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3 "Jin Ha Park"
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Ethics
Evaluation of Informed Consent for Withholding and Withdrawal of Life Support in Korean Intensive Care Units
Jin Ha Park, Shin Ok Koh, Jin Sun Cho, Sungwon Na
Korean J Crit Care Med. 2015;30(2):73-81.   Published online May 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.2.73
  • 7,494 View
  • 80 Download
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Background
The goal of this study was to analyze the process and characteristics of withholding or withdrawal of life support (WLS) in Korean intensive care units (ICUs). Methods: This was a single-centered retrospective analysis of patients who died in the ICUs of a tertiary hospital in Korea from January to December 2012. WLS informed consents and clinical data were analyzed. Results: Of 285 deaths during the study period, informed consents for WLS were obtained from 228 patients (80.0%). All WLS decisions were made by family members after the patient’s loss of decision-making capacity. Decisions were made most frequently by the patient’s son (50.6%). Patients in the WLS group were older than those in the non-WLS group, and older age was associated with the WLS decision. Thirty-seven patients (16.2%) died within one hour of WLS approval, and 182 patients (79.8%) died on the day of WLS approval. The most frequently withheld life support modality was chest compression (100%), followed by defibrillation (95.9%) and pacemaker insertion (63.3%). Conclusions: Aggressive and invasive life support measures were those most frequently withheld or withdrawn by decision-makers in Korean ICUs. The most common proxy was the son, rather than the spouse.

Citations

Citations to this article as recorded by  
  • Decision-making regarding withdrawal of life-sustaining treatment and the role of intensivists in the intensive care unit: a single-center study
    Seo In Lee, Kyung Sook Hong, Jin Park, Young-Joo Lee
    Acute and Critical Care.2020; 35(3): 179.     CrossRef
  • Family-Clinician Communication About End-of-Life Care in Korea
    Minjeong Jo, Yang-Sook Yoo, George Knafl, Marcia Van Riper, Linda Beeber, Mi-Kyung Song
    Journal of Hospice & Palliative Nursing.2017; 19(6): 597.     CrossRef
Pulmonary
Predicting Delayed Ventilator Weaning after Lung Transplantation: The Role of Body Mass Index
Sarah Soh, Jin Ha Park, Jeong Min Kim, Min Jung Lee, Shin Ok Koh, Hyo Chae Paik, Moo Suk Park, Sungwon Na
Korean J Crit Care Med. 2014;29(4):273-280.   Published online November 30, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.4.273
  • 7,472 View
  • 69 Download
AbstractAbstract PDF
BACKGROUND
Weaning from mechanical ventilation is difficult in the intensive care unit (ICU). Many controversial questions remain unanswered concerning the predictors of weaning failure. This study investigates patient characteristics and delayed weaning after lung transplantation.
METHODS
This study retrospectively reviewed the medical records of 17 lung transplantation patients from October 2012 to December 2013. Patients able to be weaned from mechanical ventilation within 8 days after surgery were assigned to an early group (n = 9), and the rest of the patients were assigned to the delayed group (n=8). Patients' intraoperative and postoperative characteristics were collected and analyzed, and conventional weaning predictors, including rapid shallow breathing index (RSBI), were also assessed.
RESULTS
The results of the early group showed a significantly shorter ICU stay in addition to a shorter hospitalization overall. Notably, the early group had a higher body mass index (BMI) than the delayed group (20.7 vs. 16.9, p = 0.004). In addition, reopening occurred more frequently in the delayed group (1/9 vs. 5/8, p = 0.05). During spontaneous breathing trials, tidal volume (TV) and arterial oxygen tension were significantly higher in the early group compared to the delayed weaning group, but differences in RSBI and respiratory rate (RR) between groups were not statistically significant.
CONCLUSIONS
Low BMI might be associated with delayed ventilator weaning in lung transplantation patients. In addition, instead of the traditional weaning predictors of RSBI and RR, TV might be a better predictor for ventilator weaning after lung transplantation.
Case Report
The Benefit of Braille for Successful Weaning off Mechanical Ventilation in Congenital Blindness and Hearing Impairment: A Case Report
So Young Yang, Yong Seon Choi, Jin Ha Park, Shin Ok Koh
Korean J Crit Care Med. 2011;26(1):45-48.
DOI: https://doi.org/10.4266/kjccm.2011.26.1.45
  • 2,454 View
  • 12 Download
AbstractAbstract PDF
To achieve adequate depth of sedation and assess the severity of pain in mechanically ventilated patients in the intensive care unit, appropriate communication with the patients is necessary. Communication is also important for successful weaning from the mechanical ventilator as well as weaning predictors, such as respiratory muscle capacity. Here, we present a case report of a 39-year-old man with congenial blindness and hearing impairment who successfully weaned off ventilator support using Braille to communicate under an optimal level of sedation and analgesia after septic shock management.

ACC : Acute and Critical Care