Skip Navigation
Skip to contents

ACC : Acute and Critical Care

OPEN ACCESS
SEARCH
Search

Previous issues

Page Path
HOME > Issue > Previous issues
18 Previous issues
Filter
Filter
Article category
Keywords
Authors
Funded articles
Volume 37 (2); May 2022
Prev issue Next issue
Review Articles
Infection
Oxygen therapy for sepsis and prevention of complications
Hayk Minasyan
Acute Crit Care. 2022;37(2):137-150.   Published online March 17, 2022
DOI: https://doi.org/10.4266/acc.2021.01200
  • 9,029 View
  • 451 Download
  • 2 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Patients with sepsis have a wide range of respiratory disorders that can be treated with oxygen therapy. Experimental data in animal sepsis models show that oxygen therapy significantly increases survival, while clinical data on the use of different oxygen therapy protocols are ambiguous. Oxygen therapy, especially hyperbaric oxygenation, in patients with sepsis can aggravate existing oxidative stress and contribute to the development of disseminated intravascular coagulation. The purpose of this article is to compare experimental and clinical data on oxygen therapy in animals and humans, to discuss factors that can influence the results of oxygen therapy for sepsis treatment in humans, and to provide some recommendations for reducing oxidative stress and preventing disseminated intravascular coagulation during oxygen therapy.

Citations

Citations to this article as recorded by  
  • Sequential respiratory support in septic patients undergoing continuous renal replacement therapy: A study based on MIMIC-III database
    Chunxia Wang, Jianli Zheng, Yilin Zhao, Tiantian Liu, Yucai Zhang
    Heliyon.2024; 10(6): e27563.     CrossRef
  • Personalized medicine targeting different ARDS phenotypes: The future of pharmacotherapy for ARDS?
    Florian Blanchard, Arthur James, Mona Assefi, Natacha Kapandji, Jean-Michel Constantin
    Expert Review of Respiratory Medicine.2023; 17(1): 41.     CrossRef
  • Current data regarding homeostasis of tissues oxygenation in pathophysiological and therapeutic circumstances
    Constantin Munteanu, Mihaela Antonina Călin, Dragoș Manea, Cristina Popescu, Mădălina Iliescu, Elena Valentina Ionescu, Liliana Stanciu, Mihaela Minea, Carmen Oprea, Doinița Oprea, Mariana Rotariu, Gelu Onose
    Balneo and PRM Research Journal.2023; 14(Vol.14, no): 565.     CrossRef
  • Current data regarding homeostasis of tissues oxygenation in pathophysiological and therapeutic circumstances
    Constantin Munteanu, Mihaela Antonina Călin, Dragoș Manea, Cristina Popescu, Mădălina Iliescu, Elena Valentina Ionescu, Liliana Stanciu, Mihaela Minea, Carmen Oprea, Doinița Oprea, Mariana Rotariu, Gelu Onose
    Balneo and PRM Research Journal.2023; 14(Vol.14, no): 565.     CrossRef
Basic science and research
Review of remimazolam and sedatives in the intensive care unit
Hey-Ran Choi, In-Ae Song
Acute Crit Care. 2022;37(2):151-158.   Published online May 30, 2022
DOI: https://doi.org/10.4266/acc.2022.00619
  • 5,266 View
  • 358 Download
  • 2 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Remimazolam is a novel intravenous ultra-short acting benzodiazepine that has the potential of being a safe and effective new sedative for use in intensive care unit (ICU) settings. Because remimazolam metabolizes rapidly by being hydrolyzed to an inactive metabolite (CNS 7054) through non-specific tissue esterase activity, specific dosing adjustment for older adults and for patients with renal or hepatic impairment patients (except for those with severe hepatic impairment) is not required. In addition, research has shown that remimazolam may be reversed by administration of flumazenil, as its half time was sufficiently short compared to flumazenil. It shows a lower incidence of cardiorespiratory depression, less injection pain, and no fatal complications such as propofol infusion syndrome and malignant hyperthermia of inhalational anesthetics. Future studies to study the suitability of remimazolam for managing the sedation of ICU patients who need sedation for a long time over several days is required.

