Acute and Critical Care

Guidelines

Pulmonary
Liberation from mechanical ventilation in critically ill patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines: Tae Sun Ha, Dong Kyu Oh, Hak-Jae Lee, Youjin Chang, In Seok Jeong, Yun Su Sim, Suk-Kyung Hong, Sunghoon Park, Gee Young Suh, So Young Park; Acute Crit Care. 2024;39(1):1-23. Published online February 28, 2024; DOI: https://doi.org/10.4266/acc.2024.00052

4,115 View
708 Download

Abstract PDF Supplementary Material: Background
Successful liberation from mechanical ventilation is one of the most crucial processes in critical care because it is the first step by which a respiratory failure patient begins to transition out of the intensive care unit and return to their own life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider not only the individual experiences of healthcare professionals, but also scientific and systematic approaches. Recently, numerous studies have investigated methods and tools for identifying when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians about liberation from the ventilator. Methods: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. Those evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved recommendations. Results: Recommendations for nine PICO (population, intervention, comparator, and outcome) questions about ventilator liberation are presented in this document. This guideline includes seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. Conclusions: We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

Pharmacology
2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit: Yijun Seo, Hak-Jae Lee, Eun Jin Ha, Tae Sun Ha; Acute Crit Care. 2022;37(1):1-25. Published online February 28, 2022; DOI: https://doi.org/10.4266/acc.2022.00094; Correction in: Acute Crit Care 2023;38(1):149

17,486 View
1,746 Download
14 Web of Science
23 Crossref

We revised and expanded the “2010 Guideline for the Use of Sedatives and Analgesics in the Adult Intensive Care Unit (ICU).” We revised the 2010 Guideline based mainly on the 2018 “Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in Adult Patients in the ICU,” which was an updated 2013 pain, agitation, and delirium guideline with the inclusion of two additional topics (rehabilitation/mobility and sleep). Since it was not possible to hold face-to-face meetings of panels due to the coronavirus disease 2019 (COVID-19) pandemic, all discussions took place via virtual conference platforms and e-mail with the participation of all panelists. All authors drafted the recommendations, and all panelists discussed and revised the recommendations several times. The quality of evidence for each recommendation was classified as high (level A), moderate (level B), or low/very low (level C), and all panelists voted on the quality level of each recommendation. The participating panelists had no conflicts of interest on related topics. The development of this guideline was independent of any industry funding. The Pain, Agitation/Sedation, Delirium, Immobility (rehabilitation/mobilization), and Sleep Disturbance panels issued 42 recommendations (level A, 6; level B, 18; and level C, 18). The 2021 clinical practice guideline provides up-to-date information on how to prevent and manage pain, agitation/sedation, delirium, immobility, and sleep disturbance in adult ICU patients. We believe that these guidelines can provide an integrated method for clinicians to manage PADIS in adult ICU patients.

