Journal Detail Information

1

Cite

Share

Thrombosed Fusiform Aneurysm Presented as Transient Lateral Medullary Ischemia: A Case Report.

Ha Cheol CHOI ; Hyoung Seok LIM ; Sun Young OH ; Byoung Soo SHIN

The Korean Journal of Critical Care Medicine.2012;27(1):52-54. doi:10.4266/kjccm.2012.27.1.52

The frequency of vertebral artery aneurysm is rare and a common presenting sign is subarachnoid hemorrhage. Lateral medullary syndrome is characterized by loss of pain and temperature sensation on the contra lateral lesion side of the body and ipsilateral lesion side of the face, dysphagia, dysarthria, ataxia, vertigo, nystagmus, and Horner syndrome. Vertebral artery dissecting aneurysm is a common cause of lateral medullary infarction. We present a rare case of a 46-year old male patient that developed ischemic attack presenting as transient lateral medullary syndrome due to thrombosed-fusiform aneurysm of vertebral artery. He was treated with aspirin and heparin, and then discharged with complete resolution of symptoms.
Aneurysm ; Aneurysm, Dissecting ; Aspirin ; Ataxia ; Deglutition Disorders ; Dysarthria ; Heparin ; Horner Syndrome ; Humans ; Infarction ; Lateral Medullary Syndrome ; Male ; Sensation ; Subarachnoid Hemorrhage ; Thrombosis ; Vertebral Artery ; Vertigo

2

Cite

Share

Healthcare Professional's Knowledge, Perception and Performance on Early Enteral Nutrition for Critically Ill Patients.

Sun Hee YUN ; Sun Jung KIM ; Eui Geum OH

The Korean Journal of Critical Care Medicine.2012;27(1):36-44. doi:10.4266/kjccm.2012.27.1.36

BACKGROUND: Proper nutritional supplement is one of the fundamental management domains for critical ill patients. While it shows positive effect on processing and prognosis of critical ill patients, early enteral nutrition is overlooked. This study explored healthcare professional's level of knowledge perception and performance on early enteral nutrition for critically ill patients. Data was collected from a convenient sample of 319 registered doctors, nurses and nutritionists in ICU at seven university hospitals. METHODS: A cross-sectional survey design was used. The participants were assessed by questionnaires, specifically designed for the study and verified for the content validity by professional reviewers related with critical ill patients. RESULTS: While the level of the perception of early enteral nutrition is high, the level of knowledge and performance are relatively low. The nurses showed a statistically significant difference on the level of knowledge, by their educational backgrounds and clinical experiences. Regarding the hospital support system, the doctors showed a significant difference on the level of perception and performance, while the nurses only showed that difference on the level of performance. It was shown that with higher the level of knowledge regarding the early enteral nutrition, the higher the level of performance. Further, the higher the level of perception, the higher the level of performance was observed. The hospital support system and the perception of the healthcare professionals are two most influential factors to affect the performance of the healthcare professionals related with the early enteral nutrition for the critically ill patients. CONCLUSION: To perform the proper early enteral nutrition, the hospital support system and the level of the healthcare professionals' perception, are two most important factors. Therefore, the efforts to build the hospital support system along with the educational provisions are needed.
Critical Illness ; Cross-Sectional Studies ; Delivery of Health Care ; Enteral Nutrition ; Humans ; Prognosis ; Surveys and Questionnaires

3

Cite

Share

Surgical Management for Pulmonary Artieriole Rupture During Subclavian Vein Catheterization: A Case Report.

Jiae MIN ; Hyun Koo KIM ; Ho Kyung SUNG ; Hyun Joo LEE ; Young Ho CHOI

The Korean Journal of Critical Care Medicine.2012;27(1):59-61. doi:10.4266/kjccm.2012.27.1.59

We experienced an extremely unusual case of a 37-year-old woman who suffered from hemothorax soon after subclavian vein catheterization. Many case reports of a hemothorax or hematoma after central vein catheterization through the great vessels, such as the subclavian vein and internal jugular vein, have been published. However, this rare case showed a pinpoint-sized active bleeding site from a pulmonary arteriole rupture. During an emergency operation using thoracoscopy-assisted minithoracotomy, this bleeding site was successfully managed by primary repair.
Adult ; Arterioles ; Catheterization ; Catheterization, Central Venous ; Catheters ; Emergencies ; Female ; Hematoma ; Hemorrhage ; Hemothorax ; Humans ; Jugular Veins ; Rupture ; Subclavian Vein ; Veins

4

Cite

Share

Transient Dilation of the Membranous Trachea after Endotracheal Intubation: A Case Report.

