Acute and Critical Care

Volume 36 (2); May 2021

Review Article

Infection
Up-to-date information on polymyxin B-immobilized fiber column direct hemoperfusion for septic shock: Chieko Mitaka, Makio Kusaoi, Izumi Kawagoe, Daizoh Satoh; Acute Crit Care. 2021;36(2):85-91. Published online April 4, 2021; DOI: https://doi.org/10.4266/acc.2021.00150

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Endotoxin adsorption therapy by polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) has been used for the treatment of septic shock patients. Endotoxin, an outer membrane component of Gram-negative bacteria, plays an important role in the pathogenesis of septic shock. Endotoxin triggers a signaling cascade for leukocytes, macrophage, and endothelial cells to secrete various mediators including cytokines and nitric oxide, leading to septic shock and multiple organ dysfunction syndrome. PMX-DHP directly adsorbed not only endotoxin but also monocytes and anandamide. It reduced blood levels of inflammatory cytokines such as interleukin (IL)-1, IL-6, tumor necrosis factor-alpha and IL-17A, adhesion molecules, plasminogen activator inhibitor 1, and high mobility group box-1. As a result, PMX-DHP increased blood pressure and reduced the dose of vasoactive-inotropic agents. PMX-DHP improved monocyte human leukocyte antigen-DR expression in patients with severe sepsis and septic shock. A post hoc analysis of EUPHRATES (Evaluating the Use of Polymyxin B Hemoperfusion in Randomized Controlled Trial of Adults Treated for Endotoxemia and Septic Shock) trial has shown that PMX-DHP significantly reduced 28-day mortality compared with the control group in septic shock patients with endotoxin activity assay level between 0.60 and 0.89. Longer duration of PMX-DHP may be another strategy to bring out the beneficial effects of PMX-DHP. Further studies are needed to confirm the efficacy of PMX-DHP treatment for septic shock.

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Methods of Extracorporeal Hemocorrection in Sepsis (Review)
V. A. Kovzel, L. A. Davydova, A. V. Karzin, S. V. Tsarenko, V. Yu. Baturova, A. A. Polupan, A. I. Gutnikov
General Reanimatology.2023; 19(2): 68. CrossRef
Modifications of peripheral perfusion in patients with vasopressor-dependent septic shock treated with polymyxin B-direct hemoperfusion
Motohiro Sekino, Yu Murakami, Shuntaro Sato, Ryosuke Shintani, Shohei Kaneko, Naoya Iwasaki, Hiroshi Araki, Taiga Ichinomiya, Ushio Higashijima, Tetsuya Hara
Scientific Reports.2023;[Epub] CrossRef
Rhabdomyolysis secondary to hypervirulent Klebsiella pneumoniae infection: A case report
Naoko Niimi, Keiko Taga, Taiju Miyagami, Toshio Naito, Chieko Mitaka
Clinical Case Reports.2022;[Epub] CrossRef
Endotoxin Activity in Patients With Extracorporeal Membrane Oxygenation Life Support: An Observational Pilot Study
Chen-Tse Lee, Chih-Hsien Wang, Wing-Sum Chan, Yun-Yi Tsai, Tzu-Jung Wei, Chien-Heng Lai, Ming-Jiuh Wang, Yih-Sharng Chen, Yu-Chang Yeh
Frontiers in Medicine.2021;[Epub] CrossRef

Original Articles

Trauma
Prevalence and clinical impact of vitamin D deficiency in critically ill Korean patients with traumatic injuries: a single-center, prospective, observational study: Kyoung Hoon Lim, Jihoon Jang, Jinyoung Park; Acute Crit Care. 2021;36(2):92-98. Published online April 29, 2021; DOI: https://doi.org/10.4266/acc.2020.00801

