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Volume 34 (3); August 2019
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Review Article
CPR/Resuscitation
Management of post-cardiac arrest syndrome
Youngjoon Kang
Acute Crit Care. 2019;34(3):173-178.   Published online August 31, 2019
DOI: https://doi.org/10.4266/acc.2019.00654
  • 29,378 View
  • 1,874 Download
  • 14 Citations
AbstractAbstract PDF
Post-cardiac arrest syndrome is a complex and critical issue in resuscitated patients undergone cardiac arrest. Ischemic-reperfusion injury occurs in multiple organs due to the return of spontaneous circulation. Bundle of management practicies are required for post-cardiac arrest care. Early invasive coronary angiography should be considered to identify and treat coronary artery obstructive disease. Vasopressors such as norepinephrine and dobutamine are the first-line treatment for shock. Maintainance of oxyhemoglobin saturation greater than 94% but less than 100% is recommended to avoid fatality. Target temperature therapeutic hypothermia helps to resuscitated patients. Strict temperature control is required and is maintained with the help of cooling devices and monitoring the core temperature. Montorings include electrocardiogram, oxymetry, capnography, and electroencephalography (EEG) along with blood pressue, temprature, and vital signs. Seizure should be treated if EEG shows evidence of seizure or epileptiform activity. Clinical neurologic examination and magnetic resonance imaging are considered to predict neurological outcome. Glycemic control and metabolic management are favorable for a good neurological outcome. Recovery from acute kidney injury is essential for survival and a good neurological outcome.