Seung CHOI ; Eun Woo LEE ; Myung Ho YUN ; Jae Young PARK ; Cheol Hwan KIM ; Jae Won BEOM ; Gun PARK

The Korean Journal of Critical Care Medicine.2012;27(1):55-58. doi:10.4266/kjccm.2012.27.1.55

Endotracheal intubation is a quick, simple and safe procedure for airway management and is used in various medical procedures. Many endotracheal tubes have a cuff system, which prevents aspiration and allows positive pressure ventilation. However excessive inflation of the cuff can cause mucosal ischemia with tracheal dilation which may result in tracheal rupture, or even death. Fortunately, mucosal ischemia of the trachea can be treated successfully with well-timed control of cuff pressure. It is essential for medical practitioners to be aware of these complications and to be able to manage them effectively if they arise. We present a case of diverticular-like dilation of the lower trachea detected by fiberoptic bronchoscopy that eventually improved in the hemoptysis patient after endotracheal intubation.
Airway Management ; Bronchoscopy ; Hemoptysis ; Humans ; Inflation, Economic ; Intubation, Intratracheal ; Ischemia ; Positive-Pressure Respiration ; Rupture ; Trachea

5

Cite

Share

Central Venous Catheter Misplaced in the Innominate Vein after Penetrating the Left Subclavian Vein in a Neonate: A Case Report.

Sang Wook SHIN ; Ji Uk YOON ; Hyeon Jeong LEE ; O Sun KWON ; Hyun Mok KIM

The Korean Journal of Critical Care Medicine.2012;27(1):49-51. doi:10.4266/kjccm.2012.27.1.49

In the pediatric ICU and operating room, a central venous catheter (CVC) provides accurate hemodynamic information and serves as a reliable route for the administration of vasoactive drugs, fluids and allogeneic blood products. The placement of CVC is associated with a complication rate of 0.4% to 20%, including hemothorax, pneumothorax, thrombosis, infection and cardiac tamponade. We describe a case of CVC being misplaced in the innominate vein after penetrating the subclavian vein during anesthesia induction for arterial switch operation. Our report discusses the mechanisms by which this mishap took place, and reviews the proper positions of the head, arm, thorax and safe depth of venipuncture for the placement of a CVC in neonates.
Anesthesia ; Arm ; Brachiocephalic Veins ; Cardiac Tamponade ; Central Venous Catheters ; Head ; Hemodynamics ; Hemothorax ; Humans ; Hypogonadism ; Infant, Newborn ; Mitochondrial Diseases ; Operating Rooms ; Ophthalmoplegia ; Phlebotomy ; Pneumothorax ; Subclavian Vein ; Thorax ; Thrombosis

6

Cite

Share

Knotting of Pulmonary Artery Catheter During Tricuspid Valve Surgery: A Case Report.

Kyung Chen LEE ; Wol Seon JUNG ; Yong Beom KIM ; Ji Yeon LEE

The Korean Journal of Critical Care Medicine.2012;27(1):45-48. doi:10.4266/kjccm.2012.27.1.45

The use of pulmonary artery catheter can be helpful in managing patients after cardiac surgery. Nevertheless, there is a risk of serious complications, such as knotting. A 61 year old man underwent tricuspid valve replacement under cardiopulmonary bypass (CPB). After implantation of a stented tissue valve in the tricuspid valve, repositioning of the catheter was performed. After weaning from CPB, an abnormal pattern of pulmonary artery pressure was suddenly observed on the monitor. Resistance was met when removing the catheter with the balloon deflated, at a 20 cm distance from the tip of the catheter. Chest radiography showed a knot in the catheter within the right brachiocephalic vein. Superior vena cava opened and the distal part of the catheter with the knot was successfully removed.
Brachiocephalic Veins ; Cardiopulmonary Bypass ; Catheters ; Humans ; Organothiophosphorus Compounds ; Pulmonary Artery ; Stents ; Thoracic Surgery ; Thorax ; Tricuspid Valve ; Vena Cava, Superior ; Weaning

7

Cite

Share

Blunt Splenic Injury by Gunshot.

