Korean Journal of Critical Care Medicine最新文献_第2页

An Ofloxacin-Induced Anaphylaxis through an IgG4-Mediated but Not IgE-Mediated Basophil Activation Mechanism 氧氟沙星诱导的过敏反应通过igg4介导而非ige介导的嗜碱性粒细胞激活机制

Korean Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI: 10.4266/kjccm.2017.00108

J. Kim, D. Seo, G. Ban, Eun-Mi Yang, Y. Shin, Y. Ye, Hae‐Sim Park

{"title":"An Ofloxacin-Induced Anaphylaxis through an IgG4-Mediated but Not IgE-Mediated Basophil Activation Mechanism","authors":"J. Kim, D. Seo, G. Ban, Eun-Mi Yang, Y. Shin, Y. Ye, Hae‐Sim Park","doi":"10.4266/kjccm.2017.00108","DOIUrl":"https://doi.org/10.4266/kjccm.2017.00108","url":null,"abstract":"We report a case of 20-year-old female patient with ofloxacin-induced anaphylaxis mediated by IgG4 antibody. One of second-generation fluoroquinolone, ofloxacin is prescribed widely to treat bacterial infections. Reports of serious hypersensitivity reactions to quinolone are increasing due to high consumption worldwide [1]. The pathogenesis of anaphylaxis caused by ofloxacin is not yet fully understood, as it is not commonly reported. There has been a report demonstrating high serum specific IgE levels to ofloxacin-human serum albumin (HSA) conjugate using enzymelinked immunosorbent assay (ELISA), enzyme-linked immunospecific assay [2]; however, this is the first report to suggest an IgG4-mediated but not IgE-mediated mechanism in a patient with ofloxacin-induced anaphylaxis. A 20-year-old female with allergic rhinitis was referred to our department for the evaluation of anaphylaxis because she had experienced generalized urticaria and dyspnea with wheezing, and hoarseness within 1 hour after oral ingestion of ofloxacin 100 mg. It was her first ingestion of ofloxacin. The patient had a history of acute, generalized urticaria and drug allergy to nonsteroidal anti-inflammatory drugs. Her mother had a history of bronchial asthma. At the initial visit, no abnormal findings were noted on physical examination and radiography/spirometry results. Her serum total IgE level was 42 kU/L. Allergy skin prick tests showed positive responses to Dermatophagoides farinae and D. pteronyssinus, but negative responses to ofloxacin at concentrations of 0.1−10 mg/ml, with a positive control being a mean wheal size of 4 mm to histamine. Ofloxacin-HSA conjugate was conducted to investigate immunologic mechanisms to detect serum specific IgE antibody to ofloxacin-HSA conjugate using ELISA as","PeriodicalId":31220,"journal":{"name":"Korean Journal of Critical Care Medicine","volume":"32 1","pages":"302 - 305"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42852176","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}

引用次数: 0

The Association of Preoperative Body Mass Index with Acute Kidney Injury in Liver Transplantation Recipients: A Retrospective Study 肝移植受者术前体重指数与急性肾损伤的相关性:一项回顾性研究

Korean Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI: 10.4266/kjccm.2017.00178

J. Y. Park, Jung‐Hyun Park, Su Sung Lee, Hyun-Su Ri, Hye-Jin Kim, Yun-Mi Choi, Yoon Ji Choi, Ji-Uk Yoon

{"title":"The Association of Preoperative Body Mass Index with Acute Kidney Injury in Liver Transplantation Recipients: A Retrospective Study","authors":"J. Y. Park, Jung‐Hyun Park, Su Sung Lee, Hyun-Su Ri, Hye-Jin Kim, Yun-Mi Choi, Yoon Ji Choi, Ji-Uk Yoon","doi":"10.4266/kjccm.2017.00178","DOIUrl":"https://doi.org/10.4266/kjccm.2017.00178","url":null,"abstract":"Background Liver transplantation (LT) is a complicated procedure with a high incidence of postoperative acute kidney injury (AKI). Previous studies indicate that even transient or mild post-LT AKI can result in critical conditions, including prolonged stays in hospitals and intensive care units and increased morbidity and mortality. The aim of this study was to investigate the association between body mass index (BMI) and occurrence of AKI in LT recipients. Methods Medical data from 203 patients who received LT surgery from January 2010 to August 2016 in a single university hospital setting were retrospectively collected and analyzed. Patients were classified as either underweight (BMI <20 kg/m2) or normal weight (20 ≤ BMI < 30 kg/m2). Demographic data, anesthetic methods, complications, and perioperative laboratory test values of each patient were assessed. Propensity analyses and logistic regression were performed to evaluate the association between BMI and post-LT AKI. Results There was no significant difference in occurrence of post-LT AKI between underweight and normal weight patients. The underweight patient group had significantly longer hospital stay compared with the normal weight patient group (P = 0.023). Conclusions BMI classification was neither a positive nor negative predictor of postoperative AKI occurrence. However, patients with lower BMI had significantly longer hospital stay compared with their counterparts. Although our study was limited by its retrospective design, our observations suggest that lower BMI might play a role in post-LT AKI.","PeriodicalId":31220,"journal":{"name":"Korean Journal of Critical Care Medicine","volume":"32 1","pages":"265 - 274"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41911224","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}

