Publications by authors named "Sung Wook Chang"

Article Synopsis
  • Intraosseous (IO) access is a useful alternative to intravenous (IV) access for patients with severe trauma when IV access is difficult, but its effectiveness has not been well studied.
  • This study analyzed data from six trauma centers in South Korea, focusing on 206 patients with traumatic cardiac arrest or shock, comparing IO access (94 patients) and IV access (112 patients).
  • The results showed that the IO group had a higher success rate (90.4% vs. 75.5%), shorter procedure time, and with the aid of a pressure bag, comparable infusion rates to IV access, especially when using a humeral site over a tibial site.
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Recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) had been introduced as an innovative procedure for severe hemorrhage in the abdomen or pelvis. We aimed to investigate risk factors associated with mortality after REBOA and construct a model for predicting mortality. This multicenter retrospective study collected data from 251 patients admitted at five regional trauma centers across South Korea from 2015 to 2022.

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Background: Fibrinogen concentrate (FC) can be administered during massive transfusions to manage trauma-induced coagulopathy. However, its effectiveness in survival remains inconclusive due to scarce high-level evidence. This study aimed to investigate the hemostatic effects of FC regarding mortality in massive hemorrhage caused by trauma.

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Purpose: Recently, trauma centers in the Republic of Korea introduced resuscitative endovascular balloon occlusion of the aorta (REBOA) for application in severe pelvic fracture cases. This study aimed to determine the efficacy of REBOA and its associated factors in enhancing survival.

Methods: Data from patients with severe pelvic injuries at two regional trauma centers from 2016 to 2020 were retrospectively reviewed.

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Purpose: As resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in an extremely emergent situation, achieving competent clinical practice is mandatory. Although there are several educational courses that teach the REBOA procedure, there have been no reports evaluating the impact of training on clinical practice. Therefore, this study is aimed to evaluate the effects of the course on procedural performance during resuscitation and on clinical outcomes.

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Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has recently gained popularity as an adjunct to resuscitation of patients with traumatic shock. However, the effectiveness of REBOA is still debated because of inconsistent indications across centers and the lack of medical records. The purpose of this study was to investigate the effectiveness and feasibility of REBOA by analyzing clinical results from a single center.

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A 59-year-old male patient presented to the emergency department after a tractor rollover accident. His Injury Severity Score was 41 points. He had multiple pelvic bone fractures and a left common femoral artery injury with soft tissue loss.

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Article Synopsis
  • * Most patients were middle-aged, predominantly male, with injuries often from auto-pedestrian accidents; high rates of cardiac arrest and mortality were noted, particularly from acute hemorrhage.
  • * Different interventions were utilized, including pelvic angiography and resuscitative endovascular balloon occlusion, with notable trends such as increased use of REBOA and pelvic binders over time, while mortality risk factors included age, initial lactate levels, and trauma severity scores.
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Traumatic chylothorax is a rare condition following blunt trauma. Although a chyle leak resulting from direct damage to the duct may occur at any level because of an anatomical variation, an airway obstruction due to thoracic duct injury after blunt trauma has never been described. Here, we report a very unusual case with airway obstruction due to thoracic duct injury after whiplash injury.

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Isolated iliac artery aneurysm (IAA) is rare, but can be fatal. Emergency surgery is performed in cases of hemorrhagic shock due to a suddenly ruptured IAA, which may have a high mortality rate because of massive non-compressible torso hemorrhage (NCTH). Recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been accepted as an alternative to aortic cross-clamping via open thoracotomy to achieve hemostasis in trauma patients with profound shock due to NCTH and is considered an emerging bridging therapy for damage control.

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Objectives: As a protective measure to slow down the transmission of coronavirus disease 2019 in Korea, social distancing was implemented from February 29, 2020. This study aimed to evaluate the prevalence of domestic incidents and intentional injury during March 2020 when social distancing was in effect.

Methods: There were 12,638 patients who visited the Level 1 trauma center of Chungnam province with injuries from domestic incidents, familial discord, and intentional injury.

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Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has emerged as a salvage technique changing the paradigm in the management of noncompressible torso hemorrhage. However, training for the REBOA procedure is rarely performed. The endovascular training for REBOA (ET-REBOA) course was conducted to develop the endovascular skills of participants.

