Skip Navigation
Skip to contents

ACC : Acute and Critical Care

OPEN ACCESS
SEARCH
Search

Search

Page Path
HOME > Search
9 "Song Yee Kim"
Filter
Filter
Article category
Keywords
Publication year
Authors
Original Articles
Cardiology
Predictors and outcomes of sepsis-induced cardiomyopathy in critically ill patients
Myung Jin Song, Sang Hoon Lee, Ah Young Leem, Song Yee Kim, Kyung Soo Chung, Eun Young Kim, Ji Ye Jung, Young Ae Kang, Young Sam Kim, Joon Chang, Moo Suk Park
Acute Crit Care. 2020;35(2):67-76.   Published online May 15, 2020
DOI: https://doi.org/10.4266/acc.2020.00024
  • 6,834 View
  • 219 Download
  • 10 Web of Science
  • 11 Crossref
AbstractAbstract PDF
Background
Sepsis-induced cardiomyopathy (SIC) occurs frequently in critically ill patients, but the clinical features and prognostic impact of SIC on sepsis outcome remain controversial. Here, we investigated the predictors and outcomes of SIC.
Methods
Patients admitted to a single medical intensive care unit from June 2016 to September 2017 were retrospectively reviewed. SIC was diagnosed by ejection fraction (EF) <50% and ≥10% decrease in baseline EF that recovered within 2 weeks.
Results
In total, 342 patients with sepsis met the inclusion criteria, and 49 patients (14.3%) were diagnosed with SIC; the latter were compared with 259 patients whose EF was not deteriorated by sepsis (non-SIC). Low systolic blood pressure and increased left ventricular end-diastolic diameter (LVEDD) were identified as predictors of SIC. SIC and non-SIC patients did not differ significantly in terms of 28-day all-cause mortality (24.5% vs. 26.3%, P=0.936). Acute Physiology and Chronic Health Evaluation II (APACHE II; hazard ratio [HR], 1.10; 95% confidential interval [CI], 1.02 to 1.18; P=0.009) and delta neutrophil index (DNI; HR, 1.02; 95% CI, 1.00 to 1.08; P=0.026) were independent risk factors for 28-day mortality with SIC. DNI, APACHE II, and lactate were identified as risk factors for 28-day mortality in sepsis patients as a whole.
Conclusions
SIC was not associated with increased mortality compared to non-SIC. Low systolic blood pressure and increased LVEDD were predictors of SIC. High APACHE II score and elevated DNI, which reflect sepsis severity, predict 28-day all-cause mortality.

