The purpose of this cross-sectional study was to examine the relationship between characteristics of severe ALS patient-caregiver couples and health related quality of life (HRQoL) in family caregivers.

The participants in this study were 89 pairs of ALS patients using ventilators and a family caregiver. The characteristics of the ALS patients and caregivers, Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised, Zarit Burden Interview and SF-36 were measured in this study. The data were collected from August 2008 to April 2009. Descriptive statistics, Pearson correlation coefficients, and canonical correlation were used for data analysis.

The physical component summary and mental component summary of the HRQoL score for family caregivers were 147.49±31.63 and 129.09±35.83, respectively. HRQoL for caregivers was related to characteristics of the ALS patient-caregiver couples, such as patient's gender, caregiver's age, gender, marital status, daily time spent in caregiving and burden with one significant canonical variable. The significant variate showed that the lower the age, the time spent in caregiving and the burden of caregivers, the higher the HRQoL of caregivers.

The support systems for caregivers considering caregiver characteristics such as demographics and burden should be implemented to improve the HRQoL of caregivers.

This study was conducted to identify endotracheal colonization and the incidence of ventilator-associated pneumonia related to the type of endotracheal suction system.

The participants in this study were ICU patients hospitalized between October 2009 to March 2010 who used ventilators for over 48 hr with closed (CSS, n=30) or open (OSS, n=32) suction systems. To standardize the pre-intervention suction system, a suctioning protocol was taught to the ICU nurses. Collected data were analyzed using χ²-test, Fisher's exact test, Wilcoxon rank sums test, Wilcoxon test, Log-rank test and Poisson regression.

Endotracheal colonization was higher in OSS than CSS from day 1 to day 8 while using a ventilator and there was a significant difference between the two groups. The CSS reached 50% of endotracheal colonization by the 4th day, whereas for the OSS, it was the 2nd day (p=.04). The incidence of ventilator-associated pneumonia showed no significant difference.

For patients with a high risk of pneumonia, CSS must be used to lower endotracheal colonization.

To determine whether the practice of not routinely changing ventilator circuits in patients who require prolonged mechanical ventilation is associated with ventilator-associated pneumonia (VAP).

Patients were divided into two groups, ventilator circuits were routinely changed every 7 days for the control group (39) and every 14 days for the experimental group (40) over a period of 1 yr (April 1, 2009-March 31, 2010). Pediatric patients (age 17 yr or less) were not included. VAP was diagnosed by the criteria of the Centers of Disease Control and Prevention (CDC). Incidence of VAP and characteristics of infection were evaluated.

In the experimental group, 2 episodes of pneumonia were observed in 40 patients and 1,322 ventilator days. The rate of VAP was 1.5 per 1,000 ventilator days. There was 1 episode of pneumonia in 39 patients and 481 ventilator days for the control group. The rate of VAP was 2.1 per 1,000 ventilator days. The difference between both groups was not significant (p=.695).

Extending ventilator circuit change interval from 7 days to 14 days does not increase the risk for VAP.

The purpose of this study was to identify muscle atrophy in critically ill patients on ventilators. A comparison was made between limb circumferences and muscle areas on the day of admission to an intensive care unit (ICU) and on the 8th day after admission.

The data were collected from 30 critically ill patients using ventilators at S hospital ICU in Seoul during the period from October 2005 to April 2006. Limb circumferences and skinfold thickness were measured on the day of admission and on the 8th day after admission to the ICU. Limb circumferences and skinfold thickness were measured on the right mid-arm, right mid-thigh, and right mid-calf using a measuring tape and a skinfold calipers. Limb muscle areas were calculated by an equation after measuring limb circumferences and skinfold thickness. The data were analyzed by paired t-test and independent t-test.

1) Mid-arm circumference, mid-thigh circumference and mid-calf circumference on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 2) Mid-arm muscle area, mid-thigh muscle area and mid-calf muscle area on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 3) Steroid and vecuronium medication didn't affect changes in limb circumferences (mid-arm, mid-thigh, mid-calf) and muscle areas (mid-arm, mid-thigh, mid-calf) on the 8th day after admission to the ICU compared to the day of admission.

Limb muscle atrophy may occur on the 8th day after admission to the ICU in critically ill patients using ventilator.