• 제목/요약/키워드: Peak Expiratory Flow Rate(PEFR)

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Auto-PEEP이 존재하는 환자에서 호흡 일에 대한 External PEEP의 효과 (The Effect of External PEEP on Work of Breathing in Patients with Auto-PEEP)

  • 진재용;임채만;고윤석;박평환;최종무;이상도;김우성;김동순;김원동
    • Tuberculosis and Respiratory Diseases
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    • 제43권2호
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    • pp.201-209
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    • 1996
  • 연구배경: Auto-PEEP 혹은 intrinsic PEEP은 호기말에 폐용적이 전체 호흡기계의 이완 용적으로 돌아오지 않음으로써, 증가된 호흡기계의 탄성반도압만큼 호기말 폐포내압(alveolar pressure) 이양의 값을 보이는 것을 말한다. Auto-PEEP 이 존재하는 만성폐쇄성폐질환 환자에게 externa1 PEEP을 적용하면 환자의 호흡 일을 줄일 수 있어서, 질환의 급성악화시 혹은 기계호흡으로부터의 이탈시 환자의 자발호흡을 보조하기 위한 요법으로 제시되고 있다. 이에 기계호흡중인 환자에서 auto-PEEP의 존재가 호흡 일에 미치는 영향을 알아보고, externa1 PEEP의 사용이 auto- PEEP에 의해 증가된 호흡 일을 줄이는지를 알아보기 위해 본 연구를 시행하였다. 방법: 호흡부전으로 기계호흡을 하고 있는 환자 15명을 대상으로 연구가 이루어 졌으며, 이들 7명에서 auto-PEEP이 관찰되었고(auto-PPEP군) 8명에서 auto-PEEP이 auto-PEEP군). 양군 간의 환자의 호흡역학적 지표의 차이를 조사하였으며, auto-PEEP이 존재하는 환자들에 대해 3cm $H_2O$의 external PEEP을 적용한 뒤 호흡역학적 지표들의 변화를 조사하였다. 호흡역학적 지표는 상시호흡량(tidal volume, 이하 $V_T$), 분당 호흡수, 분당환기량 (minute ventilation 이하 $V_E$), 최고흡기유량(peak inspiratory flow rate, 이하 PIFR), 최고호기유행peak expiratory flow rate, 이하 PEFR), 최고흡기압(peak inspiratory pressure, 이하 PIP), $T_I/T_{TOT}$, auto-PEEP, 폐 동적탄성 (dynamic compliance of lung, 이하 Cdyn), 호기 기도저항(expiratory airway resistance, 이하 RAWe), 평균 기도저항(mean airway resistance, 이하 RAWm), $P_{0.1}$, 환자에 의해 수행되는 호흡 일 (work of breathing performed by patient, 이하 호흡 일), pressure-time product(이하 PTP)등이었다.

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만성 폐쇄성 폐질환 환자의 중증도 분류시 FEV1과 PEFR의 연관성 (The Relationship between FEV1 and PEFR in the Classification of the Severity in COPD Patients)

  • 신상열;윤재호;김순종;유광하
    • Tuberculosis and Respiratory Diseases
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    • 제58권5호
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    • pp.507-514
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    • 2005
  • 연구배경 : COPD환자에서 질환의 중증도, 치료 반응정도, 급성악화등을 평가하는데 $FEV_1$과 PEFR이 중요한 측정지표로 사용되고 있다. 하지만 COPD환자에서 PEFR과 $FEV_1$의 일치성에 대해서는 잘 알려져 있지 않아 PEFR 측정이 중증도 분류 검사로 사용이 가능한지는 모르는 상태이다. 방 법 : 2003년 9월부터 2004년 8월까지 건국대학교 병원호흡기 내과 외래에서 진료받은 COPD환자 125명을 대상으로 $FEV_1$과 PEFR을 측정하여 그 결과를 통계, 분석하였다. 결 과 : $FEV_1$ 예측치의 평균은 $56.98{\pm}18.21$이었고 PEFR 예측치의 평균은 $70{\pm}27.60$로 PEFR 예측치가 $FEV_1$ 예측치보다 13%정도 높게 측정 되었다. 두 검사 사이에는 유의한 상관관계가 있었다. COPD환자들의 나이와 PEFR 과는 유의한 상관관계가 없었다. 주관적 증상인 호흡 곤란과 PEFR 과는 유의한 상관관계가 있었다. 결 론 : COPD 환자들에서 PEFR 을 이용한 중증도 분류시 $FEV_1$에 비해 경한 쪽으로 분류되는 성향이 있으므로 증상이 심한 경우 중증도 분류 해석에 주의를 요해야 하겠다. COPD 환자들에서 중증도 분류가 확정된 경우 추적 관찰은 PEFR 값으로 $FEV_1$을 대체하는 것이 가능할 것으로 생각된다.

