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15 "Chi Ryang Chung"
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Original Article
CPR/Resuscitation
Prognostic significance of respiratory quotient in patients undergoing extracorporeal cardiopulmonary resuscitation in Korea
Yun Im Lee, Ryoung-Eun Ko, Soo Jin Na, Jeong-Am Ryu, Yang Hyun Cho, Jeong Hoon Yang, Chi Ryang Chung, Gee Young Suh
Acute Crit Care. 2023;38(2):190-199.   Published online May 25, 2023
DOI: https://doi.org/10.4266/acc.2022.01438
  • 724 View
  • 48 Download
  • 1 Citations
AbstractAbstract PDF
Background
Respiratory quotient (RQ) may be used as a tissue hypoxia marker in various clinical settings but its prognostic significance in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) is not known. Methods: Medical records of adult patients admitted to the intensive care units after ECPR in whom RQ could be calculated from May 2004 to April 2020 were retrospectively reviewed. Patients were divided into good neurologic outcome and poor neurologic outcome groups. Prognostic significance of RQ was compared to other clinical characteristics and markers of tissue hypoxia. Results: During the study period, 155 patients were eligible for analysis. Of them, 90 (58.1%) had a poor neurologic outcome. The group with poor neurologic outcome had a higher incidence of out-of-hospital cardiac arrest (25.6% vs. 9.2%, P=0.010) and longer cardiopulmonary resuscitation to pump-on time (33.0 vs. 25.2 minutes, P=0.001) than the group with good neurologic outcome. For tissue hypoxia markers, the group with poor neurologic outcome had higher RQ (2.2 vs. 1.7, P=0.021) and lactate levels (8.2 vs. 5.4 mmol/L, P=0.004) than the group with good neurologic outcome. On multivariable analysis, age, cardiopulmonary resuscitation to pump-on time, and lactate levels above 7.1 mmol/L were significant predictors for a poor neurologic outcome but not RQ. Conclusions: In patients who received ECPR, RQ was not independently associated with poor neurologic outcome.

Citations

Citations to this article as recorded by  
  • Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest and in-hospital cardiac arrest with return of spontaneous circulation: be careful when comparing apples to oranges
    Hwa Jin Cho, In Seok Jeong, Jan Bělohlávek
    Acute and Critical Care.2023; 38(2): 242.     CrossRef
Images in critical care
Pulmonary
Acute lung injury following occupational exposure to nitric acid
Ji Hoon Jang, Sung Yeon Hwang, Chi Ryang Chung, Gee Young Suh, Ryoung-Eun Ko
Acute Crit Care. 2021;36(4):395-396.   Published online November 26, 2021
DOI: https://doi.org/10.4266/acc.2021.01557
  • 2,507 View
  • 79 Download
PDF
Erratum
Primary Invasive Intestinal Aspergillosis in a Non-Severely Immunocompromised Patient
Eunmi Gil, Tae Sun Ha, Gee Young Suh, Chi Ryang Chung, Chi-Min Park
Korean J Crit Care Med. 2016;31(3):263-263.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.2.129.e01
Corrects: Acute Crit Care 2016;31(2):129
  • 4,469 View
  • 65 Download
PDF
Original Article
Infection/Pharmacology
Clinical Effectiveness and Nephrotoxicity of Aerosolized Colistin Treatment in Multidrug-Resistant Gram-Negative Pneumonia
Seung Yong Park, Mi Seon Park, Chi Ryang Chung, Ju Sin Kim, Seoung Ju Park, Heung Bum Lee
Korean J Crit Care Med. 2016;31(3):208-220.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00129
  • 12,535 View
  • 279 Download
  • 2 Citations
AbstractAbstract PDF
Background
Colistin (polymyxin E) is active against multidrug-resistant Gram-negative bacteria (MDR-GNB). However, the effectiveness of inhaled colistin is unclear. This study was designed to assess the effectiveness and safety of aerosolized colistin for the treatment of ventilator-associated pneumonia (VAP) caused by MDR-GNB.
Methods
In this retrospective longitudinal study, we evaluated the medical records of 63 patients who received aerosolized colistin treatment for VAP caused by MDR-GNB in the medical intensive care unit (MICU) from February 2012 to March 2014.
Results
A total of 25 patients with VAP caused by MDR-GNB were included in this study. The negative conversion rate was 84.6% after treatment, and acute kidney injury (AKI) occurred in 11 patients (44%, AKI group). The average length of MICU stay and colistin treatment- related factors, such as daily and total cumulative doses and administration period, were not significantly different between groups. In-hospital mortality tended to be higher in the AKI group (p = 0.07). Multivariate analysis showed that a body mass index less than 18 was an independent risk factor of mortality (odds ratio [OR] = 21.95, 95% confidence interval [CI] 1.59-302.23; p = 0.02). Notably, AKI occurrence was closely related to the administration of more than two nephrotoxic drugs combined with aerosolized colistin (OR = 15.03, 95% CI 1.40-161.76; p = 0.025) and septic shock (OR = 8.10, 95% CI 1.40-161.76; p = 0.04).
Conclusions
The use of adjunctive aerosolized colistin treatment appears to be a relatively safe and effective option for the treatment of VAP caused by MDR-GNB. However, more research on the concomitant use of nephrotoxic drugs with aerosolized colistin will be necessary, as this can be an important risk factor of development of AKI.

