• Title/Summary/Keyword: Lateral decubitus

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Effects of Three Recumbent Postures on Autonomic Nervous System in Patients with Coronary Artery Disease

  • Kim, Wuon-Shik;Hwang, In-Kyoung;Choi, Hyoung-Min
    • International Journal of Vascular Biomedical Engineering
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    • v.3 no.2
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    • pp.10-16
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    • 2005
  • Because patients with coronary artery disease (CAD) have depressed vagal modulation and the mortality risk from acute myocardial infarction is lower in patients with higher vagal modulation, methods that can increase vagal modulation are desirable in patients with CAD. We intended to inspect the effect of recumbent posture on vagal modulation. By using angiography, 33 patients with abnormal (CAD group) and 33 patients with normal coronary arteries (control group) were studied. The nonlinear as well as the linear characteristics of heart rate variability (HRV) were analyzed on these patients in three recumbent postures: namely, the supine, right lateral decubitus, and left lateral decubitus postures. The lower the normalized high-frequency power (nHF) in the supine or left lateral decubitus posture, the higher the increase in the nHF when the posture was changed from supine or left lateral decubitus to right lateral decubitus in both groups of patients. Right lateral decubitus posture can lead to the highest vagal modulation and the lowest sympathetic modulation among the three recumbent postures in both normal and patients with CAD. Therefore, the right lateral decubitus posture can be used as an effective physiologic vagal enhancer in patients with CAD.

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A Study on Change Image According to Recumbent Position Holding Time for Patient Safety (In Chest Lateral Decubitus Examination) (환자안전을 고려한 횡와위 유지시간에 따른 영상변화에 관한 연구 (흉부 측와위 촬영 시))

  • Kim, Ki-Jin;Jeong, Chang-Min;Yoo, Se-Jong;Choi, Won-Jin;Kim, Jeong-Ho
    • Journal of the Korea Safety Management & Science
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    • v.18 no.1
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    • pp.147-152
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    • 2016
  • Chest lateral decubitus is a chest examination to determine the persence of pleural fluid in thorax. In this study, we prepare recumbent holding position time standard of chest lateral decubitus. The records of 15 patients with chest lateral decubitus between May and Jun. Recumbent holding time is 30, 60, 90, 120, 180, 210, 240 seconds. The result is fluid level change between 0.88mm to 9.63. Fluid heigh change between 9.9 percent to 42.5 percent. We can confirm fluid level change with chest decubitus image. The proper time for fluid level change is 180 seconds.

The Effect of Positioning with Mechanically Ventilatory Acute Respitatory Failure Patients on Arterial Oxygen Partial Pressure and Alveolar-arterial Oxygen tension (인공호흡기를 부착한 급성 호흡부전 환자에서 폐병변 부위에 따른 체위적용이 동맥혈 가스분압 및 폐포동맥간 산소 분압차에 미치는 영향)

