• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.16.2-16
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• 1987

최근 전신마취의 발달로 외과영역에서는 괄목할만한 수술적 진전을 보여 왔으나, 이에 못지 않게 전신마취에 의한 여러 가지 합병증의 보고가 늘고 있다. 특히 이비인후과영역에서는 술후 뚜렷한 원인없이 사성 및 호흡곤란 등을 호소하는 환자들을 종종 접하게 되며, 추정할 수 있는 유인으로는 대개 후두 및 기관점막의 염증, 후두결절, 후두육아종 등이 대부분이나 때로 매우 희귀하지만 원인 불명의 성대마비로 인한 경우도 있다. 저자는 최근 술전에 전혀 후두증상이 없었던 환자로서 기관내 삽관마취하 이하선 혼합종수술후에 속발한 일측성 반회신경마비례를 경험하였기에 문헌적 고찰과 함께 보고하고자 한다.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1401-1404
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• 1996

Central venous line insertion is an essential procedure in a cardiac operation. For this, percuteneous Insertion is usually done in the internal jugular vein or the subclavian vein. However, this method can create such complications as pneumothorax and hemothorax, and repeated failure in inserting the cathet r, especially in infant and child patients, can waste excessive time. Consequently, in our hospital, catheterization of the innominate vein was done after the completion of sternotomy in the cardiac operation of infant and child patients weighing under 1 Okg. During operation, the catheter was placed in the left atrium through the foramen ovate or pulmonary artery to be used for pressure monitoring. When the patient's hemodynamic became stabilized, the catheter was withdrawn to either the right atrium or superior vena casa to be used as the channel for fluid replacement or drug administration. In our hospital, this procedure has been used in 96 cases since 1989. No complications such as pneumothorax and hemothorax occilrred, and neither bleeding after the removal of the catheter was seen.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.89-93
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• 2019

Preterm infants have higher possibility of undergoing endotracheal intubation after birth than normal children due to medical conditions. Developmental disturbances of primary incisors following intubation can occur as crown malformation, enamel defects, delayed eruption, displacement of dental follicle in crypt, groove formation of palate or alveolar ridge, acquired cleft palate, and dental arch distortion. This clinical report presents the effect of intubation on primary dentition of preterm infants. A 2-year-old girl with cerebral palsy and premature birth history visited our clinic with chief complaint of unerupted primary upper incisor. A 1-year-old boy with cerebral palsy, status epilepticus and premature birth history visited our clinic due to crown malformation. Developmental disturbances of primary incisors in these cases were not related to the patients' systemic disease, and there were no history of dental trauma. A long term endotracheal intubation prior to tooth eruption might have caused local trauma on alveolar ridge. It is very important to monitor dental problems of preterm infants who had experienced endotracheal intubation during neonatal period. Due to influences on both primary and permanent teeth, periodic re-evaluation of affected areas and establishment of comprehensive treatment plans are necessary.

• Proceedings of the KAIS Fall Conference
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• 2011.05b
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• pp.1061-1063
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• 2011

본 연구는 병원전 단계 기도기 시뮬레이션 교육에 대한 연구로 연구대상은 응급구조학과 4학년 학생 22명으로 구성하였다. 교육시간은 10분 동안 3개의 기도유지기에 대한 전체 강의가 있었고, 10분 동안 마네킹을 이용하여 세 가지 기도기의 사용방법을 교육하고 실습을 시행하였다. 응급구조학과 학생을 대상으로 Airway management trainer Simman를 이용한 기도 내 이물 제거 모델에서 매킨토시후두경과 GlideScope and the AWS$^{(R)}$, McGrath$^{(R)}$ 비디오 후두경의 기관내 삽관 성공률과 삽관 시간, 시행자의 선호도를 비교한 결과 의미 있는 차이를 보였다. 마네킨을 이용한 병원전 기도기인 1차 시도에서는 유의한 차이를 보였지만 2차에서 숙련이 된 경우이라서 큰차이를 보이지 않았다. 기관내 삽관 기구의 선호도 조사에서는 Pentax AWS를 가장 선호하였다.

• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.439-442
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• 2004

Background : Extubation failure and reintubation increase the morbidity and the mortality rate. Several extubation criteria and risk factors for extubation failure have been recommended. However, some patients present with extubation failure even after a planned extubation. The aim of this study was to evaluate the clinical characteristics of patients with extubation failure after a planned extubation. Methods : Thirty one patients who presented with planned extubation were included. Extubation failure was defined as reintubation within 48 hours after extubation. The clinical, respiratory and hemodynamic parameters between extubation success and failure group were compared. Results : Six patients were included in the failure group. The extubation failure rate was 19.4%. The age, periods of intubation and heart rates were significantly different between the extubation success and failure group. In the success and failure group, the mean age were $60.4{\pm}15.65$ vs. $80.3{\pm}7.17$ year, the intubation periods were $7.12{\pm}2.47$ vs. $13.83{\pm}2.4$ day and the heart rates were $94.32{\pm}5.77$ vs. $110.67{\pm}3.78/min$, respectively. Conclusion : Old age and patients intubated for periods will require a will careful assessment before extubation. Extensive cardiac evaluations before extubation will also be needed.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.162-169
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• 2007

