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Volume 34 (4); November 2019
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Review Article
Nutrition
Fluid management in perioperative and critically ill patients
Dongho Kang, Kyung Yeon Yoo
Acute Crit Care. 2019;34(4):235-245.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00717
  • 9,240 View
  • 804 Download
  • 7 Citations
AbstractAbstract PDF
Fluid therapy to restore and/or maintain tissue perfusion may affect patient outcomes in perioperative, emergency, and intensive care. Kinetic analyses and outcome-oriented studies have provided more insight into fluid management. Crystalloids are slowly distributed to the interstitial space, and the efficiency (proportion of infused fluid retained in the bloodstream) is 50%−75% as long as infusion continues and may increase up to 100% when the arterial pressure has decreased. Elimination of the infused fluid during general anesthesia and surgery is very slow, amounting to only 10%–20% compared with that in conscious patients. When the endothelial glycocalyx layer is degraded in sepsis or trauma-induced systemic inflammation, turnover of colloids and crystalloids is accelerated and the efficiency is reduced, which may lead to tissue edema, inflammation, poor wound healing, and organ dysfunction. Balanced crystalloids are pragmatic initial resuscitation fluids and improve patient outcomes compared to saline (0.9% sodium chloride). Albumin may be beneficial, but other synthetic colloids appear to increase the risk of acute kidney injury and death among patients in the intensive care unit. Fluid kinetics is likely to change based on patient physiological conditions (e.g., general anesthesia, surgery, stress, dehydration, blood pressure, or inflammation) and fluid types. To maximize efficacy and minimize iatrogenic side effects, fluids should be prescribed based on individual patient factors, disease states, and other treatment remedies.

Citations

Citations to this article as recorded by  
  • Meropenem pharmacokinetics in critically ill patients with or without burn treated with or without continuous veno‐venous haemofiltration
    Daniel J. Selig, Kevin S. Akers, Kevin K. Chung, Kaitlin A. Pruskowski, Jeffrey R. Livezey, Elaine D. Por
    British Journal of Clinical Pharmacology.2022; 88(5): 2156.     CrossRef
  • Does perioperative fluid management affect the development of postoperative complications in major gastrointestinal tract surgery? A retrospective cohort study
    Mehmet Mustafa ALTINTAŞ, Kemal Tolga SARAÇOĞLU, Aytaç Emre KOCAOĞLU, Fırat MÜLKÜT, Ayten SARACOĞLU, Selçuk KAYA, Ayhan ÇEVİK
    Journal of Surgery and Medicine.2022; 6(2): 90.     CrossRef
  • A Porcine Sepsis Model With Numerical Scoring for Early Prediction of Severity
    Attila Rutai, Bettina Zsikai, Szabolcs Péter Tallósy, Dániel Érces, Lajos Bizánc, László Juhász, Marietta Zita Poles, József Sóki, Zain Baaity, Roland Fejes, Gabriella Varga, Imre Földesi, Katalin Burián, Andrea Szabó, Mihály Boros, József Kaszaki
    Frontiers in Medicine.2022;[Epub]     CrossRef
  • Risk Factors for and Outcomes Associated With Peri-Intubation Hypoxemia: A Multicenter Prospective Cohort Study
    Nathan J. Smischney, Ashish K. Khanna, Ernesto Brauer, Lee E. Morrow, Uchenna R. Ofoma, David A. Kaufman, Ayan Sen, Chakradhar Venkata, Peter Morris, Vikas Bansal
    Journal of Intensive Care Medicine.2021; 36(12): 1466.     CrossRef
  • Inflammatory response, fluid balance and outcome in emergency high‐risk abdominal surgery
    Mirjana Cihoric, Henrik Kehlet, Morten L. Lauritsen, Jakob Højlund, Katrine Kanstrup, Nicolai B. Foss
    Acta Anaesthesiologica Scandinavica.2021; 65(6): 730.     CrossRef
  • A review on the physiological and pathophysiological role of endothelial glycocalyx
    Huan‐qiu Liu, Ji Li, Cheng‐luan Xuan, Hai‐chun Ma
    Journal of Biochemical and Molecular Toxicology.2020;[Epub]     CrossRef
  • Science‐in‐brief: The role of the glycocalyx in critically ill patients with reference to the horse
    Bettina Dunkel
    Equine Veterinary Journal.2020; 52(6): 790.     CrossRef
Original Articles
Rapid response system
Effect of a rapid response system on code rates and in-hospital mortality in medical wards
Hong Yeul Lee, Jinwoo Lee, Sang-Min Lee, Sulhee Kim, Eunjin Yang, Hyun Joo Lee, Hannah Lee, Ho Geol Ryu, Seung-Young Oh, Eun Jin Ha, Sang-Bae Ko, Jaeyoung Cho
Acute Crit Care. 2019;34(4):246-254.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00668
  • 4,530 View
  • 174 Download
  • 2 Citations
AbstractAbstract PDF
Background
To determine the effects of implementing a rapid response system (RRS) on code rates and in-hospital mortality in medical wards.
Methods
This retrospective study included adult patients admitted to medical wards at Seoul National University Hospital between July 12, 2016 and March 12, 2018; the sample comprised 4,224 patients admitted 10 months before RRS implementation and 4,168 patients admitted 10 months following RRS implementation. Our RRS only worked during the daytime (7 AM to 7 PM) on weekdays. We compared code rates and in-hospital mortality rates between the preintervention and postintervention groups.
Results
There were 62.3 RRS activations per 1,000 admissions. The most common reasons for RRS activation were tachypnea or hypopnea (44%), hypoxia (31%), and tachycardia or bradycardia (21%). Code rates from medical wards during RRS operating times significantly decreased from 3.55 to 0.96 per 1,000 admissions (adjusted odds ratio [aOR], 0.29; 95% confidence interval [CI], 0.10 to 0.87; P=0.028) after RRS implementation. However, code rates from medical wards during RRS nonoperating times did not differ between the preintervention and postintervention groups (2.60 vs. 3.12 per 1,000 admissions; aOR, 1.23; 95% CI, 0.55 to 2.76; P=0.614). In-hospital mortality significantly decreased from 56.3 to 42.7 per 1,000 admissions after RRS implementation (aOR, 0.79; 95% CI, 0.64 to 0.97; P=0.024).
Conclusions
Implementation of an RRS was associated with significant reductions in code rates during RRS operating times and in-hospital mortality in medical wards.

