• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.434-438
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• 2004

Background : An excessive endotracheal cuff pressure can cause tracheal injury, and insufficient cuff pressure may not generate an effective cuff seal. The peak inspiratory pressure influences the minimal occlusion pressure of the endotracheal tube cuff. However, the relationship between the minimal occlusion pressure and the tidal volume has not been investigated. This study was conducted to estimate the relationship between the tidal volume and the minimal occlusion pressure of the cuff. Methods : Ten mechanically ventilated patients were included. The minimal occlusion pressure of the cuff was measured using a pressure gauge. The basal tidal volume was increased and decreased as much as 10% whilst maintaining the same peak inspiratory pressure. The, minimal occlusion pressures were then measured in the high and low tidal volume state, respectively. Results : The peak inspiratory pressure was $32.6{\pm}4.72cmH_2O$ and the minimal occlusion pressure was $19.0{\pm}2.26$ mmHg in the basal ventilator setting. There was a significant relationship between the peak inspiratory pressure and the minimal occlusion pressure(r=0.77, p<0.01). The minimal occlusion pressure of the cuff was increased to $20.3{\pm}2.4$ mmHg in the high tidal volume state(p<0.05), and decreased to $16.8{\pm}3.01$ mmHg in the low tidal volume state (p<0.001). Conclusion : The minimal occlusion pressure of the cuff can be influenced by changes in the tidal volume as well as by the peak inspiratory pressure.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.61 no.6
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• pp.885-890
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• 2012

In this study, a new blood pressure measuring system was proposed and implemented. An additional small-cuff was placed on the center of a inner cuff to measure morphological signals and new oscillometric ratio. The proposed BP-measuring system is composed of an external cuff, an inner cuff and a small-cuff. Oscillation signal from small-cuff is interpolated with 7th-order fitting polynomials and SBP, DBP ratio were 22.2% and 87.7%. Experimental data were gathered from 20 volunteers ($25{\pm}4$ years) and arterial blood pressure values were compared with auscultation, sphygmomanometers, small-cuff and inner-cuff. As a result, the difference in systolic BP between auscultation and the small-cuff was 1.93(${\pm}1.28$) mmHg, and the inner-cuff was 4.53(${\pm}4.39$) mmHg, and sphygmomanometer was 6.68(${\pm}3.99$) mmHg, and the corresponding difference in diastolic BP was 2.50(${\pm}2.04$) mmHg, 3.50(${\pm}3.19$) mmHg, 7.35(${\pm}5.62$), respectively.

• The Korean Journal of Emergency Medical Services
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• v.21 no.2
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• pp.7-15
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• 2017

Purpose: This study investigated the effectiveness of education regarding cuff pressure following endotracheal tube intubation using a quasi-experimental design with a pre- and posttest non-equivalent control group. Methods: A total of 78 students from two universities participated in an education intervention on the importance of cuff pressure after endotracheal tube intubation between October and December, 2016. The intervention lasted 40 minutes. Data were collected from each student before the intervention and one week following the intervention. Analyses were conducted using chi-square tests, Fisher's exact tests, and analysis of covariance. Results: A total of 38 students were assigned to the experimental group and 40 to the control group. The educational intervention of cuff pressure following endotracheal tube intubation was associated with prevention of possible complications from excessive cuff pressure (F=121.02, p<.001). Conclusion: Training with a pressure gauge and an intubation manikin is necessary to determine the appropriate cuff pressure in the intubation protocol of the practical examination in the emergency medical technology.

• International Journal of Precision Engineering and Manufacturing
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• v.7 no.2
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• pp.30-35
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• 2006

The purpose of this study is to develop a new cuff to improve the accuracy of blood pressure measurement, and to evaluate the performance of the developed system. We added a small bladder to the normal cuff, which we refer to as the double bladder system. The system that we developed for blood pressure measurement was based on the oscillometric method using a double bladder. This system was developed in order to reduce the oscillation noise and to amplify the signal of pure blood pressure. An oscillometric signal database based on the developed system was evaluated according to the ANSI/AAMI/SP10-1992 standard. The correlation coefficients between the cuff of the double bladder and the normal cuff were 0.98 for systolic pressure and 0.94 for diastolic pressure. The mean differences and the standard deviations between the average blood pressure obtained from a mercury manometer and that obtained from an automated sphygmomanometer were -0.7mmHg and 4.9mmHg for systolic, and -1.4mmHg and 5.4mmHg for diastolic pressure. We conclude that the proposed double bladder-based cuff system improves the accuracy of oscillometric blood pressure measurement. The developed system reduces the range of error by about $44{\sim}62%$ for systolic pressure and about $6{\sim}21%$ for diastolic pressure compared to the most recently developed, commercially available sphygmomanometers.

