Multicenter validation of a machine learning model to predict intensive care unit readmission within 48 hours after discharge.

Background: Intensive care unit (ICU) readmission is a crucial indicator of patient safety. However, discharge decisions often rely on subjective assessment due to a lack of standardized guidelines. We aimed to develop a machine-learning model to predict ICU readmission within 48 h and compare its performance to traditional scoring systems.

Feasibility of estimating tidal volume from electrocardiograph-derived respiration signal and respiration waveform.

Purpose: Estimating tidal volume (V) from electrocardiography (ECG) can be quite useful during deep sedation or spinal anesthesia since it eliminates the need for additional monitoring of ventilation. This study aims to validate and compare V estimation methodologies based on ECG-derived respiration (EDR) using real-world clinical data.

Materials And Methods: We analyzed data from 90 critically ill patients for general analysis and two critically ill patients for constrained analysis.

Impact of renal replacement therapy modality on coagulation and platelet function in critically ill patients: A prospective observational study.

Background: Renal replacement therapy (RRT) may affect coagulation and platelet function in critically ill patients. However, the mechanism and the difference in the impact on coagulation between intermittent hemodialysis (iHD) and continuous renal replacement therapy (CRRT) remains unclear. This study aimed to investigate and compare the impact of iHD and CRRT on coagulation and platelet function.

Efficacy of Virtual Visitation in ICU During COVID-19 Pandemic: The ICU Visits Randomized Controlled Trial.

Objectives: This study aimed to demonstrate the impact of virtual visits on the satisfaction of family members and the anxiety and depression of patients in the ICU during the COVID-19 pandemic.

Design: A single-center, randomized controlled trial.

Setting: This study was conducted from July 2021 to May 2022, in the Seoul National University Hospital.

VASOPRESSOR REDUCTION EFFECT OF POLYMYXIN B HEMOPERFUSION IN PATIENTS WITH PERITONITIS-INDUCED SEPTIC SHOCK: A PROPENSITY SCORE-MATCHED ANALYSIS.

Background : This study aimed to evaluate the effect of polymyxin B hemoperfusion (PMX-HP) in patients with peritonitis-induced septic shock who still required high-dose vasopressors after surgical source control. Methods : This retrospective study included adult patients admitted to the surgical intensive care unit (ICU) at Seoul National University Hospital between July 2014 and February 2021 who underwent major abdominal surgery to control the source of sepsis. Patients were divided into two groups based on whether PMX-HP was applied after surgery or not.

Perioperative urinary ketosis and metabolic acidosis in patients fasted for undergoing gynecologic surgery.

Background: Our bodies have adaptive mechanisms to fasting, in which glycogen stored in the liver and muscle protein are broken down, but also lipid mobilisation is triggered. As a result, glycerol and fatty acids are released into the bloodstream, increasing the production of ketone bodies in liver. However, there are limited studies on the incidence of perioperative urinary ketosis, the intraoperative blood glucose changes and metabolic acidosis after fasting for surgery in non-diabetic adult patients.

Real-time machine learning model to predict short-term mortality in critically ill patients: development and international validation.

Background: A real-time model for predicting short-term mortality in critically ill patients is needed to identify patients at imminent risk. However, the performance of the model needs to be validated in various clinical settings and ethnicities before its clinical application. In this study, we aim to develop an ensemble machine learning model using routinely measured clinical variables at a single academic institution in South Korea.

Real-time machine learning model to predict in-hospital cardiac arrest using heart rate variability in ICU.

Predicting in-hospital cardiac arrest in patients admitted to an intensive care unit (ICU) allows prompt interventions to improve patient outcomes. We developed and validated a machine learning-based real-time model for in-hospital cardiac arrest predictions using electrocardiogram (ECG)-based heart rate variability (HRV) measures. The HRV measures, including time/frequency domains and nonlinear measures, were calculated from 5 min epochs of ECG signals from ICU patients.

The effect of audiovisual feedback of monitor/defibrillators on percentage of appropriate compression depth and rate during cardiopulmonary resuscitation.

Background: High quality cardiopulmonary resuscitation (CPR) is one of the key elements of the survival chain in cardiac arrest. Audiovisual feedback of chest compressions have been suggested to be beneficial by increasing the quality of CPR in the simulated cardiac arrests.

Methods: A prospective before and after study was performed to investigate the effect of a real-time audiovisual feedback system on CPR quality during in-hospital cardiac arrest in intensive care units from November 2018 to February 2022.

Timing of prophylactic antibiotics administration and suspected systemic infection after percutaneous biliary intervention.

Background/purpose: Prophylactic antibiotics administration before percutaneous biliary intervention (PBI) is currently recommended, but the underlying evidence is mostly extrapolated from prophylactic antibiotics before surgery. The aim of this study was to evaluate the impact of prophylactic antibiotics administration timing on the incidence of suspected systemic infection after PBI.

Methods: The incidence of suspected systemic infection after PBI was compared in patients who received prophylactic antibiotics at four different time intervals between antibiotics administration and skin puncture for PBI.

