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Review Article
Neurosurgery
Brain-lung interaction: a vicious cycle in traumatic brain injury
Ariana Alejandra Chacón-Aponte, Érika Andrea Durán-Vargas, Jaime Adolfo Arévalo-Carrillo, Iván David Lozada-Martínez, Maria Paz Bolaño-Romero, Luis Rafael Moscote-Salazar, Pedro Grille, Tariq Janjua
Acute Crit Care. 2022;37(1):35-44.   Published online February 11, 2022
DOI: https://doi.org/10.4266/acc.2021.01193
  • 15,168 View
  • 901 Download
  • 13 Web of Science
  • 16 Crossref
AbstractAbstract PDF
The brain-lung interaction can seriously affect patients with traumatic brain injury, triggering a vicious cycle that worsens patient prognosis. Although the mechanisms of the interaction are not fully elucidated, several hypotheses, notably the “blast injury” theory or “double hit” model, have been proposed and constitute the basis of its development and progression. The brain and lungs strongly interact via complex pathways from the brain to the lungs but also from the lungs to the brain. The main pulmonary disorders that occur after brain injuries are neurogenic pulmonary edema, acute respiratory distress syndrome, and ventilator-associated pneumonia, and the principal brain disorders after lung injuries include brain hypoxia and intracranial hypertension. All of these conditions are key considerations for management therapies after traumatic brain injury and need exceptional case-by-case monitoring to avoid neurological or pulmonary complications. This review aims to describe the history, pathophysiology, risk factors, characteristics, and complications of brain-lung and lung-brain interactions and the impact of different old and recent modalities of treatment in the context of traumatic brain injury.