Citations

Citations to this article as recorded by  
  • Remimazolam: A New Ingress in Cardiac Surgical Intensive Care Unit
    Minati Choudhury, Poonam Malhotra Kapoor
    Journal of Cardiac Critical Care TSS.2023; 7: 133.     CrossRef
  • Safety and efficacy of remimazolam tosilate combined with low-dose fentanyl for procedural sedation in obese patients undergoing gastroscopy: study protocol for a single-centre, double-blind, randomised controlled trial
    Lijuan Yan, Xiao Wang, Zhenyi Chen, Ningning Wu, Hao Li, Bin Yang
    BMJ Open.2023; 13(12): e079095.     CrossRef
  • Remimazolam: An Updated Review of a New Sedative and Anaesthetic
    Qinxue Hu, Xing Liu, Chengli Wen, Duo Li, Xianying Lei
    Drug Design, Development and Therapy.2022; Volume 16: 3957.     CrossRef
  • Análisis nacional de la sedación aplicada en pacientes de cuidados críticos
    Grace Pamela López Pérez, Melani Dayana Carrera Casa, Gissela Lizbeth Amancha Moyulema, Yadira Nathaly Chicaiza Quilligana, Ana Belén Guamán Tacuri, Joselyn Mireya Iza Arias
    Salud, Ciencia y Tecnología.2022; 2(S1): 234.     CrossRef
Original Articles
Pulmonary
Association of pulmonary arterial pressure with volume status in patients with acute respiratory distress syndrome receiving extracorporeal membrane oxygenation
Tae Hwa Hong, Hyoung Soo Kim, Sunghoon Park
Acute Crit Care. 2022;37(2):159-167.   Published online March 11, 2022
DOI: https://doi.org/10.4266/acc.2021.00927
  • 4,460 View
  • 215 Download
AbstractAbstract PDFSupplementary Material
Background
Data on pulmonary hemodynamic parameters in patients with acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO) are scarce.
Methods
The associations between pulmonary artery catheter parameters for the first 7 days of ECMO, fluid balance, and hospital mortality were investigated in adult patients (aged ≥19 years) who received venovenous ECMO for refractory ARDS between 2015 and 2017.
Results
Twenty patients were finally included in the analysis (median age, 56.0 years; interquartile range, 45.5–68.0 years; female, n=10). A total of 140 values were collected for each parameter (i.e., 7 days×20 patients). Net fluid balance was weakly but significantly correlated with systolic and diastolic pulmonary arterial pressures (PAPs; r=0.233 and P=0.011; r=0.376 and P<0.001, respectively). Among the mechanical ventilation parameters, above positive end-expiratory pressure was correlated with systolic PAP (r=0.191 and P=0.025), and static compliance was negatively correlated with diastolic PAP (r=−0.169 and P=0.048). Non-survivors had significantly higher systolic PAPs than in survivors. However, in multivariate analysis, there was no significant association between mean systolic PAP and hospital mortality (odds ratio, 1.500; 95% confidence interval, 0.937–2.404; P=0.091).
Conclusions
Systolic PAP was weakly but significantly correlated with net fluid balance during the early ECMO period in patients with refractory ARDS receiving ECMO.
Infection
Comparison of critically ill COVID-19 and influenza patients with acute respiratory failure
Mehmet Yildirim, Burcin Halacli, Mehmet Yasir Pektezel, Berrin Er, Ismail Tuna Geldigitti, Gulay Tok, Ebru Ortac Ersoy, Arzu Topeli
Acute Crit Care. 2022;37(2):168-176.   Published online March 11, 2022
DOI: https://doi.org/10.4266/acc.2021.00920
  • 5,972 View
  • 235 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
Coronavirus disease 2019 (COVID-19) is one of the biggest pandemic causing acute respiratory failure (ARF) in the last century. Seasonal influenza carries high mortality, as well. The aim of this study was to compare features and outcomes of critically-ill COVID-19 and influenza patients with ARF.
Methods
Patients with COVID-19 and influenza admitted to intensive care unit with ARF were retrospectively analyzed.
Results
Fifty-four COVID-19 and 55 influenza patients with ARF were studied. Patients with COVID-19 had 32% of hospital mortality, while those with influenza had 47% (P=0.09). Patients with influenza had higher Eastern Cooperative Oncology Group, Clinical Frailty Scale, Acute Physiology and Chronic Health Evaluation II and admission Sequential Organ Failure Assessment (SOFA) scores than COVID-19 patients (P<0.01). Secondary bacterial infection, admission acute kidney injury, procalcitonin level above 0.2 ng/ml were the independent factors distinguishing influenza from COVID-19 while prone positioning differentiated COVID-19 from influenza. Invasive mechanical ventilation (odds ratio [OR], 42.16; 95% confidence interval [CI], 9.45–187.97), admission SOFA score more than 4 (OR, 5.92; 95% CI, 1.85–18.92), malignancy (OR, 4.95; 95% CI, 1.13–21.60), and age more than 65 years (OR, 3.31; 95% CI, 0.99–11.03) were found to be independent risk factors for hospital mortality.
Conclusions
There were few differences in clinical features of critically-ill COVID-19 and influenza patients. Influenza cases had worse performance status and disease severity. There was no significant difference in hospital mortality rates between COVID-19 and influenza patients.