Citations

Citations to this article as recorded by  
  • Unilateral Pulmonary Edema After Robotically Assisted Mitral Valve Repair Requiring Veno-Venous Extracorporeal Membrane Oxygenation
    Dan Viox, Richa Dhawan, Husam H. Balkhy, Daniel Cormican, Himani Bhatt, Andre Savadjian, Mark A. Chaney
    Journal of Cardiothoracic and Vascular Anesthesia.2022; 36(1): 321.     CrossRef
  • Evaluation of Unfractionated Heparin Dosing by Antifactor Xa During Targeted Temperature Management Post Cardiac Arrest
    Carrigan Belcher, Vivek Kataria, Klayton M Ryman, Xuan Wang, Joon Yong Moon, Ariel Modrykamien, Adan Mora
    Hospital Pharmacy.2022; 57(4): 504.     CrossRef
  • Post-Cardiac Arrest Syndrome Is Not Associated With an Early Bacterial Translocation
    Eirini Filidou, Gesthimani Tarapatzi, Michail Spathakis, Panagiotis Papadopoulos, Charalampos Papadopoulos, Leonidas Kandilogiannakis, George Stavrou, Eleni Doumaki, Antonia Sioga, Soultana Meditskou, Konstantinos Arvanitidis, Theodora Papamitsou, Vassili
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  • Exogenous Nicotinamide Adenine Dinucleotide Attenuates Postresuscitation Myocardial and Neurologic Dysfunction in a Rat Model of Cardiac Arrest
    Chenglei Su, Yan Xiao, Guozhen Zhang, Lian Liang, Hui Li, Cheng Cheng, Tao Jin, Jennifer Bradley, Mary A. Peberdy, Joseph P. Ornato, Martin J. Mangino, Wanchun Tang
    Critical Care Medicine.2022; 50(2): e189.     CrossRef
  • The Inhibition of Zinc Excitotoxicity and AMPK Phosphorylation by a Novel Zinc Chelator, 2G11, Ameliorates Neuronal Death Induced by Global Cerebral Ischemia
    Dae Ki Hong, Jae-Won Eom, A Ra Kho, Song Hee Lee, Beom Seok Kang, Si Hyun Lee, Jae-Young Koh, Yang-Hee Kim, Bo Young Choi, Sang Won Suh
    Antioxidants.2022; 11(11): 2192.     CrossRef
  • Nurses’ experiences of ethical and legal issues in post-resuscitation care: A qualitative content analysis
    Mahnaz Zali, Azad Rahmani, Kelly Powers, Hadi Hassankhani, Hossein Namdar-Areshtanab, Neda Gilani
    Nursing Ethics.2022; : 096973302211335.     CrossRef
  • Diet-related complications according to the timing of enteral nutrition support in patients who recovered from out-of-hospital cardiac arrest: a propensity score matched analysis
    Gun Woo Kim, Young-Il Roh, Kyoung-Chul Cha, Sung Oh Hwang, Jae Hun Han, Woo Jin Jung
    Acute and Critical Care.2022; 37(4): 610.     CrossRef
  • Survivorship After Sudden Cardiac Arrest: Establishing a Framework for Understanding and Care Optimization
    Troy Seelhammer, Erica Wittwer
    Journal of Cardiothoracic and Vascular Anesthesia.2021; 35(2): 368.     CrossRef
  • Metformin prevents brain injury after cardiopulmonary resuscitation by inhibiting the endoplasmic reticulum stress response and activating AMPK-mediated autophagy
    Libo Chuan, Lei Zhang, Hao Fu, Ying Yang, Quanyu Wang, Xingpeng Jiang, Zhengchao Li, Kuang Ni, Li Ding
    Scottish Medical Journal.2021; 66(1): 16.     CrossRef
  • Fast hypothermia induced by extracorporeal circuit cooling alleviates renal and intestinal injury after cardiac arrest in swine
    Jiangang Wang, Lin Shi, Jiefeng Xu, Wen Zhou, Mao Zhang, Chunshuang Wu, Qijiang Chen, Xiaohong Jin, Jungen Zhang