Citations

Citations to this article as recorded by  
  • Improving sepsis recognition and management
    Merrilee I Cox, Hillary Voss
    Current Problems in Pediatric and Adolescent Health Care.2021; 51(4): 101001.     CrossRef
  • Evidence revealed the effects of rapid response system
    Jae Hwa Cho
    Acute and Critical Care.2019; 34(4): 282.     CrossRef
Trauma
The association between the initial lactate level and need for massive transfusion in severe trauma patients with and without traumatic brain injury
Young Hoon Park, Dong Hyun Ryu, Byung Kook Lee, Dong Hun Lee
Acute Crit Care. 2019;34(4):255-262.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00640
  • 3,680 View
  • 121 Download
AbstractAbstract PDF
Background
Exsanguination is a major cause of death in severe trauma patients. The purpose of this study was to analyze the prognostic impact of the initial lactate level for massive transfusion (MT) in severe trauma. We divided patients according to subgroups of traumatic brain injury (TBI) and non-TBI.
Methods
This single-institution retrospective study was conducted on patients who were admitted to hospital for severe trauma between January 2016 and December 2017. TBI was defined by a head Abbreviated Injury Scale ≥3. Receiver operating characteristic analysis was used to analyze the prognostic impact of the lactate level. Multivariate analyses were performed to evaluate the relationship between the MT and lactate level. The primary outcome was MT.
Results
Of the 553 patients, MT was performed in 62 patients (11.2%). The area under the curve (AUC) for the lactate level for predicting MT was 0.779 (95% confidence interval [CI], 0.742 to 0.813). The AUCs for lactate level in the TBI and non-TBI patients were 0.690 (95% CI, 0.627 to 0.747) and 0.842 (95% CI, 0.796 to 0.881), respectively. In multivariate analyses, the lactate level was independently associated with the MT (odds ratio [OR], 1.179; 95% CI, 1.070 to 1.299). The lactate level was independently associated with MT in non-TBI patients (OR, 1.469; 95% CI, 1.262 to 1.710), but not in TBI patients.
Conclusions
The initial lactate level may be a possible prognostic factor for MT in severe trauma. In TBI patients, however, the initial lactate level was not suitable for predicting MT.
Thoracic Surgery
How small is enough for the left heart decompression cannula during extracorporeal membrane oxygenation?
Sua Kim, Jin Seok Kim, Jae Seung Shin, Hong Ju Shin
Acute Crit Care. 2019;34(4):263-268.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00577
  • 5,160 View
  • 119 Download
  • 7 Citations
AbstractAbstract PDF
Background
Left ventricular (LV) distension is a recognizable problem accompanied by subsequent complications during venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, no gold standard for LV decompression has been established, and no minimal flow requirement has been designated. Thus, we evaluated the efficacy of the 8-Fr Mullins sheath for left heart decompression during VA-ECMO in adult patients.
Methods
Left heart decompression was performed when severe pulmonary edema was detected on chest radiography or when no generation of pulse pressure followed severe LV dysfunction in patients receiving VA-ECMO. We punctured the interatrial septum and inserted an 8-Fr Mullins sheath into the left atrium via the femoral vein. The sheath was connected to the venous catheter used for ECMO. The catheter was maintained during VA-ECMO.
Results
The left heart decompression procedure was performed in seven of 35 patients who received VA-ECMO between February 2017 and June 2018. Three patients had acute myocardial infarction; three, fulminant myocarditis; and one, dilated cardiomyopathy. Four patients showed noticeable improvement of pulmonary edema within 3 days, and three patients with a pulse pressure of <10 mm Hg showed an increase in pulse pressure of >20 mm Hg within 24 hours from the left heart decompression procedure. All seven patients were successfully weaned from VA-ECMO. No complications related to the left heart decompression procedure occurred.
Conclusions
An 8-Fr sheath may be a possible option for left heart decompression in adult patients with LV distension under VA-ECMO who are expecting recovery of LV function.

