Acute and Critical Care

Original Article

Trauma
Comparison of ropivacaine, bupivacaine, and lignocaine in femoral nerve block to position fracture femur patients for central neuraxial blockade in Indian population: Manik Seth, Santvana Kohli, Madhu Dayal, Arin Choudhury; Acute Crit Care. 2024;39(2):275-281. Published online May 30, 2024; DOI: https://doi.org/10.4266/acc.2023.01606

9,403 View
205 Download
2 Web of Science
3 Crossref

Background
Patients with a fractured femur experience intense pain during positioning for neuraxial block for definitive surgery. Femoral nerve block (FNB) is therefore often given prior to positioning for analgesia. In our study, we compare the onset and quality of block of 0.25% bupivacaine, 0.5% ropivacaine, and 1.5% lignocaine for FNB in fracture femur patients.
Methods
Seventy-five adult femur fracture patients were equally and randomly divided into three groups to receive 15 ml of either 0.25% bupivacaine (group B), 0.5% ropivacaine (group R), or 1.5% lignocaine (group L) for FNB prior to positioning for neuraxial blockade. Onset and quality of block were assessed, as well as improvement in visual analog scale (VAS) score, ease of positioning, and patient satisfaction.
Results
Percentage decrease in VAS was found to be highest in group R (82.8%) followed by groups L and B. Time to achieve a VAS of less than 4 was found to be 26.2±2.4 minutes in group B, 8.5±1.9 minutes in group R, and 4.1±0.7 minutes in group L (P<0.001). In group B, 12 patients required additional fentanyl to achieve a VAS <4. Patient positioning was reported to be satisfactory in all patients in group R and L, while in B it was satisfactory in 13 (52%) patients only. Patient acceptance of FNB was 100% in group R and L, but only 64% in group B.
Conclusions
Based on our findings, 0.5% ropivacaine is a favorable choice for FNB due to early onset, ability to yield a good quality block, and good safety profile.

Citations

Citations to this article as recorded by

Efficacy and Safety of Ropivacaine versus Levobupivacaine in Ultrasound-Guided Femoral Nerve Blocks for Perioperative Analgesia in Femur Fracture Patients: A Systematic Review
Arpita Chowdhury, Vaskar Majumdar, Chirasree Chowdhury, Bhaskar Biswas, Simmons Debbarma
International Journal of Health Sciences and Research.2026; : 238. CrossRef
Concentration of local anesthetics is important in nerve blocks
Raghuraman M. Sethuraman
Acute and Critical Care.2025; 40(1): 150. CrossRef
Post-surgical pain: evolving drug treatments and challenges
Mohammad Khudirat, Loay Allafy, Bhuvrit Raj Dhakal, Adriana Baranov, Alparslan Turan
Expert Opinion on Pharmacotherapy.2025; 26(18): 2027. CrossRef

Review Article

Cardiology
Beta-blocker therapy in patients with acute myocardial infarction: not all patients need it: Seung-Jae Joo; Acute Crit Care. 2023;38(3):251-260. Published online August 31, 2023; DOI: https://doi.org/10.4266/acc.2023.00955

54,049 View
2,994 Download
16 Web of Science
19 Crossref

Abstract PDF

Most of the evidences for beneficial effects of beta-blockers in patients with acute myocardial infarction (AMI) were from the clinical studies published in the pre-reperfusion era when anti-platelet drugs, statins or inhibitors of renin-angiotensin-aldosterone system which are known to reduce cardiovascular mortality of patients with AMI were not introduced. In the reperfusion era, beta-blockers’ benefit has not been clearly shown except in patients with reduced ejection fraction (EF; ≤40%). In the era of the early reperfusion therapy for AMI, a number of patients with mildly reduced EF (>40%, <50%) or preserved EF (≥50%) become increasing. However, because no randomized clinical trials are available until now, the benefit and the optimal duration of oral treatment with beta-blockers in patients with mildly reduced or preserved EF are questionable. Registry data have not showed the association of oral beta-blocker therapy with decreased mortality in survivors without heart failure or left ventricular systolic dysfunction after AMI. In the Korea Acute Myocardial Infarction Registry-National Institute of Health of in-hospital survivors after AMI, the benefit of beta-blocker therapy at discharge was shown in patients with reduced or mildly reduced EF, but not in those with preserved EF, which provides new information about beta-blocker therapy in patients without reduced EF. However, clinical practice can be changed when the results of appropriate randomized clinical trials are available. Ongoing clinical trials may help to answer the unresolved issues of beta-blocker therapy in patients with AMI.