引用次数: 2

Biochemical Markers as Predictors of In-Hospital Mortality in Patients with Severe Trauma: A Retrospective Cohort Study 生化指标作为严重创伤患者住院死亡率的预测指标:一项回顾性队列研究

Korean Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI: 10.4266/kjccm.2017.00360

H. Jang, H. Park, Tae Won Yang, J. Yang, Sung Hwan Kim, S. Moon, J. Byun, C. Lee, J. W. Kim, Dong Hun Kang, K. Baek

{"title":"Biochemical Markers as Predictors of In-Hospital Mortality in Patients with Severe Trauma: A Retrospective Cohort Study","authors":"H. Jang, H. Park, Tae Won Yang, J. Yang, Sung Hwan Kim, S. Moon, J. Byun, C. Lee, J. W. Kim, Dong Hun Kang, K. Baek","doi":"10.4266/kjccm.2017.00360","DOIUrl":"https://doi.org/10.4266/kjccm.2017.00360","url":null,"abstract":"Background Initial evaluation of injury severity in trauma patients is an important and challenging task. We aimed to assess whether easily measurable biochemical parameters (hemoglobin, pH, and prothrombin time/international normalized ratio [PT/INR]) can predict in-hospital mortality in patients with severe trauma. Methods This retrospective study involved review of the medical records of 315 patients with severe trauma and an injury severity score >15 who were managed at Gyeongsang National University Hospital between January 2005 and December 2015. We extracted the following data: in-hospital mortality, injury severity score, and initial hemoglobin level, pH, and PT/INR. The predictive values of these variables were compared using receiver operation characteristic curves. Results Of the 315 patients, 72 (22.9%) died. The in-hospital mortality rates of patients with hemoglobin levels <8.4 g/dl and ≥8.4 g/dl were 49.8% and 9.9%, respectively (P < 0.001). At a cutoff hemoglobin level of 8.4 g/dl, the sensitivity and specificity values for mortality were 81.9% and 86.4%, respectively. At a pH cutoff of 7.25, the sensitivity and specificity values for mortality were 66.7% and 77.8%, respectively; 66.7% of patients with a pH <7.25 died versus 22.2% with a pH ≥7.25 (P < 0.001). The in-hospital mortality rates for patients with PT/INR values ≥1.4 and <1.4 were 37.5% and 16%, respectively (P < 0.001; sensitivity, 37.5%; specificity, 84%). Conclusions Using the suggested cutoff values, hemoglobin level, pH, and PT/INR can simply and easily be used to predict in-hospital mortality in patients with severe trauma.","PeriodicalId":31220,"journal":{"name":"Korean Journal of Critical Care Medicine","volume":"32 1","pages":"240 - 246"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44887216","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}

引用次数: 2

Clinical Application of the Quick Sepsis-Related Organ Failure Assessment Score at Intensive Care Unit Admission in Patients with Bacteremia: A Single-Center Experience of Korea 脓毒症相关器官衰竭快速评估评分在重症监护病房收治菌血症患者中的临床应用:韩国单中心经验

Korean Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI: 10.4266/kjccm.2017.00241

