Journal of Yeungnam Medical Science

Original article

Outcomes in patients with out-of-hospital cardiac arrest according to prehospital advanced airway management timing: a retrospective observational study: Sang-Hun Lee, Hyun Wook Ryoo; Received April 1, 2024 Accepted May 9, 2024 Published online July 18, 2024; DOI: https://doi.org/10.12701/jyms.2024.00332 [Epub ahead of print]

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Abstract PDF: Background
In patients with out-of-hospital cardiac arrest (OHCA), guidelines recommend advanced airway (AA) management at the advanced cardiovascular life support stage; however, the ideal timing remains controversial. Therefore, we evaluated the prognosis according to the timing of AA in patients with OHCA.
Methods
We conducted a retrospective observational study of patients with OHCA at six major hospitals in Daegu Metropolitan City, South Korea, from August 2019 to June 2022. We compared groups with early and late AA and evaluated prognosis, including recovery of spontaneous circulation (ROSC), survival to discharge, and neurological evaluation, according to AA timing.
Results
Of 2,087 patients with OHCA, 945 underwent early AA management and 1,142 underwent late AA management. The timing of AA management did not influence ROSC in the emergency department (5–6 minutes: adjusted odds ratio [aOR], 0.97; p=0.914; 7–9 minutes: aOR, 1.37; p=0.223; ≥10 minutes: aOR, 1.32; p=0.345). The timing of AA management also did not influence survival to discharge (5–6 minutes: aOR, 0.79; p=0.680; 7–9 minutes: aOR, 1.04; p=0.944; ≥10 minutes: aOR, 1.86; p=0.320) or good neurological outcomes (5–6 minutes: aOR, 1.72; p=0.512; 7–9 minutes: aOR, 0.48; p=0.471; ≥10 minutes: aOR, 0.96; p=0.892).
Conclusion
AA timing in patients with OHCA was not associated with ROSC, survival to hospital discharge, or neurological outcomes.

Review article

Pathological interpretation of connective tissue disease-associated lung diseases: Kun Young Kwon; Yeungnam Univ J Med. 2019;36(1):8-15. Published online January 15, 2019; DOI: https://doi.org/10.12701/yujm.2019.00101

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Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.

Citations

Citations to this article as recorded by

Multidisciplinary Approach to the Diagnosis of Idiopathic Interstitial Pneumonias: Focus on the Pathologist’s Key Role
Stefano Lucà, Francesca Pagliuca, Fabio Perrotta, Andrea Ronchi, Domenica Francesca Mariniello, Giovanni Natale, Andrea Bianco, Alfonso Fiorelli, Marina Accardo, Renato Franco
International Journal of Molecular Sciences.2024; 25(7): 3618. CrossRef
Acute fibrinous and organizing pneumonia: two case reports and literature review
Haihong Chen, Yukun Kuang, Xinyan Huang, Ziyin Ye, Yangli Liu, Canmao Xie, Ke-Jing Tang
Diagnostic Pathology.2021;[Epub] CrossRef

Case Report

Successful difficult airway management using GlideScope video laryngoscope in a child with Cornelia de Lange Syndrome: Sang-Jin Park, Eun Kyung Choi, Suyong Park, Kunjin Bae, Deokhee Lee; Yeungnam Univ J Med. 2018;35(2):219-221. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.219

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Abstract PDF: Management of airway in a child with Cornelia de Lange Syndrome (CdLS) should be given due consideration because most of them have the problems related to difficult airway. The GlideScope video laryngoscope can be attempted during routine intubation, however it is mostly used in case of difficulty. With adequate preoperative airway assessment, we used the pediatric video laryngoscope as useful alternative airway device in a child with CdLS and orotracheal intubation proceeded uneventfully.

Original Article

Effects of small tidal volume and positive end-expiratory pressure on oxygenation in pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation: Sung Hye Byun, So Young Lee, Jin Yong Jung; Yeungnam Univ J Med. 2018;35(2):165-170. Published online December 20, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.165