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Abstract PDF: Background
This study investigated the prevalence and impact of 25-hydroxyvitamin D (25(OH) vitamin D) deficiency in critically ill Korean patients with traumatic injuries.
Methods
This prospective observational cohort study assessed the 25(OH) vitamin D status of consecutive trauma patients admitted to the trauma intensive care unit (TICU) of Kyungpook National University Hospital between January and December 2018. We analyzed the prevalence of 25(OH) vitamin D deficiency and its impact on clinical outcomes.
Results
There were no significant differences in the duration of mechanical ventilation (MV), lengths of TICU and hospital stays, and rates of nosocomial infection and mortality between patients with 25(OH) vitamin D <20 ng/ml and those with 25(OH) vitamin D ≥20 ng/ml within 24 hours of TICU admission. The duration of MV and lengths of TICU and hospital stays were shorter and the rate of nosocomial infection was lower in patients with 25(OH) vitamin D level ≥20 ng/ml on day 7 of hospitalization. The duration of MV, lengths of TICU and hospital stays, and nosocomial infection rate were significantly lower in patients with increased concentrations compared with those with decreased concentrations on day 7 of hospitalization, but the mortality rate did not differ significantly.
Conclusions
The 25(OH) vitamin D level measured within 24 hours after TICU admission was unrelated to clinical outcomes in critically ill patients with traumatic injuries. However, patients with increased 25(OH) vitamin D level after 7 days of hospitalization had better clinical outcomes than those with decreased levels.

Surgery
Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study: Hye-Bin Kim, Sungwon Na, Hyo Chae Paik, Hyeji Joo, Jeongmin Kim; Acute Crit Care. 2021;36(2):99-108. Published online April 5, 2021; DOI: https://doi.org/10.4266/acc.2020.01144

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Abstract PDF

Background
Lung transplantation (LT) is an accepted therapeutic modality for end-stage lung disease patients. Intensive care unit (ICU) readmission is a risk factor for mortality after LT, for which consistent risk factors have not been elucidated. Thus, we investigated the risk factors for ICU readmission during index hospitalization after LT, particularly regarding the posttransplant condition of LT patients.
Methods
In this retrospective study, we investigated all adult patients undergoing LT between October 2012 and August 2017 at our institution. We collected perioperative data from electronic medical records such as demographics, comorbidities, laboratory findings, ICU readmission, and in-hospital mortality.
Results
We analyzed data for 130 patients. Thirty-two patients (24.6%) were readmitted to the ICU 47 times during index hospitalization. At the initial ICU discharge, the Sequential Organ Failure Assessment (SOFA) score (odds ratio [OR], 1.464; 95% confidence interval [CI], 1.083−1.978; P=0.013) and pH (OR, 0.884; 95% CI, 0.813−0.962; P=0.004; when the pH value increases by 0.01) were related to ICU readmission using multivariable regression analysis and were still significant after adjusting for confounding factors. Thirteen patients (10%) died during the hospitalization period, and the number of ICU readmissions was a significant risk factor for in-hospital mortality. The most common causes of ICU readmission and in-hospital mortality were infection-related.
Conclusions
The SOFA score and pH were associated with increased risk of ICU readmission. Early postoperative management of these factors and thorough posttransplantation infection control can reduce ICU readmission and improve the prognosis of LT patients.

