• Tuberculosis and Respiratory Diseases
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• v.64 no.6
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• pp.445-450
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• 2008

Background: As the number of older-aged people increases, the number of elderly patients who receive critical care services is expected to increase substantially. The objective of this study was to examine the clinical characteristics and outcomes of elderly patients who receive mechanical ventilation for more than 30 days in the medical intensive care unit (MICU) at a university hospital. Methods: We retrospectively examined forty-one elderly patients (${\geq}65$ years old) who were receiving mechanical ventilation, from April 2004 to March 2007, for periods exceeding 30 days at the MICU at Eulji University Hospital. Results: The MICU and hospitalmortality rate were 60.9% and 65.9%, respectively. The mean length of the ICU stay was 57.5 days and the mean duration of mechanical ventilation was 49.3 days. The most common reason for MICU admission was acute respiratory failure (73.2%), followed by sepsis (12.2%), neurological problems (9.8%), and gastrointestinal bleeding (4.9%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher for the nonsurvivors than for the survivors (28.0 vs. 25.0, respectively, p=0.03). The nonsurvivors received more red blood cell (RBC) transfusions during their ICU stay than did the survivors (84.0% vs. 43.8%, respectively p=0.007). The factors associated with hospital death were the APACHE II score and if the patient had received a RBC transfusion. Conclusion: The APACHE II score and a RBC transfusion were predictors of increased hospital mortality for the elderly patients who were on prolonged mechanical ventilation. These predictors may assist physicians to make clinical decisions for this patient population.

• Journal of The Korea Institute of Healthcare Architecture
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• v.25 no.3
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• pp.47-55
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• 2019

Purpose: This study tries to propose the dimensions and area related to patient bed and surroundings in ICU considering nurses' observation and medical care. Methods: Literature survey, 11 Case studies, some Interviews with nurses and measuring of medical equipments' dimension in ICU have been mobilized in order to deepen the ICU bed area standards. Results: 0.3m clearance between head wall and patient bed is necessary for emergency cases. The minimum distance at the foot of the bed should not be less than 0.9m for EMR cart and medical tray. The clear floor area of one bed and surroundings in open ward is $10.2m^2(3m{\times}3.4m)$. In a single-bed patient room, the minimum clear floor area is $16.0m^2(4m{\times}4m)$. Considering the control of cross infection in ICU, Single bed patient room is recommended. Implications: The result of this study can be applied to the design of ICU and legislation of ICU standard.

• Journal of Environmental Health Sciences
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• v.29 no.1
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• pp.1-7
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• 2003

This study was carried out to investigate the airborne microbial pollution in hospital environment. Using a mechanical air sampler, microbiological samples were taken from intensive care unit, general ward room, patients wailing room and outdoor of 20 hospitals in Seoul, Korea. The concentration of airborne bacteria and fungi ranged 97-410 cfu/㎥ and 37-77 cfu/㎥, respectively and patients waiting room had highest bacterial count. 10 genera of molds were identified and the most frequently recovered molds were Aspergillus, followed by Penicillium, Alternaria and Cladosporium. Among Staphylococcus species, S. haemolyticus and S. epidermidis were predominant and 47% of Staphylococcus species were isolated from intensive rare unit.

• 한국보건간호학회:학술대회논문집
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• 1997.12a
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• pp.45-45
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• 1997

• Journal of the korean veterinary medical association
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• v.44 no.2
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• pp.176-180
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• 2008

혈장과 합성 클로이드의 사용은 환자 관리에 중요하며 소생요법의 기본적인 부분을 차지한다. 하지만 각각의 환자를 위한 가장 적절한 클로이드 용액을 선택은 어려울 수 있다. 환자의 내재질환에 대한 병적 과정, 최근 심혈관 상태, 응고계 상태뿐만 아니라 각각의 클로이드 용액에 대한 성질과 부작용을 이해함으로써 개개의 환자를 위한 적절한 수액요법을 적용할 수 있다.

