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6 "Kyung Chan Kim"
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Original Article
Pulmonary
Association between mechanical power and intensive care unit mortality in Korean patients under pressure-controlled ventilation
Jae Kyeom Sim, Sang-Min Lee, Hyung Koo Kang, Kyung Chan Kim, Young Sam Kim, Yun Seong Kim, Won-Yeon Lee, Sunghoon Park, So Young Park, Ju-Hee Park, Yun Su Sim, Kwangha Lee, Yeon Joo Lee, Jin Hwa Lee, Heung Bum Lee, Chae-Man Lim, Won-Il Choi, Ji Young Hong, Won Jun Song, Gee Young Suh
Acute Crit Care. 2024;39(1):91-99.   Published online January 26, 2024
DOI: https://doi.org/10.4266/acc.2023.00871
  • 1,115 View
  • 106 Download
AbstractAbstract PDFSupplementary Material
Background
Mechanical power (MP) has been reported to be associated with clinical outcomes. Because the original MP equation is derived from paralyzed patients under volume-controlled ventilation, its application in practice could be limited in patients receiving pressure-controlled ventilation (PCV). Recently, a simplified equation for patients under PCV was developed. We investigated the association between MP and intensive care unit (ICU) mortality. Methods: We conducted a retrospective analysis of Korean data from the Fourth International Study of Mechanical Ventilation. We extracted data of patients under PCV on day 1 and calculated MP using the following simplified equation: MPPCV = 0.098 ∙ respiratory rate ∙ tidal volume ∙ (ΔPinsp + positive end-expiratory pressure), where ΔPinsp is the change in airway pressure during inspiration. Patients were divided into survivors and non-survivors and then compared. Multivariable logistic regression was performed to determine association between MPPCV and ICU mortality. The interaction of MPPCV and use of neuromuscular blocking agent (NMBA) was also analyzed. Results: A total of 125 patients was eligible for final analysis, of whom 38 died in the ICU. MPPCV was higher in non-survivors (17.6 vs. 26.3 J/min, P<0.001). In logistic regression analysis, only MPPCV was significantly associated with ICU mortality (odds ratio, 1.090; 95% confidence interval, 1.029–1.155; P=0.003). There was no significant effect of the interaction between MPPCV and use of NMBA on ICU mortality (P=0.579). Conclusions: MPPCV is associated with ICU mortality in patients mechanically ventilated with PCV mode, regardless of NMBA use.
Corrigendum
Infection
Corrigendum to “Methylprednisolone pulse therapy for critically ill patients with COVID-19: a cohort study”
Keum-Ju Choi, Soo Kyun Jung, Kyung Chan Kim, Eun Jin Kim
Acute Crit Care. 2023;38(2):249-249.   Published online May 25, 2023
DOI: https://doi.org/10.4266/acc.2022.00941.e1
Corrects: Acute Crit Care 2023;38(1):57
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  • 47 Download
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Original Articles
Infection
Methylprednisolone pulse therapy for critically ill patients with COVID-19: a cohort study
Keum-Ju Choi, Soo Kyun Jung, Kyung Chan Kim, Eun Jin Kim
Acute Crit Care. 2023;38(1):57-67.   Published online February 7, 2023
DOI: https://doi.org/10.4266/acc.2022.00941
Correction in: Acute Crit Care 2023;38(2):249
  • 4,468 View
  • 154 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
The guidelines recommend the use of dexamethasone 6 mg or an equivalent dose in patients with coronavirus disease 2019 (COVID-19) who require supplemental oxygen. Given that the severity of COVID-19 varies, we investigated the effect of a pulse dose of corticosteroids on the clinical course of critically ill patients with COVID-19. Methods: This single-center, retrospective cohort study was conducted between September and December 2021, which was when the Delta variant of the COVID-19 virus was predominant. We evaluated the mortality and oxygenation of severe to critical COVID-19 cases between groups that received dexamethasone 6 mg for 10 days (control group) and methylprednisolone 250 mg/day for 3 days (pulse group). Results: Among 44 patients, 14 and 30 patients were treated with control steroids and pulse steroids, respectively. There was no difference in disease severity, time from COVID-19 diagnosis to steroid administration, or use of remdesivir or antibacterial agents between the two groups. The pulse steroid group showed a significant improvement in oxygenation before and after steroid treatment (P<0.001) compared with the control steroid group (P=0.196). There was no difference in in-hospital mortality (P=0.186); however, the pulse steroid group had a lower mortality rate (23.3%) than the control steroid group (42.9%). There was a significant difference in the length of hospital stay between both two groups (P=0.039). Conclusions: Pulse steroids showed no mortality benefit but were associated with oxygenation improvement and shorter hospital stay than control steroids. Hyperglycemia should be carefully monitored with pulse steroids.

