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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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AbstractAbstract PDFSupplementary 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.
Pulmonary
Risk factors for mortality in intensive care unit patients with Stenotrophomonas maltophilia pneumonia in South Korea
Yong Hoon Lee, Jaehee Lee, Byunghyuk Yu, Won Kee Lee, Sun Ha Choi, Ji Eun Park, Hyewon Seo, Seung Soo Yoo, Shin Yup Lee, Seung-Ick Cha, Chang Ho Kim, Jae Yong Park
Acute Crit Care. 2023;38(4):442-451.   Published online November 21, 2023
DOI: https://doi.org/10.4266/acc.2023.00682
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  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Background
Stenotrophomonas maltophilia has been increasingly recognized as an opportunistic pathogen associated with high morbidity and mortality. Data on the prognostic factors associated with S. maltophilia pneumonia in patients admitted to intensive care unit (ICU) are lacking.
Methods
We conducted a retrospective analysis of data from 117 patients with S. maltophilia pneumonia admitted to the ICUs of two tertiary referral hospitals in South Korea between January 2011 and December 2022. To assess risk factors associated with in-hospital mortality, multivariable logistic regression analyses were performed.
Results
The median age of the study population was 71 years. Ventilator-associated pneumonia was 76.1% of cases, and the median length of ICU stay before the first isolation of S. maltophilia was 15 days. The overall in-hospital mortality rate was 82.1%, and factors independently associated with mortality were age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.00–1.09; P=0.046), Sequential Organ Failure Assessment (SOFA) score (OR, 1.21; 95%; CI, 1.02–1.43; P=0.025), corticosteroid use (OR, 4.19; 95% CI, 1.26–13.91; P=0.019), and polymicrobial infection (OR, 95% CI 0.07–0.69). However, the impact of appropriate antibiotic therapy on mortality was insignificant. In a subgroup of patients who received appropriate antibiotic therapy (n=58), antibiotic treatment modality-related variables, including combination or empirical therapy, also showed no significant association with survival.
Conclusions
Patients with S. maltophilia pneumonia in ICU have high mortality rates. Older age, higher SOFA score, and corticosteroid use were independently associated with increased in-hospital mortality, whereas polymicrobial infection was associated with lower mortality. The effect of appropriate antibiotic therapy on prognosis was insignificant.