Citations

Citations to this article as recorded by

Finn Waagstein and the paradigm shift in the treatment of heart failure with β-adrenergic receptor antagonists (‘β-blockers’)
Kristina Lorenz, Ursula Ravens
Naunyn-Schmiedeberg's Archives of Pharmacology.2026; 399(3): 3133. CrossRef
Pharmacology of Atenolol: A β1-Selective Adrenoceptor Inhibitor
Mohammad Shah Amran, Nasrin Akhter, Fareha Anan Shristy, Sumaiya Rahman, Runa Akter, Mohammad Josim Uddin
Biomedical & Pharmacology Journal.2026; 1(19): 15. CrossRef
β2 adrenergic receptors orchestrate neutrophil demargination and recruitment to the ischemic heart following myocardial infarction
Albert Dahdah, Krishna P. Maremanda, Mathankumar Marimuthu, Ki Ho Park, Robert M. Jaggers, Dipanjan Chattopadhyay, Wang Qiang, Nitin Nitin, Stavros Stavrakis, Tarun W. Dasari, Viorel I. Șuicã, Raluca M. Boteanu, Elena Uyy, Felicia Antohe, Douglas G. Tille
Nature Communications.2026;[Epub] CrossRef
Reflections on Oral Beta Blocker Therapy and Long-term Outcomes after Myocardial Infarction in Preserved Left Ventricular Function
Reza Yaghoubi Nezhad, Hossein Zare, Ali Abasi
Cardiovascular Drugs and Therapy.2026;[Epub] CrossRef
Rosa davurica Pall. as a Functional Food in Ameliorating Acute Myocardial Ischemia: An Integrated Multi‐Omics Study on TNF‐α and Oxidative Stress
Zeyu Yi, Siyu Liu, Lincheng Bai, Fan Yang, Zhenkun Wang, Xiubo Zhu, Zunpeng Shu, Hua Han, Xiaojin Yu
Chemistry & Biodiversity.2026;[Epub] CrossRef
Chronic β-Blockade and Systemic Homeostasis: Molecular Integration of Cardiorenal and Immune Pathways, a Narrative Review
Jason Park, Amethyst Hamanaka, Issac Park, Hosam Gharib Abdelhady
Biomolecules.2025; 15(12): 1653. CrossRef
Beta-Blockers in Patients With Myocardial Infarction: A Meta-Analysis
Mushood Ahmed, Areeba Ahsan, Aimen Shafiq, Hasan Ahmad, Raheel Ahmed, Jamal S. Rana, Marat Fudim, Gregg C. Fonarow
American Journal of Therapeutics.2025; 32(4): e351. CrossRef
Neuroimmune Interactions and Their Role in Immune Cell Trafficking in Cardiovascular Diseases and Cancer
Yutang Wang, Jack C. Anesi, Indu S. Panicker, Darcy Cook, Prapti Bista, Yan Fang, Ernesto Oqueli
International Journal of Molecular Sciences.2025; 26(6): 2553. CrossRef
Elevated serum amylase concentrations are associated with worse in-hospital outcomes among patients with acute myocardial infarction
Marijana Mikacic, Marko Kumric, Iva Rancic Vidic, Duska Glavas, Tina Ticinovic Kurir, Josko Bozic, Josip Andelo Borovac
BMC Cardiovascular Disorders.2025;[Epub] CrossRef
Cardiac arrhythmia following acute myocardial infarction: a retrospective analysis of 27,648 hospitalized patients in a tertiary heart hospital
Nidal Asaad, Ayman El-Menyar, Rajvir Singh, Betsy Varughese, Shahul Hameed Khan, Hajar AlBinali, Jassim Al Suwaidi
Monaldi Archives for Chest Disease.2025;[Epub] CrossRef
Beta-Adrenergic Blockers for Acute Myocardial Infarction: 50 years of Expert Opinions in Cecil Textbook of Medicine
Peter Manu, Gheorghe-Andrei Dan
American Journal of Therapeutics.2025; 32(3): e274. CrossRef
Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction
Min-Wook Bae, Seong-guen Moon, Kyung-Tae Jung, Won-Ho Kim, Sang-Hyun Park, Jihun Ahn, Jin-Yong Hwang, Seok Kyu Oh, Seung Ho Hur, Myung Ho Jung, Kyu-Sun Lee
Frontiers in Cardiovascular Medicine.2025;[Epub] CrossRef
Identification and Validation of Calcium-Related Diagnostic Markers for Acute Myocardial Infarction via Bioinformatics Analysis and Machine Learning
Biao Wang, Jianhong Chen, Leili Wang, Yanli Liu, Liu Miao
International Heart Journal.2025; 66(4): 639. CrossRef
A hypoxia-on-a-chip platform for modeling ischemic arrhythmogenesis and evaluating the effects of levosimendan and OR-1896 on ischemic human iPSC-derived cardiomyocytes
Mahmoud Gaballah, Kaisla Walls, Fatma Zakzook, Joose Kreutzer, Jouko Levijoki, Katriina Aalto-Setälä
Frontiers in Bioengineering and Biotechnology.2025;[Epub] CrossRef
In-hospital cardiac arrest after STEMI: prevention strategies and post-arrest care
Walker Boyd, Wesley Young, Mehmet Yildiz, Timothy D. Henry, Kari Gorder
Expert Review of Cardiovascular Therapy.2024; 22(8): 379. CrossRef
Association between Inflammation and New-Onset Atrial Fibrillation in Acute Coronary Syndromes
Ruxandra-Maria Băghină, Simina Crișan, Silvia Luca, Oana Pătru, Mihai-Andrei Lazăr, Cristina Văcărescu, Alina Gabriela Negru, Constantin-Tudor Luca, Dan Gaiță
Journal of Clinical Medicine.2024; 13(17): 5088. CrossRef
Use of Early Intravenous Beta Blockers in Patients with Acute ST-Segment Elevation Myocardial Infarction Without Heart Failure—Revival or Requiem?
Azka Latif, Xiaoming Jia
Cardiovascular Drugs and Therapy.2024; 38(5): 973. CrossRef
Progress in Disease Modeling for Myocardial Infarction and Coronary Artery Disease: Bridging In Vivo and In Vitro Approaches
Riya Kar, Debabrata Mukhopadhyay, Ramcharan Singh Angom
Hearts.2024; 5(4): 429. CrossRef
Optimal duration of medical therapy for patients with acute myocardial infarction
Ki Yung Boo, Seung-Jae Joo, Jae-Geun Lee, Joon-Hyouk Choi, Song-Yi Kim, Geum Ko, Hae Eun Yun, Myung Ho Jeong
Medicine.2024; 103(48): e40697. CrossRef

