• Archives of Plastic Surgery
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• 제38권6호
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• pp.871-874
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• 2011

Purpose: In some patients with velopharyngeal insufficiency (VPI), Hypernasality can persist after surgical management. Continuous Positive Airway Pressure (CPAP) is applied to these patients for treating hypernasality. The purpose of this study is to report follow-up results of postoperative CPAP therapy. Methods: After performing palatal lengthening, CPAP therapy was applied to three patients for eight weeks from July of 2008 to November of 2009. Perceptual evaluation, nasometry, and nasopharyngeal endoscopy were performed to evaluate hypernasality, nasalance and size of the gap at velopharyngeal port. Each evaluation was made before surgery, right after CPAP therapy and during follow-up of more than a year after CPAP therapy. Results: All of the patients showed improvement in hypernasality right after CPAP therapy according to the auditory perceptual evaluation, nasometry and nasopharyngeal endoscopy. But the improvement in hypernasality in these patients did not last during follow-up. Conclusion: In this study, our results suggest that CPAP therapy is effective in reducing hypernasality for postoperative VPI patients immediately after the therapy, but hypernasality may be worsen in some patients during follow-up. Therefore we recommend follow-ups after CPAP therapy to see if the efficacy of CPAP therapy lasts.

• 음성과학
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• 제14권4호
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• pp.261-271
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• 2007

The purpose of this study was to determine the effectiveness of CPAP (Continuous Positive Airway Pressure) therapy on the treatment of hypernasality in patients with cleft lips and palates. 7 preschool children with severe hypernasality participated in the study. Acoustic measurements of nasality were done by using the NasalView (version 1.31). Results showed that the nasalance values were reduced linearly in both vowels according to the treatment period. The sharp treatment effect was observed at the beginning stage. The nasality values of the vowel /i/ showed a sharp decrease at the Evaluation Phase 1 and 2 and a small increase at the Phase 4 followed by a drop in the end. Further studies would be desirable for various patients with different disorder types.

• Radiation Oncology Journal
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• 제36권1호
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• pp.79-84
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• 2018

Deep inspiration breathing hold (DIBH) compared to free-breathing (FB) during radiotherapy (RT) has significantly decreased radiation dose to heart and has been one of the techniques adopted for patients with breast cancer. However, patients who are unable to make suitable deep inspiration breath may not be eligible for DIBH, yet still need to spare the heart and lung during breast cancer RT (left-sided RT in particular). Continuous positive airway pressure (CPAP) is a positive airway pressure ventilator, which keeps the airways continuously open and subsequently inflates the thorax resembling thoracic changes from DIBH. In this report, authors applied CPAP instead of FB during left-sided breast cancer RT including internal mammary node in a patient who was unable to tolerate DIBH, and substantially decreased radiation dose the heart and lung with CPAP compared to FB.

• Child Health Nursing Research
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• 제17권2호
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• pp.145-152
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• 2011

Purpose: To evaluate the efficacy of Optimal humidification during Nasal Continuous Positive Airway Pressure (nCPAP) for Extremely Low Birth Weight Infant (ELBWI). Methods: The study design was a pre-test-post-test nonequivalent nonsynchronized quasi-experimental design. The participants were 218 ELBWI on nCPAP (experimental group: 102 and control group: 116). Data collection was conducted from January 2005 to April 2010. In order to measure and analyze the nCPAP duration, reintubation and nasal condition, Chi-square test and t-test were used. Results: Hypothesis 1, that the duration with nCPAP in the experimental group is longer than that of the control group and hypothesis 2-3, that the rate of reintubation and nasal problems in the experimental group are lower than the control group, were all supported as there were statistically significant differences between two groups. Conclusion: The findings suggest that the Optimal humidification in this study is an efficient intervention because it helps increase the last time of nCPAP with ELBWI and minimize complications. It is expected that Optimal humidification is beneficial and helpful in preventing and caring for respiratory problems in these infants.

• 말소리와 음성과학
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• 제4권3호
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• pp.171-177
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• 2012

The purpose of this study was to investigate whether CPAP therapy was effective for reducing the degree of hypernasality in individuals with repaired cleft palate and whether the efficacy of CPAP therapy was maintained. Five individuals with cleft palate participated in an 8-week home-based CPAP program. Results from perceptual evaluation of hypernasality and nasalance scores before and after CPAP therapy and at the follow-up speech evaluation were compared. The results of the study showed that the responses of the CPAP therapy were various among individuals. Three individuals exhibited reductions in the degree of perceived hypernasality, while nasalance scores in all individuals decreased after the therapy. The results showed that the effect of CPAP therapy was generally maintained until approximately three months after the completion of CPAP therapy.

• 대한불안의학회지
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• 제4권2호
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• pp.157-159
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• 2008

저자들은 심한 수면 무호흡증을 가진 성인 남자에서,CPAP 치료 후 조증 및 경조증 삽화가 유발된 증례를 보고하였다. 본 증례는 정신과적 병력 및 가족력이 없던 환자에게서 CPAP 치료 후 조증 삽화와 경조증 삽화가 연속해서 유발된 첫 번째 보고이다. 환자는 CPAP 치료 시작 직후부터 약 한달 동안 기분 고양감과 목적지향 활동의 증가를 보이다가 2~3일만에 정신병적 증상이 동반된 조증 삽화를 보였다. 또한 퇴원 후 투약을 지속하면서 다시 CPAP치료를 한 직후 경조증 삽화로 추정되는 일련의 기분 및행동 변화가 나타났다. 따라서 이 환자의 조증 삽화와 경조증 삽화로 추정되는 기분 변화는 CPAP 치료로 유발되었을 가능성이 있다고 판단되었다. 폐쇄성 무호흡증이 심하여 CPAP 치료가 처방되는 경우에 임상의들은 정신과적 질환의 기왕력이나 위험 인자가 없는 환자에서도 조증상태가 발생할 수 있는 가능성에 대해 유의하여야 하고, 주기적으로 객관적인 척도를 사용하여 기분 변화 정도를 점검할 필요가 있다. 특히 CPAP 사용 후 특별한 이유 없이 행동 변화나 기분 고양의 정도가 심해질 때는 조증 가능성을 의심해 보아야 할 것으로 사료된다.

