Change in management and outcome of mechanical ventilation in Korea: a prospective observational study
- Author:
Jae Kyeom SIM
1
;
Sang-Min LEE
;
Hyung Koo KANG
;
Kyung Chan KIM
;
Young Sam KIM
;
Yun Seong KIM
;
Won-Yeon LEE
;
Sunghoon PARK
;
So Young PARK
;
Ju-Hee PARK
;
Yun Su SIM
;
Kwangha LEE
;
Yeon Joo LEE
;
Jin Hwa LEE
;
Heung Bum LEE
;
Chae-Man LIM
;
Won-Il CHOI
;
Ji Young HONG
;
Won Jun SONG
;
Gee Young SUH
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2022;37(3):618-630
- CountryRepublic of Korea
- Language:English
-
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.