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Abstract PDF

Background
The purpose of this study was to investigate whether tidal volume (TV) of 8 mL/kg without positive end-expiratory pressure (PEEP) and TV of 6 mL/kg with or without PEEP in pressure-controlled ventilation-volume guaranteed (PCV-VG) mode can maintain arterial oxygenation and decrease inspiratory airway pressure effectively during one-lung ventilation (OLV).
Methods
The study enrolled 27 patients undergoing thoracic surgery. All patients were ventilated with PCVVG mode. During OLV, patients were initially ventilated with TV 8 mL/kg (group TV8) without PEEP. Ventilation was subsequently changed to TV 6 mL/kg with PEEP (5 cmH2O; group TV6+PEEP) or without (group TV6) in random sequence. Peak inspiratory pressure (Ppeak), mean airway pressure (Pmean), and arterial blood gas analysis were measured 30 min after changing ventilator settings. Ventilation was then changed once more to add or eliminate PEEP (5 cmH2O), while maintaining TV 6 mL/kg. Thirty min after changing ventilator settings, the same parameters were measured once more.
Results
The Ppeak was significantly lower in group TV6 (19.3±3.3 cmH2O) than in group TV8 (21.8±3.1 cmH2O) and group TV6+PEEP (20.1±3.4 cmH2O). PaO2 was significantly higher in group TV8 (242.5±111.4 mmHg) than in group TV6 (202.1±101.3 mmHg) (p=0.044). There was no significant difference in PaO2 between group TV8 and group TV6+PEEP (226.8±121.1 mmHg). However, three patients in group TV6 were dropped from the study because PaO2 was lower than 80 mmHg after ventilation.
Conclusion
It is postulated that TV 8 mL/kg without PEEP or TV 6 mL/kg with 5 cmH2O PEEP in PCV-VG mode during OLV can safely maintain adequate oxygenation.

Citations

Citations to this article as recorded by

Pressure-Controlled Ventilation-Volume Guaranteed Mode Combined with an Open-Lung Approach Improves Lung Mechanics, Oxygenation Parameters, and the Inflammatory Response during One-Lung Ventilation: A Randomized Controlled Trial
Jianli Li, Baogui Cai, Dongdong Yu, Meinv Liu, Xiaoqian Wu, Junfang Rong
BioMed Research International.2020; 2020: 1. CrossRef

Case Reports

Anesthetic Management of a Patient with Kimura's Disease.: Eun Ji Choi, Sang Jin Park; Yeungnam Univ J Med. 2009;26(1):38-43. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.38

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Abstract PDF: Kimura's disease is an idiopathic chronic condition, associated with a high-titer of IgE and peripheral eosinophilia. It frequently presents as a solitary or multiple lesions in the head and neck area. During the perioperative period, anesthesiologists should understand the anatomical structures of the patient who has Kimura's disease involvement of the head and neck, especially the airway. It is important to pay attention to the occurrence of signs and symptoms of acute allergic reactions related to a high-titer of IgE and eosinophilia. We report our experience with anesthetic management in an 18-year-old patient with multiple neck masses due to Kimura's disease.

Aspiration Pneumonia after General Anesthesia Using Laryngeal Mask Airway: A case report.: Deok Hee Lee, Ki Ho Park; Yeungnam Univ J Med. 2004;21(1):127-131. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.127

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Abstract PDF: A laryngeal mask airway (LMA) has many advantages in the management of airway emergencies or the treatment of patients in whom intubation is difficult, but the use of LMA during positive ventilation may seem inappropriate to protect the airway because of the risk of pulmonary aspiration of regurgitated gastric contents. We experienced aspiration pneumonia after general anesthesia using LMA in patient who suffered from panperitonitis. It is considered that the main reason for aspiration pneumonia was a leakage of gastric content through the space surrounding the nasogastric tube while under high airway inflation pressure. We concluded that when LMA or the Proseal laryngeal mask airway (PLMA) is chosen for the use in difficult intubations, careful patient-suitability selection and the correct knowledge of LMA and PLMA are needed to protect the airway against aspiration.

A Case of Subcutaneous Emphysema without Associated Injuries at Neck from Motorcycle Accident.: Jung Ho Kim, Sam Beom Lee, Byung Soo Do; Yeungnam Univ J Med. 2003;20(2):217-222. Published online December 31, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.2.217

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Abstract PDF: Subcutaneous emphysema defines collection of air in subcutaneous spaces of body. It is usually originated from air in upper airway and lower respiratory tract such as larynx, trachea, bronchus and lungs. Air in subcutaneous spaces derives from leakage of air due to tearing or ruptures of airway structures, and also accompanies pneumothorax or pneumomediastinum and/or rib or sternal fractures or other major airway injuries. We experienced a case of subcutaneous emphysema caused by laryngeal injury without any associated airway injuries at neck from motorcycle accident, so we would report a case with the review of literatures.

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