Acute and Critical Care

Review Article

Cardiology
Venoarterial extracorporeal membrane oxygenation as a rescue strategy in high-risk pulmonary thromboembolism: Woo Jin Jang, Ik Hyun Park, Gyu Tae Park, Tae Wan Kim, Won-Young Kim; Acute Crit Care. 2026;41(3):506-514. Published online August 19, 2026; DOI: https://doi.org/10.4266/acc.002236

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Abstract PDF: Acute high-risk pulmonary thromboembolism (PTE) is the most severe clinical manifestation of venous thromboembolism, carrying a substantial mortality rate, particularly when complicated by cardiogenic shock or cardiac arrest. Although current guidelines recommend systemic thrombolysis for high-risk PTE in the absence of contraindications, this approach is associated with a significant risk of major hemorrhage and may be precluded in patients with severe comorbidities, advanced frailty, or elevated perioperative risk. Consequently, venoarterial extracorporeal membrane oxygenation (VA-ECMO) has emerged as an important mechanical circulatory support strategy for this vulnerable cohort. By bypassing the obstructed pulmonary vascular bed, VA-ECMO facilitates rapid hemodynamic stabilization, mechanically unloads the strained right ventricle, and reverses systemic hypoperfusion. This review elucidates the pathophysiological rationale for right ventricular unloading in high-risk PTE and examines the evolving approach toward catheter-directed interventions and patient-tailored treatment strategies. Furthermore, we evaluate the clinical outcomes of VA-ECMO when deployed either as a stand-alone therapy bridge to recovery alongside systemic anticoagulation or as a bridge to definitive active thrombus clearance.

Original Articles

CPR/Resuscitation
Risk factors for chest trauma associated with prehospital mechanical chest compression after non-traumatic out-of-hospital cardiac arrest in a South Korean regional registry: June-sung Kim, Hannah Park, Won Young Kim; Acute Crit Care. 2026;41(2):356-363. Published online May 28, 2026; DOI: https://doi.org/10.4266/acc.002225

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Abstract PDF Supplementary Material: Background
Mechanical chest compression devices are increasingly used during cardiopulmonary resuscitation, particularly in the prehospital setting, where maintaining high-quality manual chest compressions is challenging. In this study, we aimed to determine whether prehospital exposure to mechanical chest compression is independently associated with increased risk of compression-related chest trauma among out-of-hospital cardiac arrest (OHCA) survivors. Methods: We retrospectively analyzed patients from our prospective OHCA registry who achieved sustained return of spontaneous circulation and underwent chest computed tomography (CT) between March 2019 and June 2023. Chest trauma was identified on imaging and categorized as rib fractures, lung contusion, pneumothorax, pneumomediastinum, hematoma, sternal fracture, or hemothorax. Multivariate logistic regression was performed to identify factors associated with chest trauma. Results: Among 634 included patients, 614 (97%) underwent chest CT, and 277 (45.1%) had evidence of chest trauma. Patients with chest trauma were more likely to be female, be older, have lower body mass index, undergo longer resuscitation, and receive prehospital mechanical chest compression. Rib fractures were the most common injury, followed by sternal fracture. Multivariate analysis showed that the use of mechanical compression in the prehospital setting was an independent risk factor for compression-related chest trauma (adjusted odds ratio, 2.33; 95% CI, 1.45– 3.74). Conclusions: Exposure to mechanical chest compression in the prehospital setting was independently associated with an increased risk of compression-related chest trauma among OHCA survivors.

Cardiology
Managing symptomatic intermediate or high-risk pulmonary embolism presenting concomitantly with intracranial bleeding: case series and literature review: Pipin Kojodjojo, Keith YC Goh, Chieh Yang Koo, Peter Chang, Philip SS Koh; Acute Crit Care. 2026;41(2):344-355. Published online March 4, 2026; DOI: https://doi.org/10.4266/acc.001075

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Abstract PDF: Background
Managing patients with concomitant intracranial bleeding (ICB) and symptomatic pulmonary embolism (PE) is challenging and there are no guidelines. Methods: We identified patients with intermediate or high-risk PE and concomitant ICB referred to our institutional PE response teams. A literature review was performed to evaluate the effectiveness and risks of various treatment strategies for this challenging clinical conundrum. Results: Two patients with subdural hematoma, symptomatic intermediate-high risk PE and deep vein thrombi were identified in our institutions. Both patients were treated with lytic-free mechanical thrombectomy combined with inferior vena cava (IVC) filter implantation. This allowed for an anticoagulation-free period, during which surgical drainage was performed. Anticoagulation was safely started several days after neurosurgery. A literature review identified 148 similar cases. There was significant risk of in-hospital mortality due to PE in patients who were left untreated. Early anticoagulation was associated with elevated risks of hematoma expansion, extracranial bleeding and residual risk of PE mortality. Patients undergoing surgical or lytic-free mechanical thrombectomy all survived to discharge without bleeding complications. Conclusions: Combining thrombolytic-free mechanical thrombectomy with an IVC filter allows for effective PE treatment and temporary avoidance of anticoagulation whilst patients undergo definitive neurosurgery for concomitant ICB. Such an approach seems safer, less invasive and more clinically effective compared to other strategies reported in the literature.

Cardiology
Utility of procalcitonin in diagnosing early postoperative sepsis after pediatric cardiac surgery in Malaysia: Muhammad Yusoff Mohd Ramdzan, Kah Kee Tan, Kok Wai Soo; Acute Crit Care. 2025;40(4):567-573. Published online November 28, 2025; DOI: https://doi.org/10.4266/acc.005016

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Abstract PDF: Background
Systemic inflammation following cardiopulmonary bypass (CPB) can interfere with analysis of routine clinical and biochemical parameters. Procalcitonin (PCT) is a potential biomarker for diagnosing early postoperative sepsis in pediatric patients following cardiac surgery utilizing CPB. This study aimed to evaluate the diagnostic accuracy of PCT compared to other biomarkers, especially C-reactive protein (CRP), in this clinical setting.
Methods
A prospective single-center study was conducted over a 10-month period during the coronavirus disease 2019 (COVID-19) pandemic (2021–2022), enrolling 89 pediatric patients postcardiac surgery. PCT, CRP, and complete blood count were analyzed, and area under the curve (AUC) was employed for statistical analysis.
Results
PCT and CRP demonstrated moderate discriminatory ability with AUCs of 0.678 and 0.635, respectively. White cell count exhibited fair discriminatory power, and platelet count performed poorly in distinguishing septic from nonseptic cases (AUC: white cell count, 0.545; platelet, 0.486).
Conclusions
PCT and CRP hold promise as diagnostic markers for early postoperative sepsis in pediatric cardiac surgery patients. However, these biomarkers are not adequate standalone indicators, emphasizing the continued need for clinical judgment supported by multiple diagnostic parameters.

Review Article

Neurology
Revolutionizing non-traumatic acute care: a review of the role of artificial intelligence and machine learning in triaging and diagnosis: Omofolarin Debellotte, Rachel Melissa Salins, Pragnya Bandari, Maria Gabriela Cerdas, Aijaz Ul Haq, Shaheen Haidrus, Misha Imtiaz, Anietom Ifechukwu Chelsea, Shaik Mohammed Yezdan Ali, Hameeda Abdul Wahab Baloch, Humza Faisal Siddiqui; Acute Crit Care. 2026;41(1):68-86. Published online November 24, 2025; DOI: https://doi.org/10.4266/acc.002200

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Abstract PDF

Acute care settings, including emergency medicine and intensive care units, comprise a substantial portion of healthcare and are essential in the prompt management of conditions that can prove fatal. Critical care conditions require timely management that can be delayed by high patient volumes and the need for complex clinical decision making. Artificial intelligence (AI) tools have been created to enhance diagnostic accuracy and optimize workflow to improve patient care. This narrative review discusses the current status of AI in acute care, with a focus on its applications in triaging and diagnosis. AI-enhanced electrocardiogram analysis, identification of myocardial infarction and acute coronary syndrome, and heart failure risk stratification led to better patient-specific management and improved results. AI models successfully determined and aided in the timely management of various acute conditions, including pneumonia, pulmonary embolism, and respiratory failure. The AI algorithms used accurately determined sepsis onset and course, superseding traditionally used clinical tools and leading to early diagnosis and reduced sepsis mortality. These models showed high sensitivity and specificity in diagnosing and triaging neurological conditions, including altered levels of consciousness, seizures, and intracranial hemorrhages. AI that involved advanced machine learning imaging software led to faster and more accurate stroke diagnosis. Diagnostic tools assisted by AI improved the detection and classification of acute pancreatitis, appendicitis, and gastrointestinal bleeding. AI has shown promising results in optimizing management in acute care settings. However, critical issues in data standardization, ethical considerations, and clinical workflow integration need to be addressed to enable clinical implementation.

Citations

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Insights into Acute Pancreatitis: Pathogenesis, Diagnosis, and Management
Silvia Carrara, Federico Cassano, Maria Terrin, Marco Spadaccini
Journal of Clinical Medicine.2026; 15(8): 2819. CrossRef

Original Articles

Cardiology
Thoracic fluid content by electrical cardiometry versus diaphragmatic excursion by ultrasound for the prediction of weaning success in patients with lung congestion: Shawky Meselhy Elshaer, Ahmed Mostafa Abdelhamid, Enas Wageh Mahdy, Samar Rafik Amin; Acute Crit Care. 2025;40(4):557-566. Published online October 15, 2025; DOI: https://doi.org/10.4266/acc.003984

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Abstract PDF: Background
Predicting the weaning outcomes is critical, since premature or delayed extubation is associated with an increased risk of mortality. This study aimed to compare two physiological indices, thoracic fluid content (TFC) and diaphragmatic excursion (DE), for predicting weaning success in mechanically ventilated patients.
Methods
This observational cohort study involved 100 mechanically ventilated patients with congested lungs who were eligible for weaning. Patients’ TFC and DE were measured using electrical cardiometry and ultrasonography, respectively, before starting the spontaneous breathing trial. Following extubation, patients were grouped into successful and failed-weaning groups, with failure defined as reintubation or a need for non-invasive ventilation within 48 hours. Respiratory and cardiovascular variables were compared. The receiver operating characteristic (ROC) curve was used to assess the ability of TFC and DE to predict weaning success.
Results
Successful weaning occurred in 73 patients (73%) and failed weaning occurred in 27 patients (27%). The two groups’ baseline characteristics were comparable; however, TFC and DE were significantly different between the failed- and successful-weaning groups (P<0.001). The area under the ROC curve (AUC) exhibited moderate predictive abilities of both the TFC and DE in predicting weaning success (AUC, 0.805, cutoff <40 kΩ−1 and AUC, 0.774, cutoff >1.45 cm). In the cardiac patient subgroup, TFC exhibited high predictive ability (AUC, 0.861), but DE did not achieve comparable results (AUC, 0.750).
Conclusions
Both TFC and DE are significant predictors for successful weaning from mechanical ventilators. In particular, a TFC of <40 kΩ−1 demonstrated an excellent ability to predict weaning success in patients with low ejection fraction.

Epidemiology
Development of a deep learning model for predicting critical events in a pediatric intensive care unit: In Kyung Lee, Bongjin Lee, June Dong Park; Acute Crit Care. 2024;39(1):186-191. Published online February 20, 2024; DOI: https://doi.org/10.4266/acc.2023.01424; Correction in: Acute Crit Care 2024;39(2):330

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Abstract PDF

Background
Identifying critically ill patients at risk of cardiac arrest is important because it offers the opportunity for early intervention and increased survival. The aim of this study was to develop a deep learning model to predict critical events, such as cardiopulmonary resuscitation or mortality.
Methods
This retrospective observational study was conducted at a tertiary university hospital. All patients younger than 18 years who were admitted to the pediatric intensive care unit from January 2010 to May 2023 were included. The main outcome was prediction performance of the deep learning model at forecasting critical events. Long short-term memory was used as a deep learning algorithm. The five-fold cross validation method was employed for model learning and testing.
Results
Among the vital sign measurements collected during the study period, 11,660 measurements were used to develop the model after preprocessing; 1,060 of these data points were measurements that corresponded to critical events. The prediction performance of the model was the area under the receiver operating characteristic curve (95% confidence interval) of 0.988 (0.9751.000), and the area under the precision-recall curve was 0.862 (0.700–1.000).
Conclusions
The performance of the developed model at predicting critical events was excellent. However, follow-up research is needed for external validation.

Citations

Citations to this article as recorded by

Clinical Applications of Data Science and Machine Learning in the Pediatric Cardiac Intensive Care Unit
Fabio Savorgnan, Pranathi Pilla, Joshua Prabhu, Saul Flores, Rohit S. Loomba, Sebastian Acosta
Pediatric Cardiology.2026;[Epub] CrossRef
Prediction of Adverse Events in Single Ventricle Physiology Infants Using Artificial Intelligence Tools
Min Yu, Lucas Saenz Gaitan, Alejandro Lopez Magallon, Craig Futterman, Fang Jin, Marius George Linguraru, Syed Muhammad Anwar, Ricardo Munoz
Critical Care Explorations.2026; 8(2): e1381. CrossRef
Artificial Intelligence in Predicting Mortality Risk for Critically Ill Children in Pediatric Intensive Care Units: A Systematic Review
Seyedeh Narjes Ahmadizadeh, Hasan Shamsi, Neda Izadi, Ali Dabbagh, Moein Ebrahimi, Marzieh Shahrabi, Fariba Shabani
Health Science Reports.2026;[Epub] CrossRef
A clinical decision support system for predicting drug-related adverse effects in pediatric patients with congenital heart disease: Development and retrospective evaluation
Esmaeel Toni, Haleh Ayatollahi, Reza Abbaszadeh, Alireza Fotuhi Siahpirani
Journal of International Medical Research.2026;[Epub] CrossRef
Impacto de la inteligencia artificial en la predicción de eventos críticos en las unidades de cuidados intensivos: implicaciones para la práctica y la toma de decisiones en enfermería
Joao Andrés Cujilan Guamán, Nicole Elizabeth Chele Sudiaga, Víctor Alfonso Gavilanes Burnhan, Jenny Verónica Tacle Flores, Ruth Alexandra Boza Ruiz
Prohominum.2025; 7(2): 209. CrossRef
Impacto de la inteligencia artificial en la predicción de eventos críticos en las unidades de cuidados intensivos: Implicaciones para la práctica y la toma de decisiones en enfermería
Joao Andrés Cujilan Guamán, Nicole Elizabeth Chele Sudiaga, Víctor Alfonso Gavilanes Burnhan, Jenny Verónica Tacle Flores, Ruth Alexandra Boza Ruiz
Más Vita.2025; 7(2): 58. CrossRef

Pulmonary
Factors related to lung function outcomes in critically ill COVID-19 patients in South Korea: Tae Hun Kim, Myung Jin Song, Sung Yoon Lim, Yeon Joo Lee, Young-Jae Cho; Acute Crit Care. 2024;39(1):100-107. Published online February 20, 2024; DOI: https://doi.org/10.4266/acc.2023.00668

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Abstract PDF Supplementary Material: Background
New variants of the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic continue to emerge. However, little is known about the effect of these variants on clinical outcomes. This study evaluated the risk factors for poor pulmonary lung function test (PFT).
Methods
The study retrospectively analyzed 87 patients in a single hospital and followed up by performing PFTs at an outpatient clinic from January 2020 to December 2021. COVID-19 variants were categorized as either a non-delta variant (November 13, 2020–July 6, 2021) or the delta variant (July 7, 2021–January 29, 2022).
Results
The median age of the patients was 62 years, and 56 patients (64.4%) were male. Mechanical ventilation (MV) was provided for 52 patients, and 36 (41.4%) had restrictive lung defects. Forced vital capacity (FVC) and diffusion capacity of the lung for carbon monoxide (DLCO ) were lower in patients on MV. Male sex (odds ratio [OR], 0.228) and MV (OR, 4.663) were significant factors for decreased DLCO . The duration of MV was associated with decreased FVC and DLCO . However, the type of variant did not affect the decrease in FVC (P=0.750) and DLCO (P=0.639).
Conclusions
Among critically ill COVID-19 patients, 40% had restrictive patterns with decreased DLCO . The reduction of PFT was associated with MV, type of variants.