Citations

Citations to this article as recorded by  
  • Testosterone and soluble ST2 as mortality predictive biomarkers in male patients with sepsis-induced cardiomyopathy
    Lu Wang, Wen Dai, Ruiyao Zhu, Tingting Long, Zhaocai Zhang, Zhenju Song, Sucheng Mu, Shasha Wang, Huijuan Wang, Jiaxi Lei, Jing Zhang, Wenfang Xia, Guang Li, Wenwei Gao, Handong Zou, Yan Li, Liying Zhan
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • Meta-Analysis of Initial Natriuretic Peptides in the Setting of Sepsis-Induced Myocardial Dysfunction
    Boyong He, Xin Wang, Liguo Shi, Hongbin Cheng, Luyi Zhao
    Biomarkers in Medicine.2024; 18(4): 145.     CrossRef
  • Prevalence and Prognosis of Sepsis-Induced Cardiomyopathy: A Systematic Review and Meta-Analysis
    Daisuke Hasegawa, Yoshiko Ishisaka, Tetsuro Maeda, Narut Prasitlumkum, Kazuki Nishida, Siddharth Dugar, Ryota Sato
    Journal of Intensive Care Medicine.2023; 38(9): 797.     CrossRef
  • Research Progress on the Mechanism and Management of Septic Cardiomyopathy: A Comprehensive Review
    Xue-Bin Pei, Bo Liu, Maciej Dyrbuś
    Emergency Medicine International.2023; 2023: 1.     CrossRef
  • Biomarkers to Predict Multiorgan Distress Syndrome and Acute Kidney Injury in Critically Ill Surgical Patients
    In Sik Shin, Da Kyung Kim, Sanghyun An, Sung Chan Gong, Moo Hyun Kim, Md Habibur Rahman, Cheol-Su Kim, Joon Hyeong Sohn, Kwangmin Kim, Hoon Ryu
    Medicina.2023; 59(12): 2054.     CrossRef
  • Risk factors of postoperative septic cardiomyopathy in perioperative sepsis patients
    Yuchang Xin, Ying Ge, Liuhui Chang, Yong Ni, Hairui Liu, Jiang Zhu
    BMC Anesthesiology.2022;[Epub]     CrossRef
  • Effect of milrinone versus placebo on hemodynamic in patients with septic shock: A randomize control trial
    Suratee Chobngam, Surat Tongyoo
    Clinical Critical Care.2022;[Epub]     CrossRef
  • Association of sepsis-induced cardiomyopathy and mortality: a systematic review and meta-analysis
    Yu-Min Lin, Mei-Chuan Lee, Han Siong Toh, Wei-Ting Chang, Sih-Yao Chen, Fang-Hsiu Kuo, Hsin-Ju Tang, Yi-Ming Hua, Dongmei Wei, Jesus Melgarejo, Zhen-Yu Zhang, Chia-Te Liao
    Annals of Intensive Care.2022;[Epub]     CrossRef
  • Association of Sepsis-Induced Cardiomyopathy and Mortality: A Systematic Review and Meta-Analysis
    Yu-Min Lin, Mei-Chuan Lee, Han Siong Toh, Wei-Ting Chang, Sih-Yao Chen, Fang-Hsiu Kuo, Hsin-Ju Tang, Yi-Ming Hua, Dongmei Wei, Jesus Melgarejo, Zhen-Yu Zhang, Chia-Te Liao
    SSRN Electronic Journal .2022;[Epub]     CrossRef
  • Sepsis-induced cardiomyopathy is associated with higher mortality rates in patients with sepsis
    Balaram Krishna J Hanumanthu, Anika Sasidharan Nair, Adarsh Katamreddy, Jason S Gilbert, Jee Young You, Obiageli Lynda Offor, Ankit Kushwaha, Ankita Krishnan, Marzio Napolitano, Leonidas Palaidimos, Joaquin Morante, Seema S. Tekwani, Suchita Mehta, Aancha
    Acute and Critical Care.2021; 36(3): 215.     CrossRef
  • The Correlation Between Whole Blood Copper (Cu), Zinc (Zn) Levels and Cu/Zn Ratio and Sepsis-Induced Left Ventricular Systolic Dysfunction (SILVSD) in Patients with Septic Shock: A Single-Center Prospective Observational Study
    Jian-Biao Meng, Ma-Hong Hu, Ming Zhang, Gong-Pai Hu, Wei Zhang, Shen-Jiang Hu
    International Journal of General Medicine.2021; Volume 14: 7219.     CrossRef
Liver
The role of bilirubin to albumin ratio as a predictor for mortality in critically ill patients without existing liver or biliary tract disease
Ji Soo Choi, Kyung Soo Chung, Eun Hye Lee, Su Hwan Lee, Sang Hoon Lee, Song Yee Kim, Ji Ye Jung, Young Ae Kang, Moo Suk Park, Young Sam Kim, Joon Chang, Ah Young Leem
Acute Crit Care. 2020;35(1):24-30.   Published online February 29, 2020
DOI: https://doi.org/10.4266/acc.2019.00738
  • 6,900 View
  • 149 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
Hyperbilirubinemia and hypoalbuminemia are frequently appeared and associated with poor prognosis in critically ill patients. We aim to evaluate the association between the bilirubin to albumin ratio and prognosis in intensive care unit (ICU) patients. Methods: This was a retrospective study of 731 patients who were admitted to the medical intensive care unit (MICU) at a tertiary-care center from July 2015 to September 2017. We analyzed the bilirubin to albumin ratio on admission to the MICU, including clinical characteristics and other examinations. Results: The overall 28-day survival of MICU patients was 69.1%. On univariate analysis, Acute Physiology and Chronic Health Evaluation (APACHE) II score (P<0.001), Sequential Organ Failure Assessment score (P<0.001), Simplified Acute Physiology Score II score (P<0.001), Creactive protein (P=0.015), and bilirubin/albumin ratio (P<0.001) were associated with mortality of ICU patients. The receiver operating characteristic curves for ICU patients mortality between bilirubin to albumin ratio and APACHE II score were not statistically significant (P=0.282). On multivariate analysis, higher APACHE II score (hazard ratio [HR], 1.05; 95% CI, 1.03 to 1.06; P<0.001) and bilirubin to albumin ratio (HR, 1.65; 95% CI, 1.23 to 2.20; P=0.001) were independently related to the ICU patient mortality. Conclusions: A higher bilirubin to albumin ratio was related to the unfavorable prognosis and mortality in critically ill patients.