Citations

Citations to this article as recorded by  
  • Stenotrophomonas maltophilia Outbreak in an ICU: Investigation of Possible Routes of Transmission and Implementation of Infection Control Measures
    Maria Luisa Cristina, Marina Sartini, Gianluca Ottria, Elisa Schinca, Giulia Adriano, Leonello Innocenti, Marco Lattuada, Stefania Tigano, David Usiglio, Filippo Del Puente
    Pathogens.2024; 13(5): 369.     CrossRef
Trauma
Association of Glasgow coma scale and endotracheal intubation in predicting mortality among patients admitted to the intensive care unit
Nader Markazi Moghaddam, Mohammad Fathi, Sanaz Zargar Balaye Jame, Mohammad Darvishi, Morteza Mortazavi
Acute Crit Care. 2023;38(1):113-121.   Published online February 22, 2023
DOI: https://doi.org/10.4266/acc.2022.00927
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AbstractAbstract PDF
Background
We assessed predictors of mortality in the intensive care unit (ICU) and investigated if Glasgow coma scale (GCS) is associated with mortality in patients undergoing endotracheal intubation (EI). Methods: From February 2020, we performed a 1-year study on 2,055 adult patients admitted to the ICU of two teaching hospitals. The outcome was mortality during ICU stay and the predictors were patients’ demographic, clinical, and laboratory features. Results: EI was associated with a decreased risk for mortality compared with similar patients (adjusted odds ratio [AOR], 0.32; P=0.030). This shows that EI had been performed correctly with proper indications. Increasing age (AOR, 1.04; P<0.001) or blood pressure (AOR, 1.01; P<0.001), respiratory problems (AOR, 3.24; P<0.001), nosocomial infection (AOR, 1.64; P=0.014), diabetes (AOR, 5.69; P<0.001), history of myocardial infarction (AOR, 2.52; P<0.001), chronic obstructive pulmonary disease (AOR, 3.93; P<0.001), immunosuppression (AOR, 3.15; P<0.001), and the use of anesthetics/sedatives/hypnotics for reasons other than EI (AOR, 4.60; P<0.001) were directly; and GCS (AOR, 0.84; P<0.001) was inversely related to mortality. In patients with trauma surgeries (AOR, 0.62; P=0.014) or other surgical categories (AOR, 0.61; P=0.024) undergoing EI, GCS had an inverse relation with mortality (accuracy=82.6%, area under the receiver operator characteristic curve=0.81). Conclusions: A variety of features affected the risk for mortality in patients admitted to the ICU. Considering GCS score for EI had the potential of affecting prognosis in subgroups of patients such as those with trauma surgeries or other surgical categories.
Trauma
Elixhauser comorbidity measures-based risk factors associated with 30-day mortality in elderly population after femur fracture surgery: a propensity scorematched retrospective case-control study
Dohyung Kim, Hyunmin Jo, Younsuk Lee, Kyoung Ok Kim
Acute Crit Care. 2020;35(1):10-15.   Published online February 29, 2020
DOI: https://doi.org/10.4266/acc.2019.00745
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  • 125 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
As the average life expectancy increases, anesthesiologists confront unique challenges in the perioperative care of elderly patients who have significant comorbidities. In this study, we evaluated Elixhauser comorbidity measures-based risk factors associated with 30day mortality in patients aged 66 years and older who underwent femur fracture surgery. Methods: We used the Medical Information Mart for Intensive Care III which contains the medical records of patients admitted to the intensive care unit (ICU) at Beth Israel Deaconess Medical Center in the United States between 2001 and 2012 to identify patients admitted to the ICU after femur fracture surgery (n=209). Patients who died within 30 days of admission (case group, n=49) were propensity score-matched to patients who did not (control group, n=98). The variables for matching were age, sex, race, anemia (hemoglobin ≤10 g/dl), and malignancy. We attempted to explain mortality via nine independent factors: hypertension, uncomplicated diabetes, complicated diabetes, congestive heart failure (CHF), cardiac arrhythmias, chronic