Publications by authors named "Chi Ryang Chung"
Background: Delirium, an acute brain dysfunction, is proposed to be highly prevalent in clinical care and shown to significantly increase the risk of mortality and dementia.
Objectives: To report on the global prevalence of clinically documented delirium and delirium-related clinical practices in wards caring for paediatric and adult patients in healthcare facilities.
Design: A prospective, cross-sectional, 39-question survey completed on World Delirium Awareness Day, 15 March 2023.
Article Synopsis
- This study investigates pulmonary fibrosis-like changes in critically ill patients with SARS-CoV-2 pneumonia during two different variant periods: delta and pre-delta.
- Clinical data and chest CT images were analyzed from a total of 184 patients across two time periods, revealing that those infected during the delta variant period displayed more severe fibrosis-like changes.
- The findings indicate that patients during the delta period had a higher frequency of significant fibrotic changes compared to the pre-delta group, suggesting the delta variant may be associated with worse pulmonary outcomes.
Article Synopsis
- After getting COVID-19 pneumonia, some patients develop lung problems like fibrosis, which is a scarring in the lungs.
- Researchers looked at 64 patients who needed help breathing in South Korea and found that more than half had signs of lung fibrosis on their scans.
- They discovered that being male and having a higher initial health score were linked to a greater chance of developing this lung issue.
Objectives: Sepsis is a leading global cause of mortality, and predicting its outcomes is vital for improving patient care. This study explored the capabilities of ChatGPT, a state-of-the-art natural language processing model, in predicting in-hospital mortality for sepsis patients.
Methods: This study utilized data from the Korean Sepsis Alliance (KSA) database, collected between 2019 and 2021, focusing on adult intensive care unit (ICU) patients and aiming to determine whether ChatGPT could predict all-cause mortality after ICU admission at 7 and 30 days.
Background: Delirium is a common complication of older people in hospitals, rehabilitation and long-term facilities.
Objective: To assess the worldwide use of validated delirium assessment tools and the presence of delirium management protocols.
Design: Secondary analysis of a worldwide one-day point prevalence study on World Delirium Awareness Day, 15 March 2023.
This study determined whether compared to conventional mechanical ventilation (MV), extracorporeal membrane oxygenation (ECMO) is associated with decreased hospital mortality or fibrotic changes in patients with COVID-19 acute respiratory distress syndrome. A cohort of 72 patients treated with ECMO and 390 with conventional MV were analyzed (February 2020-December 2021). A target trial was emulated comparing the treatment strategies of initiating ECMO vs no ECMO within 7 days of MV in patients with a PaO/FiO < 80 or a PaCO ≥ 60 mmHg.
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- Lactate is a common marker for sepsis but has limitations, prompting research into new biomarkers like plasma renin concentration and renin activity for better outcomes in patients with septic shock.
- A study involving 117 patients assessed the diagnostic accuracy of these renin measures along with lactate levels to predict mortality and kidney issues.
- Results indicated that while renin concentration and activity were similar to lactate in predicting 28-day mortality, they were more effective in forecasting acute kidney injury (AKI).
Objectives: To study the impact of a restrictive calcium replacement protocol in comparison with a liberal one in patients with septic shock.
Material And Methods: Multicenter retrospective before-after study that estimated the impact of implementing a restrictive calcium replacement protocol in patients with septic shock. Patients admitted to an intensive care unit between May 2019 and April 2021 were assigned to liberal calcium replacement, and those admitted between May 2021 and April 2022 were assigned to a restrictive protocol.
In a case of contrast media-induced anaphylactic shock managed with epinephrine, a 57-year-old male developed lactic acidosis without cardiogenic shock or global hypoperfusion, highlighting epinephrine's potential to trigger lactic acidosis. Despite previous management of similar reactions with antihistamines and corticosteroids, this case required intensive care unit admission and emergency intervention, with lactate levels peaking alarmingly. The rapid resolution of acidosis following epinephrine discontinuation underscores the need for careful monitoring and the consideration of alternative vasopressor strategies in severe anaphylaxis, illustrating the complex relationship between epinephrine's metabolic effects and anaphylaxis-induced tissue hypoperfusion.
View Article and Find Full Text PDFThe massive transfusion protocol (MTP) can improve the outcomes of trauma patients with hemorrhagic shock and some patients with non-traumatic hemorrhagic shock. However, no information is available regarding whether MTP can improve the outcomes of acute variceal bleeding (AVB). This study aimed to determine the effects of MTP on the outcomes of patients with AVB.
View Article and Find Full Text PDFBackground: Limited data are available on the relationship of disseminated intravascular coagulation (DIC) with mortality in patients receiving extracorporeal membrane oxygenation (ECMO). Thus, we investigated the association of DIC score and antithrombin (AT) III with clinical outcomes in patients undergoing ECMO.
Methods: We analyzed 703 patients who underwent ECMO between January 2014 and May 2022 at Samsung Medical Center.