Citations

Citations to this article as recorded by  
  • Comparison of Clinical Characteristics and Outcomes in Intensive Care Units Between Patients with Coronavirus Disease 2019 (COVID-19) and Patients with Influenza: A Systematic Review and Meta-Analysis
    Zhuan Zhong, Xin Wang, Jia Guo, Xingzhao Li, Yingying Han
    Journal of Intensive Care Medicine.2024;[Epub]     CrossRef
  • Acute kidney injury in patients with COVID-19 compared to those with influenza: a systematic review and meta-analysis
    Chiu-Ying Hsiao, Heng-Chih Pan, Vin-Cent Wu, Ching-Chun Su, Tzu-Hsuan Yeh, Min-Hsiang Chuang, Kuan-Chieh Tu, Hsien-Yi Wang, Wei-Chih Kan, Chun-Chi Yang, Jui-Yi Chen
    Frontiers in Medicine.2023;[Epub]     CrossRef
  • Comparison of Clinical Features and Outcomes between SARS-CoV-2 and Non-SARS-CoV-2 Respiratory Viruses Associated Acute Respiratory Distress Syndrome: Retrospective Analysis
    Manbong Heo, Jong Hwan Jeong, Sunmi Ju, Seung Jun Lee, Yi Yeong Jeong, Jong Deog Lee, Jung-Wan Yoo
    Journal of Clinical Medicine.2022; 11(8): 2246.     CrossRef
Pulmonary
The role of nafamostat mesilate as a regional anticoagulant during extracorporeal membrane oxygenation
Jae Ha Lee, Jin Han Park, Ji Hoon Jang, Se Hun Kim, Sung Yong Hong, Woon Heo, Dong-Hwan Lee, Hye Sook Choi, Ki Hoon Kim, Hang-Jea Jang
Acute Crit Care. 2022;37(2):177-184.   Published online April 20, 2022
DOI: https://doi.org/10.4266/acc.2021.01312
  • 4,077 View
  • 252 Download
  • 6 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Background
Anticoagulation during extracorporeal membrane oxygenation (ECMO) usually is required to prevent thrombosis. The aim of this study was to investigate the usefulness of nafamostat mesilate (NM) as a regional anticoagulant during veno-arterial ECMO (VA-ECMO) treatment. Methods: We retrospectively reviewed the medical records of 16 patients receiving VA-ECMO and NM from January 2017 to June 2020 at Haeundae Paik Hospital. We compared clinical and laboratory data, including activated partial thromboplastin time (aPTT), which was measured simultaneously in patients and the ECMO site, to estimate the efficacy of regional anticoagulation. Results: The median patient age was 68.5 years, and 56.3% of patients were men. Cardiovascular disease was the most common primary disease (75.0%) requiring ECMO treatment, followed by respiratory disease (12.5%). The median duration of ECMO treatment was 7.5 days. Among 16 patients, seven were switched to NM after first using heparin as an anticoagulation agent, and nine received only NM. When comparing aPTT values in the NM group between patients and the ECMO site, that in patients was significantly lower than that at the ECMO site (73.57 vs. 79.25 seconds; P=0.010); in contrast, no difference was observed in the heparin group. Conclusions: NM showed efficacy as a regional anticoagulation method by sustaining a lower aPTT value compared to that measured at the ECMO site. NM should be considered as a safer regional anticoagulation method in VA-ECMO for patients at high risk of bleeding.

Citations

Citations to this article as recorded by  
  • Management of cardiopulmonary bypass in patients with ischemic and hemorrhagic strokes in surgery for active infective endocarditis
    Takahiro Yamazato, Hiroshi Munakata, Yutaka Okita
    Indian Journal of Thoracic and Cardiovascular Surgery.2024; 40(S1): 61.     CrossRef
  • Approach to Decompensated Right Heart Failure in the Acute Setting
    Catherine V. Levitt, Caitlin A. Williams, Jalil Ahari, Ali Pourmand
    Journal of Clinical Medicine.2024; 13(3): 869.     CrossRef
  • Critical Care Management of Severe Asthma Exacerbations
    Shameek Gayen, Stephen Dachert, Bilal Lashari, Matthew Gordon, Parag Desai, Gerard Criner, Juan Cardet, Kartik Shenoy
    Journal of Clinical Medicine.2024; 13(3): 859.     CrossRef
  • Complications and Outcomes in 39,864 Patients Receiving Standard Care Plus Mechanical Circulatory Support or Standard Care Alone for Infarct-Associated Cardiogenic Shock
    Jan-Sören Padberg, Jannik Feld, Leonie Padberg, Jeanette Köppe, Lena Makowski, Joachim Gerß, Patrik Dröge, Thomas Ruhnke, Christian Günster, Stefan Andreas Lange, Holger Reinecke
    Journal of Clinical Medicine.2024; 13(4): 1167.     CrossRef
  • Extra-Corporeal Membrane Oxygenation in Pregnancy
    Tatsiana Romenskaya, Yaroslava Longhitano, Aman Mahajan, Gabriele Savioli, Antonio Voza, Manfredi Tesauro, Christian Zanza
    Journal of Clinical Medicine.2024; 13(6): 1634.     CrossRef
  • Anticoagulants in adult extracorporeal membrane oxygenation: alternatives to standardized anticoagulation with unfractionated heparin
    Shu Tang, Liqing Xu, Hui Li, Zhanshen Wu, Qiang Wen
    European Journal of Clinical Pharmacology.2023; 79(12): 1583.     CrossRef
Nephrology
Measured versus estimated creatinine clearance in critically ill patients with acute kidney injury: an observational study
Sara Kadivarian, Fatemeh Heydarpour, Hasanali Karimpour, Foroud Shahbazi
Acute Crit Care. 2022;37(2):185-192.   Published online April 22, 2022
DOI: https://doi.org/10.4266/acc.2021.01256
  • 5,681 View
  • 341 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
Acute kidney injury (AKI) commonly occurs in critically ill patients. Estimation of renal function and antibiotics dose adjustment in patients with AKI is a challenging issue.
Methods
Urinary creatinine clearance was measured in a 6-hour urine collection from patients with acute kidney injuries. The correlations between different formulas including the modified Cockcroft-Gault, modification of diet in renal disease, chronic kidney disease-epidemiology collaboration, Jelliffe, kinetic-glomerular filtration rate (GFR), Brater, and Chiou formulas were considered. The pattern of the prescribed antimicrobial agents was also compared with the patterns in the available resources.
Results
Ninety-five patients with acute kidney injuries were included in the research. The mean age of the participants was 63.11±17.58 years old. The most patients (77.89%) were in stage 1 of AKI according to the Acute Kidney Injury Network criteria, followed by stage 2 (14.73%) and stage 3 (7.36), respectively. None of the formulations had a high or very high correlation with the measured creatinine clearance. In stage 1, Chiou (r=0.26), and in stage 2 and 3, kinetic-GFR (r=0.76 and r=0.37) had the highest correlation coefficient. Antibiotic over- and under-dosing were frequently observed in the study.
Conclusions
The results showed that none of the static methods can predict the measured creatinine clearance in the critically ill patients. The dynamic methods such as kinetic-GFR can be helpful for patients who do not receive diuretics and vasopressors. Further studies are needed to confirm our results.