Citations

Citations to this article as recorded by  
  • Baricitinib and Pulse Steroids Combination Treatment in Hyperinflammatory COVID-19: A Rheumatological Approach in the Intensive Care Unit
    Francesco Ferro, Gaetano La Rocca, Elena Elefante, Nazzareno Italiano, Michele Moretti, Rosaria Talarico, Erika Pelati, Katia Valentini, Chiara Baldini, Roberto Mozzo, Luigi De Simone, Marta Mosca
    International Journal of Molecular Sciences.2024; 25(13): 7273.     CrossRef
Pulmonary
Experience of percutaneous tracheostomy in critically ill COVID-19 patients
Eun Jin Kim, Eun-Hyung Yoo, Chi Young Jung, Kyung Chan Kim
Acute Crit Care. 2020;35(4):263-270.   Published online November 12, 2020
DOI: https://doi.org/10.4266/acc.2020.00444
  • 6,649 View
  • 153 Download
  • 5 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Background
Coronavirus disease 2019 (COVID-19) is a highly contagious disease that causes respiratory failure. Tracheostomy is an essential procedure in critically ill COVID-19 patients; however, it is an aerosol-generating technique and thus carries the risk of infection transmission. We report our experience with percutaneous tracheostomy and its safety in a real medical setting.
Methods
During the COVID-19 outbreak, 13 critically ill patients were admitted to the intensive care unit (ICU) at Daegu Catholic University Medical Center between February 24 and April 30, 2020. Seven of these patients underwent percutaneous tracheostomy using Ciaglia Blue Rhino. The medical environment, percutaneous tracheostomy method, and COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) results were retrospectively reviewed. After treatment, the COVID-19 infection status of healthcare personnel was investigated by RT-PCR.
Results
The ICU contained negative pressure cohort areas and isolation rooms, and healthcare personnel wore a powered air-purifying respirator system. We performed seven cases of percutaneous tracheostomy in the same way as in patients without COVID-19. Five patients (71.4%) tested positive for COVID-19 by RT-PCR at the time of tracheostomy. The median cycle threshold value for the RNA-dependent RNA polymerase was 30.60 (interquartile range [IQR], 25.50–36.56) in the upper respiratory tract and 35.04 (IQR, 28.40–36.74) in the lower respiratory tract. All healthcare personnel tested negative for COVID-19 by RT-PCR.
Conclusions
Percutaneous tracheostomy was performed with conventional methods in the negative pressure cohort area. It was safe to perform percutaneous tracheostomy in an environment of COVID-19 infection.

