J Korean Med Sci.  2014 Jun;29(6):864-870. 10.3346/jkms.2014.29.6.864.

Clinical Demographics and Outcomes in Mechanically Ventilated Patients in Korean Intensive Care Units

• Jeong BH
• Suh GY
• An JY
• Park MS
• Lee JH
• Lee MG
• Kim JH
• Kim YS
• Choi HS
• Kim KC
• Lee WY
• Koh Y

• KMID: 1796952
• DOI: http://doi.org/10.3346/jkms.2014.29.6.864

Abstract

Knowledge of clinical demographics and outcomes of mechanically ventilated patients is important but there are few prospectively collected data in Korea. The objective of the present study was to describe the current status of mechanically ventilated patients in Korea as of 2010. We analyzed the data of Korean patients (275 patients in 12 Korean intensive care units [ICU]) participating in a multinational prospective cohort study on mechanical ventilation. The most common indication for mechanical ventilation was pneumonia (23%). Pressure-limited ventilation modes were preferred over volume-cycled ventilation modes. Non-invasive positive pressure ventilation was used in only seven (2%) patients as the initial ventilatory support. Median duration of mechanical ventilation was 7 days and ICU mortality was 36%. The multiple logistic regression model revealed that the Simplified Acute Physiology Score II (SAPS II) score at ICU admission (odds ratio [OR], 1.034; 95% confidence interval [CI], 1.001-1.036; P=0.033), peak pressure (OR, 1.054; 95% CI, 1.016-1.095; P=0.006), and the number of failed organs (OR, 2.132; 95% CI, 1.634-2.781; P<0.001) were independently associated with ICU mortality. This study provides a snapshot of current practice of mechanical ventilation in Korea.

Keyword

Respiration, Artificial; Epidemiology; Data collection; Outcome; Korea

MeSH Terms

Acute Disease
Aged
Cohort Studies
Demography
Female
Hospital Mortality
Humans
Intensive Care Units/*statistics & numerical data
Length of Stay
Male
Middle Aged
Odds Ratio
Prognosis
Prospective Studies
Republic of Korea
*Respiration, Artificial
Respiratory Insufficiency/*diagnosis/epidemiology/mortality
Sepsis/etiology
Severity of Illness Index

Figure

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  Fig. 1 Initial settings of ventilator according to reason for initiating mechanical ventilation. Boxes indicate interquartile ranges and whiskers indicate 10 to 90 percentile ranges. *P<0.05 by Bonferroni adjusted Mann-Whitney U-test. TV, tidal volume; PBW, predicted body weight; PEEP, positive end-expiratory pressure; ARDS, acute respiratory distress syndrome; ARF-CPD, acute respiratory failure on chronic pulmonary disease.

• 

  Fig. 2 Ventilator modes used each day during the course of mechanical ventilation. Bar graphs indicate the total number of patients who received mechanical ventilation by days from the start of mechanical ventilation. Lines indicate the percentage of ventilatory mode by each day, respectively. PCV, pressure control ventilation; A/C, assist/control mode; SIMV-PS, synchronized intermittent mandatory ventilation with pressure support; PSV, pressure support ventilation; PRVC, pressure regulated volume control.

• 

  Fig. 3 Clinical course of patients who received mechanical ventilator support. NIV, non-invasive ventilator; IMV, invasive mechanical ventilator; MV, mechanical ventilation.

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