Pub Date : 2016-02-29DOI: 10.4266/KJCCM.2016.31.1.10
S. Kim, Wonsuk Song, Y. Won, J. Yang, C. Choi
{"title":"Outcome of External Ventricular Drainage according to the Operating Place: the Intensive Care Unit versus Operating Room","authors":"S. Kim, Wonsuk Song, Y. Won, J. Yang, C. Choi","doi":"10.4266/KJCCM.2016.31.1.10","DOIUrl":"https://doi.org/10.4266/KJCCM.2016.31.1.10","url":null,"abstract":"","PeriodicalId":255255,"journal":{"name":"The Korean Journal of Critical Care Medicine","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115042850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-11-30DOI: 10.4266/KJCCM.2015.30.4.343
Se Hun Kim, C. Her
This report describes a case of 88-year-old women who developed central venous catheter-related bilateral hydrothorax, in which left pleural effusion, while right pleural effusion was being drained. The drainage prevented accumulation of fluid in the right pleural space, indicating that there was neither extravasation of infusion fluid nor connection between the two pleural cavities. The only explanation for bilateral hydrothorax in this case is lymphatic connections. Although vascular injuries by central venous catheter can cause catheter-related hydrothorax, it is most likely that the positioning of the tip of central venous catheter within the lymphatic duct opening in the right sub-clavian-jugular confluence or superior vena cava causes the catheter-related hydrothorax. Pericardial effusion can also result from retrograde lymphatic flow through the pulmonary lymphatic chains.
{"title":"Central Venous Catheter-Related Hydrothorax","authors":"Se Hun Kim, C. Her","doi":"10.4266/KJCCM.2015.30.4.343","DOIUrl":"https://doi.org/10.4266/KJCCM.2015.30.4.343","url":null,"abstract":"This report describes a case of 88-year-old women who developed central venous catheter-related bilateral hydrothorax, in which left pleural effusion, while right pleural effusion was being drained. The drainage prevented accumulation of fluid in the right pleural space, indicating that there was neither extravasation of infusion fluid nor connection between the two pleural cavities. The only explanation for bilateral hydrothorax in this case is lymphatic connections. Although vascular injuries by central venous catheter can cause catheter-related hydrothorax, it is most likely that the positioning of the tip of central venous catheter within the lymphatic duct opening in the right sub-clavian-jugular confluence or superior vena cava causes the catheter-related hydrothorax. Pericardial effusion can also result from retrograde lymphatic flow through the pulmonary lymphatic chains.","PeriodicalId":255255,"journal":{"name":"The Korean Journal of Critical Care Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122494223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-11-30DOI: 10.4266/KJCCM.2015.30.4.358
J. Roh, E. Park, Joon Cheol Song, Y. Oh, T. Kim, Hyo Suk Kim, Sungmin Lim
Coronary artery ectasia (CAE) is a rare condition defined as the dilatation of coronary artery to at least 1.5 times larger than the normal adjacent coronary artery. Clinical manifestations of CAE vary, ranging from asymptomatic to ST-segment elevation myocardial infarction (STEMI). Because of its rarity and clinical diversity, the best treatment strategy and prognosis for CAE remain unclear. We describe a case of STEMI caused by intracoronary thrombus formation within an ectatic area in a patient with liver cirrhosis (LC). The patient was successfully managed by thrombus aspiration only, without balloon angioplasty or stent implantation, and maintained by dual antiplatelet therapy with aspirin and ticagrelor, a potent new P2Y12 inhibitor.