Citations

Citations to this article as recorded by  
  • Aerosolized antibiotics in the treatment of hospital-acquired pneumonia/ventilator-associated pneumonia
    Yun Jung Jung, Eun Jin Kim, Young Hwa Choi
    The Korean Journal of Internal Medicine.2022; 37(1): 1.     CrossRef
  • Changes in Renal Function by Nebulized Colistimethate Treatment
    Hye Jin Ahn, Yoo Jin Jung, Jae Song Kim, Soo Hyun Kim, Eun Sun Son
    Korean Journal of Clinical Pharmacy.2017; 27(2): 92.     CrossRef
Case Reports
Infection
Primary Invasive Intestinal Aspergillosis in a Non-Severely Immunocompromised Patient
Eunmi Gil, Tae Sun Ha, Gee Young Suh, Chi Ryang Chung, Chi-Min Park
Korean J Crit Care Med. 2016;31(2):129-133.   Published online May 31, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.2.129
Correction in: Acute Crit Care 2016;31(3):263
  • 7,498 View
  • 114 Download
  • 1 Citations
AbstractAbstract PDF
Invasive aspergillosis (IA) is most commonly seen in patients with risk factors, such as cytotoxic chemotherapy, prolonged neutropenia, corticosteroids, transplantation and acquired immune deficiency syndrome. IA commonly occurs in the respiratory tract. Extrapulmonary aspergillosis is usually a part of a disseminated infection, and primary invasive intestinal aspergillosis is very rare. Herein, we report a case of an immunocompetent 53-year-old male who suffered recurrent septic shock in the intensive care unit (ICU) and was finally diagnosed as invasive intestinal aspergillosis without dissemination. IA is rarely considered for patients who do not have an immune disorder. Thus, when such cases do occur, the diagnosis is delayed and the clinical outcome is often poor. However, there is a growing literature reporting IA cases in patients without an immune disorder, mostly among ICU patients. Primary intestinal aspergillosis should be considered for critically ill patients, especially with severe disrupted gastrointestinal mucosal barrier.

