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Erratum
Comparison of Morphine and Remifentanil on the Duration of Weaning from Mechanical Ventilation
Jae Myeong Lee, Seong Heon Lee, Sang Hyun Kwak, Hyeon Hui Kang, Sang Haak Lee, Jae Min Lim, Mi Ae Jeong, Young Joo Lee, Chae Man Lim
Korean J Crit Care Med. 2016;31(4):381-381.   Published online November 30, 2016
DOI: https://doi.org/10.4266/kjccm.2014.29.4.281.e01
Corrects: Acute Crit Care 2014;29(4):281
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  • 100 Download
  • 1 Crossref
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Citations

Citations to this article as recorded by  
  • Early Sedation Depth and Clinical Outcomes in Mechanically Ventilated Patients in a Hospital: Retrospective Cohort Study
    Jeong Mi Hwang, Su Jung Choi
    Asian Nursing Research.2023; 17(1): 15.     CrossRef
Randomized Controlled Trial
Pharmacology/Pulmonary
Comparison of Morphine and Remifentanil on the Duration of Weaning from Mechanical Ventilation
Jae Myeong Lee, Seong Heon Lee, Sang Hyun Kwak, Hyeon Hui Kang, Sang Haak Lee, Jae Min Lim, Mi Ae Jeong, Young Joo Lee, Chae Man Lim
Korean J Crit Care Med. 2014;29(4):281-287.   Published online November 30, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.4.281
Correction in: Acute Crit Care 2016;31(4):381
  • 6,324 View
  • 124 Download
  • 1 Crossref
AbstractAbstract PDF
BACKGROUND
A randomized, multicenter, open-label, parallel group study was performed to compare the effects of remifentanil and morphine as analgesic drugs on the duration of weaning time from mechanical ventilation (MV).
METHODS
A total of 96 patients with MV in 6 medical and surgical intensive care units were randomly assigned to either, remifentanil (0.1-0.2 mcg/kg/min, n = 49) or morphine (0.8-35 mg/hr, n = 47) from the weaning start. The weaning time was defined as the total ventilation time minus the sum of controlled mode duration.
RESULTS
Compared with the morphine group, the remifentanil-based analgesic group showed a tendency of shorter weaning time (mean 143.9 hr, 89.7 hr, respectively: p = 0.069). Secondary outcomes such as total ventilation time, successful weaning rate at the 7th of MV day was similar in both groups. There was also no difference in the mortality rate at the 7th and 28th hospital day. Kaplan-Meyer curve for weaning was not different between the two groups.
CONCLUSIONS
Remifentanil usage during the weaning phase tended to decrease weaning time compared with morphine usage.

Citations

Citations to this article as recorded by  
  • Comparison between remifentanil and other opioids in adult critically ill patients
    Shuguang Yang, Huiying Zhao, Huixia Wang, Hua Zhang, Youzhong An
    Medicine.2021; 100(38): e27275.     CrossRef
Case Reports
Cardiology/Pulmonary
Recovery from Acute Respiratory Distress Syndrome with Long-Run Extracorporeal Membrane Oxygenation
Jin Jeon, Jin Won Huh, Chae Man Lim, Younsuck Koh, Sang Bum Hong
Korean J Crit Care Med. 2014;29(3):212-216.   Published online August 31, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.3.212
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  • 66 Download
  • 1 Crossref
AbstractAbstract PDF
Acute respiratory distress syndrome (ARDS) is a severe lung disease associated with high mortality despite recent advances in management. Significant advances in extracorporeal membrane oxygenation (ECMO) devices and management allow short-term support for patients with acute reversible respiratory failure and can serve as a bridge to transplantation in patients with irreversible respiratory failure. When ARDS does not respond to conventional treatment, ECMO and the interventional lung assist membrane (iLA) are the most widely used complementary treatment options. Here, we report a clinical case of an adult patient who required prolonged duration venovenous (VV)-ECMO for severe ARDS resulting in improvement while waiting for lung transplantation.