• Tuberculosis and Respiratory Diseases
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• v.59 no.2
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• pp.151-156
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• 2005

Background : Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in hospital-acquired infection, and is prevalent in intensive care units (ICU). The MRSA colonization rates of the nares and throat were examined in both the ICU and general ward. This study was performed to investigate the MRSA rate and necessity for MRSA screening cultures in patients admitted to ICU. Methods : Between June and September 2004, those patients admitted to both the medical ICU and general ward participated in this study. Bacterial cultures were performed on swabs of the nares and throat taken within 24 hours of admission. Clinical data were also collected. Results : One hundred and twenty one patients and 84 patients, admitted to the medical ICU and medical general ward, respectively, were investigated. The numbers of nasal MRSA colonization in the ICU and general ward were 3 (2.5%) and 3 (3.6%), respectively. There were 2 (1.7%) cases of throat MRSA colonization in the ICU, but none in the general ward. The MRSA colonization rates of the nares and throat were no different between the ICU and general ward. There were no significant differences in the previous admission, operation history and admission route between the ICU and general ward groups. Conclusion : The MRSA colonization rates of the nares and throat were 3.3 and 3.6% in the ICU and the general ward, respectively. The MRSA screening test does not appear to be required in all patients admitted to the ICU, but further studies, including high-risk patients, are recommended.

• Journal of the Korea Convergence Society
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• v.12 no.12
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• pp.563-572
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• 2021

This study conducted a network meta-analysis to compare the effectiveness and ranking of pressure ulcer preventive programs in intensive care units. A frequency network meta-analysis was performed to identify evidence from relevant randomized control trials. A total of 10 randomized control trials involving 5 intervention subgroups were included in this study. Based on the ranking probabilities(P-Score), preventive materials was ranked as the most effective among all programs (P-Score 85.3.%: OR=0.12, 95% CI: 0.03, 0.49). Next was silicone foam dressing(P-Score 84.5%: OR=0.14, 95% CI: 0.05, 0.38), care bundle(P-Score 60.0%: OR=0.29, 95% CI: 0.07, 1.25), reposition (P-Score 32.3%: OR=0.66, 95% CI: 0.21, 2.09) and synthetic fabrics (P-Score 23.8%: OR=0.85, 95% CI: 0.20, 3.65). It is necessary to develop practical and efficient interventions that can prevent pressure ulcers in intensive care unit patients, improve patient safety, and reduce nurses' workload.

• Journal of Korean Critical Care Nursing
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• v.16 no.1
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• pp.28-43
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• 2023

Purpose : Intensive care unit (ICU) diaries have been implemented across the international ICU community. This study aimed to comprehend the meaning and nature of the lived experience of patients' families using the ICU diary in Korea. Methods : This qualitative study adopted van Manen's hermeneutic phenomenology. The participants comprised eight women and two men who were the family members of patients in the ICU for more than three days. Data were collected using in-depth interviews and observation from July 2018 to January 2019. Results : Patients' families who experienced the ICU diary recognized it with six beings according to time: a good idea, forgotten stuff, burdensome work, touching service, my stuff, and a thing in the memory. The ICU diary had three essential meanings for the families: communication, solace and hope, and a record of life. These findings were rearranged according to van Manen's fundamental existential, and the lived things and lived others were remarkably confirmed. Conclusion : Patients' families experienced various ICU diary forms over time and recognized an ICU diary as a means of communication. Therefore, the ICU diary is expected to be used as an intervention between families and healthcare providers in the ICU to support mutual communication.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.522-529
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• 2005

Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

• Tuberculosis and Respiratory Diseases
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• v.65 no.4
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• pp.292-300
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• 2008

Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit. Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation for more than 48 hours in the medical ICU of one tertiary referral hospital. Results: The mean age of the patients was $60.3{\pm}15.6$ years and 34.0% were female. The initial mean APACHE III score was $72.3{\pm}25$. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score >70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality. Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly associated with the outcome of mechanical ventilatory support in patients with respiratory failure.