Original Article

CPR/Resuscitation
Risk factors associated with inpatient cardiac arrest during emergency endotracheal intubation at general wards: Chul Park; Acute Crit Care. 2019;34(3):212-218. Published online August 31, 2019; DOI: https://doi.org/10.4266/acc.2019.00598; Correction in: Acute Crit Care 2020;35(3):228

11,287 View
177 Download
18 Web of Science
16 Crossref

Abstract PDF

Background
Peri-intubation cardiac arrest (PICA) following emergent endotracheal intubation (ETI) is a rare, however, potentially preventable type of cardiac arrest. Limited published data have described factors associated with inpatient PICA and patient outcomes. The aim of this study was to identify risk factors associated with PICA among hospitalized patients emergently intubated at a general ward as compared to non-PICA inpatients. In addition, we identified a difference of clinical outcomes in patients between PICA and other types of inpatient cardiac arrest (OTICA).
Methods
We conducted a retrospective observational study of patients at two institutions between January 2016 to December 2017. PICA was defined in patients emergently intubated who experienced cardiac arrest within 20 minutes after ETI. The non-PICA group consisted of inpatients emergently intubated without cardiac arrest. Risk factors for PICA were identified through univariate and multivariate logistic regression analysis. Clinical outcomes were compared between PICA and OTICA.
Results
Fifteen episodes of PICA occurred during the study period, accounting for 3.6% of all inpatient arrests. Intubation-related shock index, number of intubation attempts, pre-ETI vasopressor use, and neuromuscular blocking agent (NMBA) use, especially succinylcholine, were independently associated with PICA. Clinical outcomes of intensive care unit and hospital length of stay, survival to discharge, and neurologic outcome at hospital discharge were not significantly different between PICA and OTICA.
Conclusions
We identified four independent risk factors for PICA, and preintubation hemodynamic stabilization and avoidance of NMBA were possibly correlated with a decreased PICA risk. Clinical outcomes of PICA were similar to those of OTICA.