CPR/Resuscitation
Prognostic significance of respiratory quotient in patients undergoing extracorporeal cardiopulmonary resuscitation in Korea: Yun Im Lee, Ryoung-Eun Ko, Soo Jin Na, Jeong-Am Ryu, Yang Hyun Cho, Jeong Hoon Yang, Chi Ryang Chung, Gee Young Suh; Acute Crit Care. 2023;38(2):190-199. Published online May 25, 2023; DOI: https://doi.org/10.4266/acc.2022.01438

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Abstract PDF

Background
Respiratory quotient (RQ) may be used as a tissue hypoxia marker in various clinical settings but its prognostic significance in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) is not known.
Methods
Medical records of adult patients admitted to the intensive care units after ECPR in whom RQ could be calculated from May 2004 to April 2020 were retrospectively reviewed. Patients were divided into good neurologic outcome and poor neurologic outcome groups. Prognostic significance of RQ was compared to other clinical characteristics and markers of tissue hypoxia.
Results
During the study period, 155 patients were eligible for analysis. Of them, 90 (58.1%) had a poor neurologic outcome. The group with poor neurologic outcome had a higher incidence of out-of-hospital cardiac arrest (25.6% vs. 9.2%, P=0.010) and longer cardiopulmonary resuscitation to pump-on time (33.0 vs. 25.2 minutes, P=0.001) than the group with good neurologic outcome. For tissue hypoxia markers, the group with poor neurologic outcome had higher RQ (2.2 vs. 1.7, P=0.021) and lactate levels (8.2 vs. 5.4 mmol/L, P=0.004) than the group with good neurologic outcome. On multivariable analysis, age, cardiopulmonary resuscitation to pump-on time, and lactate levels above 7.1 mmol/L were significant predictors for a poor neurologic outcome but not RQ.
Conclusions
In patients who received ECPR, RQ was not independently associated with poor neurologic outcome.

Citations

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Post-resuscitation care after adult extracorporeal cardiopulmonary resuscitation: A scoping review
Tommaso Scquizzato, Gioia Moscoloni, Alexander Supady, Darryl Abrams, Fabio Silvio Taccone, Claudio Sandroni, Jason Bartos, Natalie Kruit, Arianna Gazzato, Alex Rosenberg, Jae-Seung Jung, Steven Ling, Aidan Burrell, Mark Dennis, Anna Mara Scandroglio
Resuscitation.2025; 217: 110880. CrossRef
Risk factors for neurological disability outcomes in patients under extracorporeal membrane oxygenation following cardiac arrest: An observational study
Amir Vahedian-Azimi, Ibrahim Fawzy Hassan, Farshid Rahimi-Bashar, Hussam Elmelliti, Anzila Akbar, Ahmed Labib Shehata, Abdulsalam Saif Ibrahim, Ali Ait Hssain
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Acute and Critical Care.2023; 38(2): 242. CrossRef

Pulmonary
Evaluating diaphragmatic dysfunction and predicting non-invasive ventilation failure in acute exacerbation of chronic obstructive pulmonary disease in India: Nupur B Patel, Gaurav Jain, Udit Chauhan, Ajeet Singh Bhadoria, Saurabh Chandrakar, Haritha Indulekha; Acute Crit Care. 2023;38(2):200-208. Published online May 25, 2023; DOI: https://doi.org/10.4266/acc.2022.01060

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Abstract PDF

Background
Baseline diaphragmatic dysfunction (DD) at the initiation of non-invasive ventilation (NIV) correlates positively with subsequent intubation. We investigated the utility of DD detected 2 hours after NIV initiation in estimating NIV failure in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients.
Methods
In a prospective-cohort design, we enrolled 60 consecutive patients with AECOPD initiated on NIV at intensive care unit admission, and NIV failure events were noted. The DD was assessed at baseline (T1 timepoint) and 2 hours after initiating NIV (T2 timepoint). We defined DD as ultrasound-assessed change in diaphragmatic thickness (ΔTDI) <20% (predefined criteria [PC]) or its cut-off that predicts NIV failure (calculated criteria [CC]) at both timepoints. A predictive-regression analysis was reported.
Results
In total, 32 patients developed NIV failure, nine within 2 hours of NIV and remaining in next 6 days. The ∆TDI cut-off that predicted NIV failure (DD-CC) at T1 was ≤19.04% (area under the curve [AUC], 0.73; sensitivity, 50%; specificity, 85.71%; accuracy; 66.67%), while that at T2 was ≤35.3% (AUC, 0.75; sensitivity, 95.65%; specificity, 57.14%; accuracy, 74.51%; hazard ratio, 19.55). The NIV failure rate was 35.1% in those with normal diaphragmatic function by PC (T2) versus 5.9% by CC (T2). The odds ratio for NIV failure with DD criteria ≤35.3 and <20 at T2 was 29.33 and 4.61, while that for ≤19.04 and <20 at T1 was 6, respectively.
Conclusions
The DD criterion of ≤35.3 (T2) had a better diagnostic profile compared to baseline and PC in prediction of NIV failure.

Citations

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Research Progress on Factors Influencing the Failure of Non-Invasive Respiratory Support Treatment
嘉祺李
Advances in Clinical Medicine.2026; 16(01): 2301. CrossRef
Explainable deep-learning models to predict diaphragmatic dysfunction and cognitive stress in ICU patients under mechanical ventilation
Yonghua Wang, Yuling Bai, Ge Jin
Frontiers in Physiology.2026;[Epub] CrossRef
Association between diaphragm thickening fraction and noninvasive ventilation failure in patients with acute respiratory failure in the emergency department
Mohammed Imaad Khateeb, Mohammad Khalid, Sachin Nayak Sujir, Siddhi Naik, Prabha Prakash, Vimal Krishnan S.
European Journal of Emergency Medicine.2026;[Epub] CrossRef
Diaphragm ultrasound as a predictor for the need for respiratory support at discharge in patients with exacerbation of chronic obstructive pulmonary disease
Chitra Veluthat, Kavitha Venkatnarayan, Sumithra Selvam, Uma Devaraj, Priya Ramachandran, Uma Maheswari Krishnaswamy
Monaldi Archives for Chest Disease.2025;[Epub] CrossRef
The Application of Diaphragm Ultrasound in Chronic Obstructive Pulmonary Disease: A Narrative Review
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Yuming Gao, Bo Yuan, Peng Fan, Mingtao Li, Jiarui Chen
Medicine.2024; 103(51): e40588. CrossRef
Advancing healthcare through thoracic ultrasound research in older patients
Simone Scarlata, Chukwuma Okoye, Sonia Zotti, Fulvio Lauretani, Antonio Nouvenne, Nicoletta Cerundolo, Adriana Antonella Bruni, Monica Torrini, Alberto Finazzi, Tessa Mazzarone, Marco Lunian, Irene Zucchini, Lorenzo Maccioni, Daniela Guarino, Silvia Fabbr
Aging Clinical and Experimental Research.2023; 35(12): 2887. CrossRef

Review Article

Basic Science and Research
Extracorporeal circulation models in small animals: beyond the limits of preclinical research: Mukhammad Kayumov, Reverien Habimana, Dowan Kim, Francis O Obiweluozor, In Seok Jeong, Hwa Jin Cho; Acute Crit Care. 2023;38(1):1-7. Published online February 28, 2023; DOI: https://doi.org/10.4266/acc.2023.00381

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Abstract PDF

Extracorporeal membrane oxygenation (ECMO) use has remarkably increased in recent years. Although ECMO has become essential for patients with refractory cardiac and respiratory failure, extracorporeal circulation (ECC) is associated with significant complications. Small-animal models of ECC have been developed and widely used to better understand ECC-induced pathophysiology. This review article summarizes the development of small-animal ECC models, including the animal species, circuit configuration, priming, perioperative procedures, cannulation, and future perspectives of small-animal ECMO models.

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Original Articles

Pulmonary
Characteristics and outcomes of patients with chronic obstructive pulmonary disease admitted to the intensive care unit due to acute hypercapnic respiratory failure: Türkay Akbaş, Harun Güneş; Acute Crit Care. 2023;38(1):49-56. Published online February 27, 2023; DOI: https://doi.org/10.4266/acc.2022.01011

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Background
The study aimed to describe the clinical course, outcomes, and prognostic factors of chronic obstructive pulmonary disease (COPD) patients with acute hypercapnic respiratory failure.
Methods
This retrospective study involved patients with acute hypercapnic respiratory failure due to COPD of any cause admitted to the intensive care unit (ICU) for non-invasive or invasive mechanical ventilation (IMV) support between December 2015 and February 2020.
Results
One hundred patients were evaluated. The main causes of acute hypercapnic respiratory failure were bronchitis, pneumonia, and heart failure. The patients’ mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 23.0±7.2, and their IMV rate was 43%. ICU, in-hospital, and 90-day mortality rates were 21%, 29%, and 39%, respectively. Non-survivors had more pneumonia, shock within the first 24 hours of admission, IMV, vasopressor use, and renal replacement therapy, along with higher APACHE II scores, lower admission albumin levels and PaO2/ FiO2 ratios, and longer ICU and hospital stays than survivors. Logistic regression analysis identified APACHE II score (odds ratio [OR], 1.157; 95% confidence interval [CI], 1.017–1.317; P=0.026), admission PaO2/FiO2 ratio (OR, 0.989; 95% CI, 0.978–0.999; P=0.046), and vasopressor use (OR, 8.827; 95% CI, 1.650–47.215; P=0.011) as predictors of ICU mortality. APACHE II score (OR, 1.099; 95% CI, 1.021–1.182; P=0.011) and admission albumin level (OR, 0.169; 95% CI, 0.056–0.514; P=0.002) emerged as predictors of 90-day mortality.
Conclusions
APACHE II scores, the PaO2/FiO2 ratio, vasopressor use, and albumin levels are significant short-term mortality predictors in severely ill COPD patients with acute hypercapnic respiratory failure.

Citations

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Pulmonary
Association between timing of intubation and mortality in patients with idiopathic pulmonary fibrosis: Eunhye Bae, Jimyung Park, Sun Mi Choi, Jinwoo Lee, Sang-Min Lee, Hong Yeul Lee; Acute Crit Care. 2022;37(4):561-570. Published online October 28, 2022; DOI: https://doi.org/10.4266/acc.2022.00444

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Abstract PDF Supplementary Material: Background
Delayed intubation is associated with poor prognosis in patients with respiratory failure. However, the effect of delayed intubation in patients with idiopathic pulmonary fibrosis (IPF) remains unknown. This study aimed to analyze whether timing of intubation after high-concentration oxygen therapy was associated with worse clinical outcomes in IPF patients.
Methods
This retrospective propensity score-matched study enrolled adult patients with IPF who underwent mechanical ventilation between January 2011 and July 2021. Patients were divided into early and delayed intubation groups. Delayed intubation was defined as use of high-concentration oxygen therapy for at least 48 hours before tracheal intubation. The primary outcome was intensive care unit (ICU) mortality, and a conditional logistic regression model was used to evaluate the association between timing of intubation and clinical outcomes.
Results
The median duration of high-concentration oxygen therapy before intubation was 0.5 days in the early intubation group (n=60) and 5.1 days in the delayed intubation group (n=36). The ICU mortality rate was 56.7% and 75% in the early and delayed intubation groups, respectively, before propensity matching (P=0.075). After matching for demographic and clinical covariates, 33 matched pairs were selected. In the propensity-matched cohort, delayed intubation significantly increased the risk of ICU mortality (adjusted odds ratio, 3.99; 95% confidence interval, 1.02–15.63; P=0.046). However, in-hospital mortality did not differ significantly between the groups.
Conclusions
In patients with IPF, delayed intubation after initiation of high-concentration oxygen therapy was significantly associated with increased risk of ICU mortality compared to early intubation.

CPR/Resuscitation
Cardiopulmonary resuscitation of infants at birth: predictable or unpredictable?: Mohammad Reza Zarkesh, Raheleh Moradi, Azam Orooji; Acute Crit Care. 2022;37(3):438-453. Published online August 29, 2022; DOI: https://doi.org/10.4266/acc.2021.01501

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Abstract PDF

Background
Anticipating the need for at-birth cardiopulmonary resuscitation (CPR) in neonates is very important and complex. Timely identification and rapid CPR for neonates in the delivery room significantly reduce mortality and other neurological disabilities. The aim of this study was to create a prediction system for identifying the need for at-birth CPR in neonates based on Machine Learning (ML) algorithms.
Methods
In this study, 3,882 neonatal medical records were retrospectively reviewed. A total of 60 risk factors was extracted, and five ML algorithms of J48, Naïve Bayesian, multilayer perceptron, support vector machine (SVM), and random forest were compared to predict the need for at-birth CPR in neonates. Two types of resuscitation were considered: basic and advanced CPR. Using five feature selection algorithms, features were ranked based on importance, and important risk factors were identified using the ML algorithms.
Results
To predict the need for at-birth CPR in neonates, SVM using all risk factors reached 88.43% accuracy and F-measure of 88.4%, while J48 using only the four first important features reached 90.89% accuracy and F-measure of 90.9%. The most important risk factors were gestational age, delivery type, presentation, and mother’s addiction.
Conclusions
The proposed system can be useful in predicting the need for CPR in neonates in the delivery room.