Citations

Citations to this article as recorded by

Potentially inappropriate medications with older people in intensive care and associated factors: a historic cohort study
Karina Sichieri, Danilo Donizetti Trevisan, Ricardo Luís Barbosa, Silvia Regina Secoli
Sao Paulo Medical Journal.2024;[Epub] CrossRef
Psychiatric Consults Associated With Longer Length of Stay in Trauma Patients—A Retrospective Study
Sanjay Balijepalli, Kathryn Mansuri, Cindy Gonzalez, Oveys Mansuri
Journal of Surgical Research.2024; 293: 46. CrossRef
Sleep in the intensive and intermediate care units: Exploring related factors of delirium, benzodiazepine use and mortality
Adrienne E. van der Hoeven, Denise Bijlenga, Ernst van der Hoeven, Mink S. Schinkelshoek, Floor W. Hiemstra, Laura Kervezee, David J. van Westerloo, Rolf Fronczek, Gert Jan Lammers
Intensive and Critical Care Nursing.2024; 81: 103603. CrossRef
Cross-cultural adaptation and validation of the Indonesian version of the Critical-care Pain Observation Tool
Luthfi Fauzy Asriyanto, Nur Chayati
International Journal of Nursing Sciences.2024; 11(1): 113. CrossRef
Postoperative Psychoses in Patients with Brain Gliomas
O. S. Zaitsev, N. P. Ilyaev, O. A. Maksakova
Psikhiatriya.2024; 21(7): 65. CrossRef
Liberation from mechanical ventilation in critically ill patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines
Tae Sun Ha, Dong Kyu Oh, Hak-Jae Lee, Youjin Chang, In Seok Jeong, Yun Su Sim, Suk-Kyung Hong, Sunghoon Park, Gee Young Suh, So Young Park
Acute and Critical Care.2024; 39(1): 1. CrossRef
Prevalence and risk factors of delirium of older adults after cardiac surgery at the intensive care unit: A retrospective study
Jeong-Ok Ryu, Gwi-Ryung Son Hong
Journal of Korean Gerontological Nursing.2024; 26(1): 113. CrossRef
Factors that influence critical care nurses’ management of sedation for ventilated patients in critical care: A qualitative study
Danielle Macpherson, Anastasia Hutchinson, Melissa J. Bloomer
Intensive and Critical Care Nursing.2024; 83: 103685. CrossRef
Content analysis of NOC outcomes related to mechanical ventilation in people with COVID-19
Erika Silva de Sá, Aline Batista Maurício, Larissa Giardini Bruni, Larissa Gabrielle Dias Vieira, Vinicius Batista Santos, Agueda Maria Ruiz Zimmer Cavalcante, Alba Lucia Bottura Leite de Barros, Viviane Martins da Silva
Revista da Escola de Enfermagem da USP.2024;[Epub] CrossRef
Análise de conteúdo de resultados NOC relacionados à ventilação mecânica em pessoas com COVID-19
Erika Silva de Sá, Aline Batista Maurício, Larissa Giardini Bruni, Larissa Gabrielle Dias Vieira, Vinicius Batista Santos, Agueda Maria Ruiz Zimmer Cavalcante, Alba Lucia Bottura Leite de Barros, Viviane Martins da Silva
Revista da Escola de Enfermagem da USP.2024;[Epub] CrossRef
From the Intensive Care Unit to Recovery: Managing Post-intensive Care Syndrome in Critically Ill Patients
Mfonido Ekong, Tejbir Singh Monga, Jean Carlo Daher, Mutyala Sashank, Setareh Reza Soltani, Nkiruka Lauretta Nwangene, Cara Mohammed, Fellipe Feijo Halfeld, Leen AlShelh, Fernanda Ayumi Fukuya, Manju Rai
Cureus.2024;[Epub] CrossRef
End‐of‐life care in the intensive care unit
M. Tanaka Gutiez, N. Efstathiou, R. Innes, V. Metaxa
Anaesthesia.2023; 78(5): 636. CrossRef
The Profile of Early Sedation Depth and Clinical Outcomes of Mechanically Ventilated Patients in Korea
Dong-gon Hyun, Jee Hwan Ahn, Ha-Yeong Gil, Chung Mo Nam, Choa Yun, Jae-Myeong Lee, Jae Hun Kim, Dong-Hyun Lee, Ki Hoon Kim, Dong Jung Kim, Sang-Min Lee, Ho-Geol Ryu, Suk-Kyung Hong, Jae-Bum Kim, Eun Young Choi, JongHyun Baek, Jeoungmin Kim, Eun Jin Kim, T
Journal of Korean Medical Science.2023;[Epub] CrossRef
The relationship between the PRE-DELIRIC score and the prognosis in COVID-19 ICU patients
Bilge Banu Taşdemir Mecit
Journal of Surgery and Medicine.2023; 7(5): 343. CrossRef
Systemic Nonsteroidal Anti-Inflammatories for Analgesia in Postoperative Critical Care Patients: A Systematic Review and Meta-Analysis of Randomized Control Trials
Chen Hsiang Ma, Kimberly B. Tworek, Janice Y. Kung, Sebastian Kilcommons, Kathleen Wheeler, Arabesque Parker, Janek Senaratne, Erika Macintyre, Wendy Sligl, Constantine J. Karvellas, Fernando G. Zampieri, Demetrios Jim Kutsogiannis, John Basmaji, Kimberle
Critical Care Explorations.2023; 5(7): e0938. CrossRef
Pain Control and Sedation in Neuro Intensive Critical Unit
Soo-Hyun Park, Yerim Kim, Yeojin Kim, Jong Seok Bae, Ju-Hun Lee, Wookyung Kim, Hong-Ki Song
Journal of the Korean Neurological Association.2023; 41(3): 169. CrossRef
Preoperative Anxiety and Its Postoperative Associated Factors in Patients Receiving Post Anesthetic Recovery Care at Surgical Intensive Care Unit
Yul Ha Lee, Hye-Ja Park
Journal of Health Informatics and Statistics.2023; 48(3): 267. CrossRef
Diagnostic Value of the Bispectral Index to Assess Sleep Quality after Elective Surgery in Intensive Care Unit
Naricha Chirakalwasan, Pongpol Sirilaksanamanon, Thammasak Thawitsri, Somrat Charuluxananan
Indian Journal of Critical Care Medicine.2023; 27(11): 795. CrossRef
Sedation of patients in intensive care units. Guidelines
V.I. Potievskaya, I.B. Zabolotskikh, I.E. Gridchik, A.I. Gritsan, A.A. Eremenko, I.A. Kozlov, A.L. Levit, V.A. Mazurok, I.V. Molchanov
Anesteziologiya i reanimatologiya.2023; (5): 6. CrossRef
Sedation for Patients with Sepsis: Towards a Personalised Approach
José Miguel Marcos-Vidal, Rafael González, María Merino, Eva Higuera, Cristina García
Journal of Personalized Medicine.2023; 13(12): 1641. CrossRef
Performance, Knowledge, and Barrier Awareness of Medical Staff Regarding the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Critical Care Patients: A Cross-Sectional Study
Hyo-Geun Song, Duckhee Chae, Sung-Hee Yoo
Korean Journal of Adult Nursing.2023; 35(4): 379. CrossRef
ICU-Induced Disability Persists With or Without COVID-19—This Is a Call for F to A Bundle Action*
Heidi Engel
Critical Care Medicine.2022; 50(11): 1665. CrossRef
Actigraphy-Based Assessment of Sleep Parameters in Intensive Care Unit Patients Receiving Respiratory Support Therapy
Jiyeon Kang, Yongbin Kwon
Journal of Korean Critical Care Nursing.2022; 15(3): 115. CrossRef

