• 제목/요약/키워드: Acid base balance

검색결과 40건 처리시간 0.025초

수술 환자에게 적용한 가온요법 연구논문 분석 (Analysis of Researches on the Warming Therapy for Surgical Patients)

  • 전점이
    • 성인간호학회지
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    • 제22권3호
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    • pp.260-270
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    • 2010
  • Purpose: The main question is systematic review of the published in Korea and foreign countries on warming therapy for surgical patients. Methods: The researchers searched at Medline, CINAHL, KERIS, Adult Nursing Association, Korean Society of Nursing Science, Korean Academy of fundamentals of Nursing, and National Assembly Library web site for the published on warming therapy for surgical patients from 1980 to 2008. Words for search were operation/surgery, warming, operation/surgery and warming. Studies were included randomized controlled trial, and there were no restrictions regarding operative phase and outcome measures. Results: 36 published researches that met the criteria were mostly published in foreign countries between 2000 and 2008 and focused on surgery with general anesthesia. Sample size ranged from 21 to 60 subjects, age range between 21 and 60 years of age. Thirty different warming therapies were reported, fifty-two different dependent variables. Outcome indicators included active external warming, intra-operative, and body temperature. 'Positive effects' and 'no effects' equaled. The most frequently reported 'positive effects' were body temperature, shivering, and acid-base balance. No effects were more likely to be heart rate, blood pressure, and hemodynamics. Conclusion: Many types of warming therapy, are reported in the literature with little information about the efficacy of each, many different dependant variables were studied. There were no consistent reports as to length of time used for warming procedures. Overall, the effects of warming therapy are inconsistent. And additional research must be down before any particular method of warming can be used with confidence as to its effectiveness. Attention must be made as to the research design, better measurement of the dependent variables. This review may serve as a base.

외과환자에 발생한 급성신부전의 진단과 치료 (Diagnosis and Management of Acute Renal Failure in Surgical Patient)

  • 권굉보
    • Journal of Yeungnam Medical Science
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    • 제1권1호
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    • pp.13-23
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    • 1984
  • Acute renal failure refers to a rapid reduction in renal function that usually occurs in an individual with no known previous renal disease. Development of a complication of acue renal failure in critically ill surgical patients is not unusual, and it causes high morbidity and mortality. Acute renal failure can be divided as Pre-renal (functional), Renal (organic), and Post-renal (obstructive) azotemia according to their etiologies. Early recognition and proper correction of pre-renal conditions are utter most important to prevent an organic damage of kidney. These measures include correction of dehydration, treatment of sepsis, and institution of shock therapy. Prolonged exposure to ischemia or nephrotoxin may lead a kidney to permanent parenchymal damage. A differential diagnosis between functional and organic acute renal failure may not be simple in many clinical settings. Renal functional parameters, such as $FENa^+$ or renal failure index, are may be of help in these situations for the differential diagnosis. Provocative test utilyzing mannitol, loop diuretics and renovascular dilators after restoration of renal circulation will give further benefits for diagnosis or for prevention of functional failure from leading to organic renal failure. Converting enzyme blocker, dopamine, calcium channel blocker, and propranolol are also reported to have some degree of renal protection from bioenergetic renal insults. Once diagnosis of acute tubular necrosis has been made, all measures should be utilized to maintain the patient until renal tubular regeneration occurs. Careful regulation of fluid, electrolyte, and acid-base balance is primary goal. Hyperkalemia over 6.5 mEq/l is a medical emergency and it should be corrected immediately. Various dosing schedules for medicines excreting through kidney have been suggested but none was proved safe and accurate. Therefore blood level of specific medicines better be checked before each dose, especially digoxin and Aminoglycosides. Indication for application of ultrafiltration hemofilter or dialysis may be made by individual base.

