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정원익,양광모,강경식 대한안전경영과학회 2004 대한안전경영과학회지 Vol.6 No.2
Domestic city gas is supplying in an about 10 million household on present 34 city gas companies because is begun to supply regularly after two 1980 years middle. But, result that focus on city gas supply spread and stable supply for supply area and neglects about safety problem, hundreds casualties such as Ahyun explosion accident and Deagu city gas explosion accident were reached in situation that occurred large size calamity occurs it is dizzliness. In the case of advanced nation, can see that accomplish system and progress that in technology after experience major accident. Therefore, grasp problem investigating safety actual conditions for city gas institution and study about solvable plan is required this. Also, must guide reform and level elevation of a domestic company safety technology through induction and development of safety technology that is suitable in supply, domestic real condition etc. Must help in power positivity that is full text executing high-quality safety education about step High firing mechanism safety technology than present safety education.
패혈증 쇼크 환자의 1시간 묶음 치료가 사망률에 미치는 영향
정원익,김준성,유재형,강진영,유지나,조연주,정성민,김원영,유승목 대한응급의학회 2019 대한응급의학회지 Vol.30 No.6
Objective: Since 2018, the surviving sepsis campaign recommended one-hour bundle therapy in septic shock patients. On the other hand, evidence for the effectiveness of bundle therapy has not been established. The object of this study was to determine the prognostic value of one-hour bundle completion in septic shock patients. Methods: This prospectively collected registry-based, retrospective observational study, between January 2016 and December 2018. A one-hour bundle in septic shock was defined by the serum lactate measurements, blood cultures, administration of antibiotics, and adequate fluid administration within one hour from emergency department admission. Eligible septic shock patients were included in the analysis, and the prognostic abilities of the completion of the one-hour bundle and each item were analyzed. The primary outcome was the 28-day mortality. Results: The study included 381 patients, and the overall 28-day mortality was 24.7%. The overall one-hour bundle completion rate was 11.3%, and each completion rate of serum lactate measurement, blood cultures, administration of antibiotics, and adequate fluid administration were 85.8%, 74.3%, 19.4%, and 48.6%, respectively. On the other hand, overall bundle completion as well as each bundle were not associated with the 28-day mortality except for adequate fluid administration (odds ratio [OR], 0.67 [95% confidence interval (CI), 0.30-1.50]; OR, 1.33 [95% CI, 0.66-2.70]; OR, 1.50 [95% CI 0.85-2.64]; OR, 1.17 [95% CI 0.66-2.07]; and OR, 0.54 [95% CI, 0.34-0.87], respectively). Multivariate logistic regression analysis showed that adequate fluid administration was independently associated with the 28-day mortality (OR, 0.22 [95% CI, 0.09-0.55]; P=0.001). Conclusion: In this study, most of the one-hour bundle completions were not associated with 28-day mortality. Although adequate fluid administration was associated with the 28-day mortality, multicenter interventional study will be needed to generalize this result.