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2. Use of extracorporeal membrane oxygenation for severe toxicological exposure.

Author

Wu, Ping, Wong, Oi Fung, Chan, Cheuk Yan, Chan, Kai Wing, Ling, Steven Kin Ho, Chow, Tin Yat Anthony, Liong, Ting, and Chan, Chi Keung

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) is used in Hong Kong to provide additional circulation and respiratory support to patients. Exposure to toxins could cause profound shock and respiratory failure. The role of using ECMO to support severe circulatory and respiratory failure in patients with a toxicological cause of admission in Hong Kong is explored in this study. Objective: This study aims to describe the local practice of the use of ECMO in poisoning in Hong Kong. Method: This was a retrospective analysis of patients receiving ECMO for toxicological‐related causes between January 2013 and December 2023. Indications, the poisons of concern, and the mortality of the patients were reviewed. Results: We reported a total of 20 cases during the study period. Fourteen of them received VA‐ECMO, and six of them received VV‐ECMO. The most common poisons in patients receiving VA‐ECMO were calcium channel blockers and beta blockers. The ICU mortality rate for patients receiving VV‐ECMO was 16.6%, whereas it was 42.8% for those receiving VA‐ECMO. Of the 4 patients who received ECPR, the mortality rate was 75%. Most of the patients who survived had excellent cerebral performance category at 3 months. Conclusion: ECMO might be a useful modality for providing temporary respiratory and circulatory support to poisoned patients. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Characteristics and outcomes of patients admitted to adult intensive care units in Hong Kong: a population retrospective cohort study from 2008 to 2018

Author

Ling, Lowell, Ho, Chun Ming, Ng, Pauline Yeung, Chan, King Chung Kenny, Shum, Hoi Ping, Chan, Cheuk Yan, Yeung, Alwin Wai Tak, Wong, Wai Tat, Au, Shek Yin, Leung, Kit Hung Anne, Chan, Jacky Ka Hing, Ching, Chi Keung, Tam, Oi Yan, Tsang, Hin Hung, Liong, Ting, Law, Kin Ip, Dharmangadan, Manimala, So, Dominic, Chow, Fu Loi, Chan, Wai Ming, Lam, Koon Ngai, Chan, Kai Man, Mok, Oi Fung, To, Man Yee, Yau, Sze Yuen, Chan, Carmen, Lei, Ella, and Joynt, Gavin Matthew

Published
2021
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4. Population sepsis incidence, mortality, and trends in Hong Kong between 2009–2018 using clinical and administrative data

Author

Ling, Lowell, primary, Zhang, Jack Zhenhe, additional, Chang, Lok Ching, additional, Chiu, Lok Ching Sandra, additional, Ho, Samantha, additional, Ng, Pauline Yeung, additional, Dharmangadan, Manimala, additional, Lau, Chi Ho, additional, Ling, Steven, additional, Man, Man Yee, additional, Fong, Ka Man, additional, Liong, Ting, additional, Yeung, Alwin Wai Tak, additional, Au, Gary Ka Fai, additional, Chan, Jacky Ka Hing, additional, Tang, Michele, additional, Liu, Ying Zhi, additional, Wu, William Ka Kei, additional, Wong, Wai Tat, additional, Wu, Peng, additional, Cowling, Benjamin J, additional, Lee, Anna, additional, and Rhee, Chanu, additional

Published
2023
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5. Population study on diagnosis, treatment and outcomes of critically ill patients with tuberculosis (2008–2018)

Author

So, Christina, primary, Ling, Lowell, additional, Wong, Wai Tat, additional, Zhang, Jack Zhenhe, additional, Ho, Chun Ming, additional, Ng, Pauline Yeung, additional, Shum, Hoi Ping, additional, Yeung, Alwin Wai Tak, additional, Sin, Kai Cheuk, additional, Chan, Jacky, additional, Au, Ka Fai, additional, Liong, Ting, additional, Ho, Eunise, additional, Chow, Fu Loi, additional, Ho, Laptin, additional, Chan, Kai Man, additional, and Joynt, Gavin Matthew, additional

Published
2022
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6. Additional file 1 of Characteristics and outcomes of patients admitted to adult intensive care units in Hong Kong: a population retrospective cohort study from 2008 to 2018

