Acute and Critical Care

Erratum

Surgery
Erratum to "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(2):250-250. Published online May 25, 2023; DOI: https://doi.org/10.4266/acc.2022.01515.e1; Corrects: Acute Crit Care 2023;38(1):21

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Original Articles

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

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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

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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

Trauma
Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture: Kang Min Kim, Myoung Jun Kim, Jae Sik Chung, Ji Wool Ko, Young Un Choi, Hongjin Shim, Ji Young Jang, Keum Seok Bae, Kwangmin Kim; Acute Crit Care. 2022;37(2):247-255. Published online April 22, 2022; DOI: https://doi.org/10.4266/acc.2021.01396

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Abstract PDF

Background
Several recent studies have shown that preperitoneal pelvic packing (PPP) effectively produces hemostasis in patients with unstable pelvic fractures. However, few studies have examined the rate of surgical site infections (SSIs) in patients undergoing PPP following an unstable pelvic fracture. The purpose of the present study was to evaluate factors associated with SSI in such patients.
Methods
We retrospectively reviewed the medical charts of 188 patients who developed hemorrhagic shock due to pelvic fracture between April 2012 and May 2021. Forty-four patients were enrolled in this study.
Results
SSI occurred in 15 of 44 patients (34.1%). The SSIs occurred more frequently in cases of repacking during the second-look surgery (0 vs. 4 [26.7%], P=0.010) and combined bladder-urethra injury (1 [3.4%] vs. 4 [26.7%], P=0.039). The incidence of SSIs was not significantly different between patients undergoing depacking within or after 48 hours (12 [41.4%] vs. 5 [33.3%], P=0.603). The mean time to diagnosis of SSI was 8.1±3.9 days from PPP. The most isolated organism was Staphylococcus epidermidis.
Conclusions
Repacking and combined bladder-urethra injury are potential risk factors for SSI in patients with unstable pelvic fracture. Close observation is recommended for up to 8 days in patients with these risk factors. Further, 48 hours after PPP, removing the packed gauze on cessation of bleeding and not performing repacking can help prevent SSI. Additional analyses are necessary with a larger number of patients with the potential risk factors identified in this study.

Citations

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Angioembolization Has Similar Efficacy and Lower Total Charges than Preperitoneal Pelvic Packing in Patients with Pelvic Ring or Acetabulum Fractures
Aaron Singh, Travis Kotzur, Ezekial Koslosky, Rishi Gonuguntla, Lorenzo Canseco, David Momtaz, Ali Seifi, Case Martin
Journal of Orthopaedic Trauma.2024;[Epub] CrossRef
Factors Associated With Pelvic Infection After Pre-Peritoneal Pelvic Packing for Hemodynamically Unstable Pelvic Fractures
Jennifer E. Baker, Husayn A. Ladhani, Caitlyn McCall, Chelsea R. Horwood, Nicole L. Werner, Barry Platnick, Clay Cothren Burlew
Surgical Infections.2024; 25(5): 399. CrossRef
Comparison of Conventional versus Modified Preperitoneal Pelvic Packing in Patients with Bleeding Pelvic Fractures: A Single-Center Retrospective Pilot Study
Sebeom Jeon, Byungchul Yu, Gil Jae Lee, Min A Lee, Jungnam Lee, Kang Kook Choi
Journal of Clinical Medicine.2024; 13(14): 4062. CrossRef
Current Management of Hemodynamically Unstable Patients with Pelvic Fracture
Kevin Harrell, Chelsea Horwood, Clay Cothren Burlew
Current Surgery Reports.2023; 11(4): 92. CrossRef
Open Fixation After Preperitoneal Pelvic Packing Is Associated With a High Surgical Site Infection Rate
Ye Joon Kim, Bryan L. Scott, Fredric M. Pieracci, Ernest E. Moore, Cyril Mauffrey, Joshua A. Parry
Journal of Orthopaedic Trauma.2023; 37(11): 547. CrossRef
Extraperitoneal pelvic packing in trauma – a review
Sajad Ahmad Salati
Polish Journal of Surgery.2022; 95(3): 46. CrossRef

Nutrition
Effectiveness of a multidisciplinary team for nutrition support in a trauma intensive care unit: Eunsuk Oh, Hongjin Shim, Hyon Ju Yon, Jin Sil Moon, Dae Ryong Kang, Ji Young Jang; Acute Crit Care. 2020;35(3):142-148. Published online August 19, 2020; DOI: https://doi.org/10.4266/acc.2020.00318

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Abstract PDF

Background
We evaluated clinical and nutritional outcomes according to multidisciplinary team involvement in nutrition support in a regional trauma intensive care unit (TICU).
Methods
We retrospectively compared the outcomes for 339 patients admitted to the TICU for >5 days depending on nutrition support team (NST) involvement (n=176) and non-NST involvement (n=163).
Results
The mean age and injury severity score (ISS) were 57.3±16.7 years and 18.6±9.7, respectively. Fifty-three patients (15.6%) had shock on admission and 182 (53.7%) underwent surgery during TICU admission. Some patients were admitted to neurosurgery (46%), general surgery (35.4%), and other (18.6%) departments. There were significant differences in the ISS, Acute Physiology and Chronic Health Evaluation (APACHE) II score, shock on TICU admission, and initial laboratory results. After propensity score matching, the total delivered/required caloric ratio and total delivered/required protein ratio were significantly higher in the NST group than in the non-NST group (calorie: 80.4% vs. 66.7%, P=0.007; protein: 93.1% vs. 68.3%, P<0.001). The NST group had an adequate protein supply more frequently than the non-NST group (protein: 48.0% vs. 25.8%, P=0.002). There was no significant difference in survival, even after adjustment for risk factors using Cox proportional hazard analysis.
Conclusions
The results of our study suggest that multidisciplinary team involvement in nutrition support in TICU patients may improve nutritional, but not clinical, outcomes.

