• Title/Summary/Keyword: Minimal ventilation

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The effects of early surfactant treatment and minimal ventilation on prevention of bronchopulmonary dysplasia in respiratory distress syndrome (미숙아 호흡곤란증후군에서 폐표면활성제의 조기 투여와 연성 환기요법이 만성폐질환의 예방에 미치는 영향에 관하여)

  • Park, Jong Jin;Lee, Pil Sang;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.44-49
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    • 2009
  • Purpose : Early surfactant treatment and minimal ventilation, bronchopulmonary dysplasia needed prolonged oxygen supplement is a problem. This study aimed to report the effects of early surfactant treatment and minimal ventilation on the prevention of bronchopulmonary dysplasia in respiratory distress syndrome. Methods : We retrospectively studied 139 premature newborn infants (gestational age, 36 weeks; birth weight, 1,500 gm) admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 2001 and December 2006. We analyzed the occurrence of bronchopulmonary dysplasia with respect to ventilator care and surfactant treatment. Results : The incidence of bronchopulmonary dysplasia was significantly higher with prolonged ventilator care, moderate to severe respiratory distress syndrome, and low Apgar score (P<0.001). Despite early surfactant treatment and minimal ventilation, mild bronchopulmonary dysplasia occurs in a considerable number of patients with mild respiratory distress syndrome. The patient group with low Apgar scores required ventilator care for a prolonged period (P=0.020). Conclusion : Early surfactant treatment and minimal ventilation shortens the duration of ventilator care; however, the preventive effects on bronchopulmonary dysplasia are limited. Therefore, not only early surfactant treatment and minimal ventilation but also appropriate management in the delivery room is essential.

Determination of Minimal Pressure Support Level During Weaning from Pressure Support Ventilation (압력보조 환기법으로 기계호흡 이탈시 최소압력보조(Minimal Pressure Support) 수준의 결정)

  • Jung, Bock-Hyun;Koh, Youn-Suck;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.380-387
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    • 1998
  • Background: Minimal pressure support(PSmin) is a level of pressure support which offset the imposed work of breathing(WOBimp) developed by endotracheal tube and ventilator circuits in pressure support ventilation While the lower applied level of pressure support compared to PSmin could induce respiratory muscle fatigue, the higher level than PSmin could keep respiratory muscle rest resulting in prolongation of weaning period during weaning from mechanical ventilation PSmin has been usually applied in the level of 5~10 cm$H_2O$, but the accurate level of PSmin is difficult to be determinated in individual cases. PSmin is known to be calculated by using the equation of "PSmin = peak inspiratory flow rate during spontaneus ventilation$\times$total ventilatory system resistance", but correlation of calculated PSmin and measured PSmin has not been known. The objects of this study were firstly to assess whether customarily applied pressure support level of 5~10 cm$H_2O$ would be appropriate to offset the imposed work of breathing among the patients under weaning process, and secondly to estimate the correlation between the measured PSmin and calculated PSmin. Method : 1) Measurement of PSmin : Intratracheal pressure changes were measured through Hi-Lo jet tracheal tube (8mm in diameter, Mallinckroft, USA) by using pulmonary monitor(CP-100 pulmonary monitor, Bicore, USA), and then pressure support level of mechanical ventilator were increased until WOBimp was reached to 0.01 J/L or less. Measured PSmin was defined as the lowest pressure to make WOBimp 0.01 J/L or less. 2) Calculation of PSmin : Peak airway pressure(Ppeak), plateau airway pressure(Pplat) and mean inspiratory flow rate of the subjects were measured on volume control mode of mechanical ventilation after sedation. Spontaneous peak inspiratory flow rates were measured on CPAP mode(O cm$H_2O$). Thereafter PSmin was calculated by using the equation "PSmin = peak inspiratory flow rate$\times$R, R = (Ppeak-Pplat)/mean inspiratory flow rate during volume control mode on mechanical ventilation". Results: Sixteen patients who were considered as the candidate for weaning from mechanical ventilation were included in the study. Mean age was 64(${\pm}14$) years, and the mean of total ventilation times was 9(${\pm}4$) days. All patients except one were males. The measured PSmin of the subjects ranged 4.0~12.5cm$H_2O$ in 14 patients. The mean level of PSmin was 7.6(${\pm}2.5\;cmH_2O$) in measured PSmin, 8.6 (${\pm}3.25\;cmH_2O$) in calculated PSmin Correlation between the measured PSmin and the calculated PSmin is significantly high(n=9, r=0.88, p=0.002). The calculated PSmin show a tendancy to be higher than the corresponding measured PSmin in 8 out of 9 subjects(p=0.09). The ratio of measured PSmin/calculated PSmin was 0.81(${\pm}0.05$). Conclusion: Minimal pressure support levels were different in individual cases in the range from 4 to 12.5 cm$H_2O$. Because the equation-driven calculated PSmin showed a good correlation with measured PSmin, the application of equation-driven PSmin would be then appropriate compared with conventional application of 5~10 cm$H_2O$ in patients under difficult weaning process with pressure support ventilation.

