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Pediatrics
An advanced pediatric early warning system: a reliable sentinel, not annoying extra work
Young Joo Han
Acute Crit Care. 2022;37(4):667-668.   Published online November 29, 2022
DOI: https://doi.org/10.4266/acc.2022.01445
  • 450 View
  • 54 Download
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Case Reports
Disseminated Neonatal Herpes Simplex Virus Infection
Bongjin Lee, Jinsol Hwang, Yu Hyeon Choi, Young Joo Han, Young Hun Choi, June Dong Park
Korean J Crit Care Med. 2013;28(4):331-335.
DOI: https://doi.org/10.4266/kjccm.2013.28.4.331
  • 2,657 View
  • 43 Download
  • 1 Citations
AbstractAbstract PDF
Disseminated neonatal herpes simplex virus (HSV) infection is one of the most severe neonatal infections, and can have devastating consequences without early proper treatment. However, the administration of acyclovir can often be delayed because the symptoms and signs of HSV infection are non-specific and because HSV polymerase chain reaction (PCR) results may be negative early in the course of HSV infection. We report a case of disseminated neonatal HSV infection that was diagnosed by type 1 HSV PCR on day 8 of admission. Despite delayed administration of acyclovir, the patient was cured and subsequently discharged after 30 days of admission. Fortunately, this patient was treated successfully, but delayed administration of acyclovir has the potential to lead to significant problems. Considering the seriousness of neonatal HSV infection, empirical acyclovir therapy should be considered if HSV infection is suspected.

Citations

Citations to this article as recorded by  
  • A Case of Herpes Simplex Virus Type 2 Encephalitis of a Newborn Delivered by a Mother without Prenatal Screening
    Eun Seob Lee, Joon Young Kim, Kon Hee Lee, Jung Won Lee, Yong Ju Lee, Yeon Joung Oh, Ji Seok Bang, Tae-Jung Sung
    Korean Journal of Perinatology.2014; 25(3): 195.     CrossRef
A Case of Exertional Heat Stroke with Acute Hepatic Failure Treated with Plasma Exchange: A Case Report
Young Joo Han, Jae Wook Choi, Woo Jin Chung, Dong In Suh, June Dong Park
Korean J Crit Care Med. 2012;27(2):130-133.
DOI: https://doi.org/10.4266/kjccm.2012.27.2.130
  • 2,705 View
  • 28 Download
  • 1 Citations
AbstractAbstract PDF
Heat stroke is a hyperthermia-induced systemic inflammatory response which may cause multiorgan dysfunction syndrome. We report a case of exertional heat stroke with acute hepatic failure in an 11-year-old boy. He initially presented hyperthermia and unconsciousness, which occurred after heavy exercise. His neurological state improved after terminating the hyperthermia by intensive cooling therapy. However, 24 hours after the initial recovery, his neurological state deteriorated again as acute hepatic injury progressed rapidly. We applied 4 times of total plasma exchange as an immunotherapy for systemic inflammatory response syndrome and acute hepatic failure expecting it to remove endogenous inflammatory factors and hepatotoxic cytokines. Following the plasma exchange, his mental state became normal and serial laboratory findings indicated improvement. He made a complete recovery without sequelae. We experienced successful treatment regarding exertional heat stroke with acute hepatic failure using plasma exchange.