Citations

Citations to this article as recorded by  
  • Uncertainty in Neurocritical Care: Recognizing Its Relevance for Clinical Decision-Making
    Luis Rafael Moscote-Salazar, William A. Florez-Perdomo, Tariq Janjua
    Indian Journal of Neurotrauma.2024; 21(01): 092.     CrossRef
  • Effects of positive end-expiratory pressure on intracranial pressure, cerebral perfusion pressure, and brain oxygenation in acute brain injury: Friend or foe? A scoping review
    Greta Zunino, Denise Battaglini, Daniel Agustin Godoy
    Journal of Intensive Medicine.2024; 4(2): 247.     CrossRef
  • Acute brain injury increases pulmonary capillary permeability via sympathetic activation-mediated high fluid shear stress and destruction of the endothelial glycocalyx layer
    Na Zhao, Chao Liu, Xinxin Tian, Juan Yang, Tianen Wang
    Experimental Cell Research.2024; 434(2): 113873.     CrossRef
  • Oral administration of lysozyme protects against injury of ileum via modulating gut microbiota dysbiosis after severe traumatic brain injury
    Weijian Yang, Caihua Xi, Haijun Yao, Qiang Yuan, Jun Zhang, Qifang Chen, Gang Wu, Jin Hu
    Frontiers in Cellular and Infection Microbiology.2024;[Epub]     CrossRef
  • Pulmonary Effects of Traumatic Brain Injury in Mice: A Gene Set Enrichment Analysis
    Wei-Hung Chan, Shih-Ming Huang, Yi-Lin Chiu
    International Journal of Molecular Sciences.2024; 25(5): 3018.     CrossRef
  • Beyond the brain: General intensive care considerations in pediatric neurocritical care
    Thao L. Nguyen, Dennis W. Simon, Yi-Chen Lai
    Seminars in Pediatric Neurology.2024; 49: 101120.     CrossRef
  • Research Progress of Hemorrhagic Stroke Combined with Stroke-Associated Pneumonia
    松 刘
    Advances in Clinical Medicine.2024; 14(05): 2336.     CrossRef
  • Ventilatory targets following brain injury
    Shaurya Taran, Sarah Wahlster, Chiara Robba
    Current Opinion in Critical Care.2023; 29(2): 41.     CrossRef
  • Targeted Nanocarriers Co-Opting Pulmonary Intravascular Leukocytes for Drug Delivery to the Injured Brain
    Jia Nong, Patrick M. Glassman, Jacob W. Myerson, Viviana Zuluaga-Ramirez, Alba Rodriguez-Garcia, Alvin Mukalel, Serena Omo-Lamai, Landis R. Walsh, Marco E. Zamora, Xijing Gong, Zhicheng Wang, Kartik Bhamidipati, Raisa Y. Kiseleva, Carlos H. Villa, Colin F
    ACS Nano.2023; 17(14): 13121.     CrossRef
  • Manejo postoperatorio de resección de tumores cerebrales en la unidad de cuidado intensivo
    Andrés Felipe Naranjo Ramírez, Álvaro de Jesús Medrano Areiza, Bryan Arango Sánchez, Juan Carlos Arango Martínez, Luis Fermín Naranjo Atehortúa
    Acta Colombiana de Cuidado Intensivo.2023;[Epub]     CrossRef
  • Modulation of MAPK/NF-κB Pathway and NLRP3 Inflammasome by Secondary Metabolites from Red Algae: A Mechanistic Study
    Asmaa Nabil-Adam, Mohamed L. Ashour, Mohamed Attia Shreadah
    ACS Omega.2023; 8(41): 37971.     CrossRef
  • American Association for the Surgery of Trauma/American College of Surgeons Committee on Trauma clinical protocol for management of acute respiratory distress syndrome and severe hypoxemia
    Jason A. Fawley, Christopher J. Tignanelli, Nicole L. Werner, George Kasotakis, Samuel P. Mandell, Nina E. Glass, David J. Dries, Todd W. Costantini, Lena M. Napolitano
    Journal of Trauma and Acute Care Surgery.2023; 95(4): 592.     CrossRef
  • The role of cardiac dysfunction and post-traumatic pulmonary embolism in brain-lung interactions following traumatic brain injury
    Mabrouk Bahloul, Karama Bouchaala, Najeh Baccouche, Kamilia Chtara, Hedi Chelly, Mounir Bouaziz
    Acute and Critical Care.2022; 37(2): 266.     CrossRef
  • Allocation of Donor Lungs in Korea
    Hye Ju Yeo
    Journal of Chest Surgery.2022; 55(4): 274.     CrossRef
  • Mapping brain endophenotypes associated with idiopathic pulmonary fibrosis genetic risk
    Ali-Reza Mohammadi-Nejad, Richard J. Allen, Luke M. Kraven, Olivia C. Leavy, R. Gisli Jenkins, Louise V. Wain, Dorothee P. Auer, Stamatios N. Sotiropoulos
    eBioMedicine.2022; 86: 104356.     CrossRef
  • Use of bedside ultrasound in the evaluation of acute dyspnea: a comprehensive review of evidence on diagnostic usefulness
    Ivan David Lozada-Martinez, Isabela Zenilma Daza-Patiño, Gerardo Jesus Farley Reina-González, Sebastián Rojas-Pava, Ailyn Zenith Angulo-Lara, María Paola Carmona-Rodiño, Olga Gissela Sarmiento-Najar, Jhon Mike Romero-Madera, Yesid Alonso Ángel-Hernandez
    Revista Investigación en Salud Universidad de Boyacá.2022;[Epub]     CrossRef
Original Articles
Neurology
Continuous heart rate variability and electroencephalography monitoring in severe acute brain injury: a preliminary study
Hyunjo Lee, Sang-Beom Jeon, Kwang-Soo Lee
Acute Crit Care. 2021;36(2):151-161.   Published online March 18, 2021
DOI: https://doi.org/10.4266/acc.2020.00703
  • 5,124 View
  • 141 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Decreases in heart rate variability have been shown to be associated with poor outcomes in severe acute brain injury. However, it is unknown whether the changes in heart rate variability precede neurological deterioration in such patients. We explored the changes in heart rate variability measured by electrocardiography in patients who had neurological deterioration following severe acute brain injury, and examined the relationship between heart rate variability and electroencephalography parameters.
Methods
Retrospective analysis of 25 patients who manifested neurological deterioration after severe acute brain injury and underwent simultaneous electroencephalography plus electrocardiography monitoring.
Results
Eighteen electroencephalography channels and one simultaneously recorded electrocardiography channel were segmented into epochs of 120-second duration and processed to compute 10 heart rate variability parameters and three quantitative electroencephalography parameters. Raw electroencephalography of the epochs was also assessed by standardized visual interpretation and categorized based on their background abnormalities and ictalinterictal continuum patterns. The heart rate variability and electroencephalography parameters showed consistent changes in the 2-day period before neurological deterioration commenced. Remarkably, the suppression ratio and background abnormality of the electroencephalography parameters had significant reverse correlations with all heart rate variability parameters.
Conclusions
We observed a significantly progressive decline in heart rate variability from the day before the neurological deterioration events in patients with severe acute brain injury were first observed.

