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Original Article
Nephrology
Clinical efficacy of blood purification using a polymethylmethacrylate hemofilter for the treatment of severe acute pancreatitis
Kiyohiko Kinjoh, Ryoji Nagamura, Yutaka Sakuda, Shoki Yamauchi, Hideta Takushi, Tadashi Iraha, Koji Idomari
Acute Crit Care. 2022;37(3):398-406.   Published online July 5, 2022
DOI: https://doi.org/10.4266/acc.2022.00192
  • 3,320 View
  • 187 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
Severe acute pancreatitis (SAP) is a systemic inflammatory disease, and it can often complicate into acute kidney injury (AKI) and acute lung injury/acute respiratory distress syndrome (ALI/ARDS). This study aimed to evaluate the clinical effectiveness of blood purification using a polymethylmethacrylate (PMMA) hemofilter.
Methods
We retrospectively examined 54 patients, who were diagnosed with SAP according to the Japanese criteria from January 2011 to December 2019.
Results
Of a total of 54 SAP patients, 26 patients progressively developed AKI and required continuous hemodialysis with a PMMA membrane hemofilter (PMMA-CHD). Acute Physiology and Chronic Health Evaluation (APACHE) II score and Sequential Organ Failure Assessment (SOFA) score were significantly higher in patients requiring PMMA-CHD than in patients not requiring hemodialysis. The lung injury scores were also significantly higher in patients requiring PMMA-CHD. Of the 26 patients, 16 patients developed ALI/ARDS and required mechanical ventilation. A total of seven patients developed severe ALI/ARDS and received additional intermittent hemodiafiltration using a PMMA hemofilter (PMMA-HDF). Although the length of intensive care unit stay was significantly longer in patients with severe ALI/ARDS, blood purification therapy was discontinued in all the patients. The survival rates at the time of discharge were 92.3% and 92.9% in patients with and without PMMA-CHD, respectively. These real mortality ratios were obviously lower than the estimated mortality ratios predicted by APACHE II scores.
Conclusions
These finding suggest that the blood purification using a PMMA hemofilter would be effective for the treatment of AKI and ALI/ARDS in SAP patients.

Citations

Citations to this article as recorded by  
  • A Retrospective Study on the Start and End of Continuous Hemodialysis using a Polymethylmethacrylate Hemofilter for Severe Acute Pancreatitis
    Kiyohiko Kinjoh, Ryoji Nagamura, Yutaka Sakuda
    Internal Medicine.2024;[Epub]     CrossRef
  • Evaluation of the therapeutic efficiency and efficacy of blood purification in the treatment of severe acute pancreatitis
    Hongwei Huang, Zhongshi Huang, Menghua Chen, Ken Okamoto, Chiara Lazzeri