Citations

Citations to this article as recorded by  
  • Satisfactory outcome with activated clotting time <160 seconds in extracorporeal cardiopulmonary resuscitation
    Beong Ki Kim, Jeong In Hong, Jinwook Hwang, Hong Ju Shin
    Medicine.2022; 101(37): e30568.     CrossRef
  • Venting during venoarterial extracorporeal membrane oxygenation
    Enzo Lüsebrink, Leonhard Binzenhöfer, Antonia Kellnar, Christoph Müller, Clemens Scherer, Benedikt Schrage, Dominik Joskowiak, Tobias Petzold, Daniel Braun, Stefan Brunner, Sven Peterss, Jörg Hausleiter, Sebastian Zimmer, Frank Born, Dirk Westermann, Holg
    Clinical Research in Cardiology.2022;[Epub]     CrossRef
  • Outcomes of left ventricular unloading with a transseptal cannula during extracorporeal membrane oxygenation in adults
    Ah‐Ram Kim, Hanbit Park, Sang‐Eun Lee, Jung‐Min Ahn, Duk‐Woo Park, Seung‐Whan Lee, Jae‐Joong Kim, Seung‐Jung Park, Jung Ae Hong, Pil‐Je Kang, Sung‐Ho Jung, Min‐Seok Kim
    Artificial Organs.2021; 45(4): 390.     CrossRef
  • Surgical minimal invasive left atrial decompression during venoarterial extracorporeal membrane oxygenation for pediatric acute fulminant myocarditis
    Li Fen Ye, Qiang Shu, Chenmei Zhang, Yong Fan, Liyang Ying, Lijun Yang, Ru Lin
    World Journal of Pediatric Surgery.2021; 4(4): e000291.     CrossRef
  • Increasing venoarterial extracorporeal membrane oxygenation flow puts higher demands on left ventricular work in a porcine model of chronic heart failure
    Pavel Hála, Mikuláš Mlček, Petr Ošťádal, Michaela Popková, David Janák, Tomáš Bouček, Stanislav Lacko, Jaroslav Kudlička, Petr Neužil, Otomar Kittnar
    Journal of Translational Medicine.2020;[Epub]     CrossRef
  • Advanced Pulmonary and Cardiac Support of COVID-19 Patients
    Keshava Rajagopal, Steven P. Keller, Bindu Akkanti, Christian Bime, Pranav Loyalka, Faisal H. Cheema, Joseph B. Zwischenberger, Aly El Banayosy, Federico Pappalardo, Mark S. Slaughter, Marvin J. Slepian
    Circulation: Heart Failure.2020;[Epub]     CrossRef
  • Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations From ASAIO—A “Living Working Document”
    Keshava Rajagopal, Steven P. Keller, Bindu Akkanti, Christian Bime, Pranav Loyalka, Faisal H. Cheema, Joseph B. Zwischenberger, Aly El Banayosy, Federico Pappalardo, Mark S. Slaughter, Marvin J. Slepian
    ASAIO Journal.2020; 66(6): 588.     CrossRef
Trauma
Risk factor, monitoring, and treatment for snakebite induced coagulopathy: a multicenter retrospective study
Yong Jun Jeon, Jong Wan Kim, SungGil Park, Dong Woo Shin
Acute Crit Care. 2019;34(4):269-275.   Published online November 18, 2019
DOI: https://doi.org/10.4266/acc.2019.00591
Correction in: Acute Crit Care 2020;35(1):56
  • 3,959 View
  • 141 Download
  • 6 Citations
AbstractAbstract PDF
Background
Snakebite can cause various complications, including coagulopathy. The clinical features of snakebite-associated coagulopathy differ from those of disseminated intravascular coagulation (DIC) caused by other diseases and its treatment is controversial.
Methods
We retrospectively reviewed the medical records of patients hospitalized for snakebite between January 2006 and September 2018.
Results
A total of 226 patients were hospitalized due to snakebite. Their median hospital stay was 4.0 days (interquartile range, 2.0 to 7.0 days). Five patients arrived at hospital with shock and one patient died. Twenty-one patients had overt DIC according to the International Society of Thrombosis and Hemostasis scoring system. Two patients developed major bleeding complications. Initial lower cholesterol level at presentation was associated with the development of overt DIC. International normalization ratio (INR) exceeding the laboratory’s measurement limit was recorded as late as 4 to 5 days after the bite. Higher antivenom doses (≥18,000 units) and transfusion of fresh frozen plasma (FFP) or cryoprecipitate did not affect prolonged INR duration or hospital stay in the overt DIC patients without bleeding.
Conclusions
Initial lower cholesterol level may be a risk factor for overt DIC following snakebite. Although patients lack apparent symptoms, the risk of coagulopathy should be assessed for at least 4 to 5 days following snakebite. Higher antivenom doses and transfusion of FFP or cryoprecipitate may be unbeneficial for coagulopathic patients without bleeding.