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In-Ae Song, Kyunghwa Lee, Sunghee Lee, Keonhee Kim, Tak Kyu Oh
Clinical Nutrition.2024; 43(2): 315. CrossRef
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Albert Barrocas, Denise Baird Schwartz, Bruce R. Bistrian, Peggi Guenter, Charles Mueller, Ronni Chernoff, Jeanette M. Hasse
Nutrition in Clinical Practice.2023; 38(1): 10. CrossRef
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Annals of Otology, Rhinology & Laryngology.2023; 132(8): 938. CrossRef
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Seunghyun Cheon, Sang-Hyeon Oh, Jung-Tae Kim, Han-Gon Choi, Hyojung Park, Jee-Eun Chung
Nutrients.2023; 15(11): 2531. CrossRef
Consultation pattern changes of parenteral nutrition with a multidisciplinary nutrition support team in a recently opened hospital in Korea: a retrospective cohort study
Kyoung Won Yoon, Hyo Jin Kim, Yujeong Im, Seul Gi Nam, Joo Yeon Lee, Hyo Gee Lee, Joong-Min Park
Annals of Clinical Nutrition and Metabolism.2023; 15(2): 57. CrossRef
Lipid emulsion treatment of cardiotoxicity caused by calcium channel blocker and beta-blocker
Ju-Tae Sohn
The American Journal of Emergency Medicine.2022; 58: 331. CrossRef
Physician Compliance with Nutrition Support Team Recommendations: Effects on the Outcome of Treatment for Critically Ill Patients
Hyon-Ju Yon, Eun-Suk Oh, Ji Young Jang, Ji Yun Jang, Hongjin Shim
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Korean Journal of Community Nutrition.2022; 27(2): 121. CrossRef
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Ju-Tae Sohn
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救急・集中治療領域重症患者における栄養管理
信人中西, 穣治小谷
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Image in Critical Care

Trauma
Trauma-Induced Retroperitoneal Paraganglioma Rupture Which Was Misunderstood as a Massive Retroperitoneal Hemorrhage: Hongjin Shim, Ji Young Jang, Yeong Ju Kim, Jung Soo Lim, Keum Seok Bae; Acute Crit Care. 2018;33(2):114-116. Published online April 26, 2018; DOI: https://doi.org/10.4266/acc.2017.00234

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Citations

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Acute haemoperitoneum caused by ruptured extra‐adrenal paraganglioma
Jae Im Lee, Su Lim Lee, Kyung Jin Seo
ANZ Journal of Surgery.2021;[Epub] CrossRef
Laparoscopic resection of a ruptured retroperitoneal paraganglioma
Shogo Zuo, Toshio Sawai, Hiromichi Kanehiro, Yasuhiro Kuroda, Masayuki Sho
Journal of Pediatric Surgery Case Reports.2020; 59: 101522. CrossRef

Case Report

Experiences of Wet Beriberi and Wernicke's Encephalopathy Caused by Thiamine Deficiency in Critically Ill Patients: Ji Young Jang, Hongjin Shim, Jae Gil Lee; Korean J Crit Care Med. 2013;28(2):156-159.; DOI: https://doi.org/10.4266/kjccm.2013.28.2.156

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Abstract PDF

Wet beriberi and Wernicke's encephalopathy (WE) are caused by thiamine deficiency and are potentially lethal and serious diseases. Thiamine deficiency occurs mainly due to poor oral intake or inadequate provision of thiamine in enteral or parenteral nutrition therapy. We report cases of wet beriberi and WE that developed after surgery in a surgical intensive care unit. The first patient, who was diagnosed with wet beriberi, underwent right total mastectomy and radical subtotal gastrectomy, simultaneously. The second was diagnosed with irreversible WE, respectively, due to long-term malnutrition. In both cases, intravenous replacement of thiamine was initiated after the admission to the surgical intensive care unit. However, comatose mentality of the second patient did not improve. As a result, we conclude that, if a patient's clinical feature is suspected to be thiamine deficiency, prompt intravenous thiamine replacement is needed.

Citations

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A Critical Case of Wernicke's Encephalopathy Induced by Hyperemesis Gravidarum
Byung Ju Kang, Min Gu Kim, Jwa Hoon Kim, Mingee Lee, Sang-Beom Jeon, Ha Il Kim, Jin Won Huh
The Korean Journal of Critical Care Medicine.2015; 30(2): 128. CrossRef

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