Citations

Citations to this article as recorded by

Feasibility and placement accuracy of a sensor-guided intraosseous device with an automated stop in a small-bone rat cadaver model: a single-arm pilot study
Markus Ortner, Clemens Hacker, Alexandra Kaider, Johann Stanek, David Russ, Ewald Unger, Victor Schmidbauer, Gunpreet Coudert Oberoi
Resuscitation Plus.2026; : 101500. CrossRef
Anticipating the Need for Advanced Resuscitation in Newborns: A 10-Year Retrospective Case-Control Study
Maria Sousa Dias, Mariana Meneses, Monica Calado Araujo, Joana Moreno, Ana Azevedo, Sara Peixoto, Claudia Ferraz
Pediatric Oncall.2025;[Epub] CrossRef
Predicting the Need for Cardiopulmonary Resuscitation in Preterm Infants in the Delivery Room Using Machine Learning Models: Analysis of a Korean Neonatal Network Database
Hyun Ho Kim
Journal of Korean Medical Science.2025;[Epub] CrossRef
Part 5: Neonatal Resuscitation: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Henry C. Lee, Marya L. Strand, Emer Finan, Jessica Illuzzi, Beena D. Kamath-Rayne, Vishal Kapadia, Melissa Mahgoub, Susan Niermeyer, Stephen M. Schexnayder, Georg M. Schmölzer, Jessica Weglarz, Amanda L. Williams, Gary M. Weiner, Myra Wyckoff, Nicole K. Y
Circulation.2025;[Epub] CrossRef

Pulmonary
Association of pulmonary arterial pressure with volume status in patients with acute respiratory distress syndrome receiving extracorporeal membrane oxygenation: Tae Hwa Hong, Hyoung Soo Kim, Sunghoon Park; Acute Crit Care. 2022;37(2):159-167. Published online March 11, 2022; DOI: https://doi.org/10.4266/acc.2021.00927

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Abstract PDF Supplementary Material

Background
Data on pulmonary hemodynamic parameters in patients with acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO) are scarce.
Methods
The associations between pulmonary artery catheter parameters for the first 7 days of ECMO, fluid balance, and hospital mortality were investigated in adult patients (aged ≥19 years) who received venovenous ECMO for refractory ARDS between 2015 and 2017.
Results
Twenty patients were finally included in the analysis (median age, 56.0 years; interquartile range, 45.5–68.0 years; female, n=10). A total of 140 values were collected for each parameter (i.e., 7 days×20 patients). Net fluid balance was weakly but significantly correlated with systolic and diastolic pulmonary arterial pressures (PAPs; r=0.233 and P=0.011; r=0.376 and P<0.001, respectively). Among the mechanical ventilation parameters, above positive end-expiratory pressure was correlated with systolic PAP (r=0.191 and P=0.025), and static compliance was negatively correlated with diastolic PAP (r=−0.169 and P=0.048). Non-survivors had significantly higher systolic PAPs than in survivors. However, in multivariate analysis, there was no significant association between mean systolic PAP and hospital mortality (odds ratio, 1.500; 95% confidence interval, 0.937–2.404; P=0.091).
Conclusions
Systolic PAP was weakly but significantly correlated with net fluid balance during the early ECMO period in patients with refractory ARDS receiving ECMO.

Citations

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Storage duration of packed red blood cells transfused during veno-venous extracorporeal membrane oxygenation is associated with elevated pulmonary artery pressure and lung injury in a sheep model
Fergal T. Temple, Gabriela Simonova, Margaret R. Passmore, Samuel R. Foley, Sara D. Diab, Kimble R. Dunster, Charles I. McDonald, Kiran Shekar, Yoke-Lin Fung, John-Paul Tung, John F. Fraser
Critical Care.2025;[Epub] CrossRef

Ethics
Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act: Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee; Acute Crit Care. 2022;37(2):237-246. Published online February 24, 2022; DOI: https://doi.org/10.4266/acc.2021.01095

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Abstract PDF Supplementary Material

Background
The Life-Sustaining Treatment (LST) Decisions Act allows withholding and withdrawal of LST, including cardiopulmonary resuscitation (CPR). In the present study, the incidence of CPR before and after implementation of the Act was compared.
Methods
This was a retrospective review involving hospitalized patients who underwent CPR at a single center between February 2016 and January 2020 (pre-implementation period, February 2016 to January 2018; post-implementation period, February 2018 to January 2020). The primary outcome was monthly incidence of CPR per 1,000 admissions. The secondary outcomes were duration of CPR, return of spontaneous circulation (ROSC) rate, 24-hour survival rate, and survival-to-discharge rate. The study outcomes were compared before and after implementation of the Act.
Results
A total of 867 patients who underwent CPR was included in the analysis. The incidence of CPR per 1,000 admissions showed no significant difference before and after implementation of the Act (3.02±0.68 vs. 2.81±0.75, P=0.255). The ROSC rate (67.20±0.11 vs. 70.99±0.12, P=0.008) and survival to discharge rate (20.24±0.09 vs. 22.40±0.12, P=0.029) were higher after implementation of the Act than before implementation.
Conclusions
The incidence of CPR did not significantly change for 2 years after implementation of the Act. Further studies are needed to assess the changes in trends in the decisions of CPR and other LSTs in real-world practice.

Citations

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Tak Kyu Oh, In-Ae Song
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Song-I Lee, Ye-Rin Ju, Da Hyun Kang, Jeong Eun Lee
BMC Palliative Care.2024;[Epub] CrossRef
For the Universal Right to Access Quality End-of-Life Care in Korea: Broadening Our Perspective After the 2018 Life-Sustaining Treatment Decisions Act
Hye Yoon Park, Min Sun Kim, Shin Hye Yoo, Jung Lee, In Gyu Song, So Yeon Jeon, Eun Kyung Choi
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Will implementation of the Life-sustaining Treatment Decisions Act reduce the incidence of cardiopulmonary resuscitation?
In-Ae Song
Acute and Critical Care.2022; 37(2): 256. CrossRef
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Review Articles

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

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Abstract 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.

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Journal of Neuroinflammation.2026;[Epub] CrossRef
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Yixi Wang, Zhu Xuanle, Wenzhe Li, Qiuyuan Huang, Jian Cui, Yan Li, Yuqian Li
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Computer Methods and Programs in Biomedicine.2026; 286: 109572. CrossRef
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Lei Gu, Yun Zhen, Zhenlin Huang, Tianbao Chen, Fuxiong Li, Kaipeng Chen
Technology and Health Care.2025; 33(1): 157. CrossRef
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European Journal of Trauma and Emergency Surgery.2025;[Epub] CrossRef
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Journal of Surgical Research.2025; 313: 526. CrossRef
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Pulmonary
Critical care management of pulmonary arterial hypertension in pregnancy: the pre-, peri- and post-partum stages: Vorakamol Phoophiboon, Monvasi Pachinburavan, Nicha Ruamsap, Natthawan Sanguanwong, Nattapong Jaimchariyatam; Acute Crit Care. 2021;36(4):286-293. Published online November 26, 2021; DOI: https://doi.org/10.4266/acc.2021.00458

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Abstract PDF

The mortality rate of pulmonary hypertension in pregnancy is 25%–56%. Pulmonary arterial hypertension is the highest incidence among this group, especially in young women. Despite clear recommendation of pregnancy avoidance, certain groups of patients are initially diagnosed during the gestational age step into the third trimester. While the presence of right ventricular failure in early gestation is usually trivial, it can be more severe in the late trimester. Current evidence shows no consensus in the management and serious precautions for each stage of the pre-, peri- and post-partum periods of this specific group. Pulmonary hypertension-targeted drugs, mode of delivery, type of anesthesia, and some avoidances should be planned among a multidisciplinary team to enhance maternal and fetal survival opportunities. Sudden circulatory collapse from cardiac decompensation during the peri- and post-partum phases is detrimental, and mechanical support such as extracorporeal membrane oxygenation should be considered for mitigating hemodynamics and extending cardiac recovery time. Our review aims to explain the pathophysiology of pulmonary arterial hypertension and summarize the current evidence for critical management and precautions in each stage of pregnancy.

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Circulation.2023; 147(7): 549. CrossRef
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Advances in Clinical Medicine.2023; 13(11): 18492. CrossRef

Case Report

Pulmonary
Successful noninvasive ventilation in a severely acidotic and hypercapnic comatose COVID-19 patient with multiple comorbidities: a case report: Joseph Abraham Poonuraparampil, Habib Md Reazaul Karim, Manu P Kesavankutty, Porika Prashanth Nayak; Acute Crit Care. 2022;37(1):120-123. Published online November 26, 2021; DOI: https://doi.org/10.4266/acc.2020.00983

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Abstract PDF

Effective use of noninvasive ventilation in patients with chronic obstructive pulmonary disease is well-known. However, noninvasive ventilation in patients presenting with altered sensorium and severe acidosis (pH <7.1) has been rarely described. Invasive mechanical ventilation is associated with high mortality in coronavirus disease 2019 (COVID-19), and use of noninvasive ventilation over invasive ventilation is an area of investigation. We report a case of COVID-19-induced acute exacerbation of chronic obstructive pulmonary disease in a 66-year-old male. His past medical history included obstructive sleep apnea, hypertension, cor pulmonale, atrial fibrillation, and amiodarone-induced hypothyroidism. On presentation, he had acute hypercapnic respiratory failure, severe acidosis (partial pressure of carbon dioxide [PCO2], 147 mm Hg; pH, 7.06), and altered mentation. The patient was successfully managed with noninvasive ventilation, avoiding endotracheal intubation, invasive ventilation, and related complications. Although precarious, a trial of noninvasive ventilation can be considered in COVID-19-induced acute exacerbation of chronic obstructive pulmonary disease with hypercapnic respiratory failure, severe acidosis, and altered mentation.

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Original Articles

Rapid response system
Analysis of avoidable cardiopulmonary resuscitation incidents with a part-time rapid response system in place: Jun Yeun Cho, Dong Seon Lee, Yun Young Choi, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Yeon Joo Lee; Acute Crit Care. 2021;36(2):109-117. Published online April 16, 2021; DOI: https://doi.org/10.4266/acc.2020.01095

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Abstract PDF Supplementary Material

Background
Although a rapid response system (RRS) can reduce the incidence of cardiopulmonary resuscitation (CPR) in general wards, avoidable CPR cases still occur. This study aimed to investigate the incidence and causes of avoidable CPR.
Methods
We retrospectively reviewed the medical records of all adult patients who received CPR between April 2013 and March 2016 (35 months) at a tertiary teaching hospital where a part-time RRS was introduced in October 2012. Four experts reviewed all of the CPR cases and determined whether each event was avoidable.
Results
A total of 192 CPR cases were identified, and the incidence of CPR was 0.190 per 1,000 patient admissions. Of these, 56 (29.2%) were considered potentially avoidable, with the most common cause being doctor error (n=32, 57.1%), followed by delayed do-not-resuscitate (DNR) placement (n=12, 21.4%) and procedural complications (n=5, 8.9%). The percentage of avoidable CPR was significantly lower in the RRS operating time group than in the RRS non-operating time group (20.7% vs. 35.5%; P=0.026). Among 44 avoidable CPR events (excluding cases related to DNR issues), the rapid response team intervened in only three cases (6.8%), and most of the avoidable CPR cases (65.9%) occurred during the non-operating time.
Conclusions
A significant number of avoidable CPR events occurred with a well-functioning, part-time RRS in place. However, RRS operation does appear to lower the occurrence of avoidable CPR. Thus, it is necessary to extend RRS operation time and modify RRS activation criteria. Moreover, policy and cultural changes are needed prior to implementing a full-time RRS.

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The effect of nurses' perceptions and satisfaction with hospital rapid response teams on burnout related to emergency situations in Korea: a cross-sectional study
Bumin Kim, Nahyun Kim
Journal of Korean Biological Nursing Science.2025; 27(2): 234. CrossRef
Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act
Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee
Acute and Critical Care.2022; 37(2): 237. CrossRef
A Review of the Commercially Available ECG Detection and Transmission Systems—The Fuzzy Logic Approach in the Prevention of Sudden Cardiac Arrest
Michał Lewandowski
Micromachines.2021; 12(12): 1489. CrossRef

Pulmonary
The effects of direct hemoperfusion with polymyxin B-immobilized fiber in patients with acute exacerbation of interstitial lung disease: Jae Ha Lee, Jin Han Park, Hyo-Jung Kim, Hyun Kuk Kim, Ji Hoon Jang, Yong Kyun Kim, Bong Soo Park, Si Hyung Park, Il Hwan Kim, Se Hun Kim, Woon Heo, Hang-Jea Jang; Acute Crit Care. 2021;36(2):126-132. Published online April 15, 2021; DOI: https://doi.org/10.4266/acc.2021.00073

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Abstract PDF

Background
Acute exacerbation of interstitial lung disease (AE-ILD) causes clinically significant deterioration and has an extremely poor prognosis with high mortality. Recently, several studies reported the effectiveness of direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) in patients with AE-ILD as a potential therapy. This study describes the clinical effectiveness and safety of PMX-DHP in patients with AE-ILD.
Methods
We retrospectively reviewed the medical records of 10 patients (11 episodes) with AE-ILD treated with PMX-DHP from January 2018 to June 2019. We compared laboratory and physiologic data of the ratio of partial pressure arterial oxygen to fraction of inspired oxygen (P/F ratio) and level of inflammatory markers before and after implementation of PMX-DHP.
Results
Ten patients were included according to the 2016 revised definition of acute exacerbation of idiopathic pulmonary fibrosis (IPF). Nine patients had IPF and one patient had fibrotic nonspecific interstitial pneumonia. Most patients (90.9%) were treated with a steroid pulse, and four patients (36.4%) were treated with an immunosuppressant. The median number of PMX-DHP cycles was 2, and the median duration of each cycle was 6 hours. After PMX-DHP, the mean P/F ratio improved (86 [range, 63–106] vs. 145 [86–260], P=0.030) and interleukin-6 and c-reactive protein decreased (79 [35–640] vs. 10 [5–25], P=0.018 and 14 [4–21] vs. 5 [2–6], P=0.019, respectively). The 30-day mortality rate was 27.3% and the 90-day mortality rate was 72.7%.
Conclusions
PMX-DHP treatment improved P/F ratio and reduced inflammatory markers in AE-ILD patients.