H. Na, E. Jeong, Insu Kim, W. Kim, Kwangha Lee

{"title":"Clinical Application of the Quick Sepsis-Related Organ Failure Assessment Score at Intensive Care Unit Admission in Patients with Bacteremia: A Single-Center Experience of Korea","authors":"H. Na, E. Jeong, Insu Kim, W. Kim, Kwangha Lee","doi":"10.4266/kjccm.2017.00241","DOIUrl":"https://doi.org/10.4266/kjccm.2017.00241","url":null,"abstract":"Background We evaluated the clinical usefulness of the quick Sepsis-Related Organ Failure Assessment (qSOFA) score (based on the 2016 definition of sepsis) at intensive care unit admission in Korean patients with bacteremia. Methods We retrospectively analyzed clinical data from 236 patients between March 2011 and February 2016. In addition to the qSOFA, the Modified Early Warning score (MEWS) and systemic inflammatory response syndrome (SIRS) criteria were calculated. Results The patients’ median age was 69 years, and 61.0% were male. Of the patients, 127 (53.8%) had a qSOFA score ≥2 points. They had significantly higher rates of septic shock, thrombocytopenia, and hyperlactatemia, and increased requirements for ventilator care, neuromuscular blocking agents, vasopressors, and hemodialysis within 72 hours after intensive care unit admission. They also had a significantly higher 28-day mortality rate. When analyzed using common thresholds (MEWS ≥5 and ≥2 SIRS criteria), patients with a MEWS ≥5 had the same results as those with a qSOFA score ≥2 (P < 0.05). However, patients with ≥2 SIRS criteria showed no significant differences. Conclusions Our results show that a qSOFA score ≥2 at admission is a useful screening tool for predicting disease severity and medical resource usage within 72 hours after admission, and for predicting 28-day mortality rates in patients with bacteremia. In addition, qSOFA scores may be more useful than SIRS criteria in terms of prognostic utility.","PeriodicalId":31220,"journal":{"name":"Korean Journal of Critical Care Medicine","volume":"32 1","pages":"247 - 255"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42357882","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}

引用次数: 4

Rapid Response Systems Reduce In-Hospital Cardiopulmonary Arrest: A Pilot Study and Motivation for a Nationwide Survey 快速反应系统减少院内心肺骤停:一项试点研究和全国调查的动机

Korean Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI: 10.4266/KJCCM.2017.00024

Yeonhee Park, J. Ahn, B. Kang, Young Seok Lee, S. Ha, Jin-Soo Min, W. Cho, S. Na, Dong-Hyun Lee, S. Park, G. Hong, Hyun-Jung Kim, Sang-song Shim, Junghyun Kim, S. Lee, So-Young Park, J. Moon

{"title":"Rapid Response Systems Reduce In-Hospital Cardiopulmonary Arrest: A Pilot Study and Motivation for a Nationwide Survey","authors":"Yeonhee Park, J. Ahn, B. Kang, Young Seok Lee, S. Ha, Jin-Soo Min, W. Cho, S. Na, Dong-Hyun Lee, S. Park, G. Hong, Hyun-Jung Kim, Sang-song Shim, Junghyun Kim, S. Lee, So-Young Park, J. Moon","doi":"10.4266/KJCCM.2017.00024","DOIUrl":"https://doi.org/10.4266/KJCCM.2017.00024","url":null,"abstract":"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.","PeriodicalId":31220,"journal":{"name":"Korean Journal of Critical Care Medicine","volume":"32 1","pages":"231 - 239"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47720602","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}

引用次数: 5

Endovascular Stenting for the Treatment of an Initially Asymptomatic Patient with Traumatic Carotid Artery Dissection 血管内支架治疗外伤性颈动脉夹层的无症状患者

Korean Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI: 10.4266/kjccm.2017.00010

S. Yun, Jong Cook Park

引用次数: 0

The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary Hospital 急性生理和慢性健康评估（APACHE）IV评分预测单个三级医院死亡率的能力

Korean Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI: 10.4266/kjccm.2016.00990

J. Choi, Young Sun Park, Young Seok Lee, Yeon Hee Park, C. Chung, D. Park, Insun Kwon, Ju Sang Lee, Na Eun Min, J. Park, S. Yoo, G. Chon, Y. Sul, J. Moon