The Association Between Institutional Case Volume of Hematopoietic Stem Cell Transplantation and Mortality.

Background: Hematopoietic stem cell transplantation (HSCT) is a complex, high-risk procedure with significant morbidity and mortality. The positive impact of higher institutional case volume on survival has been reported in various high-risk procedures. The association between annual institutional HSCT case volume and mortality was analyzed using the National Health Insurance Service database.

Early Postoperative Fever and Atelectasis in Patients Undergoing Upper Abdominal Surgery.

Background: Atelectasis is a common complication after upper abdominal surgery and considered as a cause of early postoperative fever (EPF) within 48 hours after surgery. However, the pathophysiologic mechanism of how atelectasis causes fever remains unclear.

Study Design: Data for adult patients who underwent elective major upper abdominal surgery under general anesthesia at Seoul National University Hospital between January and December of 2021 were retrospectively analyzed.

Impact of institutional case volume on intensive care unit mortality.

The primary aim of this review is to explore current knowledge on the relationship between institutional intensive care unit (ICU) patient volume and patient outcomes. Studies indicate that a higher institutional ICU patient volume is positively correlated with patient survival. Although the exact mechanism underlying this association remains unclear, several studies have proposed that the cumulative experience of physicians and selective referral between institutions may play a role.

The Profile of Early Sedation Depth and Clinical Outcomes of Mechanically Ventilated Patients in Korea.

Background: Current international guidelines recommend against deep sedation as it is associated with worse outcomes in the intensive care unit (ICU). However, in Korea the prevalence of deep sedation and its impact on patients in the ICU are not well known.

Methods: From April 2020 to July 2021, a multicenter, prospective, longitudinal, noninterventional cohort study was performed in 20 Korean ICUs.

Impact of institutional case volume of solid organ transplantation on patient outcomes and implications for healthcare policy in Korea.

Solid organ transplantation is distinguished from other high-risk surgical procedures by the fact that it utilizes an extremely limited and precious resource and requires a multidisciplinary team approach. For several decades, institutional experience, as quantified by center volume, has been shown to be strongly associated with patient outcomes and graft survival after solid organ transplantation. The United States has implemented a minimum case volume requirement and performance standards for accreditation as a validated transplantation center.

Continuous versus intermittent infusion of human antithrombin III concentrate in the immediate postoperative period after liver transplantation.

Antithrombin-III (AT-III) concentrates have been used in the immediate postoperative period after liver transplantation to prevent critical thrombosis. We aimed to investigate a more appropriate method for AT-III concentrate administration to maintain plasma AT-III activity level within the target range. In this randomized controlled trial, 130 adult patients undergoing living-donor liver transplantation were randomized to either the intermittent group or continuous group.

Effect of Hospital Case-Volume on Mortality after Ovarian Cancer Surgery: A Population-Based Retrospective Cohort Study.

Objectives: The goal of ovarian cancer surgery has recently shifted from optimal cytoreduction to more complete resection. This study attempted to reassess and update the association between surgical case-volume and both in-hospital and long-term mortality after ovarian cancer surgery using recent data.

Design: This study is a population-based retrospective cohort study.

Institutional case volume and mortality after aortic and mitral valve replacement: a nationwide study in two Korean cohorts.

Background: There are only a handful of published studies regarding the volume-outcome relationship in heart valve surgery. We evaluated the association between institutional case volume and mortality after aortic valve replacement (AVR) and mitral valve replacement (MVR).

Methods: Two separate cohorts of all adults who underwent AVR or MVR, respectively, between 2009 and 2016 were analyzed using a Korean healthcare insurance database.

Hospital case-volume and mortality after lung cancer surgery: A population-based retrospective cohort study.

Objectives: Recent advances in lung cancer treatment warrants reassessment of the volume-outcome association in lung cancer surgery. This study reassessed the relationship between surgical case-volume and both in-hospital and long-term mortality after lung cancer surgery using a current database to reflect recent advances.

Materials And Methods: Using the database of the National Health Insurance Service in Korea, data of all adult patients who underwent lung cancer surgery in Korea between 2005 and 2019 were obtained.

Efficacy of nutritional support protocol for patients with pressure ulcer: comparison of before and after the protocol.

Objectives: Because most patients who develop pressure ulcer (PU) are malnourished, additional nutritional support is important for PU improvement. The aim of this study was to investigate the potential benefit of a simple nutritional support protocol in PU improvement.

Methods: This study was a comparative before-and-after study, prospectively performed from May to December 2020.

Risk prediction models incorporating institutional case volume for mortality after hip fracture surgery in the elderly.

Introduction: While higher institutional case volume is associated with better postoperative outcomes in various types of surgery, institutional case volume has been rarely included in risk prediction models for surgical patients. This study aimed to develop and validate the predictive models incorporating institutional case volume for predicting in-hospital mortality and 1-year mortality after hip fracture surgery in the elderly.

Materials And Methods: Data for all patients (≥ 60 years) who underwent surgery for femur neck fracture, pertrochanteric fracture, or subtrochanteric fracture between January 2008 and December 2016 were extracted from the Korean National Health Insurance Service database.