Citations

Citations to this article as recorded by  
  • Aspergillus fumigatus cholangitis in a patient with cholangiocarcinoma: case report and review of the literature
    Kathrin Rothe, Sebastian Rasch, Nina Wantia, Alexander Poszler, Joerg Ulrich, Christoph Schlag, Wolfgang Huber, Roland M. Schmid, Dirk H. Busch, Tobias Lahmer
    Infection.2021; 49(1): 159.     CrossRef
Cardiology
Use of Polymyxin B Hemoperfusion in a Patient with Septic Shock and Septic Cardiomyopathy Who Was Placed on Extracorporeal Membrane Oxygen Support
Sun Hye Shin, Hyun Lee, Aeng Ja Choi, Kylie Hae Jin Chang, Gee Young Suh, Chi Ryang Chung
Korean J Crit Care Med. 2016;31(2):123-128.   Published online May 31, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.2.123
  • 19,389 View
  • 171 Download
AbstractAbstract PDF
Although shock in sepsis is usually managed successfully by conventional medical treatment, a subset of cases do not respond and may require salvage therapies such as veno-arterial extracorporeal membrane oxygenation (VA ECMO) support as well as an attempt to remove endotoxins. However, there are limited reports of attempts to remove endotoxins in patients with septic shock on VA ECMO support. We recently experienced a case of septic shock with severe myocardial injury whose hemodynamic improvement was unsatisfactory despite extracorporeal membrane oxygenation (ECMO) support. Since the cause of sepsis was acute pyelonephritis and blood cultures grew gram-negative bacilli, we additionally applied polymyxin B direct hemoperfusion (PMX-DHP) to the ECMO circuit and were able to successfully taper off vasopressors and wean off ECMO support. To the best of our knowledge, this is the first adult case in which PMX-DHP in addition to ECMO support was successfully utilized in a patient with septic shock. This case indicates that additional PMX-DHP therapy may be beneficial and technically feasible in patients with septic shock with severe myocardial injury refractory to ECMO support.
Infection
Disseminated Gastrointestinal Mucormycosis in Immunocompromised Disease
Tae Sun Ha, Chi-Min Park, Jeong Hoon Yang, Yang Hyun Cho, Chi Ryang Chung, Kyeongman Jeon, Gee Young Suh
Korean J Crit Care Med. 2015;30(4):323-328.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.323
  • 5,167 View
  • 79 Download
  • 2 Citations
AbstractAbstract PDF
Mucormycosis is an uncommon opportunistic fungal infection mostly affecting immunocompromised patients and gastrointestinal mucormycosis is a rare and life-threatening. We describe a 31-year-old man with a history of idiopathic cyclic neutropenia who developed perforations of the stomach and intestine and intra-abdominal bleeding due to disseminated gastrointestinal mucormycosis after the initial operation.

Citations

Citations to this article as recorded by  
  • A Fatal Case of Disseminated Intestinal Mucormycosis in a Patient with Vibrio Sepsis
    Seungwoo Chung, Hyun-Jung Sung, Jong Won Chang, Ile Hur, Ho Cheol Kim
    Journal of Acute Care Surgery.2021; 11(3): 133.     CrossRef
  • Gastric Mucormycosis Followed by Traumatic Cardiac Rupture in an Immunocompetent Patient
    Sang Won Lee, Hyun Seok Lee
    The Korean Journal of Gastroenterology.2016; 68(2): 99.     CrossRef
Infection/Surgery
Refractory Septic Shock Treated with Nephrectomy under the Support of Extracorporeal Membrane Oxygenation
Young Kun Lee, Jeong Am Ryu, Jeong Hoon Yang, Chi-Min Park, Gee Young Suh, Kyeongman Jeon, Chi Ryang Chung
Korean J Crit Care Med. 2015;30(3):176-179.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.176
  • 4,281 View
  • 69 Download
AbstractAbstract PDF
Conventional medical therapies have not been very successful in treating adults with refractory septic shock. The effects of direct hemoperfusion using polymyxin B and veno-arterial extracorporeal membrane oxygenation (ECMO) for refractory septic shock remain uncertain. A 66-year-old man was admitted to the emergency department and suffered from sepsis-induced hemodynamic collapse. For hemodynamic improvement, we performed direct hemoperfusion using polymyxin B. Computed tomography scan of this patient revealed emphysematous pyelonephritis (EPN), for which he underwent emergent nephrectomy with veno-arterial ECMO support. To the best of our knowledge, this is the first report of successful treatment of EPN with refractory septic shock using polymyxin B hemoperfusion and nephrectomy under the support of ECMO.
Original Article
Pulmonary
Factors Affecting Invasive Management after Unplanned Extubation in an Intensive Care Unit
A Lan Lee, Chi Ryang Chung, Jeong Hoon Yang, Kyeongman Jeon, Chi-Min Park, Gee Young Suh
Korean J Crit Care Med. 2015;30(3):164-170.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.164
  • 4,485 View
  • 100 Download
  • 1 Citations
AbstractAbstract PDF
Background
Unplanned extubation (UE) of patients requiring mechanical ventilation in an intensive care unit (ICU) is associated with poor outcomes for patients and organizations. This study was conducted to assess the clinical features of patients who experienced UE and to determine the risk factors affecting reintubation after UE in an ICU.
Methods
Among all adult patients admitted to the ICU in our institution who required mechanical ventilation between January 2011 and December 2013, those in whom UE was noted were included in the study. Data were categorized according to noninvasive or invasive management after UE.
Results
The rate of UE was 0.78% (the number of UEs per 100 days of mechanical ventilation). The incidence of self-extubation was 97.2%, while extubation was accidental in the remaining patients. Two cases of cardiac arrest combined with respiratory arrest after UE were noted. Of the 214 incidents, 54.7% required invasive management after UE. Long duration of mechanical ventilation (odds ratio [OR] 1.52; 95% confidence interval [CI] 1.32-1.75; p = 0.000) and high ICU mortality (OR 4.39; 95% CI 1.33-14.50; p = 0.015) showed the most significant association with invasive management after UE. In multivariate analysis, younger age (OR 0.96; 95% CI 0.93-0.99; p = 0.005), medical patients (OR 4.36; 95% CI 1.95-9.75; p = 0.000), use of sedative medication (OR 4.95; 95% CI 1.97-12.41; p = 0.001), large amount of secretion (OR 2.66; 95% CI 1.01-7.02; p = 0.049), and low PaO2/FiO2 ratio (OR 0.99; 95% CI 0.98-0.99; p = 0.000) were independent risk factors of invasive management after UE.
Conclusions
To prevent unfavorable clinical outcomes, close attention and proper ventilatory support are required for patients with risk factors who require invasive management after UE.