{"title":"ST-Segment Elevation Myocardial Infarction as a Result of Coronary Artery Ectasia-Related Intracoronary Thrombus in a Patient with Liver Cirrhosis","authors":"J. Roh, E. Park, Joon Cheol Song, Y. Oh, T. Kim, Hyo Suk Kim, Sungmin Lim","doi":"10.4266/KJCCM.2015.30.4.358","DOIUrl":"https://doi.org/10.4266/KJCCM.2015.30.4.358","url":null,"abstract":"Coronary artery ectasia (CAE) is a rare condition defined as the dilatation of coronary artery to at least 1.5 times larger than the normal adjacent coronary artery. Clinical manifestations of CAE vary, ranging from asymptomatic to ST-segment elevation myocardial infarction (STEMI). Because of its rarity and clinical diversity, the best treatment strategy and prognosis for CAE remain unclear. We describe a case of STEMI caused by intracoronary thrombus formation within an ectatic area in a patient with liver cirrhosis (LC). The patient was successfully managed by thrombus aspiration only, without balloon angioplasty or stent implantation, and maintained by dual antiplatelet therapy with aspirin and ticagrelor, a potent new P2Y12 inhibitor.","PeriodicalId":255255,"journal":{"name":"The Korean Journal of Critical Care Medicine","volume":"307 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116256753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-11-30DOI: 10.4266/KJCCM.2015.30.4.295
H. Chang, Y. Cho, Susan A. Cho, K. Sung, P. Park
We report a case of successful heart transplantation after 67 days of support with venoarterial extracorporeal membrane oxygenation (ECMO) in a patient who underwent surgery for type A aortic dissection and myocardial infarction complicated by irreversible myocardial damage and a deep sternal wound infection. During ECMO support, left heart vent and distal limb perfusion were performed. Mediastinitis was treated with mediastinal washout and irrigation. Multiple complications from peripheral ECMO were successfully managed.
{"title":"Extracorporeal Membrane Oxygenation for 67 Days as a Bridge to Heart Transplantation in a Postcardiotomy Patient with Failing Heart and Mediastinitis","authors":"H. Chang, Y. Cho, Susan A. Cho, K. Sung, P. Park","doi":"10.4266/KJCCM.2015.30.4.295","DOIUrl":"https://doi.org/10.4266/KJCCM.2015.30.4.295","url":null,"abstract":"We report a case of successful heart transplantation after 67 days of support with venoarterial extracorporeal membrane oxygenation (ECMO) in a patient who underwent surgery for type A aortic dissection and myocardial infarction complicated by irreversible myocardial damage and a deep sternal wound infection. During ECMO support, left heart vent and distal limb perfusion were performed. Mediastinitis was treated with mediastinal washout and irrigation. Multiple complications from peripheral ECMO were successfully managed.","PeriodicalId":255255,"journal":{"name":"The Korean Journal of Critical Care Medicine","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131214992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-11-30DOI: 10.4266/KJCCM.2015.30.4.265
W. Choi, Jin Joo Kim, Hyuk-Jun Yang
Background: The aim of this study was to retrospectively evaluate and analyze the brain magnetic resonance imaging (B-MRI) findings of patients with a favorable neurological outcome following cerebral performance category (CPC) after out-of-hospital cardiac arrest (OHCA) at single university hospital emergency center. Methods: Patients with return of spontaneous circulation (> 24 h) after OHCA who were older than 16 years of age and who had been admitted to the emergency intensive care unit (EICU) for over a 57-month period between July 2007 and March 2012 and survived with a favorable neurological outcome were enrolled. B-MRI was taken after recovery of their mental status. Results: Fifty-two patients among the 305 admitted patients had a good CPC, and 33 patients’ B-MRI were analyzed (CPC 1: 26 patients, CPC 2: 7 patients). Among these, 18 (54.5%) patients had a normal finding on B-MRI. On the other hand, ischemia/infarction/microangiopathy compatible with hypoxic-ischemic encephalopathy (HIE) were found on various brain areas including subcortical white matter (7/13), cerebral cortex, central semiovlae, basal ganglia, putamen, periventricular white matter, and cerebellum. Conclusions: Survivors with a favorable neurological outcome from OHCA showed HIE on B-MRI, especially all of the patients with a CPC 2. More detail neurologic category including brain imaging would be needed to categorize patients with favorable outcome after OHCA.