Citations

Citations to this article as recorded by

Incidence and predisposing factors associated with peri-intubation cardiac arrest: A systematic review and meta-analysis
Nattikarn Meelarp, Wachira Wongtanasarasin
Turkish Journal of Emergency Medicine.2025; 25(2): 130. CrossRef
Risk Factors of Peri-Intubation Cardiac Arrest in Critically Ill Patients Presenting to the Emergency Department of a Low-Income Country: A Case-Control Study
Noman Ali, Nazir Najeeb Kapadia, Salman Muhammad Soomar, Ahmed Raheem, Naheed Habibullah, Zahra Habib, Shahan Waheed
The Journal of Emergency Medicine.2025; 76: 26. CrossRef
Atemwegssicherung in HD: Standards für Videolaryngoskopie und flexible Endoskopie
Katharina Hardt, Henning Niedmers, Frank Wappler
AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie.2025; 60(07/08): 415. CrossRef
Nomogram model for predicting post-intubation cardiac arrest in the emergency department: a retrospective study
Xiaohua Lou, Bingwen Zhang, Miaomiao Jin, Yuan Fang, Daoyuan Jin, Hao Zhou
Resuscitation Plus.2025; 26: 101115. CrossRef
Cardiac Arrest Caused by Tracheal Intubation During Anesthesia Induction: A Case Report
Haiyun Gu, Haikun Zhang, Le Cao, Jinxiang Yu, Tao Zhao
Clinical Case Reports.2025;[Epub] CrossRef
Risk factors for peri-intubation cardiac arrest: A systematic review and meta-analysis
Ting-Hao Yang, Shih-Chieh Shao, Yi-Chih Lee, Chien-Han Hsiao, Chieh-Ching Yen
Biomedical Journal.2024; 47(3): 100656. CrossRef
Patient Safety in Anesthesiology: Progress, Challenges, and Prospects
Wafaa Harfaoui, Mustapha Alilou, Ahmed Rhassane El Adib, Saad Zidouh, Aziz Zentar, Brahim Lekehal, Lahcen Belyamani, Majdouline Obtel
Cureus.2024;[Epub] CrossRef
Reverse shock index (RSI) as a predictor of post-intubation cardiac arrest (PICA)
Mehdi Torabi, Ghazal Soleimani Mahani, Moghaddameh Mirzaee
International Journal of Emergency Medicine.2023;[Epub] CrossRef
Incidence and factors associated with out-of-hospital peri-intubation cardiac arrest: a secondary analysis of the CURASMUR trial
Cédric Gil-Jardiné, Patricia Jabre, Frederic Adnet, Thomas Nicol, Patrick Ecollan, Bertrand Guihard, Cyril Ferdynus, Valery Bocquet, Xavier Combes
Internal and Emergency Medicine.2022; 17(2): 611. CrossRef
Risk factors associated with peri-intubation cardiac arrest in the emergency department
Ting-Hao Yang, Kuan-Fu Chen, Shi-Ying Gao, Chih-Chuan Lin
The American Journal of Emergency Medicine.2022; 58: 229. CrossRef
Comparison of video-stylet and conventional laryngoscope for endotracheal intubation in adults with cervical spine immobilization: A PRISMA-compliant meta-analysis
I-Wen Chen, Yu-Yu Li, Kuo-Chuan Hung, Ying-Jen Chang, Jen-Yin Chen, Ming-Chung Lin, Kuei-Fen Wang, Chien-Ming Lin, Ping-Wen Huang, Cheuk-Kwan Sun
Medicine.2022; 101(33): e30032. CrossRef
Peri-Intubation Cardiorespiratory Arrest Risk in Pediatric Patients: A Systematic Review
Rohit S. Loomba, Riddhi Patel, Elizabeth Kunnel, Enrique G. Villarreal, Juan S. Farias, Saul Flores
Journal of Pediatric Intensive Care.2022;[Epub] CrossRef
Comparison of Suction Rates Between a Standard Yankauer, a Commercial Large-Bore Suction Device, and a Makeshift Large-Bore Suction Device
Dhimitri A. Nikolla, Briana King, Andrew Heslin, Jestin N. Carlson
The Journal of Emergency Medicine.2021; 61(3): 265. CrossRef
Emergency Airway Management Outside the Operating Room: Current Evidence and Management Strategies
Kunal Karamchandani, Jonathan Wheelwright, Ae Lim Yang, Nathaniel D. Westphal, Ashish K. Khanna, Sheila N. Myatra
Anesthesia & Analgesia.2021; 133(3): 648. CrossRef
Further Validation of a Novel Acute Myocardial Infarction Risk Stratification (nARS) System for Patients with Acute Myocardial Infarction
Shinnosuke Sawano, Kenichi Sakakura, Kei Yamamoto, Yousuke Taniguchi, Takunori Tsukui, Masaru Seguchi, Hiroshi Wada, Shin-ichi Momomura, Hideo Fujita
International Heart Journal.2020; 61(3): 463. CrossRef
Corrigendum to: Risk factors associated with inpatient cardiac arrest during emergency endotracheal intubation at general wards
Chul Park
Acute and Critical Care.2020; 35(3): 228. CrossRef

Case Report

Nephrology
Sudden Intraoperative Hyperkalemia during Laparoscopic Radical Nephrectomy in a Patient with Underlying Renal Insufficiency: Sung Hoon Jung, Yun-Joung Han, Sang Ho Shin, Hyo Seon Lee, Ji Young Lee; Acute Crit Care. 2017;33(4):271-275. Published online November 21, 2018; DOI: https://doi.org/10.4266/acc.2016.00696

