Characteristics and management of mechanically ventilated patients in South Korea compared with other high-income Asian countries and regions.

Background: This study investigated the characteristics of mechanically ventilated patients in South Korean intensive care units (ICUs).

Methods: We conducted a subgroup analysis of a multinational observational study. Data from 271 mechanically ventilated patients in South Korean ICUs were analyzed for demographics, ventilation practices, and mortality, and were compared with those of 327 patients from other high-income Asian countries.

Serum proteomes and their prognostic values in sepsis patients admitted to a medical intensive care unit: a single-center study using SWATH-MS proteomics.

Background: Recent developments in proteomics suggest opportunities to understand the pathophysiological heterogeneity of sepsis and provide precision medicine tailored to individual patients. This study aims to evaluate the serum proteomic profiles of patients with sepsis using Sequential Window Acquisition of All Theoretical Mass Spectra proteomics and identify novel biomarkers for assessing sepsis severity and predicting patient outcomes in the ICU.

Methods: This retrospective cohort study included 217 adult patients diagnosed with bacterial sepsis who were admitted to a medical ICU at a single tertiary hospital between January 2011 and January 2020, along with 292 healthy controls.

Optimal time and volume of fluid resuscitation in patients with sepsis: a nationwide multicenter cohort study.

The optimal fluid resuscitation strategy for managing sepsis remains unknown. We aimed to examine the independent and joint associations of infusion time and volume of fluid resuscitation on mortality in patients with sepsis. We analyzed adult patients with sepsis who received > 20 mL/kg of fluid for initial resuscitation within 6 h after the start of fluid resuscitation from prospectively collected nationwide data at 15 hospitals in South Korea between September 2019 and December 2022.

Physical and Cognitive Impairments at ICU Discharge are Associated with High Long-Term Mortality in ICU Survivors with Solid Malignancies: A Retrospective Cohort Study.

Background: Many ICU survivors experience post-ICU physical, cognitive, or mental impairments. In ICU survivors with solid malignancies, post-ICU impairments can impede further cancer treatments and negatively impact their outcomes. This study aimed to investigate post-ICU mortalities and their risk factors at ICU discharge in ICU survivors with solid malignancies.

Gaylussacin, a stilbene glycoside, inhibits chronic obstructive pulmonary disease in mice.

Chronic obstructive pulmonary disease (COPD) is a major cause of human mortality worldwide and is closely associated with chronic inflammation triggered by environmental toxicants such as lead (Pb) and cadmium (Cd). However, the molecular mechanisms linking Pb/Cd exposure to COPD pathogenesis and effective therapeutic strategies remain poorly defined. In this study, we established a mouse model of environmentally induced COPD by exposing mice to Pb/Cd aerosols using a specialized nebulizer system.

High Tidal Volume Variability Is Associated With Worse Outcomes in Patients With ARDS.

The impact of spontaneous breathing during mechanical ventilation on the outcome of ARDS has yet to be established. This study aimed to evaluate the effect of tidal volume variability on ventilator-free days in mechanically ventilated subjects with ARDS using high-resolution tidal volume data collected through patient monitors. This single-center, retrospective cohort study included adult subjects with ARDS who received mechanical ventilation in our medical ICU between April 2018 and July 2019.

Physiological effects of bi-level high-flow nasal cannula in healthy individuals: a proof of concept trial.

Background: High-flow nasal cannula (HFNC) delivers a continuous, unidirectional high flow of oxygen (Uniflow) throughout the respiratory cycle. Despite its positive pressure effects in the nasopharynx, the persistent high flow during expiration imposes additional work of breathing and disrupts the patient's neural respiratory cycle. We devised a bi-level high-flow system (Biflow) allowing separate flow rate adjustments for inspiration and expiration.

Corticosteroid Therapy for Diffuse Alveolar Hemorrhage with Respiratory Failure in Hematologic Malignancies: A Retrospective Cohort Study.