Review Article

Neurology
Prevention and management of delirium in critically ill adult patients in the intensive care unit: a review based on the 2018 PADIS guidelines: Seung Yong Park, Heung Bum Lee; Acute Crit Care. 2019;34(2):117-125. Published online April 17, 2019; DOI: https://doi.org/10.4266/acc.2019.00451

22,146 View
1,377 Download
41 Web of Science
43 Crossref

Abstract PDF

Delirium is an acute, confusional state characterized by altered consciousness and a reduced ability to focus, sustain, or shift attention. It is associated with a number of complex underlying medical conditions and can be difficult to recognize. Many critically ill patients (e.g., up to 80% of patients in the intensive care unit [ICU]) experience delirium due to underlying medical or surgical health problems, recent surgical or other invasive procedures, medications, or various noxious stimuli (e.g., underlying psychological stressors, mechanical ventilation, noise, light, patient care interactions, and drug-induced sleep disruption or deprivation). Delirium is associated with a longer duration of mechanical ventilation and ICU admittance as well as an increased risk of death, disability, and long-term cognitive dysfunction. Therefore, the early recognition of delirium is important and ICU medical staff should devote careful attention to both watching for the occurrence of delirium and its prevention and management. This review presents a brief overview of delirium and an update of the literature with reference to the 2018 Society of Critical Care Medicine Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU.