Author

Ling, Lowell, Ho, Chun Ming, Ng, Pauline Yeung, Chan, King Chung Kenny, Shum, Hoi Ping, Cheuk Yan Chan, Yeung, Alwin Wai Tak, Wong, Wai Tat, Shek Yin Au, Leung, Kit Hung Anne, Chan, Jacky Ka Hing, Ching, Chi Keung, Oi Yan Tam, Hin Hung Tsang, Liong, Ting, Law, Kin Ip, Manimala Dharmangadan, So, Dominic, Chow, Fu Loi, Chan, Wai Ming, Koon Ngai Lam, Chan, Kai Man, Oi Fung Mok, To, Man Yee, Sze Yuen Yau, Chan, Carmen, Lei, Ella, and Joynt, Gavin Matthew

Abstract

Additional file 1: Supplementary Table 1. Adult General ICUs in Hong Kong Public Hospitals in 2019. Acute adult hospital beds were calculated from total hospital beds excluding paediatric, rehabilitation and palliative care beds.

Published
2021
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7. Additional file 6 of Characteristics and outcomes of patients admitted to adult intensive care units in Hong Kong: a population retrospective cohort study from 2008 to 2018

Author

Ling, Lowell, Ho, Chun Ming, Ng, Pauline Yeung, Chan, King Chung Kenny, Shum, Hoi Ping, Cheuk Yan Chan, Yeung, Alwin Wai Tak, Wong, Wai Tat, Shek Yin Au, Leung, Kit Hung Anne, Chan, Jacky Ka Hing, Ching, Chi Keung, Oi Yan Tam, Hin Hung Tsang, Liong, Ting, Law, Kin Ip, Manimala Dharmangadan, So, Dominic, Chow, Fu Loi, Chan, Wai Ming, Koon Ngai Lam, Chan, Kai Man, Oi Fung Mok, To, Man Yee, Sze Yuen Yau, Chan, Carmen, Lei, Ella, and Joynt, Gavin Matthew

Abstract

Additional file 6: Supplementary Table 5. Comparison of APACHE IV Predicted and Observed Hospital Mortality. The study cohort was divided into 10 deciles of APACHE IV predicted mortality groups. Observed number of hospital deaths was compared with APACHE IV predicted number of deaths in each group. 510 patients did not have APACHE IV predicted mortality due to missing data and were not included in this table. APACHE, Acute Physiology and Chronic Health Evaluation.

Published
2021
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8. Additional file 4 of Characteristics and outcomes of patients admitted to adult intensive care units in Hong Kong: a population retrospective cohort study from 2008 to 2018

Author

Ling, Lowell, Ho, Chun Ming, Ng, Pauline Yeung, Chan, King Chung Kenny, Shum, Hoi Ping, Cheuk Yan Chan, Yeung, Alwin Wai Tak, Wong, Wai Tat, Shek Yin Au, Leung, Kit Hung Anne, Chan, Jacky Ka Hing, Ching, Chi Keung, Oi Yan Tam, Hin Hung Tsang, Liong, Ting, Law, Kin Ip, Manimala Dharmangadan, So, Dominic, Chow, Fu Loi, Chan, Wai Ming, Koon Ngai Lam, Chan, Kai Man, Oi Fung Mok, To, Man Yee, Sze Yuen Yau, Chan, Carmen, Lei, Ella, and Joynt, Gavin Matthew

Abstract

Additional file 4: Supplementary Table 4. Trends in Admission Diagnosis Category. Description: Admission diagnosis were categorized into different systems. *Sepsis was coded when patient had proven or suspected infection with ≥2 systemic inflammatory response syndrome criteria.