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Percutaneous intervention is widely used to treat peripheral vascular disease. Ipsilateral antegrade femoral arterial access for femoropopliteal disease provides a mechanical advantage with regard to wire and stent control; however, it is associated with vascular complications and significant morbidity and mortality secondary to retroperitoneal hemorrhage from a high puncture site or vascular closure device (VCD) failure. Currently, resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed as damage control surgery in patients with non-compressible torso hemorrhage.

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Background: As the population of patients with end-stage renal disease has grown older, the proportion of patients with poorly preserved vasculature has concomitantly increased. Thus, arteriovenous grafts (AVG) have been used more frequently to access blood vessels for hemodialysis. Despite this increasing demand, studies of AVG are limited.

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Article Synopsis
  • EndoVascular and Hybrid Trauma Management (EVTM) has been introduced for severe pelvic ring injuries, employing techniques like Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) to manage hemorrhage, though data on its effectiveness is limited.
  • A study of 72 trauma patients with severe pelvic injuries found that most had blunt traumas, with traffic accidents being the most common cause, and REBOA was primarily used in the highest zone of aortic occlusion (zone 1).
  • The overall mortality rate was noted to be 54.2%, with early mortality at 44.4%, influenced by various factors such as pH levels and blood pressure, although these
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Surgical stabilization of rib fractures has been accepted and successfully performed for the management of patients with multiple rib fractures. Several types of devices, such as titanium bar, plate, and screws, are used for rib stabilization. Titanium devices provide a strong support for rib fixation and chest wall reconstruction and are rarely associated with complications.

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Background: Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) may improve Systolic Blood Pressure (SBP) in hypovolemic shock. It has, however, not been studied in patients with impending traumatic cardiac arrest (ITCA). We aimed to study the feasibility and clinical outcome of REBOA in patients with ITCA using data from the ABOTrauma Registry.

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Background: The assessment of hemodynamic variables is a mainstay in the management of critically ill patients. Hemodynamic variables may help physicians to choose among use of a vasopressor, an inotropic agent, or discontinuation of drugs. In this study, we aimed to investigate the usefulness of advanced hemodynamic variables in clinical decision-making.

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Noncompressible torso hemorrhage (NCTH), if not controlled promptly, leads to death. In the acute setting, aortic occlusion can be performed as damage control surgery (DCS) for hemorrhage originating from the abdomen and pelvis. With the development of endovascular technology, an intra-aortic balloon can be used to achieve aortic occlusion and decrease hemorrhage.

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Pulmonary contusion complicated with endobronchial hemorrhage is potentially life-threatening, particularly in patients with tracheobronchial tree disruption and severe airway bleeding after blunt trauma, and pose a high mortality risk. In such cases, extracorporeal membrane oxygenation (ECMO) can be used as a salvage treatment modality. However, the use of ECMO for moribund trauma patients with respiratory failure may be limited for several reasons, such as intractable bleeding.

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Delayed massive hemothorax requiring surgery is relatively uncommon and can potentially be life-threatening. Here, we aimed to describe the nature and cause of delayed massive hemothorax requiring immediate surgery. Over 5 years, 1,278 consecutive patients were admitted after blunt trauma.

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A 49-year-old female presented to the emergency department after multiple stab injuries. Bilateral thoracostomy was performed due to a right hemopneumothorax and a left pneumothorax without tracheoesophageal and vascular injury. On admission day 4, a significant amount of milky fluid was collected in the drain after initiation of regular diet.

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Background: Maintenance of adequate vascular access for hemodialysis is important in patients with end-stage renal disease. Once arteriovenous fistula (AVF) occlusion occurs, the patient should be treated with rescue therapy. This study was performed to evaluate the results of a rescue therapy for AVF occlusion.

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Background: Surgical treatment of stage I non-small cell lung cancer (NSCLC) can be performed either by thoracotomy or by employing video-assisted thoracic surgery (VATS). The aim of this study was to evaluate the feasibility of VATS lobectomy for pathologic stage I NSCLC.

Material And Methods: Between December 2003 and December 2007, 529 patients with pathologic stage I NSCLC underwent lobectomies (373 thoracotomy, 156 VATS).

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Background: During the past decade, video-assisted thoracic surgery (VATS) lobectomy has been performed with increasing frequency in patients with early-stage non-small cell lung cancer (NSCLC). However, questions remain as to whether VATS lobectomy reduces local recurrence and improves long-term survival in patients with NSCLC.

Methods: We retrospectively reviewed short-term and midterm outcomes, including postoperative morbidity, mortality, recurrence rate, and survival, in patients undergoing VATS lobectomy.

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