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인공호흡기를 사용한 환자에 있어서 상기도 감염에 대한 임상고찰
김인세,이영애,나계환,김영숙,김종래,박광원 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.3
The control of infection in the intensive care unit is a very important problem in the treatment of critically ill patients. Moreover for the patient who is receiving artificial ventilation, possibity of cross-infection may impose an added risk when the general condition is poor. This study was undertaken to investigate the incidence of upper respiratory tract infection in patients requiring prolonged respiratory care who were admitted to the I.C.U. The total number of cases in this study was 48, and the patients were equally devided in two groups, group one consisting of 24 cases who had respiratory care with early tracheostomy (transtracheostomy intubation) and group two who had received respiraory care through oral or nasotracheal intubation without tracheostomy. Specimens for bacteriologic culture were taken especially from the regions of the upper respiratory tract, and the results were compared for the two groups. All patients had respiratory care through artificial ventilators using either the pressure preset or volume preset type. The results obtained from the bacteriologic culture were as follows: 1. The most frequently found organism was pseudomonas aeruginosa, and next was staphylococcus, followed by β-streptococcus and E. coli. 2. The greatest number of organisms in group one was seen on the third day, and in group two on the first day of respiratory care. 3. In group one, the kinds of organisms were more variable than in group two. From the data shown, the most frequently found organisms in the I.C.U. were pseudomonas aeruginosa, β-streptococcus, and E. coli. There was little difference in the aspects of upper respiratory infection between the patients with transtracheal intubation and the patients with translaryngeal intubation without tracheostomy.