Citations

Citations to this article as recorded by  
  • Role of serum bilirubin-to-albumin ratio as a prognostic index in critically ill children
    You Min Kang, Ga Eun Kim, Mireu Park, Jong Deok Kim, Min Jung Kim, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Son, Soo Yeon Kim
    Clinical and Experimental Pediatrics.2023; 66(2): 85.     CrossRef
  • Association between total bilirubin/Albumin ratio and all-cause mortality in acute kidney injury patients: A retrospective cohort study
    Ximei Huang, Yunhua Huang, Min Chen, Lin Liao, Faquan Lin, Eranga Sanjeewa Wijewickrama
    PLOS ONE.2023; 18(11): e0287485.     CrossRef
  • The value of albumin-related ratios in predicting disease severity and mortality in acute cholangitis
    Bayram YEŞİL, Bünyamin SEVİM
    Journal of Health Sciences and Medicine.2023; 6(6): 1244.     CrossRef
  • Hepatic dysfunction in critically ill patients
    Jeong Hoon Yang
    Acute and Critical Care.2020; 35(1): 44.     CrossRef
Letter to the Editor
Thoracic Surgery
Extracorporeal Membrane Oxygenation Bridge to Lung Transplantation in a Patient with Hermansky-Pudlak Syndrome and Progressive Pulmonary Fibrosis
Wooho Sim, Song Yee Kim, Jinu Han, Tyler Hyungtaek Rim, Jin Gu Lee, Hyo Chae Paik, Moo Suk Park
Acute Crit Care. 2019;34(1):95-98.   Published online February 28, 2019
DOI: https://doi.org/10.4266/acc.2018.00402
  • 5,411 View
  • 97 Download
  • 4 Web of Science
  • 4 Crossref
PDF

Citations

Citations to this article as recorded by  
  • Hermansky–Pudlak syndrome pulmonary fibrosis: a rare inherited interstitial lung disease
    Tadafumi Yokoyama, Bernadette R. Gochuico
    European Respiratory Review.2021; 30(159): 200193.     CrossRef
  • Selection Criteria for Lung Transplantation: Controversies and New Developments
    Hanne Beeckmans, Saskia Bos, Robin Vos
    Seminars in Respiratory and Critical Care Medicine.2021; 42(03): 329.     CrossRef
  • Hermansky–Pudlak syndrome: Mutation update
    Marjan Huizing, May C. V. Malicdan, Jennifer A. Wang, Hadass Pri‐Chen, Richard A. Hess, Roxanne Fischer, Kevin J. O'Brien, Melissa A. Merideth, William A. Gahl, Bernadette R. Gochuico
    Human Mutation.2020; 41(3): 543.     CrossRef
  • Hermansky-Pudlak syndrome-associated pneumothorax with rapid progression of respiratory failure: a case report
    Yukari Kato, Motoyasu Kato, Hiroaki Ihara, Eri Hayakawa, Kohei Shibayama, Keita Miura, Tomoko Yamada, Yoichiro Mitsuishi, Takehito Shukuya, Jun Ito, Takeshi Matsunaga, Tadashi Sato, Kenji Suzuki, Kazuhisa Takahashi
    BMC Pulmonary Medicine.2020;[Epub]     CrossRef
Review Articles
Pulmonary
Critical Care before Lung Transplantation
Jin Gu Lee, Moo Suk Park, Su Jin Jeong, Song Yee Kim, Sungwon Na, Jeongmin Kim, Hyo Chae Paik
Acute Crit Care. 2018;33(4):197-205.   Published online November 30, 2018
DOI: https://doi.org/10.4266/acc.2018.00367
  • 8,159 View
  • 253 Download
  • 3 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Lung transplantation is widely accepted as the only viable treatment option for patients with end-stage lung disease. However, the imbalance between the number of suitable donor lungs available and the number of possible candidates often results in intensive care unit (ICU) admission for the latter. In the ICU setting, critical care is essential to keep these patients alive and to successfully bridge to lung transplantation. Proper management in the ICU is also one of the key factors supporting long-term success following transplantation. Critical care includes the provision of respiratory support such as mechanical ventilation (MV) and extracorporeal life support (ECLS). Accordingly, a working knowledge of the common critical care issues related to these unique patients and the early recognition and management of problems that arise before and after transplantation in the ICU setting are crucial for long-term success. In this review, we discuss the management and selection of candidates for lung transplantation as well as existing respiratory support strategies that involve MV and ECLS in the ICU setting.

