• International Journal of Advanced Culture Technology
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• v.6 no.3
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• pp.211-215
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• 2018

Ventilator-associated pneumonia (VAP) is a lung infection that develops in patients receiving mechanical ventilation. VAP contributes to about 50% of hospital-acquired pneumonia in ICU settings. One of the recommendation of the Institute of for Healthcare Improvement ventilator bundle is HOB elevation. HOB elevation affects shearing forces and makes higher risk for pressure injury development. Pressure injury (PI) is localized damage to the skin over a bony prominence. PI prevention guidelines recommend that HOB positioning should be lower to reduce risk for PI development which contradicts VAP prevention guidelines for the HOB between 30 and 45 degrees for ICU patients. This presents a care dilemma and tension. The purpose of this study was to perform a secondary data analysis using cumulative electronic health record data in order to determine the association of HOB elevation with VAP and PI in ICU patients. A secondary data analysis was conducted to determine whether HOB elevation is associated with VAP and PI. HOB elevation was not likely to be associated with VAP prevention whereas it was likely to be related to PI development. This is somewhat contrary to popular data and publications. Prospective cohort study is desired to inform us in an evidence-based fashion what actually is optimal HOB elevation for ventilated patients in ICU settings.

• Korean Journal of Air-Conditioning and Refrigeration Engineering
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• v.17 no.4
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• pp.347-354
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• 2005

This paper compared vertical temperature distribution between the existing balcony model without ventilator facilities and the improved balcony model with ventilator facilities using differential equation. As the air inside of balcony is heated by solar radiation this heated air is not exhausted in the existing balcony, remaining stagnant. The air temperature distribution was $26.7{\sim}29.3^{\circ}C$ in balcony without natural ventilator system. This heated air affected the rising air temperature of adjacent spaces such as living room and bedroom in the existing balcony. But, as the heated air inside of the improved balcony model is exhausted through natural ventilator facilities in summer, the air temperature in balcony has fallen. The air temperature distribution in improved balcony was $24.8{\sim}26.7^{\circ}C$ for the inlet air speed of 1 m/s and $24.6{\sim}26.7^{\circ}C$ for the inlet air speed of 3 m/s. The energy consumption of the improved balcony is 2.5 times less than of the existing balcony. The improved balcony with the closed damper makes a roll as the existing balcony in the aspect of the heating effect. When the heated air in the improved balcony is supplied, the air temperature is raised and the ventilation effect in adjacent spaces was improved.

• Journal of Home Health Care Nursing
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• v.20 no.1
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• pp.5-15
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• 2013

Purpose: This study aimed to investigate the self-care education experience, self-care performance, and home care service needs of patients with rare and incurable diseases who use a home ventilator. Methods: From2 ventilator rental companies and 5 hospitals, records of 162 subjects were collected to obtain data regarding self-care education experience (23 items) and home care service needs (25 items). Results: Of the subjects, 65.4% were male and 55.6% had a myotrophic lateral sclerosis. The items with the highest and lowest levels of self-care education experience were "using the ventilator"(94.0%) and "community-available resource information"(27.0%), respectively. Meanwhile, self-care was performed well in terms of "personal hygiene"(59.6%) but not performed well in "community-available resource information"(23.7%). "Health status assessment" had the highest need(88.2%) of home care services. Generally, the need of home care services was higher for the patients using invasive ventilators than that for those using non-invasive ventilators. Conclusion: Home care nurses need to not only provide physical care for the patients but also strengthen their roles of enhancing patient access to and utilization of various community resources to provide systematic and individualized training and care.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.737-743
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• 1995