Background: Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO.
Methods: We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021.
This retrospective cohort study aimed to evaluate the association between ambulatory status at discharge and six-month post-discharge mortality among adults with coronavirus disease (COVID-19). We analyzed data from 398 patients aged over 18 admitted to a tertiary hospital in South Korea between December 2019 and June 2022. Patients were classified into two groups based on their ambulatory status at discharge: ambulatory (able to walk independently, n = 286) and non-ambulatory (unable to walk independently, requiring wheelchair or bed-bound, n = 112).
View Article and Find Full Text PDFAims: Unplanned intensive care unit (ICU) readmissions contribute to increased morbidity, mortality, and healthcare costs. The severity of patient illness at ICU discharge may predict early ICU readmission. Thus, in this study, we investigated the association of cardiac ICU (CICU) discharge Sequential Organ Failure Assessment (SOFA) score with unplanned CICU readmission in patients admitted to the CICU.
View Article and Find Full Text PDFPulmonary artery catheterization (PAC) has been used as a clinical standard for cardiac output (CO) measurements on humans. On animals, however, an ultrasonic flow sensor (UFS) placed around the ascending aorta or pulmonary artery can measure CO and stroke volume (SV) more accurately. The objective of this paper is to compare CO and SV measurements using a noninvasive electrical impedance tomography (EIT) device and three invasive devices using UFS, PAC-CCO (continuous CO) and arterial pressure-based CO (APCO).
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- Cancer patients face high risks of short-term deterioration due to their treatments and complications, prompting the use of a rapid response system (RRS) to identify at-risk individuals.
- A retrospective study analyzed data from nearly 20,000 oncology patients admitted between 2016 and 2020 to develop a deep learning-based early warning score (Can-EWS) for predicting clinical deterioration.
- Two models were created, with Can-EWS V2 showing significantly better performance in predicting deterioration than existing methods, achieving a high area under the receiver operating curve (AUROC) of 0.898, demonstrating its effectiveness in clinical settings.
Article Synopsis
- * A systematic review of 11 studies published since 2004 was conducted, highlighting that while some results suggested shorter ICU stays, the overall evidence lacked consistency and reliability due to methodological issues.
- * Early EN was associated with a higher risk of intestinal-related complications in one study, but this finding was not supported by the majority of the reviewed literature, indicating that more robust research is needed in this area.
Background: Only some studies have directly compared and analyzed the roles of activated partial thromboplastin time (aPTT) and activated clotting time (ACT) in coagulation monitoring during argatroban administration.
Objectives: This study aims to assess the correlation of argatroban dose with ACT and aPTT values and to identify the optimal coagulation test for argatroban dose adjustment.
Methods: We evaluated 55 patients on extracorporeal membrane oxygenation (ECMO) who received argatroban for more than 72 hours.
Background: Respiratory quotient (RQ) may be used as a tissue hypoxia marker in various clinical settings but its prognostic significance in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) is not known.
Methods: Medical records of adult patients admitted to the intensive care units after ECPR in whom RQ could be calculated from May 2004 to April 2020 were retrospectively reviewed. Patients were divided into good neurologic outcome and poor neurologic outcome groups.
Article Synopsis
- The study examined how gender affects in-hospital mortality due to sepsis across different age groups, using data from a Korean nationwide cohort.
- A total of 6,442 patients were analyzed, revealing that although overall men had higher mortality odds (OR 1.15), younger men (19-50) had significantly lower mortality risk compared to women in the same age group (OR 0.57).
- Results showed distinct infection patterns and mortality trends: men experienced more respiratory infections, while women had more urinary tract infections, with men's mortality risk increasing linearly with age until 80, while women's risk remained stable until then.
A dysregulated hyperinflammatory response is a key pathogenesis of severe COVID-19, but optimal immune modulator treatment has not been established. To evaluate the clinical effectiveness of double (glucocorticoids and tocilizumab) and triple (plus baricitinib) immune modulator therapy for severe COVID-19, a retrospective cohort study was conducted. For the immunologic investigation, a single-cell RNA sequencing analysis was performed in serially collected PBMCs and neutrophil specimens.
View Article and Find Full Text PDFBackground: This study aimed to determine the optimal position of venovenous extracorporeal membrane oxygenation (V-V ECMO) draining cannulas for refractory respiratory failure based on short-term clinical results.
Methods: In total, 278 patients underwent V-V ECMO at our hospital between 2012 and 2020. Those who underwent V-V ECMO with a femorojugular configuration were included.
Background: Limited data are available on the association of malnutrition with the occurrence of delirium in the cardiac intensive care unit (CICU). Thus, we aimed to analyze whether nutritional indices and their components can predict the development of delirium in CICU.
Methods: We enrolled 2,783 patients admitted to the CICU of Samsung Medical Center for more than 24 h between September 2012 and December 2018.