Citations

Citations to this article as recorded by  
  • Optimizing the prelung transplant candidate
    John Pagteilan, Scott Atay
    Current Opinion in Organ Transplantation.2024; 29(1): 37.     CrossRef
  • Awakening in extracorporeal membrane oxygenation as a bridge to lung transplantation
    Su Hwan Lee
    Acute and Critical Care.2022; 37(1): 26.     CrossRef
  • Recipient Management before Lung Transplantation
    Hyoung Soo Kim, Sunghoon Park
    Journal of Chest Surgery.2022; 55(4): 265.     CrossRef
  • Outcomes of Patients on the Lung Transplantation Waitlist in Korea: A Korean Network for Organ Sharing Data Analysis
    Hye Ju Yeo, Dong Kyu Oh, Woo Sik Yu, Sun Mi Choi, Kyeongman Jeon, Mihyang Ha, Jin Gu Lee, Woo Hyun Cho, Young Tae Kim
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
    Nam Eun Kim, Ala Woo, Song Yee Kim, Ah Young Leem, Youngmok Park, Se Hyun Kwak, Seung Hyun Yong, Kyungsoo Chung, Moo Suk Park, Young Sam Kim, Ha Eun Kim, Jin Gu Lee, Hyo Chae Paik, Su Hwan Lee
    Respiratory Research.2021;[Epub]     CrossRef
Pulmonary
Critical Care after Lung Transplantation
Song Yee Kim, Su Jin Jeong, Jin Gu Lee, Moo Suk Park, Hyo Chae Paik, Sungwon Na, Jeongmin Kim
Acute Crit Care. 2018;33(4):206-215.   Published online November 30, 2018
DOI: https://doi.org/10.4266/acc.2018.00360
  • 16,839 View
  • 653 Download
  • 8 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Since the first successful lung transplantation in 1983, there have been many advances in the field. Nevertheless, the latest data from the International Society for Heart and Lung Transplantation revealed that the risk of death from transplantation is 9%. Various aspects of postoperative management, including mechanical ventilation, could affect intensive care unit stay, hospital stay, and immediate postoperative morbidity and mortality. Complications such as reperfusion injury, graft rejection, infection, and dehiscence of anastomosis increase fatal adverse side effects immediately after surgery. In this article, we review the possible immediate complications after lung transplantation and summarize current knowledge on prevention and treatment.

