• Title/Summary/Keyword: 중환자

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Relationships among Citical Care Competence, Knowledge related Critical Care, and Satisfaction with Clinical Practice of Nursing Students at a College (일개대학 간호 학생의 중환자 간호 수행 능력과 간호지식 및 실습만족도의 관계)

  • Yang, Jin-Ju
    • The Journal of the Korea Contents Association
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    • v.11 no.12
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    • pp.998-1006
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    • 2011
  • Purpose: The purpose of this study was to identify the relationships among critical care competence, knowledge related to critical care, and satisfaction with clinical practice from third year college nursing students. Methods: The data were collected from questionnaires concerning critical care competence, knowledge related to critical care, and satisfaction with clinical practice given to 85 nursing students during June 2009. Results: The mean score of total critical care competence was 84.01 (${\pm}14.78$). Total knowledge related to critical care was 6.99 (${\pm}1.97$). Finally, satisfaction with clinical practice was 86.88 (${\pm}9.47$). Regarding critical care competence, common critical care competence was highest followed by neurologic care competence, cardiovascular care competence, and finally respiratory care competence. The mean score of knowledge related to cardiovascular care was highest followed by common critical care knowledge, respiratory care knowledge, and neurologic care knowledge for knowledge related to critical care competence. Critical care competence had a significant positive correlation with satisfaction with clinical practice but had no correlation with knowledge related to critical care. Conclusion: Results of this study suggest that developing educations of clinical practice in hospitals and laboratory practice in colleges for respiratory and cardiovascular critical care is necessary to promote critical care competence and satisfy clinical experiences of nursing students.

Evaluation of Critical Patient Severity Classification System(CPSCS) for neurocritical patients in intensive unit (신경계중환자에게 적용한 중환자 중증도 분류도구 연구)

  • Kim, Hee-Jeonh
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5238-5246
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    • 2012
  • This study was done to identify the evaluation of CPSCS for neurocritical patients and provide effective nursing interventions for these patients. Data were collected from medical records of 203 neurocritical patients over 18 years of age who were admitted to the ICU of C University Hospital during the period from January 2008 to May 2009 and from October 2011 to December 2011. Collected data were analyzed through t-test, ANOVA test, Person's correlation analysis, trend analysis, stepwise multiple regression. The average CPSCS score was $112.09{\pm}18.91$ and there was a significant trendency for higher severity to lead to higher CPSCS's scores(survival: J-T:9.795, die: J-T:5.415, p=<.001). The scores of the respective areas follows measurement of vital sign($3.74{\pm}2.15$), monitoring($28.97{\pm}4.31$), activity daily living ($34.99{\pm}3.66$), feeding($.19{\pm}.98$), intravenous infusion ($18.20{\pm}8.27$), treatment/procedure ($16.93{\pm}4.90$), respiratory therapy($8.61{\pm}7.07$). By means of stepwise multiple regression analysis, the intravenous therapy & medication, respiratory therapy, activities of daily living, and monitoring area that contains the model showed a significant (F=2073.963, p<.001), and they explained 98.1% of CPSCS. These findings provide information that is relevant in designing interventions to enhance CPSCS among neurocritical patients in hospital.

An Efficient Dynamic Workload Balancing Strategy (DNN을 이용한 중환자 상태 징후 조기 예측)

  • Hyun-Suk Yoon;Gil-Sik Park;Hae-Jong Joo
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2024.01a
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    • pp.325-327
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    • 2024
  • 국내외에서 AI기반 의료 솔루션 시장은 빠른 속도로 확장 중이며 이에 따른 다양한 의학 분야에서 많은 기법을 통한 의료 AI 시스템이 등장하고 있다. 그러나 기존 다양한 AI 연구가 이뤄짐에도 아직 중환자의 징후 예측에는 많은 어려움이 있다. 또한, 중환자의 경우 현재 의료진만으로 모든 환자를 필요한 시기에 진료하기엔 어려움이 있고 환자 상태 조기 예측이 필수적임을 관련 다양한 의학 기사를 통해 쉽게 인지할 수 있다. 본 연구에서는 위와 같은 문제점을 해결하고자 중환자의 진료 결과 데이터를 활용하여 환자의 진료 후 상태를 예측하는 모델을 생성하였다. '용인시산업진흥원'에서 제공하는 60만여 건에 달하는 환자 데이터를 수집하여, 중환자 상태 징후를 조기에 예측할 수 있는 머신러닝/딥러닝 기반 알고리즘으로 구현한 여러 모델에 대해 비교했을 때 딥러닝(DNN) 기반 모델이 약 92%의 분류 정확도를 측정할 수 있었다.