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목질계 바이오매스의 묽은 산 가수분해 공정에서 포도당 분해물 거동 (Behaviors of Glucose Decomposition during Dilute-Acid Hydrolysis of Lignocellulosic Biomass)

  • 정태수;오경근
    • KSBB Journal
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    • 제24권3호
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    • pp.267-272
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    • 2009
  • 셀룰로오즈는 포도당 단위체가 $\beta$-1,4-glucoside결합을 이뤄 긴 사슬형태를 띈다. 또한 리그노셀룰오로직 물질에서의 셀룰로오즈 중 $50{\sim}90%$는 수소결합에 의해 결정형으로 존재하고 나머지 부분은 무정형으로 존재한다. 본 연구에서는 셀룰로오즈를 구성하는 포도당의 분해 생성물을 화인하기 위해 셀룰로오직 바이오매스 (유채대)와 1.5 g/l의 순수한 포도당을 반응온도 $164^{\circ}C$, 산 농도 0.77% (w/w) $H_2SO_4$, $0{\sim}20$ min동안 묽은 산 가수분해 시켜 분해물의 생성량 변화를 관찰하였다. 포도당을 묽은 산에 의해 분해시키면 탈수반응에 의해 1,6-anhydroglucose가 생성되며, 또한 포도당의 이성질체인 과당으로 전환되고 이 과당은 HMF와 포름산으로 전환된다. 또한 산 농도, 반응온도가 포도당 분해에 영향을 미치는 주요 변수임을 확인할 수 있었다. 그리고 분해생성물 중 하나인 HMF 1.308 g/l를 반응온도 $164^{\circ}C$, 산 농도 0.77% (w/w) $H_2SO_4$, $0{\sim}20$ min동안 산 가수분해 시켜 HMF와 HMF 분해물의 변화를 확인하였다.

초저체온 순환정지시 $\alpha$-STAT와 pH-STAT 조절법의 비교분석 -어린돼지를 이용한 실험모델에서- (Comparative Analysis of $\alpha$-STAT and pH-STAT Strategies During Deep Hypothermic Circulatory Arrest in the Young Pig)

  • 김원곤;임청;문현종;원태희;김용진
    • Journal of Chest Surgery
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    • 제31권6호
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    • pp.553-559
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    • 1998
  • 서론: 초저체온 순환정지법은 일부 심장수술에서 매우 유용하게 사용되고 있다. 그러나 사람은 정상 생리상태에서 이 정도 저체온에 노출되는 적이 없기 때문에 초저체온 상태에서 $\alpha$-STAT와 pH-STAT 산-염기 조절법 중 어느 쪽을 택하는 것이 좋으냐에는 여전히 이론이 많다. 본실험에서는 어린 돼지에서 초저체온 순환정지 실험모델을 확립한뒤 pH-STAT와 $\alpha$-STAT 간에 (1) 심폐바이패스 냉각 및 재가온시 뇌냉각 및 재가온 속도 비교, (2) 뇌혈류, 뇌대사 및 뇌혈류/뇌대사 비의 변화 양상 분석, 그리고 (3) 초저체온 순환정지후 뇌부종 정도를 비교 분석하였다. 대상 및 방법: 25~30 KG의 어린 돼지를 실험군마다 7마리씩 사용하였다. 마취후 두개골을 절제하고 상시상동 삽관을 통해 뇌혈류를 측정하였다. 그리고 정중흉골절개술 및 캐뉼라 삽관후 심폐바이패스를 시행하였다. 막형 산화기와 롤러펌프를 사용하였고, 관류속도는 2500 ml/min로 유지시켰다. 심폐바이패스 시작후 첫 10~15분 동안 정상체온 관류를 시행한 뒤 이어 $20^{\circ}C$(비인두체온) 까지 관류냉각을 시행하였다. $20^{\circ}C$에서 40분 동안 완전순환정지를 시행하였다. 냉각기간 동안 실험군에 따라 $\alpha$-STAT 또는 pH-STAT에 따른 산-염기 조절을 시행하였다. 순환정지후에는 정상 체온까지 재가온하였다. 재가온 종료후 실험동물을 희생시키고 뇌를 추출하였다. 뇌혈류 및 뇌대사 측정은 바이패스전, 냉각전, 순환정지전, 재가온후 15분, 재가온 종료시, 재가온 종료후 1시간에 각각 시행하였다. 결과: 양군간 냉각시간은 $\alpha$-STAT군이 16.57$\pm$5.13분으로 pH-STAT 군의 22.83$\pm$2.14분 보다 유의하게 짧았으나(P<0.05), 재가온시간에서는 $\alpha$-STAT군(40.0$\pm$5.07분)과 pH-STAT군(46.5$\pm$6.32) 사이에 유의한 차이는 없었다. 뇌혈류 및 뇌대사에서는 pH-STAT군이 $\alpha$-STAT군에 비하여 높은 경향을 보였지만 통계학적으로 유의한 차이는 없었다. 뇌혈류량/뇌대사율의 비에서도 두군간에 차이가 없었다. 그러나 두 실험군내에서 체온변화에 따른 뇌혈류량 및 뇌대사의 차이는 유의하였다. 특히 비인두체온 20도에서는 뇌대사율의 감소가 뇌혈류의 감소 보다 더욱 커서 결과적으로 뇌혈류량/뇌대사율의 비는 1 보다 높은 수치로 기록되었다. 뇌수분양은 두 실험군간에 유의한 차이는 없었다. 결론: 본 실험에서 $\alpha$-stat와 pH-STAT 산염기 조절법간에 냉각시간 이외에는 유의한 차이가 없음을 알 수 있었다.