Citations

Citations to this article as recorded by  
  • SWOT and Root Cause Analyses of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis
    Pradeep Tyagi, Shachi Tyagi, Laurence Stewart, Scott Glickman
    Antibiotics.2024; 13(4): 328.     CrossRef
  • Estimated glomerular filtration rates are higher when creatinine‐based equations are compared with a cystatin C‐based equation in coronavirus disease 2019
    Anders O. Larsson, Michael Hultström, Robert Frithiof, Miklos Lipcsey, Ulf Nyman, Mats B. Eriksson
    Acta Anaesthesiologica Scandinavica.2023; 67(2): 213.     CrossRef
  • Selection of appropriate reference creatinine estimate for acute kidney injury diagnosis in patients with severe trauma
    Kangho Lee, Dongyeon Ryu, Hohyun Kim, Sungjin Park, Sangbong Lee, Chanik Park, Gilhwan Kim, Sunhyun Kim, Nahyeon Lee
    Acute and Critical Care.2023; 38(1): 95.     CrossRef
Infection
Incidence and risk factors associated with early death in patients with emergency department septic shock
Matthew S. Reaven, Nigel L. Rozario, Maggie S. J. McCarter, Alan C. Heffner
Acute Crit Care. 2022;37(2):193-201.   Published online February 11, 2022
DOI: https://doi.org/10.4266/acc.2021.00857
  • 4,602 View
  • 265 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Limited research has explored early mortality among patients presenting with septic shock. The objective of this study was to determine the incidence and factors associated with early death following emergency department (ED) presentation of septic shock.
Methods
A prospective registry of patients enrolled in an ED septic shock clinical pathway was used to identify patients. Patients were compared across demographic, comorbid, clinical, and treatment variables by death within 72 hours of ED presentation.
Results
Among the sample of 2,414 patients, overall hospital mortality was 20.6%. Among patients who died in the hospital, mean and median time from ED presentation to death were 4.96 days and 2.28 days, respectively. Death at 24, 48, and 72 hours occurred in 5.5%, 9.5%, and 11.5% of patients, respectively. Multivariate regression analysis demonstrated that the following factors were independently associated with early mortality: age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.03–1.05), malignancy (OR, 1.53; 95% CI, 1.11–2.11), pneumonia (OR, 1.39; 95% CI, 1.02–1.88), urinary tract infection (OR, 0.63; 95% CI, 0.44–0.89), first shock index (OR, 1.85; 95% CI, 1.27–2.70), early vasopressor use (OR, 2.16; 95% CI, 1.60–2.92), initial international normalized ratio (OR, 1.14; 95% CI, 1.07–1.27), initial albumin (OR, 0.55; 95% CI, 0.44–0.69), and first serum lactate (OR, 1.21; 95% CI, 1.16–1.26).
Conclusions
Adult septic shock patients experience a high rate of early mortality within 72 hours of ED arrival. Recognizable clinical factors may aid the identification of patients at risk of early death.