{"title":"Brain Magnetic Resonance Imaging in Patients with Favorable Outcomes after Out-of-Hospital Cardiac Arrest: Many Have Encephalopathy Even with a Good Cerebral Performance Category Score","authors":"W. Choi, Jin Joo Kim, Hyuk-Jun Yang","doi":"10.4266/KJCCM.2015.30.4.265","DOIUrl":"https://doi.org/10.4266/KJCCM.2015.30.4.265","url":null,"abstract":"Background: The aim of this study was to retrospectively evaluate and analyze the brain magnetic resonance imaging (B-MRI) findings of patients with a favorable neurological outcome following cerebral performance category (CPC) after out-of-hospital cardiac arrest (OHCA) at single university hospital emergency center. Methods: Patients with return of spontaneous circulation (> 24 h) after OHCA who were older than 16 years of age and who had been admitted to the emergency intensive care unit (EICU) for over a 57-month period between July 2007 and March 2012 and survived with a favorable neurological outcome were enrolled. B-MRI was taken after recovery of their mental status. Results: Fifty-two patients among the 305 admitted patients had a good CPC, and 33 patients’ B-MRI were analyzed (CPC 1: 26 patients, CPC 2: 7 patients). Among these, 18 (54.5%) patients had a normal finding on B-MRI. On the other hand, ischemia/infarction/microangiopathy compatible with hypoxic-ischemic encephalopathy (HIE) were found on various brain areas including subcortical white matter (7/13), cerebral cortex, central semiovlae, basal ganglia, putamen, periventricular white matter, and cerebellum. Conclusions: Survivors with a favorable neurological outcome from OHCA showed HIE on B-MRI, especially all of the patients with a CPC 2. More detail neurologic category including brain imaging would be needed to categorize patients with favorable outcome after OHCA.","PeriodicalId":255255,"journal":{"name":"The Korean Journal of Critical Care Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132909375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-11-30DOI: 10.4266/KJCCM.2015.30.4.329
Bongjin Lee, Hyung Joo Jeong, Yu Hyeon Choi, C. Choi, June-Dong Park
Phacomatosis pigmentovascularis (PPV) is a rare syndrome characterized by concurrent nevus flammeus (capillary malformation) and pigmentary nevus. According to current research, the major pathophysiologic mechanism in PPV is venous dysplasia with resultant compensatory collateral channels and venous hypertension. Arterial involvement is rare. We herein report our experience on renovascular hypertension, intermittent claudication, and severe rhabdomyolysis due to diffuse stenosis of multiple arteries in a patient with PPV type IIb associated with SWS.
{"title":"Severe Rhabdomyolysis in Phacomatosis Pigmentovascularis Type IIb associated with Sturge-Weber Syndrome","authors":"Bongjin Lee, Hyung Joo Jeong, Yu Hyeon Choi, C. Choi, June-Dong Park","doi":"10.4266/KJCCM.2015.30.4.329","DOIUrl":"https://doi.org/10.4266/KJCCM.2015.30.4.329","url":null,"abstract":"Phacomatosis pigmentovascularis (PPV) is a rare syndrome characterized by concurrent nevus flammeus (capillary malformation) and pigmentary nevus. According to current research, the major pathophysiologic mechanism in PPV is venous dysplasia with resultant compensatory collateral channels and venous hypertension. Arterial involvement is rare. We herein report our experience on renovascular hypertension, intermittent claudication, and severe rhabdomyolysis due to diffuse stenosis of multiple arteries in a patient with PPV type IIb associated with SWS.","PeriodicalId":255255,"journal":{"name":"The Korean Journal of Critical Care Medicine","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134089841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-11-30DOI: 10.4266/KJCCM.2015.30.4.241
Hyun Don Joo, S. Ann, S. Ryou, Youn Seup Kim, Jong Wan Kim, D. Kim
Background: Few reports have documented the clinical characteristics and treatment outcomes of adult patients with Elizabethkingia meningoseptica infection. Methods: Medical records of patients over 18 years of age and suspected of having an E. meningoseptica infection from March 1, 2006 to February 28, 2013 were reviewed retrospectively. Their clinical characteristics, antimicrobial susceptibility results, and treatment outcomes were analyzed. Results: E. meningoseptica was isolated from 30 patients. Median age was 68.5 years, and infections were more frequent in males (17, 56.7%). The most common isolation source was sputum (23, 76.7%), and pneumonia was the most common condition (21, 70%) after excluding two cases of colonization. This bacterium was most susceptible to minocycline (27, 90%) and fluoroquinolones, including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%). The mortality rate due directly to E. meningoseptica infection was 20% (6/30), and uncontrolled pneumonia was the only cause of death. After isolating E. meningoseptica, the numbers of patients with pneumonia (9/9, 100% vs. 12/21, 57.1%), history of hemodialysis (5/9, 55.6% vs. 3/21, 14.3%), tracheostomy (8/9, 88.9 vs. 10/21, 47.6%), and median Charlson comorbidity index score (6 [range, 3–9] vs. 4 [range, 0–9]) were significantly higher in non-survivors than those in survivors (p < 0.05, for each). However, only 12 (40%) patients received appropriate antibiotics. Conclusions: E. meningoseptica infection most commonly presented as pneumonia in adults with severe underlying diseases. Despite the high mortality rate, the rate of appropriate antibiotic use was notably low.