12,799 View
134 Download
3 Web of Science
3 Crossref

Abstract PDF

We experienced a case of severe intraoperative hyperkalemia during laparoscopic radical nephrectomy in a 60-year-old male patient with renal insufficiency, whose hypertension had been managed by preoperative angiotensin II receptor blocker (ARB) and adrenergic beta-antagonist. After renal vessel ligation, his intraoperative potassium concentration suddenly increased to 7.0 mEq/L, but his electrocardiography (ECG) did not show any significant change. While preoperative ARB therapy has been regarded as a contributing factor for further aggravation of underlying renal insufficiency, we assumed that nephrectomy itself and rhabdomyolysis caused by surgical trauma also aggravated the underlying renal dysfunction and resulted in sudden hyperkalemia. Hyperkalemia was managed successfully with calcium gluconate, insulin, furosemide and crystalloid loading during the intraoperative and immediate postoperative periods, and potassium concentration decreased to 5.0 mEq/L at 8 hours after the operation. The patient’s hospital course was uncomplicated, but his renal function deteriorated further.

Citations

Citations to this article as recorded by

Hyperkalemia in pediatric nephrectomy: a common complication
Abigail Schnaith, Chia-shi Wang, Hui Huang, Adrianna Westbrook, H. Stella Shin, Larry A. Greenbaum
Pediatric Nephrology.2026; 41(6): 1761. CrossRef
Robotic‐Assisted Radical Cystectomy and Acute Intraoperative Hyperkalemia: A Case Series
Amro Khalili, Christian K. Raphael, Rasha Shreim, Nancy Abou Nafeh, Cynthia Karam
Clinical Case Reports.2025;[Epub] CrossRef
Acute Intraoperative Hyperkalemia During Robot-Assisted Radical Cystectomy: A Case Report
Nivedhyaa Srinivasaraghavan, Vallary Modh, Arun Menon
A&A Practice.2022; 16(12): e01650. CrossRef

Original Article

Infection
The Effects of Flecainide Acetate on Inflammatory-Immune Response in Lipopolysaccharide-Stimulated Neutrophils and on Mortality in Septic Rats: Shi Young Chung, Jinyoung Kim, Hong Bum Bae, Tran Duc Tin, Wan Ju, Sang Hyun Kwak; Acute Crit Care. 2018;33(1):34-41. Published online February 28, 2018; DOI: https://doi.org/10.4266/acc.2017.00577

11,106 View
138 Download
2 Web of Science
2 Crossref

Abstract PDF

Background
Flecainide acetate is a drug used primarily for cardiac arrhythmia. Some studies also imply that flecainide acetate has the potential to regulate inflammatory-immune responses; however, its mechanism of action is contended. We determined the effects of flecainide acetate on lipopolysaccharide (LPS)-stimulated human neutrophils in vitro and on mortality in a septic rat model.
Methods
Neutrophils from human blood were cultured with varying concentrations of flecainide acetate (1 μM, 10 μM, or 100 μM) with or without LPS (100 ng/ml). To assess neutrophil activation, the protein levels of tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-6 and IL-8 were measured after a 4-hour culture period. To assess the intracellular signaling pathways, the levels of phosphorylation of p38 mitogen-activated protein kinase (p38), extracellular signal-regulated kinase (ERK) 1/2, and c-Jun N-terminal kinase (JNK) were measured after a 30-minute culture period, and the nuclear translocation of nuclear factor (NF)-κB was measured after a 1-hour culture period. Additionally, the survival rate was investigated in a rat sepsis model.
Results
Flecainide acetate down-regulated the activation of proinflammatory cytokines, including TNF-α and IL-6 and IL-8, and intracellular signaling pathways including ERK 1/2 and NF-κB. Flecainide acetate also improved the survival rate in the rat sepsis model.
Conclusions
Collectively, these findings indicate that flecainide acetate can improve survival in a rat sepsis model by attenuating LPS-induced neutrophil responses. We therefore suggest that flecainide acetate plays an important role in modulating inflammatoryimmune responses.

Citations

Citations to this article as recorded by

Protective Role of Astaxanthin in Regulating Lipopolysaccharide-Induced Inflammation and Apoptosis in Human Neutrophils
Seongheon Lee, Sung Kuk Son, Eunye Cho, Sungah Yoo, Eun-A Jang, Sang Hyun Kwak
Current Issues in Molecular Biology.2024; 46(8): 8567. CrossRef
Persistence is key: unresolved immune dysfunction is lethal in both COVID-19 and non-COVID-19 sepsis
Andy Y. An, Arjun Baghela, Peter Zhang, Reza Falsafi, Amy H. Lee, Uriel Trahtemberg, Andrew J. Baker, Claudia C. dos Santos, Robert E. W. Hancock
Frontiers in Immunology.2023;[Epub] CrossRef