Citations

Citations to this article as recorded by  
  • 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
Extracorporeal Membrane Oxygenation (ECMO) and Iliac Vein Injury
Sang Ook Ha, Jae Seok Park, So Hee Park, Chae Man Lim, Younsuck Koh, Sang Bum Hong
Korean J Crit Care Med. 2013;28(3):197-200.
DOI: https://doi.org/10.4266/kjccm.2013.28.3.197
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AbstractAbstract PDF
The use of extracorporeal membrane oxygenation (ECMO) has increased after the 2009 pandemic H1N1 infections, and the ECMO-related complications have also increased. Specifically, the mechanical vessel injury due to catheter cannulation seems to be less frequent than other complications, but there is a risk of hemorrhagic shock which requires special attention. We experienced a case of successful management with graft stenting during ECMO operation for iliac vein injury. A 56-year-old female patient with non-small cell lung cancer developed endobronchial obstruction, and ECMO was applied for the ECMO-assisted rigid bronchoscopy. During catheter cannulation, hypovolemic shock was developed due to her right external iliac vein injury. We detected the hemorrhage with bedside ultrasound at an early stage and the hemorrhage was effectively managed with graft stenting on ECMO.
A Case of Pumpless Interventional Lung Assist Application in a Tuberculosis Destroyed Lung Patient with Severe Hypercapnic Respiratory Failure
So Hee Park, Sang Ook Ha, Jae Seok Park, Sang Bum Hong, Tae Sun Shim, Chae Man Lim, Younsuck Koh
Korean J Crit Care Med. 2013;28(3):192-196.
DOI: https://doi.org/10.4266/kjccm.2013.28.3.192
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  • 22 Download
AbstractAbstract PDF
Pumpless extracorporeal interventional lung assist (iLA) is a rescue therapy allowing effective carbon dioxide removals and lung protective ventilator settings. Herein, we report the use of a pumpless extracorporeal iLA in a tuberculosis destroyed lung (TDL) patient with severe hypercapnic respiratory failures. A 35-year-old male patient with TDL was intubated due to CO2 retention and altered mentality. After 11 days, Ventilator Associated Pneumonia (VAP) had developed. Despite the maximal mechanical ventilator support, his severe respiratory acidosis was not corrected. We applied the iLA for the management of refractory hypercapnia with respiratory acidosis. This case suggests that the iLA is an effective rescue therapy for TDL patients with ventilator refractory hypercapnia.
Original Articles
Rebound Inflammation Associated with Rewarming from Hypothermia in an Endotoxin-Injured Lung
Chae Man Lim
Korean J Crit Care Med. 2013;28(2):80-85.
DOI: https://doi.org/10.4266/kjccm.2013.28.2.80
  • 2,603 View
  • 14 Download
AbstractAbstract PDF
BACKGROUND
Hypothermia is known to suppress inflammation in various experimental and clinical settings. We wanted to investigate how the suppressed inflammation by hypothermia is affected during rewarming.
METHODS
Mice were being assigned to normothermia (37degrees C) or hypothermia (32degrees C). After 30 minutes at the assigned temperature, lipopolysaccharide was administered intratracheally. The mice were then randomly grouped and subjected to 4 hours of normothermia (N), 24 hours of normothermia (NN), 4 hours of hypothermia (H), or 4 hours of hypothermia followed by normothermia for the next 20 hours (HN). In another experiment, other HN mice were treated with varying doses of anti-TNF-alpha or anti-IL-1beta antibodies (0, 6.25, 12.5, 25, and 50 microg/250 microl) immediately prior to rewarming.
RESULTS
The neutrophil counts of BAL fluid (x104/ml) were 23.0 +/- 13.1 in the N, 6.4 +/- 3.1 in the H (p = 0.002 vs N), 20.4 +/- 10.2 in the NN, and 49.7 +/- 21.0 in the HN (p = 0.005 vs H; p < 0.001 vs NN). Myeloperoxidase activity of the lung (unit/microg) was 6.7 +/- 2.9, 7.9 +/- 1.9, 17.8 +/- 4.0 (p < 0.001 vs N), and 12.9 +/- 5.9 (p = 0.034 vs H, p = 0.028 vs NN), respectively. Compared with control HN, total WBC and neutrophil counts of mice treated with anti-TNF-alpha antibody or anti-IL-1beta antibody prior to rewarming were lower at all tested doses. The combination of both anti-TNF-alpha or anti-IL-1beta antibodies was not increasingly reducing the neutrophilic sequestration.
CONCLUSIONS
Rewarming from induced hypothermia resulted in augmentation of neutrophilic sequestration of endotoxin-injured lung. Treatment with antibodies against TNF-alpha or IL-1beta prevented this rebound of neutrophilic infiltration.
Usefulness of Screening Criteria System Used by Medical Alert Team in a General Hospital
Hyejin Joo, So Hee Park, Sang Bum Hong, Chae Man Lim, Younsuck Koh, Young Seok Lee, Jin Won Huh
Korean J Crit Care Med. 2012;27(3):151-156.
DOI: https://doi.org/10.4266/kjccm.2012.27.3.151
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  • 4 Crossref
AbstractAbstract PDF
BACKGROUND
Rapid response team (RRT) is becoming an essential part of patient safety by the early recognition and management of patients on general hospital wards. In this study, we analyzed the usefulness of screening criteria of RRT used at Asan Medical Center.
METHODS
On a retrospective basis, we reviewed the records of 675 cases in 543 patients that were managed by RRT (called medical alert team in the Asan Medical Center), from July 2011 to December 2011. The medical alert team was acted by requests of attending doctors or nurses or the medical alert system (MAS) criteria composed of abnormal vital sign, neurology, laboratory data and increasing oxygen demand. We investigated the patterns of MAS criteria for targeting the patients who were managed by the medical alert team.
RESULTS
Respiratory distress (RR > 25/min) was the most common item for identifying patients whose condition had worsened. The criteria consist with respiratory distress and abnormal blood pressure (mean BP < 60 mmHg or systolic BP < 90 mmHg) found 70.0% of patients with deteriorated conditions. Vital sign (RR > 25/min, mean BP < 60 mmHg or systolic BP < 90 mmHg, pulse rate, PR > 130/min or < 50/min) and oxygen demand found 79.2% of them. Vital signs, arterial blood gas analysis (ABGA) with lactate level (pH, pO2, pCO2, and lactate) and O2 demand found 98.6% of patient conditions had worsened.
CONCLUSIONS
Vital signs, especially RR > 25/min is useful criteria for detecting patients whose conditions have deteriorated. The addition of ABGA data with lactate levels leads to a more powerful screening tool.

