• Journal of Korean Neurosurgical Society
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• 제51권3호
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• pp.173-176
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• 2012

This report describes a rare case of postoperative hyperventilation attack after an endoscopic third ventriculostomy in a 46-year-old woman. About 60 min after the termination of the operation, an intractable hyperventilation started with respiratory rate of 65 breaths/min and $EtCO_2$, 16.3 mm Hg. Sedation with benzodiazepine, thiopental sodium, fentanyl, and propofol/remifentanil infusion was tried under a rebreathing mask at a 4 L/min of oxygen. With aggressive sedative challenges, ventilation pattern was gradually returned to normal during the 22 hrs of time after the surgery. A central neurogenic hyperventilation was suspected due to the stimulating central respiratory center by cold acidic irrigation solution during the neuroendoscopic procedure.

• 대한장애인치과학회지
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• 제10권2호
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• pp.106-113
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• 2014

저자 등은 개원 치과의원에서 하악 매복지치 발치중 유발된 불안장애와 과환기증 및 발치 창상 주위 출혈과 동통을 보였던 57세 여환을 신속한 정신안정법 적용하에 수액 약물요법과 외과적 처치(잔존 치근 남긴채 창상 지혈, 봉합, 배액술 등)로 관리하여 양호한 경과를 치험하면서, 평소 진료시 정신과적 장애문제에 큰 관심을 가져야 하며, 특히 수술시 스트레스 감소법에 더욱 유념하게 되었다.

• 대한간호학회지
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• 제23권2호
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• pp.245-254
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• 1993

The purpose of this study was to identify effective methods to minimize increases in intracranial pressure(IICP ) during endotracheal suction by means of comparing two methods of hyperventilation and oxygen supply before and after endotracheal suction. In order to evaluate the effects of these two methods, the ICP during suctioning and the sustained time of IICP were measured. For hyperventilation, ambu-bagging was done 10 times for 30 seconds with a tidal volume of 800-900m1. For oxygen supply, 100 percent oxygen was supplied for 2 minutes before and after suction. The subjects for this study were 12 neurosurgical patients who had had a subarachnoid bolt inserted for ICP monitoring and they were all on mechanical ventilatory support in a surgical intensive care unit of Seoul National University Hospital from July 1, 1991 to March 31, 1992. In each patient hyperventilation was performed five times and oxygen supply was given five times and intracranial pressures were measured immediately before and every 30 seconds for 15 minutes after suction. For case assignments counterbalancing and repeated measure designs were combined. And so the total number of experiments were sixty for each group. The effects of hyperventilation and oxygen supply on the IICP and the sustained time of IICP after suction were analyzed by t-test. The results of study were as follows 1. There was a significant difference between the two groups in the increased ICP during suction (t=2.49, p=.014). 2. The sustained time of IICP after suctioning in the oxygen supply group was shorter than that in the hyperventilation group(t=2.35, p=.020) In summary, the Increase in the ICP during suction was lower and the time for the ICP to return to the presuction level was shorter in the oxygen supply group as compared to the hyperventilation group. Therefore, oxygen supply can be re commended before and after endotracheal suction.

• 척추신경추나의학회지
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• 제7권1호
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• pp.75-83
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• 2012

Objectives : The purpose of this study is to investigate the clinical application of acupuncture treatment to a cervical herniated intervertebral disc patient with hyperventilation syndrome developed after magnetic resonance imaging(MRI). Methods : A patient with cervical herniated intervertebral disc got hyperventilation syndrome after taking magnetic resonance imaging. To relieve symptoms, we took paperbag breathing first aid, but it had no effect. So we used acupuncture therapy with strong stimulation. To measure the outcome of the patient's improvement, we observed change of vital sign and verbal numerical rating scale(VNRS). Results : After 8 minutes of acupuncture treatment, the patient had significant improvement in change of vital sign and verbal numerical rating scale(VNRS). Conclusions : In emergency situation, acupuncture treatment as a first aid has a positive effect to control hyperventilation syndrome.

• 대한치과마취과학회지
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• 제14권1호
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• pp.63-71
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• 2014

Extension of advanced odontogenic infection from deep neck fascial spaces into the mediastinum is heralded by chest pain, dyspnea, fever, and radiographic demonstration of mediastinal widening. The critical care should be done in a team approach by multiple medical and dental departments, such as, oral & maxillofacial surgery, otolaryngology, anesthesiology, chest surgery, and infection medicine. Especially, fluid & drug therapy, adequate incision & drainage and systemic supportive psychosedation care are important. But, acute hyperventilation can be produced by several distinct causes: severe anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The orofacial fears about acute pain, trismus, dysphagia, swelling and oral surgical treatment lead to the severe anxiety and increased blood catecholamine level by stress. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the care, hyperventilation was occurred during psychosedation and local anesthesia for incision and drainage of the masticatory fascial space abscess with deep neck infection & mediastinitis. We suggest that the dental patient with advanced odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

• 대한치과마취과학회지
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• 제2권2호
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• pp.107-113
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• 2002

Hyperventilation is defined as ventilation in excess of that required to maintain normal blood $PaO_2$ and $PaCO_2$. It is produced by several distinct causes: anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The dental fears about acute pain, needle, drill and dental surgery lead to the severe anxiety and increased blood catecholamine level. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the gentle care, two cases of hyperventilation were occurred during local anesthesia for incision and drainage of acute odontogenic infectious lesions. We suggest that the dental patients with acute odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

• 대한한방소아과학회지
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• 제21권3호
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• pp.97-107
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• 2007

Objectives The purpose of this study is to report a case showed significant consult in treating Idiopathic chronic hyperventilation patient with oriental medicine. Methods The patient had suffered from dysypnea for 7 months, so we treated her with herbal medicine, acupuncture, laser, CEP nebulizer and cupping. Results and Conclusions This study shows that oriental medicine works for treating Idiopathic chronic hyperventilation. For more accurate studies, further studies are needed with more clinical cases.