    PLOS ONE.2024; 19(1): e0296641.     CrossRef
  • Enhancing Immune Protection in Hemodialysis Patients: Role of the Polymethyl Methacrylate Membrane
    Rossana Franzin, Alessandra Stasi, Gianvito Caggiano, Elena Squiccimarro, Vincenzo Losappio, Marco Fiorentino, Carlo Alfieri, Giovanni Stallone, Loreto Gesualdo, Giuseppe Castellano
    Blood Purification.2023; : 27.     CrossRef
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
  • 15,216 View
  • 902 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 Article
Basic science and research
The effects of BMS-470539 on lipopolysaccharide-induced acute lung injury
Eun-A Jang, Jin-Young Kim, Tran Duc Tin, Ji-A Song, Seong-Heon Lee, Sang-Hyun Kwak
Acute Crit Care. 2019;34(2):133-140.   Published online May 31, 2019
DOI: https://doi.org/10.4266/acc.2019.00507
  • 7,565 View
  • 162 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Background
Overactivation of inflammatory cells, including macrophages and neutrophils, is associated with acute lung injury. BMS-470539 is a selective agonist of melanocortin 1 receptor, which triggers the inhibition of proinflammatory responses, suppressing neutrophil infiltration and protecting tissue. This study evaluated the effects of BMS-470539 on lipopolysaccharide-induced acute lung injury in a mouse model.
Methods
Mice received a subcutaneous injection of saline or BMS-470539 (18.47 mg/kg) 1 hour before an intratracheal injection of saline or lipopolysaccharide (20 μg). Mice were sacrificed to analyze the severity of pulmonary edema (lung wet-to-dry weight [W/D] ratio) and inflammatory responses (level of leukocytes, polymorphonuclear neutrophils [PMNs] and tumor necrosis factor alpha [TNF-α] in bronchoalveolar lavage fluid [BALF]), and neutrophil infiltration (myeloperoxidase activity). TNF-α activation was also measured in neutrophils from bone marrow. Survival was investigated in a second-hit sepsis mouse model.
Results
BMS-470539 improved sepsis-induced pulmonary edema, as demonstrated by a decreased W/D ratio (5.76%±0.83% to 3.81%±0.86%, P<0.05). The inflammatory response also improved, as shown by decreased levels of leukocytes (551±116 to 357±86×10²/mm³, P<0.05), PMNs (51.52%±16.23% to 18.41%±7.25%, P<0.01), and TNF-α (550±338 to 128±52 pg/ml, P<0.01) in the BALF. BMS-470539 also improved the inflammatory response, as shown by TNF-α levels (850±158 to 423±59 pg/ml, P<0.01) in neutrophils. BMS-470539 downregulated neutrophil infiltration in the lung (myeloperoxidase: 654±98 to 218±89 U/g, P<0.001). Lastly, BMS improved the survival rate (0% to 70%, P<0.01) in a mice multiple organ failure model.
Conclusions
BMS-470539 improved lipopolysaccharide-induced acute lung injury and mortality in mice by affecting the inflammatory response.