Citations

Citations to this article as recorded by  
  • Association of Depressive and Somatic Symptoms with Heart Rate Variability in Patients with Traumatic Brain Injury
    Seung Don Yoo, Eo Jin Park
    Journal of Clinical Medicine.2022; 12(1): 104.     CrossRef
  • Influencing Cardiovascular Outcomes through Heart Rate Variability Modulation: A Systematic Review
    Alexandru Burlacu, Crischentian Brinza, Iolanda Valentina Popa, Adrian Covic, Mariana Floria
    Diagnostics.2021; 11(12): 2198.     CrossRef
Nutrition
Effectiveness of a multidisciplinary team for nutrition support in a trauma intensive care unit
Eunsuk Oh, Hongjin Shim, Hyon Ju Yon, Jin Sil Moon, Dae Ryong Kang, Ji Young Jang
Acute Crit Care. 2020;35(3):142-148.   Published online August 19, 2020
DOI: https://doi.org/10.4266/acc.2020.00318
  • 6,417 View
  • 189 Download
  • 9 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Background
We evaluated clinical and nutritional outcomes according to multidisciplinary team involvement in nutrition support in a regional trauma intensive care unit (TICU).
Methods
We retrospectively compared the outcomes for 339 patients admitted to the TICU for >5 days depending on nutrition support team (NST) involvement (n=176) and non-NST involvement (n=163).
Results
The mean age and injury severity score (ISS) were 57.3±16.7 years and 18.6±9.7, respectively. Fifty-three patients (15.6%) had shock on admission and 182 (53.7%) underwent surgery during TICU admission. Some patients were admitted to neurosurgery (46%), general surgery (35.4%), and other (18.6%) departments. There were significant differences in the ISS, Acute Physiology and Chronic Health Evaluation (APACHE) II score, shock on TICU admission, and initial laboratory results. After propensity score matching, the total delivered/required caloric ratio and total delivered/required protein ratio were significantly higher in the NST group than in the non-NST group (calorie: 80.4% vs. 66.7%, P=0.007; protein: 93.1% vs. 68.3%, P<0.001). The NST group had an adequate protein supply more frequently than the non-NST group (protein: 48.0% vs. 25.8%, P=0.002). There was no significant difference in survival, even after adjustment for risk factors using Cox proportional hazard analysis.
Conclusions
The results of our study suggest that multidisciplinary team involvement in nutrition support in TICU patients may improve nutritional, but not clinical, outcomes.