천식환자에 대한 키네시오 테이핑의 효과 (The Effect of Kinesio Taping as to Asthmatic)

  • 이덕순;김찬규;조병모
    • 대한물리치료과학회지
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    • 제9권1호
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    • pp.9-15
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    • 2002
  • The asthma is a clinical syndrome having three symptoms; dyspnea, wheezing and coughing, due to the narrowing of trachea in pulmonary system. Specially the asthma is common in children. The study was designed to identify the effect of Kinesio Taping Treatment as to asthmatic children. The Kinesio Taping Treatment was used on the Pectoralis major and Posterior diaphragm of twenty five asthmatic children(19 male, 6 female) for the period from September 1, 2001 to September 20, 2001. Peak expiratory flow rate(PEFR) for the condition of pulmonary function was measured using the Pocket Peak and wheeling and coughing symptom were measured using questionnaire. The results of this study are as follows: 1. There were statistically significant differences between before using the taping and after the kinesio taping increase of the PEFR(p<0.001). 2 There were statistically significant differences between before using the kinesio taping and after the kinesio taping improvement of the wheezing sign(p<0.001). 3. There were statistically significant differences between before using the kinesio taping and after the kinesio taping improvement of the coughing symptom(p<0.001).

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천종혈(SI11) 자침이 자각적 호흡곤란 환자의 폐기능변화에 미치는 영향 (The Effect of Acupuncture Therapy of Tian-zong (SI11) on Pulmonary Function Test of Patients with Dyspnea)

  • 주창엽;이재성;황우석;정희재;정승기;이형구
    • 대한한의학회지
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    • 제23권3호
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    • pp.96-103
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    • 2002
  • Objectives : Dyspnea is one of the most common symptoms that we meet, but so far there has been no research about the effects of acupuncture therapy on it. This study was performed in order to evaluate the effect of acupuncture therapy on dyspnea by means of using objective indexes. Methods : The effect of acupuncture therapy was assessed by analyzing the pulmonary function test (PFT) in 10 patients, who had suffered from dyspnea and had pain at the acupuncture point Tian-zong (SI11) when it was compressed by a finger, at our outpatient department. Each patient was treated with acupuncture therapy at both sides of Tian-zong. We compared the results of pre-treatment and post-treatment PFTs, including forced vital capacity (FVC), forced expiratory volume in one second (FEV 1.0), and peak expiratory flow rate (PEFR). Results : FVCs of pre-treatment and post-treatment PFTs were $2.23{\pm}0.34(L)$ and $2.40{\pm}0.36(L)$ respectively (P<0.01). FEV1.0s of pre-treatment and post-treatment PFTs were $1.54{\pm}0.37(L)$ and $1.65{\pm}0.41(L)$ respectively (p<0.05). PEFRs of pre-treatment and post-treatment PFTs were $3.41{\pm}1.26(L)$ and $3.93{\pm}1.42(L)$ respectively (p<0.05). Conclusions From the above data, we conclude that FVC, FEV1.0, and PEFR in dyspneic patients have been improved after acupuncture therapy of Tian-zong, so acupuncture therapy of Tian-zong may relieve the dyspnea symptom.