Background: Although DAH in hematopoietic stem cell transplantation recipients is commonly treated with systemic corticosteroids, the efficacy of steroid therapy on DAH with respiratory failure in hematologic malignancy patients has not been studied. We aimed to investigate the effectiveness of steroid therapy in hematologic malignancy patients who developed DAH with respiratory failure and required treatment in the intensive care unit (ICU).

Methods: Among DAH patients with leukemia, lymphoma, or multiple myeloma, those who were not admitted to the ICU were excluded.

Prognostic value of cardiac CT-derived RV dysfunction in lung transplantation candidates: A single-center retrospective study.

Background: There are no specific criteria for listing and prioritizing lung transplantation (LTx) candidates based on the severity of right ventricular (RV) dysfunction. We evaluated the prognostic value of cardiac CT-derived right ventricular ejection fraction (RVEF) in LTx candidates.

Methods: This retrospective study included patients who were listed for LTx and underwent cardiac computed tomography (CT) between September 2019 and December 2023.

Improved Results Over Time With Bridge-to-Lung Transplantation: A 10-Year Experience of a Single High-Volume Center.

When donor scarcity limits timely lung transplantation (LTx), extracorporeal membrane oxygenation (ECMO) as a bridge to transplantation (BTT) can prolong survival and delay deconditioning until the donor lungs become available. We reviewed 10-year BTT experiences of a single high-volume center, where 99 (59%) were on ECMO BTT among 169 eligible adult LTx cases. Both 28-day and 2-year survivals did not differ between BTT and non-BTT.

Short-term and long-term outcomes of critically ill patients with solid malignancy: a retrospective cohort study.

Background/aims: With the global increase in patients with solid malignancies, it is helpful to understand the outcomes of intensive care unit (ICU) admission for these patients. This study evaluated the risk factors for ICU mortality and the shortand long-term outcomes in patients with solid malignancies who had unplanned ICU admission.

Methods: This retrospective cohort study included patients with solid malignancies treated at the medical ICU of a single tertiary center in South Korea between 2016 and 2022.

Tobacco-induced hyperglycemia promotes lung cancer progression via cancer cell-macrophage interaction through paracrine IGF2/IR/NPM1-driven PD-L1 expression.

Tobacco smoking (TS) is implicated in lung cancer (LC) progression through the development of metabolic syndrome. However, direct evidence linking metabolic syndrome to TS-mediated LC progression remains to be established. Our findings demonstrate that 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone and benzo[a]pyrene (NNK and BaP; NB), components of tobacco smoke, induce metabolic syndrome characteristics, particularly hyperglycemia, promoting lung cancer progression in male C57BL/6 J mice.

Outcomes of Lung Transplantation in Patients With Right Ventricular Dysfunction: A Single-Center Retrospective Analysis Comparing ECMO Configurations in a Bridge-to-Transplant Setting.

This study aimed to assess the lung transplantation (LT) outcomes of patients with right ventricular dysfunction (RVD), focusing on the impact of various extracorporeal membrane oxygenation (ECMO) configurations. We included adult patients who underwent LT with ECMO as a bridge-to-transplant from 2011 to 2021 at a single center. Among patients with RVD ( = 67), veno-venous (V-V) ECMO was initially applied in 79% (53/67) and maintained until LT in 52% (35/67).

The association of arterial partial oxygen pressure with mortality in critically ill sepsis patients: a nationwide observational cohort study.

Background: Although several trials were conducted to optimize the oxygenation range in intensive care unit (ICU) patients, no studies have yet reached a universal recommendation on the optimal a partial pressure of oxygen in arterial blood (PaO) range in patients with sepsis. Our aim was to evaluate whether a relatively high arterial oxygen tension is associated with longer survival in sepsis patients compared with conservative arterial oxygen tension.

Methods: From the Korean Sepsis Alliance nationwide registry, patients treated with liberal PaO (PaO ≥ 80 mm Hg) were 1:1 matched with those treated with conservative PaO (PaO < 80 mm Hg) over the first three days after ICU admission according to the propensity score.

