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호흡기내과 의사를 위한 Respiratory Review of 2010

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Author(s)
박지혜채진녕최원일
Keimyung Author(s)
Choi, Won Il
Department
Dept. of Internal Medicine (내과학)
Journal Title
Tuberculosis and Respiratory Diseases
Issued Date
2010
Volume
69
Issue
2
Keyword
Critical CareRespiratory Distress SyndromeAdultExtracorporeal Membrane OxygenationGlucoseInfection
Abstract
The year of 2009∼2010 brought a number of concepts and new ideas were evaluated with promising results.
However, some studies that challenged many beliefs. In acute respiratory distress syndrome (ARDS), recent clinical
studies took into consideration of pathophysiologic changes of respiratory system compliance. Meta-analysis of
positive end-expiratory pressure trials showed survival benefit of high positive end-expiratory pressure in ARDS.
Until now, prone positioning did not show survival benefit in patients with ARDS. Extracorporeal membrane
oxygenation (ECMO) based management improved survival in patients with severe ARDS. ECMO can be a
management option in severe ARDS. Sedation is a standard practice in critically ill patients needing mechanical
ventilation. However, Danish group reported less sedation of critically ill patients receiving mechanical ventilation
was associated with an increase in days without ventilation. Although this single center study has some limitations,
the overall results are promising. Use of maximal sterile barrier precautions (mask, sterile gown, sterile gloves,
and large sterile drapes) with chlorhexidine-impregnated dressing reduced central venous catheter related infection.
Selective oropharyngeal decontamination (application of topical antibiotics in the oropharynx) reduced the mortality
rate of an intensive care unit (ICU) population. Normoglycemia in Intensive Care Evaluation and Survival Using
Glucose Algorithm Regulation (NICE-SUGAR) trial reported intensive glucose control increased mortality among
adults in the ICU. Some of the results of above papers are promising. However, some ideas may need for more
frequent individual assessment and increase the workload of ICU staffs. Before implementation of new practice
in ICU, we should take into consideration of individual hospital situation including human and material resources.
Key Words: Critical Care; Respiratory Distress Syndrome, Adult; Extracorporeal Membrane Oxygenation; Glucose;
Infection
Alternative Title
Critical Care Medicine
Keimyung Author(s)(Kor)
최원일
Publisher
School of Medicine
Citation
박지혜 et al. (2010). 호흡기내과 의사를 위한 Respiratory Review of 2010. Tuberculosis and Respiratory Diseases, 69(2), 75–80. doi: 10.4046/trd.2010.69.2.75
Type
Article
ISSN
1738-3536
DOI
10.4046/trd.2010.69.2.75
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34785
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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