Citations

Citations to this article as recorded by  
  • Sedation and Analgesia in Patients Undergoing Tracheostomy in COVID-19, a Multi-Center Registry
    Christopher M. Kapp, Ardian Latifi, David Feller-Kopman, Joshua H. Atkins, Esther Ben Or, David Dibardino, Andrew R. Haas, Jeffrey Thiboutot, Christoph T. Hutchinson
    Journal of Intensive Care Medicine.2022; 37(2): 240.     CrossRef
  • Percutaneous Tracheostomy in Respiratory Failure Due to COVID-19
    Samuel E. Cohen, Angelena R. Lopez, Philip K. Ng, Oren A. Friedman, George E. Chaux
    Journal of Bronchology & Interventional Pulmonology.2022; 29(2): 125.     CrossRef
  • Expert consensus on the diagnosis and treatment of severe and critical coronavirus disease 2019 (COVID-19)
    You Shang, Jianfeng Wu, Jinglun Liu, Yun Long, Jianfeng Xie, Dong Zhang, Bo Hu, Yuan Zong, Xuelian Liao, Xiuling Shang, Renyu Ding, Kai Kang, Jiao Liu, Aijun Pan, Yonghao Xu, Changsong Wang, Qianghong Xu, Xijing Zhang, Jicheng Zhang, Ling Liu, Jiancheng Z
    Journal of Intensive Medicine.2022; 2(4): 199.     CrossRef
  • Commentary: Coronavirus disease 2019 (COVID-19) tracheostomies—The “how” but not the “why” or “when”
    Benjamin Wei, Peter Abraham
    JTCVS Techniques.2021; 6: 190.     CrossRef
  • Association of Tracheostomy With Outcomes in Patients With COVID-19 and SARS-CoV-2 Transmission Among Health Care Professionals
    Phillip Staibano, Marc Levin, Tobial McHugh, Michael Gupta, Doron D. Sommer
    JAMA Otolaryngology–Head & Neck Surgery.2021; 147(7): 646.     CrossRef
  • Tracheostomy in COVID Times
    Yatin Mehta, Gaurav Kochar
    Journal of Cardiac Critical Care TSS.2021; 5(02): 082.     CrossRef
Pediatrics
Characteristics, management and clinical outcomes of patients with sepsis: a multicenter cohort study in Korea
Kyeongman Jeon, Soo Jin Na, Dong Kyu Oh, Sunghoon Park, Eun Young Choi, Seok Chan Kim, Gil Myeong Seong, Jeongwon Heo, Youjin Chang, Won Gun Kwack, Byung Ju Kang, Won-Il Choi, Kyung Chan Kim, So Young Park, Sang Hyun Kwak, Yoon Mi Shin, Heung Bum Lee, So Hee Park, Jae Hwa Cho, Beongki Kim, Chae‐Man Lim
Acute Crit Care. 2019;34(3):179-191.   Published online July 1, 2019
DOI: https://doi.org/10.4266/acc.2019.00514
  • 8,721 View
  • 322 Download
  • 21 Web of Science
  • 23 Crossref
AbstractAbstract PDF
Background
Mortality rates associated with sepsis have increased progressively in Korea, but domestic epidemiologic data remain limited. The objective of this study was to investigate the characteristics, management and clinical outcomes of sepsis patients in Korea.
Methods
This study is a multicenter retrospective cohort study. A total of 64,021 adult patients who visited an emergency department (ED) within one of the 19 participating hospitals during a 1-month period were screened for eligibility. Among these, patients diagnosed with sepsis based on the third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) were included in the study.
Results
Using the Sepsis-3 criteria, 977 sepsis patients were identified, among which 36.5% presented with septic shock. The respiratory system (61.8%) was the most common site of infection. The pathogen involved was identified in 444 patients (45.5%) and multi-drug resistance (MDR) pathogens were isolated in 171 patients. Empiric antibiotic therapy was appropriate in 68.6% of patients, but the appropriateness was significantly reduced in infections associated with MDR pathogens as compared with non-MDR pathogens (58.8% vs. 76.0%, P<0.001). Hospital mortality was 43.2% and 18.5% in sepsis patients with and without shock, respectively. Of the 703 patients who survived to discharge, 61.5% were discharged to home and 38.6% were transferred to other hospitals or facilities.
Conclusions
This study found the prevalence of sepsis in adult patients visiting an ED in Korea was 1.5% (15.2/1,000 patients). Patients with sepsis, especially septic shock, had a high mortality and were often referred to step-down centers after acute and critical care.