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Pulmonary functions of patients with isolated mandibular fractures: a preliminary report

  • Famurewa, Bamidele Adetokunbo;Oginni, Fadekemi Olufunmilayo;Aregbesola, Stephen Babatunde;Erhabor, Gregory Efosa
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권1호
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    • pp.36-40
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    • 2020
  • Objectives: The aim of this study was to evaluate pulmonary function in patients with mandibular fractures and to determine the pattern of pulmonary functions in these patients. Materials and Methods: This was a cross-sectional study of pulmonary functions in Nigerian non-smoking patients with isolated mandibular fractures managed at our health institution from December 2015 to June 2017. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR), and ratio of FEV1 to FVC (FEV1/FVC) were measured for all participants using a portable spirometer just before treatment. The pulmonary indices were compared with the predicted reference values for Nigerians to determine the respiratory pattern. Results: Forty participants consisting of six females (15.0%) and thirty-four males (85.0%) with a female to male ratio of 1:5.7 were included in this study. The mean patient age was 34.5±13.1 years (range, 17-63 years). The mean FVC, FEV1, FEV1/FVC, and PEFR were 3.8±1.2 L, 3.0±1.0 L, 74.3%±13.8%, and 5.2±2.2 L/s, respectively. Comparison of data with predicted values revealed that 17 subjects (42.5%) had normal pulmonary function pattern while 23 subjects (57.5%) had features suggestive of obstructive and restrictive pulmonary function patterns. Conclusion: Isolated mandibular fractures presented with abnormal pulmonary function pattern.

Relationship between Thoracic Kyphosis and Selected Cardiopulmonary Parameters and Respiratory Symptoms of Patients with Chronic Obstructive Pulmonary Disease and Asthma

  • Aweto, Happiness Anulika;Adodo, Rachel Ilojegbe
    • The Journal of Korean Physical Therapy
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    • 제33권4호
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    • pp.179-186
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    • 2021
  • Background: Patients with advanced asthma and chronic obstructive pulmonary disease (COPD) have postural deviations such as thoracic hyperkyphosis, forward shoulder posture (FSP) due to an increase in head and cervical protraction, reduced shoulder range of motion and a corresponding increase in scapula elevation and upward rotation. Unlike congenital vertebral kyphosis that are permanent and rigid deformities with bony and other structural deformations which cause respiratory impairment, these deformities in these patients may be more flexible. Since the thoracic hyperkyphosis has been implicated as having adverse health consequences it is necessary to evaluated the relationship between thoracic kyphosis and cardiopulmonary functions of patients with COPD and asthma. Methods: It was a cross-sectional analytical study. Eighty-four eligible patients with COPD and asthma were recruited from the Respiratory Unit, Department of Medicine, Lagos University Teaching Hospital (LUTH), and basic anthropometric parameters, pulmonary parameters, cardiovascular parameters, thoracic kyphosis (Cobb) angle and presence of respiratory symptoms of participants were assessed. Data was analyzed using SPSS version 20. Results: There was no significant correlation between the thoracic kyphosis and selected pulmonary parameters (Forced Expiratory Volume in one second (FEV1, p=0.36), Forced Vital Capacity (FVC, p=0.95), Peak Expiratory Flow Rate (PEFR, p=0.16), Thoracic expansion (TE, p=0.27)/cardiovascular parameters (Systolic Blood Pressure (SBP, p=0.108), Diastolic Blood Pressure (DBP, p=0.17) and Pulse Rate (PR, p=0.93) as well as the respiratory symptoms (SGRQ scores, p=0.11) in all subjects. Conclusion: There was no relationship between thoracic kyphosis and selected pulmonary/cardiovascular parameters as well as respiratory symptoms in patients with COPD and asthma.