Citations

Citations to this article as recorded by  
  • Influence of the Rapid Response Team Activation via Screening by Nurses on Unplanned Intensive Care Unit Admissions
    Ye-Ji Huh, Seongmi Moon, Eun Kyeung Song, Minyoung Kim
    Korean Journal of Adult Nursing.2020; 32(5): 539.     CrossRef
  • Early Experience of Medical Alert System in a Rural Training Hospital: a Pilot Study
    Maru Kim
    The Korean Journal of Critical Care Medicine.2017; 32(1): 47.     CrossRef
  • Temporal patterns of change in vital signs and Cardiac Arrest Risk Triage scores over the 48 hours preceding fatal in‐hospital cardiac arrest
    HyunSoo Oh, KangIm Lee, WhaSook Seo
    Journal of Advanced Nursing.2016; 72(5): 1122.     CrossRef
  • A combination of early warning score and lactate to predict intensive care unit transfer of inpatients with severe sepsis/septic shock
    Jung-Wan Yoo, Ju Ry Lee, Youn Kyung Jung, Sun Hui Choi, Jeong Suk Son, Byung Ju Kang, Tai Sun Park, Jin-Won Huh, Chae-Man Lim, Younsuck Koh, Sang Bum Hong
    The Korean Journal of Internal Medicine.2015; 30(4): 471.     CrossRef
Clinical Characteristics and Prognosis of Patients with Intracranial Hemorrhage during Mechanical Ventilation
Go Woon Kim, Jin Won Huh, Younsuck Koh, Chae Man Lim, Sang Bum Hong
Korean J Crit Care Med. 2012;27(2):94-101.
DOI: https://doi.org/10.4266/kjccm.2012.27.2.94
  • 7,197 View
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AbstractAbstract PDF
BACKGROUND
Intracranial hemorrhage is a serious disease associated with high mortality and morbidity, and develops suddenly without warning. Although there were known risk factors, it is difficult to prevent brain hemorrhage from critically ill patients in the intensive care unit (ICU). There are several reports that brain hemorrhage, in critically ill patients, occurred in connection with respiratory diseases. The aim of our study is to describe the baseline characteristics and prognosis of patients with intracranial hemorrhage during mechanical ventilation in the ICU.
METHODS
We retrospectively reviewed the medical records of 56 patients, who developed intracranial hemorrhage in a medical ICU, from May 2008 to December 2011. During the mechanical ventilation in the ICU, patients were implemented with a weaning process, following ACCP (American College of Chest Physicians) criteria. Also, we compared patients with brain hemorrhage to those without brain hemorrhage.
RESULTS
Thirty two of the 56 patients (57.1%) were male, and median ages were 63 (17-90) years. The common type of brain hemorrhage confirmed was intracerebral hemorrhage/intraventricular hemorrhage (52.2%). The duration from mechanical ventilation to brain hemorrhage was 6 (0-58) days. Overall hospital mortality was 57.1%, and ICU mortality was 44.6%. The most common cause of death was brain hemorrhage (40.6%). In comparison to patients without brain hemorrhage, study patients showed less use of anticoagulants and lower ventilator pressure. Our study showed that the use of vasopressor, systolic blood pressure, peak airway pressure, and platelet count were associated with brain hemorrhage.
CONCLUSIONS
Intracranial hemorrhage showed high mortality in critically ill patients with mechanical ventilation. In the future, large case-control study will be needed to evaluate the risk factors of cerebral hemorrhage.
Case Report
A Case of iLA Application in a Patient with Refractory Asthma Who Is Nonresponsive to Conventional Mechanical Ventilation: A Case Report
Young Seok Lee, Hyejin Joo, Jae Young Moon, Jin Won Huh, Yeon Mok Oh, Chae Man Lim, Younsuck Koh, Sang Bum Hong
Korean J Crit Care Med. 2012;27(2):108-110.
DOI: https://doi.org/10.4266/kjccm.2012.27.2.108
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  • 2 Crossref
AbstractAbstract PDF
Refractory asthma with hypercapnia is a near-fatal disease. Pumpless Extracorporeal Interventional Lung Assist (iLA) may be considered as an alternative therapy for the disease as it removes the carbon dioxide effectively. Nevertheless, clinical outcome studies regarding iLA in patients suffering from refractory asthma have rarely been applied. Here, we reported our experience with iLA for the treatment of refractory asthma with hypercapnia. In our case, the patient had refractory asthma which was not controlled with medical treatment or mechanical ventilation. We applied iLA since hypercapnia was not resolved despite mechanical ventilation. After iLA implantation effectively reduced the carbon dioxide, the clinical condition of our patient improved. In conclusion, iLA is a useful tool for patient suffering from refractory asthma with hypercapnia.