Review Article

Pharmacology
Assessment and Treatment of Pain in Adult Intensive Care Unit Patients: Jun Mo Park, Ji Hyun Kim; Korean J Crit Care Med. 2014;29(3):147-159. Published online August 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.3.147

29,965 View
822 Download
3 Crossref

Abstract PDF

In most cases, patients admitted to an intensive care unit (ICU) have suffered from severe trauma, undergone major surgery or been treated for a serious medical illness. Although they often experience more intense pain than general ward patients, they are frequently unable to communicate their experiences to health care providers, thus preventing accurate assessment and treatment of their pain. If appropriate measures are not taken to treat pain in critically ill patients, stress response or sympathetic overstimulation can lead to complications. The short-term consequences of untreated pain include higher energy expenditure and immunomodulation. Longer-term, untreated pain increases the risk of post-traumatic stress disorder. Because pain is quite subjective, the accurate assessment of pain is very difficult in the patients with impaired communication ability. The current most valid and reliable behavioral pain scales used to assess pain in adult ICU patients are the Behavioral Pain Scale and the Critical-Care Pain Observation Tool. Once pain has been accurately assessed using these methods, various pharmacologic and non-pharmacologic therapies should be performed by the multidisciplinary care team. Accurate assessment and proper treatment of pain in adult ICU patients will improve patients outcome, which reduces the stress response and decreases the risk of post-traumatic stress disorder.

Citations

Citations to this article as recorded by

Nurses’ knowledge, practice, and associated factors of pain assessment in critically ill adult patients at public hospitals, Addis Ababa, Ethiopia
Temesgen Ayenew, Berhanu Melaku, Mihretie Gedfew, Haile Amha, Keralem Anteneh Bishaw
International Journal of Africa Nursing Sciences.2021; 15: 100361. CrossRef
Impact of Pain Management Algorithm on Pain Intensity of Patients with Loss of Consciousness Hospitalized in Intensive Care Unit: A Clinical Trial
Zahra Dehghani, Asadollah Keikhaei, Fariba Yaghoubinia, Aliakbar Keykha, Masoom Khoshfetrat
Medical - Surgical Nursing Journal.2019;[Epub] CrossRef
Ignorance may be Bliss (for Intensivists), but not for ICU Patients!
Atul P. Kulkarni, Sumitra G Bakshi
Indian Journal of Critical Care Medicine.2019; 23(4): 161. CrossRef

Original Articles

Multicenter Prospective Observational Study about the Usage Patterns of Sedatives, Analgesics and Neuromuscular Blocking Agents in the Patients Requiring More Than 72 Hours Mechanical Ventilation in Intensive Care Units of Korea: Hang Jea Jang, Seung Won Ra, Bum Jin Oh, Chae Man Lim, Younsuck Koh, Sang Bum Hong; Korean J Crit Care Med. 2009;24(3):145-151.; DOI: https://doi.org/10.4266/kjccm.2009.24.3.145

4,370 View
52 Download
3 Crossref

Abstract PDF

BACKGROUND
To investigate the usage patterns of sedatives, analgesics and neuromuscular blocking agents (NMBAs) in patients requiring mechanical ventilation more than 72 hours in intensive care units (ICUs) of Korea.
METHODS
A total of 536 patients continuing mechanical ventilation more than 72 hours had been enrolled among the twenty-one ICUs of Korea from May 2003 to July 2003. Data about mechanical ventilation, the use of sedatives, analgesics, and NMBAs were prospectively collected for four weeks. We analyzed the patterns of using these drugs and effects on outcomes.
RESULTS
More than half of the patients (50.4%) received sedative drug alone. Most commonly used sedatives and analgesics were midazolam and morphine. NMBAs were administered in 41% of the patients. Volume controlled ventilation mode was associated with more frequent use of NMBAs. There were no significant differences in outcome variables among the usage patterns of sedatives, analgesics and NMBAs.
CONCLUSIONS
Our investigation shows that analgesics were much less frequently used in the intensive care units of Korea compared with the use of sedatives. And the use of NMBAs were quite a common.

Citations

Citations to this article as recorded by

Change in management and outcome of mechanical ventilation in Korea: a prospective observational study
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
The Korean Journal of Internal Medicine.2022; 37(3): 618. CrossRef
Pressure Ulcer Prevalence and Risk Factors at the Time of Intensive Care Unit Admission
Hye Ran Kwak, Jiyeon Kang
Korean Journal of Adult Nursing.2015; 27(3): 347. CrossRef
Clinical Demographics and Outcomes in Mechanically Ventilated Patients in Korean Intensive Care Units
Byeong-Ho Jeong, Gee Young Suh, Jin Young An, Moo Suk Park, Jin Hwa Lee, Myung-Goo Lee, Je Hyeong Kim, Yun Seong Kim, Hye Sook Choi, Kyung Chan Kim, Won-Yeon Lee, Younsuck Koh
Journal of Korean Medical Science.2014; 29(6): 864. CrossRef

The Effects of Propofol on Blood-Brain Barrier Disruption with Mannitol Infusion in Cervical Sympathetic Nerve Blocked Rats: Jin Young Lee, Soo Han Yoon, Jae Hyung Kim, Yun Jeong Chae, Young Joo Lee, Jin Soo Kim, Bong Ki Moon; Korean J Crit Care Med. 2002;17(2):95-99.

