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Korean J Crit Care Med > Volume 2(1); 1987 > Article
Korean Journal of Critical Care Medicine 1987;2(1): 50-59.
중환실의 호흡관리 실태 보고
고신옥, 오흥근
Department of Anesthesiology Yonsei University college of Medicine Seoul Korea
Clinical Survey of Paitents on Ventilar Support in the Intensive Care Unit
Shin Ok Koh, Hung Kun Oh
Department of Anesthesiology Yonsei University college of Medicine Seoul Korea
The Intensive Care Unit(ICU) of Severance Hospital was opened on October 18, 1968 with 7 beds and expanded to 19 beds on February 2, 1981. Statistical analysis of ICU patients was already been reported twice: 1. from 1970 to 1977 with 3,072 cases and 2. from 1975 to 1981 with 4.348 cases The following is a report of clinical analysis of 1,458 ventilator eases which comprised 33. 5% of ICU patients from march 1975 to February 1982. Until 1979 pressure and volume cycled ventilators were used in even ratio; however, since 1980, volume-cycled ventilators such as the Bennett MAI and the Bourns LS 104-150 were mainly used. The ratio of ventilator eases from the Department of Internal Medicine and Cardiac Surgery remained almost constant at 30: 30 from 1975 to 1977 However since 1978, the Cardiac Surgery ventilator cases increased to over 50% of the total. The number of ventilator cases be low the ten year age group was 396 cases, about 27 of the total. They have increased year by year. Among 537 ventilator cases in 1981, the Bennett MAI and II were used in 225, 203 cases respectively. In the under 1 year old age group, 36 cases(43.9%) and 30 cases(36.6%) were put on with the Bourns LS 104-150 and Drager babylog I respectively. 487(90.7%) of cases were supported with controlled mechanical ventilation(CMV) mode and 135(25%) with the positive end expiratory pressure (PEEP). Of 537 cases, 441(85%) were disconnected from the ventilator within 3 days. Death according to duration of ventilator support were 47(18.8%), 38(23.8%) and 14(36.9%,) in 1., 2 and 10 days respecitively. But, for the period of 10~19 days, the number of deaths was 4(36.4%) and for 20 or more days 1 cases(25%) 3. Incidence of causative disease for ventilator support was postcardiac operation cases(301 case, 56%) followed by CNS(central nervous system), 1RDS(idiopathic respiratory distress syndrome), and laparotomy cases in that order. All ventilator cases with neuromuscular disease survived, but none with DIC(Disseminated Intravascular Coagulopathy) did. From above results it can be conciuded that ventilator support cases are increasing and the attendant mortality rate is decreasing year by year.
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