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간기능장애를 동반한 임신악조(姙娠惡阻)환자의 치험 1례(例)에 대한 임상보고 (A Case Report of Complaining of Disturbed Liver Function in Hyperemesis Gravidarium)

  • 유영기;배상진;김형준;이동녕
    • 대한한방부인과학회지
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    • 제19권4호
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    • pp.279-286
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    • 2006
  • Purpose : The purpose of this study is to report the effect of oriental treatments to hyperemesis gravidarum in disturbed liver function. Methods : Hyperemesis gravidarum is a severe and intractable form of nausea and vomiting in pregnancy. It is a diagnosis of exclusion and may result in weight loss; nutritional deficiencies; and abnormalities in fluids, electrolyte levels, and acid-base balance. The peak incidence is at 4, 8-16 weeks of pregnancy. Interestingly, nausea and vomiting of pregnancy is generally associated with a lower rate of miscarriage. However disturbed diver dunction with Hyperemesis gravidarium is rare very and dangerous. Traditionally, oriental medical therapy has been used to patients with hyperemesis gravidarum and showed effective result. We treated 1 patient who had hyperemesis gravidarum in disturbed diver dunction at Se-Myung university Oriental Hospital in affiliation by Herbal medication, acupuncture and moxa therapy and got good result from them. Results : As a result, symptoms are remarkably alleviated and liver function test are improved. Conclusion : Therefore we would like to report that it is effective to cure the hyperemesis gravidarum in disturbed liver function through the herb-medication and acupuncture treatment.

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어류의 아기미의 조직학적 구조와 병변 (The histological structure and the pathological lesions of gill in teleosts)

  • 허민도;정현도
    • 한국어병학회지
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    • 제6권1호
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    • pp.65-70
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    • 1993
  • 아가미는 체조직 중에서도 가장 섬세하고도 미묘하게 적응된 조직학적 구조를 갖고 있을 뿐 아니라 환경수에 직접 노출되어 있기 때문에 수중의 각종 생물학적 및 물리화학적 유해인자에 쉽게 영향을 받을 수 있는 곳이다. 아가미를 구성하는 조직성분중에서도 특히 이차새변상피는 단층 내지 두층의 얇은 상피세포로 구성되어 있어 효율적인 가스교환을 할 수 있게 하지만, 이러한 구조의 특수성이 오히려 각종 유해 인자의 침입 또는 이들에 의한 손상을 쉽게 할 수 있다. 아가미는 호흡기능 뿐만 아니라, 장 및 신장과 함께 삼투압의 조절, 노폐물의 배설의 기능도 갖는다. 그러므로, 새변상피의 괴사나 비후와 같은 형태학적 변화는 호흡, 분비 및 배설기능의 장애를 야기할 수 있으므로 새변상피의 기능적 및 형태학적 유지는 무엇보다 중요하다 하겠다. 여기에서는 어떤 특정질병 또는 원인체에 관련한 병리조직학적 변화보다는 일반적으로 아가미조직의 조직학적 특수성을 우선 깊이 이해하고, 그 특성에 관련된 비특이적인 병리조직학적 변화를 중심으로 기술함으로써, 특정 원인체와의 병리조직학적 반응에 대한 보다 정확한 해석을 기하고자 이미 보고 및 출판된 정보를 토대로 하여 여기에 정리하였다.