Citations

Citations to this article as recorded by  
  • Aspergillus Galactomannan Titer as a Diagnostic Marker of Invasive Pulmonary Aspergillosis in Lung Transplant Recipients: A Single-Center Retrospective Cohort Study
    Eun-Young Kim, Seung-Hyun Yong, Min-Dong Sung, A-La Woo, Young-Mok Park, Ha-Eun Kim, Su-Jin Jung, Song-Yee Kim, Jin-Gu Lee, Young-Sam Kim, Hyo-Chae Paik, Moo-Suk Park
    Journal of Fungi.2023; 9(5): 527.     CrossRef
  • Nontuberculous mycobacterial infection after lung transplantation: A single-center experience in South Korea
    Youngmok Park, Nam Eun Kim, Se Hyun Kwak, Moo Suk Park, Su Jin Jeong, Jin Gu Lee, Hyo Chae Paik, Song Yee Kim, Young Ae Kang
    Journal of Microbiology, Immunology and Infection.2022; 55(1): 123.     CrossRef
  • Medical Complications of Lung Transplantation
    Moo Suk Park
    Journal of Chest Surgery.2022; 55(4): 338.     CrossRef
  • Roles of electrical impedance tomography in lung transplantation
    Hui Jiang, Yijiao Han, Xia Zheng, Qiang Fang
    Frontiers in Physiology.2022;[Epub]     CrossRef
  • Perioperative anidulafungin combined with triazole prophylaxis for the prevention of early invasive candidiasis in lung transplant recipients
    Emily Sartain, Kelly Schoeppler, Barrett Crowther, Joshua B. Smith, Maheen Z. Abidi, Todd J. Grazia, Mark Steele, Terri Gleason, Krista Porter, Alice Gray
    Transplant Infectious Disease.2021;[Epub]     CrossRef
  • The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea
    Yae-Jee Baek, Yun-Suk Cho, Moo-Hyun Kim, Jong-Hoon Hyun, Yu-Jin Sohn, Song-Yee Kim, Su-Jin Jeong, Moo-Suk Park, Jin-Gu Lee, Hyo-Chae Paik
    Journal of Fungi.2021; 7(8): 639.     CrossRef
  • Panel-Reactive and Donor-Specific Antibodies before Lung Transplantation can Affect Outcomes in Korean Patients Receiving Lung Transplantation
    Sung Woo Moon, Moo Suk Park, Jin Gu Lee, Hyo Chae Paik, Young Tae Kim, Hyun Joo Lee, Samina Park, Sun Mi Choi, Do Hyung Kim, Woo Hyun Cho, Hye Ju Yeo, Seung-il Park, Se Hoon Choi, Sang-Bum Hong, Tae Sun Shim, Kyung-Wook Jo, Kyeongman Jeon, Byeong-Ho Jeong
    Yonsei Medical Journal.2020; 61(7): 606.     CrossRef
  • A proof-of principal study using phase-contrast imaging for the detection of large airway pathologies after lung transplantation
    Stephan Umkehrer, Carmela Morrone, Julien Dinkel, Laura Aigner, Maximilian F. Reiser, Julia Herzen, Ali Ö. Yildirim, Franz Pfeiffer, Katharina Hellbach
    Scientific Reports.2020;[Epub]     CrossRef
Original Articles
Pulmonary
Feasibility of Immediate in-Intensive Care Unit Pulmonary Rehabilitation after Lung Transplantation: A Single Center Experience
Joo Han Song, Ji-Eun Park, Sang Chul Lee, Sarang Kim, Dong Hyung Lee, Eun Kyoung Kim, Song Yee Kim, Ji Cheol Shin, Jin Gu Lee, Hyo Chae Paik, Moo Suk Park
Acute Crit Care. 2018;33(3):146-153.   Published online August 31, 2018
DOI: https://doi.org/10.4266/acc.2018.00129
  • 6,854 View
  • 145 Download
  • 4 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Physical function may influence perioperative outcomes of lung transplantation. We investigated the feasibility of a pulmonary rehabilitation program initiated in the immediate postoperative period at an intensive care unit (ICU) for patients who underwent lung transplantation.
Methods
We retrospectively evaluated 22 patients who received pulmonary rehabilitation initiated in the ICU within 2 weeks after lung transplantation at our institution from March 2015 to February 2016. Levels of physical function were graded at the start of pulmonary rehabilitation and then weekly throughout rehabilitation according to criteria from our institutional pulmonary rehabilitation program: grade 1, bedside (G1); grade 2, dangling (G2); grade 3, standing (G3); and grade IV, gait (G4).
Results
The median age of patients was 53 years (range, 25 to 73 years). Fourteen patients (64%) were males. The initial level of physical function was G1 in nine patients, G2 in seven patients, G3 in four patients, and G4 in two patients. Patients started pulmonary rehabilitation at a median of 7.5 days (range, 1 to 29 days) after lung transplantation. We did not observe any rehabilitation-related complications during follow-up. The final level of physical function was G1 in six patients, G3 in two patients, and G4 in 14 patients. Fourteen of the 22 patients were able to walk with or without assistance, and 13 of them maintained G4 until discharge; the eight remaining patients never achieved G4.
Conclusions
Our results suggest the feasibility of early pulmonary rehabilitation initiated in the ICU within a few days after lung transplantation.

