Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Proposal of New Criteria for Assessing Respiratory Impairment

새로운 호흡기 장애 판정 기준의 제안

  • Park, Joo-Hun (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Lee, Jae-Seung (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Huh, Jin-Won (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Yeon-Mok (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang-Do (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sei-Won (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Yoon, Ho-Il (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Deog-Kyeom (Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center) ;
  • Lee, Chang-Hoon (Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center) ;
  • Park, Myung-Jae (Department of Internal Medicine, Kyung Hee University Hospital) ;
  • Kim, Eun-Kyung (Department of Internal Medicine, CHA Bundang Medical Center, CHA University) ;
  • Park, Yong-Bum (Department of Internal Medicine, Hallym University Sacred Heart Hospital) ;
  • Hwang, Yong-Il (Department of Internal Medicine, Hallym University Sacred Heart Hospital) ;
  • Jung, Ki-Suck (Department of Internal Medicine, Hallym University Sacred Heart Hospital) ;
  • Park, Hye-Yoon (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lim, Seong-Yong (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jung, Ji-Ye (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Young-Sam (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Hui-Jung (Department of Internal Medicine, Wonkwang University Sanbon Hospital) ;
  • Rhee, Chin-Kook (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Yoon, Hyoung-Kyu (Department of Internal Medicine, Yeouido St. Marry's Hosital, The Catholic University of Korea College of Medicine) ;
  • Kim, Young-Kyoon (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Jin-Woo (Department of Internal Medicine, Uijeongbu St. Marry's Hospital, The Catholic University of Korea College of Medicine) ;
  • Yoo, Jee-Hong (Department of Internal Medicine, Kyung Hee University Hospital) ;
  • Yoo, Kwang-Ha (Department of Internal Medicine, Konkuk University College of Medicine)
  • 박주헌 (아주대학교 의과대학 호흡기내과학교실) ;
  • 이재승 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 허진원 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 오연목 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 이상도 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 이세원 (분당서울대병원 내과) ;
  • 윤호일 (분당서울대병원 내과) ;
  • 김덕겸 (서울시립 보라매병원 내과) ;
  • 이창훈 (서울시립 보라매병원 내과) ;
  • 박명재 (경희대병원 내과) ;
  • 김은경 (차의과대학교 분당차병원 내과) ;
  • 박용범 (한림대학교 강동성심병원 내과) ;
  • 황용일 (한림대학교 성심병원 내과) ;
  • 정기석 (한림대학교 성심병원 내과) ;
  • 박혜윤 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 임성용 (성균관대학교 의과대학 내과학교실 강북삼성병원 호흡기내과) ;
  • 정지예 (연세대학교 의과대학 내과학교실) ;
  • 김영삼 (연세대학교 의과대학 내과학교실) ;
  • 김휘정 (원광대학교 의과대학 산본병원 내과학교실) ;
  • 이진국 (가톨릭대학교 의과대학 서울성모병원 내과학교실) ;
  • 윤형규 (가톨릭대학교 의과대학 여의도성모병원 내과학교실) ;
  • 김영균 (가톨릭대학교 의과대학 서울성모병원 내과학교실) ;
  • 김진우 (가톨릭대학교 의과대학 의정부성모병원 내과학교실) ;
  • 유지홍 (경희대병원 내과) ;
  • 유광하 (건국대학교 의과대학 내과학교실)
  • Received : 2011.02.09
  • Accepted : 2011.03.14
  • Published : 2011.03.30
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Abstract

Social welfare services for respiratory-disabled persons in Korea are offered based on the respiratory impairment grade, which is determined by 3 clinical parameters; dyspnea, forced expiratory volume in 1 second ($FEV_1$), and arterial oxygen tension. This grading system has several limitations in the objective assessment of respiratory impairment. We reviewed several guidelines for the evaluation of respiratory impairment and relevant articles. Then, we discussed a new grading system with respiratory physicians. Both researchers and respiratory physicians agreed that pulmonary function tests are essential in assessing the severity of respiratory impairment, forced vital capacity (FVC), $FEV_1$ and single breath diffusing capacity ($DL_{co}$) are the primarily recommended tests. In addition, we agreed that arterial blood gas analysis should be reserved for selected patients. In conclusion, we propose a new respiratory impairment grading system utilizing a combination FVC, $FEV_1$ and $DL_{co}$ scores, with more social discussion included.

Keywords

References

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