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The association of the Sequential Organ Failure Assessment score at intensive care unit discharge with intensive care unit readmission in the cardiac intensive care unit
Yonghoon Shin, Ji Hoon Jang, Ryoung-Eun Ko, Soo Jin Na, Chi Ryang Chung, Ki Hong Choi, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang
European Heart Journal: Acute Cardiovascular Care.2024; 13(4): 354. CrossRef
Cardiothoracic Transplant Anesthesia: Selected Highlights: Part I—Lung Transplantation
Andrew M. Courtwright, Jagan Devarajan, Ashley Virginia Fritz, Archer Kilbourne Martin, Barbara Wilkey, Sudhakar Subramani, Christopher M. Cassara, Justin N. Tawil, Andrea N. Miltiades, Michael L. Boisen, Brandi A. Bottiger, Angela Pollak, Theresa A. Gelz
Journal of Cardiothoracic and Vascular Anesthesia.2023; 37(6): 884. CrossRef
Status and Risk Factors in Patients Requiring Unplanned Intensive Care Unit Readmission Within 48 Hours: A Retrospective Propensity-Matched Study in China
Yan-Ling Yin, Mei-Rong Sun, Kun Zhang, Yu-Hong Chen, Jie Zhang, Shao-Kun Zhang, Li-Li Zhou, Yan-Shuo Wu, Peng Gao, Kang-Kang Shen, Zhen-Jie Hu
Risk Management and Healthcare Policy.2023; Volume 16: 383. CrossRef
Comment on “Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study”
Maida Qazi, Mahnoor Amin
Acute and Critical Care.2023; 38(2): 234. CrossRef
Reply to comment on “Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study”
Hye-Bin Kim, Sungwon Na, Hyo Chae Paik, Hyeji Joo, Jeongmin Kim
Acute and Critical Care.2023; 38(2): 236. CrossRef
Predicting outcomes, describing complications and optimising rehabilitation in patients undergoing lung transplantation
Massimiliano Polastri, Gian Maria Paganelli
International Journal of Therapy and Rehabilitation.2023; 30(10): 1. CrossRef

Rapid response system
Analysis of avoidable cardiopulmonary resuscitation incidents with a part-time rapid response system in place: Jun Yeun Cho, Dong Seon Lee, Yun Young Choi, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Yeon Joo Lee; Acute Crit Care. 2021;36(2):109-117. Published online April 16, 2021; DOI: https://doi.org/10.4266/acc.2020.01095

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Abstract PDF Supplementary Material

Background
Although a rapid response system (RRS) can reduce the incidence of cardiopulmonary resuscitation (CPR) in general wards, avoidable CPR cases still occur. This study aimed to investigate the incidence and causes of avoidable CPR.
Methods
We retrospectively reviewed the medical records of all adult patients who received CPR between April 2013 and March 2016 (35 months) at a tertiary teaching hospital where a part-time RRS was introduced in October 2012. Four experts reviewed all of the CPR cases and determined whether each event was avoidable.
Results
A total of 192 CPR cases were identified, and the incidence of CPR was 0.190 per 1,000 patient admissions. Of these, 56 (29.2%) were considered potentially avoidable, with the most common cause being doctor error (n=32, 57.1%), followed by delayed do-not-resuscitate (DNR) placement (n=12, 21.4%) and procedural complications (n=5, 8.9%). The percentage of avoidable CPR was significantly lower in the RRS operating time group than in the RRS non-operating time group (20.7% vs. 35.5%; P=0.026). Among 44 avoidable CPR events (excluding cases related to DNR issues), the rapid response team intervened in only three cases (6.8%), and most of the avoidable CPR cases (65.9%) occurred during the non-operating time.
Conclusions
A significant number of avoidable CPR events occurred with a well-functioning, part-time RRS in place. However, RRS operation does appear to lower the occurrence of avoidable CPR. Thus, it is necessary to extend RRS operation time and modify RRS activation criteria. Moreover, policy and cultural changes are needed prior to implementing a full-time RRS.

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Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act
Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee
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A Review of the Commercially Available ECG Detection and Transmission Systems—The Fuzzy Logic Approach in the Prevention of Sudden Cardiac Arrest
Michał Lewandowski
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Nursing
Association between perception of caring behaviors and self-efficacy in patients with cardiovascular disease at coronary care units: a cross-sectional study: Leila Kargar, Zahra Khademian, Masoume Rambod; Acute Crit Care. 2021;36(2):118-125. Published online April 29, 2021; DOI: https://doi.org/10.4266/acc.2020.00752