背景:关于成人伊莉莎白菌脑膜炎败血症感染的临床特征和治疗结果的报道很少。方法:回顾性分析我院2006年3月1日至2013年2月28日收治的18岁以上疑似脑膜炎脓毒杆菌感染患者的病历。分析其临床特点、药敏结果及治疗结果。结果:从30例患者中分离出脑膜炎脓毒杆菌。中位年龄68.5岁，男性感染率较高(17.7%，56.7%)。痰是最常见的分离源(23例，76.7%)，排除2例定植后，肺炎是最常见的分离源(21例，70%)。该菌对米诺环素(27,90%)和氟喹诺酮类药物最敏感，包括左氧氟沙星(20,66.7%)和环丙沙星(18,60%)。直接感染脑膜炎脓毒杆菌的死亡率为20%(6/30)，未控制的肺炎是唯一的死亡原因。分离脑膜炎脓毒杆菌后，非存活患者中肺炎(9/9,100% vs. 12/21, 57.1%)、血液透析史(5/9,55.6% vs. 3/21, 14.3%)、气管造口术(8/9,88.9 vs. 10/21, 47.6%)和Charlson共病指数中位数评分(6[范围，3-9]vs. 4[范围，0-9])的患者数量均显著高于存活患者(p < 0.05)。然而，只有12例(40%)患者接受了适当的抗生素治疗。结论:脑膜炎脓毒杆菌感染在有严重基础疾病的成人中最常表现为肺炎。尽管死亡率很高，但适当使用抗生素的比率却很低。
{"title":"Experience with Elizabethkingia meningoseptica Infection in Adult Patients at a Tertiary Hospital","authors":"Hyun Don Joo, S. Ann, S. Ryou, Youn Seup Kim, Jong Wan Kim, D. Kim","doi":"10.4266/KJCCM.2015.30.4.241","DOIUrl":"https://doi.org/10.4266/KJCCM.2015.30.4.241","url":null,"abstract":"Background: Few reports have documented the clinical characteristics and treatment outcomes of adult patients with Elizabethkingia meningoseptica infection. Methods: Medical records of patients over 18 years of age and suspected of having an E. meningoseptica infection from March 1, 2006 to February 28, 2013 were reviewed retrospectively. Their clinical characteristics, antimicrobial susceptibility results, and treatment outcomes were analyzed. Results: E. meningoseptica was isolated from 30 patients. Median age was 68.5 years, and infections were more frequent in males (17, 56.7%). The most common isolation source was sputum (23, 76.7%), and pneumonia was the most common condition (21, 70%) after excluding two cases of colonization. This bacterium was most susceptible to minocycline (27, 90%) and fluoroquinolones, including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%). The mortality rate due directly to E. meningoseptica infection was 20% (6/30), and uncontrolled pneumonia was the only cause of death. After isolating E. meningoseptica, the numbers of patients with pneumonia (9/9, 100% vs. 12/21, 57.1%), history of hemodialysis (5/9, 55.6% vs. 3/21, 14.3%), tracheostomy (8/9, 88.9 vs. 10/21, 47.6%), and median Charlson comorbidity index score (6 [range, 3–9] vs. 4 [range, 0–9]) were significantly higher in non-survivors than those in survivors (p < 0.05, for each). However, only 12 (40%) patients received appropriate antibiotics. Conclusions: E. meningoseptica infection most commonly presented as pneumonia in adults with severe underlying diseases. Despite the high mortality rate, the rate of appropriate antibiotic use was notably low.","PeriodicalId":255255,"journal":{"name":"The Korean Journal of Critical Care Medicine","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133370830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-11-30DOI: 10.4266/KJCCM.2015.30.4.272
H. Seo, B. Oh, E. Park, Y. Min, S. Choi
Background: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33C target temperature management. Methods: A retrospective study was conducted on patients who underwent 33C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. Results: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 ± 0.15 μg/kg/ h. Decisions of charged doctor’s were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. Conclusions: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33C targeted temperature management.