Citations

Citations to this article as recorded by  
  • Impact of a multidisciplinary collaborative nutritional treatment model in patients who are critically ill with neurological disorders: A randomized controlled trial
    Bao-Di Gu, Yun Wang, Rong Ding
    Technology and Health Care.2024; 32(3): 1767.     CrossRef
  • Implementation of a multidisciplinary nutritional support team and clinical outcomes in critically ill patients with COVID-19
    In-Ae Song, Kyunghwa Lee, Sunghee Lee, Keonhee Kim, Tak Kyu Oh
    Clinical Nutrition.2024; 43(2): 315.     CrossRef
  • Nutrition support teams: Institution, evolution, and innovation
    Albert Barrocas, Denise Baird Schwartz, Bruce R. Bistrian, Peggi Guenter, Charles Mueller, Ronni Chernoff, Jeanette M. Hasse
    Nutrition in Clinical Practice.2023; 38(1): 10.     CrossRef
  • Multidisciplinary Difficult Airway Team Characteristics, Airway Securement Success, and Clinical Outcomes: A Systematic Review
    Vinciya Pandian, Talha U. Ghazi, Marielle Qiaoshu He, Ergest Isak, Abdulmalik Saleem, Lindsay R. Semler, Emily C. Capellari, Michael J. Brenner
    Annals of Otology, Rhinology & Laryngology.2023; 132(8): 938.     CrossRef
  • Nutrition Therapy by Nutrition Support Team: A Comparison of Multi-Chamber Bag and Customized Parenteral Nutrition in Hospitalized Patients
    Seunghyun Cheon, Sang-Hyeon Oh, Jung-Tae Kim, Han-Gon Choi, Hyojung Park, Jee-Eun Chung
    Nutrients.2023; 15(11): 2531.     CrossRef
  • Consultation pattern changes of parenteral nutrition with a multidisciplinary nutrition support team in a recently opened hospital in Korea: a retrospective cohort study
    Kyoung Won Yoon, Hyo Jin Kim, Yujeong Im, Seul Gi Nam, Joo Yeon Lee, Hyo Gee Lee, Joong-Min Park
    Annals of Clinical Nutrition and Metabolism.2023; 15(2): 57.     CrossRef
  • Lipid emulsion treatment of cardiotoxicity caused by calcium channel blocker and beta-blocker
    Ju-Tae Sohn
    The American Journal of Emergency Medicine.2022; 58: 331.     CrossRef
  • Physician Compliance with Nutrition Support Team Recommendations: Effects on the Outcome of Treatment for Critically Ill Patients
    Hyon-Ju Yon, Eun-Suk Oh, Ji Young Jang, Ji Yun Jang, Hongjin Shim
    Journal of Acute Care Surgery.2022; 12(1): 1.     CrossRef
  • Nutritional Status of Intensive Care Unit Patients According to the Referral to the Nutrition Support Team and Compliance with the Recommendations
    Yunjin Sohn, Taisun Hyun
    Korean Journal of Community Nutrition.2022; 27(2): 121.     CrossRef
  • Lipid emulsion dosage used for resuscitation after drug toxicity
    Ju-Tae Sohn
    The American Journal of Emergency Medicine.2022; 59: 168.     CrossRef
  • Intensive care management of traumatic brain injury: How can mnemonics help?
    Biljana Damnjanović, Jovana Stanisavljević, Adi Hadžibegović, Ivan Rović, Đuro Šijan, Nemanja Jovanović, Sanja Ratković, Marija Milenković
    Serbian Journal of Anesthesia and Intensive Therapy.2022; 44(5-6): 105.     CrossRef
  • 救急・集中治療領域 重症患者における栄養管理
    信人 中西, 穣治 小谷
    The Japanese Journal of SURGICAL METABOLISM and NUTRITION.2022; 56(6): 229.     CrossRef
  • Urinary Titin N-Fragment as a Biomarker of Muscle Atrophy, Intensive Care Unit-Acquired Weakness, and Possible Application for Post-Intensive Care Syndrome
    Nobuto Nakanishi, Rie Tsutsumi, Kanako Hara, Masafumi Matsuo, Hiroshi Sakaue, Jun Oto
    Journal of Clinical Medicine.2021; 10(4): 614.     CrossRef
  • Lack of evidence for a nutritional support team in a trauma intensive care unit?
    Jae Hwa Cho
    Acute and Critical Care.2020; 35(3): 205.     CrossRef
Trauma
Inclusion of lactate level measured upon emergency room arrival in trauma outcome prediction models improves mortality prediction: a retrospective, single-center study
Jonghwan Moon, Kyungjin Hwang, Dukyong Yoon, Kyoungwon Jung
Acute Crit Care. 2020;35(2):102-109.   Published online May 31, 2020
DOI: https://doi.org/10.4266/acc.2019.00780
  • 4,277 View
  • 154 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
This study aimed to develop a model for predicting trauma outcomes by adding arterial lactate levels measured upon emergency room (ER) arrival to existing trauma injury severity scoring systems.
Methods
We examined blunt trauma cases that were admitted to our hospital during 2010– 2014. Eligibility criteria were cases with an Injury Severity Score of ≥9, complete Trauma and Injury Severity Score (TRISS) variable data, and lactate levels that were assessed upon ER arrival. Survivor and non-survivor groups were compared and lactate-based prediction models were generated using logistic regression. We compared the predictive performances of traditional prediction models (Revised Trauma Score [RTS] and TRISS) and lactate-based models using the area under the curve (AUC) of receiver operating characteristic curves.
Results
We included 829 patients, and the in-hospital mortality rate among these patients was 21.6%. The model that used lactate levels and age provided a significantly better AUC value than the RTS model. The model with lactate added to the TRISS variables provided the highest Youden J statistic, with 86.0% sensitivity and 70.8% specificity at a cutoff value of 0.15, as well as the highest predictive value, with a significantly higher AUC than the TRISS.
Conclusions
These findings indicate that lactate testing upon ER arrival may help supplement or replace traditional physiological parameters to predict mortality outcomes among Korean trauma patients. Adding lactate levels also appears to improve the predictive abilities of existing trauma outcome prediction models.