Citations

Citations to this article as recorded by  
  • Exosomes Derived from ADSCs Attenuate Sepsis-Induced Lung Injury by Delivery of Circ-Fryl and Regulation of the miR-490-3p/SIRT3 Pathway
    Weijun Shen, Xuan Zhao, Shitong Li
    Inflammation.2022; 45(1): 331.     CrossRef
  • Dichotomous Role of Tumor Necrosis Factor in Pulmonary Barrier Function and Alveolar Fluid Clearance
    Rudolf Lucas, Yalda Hadizamani, Perenlei Enkhbaatar, Gabor Csanyi, Robert W. Caldwell, Harald Hundsberger, Supriya Sridhar, Alice Ann Lever, Martina Hudel, Dipankar Ash, Masuko Ushio-Fukai, Tohru Fukai, Trinad Chakraborty, Alexander Verin, Douglas C. Eato
    Frontiers in Physiology.2022;[Epub]     CrossRef
  • NDP-MSH treatment recovers marginal lungs during ex vivo lung perfusion (EVLP)
    Caterina Lonati, Michele Battistin, Daniele E. Dondossola, Giulia A. Bassani, Daniela Brambilla, Riccardo Merighi, Patrizia Leonardi, Andrea Carlin, Marica Meroni, Alberto Zanella, Anna Catania, Stefano Gatti
    Peptides.2021; 141: 170552.     CrossRef
  • Antifibrotic and Anti-Inflammatory Actions of α-Melanocytic Hormone: New Roles for an Old Player
    Roshan Dinparastisaleh, Mehdi Mirsaeidi
    Pharmaceuticals.2021; 14(1): 45.     CrossRef
  • Activation of Melanocortin Receptors as a Potential Strategy to Reduce Local and Systemic Reactions Induced by Respiratory Viruses
    Caterina Lonati, Stefano Gatti, Anna Catania
    Frontiers in Endocrinology.2020;[Epub]     CrossRef
Case Report
Pulmonary
Lung injury associated with inhalation of effective microorganism blends
Jee-min Kim, Yoon Jin Kwak, Ho Il Yoon
Acute Crit Care. 2020;35(2):122-126.   Published online April 8, 2019
DOI: https://doi.org/10.4266/acc.2018.00332
  • 10,083 View
  • 122 Download
AbstractAbstract PDF
Since 2009, effective microorganisms (EMs) have been supplied by the local government to the citizens of Seongnam, Korea, for various environment-protective uses including manufacturing detergents, cosmetics and humidifier disinfectants. A 68-year-old man who had placed an EM blends into a humidifier for inhalation visited the emergency room with complaints of fever and dyspnea. He was in a shock state with hypoxia. Chest computed tomography revealed diffuse ground-glass opacities that were dominant in the bilateral upper lobes. Fiberoptic bronchoscopy with bronchoalveolar lavage and transbronchial lung biopsy was performed. Bronchoalveolar lavage fluid analysis and biopsy findings were consistent with alveolar hemorrhage. All microbiological and virological test results were negative. His symptoms and radiographic opacities had improved markedly after several days of conservative care, and he was discharged healthy after 1 week of hospital stay.
Original Articles
Basic science and research
Anti-inflammatory Role of Mesenchymal Stem Cells in an Acute Lung Injury Mouse Model
Jin Won Huh, Won Young Kim, Yun Young Park, Chae-Man Lim, Younsuck Koh, Mi-Jung Kim, Sang-Bum Hong
Acute Crit Care. 2018;33(3):154-161.   Published online August 31, 2018
DOI: https://doi.org/10.4266/acc.2018.00619
  • 6,199 View
  • 189 Download
  • 9 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary Material
Background
Mesenchymal stem cells (MSCs) attenuate injury in various lung injury models through paracrine effects. We hypothesized that intratracheal transplantation of allogenic MSCs could attenuate lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice, mediated by anti-inflammatory responses.
Methods
Six-week-old male mice were randomized to either the control or the ALI group. ALI was induced by intratracheal LPS instillation. Four hours after LPS instillation, MSCs or phosphate-buffered saline was randomly intratracheally administered. Neutrophil count and protein concentration in bronchoalveolar lavage fluid (BALF); lung histology; levels of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and macrophage inflammatory protein-2; and the expression of proliferation cell nuclear antigen (PCNA), caspase-3, and caspase-9 were evaluated at 48 hours after injury.
Results
Treatment with MSCs attenuated lung injury in ALI mice by decreasing protein level and neutrophil recruitment into the BALF and improving the histologic change. MSCs also decreased the protein levels of proinflammatory cytokines including IL-1β, IL-6, and TNF-α, but had little effect on the protein expression of PCNA, caspase-3, and caspase-9.
Conclusions
Intratracheal injection of bone marrow-derived allogenic MSCs attenuates LPSinduced ALI via immunomodulatory effects.

