• 제목/요약/키워드: Home mechanical ventilation

검색결과 13건 처리시간 0.019초

Home mechanical ventilation in children with chronic respiratory failure: a narrative review

  • Soyoung Kwak
    • Journal of Yeungnam Medical Science
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    • 제40권2호
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    • pp.123-135
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    • 2023
  • Advances in perinatal and pediatric intensive care and recent advances in mechanical ventilation during the last two decades have resulted in an exponential increase in the number of children undergoing home mechanical ventilation (HMV) treatment. Although its efficacy in chronic respiratory failure is well established, HMV in children is more complex than that in adults, and there are more considerations. This review outlines clinical considerations for HMV in children. The goal of HMV in children is not only to correct alveolar hypoventilation but also to maximize development as much as possible. The modes of ventilation and ventilator settings, including ventilation masks, tubing, circuits, humidification, and ventilator parameters, should be tailored to the patient's individual characteristics. To ensure effective HMV, education for the parent and caregiver is important. HMV continues to change the scope of treatment for chronic respiratory failure in children in that it decreases respiratory morbidity and prolongs life spans. Further studies on this topic with larger scale and systemic approach are required to ensure the better outcomes in this population.

가정용 인공호흡기 관련 안전사고 특성 및 손상 영향 요인 분석: 상급종합병원 일반병동 환자 중심으로 (Factor Associated with Injury Related to Home Mechanical Ventilation in General Ward Patients: A Retrospective Study)

  • 김향숙;최모나;양용숙
    • 임상간호연구
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    • 제26권2호
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    • pp.131-140
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    • 2020
  • Purpose: This study aims to describe the characteristics of safety incidents and factors associated with injury for patients with Home Mechanical Ventilation (HMV) at the hospital. Methods: This is a retrospective study. Data were collected from the work log of respiratory home care nurses and the patients' electronic medical records were investigated. In order to compare group differences, independent t-test and χ2 test were used. Associated factors with injury development were identified by generalized mixed modeling analysis controlling for age and gender. Results: A total of 304 patients on HMV were included in this study, among which 129 (42.4%) experienced 352 HMV-related incidents. Mean frequency of incidents for each patient was 5.11±3.98, ranged from 1 to 15 times. In 19.0% of the incidents, injury was developed. Types of incident and persons involved in the incidents were significantly associated with the patient's injury. In the case of the safety incidents, patient's injury was significantly higher in accidents caused by respiratory circuit problems compared to those caused by problems with the ventilator operation by the medical staff (coefficient=1.25, p=.020). In addition, in the case of those involved in the safety incidents, patient's injury was significantly higher in the accident caused by the patient family members or caregivers than that caused by the medical personnel (coefficient=1.25, p=.019). Conclusion: In order to minimize injury caused by incidents in patients with HMV, hospitals need to provide systemic education to their medical staff and caregivers to enhance awareness of the importance of reporting and safety management.

가정용 인공 호흡기를 사용하는 소아의 임상적 고찰 (Clinical Study of Children Using Home Mechanical Ventilation)

  • 안영준;이승현;김효빈;박성종;고태성;홍수종
    • Clinical and Experimental Pediatrics
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    • 제48권4호
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    • pp.401-405
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    • 2005
  • 목 적 : 급성 호흡부전증, 호흡중추장애, 신경근 질환 등으로 인한 만성 호흡부전 환자들이 가정용 인공 호흡기의 도입으로 가정에서 기계 환기를 받을 수 있게 되어 생명을 연장시키고, 삶의 질을 향상시킬 수 있어 그 사용하는 예가 증가하고 있다. 그러나 이에 대한 임상자료가 거의 없어 저자들은 인공 호흡기를 장착한 환아들을 대상으로 임상실태를 조사하였다. 방 법 : 1997년부터 2003년까지 서울아산병원 소아 중환자실에 입원 후 가정용 인공 호흡기를 장착한 21명의 환아들을 대상으로 하여 후향적으로 의무기록을 분석하고 전화면담을 시행하였다. 결 과 : 대상 환아들은 21명으로 남아 15명, 여아 6명이었다. 인공 호흡기를 장착하였을 때 중간 연령은 31개월(범위 : 2-150개월)이었으며, 호흡기를 장착한 중간 기간은 25개월(범위 : 2-68개월)이었다. 환아들의 원인 질환으로는 호흡중추장애를 포함한 신경근 질환이 16례, 급성 호흡곤란을 포함한 폐질환이 4례, 유전성 대사질환이 1례였다. 인공 호흡기 양식은 압력 조절 양식이 16례(76%), 용적 조절 양식이 5례(24%), 산소가 필요한 경우는 13례(62%)였고, 인공 호흡기를 조금이라도 이탈할 수 있었던 경우는 3례(14%)였다. 기계고장은 19개월마다 1회 발생하였고, 인공 호흡기 장착 후 평균 입원 횟수는 매년 1.7회, 그 원인으로는 폐렴(68%)이 가장 많았다. 추적 관찰한 결과 사망한 환아는 9명(43%)이었고, 사망원인은 기관지 튜브 폐쇄가 4례였다. 인공 호흡기 대여, 산소발생기, 영양식, 진찰 및 치료비용 등을 포함한 모든 의료비용은 월간 평균 111만원이었다. 결 론 : 최근 가정용 인공 호흡기 사용이 증가하고 있으며, 사망원인으로 기관지 튜브 폐쇄가 많아 주의 및 관리를 필요로 하고 인공 호흡기를 장착한 가정에 경제적 어려움이 있어 사회적 관심과 제도적 지원이 필요할 것으로 사료된다.