Citations

Citations to this article as recorded by  
  • Plasma interleukin responses as predictors of outcome stratification in patients after major trauma: a prospective observational two centre study
    Matthew Allan Jones, James Hanison, Renata Apreutesei, Basmah Allarakia, Sara Namvar, Deepa Shruthi Ramaswamy, Daniel Horner, Lucy Smyth, Richard Body, Malachy Columb, Mahesan Nirmalan, Niroshini Nirmalan
    Frontiers in Immunology.2023;[Epub]     CrossRef
  • Admission Lactate and Base Deficit in Predicting Outcomes of Pediatric Trauma
    Yo Huh, Yura Ko, Kyungjin Hwang, Kyoungwon Jung, Yoon-ho Cha, Yoo Jin Choi, Jisook Lee, Jung Heon Kim
    Shock.2021; 55(4): 495.     CrossRef
Trauma
Timing and Associated Factors for Sepsis-3 in Severe Trauma Patients: A 3-Year Single Trauma Center Experience
Seungwoo Chung, Donghwan Choi, Jayun Cho, Yo Huh, Jonghwan Moon, Junsik Kwon, Kyoungwon Jung, John-Cook Jong Lee, Byung Hee Kang
Acute Crit Care. 2018;33(3):130-134.   Published online August 31, 2018
DOI: https://doi.org/10.4266/acc.2018.00122
  • 8,366 View
  • 223 Download
  • 14 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Background
We hypothesized that the recent change of sepsis definition by sepsis-3 would facilitate the measurement of timing of sepsis for trauma patients presenting with initial systemic inflammatory response syndrome. Moreover, we investigated factors associated with sepsis according to the sepsis-3 definition.
Methods
Trauma patients in a single level I trauma center were retrospectively reviewed from January 2014 to December 2016. Exclusion criteria were younger than 18 years, Injury Severity Score (ISS) <15, length of stay <8 days, transferred from other hospitals, uncertain trauma history, and incomplete medical records. A binary logistic regression test was used to identify the risk factors for sepsis-3.
Results
A total of 3,869 patients were considered and, after a process of exclusion, 422 patients were reviewed. Fifty patients (11.85%) were diagnosed with sepsis. The sepsis group presented with higher mortality (14 [28.0%] vs. 17 [4.6%], P<0.001) and longer intensive care unit stay (23 days [range, 11 to 35 days] vs. 3 days [range, 1 to 9 days], P<0.001). Multivariate analysis demonstrated that, in men, high lactate level and red blood cell transfusion within 24 hours were risk factors for sepsis. The median timing of sepsis-3 was at 8 hospital days and 4 postoperative days. The most common focus was the respiratory system.
Conclusions
Sepsis defined by sepsis-3 remains a critical issue in severe trauma patients. Male patients with higher ISS, lactate level, and red blood cell transfusion should be cared for with caution. Reassessment of sepsis should be considered at day 8 of hospital stay or day 4 postoperatively.