Citations

Citations to this article as recorded by  
  • Re-Intubation Among Critical Care Patients: A Scoping Review
    Thandar Soe Sumaiyah Jamaludin, Mohd Said Nurumal, Nur Syila Syahida Syaziman, Syuhada Suhaimi, Muhammad Kamil Che Hasan
    INTERNATIONAL JOURNAL OF CARE SCHOLARS.2021; 4(Supp1): 93.     CrossRef
Case Reports
Cardiology/Pulmonary
Complicated Pulmonary Pseudocyst Following Traumatic Lung Injury Rescued by Extracorporeal Membrane Oxygenation
Sung Bum Park, Dae Sang Lee, Jeong Am Ryu, Jong Ho Cho, Yang Hyun Cho, Chi Ryang Chung, Jeong Hoon Yang, Kyeongman Jeon, Gee Young Suh, Chi Min Park
Korean J Crit Care Med. 2014;29(3):201-206.   Published online August 31, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.3.201
  • 4,993 View
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AbstractAbstract PDF
Traumatic pulmonary pseudocyst is a rare complication of blunt chest trauma that usually appears immediately in children or young adults and is characterized by a single or multiple pulmonary cystic lesions on chest radiography and has spontaneous resolution of the radiologic manifestations. However, we experienced a case of a delayed complicated pulmonary pseudocyst in a 17-year-old boy following severe traumatic acute respiratory distress syndrome rescued by Veno-venous extracorporeal membrane oxygenation (ECMO). In this case, the pseudocyst appeared on the 12th day after trauma and transformed into an infected cyst. Veno-venous ECMO was successfully maintained for 20 days without anticoagulation.
Cardiology
Use of Extracorporeal Membrane Oxygenation for Optimal Organ Donation
Jeong Hoon Yang, Yang Hyun Cho, Chi Ryang Chung, Kyeongman Jeon, Chi Min Park, Gee Young Suh
Korean J Crit Care Med. 2014;29(3):194-196.   Published online August 31, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.3.194
  • 4,484 View
  • 59 Download
  • 2 Citations
AbstractAbstract PDF
We report a case of extracorporeal membrane oxygenation (ECMO) support for donor organ preservation in a brain-dead patient following out-of-hospital cardiac arrest. A 43-year-old male patient was referred to the emergency department after an out-of-hospital cardiac arrest caused by ventricular fibrillation. Spontaneous circulation was restored after 8 minutes of cardiopulmonary resuscitation. ECMO was implemented because of hemodynamic deterioration. The patient then underwent coronary angiography and was implanted with a drug-eluting stent because of occlusion at the proximal portion of the right coronary artery. After 144 hours, brain death was established, and ECMO support for optimal oxygen delivery was sustained until organ retrieval after consent for donation was received from the family. Liver and kidneys were successfully transplanted to three recipients, respectively.