Citations

Citations to this article as recorded by  
  • Early Prediction of Mortality for Septic Patients Visiting Emergency Room Based on Explainable Machine Learning: A Real-World Multicenter Study
    Sang Won Park, Na Young Yeo, Seonguk Kang, Taejun Ha, Tae-Hoon Kim, DooHee Lee, Dowon Kim, Seheon Choi, Minkyu Kim, DongHoon Lee, DoHyeon Kim, Woo Jin Kim, Seung-Joon Lee, Yeon-Jeong Heo, Da Hye Moon, Seon-Sook Han, Yoon Kim, Hyun-Soo Choi, Dong Kyu Oh, S
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Deficits in blood culture collection in the emergency department if sepsis is suspected: results of a retrospective cohort study
    Charlotte Berninghausen, Frank Schwab, Alexander Gropmann, Bernd A. Leidel, Rajan Somasundaram, Lydia Hottenbacher, Petra Gastmeier, Sonja Hansen
    Infection.2024;[Epub]     CrossRef
  • Pre-Sepsis Length of Hospital Stay and Mortality: A Nationwide Multicenter Cohort Study
    Joong-Yub Kim, Hong Yeul Lee, Jinwoo Lee, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Chae-Man Lim, Sang-Min Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Development and validation of an interpretable model for predicting sepsis mortality across care settings
    Young Seok Lee, Seungbong Han, Ye Eun Lee, Jaehwa Cho, Young Kyun Choi, Sun-Young Yoon, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Chae-Man Lim, Jae Young Moon, Sang‑Bum Hong, Suk‑Kyung Hong, Gee Young Suh, Kyeongman Jeon, Ryoung‑Eun Ko, Young‑Jae Cho, Yeon
    Scientific Reports.2024;[Epub]     CrossRef
  • Platelet indices in critically ill septic patients as a predictor of mortality
    Rehab Salah Taha, Mohamed Elsayed Afandy, Abdelaziz Hamid Elbadawi, Mohamed Samir Abd El Ghafar
    Egyptian Journal of Anaesthesia.2023; 39(1): 56.     CrossRef
  • Antibiogram of Multidrug-Resistant Bacteria Based on Sepsis Onset Location in Korea: A Multicenter Cohort Study
    Hyung-Jun Kim, Dong Kyu Oh, Sung Yoon Lim, Young-Jae Cho, Sunghoon Park, Gee Young Suh, Chae-Man Lim, Yeon Joo Lee
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • HYPOTENSION AT THE TIME OF SEPSIS RECOGNITION IS NOT ASSOCIATED WITH INCREASED MORTALITY IN SEPSIS PATIENTS WITH NORMAL LACTATE LEVELS
    Ji Hwan Kim, Yong Kyun Kim, Dong Kyu Oh, Kyeongman Jeon, Ryoung-Eun Ko, Gee Young Suh, Sung Yun Lim, Yeon Joo Lee, Young-Jae Cho, Mi-Hyeon Park, Sang-Bum Hong, Chae-Man Lim, Sunghoon Park
    Shock.2023; 59(3): 360.     CrossRef
  • Mortality among adult patients with sepsis and septic shock in Korea: a systematic review and meta-analysis
    Myeong Namgung, Chiwon Ahn, Yeonkyung Park, Il-Youp Kwak, Jungguk Lee, Moonho Won
    Clinical and Experimental Emergency Medicine.2023; 10(2): 157.     CrossRef
  • Effects of prior antiplatelet and/or nonsteroidal anti-inflammatory drug use on mortality in patients undergoing abdominal surgery for abdominal sepsis
    Se Hun Kim, Ki Hoon Kim
    Surgery.2023; 174(3): 611.     CrossRef
  • Clinical effects of bacteremia in sepsis patients with community-acquired pneumonia
    Tae Wan Kim, Se-Uk Lee, Boram Park, Kyeongman Jeon, Sunghoon Park, Gee Young Suh, Dong Kyu Oh, Soo Yeon Lee, Mi Hyeon Park, Haein Lee, Chae-man Lim, Ryoung-Eun Ko, Sang-Bum Hong, Suk-Kyung Hong, Yeon Joo Lee, Young-Jae Cho, Sung Yoon Lim, Jeongwon Heo, Ja
    BMC Infectious Diseases.2023;[Epub]     CrossRef
  • Current status of treatment of acute respiratory failure in Korea
    Yong Jun Choi, Jae Hwa Cho
    Journal of the Korean Medical Association.2022; 65(3): 124.     CrossRef
  • Clinical Characteristics and Outcomes of Neutropenic Sepsis: A Multicenter Cohort Study
    Soo Jin Na, Dong Kyu Oh, Sunghoon Park, Yeon Joo Lee, Sang-Bum Hong, Mi-Hyun Park, Ryoung-Eun Ko, Chae-Man Lim, Kyeongman Jeon
    Shock.2022; 57(5): 659.     CrossRef
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    Dong-gon Hyun, Su Yeon Lee, Jee Hwan Ahn, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Chae-Man Lim, Dong Kyu Oh, Gee Young Suh, Kyeongman Jeon, Ryoung-Eun Ko, Young-Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Sunghoon Park, Jeongwon Heo, Jae-myeong Lee, Kyung Cha
    Critical Care.2022;[Epub]     CrossRef
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    Chan Hee Park, Jeong Woo Lee, Hak Jae Lee, Dong Kyu Oh, Mi Hyeon Park, Chae-Man Lim, Suk-Kyung Hong, Chae-Man Lim, Sang-Bum Hong, Dong Kyu Oh, Gee Young Suh, Kyeongman Jeon, Ryoung-Eun Ko, Young-Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Sunghoon Park, Chae-Ma