A 4-Year Follow-up Cohort Study of the Respiratory Functions in Toner-handling Workers

  • Yanagi, Nobuaki;Kitamura, Hiroko;Mizuno, Mitsuhito;Hata, Koichi;Uchiyama, Tetsuro;Kuga, Hiroaki;Matsushita, Tetsuhiro;Kurosaki, Shizuka;Uehara, Masamichi;Ogami, Akira;Higashi, Toshiaki
    • Safety and Health at Work
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    • 제5권4호
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    • pp.222-226
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    • 2014
  • Background: Focusing on the respiratory function for health effect indices, we conducted a cross-sectional study on workers who did and did not handle toner to compare the longitudinal changes. Methods: Among 116 individuals who worked for a Japanese business equipment manufacturer and participated in the study, the analysis included 69 male workers who we were able to follow up for 4 years. We categorized the 40 workers engaged in toner-handling work as the exposed group and the 29 workers not engaged in these tasks as the referent group, and compared their respiratory function test results: peak expiratory flow rate (PEFR), vital capacity (VC), predicted vital capacity (%VC), forced expiratory volume in 1 second ($FEV_1$), and forced expiratory volume in 1 second as a percent of forced vital capacity ($FEV_1%$). Results: The cross-sectional study of the respiratory function test results at the baseline and at the $5^{th}$ year showed no statistically significant differences in PEFR, VC, %VC, $FEV_1$, and $FEV_1%$ between the exposed and referent workers. Also, respiratory function time-course for 4 years was calculated and compared between the groups. No statistically significant differences were shown. Conclusion: Our study does not suggest any toner exposure effects on respiratory function. However, the number of subjects was small in our study; studies of larger populations will be desired in the future.

한방호흡재활치료를 시행한 만성폐쇄성폐질환 환자 2례 (Chronic Obstructive Pulmonary Disease Patients Treated with Korean Medicine Pulmonary Rehabilitation: Two case reports)

  • 김태현;이수원;유이란;이은정;정인철;박양춘
    • 대한한의학회지
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    • 제41권3호
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    • pp.162-172
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    • 2020
  • Objectives: The purpose of study was to report the clinical improvement of Chronic Obstructive Pulmonary Disease (COPD) patients treated with Korean medicine pulmonary rehabilitation. Methods: The patients were treated with Lung-conduction exercise, Chuna manual therapy, Exercise therapy. To assess the treatment outcomes, we used the pulmonary function test (PFT), modified medical research council scale (mMRC), 6-minute walk distance (6MWD), peak expiratory flow rate (PEFR), COPD assessment test (CAT), St. George respiratory questionnaire (SGRQ). Results: After treatments, the patient's clinical symptoms were improved with CAT, SGRQ's significant decrease and PFT, mMRC, 6MWD and PEFR were maintained or improved slightly. Conclusions: The Korean medicine pulmonary rehabilitation was effective in the treatment of COPD patients. This study suggested the possibility of Korean Medicine pulmonary rehabilitation program in the clinic.

호흡곤란을 주소로 하는 COVID-19 후유증 환자에 대한 한방호흡재활치료 치험 1례 (A Case Report on a Patient with Late Complications of COVID-19 Complaining of Dyspnea Treated with Korean Medicine Pulmonary Rehabilitation)

  • 이수원;김태현;이은정;정인철;박양춘
    • 대한한의학회지
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    • 제43권1호
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    • pp.171-179
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    • 2022
  • 본 증례에서는 COVID-19 후유증기에 호흡곤란을 주소로 내원한 환자에 대하여 한방 호흡재활치료를 시행한 결과 호흡곤란, 기침 등의 증상 및 삶의 질에 임상적으로 의미 있는 호전이 있었고, 향후 COVID-19 후유증 환자에 한방 치료를 활용할 수 있음을 제시하였기에 증례를 보고하는 바이다.

