Change in management and outcome of mechanical ventilation in Korea: a prospective observational studyopen access
- Authors
- Sim, Jae Kyeom; Lee, Sang-Min; Kang, Hyung Koo; Kim, Kyung Chan; Kim, Young Sam; Kim, Yun Seong; Lee, Won-Yeon; Park, Sunghoon; Choi, Wonil; Suh, Gee Young
- Issue Date
- May-2022
- Publisher
- KOREAN ASSOC INTERNAL MEDICINE
- Keywords
- Correspondence to; Respiration; artificial; Pain; Agitation; Ventilator weaning
- Citation
- KOREAN JOURNAL OF INTERNAL MEDICINE, v.37, no.3, pp.618 - 630
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- KOREAN JOURNAL OF INTERNAL MEDICINE
- Volume
- 37
- Number
- 3
- Start Page
- 618
- End Page
- 630
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/189150
- DOI
- 10.3904/kjim.2020.285
- ISSN
- 1226-3303
- Abstract
- Background/Aims: There are few studies describing contemporary status of mechanical ventilation in Korea. We investigated changes in management and outcome of mechani-cal ventilation in Korea.
Methods: International, prospective observational cohort studies have been conducted every 6 years since 1998. Korean intensive care units (ICUs) participated in 2010 and 2016 cohorts. We compared 2016 and 2010 Korean data.
Results: Two hundred and twenty-six patients from 18 ICUs and 275 patients from 12 ICUs enrolled in 2016 and 2010, respectively. In 2016 compared to 2010, use of non-inva-sive ventilation outside ICU increased (10.2% vs. 2.5%, p = 0.001). Pressure-control venti-lation was the most common mode in both groups. Initial tidal volume (7.1 mL/kg vs. 7.4 mL/kg, p = 0.372) and positive end-expiratory pressure (6 cmH(2)O vs. 6 cmH(2)O, p = 0.141) were similar, but peak pressure (22 cmH(2)O vs. 24 cmH(2)O, 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.
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