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A Study on Oil Separation Performance of Crank-Case Ventilation System (크랭크실 환기장치의 오일 분리효율에 관한 연구)

  • Seo, Joon-Ho;Na, Byung-Chul;Kim, Jin-Yong;Park, Seung-Uk;Lim, Dae-Soon
    • Transactions of the Korean Society of Automotive Engineers
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    • v.16 no.3
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    • pp.144-150
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    • 2008
  • This research aims to develop parts for advanced fuel/oil filtering re-circulation applicable to this kind of regulation proof engines. These parts can playa role of converting traditional air emission type crankcase into recovery type crankcase so that the engine can deal with environmental regulations, which do not allow minimal amount of toxic gas discharge. For the experiment, test method and specially made testing equipment are prepared. The results showed that oil separation efficiency of the cone type CCV(Crank Case Ventilation) system was higher than one of cylinder type both in bench test and in engine.

A Study on the Adaptive Reuse Techniques through the History of Buildings in the Historic Urban Area - Focused on the Deep and Narrow Lots of Nammun-ro 2Ga, Cheongju - (역사적 도심 내 건축물의 이력을 통해 본 재생기법에 관한 연구 -청주시 남문로 2가동의 세장형 필지를 대상으로-)

  • Kim, Tai-Young
    • Journal of the Korean Institute of Rural Architecture
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    • v.22 no.2
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    • pp.1-8
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    • 2020
  • This study is intended to derive the adaptive reuse techniques through the history and aspects of new construction, extension, repair, and other works, limited to the deep and narrow lots facing Seongan-gil and Nammun-gil in Nammun-ro 2 ga of Cheongju, the historic urban area. The results are as follows. 1) In the case of newly built reinforced concrete buildings, the central part of the top floor of the residence or all floors are opened to the open space(void) to facilitate lighting and ventilation. This is developed as a convection phenomenon due to the temperature difference from the slits between buildings, which affects the entire air flow of the block. 2) The buildings of extension and repair are composed of two-story masonry or steel frame, both the front store facing the road and the house on the back, but it looks like one because it is in contact with each other. If only a small gap between the front and rear buildings is restored to an external space or a space equipped with sun light, a small breath can be provided in lighting and ventilation. 3) The existing two-story wooden stores and houses have lost their external space due to repairs. With minimal intervention to restore the small courtyard, slits, and space under the eaves, it will not only improve lighting and ventilation, but also create a unique appearance as a segment of the elongated store.

Simulation study for Bag-Valve-Mask application guideline on pathologic pulmonary condition (모형폐의 물리적 특성 변화에 따른 Bag-Valve-Mask의 사용방법 연구)

  • Choi, Hae-Kyung;Jung, Hyung-Keon
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.3
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    • pp.21-28
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    • 2013
  • Purpose: The purpose of this study is to get basic user guidelines of safe and efficient bag-valve-mask application on patients having abnormal pathophysiological pulmonary conditions. Methods: This study was performed by pre-qualified 35 EMS junior and senior students. Participants were instructed to compress ambulatory bag randomly about half, one-third, one-fourth within different airway resistance and pulmonary compliance. Resultant tidal volume and pulmonary wedge pressures on RespiTranier monitor were analysed in relation to pulmonary physiologic index. Results: At least over half compression of bag guaranteed minimal tidal volume regardless of pulmonary conditions. There was no increase of pulmonary wedge pressure above the level of barotrauma on half compression at any pulmonary conditions. Conclusion: Assisted ventilation with ambulatory bag on patients with pathological pulmonary conditions should be over half compressed regardless of respiratory disease entity.

A Study of the Safety Assessment for Combustion Products in the Exposure Human Bodies Rounding Missile Ejection (유도탄 사출시 연소 생성물의 인체 안전성 평가에 관한 연구)

  • Song, Kee Hyeok;Chung, Sung-Hak
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.37 no.4
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    • pp.269-273
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    • 2014
  • The objective of this study is to safety assessment for human body on the guided missile combustion products. This study is to verify the safety assessment when operating the interior missile ejection take on verify the safety of the human body. During the missile ejection of combustion products, this study is analyzed combustion products. Result are accepted NIOSH and KOSHA of the safe guideline, and 6 exposure gas to the specified values 42% (CO), 22% ($CO_2$), not detected (others) are within minimal exposures criteria of the reference value respectively. Contribution of these results supported that interior missile ejection during combustion products may have been ensured human safely. Therefore, the future for improving the environmental safety of the shooting projectile steel plate round, dust collector, ventilation and other facilities is to improve environmental safety and efficient renovated design needed by target focused areas.