  • Hwang, Hee Joung;Park, Hye Ja
    • Korean Journal of Adult Nursing
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    • v.12 no.2
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    • pp.234-244
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    • 2000
  • It is widely recognized that manipulation of body position takes advantage of the influences of gravity for improving oxygenation. The study aims to determine the effects of positioning(supine, prone, right lateral decubitus and left lateral decubitus positions) applied to the mechanically ventilatory acute respiratory failure patients on arterial oxygen partial pressure($PaO_2$), alveolar arterial oxygen tension difference($AaDO_2$), mean aterial pressure, peak inspiratory pressure and plateau pressure. Thirty two acute respiratory failure patients admitted to the medical intensive care unit at Kangnam St. Mary's Hospital, The Catholic University of Korea from March 1997 to January 1998, were divided into three groups by radiographic evidence of unilateral or bilateral lung disease. In group 1 with dominant right lung disease were twelve subjects, group 2 with dominant left lung disease had eight subjects and group 3 had twelve subjects with bilateral lung disease. The variables were measured in 30 minutes after each position of supine, prone, good lung down lateral decubitus and sick lung down lateral decubitus position. The position order was done at random by Latin squre design. The results are as follows; 1) With group 1 patients, the $PaO_2$ in the left lateral decubitus and prone position were $126.8{\pm}30.8$ mmHg and $106.7{\pm}36.8$ mmHg, respectively(p=0.0001). 2) With group 2 patients, the $PaO_2$ in the prone and the right lateral decubitus position were $121.7{\pm}44.7$ mmHg and $118.5{\pm}31.7$ mmHg, respectively (p=0.0018). 3) With group 3 patients, the $PaO_2$ was $143.6{\pm}36.6$ mmHg in the prone position (p=0.0001). 4) With group 1 patients, the $AaDO_2$ in the left lateral decubitus and the right lateral decubitus position were $178.1{\pm}29.7$ mmHg and $233.1{\pm}24.4$ mmHg, respectively(p=0.0001). 5) With group 2 patients, the $AaDO_2$ in the prone and the left lateral decubitus postion were $184.0{\pm}39.5$ mmHg and $231.0{\pm}23.9$ mmHg, respectively(p=0.0019). 6) With group 3 patients, the $AaDO_2$ in the prone and the supine postion were $377.1{\pm}35.6$ mmHg and $435.7{\pm}13.1$ mmHg, respectively (p=0.0001). 7) There were no differences among the mean arterial pressure, peak inspiratory pressure and plateau pressure for each of the supine, prone, left lateral decubitus and right lateral decubitus position. The results suggest that oxygenation may improve in mechanically ventilatory patients with unilateral lung disease when the position is good lung dependent and prone, and patients with bilateral lung disease when the position is prone without any effects on the mean arterial pressure and airway pressure. It is suggested that body positions improve ventilation/perfusion matching and oxygenation need to be specified in patient care plans.

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Utility Comparison of Chest Lateral Decubitus Projection with AP and PA Position (흉부 측와위 촬영 시 전후방향과 후전방향 검사의 유용성 비교)

  • Choi, Guirack
    • Journal of the Korean Society of Radiology
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    • v.7 no.3
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    • pp.233-238
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    • 2013
  • Chest lateral decubitus radiation exposure PA be carried out in general, but emergency patient or the patient's discomfort in the body examination had a lot of inconvenience. In this study, we compared AP and PA image quality, patient safety, and analysis of the examination effectiveness between the two tests was to evaluate the usefulness. Pleurisy or pneumothorax in patients with suspected or diagnosed chest lateral decubitus radiation exposure 30 consecutive patients (male 20 patients, 10 females) were included in the study. Image quality evaluation method microstructure of lung, wide areas of diagnosis, a clear air-fluid interface, the patient rotate, cardiac shadow and sharp diaphragmatic was based on Department of Radiology specialist, division of pulmonology resident blind test was evaluated by four people. Chest decubitus by radiation exposure the AP and PA position examination the usefulness of comparative analysis Image quality in the AP and PA, whereas there was no significant difference in attitude, Stability of the patient and Radiation's examination efficiency AP position compared to the position of PA scores were higher. PA position does not require a examination may be of AP position in a position to suggest that.

Outcomes of Internal Fixation with Compression Hip Screws in Lateral Decubitus Position for Treatment of Femoral Intertrochanteric Fractures