{"title":"The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary Hospital","authors":"J. Choi, Young Sun Park, Young Seok Lee, Yeon Hee Park, C. Chung, D. Park, Insun Kwon, Ju Sang Lee, Na Eun Min, J. Park, S. Yoo, G. Chon, Y. Sul, J. Moon","doi":"10.4266/kjccm.2016.00990","DOIUrl":"https://doi.org/10.4266/kjccm.2016.00990","url":null,"abstract":"Background The Acute Physiology and Chronic Health Evaluation (APACHE) II model has been widely used in Korea. However, there have been few studies on the APACHE IV model in Korean intensive care units (ICUs). The aim of this study was to compare the ability of APACHE IV and APACHE II in predicting hospital mortality, and to investigate the ability of APACHE IV as a critical care triage criterion. Methods The study was designed as a prospective cohort study. Measurements of discrimination and calibration were performed using the area under the receiver operating characteristic curve (AUROC) and the Hosmer-Lemeshow goodness-of-fit test respectively. We also calculated the standardized mortality ratio (SMR). Results The APACHE IV score, the Charlson Comorbidity index (CCI) score, acute respiratory distress syndrome, and unplanned ICU admissions were independently associated with hospital mortality. The calibration, discrimination, and SMR of APACHE IV were good (H = 7.67, P = 0.465; C = 3.42, P = 0.905; AUROC = 0.759; SMR = 1.00). However, the explanatory power of an APACHE IV score >93 alone on hospital mortality was low at 44.1%. The explanatory power was increased to 53.8% when the hospital mortality was predicted using a model that considers APACHE IV >93 scores, medical admission, and risk factors for CCI >3 coincidentally. However, the discriminative ability of the prediction model was unsatisfactory (C index <0.70). Conclusions The APACHE IV presented good discrimination, calibration, and SMR for hospital mortality.","PeriodicalId":31220,"journal":{"name":"Korean Journal of Critical Care Medicine","volume":"32 1","pages":"275 - 283"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49208746","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}

引用次数: 11

Challenges to Overcome Barriers against Successful Implementation of Rapid Response Systems 克服阻碍快速反应系统成功实施的障碍的挑战

Korean Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI: 10.4266/kjccm.2017.00451

E. Choi

{"title":"Challenges to Overcome Barriers against Successful Implementation of Rapid Response Systems","authors":"E. Choi","doi":"10.4266/kjccm.2017.00451","DOIUrl":"https://doi.org/10.4266/kjccm.2017.00451","url":null,"abstract":"In Korea, patient’s safety is becoming an important issue. Patients who experience adverse events during their hospital stay, including cardiopulmonary arrest, unplanned intensive care unit admissions, and unexpected death, show clear signs of deterioration in the hours preceding the event [1,2]. About one-half of the serious adverse events are deemed to be preventable [3]. Patients often show some signs of physiological deterioration for several hours (median 6 hours) before cardiac arrest [4,5]. Early recognition and response to patient deterioration have reduced the potential impact of such adverse events [6,7]. Health professionals need to recognize and respond to early signs of patient deterioration and activate rapid response systems (RRSs) to provide rapid medical intervention. RRSs have been developed for timely identification and treatment of patients in general wards at risk for clinical deterioration [8]. RRSs have been implemented widely around the world over the past two decades and have been shown to effectively reduce in-hospital cardiopulmonary arrests. Recently, RRSs have been implemented in some large hospital in Korea; their effectiveness was uncertain. This is the first multicenter survey on the impacts of RRSs. Implementation of RRSs showed a statistically significant reduction of the cardiopulmonary arrest rates (odds ratio [OR], 0.731; 95% confidence interval [CI], 0.577 to 0.927; P = 0.009), whereas cardiopulmonary resuscitation 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). RRS can diminish in-hospital cardiopulmonary arrests and improve patient safety through earlier identification and treatment attempts. Despite these benefits, there have been barriers against successful implementation of RRS. First, there is a lack of specialists and physicians for RRS implementation. Also, the optimal composition of the RRS team is uncertain. Two previous single-center reports did not show the benefits of intensivist-led teams compared with registrar or resident-led teams [9,10].","PeriodicalId":31220,"journal":{"name":"Korean Journal of Critical Care Medicine","volume":"32 1","pages":"295 - 296"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49356612","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}

引用次数: 0

Utility of Volume Assessment Using Bioelectrical Impedance Analysis in Critically Ill Patients Receiving Continuous Renal Replacement Therapy: A Prospective Observational Study 应用生物电阻抗分析对接受持续肾脏替代治疗的危重病人进行容量评估:一项前瞻性观察研究

Korean Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI: 10.4266/kjccm.2017.00136