Citations

Citations to this article as recorded by  
  • The Effectiveness of Adipose Tissue-Derived Mesenchymal Stem Cells Mixed with Platelet-Rich Plasma in the Healing of Inflammatory Bowel Anastomoses: A Pre-Clinical Study in Rats
    Georgios Geropoulos, Kyriakos Psarras, Maria Papaioannou, Vasileios Geropoulos, Argyri Niti, Christina Nikolaidou, Georgios Koimtzis, Nikolaos Symeonidis, Efstathios T. Pavlidis, Georgios Koliakos, Theodoros E. Pavlidis, Ioannis Galanis
    Journal of Personalized Medicine.2024; 14(1): 121.     CrossRef
  • Cyclic Phytosphingosine-1-Phosphate Primed Mesenchymal Stem Cells Ameliorate LPS-Induced Acute Lung Injury in Mice
    Youngheon Park, Jimin Jang, Jooyeon Lee, Hyosin Baek, Jaehyun Park, Sang-Ryul Cha, Se Bi Lee, Sunghun Na, Jae-Woo Kwon, Seok-Ho Hong, Se-Ran Yang
    International Journal of Stem Cells.2023; 16(2): 191.     CrossRef
  • Mesenchymal stem cells and their derived exosomes to combat Covid–19
    Maryam Yousefi Dehbidi, Nima Goodarzi, Mohammad H. Azhdari, Mohammad Doroudian
    Reviews in Medical Virology.2022;[Epub]     CrossRef
  • Stem Cell‐based therapies for COVID‐19‐related acute respiratory distress syndrome
    Hoi Wa Ngai, Dae Hong Kim, Mohamed Hammad, Margarita Gutova, Karen Aboody, Christopher D. Cox
    Journal of Cellular and Molecular Medicine.2022; 26(9): 2483.     CrossRef
  • Development of a physiomimetic model of acute respiratory distress syndrome by using ECM hydrogels and organ-on-a-chip devices
    Esther Marhuenda, Alvaro Villarino, Maria Narciso, Linda Elowsson, Isaac Almendros, Gunilla Westergren-Thorsson, Ramon Farré, Núria Gavara, Jorge Otero
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Advances in mesenchymal stromal cell therapy for acute lung injury/acute respiratory distress syndrome
    Chang Liu, Kun Xiao, Lixin Xie
    Frontiers in Cell and Developmental Biology.2022;[Epub]     CrossRef
  • Auxiliary role of mesenchymal stem cells as regenerative medicine soldiers to attenuate inflammatory processes of severe acute respiratory infections caused by COVID-19
    Peyvand Parhizkar Roudsari, Sepideh Alavi-Moghadam, Moloud Payab, Forough Azam Sayahpour, Hamid Reza Aghayan, Parisa Goodarzi, Fereshteh Mohamadi-jahani, Bagher Larijani, Babak Arjmand
    Cell and Tissue Banking.2020; 21(3): 405.     CrossRef
  • The Role of MSC Therapy in Attenuating the Damaging Effects of the Cytokine Storm Induced by COVID-19 on the Heart and Cardiovascular System
    Georgina M. Ellison-Hughes, Liam Colley, Katie A. O'Brien, Kirsty A. Roberts, Thomas A. Agbaedeng, Mark D. Ross
    Frontiers in Cardiovascular Medicine.2020;[Epub]     CrossRef
Basic science and research
Flecainide Improve Sepsis Induced Acute Lung Injury by Controlling Inflammatory Response
Jia Song, Young joong Suh, Hyun jung Lee, Eun a Jang, Hong-beom Bae, Sang-Hyun Kwak
Korean J Crit Care Med. 2016;31(3):194-201.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00157
  • 7,746 View
  • 128 Download
AbstractAbstract PDF
Background
Flecainide is an antiarrhythmic agent that is used primarily in the treatment of cardiac arrhythmias. Some evidences also suggest that flecainide can participate in alveolar fluid clearance and inflammatory responses. This experiment was aimed to evaluate the effects of flecainide on sepsis induced acute lung injury in a rat model.
Methods
Rats were treated with subcutaneous infusion of saline or flecainide (0.1 or 0.2 mg/kg/hr) by a mini-osmotic pump. Subcutaneous infusion was started 3 hours before and continued until 8 hours after intraperitoneal injection of saline or endotoxin. Animals were sacrificed for analyses of severity of acute lung injury with wet to dry (W/D) ratio and lung injury score (LIS) in lung and inflammatory responses with level of leukocyte, polymorphonuclear neutrophils (PMNs) and inteleukin-8 (IL-8) in bronchoalveolar lavages fluid (BALF).