Citations

Citations to this article as recorded by  
  • A simple mortality risk prediction score for viper envenoming in India (VENOMS): A model development and validation study
    Maya Gopalakrishnan, Suman Saurabh, Pramod Sagar, Chanaveerappa Bammigatti, Tarun Kumar Dutta, Nicholas R. Casewell
    PLOS Neglected Tropical Diseases.2022; 16(2): e0010183.     CrossRef
  • Attempt for a Recombinant Thrombomodulin Alpha Treatment in a Rat Disseminated Intravascular Coagulation Model Using Yamakagashi (Rhabdophis tigrinus) Venom
    Akihiko Yamamoto, Takashi Ito, Toru Hifumi
    Toxins.2022; 14(5): 322.     CrossRef
  • Coagulopathy following Crotaliπae snakebites in northeast Florida
    Satish Maharaj, Karan Seegobin, Simone Chang
    Blood Coagulation & Fibrinolysis.2022; 33(4): 220.     CrossRef
  • Unmasking the ties of snake bite poisoning and COVID-19
    Anjuman Chander, Tanvir Samra, Sekar Loganathan, Varun Mahajan
    Ain-Shams Journal of Anesthesiology.2022;[Epub]     CrossRef
  • Venom induced consumption coagulopathy and performance of 20-min whole blood clotting test for its detection in viperid envenomation
    Bayye Rajkumar, Kolar Vishwanath Vinod, Rakhee Kar, Premkumar Ramasubramani
    Journal of the Royal College of Physicians of Edinburgh.2022; 52(3): 232.     CrossRef
  • The effect of myocardial injury on the clinical course of snake envenomation in South Korea
    J. M. Moon, Y. J. Koo, B. J. Chun, K. H. Park, Y. S. Cho, J. C. Kim, S. D. Lee, Y. R. Min, H. S. Park
    Clinical Toxicology.2021; 59(4): 286.     CrossRef
Trauma
Lund and Browder chart—modified versus original: a comparative study
Arun Murari, Kaushal Neelam Singh
Acute Crit Care. 2019;34(4):276-281.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00647
  • 15,494 View
  • 469 Download
  • 12 Citations
AbstractAbstract PDF
Background
The Lund and Browder (LB) chart is currently the most accurate and widely used chart to calculate total body surface area affected by a burn injury. However, it is not easy to use charts to calculate burn percentages because of the difficulty in performing mathematical calculations with the percentages attributed to various body regions that are only partially burned. It is also cumbersome to have to perform mental calculations, especially in emergency situations.
Methods
We compared results from the LB chart with a modified Lund and Browder (MLB) chart using 10 assessors on five different burn wounds each drawn on both charts.
Results
Variability of results was significantly reduced using the MLB chart compared to the LB chart.
Conclusions
Assessments performed using the MLB chart are less variable than those using the LB chart. Using this chart will help burn care providers rapidly, accurately, and reliably estimate burn extent.