Citations

Citations to this article as recorded by

Analytical Review of Unplanned Extubation in Intensive Care Units and Recommendation on Multidisciplinary Preventive Approaches
Antonious Anis, Ravi Patel, Maged A Tanios
Journal of Intensive Care Medicine.2024; 39(6): 507. CrossRef
Precision Anesthesia in 2050
Frederick H. Kuo, Brant H. Tudor, Geoffrey M. Gray, Luis M. Ahumada, Mohamed A. Rehman, Scott C. Watkins
Anesthesia & Analgesia.2024; 138(2): 326. CrossRef
Nursing Intervention to Prevent and Manage Delirium in Critically Ill Patients: A Scoping Review
Filipa Fernandes, Mariana Santos, Ana Margarida Anacleto, Cátia Jerónimo, Óscar Ferreira, Cristina Lavareda Baixinho
Healthcare.2024; 12(11): 1134. CrossRef
Association Between Pupil Light Reflex and Delirium in Adults With Traumatic Brain Injury: Preliminary Findings
Alexandra Lapierre, Annie Proulx, Céline Gélinas, Stéphanie Dollé, Sheila Alexander, David Williamson, Francis Bernard, Caroline Arbour
Journal of Neuroscience Nursing.2024;[Epub] CrossRef
Incidence, characteristics and risk factors of delirium in the intensive care unit: An observational study
Öznur Erbay Dalli, Nermin Kelebek Girgin, Ferda Kahveci
Journal of Clinical Nursing.2023; 32(1-2): 96. CrossRef
Sustained adherence to a delirium guideline five years after implementation in an intensive care setting: A retrospective cohort study
Marlies van Bochove-Waardenburg, Mathieu van der Jagt, Janneke de Man-van Ginkel, Erwin Ista
Intensive and Critical Care Nursing.2023; 76: 103398. CrossRef
Impact of critical care pharmacist‐led interventions on pain, agitation, and delirium in mechanically ventilated adults: A systematic review
Mitchell S. Buckley, Russel J. Roberts, Melanie J. Yerondopoulos, Audrey K. Bushway, Grace C. Korkames, Sandra L. Kane‐Gill
JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY.2023; 6(9): 1041. CrossRef
Delirium in the intensive care unit: a narrative review
Stefania Renzi, Nicola Gitti, Simone Piva
Journal of Gerontology and Geriatrics.2023; 71(1): 22. CrossRef
Delirio y su relación con la supervivencia en pacientes geriátricos con neumonía grave por SARS-CoV-2 en un hospital de tercer nivel de atención en México
Cynthia Daniela Bazán Acevedo, Edgar Fernández Muñoz, Netzahualcóyotl González Pérez, Lilia López Carrillo
Medicina Crítica.2023; 37(1): 35. CrossRef
Effect of using eye masks and earplugs in preventing delirium in intensive care patients: A single‐blinded, randomized, controlled trial
Gülşen Kiliç, Sultan Kav
Nursing in Critical Care.2023; 28(5): 698. CrossRef
Yoğun Bakım Deliryumunun Erken Tespitinde Rekalibre PRE-DELIRIC Modelinin Prospektif Değerlendirilmesi
Öznur ERBAY DALLI, Gülbahar ÇALIŞKAN, Yasemin YILDIRIM, Nermin KELEBEK GİRGİN
Uludağ Üniversitesi Tıp Fakültesi Dergisi.2023; 49(1): 55. CrossRef
Still WALKing-FOR: 2-year sustainability of the ‘WALK FOR’ intervention
Efrat Gil, Anna Zisberg, Efrat Shadmi, Nurit Gur-Yaish, Ksenya Shulyaev, Yehudith Chayat, Maayan Agmon
Age and Ageing.2023;[Epub] CrossRef
Optimization of Care for the Elderly Surgical Emergency Patient
Rachel Lynne Warner, Nadia Iwanyshyn, Donald Johnson, David J. Skarupa
Surgical Clinics of North America.2023; 103(6): 1253. CrossRef
Identification and Best Practice Management of Comorbid Geri-Psych Conditions in Critical Care
Noel Koller-Ditto
Critical Care Nursing Clinics of North America.2023; 35(4): 481. CrossRef
Inclusion of frailty improved performance of delirium prediction for elderly patients in the cardiac intensive care unit (D-FRAIL): A prospective derivation and external validation study