Citations

Citations to this article as recorded by  
  • Early Prediction of Mortality for Septic Patients Visiting Emergency Room Based on Explainable Machine Learning: A Real-World Multicenter Study
    Sang Won Park, Na Young Yeo, Seonguk Kang, Taejun Ha, Tae-Hoon Kim, DooHee Lee, Dowon Kim, Seheon Choi, Minkyu Kim, DongHoon Lee, DoHyeon Kim, Woo Jin Kim, Seung-Joon Lee, Yeon-Jeong Heo, Da Hye Moon, Seon-Sook Han, Yoon Kim, Hyun-Soo Choi, Dong Kyu Oh, S
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Red cell distribution width and in‐hospital mortality in septic shock: A public database research
    Qiong Ding, Yingjie Su, Changluo Li, Ning Ding
    International Journal of Laboratory Hematology.2022; 44(5): 861.     CrossRef
Nursing
The effect of time management education on critical care nurses’ prioritization: a randomized clinical trial
Fatemeh Vizeshfar, Mahnaz Rakhshan, Fatemeh Shirazi, Roya Dokoohaki
Acute Crit Care. 2022;37(2):202-208.   Published online April 28, 2022
DOI: https://doi.org/10.4266/acc.2021.01123
  • 8,138 View
  • 424 Download
  • 4 Web of Science
  • 7 Crossref
AbstractAbstract PDF
necessiBackground: Nurses are at the forefront of patient care, and time management skills can increase their ability to make decisions faster. This study aimed to assess the effect of a time management workshop on prioritization and time management skills among nurses of emergency and intensive care units.
Methods
This randomized clinical trial was performed with 215 nurses. The educational intervention about time management was held in the form of a workshop for the intervention group. The time management questionnaire was completed by both groups before, immediately after, and 3 months after the intervention.
Results
Most participants were female (n=191, 88%), with a mean age of 31.82 years (range, 22–63 years). Additionally, the participants’ work experience ranged from 1 to 30 years (mean±standard deviation, 8.00±7.15 years). After the intervention, the mean score of time management increased significantly in the intervention group, but no significant difference was observed in this regard in the control group. The results also revealed a significant difference between the intervention and control groups regarding the mean score of time management 3 months after the intervention (P<0.001).
Conclusions
Time management training helped nurses adjust the time required to perform and prioritize various tasks.

Citations

Citations to this article as recorded by  
  • Nursing core competencies for postresuscitation care in Iran: a qualitative study
    Mahnaz Zali, Azad Rahmani, Kelly Powers, Hadi Hassankhani, Hossein Namdar-Areshtanab, Neda Gilani
    BMJ Open.2024; 14(1): e074614.     CrossRef
  • Critical care nurses’ experiences of caring challenges during post-resuscitation period: a qualitative content analysis
    Mahnaz Zali, Azad Rahmani, Hadi Hassankhani, Hossein Namdar-Areshtanab, Neda Gilani, Arman Azadi, Mansour Ghafourifard
    BMC Nursing.2024;[Epub]     CrossRef
  • A Systemic Model for Resilience and Time Management in Healthcare Academia: Application in a Dental University Setting
    Maria Antoniadou, Rallis Antoniadis
    Applied Sciences.2024; 14(11): 4918.     CrossRef
  • Impact of Time Optimization Intervention on Work Execution and Burnout among Nurses Working at Intensive Care Unit
    Angelin Santhakumari H, Manjula Annamalai, Porkodi Arjunan, Adithya. A. Venka
    Salud, Ciencia y Tecnología.2024; 4: 1115.     CrossRef
  • Impact of time management program on stress and coping strategies adopted by nursing students with regard to academic performance
    Juby Mary Chacko, Achamma Varghese, Nirmala Rajesh
    IP Journal of Paediatrics and Nursing Science.2023; 6(1): 48.     CrossRef
  • Perceived clinical competence and predictive role of time management in nursing students
    Maryam Behdarvand, Mehrnaz Ahmadi, Nasrin Khajeali
    Nurse Education in Practice.2023; 72: 103789.     CrossRef
  • Examining the impact of time management and resilience training on work-family conflict among Iranian female nurses: a randomized controlled trial
    Sedigheh Peykar, Hakimeh Vahedparast, Tayebeh Gharibi, Razieh Bagherzadeh
    BMC Nursing.2023;[Epub]     CrossRef
Pediatrics
Hearing screening outcomes in pediatric critical care survivors: a 1-year report
Pattita Suwannatrai, Chanapai Chaiyakulsil
Acute Crit Care. 2022;37(2):209-216.   Published online March 8, 2022
DOI: https://doi.org/10.4266/acc.2021.00899
  • 3,032 View
  • 159 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Hearing loss is a potentially serious complication that can occur after surviving a critical illness. Study on screening for hearing problems in pediatric critical care survivors beyond the neonatal period is lacking. This study aimed to identify the prevalence of abnormal hearing screening outcomes using transitory evoked otoacoustic emission (TEOAE) screening in children who survived critical illness and to find possible associating factors for abnormal hearing screening results.
Methods
This study was a single-center, prospective, observational study. All children underwent otoscopy to exclude external and middle ear abnormalities before undergoing TEOAE screening. The screening was conducted before hospital discharge. Descriptive statistics, chi-square, and logistic regression tests were used for data analysis.
Results
A total of 92 children were enrolled. Abnormal TEOAE responses were identified in 26 participants (28.3%). Children with abnormal responses were significantly younger than those with normal responses with a median age of 10.0 months and 43.5 months, respectively (P<0.001). Positive association with abnormal responses was found in children younger than 12 months of age (adjusted odds ratio [OR], 3.07; 95% confidence interval [CI], 1.06–8.90) and children with underlying genetic conditions (adjusted OR, 6.95; 95% CI, 1.49–32.54).
Conclusions
Our study demonstrates a high prevalence of abnormal TEOAE screening responses in children surviving critical illness, especially in patients younger than 12 months of age. More extensive studies should be performed to identify the prevalence and associated risk factors of hearing problems in critically ill children.