    The American Journal of Emergency Medicine.2021; 47: 231.     CrossRef
  • Importance of pulse pressure after extracorporeal cardiopulmonary resuscitation
    Seok In Lee, Yong Su Lim, Chul‐Hyun Park, Woo Sung Choi, Chang Hyu Choi
    Journal of Cardiac Surgery.2021; 36(8): 2743.     CrossRef
  • Transient Global Ischemia-Induced Brain Inflammatory Cascades Attenuated by Targeted Temperature Management
    Dae Ki Hong, Yoo Seok Park, Ji Sun Woo, Ju Hee Kim, Jin Ho Beom, Sung Phil Chung, Je Sung You, Sang Won Suh
    International Journal of Molecular Sciences.2021; 22(10): 5114.     CrossRef
  • Updates on the Management of Neurologic Complications of Post–Cardiac Arrest Resuscitation
    Yunis Mayasi, Romergryko G. Geocadin
    Seminars in Neurology.2021; 41(04): 388.     CrossRef
  • Post–Cardiac Arrest Syndrome
    Linda Dalessio
    AACN Advanced Critical Care.2020; 31(4): 383.     CrossRef
Original Articles
Pediatrics
Characteristics, management and clinical outcomes of patients with sepsis: a multicenter cohort study in Korea
Kyeongman Jeon, Soo Jin Na, Dong Kyu Oh, Sunghoon Park, Eun Young Choi, Seok Chan Kim, Gil Myeong Seong, Jeongwon Heo, Youjin Chang, Won Gun Kwack, Byung Ju Kang, Won-Il Choi, Kyung Chan Kim, So Young Park, Sang Hyun Kwak, Yoon Mi Shin, Heung Bum Lee, So Hee Park, Jae Hwa Cho, Beongki Kim, Chae‐Man Lim
Acute Crit Care. 2019;34(3):179-191.   Published online July 1, 2019
DOI: https://doi.org/10.4266/acc.2019.00514
  • 6,237 View
  • 275 Download
  • 14 Citations
AbstractAbstract PDF
Background
Mortality rates associated with sepsis have increased progressively in Korea, but domestic epidemiologic data remain limited. The objective of this study was to investigate the characteristics, management and clinical outcomes of sepsis patients in Korea.
Methods
This study is a multicenter retrospective cohort study. A total of 64,021 adult patients who visited an emergency department (ED) within one of the 19 participating hospitals during a 1-month period were screened for eligibility. Among these, patients diagnosed with sepsis based on the third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) were included in the study.
Results
Using the Sepsis-3 criteria, 977 sepsis patients were identified, among which 36.5% presented with septic shock. The respiratory system (61.8%) was the most common site of infection. The pathogen involved was identified in 444 patients (45.5%) and multi-drug resistance (MDR) pathogens were isolated in 171 patients. Empiric antibiotic therapy was appropriate in 68.6% of patients, but the appropriateness was significantly reduced in infections associated with MDR pathogens as compared with non-MDR pathogens (58.8% vs. 76.0%, P<0.001). Hospital mortality was 43.2% and 18.5% in sepsis patients with and without shock, respectively. Of the 703 patients who survived to discharge, 61.5% were discharged to home and 38.6% were transferred to other hospitals or facilities.
Conclusions
This study found the prevalence of sepsis in adult patients visiting an ED in Korea was 1.5% (15.2/1,000 patients). Patients with sepsis, especially septic shock, had a high mortality and were often referred to step-down centers after acute and critical care.