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Evaluation of the Clinical usefulness of Critical Severity Classification System(CPSCS) and Glasgow coma scale(GCS) for Neurologic Patients in Intensive care units (중환자 중증도 분류도구와 Glasgow coma scale의 임상적 유용성 평가)

  • Kim, Hee-jeong;Kim, Jee-hee
    • Proceedings of the Korea Contents Association Conference
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    • 2012.05a
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    • pp.343-344
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    • 2012
  • 본 연구는 중증도가 높은 신경계중환자를 대상으로 중환자 중증도 분류도구와 Glasgow coma scale 적용의 유용성을 검정하고자 하는데 있다. 본 연구에서 대상자의 일반적 특성 및 임상 관련 특성에 따른 사망률 확인, 중환자 중증도 분류도구(CPSCS)의 일반적 특성, 임상관련 특성에 따른 중증도 차이, GCS의 일반적 특성과 임상관련 특성에 따른 중증도 차이를 파악하고, 임상적 유용성을 검정하고자 한다.

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Clinical Aspects of Bacteremia in Medical and Surgical Intensive Care Units (내과 및 외과계 중환자실 환자 균혈증의 임상적 고찰)

  • Kim, Eun-Ok;Lim, Chae-Man;Lee, Jae-Kyoon;Mung, Sung-Jae;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Park, Pyung-Hwan;Choi, Jong-Moo;Pai, Chik-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.535-547
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    • 1995
  • Background: Intensive care units(ICUs) probably represent the single largest identifiable source of infection within the hospital. Although there are several studies on ICU infections in respect to their bacteriology or mortality rate for individual types of ICU, few studies have compared ICU infections between different types of ICU. The aim of this study was to identify clinical differences in bacteremia between medical ICU(MICU) and surgical ICU(SICU) patients. Methods: 256 patients with bacteremia were retrospectively evaluated. Medical records were reviewed to obtain the clinical and bacteriologic informations. Results: 1) The mean age of the patients with bacteremia of MICU($58.6{\pm}17.2\;yr$) was greater than that of all MICU patients($54.3{\pm}17.1\;yr$)(p<0.01), but there was no significant difference in SICU patients(patients with bacteremia of SICU: $56.3{\pm}18.6\;yr$, all SICU patients: $62.0{\pm}16.8$)(p>0.05). ICU stay was longer(MICU patients: $23.4{\pm}40.8$ day, SICU patients: $30.3{\pm}26.8$ day) than the mean stay of all patients($6.8{\pm}15.5$ day)(p<0.05, respectively). Bacteremia of both ICU patients developed past the average day of ICU stay(all MICU patients: 7.9 day, all SICU patients: 6.0 day, MICU bacteremia: 19th day, SICU bacteremia: 17th day of ICU stay)(p<0.05, respectively). 2) There were no significant differences in mean age, sex, and length of stay of both ICU patients with bacteremia. 3) Use of antibiotics or steroid, use of percutaneous devices and invasive procedures before development of bacteremia were more frequent in SICU patients than in MICU patients(prior antibiotics use: MICU 45%, SICU 63%, p<0.05; steroid use: MICU 14%, SICU 36%, p<0.01; use of percutaneous devices: MICU 19%, SICU 39%, p<0.01; invasive procedures: MICU 19%, SICU 61 %, p<0.01). 4) The prevalence of community acquired infections was significantly higher in MICU patients than in SICU patients(MICU 42%, SICU 9%)(p<0.01), whereas SICU patients showed higher prevalence of ICU-acquired infection than MICU patients(MICU 48%, SICU 78%)(p<0.01). 5) There were no differences in causative organisms, primary sites of infection and time interval to bacteremia between both ICUs. 6) There were no significant differences in outcome according to pathogenic organisms or primary sites of infection. 7) The mortality rate was higher in patients with bacteremia than without bacteremia(MICU mortality rate: patients with bacteremia 72.5%, patients without bacteremia 36.0%, p<0.01; SICU mortality rate: patients with bacteremia 40.3%, patients without bacteremia 8.5%, p<0.05), and the mortality rate of MICU bacteremia was significantly higher compared with that of SICU bacteremia(MICU 72.5%, SICU 40.3%)(p<0.01). Conclusion: ICU patients with bacteremia stayed longer before the development of bacteremia, and showed higher mortality than the overall ICU population. The incidence of bacteremia was higher in MICU patients than SICU patients. MICU patients with bacteremia showed higher prevalence of liver diseases and acute respiratory failure, community-acquired bacteremia and greater mortality rate than SICU patients with bacteremia. SICU patients with bacteremia, on the other hand, showed higher prevalence of trauma, prior use of immunosuppressive agents, invasive procedures, and ICU-acquired bacteremia, and lower mortality rate than MICU patients with bacteremia.

