• Title/Summary/Keyword: Pneumonia, Aspiration

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Laryngotracheal Separation for Chronic Intractable Aspiration (만성 흡인에 대한 후두기관 분리술의 유용성)

  • 이강진;성명훈;박범정;성원진;노종렬;민양기;이철희;이재서;김광현
    • Korean Journal of Bronchoesophagology
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    • v.7 no.2
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    • pp.140-145
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    • 2001
  • Background and Objectives: Intractable aspiration in patients with impaired protective function of the larynx often results in multiple episode of aspiration pneumonia, repeated hospitalizations and expensive nursing care. The purpose of this study was to review the authors’experience and Patient outcome with the laryngotracheal separation (LTS) procedure. Materials and Methods A retrospective review of 9 patients who underwent LTS between 1996 and 2001 was conducted. Ages ranged from 3 to 72 years. Results : Seven patients were expected to have morbid aspiration as a consequence of acquired neurologic injuries and two were congenital neurologic injuries. Two patients had a postoperative fistula, which was well controlled with local wound care and minor procedure. Following LTS, aspiration was effectively controlled in all patients and four were able to tolerate a regular diet. Conclusion : LTS is a low-risk, successful. definitive procedure which decreases the potential for aspiration, pulmonary complication, hospitalizations and increases quality of life, especially in patent with irreversible upper airway dysfunction and Poor speech potential.

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A Static Scintigraphy for Imaging Aspiration Using Semi-Solid Food (반고형식을 이용한 정적 흡인 영상법)

  • Yoon, Min-Ki;Hwang, Kyung-Hoon;Choe, Won-Sick
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.6
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    • pp.327-331
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    • 2006
  • Purpose: Aspiration scintigraphy is a procedure of nuclear imaging to evaluate aspiration and of quantifying the amount of aspirate. The ultimate goal of our study is to define the correlation between aspiration and aspiration pneumonia by aspiration scintigraphy and this is a preliminary report of its trial. Materials and methods: Ten patients with positive findings by videofluoroscopy were selected. The patients ingested semi-solid food containing Tc-99m tin colloid 92.5 MBq (2.5 mCi) and images were acquired immediately after the ingestion and 3 hrs later. A fraction of aspiration to the ingested was calculated using an equation with a decay correction. Results: Five patients were interpreted positive by aspiration scintigraphy. Four patients were positive at initial images and the fractions of aspiration were 0.11%, 0.11%, 0.81%, and 0.11%. The one patient who was shown aspirated at both images had initial 5.82% and delayed 2.26%. Conclusion: Aspiration scintigraphy enables us to localize the aspiration at any desired time of the test and to quantify its amount. Follow-up studies are warranted.

Surgical Strategies for Prevention and Treatment of Airway Aspiration in Head and Neck Cancer Patients (두경부암 환자에서 기도 흡인의 예방과 치료를 위한 수술 전략)

  • Baek, Min Kwan;Kim, Dong Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.9-13
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    • 2018
  • Postoperative airway aspiration is not uncommon in patients with head and neck cancer. Airway aspiration has serious consequences, such as swallowing disorders, nutrition-related health problem, or reducing the quality of life due to maintenance of tracheal or nasogastric tubes. The postoperative oropharyngeal defect due to the surgery may interfere with normal swallowing reflex, or the laryngeal dysfunction caused by radiation therapy may cause severe airway aspiration, which may lead to complications such as dyspnea and pneumonia. Complete removal of the disease is also important in the treatment of head and neck cancer, but it is necessary to select a method to avoid and predict the occurrence of airway aspiration according to the treatment method. The most important factor to prevent airway aspiration after surgery is to preserve the proper volume of the oropharynx and to preserve at least one of the cricoarytenoid joint function. It is also the most effective way to reduce additional complications by seeking appropriate surgical treatment according to airway aspiration status. The purpose of this study is to review the operative methods that can induce airway aspiration and consider the prevention and treatment strategy through review of the literature.

Reasons and Risk Factors for Readmission Following Hospitalization for Community-acquired Pneumonia in South Korea

  • Jang, Jong Geol;Ahn, June Hong
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.2
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    • pp.147-156
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    • 2020
  • Background: Limited studies have been performed to assess readmission following hospitalization for community-acquired pneumonia (CAP) in an Asian population. We evaluated the rates, reasons, and risk factors for 30-day readmission following hospitalization for CAP in the general adult population of Korea. Methods: We performed a retrospective observational study of 1,021 patients with CAP hospitalized at Yeungnam University from March 2012 to February 2014. The primary end point was all-cause hospital readmission within 30 days following discharge after the initial hospitalization. Hospital readmission was classified as pneumonia-related or pneumonia-unrelated readmission. Results: During the study period, 862 patients who survived to hospital discharge were eligible for inclusion and among them 72 (8.4%) were rehospitalized within 30 days. In the multivariable analysis, pneumonia-related readmission was associated with para/hemiplegia, malignancy, pneumonia severity index class ≥4 and clinical instability ≥1 at hospital discharge. Comorbidities such as chronic lung disease and chronic kidney disease, treatment failure, and decompensation of comorbidities were associated with the pneumonia-unrelated 30-day readmission rate. Conclusion: Rehospitalizations within 30 days following discharge were frequent among patients with CAP. The risk factors for pneumonia-related and -unrelated readmission were different. Aspiration prevention, discharge at the optimal time, and close monitoring of comorbidities may reduce the frequency of readmission among patients with CAP.

