
Correction in: Acute Crit Care 2019;34(2):172
  • 7,755 View
  • 172 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
The 2016 Society of Critical Care Medicine (SCCM)/European Society of Intensive Care Medicine (ESICM) task force for Sepsis-3 devised new definitions for sepsis, sepsis with organ dysfunction and septic shock. Although Sepsis-3 was data-driven, evidence-based approach, East Asian descents comprised minor portions of the project population. Methods: We selected Korean participants from the fever and antipyretics in critically ill patients evaluation (FACE) study, a joint study between Korea and Japan. We calculated the concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria and evaluated mortality rates of sepsis, sepsis with organ dysfunction, and septic shock by Sepsis-3 criteria using the selected data. Results: Korean participants of the FACE study were 913 (383 with sepsis and 530 without sepsis by Sepsis-2 criteria). The concordance rate for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria was 55.4%. The intensive care unit (ICU) and 28-day mortality rates of sepsis, sepsis with organ dysfunction, and septic shock patients according to Sepsis-3 criteria were 26.2% and 31.0%, 27.5% and 32.5%, and 40.8% and 43.4%, respectively. The quick Sequential Organ Failure Assessment (qSOFA) was inferior not only to SOFA but also to systemic inflammatory response syndrome (SIRS) for predicting ICU and 28-day mortality. Conclusions: The concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria were low. Mortality rate for septic shock in Koreans was consistent with estimates made by the 2016 SCCM/ESICM task force. SOFA and SIRS were better than qSOFA for predicting ICU and 28-day mortality in Korean ICU patients.

Citations

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Basic science and research
Prognostic Implication of Adrenocortical Response during the Course of Critical Illness
Jin Hwa Song, Jung Hee Kim, Sang-Min Lee, Jinwoo Lee
Acute Crit Care. 2019;34(1):38-45.   Published online January 30, 2019
DOI: https://doi.org/10.4266/acc.2018.00339
  • 7,021 View
  • 127 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDFSupplementary Material
Background
Critical illness-related corticosteroid insufficiency (CIRCI) and adrenocorticotropic hormone (ACTH)-cortisol dissociation are hormonal conditions frequently observed in patients in the intensive care unit (ICU). The aim of this study was to evaluate the association between ACTH-cortisol dissociation and clinical outcomes of critically ill patients. Methods: We retrospectively reviewed the medical records of 94 ICU patients who underwent two rapid cosyntropin tests during hospital admission and compared the clinical aspects of patients with and without ACTH-cortisol dissociation. ACTH-cortisol dissociation was defined as plasma ACTH and serum cortisol concentrations of <22 pmol/L and >600 nmol/L, respectively. Results: Dissociation was present in 30 of the 94 patients (31.9%). Patients with ACTH-cortisol dissociation in the initial test had significantly higher hospital mortality rate than those in the control group (55% vs. 25.7%, P=0.013) There was no difference in hospital mortality between patients classified as having CIRCI and those who were not. In multivariate adjusted Cox regression analysis, the mortality risk was higher in the group with ACTH-cortisol dissociation (hazard ratio, 2.98; 95% confidence interval, 1.34 to 6.63; P=0.007). Patients with dissociation in two consecutive stimulation tests showed the highest hospital mortality rate among groups classified according to stimulation test results (100% vs. 31.3%). Conclusions: The hospital mortality was higher in ICU patients diagnosed with ACTH-cortisol dissociation. It is clinically feasible to evaluate the presence of ACTH-cortisol dissociation by analyzing rapid ACTH stimulation test results in critically ill patients.