    BMC Infectious Diseases.2022;[Epub]     CrossRef
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    L. I. Gomanova, A. Y. Brazhnikov
    Epidemiology and Vaccinal Prevention.2021; 20(3): 107.     CrossRef
  • Characteristics, Management, and Clinical Outcomes of Patients with Hospital-Acquired and Ventilator-Associated Pneumonia: A Multicenter Cohort Study in Korea
    Ryoung-Eun Ko, Kyung Hoon Min, Sang-Bum Hong, Ae-Rin Baek, Hyun-Kyung Lee, Woo Hyun Cho, Changhwan Kim, Youjin Chang, Sung-Soon Lee, Jee Youn Oh, Heung Bum Lee, Soohyun Bae, Jae Young Moon, Kwang Ha Yoo, Kyeongman Jeon
    Tuberculosis and Respiratory Diseases.2021; 84(4): 317.     CrossRef
  • Clinical Usefulness of Red Cell Distribution Width/Albumin Ratio to Discriminate 28-Day Mortality in Critically Ill Patients with Pneumonia Receiving Invasive Mechanical Ventilation, Compared with Lacate/Albumin Ratio: A Retrospective Cohort Study
    Jong Hwan Jeong, Manbong Heo, Seung Jun Lee, Yi Yeong Jeong, Jong Deog Lee, Jung-Wan Yoo
    Diagnostics.2021; 11(12): 2344.     CrossRef
  • Review of 20 Years of Continuous Quality Improvement of a Rapid Response System, at Four Institutions, to Identify Key Process Responsible for Its Success
    Mary Anne Vandegrift, Robert Granata, Vicken Y. Totten, John Kellett, Frank Sebat
    Critical Care Explorations.2021; 3(8): e0448.     CrossRef
  • An Update on Sepsis Biomarkers
    Mi-Hee Kim, Jung-Hyun Choi
    Infection & Chemotherapy.2020; 52(1): 1.     CrossRef
  • Normothermia in Patients With Sepsis Who Present to Emergency Departments Is Associated With Low Compliance With Sepsis Bundles and Increased In-Hospital Mortality Rate*
    Sunghoon Park, Kyeongman Jeon, Dong Kyu Oh, Eun Young Choi, Gil Myeong Seong, Jeongwon Heo, Youjin Chang, Won Gun Kwack, Byung Ju Kang, Won-Il Choi, Kyung Chan Kim, So Young Park, Yoon Mi Shin, Heung Bum Lee, So Hee Park, Seok Chan Kim, Sang Hyun Kwak, Ja
    Critical Care Medicine.2020; 48(10): 1462.     CrossRef
  • Prevention of sepsis in an aging society
    Youngjoon Kang
    Acute and Critical Care.2019; 34(3): 221.     CrossRef
  • Optimal antimicrobial therapy and antimicrobial stewardship in sepsis and septic shock
    Hyeri Seok, Dae Won Park
    Journal of the Korean Medical Association.2019; 62(12): 638.     CrossRef
  • Sepsis
    Yunghee Lee, Young-Jae Cho
    The Korean Journal of Medicine.2019; 94(6): 495.     CrossRef
Case Report
Pulmonary
Extraction of Endobronchial Tooth by Flexible Bronchoscopy Using Fishnet Basket in Patients of Intensive Care Unit with Artificial Airway
Kyung Chan Kim
Korean J Crit Care Med. 2014;29(1):38-42.   Published online February 28, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.1.38
  • 6,533 View
  • 84 Download
  • 1 Crossref
AbstractAbstract PDF
Foreign body aspiration into the tracheobronchial tree can cause serious problems. Tooth aspiration can occur during emergency endotracheal intubation. However, removal of a tooth from the airway is difficult because of the round shape and smooth surface of the tooth. Here, I report extraction of a tooth from the airway by flexible bronchoscopy using fishnet basket in intensive care patients. The procedure was performed in six patients. All patients were critically ill with an artificial airway (n = 4; endotracheal tube, n = 2; tracheostomy tube). The tooth location was right bronchial tree in three patients and left bronchial tree in three patients. Tooth extraction failed in two patients because the teeth were impacted in the distal bronchus during bronchoscopy. There was no complication such as life threatening arrhythmia or hypoxemia during the procedure. Using flexible bronchoscopy with a fishnet basket, we were able to extract aspirated teeth from patients with an artificial airway.

Citations

Citations to this article as recorded by  
  • Retrieval of Aspirated Teeth in an Adult Polytrauma Patient using Pediatric Flexible Fiberoptic Bronchoscopy Allied with Endoscopic Rat Tooth Alligator Jaw Grasping Forceps
    Ali Al Bshabshe, Omprakash Palanivel, Amer Hassan Assiri, Nasser Mohammed Alwadai
    Indian Journal of Respiratory Care.2020; 9(2): 236.     CrossRef

ACC : Acute and Critical Care