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논문 기본 정보

자료유형
학술저널
저자정보
Hyun Dong-gon (Department of Pulmonary and Critical Care Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea.) Ahn Jee Hwan (Department of Pulmonary and Critical Care Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea.) Gil Ha-Yeong (Medical Research Project Team IM Medical Pfizer Korea Pharmaceuticals Limited Company Seoul Korea.) Nam Chung Mo (Department of Preventive Medicine Yonsei University College of Medicine Seoul Korea.) Yun Choa (Division of Biostatistics Department of Biomedical Systems Informatics Yonsei University College of Medicine Seoul Korea.) Lee Jae-Myeong (Division of Acute Care Surgery Department of Surgery Korea University Anam Hospital Korea University College of Medicine Seoul Korea.) Kim Jae Hun (Department of Trauma and Surgical Critical Care and Biomedical Research Institute Pusan National University Hospital Pusan National University School of Medicine Busan Korea.) Lee Dong-Hyun (Department of Intensive Care Medicine Dong-A University Hospital Busan Korea.) Kim Ki Hoon (Department of Surgery Haeundae Paik Hospital Inje University College of Medicine Busan Korea.) Kim Dong Jung (Department of Thoracic) Lee Sang-Min (Department of Critical Care Medicine Internal Medicine Seoul National University Hospital Seoul Korea.) Ryu Ho-Geol (Department of Critical Care Medicine Anesthesiology and Pain Medicine Seoul National University Hospital Seoul Korea.) Hong Suk-Kyung (Department of Acute Care Surgery Asan Medical Center University of Ulsan College of Medicine Seoul Korea.) Kim Jae-Bum (Department of Thoracic and Cardiovascular Surgery Keimyung University School of Medicine Daegu Korea.) Choi Eun Young (Division of Pulmonology and Allergy Department of Internal Medicine Regional Center for Respiratory Diseases Yeungnam University Medical Center College of Medicine Yeungnam University Daegu Korea.) Baek JongHyun (Department of Thoracic and Cardiovascular Surgery Yeungnam University Medical Center College of Medicine Yeungnam University Daegu Korea.) Kim Jeoungmin (Division of Critical Care Medicine Department of Anesthesiology and Pain Medicine Yonsei University College of Medicine Seoul Korea.) Kim Eun Jin (Department of Internal Medicine Daegu Catholic University Medical Center Daegu Catholic University School of Medicine Daegu Korea.) Park Tae Yun (Division of Pulmonary and Critical Care Medicine Department of Internal Medicine Seoul Metropolitan Government-Seoul National University Boramae Medical Center Seoul Korea.) Kim Je Hyeong (Department of Critical Care Medicine Korea University Ansan Hospital Korea University College of Medicine Ansan Korea.) Park Sunghoon (Department of Pulmonary Allergy and Critical Care Medicine Hallym University Sacred Heart Hospital Hwaseong Korea.) Park Chi-Min (Department of Critical Care Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.) Jung Won Jai (Department of Pulmonary Allergy and Critical Care Medicine Korea University Anam Hospital Korea University College of Medicine Seoul Korea.) Choi Nak-Jun (Division of Acute Care Surgery Department of Surgery Korea University Guro Hospital Seoul Korea.) Jang Hang-Jea (Department of Internal Medicine Inje University Haeundae Paik Hospital Busan Korea.) Lee Su Hwan (Division of Pulmonology and Critical Care Medicine Department of Internal Medicine Severance Hospital Yonsei University College of Medicine Seoul Korea.) Lee Young Seok (Division of Pulmonary Allergy and Critical Care Medicine Department of Internal Medicine Korea University Guro Hospital Seoul Korea.) Suh Gee Young (Division of Pulmonary and Critical Care Medicine Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.) Choi Woo-Sung (Department of Emergency Medicine Gachon University Gil Medical Center Incheon Korea.) Lee Keu Sung (Department of Pulmonary and Critical Care Medicine Ajou University School of Medicine Suwon Korea.) Kim Hyung Won (Division of Acute Care Surgery Department of Surgery Hallym University Sacred Heart Hospital Anyang Korea.) Min Young-Gi (Department of Emergency Medicine Ajou University School of Medicine Suwon Korea.) Lee Seok Jeong (Department of Internal Medicine Yonsei University Wonju College of Medicine Wonju Korea.) Lim Chae-Man (Department of Pulmonary and Critical Care Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.38 No.19
발행연도
2023.5
수록면
1 - 13 (13page)
DOI
10.3346/jkms.2023.38.e141

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Background: Current international guidelines recommend against deep sedation as it is associated with worse outcomes in the intensive care unit (ICU). However, in Korea the prevalence of deep sedation and its impact on patients in the ICU are not well known. Methods: From April 2020 to July 2021, a multicenter, prospective, longitudinal, noninterventional cohort study was performed in 20 Korean ICUs. Sedation depth extent was divided into light and deep using a mean Richmond Agitation–Sedation Scale value within the first 48 hours. Propensity score matching was used to balance covariables; the outcomes were compared between the two groups. Results: Overall, 631 patients (418 [66.2%] and 213 [33.8%] in the deep and light sedation groups, respectively) were included. Mortality rates were 14.1% and 8.4% in the deep and light sedation groups (P = 0.039), respectively. Kaplan-Meier estimates showed that time to extubation (P < 0.001), ICU length of stay (P = 0.005), and death (P = 0.041) differed between the groups. After adjusting for confounders, early deep sedation was only associated with delayed time to extubation (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.55– 0.80; P < 0.001). In the matched cohort, deep sedation remained significantly associated with delayed time to extubation (HR, 0.68; 95% CI, 0.56–0.83; P < 0.001) but was not associated with ICU length of stay (HR, 0.94; 95% CI, 0.79–1.13; P = 0.500) and in-hospital mortality (HR, 1.19; 95% CI, 0.65–2.17; P = 0.582). Conclusion: In many Korean ICUs, early deep sedation was highly prevalent in mechanically ventilated patients and was associated with delayed extubation, but not prolonged ICU stay or in-hospital death.
#Deep Sedation #Critical Illness #Mortality #Critical Care #Ventilator

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