Cardiac function associated with home ventilator care in Duchenne muscular dystrophy

  • Lee, Sangheun;Lee, Heeyoung;Eun, Lucy Youngmin;Gang, Seung Woong
    • Clinical and Experimental Pediatrics
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    • 제61권2호
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    • pp.59-63
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    • 2018
  • Purpose: Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. Methods: We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. Results: Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older ($16.25{\pm}1.85years$) than those in the nonventilator group ($14.73{\pm}1.36years$) (P=0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity ($1,038{\pm}620.41mL$) than the nonventilator group ($1,455{\pm}603.2mL$). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio ($1.7{\pm}0.44$) was lower in the home ventilator group than in the nonventilator group ($2.02{\pm}0.62$. The mitral valve annular systolic velocity was higher in the home ventilator group (estimated ${\beta}$, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. Conclusion: Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.

애완동물과의 공생을 고려한 공동주택 계획요소 연구 (A Study on the Planning Elements for Apartment Residents Living with Companion Animals)

  • 김선아;이연숙;이수진
    • KIEAE Journal
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    • 제5권2호
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    • pp.27-34
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    • 2005
  • The purpose of this study were to examine actual conditions of apartment residents living with their companion animals and to identify their residential stress and needs of planning elements under those conditions. Questionnaire survey was adopted in this study, and 100 cases were used for data analysis. The subjects for this study were limited to the residents breeding pets in their apartments. The results of this study are as follows: Most of the residents share their living spaces with pets together like their family without spatial restrictions. They indicated problems related to breeding pets in their residence such as walking the dog, cleaning home, leaving pets alone, noise and unpleasant smell. However, they didn't seem to be stressed a lot for their living environments. In terms of residential planning elements, floor plans for effective natural ventilation, balcony with sufficient sunlight, sound proof system, easy-maintenance interior material, unlash area, rubbish bin, mechanical ventilation and central vacuum system and safe electric outlet were highly indicated.

무부하 압축기에 의한 냉장고 기계실 소음의 능동제어 (Active Control of Noise Transmitted through Ventilation Openings of the Machinery Room of Refrigerator)

  • 구정모;정의봉;김태훈;홍진숙
    • 한국소음진동공학회논문집
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    • 제26권4호
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    • pp.475-482
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    • 2016
  • The active control of noise generated by the compressor and transmitted out of the machine room through the windows is implemented based on the FIR filter. The machine room contains most of noise sources of electric home appliances, air-conditioners and refrigerators, for example. To actively reduce the noise from the machinery room. In this paper, the transfer function of the controller for minimization of the acoustic power transmitted through the windows is mathematically formulated. The transfer functions required for implementation of the active controller are the measured. The measurements are conducted in this initial stage under the operation of the compressor with no load. For improvement of the reliability of the transfer function of the compressor to the acoustic power, additional operational measurements are performed. The real time controller is implemented based on the FIR filter using the measured transfer functions and the performance of the active controller is estimated. Control performance is measured about 3 dB ~ 10 dB in reduction of the sound power at the peaks of the compressor noise.

Hospice and Palliative Care for Patients in the Intensive Care Unit: Current Status in Countries Other than Korea

  • Minkyu Jung
    • Journal of Hospice and Palliative Care
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    • 제26권1호
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    • pp.22-25
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    • 2023
  • Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

Non-Surgical Management of Critically Compromised Airway Due to Dilatation of Interposed Colon

  • Min, Jinsoo;Cho, Young-Jae
    • Tuberculosis and Respiratory Diseases
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    • 제79권2호
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    • pp.98-100
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    • 2016
  • We present a rare case of critically compromised airway secondary to a massively dilated sequestered colon conduit after several revision surgeries. A 71-year-old male patient had several operations after the diagnosis of gastric cancer. After initial treatment of pneumonia in the pulmonology department, he was transferred to the surgery department for feeding jejunostomy because of recurrent aspiration. However, he had respiratory failure requiring mechanical ventilation. The chest computed tomography (CT) scan showed pneumonic consolidation at both lower lungs and massive dilatation of the substernal interposed colon compressing the trachea. The dilated interposed colon was originated from the right colon, which was sequestered after the recent esophageal reconstruction with left colon interposition resulting blind pouch at both ends. It was treated with CT-guided pigtail catheter drainage via right supraclavicular route, which was left in place for 2 weeks, and then removed. The patient remained well clinically, and was discharged home.