Citations

Citations to this article as recorded by  
  • A biomarker panel of C-reactive protein, procalcitonin and serum amyloid A is a predictor of sepsis in severe trauma patients
    Mei Li, Yan-jun Qin, Xin-liang Zhang, Chun-hua Zhang, Rui-juan Ci, Wei Chen, De-zheng Hu, Shi-min Dong
    Scientific Reports.2024;[Epub]     CrossRef
  • Identifying biomarkers deciphering sepsis from trauma-induced sterile inflammation and trauma-induced sepsis
    Praveen Papareddy, Michael Selle, Nicolas Partouche, Vincent Legros, Benjamin Rieu, Jon Olinder, Cecilia Ryden, Eva Bartakova, Michal Holub, Klaus Jung, Julien Pottecher, Heiko Herwald
    Frontiers in Immunology.2024;[Epub]     CrossRef
  • The Road to Sepsis in Geriatric Polytrauma Patients—Can We Forecast Sepsis in Trauma Patients?
    Cédric Niggli, Philipp Vetter, Jan Hambrecht, Hans-Christoph Pape, Ladislav Mica
    Journal of Clinical Medicine.2024; 13(6): 1570.     CrossRef
  • Defining Posttraumatic Sepsis for Population-Level Research
    Katherine Stern, Qian Qiu, Michael Weykamp, Grant O’Keefe, Scott C. Brakenridge
    JAMA Network Open.2023; 6(1): e2251445.     CrossRef
  • Strategies for the treatment of femoral fractures in severely injured patients: trends in over two decades from the TraumaRegister DGU®
    Felix M. Bläsius, Markus Laubach, Hagen Andruszkow, Philipp Lichte, Hans-Christoph Pape, Rolf Lefering, Klemens Horst, Frank Hildebrand
    European Journal of Trauma and Emergency Surgery.2022; 48(3): 1769.     CrossRef
  • Infectious Diseases-Related Emergency Department Visits Among Non-Elderly Adults with Intellectual and Developmental Disabilities in the United States: Results from the National Emergency Department Sample, 2016
    Hussaini Zandam, Monika Mitra, Ilhom Akobirshoev, Frank S. Li, Ari Ne'eman
    Population Health Management.2022; 25(3): 335.     CrossRef
  • Patient, provider, and system factors that contribute to health care–associated infection and sepsis development in patients after a traumatic injury: An integrative review
    Debbie Tan, Taneal Wiseman, Vasiliki Betihavas, Kaye Rolls
    Australian Critical Care.2021; 34(3): 269.     CrossRef
  • Accuracy of Procalcitonin Levels for Diagnosis of Culture-Positive Sepsis in Critically Ill Trauma Patients: A Retrospective Analysis
    Aisha Bakhtiar, Syed Jawad Haider Kazmi, Muhammad Sohaib Asghar, Muhammad Nadeem Khurshaidi, Salman Mazhar, Noman A Khan, Nisar Ahmed, Farah Yasmin, Rabail Yaseen, Maira Hassan
    Cureus.2021;[Epub]     CrossRef
  • An Evaluation of the Effect of Performance Improvement and Patient Safety Program Implemented in a New Regional Trauma Center of Korea
    Yo Huh, Junsik Kwon, Jonghwan Moon, Byung Hee Kang, Sora Kim, Jayoung Yoo, Seoyoung Song, Kyoungwon Jung
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • The impact of infection complications after trauma differs according to trauma severity
    Akira Komori, Hiroki Iriyama, Takako Kainoh, Makoto Aoki, Toshio Naito, Toshikazu Abe
    Scientific Reports.2021;[Epub]     CrossRef
  • Gene Expression–Based Diagnosis of Infections in Critically Ill Patients—Prospective Validation of the SepsisMetaScore in a Longitudinal Severe Trauma Cohort
    Simone Thair, Caspar Mewes, José Hinz, Ingo Bergmann, Benedikt Büttner, Stephan Sehmisch, Konrad Meissner, Michael Quintel, Timothy E. Sweeney, Purvesh Khatri, Ashham Mansur
    Critical Care Medicine.2021; 49(8): e751.     CrossRef
  • Immunometabolic signatures predict risk of progression to sepsis in COVID-19
    Ana Sofía Herrera-Van Oostdam, Julio E. Castañeda-Delgado, Juan José Oropeza-Valdez, Juan Carlos Borrego, Joel Monárrez-Espino, Jiamin Zheng, Rupasri Mandal, Lun Zhang, Elizabeth Soto-Guzmán, Julio César Fernández-Ruiz, Fátima Ochoa-González, Flor M. Trej
    PLOS ONE.2021; 16(8): e0256784.     CrossRef
  • Sepsis in Trauma: A Deadly Complication
    Fernanda Mas-Celis, Jimena Olea-López, Javier Alberto Parroquin-Maldonado
    Archives of Medical Research.2021; 52(8): 808.     CrossRef
  • New automated analysis to monitor neutrophil function point-of-care in the intensive care unit after trauma
    Lillian Hesselink, Roy Spijkerman, Emma de Fraiture, Suzanne Bongers, Karlijn J. P. Van Wessem, Nienke Vrisekoop, Leo Koenderman, Luke P. H. Leenen, Falco Hietbrink
    Intensive Care Medicine Experimental.2020;[Epub]     CrossRef
Trauma
Biochemical Markers as Predictors of In-Hospital Mortality in Patients with Severe Trauma: A Retrospective Cohort Study
Ha Nee Jang, Hyun Oh Park, Tae Won Yang, Jun Ho Yang, Sung Hwan Kim, Seong Ho Moon, Joung Hun Byun, Chung Eun Lee, Jong Woo Kim, Dong Hun Kang, Kyeong Hee Baek
Korean J Crit Care Med. 2017;32(3):240-246.   Published online August 31, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00360
  • 8,121 View
  • 136 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Initial evaluation of injury severity in trauma patients is an important and challenging task. We aimed to assess whether easily measurable biochemical parameters (hemoglobin, pH, and prothrombin time/international normalized ratio [PT/INR]) can predict in-hospital mortality in patients with severe trauma. Methods: This retrospective study involved review of the medical records of 315 patients with severe trauma and an injury severity score >15 who were managed at Gyeongsang National University Hospital between January 2005 and December 2015. We extracted the following data: in-hospital mortality, injury severity score, and initial hemoglobin level, pH, and PT/INR. The predictive values of these variables were compared using receiver operation characteristic curves. Results: Of the 315 patients, 72 (22.9%) died. The in-hospital mortality rates of patients with hemoglobin levels <8.4 g/dl and ≥8.4 g/dl were 49.8% and 9.9%, respectively (P < 0.001). At a cutoff hemoglobin level of 8.4 g/dl, the sensitivity and specificity values for mortality were 81.9% and 86.4%, respectively. At a pH cutoff of 7.25, the sensitivity and specificity values for mortality were 66.7% and 77.8%, respectively; 66.7% of patients with a pH <7.25 died versus 22.2% with a pH ≥7.25 (P < 0.001). The in-hospital mortality rates for patients with PT/INR values ≥1.4 and <1.4 were 37.5% and 16%, respectively (P < 0.001; sensitivity, 37.5%; specificity, 84%). Conclusions: Using the suggested cutoff values, hemoglobin level, pH, and PT/INR can simply and easily be used to predict in-hospital mortality in patients with severe trauma.

