• Korean Journal of Clinical Pharmacy
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• v.32 no.3
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• pp.251-259
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• 2022

Background: Intravenous fluid therapy is one of the most common interventions in critically ill patients. Normal saline is frequently used, but there have been some concerns about hyperchloremia. Due to closer to plasma composition, crystalloids have been used as alternatives to normal saline. However, the optimal choice of resuscitative fluids remains controversial. Methods: MEDLINE, EMBASE, and CENTRAL were comprehensively searched until July 2021 to compare balanced crystalloids with normal saline in critically ill patients with the risk factors for multiple organ dysfunction syndromes (MODS).The primary endpoint was composite mortality. Secondary outcomes were acute kidney injury (AKI)/acute renal failure (ARF), and new receipt of renal replacement therapy (RRT). Results: A total of 1,240 studies were searched, and finally, 8 randomized controlled trials and 5 cohort studies were included. In the meta-analysis of composite mortality of 30,710 patients, balanced crystalloids compared to normal saline were significantly associated with reduced mortality (OR 0.80, 95% CI 0.68-0.95). In AKI/ARF, balanced crystalloids had a lower risk than normal saline (OR 0.91, 95% CI 0.84-0.99). There was no difference between balanced crystalloids and normal saline in risk of new receipt of RRT (OR 0.91, 95% CI 0.80-1.04). Conclusion: In fluid resuscitation for patients at high risk of MODS, the use of balanced crystalloids showed a significantly lower incidence of mortality compared to normal saline.

• Journal of Trauma and Injury
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• v.19 no.2
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• pp.178-182
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• 2006

Compartment syndrome has a wide spectrum from muscle pain to a life- threatening condition, such as acute renal failure and disseminated intravascular coagulation (DIC). Intracerebral hemorrhage (ICH) due to compartment syndrome has not been reported. We report a patient who presented with ICH leading to death. A 25-year-old female with no significant past history developed extensive compartment syndrome followed by rhabdomyolysis, acute renal failure, DIC, and ICH. Although the patient underwent a fasciotomy and hemodialysis and received aggressive resuscitation with massive transfusions of blood and intravenous fluids, she died. This case stresses the importance of early diagnosis and prompt treatment of compartment syndrome to prevent devastating complications.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.264-266
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• 2016

A 21-year-old healthy Korean man worked on a building construction site every day for almost 2 months and exercised every day for 1 or 2 hours after working hard. He felt dizziness, nausea, and experienced vomiting and body aches immediately after exercise and immediately took cold medicines including acetaminophen, cimetidine, bepotastine, and Codenal? complex for the common cold symptoms for 2 days because he was scheduled to participate in navy training at that time. He complained of severe trapezius pain and aches in his left calf 3 days after joining the Navy training. Testing revealed creatine phosphokinase (CPK) 6260 U/L, myogloblin 176 mcg/L in the urine, liver enzymes increased, and oliguria, suggesting rhabdomyolysis. He recovered with intravenous fluids without any complications.

• Korean Journal of Veterinary Research
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• v.50 no.3
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• pp.253-257
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• 2010

A 3-year-old female Thoroughbred racehorse was presented following the accidental oral and skin administration of amitraz. This case report describes the clinical signs and the treatment of this horse. Clinical signs of amitraz toxicosis are associated with the stimulation of alpha2-adrenergic receptors. Amitraz is seldom fatal because the effects can be reversed by alpha2-adrenergic antagonists. The horse displayed typical clinical signs of colic, including pawing, small hard drops, tranquillisation, depression, ataxia, muscular incoordination and impaction colic lasting up to 7 days. The syndrome was accompanied by mild dehydration. The horse survived after persistent symptomatic treatment, including the giving of intravenous fluids, antibiotics, multiple doses of mineral oil per os, nonsteroidal anti-inflammatory drugs and dexamethasone intramuscularly and intravenously.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.60-63
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• 2006

Vasodilatory shock has been implicated in life-threatening complications after cardiac surgery. This syndrome may result from the vasopressin deficiency following cardiopulmonary bypass (CPB), which do not respond to fluids or usual intravenous inotropes. We used arginine-vasopressin in adults with vasodilatory shock coming on cardiopulmonary bypass. Therefore, we report these cases with a review of articles.

• Clinical and Experimental Pediatrics
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• v.60 no.10
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• pp.333-336
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• 2017

Coxsackievirus A16 (CA16), which primarily causes hand, foot, and mouth disease (HFMD), is associated with complications, such as encephalitis, acute flaccid paralysis, myocarditis, pericarditis, and shock. However, no case of pancreatitis associated with CA16 has been reported in children. We report a case of CA16-associated acute pancreatitis in a 3-year-old girl with HFMD. She was admitted because of poor oral intake and high fever for 1 day. Maculopapular rashes on both hands and feet and multiple vesicles on the soft palate were observed on physical examination. She was treated conservatively with intravenous fluids. On the fourth hospital day, she had severe abdominal pain and vomiting. The serum levels of amylase and lipase were remarkably elevated (amylase, 1,902 IU/L; reference range, 28-100 IU/L; lipase, >1,500 IU/L; reference range, 13-60 IU/L), and ultrasonography showed diffuse swelling of the pancreas with a small amount of ascites. The real-time reverse transcription polymerase chain reaction result from a stool sample was positive for CA16. CA16 can cause acute pancreatitis, and should be considered in the differential diagnosis of abdominal pain in children with HFMD.