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EFFECTS OF LYSINE AND SODIUM ON THE GROWTH PERFORMANCE, BONE PARAMETER, SERUM COMPOSITION AND LYSINE-ARGININE ANTAGONISM IN BROILER CHICKS

  • Yun, C.H.;Han, I.K.;Choi, Y.J.;Park, B.C.;Lee, H.S.
    • Asian-Australasian Journal of Animal Sciences
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    • 제4권4호
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    • pp.353-360
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    • 1991
  • An experiment with completely randomized design was performed to investigate the effects of lysine and supplemented sodium on growth performance, nutrients utilization, acid-base balance and lysine arginine antagonism in broiler chicks. The experiment was carried out with 3 levels of dietary lysine (0.6, 1.2 and 1.8%) and 3 levels of sodium(0.4, 0.8 and 1.2%) for an experimental period of 7 weeks. Body weight gain of 1.2% lysine group was significantly (p<0.01) higher than that of low or high lysine group. The highest feed consumption was obtained at 1.2% lysine and 0.4% sodium supplemented level (ML-1.2) and the lowest at LL-1.2. The best feed efficiency was obtained at ML-0.8 level and the worst at LL-1.2 level. Mortalities of high (1.8%) and low (0.6%) lysine groups were significantly (p<0.05) higher than medium lysine (1.2%) group. Among the sodium levels, the mortality at 1.2% sodium supplemented level was significantly (p<0.01) different by the levels of dietary lysine. Lysine-arginine antagonism was observed in high lysine diet. Among the lysine levels, the lowest none weight and length were shown in low lysine group. Interactions between lysine and sodium were significantly (p<0.05) shown in femur weight. The levels of sodium and lysine affected significantly (p<0.01) the utilization of nitrogen, ether extract, total carbohydrate and energy.

선천성(先天性) 심장병(心臟病)의 개심술(開心術) -6례(例) 수술경험(手術經驗) - (Open Heart Surgery for Six Cases of the Conegnital Heart Disease)

  • 이성행;이성구;한승세;이길노;김송명;이광숙;이종국
    • Journal of Chest Surgery
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    • 제9권2호
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    • pp.220-238
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    • 1976
  • Six cases of congenital heart disease were operated on by means of cardiopulmonary bypass between December, 1975 and April, 1976. Two cases of ventricular septal defects (VSD), two cases of VSD, associated with ruptured aneurysm of sinus Valsalva, two cases of atrial septal defects (ASD) and one case of pulmonic stenosis with patent ductus arteriosus were operated. Sarns roller pumps and Bentley Temptrol oxygenators were used for extracorporeal circulation. Pump oxygenator was primed with Ringer's lactate solution, 5% dextrose in water, mannitol, and ACD blood. Flow rate ranged from 2.0 to $2.4L/M^2/min$. Bicarbonate was added to the oxygenator with estimated amount as 15 mEq/L/hr. Venous catheters were introduced into superior and inferior vena cava, and oxygenated blood was returned to the body through aortic cannula inserted into ascending aorta. Moderate hypothermia ($30^{\circ}C$) was induced by core cooling. Aorta was cross clamped for 15 minutes and released for 3 minutes, and repeated clamping when necessary. Atrial and ventricular septal efects were closed by direct sutures. Aneurysms of sinus Valsalva ruptured into the right ventricle were repaired through right ventriculotomy by d:rect closure with Dacron patch reinforcement. Cardiopulmonary bypass time varied from 66 to 209 minutes, and aorta cross clamping time ranged from 13 to 56 minutes. Postoperative bleeding was minimal except one case who needed for evacuation of substernal hematoma. Intra- and postoperative urinary output was satisfactory. Acid-base balance, partial pressure of $O_2$, electrolytes, and hematological changes during intra- and post-perfusion period remained at the acceptable ranges. No mortality was experienced.

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Serum Mineral and Haematobiochemical Profile of Microfilariae Infected Cattle in India: Its Effects on Production and Therapy

