Korean J Intern Med.
2022 May;37(3):618-630. 10.3904/kjim.2020.285.
Change in management and outcome of mechanical ventilation in Korea: a prospective observational study
- Sim JK1
- Lee SM2
- Kang HK3
- Kim KC4
- Kim YS5
- Kim YS6
- Lee WY7
- Park S8
- Park SY9
- Park JH10
- Sim YS11
- Lee K12
- Lee YJ13
- Lee JH14
- Lee HB15
- Lim CM16
- Choi WI17
- Hong JY18
- Song WJ1,19
- Suh GY
1,19
- Affiliations
-
- 1Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- 3Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
- 4Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
- 5Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 6Divison of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- 7Divison of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
- 8Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
- 9Department of Pulmonary and Critical Care Medicine, Department of Medicine, Kyung Hee University Medical Center, Seoul, Korea
- 10Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- 11Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
- 12Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- 13Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 14Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ewha Womans University School of Medicine, Seoul, Korea
- 15Division of Allergy and Respiratory Diseases, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, Korea
- 16Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 17Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Korea
- 18Division of Pulmonary and Critical Care Medicine, Department of Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
- 19Divison of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- KMID: 2529659
- DOI: http://doi.org/10.3904/kjim.2020.285
Abstract
- Background/Aims
There are few studies describing contemporary status of mechanical ventilation in Korea. We investigated changes in management and outcome of mechanical 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-invasive ventilation outside ICU increased (10.2% vs. 2.5%, p = 0.001). Pressure-control ventilation 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 cmH2O vs. 6 cmH2O, p = 0.141) were similar, but peak pressure (22 cmH2O vs. 24 cmH2O, 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% 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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