설비공학 분야의 최근 연구 동향 : 2013년 학회지 논문에 대한 종합적 고찰 (Recent Progress in Air-Conditioning and Refrigeration Research : A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2013)

  • 이대영;김사량;김현정;김동선;박준석;임병찬
    • 설비공학논문집
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    • 제26권12호
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    • pp.605-619
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    • 2014
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2013. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) The research works on the thermal and fluid engineering have been reviewed as groups of fluid machinery, pipes and relative parts including orifices, dampers and ducts, fuel cells and power plants, cooling and air-conditioning, heat and mass transfer, two phase flow, and the flow around buildings and structures. Research issues dealing with home appliances, flows around buildings, nuclear power plant, and manufacturing processes are newly added in thermal and fluid engineering research area. (2) Research works on heat transfer area have been reviewed in the categories of heat transfer characteristics, pool boiling and condensing heat transfer and industrial heat exchangers. Researches on heat transfer characteristics included the results for general analytical model for desiccant wheels, the effects of water absorption on the thermal conductivity of insulation materials, thermal properties of Octadecane/xGnP shape-stabilized phase change materials and $CO_2$ and $CO_2$-Hydrate mixture, effect of ground source heat pump system, the heat flux meter location for the performance test of a refrigerator vacuum insulation panel, a parallel flow evaporator for a heat pump dryer, the condensation risk assessment of vacuum multi-layer glass and triple glass, optimization of a forced convection type PCM refrigeration module, surface temperature sensor using fluorescent nanoporous thin film. In the area of pool boiling and condensing heat transfer, researches on ammonia inside horizontal smooth small tube, R1234yf on various enhanced surfaces, HFC32/HFC152a on a plain surface, spray cooling up to critical heat flux on a low-fin enhanced surface were actively carried out. In the area of industrial heat exchangers, researches on a fin tube type adsorber, the mass-transfer kinetics of a fin-tube-type adsorption bed, fin-and-tube heat exchangers having sine wave fins and oval tubes, louvered fin heat exchanger were performed. (3) In the field of refrigeration, studies are categorized into three groups namely refrigeration cycle, refrigerant and modeling and control. In the category of refrigeration cycle, studies were focused on the enhancement or optimization of experimental or commercial systems including a R410a VRF(Various Refrigerant Flow) heat pump, a R134a 2-stage screw heat pump and a R134a double-heat source automotive air-conditioner system. In the category of refrigerant, studies were carried out for the application of alternative refrigerants or refrigeration technologies including $CO_2$ water heaters, a R1234yf automotive air-conditioner, a R436b water cooler and a thermoelectric refrigerator. In the category of modeling and control, theoretical and experimental studies were carried out to predict the performance of various thermal and control systems including the long-term energy analysis of a geo-thermal heat pump system coupled to cast-in-place energy piles, the dynamic simulation of a water heater-coupled hybrid heat pump and the numerical simulation of an integral optimum regulating controller for a system heat pump. (4) In building mechanical system research fields, twenty one studies were conducted to achieve effective design of the mechanical systems, and also to maximize the energy efficiency of buildings. The topics of the studies included heating and cooling, HVAC system, ventilation, and renewable energies in the buildings. Proposed designs, performance tests using numerical methods and experiments provide useful information and key data which can improve the energy efficiency of the buildings. (5) The field of architectural environment is mostly focused on indoor environment and building energy. The main researches of indoor environment are related to infiltration, ventilation, leak flow and airtightness performance in residential building. The subjects of building energy are worked on energy saving, operation method and optimum operation of building energy systems. The remained studies are related to the special facility such as cleanroom, internet data center and biosafety laboratory. water supply and drain system, defining standard input variables of BIM (Building Information Modeling) for facility management system, estimating capability and providing operation guidelines of subway station as shelter for refuge and evaluation of pollutant emissions from furniture-like products.

태양광 패널 설치를 고려한 건축 디자인 지침 개발 연구 (A Study on the Building Design Guideline Development Considering Photovoltaic Panel Installation)

  • 문창호
    • 대한건축학회연합논문집
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    • 제21권4호
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    • pp.139-146
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    • 2019
  • The purpose of this study is to propose the building design guideline considering photovoltaic panel installation through the analysis of relevant guidelines from home and abroad in terms of building design and solar panel installation. Conclusions can be summarized as followings; Considerations in building design : selection of the site with high solar accessibility, avoidance of the shade from the adjacent building & trees, south facing orientation of solar panel in building design, removal of shade on the solar panel from the part of building itself, load consideration of solar panel & fixing materials, safe passage securement for solar system maintenance, and planning of piping and mechanical room for solar system. Considerations in solar panel installation : harmonizing of solar panel with surrounding environment, unity of solar panel orientation & slope, regular maintenance of solar system, (in case of flat roof installation) solar panel installation afloat over the roof, installation area within the roof floor, and lower than parapet height, (in case of sloped roof installation) solar panel installation parallel with the roof slope, ventilation space securement below the panel, installation area within the roof surface, and similar material installation in empty space.