Citations

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  • Serum ACTH and Cortisol Level is Associated with the Acute Gastrointestinal Injury Grade in ICU Patients
    Wen Xu, Yuzhen Qiu, Hongping Qiu, Ming Zhong, Lei Li
    International Journal of General Medicine.2024; Volume 17: 127.     CrossRef
  • PROGNOSTIC VALUE OF LOW-DOSE ADRENOCORTICOTROPIC HORMONE TEST IN CRITICALLY ILL PATIENTS
    Ahmad B. Abdelrehim, Fatma M. Mohsen, Mostafa A. Haredi, Zeinab Abdel Hameed, Walaa H. Ibrahim
    Shock.2023; 59(6): 871.     CrossRef
  • Copeptin and stress-induced hyperglycemia in critically ill patients: A prospective study
    Lilian Rodrigues Henrique, Daisy Crispim, Tarsila Vieceli, Ariell Freires Schaeffer, Priscila Bellaver, Cristiane Bauermann Leitão, Tatiana Helena Rech, Antonio Palazón-Bru
    PLOS ONE.2021; 16(4): e0250035.     CrossRef
  • Comparison of salivary and serum cortisol levels in mechanically ventilated patients and non-critically ill patients
    Jung Hee Kim, Yoon Ji Kim, Sang-Min Lee, Jinwoo Lee
    Acute and Critical Care.2020; 35(3): 149.     CrossRef
Ethics
Characteristics and Outcomes of Potentially Inappropriate Admissions to the Intensive Care Unit
Sooim Sin, Sang-Min Lee, Jinwoo Lee
Acute Crit Care. 2019;34(1):46-52.   Published online February 28, 2019
DOI: https://doi.org/10.4266/acc.2018.00388
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AbstractAbstract PDFSupplementary Material
Background
Admission of patients perceived as potentially inappropriate for intensive care is a very sensitive and controversial issue. We aimed to evaluate the use of medical resources in the intensive care unit (ICU) and outcomes of patients according to a physician’s judgment of appropriateness. Methods: ICU physicians classified patients who were admitted to the medical ICU of a tertiary hospital as appropriate or inappropriate for intensive care within 24 hours of admission. Patient outcomes including mortality were analyzed according to appropriateness. Additionally, the usage and duration of mechanical ventilation (MV), renal replacement therapy (RRT), and extracorporeal membrane oxygenation (ECMO) were analyzed according to appropriateness. Results: In total, 105 patients (male, 55.4%; mean age, 62 years) were included. Twelve (11.4%) patients were considered inappropriate for intensive care based on guidance published by the Society of Critical Care Medicine through a questionnaire survey of physicians. There was no significant difference between patients considered inappropriate or appropriate for ICU admission regarding the use and duration of MV, RRT, and ECMO. In contrast, the ICU, in-hospital, 28-day, 90-day, and total mortality rates were significantly higher among patients with inappropriate admission than among patients with appropriate admission (ICU mortality: 50.0% vs. 25.8%, P=0.008; in-hospital mortality: 58.3% vs. 43.0%, P=0.028; 28-day mortality: 58.3% vs. 33.3%, P=0.019; 90-day mortality: 66.7% vs. 44.1%, P=0.023). Conclusions: Despite higher mortality, the amount of medical resources used for patients considered potentially inappropriate for intensive care did not differ from the resources used for patients considered suitable for ICU care.

Citations

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  • Characteristics of critically ill patients with cancer associated with intensivist's perception of inappropriateness of ICU admission: A retrospective cohort study
    Carla Marchini Dias da Silva, Bruno Adler Maccagnan Pinheiro Besen, Antônio Paulo Nassar Jr
    Journal of Critical Care.2024; 79: 154468.     CrossRef
  • Association of appropriateness for ICU admission with resource use, organ support and long-term survival in critically ill cancer patients
    Carla Marchini Dias Silva, Janaina Naiara Germano, Anna Karolyne de Araujo Costa, Giovanna Alves Gennari, Pedro Caruso, Antonio Paulo Nassar Jr
    Internal and Emergency Medicine.2023; 18(4): 1191.     CrossRef
  • Performance and Sociodemographic Determinants of Excess Outpatient Demand of Rural Residents in China: A Cross-Sectional Study
    Yanchen Liu, Yingchun Chen, Xueyan Cheng, Yan Zhang
    International Journal of Environmental Research and Public Health.2020; 17(16): 5963.     CrossRef
Surgery
Association of Immediate Postoperative Temperature in the Surgical Intensive Care Unit with 1-Year Mortality: Retrospective Analysis Using Digital Axillary Thermometers
Jiwook Kim, Tak Kyu Oh, Jaebong Lee, Saeyeon Kim, In-Ae Song
Acute Crit Care. 2019;34(1):53-59.   Published online January 9, 2019
DOI: https://doi.org/10.4266/acc.2019.00255
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AbstractAbstract PDFSupplementary Material
Background
Postoperative body temperature is closely associated with prognosis although there is limited research regarding this association at postoperative intensive care unit (ICU) admission. Furthermore, no studies have used digital axillary thermometers to measure postoperative body temperature. This study investigated the association between mortality and postoperative temperature measured using a digital axillary thermometer within 10 minutes after ICU admission. Methods: This retrospective observational study evaluated data from adult patients admitted to an ICU after elective or emergency surgery. The primary outcome was 1-year mortality after ICU admission. Multivariable logistic regression analysis with restricted cubic splines was used to evaluate the association between temperature and outcomes. Results: We evaluated data from 5,868 patients admitted between January 1, 2013 and May 31, 2016, including 5,311 patients (90.5%) who underwent noncardiovascular surgery and 557 patients (9.5%) who underwent cardiovascular surgery. Deviation from the median temperature (36.6°C) was associated with increases in 1-year mortality (≤ 36.6°C: linear coefficient, –0.531; P<0.001 and ≥36.6°C: spline coefficient, 0.756; P<0.001). Similar statistically significant results were observed in the noncardiovascular surgery group, but not in the cardiovascular surgery group. Conclusions: An increase or decrease in body temperature (vs. 36.6°C) measured using digital axillary thermometers within 10 minutes of postoperative ICU admission was associated with increased 1-year mortality. However, no significant association was observed after cardiovascular surgery. These results suggest that postoperative temperature is associated with longterm mortality in patients admitted to the surgical ICU in the postoperative period.