3,355 View
12 Download

Abstract PDF: BACKGROUND
Blood brain barrier disruption (BBBD)increases therapeutic agents delivery to brain diseases.Increasing the delivery of therapeutic drugs to the brainimproves out come f or patients with brain tumors.Cervical sympathetic chain block can increase the degree of mannitol induced blood brain barrier disruption in rats.Anesthetic agents may modify hyperosmolar blood brain barrier disruption.Therefore we evaluated the effecfs of pentobarbital and propofol on mannitol induced blood brain barrier disruption(BBBD)in cervical sympathetic nerve blocked rats.
METHODS
14 male Sprague-Dawley rats were divided into 2 groups.Intravenous pentobarbital (group 1,n=7)and propofol (group 2,n=7)were administrated.Rats was blocked with 0.5% bupivacaine on right cervical sympathetic chain.All rats received 37degrees C,25%mannitol (1.75 g/kg) via right carotid artery.BBBD was estimated by Evans blue staining in cerebral hemisphere.
RESULTS
Both groups showed BBBD in right side hemisphere and there was no significant difference between group 1 and group 2 in right side hemisphere.
CONCLUSIONS
The results suggest that propofol could be used to be anesthetics for BBBD in cervical sympathetic blocked rats.

Clinical Evaluation of One Lung Ventilation during General Anesthesia: Seung Woon Lim; Korean J Crit Care Med. 2000;15(2):98-101.

2,823 View
28 Download

Abstract PDF: BACKGROUND
Separation of two lungs during anesthesia is necessary for the purpose of isolation of one lung from the other to prevent spillage or contamination and facilitating surgical exposure by collapsing the lung in the operative hemithorax. Several techniques are available for providing one-lung anesthesia. This study was performed to evaluate which technique is favored and why it is favored for one-lung ventilation.
METHODS
We studied 70 patients scheduled for thoracic surgery aided by collapse of the ipsilateral lung. We analyzed frequency of each technique, efficacy of lung collapse, adequacy of one-lung ventilation, blood gases and complications.
RESULTS
In the 63 patients out of 70 patients, the double-lumen tubes were used. Left-sided were used in 57 patients and right-sided were used in 6 patients. There were 3 complications: tracheal rupture, right bronchial rupture and post-operative edema of vocal cords. Bronchial blockers were inserted in 7 patients. It was failed in two cases. Ventilation and oxygenation were respectively good in all patients.
CONCLUSIONS
We favored the double-lumen endotrachial tube than Univent blocker. Malposition was frequently seen with the Univent and serious complication was occasionally seen with the double-lumen tube. However surgical exposure and oxygenation was provided with any method, when position was corrected adequately.

The Effect of Cervical Sympathetic Nerve Block on Blood-brain Barrier Disruption with Mannitol Infusion in Rats: Bong Ki Moon, Soo Han Yoon, Young Joo Lee, Chul Ryung Hur, Chang Ho Kim, Sung Jung Lee, Young Seok Lee; Korean J Crit Care Med. 1997;12(1):69-74.

2,453 View
20 Download

Abstract PDF: BACKGOUND: The barrier can be altered by a number of insults to the brain (e.g., hypertension, freezing, trauma, drug). But the effect of the blood brain barrier distruction immediately after the neural change is unknown. In the present study, we focused on the BBBD after cervical sympathetic chain block.
METHODS
13 male Sprague-Dawley rats were divided into 2 groups. Group 1 (N=7) was blocked with 0.5% bupivacaine on the right cervical sympathetic chain and group 2 (N=6) was blocked with 0.5% bupivacaine on the bilateral cervical sympathetic chain. All rats received 37degrees C, 25% mannitol (1.75 g/kg) via right carotid artery and then, the effect of cervical sympathetic chain block on blood-brain barrier disruption of four cerebral compartment using 99mTc-human serum albumin and Evans blue was evaluated.
RESULTS
Both groups showed blood-brain barrier disruption and there was no significant difference between group 1 and group 2 in the anterior and posterior hemisphere of the right side brain. But group 2 showed significant blood-brain barrier disruption than group 1 in anterior and posterior hemisphere of the left brain (p<0.01).
CONCLUSIONS
This results suggest that cervical sympathetic chain block can increase the degree of mannitol-induced blood-brain barrier disruption via neural arch or blood flow change.