Citations

Citations to this article as recorded by  
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    Rehab Salah Taha, Mohamed Elsayed Afandy, Abdelaziz Hamid Elbadawi, Mohamed Samir Abd El Ghafar
    Egyptian Journal of Anaesthesia.2023; 39(1): 56.     CrossRef
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    Yong Jun Choi, Jae Hwa Cho
    Journal of the Korean Medical Association.2022; 65(3): 124.     CrossRef
  • Clinical Characteristics and Outcomes of Neutropenic Sepsis: A Multicenter Cohort Study
    Soo Jin Na, Dong Kyu Oh, Sunghoon Park, Yeon Joo Lee, Sang-Bum Hong, Mi-Hyun Park, Ryoung-Eun Ko, Chae-Man Lim, Kyeongman Jeon
    Shock.2022; 57(5): 659.     CrossRef
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    Dong-gon Hyun, Su Yeon Lee, Jee Hwan Ahn, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Chae-Man Lim, Dong Kyu Oh, Gee Young Suh, Kyeongman Jeon, Ryoung-Eun Ko, Young-Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Sunghoon Park, Jeongwon Heo, Jae-myeong Lee, Kyung Cha
    Critical Care.2022;[Epub]     CrossRef
  • Clinical outcomes and prognostic factors of patients with sepsis caused by intra-abdominal infection in the intensive care unit: a post-hoc analysis of a prospective cohort study in Korea
    Chan Hee Park, Jeong Woo Lee, Hak Jae Lee, Dong Kyu Oh, Mi Hyeon Park, Chae-Man Lim, Suk-Kyung Hong, Chae-Man Lim, Sang-Bum Hong, Dong Kyu Oh, Gee Young Suh, Kyeongman Jeon, Ryoung-Eun Ko, Young-Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Sunghoon Park, Chae-Ma
    BMC Infectious Diseases.2022;[Epub]     CrossRef
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    L. I. Gomanova, A. Y. Brazhnikov
    Epidemiology and Vaccinal Prevention.2021; 20(3): 107.     CrossRef
  • Characteristics, Management, and Clinical Outcomes of Patients with Hospital-Acquired and Ventilator-Associated Pneumonia: A Multicenter Cohort Study in Korea
    Ryoung-Eun Ko, Kyung Hoon Min, Sang-Bum Hong, Ae-Rin Baek, Hyun-Kyung Lee, Woo Hyun Cho, Changhwan Kim, Youjin Chang, Sung-Soon Lee, Jee Youn Oh, Heung Bum Lee, Soohyun Bae, Jae Young Moon, Kwang Ha Yoo, Kyeongman Jeon
    Tuberculosis and Respiratory Diseases.2021; 84(4): 317.     CrossRef
  • Clinical Usefulness of Red Cell Distribution Width/Albumin Ratio to Discriminate 28-Day Mortality in Critically Ill Patients with Pneumonia Receiving Invasive Mechanical Ventilation, Compared with Lacate/Albumin Ratio: A Retrospective Cohort Study
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    Diagnostics.2021; 11(12): 2344.     CrossRef
  • Review of 20 Years of Continuous Quality Improvement of a Rapid Response System, at Four Institutions, to Identify Key Process Responsible for Its Success
    Mary Anne Vandegrift, Robert Granata, Vicken Y. Totten, John Kellett, Frank Sebat
    Critical Care Explorations.2021; 3(8): e0448.     CrossRef
  • An Update on Sepsis Biomarkers
    Mi-Hee Kim, Jung-Hyun Choi
    Infection & Chemotherapy.2020; 52(1): 1.     CrossRef
  • Normothermia in Patients With Sepsis Who Present to Emergency Departments Is Associated With Low Compliance With Sepsis Bundles and Increased In-Hospital Mortality Rate*
    Sunghoon Park, Kyeongman Jeon, Dong Kyu Oh, Eun Young Choi, Gil Myeong Seong, Jeongwon Heo, Youjin Chang, Won Gun Kwack, Byung Ju Kang, Won-Il Choi, Kyung Chan Kim, So Young Park, Yoon Mi Shin, Heung Bum Lee, So Hee Park, Seok Chan Kim, Sang Hyun Kwak, Ja
    Critical Care Medicine.2020; 48(10): 1462.     CrossRef
  • Prevention of sepsis in an aging society
    Youngjoon Kang
    Acute and Critical Care.2019; 34(3): 221.     CrossRef
  • Optimal antimicrobial therapy and antimicrobial stewardship in sepsis and septic shock
    Hyeri Seok, Dae Won Park
    Journal of the Korean Medical Association.2019; 62(12): 638.     CrossRef
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    The Korean Journal of Medicine.2019; 94(6): 495.     CrossRef
Ethics
The quality of dying and death for patients in intensive care units: a single center pilot study
Yanghwan Choi, Myoungrin Park, Da Hyun Kang, Jooseon Lee, Jae Young Moon, Heejoon Ahn
Acute Crit Care. 2019;34(3):192-201.   Published online April 8, 2019
DOI: https://doi.org/10.4266/acc.2018.00374
  • 6,199 View
  • 139 Download
  • 6 Citations
AbstractAbstract PDFSupplementary Material
Background
To identify the necessary care for dying patients in intensive care units (ICUs), we designed a retrospective study to evaluate the quality of dying and death (QODD) experienced by the surrogates of patients with medical illness who died in the ICU of a tertiary referral hospital.
Methods
To achieve our objective, the authors compared the QODD scores as appraised by the relatives of patients who died of cancer under hospice care with those who died in the ICU. For this study, a Korean version of the QODD questionnaire was developed, and individual interviews were also conducted.
Results
Sixteen people from the intensive care group and 23 people from the hospice care group participated in the survey and completed the questionnaire. The family members of patients who died in the ICU declined participation at a high rate (50%), with the primary reason being to avoid bringing back painful memories (14 people, 87.5%). The relatives of the intensive care group obtained an average total score on the 17-item QODD questionnaire, which was significantly lower than that of the relatives of the hospice group (48.7±15.5 vs. 60.3±14.8, P=0.03).
Conclusions
This work implies that there are unmet needs for the care of dying patients and for the QODD in tertiary hospital ICUs. This result suggests that shared decision making for advance care planning should be encouraged and that education on caring for dying patients should be provided to healthcare professionals to improve the QODD in Korean ICUs.