Citations

Citations to this article as recorded by  
  • Extracorporeal Membrane Oxygenation for the Support of a Potential Organ Donor with a Fatal Brain Injury before Brain Death Determination
    Sung Wook Chang, Sun Han, Jung Ho Ko, Jae-Wook Ryu
    Korean Journal of Critical Care Medicine.2016; 31(2): 169.     CrossRef
  • The Use of Extracorporeal Circulation in Suspected Brain Dead Organ Donors with Cardiopulmonary Collapse
    Hyun Lee, Yang Hyun Cho, Kiick Sung, Jeong Hoon Yang, Chi Ryang Chung, Kyeongman Jeon, Gee Young Suh
    Journal of Korean Medical Science.2015; 30(12): 1911.     CrossRef
Original Articles
Cardiology
Inter-Hospital Transportation of Patients on Extracorporeal Life Support: A Single Center Experience
Yang Hyun Cho, Ji Hyuk Yang, Jin Ho Choi, Jeong Hoon Yang, Kyeongman Jeon, Chi Ryang Chung, Gee Young Suh
Korean J Crit Care Med. 2014;29(2):83-87.   Published online May 31, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.2.83
  • 4,413 View
  • 56 Download
  • 3 Citations
AbstractAbstract PDF
Background
Extracorporeal life support (ECLS) is an effective life-saving tool for patients in refractory cardiac or respiratory failure. Although transportation of patients on ECLS is challenging, it is necessary in some instances. We report our initial experience of transporting patients on ECLS.
Methods
The study period was between January 2004 and August 2013. We reviewed our ECLS database and identified four patients who were transported to our institution on ECLS. We excluded patients who were not transported by our ECLS team.
Results
There were no clinically significant events during transportation. ECLS indications included acute respiratory distress syndrome in two patients, stress-induced cardiomyopathy induced by pneumonia sepsis in one patient, and cardiac arrest caused by amyloid cardiomyopathy in another patient. One patient was transported by helicopter and three patients were transported in an oversized ambulance. Three patients were successfully weaned off ECLS and discharged without significant complications.
Conclusions
Inter-hospital transport can be safely performed by an experienced ECLS team. Successful transport may improve patient outcome and the ECLS programs of both referring and referral hospitals.

Citations

Citations to this article as recorded by  
  • Outcomes of Urgent Interhospital Transportation for Extracorporeal Membrane Oxygenation Patients
    Jun Tae Yang, Hyoung Soo Kim, Kun Il Kim, Ho Hyun Ko, Jung Hyun Lim, Hong Kyu Lee, Yong Joon Ra
    Journal of Chest Surgery.2022; 55(6): 452.     CrossRef
  • Outcomes of transported and in-house patients on extracorporeal life support: a propensity score-matching study
    Heemoon Lee, Kiick Sung, Gee Young Suh, Chi Ryang Chung, Jeong Hoon Yang, Kyeongman Jeon, Keumhee Chough Carriere, Joong Hyun Ahn, Yang Hyun Cho
    European Journal of Cardio-Thoracic Surgery.2019;[Epub]     CrossRef
  • Inter-Facility Transport on Extracorporeal Life Support: Clinical Outcomes and Comparative Analysis with In-house Patients
    Tae Hee Hong, Heemoon Lee, Jae Jun Jung, Yang Hyun Cho, Kiick Sung, Ji-Hyuk Yang, Young-Tak Lee, Su Hyun Cho, R.N.
    The Korean Journal of Thoracic and Cardiovascular Surgery.2017; 50(5): 363.     CrossRef
Pulmonary/Surgery
Safety and Feasibility of Percutaneous Dilatational Tracheostomy Performed by Intensive Care Trainee
Daesang Lee, Chi Ryang Chung, Sung Bum Park, Jeong Am Ryu, Joongbum Cho, Jeong Hoon Yang, Chi Min Park, Gee Young Suh, Kyeongman Jeon
Korean J Crit Care Med. 2014;29(2):64-69.   Published online May 31, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.2.64
  • 4,427 View
  • 74 Download
  • 9 Citations
AbstractAbstract PDF
Background
Percutaneous dilatational tracheostomy (PDT) performed by an intensivist in critically ill patients is currently popular. Many studies support the safety and feasibility of PDT. However, there is limited data on the safety and feasibility of PDT performed by intensive care trainees.
Methods
To evaluate the safety and feasibility of PDT performed by intensive care trainees and to compare these with those performed by intensivists, we retrospectively analyzed the clinical characteristics and adverse events of all prospectively registered patients who underwent PDT by ICT or intensivists in intensive care units (ICUs) from August 2010 to August 2013.
Results
In the study period, 203 patients underwent PDT in ICUs; 139 (68%) by trainees and 64 (32%) by intensivists. There were no statistically significant differences in clinical characteristics including demographics, laboratory findings, and parameters of mechanical ventilation between the two groups. Procedure times and outcomes of the patients were not different between the two groups. The majority of complications observed in 24 hours after PDT were bleeding; however, there was no significant difference between the two groups (trainee 10.8% vs. intensivist 9.4%, p = 0.758). There was no procedure-related death in the two groups.
Conclusions
PDT performed by intensive care trainees was safe and feasible. However, further well-designed studies should be conducted to confirm our results.