pulmonary disease, renal failure, neurological disorders other than paralysis, and peripheral vascular disease. Results: Logistic regression identified three significant risk factors: CHF, arrhythmias, and neurological disorders other than paralysis. The odds ratio (OR) for the 30-day mortality of CHF was 4.99 (95% confidence interval [CI], 2.18 to 12.06). The equivalent ORs for cardiac arrhythmias and neurological disorders other than paralysis were 2.61 (95% CI, 1.14 to 6.21) and 2.40 (95% CI, 0.95 to 6.48), respectively. Conclusions: Identifying patients with these risk factors (CHF, arrhythmias, and neurological disorders other than paralysis) will assist clinicians with perioperative planning and provide caregivers with valuable information for decision-making.

Citations

Citations to this article as recorded by  
  • A machine learning-based prediction model for in-hospital mortality among critically ill patients with hip fracture: An internal and external validated study
    Mingxing Lei, Zhencan Han, Shengjie Wang, Tao Han, Shenyun Fang, Feng Lin, Tianlong Huang
    Injury.2023; 54(2): 636.     CrossRef
  • Complications and hospitalization costs in patients with hypothyroidism following total hip arthroplasty
    Yuanyuan Huang, Yuzhi Huang, Yuhang Chen, Qinfeng Yang, Binyan Yin
    Journal of Orthopaedic Surgery and Research.2023;[Epub]     CrossRef
  • How age and gender influence proximal humerus fracture management in patients older than fifty years
    Akshar H. Patel, J. Heath Wilder, Sione A. Ofa, Olivia C. Lee, Michael C. Iloanya, Felix H. Savoie, William F. Sherman
    JSES International.2022; 6(2): 253.     CrossRef
  • Comorbidity indices in orthopaedic surgery: a narrative review focused on hip and knee arthroplasty
    SaTia T. Sinclair, Ahmed K. Emara, Melissa N. Orr, Kara M. McConaghy, Alison K. Klika, Nicolas S. Piuzzi
    EFORT Open Reviews.2021; 6(8): 629.     CrossRef
CPR/Resuscitation
Risk factors associated with inpatient cardiac arrest during emergency endotracheal intubation at general wards
Chul Park
Acute Crit Care. 2019;34(3):212-218.   Published online August 31, 2019
DOI: https://doi.org/10.4266/acc.2019.00598
Correction in: Acute Crit Care 2020;35(3):228
  • 6,837 View
  • 151 Download
  • 10 Web of Science
  • 10 Crossref
AbstractAbstract PDF
Background
Peri-intubation cardiac arrest (PICA) following emergent endotracheal intubation (ETI) is a rare, however, potentially preventable type of cardiac arrest. Limited published data have described factors associated with inpatient PICA and patient outcomes. The aim of this study was to identify risk factors associated with PICA among hospitalized patients emergently intubated at a general ward as compared to non-PICA inpatients. In addition, we identified a difference of clinical outcomes in patients between PICA and other types of inpatient cardiac arrest (OTICA).
Methods
We conducted a retrospective observational study of patients at two institutions between January 2016 to December 2017. PICA was defined in patients emergently intubated who experienced cardiac arrest within 20 minutes after ETI. The non-PICA group consisted of inpatients emergently intubated without cardiac arrest. Risk factors for PICA were identified through univariate and multivariate logistic regression analysis. Clinical outcomes were compared between PICA and OTICA.
Results
Fifteen episodes of PICA occurred during the study period, accounting for 3.6% of all inpatient arrests. Intubation-related shock index, number of intubation attempts, pre-ETI vasopressor use, and neuromuscular blocking agent (NMBA) use, especially succinylcholine, were independently associated with PICA. Clinical outcomes of intensive care unit and hospital length of stay, survival to discharge, and neurologic outcome at hospital discharge were not significantly different between PICA and OTICA.
Conclusions
We identified four independent risk factors for PICA, and preintubation hemodynamic stabilization and avoidance of NMBA were possibly correlated with a decreased PICA risk. Clinical outcomes of PICA were similar to those of OTICA.