Results
Flecainide markedly improved dose dependently sepsis induced acute lung injury as analysed by W/D ratio (from 2.24 ± 0.11 to 1.76 ± 0.09, p < 0.05) and LIS (from 3 to 1, p < 0.05), and inflammatory response as determined by leukocyte (from 443 ± 127 to 229 ± 95, p < 0.05), PMNs (from 41.43 ± 17.63 to 2.43 ± 2.61, p < 0.05) and IL-8 (from 95.00 ± 15.28 to 40.00 ± 10.21, p < 0.05) in BALF.
Conclusions
Flecanide improve sepsis induced acute lung injury in rats by controlling inflammatory responses.
Case Reports
Cardiology/Thoracic Surgery
The Use of Extracorporeal Membrane Oxygenation in the Surgical Repair of Bronchial Rupture
Ju-Hee Park, Junghyeon Lim, Jaejin Lee, Hee Sung Lee
Korean J Crit Care Med. 2016;31(1):54-57.   Published online February 29, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.1.54
  • 4,617 View
  • 78 Download
AbstractAbstract PDF
Extracorporeal membrane oxygenation (ECMO) has been used successfully in critically ill patients with traumatic lung injury and offers an additional treatment modality. ECMO is mainly used as a bridge treatment to delayed surgical management; however, only a few case reports have presented the successful application of ECMO as intraoperative support during the surgical repair of traumatic bronchial injury. A 38-year-old man visited our hospital after a blunt chest trauma. His chest imaging showed hemopneumothorax in the left hemithorax and a finding suspicious for left main bronchus rupture. Bronchoscopy was performed and confirmed a tear in the left main bronchus and a congenital tracheal bronchus. We decided to provide venovenous ECMO support during surgery for bronchial repair. We successfully performed main bronchial repair in this traumatic patient with a congenital tracheal bronchus. We suggest that venovenous ECMO offers a good option for the treatment of bronchial rupture when adequate ventilation is not possible.
Cardiology/Anesthesiology
Early Extracorporeal Membrane Oxygenation for Massive Aspiration during Anesthesia Induction
Namo Kim, Kwan Hyung Kim, Jeong Min Kim, Su Youn Choi, Sungwon Na
Korean J Crit Care Med. 2015;30(2):109-114.   Published online May 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.2.109
  • 7,018 View
  • 91 Download
  • 2 Crossref
AbstractAbstract PDF
Although the incidence is not high in the general surgical population, pulmonary aspiration of gastric contents can result in serious long-term morbidity and mortality. We report a case of early use of extracorporeal membrane oxygenation (ECMO) to correct severe hypoxemia refractory to conventional mechanical ventilation in a patient with massive aspiration of gastric contents immediately followed by acute lung injury during general anesthesia induction. A 64-year-old woman diagnosed with stomach cancer was scheduled for elective diagnostic laparoscopy. Although there was no sign of gastrointestinal tract obstruction and midnight Nil per Os (NPO) was performed before the operation, pulmonary aspiration occurred during the induction of anesthesia. Despite the endotracheal intubation with mechanical ventilation, severe hypoxemia with hypercapnea persisted. Medical team agreed with applying veno-venous (VV) ECMO, and her blood gas analysis results became stable. ECMO was weaned successfully 9 days after the first aspiration event had occurred. Based on this case, early application of extracorporeal life support can have survival benefits.