Citations

Citations to this article as recorded by  
  • Comparison of Conventional Surgical Tracheostomy and Percutaneous Dilatational Tracheostomy in the Neurosurgical Intensive Care Unit
    Sungdae Lim, Hyun Park, Ja Myoung Lee, Kwangho Lee, Won Heo, Soo-Hyun Hwang
    Korean Journal of Neurotrauma.2022; 18(2): 246.     CrossRef
  • Prediction of successful de-cannulation of tracheostomised patients in medical intensive care units
    Chul Park, Ryoung-Eun Ko, Jinhee Jung, Soo Jin Na, Kyeongman Jeon
    Respiratory Research.2021;[Epub]     CrossRef
  • Severe pain-related adverse events of percutaneous dilatational tracheostomy performed by a neurointensivist compared with conventional surgical tracheostomy in neurocritically ill patients
    Yong Oh Kim, Chi Ryang Chung, Chi-Min Park, Gee Young Suh, Jeong-Am Ryu
    BMC Neurology.2020;[Epub]     CrossRef
  • Is percutaneous dilatational tracheostomy with bronchoscopic guidance better than without?
    Jinsun Chang, Hong-Joon Shin, Yong-Soo Kwon, Yu-Il Kim, Sung-Chul Lim, Tae-Ok Kim
    Acute and Critical Care.2020; 35(2): 127.     CrossRef
  • Safety and feasibility of ultrasound-guided insertion of peripherally inserted central catheter performed by an intensive care trainee
    Yongwoo Lee, Jeong-Am Ryu, Yong Oh Kim, Eunmi Gil, Young-Mok Song
    Journal of Neurocritical Care.2020; 13(1): 41.     CrossRef
  • Safety and Feasibility of Percutaneous Dilatational Tracheostomy Performed by a Neurointensivist Compared with Conventional Surgical Tracheostomy in Neurosurgery Intensive Care Unit
    John Kwon, Yong Oh Kim, Jeong-Am Ryu
    Journal of Neurointensive Care.2019; 2(2): 64.     CrossRef
  • Safety and Feasibility of Percutaneous Dilatational Tracheostomy in the Neurocritical Care Unit
    Dong Hyun Lee, Jin-Heon Jeong
    Journal of Neurocritical Care.2018; 11(1): 32.     CrossRef
  • Percutaneous Dilatational Tracheostomy in Critically Ill Patients Taking Antiplatelet Agents
    Sung-Jin Nam, Ji Young Park, Hongyeul Lee, Taehoon Lee, Yeon Joo Lee, Jong Sun Park, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Young-Jae Cho
    Korean Journal of Critical Care Medicine.2014; 29(3): 183.     CrossRef
  • Is Percutaneous Dilatational Tracheostomy Safe to Perform in the Intensive Care Unit?
    Jae Hwa Cho
    Korean Journal of Critical Care Medicine.2014; 29(2): 57.     CrossRef
Case Report
Gastroenterology/Pulmonary
Respiratory Complications Associated with Insertion of Small-Bore Feeding Tube in Critically Ill Patients
Jeong Am Ryu, Joongbum Cho, Sung Bum Park, Daesang Lee, Chi Ryang Chung, Jeong Hoon Yang, Kyeongman Jeon, Gee Young Suh, Chi Min Park
Korean J Crit Care Med. 2014;29(2):131-136.   Published online May 31, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.2.131
  • 6,636 View
  • 67 Download
  • 3 Citations
AbstractAbstract PDF
Small-bore flexible feeding tubes decrease the risk of ulceration of the nose, pharynx, and stomach compared with large-bore and more rigid tubes. However, small-bore feeding tubes have more respiratory system complications, such as pneumothorax, hydropneumothorax, bronchopleural fistula, and pneumonia, which are associated with significant morbidity and mortality. Thus, it is important to confirm the correct position of feeding tubes. Chest X-ray is the gold standard to detect tracheal malpositioning of the feeding tube. We present three cases in which intubated patients exhibited an altered mental state. An assistant guide wire was used at the insertion of small-bore feeding tubes. These conditions are thought to be potential risk factors for tracheobronchial malpositioning of feeding tubes.