  • Park, Cheon-Gon;Yoon, Taek-Rim;Park, Kyung-Soon
    • Hip & pelvis
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    • v.30 no.4
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    • pp.254-259
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    • 2018
  • Purpose: Internal fixation using compression hip screws (CHS) and traction tables placing patients in the supine position is a gold standard option for treating intertrochanteric fractures; however, at our institution, we approach this treatment with patients in a lateral decubitus position. Here, the results of 100 consecutive elderly (i.e., ${\geq}45$ years of age) patients who underwent internal fixation with CHS in lateral decubitus position are analyzed. Materials and Methods: Between March 2009 and May 2011, 100 consecutive elderly patients who underwent internal fixation with CHS for femoral intertrochanteric fracture were retrospectively reviewed. Clinical outcomes (i.e., Koval score, Harris hip score [HHS]) and radiographic outcomes (i.e., bone union time, amount of sliding of lag screw, tip-apex distance [TAD]) were evaluated. Results: Clinical assessments revealed that the average postoperative Koval score decreased from 1.4 to 2.6 (range, 0-5; P<0.05); HHS was 85 (range, 72-90); and mean bone union time was 5.0 (range, 2.0-8.2) months. Radiographic assessments revealed that anteroposterior average TAD was 6.95 (range, 1.27-14.63) mm; lateral average TAD was 7.26 (range, 1.20-18.43) mm; total average TAD was 14.21 (range, 2.47-28.66) mm; average lag screw sliding was 4.63 (range, 0-44.81) mm; and average angulation was varus $0.72^{\circ}$(range, $-7.6^{\circ}-12.7^{\circ}$). There were no cases of screw tip migration or nonunion, however, there were four cases of excessive screw sliding and six cases of varus angulation at more than $5^{\circ}$. Conclusion: CHS fixation in lateral decubitus position provides favorable clinical and radiological outcomes. This technique is advisable for regular CHS fixation of intertrochanteric fractures.

Arthroscopic rotator cuff surgery without traction system in the lateral position (측와위에서 견인 기구 없이 시행하는 견관절경하 회전근 개 수술)

  • Moon, Young-Lae;Jung, Heuk-Jun
    • Clinics in Shoulder and Elbow
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    • v.6 no.1
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    • pp.50-54
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    • 2003
  • Object: To evaluate the efficiencies of the arthroscopic rotator cuff surgery which is Performed without the traction system in the lateral decubitus position. Methods: Twenty-nine cases of the arthroscopic rotator cuff surgery performed without the traction system in the lateral decubitus position were studied from February, 2002 to January, 2005. We performed a repair using the arthroscopic debridement and the arthroscopic rotator cuff repair, or using the mini-open incision technique after the confirmation of rotator cuff tear, then, the arthroscopic subacromial decompression was performed after the confirmation of subacromial lesions Results: We could easily find the subscapularis tear which was often overlooked in the arthroscopic rotator cuff surgery performed with the traction surgery by the relaxation of the subscapularis, as the arm position was internally rotate about 45 to 70 degrees from abducted position. We found that the operation time was reduced 14 minutes shorter than the operation time of the controlled group which had the surgery with the traction system on the average. We also found that there were no neurovascular complications from all cases. Conclusions: The arthroscopic rotator cuff surgery without traction system in the lateral decubitus position provided the better visual field, easy manipulation of the joint and reducing operation time.

Beach-chair lateral traction position using a lateral decubitus distracter in shoulder arthroscopy

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.164-164
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    • 2008
  • The beach-chair traction position is designed to allow the use of traction while allowing the surgeon to orient the shoulder in an upright position and convert to an open procedure, if necessary. The patient is placed in the beach-chair position under general anesthesia. A three-point shoulder holder (Arthrex, Naples, Florida) is attached to the rail of the operating table on the same side as the surgeon, whereas it is placed on the side opposite the surgeon in the lateral decubitus position. A shoulder traction and rotation sleeve (Arthrex) are affixed to the arm following the manufacturer's instructions. Positioning the thumb toward the closed side of the sleeve ensures a field for the anterior portion of the rotator cuff and prevents the tendency of the suspension apparatus to place the arm in internal rotation. The arm is maintained in 30 to 40 degree abduction and 30 to 40 degree flexion by controlling the length and height of the bar and the location of the universal clamp. The universal clamp allows multiple planes of adjustment to control abduction and forward movement of the arm. The sleeve is attached to the longitudinal traction cable using a sterile hook, and a lateral strap is secured around the proximal portion of the sleeve to the overhead traction cable to ensure a field for glenohumeral reconstruction. The use of a lateral strap permits ideal shoulder positioning for improved access to the anterior and inferior glenohumeral joint. The lateral strap can be released or removed to widen the subacromial space during subacromial decompression or rotator cuff repair. A 10-lb weight is attached to the longitudinal traction cable for an average-sized person.

