Impact of medical crisis on the critical care system in South Korea.

Background: The ongoing medical crisis in Korea has severely impacted the operational environment of intensive care units (ICU), posing significant challenges to quality care for critically ill patients. This study aimed to evaluate the effects of the ongoing crisis on ICUs.

Methods: A survey was conducted in July 2024 among intensivists in charge of ICUs at institutions accredited by the Korean Society of Critical Care Medicine for critical care.

Increase of α-Synuclein in the Peripheral Blood of Subjects with Methamphetamine Use Disorder.

Objective: Methamphetamine (MA) use has created significant public health problems worldwide. Its chronic abuse causes neurotoxicity resulting in disruption of neural plasticity and early onset of neurodegenerative diseases. Therefore, there is need for a biomarker to evaluate the neurotoxicity caused by MA.

Videofluoroscopic swallowing study predicts clinical outcomes in critically Ill children with dysphagia: a retrospective observational study.

Background: This retrospective observational study aimed to investigate the features of acute dysphagia observed during videofluoroscopic swallowing study (VFSS) in critically ill children and their potential to anticipate clinical outcomes.

Methods: Administrative healthcare data of children aged 1-18 were analyzed. Data were collected from the pediatric intensive care unit (PICU) of a single tertiary medical center in South Korea between March 2019 and December 2022.

Simulating the effects of reducing transfer latency from the intensive care unit on intensive care unit bed utilization in a Korean Tertiary Hospital.

Background: Latency in transferring patients from intensive care units (ICUs) to general wards impedes the optimal allocation of ICU resources, underscoring the urgency of initiatives to reduce it. This study evaluates the extent of ICU transfer latency and assesses the potential benefits of minimizing it.

Methods: Transfer latency was measured as the time between the first transfer request and the actual ICU discharge at a single-center tertiary hospital in 2021.

Effect of high-flow nasal cannula therapy on mechanical ventilation duration in the pediatric intensive care unit.

Background: High-flow nasal cannula (HFNC) therapy has gained popularity in the pediatric intensive care unit (PICU). However, the nationwide effect of HFNC on mechanical ventilation duration has not been studied.

Methods: We retrospectively analyzed pediatric patients (28 days to 17 years old) admitted to tertiary ICUs for respiratory support from 2012 to 2019 using the Korean National Health Insurance database.

Pediatric Extracorporeal Membrane Oxygenation in Korea: A Multicenter Retrospective Study on Utilization and Outcomes Spanning Over a Decade.

Background: Over the last decade, extracorporeal membrane oxygenation (ECMO) use in critically ill children has increased and is associated with favorable outcomes. Our study aims to evaluate the current status of pediatric ECMO in Korea, with a specific focus on its volume and changes in survival rates based on diagnostic indications.

Methods: This multicenter study retrospectively analyzed the indications and outcomes of pediatric ECMO over 10 years in patients at 14 hospitals in Korea from January 2012 to December 2021.

Complications of the Central Nervous System in Pediatric Patients With Common Cold Coronavirus Infection During 2014-2019.

Background: In pediatric patients, the common cold coronavirus (ccCoV) usually causes mild respiratory illness. There are reports of coronavirus causing central nervous system (CNS) infection in experimental animal models. Some immunocompromised patients have also been reported to have fatal CNS infections with ccCoV.

Clinical Manifestations and Genotype of Primary Ciliary Dyskinesia Diagnosed in Korea: Multicenter Study.

Purpose: Primary ciliary dyskinesia (PCD) is a genetically heterogeneous disorder that leads to secondary ciliary dysfunction. PCD is a rare disease, and data on it are limited in Korea. This study systematically evaluated the clinical symptoms, diagnostic characteristics, and treatment modalities of pediatric PCD in Korea.

Individualized Goal Setting for Pediatric Intensive Care Unit-Based Rehabilitation Using the Canadian Occupational Performance Measure.

The Canadian Occupational Performance Measure (COPM) is a client-centered outcome measure that facilitates the prioritization of individualized interventions. Given the rising emphasis on individualized intervention in pediatric intensive care units (PICUs), this cross-sectional study aimed to explore caregivers' perspectives on their children's functional goals within PICUs. From 1 September 2020 to 26 June 2022, caregivers of 41 children aged 1-18 years completed the COPM within 48 h of PICU admission.

Incidence and Mortality Trends in Critically Ill Children: A Korean Population-Based Study.

Background: Monitoring mortality trends can help design ways to improve survival, but observation of national mortality trends in critically ill children is lacking for the Korean population.

Methods: We analyzed the incidence and mortality trends of children younger than 18 years admitted to an intensive care unit (ICU) from 2012 to 2018 using the Korean National Health Insurance database. Neonates and neonatal ICU admissions were excluded.

Trends in Incidences and Survival Rates in Pediatric In-Hospital Cardiopulmonary Resuscitation: A Korean Population-Based Study.

Background Although the outcome of cardiopulmonary resuscitation (CPR) is still unsatisfactory, there are few studies about temporal trends of in-hospital CPR incidence and mortality. We aimed to evaluate nationwide trends of in-hospital CPR incidence and its associated risk factors and mortality in pediatric patients using a database of the Korean National Health Insurance between 2012 and 2018. Methods and Results We excluded neonates and neonatal intensive care unit admissions.

Effect of life-sustaining treatment decision law on pediatric in-hospital cardiopulmonary resuscitation rate: A Korean population-based study.

Aim: The 2018 life-sustaining treatment (LST) decision law is expected to improve end-of-life quality in Korea. This study evaluated the national effect of the LST decision law on the cardiopulmonary resuscitation (CPR) rate among pediatric patients who died during hospital admission.