Young Hoon SUL ; Sang Il LEE ; Kwang Sik CHEON ; Jae Young MOON ; Jun Wan LEE ; In Sang SONG

The Korean Journal of Critical Care Medicine.2013;28(4):340-343. doi:10.4266/kjccm.2013.28.4.340

Trauma is frequently not purely penetrating or purely blunt. Such mixed trauma can result from the mechanism of injury. Recently, we encountered a patient who accidentally shot himself with a shotgun. He had a 15 x 8-cm-sized penetrating injury on left flank that did not penetrate into the peritoneal cavity and a blunt splenic injury with hemoperitoneum. Surgical and interventional treatments were performed for each injury. We present this case with a review of the related literature.
Hemoperitoneum ; Humans ; Peritoneal Cavity

8

Cite

Share

Initiation of Continuous Renal Replacement Therapy and Clinical Outcome in Septic Shock Patients with Acute Kidney Injury.

Seung Mok RYOO ; Won Young KIM ; Sang Sik CHOI ; Jin Won HUH ; Sang Bum HONG ; Chae Man LIM ; Younsuck KOH

The Korean Journal of Critical Care Medicine.2012;27(1):29-35. doi:10.4266/kjccm.2012.27.1.29

BACKGROUND: Initiation of renal replacement therapy (RRT) in critically ill septic shock patients with acute kidney injury is highly subjective and may influence outcome. The aim of this study is to evaluate the relationship between initiation of RRT and 28 day mortality in patients with severe sepsis and septic shock (SSSS). METHODS: All patients diagnosed with SSSS and treated at the medical intensive care unit (ICU) in university-affiliated hospital from January 2005 to December 2006 were reviewed. Initiation of RRT was stratified into "early" and "late" by RIFLE (Risk, Injury, Failure, Loss, and End-stage) criteria and blood urea nitrogen (BUN) at the time RRT began. The primary outcome was death after 28 days from any cause. RESULTS: Of the 326 patients diagnosed with SSSS and admitted into the medical ICU during the study period, 78 patients received RRT. Mean age was 61.5 +/- 14.7 years old and 54 patients were male (69.2%). The initiation of RRT was categorized into early (Risk, and Injury) and late (Failure) by RIFLE criteria and also categorized into early (BUN < 75 mg/dl) and late (BUN > or = 75 mg/dl). When the relationship between RIFLE criteria and 28 day mortality was compared, no significant difference was shown (70.8% vs. 73.3%, p = 0.81). The initiation of RRT by BUN also showed no significant difference in 28 day mortality (77.3% vs. 69.6%, p = 0.50). CONCLUSIONS: Initiation of RRT, stratified into "early" and "late" by RIFLE and BUN, showed no significant difference in 28 day mortality regarding patient with SSSS.
Acute Kidney Injury ; Blood Urea Nitrogen ; Critical Illness ; Humans ; Intensive Care Units ; Male ; Renal Replacement Therapy ; Sepsis ; Shock, Septic

9

Cite

Share

Transfusion-related Acute Lung Injury.

Miok KIM

The Korean Journal of Critical Care Medicine.2012;27(1):1-4. doi:10.4266/kjccm.2012.27.1.1

Transfusion-related acute lung injury (TRALI) is a significant cause of iatrogenic injuries in patients. It is also the major cause of transfusion-associated fatalities. Pathophysiologic mechanism is an implicated donor of HLA. Neutrophil antibodies and biologic response modifiers are accumulated in the stored blood products. Pulmonary endothelial activation of the host may be the response from these mediators. Treatment is supportive and will be subjected to other forms of ALL/ARDS. Diverting donors at high risk for alloimmunization may decrease the incidence of such cases.
Acute Lung Injury ; Antibodies ; Blood Transfusion ; Humans ; Incidence ; Neutrophils ; Tissue Donors

10

Cite

Share

Difficult intubation managed by laryngeal mask airway: 4 cases-.

Chyun Kyu CHO ; Gil Hoi KOO ; Hong Seok YANG

The Korean Journal of Critical Care Medicine.1991;6(2):115-121.

No abstract available.
Intubation* ; Laryngeal Masks*

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share