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KMID : 0377619770330050511
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Korean Jungang Medical Journal
1977 Volume.33 No. 5 p.511 ~ p.516
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A Clinical Study on Evaluatings and Nursing Cares in the Comatose Patients
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Abstract
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This present study was carried out in the recovery room (I.C.U.) at the Chosun University hospital for 12 months from March 1, 1976 through February 28, 1977 by investigating 100 patients selected from among those who treated due to comatose state.
There are many theories on the physiology and pathology of consciousness and coma. Among these, an even more important nonspecific activating mechanism, the ascending reticular activating system (ARAS), was discovered shortly by Moruzzi and Magoun, who along with their colleagues have made numerous important contributions to this field. They identified the ARAS within the rostral reticular formation, extending from the midbrain to the hypothalamus and thalamus, and demonstrated that it had diffuse projections to the cerebral cortex and profoundly influenced arousal system.
Anatomically, the reticular formation has vexingly indistinct boundaries and extends along the core of the central brain stem from the lower medulla to the thalamus, incorporating both small and large neurons. In the thalamus, the reticular formation is interspersed among the main sensory nuclei. The reticular activating system receives collateral’s from and is stimulated by every major somatic and special sensory pathways.
The results obtained were as follows;
1) The percentage of comatose patient (126 cases) to the total admitted to all wards (5739 cases) was 2.2% and the ratio of male to female was 2 9 : 1. 2) Of the 1O4 cases of comatose patients, the patients of neurosurgical depart-ment were 47 cases, internal medicine were 26 cases, pediatric department were 10 cases, and others.
3) Among the preexisting causes of comatose patients, head injuries were 43 cases, C.V.A. were 24 cases, encephalitis were 9 cases and others.
4) There was an increase in the mortality rate when comatose state persisted for more then 72 hours, but there was two survivors after even more 7 days of comatose state.
5) The mortality rate during the admission was 42% in total, 48.9% in head injuries, 37.5% in C.V.A., 44.4% in encephalitis and others.
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