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  • SAGE Publications  (4)
  • Hong, Sang-Bum  (4)
  • 1
    Online Resource
    Online Resource
    Epidemiology and Clinical Characteristics of Bloodstream Infection in Patients Under Extracorporeal Membranous Oxygenation
    SAGE Publications ; 2021
    In:  Journal of Intensive Care Medicine Vol. 36, No. 9 ( 2021-09), p. 1053-1060
    Details
    In: Journal of Intensive Care Medicine, SAGE Publications, Vol. 36, No. 9 ( 2021-09), p. 1053-1060
    Abstract: Bloodstream infection (BSI) is an important complication of extracorporeal membranous oxygenation (ECMO) and a major cause of mortality. This study evaluated the epidemiological and clinical characteristics of BSI that occur during ECMO application according to microbial etiology. Methods: Adult patients who underwent ECMO from January 2009 to December 2016 were retrospectively analyzed for BSI episodes at a 2,700-bed, tertiary center. Epidemiological and clinical characteristics and outcomes of BSI were evaluated and were compared for etiologic groups (gram-positive cocci, gram-negative rods, and fungi groups). Risk factors for 14-day mortality were analyzed. Results: A total of 1,100 patients underwent ECMO during the study period, and 65 BSI episodes occurred in 61 patients. The BSI incidence was 8.3 episodes/1,000 ECMO days, which significantly decreased over time ( P = 0.03), primarily in gram-positive cocci BSI. Gram-positive cocci, gram-negative rods, and fungi accounted for 38%, 40%, and 22% of the 73 blood isolates, respectively. Baseline characteristics were comparable between groups. Catheter-related infection (CRI) and pneumonia were the most common sources of BSI; 52% of gram-positive cocci BSIs and 79% of fungi BSIs were caused by CRI, and 75% of gram-negative BSIs by pneumonia. Patients with gram-negative rods BSI died more frequently and earlier than those with other BSIs. Independent risk factors for 14-day mortality were older age and gram-negative rods BSI. Conclusions: The decreased BSI incidence during ECMO was mainly because of the decrease of gram-positive cocci BSI. The high early mortality of gram-negative rods BSI makes prevention and adequate treatment necessary.
    Type of Medium: Online Resource
    ISSN: 0885-0666 , 1525-1489
    URL: Article
    DOI: 10.1177/0885066620985538
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2001472-7
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  • 2
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    Development and validation of an arterial blood gas analysis interpretation algorithm for application in clinical laboratory services
    SAGE Publications ; 2011
    In:  Annals of Clinical Biochemistry: International Journal of Laboratory Medicine Vol. 48, No. 2 ( 2011-03), p. 130-135
    Details
    In: Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, SAGE Publications, Vol. 48, No. 2 ( 2011-03), p. 130-135
    Abstract: Arterial blood gas analysis (ABGA) is a useful test that estimates the acid–base status of patients. However, numerically reported test results make rapid interpretation difficult. To overcome this problem, we have developed an algorithm that automatically interprets ABGA results, and assessed the validity of this algorithm for applications in clinical laboratory services. Methods The algorithm was developed based on well-established guidelines using three test results (pH, PaCO 2 and [HCO 3 − ]) as variables. Ninety-nine ABGA test results were analysed by the algorithm. The algorithm's interpretations and the interpretations of two representative web-based ABGA interpretation programs were compared with those of two experienced clinicians. Results The concordance rates between the interpretations of each of the two clinicians and the algorithm were 91.9% and 97.0%, respectively. The web-based programs could not issue definitive interpretations in 15.2% and 25.3% of cases, respectively, but the algorithm issued definitive interpretations in all cases. Of the 10 cases that invoked disagreement among interpretations by the algorithm and the two clinicians, half were interpreted as compensated acid–base disorders by the algorithm but were assessed as normal by at least one of the two clinicians. In no case did the algorithm indicate a normal condition that the clinicians assessed as an abnormal condition. Conclusions The interpretations of the algorithm showed a higher concordance rate with those of experienced clinicians than did two web-based programs. The algorithm sensitively detected acid–base disorders. The algorithm may be adopted by the clinical laboratory services to provide rapid and definitive interpretations of test results.