• Journal of Yeungnam Medical Science
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• 제11권1호
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• pp.167-180
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• 1994

좌우 경동맥을 결찰하여 혈뇌장벽에 변화를 일으킨 백토에서 뇌압하강제(mannitol, steroid) 및 뇌압하강 방법(과호흡)의 효과를 관찰하였다. Mannitol군에서는 steroid군, 과호흡군에 비해 뇌압감소가 통계적으로 유의하게 있었으며, 시간적으로 mannitol 투여 후 25~30분까지 뇌압이 45%까지 감소하여 지속되었다. Steroid군에서는 mannitol군보다는 뇌압 절대치의 감소폭은 적었지만, 과호흡군 보다 2배 이상의 뇌압감소가 있었고, mannitol군보다 더욱 오랫동안 뇌압감소의 효과가 지속되었다. 과호흡군에서는 mannitol군, steroid군에서보다는 뇌압감소 효과가 적었으나, 과호흡 시행 후 10분까지 13.5~16.7%의 뇌압감소가 있었고, 그 이후 시간 경과에 따른 더 이상의 뇌압감소 효과는 없었다. Mannitol, steroid, 과호흡군을 모두 시행한 복합치료군에서는 mannitol 및 steroid, 과호흡을 각각 시행한 군에서보다 뇌압 감소가 더욱 현저하게 이루어져 30분까지 48~52%의 뇌압감소가 있었다. 이상의 결과로 미루어보아 뇌허혈성 뇌졸중 환자에서 mannitol 및 steroid사용과 병행하여 과호흡을 실시함으로써 뇌압감소를 위한 적절한 치료의 지표가 될 것이라 판단다.

• 동의신경정신과학회지
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• 제27권4호
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• pp.215-221
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• 2016

Objectives: The purpose of this study was to examine the relationship between pathological patterns and hyperventilation syndrome, using pathological pattern and Nijmegen questionnaires. Methods: 33 healthy adults were asked to complete the Cold-Heat-, Phlegm-, Yin deficiency, and Lao Juan (勞倦)-pattern questionnaires, the Chalder fatigue scale, and the Nijmegen questionnaire at Kyung Hee University Hospital. We performed Pearson correlation analyses between the pathological pattern questionnaires and the Nijmegen questionnaire. The questionnaires were composed of several factors. Therefore, each factor and Nijmegen questionnaire score were also analyzed. Results: All of the pattern questionnaire scores had a positive correlation with the Nijmegen questionnaire score. The phlegm pattern, in particular, and the LaoJuan (勞倦) questionnaire scores had high correlation coefficients. The coefficient for the phlegm pattern was 0.856 and the coefficient for the LaoJuan (勞倦) pattern questionnaire was 0.855. Conclusions: The results mean that the pathological pattern questionnaires could be one of the reference materials to evaluate hyperventilation syndrome. Furthermore, improvement of pathological patterns may be helpful for treating hyperventilation syndrome, together with conventional therapies including breathing training.

• 대한한방내과학회지
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• 제19권1호
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• pp.157-167
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• 1998

Background and Purpose : Cerebrovascular reactivity(CVR) can be estimated by measuring the change of cerebral blood flow that occurs during vasostimulation. To estimate the cerebrovascular reactivity, we investigated the change of flow velocity of the middle cerebral artery(MCA) during hyperventilation and hypoventilation with the transcranial doppler. So we studied whether the CVR measured by this method could show a significant difference between the normal and the cerebral infarction subjects and whether the CVR may decrease with age in normal subjects. Methods : Using transcranial doppler, we measured the mean velocity(Vm), the pulsatility index(P.I.) at the resting state, the end of breath-holding and the end of hyperventilation in 36 normal and 10 cerebral infarction subjects, so we calculated the percentile change of mean velocity(%${\Delta}$Vm) and P.I.(%${\Delta}$P.I.) after the vasostimulation. We estimated the change of Vm, P.I., %${\Delta}$Vm and %${\Delta}$P.I. by the age group and compared those parameters between the age-matched normal control and cerebral infarction subjects. Results : The Vm in MCA significantly decreased with age(p<0.05), but there was no significant difference in Vm and P.I. between normal and cerebral infarction subjects. The %${\Delta}$Vm and %${\Delta}$P.I. in response to hyperventilation significantly decreased with age in MCA and there was significant difference in $%{\Delta}Vm$ of MCA after breath-holding between the normal and cerebral infarction subjects. Conclusion : The breath-holding and hyperventilation tests could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied in the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.