Citations

Citations to this article as recorded by  
  • Physiological and electrophysiological evaluation of the hearing system in low birth weight neonates treated with cholestin: a cohort study
    Nastaran Khosravi, Malihah Mazaheryazdi, Majid Kalani, Nasrin Khalesi, Zinat Shakeri, Saeedeh Archang, Maryam Archang
    The Egyptian Journal of Otolaryngology.2023;[Epub]     CrossRef
Pediatrics
Early postoperative arrhythmias after pediatric congenital heart disease surgery: a 5-year audit from a lower- to middle-income country
Sidra Ishaque, Saleem Akhtar, Asma Akbar Ladak, Russell Seth Martins, Muhammad Kamran Younis Memon, Alisha Raza Kazmi, Fatima Mahmood, Anwar ul Haque
Acute Crit Care. 2022;37(2):217-223.   Published online February 3, 2022
DOI: https://doi.org/10.4266/acc.2020.00990
  • 4,322 View
  • 201 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Arrhythmias are known complication after surgery for congenital heart disease (CHD). This study aimed to identify and discuss their immediate prevalence, diagnosis and management at a tertiary care hospital in Pakistan. Methods: A retrospective study was conducted at a tertiary care hospital in Pakistan between January 2014 and December 2018. All pediatric (<18 years old) patients admitted to the intensive care unit and undergoing continuous electrocardiographic monitoring after surgery for CHD were included in this study. Data pertaining to the incidence, diagnosis, and management of postoperative arrhythmias were collected. Results: Amongst 812 children who underwent surgery for CHD, 185 (22.8%) developed arrhythmias. Junctional ectopic tachycardia (JET) was the most common arrhythmia, observed in 120 patients (64.9%), followed by complete heart block (CHB) in 33 patients (17.8%). The highest incidence of early postoperative arrhythmia was seen in patients with atrioventricular septal defects (64.3%) and transposition of the great arteries (36.4%). Patients were managed according to the Pediatric Advanced Life Support guidelines. JET resolved successfully within 24 hours in 92% of patients, while 16 (48%) patients with CHB required a permanent pacemaker. Conclusions: More than one in five pediatric patients suffered from early postoperative arrhythmias in our setting. Further research exploring predictive factors and the development of better management protocols of patients with CHB are essential for reducing the morbidity and mortality associated with postoperative arrhythmia.

Citations

Citations to this article as recorded by  
  • Prevalence and risk factors analysis of early postoperative arrhythmia after congenital heart surgery in pediatric patients
    Ketut Putu Yasa, Arinda Agung Katritama, I. Komang Adhi Parama Harta, I. Wayan Sudarma
    Journal of Arrhythmia.2024; 40(2): 356.     CrossRef
  • Improvements in Accuracy and Confidence in Rhythm Identification After Cardiac Surgery Using the AtriAmp Signals
    Diane H. Brown, Xiao Zhang, Awni M. Al-Subu, Nicholas H. Von Bergen
    Journal of Intensive Care Medicine.2023; 38(9): 809.     CrossRef
Pediatrics
Determining the diagnostic value of tracheal intubation by palpation and auscultation methods compared to the chest X-ray method in children
Gholamreza Masoumi, Mojtaba Mansouri, Omid Fathali
Acute Crit Care. 2022;37(2):224-229.   Published online February 3, 2022
DOI: https://doi.org/10.4266/acc.2021.00787
  • 3,501 View
  • 178 Download
AbstractAbstract PDF
Background
It is important to determine the proper location of tracheal tube for proper ventilation. In this study, we compared the diagnostic value of tracheal intubation with two methods of palpation and auscultation with chest X-ray (CXR) method in pediatric.
Methods
In this interventional study, 80 patients under 6 years of age were included. After tracheal intubation appropriate depth of tracheal tube was determined by auscultation and recorded, then by palpation depth of tracheal tube determined and tube was fixed. The length of the tube was calculated with the standard formula based on age. After surgery, CXR was taken and, according to the landmark, the distance from the end of the tube to the anterior lower tooth was recorded.
Results
Interclass correlation coefficient (ICC) between the palpation method and the standard method in the number of fixing tracheal intubation was 0.573, which shows the average and significant correlation between these two methods in determining the fixed number of tracheal intubation. ICC between the auscultation and the standard method in fixing tracheal intubation number was 0.430, which shows the average and significant agreement between these two methods in determining the fixed number of tracheal intubation. There is no significant relationship between sex and the average number of fixing tracheal intubation in all methods.
Conclusions
This study has shown that both palpation and auscultation methods are appropriate, but with a slightly higher palpation ICC, the palpation can be considered relatively better.
Pulmonary
Cinematic virtual reality for anxiety management in mechanically ventilated patients: a feasibility and pilot study
Alexander C. Haley, David A. Wacker
Acute Crit Care. 2022;37(2):230-236.   Published online February 4, 2022
DOI: https://doi.org/10.4266/acc.2021.00843
  • 4,524 View
  • 213 Download
  • 2 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
Mechanically ventilated patients experience anxiety for many reasons. Pharmacological treatments such as benzodiazepines are commonly employed to manage anxiety; however, these therapies often cause undesired side effects. Additional therapies for anxiety management are needed. We sought to determine whether cell phone-based virtual reality therapy could feasibly be used for anxiety management in mechanically ventilated patients.
Methods
Mechanically ventilated subjects underwent at least one session of virtual reality therapy in which they were shown a cinematic video of an outdoor green space or blue space with 360° visual range of motion. Goal session duration was 5 minutes. The primary outcome was incidence of predefined patient safety events, including self-extubation and accidental removal of tubes or lines.
Results
Ten subjects underwent a total of 18 virtual reality sessions. Fifteen sessions lasted the planned 5 minutes, one session was extended at participant request, and two sessions were terminated early at participant request. There were no occurrences of the predefined safety events, and no occurrences of cybersickness. Use of a visual analog scale to measure anxiety level was feasible for this pilot study, demonstrating feasibility of this scale for future, larger scale studies.
Conclusions
Virtual reality therapy shows potential as a means of managing anxiety in patients undergoing mechanical ventilation, and further rigorous exploration with this protocol is feasible.

