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2 "trauma centers"
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Trauma
Bedside peripherally inserted central catheter placement in trauma intensive care unit in South Korea: a comparative analysis of safety and tip positioning accuracy
Jung Rae Cho, Hancheol Jo, Dae Sung Ma, Dong Hun Kim
Acute Crit Care. 2026;41(3):631-640.   Published online August 31, 2026
DOI: https://doi.org/10.4266/acc.002964
  • 449 View
  • 19 Download
AbstractAbstract PDF
Background
Transporting critically ill trauma patients for fluoroscopy-guided peripherally inserted central catheter (PICC) placement poses substantial risks. This study evaluated the clinical outcomes of bedside PICC insertion using a surface anatomical landmark-based measurement in a trauma intensive care unit (ICU). Methods: This retrospective cohort study included trauma ICU patients who underwent PICC insertion between September 2023 and August 2024 at a regional trauma center. Insertion location was categorized as bedside or fluoroscopy-guided. Outcomes included optimal tip positioning, aberrant-course malposition, complication rates, and catheter dwell time. Multivariable linear regression identified factors associated with PICC duration. Results: Among 282 PICC procedures (171 bedside, 111 fluoroscopy), the bedside group had significantly higher injury severity scores and more frequent mechanical ventilation. Using the cmbased carina-distance criterion, optimal tip positioning was achieved in 73.1% of bedside and 65.5% of evaluable fluoroscopy-guided insertions (P=0.184). However, using the vertebral body unit-based radiologic criterion, target-zone achievement was lower in the bedside group than in the fluoroscopy group (48.5% vs. 64.9%). Initial aberrant-course malposition occurred in nine bedside insertions (5.3%) and in no fluoroscopy-guided insertions, and all were corrected before clinical use. Overall complication rates were comparable (17.5% vs. 18.0%, P=0.919). Conclusions: Bedside PICC insertion using a surface anatomical measurement method may be a feasible transport-free option for selected critically ill trauma ICU patients.
Trauma
Factors associated with unplanned intensive care unit readmission among trauma patients in Republic of Korea
Yongwoong Lee, Byung Hee Kang
Acute Crit Care. 2024;39(4):583-592.   Published online November 22, 2024
DOI: https://doi.org/10.4266/acc.2024.00584
  • 4,777 View
  • 173 Download
  • 1 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
In trauma patients, unplanned intensive care unit (ICU) readmission (UIR) is associated with poor clinical outcomes. In this study, we aimed to analyze associated factors for UIR in trauma patients.
Methods
This retrospective study was conducted on trauma patients admitted to the ICU at a trauma center from January 2016 to December 2022. Clinical information at admission, the first ICU hospitalization, first discharge from the ICU, and reasons for readmission were collected. Patients who were successfully discharge from the ICU were compared to UIR patients. Logistic regression was performed to determine the factors with a significant impact on ICU readmission.
Results
Here, 5,529 patients were admitted to the ICU over 7 years, and 212 patients (3.8%) experienced UIR. Among patients who experienced UIR, 9 (4.2%) died. In the UIR patients, hospital stay (20 days [interquartile range, 13–35] vs. 45 days [28–67], P<0.001), total ICU stay (5 days [3– 11] vs. 17 days [9–35], P<0.001), and complications during the first ICU hospitalization were significantly higher. The most common reason for UIR was respiratory problem (53.8%). In multivariable analysis, cervical spine operation during the first ICU hospitalization (odds ratio, 6.56; 95% CI, 3.62–11.91; P<0.001), renal replacement therapy (RRT; 3.52, 2.06–5.99, P<0.001), and massive blood transfusion protocol (MTP; 1.74, 1.08–2.81, P=0.023) were most highly related with UIR.
Conclusions
Because UIR patients had poor outcomes, trauma patients who underwent cervical spine operation, RRT, or MTP require monitoring in the general ward, especially for respiratory problems.

Citations

Citations to this article as recorded by  
  • Circulation-first trauma resuscitation and mortality: A 9-year single-center retrospective study
    Donghwan Choi, Kyoungwon Jung
    Journal of Trauma and Acute Care Surgery.2026; 100(4): 620.     CrossRef
  • Factors Associated with Acute Deterioration in General Ward Patients Receiving Oxygen Therapy
    Ahyoung Choi, Minyoung Kim
    Journal of Korean Critical Care Nursing.2026; 19(2): 39.     CrossRef
  • Unplanned intensive care unit admissions in trauma patients: A critical appraisal
    Amlan Swain, Deb Sanjay Nag, Jayanta Kumar Laik, Seelora Sahu, Mrunalkant Panchal, Shivani Srirala
    World Journal of Critical Care Medicine.2025;[Epub]     CrossRef
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