Citations

Citations to this article as recorded by  
  • Assessment of the Initial Risk Factors for Mortality among Patients with Severe Trauma on Admission to the Emergency Department
    Hyun Oh Park, Jun Young Choi, In Seok Jang, Jong Duk Kim, Jae Won Choi, Chung Eun Lee
    The Korean Journal of Thoracic and Cardiovascular Surgery.2019; 52(6): 400.     CrossRef
  • The thorax trauma severity score and the trauma and injury severity score
    Seong Ho Moon, Jong Woo Kim, Joung Hun Byun, Sung Hwan Kim, Jun Young Choi, In Seok Jang, Chung Eun Lee, Jun Ho Yang, Dong Hun Kang, Ki Nyun Kim, Hyun Oh Park
    Medicine.2017; 96(42): e8317.     CrossRef
Review
Surgery
Management of Critical Burn Injuries: Recent Developments
David J. Dries, John J. Marini
Korean J Crit Care Med. 2017;32(1):9-21.   Published online February 17, 2017
DOI: https://doi.org/10.4266/kjccm.2016.00969
  • 26,107 View
  • 1,552 Download
  • 8 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve vital organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage problems related to thermal injury, including lightning and electrical injuries.
Methods
A selected review is provided of key management concepts as well as of recent reports published by the American Burn Association.
Results
The burn-injured patient is easily and frequently over resuscitated, with ensuing complications that include delayed wound healing and respiratory compromise. A feedback protocol designed to limit the occurrence of excessive resuscitation has been proposed, but no new “gold standard” for resuscitation has replaced the venerated Parkland formula. While new medical therapies have been proposed for patients sustaining inhalation injury, a paradigm-shifting standard of medical therapy has not emerged. Renal failure as a specific contributor to adverse outcome in burns has been reinforced by recent data. Of special problems addressed in burn centers, electrical injuries pose multisystem physiologic challenges and do not fit typical scoring systems.
Conclusion
Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections have been presented. The value of the burn center in care of the problems of electrical exposure, both manmade and natural, is demonstrated in recent reports.