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Abstract PDF

Background
Assessing and improving patient self-efficacy are among the major roles of nurses. Nurses are also responsible for providing direct patient care, and they play a major role in improving patient care quality. Therefore, it is essential to evaluate nurses’ care-giving behaviors. This study aimed to determine the association between caring behaviors and self-efficacy in patients with cardiovascular disease.
Methods
In this cross-sectional study, 400 patients with cardiovascular disease who were admitted to hospitals in Jahrom, southern Iran, were selected through a stratified sampling. The Caring Behaviors Inventory and the Strategies Used by People to Promote Health questionnaires were used to collect data. Data were analyzed using descriptive statistics, Kolmogorov-Smirnov test and Spearman correlation coefficient in SPSS ver. 22.
Results
Results showed significant relationships between perception of caring behaviors and self-efficacy (r=0.16, P=0.001) as well as subscales of respectful deference to others (r=0.12, P=0.01), assurance of human presence (r=0.12, P=0.02), and positive connectedness (r=0.18, P=0.001). Additionally, among the subscales of caring behaviors, “attentive to others’ experience,” with a mean of 5.17±1.10, was the highest priority and “positive connectedness,” with a mean of 4.81±1.31, was the lowest priority for patients. The mean self-efficacy score was 73.94±29.78, and 169 patients (43.2%) had low self-efficacy.
Conclusions
Given the positive relationship between perception of caring behaviors and self-efficacy in patients with cardiovascular disease, self-efficacy could be improved by paying more attention to patient care priorities and improving patient perception of caring behaviors.

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Atallah Alenezi, Fahad M. Alhowaymel, Abdulaziz F. Abaoud, Mona Hamdy Mostafa
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The mediating role of psychological capital on the relationship between authentic leadership and nurses’ caring behavior: a cross-sectional study
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Zhangrou Rao†, Hui Shi†*, Zhezhen Jiang†, Jing Hu, Lanping Hu, Manjuan Xu, Regis Ernest Mendame Ehya, Guy-Armel Bounda*
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Pulmonary
The effects of direct hemoperfusion with polymyxin B-immobilized fiber in patients with acute exacerbation of interstitial lung disease: Jae Ha Lee, Jin Han Park, Hyo-Jung Kim, Hyun Kuk Kim, Ji Hoon Jang, Yong Kyun Kim, Bong Soo Park, Si Hyung Park, Il Hwan Kim, Se Hun Kim, Woon Heo, Hang-Jea Jang; Acute Crit Care. 2021;36(2):126-132. Published online April 15, 2021; DOI: https://doi.org/10.4266/acc.2021.00073

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Abstract PDF

Background
Acute exacerbation of interstitial lung disease (AE-ILD) causes clinically significant deterioration and has an extremely poor prognosis with high mortality. Recently, several studies reported the effectiveness of direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) in patients with AE-ILD as a potential therapy. This study describes the clinical effectiveness and safety of PMX-DHP in patients with AE-ILD.
Methods
We retrospectively reviewed the medical records of 10 patients (11 episodes) with AE-ILD treated with PMX-DHP from January 2018 to June 2019. We compared laboratory and physiologic data of the ratio of partial pressure arterial oxygen to fraction of inspired oxygen (P/F ratio) and level of inflammatory markers before and after implementation of PMX-DHP.
Results
Ten patients were included according to the 2016 revised definition of acute exacerbation of idiopathic pulmonary fibrosis (IPF). Nine patients had IPF and one patient had fibrotic nonspecific interstitial pneumonia. Most patients (90.9%) were treated with a steroid pulse, and four patients (36.4%) were treated with an immunosuppressant. The median number of PMX-DHP cycles was 2, and the median duration of each cycle was 6 hours. After PMX-DHP, the mean P/F ratio improved (86 [range, 63–106] vs. 145 [86–260], P=0.030) and interleukin-6 and c-reactive protein decreased (79 [35–640] vs. 10 [5–25], P=0.018 and 14 [4–21] vs. 5 [2–6], P=0.019, respectively). The 30-day mortality rate was 27.3% and the 90-day mortality rate was 72.7%.
Conclusions
PMX-DHP treatment improved P/F ratio and reduced inflammatory markers in AE-ILD patients.

