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2 "Yong Jun Choi"
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Original Article
Epidemiology
Trends and management of acute respiratory failure in hospitalized patients: a multicenter retrospective study in South Korea
Won Jin Yang, Yong Jun Choi, Kyung Soo Chung, Ji Soo Choi, Bo Mi Jung, Jae Hwa Cho
Acute Crit Care. 2025;40(2):171-185.   Published online May 28, 2025
DOI: https://doi.org/10.4266/acc.004728
  • 5,077 View
  • 135 Download
AbstractAbstract PDFSupplementary Material
Background
Acute respiratory failure (ARF) is the leading cause of hospitalization and is associated with in-hospital mortality. This study aimed to elucidate the epidemiology and clinical outcomes of ARF.
Methods
We retrospectively screened patients admitted to three hospitals in South Korea between January 2018 and December 2022. We included individuals aged 18 years, diagnosed with either type 1 ARF (arterial oxygen partial pressure [PaO2] <60 mm Hg) or type 2 ARF (arterial carbon dioxide partial pressure (PaCO2) >45 mm Hg) with a pH of <7.35, or diagnosed with the combined-type ARF.
Results
Among the 768,700 hospitalized patients, 33,278 (4.3%) developed ARF. The most common cause of ARF was sepsis (15,757 patients, 47.3%), and the most frequent comorbidity was malignancy (15,403 patients, 43.6%). Among ARF patients, 15,671 (47.1%) required intensive care unit transfer, while 8,980 (27.0%) experienced in-hospital mortality. Over 5 years, the proportion of ARF patients aged 80 years and older has shown a consistent annual increase (coefficient, 0.085 and Ptrend <0.001). Concurrently, the in-hospital mortality rate exhibited an upward trend, increasing from 25.5% in 2018 to 29.3% in 2022 (coefficient, 1.017 and Ptrend<0.001). Among the respiratory support methods used for patients with ARF over the 5-year period, high-flow nasal cannula usage steadily increased (coefficient, 4.137 and Ptrend<0.001), whereas the use of invasive mechanical ventilation declined (coefficient, –0.983 and Ptrend<0.001).
Conclusions
ARF frequency and in-hospital mortality rates are increasing, driven by various etiologies. Despite these trends, research on the epidemiology and individualized treatments for older patients is limited, highlighting the need for nationwide prospective multicenter studies.
Guideline
Meta-analysis
Early management of adult sepsis and septic shock: Korean clinical practice guidelines
Chul Park, Nam Su Ku, Dae Won Park, Joo Hyun Park, Tae Sun Ha, Do Wan Kim, So Young Park, Youjin Chang, Kwang Wook Jo, Moon Seong Baek, Yijun Seo, Tae Gun Shin, Gina Yu, Jongmin Lee, Yong Jun Choi, Ji Young Jang, Yun Tae Jung, Inseok Jeong, Hwa Jin Cho, Ala Woo, Sua Kim, Dae-Hwan Bae, Sung Wook Kang, Sun Hyo Park, Gee Young Suh, Sunghoon Park
Acute Crit Care. 2024;39(4):445-472.   Published online November 18, 2024
DOI: https://doi.org/10.4266/acc.2024.00920
  • 36,507 View
  • 1,605 Download
  • 4 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary Material
Background
Despite recent advances and global improvements in sepsis recognition and supportive care, mortality rates remain high, and adherence to sepsis bundle components in Korea is low. To address this, the Korean Sepsis Alliance, affiliated with the Korean Society of Critical Care Medicine, developed the first sepsis treatment guidelines for Korea based on a comprehensive systematic review and meta-analysis.
Methods
A de novo method was used to develop the guidelines. Methodologies included determining key questions, conducting a literature search and selection, assessing the risk of bias, synthesizing evidence, and developing recommendations. The certainty of evidence and the strength of recommendations were determined using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Draft recommendations underwent internal and external review processes and public hearings. The development of these guidelines was supported by a research grant from the Korean Disease Control and Prevention Agency.