Citations

Citations to this article as recorded by  
  • Risk factors for peri-intubation cardiac arrest: A systematic review and meta-analysis
    Ting-Hao Yang, Shih-Chieh Shao, Yi-Chih Lee, Chien-Han Hsiao, Chieh-Ching Yen
    Biomedical Journal.2023; : 100656.     CrossRef
  • Reverse shock index (RSI) as a predictor of post-intubation cardiac arrest (PICA)
    Mehdi Torabi, Ghazal Soleimani Mahani, Moghaddameh Mirzaee
    International Journal of Emergency Medicine.2023;[Epub]     CrossRef
  • Incidence and factors associated with out-of-hospital peri-intubation cardiac arrest: a secondary analysis of the CURASMUR trial
    Cédric Gil-Jardiné, Patricia Jabre, Frederic Adnet, Thomas Nicol, Patrick Ecollan, Bertrand Guihard, Cyril Ferdynus, Valery Bocquet, Xavier Combes
    Internal and Emergency Medicine.2022; 17(2): 611.     CrossRef
  • Risk factors associated with peri-intubation cardiac arrest in the emergency department
    Ting-Hao Yang, Kuan-Fu Chen, Shi-Ying Gao, Chih-Chuan Lin
    The American Journal of Emergency Medicine.2022; 58: 229.     CrossRef
  • Comparison of video-stylet and conventional laryngoscope for endotracheal intubation in adults with cervical spine immobilization: A PRISMA-compliant meta-analysis
    I-Wen Chen, Yu-Yu Li, Kuo-Chuan Hung, Ying-Jen Chang, Jen-Yin Chen, Ming-Chung Lin, Kuei-Fen Wang, Chien-Ming Lin, Ping-Wen Huang, Cheuk-Kwan Sun
    Medicine.2022; 101(33): e30032.     CrossRef
  • Peri-Intubation Cardiorespiratory Arrest Risk in Pediatric Patients: A Systematic Review
    Rohit S. Loomba, Riddhi Patel, Elizabeth Kunnel, Enrique G. Villarreal, Juan S. Farias, Saul Flores
    Journal of Pediatric Intensive Care.2022;[Epub]     CrossRef
  • Comparison of Suction Rates Between a Standard Yankauer, a Commercial Large-Bore Suction Device, and a Makeshift Large-Bore Suction Device
    Dhimitri A. Nikolla, Briana King, Andrew Heslin, Jestin N. Carlson
    The Journal of Emergency Medicine.2021; 61(3): 265.     CrossRef
  • Emergency Airway Management Outside the Operating Room: Current Evidence and Management Strategies
    Kunal Karamchandani, Jonathan Wheelwright, Ae Lim Yang, Nathaniel D. Westphal, Ashish K. Khanna, Sheila N. Myatra
    Anesthesia & Analgesia.2021; 133(3): 648.     CrossRef
  • Further Validation of a Novel Acute Myocardial Infarction Risk Stratification (nARS) System for Patients with Acute Myocardial Infarction
    Shinnosuke Sawano, Kenichi Sakakura, Kei Yamamoto, Yousuke Taniguchi, Takunori Tsukui, Masaru Seguchi, Hiroshi Wada, Shin-ichi Momomura, Hideo Fujita
    International Heart Journal.2020; 61(3): 463.     CrossRef
  • Corrigendum to: Risk factors associated with inpatient cardiac arrest during emergency endotracheal intubation at general wards
    Chul Park
    Acute and Critical Care.2020; 35(3): 228.     CrossRef
Trauma
Timing and Associated Factors for Sepsis-3 in Severe Trauma Patients: A 3-Year Single Trauma Center Experience
Seungwoo Chung, Donghwan Choi, Jayun Cho, Yo Huh, Jonghwan Moon, Junsik Kwon, Kyoungwon Jung, John-Cook Jong Lee, Byung Hee Kang
Acute Crit Care. 2018;33(3):130-134.   Published online August 31, 2018
DOI: https://doi.org/10.4266/acc.2018.00122
  • 8,293 View
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  • 14 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Background
We hypothesized that the recent change of sepsis definition by sepsis-3 would facilitate the measurement of timing of sepsis for trauma patients presenting with initial systemic inflammatory response syndrome. Moreover, we investigated factors associated with sepsis according to the sepsis-3 definition.
Methods
Trauma patients in a single level I trauma center were retrospectively reviewed from January 2014 to December 2016. Exclusion criteria were younger than 18 years, Injury Severity Score (ISS) <15, length of stay <8 days, transferred from other hospitals, uncertain trauma history, and incomplete medical records. A binary logistic regression test was used to identify the risk factors for sepsis-3.
Results
A total of 3,869 patients were considered and, after a process of exclusion, 422 patients were reviewed. Fifty patients (11.85%) were diagnosed with sepsis. The sepsis group presented with higher mortality (14 [28.0%] vs. 17 [4.6%], P<0.001) and longer intensive care unit stay (23 days [range, 11 to 35 days] vs. 3 days [range, 1 to 9 days], P<0.001). Multivariate analysis demonstrated that, in men, high lactate level and red blood cell transfusion within 24 hours were risk factors for sepsis. The median timing of sepsis-3 was at 8 hospital days and 4 postoperative days. The most common focus was the respiratory system.
Conclusions
Sepsis defined by sepsis-3 remains a critical issue in severe trauma patients. Male patients with higher ISS, lactate level, and red blood cell transfusion should be cared for with caution. Reassessment of sepsis should be considered at day 8 of hospital stay or day 4 postoperatively.

