Acute and Critical Care

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

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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

Risk factors for neurological disability outcomes in patients under extracorporeal membrane oxygenation following cardiac arrest: An observational study
Amir Vahedian-Azimi, Ibrahim Fawzy Hassan, Farshid Rahimi-Bashar, Hussam Elmelliti, Anzila Akbar, Ahmed Labib Shehata, Abdulsalam Saif Ibrahim, Ali Ait Hssain
Intensive and Critical Care Nursing.2024; 83: 103674. CrossRef
What factors are effective on the CPR duration of patients under extracorporeal cardiopulmonary resuscitation: a single-center retrospective study
Amir Vahedian-Azimi, Ibrahim Fawzy Hassan, Farshid Rahimi-Bashar, Hussam Elmelliti, Anzila Akbar, Ahmed Labib Shehata, Abdulsalam Saif Ibrahim, Ali Ait Hssain
International Journal of Emergency Medicine.2024;[Epub] CrossRef
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

Editorial

Hepatic dysfunction in critically ill patients: Jeong Hoon Yang; Acute Crit Care. 2020;35(1):44-45. Published online February 29, 2020; DOI: https://doi.org/10.4266/acc.2020.00052

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Case Report

Basic science and research
Spinal Cord Infarction in a Patient Undergoing Veno-arterial Extracorporeal Membrane Oxygenation: Beomsu Shin, Yang Hyun Cho, Jin-Ho Choi, Jeong Hoon Yang; Acute Crit Care. 2018;33(3):187-190. Published online August 31, 2018; DOI: https://doi.org/10.4266/acc.2016.00556

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Abstract PDF

Spinal cord infarction is an uncommon, but serious disorder characterized by severe motor impairment and bladder and bowel dysfunction. Spinal cord infarction is likely caused by hypoperfusion at the thoraco-lumbar spinal cord due to diverse reasons. An 81-year-old woman without motor or neurologic dysfunction presented with cardiogenic shock due to acute myocardial infarction. We performed veno-arterial extracorporeal membrane oxygenation (VA ECMO) to maintain adequate organ perfusion. Lower limb weakness was noted on day 1 of ECMO support. Although the symptom persisted, we could not carry out further evaluation because of her hemodynamic instability. After removal of ECMO, spinal magnetic resonance imaging was performed and showed a signal abnormality extending from the level of T5 to the conus medullaris. The patient underwent conservative management, but eventually experienced limb paralysis. Herein, we report a case of spinal cord infarction in a patient with myocardial infarction during VA ECMO support.

Citations

Citations to this article as recorded by

Neurological Complications of the Lower Extremities After Femoral Cannulated Extracorporeal Membrane Oxygenation: A Systematic Review
Frauke Johannes, Rahel Frohofer-Vollenweider, Yvonne Teuschl
Journal of Intensive Care Medicine.2024; 39(6): 534. CrossRef
In patients supported with peripheral veno-arterial extracorporeal membrane oxygenation, what factors are associated with the development of spinal cord ischaemia?
Alison Zhu, Charis Tan, Richard Chard, Yishay Orr
Interdisciplinary CardioVascular and Thoracic Surgery.2024;[Epub] CrossRef
Spinal Cord Infarction During Extracorporeal Membrane Oxygenation：A Case Series and Review of the Literature
Hui Meng, Fang He, Xianrang Yan, Lanchun Chen, Xiaohong lin, Xiaolong She, Xuetao Yu
Journal of Intensive Care Medicine.2024; 39(12): 1274. CrossRef
Spinal Cord Injury Following Venoarterial Extracorporeal Membrane Oxygenation: A Scoping Review
Eric Bain, Roopa Rao, Maya Guglin
Journal of Cardiothoracic and Vascular Anesthesia.2024;[Epub] CrossRef
Spinal cord infarction after withdrawal of veno-arterial extracorporeal membrane oxygenation for cardiogenic shock: A case report
Hideya Itagaki, Kohei Suzuki, Tomoya Oizumi, Keiko Nakagawa, Yoshinobu Abe, Tomoyuki Endo
Medicine.2022; 101(45): e31743. CrossRef
Imaging Adult ECMO
Ramya Gaddikeri, Jennifer Febbo, Palmi Shah
Current Problems in Diagnostic Radiology.2021; 50(6): 884. CrossRef
Extracorporeal membrane oxygenation-related spinal cord infarction: A case report
Shih-Chao Chien, Li-Kuo Kuo, Shih-Chun Chien, Yu-Jang Su
Interdisciplinary Neurosurgery.2021; 23: 101028. CrossRef
Spinal Cord Infarction During Femoral Venoarterial Extracorporeal Membrane Oxygenation
Michael Salna, James Beck, Josh Willey, Koji Takeda
The Annals of Thoracic Surgery.2021; 111(4): e279. CrossRef
Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, Jacob Gutsche
Journal of Cardiothoracic and Vascular Anesthesia.2021; 35(12): 3496. CrossRef
Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: An Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, Jacob Gutsche
Anesthesia & Analgesia.2021;[Epub] CrossRef
Spinal cord infarction and peripheral extracorporeal membrane oxygenation: a case series
Shivanand Gangahanumaiah, Michael Zhu, Robyn Summerhayes, Silvana F Marasco, Kyriakos Dimitriadis, Milenko Zoran Cankovic, Vasilios Giampatzis, Panagiotis Xaplanteris, Hibba Kurdi, Aiste Monika Jakstaite
European Heart Journal - Case Reports.2021;[Epub] CrossRef

