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Erratum
Complications of Central Venous Totally Implantable Access Port: Internal Jugular Versus Subclavian Access
Pil Young Jung, Hoon Ryu, Jae Hung Jung, Eunbi Lee, Joong Hwan Oh, Chun Sung Byun, Il Hwan Park
Korean J Crit Care Med. 2015;30(4):365-365.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.365
Corrects: Acute Crit Care 2015;30(1):13
  • 3,524 View
  • 59 Download
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Case Report
Cardiology/Thoracic Surgery
Cardiac Rupture of the Junction of the Right Atrium and Superior Vena Cava in Blunt Thoracic Trauma
Chun Sung Byun, Il Hwan Park, Tae Hoon Kim, Eunbi Lee, Joong Hwan Oh
Korean J Crit Care Med. 2015;30(1):27-30.   Published online February 28, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.1.27
  • 6,645 View
  • 74 Download
AbstractAbstract PDF
Cardiac rupture following blunt thoracic trauma is rarely encountered, since it commonly causes death at the scene. With advances in critical care, blunt cardiac rupture has been successfully treated with well-organized team approach including an emergency physician, anesthesiologist, and cardiac surgeon. We encountered a patient with blunt cardiac rupture of the junction of the superior vena cava and right atrium that extended 7 cm to the right ventricular junction. The patient was successfully resuscitated after a closed thoracostomy and pericardiocentesis with fluid loading. Cardiac injury was repaired via mid-sternotomy without cardiopulmonary bypass. The patient recovered without complications and was discharged on the 7th day after surgery.
Original Articles
Thoracic Surgery
Complications of Central Venous Totally Implantable Access Port: Internal Jugular Versus Subclavian Access
Pil Young Jung, Hoon Ryu, Jae Hung Jung, Eunbi Lee, Joong Hwan Oh, Chun Sung Byun, Il Hwan Park
Korean J Crit Care Med. 2015;30(1):13-17.   Published online February 28, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.1.13
Correction in: Acute Crit Care 2015;30(4):365
  • 7,433 View
  • 93 Download
  • 1 Crossref
AbstractAbstract PDF
Background
Totally implantable access port (TIAP) provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. Methods: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92) and subclavian approach (Group 2, n = 79) between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. Results: Median follow-up for TIAP was 278 days (range, 1-1868). Twenty four complications were occurred (14.0%), including pneumothorax (n = 1, 0.6%), migration/malposition (n = 4, 2.3%), pinch-off syndrome (n = 4, 2.3%), malfunction (n = 2, 1.1%), infection (n = 8, 4.7%), and venous thrombosis (n = 5, 2.9%). The overall incidence was 8.7% and 20.3% in each group (p = 0.030). Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033). The mechanical complication free probability is significantly higher in group 1 (p = 0.040). Conclusions: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.

Citations

Citations to this article as recorded by  
  • Internal jugular vein versus subclavian vein as the percutaneous insertion site for totally implantable venous access devices: a meta-analysis of comparative studies
    Shaoyong Wu, Jingxiu Huang, Zongming Jiang, Zhimei Huang, Handong Ouyang, Li Deng, Wenqian Lin, Jin Guo, Weian Zeng
    BMC Cancer.2016;[Epub]     CrossRef
Development and Experimental Evaluation of Respiratory Assist Device by Use of Right Thoracic Negative Pressure Ventilation
Joong Hwan Oh, Sang Hun Lee, Hyun Kyo Lim, Young Hee Lee, Sung Hoon Kim
Korean J Crit Care Med. 2005;20(2):165-169.
  • 1,401 View
  • 14 Download
AbstractAbstract PDF
BACKGROUND
A diaphragm pacing with electrical stimulation is a new respiratory assist device which has advantages over mechanical ventilation. Unilateral phrenic nerve stimulation makes uneven distribution of intrathoracic negative pressure and most likely relates to paradoxical motion of the diaphragm. Our purpose is to investigate a respiratory effect of right phrenic nerve pacing after thoracotomy compared with bilateral pacing. METHODS: Five dogs were examined under the general anesthesia. Right 5th intercostal space was opened. Two pacing leads were placed around the phrenic nerve and connected to the stimulator. Chest wall was closed after chest tube insertion. Ventilator was off without self respiration. Swan-Ganz catheter was introduced to the pulmonary artery, cardiac output, central venous pressure (CVP), pulmonary capillary wedge pressure (PCWP). Arterial blood gases (PO2 & PCO2), end-tidal PCO2 (PETCO2) and tidal volume were measured with nerve stimulation. Left phrenic nerve was managed as the same manner. RESULTS: Right phrenic nerve pacing resulted in a tidal volume of 186+/-5 ml, PETCO2 of 55.0+/-2.3 mmHg, Arterial PO2 of 115+/-12 mmHg, PCO2 of 59+/-4 mmHg, Cardiac output of 2.3+/-0.5 L/min, CVP of 12.0+/-2.3 mmHg, PCWP of 14.2+/-2.5 mmHg. Bilateral phrenic nerve pacing resulted in a tidal volume of 418+/-3 ml, PETCO2 of 47.0+/-2.7 mmHg, PO2 of 289+/-10 mmHg, PCO2 of 42+/-3 mmHg, Cardiac output of 3.1+/-0.4 L/min, CVP of 10.2+/-2.5 mmHg, PCWP of 14.5+/-2.7 mmHg. Right phrenic nerve pacing showed significantly lower tidal volume, PO2 and higher PETCO2 and arterial blood PCO2 (p<0.05).
CONCLUSIONS
Right phrenic nerve pacing plays a role to develop respiratory assist. However the effect is less than the bilateral pacing.

ACC : Acute and Critical Care