Citations

Citations to this article as recorded by  
  • Quality of dying and death in intensive care units: family satisfaction
    Fur-Hsing Wen, Ming Chu Chiang, Chung-Chi Huang, Tsung-Hui Hu, Wen-Chi Chou, Li-Pang Chuang, Siew Tzuh Tang
    BMJ Supportive & Palliative Care.2023; : spcare-2022-003950.     CrossRef
  • Development of an End-of-Life Nursing Care Protocol for Intensive Care Units
    Jungeun Kim, Hye Young Yun, Euni Ji Kim, Hyunsook Kim, Geon Ah Kim, Sung Ha Kim, Jayoung Koo, Ju Youn Park, Aisoon Park, Eugene Han, So Yeon Kim, Jihye Jeong, Sanghee Kim
    Journal of Hospice & Palliative Nursing.2022; 24(4): E159.     CrossRef
  • Nurses’ perceptions of barriers and supportive behaviors in end-of-life care in the intensive care unit: a cross-sectional study
    Dan-dan Xu, Dan Luo, Jie Chen, Ji-li Zeng, Xiao-lin Cheng, Jin Li, Juan-juan Pei, Fen Hu
    BMC Palliative Care.2022;[Epub]     CrossRef
  • The Quality of Dying and Death of Advanced Cancer Patients in Palliative Care and Its Association With Place of Death and Quality of Care
    Daniel Gutiérrez-Sánchez, Rafael Gómez-García, María Luisa Martín Roselló, Antonio I. Cuesta-Vargas
    Journal of Hospice & Palliative Nursing.2021; 23(3): 264.     CrossRef
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    Tera Cushman, David B. Waisel, Miriam M. Treggiari
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    International Journal of Environmental Research and Public Health.2020; 17(12): 4443.     CrossRef
Pulmonary
Reduction of PaCO2 by high-flow nasal cannula in acute hypercapnic respiratory failure patients receiving conventional oxygen therapy
Hyun Woo Lee, Sun Mi Choi, Jinwoo Lee, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Sang-Min Lee
Acute Crit Care. 2019;34(3):202-211.   Published online August 31, 2019
DOI: https://doi.org/10.4266/acc.2019.00563
  • 7,346 View
  • 187 Download
  • 11 Citations
AbstractAbstract PDF
Background
It has been suggested that a high-flow nasal cannula (HFNC) could help to remove carbon dioxide (CO2) from anatomical dead spaces, but evidence to support that is lacking. The objective of this study was to elucidate whether use of an HFNC could reduce the arterial partial pressure of CO2 (PaCO2) in patients with acute hypercapnic respiratory failure who are receiving conventional oxygen (O2) therapy.
Methods
A propensity score-matched observational study was conducted to evaluate patients treated with an HFNC for acute hypercapnic respiratory failure from 2015 to 2016. The hypercapnia group was defined as patients with a PaCO2 >50 mm Hg and arterial pH <7.35.
Results
Eighteen patients in the hypercapnia group and 177 patients in the nonhypercapnia group were eligible for the present study. Eighteen patients in each group were matched by propensity score. Decreased PaCO2 and consequent pH normalization over time occurred in the hypercapnia group (P=0.002 and P=0.005, respectively). The initial PaCO2 level correlated linearly with PaCO2 removal after the use of an HFNC (R2=0.378, P=0.010). The fraction of inspired O2 used in the intensive care unit was consistently higher for 48 hours in the nonhypercapnia group. Physiological parameters such as respiratory rate and arterial partial pressure of O2 improved over time in both groups.
Conclusions
Physiological parameters can improve after the use of an HFNC in patients with acute hypercapnic respiratory failure given low-flow O2 therapy via a facial mask. Further studies are needed to identify which hypercapnic patients might benefit from an HFNC.

