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An Evaluation of Pediatric Intensive Care : 소아 중환자 관리의 고찰

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Kim, Seong Deok; Kim, Yong Lack; Kim, Kwang Woo; Kim, Yong Jin; Rho, Joon Ryang; Suh, Kyung Phill; Yun, Chong Ku

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Seoul National University College of Medicine
Seoul J Med, Vol.28 No.4, pp. 369-377
Pediatric Intensive Care Unit (PICU)Therapeutic Intervention Scoring System (TlSS)Fatality rate
After reviewing the pediatric intensive care for the 742 patients at PICU for 11
months from February to December, 1986, we obtained the following results: The patients
in thoracic surgery occupied 78.2% of all patients at PICU. The rate of admission to
PICU was 86.8% in thoracic surgery and 33.9% in neurosurgery. The patients in pediatrics
stayed at PICU for 11.3 days, in neurosurgery for 5.7 days and in thoracic surgery for 5.1
days. Duration of ventilatory support was 198.4 hours in pediatrics, 59.7 hours in
pediatric surgery and 50.6 hours in thoracic surgery. Fatality rate reached 18.4% in pediatrics,
14.6% in pediatric surgery and 6.0% in thoracic surgery. Among patients who were below 1
year of age and who stayed longer than 8 days, fatality rate was highest 46.4% of deaths
at PICU was due to the low cardiac output syndrome. All the patients admitted to PICU
had their TISS scores more than 10, which meant an increased level of critical care. TISS
scores for survivors were lower than those for nonsurvivors and were decreased with time.
The fatality rate of the patients with TISS scores more then 50 was 19.4%, so TISS scores
could be used to assess the severity of patients indirectly. With above results, we should
suggest minimal requirement of equipments for modern PICU and some guidelines for
the maintenance of PICU in Korea.
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