    Type of Medium: Online Resource
    ISSN: 0004-5632 , 1758-1001
    URL: Article
    DOI: 10.1258/acb.2010.010180
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2041298-8
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  • 3
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    Online Resource
    Clinical outcomes of patients receiving prolonged extracorporeal membrane oxygenation for respiratory support
    SAGE Publications ; 2019
    In:  Therapeutic Advances in Respiratory Disease Vol. 13 ( 2019-01), p. 175346661984894-
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    In: Therapeutic Advances in Respiratory Disease, SAGE Publications, Vol. 13 ( 2019-01), p. 175346661984894-
    Abstract: There are limited data regarding prolonged extracorporeal membrane oxygenation (ECMO) support, despite increase in ECMO use and duration in patients with respiratory failure. The objective of this study was to investigate the outcomes of severe acute respiratory failure patients supported with prolonged ECMO for more than 28 days. Methods: Between January 2012 and December 2015, all consecutive adult patients with severe acute respiratory failure who underwent ECMO for respiratory support at 16 tertiary or university-affiliated hospitals in South Korea were enrolled retrospectively. The patients were divided into two groups: short-term group defined as ECMO for ⩽28 days and long-term group defined as ECMO for more than 28 days. In-hospital and 6-month mortalities were compared between the two groups. Results: A total of 487 patients received ECMO support for acute respiratory failure during the study period, and the median support duration was 8 days (4–20 days). Of these patients, 411 (84.4%) received ECMO support for ⩽28 days (short-term group), and 76 (15.6%) received support for more than 28 days (long-term group). The proportion of acute exacerbation of interstitial lung disease as a cause of respiratory failure was higher in the long-term group than in the short-term group (22.4% versus 7.5%, p  〈  0.001), and the duration of mechanical ventilation before ECMO was longer (4 days versus 1 day, p  〈  0.001). The hospital mortality rate (60.8% versus 69.7%, p = 0.141) and the 6-month mortality rate (66.2% versus 74.0%, p = 0.196) were not different between the two groups. ECMO support longer than 28 days was not associated with hospital mortality in univariable and multivariable analyses. Conclusions: Short- and long-term survival rates among patients receiving ECMO support for more than 28 days for severe acute respiratory failure were not worse than those among patients receiving ECMO for 28 days or less.
    Type of Medium: Online Resource
    ISSN: 1753-4666 , 1753-4666
    URL: Article
    DOI: 10.1177/1753466619848941
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2387506-9
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  • 4
    Online Resource
    Online Resource
    Prognosis of Acute Respiratory Distress Syndrome in Patients With Hematological Malignancies
    SAGE Publications ; 2020
    In:  Journal of Intensive Care Medicine Vol. 35, No. 4 ( 2020-04), p. 364-370
    Details
    In: Journal of Intensive Care Medicine, SAGE Publications, Vol. 35, No. 4 ( 2020-04), p. 364-370
    Abstract: The intensive care unit (ICU) admission of patients with hematologic malignancies is gradually increasing. Life-threatening events are common, and acute respiratory distress syndrome (ARDS) is one of the most critical conditions. The aim of this study was to investigate the clinical characteristics and outcomes of ARDS in patients with hematological malignancies admitted to the ICU. Methods: A retrospective study was performed on all patients with ARDS with hematological malignancies in a single tertiary teaching hospital between 2008 and 2015. Data on the treatment of and the outcomes of ARDS were collected to determine the clinical characteristics associated with ICU mortality. Results: During the 8-year study period, among a total of 821 patients with ARDS admitted to the ICU, all 185 patients with hematological malignancies were included in the analysis. Most of the patients (88.1%) had moderate-to-severe ARDS, and the median PaO 2 /FiO 2 ratio was 122 (interquartile range: 88-157). The overall ICU mortality rate was 57.3% (50.0% for mild, 52.0% for moderate, and 67.7% for severe ARDS). After the univariate and the multivariate logistic regressions, the factors independently associated with a higher ICU mortality were severe ARDS (odds ratio [OR]: 2.47; 95% confidence interval [CI] : 1.17-5.25), identification of carbapenem-resistant gram-negative bacteria (OR: 6.61; 95% CI: 1.31-33.41), the amount of blood product transfusion (OR: 1.25; 95% CI: 1.13-1.38), and the progressive or refractory disease (OR: 3.01; 95% CI: 1.31-6.91). Mortality was independently lower in patients who received the initial low tidal volume ventilation (OR: 0.37, 95% CI: 0.14-0.96). Conclusion: The outcome of ARDS in patients with hematological malignancies is associated with the severity of the underlying diseases, the presence of multidrug-resistance pathogens, and the amount of transfusion; however, strict application of low tidal volume ventilation may improve the outcome of these patients at the time of diagnosis.
    Type of Medium: Online Resource
    ISSN: 0885-0666 , 1525-1489
    URL: Article
    DOI: 10.1177/0885066617753566
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2001472-7
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