Published
2021
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9. Additional file 2 of Characteristics and outcomes of patients admitted to adult intensive care units in Hong Kong: a population retrospective cohort study from 2008 to 2018

Author

Ling, Lowell, Ho, Chun Ming, Ng, Pauline Yeung, Chan, King Chung Kenny, Shum, Hoi Ping, Cheuk Yan Chan, Yeung, Alwin Wai Tak, Wong, Wai Tat, Shek Yin Au, Leung, Kit Hung Anne, Chan, Jacky Ka Hing, Ching, Chi Keung, Oi Yan Tam, Hin Hung Tsang, Liong, Ting, Law, Kin Ip, Manimala Dharmangadan, So, Dominic, Chow, Fu Loi, Chan, Wai Ming, Koon Ngai Lam, Chan, Kai Man, Oi Fung Mok, To, Man Yee, Sze Yuen Yau, Chan, Carmen, Lei, Ella, and Joynt, Gavin Matthew

Abstract

Additional file 2: Supplementary Table 2. Discharge destination in hospital survivors. *Includes patients who were discharged against medical advice. Discharge destination was missing in 54 patients.

Published
2021
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10. Additional file 3 of Characteristics and outcomes of patients admitted to adult intensive care units in Hong Kong: a population retrospective cohort study from 2008 to 2018

Author

Ling, Lowell, Ho, Chun Ming, Ng, Pauline Yeung, Chan, King Chung Kenny, Shum, Hoi Ping, Cheuk Yan Chan, Yeung, Alwin Wai Tak, Wong, Wai Tat, Shek Yin Au, Leung, Kit Hung Anne, Chan, Jacky Ka Hing, Ching, Chi Keung, Oi Yan Tam, Hin Hung Tsang, Liong, Ting, Law, Kin Ip, Manimala Dharmangadan, So, Dominic, Chow, Fu Loi, Chan, Wai Ming, Koon Ngai Lam, Chan, Kai Man, Oi Fung Mok, To, Man Yee, Sze Yuen Yau, Chan, Carmen, Lei, Ella, and Joynt, Gavin Matthew

Abstract

Additional file 3: Supplementary Table 3. Outcomes by reason for ICU admission. Values are in median and (interquartile range) unless specified. APACHE, Acute Physiology and Chronic Health Evaluation; APS, Acute Physiology Score; LOS, length of stay; SMR, standardized mortality ratio.

Published
2021
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11. Population study on diagnosis, treatment and outcomes of critically ill patients with tuberculosis (2008–2018)

Author

So, Christina, Ling, Lowell, Wong, Wai Tat, Zhang, Jack Zhenhe, Ho, Chun Ming, Ng, Pauline Yeung, Shum, Hoi Ping, Yeung, Alwin Wai Tak, Sin, Kai Cheuk, Chan, Jacky, Au, Ka Fai, Liong, Ting, Ho, Eunise, Chow, Fu Loi, Ho, Laptin, Chan, Kai Man, and Joynt, Gavin Matthew

Abstract

BackgroundTuberculosis (TB) is a preventable and curable disease, but mortality remains high among those who develop sepsis and critical illness from TB.MethodsThis was a population-based, multicentre retrospective cohort study of patients admitted to all 15 publicly funded Hong Kong adult intensive care units (ICUs) between 1 April 2008 and 31 March 2019. 940 adult critically ill patients with at least one positive Mycobacterium tuberculosis(MTB) culture were identified out of 133 858 ICU admissions. Generalised linear modelling was used to determine the impact of delay in TB treatment on hospital mortality. Trend of annual Acute Physiology and Chronic Health Evaluation (APACHE) IV-adjusted standardised mortality ratio (SMR) over the 11-year period was analysed by Mann-Kendall’s trend test.ResultsICU and hospital mortality were 24.7% (232/940) and 41.1% (386/940), respectively. Of those who died in the ICU, 22.8% (53/232) never received antituberculosis drugs. SMR for ICU patients with TB remained unchanged over the study period (Kendall’s τb=0.37, p=0.876). After adjustment for age, Charlson comorbidity index, APACHE IV, albumin, vasopressors, mechanical ventilation and renal replacement therapy, delayed TB treatment was directly associated with hospital mortality. In 302/940 (32.1%) of patients, TB could only be established from MTB cultures alone as Ziehl-Neelsen staining or PCR was either not performed or negative. Among this group, only 31.1% (94/302) had concurrent MTB PCR performed.ConclusionsSurvival of ICU patients with TB has not improved over the last decade and mortality remains high. Delay in TB treatment was associated with higher hospital mortality. Use of MTB PCR may improve diagnostic yield and facilitate early treatment.

Published
2023
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