Citations

Citations to this article as recorded by  
  • Massive aspiration syndrome: a possible indication for “emergent” veno-venous extracorporeal membrane oxygenation?: a case report
    Emiliano Gamberini, Venerino Poletti, Emanuele Russo, Alessandro Circelli, Marco Benni, Giovanni Scognamiglio, Domenico Pietro Santonastaso, Costanza Martino, Linda Domenichini, Romina Biondi, Giorgia Bastoni, Etrusca Brogi, Luca Ansaloni, Federico Coccol
    Journal of Medical Case Reports.2021;[Epub]     CrossRef
  • Extracorporeal Membrane Oxygenation Therapy for Aspiration Pneumonia in a Patient following Left Pneumonectomy for Lung Cancer
    Jangwhan Jo, Yang Gi Ryu
    Korean Journal of Critical Care Medicine.2016; 31(2): 156.     CrossRef
Pulmonary
Lobar Bronchial Rupture with Persistent Atelectasis after Blunt Trauma
Jun Hyun Kim, Kyung Woo Kim, Chu Sung Cho, Sang Il Lee, Ji Yeon Kim, Kyung Tae Kim, Won Joo Choe, Jang Su Park, Jung Won Kim
Korean J Crit Care Med. 2014;29(4):344-347.   Published online November 30, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.4.344
  • 6,828 View
  • 50 Download
AbstractAbstract PDF
Rupture limited to the lobar bronchus from blunt trauma is especially rare, and the symptoms are light so diagnosis is difficult. In a patient who visited the hospital complaining of shortness of breath after falling down, atelectasis continued in the chest x-ray. Four days after visiting the hospital, a left upper lobar bronchial rupture was diagnosed through a bronchoscopy and 3 dimensional chest computerized tomography. When diagnosis is delayed in the case of a rupture limited to the lobar bronchus, bronchial obstruction can occur from the formation of granulation tissue, so regular monitoring is important. Therefore, when atelectasis continues after blunt trauma, it is important to differentially diagnose a lobar bronchial rupture through tests such as bronchoscopy.
Original Article
Rebound Inflammation Associated with Rewarming from Hypothermia in an Endotoxin-Injured Lung
Chae Man Lim
Korean J Crit Care Med. 2013;28(2):80-85.
DOI: https://doi.org/10.4266/kjccm.2013.28.2.80
  • 2,565 View
  • 14 Download
AbstractAbstract PDF
BACKGROUND
Hypothermia is known to suppress inflammation in various experimental and clinical settings. We wanted to investigate how the suppressed inflammation by hypothermia is affected during rewarming.
METHODS
Mice were being assigned to normothermia (37degrees C) or hypothermia (32degrees C). After 30 minutes at the assigned temperature, lipopolysaccharide was administered intratracheally. The mice were then randomly grouped and subjected to 4 hours of normothermia (N), 24 hours of normothermia (NN), 4 hours of hypothermia (H), or 4 hours of hypothermia followed by normothermia for the next 20 hours (HN). In another experiment, other HN mice were treated with varying doses of anti-TNF-alpha or anti-IL-1beta antibodies (0, 6.25, 12.5, 25, and 50 microg/250 microl) immediately prior to rewarming.
RESULTS
The neutrophil counts of BAL fluid (x104/ml) were 23.0 +/- 13.1 in the N, 6.4 +/- 3.1 in the H (p = 0.002 vs N), 20.4 +/- 10.2 in the NN, and 49.7 +/- 21.0 in the HN (p = 0.005 vs H; p < 0.001 vs NN). Myeloperoxidase activity of the lung (unit/microg) was 6.7 +/- 2.9, 7.9 +/- 1.9, 17.8 +/- 4.0 (p < 0.001 vs N), and 12.9 +/- 5.9 (p = 0.034 vs H, p = 0.028 vs NN), respectively. Compared with control HN, total WBC and neutrophil counts of mice treated with anti-TNF-alpha antibody or anti-IL-1beta antibody prior to rewarming were lower at all tested doses. The combination of both anti-TNF-alpha or anti-IL-1beta antibodies was not increasingly reducing the neutrophilic sequestration.
CONCLUSIONS
Rewarming from induced hypothermia resulted in augmentation of neutrophilic sequestration of endotoxin-injured lung. Treatment with antibodies against TNF-alpha or IL-1beta prevented this rebound of neutrophilic infiltration.
Case Report
Transfusion-Related Acute Lung Injury after Stored Packed Red Blood Cell Transfusion: A Case Report
Ho Hyun Kim, Dong Kyu Lee, Chan Yong Park, Jae Kyoon Ju, Jung Chul Kim
Korean J Crit Care Med. 2013;28(2):141-145.
DOI: https://doi.org/10.4266/kjccm.2013.28.2.141
  • 3,081 View
  • 37 Download
  • 1 Crossref
AbstractAbstract PDF
Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related mortalities. Each type of blood product is likely to cause TRALI. Patients with TRALI present with dyspnea/respiratory distress and fever. The symptoms, signs and chest radiological findings in TRALI are similar to transfusion associated circulatory overload. Therefore, it is difficult to distinguish such from circulatory overloads. We report a case of TRALI in a 49-year-old woman after stored packed red blood cell transfusion. The patient developed hypoxemia and pulmonary edema after packed red blood cell transfusion during postoperative period. The patient completely recovered after an oxygen support for 3 days.

