PURPOSE: The purpose of this study was to identify a research trend of studies related to the Do-Not-Resuscitate (DNR) decision making process in Korea. METHODS: Assessing through five computerized databases, 889 studies were reviewed and of these 32 were included. An integrative literature review and text network analysis were applied to examine the research. The keywords from each article's abstracts were extracted by using a program, KrKwic. RESULTS: The number of studies on DNR decision has been increasing, especially since 2011. A descriptive study design (59%) was most commonly used in the research. In relation to factors affecting DNR decision, 97% of the studies stated patient factors and 66% stated family factors. 'Patient', 'DNR', 'decision', 'treatment', 'life', 'family' were the major keywords, and 'patient' and 'care' were dominant keywords that ranked high in coappearance frequency. CONCLUSION: Studies related to DNR decision have been increasing, and themes of the studies have also been broader. Further research is required to investigate factors affecting DNR decision in specific populations such as cancer patients, the elderly, patients with end-stage of chronic diseases etc. Moreover, a comparative study is necessary to define differences of research trends related to DNR decision making process between Korea and other countries.
Aged ; Chronic Disease ; Decision Making ; Humans ; Korea ; Resuscitation Orders

Iron supplements such as ferrous sulfate tablets are usually used to treat iron-deficiency anemia in some elderly patients with primary neurologic disorders or decreased gag reflexes due to stroke, senile dementia, or parkinsonism. While the aspiration of ferrous sulfate is rarely reported, it is a potentially life-threatening condition that can lead to airway necrosis and bronchial stenosis. A detailed history and high suspicion of aspiration are required to avoid delays in diagnosis and treatment. The diagnosis can be confirmed by bronchoscopic examination and a tissue biopsy. Early removal of the aspirated tablet prevents acute complications, such as bronchial necrosis, hemoptysis, and lobar consolidation. Tablet removal is also necessary to prevent late bronchial stenosis. We presented the first case in Korea of a ferrous sulfate tablet aspiration that induced severe endobronchial inflammation.
Aged ; Alzheimer Disease ; Anemia, Iron-Deficiency ; Biopsy ; Bronchi ; Bronchoscopy ; Constriction, Pathologic ; Diagnosis ; Foreign Bodies ; Hemoptysis ; Humans ; Inflammation* ; Iron ; Korea ; Necrosis ; Nervous System Diseases ; Parkinsonian Disorders ; Reflex ; Respiratory Aspiration ; Stroke ; Tablets

PURPOSE: CHARGE syndrome consists of multiple malformation including coloboma, heart defect, choanal atresia, growth or developmental retardation, genital anomalies, and ear anomalies. The aim of this study was to evaluate the respiratory problems in children with CHARGE syndrome. METHODS: Out of 9 patients with CHARGE syndrome, medical records from 8 patients showing respiratory distress or respiratory failure were retrospectively reviewed. We investigated the causes of respiratory problems by physical examination, endoscopy, echocardiogram, computed tomography, rigid bronchoscopy, swallowing test, and 24-hour impedence monitoring. RESULTS: Five patients required endotracheal intubation soon after birth due to bilateral choanal atresia (n=2) and congenital heart diseases (n=3). Three patients were intubated within a month because of surgery for complex heart diseases (n=2) or recurrent apnea (n=1). Tracheostomy was performed in 3 patients who showed primary or secondary subglottic stenosis. Among 8 patients who had aspiration or respiratory distress after feeding, cricopharyngeal incoordination and gastroesophageal reflux disease were found in 7 and 2 children, respectively. One patient died of aspiration during oral feeding. CONCLUSION: Patients with CHARGE syndrome manifest respiratory distress or failure due to various causes including congenital anomaly in the airway, cardiac anomaly, neurologic or gastrointestinal problems. Therefore, pediatricians should be alert to the respiratory symptoms and signs in CHARGE syndrome and take active intervention from the birth to improve their long-term prognosis.
Apnea ; Ataxia ; Bronchoscopy ; CHARGE Syndrome* ; Child ; Choanal Atresia ; Coloboma ; Constriction, Pathologic ; Deglutition ; Ear ; Endoscopy ; Feeding Methods ; Gastroesophageal Reflux ; Heart ; Heart Diseases ; Humans ; Intubation, Intratracheal ; Medical Records ; Parturition ; Physical Examination ; Prognosis ; Respiratory Insufficiency ; Retrospective Studies ; Tracheostomy