Rongrong Guo, Shan Zhang, Saiying Yu, Xiangyu Li, Xinju Liu, Yanling Shen, Jinling Wei, Ying Wu
International Journal of Nursing Studies.2023; 147: 104582. CrossRef
Motion Detectors as Additional Monitoring Devices in the Intensive Care Unit—A Proof-of-Concept Study
Gülmisal Güder, Eva von Rein, Thomas Flohr, Dirk Weismann, Dominik Schmitt, Stefan Störk, Stefan Frantz, Vincent Kratzer, Christian Kendi
Applied Sciences.2023; 13(16): 9319. CrossRef
The risk factors of postoperative cognitive dysfunction in patients undergoing carotid endarterectomy: an updated meta-analysis
Jinhua He, Ran Duan, Peng Qiu, Huanhuan Zhang, Meng Zhang, Meinv Liu, Xiaoqian Wu, Jianli Li
Journal of Cardiothoracic Surgery.2023;[Epub] CrossRef
Sedation for Patients with Sepsis: Towards a Personalised Approach
José Miguel Marcos-Vidal, Rafael González, María Merino, Eva Higuera, Cristina García
Journal of Personalized Medicine.2023; 13(12): 1641. CrossRef
Le delirium, un syndrome mal connu
Jean-Pierre Bénézech
La Revue de l'Infirmière.2022; 71(277): 42. CrossRef
Associations of Smoking With Delirium and Opioid Use in Older Adults With Traumatic Hip Fracture
Kristin Salottolo, Richard Meinig, Landon Fine, Michael Kelly, Robert Madayag, Francie Ekengren, Allen Tanner, David Bar-Or
JAAOS: Global Research and Reviews.2022;[Epub] CrossRef
O papel do enfermeiro na prevenção do delirium no paciente adulto/idoso crítico
Cláudia Oliveira, Cátia Filipa Garnacho Martins Nobre, Rita Margarida Dourado Marques, Maria Manuela Madureira Lebre Mendes, Patrícia Cruz Pontífice Sousa
Revista Cuidarte.2022;[Epub] CrossRef
Predictors of sedation period for critical illness patients focusing on early rehabilitation on the bed
Yosuke Morimoto, Tsubasa Watanabe, Masato Oikawa, Masatoshi Hanada, Motohiro Sekino, Tetsuya Hara, Ryo Kozu
Scientific Reports.2022;[Epub] CrossRef
The Age-adjusted Charlson Comorbidity Index predicts post-operative delirium in the elderly following thoracic and abdominal surgery: A prospective observational cohort study
Jing Liu, Jianli Li, Jinhua He, Huanhuan Zhang, Meinv Liu, Junfang Rong
Frontiers in Aging Neuroscience.2022;[Epub] CrossRef
The Effects of Pain, Agitation, Delirium, Immobility, and Sleep Disruption Education on Novice Nurses in Adult Intensive Care Units
Szu-Ying Lee, Chieh-Yu Liu, Te-Yu Wu
Healthcare.2022; 10(8): 1538. CrossRef
Pain Assessment with the BPS and CCPOT Behavioral Pain Scales in Mechanically Ventilated Patients Requiring Analgesia and Sedation
Katarzyna Wojnar-Gruszka, Aurelia Sega, Lucyna Płaszewska-Żywko, Stanisław Wojtan, Marcelina Potocka, Maria Kózka
International Journal of Environmental Research and Public Health.2022; 19(17): 10894. CrossRef
Item analysis of the Korean version of the Intensive Care Experience Questionnaire: Using the Rasch Model based on Item Response Theory
Jiyeon Kang, Minhui Kim
Journal of Korean Critical Care Nursing.2022; 15(3): 37. CrossRef
Complex Hallucinations in Hospitalized Rehabilitation Patients With COVID-19
Mari Tobita, Shan-Pin Fanchiang, Aida Saldivar, Sarah Taylor, Barry Jordan
Archives of Rehabilitation Research and Clinical Translation.2022; 4(4): 100234. CrossRef
Effects of uncomfortable care and histamine H2-antagonists on delirium in acute stroke: A propensity score analysis
Tomoki Nakamizo, Toshie Kanda, Yosuke Kudo, Eriko Sugawara, Erina Hashimoto, Ayana Okazaki, Makoto Usuda, Toru Nagai, Hiroshi Hara, Ken Johkura
Journal of the Neurological Sciences.2021; 420: 117251. CrossRef
Critical Care Considerations for Damage Control in a Trauma Patient
Shannon Gaasch
AACN Advanced Critical Care.2021; 32(1): 64. CrossRef