背景:本研究旨在探讨在33℃目标温度管理期间给予右美托咪定后的心动过缓的不良反应。方法:回顾性研究在49个月的研究期间在急诊科接受33℃目标体温管理的患者。我们收集的数据包括年龄、性别、体重、诊断、心动过缓的发生、目标体温管理时间、镇静药物以及一些临床和实验室结果。我们对与心动过缓相关的因素进行了逻辑回归分析。结果:共入选患者68例。其中39例(57.4%)出现心动过缓，56例(82.4%)采用右美托咪定治疗。一氧化碳中毒组与心脏骤停组和体重较高组相比，心动过缓的优势比分别为7.448(95%可信区间[CI] 1.834 ~ 30.244, p = 0.005)和1.058 (95% CI 1.002 ~ 1.123, p = 0.044)。右美托咪定组右美托咪定输注速度为0.41±0.15 μg/kg/ h，收费医生的决定是1)减慢输注速度，2)停止输注或给予阿托品治疗心动过缓。没有病例需要心脏起搏或恶化到心脏停止。结论:右美托咪定在33℃目标温度管理期间，虽常发生心动过缓，但降低输注速度或停止输注后，心动过缓可完全恢复。然而，将右美托咪定的输注速率降低到低于标准维持剂量可能是必要的，以防止在33℃目标温度管理期间体重较高或一氧化碳中毒的患者发生心动过缓。
{"title":"Dexmedetomidine Use in Patients with 33℃ Targeted Temperature Management: Focus on Bradycardia as an Adverse Effect","authors":"H. Seo, B. Oh, E. Park, Y. Min, S. Choi","doi":"10.4266/KJCCM.2015.30.4.272","DOIUrl":"https://doi.org/10.4266/KJCCM.2015.30.4.272","url":null,"abstract":"Background: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33C target temperature management. Methods: A retrospective study was conducted on patients who underwent 33C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. Results: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 ± 0.15 μg/kg/ h. Decisions of charged doctor’s were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. Conclusions: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33C targeted temperature management.","PeriodicalId":255255,"journal":{"name":"The Korean Journal of Critical Care Medicine","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134330921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-11-30DOI: 10.4266/KJCCM.2015.30.4.323
T. Ha, C. Park, Jeong Hoon Yang, Y. Cho, C. Chung, K. Jeon, G. Suh
Mucormycosis is an uncommon opportunistic fungal infection mostly affecting immunocompromised patients and gastrointestinal mucormycosis is a rare and life-threatening. We describe a 31-year-old man with a history of idiopathic cyclic neutropenia who developed perforations of the stomach and intestine and intra-abdominal bleeding due to disseminated gastrointestinal mucormycosis after the initial operation.
{"title":"Disseminated Gastrointestinal Mucormycosis in Immunocompromised Disease","authors":"T. Ha, C. Park, Jeong Hoon Yang, Y. Cho, C. Chung, K. Jeon, G. Suh","doi":"10.4266/KJCCM.2015.30.4.323","DOIUrl":"https://doi.org/10.4266/KJCCM.2015.30.4.323","url":null,"abstract":"Mucormycosis is an uncommon opportunistic fungal infection mostly affecting immunocompromised patients and gastrointestinal mucormycosis is a rare and life-threatening. We describe a 31-year-old man with a history of idiopathic cyclic neutropenia who developed perforations of the stomach and intestine and intra-abdominal bleeding due to disseminated gastrointestinal mucormycosis after the initial operation.","PeriodicalId":255255,"journal":{"name":"The Korean Journal of Critical Care Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123887022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-11-30DOI: 10.4266/KJCCM.2015.30.4.318
Jin Kyung Park, Sungho Kim, Heekang Kim, Duk-Hyun Lee
Original Articles Implementing a Sepsis Resuscitation Bundle Improved Clinical Outcome: A Before-and-After Study (250) Extended-Spectrum β-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care Unit (257) Clinical Characteristics of Respiratory Extracorporeal Life Support in Elderly Patients with (266) Severe Acute Respiratory Distress Syndrome Predicting Delayed Ventilator Weaning after Lung Transplantation: The Role of Body Mass Index (273) Comparison of Morphine and Remifentanil on the Duration of Weaning from Mechanical Ventilation (281) Acute Physiologic and Chronic Health Examination II and Sequential Organ Failure Assessment Scores for Predicting (288) Outcomes of Out-of-Hospital Cardiac Arrest Patients Treated with Therapeutic Hypothermia Effectiveness of Bradycardia as a Single Parameter in the Pediatric Acute Response System (297) Prognostic Value and Optimal Sampling Time of S-100B Protein for Outcome Prediction in (304) Cardiac Arrest Patients Treated with Therapeutic Hypothermia Change in Red Cell Distribution Width as Predictor of Death and Neurologic Outcome in (313) Patients Treated with Therapeutic Hypothermia after Out-of-Hospital Cardiac Arrest Traumatic Liver Injury: Factors Associated with Mortality (320)
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