Citations

Citations to this article as recorded by  
  • A biomarker panel of C-reactive protein, procalcitonin and serum amyloid A is a predictor of sepsis in severe trauma patients
    Mei Li, Yan-jun Qin, Xin-liang Zhang, Chun-hua Zhang, Rui-juan Ci, Wei Chen, De-zheng Hu, Shi-min Dong
    Scientific Reports.2024;[Epub]     CrossRef
  • Identifying biomarkers deciphering sepsis from trauma-induced sterile inflammation and trauma-induced sepsis
    Praveen Papareddy, Michael Selle, Nicolas Partouche, Vincent Legros, Benjamin Rieu, Jon Olinder, Cecilia Ryden, Eva Bartakova, Michal Holub, Klaus Jung, Julien Pottecher, Heiko Herwald
    Frontiers in Immunology.2024;[Epub]     CrossRef
  • The Road to Sepsis in Geriatric Polytrauma Patients—Can We Forecast Sepsis in Trauma Patients?
    Cédric Niggli, Philipp Vetter, Jan Hambrecht, Hans-Christoph Pape, Ladislav Mica
    Journal of Clinical Medicine.2024; 13(6): 1570.     CrossRef
  • Defining Posttraumatic Sepsis for Population-Level Research
    Katherine Stern, Qian Qiu, Michael Weykamp, Grant O’Keefe, Scott C. Brakenridge
    JAMA Network Open.2023; 6(1): e2251445.     CrossRef
  • Strategies for the treatment of femoral fractures in severely injured patients: trends in over two decades from the TraumaRegister DGU®
    Felix M. Bläsius, Markus Laubach, Hagen Andruszkow, Philipp Lichte, Hans-Christoph Pape, Rolf Lefering, Klemens Horst, Frank Hildebrand
    European Journal of Trauma and Emergency Surgery.2022; 48(3): 1769.     CrossRef
  • Infectious Diseases-Related Emergency Department Visits Among Non-Elderly Adults with Intellectual and Developmental Disabilities in the United States: Results from the National Emergency Department Sample, 2016
    Hussaini Zandam, Monika Mitra, Ilhom Akobirshoev, Frank S. Li, Ari Ne'eman
    Population Health Management.2022; 25(3): 335.     CrossRef
  • Patient, provider, and system factors that contribute to health care–associated infection and sepsis development in patients after a traumatic injury: An integrative review
    Debbie Tan, Taneal Wiseman, Vasiliki Betihavas, Kaye Rolls
    Australian Critical Care.2021; 34(3): 269.     CrossRef
  • Accuracy of Procalcitonin Levels for Diagnosis of Culture-Positive Sepsis in Critically Ill Trauma Patients: A Retrospective Analysis
    Aisha Bakhtiar, Syed Jawad Haider Kazmi, Muhammad Sohaib Asghar, Muhammad Nadeem Khurshaidi, Salman Mazhar, Noman A Khan, Nisar Ahmed, Farah Yasmin, Rabail Yaseen, Maira Hassan
    Cureus.2021;[Epub]     CrossRef
  • An Evaluation of the Effect of Performance Improvement and Patient Safety Program Implemented in a New Regional Trauma Center of Korea
    Yo Huh, Junsik Kwon, Jonghwan Moon, Byung Hee Kang, Sora Kim, Jayoung Yoo, Seoyoung Song, Kyoungwon Jung
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • The impact of infection complications after trauma differs according to trauma severity
    Akira Komori, Hiroki Iriyama, Takako Kainoh, Makoto Aoki, Toshio Naito, Toshikazu Abe
    Scientific Reports.2021;[Epub]     CrossRef
  • Gene Expression–Based Diagnosis of Infections in Critically Ill Patients—Prospective Validation of the SepsisMetaScore in a Longitudinal Severe Trauma Cohort
    Simone Thair, Caspar Mewes, José Hinz, Ingo Bergmann, Benedikt Büttner, Stephan Sehmisch, Konrad Meissner, Michael Quintel, Timothy E. Sweeney, Purvesh Khatri, Ashham Mansur
    Critical Care Medicine.2021; 49(8): e751.     CrossRef
  • Immunometabolic signatures predict risk of progression to sepsis in COVID-19
    Ana Sofía Herrera-Van Oostdam, Julio E. Castañeda-Delgado, Juan José Oropeza-Valdez, Juan Carlos Borrego, Joel Monárrez-Espino, Jiamin Zheng, Rupasri Mandal, Lun Zhang, Elizabeth Soto-Guzmán, Julio César Fernández-Ruiz, Fátima Ochoa-González, Flor M. Trej
    PLOS ONE.2021; 16(8): e0256784.     CrossRef
  • Sepsis in Trauma: A Deadly Complication
    Fernanda Mas-Celis, Jimena Olea-López, Javier Alberto Parroquin-Maldonado
    Archives of Medical Research.2021; 52(8): 808.     CrossRef
  • New automated analysis to monitor neutrophil function point-of-care in the intensive care unit after trauma
    Lillian Hesselink, Roy Spijkerman, Emma de Fraiture, Suzanne Bongers, Karlijn J. P. Van Wessem, Nienke Vrisekoop, Leo Koenderman, Luke P. H. Leenen, Falco Hietbrink
    Intensive Care Medicine Experimental.2020;[Epub]     CrossRef
Pulmonary/Cardiology
Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung Transplants
Ha Yeon Kim, Sungwon Na, Hyo Chae Paik, Jonglin Ha, Jeongmin Kim
Korean J Crit Care Med. 2015;30(4):286-294.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.286
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AbstractAbstract PDF
Background
Extracorporeal membrane oxygenation (ECMO) is administered for a few days after lung transplantation (LTx) in recipients who are expected to have early graft dysfunction. Despite its life-saving potential, immediate postoperative ECMO has life-threatening complications such as postoperative bleeding. We investigated the risk factors related to the use of immediate postoperative ECMO.
Methods
We retrospectively reviewed the records of 60 LTx patients who were at our institution from October 2012 to May 2015. Perioperative variables associated with postoperative ECMO were compared between the two groups.
Results
There were 26 patients who received postoperative ECMO (ECMO group) and 34 patients who did not (control group). Multivariate regression analysis revealed preoperative ECMO (odds ratio [OR] 12.55, 95% confidence intervals [CI] 1.34 – 117.24, p = 0.027) and lower peripheral pulse oxymetry saturation (SpO2) at the end of surgery (OR 0.71, 95% CI 0.54 – 0.95, p = 0.019) were independent risk factors for postoperative ECMO in LTx patients. The incidences of complications, such as re-operation, tracheostomy, renal failure and postoperative atrial fibrillation, were higher in the ECMO group. There was no difference in the duration of postoperative intensive care unit stay or postoperative 30-day mortality between the two groups.
Conclusions
The preoperative ECMO and lower SpO2 at the end of surgery were associated with postoperative ECMO. Further, postoperative adverse events were higher in the ECMO group compared with the control group. This study suggests that determination of postoperative ECMO requires careful consideration because of the risks of postoperative ECMO in LTx patients.