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Yuki Hattori, Nobutaka Chiba, Shingo Ihara, Jun Sato, Katsuhiro Nakagawa, Takeshi Saito, Kosaku Kinoshita
Annals of Medicine & Surgery.2026; 88(8): 5477. CrossRef
Inflammatory and Coagulation Marker Changes in PMX-DHP-Treated COVID-19 Patients
Akinari Tsukada, Daisuke Katagiri, Shinyu Izumi, Junko Terada-Hirashima, Yosuke Shimizu, Yukari Uemura, Masaaki Toda, Taro Yasuma, Corina N D'Alessandro Gabazza, Hajime Fujimoto, Tetsu Kobayashi, Esteban Cesar Gabazza, Masaya Sugiyama, Eisei Noiri, Shinji
Cureus.2025;[Epub] CrossRef
Polymyxin B-hemoperfusion in patients with acute exacerbation of idiopathic pulmonary fibrosis: a single-center prospective pilot study
Min Jee Kim, Jiyoul Yang, Jin Woo Song
The Korean Journal of Internal Medicine.2025; 40(3): 458. CrossRef
Polymyxin B-hemoperfusion in acute exacerbation of idiopathic pulmonary fibrosis: a feasibility step forward
Won-Il Choi
The Korean Journal of Internal Medicine.2025; 40(3): 345. CrossRef
Clinical trials on acute exacerbations of interstitial lung diseases
Panagiota Tsiri, Fabiola Murgolo, Bruno Crestani
Expert Review of Respiratory Medicine.2025; 19(11): 1127. CrossRef
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Min Li, Yu Du, Xiaojuan Yang
Rheumatology and Therapy.2025; 12(5): 815. CrossRef
Polymyxin B-immobilised fibre column treatment for acute exacerbation of idiopathic pulmonary fibrosis patients with mechanical ventilation: a nationwide observational study
Nobuyasu Awano, Taisuke Jo, Takehiro Izumo, Minoru Inomata, Yu Ito, Kojiro Morita, Hiroki Matsui, Kiyohide Fushimi, Hirokazu Urushiyama, Takahide Nagase, Hideo Yasunaga
Journal of Intensive Care.2023;[Epub] CrossRef
Changes in Oxygenation and Serological Markers in Acute Exacerbation of Interstitial Lung Disease Treated with Polymyxin B Hemoperfusion
Song-I Lee, Chaeuk Chung, Dongil Park, Da Hyun Kang, Jeong Eun Lee
Journal of Clinical Medicine.2022; 11(9): 2485. CrossRef

Rapid response system
Effectiveness of a daytime rapid response system in hospitalized surgical ward patients: Eunjin Yang, Hannah Lee, Sang-Min Lee, Sulhee Kim, Ho Geol Ryu, Hyun Joo Lee, Jinwoo Lee, Seung-Young Oh; Acute Crit Care. 2020;35(2):77-86. Published online May 13, 2020; DOI: https://doi.org/10.4266/acc.2019.00661

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Abstract PDF Supplementary Material

Background
Clinical deteriorations during hospitalization are often preventable with a rapid response system (RRS). We aimed to investigate the effectiveness of a daytime RRS for surgical hospitalized patients.
Methods
A retrospective cohort study was conducted in 20 general surgical wards at a 1,779-bed University hospital from August 2013 to July 2017 (August 2013 to July 2015, pre-RRS-period; August 2015 to July 2017, post-RRS-period). The primary outcome was incidence of cardiopulmonary arrest (CPA) when the RRS was operating. The secondary outcomes were the incidence of total and preventable cardiopulmonary arrest, in-hospital mortality, the percentage of “do not resuscitate” orders, and the survival of discharged CPA patients.
Results
The relative risk (RR) of CPA per 1,000 admissions during RRS operational hours (weekdays from 7 AM to 7 PM) in the post-RRS-period compared to the pre-RRS-period was 0.53 (95% confidence interval [CI], 0.25 to 1.13; P=0.099) and the RR of total CPA regardless of RRS operating hours was 0.76 (95% CI, 0.46 to 1.28; P=0.301). The preventable CPA after RRS implementation was significantly lower than that before RRS implementation (RR, 0.31; 95% CI, 0.11 to 0.88; P=0.028). There were no statistical differences in in-hospital mortality and the survival rate of patients with in-hospital cardiac arrest. Do-not-resuscitate decisions significantly increased during after RRS implementation periods compared to pre-RRS periods (RR, 1.91; 95% CI, 1.40 to 2.59; P<0.001).
Conclusions
The day-time implementation of the RRS did not significantly reduce the rate of CPA whereas the system effectively reduced the rate of preventable CPA during periods when the system was operating.

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Médecine périopératoire et situations particulières
Julien Amour, Paul Balendraud, Jacques Boddaert, Pierre Bouzat, Laure Champ-Rigot, Olivier Clovet, Judith Cohen-Bittan, Isabelle Constant, Charles Court, Sabine Drevet, Christophe Hulet, Eric Jeziorski, Olivier Joannes-Boyau, Hélène Kovacsik, Morgan Le Gu
Anesthésie & Réanimation.2026; 12(1): 73. CrossRef
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Akiko Ogawa, Yoko Tsuchiya, Ikue Sakemi, Nobuo Kutsuna
BMJ Open Quality.2026; 15(1): e003949. CrossRef
The effect of nurses' perceptions and satisfaction with hospital rapid response teams on burnout related to emergency situations in Korea: a cross-sectional study
Bumin Kim, Nahyun Kim
Journal of Korean Biological Nursing Science.2025; 27(2): 234. CrossRef
Education, Implementation, and Teams: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations
Robert Greif, Adam Cheng, Cristian Abelairas-Gómez, Katherine S. Allan, Jan Breckwoldt, Andrea Cortegiani, Aaron J. Donoghue, Kathryn J. Eastwood, Barbara Farquharson, Ming-Ju Hsieh, Tracy Kidd, Ying-Chih Ko, Kasper G. Lauridsen, Yiqun Lin, Andrew S. Lock
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Rebecca J. Piasecki, Cheryl R. Dennison Himmelfarb, Kelly T. Gleason, Rachel M. Justice, Elizabeth A. Hunt
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Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee
Acute and Critical Care.2022; 37(2): 237. CrossRef
Estructura y función de los equipos de respuesta rápida para la atención de adultos en contextos hospitalarios de alta complejidad: Revisión sistemática de alcance
Juliana Vanessa Rincón-López, Diego Larrotta-Castillo, Kelly Estrada-Orozco, Hernando Gaitán-Duarte
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Pediatric
Effects of the presence of a pediatric intensivist on treatment in the pediatric intensive care unit: Jung Eun Kwon, Da Eun Roh, Yeo Hyang Kim; Acute Crit Care. 2020;35(2):87-92. Published online May 12, 2020; DOI: https://doi.org/10.4266/acc.2019.00752

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Abstract PDF

Background
There are few studies on the effect of intensivist staffing in pediatric intensive care units (PICUs) in Korea. We aimed to evaluate the effect of pediatric intensivist staffing on treatment outcomes in a Korean hospital PICU.
Methods
We analyzed two time periods according to pediatric intensivist staffing: period 1, between November 2015 to January 2017 (no intensivist staffing, n=97) and period 2, between February 2017 to February 2018 (intensivists staffing, n=135).
Results
Median age at admission was 5.4 years (range, 0.7–10.3 years) in period 1 and 3.6 years (0.2–5.1 years) in period 2 (P=0.013). The bed occupancy rate decreased in period 2 (75%; 73%–88%) compared to period 1 (89%; 81%–94%; P=0.015). However, the monthly bed turnover rate increased in period 2 (2.2%; 1.9%–2.7%) compared to period 1 (1.5%, 1.1%– 1.7%; P=0.005). In both periods, patients with chronic neurologic illness were the most common. Patients with cardiovascular problems were more prevalent in period 2 than period 1 (P=0.008). Daytime admission occurred more frequently in period 2 than period 1 (63% vs. 39%, P<0.001). The length of PICU stay, parameters related with mechanical ventilation and tracheostomy, and pediatric Sequential Organ Failure Assessment score were not different between periods. Sudden cardiopulmonary resuscitations occurred in two cases during period 1, but no case occurred during period 2.
Conclusions
Pediatric intensivist staffing in the PICU may affect efficient ICU operations.

Citations

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Case Report

Pulmonary
Direct hemoperfusion with polymyxin B-immobilized fiber column in a patient with acute exacerbation of idiopathic pulmonary fibrosis: Shin Young Kim, Jin Han Park, Hyo Jung Kim, Hang Jea Jang, Hyun Kuk Kim, Seung Hoon Kim, Jae Ha Lee; Acute Crit Care. 2020;35(4):302-306. Published online April 13, 2020; DOI: https://doi.org/10.4266/acc.2020.00038

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Abstract PDF: Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease characterized by dyspnea and a worsening of the lung function. Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) are defined by a clinically significant respiratory deterioration, that typically develops in less than 1 month, accompanied by new radiologic abnormalities on high-resolution computed tomography, including diffused and bilateral ground-glass opacification, along with an absence of other obvious clinical etiologies. Recently, AE-IPF has gained significant importance as a major cause of mortality and morbidity. However, despite the extremely poor prognosis of the condition, no well-validated therapeutic interventions are currently available. Therefore, novel treatment modalities are being investigated and applied in addition to conventional treatments. Among them, several studies have reported that a direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP), developed for endotoxin removal in septic shock, has an effect on AE-IPF. We describe two cases of PMX-DHP treatment with conflicting results. One patient successfully recovered via a PMX-DHP in severe AE-IPF that required extracorporeal membrane oxygenation (ECMO). PMX-DHP subsequently improved oxygenation (PaO2/FiO2 ratio) and decreased the levels of inflammatory markers (interleukin-6, C-reactive protein, and white blood cells). The patient dramatically recovered without the need for ECMO. PMX-DHP may be considered an alternative therapy in AE-IPF patients requiring mechanical ventilation or ECMO.

Review Article

CPR/Resuscitation
Role of extracorporeal cardiopulmonary resuscitation in adults: Hongsun Kim, Yang Hyun Cho; Acute Crit Care. 2020;35(1):1-9. Published online February 29, 2020; DOI: https://doi.org/10.4266/acc.2020.00080

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Abstract PDF

Extracorporeal cardiopulmonary resuscitation (ECPR) has been performed with increasing frequency worldwide to improve the low survival rate of conventional cardiopulmonary resuscitation (CCPR). Several studies have shown that among patients who experience in-hospital cardiac arrest, better survival outcomes and neurological outcomes can be expected after ECPR than after CCPR. However, studies have not clearly shown a short-term survival benefit of ECPR for patients who experience out-of-hospital cardiac arrest. Favorable outcomes are associated with a shorter low-flow time, an initial shockable rhythm, lower serum lactate levels, higher blood pH, and a lower Sequential Organ Failure Assessment score. Indications for ECPR include young age, witnessed arrest with bystander cardiopulmonary resuscitation, an initial shockable rhythm, correctable causes such as a cardiac etiology, and no return of spontaneous circulation within 10–20 minutes of CCPR. ECPR is a complex intervention that requires a highly trained team, specialized equipment, and multidisciplinary support within a healthcare system, and it has the risk of several life-threatening complications. Therefore, physicians should carefully select patients for ECPR who can gain the most benefit, instead of applying ECPR indiscriminately.