Citations

Citations to this article as recorded by  
  • Interventional lung assist and extracorporeal membrane oxygenation in a patient with near-fatal asthma
    Seok Jeong Lee, Yong Sung Cha, Chun Sung Byun, Sang-Ha Kim, Myoung Kyu Lee, Suk Joong Yong, Won-Yeon Lee
    The American Journal of Emergency Medicine.2017; 35(2): 374.e3.     CrossRef
  • Pumpless extracorporeal interventional lung assist for bronchiolitis obliterans after allogenic peripheral blood stem cell transplantation for acute lymphocytic leukemia
    Yeon-Hee Park, Chae-Uk Chung, Jae-Woo Choi, Sang-Ok Jung, Sung-Soo Jung, Jeong-Eun Lee, Ju-Ock Kim, Jae-Young Moon
    Yeungnam University Journal of Medicine.2015; 32(2): 98.     CrossRef
Original Articles
Initiation of Continuous Renal Replacement Therapy and Clinical Outcome in Septic Shock Patients with Acute Kidney Injury
Seung Mok Ryoo, Won Young Kim, Sang Sik Choi, Jin Won Huh, Sang Bum Hong, Chae Man Lim, Younsuck Koh
Korean J Crit Care Med. 2012;27(1):29-35.
DOI: https://doi.org/10.4266/kjccm.2012.27.1.29
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AbstractAbstract PDF
BACKGROUND
Initiation of renal replacement therapy (RRT) in critically ill septic shock patients with acute kidney injury is highly subjective and may influence outcome. The aim of this study is to evaluate the relationship between initiation of RRT and 28 day mortality in patients with severe sepsis and septic shock (SSSS).
METHODS
All patients diagnosed with SSSS and treated at the medical intensive care unit (ICU) in university-affiliated hospital from January 2005 to December 2006 were reviewed. Initiation of RRT was stratified into "early" and "late" by RIFLE (Risk, Injury, Failure, Loss, and End-stage) criteria and blood urea nitrogen (BUN) at the time RRT began. The primary outcome was death after 28 days from any cause.
RESULTS
Of the 326 patients diagnosed with SSSS and admitted into the medical ICU during the study period, 78 patients received RRT. Mean age was 61.5 +/- 14.7 years old and 54 patients were male (69.2%). The initiation of RRT was categorized into early (Risk, and Injury) and late (Failure) by RIFLE criteria and also categorized into early (BUN < 75 mg/dl) and late (BUN > or = 75 mg/dl). When the relationship between RIFLE criteria and 28 day mortality was compared, no significant difference was shown (70.8% vs. 73.3%, p = 0.81). The initiation of RRT by BUN also showed no significant difference in 28 day mortality (77.3% vs. 69.6%, p = 0.50).
CONCLUSIONS
Initiation of RRT, stratified into "early" and "late" by RIFLE and BUN, showed no significant difference in 28 day mortality regarding patient with SSSS.
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
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  • 5 Crossref
AbstractAbstract 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
Case Report
Extracorporeal Membrane Oxygenation as a Bridge to Definitive Airway Security in 3 Severe Acute Extrinsic Airway Compression Patients: A Case Report
Jiwon Lyu, Jin Won Huh, Chae Man Lim, Youn Suck Koh, Sang Bum Hong
Korean J Crit Care Med. 2011;26(1):29-33.
DOI: https://doi.org/10.4266/kjccm.2011.26.1.29
  • 2,345 View
  • 23 Download
AbstractAbstract PDF
Extracorporeal membrane oxygenation (ECMO) has been used for cardiac and respiratory failure for over 30 years. Recently, however, ECMO has emerged as a useful means of short-term support in the management of hypoxic patients for nontraditional indications. Here, we report the use of veno-venous ECMO as a bridge to support a patient with severe airway obstruction because of tumor compression. Case 1: A patient with extrinsic airway compression secondary to a large metastatic cancer on neck was successfully managed using ECMO. Case 2: The successful use of ECMO to support a patient with extrinsic airway compression secondary to a recurred thyroid cancer. Case 3: A pregnant woman with airway obstruction secondary to metastatic lymphadenopathy of lung cancer who underwent successful tracheal stent insertion. The 3 patients were successfully weaned off ECMO without any complication. Although these conditions are uncommon indications, ECMO is a potential option for such life-threatening conditions.
