Acute and Critical Care

Original Article

Surgery
Adjuvant intravenous immunoglobulin administration on postoperative critically ill patients with secondary peritonitis: a retrospective study: Young Un Choi, Jun Gi Kim, Ji Young Jang, Tae Hwa Go, Kwangmin Kim, Keum Seok Bae, Hongjin Shim; Acute Crit Care. 2023;38(1):21-30. Published online February 27, 2023; DOI: https://doi.org/10.4266/acc.2022.01515; Correction in: Acute Crit Care 2023;38(2):250

2,678 View
123 Download
1 Web of Science
1 Crossref

Background
The use of intravenous immunoglobulin (IVIG) in sepsis patients from bowel perforation is still debatable. However, few studies have evaluated the effect of IVIG as an adjuvant therapy after source control. This study aimed to analyze the effect of IVIG in critically ill patients who underwent surgery due to secondary peritonitis.
Methods
In total, 646 medical records of surgical patients who were treated for secondary peritonitis were retrospectively analyzed. IVIG use, initial clinical data, and changes in Sequential Organ Failure Assessment (SOFA) score over the 7-day admission in the intensive care unit for sepsis check, base excess, and delta neutrophil index (DNI) were analyzed. Mortalities and periodic profiles were assessed. Propensity scoring matching as comparative analysis was performed in the IVIG group and non-IVIG group.
Results
General characteristics were not different between the two groups. The survival curve did not show a significantly reduced mortality in the IVIG. Moreover, the IVIG group did not have a lower risk ratio for mortality than the non-IVIG group. However, when the DNI were compared during the first 7 days, the reduction rate in the IVIG group was statistically faster than in the non-IVIG group (P<0.01).
Conclusions
The use of IVIG was significantly associated with faster decrease in DNI which means faster reduction of inflammation. Since the immune system is rapidly activated, the additional use of IVIG after source control surgery in abdominal sepsis patients, especially those with immunocompromised patients can be considered. However, furthermore clinical studies are needed.

Citations

Citations to this article as recorded by

USING INTRAVENOUS IMMUNOGLOBULIN IN A PATIENT WITH SEPTIC SHOCK AND MULTIPLE COMORBIDITIES: A REVIEW BASED ON A CLINICAL CASE
Nataliya Matolynets, Jacek Rolinski, Khrystyna Lishchuk-Yakymovych, Yaroslav Tolstyak
Proceeding of the Shevchenko Scientific Society. Medical Sciences.2023;[Epub] CrossRef

Reviews

Basic science and research
The Role of Oliguria and the Absence of Fluid Administration and Balance Information in Illness Severity Scores: Neil J. Glassford, Rinaldo Bellomo; Korean J Crit Care Med. 2017;32(2):106-123. Published online May 31, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00192

13,914 View
326 Download
4 Web of Science
4 Crossref

Abstract PDF

Urinary examination has formed part of patient assessment since the earliest days of medicine. Current definitions of oliguria are essentially arbitrary, but duration and intensity of oliguria have been associated with an increased risk of mortality, and this risk is not completely attributable to the development of concomitant acute kidney injury (AKI) as defined by changes in serum creatinine concentration. The increased risk of death associated with the development of AKI itself may be modified by directly or indirectly by progressive fluid accumulation, due to reduced elimination and increased fluid administration. None of the currently extant major illness severity scoring systems or outcome prediction models use modern definitions of AKI or oliguria, or any values representative of fluid volumes variables. Even if a direct relationship with mortality is not observed, then it is possible that fluid balance or fluid volume variables mediate the relationship between illness severity and mortality in the renal and respiratory physiological domains. Fluid administration and fluid balance may then be an important, easily modifiable therapeutic target for future investigation. These relationships require exploration in large datasets before being prospectively validated in groups of critically ill patients from differing jurisdictions to improve prognostication and mortality prediction.