Background: Pneumonia is a frequent complication in patients undergoing mechanical ventilation, Quantitative culture of protected specimen brush(PSB) have shown satisfactory diagnostic accuracy for the diagnosis of ventilator-associated pneumonia. However PSB method is invasive, expensive, and require a bronchoscopic procedure. But endotracheal aspiration(EA) is simple and less expensive. The purpose of our study was to investigate the diagnosic value of EA quantitative cultures. Method: We studied 15 cases of ventilator-associated pneumonia(for >72h of mechanical ventilation) patients. Patients were divided into two diagnostic categories. Group I was the patients who were suspicious of clinical pneumonia, Group II was the patients for control. The obtained samples by EA and PSB were homogenized for quantitative culture with a calibrated loop method in all patients. Result: Using $10^3cfu/ml$, $10^5cfu/ml$ as threshold in quantitative culture of PSB, EA respectively, we found that EA quantitative cultures represented a relatively sentive(70%) and relatively specific (60%) method to diagnose the ventilator-associated pneumonia. Conclusion: Although EA quantitative cultures are less specific than PSB for diagnosing ventilator-associated pneumonia. EA quantitative cultures correlated with PSB quantitative culture in patients with clinical pneumonia and may be used to treat these patients when bronchoscopic procedures are not available.

• Proceedings of the SAREK Conference
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• 2005.06a
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• pp.76-76
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• 2005

• Journal of Chest Surgery
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• v.32 no.12
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• pp.1135-1139
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• 1999

Multistage unifocalization and complete repair have been performed for pulmonary atresia ventricular septal defect and major aortopulmonary collateral arteries. We reported a case that divided major aortopulmonary collateral artery was changed into an aneurysm that compressed the left main bronchus. A 1-year-8-month old boy was operated. The Rastelli operation with left pulmonary artery reconstructuion ligation of patent ductus arteriosus and take-down of right Blalock-Taussing shunt was performed on the patient who had pulmonary atreisia ventricular septal defect patent ductus arteriosus and MAPCA at 1 year and 8 months of his age. He previously underwent the unifocalization and right B-T shunt at 9 months of age,. He repeatedly had difficulty in weaning from the mechanical ventilator, After removing the aneurysm from the divided MAPCA that compressed the left main bronchus externally it was possible to wean him from the mechanical ventilator.

• Journal of Korean Academy of Nursing
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• v.30 no.4
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• pp.995-1005
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• 2000

This study was performed to identify the physiological and psychological variables related to successful weaning from a mechanical ventilator. The subjects of this study were 22 patients who received mechanical ventilation therapy for more than 3 days in intensive care units. Before the weaning trial, baseline data for following physiologic variables were obtained: spontaneous respiration rate, blood pressure, pulse rate, PaO2, PaCO2, PEEP, static compliance, minute ventilation, tidal volume, rapid shallow breathing index(f/VT), SaO2, PaO2/FiO2 and mean arterial pressure. During spontaneous breathing, physiologic and psychologic variables such as vital signs, ABG, perspiration, chest retraction, paradoxical respiration, dyspnea, anxiety, confidence and efficacy were measured. Successful weaning was defined as sustaining spontaneous respiration over 24 hours after extubation. Weaning failure was defined as the development of more than one of following signs: (1) hypoxemia, (2) CO2 retention or (3) perspiration, tachypnea, chest retraction, tachycardia, arrhythmia, hypotension or hypertension. Subjects (N=18) who successfully weaned from mechanical ventilator were compared with subjects (N=4) who failed. The results are as follows; Eighteen percents of the subjects failed during the weaning trial. Most subjects in the failed group were mechanically ventilated for long-time. This result shows that the success of weaning is more difficult in long-term ventilation patients. In the baseline data that was measured before weaning trial, the mean score of PaO2 in the successfully weaned group was 121mmHg. This is significantly higher than the mean score of PaO2 in the failed group(95mmHg). However, the scores of pH, tidal volume, f/VT, pulse rates, blood pressure, mean airway pressure, SaO2, and PaCO2 were similar between the two groups. Specially the scores of f/VT index as a predominant predictor for successful weaning were not significant (f/VT=44.4) and (f/VT=47). During spontaneous breathing, the scores of dyspnea and anxiety level in the successfully weaned group were less than those of the failed group. On the contrary, the scores of confidence and efficacy in the successful group were greater than those of the failed group. In conclusion, the baseline data that were measured before weaning trial were similar between the both groups, therefore future studies are needed to focus on searching other variables besides physiological parameters related to weaning outcome.