Citations

Citations to this article as recorded by  
  • Opportunities for Managing Pain and Anxiety in the Intensive Care Unit Using Virtual Reality: Perspectives from Bedside Care Providers
    Isabella P. Garito, Samantha Lewis-Fung, Brenna Lawson, Hannah Gabrielle Gray, Christopher Smith, Lora Appel
    Journal of Medical Extended Reality.2024; 1(1): 53.     CrossRef
  • Virtual Reality Therapy for People With Epilepsy and Related Anxiety: Protocol for a 3-Phase Pilot Clinical Trial
    Hannah Gabrielle Gray, Danielle Tchao, Samantha Lewis-Fung, Susanna Pardini, Laurence R Harris, Lora Appel
    JMIR Research Protocols.2023; 12: e41523.     CrossRef
  • Virtual and augmented reality in intensive care medicine: a systematic review
    Dominika Kanschik, Raphael Romano Bruno, Georg Wolff, Malte Kelm, Christian Jung
    Annals of Intensive Care.2023;[Epub]     CrossRef
  • A study to assess the communication and level of anxiety among mechanically ventilated conscious patients in intensive care units of sree mookambika medical college hospital at kanyakumari district
    Derlin A. Ahisha, Retnam C. Ajitha
    i-manager's Journal on Nursing.2023; 13(2): 20.     CrossRef
Ethics
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
Acute Crit Care. 2022;37(2):237-246.   Published online February 24, 2022
DOI: https://doi.org/10.4266/acc.2021.01095
  • 4,166 View
  • 199 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary Material
Background
The Life-Sustaining Treatment (LST) Decisions Act allows withholding and withdrawal of LST, including cardiopulmonary resuscitation (CPR). In the present study, the incidence of CPR before and after implementation of the Act was compared.
Methods
This was a retrospective review involving hospitalized patients who underwent CPR at a single center between February 2016 and January 2020 (pre-implementation period, February 2016 to January 2018; post-implementation period, February 2018 to January 2020). The primary outcome was monthly incidence of CPR per 1,000 admissions. The secondary outcomes were duration of CPR, return of spontaneous circulation (ROSC) rate, 24-hour survival rate, and survival-to-discharge rate. The study outcomes were compared before and after implementation of the Act.
Results
A total of 867 patients who underwent CPR was included in the analysis. The incidence of CPR per 1,000 admissions showed no significant difference before and after implementation of the Act (3.02±0.68 vs. 2.81±0.75, P=0.255). The ROSC rate (67.20±0.11 vs. 70.99±0.12, P=0.008) and survival to discharge rate (20.24±0.09 vs. 22.40±0.12, P=0.029) were higher after implementation of the Act than before implementation.
Conclusions
The incidence of CPR did not significantly change for 2 years after implementation of the Act. Further studies are needed to assess the changes in trends in the decisions of CPR and other LSTs in real-world practice.