Citations

Citations to this article as recorded by  
  • Post-operative, inpatient rehabilitation after lung transplant evaluation (PIRATE): A feasibility randomized controlled trial
    Benjamin J Tarrant, Elizabeth Quinn, Rebecca Robinson, Megan Poulsen, Louise Fuller, Greg Snell, Bruce R Thompson, Brenda M Button, Anne E Holland
    Physiotherapy Theory and Practice.2023; 39(7): 1406.     CrossRef
  • Early Gait Function After Lung Transplantation in Patients With and Without Pretransplant Extracorporeal Membrane Oxygenation Support
    Junghwa Do, Hyojin Lim, Kyung Cheon Seo, Suyoung Park, HyeRin Joo, Junghoon Lee, Eunjae Ko, Jaehwal Lim, Ho Cheol Kim, Dongkyu Oh, Sang-Bum Hong, Won Kim
    Transplantation Proceedings.2023; 55(3): 616.     CrossRef
Basic science and research
Changes in Insulin-like Growth Factor-1 Level in Patients with Sepsis and Septic Shock
Sang Hoon Lee, Byung Hoon Park, Joo Han Song, Song Yee Kim, Kyung Soo Chung, Eun Young Kim, Ji Ye Jung, Young Sam Kim, Se Kyu Kim, Joon Chang, Moo Suk Park
Korean J Crit Care Med. 2016;31(4):324-333.   Published online November 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00024
  • 7,339 View
  • 117 Download
AbstractAbstract PDF
Background
Despite many ongoing, prospective studies on the topic, sepsis still remains one of the main causes of death in hospital. The hormone insulin-like growth factor 1 (IGF-1) has a similar molecular structure to that of insulin. IGF-1 exerts anabolic effects and plays important roles in both normal physiology and pathologic processes. Previous studies have observed low serum IGF-1 level in patients with critical illnesses. Here, we evaluated changes in IGF-1 level based on survival of septic patients.
Methods
We evaluated 140 patients with sepsis and septic shock (21 with sepsis and 119 with septic shock) admitted to the intensive care unit of a university-affiliated hospital in Korea. Serum IGF-1 level was measured on days 0, 1, 3, and 7. Patients with liver disease were excluded from this study. All data were analyzed using SPSS version 20 (SPSS Inc., Chicago, IL, USA).
Results
Patients with septic shock had significantly lower serum IGF-1 level on days 1 and 3 than patients without septic shock (p = 0.002 and p = 0.007, respectively). Generally, there was a negative relationship between IGF-1 and serum cortisol levels; however, this relationship was only significant on day 3 (p = 0.029). Furthermore, renin showed significantly negative correlation with IGF-1 on day 3 (p = 0.038). IGF-1 level did not show significant difference between survivors and non-survivors.
Conclusions
Our results showed that IGF-1 was associated with septic shock, and that the IGF-1 axis is severely disrupted in septic patients. Additionally, serum cortisol and renin levels were associated with IGF-1 level.
Case Reports
Genetic
Lethal Hyperammonemia due to Ornithine Transcarbamylase Deficiency in a Patient with Severe Septic Shock
Ji An Hwang, Joo Han Song, Young Seok Lee, Kyung Soo Chung, Song Yee Kim, Eun Young Kim, Ji Ye Jung, Young Ae Kang, Young Sam Kim, Joon Chang, Moo Suk Park
Korean J Crit Care Med. 2016;31(2):140-145.   Published online May 31, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.2.140
  • 7,362 View
  • 83 Download
AbstractAbstract PDF
Severe hyperammonemia can occur as a result of inherited or acquired liver enzyme defects in the urea cycle, among which ornithine transcarbamylase deficiency (OTCD) is the most common form. We report a very rare case of a 45-year-old Korean male who was admitted to the intensive care unit (ICU) due to severe septic shock with acute respiratory failure caused by Pneumocystis jiroveci pneumonia. During his ICU stay with ventilator care, the patient suffered from marked hyperammonemia (>1,700 μg/dL) with abrupt mental change leading to life-threatening cerebral edema. Despite every effort including continuous renal replacement therapy and use of a molecular adsorbent recirculating system (extracorporeal liver support–albumin dialysis) to lower his serum ammonia level, the patient was not recovered. The lethal hyperammonemia in the patient was later proven to be a manifestation of acquired liver enzyme defect known as OTCD, which is triggered by serious catabolic conditions, such as severe septic shock with acute respiratory failure.
Hematology/Pulmonary
Hemophagocytic Lymphohistiocytosis after Lung Transplantation
Ah Young Leem, Sung Woo Moon, Song Yee Kim, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Hyo Chae Paik, June Won Cheong, Kyung Soo Chung
Korean J Crit Care Med. 2015;30(1):38-41.   Published online February 28, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.1.38
  • 57,836 View
  • 80 Download
AbstractAbstract PDF
Hemophagocytic lymphohistiocytosis (HLH) is a rare but fatal complication after solid organ transplantation. Acquired forms of HLH are described in association with severe sepsis, autoimmune disorders, malignancy, immune-compromised states, infections, and solid organ transplantation. We experienced a case of hemophagocytic lymphohistiocytosis after bilateral lung transplantation. Leukopenia, thrombocytopenia, and hyperbilirubinemia were noted and became aggravated 50 days after transplantation. Diagnosis of HLH was based on clinical and laboratory findings of splenomegaly, cytopenia, elevated ferritin, elevated interleukin-2 receptor, and hemophagocytosis in bone marrow. Other features such as elevated bilirubin, lactate dehydrogenase, and D-dimer which can be present in HLH were also noted. The patient was immediately treated with etoposide and dexamethasone. Despite aggressive therapy, the patient deteriorated and died. Awareness of the diagnostic criteria of HLH after lung transplantation is important for clinicians.

ACC : Acute and Critical Care