Citations

Citations to this article as recorded by  
  • EasyTBSA as a method for calculating total body surface area burned: a validation study
    Cindy D Colson, Emily C Alberto, Zachary P Milestone, Nikita Batra, Tyler Salvador, Hadi Fooladi, Kevin Cleary, Rima Izem, Randall S Burd
    Emergency Medicine Journal.2023; : emermed-2022-212308.     CrossRef
  • A 1% TBSA Chart Reduces Math Errors While Retaining Acceptable First-Estimate Accuracy
    William C Ray, Adrian Rajab, Hope Alexander, Brianna Chmil, Robert Wolfgang Rumpf, Rajan Thakkar, Madhubalan Viswanathan, Renata Fabia
    Journal of Burn Care & Research.2022; 43(3): 665.     CrossRef
  • Body mapping chart for estimation of percentage of body surface area in mesocephalic dogs
    Andrea Henriksson, Kendon Kuo, Katherine Gerken, Kelsey Cline, Adrien‐Maxence Hespel, Robert Cole, Rachel Moon
    Journal of Veterinary Emergency and Critical Care.2022; 32(3): 350.     CrossRef
  • The Nursing Effect of Different Dressings on Local Small Area Burn Wound
    娟 李
    Nursing Science.2022; 11(02): 279.     CrossRef
  • Integrating the Patient's Voice in Toxicity Reporting and Treatment Decisions for Breast Radiotherapy
    Sara R. Alcorn, Kimberly S. Corbin, Dean A. Shumway
    Seminars in Radiation Oncology.2022; 32(3): 207.     CrossRef
  • The relationships between routine admission blood tests and burn size, and length of stay in intensive care unit
    Eng-Kean Yeong, Kwang-Yi Tung, Chin-Hao Chang, Shang-Jie Tsai
    Journal of the Formosan Medical Association.2022; 121(12): 2512.     CrossRef
  • Estimation of percent body surface area in cats with use of computed tomography
    Andrea Henriksson, Jack Hamersky, Kendon Kuo, Katherine Gerken, Rachel Moon
    Journal of Veterinary Emergency and Critical Care.2022; 32(6): 743.     CrossRef
  • Effect of Different Itraconazole Dosing Regimens on Cure Rates, Treatment Duration, Safety, and Relapse Rates in Adult Patients With Tinea Corporis/Cruris
    Ananta Khurana, Aastha Agarwal, Diksha Agrawal, Sanjeet Panesar, Manik Ghadlinge, Kabir Sardana, Khushboo Sethia, Shalini Malhotra, Ankit Chauhan, Nirmala Mehta
    JAMA Dermatology.2022; 158(11): 1269.     CrossRef
  • Hallway Gait Monitoring System Using an In-Package Integrated Dielectric Lens Paired with a mm-Wave Radar
    Hajar Abedi, Jennifer Boger, Plinio Pelegrini Morita, Alexander Wong, George Shaker
    Sensors.2022; 23(1): 71.     CrossRef
  • To compare the effect of sea buckthorn and silver sulfadiazine dressing on period of wound healing in patients with second‐degree burns: A randomized triple‐blind clinical trial
    Mehrdad Abdullahzadeh, Saeed Shafiee
    Wound Repair and Regeneration.2021; 29(5): 732.     CrossRef
  • State of the Art: An Update on Adult Burn Resuscitation
    Jacqueline M. Causbie, Lauren A. Sattler, Anthony P. Basel, Garrett W. Britton, Leopoldo C. Cancio
    European Burn Journal.2021; 2(3): 152.     CrossRef
  • Lifetime Ambient UV Radiation Exposure and Risk of Basal Cell Carcinoma by Anatomic Site in a Nationwide U.S. Cohort, 1983–2005
    Mark P. Little, Terrence Lee, Michael G. Kimlin, Cari M. Kitahara, Rui Zhang, Bruce H. Alexander, Martha S. Linet, Elizabeth K. Cahoon
    Cancer Epidemiology, Biomarkers & Prevention.2021; 30(10): 1932.     CrossRef
Editorial
Evidence revealed the effects of rapid response system
Jae Hwa Cho
Acute Crit Care. 2019;34(4):282-283.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00710
  • 3,529 View
  • 93 Download
PDF
Case Reports
Infection
A successful application of adult polymyxin B-immobilized fiber column hemoperfusion to a neonate with septic shock
Young A Kim, Hyungtae Kim, Yu-Mi Kim, Su Eun Park
Acute Crit Care. 2019;34(4):284-288.   Published online November 6, 2018
DOI: https://doi.org/10.4266/acc.2017.00528
  • 10,075 View
  • 159 Download
  • 5 Citations
AbstractAbstract PDF
Direct hemoperfusion therapy with a polymyxin B-immobilized fiber column (PMX-HP) has been introduced as a therapeutic option for gram negative bacterial septic shock in adults. However, its use in neonates and children has not yet been established. We successfully performed hemoperfusion therapy using an adult polymyxin B-immobilized fiber column in a neonate with carbapenem resistant Acinetobacter baumannii septic shock. The application was technically feasible because the neonate was on extracorporeal membrane oxygenation (ECMO). Although it did not rescue the patient, there was significant short-lasting improvement in pulmonary oxygenation and hemodynamics, leading to wean the patient from ECMO. PMX-HP could be used as an adjunctive treatment for selected neonatal and pediatric patients with gram negative bacterial septic shock.