Results
In these guidelines, we focused on early treatments for adult patients with sepsis and septic shock. Through the guideline development process, 12 key questions and their respective recommendations were formulated. These include lactate measurement, fluid therapies, target blood pressure, antibiotic administration, use of vasopressors and dobutamine, extracorporeal membrane oxygenation, and echocardiography.
Conclusions
These guidelines aim to support medical professionals in making appropriate decisions about treating adult sepsis and septic shock. We hope these guidelines will increase awareness of sepsis and reduce its mortality rate.

Citations

Citations to this article as recorded by  
  • Comparison between norepinephrine plus epinephrine and norepinephrine plus vasopressin after return of spontaneous circulation in patients with out-of-hospital cardiac arrest
    Sejoong Ahn, Bo-Yeong Jin, Sukyo Lee, Jong-Hak Park, Hanjin Cho, Sungwoo Moon, Sang Kuk Han, Phil Cho Choi, Young Hwan Lee, Sang O. Park, Jong Seok Lee, Ki Young Jeong, Sung Hyuk Choi, Young Hoon Yoon, Su Jin Kim, Kap Su Han, Min Seob Sim, Gun Tak Lee, Yo
    Scientific Reports.2025;[Epub]     CrossRef
  • Recommendations for the use of biomarkers for the management of adults with sepsis: a scoping review and critical appraisal
    Miriam Mateos-Haro, Ana Garcia-Santa-Vinuela, Daniel Molano-Franco, Ivan Solà, Federico Gordo-Vidal, María Cruz Martín-Delgado, Jesus Lopez-Alcalde, Javier Zamora
    BMJ Open.2025; 15(7): e090922.     CrossRef
  • Regional Adherence to Early Sepsis Management Bundle and Associated Mortality in Hong Kong Between 2009–2018
    Jack Zhenhe Zhang, Chun Hei Chan, Lok Ching Chang, Lok Ching Sandra Chiu, Pauline Yeung Ng, Manimala Dharmangadan, Eunise Ho, Steven Ling, Man Yee Man, Ka Man Fong, Ting Liong, Alwin Wai Tak Yeung, Ka Fai Au, Jacky Ka Hing Chan, Michele Tang, Katy Hoi Ki
    Open Forum Infectious Diseases.2025;[Epub]     CrossRef
  • Outcomes of septic shock from urinary and non-urinary sources in nonagenarians and centenarians admitted to intensive care units
    Je Min Suh, Laurence Weinberg, Nattaya Raykateeraroj, Jerry Lim, Angelina Yoon, David Pilcher, Dong-Kyu Lee
    Scientific Reports.2025;[Epub]     CrossRef
  • Association between emergency department–to–intensive care unit transfer time and mortality in patients with septic shock: a target trial emulation with septic shock in South Korea
    Ji Hyun Cha, Danbee Kang, Ryoung-Eun Ko, Won Young Kim, Dong-gon Hyun, Yeon Joo Lee, Woo Hyun Cho, Sunghoon Park, Juhee Cho, Gee Young Suh
    Acute and Critical Care.2025; 40(4): 548.     CrossRef
  • Early Versus Delayed Norepinephrine Initiation in Septic Shock: A Systematic Review and Meta-Analysis of Randomized and Observational Studies
    Chibuzo C Manafa, Oluwayemisi E Ekor, Akintunde C Akinboboye, Okelue E Okobi, Gift Ojukwu, Osemwegie O Ugbo, Michael U Mochu, Emasenyie Isikwei, Sergio Hernandez Borges, Miguel Diaz-Miret
    Cureus.2025;[Epub]     CrossRef
  • Quality assessment of clinical practice guidelines for sepsis and variations in recommendations
    Hong-Yan Li, Shan-Ling Jiang, Jing Wang, Hai-Shan Wang, Li-Hong Wang
    BMC Infectious Diseases.2025;[Epub]     CrossRef
  • Evidence-Based Interventions for Sepsis Management in Critically Ill Adults: A Systematic Review
    Elsa Jardim Sousa, Michelle de Soresa Virissimo, Abel Mendonça Viveiros, Ana Alves, Valter Gonçalves
    European Journal of Medical and Health Research.2025; 3(6): 232.     CrossRef
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