• Korean Journal of Adult Nursing
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• v.21 no.5
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• pp.538-546
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• 2009

Purpose: The purpose of this study was to identify the effects of cuff pressure on postoperative sore throat. Methods: Data were collected from January 4 through May 15, 2008. Among the 60 patients, 30 patients were randomly assigned to the control group and the rest to the experimental group. Initial cuff pressure of both groups was set at 20 $cmH_2O$. The experimental group was maintained at 20 $cmH_2O$ throughout the anesthesia, while the control group was not regulated further. Sore throat was assessed at postoperative 1, 24 and 72 hours. Data were analyzed using Mann-Whitney test and Spearman's rho coefficients. Results: Cuff pressure in control group increased from 20 to 43 $cmH_2O$ within 3 hours after induction. However, the experimental group showed that there was apparently a reduced rate of sore throat at postoperative 24 hours (p = .048), and 72 hours (p = .002) than in the control group. However, no outstanding differences between both groups at postoperative 1 hour (p = .081) were detected. The correlation between cuff pressure and sore throat was statistically significant ($r_s$ = .590, p < .001). Conclusion: We conclude that maintaining cuff pressure at 20 $cmH_2O$ could be an effective means to reduce sore throat in surgical patients with inhalation anesthesia.

• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.156-165
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• 2002

Background: A tracheal stenosis is caused by mucosal ischemic injury related to a high cuff pressure ($P_{cuff}$) of the endotracheal tube. In contrast, aspiration of the upper airway secretion and impaired gas exchange due to cuff leakage is related to a low $P_{cuff}$. To prevent these complications, the $P_{cuff}$ should be kept appropriately because the appropriate $P_{cuff}$ appears to change according to the patient's daily respiratory mechanics. However, the constant cuff volume($V_{cuff}$) has frequently been instilled to the cuff balloon on a daily basis to maintain the optimal $P_{cuff}$ instead of monitoring the $P_{cuff}$ directly at the patients' bedside. To address the necessity of continuous $P_{cuff}$ monitoring, the change in the $P_{cuff}$ was evaluated at various $V_{cuff}$ levels on a daily basis in patients with long-term mechanical ventilation. The utility of mercury column sphygmomanometer for the continuous monitoring $P_{cuff}$ was also investigated. Method: The change in $P_{cuff}$ according to the increase in $V_{cuff}$ was observed in 17 patients with prolonged endotracheal intubation for mechanical ventilation for 2 week or more. This maneuver measured the change in $P_{cuff}$ daily during the mechanical ventilation days. In addition, the $P_{cuff}$ measured by mercury column sphygmomanometer was compared with the $P_{cuff}$ measured by an automatic cuff pressure manager. Results : There were no statistically significant changes of $P_{cuff}$ during more than 14 days of intubation for mechanical ventilation. However the $V_{cuff}$ required to maintain the appropriate $P_{cuff}$ varied from 1.9 cc to 9.6 cc. In addition, the intra-individual variation of the $P_{cuff}$ was observed from 10 $cmH_2O$ to 46 $cmH_2O$ at constant 3 cc $V_{cuff}$. The $P_{cuff}$ measured by the bedside mercury column sphygmomanometer is well coincident with that measured by the automatic cuff pressure manager. Conclusion: Continuous monitoring and management of the $P_{cuff}$ to maintain the appropriate $P_{cuff}$ level in order to prevent cuff related problems during long-term mechanical ventilation is recommended. For this purpose, mercury column sphygmomanometer may replace the specific cuff pressure monitoring equipment.