Citations

Citations to this article as recorded by

Cardiac arrest caused by acute gastric dilatation in a bulimia patient: a case report
Qi Cai, Menglong Song, Hongqiong Peng, Hua Jiang, Ping Zhou
Frontiers in Medicine.2026;[Epub] CrossRef
Clinical Impact of the Transient Return of Spontaneous Circulation Before Extracorporeal Cardiopulmonary Resuscitation in Patients with Refractory Out-of-Hospital Cardiac Arrest: A Nationwide Observational Study
Haksun Kim, Jae-Guk Kim, Gu-Hyun Kang, Yong-Soo Jang, Wonhee Kim, Hyun-Young Choi, Chiwon Ahn
Journal of Clinical Medicine.2026; 15(10): 3584. CrossRef
Prognostic Impact of Transient Return of Spontaneous Circulation According to Low-Flow Time in Patients with Out-of-Hospital Cardiac Arrest Undergoing Extracorporeal Cardiopulmonary Resuscitation: A Nationwide Cohort Study
Seongjin Noh, Jae-Guk Kim, Gu-Hyun Kang, Yong-Soo Jang, Wonhee Kim, Hyun-Young Choi
Journal of Clinical Medicine.2026; 15(19): 7354. CrossRef
Emergency department extracorporeal membrane oxygenation: Current concepts, systems-based implementation, and future directions
Yunus Emre Özlüer, Ahmet Melih Savaş, Merve Serin, Ali Kocailik
Turkish Journal of Emergency Medicine.2026; 26(4): 263. CrossRef
Acute kidney injury as a prognostic predictor of in-hospital mortality and neurological outcomes in patients after extracorporeal cardiopulmonary resuscitation
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Perfusion.2025; 40(4): 974. CrossRef
Extracorporeal CPR Performance Metrics in Adult In-Hospital Cardiac Arrest: A Stepwise and Evidence-Based Appraisal of the VA-ECMO Implementation Process
Timothy Ford, Brent Russell, Pritee Tarwade
Journal of Clinical Medicine.2025; 14(15): 5330. CrossRef
The effect of percutaneous coronary intervention after extracorporeal cardiopulmonary resuscitation on survival for out of hospital cardiac arrest: a causal inference analysis
Laith Alhuneafat, Thomas A Murray, Nicholas J Johnson, Cindy Hsu, Brian Grunau, Tamas Alexy, Demetris Yannopoulos, Jason Bartos, Joseph E. Tonna
Resuscitation Plus.2025; 26: 101103. CrossRef
Impact of independent early stage extracorporeal cardiopulmonary resuscitation in the emergency department following the establishment of an extracorporeal life support team
Zhan-Xiao Liu, Ya Yang, Huan-Huan Song, Wei Liu, Peng Sun, Cai-Wei Lin
Heliyon.2024; 10(1): e23411. CrossRef
Mechanical circulatory support for cardiogenic shock: a network meta-analysis of randomized controlled trials and propensity score-matched studies
Christopher Jer Wei Low, Ryan Ruiyang Ling, Michele Petrova Xin Ling Lau, Nigel Sheng Hui Liu, Melissa Tan, Chuen Seng Tan, Shir Lynn Lim, Bram Rochwerg, Alain Combes, Daniel Brodie, Kiran Shekar, Susanna Price, Graeme MacLaren, Kollengode Ramanathan
Intensive Care Medicine.2024; 50(2): 209. CrossRef
What factors are effective on the CPR duration of patients under extracorporeal cardiopulmonary resuscitation: a single-center retrospective study
Amir Vahedian-Azimi, Ibrahim Fawzy Hassan, Farshid Rahimi-Bashar, Hussam Elmelliti, Anzila Akbar, Ahmed Labib Shehata, Abdulsalam Saif Ibrahim, Ali Ait Hssain
International Journal of Emergency Medicine.2024;[Epub] CrossRef
Extracorporeal Cardiopulmonary Resuscitation: Life-saving or Resource Wasting?
Andrea M Elliott, Sean van Diepen, Steven M Hollenberg, Samuel Bernard
US Cardiology Review.2024;[Epub] CrossRef
Variability in patient selection criteria across extracorporeal cardiopulmonary resuscitation (ECPR) systems: A systematic review
Amani Alenazi, Mohammed Aljanoubi, Joyce Yeung, Jason Madan, Samantha Johnson, Keith Couper
Resuscitation.2024; 204: 110403. CrossRef
Clinician Perspectives on Cannulation for Extracorporeal Cardiopulmonary Resuscitation: A Mixed Methods Analysis
Devindi Wanigasekara, Vincent A. Pellegrino, Aidan JC. Burrell, Nyein Aung, Shaun D. Gregory
ASAIO Journal.2023; 69(3): 332. CrossRef
Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with cardiac arrest: a comparative meta-analysis and trial sequential analysis
Christopher Jer Wei Low, Kollengode Ramanathan, Ryan Ruiyang Ling, Maxz Jian Chen Ho, Ying Chen, Roberto Lorusso, Graeme MacLaren, Kiran Shekar, Daniel Brodie
The Lancet Respiratory Medicine.2023; 11(10): 883. CrossRef
Anticoagulation strategies in patients with extracorporeal membrane oxygenation: A network meta‐analysis and systematic review
Jiale Chen, Guoquan Chen, Wenyi Zhao, Wenxing Peng
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy.2023; 43(10): 1084. CrossRef
Prophylactic antibiotic treatment for preventing nosocomial infection in extracorporeal membrane oxygenation–resuscitated circulatory arrest patients
Lan-Pin Kuo, Yi-Chen Wang, Po-Lin Chen, Wei-Hung Lin, Wei-Ming Wang, Chao-Jung Shih, Pei-Ni Yang, Yu-Ning Hu, Chih-Hsin Hsu, Jun-Neng Roan, Meng-Ta Tsai
JTCVS Open.2023; 16: 582. CrossRef
Lethal abdominal compartment syndrome after extracorporeal cardiopulmonary resuscitation in a patient with out-of-hospital cardiac arrest: a case report
Gun Jik Kim, Kyoung Hoon Lim, Tak-hyuk Oh, Hyun-Joo Lee, Deokbi Hwang, Hanna Jung
International Journal of Emergency Medicine.2023;[Epub] CrossRef
How effective is extracorporeal life support for patients with out-of-hospital cardiac arrest initiated at the emergency department? A systematic review and meta-analysis
Wachira Wongtanasarasin, Sarunsorn Krintratun, Witina Techasatian, Daniel K. Nishijima, Gaetano Santulli
PLOS ONE.2023; 18(11): e0289054. CrossRef
Treatment of Refractory Cardiac Arrest by Controlled Reperfusion of the Whole Body: A Multicenter, Prospective Observational Study
Georg Trummer, Christoph Benk, Jan-Steffen Pooth, Tobias Wengenmayer, Alexander Supady, Dawid L. Staudacher, Domagoj Damjanovic, Dirk Lunz, Clemens Wiest, Hug Aubin, Artur Lichtenberg, Martin W. Dünser, Johannes Szasz, Dinis Dos Reis Miranda, Robert J. va
Journal of Clinical Medicine.2023; 13(1): 56. CrossRef
Extended cardiopulmonary resuscitation: from high fidelity simulation scenario to the first clinical applications in Poznan out-of-hospital cardiac arrest program
Maciej Sip, Mateusz Puslecki, Marek Dabrowski, Tomasz Klosiewicz, Radoslaw Zalewski, Marcin Ligowski, Ewa Goszczynska, Christopher Paprocki, Marek Grygier, Maciej Lesiak, Marek Jemielity, Bartłomiej Perek
Perfusion.2022; 37(1): 46. CrossRef
Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: first results and outcomes of a newly established ECPR program in a large population area
Ilija Djordjevic, Christopher Gaisendrees, Christoph Adler, Kaveh Eghbalzadeh, Simon Braumann, Borko Ivanov, Julia Merkle, Antje-Christin Deppe, Elmar Kuhn, Robert Stangl, Alex Lechleuthner, Christian Miller, Roman Pfister, Navid Mader, Stephan Baldus, An
Perfusion.2022; 37(3): 249. CrossRef
Impact of left ventricular unloading using a peripheral Impella®‐pump in eCPR patients
Christopher Gaisendrees, Ilija Djordjevic, Anton Sabashnikov, Christopher Adler, Kaveh Eghbalzadeh, Borko Ivanov, Sebastian Walter, Georg Schlachtenberger, Julia Merkle‐Storms, Stephen Gerfer, Henning Carstens, Antje‐Christin Deppe, Elmar Kuhn, Thorsten W
Artificial Organs.2022; 46(3): 451. CrossRef
Vascular complications based on mode of extracorporeal membrane oxygenation
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Journal of Vascular Surgery.2022; 75(6): 2037. CrossRef
Efficacy of a temporary CentriMag ventricular assist device in acute fulminant myocarditis patients revived with extracorporeal cardiopulmonary resuscitation
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Journal of the Formosan Medical Association.2022; 121(10): 1917. CrossRef
Anticoagulation Strategies during Extracorporeal Membrane Oxygenation: A Narrative Review
Sasa Rajsic, Robert Breitkopf, Dragana Jadzic, Marina Popovic Krneta, Helmuth Tauber, Benedikt Treml
Journal of Clinical Medicine.2022; 11(17): 5147. CrossRef
Outcomes of Pediatric Extracorporeal Cardiopulmonary Resuscitation: A Systematic Review and Meta-Analysis
Abdelaziz Farhat, Ryan Ruiyang Ling, Christopher L. Jenks, Wynne Hsing Poon, Isabelle Xiaorui Yang, Xilong Li, Yulun Liu, Cindy Darnell-Bowens, Kollengode Ramanathan, Ravi R. Thiagarajan, Lakshmi Raman
Critical Care Medicine.2021; 49(4): 682. CrossRef
Prediction of successful weaning off ECMO support after ECPR: Is pulse pressure crucial for success?
Ilija Djordjevic, Thorsten Wahlers
Journal of Cardiac Surgery.2021; 36(8): 2751. CrossRef
Impact of age on the outcomes of extracorporeal cardiopulmonary resuscitation: analysis using inverse probability of treatment weighting
Young Su Kim, Yang Hyun Cho, Jeong Hoon Yang, Ji-Hyuk Yang, Suryeun Chung, Gee Young Suh, Kiick Sung
European Journal of Cardio-Thoracic Surgery.2021; 60(6): 1318. CrossRef
Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience
Dong-Geum Shin, Sang-Deock Shin, Donghoon Han, Min-Kyung Kang, Seung-Hun Lee, Jihoon Kim, Jung-Rae Cho, Kunil Kim, Seonghoon Choi, Namho Lee
Medicina.2021; 57(9): 886. CrossRef
Critical care management of pulmonary arterial hypertension in pregnancy: the pre-, peri- and post-partum stages
Vorakamol Phoophiboon, Monvasi Pachinburavan, Nicha Ruamsap, Natthawan Sanguanwong, Nattapong Jaimchariyatam
Acute and Critical Care.2021; 36(4): 286. CrossRef
Brain natriuretic peptide levels predict 6-month mortality in patients with cardiogenic shock who were weaned off extracorporeal membrane oxygenation
Hyoung Soo Kim, Kyu Jin Lee, Sang Ook Ha, Sang Jin Han, Kyoung-Ha Park, Sun Hee Lee, Yong Il Hwang, Seung Hun Jang, Sunghoon Park
Medicine.2020; 99(29): e21272. CrossRef
Role and Prognosis of Extracorporeal Life Support in Patients Who Develop Cardiac Arrest during or after Office-Based Cosmetic Surgery
Seong Soon Kwon, Byoung-Won Park, Min-Ho Lee, Duk Won Bang, Min-Su Hyon, Won-Ho Chang, Hong Chul Oh, Young Woo Park
The Korean Journal of Thoracic and Cardiovascular Surgery.2020; 53(5): 277. CrossRef

Original Article

Rapid response system
Effect of a rapid response system on code rates and in-hospital mortality in medical wards: Hong Yeul Lee, Jinwoo Lee, Sang-Min Lee, Sulhee Kim, Eunjin Yang, Hyun Joo Lee, Hannah Lee, Ho Geol Ryu, Seung-Young Oh, Eun Jin Ha, Sang-Bae Ko, Jaeyoung Cho; Acute Crit Care. 2019;34(4):246-254. Published online November 29, 2019; DOI: https://doi.org/10.4266/acc.2019.00668

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Abstract PDF

Background
To determine the effects of implementing a rapid response system (RRS) on code rates and in-hospital mortality in medical wards.
Methods
This retrospective study included adult patients admitted to medical wards at Seoul National University Hospital between July 12, 2016 and March 12, 2018; the sample comprised 4,224 patients admitted 10 months before RRS implementation and 4,168 patients admitted 10 months following RRS implementation. Our RRS only worked during the daytime (7 AM to 7 PM) on weekdays. We compared code rates and in-hospital mortality rates between the preintervention and postintervention groups.
Results
There were 62.3 RRS activations per 1,000 admissions. The most common reasons for RRS activation were tachypnea or hypopnea (44%), hypoxia (31%), and tachycardia or bradycardia (21%). Code rates from medical wards during RRS operating times significantly decreased from 3.55 to 0.96 per 1,000 admissions (adjusted odds ratio [aOR], 0.29; 95% confidence interval [CI], 0.10 to 0.87; P=0.028) after RRS implementation. However, code rates from medical wards during RRS nonoperating times did not differ between the preintervention and postintervention groups (2.60 vs. 3.12 per 1,000 admissions; aOR, 1.23; 95% CI, 0.55 to 2.76; P=0.614). In-hospital mortality significantly decreased from 56.3 to 42.7 per 1,000 admissions after RRS implementation (aOR, 0.79; 95% CI, 0.64 to 0.97; P=0.024).
Conclusions
Implementation of an RRS was associated with significant reductions in code rates during RRS operating times and in-hospital mortality in medical wards.

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Critical Care Medicine.2024; 52(2): 314. CrossRef
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Orvosi Hetilap.2021; 162(20): 782. CrossRef
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Review Article

CPR/Resuscitation
Management of post-cardiac arrest syndrome: Youngjoon Kang; Acute Crit Care. 2019;34(3):173-178. Published online August 31, 2019; DOI: https://doi.org/10.4266/acc.2019.00654

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Abstract PDF

Post-cardiac arrest syndrome is a complex and critical issue in resuscitated patients undergone cardiac arrest. Ischemic-reperfusion injury occurs in multiple organs due to the return of spontaneous circulation. Bundle of management practicies are required for post-cardiac arrest care. Early invasive coronary angiography should be considered to identify and treat coronary artery obstructive disease. Vasopressors such as norepinephrine and dobutamine are the first-line treatment for shock. Maintainance of oxyhemoglobin saturation greater than 94% but less than 100% is recommended to avoid fatality. Target temperature therapeutic hypothermia helps to resuscitated patients. Strict temperature control is required and is maintained with the help of cooling devices and monitoring the core temperature. Montorings include electrocardiogram, oxymetry, capnography, and electroencephalography (EEG) along with blood pressue, temprature, and vital signs. Seizure should be treated if EEG shows evidence of seizure or epileptiform activity. Clinical neurologic examination and magnetic resonance imaging are considered to predict neurological outcome. Glycemic control and metabolic management are favorable for a good neurological outcome. Recovery from acute kidney injury is essential for survival and a good neurological outcome.

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International Journal of Molecular Sciences.2026; 27(14): 6366. CrossRef
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Muhammad Shoaib, Nancy Kim, Rishabh C. Choudhary, Blanca Espin, Mitsuaki Nishikimi, Ann Iverson, Tsukasa Yagi, Seyedeh Shadafarin Marashi Shoshtari, Koichiro Shinozaki, Lance B. Becker, Junhwan Kim
Free Radical Research.2023; 57(5): 384. CrossRef
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Scottish Medical Journal.2021; 66(1): 16. CrossRef
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The American Journal of Emergency Medicine.2021; 47: 231. CrossRef
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Journal of Cardiac Surgery.2021; 36(8): 2743. CrossRef
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International Journal of Molecular Sciences.2021; 22(10): 5114. CrossRef
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Seminars in Neurology.2021; 41(04): 388. CrossRef
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Linda Dalessio
AACN Advanced Critical Care.2020; 31(4): 383. CrossRef

Original Article

Pulmonary
Use of extracorporeal membrane oxygenation in patients with acute high-risk pulmonary embolism: a case series with literature review: You Na Oh, Dong Kyu Oh, Younsuck Koh, Chae-Man Lim, Jin-Won Huh, Jae Seung Lee, Sung-Ho Jung, Pil-Je Kang, Sang-Bum Hong; Acute Crit Care. 2019;34(2):148-154. Published online May 31, 2019; DOI: https://doi.org/10.4266/acc.2019.00500

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Abstract PDF

Background
Although extracorporeal membrane oxygenation (ECMO) has been used for the treatment of acute high-risk pulmonary embolism (PE), there are limited reports which focus on this approach. Herein, we described our experience with ECMO in patients with acute high-risk PE.
Methods
We retrospectively reviewed medical records of patients diagnosed with acute highrisk PE and treated with ECMO between January 2014 and December 2018.
Results
Among 16 patients included, median age was 51 years (interquartile range [IQR], 38 to 71 years) and six (37.5%) were male. Cardiac arrest was occurred in 12 (75.0%) including two cases of out-of-hospital arrest. All patients underwent veno-arterial ECMO and median ECMO duration was 1.5 days (IQR, 0.0 to 4.5 days). Systemic thrombolysis and surgical embolectomy were performed in seven (43.8%) and nine (56.3%) patients, respectively including three patients (18.8%) received both treatments. Overall 30-day mortality rate was 43.8% (95% confidence interval, 23.1% to 66.8%) and 30-day mortality rates according to the treatment groups were ECMO alone (33.3%, n=3), ECMO with thrombolysis (50.0%, n=4) and ECMO with embolectomy (44.4%, n=9).
Conclusions
Despite the vigorous treatment efforts, patients with acute high-risk PE were related to substantial morbidity and mortality. We report our experience of ECMO as rescue therapy for refractory shock or cardiac arrest in patients with PE.

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JBJS Case Connector.2026;[Epub] CrossRef
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Yoh Arita, Kota Takaki, Hironori Orihashi, Katsukiyo Kitabayashi, Nobuyuki Ogasawara
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Samir Ali, Christiaan L. Meuwese, Xavier J. R. Moors, Dirk W. Donker, Anina F. van de Koolwijk, Marcel C. G. van de Poll, Diederik Gommers, Dinis Dos Reis Miranda
Netherlands Heart Journal.2024; 32(4): 148. CrossRef
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Journal of Clinical Medicine.2024; 13(9): 2468. CrossRef
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Joshua B. Goldberg, Jay Giri, Taisei Kobayashi, Marc Ruel, Alexander J.C. Mittnacht, Belinda Rivera-Lebron, Abe DeAnda, John M. Moriarty, Thomas E. MacGillivray
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World Journal of Clinical Cases.2022; 10(12): 3899. CrossRef
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Catheterization and Cardiovascular Interventions.2022; 100(2): 274. CrossRef
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Tuberculosis and Respiratory Diseases.2022; 85(3): 249. CrossRef
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Vascular Medicine.2020; 25(5): 460. CrossRef
Evidence-Based Minireview: Advanced therapies and extracorporeal membrane oxygenation for the management of high-risk pulmonary embolism
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Case Reports

Pulmonary
Central extracorporeal membrane oxygenation and early rehabilitation for persistent severe pulmonary hypertension following pulmonary endarterectomy: Gil Myeong Seong, Sang-Bum Hong, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Jae Won Lee, Sung-Ho Jung, Duck-Woo Park, Jae Seung Lee; Acute Crit Care. 2019;34(2):158-164. Published online November 7, 2018; DOI: https://doi.org/10.4266/acc.2016.01032

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Abstract PDF

Chronic thromboembolic pulmonary hypertension is potentially curable with a pulmonary endarterectomy. However, approximately 20% of patients have persistent pulmonary hypertension after pulmonary endarterectomy, which is a major risk factor for postoperative death. Here, we report a 34-year-old woman who suffered persistent severe pulmonary hypertension following a successful pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Extracorporeal membrane oxygenation (ECMO) and atrial septostomy were successfully performed as rescue treatments, and active rehabilitation during ECMO was prescribed to facilitate recovery.