Citations

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  • Therapeutic plasma exchange in the treatment of exertional heat stroke and multiorgan failure
    Vimal Master Sankar Raj, Amanda Alladin, Brent Pfeiffer, Chryso Katsoufis, Marissa Defreitas, Alicia Edwards-Richards, Jayanthi Chandar, Wacharee Seeherunvong, Gwenn McLaughlin, Gaston Zilleruelo, Carolyn L. Abitbol
    Pediatric Nephrology.2013; 28(6): 971.     CrossRef
Original Article
Predictors of Mortality and Complication in Pediatric Patients Who Require Continuous Renal Replacement Therapy in Pediatric Intensive Care Unit
Jae Wook Choi, Woo Jin Chung, Young Joo Han, Ju Kyung Lee, Dong In Suh, June Dong Park, Young Yull Koh
Korean J Crit Care Med. 2011;26(3):171-176.
DOI: https://doi.org/10.4266/kjccm.2011.26.3.171
  • 2,618 View
  • 34 Download
  • 1 Citations
AbstractAbstract PDF
BACKGROUND
The objective of this study is to analyze the factors associated with mortality and complication in children requiring continuous renal replacement therapy (CRRT) in a pediatric intensive care unit.
METHODS
We retrospectively analyzed 96 patients who required CRRT at a pediatric intensive care unit in Seoul National University Hospital between April 2005 and April 2011. We evaluated the clinical features, diagnosis, mortality risk factors and complications related to CRRT.
RESULTS
Univariate and multivariate analyses were performed to analyze the mortality risk factors of patients requiring CRRT. The overall mortality was 56.3%, the median age was 8 years, and the ages ranged from 4 days to 22 years. The median weight of the patients was 7.9 kg, and the weights ranged from 3.6-72.9 kg. 16 patients were diagnosed with primary renal disease, and the remainder with other underlying diseases. Mortality was higher in children who received stem cell transplantation and in children with a diagnosis of imunologic disease and neurologic disease. The Pediatric Risk of Mortality (PRISM) III score at initiating CRRT was 17.8 +/- 8.9 and the degree of fluid overload at CRRT (FO%) was 12.9 +/- 16.0. The PRISM III score at the start of CRRT and low uric acid level were the factors associated with an increased risk of mortality. Of the 96 children, 13 (13.53%) presented problems of venous catheterization. Hypotension during connection to CRRT was detected in 28 patients (29.2%). Clinically significant hemorrhage occurred in 10 patients (10.4%).
CONCLUSIONS
Children who require CRRT have a high mortality rate. The higher score of PRISM III at the starting time of CRRT and the lower uric acid level are the factors associated with a higher mortality. The most frequent complication of CRRT was hypotension on connection to CRRT.

Citations

Citations to this article as recorded by  
  • Continuous Renal Replacement Therapy in the Neonatal Intensive Care Unit: A Single-Center Study
    Moon-yeon Oh, Byong Sop Lee, Seong-Hee Oh, Hee Jin Jang, Hyun-Jeong Do, Ellen Ai-Rhan Kim, Ki-Soo Kim, Joo Hoon Lee, Young Seo Park, Beom-Hee Lee, Han-Wook Yoo
    Neonatal Medicine.2014; 21(4): 244.     CrossRef
Case Report
A Case of Severe Acute Exacerbation of Bronchial Asthma Treated with Low Minute Ventilation: A Case Report
Young Joo Han, Dong In Suh, Young Seung Lee, June Dong Park
Korean J Crit Care Med. 2010;25(4):257-262.
DOI: https://doi.org/10.4266/kjccm.2010.25.4.257
  • 2,926 View
  • 84 Download
AbstractAbstract PDF
We report a case of severe status asthmaticus in a 3-year-old boy who required mechanical ventilatory support. He initially presented with rapidly progressing respiratory distress and spontaneous air leaks. Although he was intubated and received mechanical ventilation, dynamic hyperinflation and air leaks were aggravated. We applied the volume control mode, providing sufficient tidal volume (10 ml/kg), a reduced respiratory rate (25/minute), and a prolonged expiratory time (1.8 seconds) to overcome dynamic hyperinflation. After allowing full expiration of trapped air, his over-expanded lung volumes were decreased and the air leaks resolved. He made a complete recovery without sequelae. Dynamic hyperinflation in asthmatic patients occurs from incomplete exhalation throughout narrowed airways. Controlled hypoventilation or permissive hypercapnia is an important lung-protective ventilator strategy and is beneficial in reducing dynamic hyperinflation. We suggest a controlled hypoventilation strategy with a prolonged expiratory time for patients in severe status asthmaticus with dynamic hyperinflation.

ACC : Acute and Critical Care