• Journal of the Korean Society for Precision Engineering
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• v.22 no.5 s.170
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• pp.181-188
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• 2005

The purpose of this study is to develop the new cuff improving the accuracy of blood pressure measurement, and to evaluate the performance of the developed system. We added a small bladder to the normal cuff which is called the double bladder system. The developed system for blood pressure measurement was based on the oscillometric method using a double bladder. This system was developed in order to reduce the oscillation noise and to amplify the signal of pure blood pressure An oscillometric signal database based on the developed system were evaluated following the standard ANSI/AAMI/SP10-1992. The correlation coefficients between cuff of double bladder and normal cuff were 0.98 for systolic and 0.94 for diastolic. Mean differences and the standard deviations between average blood pressure of mercury sphygmomanometer and automated sphygmomanometer were -0.7mmHg and 4.9mmHg for systolic, and -1.4mmHg and 5.4mmHg for diatolic, respectively. We conclude that the proposed double bladder based cuff system improves the accuracy of the oscillometric blood pressure measurement. The developed system reduces the error range about $44\~62\%$ for systolic and about $6\~21\%$ for diastolic compared to the recently developed commercially available sphygmomanometers.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.16 no.1
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• pp.6-13
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• 2009

Purpose: The purpose of this study was to identify differences in blood pressure according to cuff size and measurement sites of the participants. Method: The participants consisted of 50 women and 50 men whose upper arm circumference was $26\sim30cm$. They had no chronic illness and gave consent to participate. Blood pressure of the wrist was measured in the sitting position, the upper arm with a standard cuff, large and small cuffs were used for measurement in supine position and the thigh in prone position. The data were analyzed with paired t-test using SPSS 12.0 program. Result: The data for the upper arm showed a difference in systolic and diastolic blood pressure depending on the site of measurement. There was a significant difference between measurements with a standard cuff and measurements with large and small cuffs. The systolic blood pressure of the wrist and the thigh were significantly lower than that of the upper arm. Conclusion: These results suggest that the selection of an appropriate cuff is an essential element in ensuring accuracy when measuring blood pressure and differences in systolic blood pressure for the upper arm, wrist and thigh indicate the need to record the measuring site when measuring blood pressure.

• Clinics in Shoulder and Elbow
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• v.19 no.1
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• pp.51-58
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• 2016

The arthroscopic rotator cuff repair is now considered a mainstream technique with highly satisfactory clinical results. However, concerns remain regarding healing failures for large and massive tears and high revision rate. In recent decades, various repair strategies and construct configurations have been developed for rotator cuff repair with the understanding that many factors contribute to the structural integrity of the repaired construct. The focus of biomechanical test in arthroscopic repair has been on increasing fixation strength and restoration of the footprint contact characteristics to provide early rehabilitation and improve healing. These include repaired rotator cuff tendon-footprint motion, increased tendon-footprint contact area and pressure, and tissue quality of tendon and bone. Recent studies have shown that a transosseous tunnel technique provides improved contact area and pressure between rotator cuff tendon and insertion footprint, and the technique of using double rows of suture anchors to recreate the native footprint attachment has been recently described. The transosseous equivalent suture bridge technique has the highest contact pressure and fixation force. In this review, the biomechanical tests about repair techniques of rotator cuff tear will be reviewed and discussed.

• Journal of Biomedical Engineering Research
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• v.37 no.1
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• pp.39-45
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• 2016

A pressure measurement system was developed to verify magnitude and position of transferred pressure on the body surface during the intermittent pneumatic compression (IPC) which is one of the most well-known methods for the prevention of deep vein thrombosis (DVT). Eighty force sensing resistors (FSR) were arranged on a mannequin leg and a hardware controller sensed, digitized, and transferred pressure data every second while IPC was being applied. Finally, sensed pressure data were color coded and visualized on the 3D model with lab-developed software. The pressure data were also saved to files for further analysis. Using this measurement system, the changing pattern of pressure was measured on the mannequin leg by changing both chamber pressure and cuff tightness. As a result, net pressure transferred onto the body surface is dependent on chamber pressure and cuff tightness. Under the same chamber pressure, the tighter a cuff was worn, the wider compressed area was and the shorter compression cycle was. Also transferred pressure was proportional to both chamber pressure and cuff tightness.