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Polymyxin B-immobilised fibre column treatment for acute exacerbation of idiopathic pulmonary fibrosis patients with mechanical ventilation: a nationwide observational study
Nobuyasu Awano, Taisuke Jo, Takehiro Izumo, Minoru Inomata, Yu Ito, Kojiro Morita, Hiroki Matsui, Kiyohide Fushimi, Hirokazu Urushiyama, Takahide Nagase, Hideo Yasunaga
Journal of Intensive Care.2023;[Epub] CrossRef
Changes in Oxygenation and Serological Markers in Acute Exacerbation of Interstitial Lung Disease Treated with Polymyxin B Hemoperfusion
Song-I Lee, Chaeuk Chung, Dongil Park, Da Hyun Kang, Jeong Eun Lee
Journal of Clinical Medicine.2022; 11(9): 2485. CrossRef

Nursing
Challenges of the patient transition process from the intensive care unit: a qualitative study: Kobra Ghorbanzadeh, Abbas Ebadi, Mohammadali Hosseini, Sadat Seyed Bagher Madah, Hamidreza Khankeh; Acute Crit Care. 2021;36(2):133-142. Published online January 28, 2021; DOI: https://doi.org/10.4266/acc.2020.00626

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Abstract PDF

Background
The transition of patients from the intensive care unit (ICU) to the general ward is challenging. This study aimed to explain the challenges that patients face during the transition process.
Methods
In this qualitative research of conventional content analysis, data collection was conducted between February 2018 and July 2019 in educational hospitals. After obtaining informed consent, purposive sampling was performed with 22 nurses, intensive care physicians, anesthesiologists, and patients and their families using in-depth semi-structured interviews until data saturation.
Results
The content analysis yielded three main themes in the challenges patients face during the transition process from the ICU: mixed feelings regarding transition (happiness/hope, worry/uncertainty, abandonment); care break (different atmosphere, the difference between the program and the quality of care, assigning care to the patient and family, and care culture and beliefs); and search for support and information (ineffective communication, self-care capacity of patient and family, ineffective and disrupted training, and weak follow-up programs), which inflicts care shock in the patients.
Conclusions
The results showed that patients and their families were in a state of care shock during the ICU transition process and were sometimes disconcerted. It is necessary to design and implement care models according to the needs and challenges patients face during the transition period from ICU (patient-centered), based on the evidence available, and after considering the field of medicine and the accessibility of care in the country. The transition process can be improved and enhanced by obtaining knowledge about ICU care and related challenges as well as organizing a learning environment.

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Anne-Marie Selzler, Leanna Lee, Dina Brooks, Raj Kohli, Louise Rose, Roger Goldstein
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Family caregivers' experiences and needs of transitional care during the transfer from intensive care unit to a general ward: A qualitative study
Yuxin Zhan, Jiaohua Yu, Yi Chen, Yufang Liu, Yingyue Wang, Yali Wan, Suyun Li
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Martina Zucchetti, Isis Marques Severo, Isabel Cristina Echer, Daniela dos Santos Marona Borba, Carmen Lucia Silva Nectoux, Karina de Oliveira Azzolin
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Pulmonary
Airway pressure release ventilation in mechanically ventilated patients with COVID-19: a multicenter observational study: John S. Zorbas, Kwok M. Ho, Edward Litton, Bradley Wibrow, Edward Fysh, Matthew H. Anstey; Acute Crit Care. 2021;36(2):143-150. Published online May 4, 2021; DOI: https://doi.org/10.4266/acc.2021.00017

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Abstract PDF

Background
Evidence prior to the coronavirus disease 2019 (COVID-19) pandemic suggested that, compared with conventional ventilation strategies, airway pressure release ventilation (APRV) can improve oxygenation and reduce mortality in patients with acute respiratory distress syndrome. We aimed to assess the association between APRV use and clinical outcomes among adult patients receiving mechanical ventilation for COVID-19 and hypothesized that APRV use would be associated with improved survival compared with conventional ventilation.
Methods
A total of 25 patients with COVID-19 pneumonitis was admitted to intensive care units (ICUs) for invasive ventilation in Perth, Western Australia, between February and May 2020. Eleven of these patients received APRV. The primary outcome was survival to day 90. Secondary outcomes were ventilation-free survival days to day 90, mechanical complications from ventilation, and number of days ventilated.
Results
Patients who received APRV had a lower probability of survival than did those on other forms of ventilation (hazard ratio, 0.17; 95% confidence interval, 0.03–0.89; P=0.036). This finding was independent of indices of severity of illness to predict the use of APRV. Patients who received APRV also had fewer ventilator-free survival days up to 90 days after initiation of ventilation compared to patients who did not receive APRV, and survivors who received APRV had fewer ventilator-free days than survivors who received other forms of ventilation. There were no differences in mechanical complications according to mode of ventilation.
Conclusions
Based on the findings of this study, we urge caution with the use of APRV in COVID-19.