Development and Validation of a Clinical Prediction Model for Sleep Disorders in the ICU: A Retrospective Cohort Study
Yun Li, Lina Zhao, Chenyi Yang, Zhiqiang Yu, Jiannan Song, Qi Zhou, Xizhe Zhang, Jie Gao, Qiang Wang, Haiyun Wang
Frontiers in Neuroscience.2021;[Epub] CrossRef
Delirium and Associated Length of Stay and Costs in Critically Ill Patients
Claudia Dziegielewski, Charlenn Skead, Toros Canturk, Colleen Webber, Shannon M. Fernando, Laura H. Thompson, Madison Foster, Vanja Ristovic, Peter G. Lawlor, Dipayan Chaudhuri, Chintan Dave, Brent Herritt, Shirley H. Bush, Salmaan Kanji, Peter Tanuseputr
Critical Care Research and Practice.2021; 2021: 1. CrossRef
Effects of a simulation‐based education programme on delirium care for critical care nurses: A randomized controlled trial
Mu‐Hsing Ho, Lee‐Fen Yu, Pu‐Hung Lin, Hui‐Chen (Rita) Chang, Victoria Traynor, Wen‐Cheng Huang, Jed Montayre, Kee‐Hsin Chen
Journal of Advanced Nursing.2021; 77(8): 3483. CrossRef
A Note on Common Apathy versus Hypoactive Delirium in Critical Illness
Jan N. M. Schieveld, Jacqueline J. M. H. Strik
American Journal of Respiratory and Critical Care Medicine.2021; 203(7): 921. CrossRef
Effect of Sedatives on In-hospital and Long-term Mortality of Critically Ill Patients Requiring Extended Mechanical Ventilation for ≥ 48 Hours
Hannah Lee, Seongmi Choi, Eun Jin Jang, Juhee Lee, Dalho Kim, Seokha Yoo, Seung-Young Oh, Ho Geol Ryu
Journal of Korean Medical Science.2021;[Epub] CrossRef
Improving delirium detection in intensive care units: Multicomponent education and training program
Liron Sinvani, Cynthia Delle Site, Tara Laumenede, Vidhi Patel, Suzanne Ardito, Anum Ilyas, Craig Hertz, Gisele Wolf‐Klein, Renee Pekmezaris, Negin Hajizadeh, Lily Thomas
Journal of the American Geriatrics Society.2021; 69(11): 3249. CrossRef
Delirium in Critical Illness Patients and the Potential Role of Thiamine Therapy in Prevention and Treatment: Findings from a Scoping Review with Implications for Evidence-Based Practice
Sandra Lange, Wioletta Mędrzycka-Dąbrowska, Adriano Friganovic, Ber Oomen, Sabina Krupa
International Journal of Environmental Research and Public Health.2021; 18(16): 8809. CrossRef
The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting
Dong Jung Kim, Bongyeon Sohn, Hakju Kim, Hyoung Woo Chang, Jae Hang Lee, Jun Sung Kim, Cheong Lim, Kay-Hyun Park
The Korean Journal of Thoracic and Cardiovascular Surgery.2020; 53(1): 8. CrossRef
INCIDENCIA DE DELIRIO SEGÚN EL REGIMEN DE VISITAS EN UNA UNIDAD DE CUIDADOS INTENSIVOS
Juan Carlos Muñoz Camargo
Enfermería Intensiva.2020; 31(2): 94. CrossRef
Incidence of delirium according to the visiting regime in an intensive care unit
J.C. Muñoz Camargo
Enfermería Intensiva (English ed.).2020; 31(2): 94. CrossRef
The Diagnostic Accuracy of Critical Care Pain Observation Tool (CPOT) in ICU Patients: A Systematic Review and Meta-Analysis
Yue Zhai, Shining Cai, Yuxia Zhang
Journal of Pain and Symptom Management.2020; 60(4): 847. CrossRef
Neurologic Manifestations of Systemic Disease: Sleep Disorders
Eric M. Davis, Chintan Ramani, Mark Quigg
Current Treatment Options in Neurology.2020;[Epub] CrossRef
Delirium
Melissa L.P. Mattison
Annals of Internal Medicine.2020; 173(7): ITC49. CrossRef
Neurological Complications and Noninvasive Multimodal Neuromonitoring in Critically Ill Mechanically Ventilated COVID-19 Patients
Denise Battaglini, Gregorio Santori, Karthikka Chandraptham, Francesca Iannuzzi, Matilde Bastianello, Fabio Tarantino, Lorenzo Ball, Daniele Roberto Giacobbe, Antonio Vena, Matteo Bassetti, Matilde Inglese, Antonio Uccelli, Patricia Rieken Macedo Rocco, N
Frontiers in Neurology.2020;[Epub] CrossRef

