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6 "In Seok Jeong"
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Guideline
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
  • 3,808 View
  • 663 Download
AbstractAbstract PDFSupplementary 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.
Editorial
CPR/Resuscitation
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 Crit Care. 2023;38(2):242-243.   Published online May 31, 2023
DOI: https://doi.org/10.4266/acc.2023.00731
  • 930 View
  • 55 Download
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Review Article
Basic science and research
Extracorporeal circulation models in small animals: beyond the limits of preclinical research
Mukhammad Kayumov, Reverien Habimana, Dowan Kim, Francis O Obiweluozor, In Seok Jeong, Hwa Jin Cho
Acute Crit Care. 2023;38(1):1-7.   Published online February 28, 2023
DOI: https://doi.org/10.4266/acc.2023.00381
  • 2,410 View
  • 201 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Extracorporeal membrane oxygenation (ECMO) use has remarkably increased in recent years. Although ECMO has become essential for patients with refractory cardiac and respiratory failure, extracorporeal circulation (ECC) is associated with significant complications. Small-animal models of ECC have been developed and widely used to better understand ECC-induced pathophysiology. This review article summarizes the development of small-animal ECC models, including the animal species, circuit configuration, priming, perioperative procedures, cannulation, and future perspectives of small-animal ECMO models.

Citations

Citations to this article as recorded by  
  • Venoarterial Extracorporeal Membrane Oxygenation Implementation in Septic Shock Rat Model
    Tianlong Wang, Mingru Zhang, Wenhao Dong, Jing Wang, Han Zhang, Yuefu Wang, Bingyang Ji
    ASAIO Journal.2024;[Epub]     CrossRef
  • Multiorgan recovery in a cadaver body using mild hypothermic ECMO treatment in a murine model
    Nodir Madrahimov, Vitalii Mutsenko, Ruslan Natanov, Dejan Radaković, André Klapproth, Mohamed Hassan, Mathias Rosenfeldt, Florian Kleefeldt, Ivan Aleksic, Süleyman Ergün, Christoph Otto, Rainer G. Leyh, Constanze Bening
    Intensive Care Medicine Experimental.2023;[Epub]     CrossRef
  • Post-Mortem Extracorporeal Membrane Oxygenation Perfusion Rat Model: A Feasibility Study
    Matthias Manfred Deininger, Carl-Friedrich Benner, Lasse Johannes Strudthoff, Steffen Leonhardt, Christian Simon Bruells, Gernot Marx, Christian Bleilevens, Thomas Breuer
    Animals.2023; 13(22): 3532.     CrossRef
Case Report
Cardiology/Pediatric
Transfusion Associated Hyperkalemia and Cardiac Arrest in an Infant after Extracorporeal Membrane Oxygenation
Do Wan Kim, Kyeong Ryeol Cheon, Duck Cho, Kyo Seon Lee, Hwa Jin Cho, In Seok Jeong
Korean J Crit Care Med. 2015;30(2):132-134.   Published online May 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.2.132
  • 7,684 View
  • 96 Download
  • 5 Crossref
AbstractAbstract PDF
Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.