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Jan-Hendrik Naendrup, Jonathan Steinke, Jorge Garcia Borrega, Sandra Emily Stoll, Per Ole Michelsen, Yannick Assion, Alexander Shimabukuro-Vornhagen, Dennis Alexander Eichenauer, Matthias Kochanek, Boris Böll
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Early spontaneous breathing for acute respiratory distress syndrome in individuals with COVID-19
Friedrich Hohmann, Lisa Wedekind, Felicitas Grundeis, Steffen Dickel, Johannes Frank, Martin Golinski, Mirko Griesel, Clemens Grimm, Cindy Herchenhahn, Andre Kramer, Maria-Inti Metzendorf, Onnen Moerer, Nancy Olbrich, Volker Thieme, Astrid Vieler, Falk Fi
Cochrane Database of Systematic Reviews.2022;[Epub] CrossRef
Respiratory system mechanics, gas exchange, and outcomes in mechanically ventilated patients with COVID-19-related acute respiratory distress syndrome: a systematic review and meta-analysis
Mallikarjuna Ponnapa Reddy, Ashwin Subramaniam, Clara Chua, Ryan Ruiyang Ling, Christopher Anstey, Kollengode Ramanathan, Arthur S Slutsky, Kiran Shekar
The Lancet Respiratory Medicine.2022; 10(12): 1178. CrossRef
Comparison of characteristics and ventilatory course between coronavirus disease 2019 and Middle East respiratory syndrome patients with acute respiratory distress syndrome
Imran Khalid, Romaysaa M Yamani, Maryam Imran, Muhammad Ali Akhtar, Manahil Imran, Rumaan Gul, Tabindeh Jabeen Khalid, Ghassan Y Wali
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Neurology
Continuous heart rate variability and electroencephalography monitoring in severe acute brain injury: a preliminary study: Hyunjo Lee, Sang-Beom Jeon, Kwang-Soo Lee; Acute Crit Care. 2021;36(2):151-161. Published online March 18, 2021; DOI: https://doi.org/10.4266/acc.2020.00703

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Abstract PDF

Background
Decreases in heart rate variability have been shown to be associated with poor outcomes in severe acute brain injury. However, it is unknown whether the changes in heart rate variability precede neurological deterioration in such patients. We explored the changes in heart rate variability measured by electrocardiography in patients who had neurological deterioration following severe acute brain injury, and examined the relationship between heart rate variability and electroencephalography parameters.
Methods
Retrospective analysis of 25 patients who manifested neurological deterioration after severe acute brain injury and underwent simultaneous electroencephalography plus electrocardiography monitoring.
Results
Eighteen electroencephalography channels and one simultaneously recorded electrocardiography channel were segmented into epochs of 120-second duration and processed to compute 10 heart rate variability parameters and three quantitative electroencephalography parameters. Raw electroencephalography of the epochs was also assessed by standardized visual interpretation and categorized based on their background abnormalities and ictalinterictal continuum patterns. The heart rate variability and electroencephalography parameters showed consistent changes in the 2-day period before neurological deterioration commenced. Remarkably, the suppression ratio and background abnormality of the electroencephalography parameters had significant reverse correlations with all heart rate variability parameters.
Conclusions
We observed a significantly progressive decline in heart rate variability from the day before the neurological deterioration events in patients with severe acute brain injury were first observed.