Ki Hyun Park, Jung-ho Shin, J. Hwang, S. H. Kim

{"title":"Utility of Volume Assessment Using Bioelectrical Impedance Analysis in Critically Ill Patients Receiving Continuous Renal Replacement Therapy: A Prospective Observational Study","authors":"Ki Hyun Park, Jung-ho Shin, J. Hwang, S. H. Kim","doi":"10.4266/kjccm.2017.00136","DOIUrl":"https://doi.org/10.4266/kjccm.2017.00136","url":null,"abstract":"Background Fluid overload prior to continuous renal replacement therapy (CRRT) is an important prognostic factor. Thus, precise evaluation of fluid status is necessary to treat such patients. In this study, we investigated whether fluid assessment using bioelectrical impedance analysis (BIA) can predict outcomes in critically ill patients requiring CRRT. Methods A prospective observational study was performed in patients who were admitted to the intensive care unit and who required CRRT. BIA was conducted before CRRT; then, the ratio of extracellular water to total body water (ECW/TBW) was derived to estimate volume status. Results A total of 31 patients treated with CRRT were included. There were 18 men (58.1%), and the median age was 67 years (interquartile range, 51 to 78 years). Fourteen patients (45.2%) died within 28 days after CRRT initiation. Patients were divided into 16 with ECW/TBW ≥0.41 and 15 with ECW/TBW <0.41. Survival rate within 28 days was different between the two groups (P = 0.044). Cox regression analysis revealed a relationship between ECW/TBW ≥0.41 and 28-day mortality, but it was not statistically significant (hazard ratio, 3.0; 95% confidence interval, 0.9 to 9.8; P = 0.061). Lastly, the area under the curve of ECW/TBW for 28-day mortality was analyzed. The area under the curve of ECW/TBW was 0.73 (95% confidence interval, 0.54 to 0.92), and this was significant (P = 0.037). Conclusions Fluid status can be assessed using BIA in critically ill patients requiring CRRT, and BIA can predict mortality. Further large trials are needed to confirm the usefulness of BIA in critically ill patients.","PeriodicalId":31220,"journal":{"name":"Korean Journal of Critical Care Medicine","volume":"32 1","pages":"256 - 264"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41446436","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}

引用次数: 18

The Role of Transbronchial Lung Biopsy in Diagnosing Pulmonary Mucormycosis in a Critical Care Unit 经支气管肺活检在重症监护室诊断肺毛霉菌病中的作用

Korean Journal of Critical Care Medicine Pub Date : 2017-05-01 DOI: 10.4266/kjccm.2017.00150

Yoonki Hong, Jinkyeong Park

{"title":"The Role of Transbronchial Lung Biopsy in Diagnosing Pulmonary Mucormycosis in a Critical Care Unit","authors":"Yoonki Hong, Jinkyeong Park","doi":"10.4266/kjccm.2017.00150","DOIUrl":"https://doi.org/10.4266/kjccm.2017.00150","url":null,"abstract":"Background Pulmonary mucormycosis (PM) is an emerging infectious disease and a life-threatening infection with high mortality. The clinical outcomes of PM have not improved significantly over the last decade because early diagnosis of PM is difficult and antifungal agents show limited activity. We evaluated the clinical manifestations of PM in a Korean tertiary hospital and identified the role of transbronchial lung biopsy (TBLB) in diagnosing PM in patients admitted to an intensive care unit. Methods The medical records of adult patients (aged 16 years and older) who met the criteria for proven or probable PM in a Korean tertiary hospital were retrospectively reviewed from January 2003 to December 2013. The clinical features, computed tomographic findings, diagnostic methods, treatment, and outcomes in patients with PM were evaluated. Results Of the nine patients, four were male. The median age was 64 years (range, 12 to 73 years). PM was proven and probable in seven and two cases, respectively. Computed tomography findings of PM were unilateral involvement in eight cases (89%), consolidation in eight (89%), ground glass opacity in four (44%), and reverse halo sign in one (11%). Six of nine cases (67%) were diagnosed as PM from TBLB via portable bronchoscopy. There were no complications after TBLB. Mortality rate was 56% (five of nine cases). Conclusions TBLB can be an easy and useful technique for diagnosing PM in the intensive care unit.","PeriodicalId":31220,"journal":{"name":"Korean Journal of Critical Care Medicine","volume":"32 1","pages":"205 - 210"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46673548","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}

引用次数: 2