Citations

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Rehabilitation during extracorporeal membrane oxygenation: bridging the gap between life support and functional recovery
Jin Ho Jang, Eunjeong Choi, Eunjeong Son, Seong Hoon Yoon, Hee Yun Seol, Seung Eun Lee, Woo Hyun Cho, Doosoo Jeon, Yun Seong Kim, Hye Ju Yeo
Acute and Critical Care.2026; 41(1): 12. CrossRef
A systematic review and meta-analysis of the timing of rehabilitation training intervention for recipients of extracorporeal membrane oxygenators
Zhen Cheng, Liping Du, Shuangqin Zheng, Xiaoheng Zheng, Lingling Cheng, Mengfei Zhang, Chenmo Shi, Tianyu Zhang, Wei Zheng, Aili Shi
Frontiers in Medicine.2026;[Epub] CrossRef
Effects of postoperative rehabilitation on functional exercise capacity, dyspnea, and quality of life after pulmonary endarterectomy: a systematic review
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CPR/Resuscitation
Acute aortic dissection developed after cardiopulmonary resuscitation: transesophageal echocardiographic observations and proposed mechanism of injury: Dong Keon Lee, Kyung Sik Kang, Yong Sung Cha, Kyoung-Chul Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang; Acute Crit Care. 2019;34(3):228-231. Published online April 26, 2018; DOI: https://doi.org/10.4266/acc.2015.00633

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Abstract PDF Supplementary Material

There has been no report about aortic dissection due to cardiopulmonary resuscitation (CPR). We present here a case of acute aortic dissection as a rare complication of CPR and propose the potential mechanism of injury on the basis of transesophageal echocardiographic observations. A 54-year-old man presented with cardiac arrest after choking and received 19 minutes of CPR in the emergency department. Transesophageal echocardiography (TEE) during CPR revealed a focal separation of the intimal layer at the descending thoracic aorta without evidence of aortic dissection. After restoration of spontaneous circulation, hemorrhagic cardiac tamponade developed. Follow-up TEE to investigate the cause of cardiac tamponade revealed aortic dissection of the descending thoracic aorta. Hemorrhagic cardiac tamponade was thought to be caused by myocardial hemorrhage from CPR.

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Journal of Clinical Medicine.2023; 12(16): 5318. CrossRef
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Resuscitation.2022; 179: 277. CrossRef
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Gentaro Yamasaki, Marie Sugimoto, Takeshi Kondo, Motonori Takahashi, Mai Morichika, Azumi Kuse, Kanako Nakagawa, Yasuhiro Ueno, Migiwa Asano
Forensic Science, Medicine and Pathology.2022; 19(3): 388. CrossRef
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Sung Oh Hwang, Woo Jin Jung, Young-Il Roh, Kyoung-Chul Cha
Clinical and Experimental Emergency Medicine.2022; 9(4): 271. CrossRef
Intra-arrest transoesophageal echocardiographic findings and resuscitation outcomes
Woo Jin Jung, Kyoung-Chul Cha, Yong Won Kim, Yoon Seop Kim, Young-Il Roh, Sun Ju Kim, Hye Sim Kim, Sung Oh Hwang
Resuscitation.2020; 154: 31. CrossRef
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JACC: Case Reports.2020; 2(8): 1150. CrossRef

Original Articles

Pulmonary
Global and Regional Ventilation during High Flow Nasal Cannula in Patients with Hypoxia: Dong Hyun Lee, Eun Young Kim, Ga Jin Seo, Hee Jung Suh, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Chae-Man Lim; Acute Crit Care. 2018;33(1):7-15. Published online January 22, 2018; DOI: https://doi.org/10.4266/acc.2017.00507; Correction in: Acute Crit Care 2021;36(2):173

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Abstract PDF

Background
High flow nasal cannula (HFNC) is known to increase global ventilation volume in healthy subjects. We sought to investigate the effect of HFNC on global and regional ventilation patterns in patients with hypoxia.
Methods
Patients were randomized to receive one of two oxygen therapies in sequence: nasal cannula (NC) followed by HFNC or HFNC followed by NC. Global and regional ventilation was assessed using electric impedance tomography.
Results
Twenty-four patients participated. Global tidal variation (TV) in the lung was higher during HFNC (NC, 2,241 ± 1,381 arbitrary units (AU); HFNC, 2,543 ± 1,534 AU; P < 0.001). Regional TVs for four iso-gravitational quadrants of the lung were also all higher during HFNC than NC. The coefficient of variation for the four quadrants of the lung was 0.90 ± 0.61 during NC and 0.77 ± 0.48 during HFNC (P = 0.035). Within the four gravitational layers of the lung, regional TVs were higher in the two middle layers during HFNC when compared to NC. Regional TV values in the most ventral and dorsal layers of the lung were not higher during HFNC compared with NC. The coefficient of variation for the four gravitational layers of the lung were 1.00 ± 0.57 during NC and 0.97 ± 0.42 during HFNC (P = 0.574).
Conclusions
In patients with hypoxia, ventilation of iso-gravitational regions of the lung during HFNC was higher and more homogenized compared with NC. However, ventilation of gravitational layers increased only in the middle layers. (Clinical trials registration number: NCT02943863).

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High-flow nasal cannulae for respiratory support in adult intensive care patients
Sharon R Lewis, Philip E Baker, Roses Parker, Andrew F Smith
Cochrane Database of Systematic Reviews.2021;[Epub] CrossRef
Failure of High-Flow Nasal Cannula Therapy in Pneumonia and Non-Pneumonia Sepsis Patients: A Prospective Cohort Study
Eunhye Kim, Kyeongman Jeon, Dong Kyu Oh, Young-Jae Cho, Sang-Bum Hong, Yeon Joo Lee, Sang-Min Lee, Gee Young Suh, Mi-Hyeon Park, Chae-Man Lim, Sunghoon Park
Journal of Clinical Medicine.2021; 10(16): 3587. CrossRef
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Rapid response system
Rapid Response Systems Reduce In-Hospital Cardiopulmonary Arrest: A Pilot Study and Motivation for a Nationwide Survey: Yeonhee Park, Jong-Joon Ahn, Byung Ju Kang, Young Seok Lee, Sang-Ook Ha, Jin-Soo Min, Woo-Hyun Cho, Se-Hee Na, Dong-Hyun Lee, Seung-Yong Park, Goo-Hyeon Hong, Hyun-Jung Kim, Sangwoo Shim, Jung-Hyun Kim, Seok-Jeong Lee, So-Young Park, Jae Young Moon; Korean J Crit Care Med. 2017;32(3):231-239. Published online August 31, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00024

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Background
Early recognition of the signs and symptoms of clinical deterioration could diminish the incidence of cardiopulmonary arrest. The present study investigates outcomes with respect to cardiopulmonary arrest rates in institutions with and without rapid response systems (RRSs) and the current level of cardiopulmonary arrest rate in tertiary hospitals. Methods: This was a retrospective study based on data from 14 tertiary hospitals. Cardiopulmonary resuscitation (CPR) rate reports were obtained from each hospital to include the number of cardiopulmonary arrest events in adult patients in the general ward, the annual adult admission statistics, and the structure of the RRS if present. Results: Hospitals with RRSs showed a statistically significant reduction of the CPR rate between 2013 and 2015 (odds ratio [OR], 0.731; 95% confidence interval [CI], 0.577 to 0.927; P = 0.009). Nevertheless, CPR rates of 2013 and 2015 did not change in hospitals without RRS (OR, 0.988; 95% CI, 0.868 to 1.124; P = 0.854). National university-affiliated hospitals showed less cardiopulmonary arrest rate than private university-affiliated in 2015 (1.92 vs. 2.40; OR, 0.800; 95% CI, 0.702 to 0.912; P = 0.001). High-volume hospitals showed lower cardiopulmonary arrest rates compared with medium-volume hospitals in 2013 (1.76 vs. 2.63; OR, 0.667; 95% CI, 0.577 to 0.772; P < 0.001) and in 2015 (1.55 vs. 3.20; OR, 0.485; 95% CI, 0.428 to 0.550; P < 0.001). Conclusions: RRSs may be a feasible option to reduce the CPR rate. The discrepancy in cardiopulmonary arrest rates suggests further research should include a nationwide survey to tease out factors involved in in-hospital cardiopulmonary arrest and differences in outcomes based on hospital characteristics.

Citations

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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 4. Adult advanced life support
Tae-Youn Kim, Gyo Jin Ahn, Kyoung-Chul Cha, Dong-Hyeok Kim, Youdong Sohn, Young Song, Gyuhong Shim, Do Kyun Kim, Yunhee Oh, Jin Wi, Chun Song Youn, Myung-Lyeol Lee, Mi Jin Lee, Byung Kook Lee, Byung Heon Lee, Jisook Lee, Chang Hee Lee, Hannah Lee, Youngbi
Clinical and Experimental Emergency Medicine.2026; 13(Suppl 1): S32. CrossRef
Education, Implementation, and Teams: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations
Robert Greif, Adam Cheng, Cristian Abelairas-Gómez, Katherine S. Allan, Jan Breckwoldt, Andrea Cortegiani, Aaron J. Donoghue, Kathryn J. Eastwood, Barbara Farquharson, Ming-Ju Hsieh, Tracy Kidd, Ying-Chih Ko, Kasper G. Lauridsen, Yiqun Lin, Andrew S. Lock
Circulation.2025;[Epub] CrossRef
Education, Implementation, and Teams: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations
Robert Greif, Adam Cheng, Cristian Abelairas-Gómez, Katherine S. Allan, Jan Breckwoldt, Andrea Cortegiani, Aaron J. Donoghue, Kathryn J. Eastwood, Barbara Farquharson, Ming-Ju Hsieh, Tracy Kidd, Ying-Chih Ko, Kasper G. Lauridsen, Yiqun Lin, Andrew S. Lock
Resuscitation.2025; 215: 110807. CrossRef
Society of Critical Care Medicine Guidelines on Recognizing and Responding to Clinical Deterioration Outside the ICU: 2023
Kimia Honarmand, Randy S. Wax, Daleen Penoyer, Geoffery Lighthall, Valerie Danesh, Bram Rochwerg, Michael L. Cheatham, Daniel P. Davis, Michael DeVita, James Downar, Dana Edelson, Alison Fox-Robichaud, Shigeki Fujitani, Raeann M. Fuller, Helen Haskell, Ma
Critical Care Medicine.2024; 52(2): 314. CrossRef
2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 4. Adult advanced life support
Jaehoon Oh, Kyoung-Chul Cha, Jong-Hwan Lee, Seungmin Park, Dong-Hyeok Kim, Byung Kook Lee, Jung Soo Park, Woo Jin Jung, Dong Keon Lee, Young Il Roh, Tae Youn Kim, Sung Phil Chung, Young-Min Kim, June Dong Park, Han-Suk Kim, Mi Jin Lee, Sang-Hoon Na, Gyu C
Clinical and Experimental Emergency Medicine.2021; 8(S): S26. CrossRef
Intensivists' Direct Management without Residents May Improve the Survival Rate Compared to High-Intensity Intensivist Staffing in Academic Intensive Care Units: Retrospective and Crossover Study Design
Jin Hyoung Kim, Jihye Kim, SooHyun Bae, Taehoon Lee, Jong-Joon Ahn, Byung Ju Kang
Journal of Korean Medical Science.2020;[Epub] CrossRef
Influence of the Rapid Response Team Activation via Screening by Nurses on Unplanned Intensive Care Unit Admissions
Ye-Ji Huh, Seongmi Moon, Eun Kyeung Song, Minyoung Kim
Korean Journal of Adult Nursing.2020; 32(5): 539. CrossRef
Rapid response systems in Korea
Bo Young Lee, Sang-Bum Hong
Acute and Critical Care.2019; 34(2): 108. CrossRef

Cardiology/Emergency
Five-year Experience of Extracorporeal Life Support in Emergency Physicians: Yong Soo Cho, Kyoung Hwan Song, Byung Kook Lee, Kyung Woon Jeung, Yong Hun Jung, Dong Hun Lee, Sung Min Lee; Korean J Crit Care Med. 2017;32(1):52-59. Published online February 28, 2017; DOI: https://doi.org/10.4266/kjccm.2016.00885

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Abstract PDF

Background
This study aimed to present our 5-year experience of extracorporeal cardiopulmonary resuscitation (ECPR) performed by emergency physicians.
Methods
We retrospectively analyzed 58 patients who underwent ECPR between January 2010 and December 2014. The primary parameter analyzed was survival to hospital discharge. The secondary parameters analyzed were neurologic outcome at hospital discharge, cannulation time, and ECPR-related complications.
Results
Thirty-one patients (53.4%) were successfully weaned from extracorporeal membrane oxygenation, and 18 (31.0%) survived to hospital discharge. Twelve patients (20.7%) were discharged with good neurologic outcomes. The median cannulation time was 25.0 min (interquartile range 20.0-31.0 min). Nineteen patients (32.8%) had ECPR-related complications, the most frequent being distal limb ischemia. Regarding the initial presentation, 52 patients (83.9%) collapsed due to a cardiac etiology, and acute myocardial infarction (33/62, 53.2%) was the most common cause of cardiac arrest.
Conclusions
The survival to hospital discharge rate for cardiac arrest patients who underwent ECPR conducted by an emergency physician was within the acceptable limits. The cannulation time and complications following ECPR were comparable to those found in previous studies.

Citations

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Samuele Bugo, Alice Bottussi, Jacopo D’Andria Ursoleo, Marta Velia Antonini, Erika Cordella, Myriam Aprile, Samuel I. Garcia, Omar Elmadhoun, Erin D. Wieruszewski, Justyna Swol, Patrick M. Wieruszewski, Fabrizio Monaco
Frontiers in Cardiovascular Medicine.2026;[Epub] CrossRef
Lactate and pH as Predictors of In-Hospital Mortality in Extracorporeal Cardiopulmonary Resuscitation: A Single-Center Retrospective Study
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Yoonjic Kim, Jeong Ho Park, Sun Young Lee, Young Sun Ro, Ki Jeong Hong, Kyoung Jun Song, Sang Do Shin
The American Journal of Emergency Medicine.2023; 64: 142. CrossRef
Extracorporeal cardiopulmonary resuscitation for adult out-of-hospital cardiac arrest patients: time-dependent propensity score-sequential matching analysis from a nationwide population-based registry
Yeongho Choi, Jeong Ho Park, Joo Jeong, Yu Jin Kim, Kyoung Jun Song, Sang Do Shin
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Pre-hospital extra-corporeal cardiopulmonary resuscitation
Ben Singer, Joshua C. Reynolds, David J. Lockey, Ben O’Brien
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Case Reports

Neurosurgery
Cardiac Arrest from Patient Position Change after Spine Surgery on a Jackson Table: Boohwi Hong, Seok Hwa Yoon, Soo-Yong Park, Seunghyun Song, Ann Youn, Ja Gyung Hwang; Acute Crit Care. 2019;34(1):86-91. Published online February 20, 2017; DOI: https://doi.org/10.4266/acc.2016.00794

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Abstract PDF

The Jackson table has minimal effects on cardiac function because it does not elevate abdominal and thoracic pressures. In addition, it decreases venous congestion and increases exposure of the surgical field. However, the hips and knees are flexed with inappropriate padding, and venostasis is promoted and increased. Pulmonary thromboembolism (PTE) is fatal; thus immediate diagnosis and treatment are essential. However, clinical signs of intraoperative PTE are difficult to discern. Thrombolytic therapy can be considered as first-line therapy, but bleeding limits its use. The authors report a case of PTE resulting from patient positional change after spine surgery, and the use of immediate postoperative recombinant tissue-type plasminogen activator.