Purpose : It is well known that suspension microlaryngeal surgery produces marked increases in arterial blood pressure and heart rate. In this study, we evaluated the effects of 10% lidocaine preoperatively sprayed for attenuation of the perioperative hemodynamic response during suspension microlaryngeal surgery. Materials and Methods : Fifty American Society of Anesthesiologists (ASA) class 1 patients scheduled for excision of a vocal polyp by suspension laryngoscopy were randomly divided into two groups (n=25 for each group). They were intubated without 10% lidocaine spray (control group) or given 1.5 mg/kg of 10% lidocaine sprayed onto the pharyngolaryngeal and intratracheal sites 90 sec prior to intubation (10% lidocaine group). Anesthesia was maintained using desflurane in $O_2/N_2O$ 50%. The arterial blood pressure and heart rate were measured at preinduction (T0), 1 min (T1), 3 min (T2), 5 min (T3) after tracheal intubation, and 1 min (T4), 3 min (T5), 5 min (T6) and 10 min (T7) after the suspension laryngoscopy. Results : In the 10% lidocaine group, the arterial blood pressure and heart rate at 1 (T1), 3 (T2) min after tracheal intubation and 1 (T4), and 3 (T5) min after suspension laryngoscopy were lower than the same measurements in the control group. Conclusion : 10% lidocaine sprayed onto the pharyngolaryngeal and intratracheal sites before intubation was an effective method for attenuation of the perioperative hemodynamic response during suspension microlaryngeal surgery.

• The Journal of Korean Medicine
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• v.17 no.1 s.31
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• pp.407-432
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• 1996

Clinical Observation was made on 37 cases of Endotracheal intubation patients in the ICU of Oriental Medical Hosptal of Tae- Jon University from January in 1992 to June in 1995. 1. There were many cases of Endotracheal intubation in ischemic attack hemorragic in order. 2. Cerebral embolism mostly occured in the MCA territory and cerebral thrombosis, ICH, in the pons, generally. 3. On admission the consciousness of the most patients was 3 to 7 point by GCS. 4. The ordinary preceeding disease was hypertension. 5. Most patients were discharged from ICU after 2 days. 5. Most patients were discharged from ICU after 2 days. 6. Endotracheal intubation was done most frequently from 1 p.m. to 3 p.m. and intubated time was less than 2 hours. 7. Endotracheal intubation was done in case of heart arrest than dyspnea cases. 8. The main complication of patients of C.V.A. in ICU were urinary tract infection, pneumonia in order. 9. There were no side effects after and by Endotracheal intubation.

• Tuberculosis and Respiratory Diseases
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• v.67 no.1
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• pp.21-26
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• 2009

Background: Non-invasive positive pressure ventilation (NPPV) ensures adequate gas exchange during bronchoscopy in spontaneously breathing, hypoxemic patients, thus avoiding endotracheal intubation. However, in some patients, endotracheal intubation is eventually required after bronchoscopy. This study investigated the incidence of intubation and predictors of a need for emergency intubation prior to NPPV bronchoscopy initiation. Methods: On a retrospective basis, we reviewed the medical records of 36 patients (median age, 55 years; interquartile range [IQR], 43~65 years) with acute hypoxemic respiratory failure who required NPPV during bronchoscopy between January 2005 and October 2007. Results: All patients were hypoxemic (median $PaO_2/FiO_2$ ratio 155; IQR 90~190), but tolerated bronchoscopy with NPPV support. SOFA score and SAPS II score immediately before NPPV initiation were 4 (3~7) and 36 (30~42), respectively. Seventeen (47%) patients needed endotracheal intubation at a median time of 22 (2~50) hours after bronchoscopy. Patients who needed intubation after bronchoscopy had a higher in-hospital mortality (11 [65%] vs. 4 [21%], p=0.017). Upon multiple logistic regression analysis, the need for intubation after bronchoscopy was independently associated with a $P_aO_2/FiO_2$ ratio (OR, 0.961; 95% CI, 0.924~0.999; p=0.047) immediately before NPPV initiation for bronchoscopy. Conclusion: The severity of the hypoxemia immediately prior to NPPV initiation for bronchoscopy was associated with the need for intubation after bronchoscopy in patients with hypoxemic respiratory failure.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.1045-1049
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• 1996

Post-intubation tracheoesophageal fistula is rare, and its management causes a serious problems to surgeons. We have experienced 4 cases in 3 patients. Simple ditcision and closure of the fistulas were done by trans-cervical approach after weaning of ventilator. The tracheal defect was closed by simple suture, and the esophageal defect was closed in two layers before a viable muscle flap was interposed between the two suture lines in order to prevent recurrence. There was one delayed tracheal stenosls and one recurrent fistula, and these complications were also managed success ully.

• Journal of Chest Surgery
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• v.32 no.8
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• pp.765-767
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• 1999

Tracheobronchial rupture following tracheal intubation is a rare complication. We experienced a case of tracheal rupture following double-lumen endotracheal tube intubation. A 76 year old female was admitted due to coughing and chest discomfort. The operation was performed with the diagnosis of congenital broncho esophageal fistula. During the operation, accidently the main trachea was ruptured longitudinally. There was no history of surgical trauma. The ruptured trachea was repaired with prolene and monofilament absorbable sutures. The cause of tracheal rupture was suspected overinflation of the cuff. The patient was discharged from the hospital without any significant complications.