ISSN 2383-4870 (Print)
ISSN 2383-4889 (Online)
2014. 11 Vol. 29 No. 04 Korean J Crit Care Med
2017 August 32(3):295-296 / https://doi.org/10.4266/kjccm.2017.00451 ISSN 2383-4870 (Print)ㆍISSN 2383-4889 (Online)
■ Editorial ■
Editorial
Do We Successfully Achieve Therapeutic Hypothermia?
(243)
Review How to Enhance Critical Care in Korea: Challenges and Vision
(246)
Original Articles Implementing a Sepsis Resuscitation Bundle Improved Clinical Outcome: A Before-and-After Study
(250)
Challenges to Overcome Barriers against Successful Implementation of Rapid Response Systems Extended-Spectrum β-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care Unit
(257)
Clinical Characteristics of Respiratory Extracorporeal Life Support in Elderly Patients with Severe Acute Respiratory Distress Syndrome
(266)
Predicting Delayed Ventilator Weaning after Lung Transplantation: The Role of Body Mass Index
(273)
Comparison of Morphine and Remifentanil on the Duration of Weaning from Mechanical Ventilation
(281)
Acute Physiologic and Chronic Health Examination II and Sequential Organ Failure Assessment Scores for Predicting Outcomes of Out-of-Hospital Cardiac Arrest Patients Treated with Therapeutic Hypothermia
(288)
Effectiveness of Bradycardia as a Single Parameter in the Pediatric Acute Response System
(297)
Prognostic Value and Optimal Sampling Time of S-100B Protein for Outcome Prediction in Cardiac Arrest Patients Treated with Therapeutic Hypothermia
(304)
Change in Red Cell Distribution Width as Predictor of Death and Neurologic Outcome in Patients Treated with Therapeutic Hypothermia after Out-of-Hospital Cardiac Arrest
(313)
Traumatic Liver Injury: Factors Associated with Mortality
(320)
Eun Young Choi Case Reports
Green Urine after Propofol Infusion in the Intensive Care Unit
(328)
Cardiac Arrest due to Recurrent Ventricular Fibrillation Triggered by Unifocal Ventricular Premature Complexes in a Silent Myocardial Infarction
(331)
Kawasaki Disease with Acute Respiratory Distress Syndrome after Intravenous Immunoglobulin Infusion
(336)
Methemoglobinemia Caused by an Inert Ingredient after Intentional Ingestion of Pesticide
(341)
Lobar Bronchial Rupture with Persistent Atelectasis after Blunt Trauma
(344)
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea 2014. 11 Vol. 29 No. 04 (243-348)
Erratum Patients with Acute Respiratory Distress Syndrome Caused by Scrub Typhus: Clinical Experiences of Eleven Patients
(348)
In Korea, patient’s safety is becoming an important issue. Patients who experience adverse events during their hospital stay, including cardiopulmonary arrest, unplanned intensive care unit admissions, and unexpected death, show clear signs of deterioration in the hours preceding the event [1,2]. About one-half of the serious adverse events are deemed to be preventable [3]. Patients often show some signs of physiological deterioration for several hours (median 6 hours) before cardiac arrest [4,5]. Early recognition and response to patient deterioration have reduced the potential impact of such adverse events [6,7]. Health professionals need to recognize and respond to early signs of patient deterioration and activate rapid response systems (RRSs) to provide rapid medical intervention. RRSs have been developed for timely identification and treatment of patients in general wards at risk for clinical deterioration [8]. RRSs have been im-
Eun Young Choi Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Namgu, Daegu 42415, Korea Tel: +82-53-623-3828 Fax: +82-53-623-8201 E-mail:
[email protected] ORCID Eun Young Choi http://orcid.org/0000-0003-2974-5447 *No potential conflict of interest relevant to this article was reported.
plemented widely around the world over the past two decades and have been shown to effectively reduce in-hospital cardiopulmonary arrests. Recently, RRSs have been implemented in some large hospital in Korea; their effectiveness was uncertain. This is the first multicenter survey on the impacts of RRSs. Implementation of RRSs showed a statistically significant reduction of the cardiopulmonary arrest rates (odds ratio [OR], 0.731; 95% confidence interval [CI], 0.577 to 0.927; P = 0.009), whereas cardiopulmonary resuscitation rates of 2013 and 2015 did not change in hospitals without RRS (OR, 0.988; 95% CI, 0.868 to 1.124; P = 0.854). RRS can diminish in-hospital cardiopulmonary arrests and improve patient safety through earlier identification and treatment attempts. Despite these benefits, there have been barriers against successful implementation of RRS. First, there is a lack of specialists and physicians for RRS implementation. Also, the optimal composition of the RRS team is uncertain. Two previous single-center reports did not show the benefits of intensivist-led teams compared with registrar or resident-led teams [9,10]. cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright ⓒ 2017 The Korean Society of Critical Care Medicine
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The majority of RRS interventions did not require the
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RRS. Moreover, the absence of government policy about
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RRS is an important issue to be addressed. In particular,
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the government needs to make efforts not to increase re-
arrests and mortality among four teaching hospitals
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in Australia. Resuscitation 2014;85:1275-81.
experiences with RSS systems between hospitals.
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https://doi.org/10.4266/kjccm.2017.00451