Original Articles
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
Korean J Crit Care Med. 2011;26(1):13-17.
DOI: https://doi.org/10.4266/kjccm.2011.26.1.13
  • 2,466 View
  • 27 Download
AbstractAbstract PDF
BACKGROUND
A dramatic decrease in circulating lymphocyte number is observed after septic shock. In this study, we assessed whether circulating lymphocyte subpopulations influence the severity and prognosis of septic shock.
METHODS
133 patients (median 65 years, range 27-88; male 63.2%) receiving intensive care for septic shock were enrolled in this study. Flow cytometry phenotyping of circulating lymphocyte subpopulations, including helper T cells, suppressor T cells, total B cells, and natural killer (NK) cells, was performed within 24 hours after the diagnosis of septic shock. After measuring the white blood cell (WBC) and differential leukocyte count, the lymphocyte subsets were analyzed. The following data were recorded: general characteristics, severity of illness as assessed by the Sequential Organ Failure Assessment (SOFA) score, and 28-day mortality.
RESULTS
The overall mortality rate at 28 days was 33.8%. SOFA score was negatively correlated with the T cell count (r = -0.175) and helper T cell count (r = -0.223). However, only low a helper T cell count was associated with the severity of septic shock (odds ratio 0.995, 95% confidence interval 0.992-0.999, p = 0.014). Using multiple logistic regression analysis for 28-day mortality, there was no significant prognostic factor among the lymphocyte subset.
CONCLUSIONS
The low helper T cell count appeared to be associated with severity, but did not show significant association with mortality.
Physiologic Effect and Safety of Pumpless Extracorporeal Interventional Lung Assist in Korean Patients with Acute Respiratory Failure
Woo Hyun Cho, Kwangha Lee, Jin Won Huh, Chae Man Lim, Younsuck Koh, Sang Bum Hong
Korean J Crit Care Med. 2010;25(4):235-240.
DOI: https://doi.org/10.4266/kjccm.2010.25.4.235
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  • 2 Crossref
AbstractAbstract PDF
BACKGROUND
Pumpless interventional lung assist (iLA) uses an extracorporeal gas exchange system without any complex blood pumping technology, and has been shown to reduce CO2 tension and permit protective lung ventilation. The feasibility and safety of iLA were demonstrated in previous studies, but there has been no experience with iLA in Korea. The purpose of this study was to evaluate the feasibility of the iLA device in terms of physiologic efficacy and safety in Korean patients with acute respiratory failure.
METHODS
iLA was implemented in patients with acute respiratory failure who satisfied the predefined criteria of our study. Initiation of iLA followed an algorithm for implementation, ventilator care, and monitoring. Following insertion of arterial and venous cannulas under ultrasound guidance, the physiologic and respiratory variables and incidence of adverse events were monitored.
RESULTS
iLA was implemented in 5 patients and the duration of iLA ranged from 7 hours to 171 hours. At 24 hours after implementation, the mean changes in pH, PaCO2, and PaO2/FiO2 ranged from 7.204 to 7.393, from 68.4 mm Hg to 33 mm Hg, and from 128.7 mm Hg to 165 mm Hg, respectively. During iLA therapy, one adverse event was observed, which presented with hematochezia without hemodynamic change.
CONCLUSIONS
iLA treatment produced effective removal of carbon dioxide and allowed for protective ventilation in severe respiratory failure. An iLA system can easily be installed by percutaneous cannulation, without procedural complications, and without significant adverse events necessitating discontinuation of iLA after implementation.