Citations

Citations to this article as recorded by  
  • A Case Report of Transfusion-Related Acute Lung Injury Induced in the Patient with HLA Antibody after Fresh Frozen Plasma Transfusion
    Ki Sul Chang, Dae Won Jun, Youngil Kim, Hyunwoo Oh, Min Koo Kang, Junghoon Lee, Intae Moon
    The Korean Journal of Blood Transfusion.2015; 26(3): 309.     CrossRef
Reviews
New Definition of Acute Respiratory Distress Syndrome
Je Hyeong Kim
Korean J Crit Care Med. 2013;28(1):10-16.
DOI: https://doi.org/10.4266/kjccm.2013.28.1.10
  • 3,637 View
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AbstractAbstract PDF
Acute respiratory distress syndrome (ARDS) is a common disorder associated with significant mortality and morbidity. The American-European Consensus Conference (AECC) definition of ARDS, established in 1994, has advanced the knowledge of ARDS by allowing the acquisition of clinical and epidemiological data, which in turn have led to improvements in care for patients with ARDS. However, after 18 years of applied research, a number of issues regarding various criteria of AECC definition have emerged. For these reason, and because all disease definitions should be reviewed periodically, the European Society of Intensive Care Medicine convened an international expert panel to revise the ARDS definition from September 30 to October 2, 2011, Berlin, Germany, with endorsement from American Thoracic Society and the Society of Critical Care Medicine. This consensus discussion, following empirical evaluation and consensus revision, addressed some of the limitations of the AECC definition by incorporating current data, physiologic concepts, and clinical trials to develop a new definition of ARDS (Berlin definition). The Berlin definition should facilitate case recognition and better match treatment options to severity in both the research trials and clinical practice.

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    Journal of the Korean Medical Association.2022; 65(3): 124.     CrossRef
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    June Hyeong Kim, Kyung Hoon Sun, Yong Jin Park
    Journal of Trauma and Injury.2019; 32(3): 136.     CrossRef
  • Case Series of Transfusion-Related Acute Lung Injury in a Tertiary Hospital and a Practical Comparison with the New Diagnostic Criteria
    Kwang Seob Lee, Sinyoung Kim, Juhye Roh, Seung Jun Choi, Hyun Ok Kim
    The Korean Journal of Blood Transfusion.2019; 30(3): 219.     CrossRef
  • Application of the Berlin definition in children with acute respiratory distress syndrome
    Soo Yeon Kim, Yoon Hee Kim, In Suk Sol, Min Jung Kim, Seo Hee Yoon, Kyung Won Kim, Myung Hyun Sohn, Kyu-Earn Kim
    Allergy, Asthma & Respiratory Disease.2016; 4(4): 257.     CrossRef
Transfusion-related Acute Lung Injury
Miok Kim
Korean J Crit Care Med. 2012;27(1):1-4.
DOI: https://doi.org/10.4266/kjccm.2012.27.1.1
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AbstractAbstract PDF
Transfusion-related acute lung injury (TRALI) is a significant cause of iatrogenic injuries in patients. It is also the major cause of transfusion-associated fatalities. Pathophysiologic mechanism is an implicated donor of HLA. Neutrophil antibodies and biologic response modifiers are accumulated in the stored blood products. Pulmonary endothelial activation of the host may be the response from these mediators. Treatment is supportive and will be subjected to other forms of ALL/ARDS. Diverting donors at high risk for alloimmunization may decrease the incidence of such cases.

