심혈관 수술 신생아의 혈당수준에 따른 환아 결과
Patient Outcomes according to Blood Glucose Level in Neonates with Cardiovascular Surgery
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초록
본 연구는 선천성 심장질환으로 심혈관 수술을 받고 중환자실에 입실한 신생아를 대상으로 수술 후 72시간 이내의 혈당수준에 따른 환아 결과의 차이를 후향적으로 분석한 조사연구이다. 2003년 1월에서 2008년 10월 31까지 5년 10개월간 P광역시 P대학교병원에서 심혈관 수술을 받은 143명의 신생아를 대상으로 얻은 자료를 분석하였다. 수집된 자료는 SPSS 18.0 프로그램을 사용하여 서술 통계와 χ2-검정으로 분석하였다. 연구결과 심혈관 수술을 받은 신생아의 혈당수준이 140 mg/dL 이상인 군은 100 mg/dL 미만군과 100-139 mg/dL군보다 병원 재원일수, 중환자실 재실일수, 인공호흡기 사용시간이 연장되었고 사망발생이 높았다. 따라서 심혈관 수술 후의 신생아 환아 간호 시 당해 간호사는 상기 5개 항목의 환아 결과에 영향을 미치는 혈당수준의 관리와 감시의 중요성에 대해 인지하고 나아가 심혈관 수술후 신생아의 혈당 관리 간호지침 마련이 필요하다고 본다.
Abstract
Purpose: The purpose of this study was to provide basic data for suitable neonate blood glucose maintenance by investigating and analyzing the blood glucose level of post cardiovascular surgery neonates in the ICU for the effect of blood glucose levels on the following outcomes; ICU stay, hospital stay, mechanical ventilation time, morbidity, and mortality. Methods: The participants were 143 neonates in the ICU after having had cardiovascular surgery. The design for this study was an investigation of the blood glucose levels of the neonates and retrospective analysis of patient outcomes according to blood glucose level. Results: The results for the neonate groups showed that the factors of hospital stay, ICU stay, mechanical ventilation time and mortality, for the group with a blood glucose level over 140 mg/dL were longer and higher than for the group with blood glucose of less than 100 mg/dL or the group between 100-139 mg/dL. Conclusion: The results of this study indicate that when caring for neonates after cardiovascular surgery, it is important to recognize the influence of blood glucose levels on patient outcomes like hospital days, ICU stay, length of time on mechanical ventilation and mortality. Further, care guidelines for neonates’ glucose level management need to be developed.
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