Citations

Citations to this article as recorded by

Management of oliguria
Marlies Ostermann, Andrew D. Shaw, Michael Joannidis
Intensive Care Medicine.2023; 49(1): 103. CrossRef
Nomenclature and diagnostic criteria for acute kidney injury – 2020 consensus of the Taiwan AKI-task force
Shao-Yu Yang, Terry Ting-Yu Chiou, Chih-Chung Shiao, Hugo You-Hsien Lin, Ming-Jen Chan, Che-Hsiung Wu, Chiao-Yin Sun, Wei-Jie Wang, Yen-Ta Huang, Vin-Cent Wu, Yung-Chang Chen, Ji-Tsung Fang, Shang-Jyh Hwang, Heng-Chih Pan
Journal of the Formosan Medical Association.2022; 121(4): 749. CrossRef
Haemodynamic frailty – A risk factor for acute kidney injury in the elderly
Neil G. Docherty, Christian Delles, Patrick D’Haese, Anita T. Layton, Carlos Martínez-Salgado, Benjamin A. Vervaet, Francisco J. López-Hernández
Ageing Research Reviews.2021; 70: 101408. CrossRef
Does Fluid Type and Amount Affect Kidney Function in Critical Illness?
Neil J. Glassford, Rinaldo Bellomo
Critical Care Clinics.2018; 34(2): 279. CrossRef

Cardiology/Surgery/Basic science and research
The Complexities of Intravenous Fluid Research: Questions of Scale, Volume, and Accumulation: Neil J Glassford, Rinaldo Bellomo; Korean J Crit Care Med. 2016;31(4):276-299. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00934

19,553 View
572 Download
15 Crossref

Abstract PDF

Despite near ubiquity, information regarding fluids consumption at a health care systems level, and patient exposure at an individual level, is surprisingly limited in the medical literature. The epidemiology of the foundational medical intervention of intravenous fluid administration is incredibly complex, with millions of patients being exposed internationally every year. Fluid is being given for different reasons, to different targets, following different triggers, by different specialties in different countries, and any observations that can be made are thought to have limited external validity to other jurisdictions and patient groups. The independent effects of fluid administration and fluid accumulation are very hard to separate from other markers of illness severity and aspects of the process of care. Fluid accumulation can result in organ injury, even when the fluid is being given to purportedly ameliorate or prevent such injury, and if it were independently associated with mortality then would be an easily accessible and modifiable risk factor for subsequent morbidity or death. Despite their ubiquity, it is clear that we have limited understanding of the effects of the intravenous fluids we use daily in the most vulnerable of patient groups. The research agenda in this field is large and urgent.