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환자에서의 젖산 측정

  • Seo, Ji-Min
    • Journal of the korean veterinary medical association
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    • v.43 no.12
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    • pp.1113-1118
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    • 2007
  • 중환자에서 조직의 저산소증을 확인하고 교정하는 것은 매우 중요하다. 혈중 젖산측정은 30년 이상 인의에서 조직의 산소화를 위한 간접적인 측정방법으로 이용되었다. 그러나 수의에서는 최근에 많이 이용되고 있는 방법이다. 비싸지 않은 간이 젖산 측정계로 중환자의 젖산을 연속적으로 모니터하는 것이 수의 응급실 및 전문병원(referral center)에서 상용화되고 있다. 수의 환자에서 혈중 젖산 측정은 질병의 심각도를 결정하고 치료 결정을 조절하는데 유용한 보조 수단이다.

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Nutritional Support for Neurocritically Ill Patients (신경계 중환자의 영양 집중 치료)

  • Jeong, Hae-Bong;Park, Soo-Hyun;Ryu, Ho Geol
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.71-80
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    • 2018
  • Nutritional assessment and support are often overlooked in the critically ill due to other urgent priorities. Unlike oxygenation, organ dysfunction, infection, or consciousness, there is no consensus of indicators. Making it difficult to evaluate the effectiveness of an intervention. Nevertheless, appropriate nutritional support in the critically ill has been associated with less morbidity and lower mortality. But, nutritional support has been considered an adjunct, for body weight maintenance and to help patients during the inflammatory phase of illness. Thus, it has been assigned a lower priority, compared to mechanical ventilation or hemodynamic stability. Recent findings have shown that nutritional support may prevent cellular injury due to oxidative stress and help strengthen the immune response. Large-scale randomized trials and clinical guidelines have shown a shift from nutritional support to nutritional therapy, with an emphasis on the importance of protein, minerals, vitamins, and trace elements. Nutrition is also important in neurocritically ill patients. Since there are few studies or recommendations with regard to the neurocritical population, the general recommendations for nutritional support should be applied.

Knowledge and Performance of Guidelines for Evaluation of New Fever in Critically Ill Adult Patients (중환자 첫 발열 평가 근거기반 가이드라인에 대한 지식과 수행 정도)

  • Yang, Jin-Ju;Jang, Keum-Seong;Choi, Ja-Yun;Ryu, Seang;Kim, Yun-Hee
    • The Journal of the Korea Contents Association
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    • v.16 no.12
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    • pp.468-479
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    • 2016
  • The purpose of this study was to investigate nurses' knowledge and performance of guidelines for evaluation of new fever in critically ill adult patients according to the level of evidence. The total participants were 145 nurses working for medical surgical unit and intensive care unit in two hospitals. The knowledge and performance mean scores of guidelines were $0.70{\pm}0.09$ and $3.08{\pm}0.31$ respectively. The evidence level 1 of guidelines had the higher performance score in high score group than low score group of knowledge groups(F=3.86, p=.023) and performance groups(F=163.14, p<.001), while the evidence level 3 of guidelines had the higher performance score in low score group than high score group of knowledge groups(F=5.99, p=.003). Knowledge and performance scores were significantly correlated (r=.25, p=.003). In Conclusion, these findings emphasize that clinical professions need to enhance both of knowledge and practice with evidence based guideline of new fever in critically ill patient.

Evidence-based Nutritional Support in the Intensive Care Unit (중환자를 위한 근거중심 영양지원)

  • Yi, Young-Hee;Oui, Mi-Sook
    • Journal of Korean Critical Care Nursing
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    • v.3 no.1
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    • pp.79-88
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    • 2010
  • Optimal nutrition serves to maintain normal organ function and to preserve body energy stores to guarantee survival during times of shortage of food. Adequate nutrition of intensive care unit (ICU) patients improves outcome, while malnutrition is strongly associated with increased morbidity and mortality rates among critically ill patients. Previously published researches showed that trials of nutritional support in critical illness rarely fulfill basic quality requirements. Nutrition support plays a vital role in the prevention and treatment of nutritional deficiencies in at-risk, critically ill patients. This paper reviewed the challenges in determining critically ill patients' nutrition requirements including nutrition assessment, determination of caloric requirements then providing them with adequate nutrition support while in the ICU with the guidelines published by Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Nutrition support can be effectively enhanced by using the guidelines.

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