Citations

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  • Construction of a nursing assessment framework for patients in anaesthesia recovery period: A modified Delphi study
    Lang Peng, Xianxian Zang, Ruili Liu, Ping Bai, Lu Wang, Guoyong Yang
    Journal of Advanced Nursing.2024;[Epub]     CrossRef
  • A prognostic model for 1-month mortality in the postoperative intensive care unit
    Mohammad Fathi, Nader Markazi Moghaddam, Saba Naderian Jahromi
    Surgery Today.2022; 52(5): 795.     CrossRef
  • Relationship Between First 24-h Mean Body Temperature and Clinical Outcomes of Post-cardiac Surgery Patients
    Fei Xu, Cheng Zhang, Chao Liu, Siwei Bi, Jun Gu
    Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
  • Rebound hypothermia after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and cardiac arrest in immediate postoperative period: a report of two cases and review of literature
    Sohan Lal Solanki, Mrida A. K. Jhingan, Avanish P. Saklani
    Pleura and Peritoneum.2020;[Epub]     CrossRef
  • Postoperative Hypothermia
    Deokkyu Kim
    Acute and Critical Care.2019; 34(1): 79.     CrossRef
Pulmonary
Protecting Postextubation Respiratory Failure and Reintubation by High-Flow Nasal Cannula Compared to Low-Flow Oxygen System: Single Center Retrospective Study and Literature Review
Minhyeok Lee, Ji Hye Kim, In Beom Jeong, Ji Woong Son, Moon Jun Na, Sun Jung Kwon
Acute Crit Care. 2019;34(1):60-70.   Published online February 28, 2019
DOI: https://doi.org/10.4266/acc.2018.00311
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AbstractAbstract PDFSupplementary Material
Background
Use of a high-flow nasal cannula (HFNC) reduced postextubation respiratory failure (PERF) and reintubation rate compared to use of a low-flow oxygen system (LFOS) in low-risk patients. However, no obvious conclusion was reached for high-risk patients. Here, we sought to present the current status of HFNC use as adjunctive oxygen therapy in a clinical setting and to elucidate the nature of the protective effect following extubation.
Methods
The medical records of 855 patients who were admitted to the intensive care unit of single university hospital during a period of 5.5 years were analyzed retrospectively, with only 118 patients ultimately included in the present research. The baseline characteristics of these patients and the occurrence of PERF and reintubation along with physiologic changes were analyzed.
Results
Eighty-four patients underwent HFNC, and the remaining 34 patients underwent conventional LFOS after extubation. Physicians preferred HFNC to LFOS in the face of highrisk features including old age, neurologic disease, moderate to severe chronic obstructive pulmonary disease, a long duration of mechanical ventilation, low baseline arterial partial pressure of oxygen to fraction of inspired oxygen ratio, and a high baseline alveolar–arterial oxygen difference. The reintubation rate at 72 hours after extubation was not different (9.5% vs. 8.8%; P=1.000). Hypoxic respiratory failure was slightly higher in the nonreintubation group than in the reintubation group (31.9% vs. 6.7%; P=0.058). Regarding physiologic effects, heart rate was only stabilized after 24 hours of extubation in the HFNC group.
Conclusions
No difference was found in the occurrence of PERF and reintubation between both groups. It is worth noting that similar PERF and reintubation ratios were shown in the HFNC group in those with certain exacerbating risk factors versus not. Caution is needed regarding delayed reintubation in the HFNC group.

