• Clinical and Experimental Pediatrics
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• 제64권12호
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• pp.630-631
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• 2021

• Tuberculosis and Respiratory Diseases
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• 제83권3호
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• pp.248-254
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• 2020

Background: Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. Methods: Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018-May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017-May 2018 (the control group). Results: Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. Conclusion: Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.

• Tuberculosis and Respiratory Diseases
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• 제79권4호
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• pp.214-233
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• 2016

There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2018년도 춘계학술대회
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• pp.149-151
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• 2018

본 연구의 목적은 R을 이용하여 주요 사망원인이 지역별로 차이가 있는지를 가시화 하고 분석하는 것이다. 국가통계포털에서 제공하는 통계청 사망원인통계를 활용하였으며, 주요 사망원인에 대해 지역별 사망률을 전국 사망률로 나누어서 지역별 사망률의 차이를 비교하고자 하였다. 이를 위해 지역 사망비율과 지역연령표준화사망비율을 정의하고 계산된 결과를 R을 이용하여 단계구분도로 도시하여 비교하였다. 지역연령표준화사망비율의 지역별 비교 결과 국내 사망원인 1위인 신생물의 경우 지역적 차이가 크지 않았으나, 사망원인 2위인 순환계통 질환은 경상도 지역, 특히 울산, 대구, 부산 및 경남에서 상대적으로 사망비율이 높게 나타났다. 그리고 사망원인 3위인 호흡계통 질환은 강원, 세종, 충북 순으로 상대적으로 높은 사망비율을 보였다.

• 대한임상독성학회지
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• 제3권2호
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• pp.86-92
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• 2005

Purpose: The main cause of death due to acute organophosphate (OP) poisoning is believed acute respiratory failure caused by cholinergic reactions. Recently, advances in respiratory and intensive care make it possible to maintain the respiratory function of patients with OP poisoning, but the mortality rates remain high. The present study clarified the hemodynamics of patients with acute lethal OP poisoning. The purpose of this study was to analyse the outcomes and predictors of mortality in patients with acute OP poisoning requiring intensive care. Methods: We reviewed medical and intensive care records of patients with acute OP poisoning admitted to emergency department and ICU between March 1998 and Aug 2005. We collected patient information regarding poisoning, clinical, and demographic features. Results: During the study period, 67 subjects treated with intensive care and ventilator management in addition to gastric decontamination standard therapy with atropine and 2-PAM. Of 67 patients, 13 died. Kaplan-Meier survival analysis demonstrated a steep decline in the cumulative survival to $86.6\%$ during the first week. Mean arterial pressure < 60 mmHg within the first 24 hours was recognized as a poor prognostic indicators among mechanical ventilated patients. Conclusion: Most OP poisoning-related deaths occurred within the first week of poisoning. Mean arterial pressure lower than 60 mmHg might be the best predictor of poor outcome. We speculated that the refractory hypotension is the leading cause of death in patients with lethal OP poisoning that receiving mechanical ventilation and maximal supportive care.

• Journal of Chest Surgery
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• 제54권1호
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• pp.36-44
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• 2021

Background: Extracorporeal membrane oxygenation (ECMO) has become increasingly accepted as a life-saving procedure for patients with severe acute respiratory distress syndrome (ARDS). This study investigated the relationship between cumulative fluid balance (CFB) and outcomes in adult ARDS patients treated with ECMO. Methods: We retrospectively analyzed the data of adult ARDS patients who received ECMO between December 2009 and December 2019 at Korea University Anam Hospital. CFB was calculated during the first 7 days after ECMO initiation. The primary endpoint was 28-day mortality. Results: The 74 patients were divided into survivor (n=33) and non-survivor (n=41) groups based on 28-day survival. Non-survivors showed a significantly higher CFB at 1-7 days (p<0.05). Cox multivariable proportional hazard regression revealed a relationship between CFB on day 3 and 28-day mortality (hazard ratio, 3.366; 95% confidence interval, 1.528-7.417; p=0.003). Conclusion: In adult ARDS patients treated with ECMO, a higher positive CFB on day 3 was associated with increased 28-day mortality. Based on our findings, we suggest a restrictive fluid strategy in ARDS patients treated with ECMO. CFB may be a useful predictor of survival in ARDS patients treated with ECMO.