Citations

Citations to this article as recorded by  
  • Transfusion-associated graft-versus-host disease, transfusion-associated hyperkalemia, and potassium filtration: advancing safety and sufficiency of the blood supply
    Kenneth E. Nollet, Alain M. Ngoma, Hitoshi Ohto
    Transfusion and Apheresis Science.2022; 61(2): 103408.     CrossRef
  • Transfusion-Associated Hyperkalemic Cardiac Arrest in Neonatal, Infant, and Pediatric Patients
    Morgan Burke, Pranava Sinha, Naomi L. C. Luban, Nikki Gillum Posnack
    Frontiers in Pediatrics.2021;[Epub]     CrossRef
  • Double-filtered leukoreduction as a method for risk reduction of transfusion-associated graft-versus-host disease
    Sejong Chun, Minh-Trang Thi Phan, Saetbyul Hong, Jehoon Yang, Yeup Yoon, Sangbin Han, Jungwon Kang, Mark H. Yazer, Jaehyun Kim, Duck Cho, Senthilnathan Palaniyandi
    PLOS ONE.2020; 15(3): e0229724.     CrossRef
  • Anticoagulation Therapy during Extracorporeal Membrane Oxygenator Support in Pediatric Patients
    Hwa Jin Cho, Do Wan Kim, Gwan Sic Kim, In Seok Jeong
    Chonnam Medical Journal.2017; 53(2): 110.     CrossRef
  • Blood Transfusion Strategies in Patients Supported by Extracorporeal Membrane Oxygenation
    Yoon Hee Kim
    The Korean Journal of Critical Care Medicine.2015; 30(3): 139.     CrossRef
Original Article
Cardiology/Neurology
Efficacy of Electroencephalographic Monitoring for the Evaluation of Intracranial Injury during Extracorporeal Membrane Oxygenation Support in Neonates and Infants
In Seok Jeong, Young Jong Woo, Do Wan Kim, Nan Yeol Kim, Hwa Jin Cho, Jae Sook Ma
Korean J Crit Care Med. 2014;29(2):70-76.   Published online May 31, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.2.70
  • 5,001 View
  • 43 Download
  • 2 Crossref
AbstractAbstract PDF
Background
Neurological complications are a serious concern during extracorporeal membrane oxygenation (ECMO) support in neonates and infants. However, evaluating brain injury during ECMO has limitations. Herein, we report our experience with bedside electroencephalographic monitoring during ECMO support and compared this to post-ECMO brain imaging studies and immediate neurologic outcomes.
Methods
We retrospectively reviewed the data for 18 children who underwent ECMO. From these subjects, we reviewed the medical records of 10 subjects who underwent bedside EEG monitoring during ECMO support. We collected data on patient demographics, clinical details of the ECMO course, electroencephalographic monitoring, brain imaging results, and neurologic outcomes.
Results
The median age was 4 months (range: 7 days-22 months), the median weight was 5 (3.6-12) kg, and the median length of ECMO therapy was 86 (27-206) hours. Eight patients (80%) were weaned successfully, and seven (70%) survived to discharge. Those with normal to mildly abnormal electroencephalographic findings had non-specific to mildly abnormal brain computed tomography findings and no neurologic impairment. Those patients with a moderately to severely abnormal electroencephalograph had markedly abnormal brain computed tomography findings and remained neurologically impaired.
Conclusions
Normal electroencephalographic findings are closely related to normal or mild neurologic impairment. Our results indicate that electroencephalographic monitoring during ECMO support can be a feasible tool for evaluating brain injury although further prospective studies are needed.

Citations

Citations to this article as recorded by  
  • Neurological monitoring in ECMO patients: current state of practice, challenges and lessons
    Hassan Aboul-Nour, Ammar Jumah, Hafsa Abdulla, Amreeta Sharma, Bradley Howell, Namita Jayaprakash, Jayna Gardner-Gray
    Acta Neurologica Belgica.2023; 123(2): 341.     CrossRef
  • Neurological Monitoring and Complications of Pediatric Extracorporeal Membrane Oxygenation Support
    Ahmed S. Said, Kristin P. Guilliams, Melania M. Bembea
    Pediatric Neurology.2020; 108: 31.     CrossRef
Case Report
Fatal Left Ventricular Thrombosis in an Infant Receiving Extracorporeal Membrane Oxygenation Support: A Case Report
Hwa Jin Cho, Byung Young Kim, Eun Song Song, Sang Gi Oh, Bong Suk Oh, In Seok Jeong
Korean J Crit Care Med. 2013;28(2):123-126.
DOI: https://doi.org/10.4266/kjccm.2013.28.2.123
  • 3,143 View
  • 16 Download
  • 2 Crossref
AbstractAbstract PDF
Thromboembolism in patients receiving extracorporeal membrane oxygenation (ECMO) support is a feared complication. Systemic anticoagulation during ECMO in patients with a massively dilated left ventricle (LV) and decreased LV systolic function is still debated. Hearin, we report a case of a 5-month old infant on ECMO support who had fatal thrombus formation in the massively dilated LV and a consequent thromboembolic event.

Citations

Citations to this article as recorded by  
  • Activated Partial Thromboplastin Time Versus Anti-Factor Xa Monitoring of Heparin Anticoagulation in Adult Venoarterial Extracorporeal Membrane Oxygenation Patients
    Caitlin E. Kulig, Kendra J. Schomer, Hugh B. Black, William E. Dager
    ASAIO Journal.2021; 67(4): 411.     CrossRef
  • Anticoagulation Therapy during Extracorporeal Membrane Oxygenator Support in Pediatric Patients
    Hwa Jin Cho, Do Wan Kim, Gwan Sic Kim, In Seok Jeong
    Chonnam Medical Journal.2017; 53(2): 110.     CrossRef

ACC : Acute and Critical Care