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Association of Depressive and Somatic Symptoms with Heart Rate Variability in Patients with Traumatic Brain Injury
Seung Don Yoo, Eo Jin Park
Journal of Clinical Medicine.2022; 12(1): 104. CrossRef
Influencing Cardiovascular Outcomes through Heart Rate Variability Modulation: A Systematic Review
Alexandru Burlacu, Crischentian Brinza, Iolanda Valentina Popa, Adrian Covic, Mariana Floria
Diagnostics.2021; 11(12): 2198. CrossRef

Editorial

Ethics
Concept of care shock during intensive care unit discharge process: Dong Hyun Lee; Acute Crit Care. 2021;36(2):162-163. Published online March 3, 2021; DOI: https://doi.org/10.4266/acc.2021.00199

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Case Report

Cardiology
Implantable cardioverter defibrillator as a treatment for massive left ventricular fibroma-induced ventricular arrhythmia in a child: In Su Choi, Hyung Ki Jeong, Hyung Wook Park, Yi-Seul Kim; Acute Crit Care. 2021;36(2):164-168. Published online May 28, 2021; DOI: https://doi.org/10.4266/acc.2020.00269

4,449 View
113 Download
1 Web of Science
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Abstract PDF

Pediatric cardiac tumors are rare. Among these, cardiac fibroma is the second most common. Its clinical manifestations depend on size and location of the tumor and include arrhythmia or obstruction to blood flow. Symptomatic cardiac fibroma is generally treated with surgical resection or cardiac transplantation. We present the case of a 12-year-old boy with a lethal ventricular arrhythmia induced by a remnant tumor that was previously partially resected. An implantable cardioverter defibrillator was inserted as the arrhythmia was resistant to medical treatment. He was discharged in stable condition with an implantable cardioverter defibrillator generator and followed up in the outpatient clinic.

Citations

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Lipid emulsion attenuates propranolol-induced early apoptosis in rat cardiomyoblasts
Seong-Ho Ok, Seung Hyun Ahn, Soo Hee Lee, Hyun-Jin Kim, Gyujin Sim, Jin Kyeong Park, Ju-Tae Sohn
Human & Experimental Toxicology.2022;[Epub] CrossRef

Letter to the Editor

Pulmonary
Vitamin C and corticosteroids in viral pneumonia: Matthew Harry Anstey, Jacky Luu, Erina Myers, Robert N Palmer, Bradley Wibrow, Kwok M Ho; Acute Crit Care. 2021;36(2):169-171. Published online March 10, 2021; DOI: https://doi.org/10.4266/acc.2020.01081

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2 Web of Science
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Citations

Citations to this article as recorded by

Emergent Drug and Nutrition Interactions in COVID-19: A Comprehensive Narrative Review
Duygu Ağagündüz, Menşure Nur Çelik, Merve Esra Çıtar Dazıroğlu, Raffaele Capasso
Nutrients.2021; 13(5): 1550. CrossRef

Erratums

Pulmonary
Erratum to “Utilization of pain and sedation therapy on noninvasive mechanical ventilation in Korean intensive care units: a multi-center prospective observational study”: Taehee Kim, Jung Soo Kim, Eun Young Choi, Youjin Chang, Won-Il Choi, Jae-Joon Hwang, Jae Young Moon, Kwangha Lee, Sei Won Kim, Hyung Koo Kang, Yun Su Sim, Tai Sun Park, Seung Yong Park, Sunghoon Park, Jae Hwa Cho; Acute Crit Care. 2021;36(2):172-172. Published online May 28, 2021; DOI: https://doi.org/10.4266/acc.2020.00164.e1; Corrects: Acute Crit Care 2020;35(4):255

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Pulmonary
Erratum to “Global and regional ventilation during high flow nasal cannula in patients with hypoxia”: Dong Hyun Lee, Eun Young Kim, Ga Jin Seo, Hee Jung Suh, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Chae-Man Lim; Acute Crit Care. 2021;36(2):173-173. Published online May 28, 2021; DOI: https://doi.org/10.4266/acc.2017.00507.e1; Corrects: Acute Crit Care 2018;33(1):7

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