Citations

Citations to this article as recorded by  
  • Successful noninvasive ventilation in a severely acidotic and hypercapnic comatose COVID-19 patient with multiple comorbidities: a case report
    Joseph Abraham Poonuraparampil, Habib Md Reazaul Karim, Manu P Kesavankutty, Porika Prashanth Nayak
    Acute and Critical Care.2022; 37(1): 120.     CrossRef
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    Jitendra Pratap Singh, Deepak Malviya, Samiksha Parashar, Soumya Sankar Nath, Archana Gautam, Neha Shrivastava
    Cureus.2022;[Epub]     CrossRef
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    Andrew Pirotte, Vivek Panchananam, Matthew Finley, Austin Petz, Tom Herrmann
    Current Emergency and Hospital Medicine Reports.2022; 10(4): 73.     CrossRef
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    Ji Hye Kim, Dong In Suh, June Dong Park
    Pediatrics International.2022;[Epub]     CrossRef
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    Onlak Ruangsomboon, Chok Limsuwat, Nattakarn Praphruetkit, Apichaya Monsomboon, Tipa Chakorn, Brian C. Hiestand
    Academic Emergency Medicine.2021; 28(5): 530.     CrossRef
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    Jingen Xia, Jiaqi Chang, Jixiang Liang, Yixuan Wang, Na Wang, Bo Xiao
    Complexity.2021; 2021: 1.     CrossRef
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    Aarshi Vipani, Christina C. Lindenmeyer, Vinay Sundaram
    Journal of Clinical Gastroenterology.2021; 55(8): 667.     CrossRef
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    Lingling Su, Qinyu Zhao, Taotao Liu, Yujun Xu, Weichun Li, Aiping Zhang
    Lung.2021; 199(5): 447.     CrossRef
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    SooHyun Bae, Minkyu Han, Changyoung Kim, Hyeji Lee, Jong-Joon Ahn, Jin Hyoung Kim, Byung Ju Kang
    Journal of Korean Medical Science.2020;[Epub]     CrossRef
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    Lucia Spicuzza, Matteo Schisano
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CPR/Resuscitation
Risk factors associated with inpatient cardiac arrest during emergency endotracheal intubation at general wards
Chul Park
Acute Crit Care. 2019;34(3):212-218.   Published online August 31, 2019
DOI: https://doi.org/10.4266/acc.2019.00598
Correction in: Acute Crit Care 2020;35(3):228
  • 5,553 View
  • 131 Download
  • 8 Citations
AbstractAbstract PDF
Background
Peri-intubation cardiac arrest (PICA) following emergent endotracheal intubation (ETI) is a rare, however, potentially preventable type of cardiac arrest. Limited published data have described factors associated with inpatient PICA and patient outcomes. The aim of this study was to identify risk factors associated with PICA among hospitalized patients emergently intubated at a general ward as compared to non-PICA inpatients. In addition, we identified a difference of clinical outcomes in patients between PICA and other types of inpatient cardiac arrest (OTICA).
Methods
We conducted a retrospective observational study of patients at two institutions between January 2016 to December 2017. PICA was defined in patients emergently intubated who experienced cardiac arrest within 20 minutes after ETI. The non-PICA group consisted of inpatients emergently intubated without cardiac arrest. Risk factors for PICA were identified through univariate and multivariate logistic regression analysis. Clinical outcomes were compared between PICA and OTICA.
Results
Fifteen episodes of PICA occurred during the study period, accounting for 3.6% of all inpatient arrests. Intubation-related shock index, number of intubation attempts, pre-ETI vasopressor use, and neuromuscular blocking agent (NMBA) use, especially succinylcholine, were independently associated with PICA. Clinical outcomes of intensive care unit and hospital length of stay, survival to discharge, and neurologic outcome at hospital discharge were not significantly different between PICA and OTICA.
Conclusions
We identified four independent risk factors for PICA, and preintubation hemodynamic stabilization and avoidance of NMBA were possibly correlated with a decreased PICA risk. Clinical outcomes of PICA were similar to those of OTICA.

Citations

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Editorials
Acute and Critical Care will be indexed in PubMed, PubMed Central, Emerging Sources Citation Index, and Scopus
Jae Hwa Cho
Acute Crit Care. 2019;34(3):219-220.   Published online August 31, 2019
DOI: https://doi.org/10.4266/acc.2019.00626
  • 3,571 View
  • 39 Download
PDF
Prevention of sepsis in an aging society
Youngjoon Kang
Acute Crit Care. 2019;34(3):221-222.   Published online August 31, 2019
DOI: https://doi.org/10.4266/acc.2019.00612
  • 3,443 View
  • 97 Download
PDF
Case Reports
Trauma
Long-term extracorporeal membrane oxygenation after severe blunt traumatic lung injury in a child
Ok Jeong Lee, Yang Hyun Cho, Jinwook Hwang, Inae Yoon, Young-Ho Kim, Joongbum Cho
Acute Crit Care. 2019;34(3):223-227.   Published online February 10, 2017
DOI: https://doi.org/10.4266/acc.2016.00472
  • 25,769 View
  • 175 Download
  • 1 Citations
AbstractAbstract PDF
Managing acute respiratory distress syndrome (ARDS) after severe blunt traumatic lung injury can be challenging. In cases where patients are refractory to conventional therapy, extracorporeal membrane oxygenation (ECMO) should be considered. In addition, the heparin-coated circuit can reduce hemorrhagic complications in patients with multiple traumas. Although prolonged ECMO may be necessary, excellent outcomes are frequently associated. In this study, we report long-term support with venovenous-ECMO applied in a child with severe blunt trauma in Korea. This 10-year-old and 30-kg male with severe blunt thoracic trauma after a car accident developed severe ARDS a few days later, and ECMO was administered for 33 days. Because of pulmonary hemorrhage during ECMO support, heparin was stopped for 3 days and then restarted. He was weaned from ECMO successfully and has been able to run without difficulty for the 2 years since discharge.