Methods: This retrospective cohort study was based on the Korean National Health Insurance database.

Effect of high-flow nasal cannula on mechanical ventilator duration in bronchiolitis patients.

Objectives: High-flow nasal cannula (HFNC) therapy is a widely used non-invasive respiratory support that may decrease invasive mechanical ventilation. This study evaluated the real-world effect of HFNC on the duration of mechanical ventilation among acute bronchiolitis patients on a nationwide level.

Methods: We retrospectively analyzed bronchiolitis patients (28 days-3 years old) who were admitted to tertiary hospitals for respiratory support from 2012 to 2019 using the Korean National Health Insurance database.

The Changes in Epidemiology of Imipenem-Resistant Bacteremia in a Pediatric Intensive Care Unit for 17 Years.

Background: infections cause high morbidity and mortality in intensive care unit (ICU) patients. However, there are limited data on the changes of long-term epidemiology of imipenem resistance in bacteremia among pediatric ICU (PICU) patients.

Methods: A retrospective review was performed on patients with bacteremia in PICU of a tertiary teaching hospital from 2000 to 2016.

Rehabilitation in critically ill children: Findings from the Korean National Health Insurance database.

Purpose: Intensive care unit (ICU) survivors suffer from physical weakness and challenges returning to daily life. With the importance of rehabilitating patients in the pediatric intensive care unit being increasingly recognized, we evaluated the prevalence of physical and occupational therapy (PT/OT)-provided rehabilitation and factors affecting its use.

Methods: We conducted a retrospective cohort analysis of rehabilitation between 2013 and 2019 using the Korean National Health Insurance database.

Tailored management of life-threatening complications related to severe obesity in a young adult with Prader-Willi syndrome.

Prader-Willi syndrome (PWS) is characterized by hypotonia, distinctive facial features, hyperphagia, obesity, short stature, hypogonadism, intellectual disability, and behavior problems. Uncontrolled hyperphagia can lead to dangerous food-seeking behavior and with life-threatening obesity. Severe obesity is prone to obstructive sleep apnea (OSA) and can lead to cor pulmonale.

Simulation Analysis of Flow Rate Variability During Microinfusions: The Effect of Vertical Displacement and Multidrug Infusion in Conventional Infusion Pumps Versus New Cylinder-Type Infusion Pumps.

Background: Medication dosing errors can occur during microinfusions when there is vertical pump displacement or multidrug infusion through a single intravenous path. We compared flow rate variability between new-generation cylinder-type infusion pumps and conventional infusion pumps under simulated conditions.

Methods: We evaluated the flow rates during microinfusions using different infusion pumps (syringe pump with 10/30/50-mL syringes, peristaltic pump, and cylinder pump).

Health disparities of critically ill children according to poverty: the Korean population-based retrospective cohort study.

Background: There is a lack of nationwide studies on critically ill patients' health disparity under the National Health Insurance (NHI) system. We evaluated health disparities in intensive care unit (ICU) admission, outcomes, and readmission in impoverished children.

Methods: We conducted a retrospective cohort study using a national database from the Korean NHI and Medical Aid Program (MAP).

Correlation between vancomycin clearance and cystatin C-based glomerular filtration rate in paediatric patients.

Aims: Because of limitations with the serum creatinine-based glomerular filtration rate (GFRcr), estimates of the serum cystatin C-based glomerular filtration rate (GFRcys) are getting attention to predict vancomycin clearance (CLvan). We evaluated the correlations between (i) CLvan and GFRcr, and (ii) CLvan and GFRcys in paediatric patients.

Methods: We evaluated a retrospective cohort of patients between 1 and 19 years old admitted to a tertiary hospital between 2017 and 2019.

The effect of bed-to-nurse ratio on hospital mortality of critically ill children on mechanical ventilation: a nationwide population-based study.

Background: Despite the high workload of mechanical ventilation, there has been a lack of studies on the association between nurse workforce and mortality in mechanically ventilated patients. We evaluated the association of the bed-to-nurse ratio with mortality in ventilated pediatric patients admitted to an intensive care unit (ICU).

Methods: We conducted a nationwide retrospective analysis by using the Korean National Health Insurance database, which categorizes the bed-to-nurse ratio into 9 grades according to the number of beds divided by the number of full-time equivalent registered nurses in a unit.

Relationship between Use of Rehabilitation Resources and ICU Readmission and ER Visits in ICU Survivors: the Korean ICU National Data Study 2008-2015.

Background: Despite the increasing importance of rehabilitation for critically ill patients, there is little information regarding how rehabilitation therapy is utilized in clinical practice. Our objectives were to evaluate the implementation rate of rehabilitation therapy in the intensive care unit (ICU) survivors and to investigate the effects of rehabilitation therapy on outcomes.

Methods: A retrospective nationwide cohort study with including > 18 years of ages admitted to ICU between January 2008 and May 2015 (n = 1,465,776).

Long-term extracorporeal membrane oxygenation after severe blunt traumatic lung injury in a child.

Managing acute respiratory distress syndrome (ARDS) after severe blunt traumatic lung injury can be challenging. In cases where patients are refractory to conventional therapy, extracorporeal membrane oxygenation (ECMO) should be considered. In addition, the heparin-coated circuit can reduce hemorrhagic complications in patients with multiple traumas.

Effects of continuous ketamine infusion on hemodynamics and mortality in critically ill children.

We investigated the hemodynamic and mortality effects of continuous ketamine infusion in critically ill pediatric patients. We conducted a retrospective cohort study in a tertiary pediatric intensive care unit (PICU). Patients who used continuous sedative from 2015 to 2017 for 24 hours or more were included.