Letter to the Editor

CPR/Resuscitation
Refractory Ventricular Arrhythmia Induced by Aconite Intoxication and Its Treatment with Extracorporeal Cardiopulmonary Resuscitation: Mi Kyoung Hong, Jeong Hoon Yang, Chi-Ryang Chung, Jinkyeong Park, Gee Young Suh, Kiick Sung, Yang Hyun Cho; Korean J Crit Care Med. 2017;32(2):228-230. Published online May 31, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00017

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Citations

Citations to this article as recorded by

A Narrative Review of Aconite Poisoning and Management
Christine Lawson, Daniel J. McCabe, Ryan Feldman
Journal of Intensive Care Medicine.2024;[Epub] CrossRef
Extracorporeal cardio-pulmonary resuscitation in poisoning: A scoping review article
Mingwei Ng, Zi Yang Wong, R. Ponampalam
Resuscitation Plus.2023; 13: 100367. CrossRef
Accidental poisoning with Aconitum: Case report and review of the literature
Giuseppe Bonanno, Mariachiara Ippolito, Alessandra Moscarelli, Giovanni Misseri, Rosaria Caradonna, Giuseppe Accurso, Andrea Cortegiani, Antonino Giarratano
Clinical Case Reports.2020; 8(4): 696. CrossRef

Case Reports

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

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Abstract 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

Gastric Mucormycosis: A Systematic Review with Metadata
Ayman M. Mustafa, Diyar A. Omar, Khanda A. Anwar, Rawa M. Ali, Dilan S. Hiwa, Deari A. Ismaeil, Karzan M. Hasan, Karokh F. Hama Hussein, Dana T. Gharib, Hoshmand R. Asaad, Ali H. Hasan, Yousif M. Mahmood, Mohammed Q. Mustafa
Barw Medical Journal.2024;[Epub] CrossRef
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

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Abstract 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

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Abstract 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

Thoracic Surgery
Subclavian Artery Laceration Caused by Pigtail Catheter Removal in a Patient with Pneumothorax: Hyo Jin Kim, Yang Hyun Cho, Gee Young Suh, Jeong Hoon Yang, Kyeongman Jeon; Korean J Crit Care Med. 2015;30(2):119-122. Published online May 31, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.2.119

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Abstract PDF

We report a case of subclavian artery laceration caused by the removal of a pigtail pleural drainage catheter in a patient with a pneumothorax. The patient was successfully resuscitated through diagnostic angiography with subsequent balloon occlusion and primary repair of the injured subclavian artery. Although pigtail drainage of a pneumothorax is known to be safe and effective, proper insertion and removal techniques should be emphasized to reduce the risk of complications.

Citations

Citations to this article as recorded by

A randomised controlled trial of intrapleural balloon intercostal chest drains to prevent drain displacement
Rachel M. Mercer, Eleanor Mishra, Radhika Banka, John P. Corcoran, Cyrus Daneshvar, Rakesh K. Panchal, Tarek Saba, Melanie Caswell, Sarah Johnstone, Daniel Menzies, Sana Ahmer, Mitra Shahidi, Amelia O. Clive, Manish Gautam, Giles Cox, Chris Orton, Judith
European Respiratory Journal.2022; 60(1): 2101753. CrossRef
AN UNUSUAL COMPLICATION OF PIGTAIL CATHETER: COLONIC PENETRATION
Yakup Ülger, Anıl Delik
Gastroenterology Nursing.2021; 44(6): 463. CrossRef
Median Sternotomy for the Management of Life-Threatening Bleeding Resulting from Proximal Upper Extremity Amputation
Hyunseong Kang, Gyu Bum Seo, Su Wan Kim
Journal of Acute Care Surgery.2020; 10(2): 58. CrossRef

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

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Abstract 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

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Abstract 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

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Abstract 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

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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

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Abstract 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

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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 Reports

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

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Abstract 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

Cardiology
Successful Use of a Peripheral Extracorporeal Membrane Oxygenator in a Patient with Chronic Heart Failure and Pneumonia: Ji Hyun Lee, Yang Hyun Cho, Gee Young Suh, Jeong Hoon Yang; Korean J Crit Care Med. 2014;29(1):52-56. Published online February 28, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.1.52

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Abstract PDF: Myocardial dysfunction can occur during severe sepsis and may accelerate in the condition of chronic decompensated heart failure. A 26-year-old female in remission from non-Hodgkin’s lymphoma presented with shock due to chronic heart failure combined with pneumonia. The patient was initially stabilized using a peripheral extracorporeal membrane oxygenator (ECMO) with antibiotics therapy, followed by left ventricular venting due to pulmonary edema that was complicated by left ventricular distension. Here, we report the successful application of ECMO to a patient with pneumonia underlying doxorubicin-induced cardiomyopathy. Although septic conditions remained unclear indication of ECMO, it might be considered a valuable therapeutic option in patients with chronic heart failure.

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