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Spinous Process-Splitting Laminectomy Versus Conventional Laminectomy: A Short-Term Outcome Study
Ahmed K Basha, Hesham Radwan, Abdelmaksod Mohammed Mousa, Ahmed Nagaty, Abdelrahman Bakry, Eslam Hussein, Mohamed Ashraf Mahmoud, Mohammed Eid
Cureus.2026;[Epub] CrossRef
Causes of Perioperative Cardiac Arrest: Mnemonic, Classification, Monitoring, and Actions
Lingzhong Meng, Mads Rasmussen, Arnoley S. Abcejo, Deyi M. Meng, Chuanyao Tong, Hong Liu
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Perioperative patient positioning following scalp tumor surgery: an anesthetic challenge
Rajnish Kumar, Nishant Sahay, Shagufta Naaz, Ansarul Haq, Rajesh Kumar
Ain-Shams Journal of Anesthesiology.2022;[Epub] CrossRef
Differential diagnosis of intraoperative cardiac arrest after spine surgery in prone position
Davi Brasil Khouri, Marina Ayres Delgado, Jadson Lardy Lemes, Marcela Morais Afonso Cruz
Saudi Journal of Anaesthesia.2022; 16(4): 485. CrossRef
Pulmonary thromboembolism due to venostasis induced by sitting position during clavicle and pelvic bone fracture surgery
Soomin LEE, Boohwi HONG, Woosik HAN, Man-Shik SHIM, Yoon-Hee KIM, Seok-Hwa YOON
Chirurgia.2021;[Epub] CrossRef

Gastroenterology
Pneumatosis Intestinalis Presenting as Small Bowel Obstruction without Bowel Ischemia after Mechanical Ventilation: Dong Joon Kim, Yong Joon Choi, Young Sun Yoo; Acute Crit Care. 2019;34(1):81-85. Published online January 17, 2017; DOI: https://doi.org/10.4266/acc.2016.00311

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Abstract PDF

Pneumatosis intestinalis (PI) is a rare condition of the presence of gas within the bowel walls. PI is associated with numerous underlying diseases, ranging from life-threatening to innocuous conditions. PI is believed to be secondary to coexisting disorders in approximately 85% of all cases. This paper reviews the case of a patient who was diagnosed seven years prior with pneumoperitoneum from unknown causes without any symptoms. The patient was admitted to the intensive care unit for the management of aspiration pneumonia and developed extensive PI after mechanical ventilation, presenting as small bowel obstruction with mesenteric torsion. Although the exact mechanism and etiology of PI are unclear, this case provides an update on the imaging features of and the clinical conditions associated with PI, as well as the management of this condition.

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S Olusola, M Choudhry, V Panem, J Wilson, S Rana, C Parmar, M Kathirvel
The Annals of The Royal College of Surgeons of England.2026; 108(7): 500. CrossRef
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Emergency Radiology.2026; 33(4): 873. CrossRef
Intestinal Pneumatosis Post Heart Transplantation: A Diagnostic and Management Challenge
Branislav Bezak, Matej Ondrusek, Andrej Domonkos, Ivo Gasparovic, Panagiotis Artemiou, Stefan Durdik, Juraj Grebac, Michal Hulman
Bratislava Medical Journal.2025; 126(9): 2276. CrossRef

Thoracic surgery
Aortic Dissection in a Survivor after Cardiopulmonary Resuscitation: Jeong-Sun Lee, Suk-Kyung Hong; Korean J Crit Care Med. 2017;32(2):218-222. Published online December 29, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00416

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Abstract PDF

We describe a case of traumatic aortic dissection associated with cardiac compression in a patient with anaphylactic cardiac arrest who underwent cardiopulmonary resuscitation (CPR). A 54-year-old man who was scheduled to undergo surgery for gastric cancer went into cardiac arrest caused by an anaphylactic reaction to prophylactic antibiotics in the operating room. Veno-arterial extracorporeal membrane oxygenation (ECMO) was performed. CPR, including chest compressions, was performed for 35 min, and the patient was transferred to the intensive care unit (ICU) after spontaneous circulation returned. The patient received ECMO for 9 hours until confirmation of normal cardiac function on transthoracic echocardiography (TTE). Twenty days after cardiac arrest, an aortic dissection and fractures in the left fourth and fifth ribs due to chest compression were detected by abdominal computed tomography. The DeBakey type III aortic dissection extended from the distal arch of the thoracic aorta to the proximal level of the renal artery, involving the celiac trunk. It was considered an uncomplicated type B aortic dissection with no sign of malperfusion of the major vessels. This case demonstrates the potential traumatic injuries that can occur after CPR and encourages proper management of mechanical complications in cardiac arrest survivors.

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Extracorporeal Life Support use during Severe Anaphylaxis: A Systematic Review and Pooled Analysis of Individual Patient Data
Eduardo Saadi Neto, Ronna L. Campbell, Autumn Brogan, Fernanda Bellolio, Aidan F. Mullan, Danielle Gerberi, Nguyen Ba Cuong, Alexander S. Finch
Journal of Cardiothoracic and Vascular Anesthesia.2026;[Epub] CrossRef
Aortic dissection after sutureless valve and chest compressions
Yoshiki Hori, Kenichiro Sato, Kei Akiyoshi
Asian Cardiovascular and Thoracic Annals.2026; 34(6): 542. CrossRef
Blunt traumatic aortic dissection death by falling: an autopsy case report
Gentaro Yamasaki, Marie Sugimoto, Takeshi Kondo, Motonori Takahashi, Mai Morichika, Azumi Kuse, Kanako Nakagawa, Yasuhiro Ueno, Migiwa Asano
Forensic Science, Medicine and Pathology.2022; 19(3): 388. CrossRef
A Case of an Aortic Dissection After Mechanical Chest Compression by LUCAS
Karen Ho, David Kopriva, Payam Dehghani
JACC: Case Reports.2020; 2(12): 1984. CrossRef
Cardiac arrest after topical application of lidocaine during microneedling procedure: A rare case
Morteza Safi, Isa Khaheshi, Fatemeh Mottaghizadeh, Mohammadreza Tabary, Nasser Malekpour Alamdari
Dermatologic Therapy.2020;[Epub] CrossRef

Cardiology/Pediatric
Suspected Pulmonary Embolism during Hickman Catheterization in a Child: What Else Should Be Considered besides Pulmonary Embolism?: Haemi Lee, Jonghyun Baek, Sangyoung Park, Daelim Jee; Korean J Crit Care Med. 2016;31(1):63-67. Published online February 29, 2016; DOI: https://doi.org/10.4266/kjccm.2016.31.1.63

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Abstract PDF: A 16-month-old girl with acute lymphoblastic leukemia expired during Hickman catheter insertion. She had undergone chemoport insertion of the left subclavian vein six months earlier and received five cycles of chemotherapy. Due to malfunction of the chemoport and the consideration of hematopoietic stem cell transplantation, insertion of a Hickmann catheter on the right side and removal of the malfunctioning chemoport were planned under general anesthesia. The surgery was uneventful during catheter insertion, but the patient experienced the sudden onset of pulseless electrical activity just after saline was flushed through the newly inserted catheter. Cardiopulmonary resuscitation was commenced aggressively, but the patient was refractory. Migration of a thrombus generated by the previous central catheter to the pulmonary circulation was suspected, resulting in a pulmonary embolism.

Original Article

Pulmonary
The Adequacy of a Conventional Mechanical Ventilator as a Ventilation Method during Cardiopulmonary Resuscitation: A Manikin Study: Hong Joon Ahn, Kun Dong Kim, Won Joon Jeong, Jun Wan Lee, In Sool Yoo, Seung Ryu; Korean J Crit Care Med. 2015;30(2):89-94. Published online May 31, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.2.89

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Abstract PDF

BACKGROUND
We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR). Background: We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR). Methods: A self-inflating bag resuscitator and a mechanical ventilator were used to test two experimental models: Model 1 (CPR manikin without chest compression) and Model 2 (CPR manikin with chest compression). Model 2 was divided into three subgroups according to ventilator pressure limits (Plimit). The self-inflating bag resuscitator was set with a ventilation rate of 10 breaths/min with the volume-marked bag-valve procedure. The mode of the mechanical ventilator was set as follows: volume-controlled mandatory ventilation of tidal volume (Vt) 600 mL, an inspiration time of 1.2 seconds, a constant flow pattern, a ventilation rate of 10 breaths/minute, a positive end expiratory pressure of 3 cmH2O and a maximum trigger limit. Peak airway pressure (Ppeak) and Vt were measured by a flow analyzer. Ventilation adequacy was determined at a Vt range of 400-600 mL with a Ppeak of ≤ 50 cmH2O. Results: In Model 1, Vt and Ppeak were in the appropriate range in the ventilation equipments. In Model 2, for the self-inflating bag resuscitator, the adequate Vt and Ppeak levels were 17%, and the Ppeak adequacy was 20% and the Vt was 65%. For the mechanical ventilator, the adequate Vt and Ppeak levels were 85%; the Ppeak adequacy was 85%; and the Vt adequacy was 100% at 60 cmH2O of Plimit. Conclusions: In a manikin model, a mechanical ventilator was superior to self-inflating bag resuscitator for maintaining adequate ventilation during chest compression.

Citations

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Manual Ventilation Performance With Safety Device in Normal Versus Decreased Lung Compliance: A Single-Center Simulation Study
Prasanna Kumar, Rachel Culbreth, Douglas S. Gardenhire, Arthur S. Slutsky, Ying J. Wu, Mark C. Kendall, Mark F. Brady
Respiratory Care.2025; 70(5): 566. CrossRef
Effect of bag valve ventilation versus mechanical ventilation after endotracheal intubation during cardiopulmonary resuscitation on outcomes following out-of-hospital cardiac arrest: a propensity score analysis
Young Min Kim, Hyun Seok Chai, Gwan Jin Park, Sang Chul Kim, Hoon Kim, Seok Woo Lee, Hyeon Jeong Park, Han Bit Kim, Hyo Been Lee, Ji Han Lee
World Journal of Emergency Medicine.2025; 16(4): 313. CrossRef
Humans vs. Machines: Mechanical Compression Devices and Their Appropriate Application in the Management of Cardiac Arrest
Emilia Clementi, Anirudh Chitale, Brian J. O’Neil, Anthony T. Lagina
Current Emergency and Hospital Medicine Reports.2023; 11(4): 133. CrossRef
Manual vs. mechanical ventilation in patients with advanced airway during CPR
Muthapillai Senthilnathan, Ramya Ravi, Srinivasan Suganya, Ranjith Kumar Sivakumar
Indian Heart Journal.2022; 74(5): 428. CrossRef
Effects of Changes in Inspiratory Time on Inspiratory Flowrate and Airway Pressure during Cardiopulmonary Resuscitation: A Manikin-Based Study
Jung Ju Lee, Su Yeong Pyo, Ji Han Lee, Gwan Jin Park, Sang Chul Kim, Hoon Kim, Suk Woo Lee, Young Min Kim, Hyun Seok Chai
Kosin Medical Journal.2021; 36(2): 100. CrossRef
Changes in peak inspiratory flow rate and peak airway pressure with endotracheal tube size during chest compression
Jung Wan Kim, Jin Woong Lee, Seung Ryu, Jung Soo Park, InSool Yoo, Yong Chul Cho, Hong Joon Ahn
World Journal of Emergency Medicine.2020; 11(2): 97. CrossRef
Mechanical Ventilation During Resuscitation: How Manual Chest Compressions Affect a Ventilator’s Function
Tillmann Speer, Wolfgang Dersch, Björn Kleine, Christian Neuhaus, Clemens Kill
Advances in Therapy.2017; 34(10): 2333. CrossRef

Case Reports

Cardiology/Pharmacology
Effective Postoperative Use of Dexmedetomidine in a Child with Severe Pulmonary Arterial Hypertension Secondary to Congenital Ventricular Septal Defect: Yong-In Kim; Korean J Crit Care Med. 2015;30(1):34-37. Published online February 28, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.1.34

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Abstract PDF: Although α2-adrenoceptor agonists are widely used as postoperative sedatives in adults, the postoperative effects in pediatric patients with secondary pulmonary arterial hypertension (PAH) due to congenital heart disease are not well known. We experienced a case of successful ventilator weaning with continuous intravenous administration of dexmedetomidine (DEX) after surgical correction in a 46-month-old child with congenital ventricular septal defect (VSD) with severe PAH. She underwent VSD closure on cardiopulmonary bypass (CPB). After successful weaning from the CPB, hemodynamics and oxygenation were stabilized on DEX and nitroglycerin in the intensive care unit. The patient was successfully weaned from the ventilator 46 hours after surgery. The transthoracic echocardiogram two weeks after surgery showed a closed VSD with no residual shunt and trivial tricuspid regurgitation (Vmax = 2.5 m/sec) without PAH.

Pulmonary
Diffuse Alveolar Hemorrhage Confirmed by Bronchoalveolar Lavage in a Patient with Hemoptysis after Sildenafil Use for Erectile Dysfunction: Kyoung Min Moon, Sun Young Jung, Min Soo Han, Yongseon Cho, Young Min Rah, Jong Woo Kim; Korean J Crit Care Med. 2015;30(1):31-33. Published online February 28, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.1.31

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Abstract PDF

A 81-year-old man was referred for respiratory failure by emergency medical technicians. He admitted at intensive care unit for ventilator treatment. Several hours before admission, he took sildenafil 100 mg for erectile dysfunction without prescription. The episodes of hemoptysis occurred several hours later. Computed tomography revealed multifocal diffuse ground-glass attenuation in both lungs. And the more we performed bronchoalveolar lavage, the more the color of it was turned into red. We treated him with empirical antibiotics and tranexamic acid, and hemoptysis was stopped in one day after admission. But in the 5th admission day, he died from sepsis combined with pneumonia caused by Acinetobacter baumannii abruptly.

