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( Juarda Gjonbrataj ),( Hyun Jung Kim ),( Hye In Jung ),( Won Il Choi ) 대한결핵 및 호흡기학회 2015 Tuberculosis and Respiratory Diseases Vol.78 No.2
Background: In sepsis patients, target mean arterial pressures (MAPs) greater than 65 mm Hg are recommended. However, there is no such recommendation for patients receiving mechanical ventilation. We aimed to evaluate the influence of MAP over the first 24 hours after intensive care unit (ICU) admission on the mortality rate at 60 days post-admission in patients showing acute hypoxemic respiratory failure under mechanical ventilation. Methods: This prospective, multicenter study included 22 ICUs and compared the mortality and clinical outcomes in patients showing acute hypoxemic respiratory failure with high (75-90 mm Hg) and low (65-74.9 mm Hg) MAPs over the first 24 hours of admission to the ICU. Results: Of the 844 patients with acute hypoxemic respiratory failure, 338 had a sustained MAP of 65-90 mm Hg over the first 24 hours of admission to the ICU. At 60 days, the mortality rates in the low (26.2%) and high (24.5%) MAP groups were not significantly different. The ICU days, hospital days, and 60-day mortality rate did not differ between the groups. Conclusion: In the first 24 hours of ICU admission, MAP range between 65 and 90 mm Hg in patients with acute hypoxemic respiratory failure under mechanical ventilation may not cause significantly differences in 60-day mortality.
Gjonbrataj, Juarda,Kim, Hyun Jung,Jung, Hye In,Choi, Won-Il The Korean Academy of Tuberculosis and Respiratory 2015 Tuberculosis and Respiratory Diseases Vol.78 No.2
Background: In sepsis patients, target mean arterial pressures (MAPs) greater than 65 mm Hg are recommended. However, there is no such recommendation for patients receiving mechanical ventilation. We aimed to evaluate the influence of MAP over the first 24 hours after intensive care unit (ICU) admission on the mortality rate at 60 days post-admission in patients showing acute hypoxemic respiratory failure under mechanical ventilation. Methods: This prospective, multicenter study included 22 ICUs and compared the mortality and clinical outcomes in patients showing acute hypoxemic respiratory failure with high (75-90 mm Hg) and low (65-74.9 mm Hg) MAPs over the first 24 hours of admission to the ICU. Results: Of the 844 patients with acute hypoxemic respiratory failure, 338 had a sustained MAP of 65-90 mm Hg over the first 24 hours of admission to the ICU. At 60 days, the mortality rates in the low (26.2%) and high (24.5%) MAP groups were not significantly different. The ICU days, hospital days, and 60-day mortality rate did not differ between the groups. Conclusion: In the first 24 hours of ICU admission, MAP range between 65 and 90 mm Hg in patients with acute hypoxemic respiratory failure under mechanical ventilation may not cause significantly differences in 60-day mortality.
Risk factors associated with provoked pulmonary embolism
( Endri Gjonbrataj ),( Ji Na Kim ),( Juarda Gjonbrataj ),( Hye In Jung ),( Hyun Jung Kim ),( Won-il Choi ) 대한내과학회 2017 The Korean Journal of Internal Medicine Vol.32 No.1
Background/Aims: This study aimed to investigate the risk factors associated with provoked pulmonary embolism (PE). Methods: This retrospective cohort study included 237 patients with PE. Patients that had transient risk factors at diagnosis were classified as having provoked PE, with the remaining patients being classified as having unprovoked PE. The baseline clinical characteristics and factors associated with coagulation were compared. We evaluated the risk factors associated with provoked PE. Results: Of the 237 PE patients, 73 (30.8%) had provoked PE. The rate of respiratory failure and infection, as well as the disseminated intravascular coagulation score and ratio of right ventricular diameter to left ventricular diameter were significantly higher in patients with provoked PE than in those with unprovoked PE. The protein and activity levels associated with coagulation, including protein C antigen, protein S antigen, protein S activity, anti-thrombin III antigen, and factor VIII, were significantly lower in patients with provoked PE than in those with unprovoked PE. Multivariate analysis showed that infection (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4 to 7.4) and protein S activity (OR, 0.97; 95% CI, 0.95 to 0.99) were significantly associated with provoked PE. Conclusions: Protein S activity and presence of infection were important factors associated with provoked PE. We should pay attention to the presence of infection in patients with provoked PE.
( Hyun Jung Kim ),( Juarda Gjonbrataj ),( Hye In Jung ),( Won Il Choi ) 대한결핵 및 호흡기학회 2014 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.118 No.-
Background: In sepsis patients, the target mean arterial pressure is recommended to be more than 65 mmHg. However, there was no recommendation of mean arterial pressure target on mechanical ventilation patients. We aimed to evaluate the influence of mean arterial pressure during the first 24 hours on 60 days mortality in patients with acute hypoxemic respiratory failure under mechanical ventilation. Methods: This is a prospective, multicenter study that includes 22 intensive care units. We compared the mortality and clinical outcomes in acute hypoxemic respiratory failure patients with mean arterial pressure 65-74.9 mmHg and mean arterial pressure 75-90 mmHg in the first 24 hours of admission in intensive care unit. Results: Among 844 patients with acute hypoxemic respiratory failure, 338 cases had a maintaining mean arterial pressure between 65 to 90 mmHg in the first 24 hours of admission in intensive care unit. At 60 days, there was no significant mortality difference between 50 patients out of 191 in low mean arterial pressure group (26.2%) and 36 out of 147 patients in high mean arterial pressure group (24.5%). The intensive care unit days, hospital days, and 60 days mortality did not differ between two groups. Conclusions: Mean arterial pressure of 65 to 74.9 mmHg, as compared with 75 to 90 mmHg in patients with acute hypoxemic respiratory failure under mechanical ventilation may not result in significant difference in 60 days mortality.