Citations

Citations to this article as recorded by  
  • Clinical usefulness of capnographic monitoring when inserting a feeding tube in critically ill patients: retrospective cohort study
    Jeong-Am Ryu, Kyoungjin Choi, Jeong Hoon Yang, Dae-Sang Lee, Gee Young Suh, Kyeongman Jeon, Joongbum Cho, Chi Ryang Chung, Insuk Sohn, Kiyoun Kim, Chi-Min Park
    BMC Anesthesiology.2016;[Epub]     CrossRef
  • Nutritional Assessment of ICU Inpatients with Tube Feeding
    Yu-Jin Kim, Jung-Sook Seo
    Journal of the Korean Dietetic Association.2015; 21(1): 11.     CrossRef
  • Respiratory Complications of Small-Bore Feeding Tube Insertion in Critically Ill Patients
    Kyoung-Jin Choi, Jeong-Am Ryu, Chi-Min Park
    JOURNAL OF ACUTE CARE SURGERY.2015; 5(1): 28.     CrossRef
Review
Hormonal Changes in Critical Condition
Heung Bum Lee, Chi Ryang Chung
Korean J Crit Care Med. 2010;25(3):123-129.
DOI: https://doi.org/10.4266/kjccm.2010.25.3.123
  • 2,247 View
  • 28 Download
  • 1 Citations
AbstractAbstract PDF
When disease or trauma progresses to a critical state, the reaction of the endocrine system in creating homeostasis is essential for survival. The association between the severity of hormonal changes and outcome in terms of morbidity and mortality has led to the challenge of development of several endocrine treatments. During sepsis, nitric oxide-mediated apoptosis is observed in the neurons and glial cells of the cerebrovascular centers of the autonomic nervous system. It is probably one of the components of the circulatory dysfunction of sepsis. The regulation of different organs was neither linear nor independent however organs were found to behave as biological oscillators coupled to each other through neurological or hormonal communication pathways. Sepsis, because of systemic inflammatory responsive syndrome, disrupts these communication pathways and leads to organ failures. Endocrine hormonal issues related to the intensive care setting are common challenges to ICU specialists. Disruptions of the endocrine system in sepsis are characterized by 1) an increase in cortisol plasma levels with a loss of the circadian rhythm of its secretion; 2) hyperglycemia due to insulin resistance and rise in hyperglycemic hormones secretion; 3) relative vasopressin deficiency; and 4) euthyroid sick syndrome or non-thyroidal illness syndrome. This article discusses the dynamic changes of four main endocrine axes: hypothalamic-pituitary-adrenal axis, insulin, vasopressin and thyroid during grave states of disease, when a patient is in critical condition.

Citations

Citations to this article as recorded by  
  • The Changing Pattern of Blood Glucose Levels and Its Association with In-hospital Mortality in the Out-of-hospital Cardiac Arrest Survivors Treated with Therapeutic Hypothermia
    Ki Tae Kim, Byung Kook Lee, Hyoung Youn Lee, Geo Sung Lee, Yong Hun Jung, Kyung Woon Jeung, Hyun Ho Ryu, Byoeng Jo Chun, Jeong Mi Moon
    Korean Journal of Critical Care Medicine.2012; 27(4): 255.     CrossRef

ACC : Acute and Critical Care