Citations

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  • Polymyxin B Hemoperfusion in Pediatric Septic Shock: Single-Center Observational Case Series
    Patcharin Saetang, Rujipat Samransamruajkit, Kanokwan Singjam, Tawatchai Deekajorndech
    Pediatric Critical Care Medicine.2022; 23(8): e386.     CrossRef
  • Controlling an Outbreak of Multidrug-resistant Acinetobacter baumannii in a Pediatric Intensive Care Unit: a Retrospective Analysis
    Joung-Hee Byun, Su Eun Park, Minhae Seo, Jeungmi Jang, Mi Sun Hwang, Ju Yeoun Song, Chulhun L. Chang, Young A Kim
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Effects of continuous renal replacement therapy with the AN69ST membrane for septic shock and sepsis-induced AKI in an infant: a case report with literature review of cytokine/mediator removal therapy in children
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    Naoto Nishizaki
    Acute and Critical Care.2020; 35(3): 226.     CrossRef
  • Case Report: Successful Use of Extracorporeal Therapies After ECMO Resuscitation in a Pediatric Kidney Transplant Recipient
    Andrey Rybalko, Anna Pytal, Mikhail Kaabak, Nadejda Rappoport, Anuar Bidzhiev, Vasilii Lastovka
    Frontiers in Pediatrics.2020;[Epub]     CrossRef
Cardiology
Two women presenting aborted sudden cardiac arrest as the first event of mitral valve disease
Sua Kim, Jae Min Shim, Seong-Mi Park
Acute Crit Care. 2019;34(4):289-293.   Published online November 13, 2018
DOI: https://doi.org/10.4266/acc.2017.00570
  • 4,413 View
  • 85 Download
  • 1 Citations
AbstractAbstract PDF
Mitral valve prolapse (MVP) is a relatively common valvular heart disease and is known to have a benign course. However, a certain subtype of MVP has a pathologic prognosis and can be accompanied by malignant cardiac arrhythmia causing sudden cardiac arrest, which can be characterized by bileaflet mitral valvular thickening and prolapse and frequent premature ventricular ectopic activity upon electrocardiography. Herein, we present two patients with bileaflet mitral prolapse who survived aborted sudden cardiac arrest. These cases show a precise MVP diagnosis that may prevent a devastating life event with the unique MVP subtype.

Citations

Citations to this article as recorded by  
  • Mitral annular disjunction identified peripartum: A case highlighting key features of a recently classified syndrome
    Monique Doran, Gemma Reemst, Kenny Ng, Courtney Shaw, Paul Stoodley
    Sonography.2022;[Epub]     CrossRef

ACC : Acute and Critical Care