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Case Reports
Infection
A successful application of adult polymyxin B-immobilized fiber column hemoperfusion to a neonate with septic shock
Young A Kim, Hyungtae Kim, Yu-Mi Kim, Su Eun Park
Acute Crit Care. 2019;34(4):284-288.   Published online November 6, 2018
DOI: https://doi.org/10.4266/acc.2017.00528
Correction in: Acute Crit Care 2023;38(4):515
  • 11,506 View
  • 181 Download
  • 6 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Direct hemoperfusion therapy with a polymyxin B-immobilized fiber column (PMX-HP) has been introduced as a therapeutic option for gram negative bacterial septic shock in adults. However, its use in neonates and children has not yet been established. We successfully performed hemoperfusion therapy using an adult polymyxin B-immobilized fiber column in a neonate with carbapenem resistant Acinetobacter baumannii septic shock. The application was technically feasible because the neonate was on extracorporeal membrane oxygenation (ECMO). Although it did not rescue the patient, there was significant short-lasting improvement in pulmonary oxygenation and hemodynamics, leading to wean the patient from ECMO. PMX-HP could be used as an adjunctive treatment for selected neonatal and pediatric patients with gram negative bacterial septic shock.

Citations

Citations to this article as recorded by  
  • Polymyxin B Hemoperfusion in Pediatric Septic Shock: Single-Center Observational Case Series
    Patcharin Saetang, Rujipat Samransamruajkit, Kanokwan Singjam, Tawatchai Deekajorndech
    Pediatric Critical Care Medicine.2022; 23(8): e386.     CrossRef
  • Controlling an Outbreak of Multidrug-resistant Acinetobacter baumannii in a Pediatric Intensive Care Unit: a Retrospective Analysis
    Joung-Hee Byun, Su Eun Park, Minhae Seo, Jeungmi Jang, Mi Sun Hwang, Ju Yeoun Song, Chulhun L. Chang, Young A Kim
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Effects of continuous renal replacement therapy with the AN69ST membrane for septic shock and sepsis-induced AKI in an infant: a case report with literature review of cytokine/mediator removal therapy in children
    Naoto Nishizaki, Riko Ueno, Yuki Nagayama, Hanako Abe, Akina Matsuda, Akira Mizutani, Kaoru Obinata, Tadaharu Okazaki, Toshiaki Shimizu
    Renal Replacement Therapy.2020;[Epub]     CrossRef
  • Suggestions and tips regarding polymyxin B-immobilized fiber column direct hemoperfusion of neonates with sepsis
    Naoto Nishizaki
    Acute and Critical Care.2020; 35(3): 226.     CrossRef
  • Case Report: Successful Use of Extracorporeal Therapies After ECMO Resuscitation in a Pediatric Kidney Transplant Recipient
    Andrey Rybalko, Anna Pytal, Mikhail Kaabak, Nadejda Rappoport, Anuar Bidzhiev, Vasilii Lastovka
    Frontiers in Pediatrics.2020;[Epub]     CrossRef
Cardiology/Pediatric
Extracorporeal Membrane Oxygenation Cannula Malposition in the Azygos Vein in a Neonate with Right-Sided Congenital Diaphragmatic Hernia
Seung Jun Choi, Chun-Soo Park, Won Kyoung Jhang, Seong Jong Park
Korean J Crit Care Med. 2016;31(2):152-155.   Published online May 31, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.2.152
  • 7,957 View
  • 90 Download
  • 4 Crossref
AbstractAbstract PDF
Malposition of the extracorporeal membrane oxygenation (ECMO) venous cannula in the azygos vein is not frequently reported. We hereby present such a case, which occurred in a neonate with right-sided congenital diaphragmatic hernia. Despite ECMO application, neither adequate flow nor sufficient oxygenation was achieved. On the cross-table lateral chest radiograph, the cannula tip was identified posterior to the heart silhouette, which implied malposition of the cannula in the azygos vein. After repositioning the cannula, the target flow and oxygenation were successfully achieved. When sufficient venous flow is not achieved, as in our case, clinicians should be alerted so they can identify the cannula tip location on lateral chest radiograph and confirm whether malposition in the azygos vein is the cause of the ineffective ECMO.