• Child Health Nursing Research
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• 제20권3호
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• pp.225-235
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• 2014

목적 본 연구는 국내외 연구의 체계적 문헌고찰을 통해 미숙아무호흡에 대한 nCPAP의 효과를 재확인하고 nIPPV 중 nSIPPV를 적용한 연구들을 구별하여 효과 차이가 있는지 확인해보고자 한다. 본 연구의 결과를 토대로 고위험신생아 간호전략을 위한 기초적인 자료를 제공하기 위해서이다. 방법 본 연구에서는 1970년 1월부터 2013년 9월까지 미숙아 무호흡증을 대상으로 nCPAP를 제공하고 그 효과를 확인한 연구를 대상으로 검색하였다. 영문 검색어는 'preterm infant', 'prematurity', 'nCPAP', 'apnea', 'trial' 이었으며 국문검색어는 '미숙아', '무호흡', '무호흡중재'로 검색하였다. 총 13편의 논문분석을 위하여 코딩의 준거분석틀에 따라 자료코딩을 하였다. 자료의 코딩에 따른 준거분석틀은 다음과 같다. 먼저 각 연구 특성에 따른 자료의 코딩은 연구자, 게재연도, 표본크기, 중재방법, 중재시간, 주요결과, 적용시간, 실험설계의 편향 유형을 조사하여 제시하였다. 코딩된 자료는 신뢰구간 95%, 통계적 유의수준 5%로 정하며 이용된 프로그램은 STATA 10.0을 이용하였다. 결과 nCPAP의 무호흡감소의 효과와 nIPPV의 차이는 -0.11 (95% CI [-0.64, 0.42])로 유의한 차이가 검증되지 않았다(Z=0.41, p=.680). 그러나 nCPAP와 nSIPPV의 효과차이는 결합추정치 -0.44 (95% CI [-0.81, -0.07)로 nSIPPV가 미숙아무호흡 감소에 효과가 있는 것으로 나타났다(Z=2.35, p=.019). nCPAP의 호흡기치료중지 성공에 대한 효과를 메타분석 한 결과 1.60 (95% CI [0.70, 3.63])이었으며 nIPPV와 차이가 검증되지 않았다(Z=1.12, p=.268). 그러나 nSIPPV는 nCPAP에 비해 결합추정치는 3.94 (95% CI [1.74, 8.90])로 호흡기치료 중지에 효과가 있는 것으로 나타났다(Z=3.29, p=.0001). 결론 미숙아의 무호흡감소와 호흡기치료의 단축을 위해 nCPAP와 nIPPV 중 nSIPPV의 효과를 확인하였으며 본 연구결과를 기초로 임상에서 활용 가능한 미숙아 호흡관리 프로토콜 개발을 위해 지속적인 연구들이 진행되어져야 할 것이다.

• 대한두개안면성형외과학회지
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• 제11권2호
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• pp.73-76
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• 2010

Purpose: There are several surgical methods for correcting a velopharyngeal insufficiency (VPI) but in some cases, it is not possible to achieve complete recovery of the velopharyngeal function. This paper introduces a new therapy for treating hypernasality without further surgery using continuous positive airway pressure (CPAP). Methods: CPAP therapy was applied to seven VPI patients for eight weeks from April of 2007 to September of 2009. All patients underwent palatoplasty for the cleft palate and six patients underwent palatal lengthening for VPI before CPAP therapy. A speech pathologist performed an auditory perceptual evaluation to evaluate the improvement in hypernasality after 8-week CPAP therapy. Results: Six patients showed an improvement in hypernasality after CPAP therapy according to the auditory perceptual evaluation. One patient with severe hypernasality responded to the early part of therapy but the hypernasality did not improve after therapy. Conclusion: CPAP therapy might be effective in reducing the hypernasality in patients with VPI by providing resistance training to strengthen the velopharyngeal closure muscles. In particular, CPAP therapy could be more effective for patients who show mild to moderate hypernasality after surgery.

• Healthcare Informatics Research
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• 제24권4호
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• pp.346-358
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• 2018

Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).

• 수면정신생리
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• 제1권2호
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• pp.172-181
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• 1994

Obstructive sleep apnea syndrome(OSAS) is most frequently diagnosed in the sleep laboratories and its severity is objectively estimated. In terms of treatment, the most prevalent method is the continuous positive airway pressure(CPAP) application as of now. However, in Korea, CPAP is still not sufficiently known and it is attributable to the fact that sleep study facilities have not been popularized. In this article, the authors present their own experience with CPAP in nine subjects with OSAS. In this study, CPAP was found to decrease stage 1 sleep and to increase stage 2 sleep, with increasing mean oxygen saturation and decreasing lowest oxygen saturation during nocturnal sleep. Also, it tended to increase sleep continuity and generally to improve sleep architecture. Rebound slow wave and/or REM sleep stages during CPAP were also noted in 8 out of 9 cases. The authors suggest that CPAP should be considered as the primary mode of treatment for patients with obstructive sleep apnea syndrome and related educational programs for physicians should be developed and provided by sleep specialists.