• Tuberculosis and Respiratory Diseases
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• 제87권3호
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• pp.319-328
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• 2024

Background: Although inhaled corticosteroids (ICS) is reportedly associated with a higher risk of pneumonia in chronic obstructive pulmonary disease (COPD), the clinical implications of ICS have not been sufficiently verified to determine their effect on the prognosis of pneumonia. Methods: The electronic health records of patients hospitalized for pneumonia with underlying COPD were retrospectively reviewed. Pneumonia was confirmed using chest radiography or computed tomography. The clinical outcomes of pneumonia in patients with COPD who received ICS and those who received long-acting bronchodilators other than ICS were compared. Results: Among the 255 hospitalized patients, 89 met the inclusion criteria. The numbers of ICS and non-ICS users were 46 and 43, respectively. The CURB-65 (confusion, uremia, respiratory rate, blood pressure, age ≥65 years) scores at the initial presentation of pneumonia were comparable between the two groups. The proportions of patients with multilobar infiltration, pleural effusion, and complicated pneumonia in the radiological studies did not vary between the two groups. Additionally, the defervescence time, proportion of mechanical ventilation, intensive care unit admission, length of hospital stays, and mortality rate at 30 and 90 days were not significantly different between the two groups. ICS use and blood eosinophils count were not associated with all pneumonia outcomes and mortality in multivariate analyses. Conclusion: The clinical outcomes of pneumonia following ICS use in patients with COPD did not differ from those in patients treated without ICS. Thus, ICS may not contribute to the severity and outcomes of pneumonia in patients with COPD.

• 한국임상수의학회지
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• 제17권1호
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• pp.83-87
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• 2000

The mortalities of the monkeys that have been raised in Everland Zoological Gardens within a designated period (1976-1999) were retrospectively analyzed based on the clinical charts and/or autopsy reports. During that period, a total of 161monkeys from 8 species were died. Noninfectious and traumatic factors, respiratory and digestive disorders account for the majority of cause of death. 62% of the death was concentrated in the winter season. The mortality of female and male was 53 and 47%, respectively. The mortality of adult monkey(62%) due to neoplasia and senile changes.

• 한국임상수의학회지
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• 제19권2호
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• pp.211-214
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• 2002

The mortalities of exotic felids that have been raised in Everland Zoological Gardens within a designated period (1976∼2001) were retrospectively analyzed based on the clinical charts and/or autopsy reports. During that period, a total of 154 exotic folios from 5 species were died. Noninfectious and traumatic factors, respiratory and digestive disorders account for the majority of cause of death. 40% of the death was concentrated in the winter season. The mortality of female and male was 55% and 45% respectively. The mortality of newborn folios(57%) were significantly higher than that of adult(32% and juvenile felids(11%) due to neonatal problems.

• 한국환경과학회지
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• 제11권10호
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• pp.1061-1068
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• 2002

To identify possible associations with concentrations of ambient air pollutants and daily mortality in Busan, this study assessed the effects of air pollution for the time period 1999-2000. Poisson regression analysis by Generalized Additive Model were conducted considering trend, season, meteorology, and day-of-the-week as confounders in a nonparametric approach. Busan had a 10% increase in mortality in persons aged 65 and older(95% Cl : 1.01-1.10) in association with IQR in $NO_2$(lagged 2 days). An increase of $NO_2$(lagged 2days) was associated with a 4% increase in respiratory mortality(Cl : 1.02-1.11) and CO(lagged 1 day) showed a 3% increase(Cl : 1.00-1.07).