• Journal of Biomedical Engineering Research
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• v.44 no.1
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• pp.19-24
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• 2023

Due to the spread of COVID-19, many patients with severe respiratory diseases have occurred worldwide, and accordingly, the use of mechanical ventilators has exploded. However, hospitals do not have systematic risk management, and the Medical Device Regulation also provides medical device risk management standards for manufacturers, but does not apply to devices in use. In this paper, we applied the Failure Mode Effects Analysis (FMEA) risk analysis technique based on the International Standard ISO 14971 (Medical Devices-Application of risk management to medical devices) for 85 mechanical ventilators of a specific model in use in hospitals. Failure modes and effects of each parts were investigated, and risk priority was derived through multiplication of each score by preparing criteria for severity, occurrence, and detection for each failure mode. As a result, it was confirmed that the microprocessor-based Patient Unit/Monitoring board in charge of monitoring scored the highest score with 36 points, and that reliability management is possible through systematic risk management according to priority.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5787-5791
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• 2014

Background: With increasing survival periods and diversification of treatment methods, treatment of critically ill cancer patients has become an important factor influencing patient prognosis. Patients with cancer are at high risk of infections and subsequent complications. This study investigated the incidence and factors contributing to the development of ventilator-associated pneumonia (VAP). Materials and Methods: This retrospective study investigated the incidence of VAP and factors leading to infection in patients admitted to the intensive care unit (ICU) of a cancer center from January 1, 2012 to December 31, 2013. Results: The incidence of VAP was 2.13 cases per 1,000 days of intubation, and 13 of 288 patients (4.5%) developed VAP. Lung cancer was the most common cancer associated with VAP (N=7, 53.9%), and longer hospital stays and intubation were associated with increased VAP incidence. In the group using a "ventilator bundle," the incidence was 1.14 cases per 1,000 days compared to 2.89 cases per 1,000 days without its use; however, this difference was not statistically significant (p=0.158). Age (${\geq}65$, OR=5.56, 95% confidence interval [CI]=1.29-23.95), surgery (OR=3.78, 95%CI=1.05-13.78), and tracheotomy (OR=4.46, 95%CI=1.00-19.85) were significant VAP risk factors. The most common causative organisms were methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (N=4, 30.8% each), followed by Acinetobacter baumannii and Candida albicans (N=2, 15.4% each). Conclusions: The incidence of pneumonia among critically ill cancer patients is highest in those with lung cancer, but lower than among non-cancer patients. The length of hospital stay and time on mechanical ventilation are important risk factors for development of VAP. Although not statistically significant, "ventilator bundle" care is an effective intervention that delays or reduces incidence of VAP. Major risk factors for VAP include age (${\geq}65$ years), surgery, and tracheostomy, while fungi, gram-negative bacteria, and multidrug-resistant organisms were identified as the major causative pathogens of VAP in this study.

• Journal of Advanced Marine Engineering and Technology
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• v.40 no.6
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• pp.468-475
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• 2016

The purpose of this study is to investigate the acoustic problems of the conventional heat recovery ventilator and to suggest the methods of noise reduction from a heat recovery ventilator according to the installed location. The noise level, in this study, was measured and discussed as the parameters of size, wind volume and sound absorbing duct length for a heat recovery ventilator based on domestic and international related standards. It is found, as a result, that almost all of noise levels from the small and medium heat recovery ventilators without the sound absorbing duct in the anechoic chamber were higher than the noise standard value of 50 dB(A) regardless of the wind volume, and the noise levels went down when a sound absorbing duct was installed. In addition, the sound pressure level relative to frequency bands according to the length of sound absorbing duct was generally decreased, as the length of sound absorbing duct in the small and medium heat recovery ventilators was big, and the sound pressure level was generally increased, as the wind volume was great.