Pulmonary Function Following Open Heart Surgery -early and late postoperative changes- (개심술후 폐기능 -수술직후 및 장기간의 추이에 대하여-)

  • 이성행
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.364-374
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    • 1980
  • Twenty-two patients were selected for evaluation of pre-and postoperative pulmonary function. These patients were performed open cardiac surgery with the extracorporeal circulation from March 1979 to July 1980 at the Department of Thoracic and Cardiovascular Surgery, Kyungbook National University Hospital. Patients were classified with ventricular septal defect 5 cases, atrial septal defect 5 cases, tetralogy of Fallot 5 cases, mitral stenosis 4 cases, rupture of aneurysm of sinus Valsalva 1 case, left atrial myxoma I case, and aortic insufficiency 1 case. The pulmonary function tests were performed and listed: [1] respiratory rate, tidal volume [TV], and minute volume[MV], [2] forced vital capacity [FVC] and forced expiratory volume[FEV 0.5 & FEV 1.0], [3] forced expiratory flow [FEF 200-1200 ml & FEF 25-75%]. [4] Maximal voluntary ventilation [MVV], [5] residual volume [RV] and functional residual capacity[FRC], measured by a helium dilution technique. Respiratory rate increased during the early postoperative days and tidal volume decreased significantly. These values returned to the preoperative levels after postoperative 5-6 days. Minute volume decreased slightly, but essentially unchanged. Preoperative mean values of the forced vital capacity, functional residual capacity and total lung capacity decreased [63.2%, 87.2% & 77.3% predicted, respectively], and early postoperatively these values decreased further [19.6%, 76.0% & 38.0% predicted], but later progressively increased to the preoperative levels. In residual volume, there was no decline in the preoperative mean values [100.9% predicted] and postoperatively the value rather increased [106.3-161.7% predicted]. Forced expiratory volume [FEV 0.5 & FEV 1.0] and forced expiratory flow [FEF 200-1200 ml & FEF 25-75%] also revealed significant declines in the early postoperative period. There was no significant difference in values of the spirometric pulmonary function tests, such as FEF 1.O and FEF 25-75% between successful weaning group [17 cases] extubated within 24 hrs post-operatively and unsuccessful weaning group [5 cases] extubated beyond 24 hrs. Static compliance and airway resistance measured for the two cases during assisted ventilation, however, any information was not obtained. Long term follow-up pulmonary function studies were carried out for 8 cases in 9 months post-operatively. All of the results returned to the pre-operative or to normal predicted levels except FVC, FEV 1.0, and FEF 25-75% those showed minimal declines compared to the pre-operative figures.

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A Study on Stabilization of Landfill by Air Ventilation in Field (공기주입방식을 통한 쓰레기 안정화의 현장적용에 관한 연구)

  • Lee, Hwan;Lee, Chae-young;Jeon, Yeon-ho;Kim, Kyung;Kim, Doo-il;Lee, Cheol-hyo
    • Journal of the Korea Organic Resources Recycling Association
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    • v.8 no.4
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    • pp.121-128
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    • 2000
  • Landfill and lysimeter experiments were conducted to estimate the optimum air injection method for the degradation of waste in landfill and the pre-stabilization. Continuous injection with low pressure and quantity can be effective for pre-stabilization of old landfill due to the lower contents of volatile solids in landfill. Air injection and landfill gas (LFG)extraction showed that the SVE (Soil Vapor Extraction) effect by air ventilation was more significant than the biodegradation of organics. Theses results suggested that they could accelerate the biological stabilization of organic waste in landfills. It is also expected that they would reduce the problems including gas emission during the landfill mining, separation and/or transportation to such levels that might be discharged directly to the atmosphere or with minimal treatment, if required.

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A Study on the Changes in Ventilator Care Rate and Outcome of Very Low Birth Weight Infants During Last Four Years (최근 4년간 극소 저출생 체중아의 인공 호흡기 치료율과 경과 변화에 관한 연구)

  • Jung, Byun Kyung;Kim, Yeoung Ju;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1073-1079
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    • 2003
  • Purpose : Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. Methods : We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. Results : Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. Conclusion : Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.

Comparison of cardiopulmonary resuscitation quality using the over-the-head and lateral conventional positions with a bag-valve-mask device performed by a single rescuer : A manikin study (백밸브마스크를 이용한 1인 심폐소생술에서 구조자 위치 변화에 따른 가슴압박과 인공호흡의 질 변화 연구)

  • Uhm, Tai-Hwan;Jung, Hyung-Keon
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.1
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    • pp.7-15
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    • 2016
  • Purpose: There are few studies on the quality of cardiopulmonary resuscitation (CPR) performed by a single rescuer using a bag-valve-mask device. The aim of this study is to compare CPR quality outcomes according to the rescuer's position or mask fixation grip method and to determine the optimal means of achieving therapeutic goals. Methods: The three CPR methods were defined as over-the-head, lateral-superior, and lateral-inferior, depending on the rescuer's position or mask fixation hand placement. CPR quality was estimated for 83 paramedic students who performed 5 minutes of CPR in a randomized sequence on a manikin using each of the three methods. Results: The over-the-head method showed no advantage for cardiac compression and ventilation quality, but minimized the rescuer's fatigue score. Conclusion: In contrast to previous studies or prevailing beliefs, the lateral-superior position is optimal for achieving therapeutic goals with moderate or minimal rescuer fatigue.