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韩国机械通气患者的特征及管理与其他高收入亚洲国家和地区的比较。

Characteristics and management of mechanically ventilated patients in South Korea compared with other high-income Asian countries and regions.

作者信息

Nam Kyung Hun, Jeon Kyeongman, Hong Suk-Kyung, Leem Ah Young, Ahn Jee Hwan, Jang Hang Jea, Byun Ki Sup, Park So Hee, Park Sojung, Shin Yoon Mi, Park Jisoo, Kang Sung Wook, Kim Jin Hyoung, Park Jinkyeong, Kim Deokkyu, Lee Bo Young, Cho Woo Hyun, Lee Kwangha, Lee Song I, Park Tai Sun, Jung Yun Jung, Kwak Sang-Hyun, Jeon Sang-Beom, Kim Sung Hyun, Jung Won Jai, Lee Sang-Min, Park Sunghoon, Sim Yun Su, Cho Young-Jae, Koh Younsuck

机构信息

Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Acute Crit Care. 2025 Sep;40(3):413-424. doi: 10.4266/acc.003336. Epub 2025 Aug 21.

Abstract

BACKGROUND

This study investigated the characteristics of mechanically ventilated patients in South Korean intensive care units (ICUs).

METHODS

We conducted a subgroup analysis of a multinational observational study. Data from 271 mechanically ventilated patients in South Korean ICUs were analyzed for demographics, ventilation practices, and mortality, and were compared with those of 327 patients from other high-income Asian countries.

RESULTS

South Korean patients were older (mean age: 67 vs. 62 years, P<0.001) and had lower ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (255.5 vs. 306.2, P<0.001). South Korean ICUs exhibited higher patient-to-nurse ratios (2.6 vs. 1.9, P<0.001) and more beds per unit (20.5 vs. 16.0, P=0.017). The use of sufficient positive end-expiratory pressure for patients (PEEP) for acute respiratory distress syndrome (ARDS) was less frequent in South Korea (62.2% vs. 91.2%, P=0.005). Mortality rates were similar between South Korean patients and those in other high-income Asian countries (38.0% vs. 34.2%, P=0.401). Significant mortality predictors in South Korea included age ≥65 years (odds ratio [OR], 4.03; P=0.039) and a Sequential Organ Failure Assessment score ≥8 (OR, 2.36; P=0.031). The presence of respiratory therapists was associated with reduced mortality (OR, 0.52; P=0.034).

CONCLUSIONS

Despite higher age and patient-to-nurse ratios in South Korean ICUs, outcomes were comparable to those in other high-income Asian countries. The suboptimal use of sufficient PEEP with ARDS indicates potential areas for improvement. Additionally, the beneficial impact of respiratory therapists on mortality rates warrants further investigation.

摘要

背景

本研究调查了韩国重症监护病房(ICU)中接受机械通气患者的特征。

方法

我们对一项跨国观察性研究进行了亚组分析。分析了韩国ICU中271例接受机械通气患者的人口统计学、通气方式和死亡率数据,并与其他高收入亚洲国家的327例患者的数据进行了比较。

结果

韩国患者年龄更大(平均年龄:67岁对62岁,P<0.001),动脉血氧分压与吸入氧分数之比更低(255.5对306.2,P<0.001)。韩国ICU的患者与护士比例更高(2.6对1.9,P<0.001),单位床位数更多(20.5对16.0,P=0.017)。韩国对急性呼吸窘迫综合征(ARDS)患者使用足够呼气末正压(PEEP)的频率较低(62.2%对91.2%,P=0.005)。韩国患者与其他高收入亚洲国家患者的死亡率相似(38.0%对34.2%,P=0.401)。韩国显著的死亡预测因素包括年龄≥65岁(比值比[OR],4.03;P=0.039)和序贯器官衰竭评估评分≥8(OR,2.36;P=0.031)。呼吸治疗师的存在与死亡率降低相关(OR,0.52;P=0.034)。

结论

尽管韩国ICU患者年龄更大且患者与护士比例更高,但结果与其他高收入亚洲国家相当。ARDS患者对足够PEEP的使用欠佳表明存在潜在的改进领域。此外,呼吸治疗师对死亡率的有益影响值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42c7/12408485/80b2bacaebd3/acc-003336f1.jpg

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