Tuberculosis and Respiratory Diseases

  • 제73권2호
  • /
  • Pages.100-106
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  • 2012
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
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The Impact of Implementing Critical Care Team on Open General Intensive Care Unit

  • Kim, Ick Hee (Department of Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine) ;
  • Park, Seung Bae (Department of Surgery, Kangwon University School of Medicine) ;
  • Kim, Seonguk (Department of Pediatrics, Konkuk University School of Medicine) ;
  • Han, Sang-Don (Department of Neurology, Konkuk University School of Medicine) ;
  • Ki, Seung Seok (Department of Gastroenterology, Konkuk University School of Medicine) ;
  • Chon, Gyu Rak (Department of Pulmonary and Critical Care Medicine, Konkuk University School of Medicine)
  • 투고 : 2012.05.16
  • 심사 : 2012.07.16
  • 발행 : 2012.08.30
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초록

Background: There are a plethora of literatures showing that high-intensity intensive care unit (ICU) physician staffing is associated with reduced ICU mortality. However, it is not widely used in ICUs because of limited budgets and resources. We created a critical care team (CCT) to improve outcomes in an open general ICU and evaluated its effectiveness based on patients' outcomes. Methods: We conducted this prospective, observational study in an open, general ICU setting, during a period ranging from March of 2009 to February of 2010. The CCT consisted of five teaching staffs. It provided rapid medical services within three hours after calls or consultation. Results: We analyzed the data of 830 patients (157 patients of the CCT group and 673 patients of the non-CCT one). Patients of the CCT group presented more serious conditions than those of the non-CCT group (acute physiologic and chronic health evaluation II [APACHE II] 20.2 vs. 15.8, p<0.001; sequential organ failure assessment [SOFA] 5.5 vs. 4.6, p=0.003). The CCT group also had significantly more patients on mechanical ventilation than those in the non-CCT group (45.9% vs. 23.9%, p<0.001). Success rate of weaning was significantly higher in the CCT group than that of the non-CCT group (61.1% vs. 44.7%, p=0.021). On a multivariate logistic regression analysis, the increased ICU mortality was associated with the older age, non-CCT, higher APACHE II score, higher SOFA score and mechanical ventilation (p<0.05). Conclusion: Although the CCT did not provide full-time services in an open general ICU setting, it might be associated with a reduced ICU mortality. This is particularly the case with patients on mechanical ventilation.

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참고문헌

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피인용 문헌

  1. Comparison of the clinical features in open and closed format intensive care units: A systematic review and meta-analysis vol.40, pp.6, 2021, https://doi.org/10.1016/j.accpm.2021.100950