• Journal of The Korean Dental Society of Anesthesiology
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• v.6 no.2 s.11
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• pp.121-126
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• 2006

Generalized anaphylaxis is a most dramatic and acutely life-threatening allergic reaction. Most fatalities from anaphylaxis occur within the first 30 minutes postantigenic exposure. The mechanism of generalized anaphylaxis is the reaction of IgE antibodies to an allergen that causes the release of histamine, bradykinin, and others. These chemical mediators cause the contraction of smooth muscles of the respiratory and intestinal tracts, as well as increased vascular permeability. Four major clinical symptoms are recognized: skin reactions, smooth muscle spasm (gastrointestinal and genitourinary tracts and respiratory smooth muscle), respiratory distress, and cardiovascular collapse. Epinephrine is the drug of choice for the management. Its syrnpathomimetic effects directly counteract most aspects of the attack. Respiration must be immediately supported by the establishment of a patent airway along with artificial ventilation. The circulation should be supported and the existing hypotension overcome by placing the victim in a position to allow gravity to aid venous return and by administering intravenous fluids, vasopressors, and corticosteroids. When an imperceptible pulse is evident, external cardiac compression must also be instituted. This is a case report of anaphylactic shock care during general anesthesia, possibly due to penicillin, pancuronium and others.

• Tuberculosis and Respiratory Diseases
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• v.82 no.1
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• pp.6-14
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• 2019

Sepsis is a life-threatening condition caused by infection and represents a substantial global health burden. Recent epidemiological studies showed that sepsis mortality rates have decreased, but that the incidence has continued to increase. Although a mortality benefit from early-goal directed therapy (EGDT) in patients with severe sepsis or septic shock was reported in 2001, three subsequent multicenter randomized studies showed no benefits of EGDT versus usual care. Nonetheless, the early administration of antibiotics and intravenous fluids is considered crucial for the treatment of sepsis. In 2016, new sepsis definitions (Sepsis-3) were issued, in which organ failure was emphasized and use of the terms "systemic inflammatory response syndrome" and "severe sepsis" was discouraged. However, early detection of sepsis with timely, appropriate interventions increases the likelihood of survival for patients with sepsis. Also, performance improvement programs have been associated with a significant increase in compliance with the sepsis bundles and a reduction in mortality. To improve sepsis management and reduce its burden, in 2017, the World Health Assembly and World Health Organization adopted a resolution that urged governments and healthcare workers to implement appropriate measures to address sepsis. Sepsis should be considered a medical emergency, and increasing the level of awareness of sepsis is essential.

• Journal of Korean Clinical Nursing Research
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• v.27 no.1
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• pp.109-119
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• 2021

Purpose: The purpose of this study was to identify and analyze the characteristics of nurses' medication errors during three years. Methods: Retrospective survey study design was used to analyze medication errors by nurses among patient safety accidents. Data were collected for three years from January, 2017 to December, 2019. Data were analyzed using frequency, percentage, 𝑥²-test, and logistic regression with SPSS 26.0 program. Results: Of a total 677 medication errors, 40.6% were caused by nurses. Among the medication errors, near miss (n=154, 56.0%), intravenous bolus injection (n=170, 61.8%), wrong dose (n=102, 37.1%) and carelessness for repetitive work (n=98, 35.6%) were the most common. Medication errors differed by department, and nurses' career, and patient safety accident type. The results of the logistic regression analysis showed that the risk factors of adverse events were medication of fluids (OR=3.93, 95% CI: 1.26~12.27), insulin subcutaneous injection (OR=39.06, 95% CI: 4.58~333.18), and occurrence of extravasation/infiltration (OR=7.26, 95% CI: 1.85~28.53). Conclusion: The simplest and most effective way to prevent medication errors is to keep 5 right, and a differentiated education program according to department and nurse career is needed rather than general education programs. Hospital-level integrated interventions such as a medication barcode system or a team nursing method are also necessary.

• Journal of Biomedical Engineering Research
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• v.24 no.4
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• pp.293-299
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• 2003

In this paper, the correlation of Pressure drop about the Newtonian and non-Newtonian fluid was investigated experimentally for vibrating intravascular lung assist device (VIVLAD) and we determined correlation equation to make a prediction about Pressure drop for designing VIVLAD. Design conditions to predict the pressure drop of the modules were studied through an experimental modeling before inserting the artificial lung assist device into as venous. Experiments were performed by distilled water, glycerol/water mixed solution(40% glycerol) of Newtonian fluids. and the bovine blood of non-Newtonian fluids. These fluids were flowed outside and parallel of hollow fiber membranes. Also we measured pressure drop according to the number of the fiber membranes which ware inserted into the inside diameter of shell of 3 cm, and developed the prediction equations by curve fitting method based on correlation between the experimental pressure drop and the frontal area or the packing density of device. The result showed that the Pressure drop and the friction factor of the water/glycerol mixed solution were similar to that of bovine blood. It was showed that the water/glycerol mixed solution (40% glycerol) could be used for measuring the pressure drop and the friction factor instead of the bovine blood. Also, we could estimate the prediction equation of pressure drop and friction factor as the function of Packing density at the number of hollow fibers. We obtained the reliance of the prediction equations because the pressure drop and the friction factor measured from the experiments were similar to that from the prediction equation. These results may be used to further usefulness for the design of VIVLAD.