Citations

Citations to this article as recorded by

Uso de fluidoterapia en el periodo perioperatorio en pacientes adultos: revisión narrativa
M.J. Colomina, P. Galán Menéndez, J. Ripollés-Melchor
Revista Española de Anestesiología y Reanimación.2024;[Epub] CrossRef
Closed-Loop Control of Fluid Resuscitation Using Reinforcement Learning
Elham Estiri, Hossein Mirinejad
IEEE Access.2023; 11: 140569. CrossRef
Fluid Stewardship of Maintenance Intravenous Fluids
John R. Carr, W. Anthony Hawkins, Andrea Sikora Newsome, Susan E. Smith, Clemmons Amber B, Christopher M. Bland, Trisha N. Branan
Journal of Pharmacy Practice.2022; 35(5): 769. CrossRef
Clinician attitudes and concordance with self-assessed and actual intravenous fluid prescribing patterns: A single-institution evaluation of survey and electronic prescribing data
Michelle C. Spiegel, Annie N. Simpson, Nandita R. Nadig, Dee W. Ford, Andrew J. Goodwin
The American Journal of the Medical Sciences.2022; 364(1): 36. CrossRef
Acetate‐ versus lactate‐buffered crystalloid solutions: A systematic review with meta‐analysis and trial sequential analysis
Karen Louise Ellekjaer, Anders Perner, Praleene Sivapalan, Morten Hylander Møller
Acta Anaesthesiologica Scandinavica.2022; 66(7): 782. CrossRef
A fuzzy model for predicting burn patients’ intravenous fluid resuscitation rate
Sayma Alam Suha, M. Akhtaruzzaman, Tahsina Farah Sanam
Healthcare Analytics.2022; 2: 100070. CrossRef
Development and implementation of a clinical decision support-based initiative to drive intravenous fluid prescribing
Michelle C. Spiegel, Annie N. Simpson, Achsah Philip, Carolyn M. Bell, Nandita R. Nadig, Dee W. Ford, Andrew J. Goodwin
International Journal of Medical Informatics.2021; 156: 104619. CrossRef
Influence of acetate containing fluid versus lactate containing fluid on acid-base status, electrolyte level, and blood lactate level in dehydrated dogs
Annika Heitland, Ute Klein-Richers, Katrin Hartmann, René Dörfelt
Veterinary World.2021; : 2714. CrossRef
Infusion fluids: a clinical pharmacologist’s view
E.A. Ushkalova, S.K. Zyryanov, K.E. Zatolochina, O.I. Butranova
Anesteziologiya i reanimatologiya.2021; (6): 100. CrossRef
Pathophysiology of Volume Administration in Septic Shock and the Role of the Clinical Pharmacist
Brittany D. Bissell, Breanne Mefford
Annals of Pharmacotherapy.2020; 54(4): 388. CrossRef
Lactate versus acetate buffered intravenous crystalloid solutions: a scoping review
Karen L. Ellekjaer, Anders Perner, Martine M. Jensen, Morten H. Møller
British Journal of Anaesthesia.2020; 125(5): 693. CrossRef
Balanced Crystalloid Solutions
Matthew W. Semler, John A. Kellum
American Journal of Respiratory and Critical Care Medicine.2019; 199(8): 952. CrossRef
Does Fluid Type and Amount Affect Kidney Function in Critical Illness?
Neil J. Glassford, Rinaldo Bellomo
Critical Care Clinics.2018; 34(2): 279. CrossRef
Resuscitation fluids
Jonathan D. Casey, Ryan M. Brown, Matthew W. Semler
Current Opinion in Critical Care.2018; 24(6): 512. CrossRef
Utility of Volume Assessment Using Bioelectrical Impedance Analysis in Critically Ill Patients Receiving Continuous Renal Replacement Therapy: A Prospective Observational Study
Ki Hyun Park, Jung-ho Shin, Jin Ho Hwang, Su Hyun Kim
The Korean Journal of Critical Care Medicine.2017; 32(3): 256. CrossRef

Case Reports

Pharmacology/Anesthesiology
Lipid Emulsion in the Successful Resuscitation of Local Anesthetic Toxicity after Ankle Block: Sang Hee Park, Sang Hyun Kwak, Kyung Yeon Yoo, Hyun Jung Lee, Keun Bae Yook, Seok Jai Kim; Korean J Crit Care Med. 2014;29(3):234-236. Published online August 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.3.234

6,421 View
96 Download

Abstract PDF: Unexpected occurrence of local anesthetic toxicity is not rare and can cause fatal complications that do not respond to any known drug of intervention. Recently, the successful use of lipid emulsion for local anesthetic toxicity has been reported and recommended as a rescue method for cardiac or neurologic complications. We report a case of seizure attack and respiratory arrest successfully recovered with the use of intravenous lipid emulsion. Clinicians must be aware of the beneficial role of lipid emulsion in cases of local anesthetic toxicity.

Continuous Infusion of Ketamine in Mechanically Ventilated Patient in Septic Shock with Status Asthmaticus: Bon Nyeo Koo, Shin Ok Koh, Sung Yong Park, Jae Kwang Shim, Sung Sik Chon; Korean J Crit Care Med. 2000;15(2):108-112.