Citations

Citations to this article as recorded by  
  • Prevalence and Trend of Depression in Burn Survivors: A Single Center Cohort Study
    V S Ranganath, Smitha Segu, B S Girish, Joel M Johns, C S Meghana
    Journal of Burn Care & Research.2024;[Epub]     CrossRef
  • SUBMICROSCOPIC CHANGES IN THE HEMOCAPILLARIES OF THE CEREBRAL HEMISCLE CAUSES CAUSED BY THERMAL BURN
    H. V. Lukyantseva, V. A. Pastukhova, O. I. Kovalchuk
    Bulletin of Problems Biology and Medicine.2021; 3(1): 268.     CrossRef
  • Kefir Accelerates Burn Wound Healing Through Inducing Fibroblast Cell Migration In Vitro and Modulating the Expression of IL-1ß, TGF-ß1, and bFGF Genes In Vivo
    Ahmad Oryan, Esmat Alemzadeh, Mohammad Hadi Eskandari
    Probiotics and Antimicrobial Proteins.2019; 11(3): 874.     CrossRef
  • Viable placental allograft as a biological dressing in the clinical management of full-thickness thermal occupational burns
    Eric L. Johnson, Elisabet K. Tassis, Georgina M. Michael, Susan G. Whittinghill
    Medicine.2017; 96(49): e9045.     CrossRef
Case Report
Trauma
Long-term extracorporeal membrane oxygenation after severe blunt traumatic lung injury in a child
Ok Jeong Lee, Yang Hyun Cho, Jinwook Hwang, Inae Yoon, Young-Ho Kim, Joongbum Cho
Acute Crit Care. 2019;34(3):223-227.   Published online February 10, 2017
DOI: https://doi.org/10.4266/acc.2016.00472
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  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Managing acute respiratory distress syndrome (ARDS) after severe blunt traumatic lung injury can be challenging. In cases where patients are refractory to conventional therapy, extracorporeal membrane oxygenation (ECMO) should be considered. In addition, the heparin-coated circuit can reduce hemorrhagic complications in patients with multiple traumas. Although prolonged ECMO may be necessary, excellent outcomes are frequently associated. In this study, we report long-term support with venovenous-ECMO applied in a child with severe blunt trauma in Korea. This 10-year-old and 30-kg male with severe blunt thoracic trauma after a car accident developed severe ARDS a few days later, and ECMO was administered for 33 days. Because of pulmonary hemorrhage during ECMO support, heparin was stopped for 3 days and then restarted. He was weaned from ECMO successfully and has been able to run without difficulty for the 2 years since discharge.

Citations

Citations to this article as recorded by  
  • Traumatic main airway rupture successfully rescued by extracorporeal membrane oxygenation: A case report
    Lijun Cao, Jun Xu, Linfeng Tang, Yuli Zhou, Xianhua Xiang
    Experimental and Therapeutic Medicine.2023;[Epub]     CrossRef
  • Extracorporeal membrane oxygenation in trauma patients: a systematic review
    Changtian Wang, Lei Zhang, Tao Qin, Zhilong Xi, Lei Sun, Haiwei Wu, Demin Li
    World Journal of Emergency Surgery.2020;[Epub]     CrossRef
Review
Neurosurgery
Therapeutic Hypothermia in Traumatic Brain injury; Review of History, Pathophysiology and Current Studies
Do-Keun Kim, Dong-Keun Hyun
Korean J Crit Care Med. 2015;30(3):143-150.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.143
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AbstractAbstract PDF
The fact that therapeutic hypothermia (TH) has lowered intracranial pressure and protected brain in severe traumatic brain injury (TBI) is well known throughout past sources and experimental data. In this paper, the result of TH in TBI needs to be confirmed. The result of North American Brain Injury Study; Hypothermia (NAVIS-H) 1 and 2, Eurotherm3235, Japan trauma society study was reviewed throughout randomized controlled study which performed recently. The prognosis was not confirmed throughout TH in NAVIS-H1; however, there was statistical significance among the group of 45 years or less and below 35 degree in celcius which checked when he or she visited initially. Hence, NAVIS-H2 study was preceded. In patient who had surgically removed hematoma, the effects of TH were proved compared to diffuse brain damage in NAVIS-H2 study. This was found in the result of Japan neurotrauma data bank. Eurotherm study has been doing, which leads to collect many data later on. The TBI of TH makes them better prognosis in patients who had surgically removed hematoma and lowered initial body temperature. Later on, it is considered further study is necessary.
Case Report
Cardiology/Thoracic Surgery
Cardiac Rupture of the Junction of the Right Atrium and Superior Vena Cava in Blunt Thoracic Trauma
Chun Sung Byun, Il Hwan Park, Tae Hoon Kim, Eunbi Lee, Joong Hwan Oh
Korean J Crit Care Med. 2015;30(1):27-30.   Published online February 28, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.1.27
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AbstractAbstract PDF
Cardiac rupture following blunt thoracic trauma is rarely encountered, since it commonly causes death at the scene. With advances in critical care, blunt cardiac rupture has been successfully treated with well-organized team approach including an emergency physician, anesthesiologist, and cardiac surgeon. We encountered a patient with blunt cardiac rupture of the junction of the superior vena cava and right atrium that extended 7 cm to the right ventricular junction. The patient was successfully resuscitated after a closed thoracostomy and pericardiocentesis with fluid loading. Cardiac injury was repaired via mid-sternotomy without cardiopulmonary bypass. The patient recovered without complications and was discharged on the 7th day after surgery.

ACC : Acute and Critical Care