Citations

Citations to this article as recorded by  
  • The Future of Research on Extracorporeal Membrane Oxygenation (ECMO)
    Ji Young Lee
    Korean Journal of Critical Care Medicine.2016; 31(2): 73.     CrossRef
Ventriculostomy-related Infections in the Neurosurgical Intensive Care Unit: The Risk Factors and the Outcomes
Jung Hwan Lee, Seung Heon Cha, Jae Il Lee, Dong Wan Kang, Jun Kyoung Ko, In Ho Han, Won Ho Cho, Byung Kwan Choi, Chang Hwa Choi
Korean J Crit Care Med. 2011;26(4):208-211.
DOI: https://doi.org/10.4266/kjccm.2011.26.4.208
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  • 1 Crossref
AbstractAbstract PDF
BACKGROUND
This study was performed to analyze the risk factors for ventriculostomy-related infections (VRIs) in the neurosurgical intensive care unit (NSICU) and the relationship between these risk factors and the patients' outcomes.
METHODS
We collected demographic, clinical, laboratory and microbiological data from all 146 consecutive adult patients who underwent ventriculostomy in the NSICU from January 2007 to December 2008. We excluded patients with ventriculostomy performed for the draining of intraventricular abscess, infection of ventriculoperitoneal shunt (V-P shunt) or previous ventriculitis. VRI was defined by positive culture from cerebrospinal fluid (CSF) obtained via the ventricular catheter.
RESULTS
VRIs were diagnosed in 26 (17.8%) of 146 patients. On average, the patients with VRIs stayed longer in the NSICU than patients without VRIs (mean duration 20 days vs. 11.9 days). All VRIs occurred in patients who had a low Acute Physiology and Chronic Health Evaluation (APACHE) IV score. In addition, the duration required to maintain ventriculostomy was longer in patients with VRIs. However, sex, mortality, the cause of ventriculosotmy, the level of consciousness, combined systemic infections, number of catheters, and performing urokinase irrigation or antibiotics irrigation via the ventriculostomy catheter were not associated with VRIs.
CONCLUSIONS
VRIs were associated with longer ICU stay. However, VRIs did not influence the overall mortality rate of patients undergoing ventriculostomy in the NSICU. Because the long duration required for maintaining ventriculostomy was the risk factor of VRI, early removal of ventriculostomy catheter must be considered.

Citations

Citations to this article as recorded by  
  • Ventriculostomy related infection in intensive care unit: Diagnostic criteria and related conditions
    Sergio Castaño Ávila, Esther Corral Lozano, Javier Maynar Moliner, Fernando Fonseca San Miguel, Elena Usón García, Yolanda Poveda Hernández, Sara Cabañes Daro-Francés, Goiatz Balziskueta Flórez, Noemi Legaristi Martínez, Amaia Quintano Rodero, Ana Tejero
    Journal of Acute Disease.2016; 5(2): 143.     CrossRef
Case Report
Atrial Fibrillation Developed after Induction of General Anesthesia in an Elderly Patient: A case report
Seok Ho Han, Jin Woo Choi
Korean J Crit Care Med. 1998;13(2):261-261.
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  • 32 Download
AbstractAbstract PDF
It is known that the incidence of arrhythmia related to anesthesia and operation is significantly higher in thoracic surgery such as cardiac, lung operation than any other operation, and atrial fibrillation is the most common arrhythmia among these arrhythmias. Besides operative sites, age and underlying cardiac problem such as hypertension, cardiomegaly can be important risk factors for intra, post-operative atrial fibrillation in non-thoracic surgery. Through many investigations, we can find that age is the most important because age related anatomical, physiological cardiac changes make elderly patients more susceptible to development of atrial fibrillation. In this case, we report atrial fibrillation that occurred after induction of general anesthesia in an elderly patient undergoing open reduction of upper arm fracture.

ACC : Acute and Critical Care