Prognosis of mechanically ventilated patients with COVID-19 after failure of high-flow nasal cannula: a retrospective cohort study.

Background: There is an argument whether the delayed intubation aggravate the respiratory failure in Acute respiratory distress syndrome (ARDS) patients with coronavirus disease 2019 (COVID-19). We aimed to investigate the effect of high-flow nasal cannula (HFNC) failure before mechanical ventilation on clinical outcomes in mechanically ventilated patients with COVID-19.

Methods: This retrospective cohort study included mechanically ventilated patients who were diagnosed with COVID-19 and admitted to the intensive care unit (ICU) between February 2020 and December 2021 at Asan Medical Center.

Clinical impact of pre-existing acute exacerbation in patients with interstitial lung disease who underwent lung transplantation.

Background: Acute exacerbation of interstitial lung disease (AE-ILD) significantly impacts prognosis, leading to high mortality rates. Although lung transplantation is a life-saving treatment for selected patients with ILD, its outcomes in those presenting with AE-ILD have yielded conflicting results compared with those with stable ILD. This study aims to investigate the impact of pre-existing AE on the prognosis of ILD patients who underwent lung transplantation.

Extended Versus Intermittent Meropenem Infusion in the Treatment of Nosocomial Pneumonia: A Retrospective Single-Center Study.

The efficacy of extended meropenem infusions in patients with nosocomial pneumonia is not well defined. Therefore, we compared the clinical outcomes of extended versus intermittent meropenem infusions in the treatment of nosocomial pneumonia. We performed a retrospective analysis of extended versus intermittent meropenem infusions in adult patients who had been treated for nosocomial pneumonia at a medical ICU between 1 May 2018 and 30 April 2020.

Impact of a cumulative positive fluid balance during the first three ICU days in patients with sepsis: a propensity score-matched cohort study.

Background: The optimal strategy for fluid management during the first few days of ICU in sepsis patients remains controversial. We aimed to investigate the impact of cumulative fluid balance during the first three days of ICU on the mortality of patients with sepsis.

Methods: This study analyzed prospectively collected data from the Korean Sepsis Alliance Database, which registered 11,981 sepsis patients from 20 hospitals.

Longitudinal trajectories of sedation level and clinical outcomes in patients who are mechanically ventilated based on a group-based trajectory model: a prospective, multicentre, longitudinal and observational study in Korea.

Objectives: Changes in sedation levels over a long time in patients who are mechanically ventilated are unknown. Therefore, we investigated the long-term sedation levels of these patients by classifying them into different longitudinal patterns.

Design: This was a multicentre, prospective, longitudinal, and observational study.

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.

Continuous Piperacillin-Tazobactam Infusion Improves Clinical Outcomes in Critically Ill Patients with Sepsis: A Retrospective, Single-Centre Study.

Continuous infusion of beta-lactam antibiotics has emerged as an alternative for the treatment of sepsis because of the favourable pharmacokinetics of continuous infusion. This study aimed to evaluate the survival benefits of continuous vs. intermittent infusion of piperacillin-tazobactam in critically ill patients with sepsis.

Mortality of patients with hospital-onset sepsis in hospitals with all-day and non-all-day rapid response teams: a prospective nationwide multicenter cohort study.

Background: Hospital-onset sepsis is associated with a higher in-hospital mortality rate than community-onset sepsis. Many hospitals have implemented rapid response teams (RRTs) for early detection and timely management of at-risk hospitalized patients. However, the effectiveness of an all-day RRT over a non-all-day RRT in reducing the risk of in-hospital mortality in patient with hospital-onset sepsis is unclear.

Reliability of Central Venous Blood Gas Values Compared With Arterial Blood Gas Values in Critically Ill Patients.

Background: Central venous blood gas (cVBG) values are correlated with arterial blood gas (ABG) values. However, the substitution of cVBG values for ABG values in critically ill patients remains uninvestigated. Thus, we investigated the reliability between cVBG and ABG values and sought to define the conditions that could improve the reliability of cVBG values as a substitute.