Citations

Citations to this article as recorded by  
  • Characteristics and outcomes of patients with do-not-resuscitate and physician orders for life-sustaining treatment in a medical intensive care unit: a retrospective cohort study
    Song-I Lee, Ye-Rin Ju, Da Hyun Kang, Jeong Eun Lee
    BMC Palliative Care.2024;[Epub]     CrossRef
  • For the Universal Right to Access Quality End-of-Life Care in Korea: Broadening Our Perspective After the 2018 Life-Sustaining Treatment Decisions Act
    Hye Yoon Park, Min Sun Kim, Shin Hye Yoo, Jung Lee, In Gyu Song, So Yeon Jeon, Eun Kyung Choi
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Comparison of the end-of-life decisions of patients with hospital-acquired pneumonia after the enforcement of the life-sustaining treatment decision act in Korea
    Ae-Rin Baek, Sang-Bum Hong, Soohyun Bae, Hye Kyeong Park, Changhwan Kim, Hyun-Kyung Lee, Woo Hyun Cho, Jin Hyoung Kim, Youjin Chang, Heung Bum Lee, Hyun-Il Gil, Beomsu Shin, Kwang Ha Yoo, Jae Young Moon, Jee Youn Oh, Kyung Hoon Min, Kyeongman Jeon, Moon S
    BMC Medical Ethics.2023;[Epub]     CrossRef
  • Will implementation of the Life-sustaining Treatment Decisions Act reduce the incidence of cardiopulmonary resuscitation?
    In-Ae Song
    Acute and Critical Care.2022; 37(2): 256.     CrossRef
  • Effect of life-sustaining treatment decision law on pediatric in-hospital cardiopulmonary resuscitation rate: A Korean population-based study
    Jaeyoung Choi, Ah Young Choi, Esther Park, Meong Hi Son, Joongbum Cho
    Resuscitation.2022; 180: 38.     CrossRef
Trauma
Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture
Kang Min Kim, Myoung Jun Kim, Jae Sik Chung, Ji Wool Ko, Young Un Choi, Hongjin Shim, Ji Young Jang, Keum Seok Bae, Kwangmin Kim
Acute Crit Care. 2022;37(2):247-255.   Published online April 22, 2022
DOI: https://doi.org/10.4266/acc.2021.01396
  • 3,610 View
  • 213 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Background
Several recent studies have shown that preperitoneal pelvic packing (PPP) effectively produces hemostasis in patients with unstable pelvic fractures. However, few studies have examined the rate of surgical site infections (SSIs) in patients undergoing PPP following an unstable pelvic fracture. The purpose of the present study was to evaluate factors associated with SSI in such patients.
Methods
We retrospectively reviewed the medical charts of 188 patients who developed hemorrhagic shock due to pelvic fracture between April 2012 and May 2021. Forty-four patients were enrolled in this study.
Results
SSI occurred in 15 of 44 patients (34.1%). The SSIs occurred more frequently in cases of repacking during the second-look surgery (0 vs. 4 [26.7%], P=0.010) and combined bladder-urethra injury (1 [3.4%] vs. 4 [26.7%], P=0.039). The incidence of SSIs was not significantly different between patients undergoing depacking within or after 48 hours (12 [41.4%] vs. 5 [33.3%], P=0.603). The mean time to diagnosis of SSI was 8.1±3.9 days from PPP. The most isolated organism was Staphylococcus epidermidis.
Conclusions
Repacking and combined bladder-urethra injury are potential risk factors for SSI in patients with unstable pelvic fracture. Close observation is recommended for up to 8 days in patients with these risk factors. Further, 48 hours after PPP, removing the packed gauze on cessation of bleeding and not performing repacking can help prevent SSI. Additional analyses are necessary with a larger number of patients with the potential risk factors identified in this study.

Citations

Citations to this article as recorded by  
  • Angioembolization Has Similar Efficacy and Lower Total Charges than Preperitoneal Pelvic Packing in Patients With Pelvic Ring or Acetabulum Fractures
    Aaron Singh, Travis Kotzur, Ezekial Koslosky, Rishi Gonuguntla, Lorenzo Canseco, David Momtaz, Ali Seifi, Case Martin
    Journal of Orthopaedic Trauma.2024; 38(5): 254.     CrossRef
  • Factors Associated With Pelvic Infection After Pre-Peritoneal Pelvic Packing for Hemodynamically Unstable Pelvic Fractures
    Jennifer E. Baker, Husayn A. Ladhani, Caitlyn McCall, Chelsea R. Horwood, Nicole L. Werner, Barry Platnick, Clay Cothren Burlew
    Surgical Infections.2024;[Epub]     CrossRef
  • Current Management of Hemodynamically Unstable Patients with Pelvic Fracture
    Kevin Harrell, Chelsea Horwood, Clay Cothren Burlew
    Current Surgery Reports.2023; 11(4): 92.     CrossRef
  • Open Fixation After Preperitoneal Pelvic Packing Is Associated With a High Surgical Site Infection Rate
    Ye Joon Kim, Bryan L. Scott, Fredric M. Pieracci, Ernest E. Moore, Cyril Mauffrey, Joshua A. Parry
    Journal of Orthopaedic Trauma.2023; 37(11): 547.     CrossRef
  • Extraperitoneal pelvic packing in trauma – a review
    Sajad Ahmad Salati
    Polish Journal of Surgery.2022; 95(3): 46.     CrossRef
Editorial
Ethics
Will implementation of the Life-sustaining Treatment Decisions Act reduce the incidence of cardiopulmonary resuscitation?
In-Ae Song
Acute Crit Care. 2022;37(2):256-257.   Published online May 30, 2022
DOI: https://doi.org/10.4266/acc.2022.00668
  • 1,941 View
  • 136 Download
PDF

ACC : Acute and Critical Care