Citations

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  • Extracorporeal membrane oxygenation in trauma patients: a systematic review
    Changtian Wang, Lei Zhang, Tao Qin, Zhilong Xi, Lei Sun, Haiwei Wu, Demin Li
    World Journal of Emergency Surgery.2020;[Epub]     CrossRef
CPR/Resuscitation
Acute aortic dissection developed after cardiopulmonary resuscitation: transesophageal echocardiographic observations and proposed mechanism of injury
Dong Keon Lee, Kyung Sik Kang, Yong Sung Cha, Kyoung-Chul Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang
Acute Crit Care. 2019;34(3):228-231.   Published online April 26, 2018
DOI: https://doi.org/10.4266/acc.2015.00633
  • 6,376 View
  • 142 Download
  • 5 Citations
AbstractAbstract PDFSupplementary Material
There has been no report about aortic dissection due to cardiopulmonary resuscitation (CPR). We present here a case of acute aortic dissection as a rare complication of CPR and propose the potential mechanism of injury on the basis of transesophageal echocardiographic observations. A 54-year-old man presented with cardiac arrest after choking and received 19 minutes of CPR in the emergency department. Transesophageal echocardiography (TEE) during CPR revealed a focal separation of the intimal layer at the descending thoracic aorta without evidence of aortic dissection. After restoration of spontaneous circulation, hemorrhagic cardiac tamponade developed. Follow-up TEE to investigate the cause of cardiac tamponade revealed aortic dissection of the descending thoracic aorta. Hemorrhagic cardiac tamponade was thought to be caused by myocardial hemorrhage from CPR.

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  • Blunt Thoracic Aortic Injury and Contemporary Management Strategy
    Ranjan Dahal, Yogesh Acharya, Alan H. Tyroch, Debabrata Mukherjee
    Angiology.2022; 73(6): 497.     CrossRef
  • Resuscitative endovascular occlusion of the aorta (REBOA) as a mechanical method for increasing the coronary perfusion pressure in non-traumatic out-of-hospital cardiac arrest patients
    Dong-Hyun Jang, Dong Keon Lee, You Hwan Jo, Seung Min Park, Young Taeck Oh, Chang Woo Im
    Resuscitation.2022; 179: 277.     CrossRef
  • Blunt traumatic aortic dissection death by falling: an autopsy case report
    Gentaro Yamasaki, Marie Sugimoto, Takeshi Kondo, Motonori Takahashi, Mai Morichika, Azumi Kuse, Kanako Nakagawa, Yasuhiro Ueno, Migiwa Asano
    Forensic Science, Medicine and Pathology.2022;[Epub]     CrossRef
  • Intra-arrest transoesophageal echocardiographic findings and resuscitation outcomes
    Woo Jin Jung, Kyoung-Chul Cha, Yong Won Kim, Yoon Seop Kim, Young-Il Roh, Sun Ju Kim, Hye Sim Kim, Sung Oh Hwang
    Resuscitation.2020; 154: 31.     CrossRef
  • Aortic Rupture as a Complication of Cardiopulmonary Resuscitation
    Prashanth Venkatesh, Edward J. Schenck
    JACC: Case Reports.2020; 2(8): 1150.     CrossRef
Image in Critical Care
CPR/Resuscitation
Surgical decontamination in ferrous sulfate intoxication
Jung-In Ko, Kyung Su Kim, Gil Joon Suh, Seong-Ho Kong, Yoon Sun Jung
Acute Crit Care. 2019;34(3):232-234.   Published online April 24, 2019
DOI: https://doi.org/10.4266/acc.2018.00409
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ACC : Acute and Critical Care