Citations

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  • Predictors and outcomes of high-flow nasal cannula failure following extubation: A multicentre observational study
    Amit Kansal, Shekhar Dhanvijay, Andrew Li, Jason Phua, Matthew Edward Cove, Wei Jun Dan Ong, Ser Hon Puah, Vicky Ng, Qiao Li Tan, Julipie Sumampong Manalansan, Michael Sharey Nocon Zamora, Michael Camba Vidanes, Juliet Tolentino Sahagun, Juvel Taculod, Ad
    Annals of the Academy of Medicine, Singapore.2021; 50(6): 467.     CrossRef
  • Flow Field Analysis of Adult High-Flow Nasal Cannula Oxygen Therapy
    Jingen Xia, Jiaqi Chang, Jixiang Liang, Yixuan Wang, Na Wang, Bo Xiao
    Complexity.2021; 2021: 1.     CrossRef
Neurosurgery
The RAP Index during Intracranial Pressure Monitoring as a Clinical Guiding for Surgically Treated Aneurysmal Subarachnoid Hemorrhage: Consecutive Series of Single Surgeon
Sung-Chul Jin, Byung Sam Choi, Jung-Soo Kim
Acute Crit Care. 2019;34(1):71-78.   Published online February 28, 2019
DOI: https://doi.org/10.4266/acc.2019.00437
  • 6,494 View
  • 134 Download
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AbstractAbstract PDF
Background
It is well known that assessing the RAP index along with intracranial pressure (ICP) monitoring in traumatic brain injury patients is helpful. We will discuss the usefulness of this assessment tool as a clinical guide for surgically treated poor grade aneurysmal subarachnoid hemorrhage (SAH).
Methods
This retrospective study included 35 patients with aneurysmal SAH who presented with World Federation of Neurosurgical Societies (WFNS) grade V SAH and received surgical treatment from January 2013 to December 2018. Emergency surgical clipping, hematoma removal, extraventricular drainage, and if needed, wide decompressive craniectomy were combined as the proper surgical treatments. Outcomes were assessed based on in-hospital survival and the Glasgow outcome scale score at 14-day follow-up. We compared the mortality rate of two groups of seven patients: ICP monitoring only (n=5) and ICP monitoring combined with the RAP index (n=2).
Results
The in-hospital 14-day mortality rate by brain lesion was 48.5% (n=17). Seven patients had real-time ICP monitoring. Before 2018, three of five patients with poor WFNS grade who received real-time ICP monitoring only died. There were no deaths in the group of two patients receiving real-time ICP monitoring and the RAP index.
Conclusions
Our data indicate that combining the RAP index and ICP monitoring can be used as markers for critical intracranial physiological parameters in poor grade WFNS patients.

Citations

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  • Multimodal Neurologic Monitoring in Children With Acute Brain Injury
    Jennifer C. Laws, Lori C. Jordan, Lindsay M. Pagano, John C. Wellons, Michael S. Wolf
    Pediatric Neurology.2022; 129: 62.     CrossRef
  • Intracranial pressure: current perspectives on physiology and monitoring
    Gregory W. J. Hawryluk, Giuseppe Citerio, Peter Hutchinson, Angelos Kolias, Geert Meyfroidt, Chiara Robba, Nino Stocchetti, Randall Chesnut
    Intensive Care Medicine.2022; 48(10): 1471.     CrossRef
  • The application value of CT radiomics features in predicting pressure amplitude correlation index in patients with severe traumatic brain injury
    Jiaqi Liu, Yingchi Shan, Guoyi Gao
    Frontiers in Neurology.2022;[Epub]     CrossRef
Editorial
Surgery
Postoperative Hypothermia
Deokkyu Kim
Acute Crit Care. 2019;34(1):79-80.   Published online January 30, 2019
DOI: https://doi.org/10.4266/acc.2018.00395
  • 38,659 View
  • 840 Download
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PDF