  • Sharma, M.C.;Joshi, Chinmay
    • Asian-Australasian Journal of Animal Sciences
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    • 제15권3호
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    • pp.357-365
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    • 2002
  • A survey was under taken of six district of Northern India viz. Bareilly, Pilibhit, Udham Singh Nagar, Nainital, Almora and Rampur. The age, breed, sex and physiological status recorded. A total number of 854 cattle examined out of which lactating (274 cases), non lactating (302 cases) heifers (128 cases), calves (82 cases) and adult male (68 cases) were examined. An incidence of 4.92 percent (42) of microfilarisis was recorded. The highest prevalence was observed in Rudrapur District of Udham Singh Nagar (33.33%, 4/12), followed by Lalkaun in Nanital District (21.74%, 10/46), Rampur (12.50%, 2/16), Bareilly (8.16%, 8/98) and Pilibhit (1.22%, 1/82). No infection was observed in Almora region. Amongst 854 cattle of different group incidence was highest in adult male (12.20%, 10/82), followed by non lactating (3.82%, 12/314) and lactating (2.70%, 2/74), (7.64%, 12/157) was found in Heifers. For haemeto-biochemical, serum minerals estimations and therapeutic study 32 animals suffering from filariasis and 18 healthy animals were taken. 16 animals were treated with ivermectin $@200{\mu}g/kg $ body weight. Effect of this disease on production has also been estimated for which body weight and milk production was observed. The main clinical manifestations observed were anaemia, loss of appetite, debility, oedematous swelling especially in the abdominal region, increased heart rate, and respiration rate. Haematological changes indicated decrease in hemoglobin, total erythrocyte count, packed cell volume, erthrocyte fragility and neutrophil, whereas there was significant increase in erythrocytes sedimentation rate (ESR), total leukocyte count (TLC), lymphocyte and eosinophils. Biochemical changes showed significant reduction in the values of serum albumin, A : G ratio, where as there was significant increase in blood glucose, blood urea nitrogen (BUN), globulin, total lipid, total cholesterol, phospholipids, serum bilirubin. Serum mineral profile also altered markedly, which indicate a significant decrease in Ca, Cu, Fe, Zn, and Mn with increase value of Na and Cl. There was no significant change in P and K values. Enzyme pattern in micro filaria infected animal indicated increased level of AST, ALT, alkaline phosphatase, ornithine carbamyl transferase, sorbitol dehydrogenase, glutamate dehydrogenase, isocitric dehydrogenase and lactate dehydrogenase. In blood gas values and acid/base balance, there was an increase in $PVCo_2$ and $PVo_2$. It has been observed that microfilaria infected cattle showed decrease in body weight and milk production. Animal treated with ivermectin showed the return of these above values toward normalcy.

Intraoperative fluid therapy for video-assisted ovariohysterectomy in dogs

  • Oliveira, Marilia Teresa de;Feranti, Joao Pedro Scussel;Coradini, Gabriela Pesamosca;Chaves, Rafael Oliveira;Correa, Luis Felipe Dutra;Linhares, Marcella Teixeira;Thiesen, Roberto;Silva, Marco Augusto Machado;Brun, Mauricio Veloso
    • Journal of Veterinary Science
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    • 제22권3호
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    • pp.44.1-44.15
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    • 2021
  • Background: Intraoperative fluids are still poorly studied in veterinary medicine. In humans the dosage is associated with significant differences in postoperative outcomes. Objectives: The aim of this study is to verify the influence of three different fluid therapy rates in dogs undergoing video-assisted ovariohysterectomy. Methods: Twenty-four female dogs were distributed into three groups: G5, G10, and G20. Each group was given 5, 10, and 20 mL·kg-1·h-1 of Lactate Ringer, respectively. This study evaluated the following parameters: central venous pressure, arterial blood pressure, heart rate, respiratory rate, temperature, acid-base balance, and serum lactate levels. Additionally, this study evaluated the following urinary variables: urea, creatinine, protein to creatinine ratio, urine output, and urine specific gravity. The dogs were evaluated up to 26 h after the procedure. Results: All animals presented respiratory acidosis during the intraoperative period. The G5 group evidenced intraoperative oliguria (0.80 ± 0.38 mL·kg-1·h-1), differing from the G20 group (2.17 ± 0.52 mL·kg-1·h-1) (p = 0.001). Serum lactate was different between groups during extubation (p = 0.036), with higher values being recorded in the G5 group (2.19 ± 1.65 mmol/L). Animals from the G20 group presented more severe hypothermia at the end of the procedure (35.93 ± 0.61℃) (p = 0.032). Only the members of the G20 group presented mean potassium values below the reference for the species. Anion gap values were lower in the G20 group when compared to the G5 and G10 groups (p = 0.017). Conclusions: The use of lactated Ringer's solution at the rate of 10 mL·kg-1·h-1 seems to be beneficial in the elective laparoscopic procedures over the 5 or 20 mL·kg-1·h-1 rates of infusion.