소아에서 비만이 운동 전후의 폐활량에 미치는 영향 (Effects of Obesity on Pulmonary Functions in Children)

  • 박석원;김황민;김종수;차재국;이혜란
    • Clinical and Experimental Pediatrics
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    • 제45권5호
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    • pp.588-595
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    • 2002
  • 목 적 : 최근에 증가하고 있는 우리나라 어린이들의 비만 정도를 살펴보고, 비만이 운동 전후의 폐활량에 미치는 영향을 보고자 본 연구를 시행하였다. 방 법 : 원주지역 초등학교 5곳의 4-6학년 학생 2,000명 중 신장별 체중 50 백분위수를 표준 체중으로 이용한 비만도가 20% 미만인 대조군 150명과 20% 이상이었던 비만군 257명을 대상으로 하였다. 2000년 10월부터 11월까지 2개월 동안 대상군을 정상, 경도비만, 중등도비만, 고도비만의 4군으로 분류하여 운동부하 전 및 후의 폐활량을 측정하였으며, 각 군간의 폐활량을 예측치에 대한 백분율로 환산하여 비교분석 하였다. 결 과 : 1) 비만에 해당하는 대상은 총 257명(19%)이었으며, 경도비만군 147명(10.9%), 중등도비만군 87명(6.4%), 고도비만군 23명(1.7%), 대조군은 150명이었다. 2) 각 군에서 측정한 $FEV_1$ 및 FVC의 예측치에 대한 백분율(%)은 대조군에서 $95.4{\pm}15.8$, $96.3{\pm}14.7$ 경도비만군에서 $88.7{\pm}10.4$, $88.5{\pm}9.6$ 중등도비만군에 서 $90.3{\pm}11.0$, $87.8{\pm}10.5$ 고도비만군에서 $75.5{\pm}8.6$, $79.3{\pm}9.3$이었으며, 대조군, 경도비만군, 중등도비만군 간에 통계학적으로 유의한 차이는 보이지 않았으나, 고도비만군에서는 다른 군에 비하여 통계학적으로 유의하게 낮았다(P<0.05). 3) PEFR의 예측치에 대한 백분율(%)은 대조군에서 $102.7{\pm}16.4$, 경도비만군에서 $92.0{\pm}11.0$, 중등도비 만군에서 $86.0{\pm}12.4$, 고도비만군에서 $74.0{\pm}9.5$이었으며, 대조군에 비해 비만군 모두에서 통계학적으로 의의있게 낮았고, 비만도가 높을수록 최대호기속도는 감소하였는데, 이는 모두 통계학적으로 유의한 차이를 보였다(P<0.05). 4) 운동부하 후 측정한 $FEV_1$, FVC, PEFR 모두, 89명(21.9%)은 운동부하 후 5분, 173명(42.5%)은 10분, 145명(35.6%)은 운동부하 후 15분에 가장 낮은 측정치를 보였다. 5) 운동부하 후 $FEV_1$, FVC, PEFR 측정치의 예측치에 대한 백분율(%)은 대조군에서 각각 $90.4{\pm}16.7$, $89.7{\pm}15.0$, $94.5{\pm}16.6$ 경도비만군 $77.1{\pm}10.5$, $74.2{\pm}9.7$, $77.2{\pm}11.6$ 중등도비만군 $76.2{\pm}11.1$, $71.3{\pm}11.4$, $68.5{\pm}13.0$ 고도비만군 $59.8{\pm}9.1$, $55.7{\pm}8.8$, $52.0{\pm}8.9$로 각 군 모두에서 운동부하 전 측정한 각 항목의 예측치에 대한 백분율보다 통계학적으로 의의있게 감소하였다. 그리고 운동부하 전 및 운동부하 후 각 항목 측정치의 예측치에 대한 백분율 차이는 비만도가 높을수록 컸으며 이는 모두 통계학적으로 유의한 차이를 보였다(P<0.05). 결 론: 운동부하 후 발생하는 기관지수축 정도는 비만아에서 더 크게 나타나며, 운동부하 전이라도 고도비만아인 경우 기관지폐쇄가 어느 정도는 존재한다고 사료된다.