Citations

Citations to this article as recorded by  
  • A Case of Pumpless Extracorporeal Interventional Lung Assist for Severe Respiratory Failure - A Case Report -
    Young-Jae Cho, Ji Yeon Seo, Yu Jung Kim, Jae-Ho Lee, Choon-Taek Lee
    Korean Journal of Critical Care Medicine.2012; 27(2): 120.     CrossRef
  • A Case of iLA Application in a Patient with Refractory Asthma Who Is Nonresponsive to Conventional Mechanical Ventilation - A Case Report -
    Young Seok Lee, Hyejin Joo, Jae Young Moon, Jin Won Huh, Yeon-Mok Oh, Chae-Man Lim, Younsuck Koh, Sang-Bum Hong
    Korean Journal of Critical Care Medicine.2012; 27(2): 108.     CrossRef
Effect of Admission Time to the Medical Intensive Care Unit on Acute Critical Patient Outcomes
Taejin Park, Sang Bum Hong, Chae Man Lim, Younsuck Koh
Korean J Crit Care Med. 2010;25(2):71-75.
DOI: https://doi.org/10.4266/kjccm.2010.25.2.71
  • 2,583 View
  • 23 Download
  • 3 Crossref
AbstractAbstract PDF
BACKGROUND
The initial management of acute critical patients is important. However, not all hospital facilities and staff are available during off-duty time. We determined the effects of intensive care unit (ICU) admission time on patient outcomes.
METHODS
This retrospective cohort study was conducted in a 28-bed medical ICU in 1 tertiary university hospital. Patients who were admitted between 1 March 2009 and 31 August 2009 were divided according to the time of admission into the "duty time group" (9 AM-5 PM on weekdays) and the "off-duty time group" (5 PM-9 AM on weekdays and at any time on weekends). The baseline characteristics and clinical outcomes were compared between these two groups. The primary endpoint of this study was hospital mortality; the secondary endpoints were ICU mortality and length of ICU stay, hospital length of stay, and mechanical ventilation time.
RESULTS
Two hundred eight (64.8%) of 321 enrolled patients were admitted during off-duty time. The baseline characteristics between the 2 groups were not significantly different. Hospital mortality was 37 (32.7%) in the "duty time group" and 82 (38.4%) in the "off-duty time group" (p = 0.237). There were no significant differences in secondary endpoints between the two groups.
CONCLUSIONS
Off-duty time admission to the ICU had no effect on hospital and ICU mortality, length of hospital and ICU stay, and mechanical ventilation time compared to duty time admission.

Citations

Citations to this article as recorded by  
  • Validity and Reliability of the Korean Version of the Partners In Health Scale (PIH-K)
    Mi-Kyeong Jeon, Jung-Won Ahn, Yeon-Hwan Park, Mi-Kyoung Lee
    Journal of Korean Critical Care Nursing.2019; 12(2): 1.     CrossRef
  • Analysis of Risk Factors to Predict Intensive Care Unit Transfer in Medical in-Patients
    Ju Ry Lee, Hye Ran Choi
    Journal of Korean Biological Nursing Science.2014; 16(4): 259.     CrossRef
  • Usefulness of Screening Criteria System Used by Medical Alert Team in a General Hospital
    Hyejin Joo, So Hee Park, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Young Seok Lee, Jin Won Huh
    Korean Journal of Critical Care Medicine.2012; 27(3): 151.     CrossRef

ACC : Acute and Critical Care