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  • Sleep quality in cynomolgus macaques (Macaca fascicularis) varies by housing type and following surgery
    Emilie A. Paterson, Carly I. O’Malley, Patricia V. Turner
    Applied Animal Behaviour Science.2024; 272: 106188.     CrossRef
  • The Effectiveness of Active External Warming of Patient Concurrently With Ice Application on the Incision Site on Post-Thoracotomy Pain and Analgesic Consumption
    Emine Kol, Serpil Ince, Abdullah Erdoğan, Bilge Karsli, Hakan Keskin, Nazmiye Özgür
    Clinical Nursing Research.2023; 32(2): 323.     CrossRef
  • Efficacy of intravenous nalbuphine for managing post-anaesthesia shivering: A systematic review and meta-analysis of randomised controlled trials with trial sequential analysis
    Abhijit Nair, Ujjwalraj Dudhedia, Manamohan Rangaiah, Suhrud Panchawagh
    Indian Journal of Anaesthesia.2023; 67(10): 853.     CrossRef
  • Determining the Effectiveness of Forced-Air Warming Blankets in Maintaining Postoperative Body Temperature: A Randomized Controlled Trial
    Ayşe Gökce Işıklı, Ümmü Yıldız Fındık
    Journal of PeriAnesthesia Nursing.2022; 37(4): 533.     CrossRef
  • Application of Care Bundles in Postanesthesia Recovery for Elderly Patients with Colorectal Cancer
    Xiaoling Yu, Lichai Chen, Shuyi Chen, Weiming Qian, Lili Fang, Ahmed Faeq Hussein
    Computational and Mathematical Methods in Medicine.2022; 2022: 1.     CrossRef
  • Mean Temperature Loss During General Anesthesia for Laparoscopic Cholecystectomy: Comparison of Males and Females
    Usama Ahmed, Hameed Ullah, Khalid Samad
    Cureus.2021;[Epub]     CrossRef
  • Postoperative hypothermia and associate factors at Debre Berhan comprehensive specialized hospital 2019: A cross sectional study
    Mengesha Dessie Allene
    International Journal of Surgery Open.2020; 24: 112.     CrossRef
  • Rebound hypothermia after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and cardiac arrest in immediate postoperative period: a report of two cases and review of literature
    Sohan Lal Solanki, Mrida A. K. Jhingan, Avanish P. Saklani
    Pleura and Peritoneum.2020;[Epub]     CrossRef
Case Reports
Gastroenterology
Pneumatosis Intestinalis Presenting as Small Bowel Obstruction without Bowel Ischemia after Mechanical Ventilation
Dong Joon Kim, Yong Joon Choi, Young Sun Yoo
Acute Crit Care. 2019;34(1):81-85.   Published online January 17, 2017
DOI: https://doi.org/10.4266/acc.2016.00311
  • 33,295 View
  • 170 Download
AbstractAbstract PDF
Pneumatosis intestinalis (PI) is a rare condition of the presence of gas within the bowel walls. PI is associated with numerous underlying diseases, ranging from life-threatening to innocuous conditions. PI is believed to be secondary to coexisting disorders in approximately 85% of all cases. This paper reviews the case of a patient who was diagnosed seven years prior with pneumoperitoneum from unknown causes without any symptoms. The patient was admitted to the intensive care unit for the management of aspiration pneumonia and developed extensive PI after mechanical ventilation, presenting as small bowel obstruction with mesenteric torsion. Although the exact mechanism and etiology of PI are unclear, this case provides an update on the imaging features of and the clinical conditions associated with PI, as well as the management of this condition.
Neurosurgery
Cardiac Arrest from Patient Position Change after Spine Surgery on a Jackson Table
Boohwi Hong, Seok Hwa Yoon, Soo-Yong Park, Seunghyun Song, Ann Youn, Ja Gyung Hwang
Acute Crit Care. 2019;34(1):86-91.   Published online February 20, 2017
DOI: https://doi.org/10.4266/acc.2016.00794
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AbstractAbstract PDF
The Jackson table has minimal effects on cardiac function because it does not elevate abdominal and thoracic pressures. In addition, it decreases venous congestion and increases exposure of the surgical field. However, the hips and knees are flexed with inappropriate padding, and venostasis is promoted and increased. Pulmonary thromboembolism (PTE) is fatal; thus immediate diagnosis and treatment are essential. However, clinical signs of intraoperative PTE are difficult to discern. Thrombolytic therapy can be considered as first-line therapy, but bleeding limits its use. The authors report a case of PTE resulting from patient positional change after spine surgery, and the use of immediate postoperative recombinant tissue-type plasminogen activator.