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  • Transfusion-related acute lung injury in a parturient diagnosed with myelodysplastic syndrome - A case report -
    Tae-Yun Sung, Young Seok Jee, Seok-jin Lee, Hwang Ju You, Ki Soon Jeong, Po-Soon Kang
    Anesthesia and Pain Medicine.2019; 14(1): 35.     CrossRef
  • Correlation between Allergic Rhinitis Prevalence and Immune Responses of Children in Ulsan: A Case-control Study
    Jiho Lee, Inbo Oh, Ahra Kim, Minho Kim, Chang sun Sim, Yangho Kim
    Korean Journal of Environmental Health Sciences.2015; 41(4): 249.     CrossRef
  • Transfusion-Related Acute Lung Injury after Stored Packed Red Blood Cell Transfusion - A Case Report -
    Ho-Hyun Kim, Dong-Kyu Lee, Chan-Yong Park, Jae-Kyoon Ju, Jung-Chul Kim
    Korean Journal of Critical Care Medicine.2013; 28(2): 141.     CrossRef
Original Article
High-frequency Chest Wall Oscillation Therapy: Clinical Effectiveness in the Patients with Pulmonary Contusion
Dae Sup Lee, Sung Wook Park, Suk Ran Yeom, Sang Kyoon Han, Sung Hwa Lee, Ji Ho Ryu
Korean J Crit Care Med. 2011;26(4):256-260.
DOI: https://doi.org/10.4266/kjccm.2011.26.4.256
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AbstractAbstract PDF
BACKGROUND
Pulmonary contusion is the most common pulmonary parenchymal injury in blunt chest trauma and may constitute a life-threatening thoracic injury. In this study, we evaluated the usefulness of high-frequency chest wall oscillation (HFCWO) therapy in patients with pulmonary contusion.
METHODS
Patients with lung contusion either received HFCWO therapy using the Vest system (Vest group; n = 18) or received conventional chest physiotherapy (non-Vest group; n = 23). The physiological parameters of the patients, length of stay in hospital and ICU, and the duration of mechanical ventilation were compared between the two groups. Variables, including pulmonary contusion score, percentage of patients receiving mechanical ventilation therapy, and PaO2/FiO2 ratio, were also analyzed.
RESULTS
The pulmonary contusion score was higher in the Vest group (p < 0.01), and mechanical ventilation was used more frequently in the Vest group (p = 0.027). Improvement in the PaO2/FiO2 ratio over the first 48 h did not differ between the Vest and Non-Vest groups. No significant differences in the physiological parameters, hospital and ICU stays, and duration of mechanical ventilation were observed between the two groups.
CONCLUSIONS
The therapeutic effect of the Vest system in patients with pulmonary contusion was similar to that of conventional chest physiotherapy. Therefore, the Vest system could be considered as an airway clearance technique in the management of patients with pulmonary contusion.

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  • Comparative Study of High Frequency Chest Wall Oscillation and Traditional Chest Physical Therapy in Intensive Care Unit Patients
    Yu-Ping Lin, Heng-Hsin Tung, Tsae-Jyy Wang
    Journal of Comprehensive Nursing Research and Care.2017;[Epub]     CrossRef
Case Report
A Case of Acute Lung Injury after Transfusion during Cesarean Section: A Case Report
Hee Jong Lee, Mi Ae Jeong, Ji Seon Jeong, Min Kyu Han, Jong Hun Jun
Korean J Crit Care Med. 2011;26(3):184-187.
DOI: https://doi.org/10.4266/kjccm.2011.26.3.184
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AbstractAbstract PDF
Transfusion-related acute lung injury (TRALI) is a serious complication following the transfusion of blood products. TRALI is under-diagnosed and under-reported because of a lack of awareness. TRALI occurs within 6 hours of transfusion in the majority of cases and its presentation is similar to other forms of acute lung injury. We report on the case of a 34-year-old pregnant woman who suffered from TRALI after transfusion during Cesarean section.

Citations

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  • Transfusion-related acute lung injury in a parturient diagnosed with myelodysplastic syndrome - A case report -
    Tae-Yun Sung, Young Seok Jee, Seok-jin Lee, Hwang Ju You, Ki Soon Jeong, Po-Soon Kang
    Anesthesia and Pain Medicine.2019; 14(1): 35.     CrossRef
  • A Case Report of Transfusion-Related Acute Lung Injury Induced in the Patient with HLA Antibody after Fresh Frozen Plasma Transfusion
    Ki Sul Chang, Dae Won Jun, Youngil Kim, Hyunwoo Oh, Min Koo Kang, Junghoon Lee, Intae Moon
    The Korean Journal of Blood Transfusion.2015; 26(3): 309.     CrossRef
  • Transfusion-Related Acute Lung Injury after Stored Packed Red Blood Cell Transfusion - A Case Report -
    Ho-Hyun Kim, Dong-Kyu Lee, Chan-Yong Park, Jae-Kyoon Ju, Jung-Chul Kim
    Korean Journal of Critical Care Medicine.2013; 28(2): 141.     CrossRef
  • A case of transfusion-related acute lung injury induced by anti-human leukocyte antigen antibodies in acute leukemia
    Sun Mi Jin, Moon Ju Jang, Ji Young Huh, Myoung Hee Park, Eun Young Song, Doyeun Oh
    The Korean Journal of Hematology.2012; 47(4): 302.     CrossRef

ACC : Acute and Critical Care