2,072 View
43 Download

Abstract PDF: Ketamine is well known for its analgesic, bronchodilating and sympathetic stimulating effect. Hence, it has been widely used for induction of patients with hypotension or asthma and also for analgesic and sedating purposes in the ICU. We presented a 62 year old female patient with ventilator support in septic shock with refractory asthma whom we managed successfully with continuous intravenous infusion of ketamine postoperatively in the ICU. The patient had a history of asthma but had been asymptomatic recently and was scheduled for an emergent explo-laparotomy under the diagnosis of acute panperitonitis. Before the induction of anesthesia, the patient was in septic shock but no wheezing could be auscultated. After the induction of general anesthesia and endotracheal intubation, wheezing was apparent in both lung fields with a high peak inspiratory pressure. Inotropics, vasopressors and bronchodilators were promptly instituted without any improvement of asthma and the patient had to be transferred to the ICU with intubated after the operation. Clinical symptoms of asthma continued throughout the first day despite using bronchodilators under mechanical ventilation but, after starting the IV infusion of ketamine, there were decrease in the peak inspiratory pressure and wheezing with a subsequent improvement in the arterial blood gas analysis findings. We could also achieve considerable analgesic and sedating effect without any decrease in the blood pressure. The patient's general physical status improved and weaning with extubation was successfully done on the 21st day and was transferred to the general ward on the 28th day.

The Use of Thiopental Sodium with BIS Monitoring in Hypoxic Brain Damage: Jae Young Kwon, Sul Ki Song, Kyung Hoon Kim, Sang Wook Shin, Seong Wan Baik; Korean J Crit Care Med. 2000;15(1):52-55.

1,482 View
10 Download

Abstract PDF: Hypoxemia is a common and potentially serious postoperative complication. Hypoxic encephalopahty may occur in prolonged hypoxemia. This condition needs brain protection. There are many brain protective methods. The primary cental nervous system protective mechanism of the barbiturates is attributed to their ability to decrease the cerebral metabolic rate, thus improving the ratio of oxygen (O2) supply to O2 demand. The electroencephalogram-derived bispectral index system (BIS) is a promising new method to predict probability of recovery of consciousness. We experienced two cases of hypoxic brain damage in recovery room. The patients were treated with thiopental and monitored with BIS. The use of thiopental as brain protection during complete global ischemia after cardiac arrest was not effective.

Original Article

Volume Changes under Isotonic Condition Containing Thiopental in Brain Astrocytoma Cells: Young Seok Lee, Bong Ki Moon, Sang Gun Han, Young Joo Lee, Jeong Yeon Hong, Kyeong Jin Lee, Soo Han Yoon, Keum Hee Chung, Hyun Jue Gill; Korean J Crit Care Med. 1998;13(2):194-197.

1,591 View
4 Download

Abstract PDF: BACKGOUND: Cell volume regulation is especially important in the brain because the brain is confined within a non-compliant vault and cannot tolerate significant perturbations in cell size. Cerebral cell volume regulation mechanisms are activated by sustained disturbances in plasma osmolality. The constancy of cell volume under physiological conditions is generally thought to reflex a balance between influx and efflux of solute and is therefore critically dependent on the properties of the plasma membrane. Cell volume regulation have not been described under isoosmotic solution. The object of the study was to know the effects of thiopental on cell volume change in isoosmotic condition.
METHODS
We made isoosmotic solution without thiopental (Group 1) and isoosmotic solution with 22.9 mM (Group 2), 16.8 mM (Group 3), 13.3 mM (Group 4) thiopental, separately, in order to study changes in cell volume under isoosmotic solution. We put cultured human brain astrocytoma cells into isoosmotic solution for each group and calculated cell volume using Coulter Counter after 30 minutes.
RESULTS
Cell volume was shown to be 5084+/-8580 (micrometer3)in Group 1, 501+/-854 (micrometer3) in Group 2, 1183+/-3839 (micrometer3) in Group 3, and 624+/-1100 (micrometer3) in Group 4. We discovered that cells in Group 2,3,4 were shrunk relative to cells in Group 1 (p<0.01). And there were significant differences in cell volume among thiopental groups.
CONCLUSIONS
Thiopental may has an effect on cell membrane properties and decrease cell volume under isoosmotic solution in brain astrocytoma cell.

First
Prev
Page of 1
Next
Last

Search