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  • Causes of Perioperative Cardiac Arrest: Mnemonic, Classification, Monitoring, and Actions
    Lingzhong Meng, Mads Rasmussen, Arnoley S. Abcejo, Deyi M. Meng, Chuanyao Tong, Hong Liu
    Anesthesia & Analgesia.2023;[Epub]     CrossRef
  • Perioperative patient positioning following scalp tumor surgery: an anesthetic challenge
    Rajnish Kumar, Nishant Sahay, Shagufta Naaz, Ansarul Haq, Rajesh Kumar
    Ain-Shams Journal of Anesthesiology.2022;[Epub]     CrossRef
  • Differential diagnosis of intraoperative cardiac arrest after spine surgery in prone position
    DaviBrasil Khouri, MarinaAyres Delgado, JadsonLardy Lemes, MarcelaMorais Afonso Cruz
    Saudi Journal of Anaesthesia.2022; 16(4): 485.     CrossRef
  • Pulmonary thromboembolism due to venostasis induced by sitting position during clavicle and pelvic bone fracture surgery
    Soomin LEE, Boohwi HONG, Woosik HAN, Man-Shik SHIM, Yoon-Hee KIM, Seok-Hwa YOON
    Chirurgia.2021;[Epub]     CrossRef
Image in Critical Care
Trauma
Splenic Liquefaction after Splenic Artery Embolization
Byung Hee Kang
Acute Crit Care. 2019;34(1):92-94.   Published online November 13, 2018
DOI: https://doi.org/10.4266/acc.2018.00073
  • 5,937 View
  • 98 Download
PDF
Letter to the Editor
Thoracic Surgery
Extracorporeal Membrane Oxygenation Bridge to Lung Transplantation in a Patient with Hermansky-Pudlak Syndrome and Progressive Pulmonary Fibrosis
Wooho Sim, Song Yee Kim, Jinu Han, Tyler Hyungtaek Rim, Jin Gu Lee, Hyo Chae Paik, Moo Suk Park
Acute Crit Care. 2019;34(1):95-98.   Published online February 28, 2019
DOI: https://doi.org/10.4266/acc.2018.00402
  • 5,302 View
  • 97 Download
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PDF

Citations

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  • Hermansky–Pudlak syndrome pulmonary fibrosis: a rare inherited interstitial lung disease
    Tadafumi Yokoyama, Bernadette R. Gochuico
    European Respiratory Review.2021; 30(159): 200193.     CrossRef
  • Selection Criteria for Lung Transplantation: Controversies and New Developments
    Hanne Beeckmans, Saskia Bos, Robin Vos
    Seminars in Respiratory and Critical Care Medicine.2021; 42(03): 329.     CrossRef
  • Hermansky–Pudlak syndrome: Mutation update
    Marjan Huizing, May C. V. Malicdan, Jennifer A. Wang, Hadass Pri‐Chen, Richard A. Hess, Roxanne Fischer, Kevin J. O'Brien, Melissa A. Merideth, William A. Gahl, Bernadette R. Gochuico
    Human Mutation.2020; 41(3): 543.     CrossRef
  • Hermansky-Pudlak syndrome-associated pneumothorax with rapid progression of respiratory failure: a case report
    Yukari Kato, Motoyasu Kato, Hiroaki Ihara, Eri Hayakawa, Kohei Shibayama, Keita Miura, Tomoko Yamada, Yoichiro Mitsuishi, Takehito Shukuya, Jun Ito, Takeshi Matsunaga, Tadashi Sato, Kenji Suzuki, Kazuhisa Takahashi
    BMC Pulmonary Medicine.2020;[Epub]     CrossRef
Corrigendum
Surgery
The Effect of Systematic Approach to Tracheostomy Care in Patients Transferred from the Surgical Intensive Care Unit to General Ward
Yooun-joong Jung, Younghwan Kim, Kyuhyouck Kyoung, Minae Keum, Taehyun Kim, Dae seong Ma, Suk-Kyung Hong
Acute Crit Care. 2019;34(1):99-99.   Published online February 28, 2019
DOI: https://doi.org/10.4266/acc.2018.00248.e02
Corrects: Acute Crit Care 2018;33(4):252
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ACC : Acute and Critical Care