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Korean J Crit Care Med > Volume 26(4); 2011 > Article
Korean Journal of Critical Care Medicine 2011;26(4): 238-244. doi: https://doi.org/10.4266/kjccm.2011.26.4.238
소아중환자실 입원 환자의 폐허탈 양상과 위험인자
정우진ㆍ최재욱ㆍ한영주ㆍ이주경ㆍ서동인ㆍ고영률ㆍ박준동
서울대학교 의과대학 소아과학교실
Atelectasis and the Risk Factors in the Patients Admitted to Pediatric Intensive Care Unit
Woo Jin Chung, Jae Wook Choi, Young Ju Han, Ju Kyung Lee, Dong In Suh, Young Yull Koh, June Dong Park
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. jdparkmd@snu.ac.kr
ABSTRACT
BACKGROUND: Atelectasis is a state of a collapsed and non-aerated region of the lung parenchyma, which is otherwise normal. This condition is usually associated with pulmonary disorders. The purpose of this study is to analyze the incidence and risk factors of atelectasis in patients admitted to the pediatric intensive care unit (PICU). METHODS: We retrospectively analyzed the clinical characteristics and chest radiography of 280 PICU patients under 18 years old. We analyzed the incidence and pattern of atelectasis and compared the incidence according to the phase and mode of mechanical ventilation. We compared the incidence of ventilator care need and respiratory disease in 93 atelectasis patients. RESULTS: Atelectasis incidence was 33.2%. The age (4.9 +/- 4.4 years) was younger and the admission-duration (17.8 +/- 25.1 days) was significantly longer in atelectasis patients (p < 0.01). Ventilator care need and respiratory disease in atelectasis patients (86.0%, 66.7% respectively) was significantly higher than in non-atelectasis patients (62.6%, 43.3% respectively) (p < 0.01). Atelectasis incidence in ventilator-required patients and respiratory-diagnosed patients (40.6%, 43.4% respectively) was significantly higher than that in non ventilator-required patients and non respiratory-diagnosed patients (15.7%, 22.6% respectively) (p < 0.01). Atelectasis was more common in the right upper lobe (55.6%) and during or after ventilator care (62.6%) (p < 0.05). Atelectasis incidence in ventilator care did not differ between the assist-control and intermittent mandatory ventilation modes. CONCLUSIONS: In the PICU, atelectasis incidence was higher in patients with ventilator care and respiratory disease. Atelectasis was more common in the right upper lobe and in the phase after ventilator initiation. Atelectasis incidence in ventilator care did not differ between ventilation modes.
Key Words: anatomic factors; atelectasis; pediatric ICU; ventilator care
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