Citations

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Transient haemoptysis after taking sildenafil
Suheyla Karaduman, Azmaeen Zarif, Alesia Talpeka, Muhammed Haseeb
BMJ Case Reports.2024; 17(7): e258050. 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

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Abstract 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

Neurology/Emergency
Acute Physiologic and Chronic Health Examination II and Sequential Organ Failure Assessment Scores for Predicting Outcomes of Out-of-Hospital Cardiac Arrest Patients Treated with Therapeutic Hypothermia: Sung Joon Kim, Yong Su Lim, Jin Seong Cho, Jin Joo Kim, Won Bin Park, Hyuk Jun Yang; Korean J Crit Care Med. 2014;29(4):288-296. Published online November 30, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.4.288

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Abstract PDF

BACKGROUND
The aim of this study was to assess the relationship between acute physiologic and chronic health examination (APACHE) II and sequential organ failure assessment (SOFA) scores and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia (TH).
METHODS
Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between January 2010 and December 2012 were retrospectively evaluated. We captured all components of the APACHE II and SOFA scores over the first 48 hours after intensive care unit (ICU) admission (0 h). The primary outcome measure was in-hospital mortality and the secondary outcome measure was neurologic outcomes at the time of hospital discharge. Receiver-operating characteristic and logistic regression analysis were used to determine the predictability of outcomes with serial APACHE II and SOFA scores.
RESULTS
A total of 138 patients were enrolled in this study. The area under the curve (AUC) for APACHE II scores at 0 h for predicting in-hospital mortality and poor neurologic outcomes (cerebral performance category: 3-5) was more than 0.7, and for SOFA scores from 0 h to 48 h the AUC was less than 0.7. Odds ratios used to determine associations between APACHE II scores from 0 h to 48 h and in-hospital mortality were 1.12 (95% confidence interval [CI], 1.03-1.23), 1.13 (95% CI, 1.04-1.23), and 1.18 (95% CI, 1.07-1.30).
CONCLUSIONS
APACHE II, but not SOFA score, at the time of ICU admission is a modest predictor of in-hospital mortality and poor neurologic outcomes at the time of hospital discharge for patients who have undergone TH after return of spontaneous circulation following OHCA.

Citations

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Multiorgan failure in patients after out of hospital resuscitation: a retrospective single center study
Yaacov Hasin, Yigal Helviz, Sharon Einav
Internal and Emergency Medicine.2024; 19(1): 159. CrossRef

Case Reports

Cardiology/Pulmonary
Complicated Pulmonary Pseudocyst Following Traumatic Lung Injury Rescued by Extracorporeal Membrane Oxygenation: Sung Bum Park, Dae Sang Lee, Jeong Am Ryu, Jong Ho Cho, Yang Hyun Cho, Chi Ryang Chung, Jeong Hoon Yang, Kyeongman Jeon, Gee Young Suh, Chi Min Park; Korean J Crit Care Med. 2014;29(3):201-206. Published online August 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.3.201

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Abstract PDF: Traumatic pulmonary pseudocyst is a rare complication of blunt chest trauma that usually appears immediately in children or young adults and is characterized by a single or multiple pulmonary cystic lesions on chest radiography and has spontaneous resolution of the radiologic manifestations. However, we experienced a case of a delayed complicated pulmonary pseudocyst in a 17-year-old boy following severe traumatic acute respiratory distress syndrome rescued by Veno-venous extracorporeal membrane oxygenation (ECMO). In this case, the pseudocyst appeared on the 12th day after trauma and transformed into an infected cyst. Veno-venous ECMO was successfully maintained for 20 days without anticoagulation.

Cardiology/Neurology
Intracranial Hemorrhage Identified in the Early Stage after Applying Extracorporeal Membrane Oxygenation to Support Cardiopulmonary Resuscitation: Yong Hwan Kim, Kyoung Yul Lee, Seong Youn Hwang; Korean J Crit Care Med. 2014;29(3):197-200. Published online August 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.3.197

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Abstract PDF: Extracorporeal membrane oxygenation support can extend the duration of cardiopulmonary resuscitation, but neurologic complications may develop. Cardiac arrest is a fairly common complication following severe intracranial hemorrhage; this complication is encountered both out-of-hospital and in-hospital with variable frequency. To prevent cerebral complications, to detect the cause of cardiac arrest, and to guide further treatment, early neuroimaging study is needed. Herein, we report a case of intracranial hemorrhage identified after extracorporeal cardiopulmonary resuscitation, in which the cause of the hemorrhage was not clear.

Original Article

Emergency
Interruption of Chest Compression for Central Venous Catheterization during Cardiopulmonary Resuscitation: Yong Oh Kim, Hyun Soo Park; Korean J Crit Care Med. 2014;29(3):172-176. Published online August 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.3.172

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Abstract PDF

BACKGROUND
Peripheral venous catheterization (PVC) is a less invasive and time consuming technique than central venous catheterization (CVC); however, for patients in circulatory collapse or receiving cardiopulmonary resuscitation (CPR), PVC cannot be achieved easily. CVC can provide not only a more effective administration route for medication, but also important hemodynamic information. Owing to the possibility of CPR interruptions and complications, CVC is recommended only after the failure of PVC. This observational study is aimed to evaluate the risks and benefits of CVC during CPR.
METHODS
This retrospective observational study was performed in the emergency department (ED) of a university hospital. Adult patients without a pulse on arrival were consecutively enrolled if subclavian CVC was performed at the beginning of CPR. Patients who already had an established intravenous route or had severe chest injuries on arrival were excluded. Closed-circuit television was used to evaluate the frequency of compression interruption. The incidence of iatrogenic pneumothorax, an acute mechanical complication associated with subclavian CVC, was investigated using chest X-ray after CPR.
RESULTS
During a 6-month period, 35 patients underwent CPR and 31 of these received subclavian CVC. Among the patients, one patient experienced iatrogenic pneumothorax (3.8%), and 13 CPR interruptions occurred in 10 subjects during subclavian CVC.
CONCLUSIONS
During CPR in 31 patients, one iatrogenic pneumothorax was caused by subclavian CVC, and CPR interruptions were observed in approximately 30% of cases.

Citations

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Femoral central venous access during emergency department cardiac arrest and sustained return of spontaneous circulation: 10‐min landmark cohort
Abdullah A. Bakhsh
Hong Kong Journal of Emergency Medicine.2026;[Epub] CrossRef
Comparison between internal jugular vein access using midline catheter and peripheral intravenous access during cardiopulmonary resuscitation in adults
Hyun Seok Chai, Young-Min Kim, Gwan Jin Park, Sang Chul Kim, Hoon Kim, Seok Woo Lee, Hyeon Jeong Park, Ji Han Lee
SAGE Open Medicine.2023;[Epub] CrossRef
Femoral venous oxygen saturation obtained during CPR predicts successful resuscitation in a pig model
Mu Jin Kim, Kyung Woon Jeung, Byung Kook Lee, Sung Soo Choi, Sang Wook Park, Kyung Hwan Song, Sung Min Lee, Yong Il Min
The American Journal of Emergency Medicine.2015; 33(7): 941. CrossRef

Case Reports

Emergency/Liver
Liver Laceration with Hemoperitoneum after Cardiopulmonary Resuscitation: Jin Wi, Dongho Shin; Korean J Crit Care Med. 2014;29(2):141-143. Published online May 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.2.141

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Abstract PDF

It is well known that external chest compression during cardiopulmonary resuscitation is frequently associated with various complications. These complications predominantly involve trauma to the heart, lungs, and chest wall, whereas cases involving intra-abdominal injury are much less frequent. The present report describes a rare case of a female patient with severe hemoperitoneum associated with liver injury after cardiopulmonary resuscitation. Although emergent angiography and embolization of the hepatic artery were performed and transfusion of various kinds of blood products was done continuously, the patient expired the next day.

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A rare case of spontaneous hemoperitoneum in a bone marrow transplant recipient on VV-ECMO
Patrick Donabedian, Amir M. Emtiazjoo, Mindaugus Rackauskas, Philip Efron, Cynthia Gries, Melissa Burger, Letitia Bible, Victoria Reams, Marc O. Maybauer, Biplab K. Saha
The American Journal of the Medical Sciences.2025; 369(2): 296. CrossRef
Major liver trauma post-mechanical cardiopulmonary resuscitation—the first reported case of survival with normal cardiovascular and neurological outcome
P Sharma, C Hernandez-Caballero
Oxford Medical Case Reports.2020;[Epub] CrossRef
Subcapsular Hepatic Hematoma after Cardiopulmonary Resuscitation
Song-I Lee
Kosin Medical Journal.2020; 35(2): 156. CrossRef
ICD lead extraction: Not a benign procedure. External chest compression: Not a benign manoeuvre
Federico Sertic, Paolo Bosco, Antonella Ferrara, Patrick Heck, Yasir Abu-Omar
JRSM Cardiovascular Disease.2017;[Epub] CrossRef

Pulmonary
Obstructive Fibrinous Tracheal Pseudomembrane Presented with Atelectasis: Jick Hwan Ha, Hyewon Lee, Young Jae Park, Hyeon Hui Kang, Hwa Sik Moon, Sang Haak Lee; Korean J Crit Care Med. 2014;29(2):110-113. Published online May 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.2.110

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71 Download
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Abstract PDF

Obstructive fibrinous tracheal pseudomembrane (OFTP) is a rare condition usually associated with endotracheal intubation. Airway obstruction caused by OFTP may occur after endotracheal tube extubation and can lead to severe respiratory distress. It is a rare but potentially fatal complication. In this report, we present a case of OFTP presented with atelectasis that caused dyspnea after extubation and was successfully treated by mechanical removal using a rigid bronchoscope.

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Obstructive fibrinous tracheal pseudomembrane in a hemodialysis patient: a case report and review of literature
Jingjing Hou, Haitao Li, Fu Niu, Xiaodan Mu, Shushen Zhang, Lining Huang, Zhigang Cai
BMC Nephrology.2025;[Epub] CrossRef
Obstructive Fibrinous Tracheal Pseudomembrane
Yoann Ammar, Juliette Vella-Boucaud, Claire Launois, Hervé Vallerand, Sandra Dury, François Lebargy, Gaëtan Deslee, Jeanne-Marie Perotin
Anesthesia & Analgesia.2017; 125(1): 172. CrossRef
Obstructive Fibrinous Tracheal Pseudomembrane: An Update
Alberto Manassero, Matteo Bossolasco
Korean Journal of Critical Care Medicine.2014; 29(3): 241. CrossRef

Original Article

Utility of the DECAF Score in Patients Admitted to Emergency Department with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Ji Hyoung Son, Jang Young Lee, Young Mo Yang, Won Young Sung, Sang Won Seo, Jin Cheol Kim, Wonsuk Lee; Korean J Crit Care Med. 2013;28(4):255-265.; DOI: https://doi.org/10.4266/kjccm.2013.28.4.255

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Abstract PDF

BACKGROUND
Exacerbations of chronic obstructive pulmonary disease (COPD) are common and can be fatal. However, it is difficult to predict the in-hospital mortality, severity and prognosis of patients. Prognostic tools are needed to assess exacerbations of COPD in the emergency department. Towards this end, we compared DECAF (dyspnea, eosinopenia, consolidation, acidemia, atrial fibrillation) score with other prognostic tools available in the emergency department.
METHODS
Consecutive patients admitted to the emergency department with exacerbations of COPD were recruited. We compared the DECAF score to CAPS (chronic obstructive pulmonary disease and asthma physiology score), BAP (blood urea nitrogen, altered mental status, pulse)-65 class and CURB (confusion, urea, respiratory rate, blood pressure)-65 score and assessed in-hospital mortality, endotracheal intubation, admission to the intensive care unit and admission to the hospital.
RESULTS
The in-hospital mortality rate was 4.9%. The DECAF score showed excellent discrimination for in-hospital mortality (AUROC = 0.72, p = 0.002), endotracheal intubation (AUROC = 0.92, p < 0.001), admission to the intensive care unit (AUROC = 0.90, p < 0.001) and admission to the hospital (AUROC = 0.83, p < 0.001).
CONCLUSIONS
The DECAF score is a simple and effective prognostic tool for assessing cases involving exacerbation of COPD in the emergency department. Emergency physicians should consider hospital admission if the DECAF score is more than 1 and consider admission to the intensive care unit and endotracheal intubation if the DECAF score is more than 3.

Citations

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Comorbidity severity adjusted model for predicting mortality in hospitalized patients with COPD
Ji Hyeon Seo, Ji Hye Lim, Hiroki Annaka
PLOS One.2026; 21(5): e0348191. CrossRef
Comparison of BAP65, DECAF, PEARL, and MEWS Scores in Predicting Respiratory Support Need in Hospitalized Exacerbation of Chronic Obstructive Lung Disease Patients
Nilüfer Aylin Acet-Öztürk, Özge Aydin-Güçlü, Merve Nur Yildiz, Ezgi Demirdöğen, Aslı Görek Dilektaşli, Funda Coşkun, Esra Uzaslan, Ahmet Ursavaş, Mehmet Karadağ
Medical Principles and Practice.2024; 33(4): 355. CrossRef
The v‐DECAF score can predict 90‐day all‐cause mortality in patients with COPD exacerbation requiring invasive mechanical ventilation
Qi‐fang Shi, Ying Sheng, Nian Zhu, Yan Tan, Xiao‐Hong Xie, Shu‐yun Wang, Jin‐fang Cai
The Clinical Respiratory Journal.2019; 13(7): 438. CrossRef
Value of the DECAF score in predicting hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease admitted to Zagazig University Hospitals, Egypt
Ramadan Nafae, Sameh Embarak, Doaa Mostafa Gad
Egyptian Journal of Chest Diseases and Tuberculosis.2015; 64(1): 35. CrossRef

Case Reports

Delayed Onset Contralateral Reexpansion Pulmonary Edema after Tension Pneumothorax: A Case Report: Dongseop Song, Jai Yun Jung; Korean J Crit Care Med. 2013;28(2):137-140.; DOI: https://doi.org/10.4266/kjccm.2013.28.2.137

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25 Download

Abstract PDF: A 16-year-old male patient presented with left side chest pain. The initial chest radiograph showed tension pneumohtorax on the left side. Air was evacuated by closed thoracostomy. About 72 hours later, during administration of general anesthesia for thoracoscopic bullectomy, unilateral pulmonary edema affecting the contralateral lung developed without definite infiltration in the left lung. The operation was suspended and the patient was admitted to the intensive care unit. A close observation of the patient and conservative therapy were enough to manage this pulmonary edema. This is a very rare manifestation of reexpansion pulmonary edema that is unpredictable and could be fatal. The clinical course is described in this article.

Airway Obstruction and Flattening of Arterial Pressure Wave during Whole Lung Lavage: A Case Report: Hyun Jung Koh, Sung Jin Hong, Ho Kyung Song, Ji Young Lee, Jin Young Chon, Ho Sik Moon, Yu Mi Ju, Hyung Mook Lee; Korean J Crit Care Med. 2013;28(2):133-136.; DOI: https://doi.org/10.4266/kjccm.2013.28.2.133

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26 Download

Abstract PDF: Whole lung lavage (WLL) is a challenging procedure; because lavage fluid may perturb the respiratory and hemodynamic systems. We observed severe airway obstruction and flattening arterial pressure wave during WLL for treatment of pulmonary alveolar proteinosis. The aim of this case report is to discuss the anesthetic requirement in order to prevent bronchospasm during WLL. Furthermore, we discuss the potential of lavage fluid to cause airway obstruction and decrease cardiac outflow through the mass effect.

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