Citations

Citations to this article as recorded by  
  • Inadvertent cannulation of the azygos vein during eCPR
    Shelina M. Jamal, Deborah S. Fruitman, Kevin M. Lichtenstein, Darren H. Freed, Natalie L. Yanchar
    Journal of Pediatric Surgery Case Reports.2021; 71: 101941.     CrossRef
  • Identification of Inadvertent Azygous Vein Cannulation Using Transthoracic Echocardiography During Venoarterial Extracorporeal Membrane Oxygenation Initiation
    Bethany G. Runkel, Jason D. Fraser, John M. Daniel, Karina M. Carlson
    CASE.2019; 3(2): 67.     CrossRef
  • Successful Extracorporeal Membrane Oxygenation After Incidental Azygos Vein Cannulation in a Neonate With Right-Sided Congenital Diaphragmatic Hernia Interruption of the Inferior Vena Cava and Azygos Continuation
    Alessandra Mayer, Genny Raffaeli, Federico Schena, Valeria Parente, Gabriele Sorrentino, Francesco Macchini, Anna Maria Colli, Lucia Mauri, Simona Neri, Irene Borzani, Ernesto Leva, Fabio Mosca, Giacomo Cavallaro
    Frontiers in Pediatrics.2019;[Epub]     CrossRef
  • The Future of Research on Extracorporeal Membrane Oxygenation (ECMO)
    Ji Young Lee
    Korean Journal of Critical Care Medicine.2016; 31(2): 73.     CrossRef
Original Article
Cardiology/Neurology
Efficacy of Electroencephalographic Monitoring for the Evaluation of Intracranial Injury during Extracorporeal Membrane Oxygenation Support in Neonates and Infants
In Seok Jeong, Young Jong Woo, Do Wan Kim, Nan Yeol Kim, Hwa Jin Cho, Jae Sook Ma
Korean J Crit Care Med. 2014;29(2):70-76.   Published online May 31, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.2.70
  • 4,807 View
  • 42 Download
  • 2 Crossref
AbstractAbstract PDF
Background
Neurological complications are a serious concern during extracorporeal membrane oxygenation (ECMO) support in neonates and infants. However, evaluating brain injury during ECMO has limitations. Herein, we report our experience with bedside electroencephalographic monitoring during ECMO support and compared this to post-ECMO brain imaging studies and immediate neurologic outcomes.
Methods
We retrospectively reviewed the data for 18 children who underwent ECMO. From these subjects, we reviewed the medical records of 10 subjects who underwent bedside EEG monitoring during ECMO support. We collected data on patient demographics, clinical details of the ECMO course, electroencephalographic monitoring, brain imaging results, and neurologic outcomes.
Results
The median age was 4 months (range: 7 days-22 months), the median weight was 5 (3.6-12) kg, and the median length of ECMO therapy was 86 (27-206) hours. Eight patients (80%) were weaned successfully, and seven (70%) survived to discharge. Those with normal to mildly abnormal electroencephalographic findings had non-specific to mildly abnormal brain computed tomography findings and no neurologic impairment. Those patients with a moderately to severely abnormal electroencephalograph had markedly abnormal brain computed tomography findings and remained neurologically impaired.
Conclusions
Normal electroencephalographic findings are closely related to normal or mild neurologic impairment. Our results indicate that electroencephalographic monitoring during ECMO support can be a feasible tool for evaluating brain injury although further prospective studies are needed.

Citations

Citations to this article as recorded by  
  • Neurological monitoring in ECMO patients: current state of practice, challenges and lessons
    Hassan Aboul-Nour, Ammar Jumah, Hafsa Abdulla, Amreeta Sharma, Bradley Howell, Namita Jayaprakash, Jayna Gardner-Gray
    Acta Neurologica Belgica.2023; 123(2): 341.     CrossRef
  • Neurological Monitoring and Complications of Pediatric Extracorporeal Membrane Oxygenation Support
    Ahmed S. Said, Kristin P. Guilliams, Melania M. Bembea
    Pediatric Neurology.2020; 108: 31.     CrossRef
Case Reports
Disseminated Neonatal Herpes Simplex Virus Infection
Bongjin Lee, Jinsol Hwang, Yu Hyeon Choi, Young Joo Han, Young Hun Choi, June Dong Park
Korean J Crit Care Med. 2013;28(4):331-335.
DOI: https://doi.org/10.4266/kjccm.2013.28.4.331
  • 3,004 View
  • 46 Download
  • 1 Crossref
AbstractAbstract PDF
Disseminated neonatal herpes simplex virus (HSV) infection is one of the most severe neonatal infections, and can have devastating consequences without early proper treatment. However, the administration of acyclovir can often be delayed because the symptoms and signs of HSV infection are non-specific and because HSV polymerase chain reaction (PCR) results may be negative early in the course of HSV infection. We report a case of disseminated neonatal HSV infection that was diagnosed by type 1 HSV PCR on day 8 of admission. Despite delayed administration of acyclovir, the patient was cured and subsequently discharged after 30 days of admission. Fortunately, this patient was treated successfully, but delayed administration of acyclovir has the potential to lead to significant problems. Considering the seriousness of neonatal HSV infection, empirical acyclovir therapy should be considered if HSV infection is suspected.

Citations

Citations to this article as recorded by  
  • A Case of Herpes Simplex Virus Type 2 Encephalitis of a Newborn Delivered by a Mother without Prenatal Screening
    Eun Seob Lee, Joon Young Kim, Kon Hee Lee, Jung Won Lee, Yong Ju Lee, Yeon Joung Oh, Ji Seok Bang, Tae-Jung Sung
    Korean Journal of Perinatology.2014; 25(3): 195.     CrossRef
Central Venous Catheter Misplaced in the Innominate Vein after Penetrating the Left Subclavian Vein in a Neonate: A Case Report
Sang Wook Shin, Ji Uk Yoon, Hyeon Jeong Lee, O Sun Kwon, Hyun Mok Kim
Korean J Crit Care Med. 2012;27(1):49-51.
DOI: https://doi.org/10.4266/kjccm.2012.27.1.49
  • 2,385 View
  • 17 Download
AbstractAbstract PDF
In the pediatric ICU and operating room, a central venous catheter (CVC) provides accurate hemodynamic information and serves as a reliable route for the administration of vasoactive drugs, fluids and allogeneic blood products. The placement of CVC is associated with a complication rate of 0.4% to 20%, including hemothorax, pneumothorax, thrombosis, infection and cardiac tamponade. We describe a case of CVC being misplaced in the innominate vein after penetrating the subclavian vein during anesthesia induction for arterial switch operation. Our report discusses the mechanisms by which this mishap took place, and reviews the proper positions of the head, arm, thorax and safe depth of venipuncture for the placement of a CVC in neonates.

ACC : Acute and Critical Care