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Change in management and outcome of mechanical ventilation in Korea: a prospective observational study

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Author(s)
Jae Kyeom SimSang-Min LeeHyung Koo KangKyung Chan KimYoung Sam KimYun Seong KimWon-Yeon LeeSunghoon ParkSo Young ParkJu-Hee ParkYun Su SimKwangha LeeYeon Joo LeeJin Hwa LeeHeung Bum LeeChae-Man LimWon-Il ChoiJi Young HongWon Jun SongGee Young Suh
Keimyung Author(s)
Choi, Won Il
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean J Intern Med
Issued Date
2022
Volume
37
Issue
3
Keyword
AgitationMechanical ventilationPainVentilator weaning
Abstract
Background/aims:
There are few studies describing contemporary status of mechanical ventilation in Korea. We investigated changes in management and outcome of mechanical ventilation in Korea.

Methods:
International, prospective observational cohort studies have been conducted every six year since 1998. Korean intensive care units (ICUs) participated in 2010 and 2016 cohorts. We compared 2016 and 2010 Korean data.

Results:
226 patients from 18 ICUs and 275 patients from 12 ICUs enrolled in 2016 and 2010, respectively. In 2016 compared to 2010, use of non-invasive ventilation outside ICU increased (10.2 vs. 2.5%, p = 0.001). Pressure-control ventilation was the most common mode in both groups. Initial tidal volume (7.1 vs. 7.4 ml/kg, p = 0.372) and positive end-expiratory pressure (6 vs. 6 cmH2O, p = 0.141) were similar, but peak pressure (22 vs. 24 cmH2O, p = 0.011) was lower in 2016. More patients received sedatives (70.7 vs. 57.0%, p = 0.002) and analgesics (86.5 vs. 51.1%, p < 0.001) in 2016. The awakening (48.4% vs. 31.0%, p = 0.002) was more frequently attempted in 2016. The accidental extubation rate decreased to one tenth of what it was in 2010 (1.1% vs. 10.2%, p < 0.001). The ICU mortality did not change (31.4% vs. 35.6%, p = 0.343) but ICU length of stay showed a decreasing trend (9 days vs 10 days, p = 0.054) in 2016.

Conclusions:
There were temporal changes in care of patients on mechanical ventilation including better control of pain and agitation, and active attempt of awakening.
Keimyung Author(s)(Kor)
최원일
Publisher
School of Medicine (의과대학)
Citation
Jae Kyeom Sim et al. (2022). Change in management and outcome of mechanical ventilation in Korea: a prospective observational study. Korean J Intern Med, 37(3), 618–630. doi: 10.3904/kjim.2020.285
Type
Article
ISSN
2005-6648
Source
https://www.kjim.org/journal/view.php?doi=10.3904/kjim.2020.285
DOI
10.3904/kjim.2020.285
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44266
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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