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Evaluation on Organ Dose and Image Quality by Changing kVp and Ion Chamber Combination while Taking Digital Chest Lateral Decubitus PA Projection (디지털 흉부 측와위 후전방향 검사 시 Ion chamber조합 설정과 관전압 변화에 따른 장기선량 및 화질 평가)

  • Lee, Jin-Soo;Park, Hyong-Hu
    • The Journal of the Korea Contents Association
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    • v.15 no.1
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    • pp.316-323
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    • 2015
  • In this study, we analyzed radiation dose and MTF with setting of Ion chamber and changing kVp so that we are able to suggest acquiring optimized diagnostic images and minimizing patient dose. we assumed right lateral decubitus position among chest decubitus projection and set 7 combination of Ion chamber. By changing kVp(100, 110, 120, 130kVp), we exposed x-ray five times respectively and calculated average value after measuring entrance dose. we input the entrance dose value to PCXMC Monte carlo simulation tool and calculated organ dose and effective dose. Then we did physical image evaluation with MTF for the purpose to compare image quality. As a result, the high kVp, entrance dose is reduced. As change of ion chamber, when selecting second ion chamber, both organ dose and effective dose were the lowest. In contrast, selecting first ion chamber was the highest. MTF is superior to set second Ion chamber and using 120 kVp. Consequently, when taking chest right lateral decubitus using Digital radiography, the optimized combination which have both reducing dose efficiently without declining image quality and aquring good qualified image is set 120 kVp and selecting second Ion chamber.

Impact of Position on Efficacy of Caudal Epidural Injection for Low Back Pain and Radicular Leg Pain Due to Central Spinal Stenosis and Lumbar Disc Hernia

  • Altun, Idiris;Yuksel, Kasim Zafer
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.205-210
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    • 2017
  • Objective : This study was performed to evaluate and compare the efficacies of caudal epidural injections performed at prone and lateral decubitus positions. Methods : A total of 120 patients suffering from low back pain and radicular leg pain were included and patients were randomly distributed into 2 groups according to the position during injection. In Group 1 (n=60; 32 women, 28 men), caudal epidural injection was performed at prone position, whereas it was implemented at lateral decubitus position in Group 2 (n=60; 33 women, 27 men). Visual analogue scale, Oswestry Disability Index (ODI), walking tolerance (WT) and standing tolerance (ST) were compared in 2 groups before and after injection. Results : In Group 1, ODI values were higher at 30th minute (p=0.007), 3rd week (p=0.043) and 6th month (p=0.013). In Group 1, ODI, VAS and ST values were improved significantly at all follow-up periods compared to initial values. In Group 1, WT scores were better than initial values at 30th minute, 3rd week and 3rd month. In Group 2, ODI scores at 30th minute, 3rd week, 3rd month and 6th month were improved while VAS and ST scores were improved at all periods after injection. WT scores were better at 30th minute, 3rd week and 3rd month compared to initial WT scores. Conclusion : Our results indicated that application of injection procedure at lateral decubitus position allowing a more concentrated local distribution may provide better relief of pain.

Video-Assisted Thoracic Surgery Esophagectomy

  • Park, Seong Yong
    • Journal of Chest Surgery
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    • v.54 no.4
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    • pp.279-285
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    • 2021
  • Thoracoscopic esophagectomy for esophageal cancer can be performed in multiple positions, such as the lateral decubitus position or prone position, using various techniques. Each approach has its own advantages and disadvantages, and surgeons can select an appropriate approach based on their preferences. Except for the reduction of pulmonary complications, the benefits of thoracoscopic esophagectomy, including oncologic outcomes, have not been proven scientifically. This review describes the approaches and procedures of thoracoscopic esophagectomy and presents scientific evidence for this procedure.