Case Report

Clinical Experience of the Lower Extremity Nerve Block for a Neurocritically Ill Patient Who is Not Able to Communicate:A Case Report: Jun Rho Yoon, Tae Kwan Kim, Je Chun Yu, Yee Suk Kim, In Soo Han, Yong Ju Oh; Korean J Crit Care Med. 2007;22(1):48-51.

2,213 View
28 Download

Abstract PDF: A 73-year-old man was scheduled for the surgical reduction of fractured femur which occurred ar 3 months ago by the accident. The mental status of the patient was stuporous (Glasgow coma scale: 5) due to the complication of the head trauma. We performed nerve blocks (femoral, sciatic, lateral femoral cutaneous, and illiohypogastric nerve blocks) for the surgical reduction of left femur with 55 ml of 0.25% ropivacaine. The electroencephalography was monitored continuously during the 4 hour operation as well as monitoring the hemodynamic and respiratory parameters. The operation was performed successfully and the patient recovered uneventfully.

Original Article

The Usage Pattern of Neuromuscular Blocker at Intensive Care Unit: Jun Gol Song, Hwa Sung Jung, Jae Do Lee, Yoon Kyung Lee, Hong Seuk Yang; Korean J Crit Care Med. 2006;21(1):28-36.

2,307 View
15 Download

Abstract PDF: BACKGROUND
The neuromuscular blocker is helpful to intubate the patients and reduce the amount of anesthetic agent. It also used at intensive care unit (ICU) to maintain airway patency, to achieve proper ventilatory care, etc. This survey is to determine the neuromuscular blocker usage patterns in ICU settings.
METHODS
Three hundred general hospitals with ICU settings were chosen. We designed a 10 itemed questionnaire which has several subquestions with multiple choices and sent it to them. After three months, forty seven hospitals returned the questionnaire and we made careful analysis with it.
RESULTS
The most frequent indication of neuromuscular blocker was to facilitate the mechanical ventilation (80.9%). Vecuronium was the most common neuromuscular blocker used (97.9%). Only 6.4% of them used peripheral nerve stimulator and the rest of them (89.4%) used clinical information to determine the degree of neuromuscular blocker. The respondents reported that recovery from muscle relaxation was needed on a periodic basis for regular neurological examinations (59.6%) in ICU settings. All respondents used the sedatives or narcotics with neuromuscular blocker and only 6.4% used reversal agents.
CONCLUSIONS
Although the rate of reply was not much (15.7%), we could get the current usage pattern of neuromuscular blocker at ICU. We recommend using short to intermediate acting neuromuscular blocker than long acting agents. Continuous infusion with careful dosage titration by peripheral nerve stimulator would be helpful to achieve rapid recovery. Additional sedatives and narcotics are beneficial to reduce the amount of neuromuscular blocker and to make patients comfortable as well.

Case Reports

One-lung Ventilation using Wire-guided Endobronchial Blocker and Single Lumen Endotracheal Tube: A Case Report: Hee Zoo Kim, Seung Hwan Oh, Chung Guk Park, Eun Hye Koo, Hye Ran Oh, Mi Kyoung Lee, Sang Ho Lim; Korean J Crit Care Med. 2005;20(1):92-96.

2,688 View
14 Download

Abstract PDF: We had done one-lung ventilation using 9 Fr wire-guided endobronchial blocker and outer diameter 41-mm flexible fiberoptic bronchoscope in ruptured esophageal patient who expected difficult tracheal intubation and in esophageal cancer patient who was in need of mechanical ventilation during and after the operation.

Labor Analgesia with Epidural Blockade in Parturient with Peripartum Cardiomyopathy: A Case Report: Tae Ha Ryu, Jae Hoon Jeong, Dong Gun Lim, Si Oh Kim; Korean J Crit Care Med. 2004;19(2):143-147.

2,638 View
42 Download

Abstract PDF: Peripartum cardiomyopathy (PPCM) is an unusual and uncommon causes of antepartum and postpartum heart failure, which may result in severe cardiac failure and death. PPCM is often unrecognized as symptoms of normal pregnancy commonly mimic those of mild heart failure but can rapidly progress to cardiac failure. We presented a case of elective labor induction in a patient with peripartum cardiomyopathy. A epidural analgesia technique was performed without difficulty for labor analgesia in parturient with peripartum cardiomyopathy. Her post-delivery course was uncomplicated but her baby has died due to respiratory failure. We suggest that vaginal delivery with careful incremental epidural alnalgesia in patient with PPCM is acceptable methods and close peripartum monitoring is essential in the management of PPCM.

First
Prev
Page of 1
Next
Last

Search