Guideline

Pulmonary
Clinical Practice Guideline of Acute Respiratory Distress Syndrome: Young-Jae Cho, Jae Young Moon, Ein-Soon Shin, Je Hyeong Kim, Hoon Jung, So Young Park, Ho Cheol Kim, Yun Su Sim, Chin Kook Rhee, Jaemin Lim, Seok Jeong Lee, Won-Yeon Lee, Hyun Jeong Lee, Sang Hyun Kwak, Eun Kyeong Kang, Kyung Soo Chung, Won-Il Choi, The Korean Society of Critical Care Medicine and the Korean Academy of Tuberculosis and Respiratory Diseases Consensus Group; Korean J Crit Care Med. 2016;31(2):76-100. Published online May 31, 2016; DOI: https://doi.org/10.4266/kjccm.2016.31.2.76

16,816 View
351 Download
6 Crossref

Abstract PDF

There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.

Citations

Citations to this article as recorded by

Association between mechanical power and intensive care unit mortality in Korean patients under pressure-controlled ventilation
Jae Kyeom Sim, Sang-Min Lee, Hyung Koo Kang, Kyung Chan Kim, Young Sam Kim, Yun Seong Kim, Won-Yeon Lee, Sunghoon Park, So Young Park, Ju-Hee Park, Yun Su Sim, Kwangha Lee, Yeon Joo Lee, Jin Hwa Lee, Heung Bum Lee, Chae-Man Lim, Won-Il Choi, Ji Young Hong
Acute and Critical Care.2024; 39(1): 91. CrossRef
Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19
Won Ho Han, Jae Hoon Lee, June Young Chun, Young Ju Choi, Youseok Kim, Mira Han, Jee Hee Kim
Acute and Critical Care.2023; 38(1): 41. CrossRef
Treatment of acute respiratory failure: invasive mechanical ventilation
Young Sam Kim
Journal of the Korean Medical Association.2022; 65(3): 151. CrossRef
Treatment of acute respiratory failure: extracorporeal membrane oxygenation
Jin-Young Kim, Sang-Bum Hong
Journal of the Korean Medical Association.2022; 65(3): 157. CrossRef
Prolonged glucocorticoid treatment in acute respiratory distress syndrome – Authors' reply
Rob Mac Sweeney, Daniel F McAuley
The Lancet.2017; 389(10078): 1516. CrossRef
Prolonged Glucocorticoid Treatment in ARDS: Impact on Intensive Care Unit-Acquired Weakness
Gianfranco Umberto Meduri, Andreas Schwingshackl, Greet Hermans
Frontiers in Pediatrics.2016;[Epub] CrossRef

Original Articles

Medical Residents' Perception and Emotional Stress on Withdrawing Life-Sustaining Therapy: Jae Young Moon, Hee Young Lee, Chae Man Lim, Younsuck Koh; Korean J Crit Care Med. 2012;27(1):16-23.; DOI: https://doi.org/10.4266/kjccm.2012.27.1.16

2,912 View
32 Download
5 Crossref

Abstract PDF

BACKGROUND
In order to promote the dignity of terminal patients, and improve end-of-life care (EOL care) in Korea, consensus guidelines to the withdrawal of life-sustaining therapies (LST) were published in October, 2009. The aim of this study was to assess the current perception of the guideline among internal medicine residents and to identify barriers to the application of the guidelines.
METHODS
The study was designed prospectively on the basis of data from e-mail survey. We surveyed 98 medical residents working in 19 medical centers.
RESULTS
75.5% of respondents agreed with withdrawing (WD) of LST and 33.3% (33/98) of respondents were unaware of the guideline. Although 58.1% of all respondents had taken an EOL care class in medical school, about 30% of residents did feel uncomfortable with communicating with patients and surrogates. The most important obstacle for decision of WD of LST was the resident's psychological stress. 39.8% of medical residents felt guilty or failure after a patient's death, and 41.8% became often or always depressed in a patient's dying.
CONCLUSIONS
In order to protect and enhance the dignity and autonomy of terminal patients, the improvement of the medical training program in the hospitals and the more concern of educational leaders are urgent.

Citations

Citations to this article as recorded by

Moral Distress Regarding End-of-Life Care Among Healthcare Personnel in Korean University Hospitals: Features and Differences Between Physicians and Nurses
Eun Kyung Choi, Jiyeon Kang, Hye Youn Park, Yu Jung Kim, Jinui Hong, Shin Hye Yoo, Min Sun Kim, Bhumsuk Keam, Hye Yoon Park
Journal of Korean Medical Science.2023;[Epub] CrossRef
The Effects of South Korean Social Workers' Professional Resources on their Understanding of a Patient's Right to End‐of‐Life Care Decisions in Long‐term Care Facilities
Sooyoun Han
Asian Social Work and Policy Review.2016; 10(2): 200. CrossRef
A Study of Social Workers’ Understanding of Elderly Patients’ and Family Caregivers’ Rights to End-of-Life Care Decisions and of Their Own Roles in the Process
Sooyoun Han
The Korean Journal of Hospice and Palliative Care.2015; 18(1): 42. CrossRef
The Current Status of Medical Decision-Making for Dying Patients in a Medical Intensive Care Unit: A Single-Center Study
Kyunghwa Shin, Jeong Ha Mok, Sang Hee Lee, Eun Jung Kim, Na Ri Seok, Sun Suk Ryu, Myoung Nam Ha, Kwangha Lee
Korean Journal of Critical Care Medicine.2014; 29(3): 160. CrossRef
The End-of-Life Care in the Intensive Care Unit
Jae Young Moon, Yong Sup Shin
Korean Journal of Critical Care Medicine.2013; 28(3): 163. CrossRef

Adequacy of Epinephrine Administration during Advanced Cardiovascular Life Support in terms of Dosing and Intervals between Doses: Seung Joon Lee, Byung Kook Lee, Kyung Woon Jeung, Hyoung Youn Lee, Tag Heo, Yong Il Min, Jong Geun Yun, Jae Hoon Lim; Korean J Crit Care Med. 2011;26(2):69-77.; DOI: https://doi.org/10.4266/kjccm.2011.26.2.69

2,533 View
26 Download
1 Crossref

Abstract PDF

BACKGROUND
Consensus guidelines clearly define how epinephrine is administered during cardiopulmonary resuscitation (CPR). In South Korea, it is not known whether epinephrine is administered in accordance with the current advanced cardiovascular life support (ACLS) guidelines during actual practice. We sought to investigate adherence to ACLS guidelines during actual CPR in terms of the dose of epinephrine and the interval between doses.
METHODS
A retrospective review of medical records was performed on 394 adult cardiac arrest patients who received CPR at an emergency room. Data including the duration of CPR, the dose of epinephrine, and the interval between doses was collected from CPR records.
RESULTS
Standard-dose epinephrine (1 mg) was used in 166 of 394 patients (42.1%). In 58.8% of patients, the average between-dose interval was within the 3-5 min recommended in the guidelines, whereas it was shorter than 3 min in 31.4% of patients. As a whole, epinephrine was administered in accordance with the current ACLS guidelines in only 96 of 394 patients (24.4%). Logistic regression analysis revealed the duration of CPR to be an independent factor affecting the use of standard-dose epinephrine and the adequate between-dose interval.
CONCLUSIONS
Epinephrine was not administered according to the ACLS guideline in most patients. A national multi-center study is required to determine whether the poor adherence to the ACLS guideline is a widespread problem. In addition, efforts to improve adherence to the ACLS guideline are required.

Citations

Citations to this article as recorded by

Reply to letter “Improving ROSC with high dose of epinephrine. Are we really?”
Kyung Woon Jeung, Hyun Ho Ryu, Kyung Hwan Song, Byung Kook Lee, Hyoung Youn Lee, Tag Heo, Yong Il Min
Resuscitation.2012; 83(3): e73. CrossRef

Review

Current Insights into Sepsis Treatments: Chang Youl Lee; Korean J Crit Care Med. 2010;25(4):207-211.; DOI: https://doi.org/10.4266/kjccm.2010.25.4.207

2,641 View
37 Download
2 Crossref

Abstract PDF

Sepsis is a common illness of intensive care unit patients that carries high morbidity and mortality, and increases hospital costs. Although mortality from sepsis remains high when compared with other critical illnesses, it has declined over the last few decades due to several adjunctive therapies and focused care programs or guidelines. In 2004, an international guideline was published that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock. Several landmark studies recently demonstrated that therapeutic strategies may substantially reduce mortality. The Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock: 2008 was updated using a new evidence-based methodology system for assessing the quality of evidence and the strengths of recommendations. Evidence-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. This article discusses the guidelines and current insights into sepsis treatment.

Citations

Citations to this article as recorded by

Prevalence of Toxin Genes and Antibiotic Resistance Profiles of Vibrio vulnificus strains isolated from Jeju Island
Eunok Kang, Man Jae Cho, Ye-Seul Heo, Eun A Koh
Journal of Food Hygiene and Safety.2023; 38(5): 381. CrossRef
Association of Peripheral Lymphocyte Subset with the Severity and Prognosis of Septic Shock
Jin Kyeong Park, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Jin Won Huh
The Korean Journal of Critical Care Medicine.2011; 26(1): 13. CrossRef

First
Prev
Page of 1
Next
Last

Search