Clinical Study of Dysphagia in Stroke Patients (1) (Preliminary paper) (뇌졸중환자의 연하장애에 관한 임상적 연구 (1))

  • Ko, Seong-Gyu
    • The Journal of Internal Korean Medicine
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    • v.18 no.1
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    • pp.62-68
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    • 1997
  • Dysphagia generally has a good prognosis after stroke involving cerebral hemisphere or braibstem, but it could have serious consquence with dehydration leading to haemoconcentration, renal failure and aspiration leading to pneumonia. This preliminary report was written for main report. The main report will be written to give an objective guide post of management and treatment in stroke patient with dysphagia. The objective guide posts were follows as, 1. Close examination for relationship between dysphagia in stroke patients and other neurological deficits 2. Influence on the prognosis of dysphagia in stroke patients by the grade of dysphagia at admission time. 3. The realtionship between the site and size of brain damage and the grade and prognosis of dysphagia 4. The frequency and prognosis of dysphagia in stroke patients according to sex and age. 5. The rate and speed of recovery with dysphagia after stroke. 6. Frequency and process of complications, aspiration pneumonia, weight loss, sore, in stroke patient group with dysphagia.

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The Oral Care Methodes for the Disabled (임상가를 위한 특집 3 - 장애인 구강관리법)

  • Lee, Hyo-Seol
    • The Journal of the Korean dental association
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    • v.49 no.12
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    • pp.749-757
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    • 2011
  • In the welfare law for the disabled in Korea, the disabled is defined as "the persons sho have significant limitations of daily or social life due to physical or mental disabilities over a long period." The number of registered domestic disabled person in 2008 survey was approximately 2.1 million. 90% of the disabled was caused by the aposteriori illness or accidents. So, in this aging society, the number of people with disabilities will increase even more. In general, people with physical and mental disabilities tend to have more oral diseases, but, are difficult to get treated. Therefore, a thorough oral care through individualized prevention is more important than ever. In this article, we review the oral care methods in dental office and home and in the hospital for the elderly and finally focus on a denture care method. According to this article, the dental professionals can be able to select and apply the oral care method in agreement with the characteristics of the disabilities. Particularly, it is important to prevent the aspiration pneumonia in the elderly in hospital.

A Case of Sandifer Syndrome (Sandifer 증후군 1례)

  • Lee, Mira;Kim, Soo Hyun;Kim, Yong Joo;Seol, In Joon
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1036-1039
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    • 2003
  • Sandifer syndrome is a rare manifestation of gastroesophageal reflux in children, occurring in association with abnormal movement of the head and neck and recurrent episodes of seizure after feeding. This syndrome may be misdiagnosed as infantile seizure and musculoskeletal disorder and may be associated with failure to thrive, anemia, aspiration pneumonia, and esophagitis. In this paper, Sandifer syndrome in a four months old male with recurrent aspiration pneumonia, apnea, and seizure after feeding is presented.

A Study on the Effectiveness and the Distribution of Isolated Strains by Sputum Collection Methods

  • Seong, Hee-Kyung;Lee, Jeong-Nyo
    • Biomedical Science Letters
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    • v.8 no.2
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    • pp.63-69
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    • 2002
  • This study was performed to investigate the effectiveness of the aspiration trap method for collection of sputum by comparing with the conventional method which was collecting specimens at canular cap swab. In this study, the author tested by two methods to collect specimens from 46 patients who were cared with tracheostomy and intubation at the intensive care unit of an university hospital in Pusan, and investigated the incidence of the lower respiratory tract infection, the consistency between the two methods, the level of specimen contamination. Major results were as follows: Among the patients, 35 were cared with tracheostomy and 11 were cared with intubation. In clinical diagnosis we were classified the subjects in to two group, 17 of pneumonia group and 29 of non-pneumonia group. A total of 247 strains were isolated. Among them, most three strains were Serratia marcescens (62 strains; 25.1%), Pseudomonas aeruginosa (52 strains; 21.1%), and Acinetobacter baumannii (19 strains; 7.8%). Out of total, 188 (76.1%) strains were Gram negative bacilli. The isolated strains by the aspiration trap method were the average 2.1 strains, but by the canular cap swab method were 1.6 strains. In spite of the high contaminated possibility from the incision site and the oral cavity swab, the low isolated rates of the canular cap may be the dried environment of the canular of cap area. But the contamination rates were 57.2% of the canular cap, 51.5% of the oral swab and 50.5% of the incision site swab, respectively. The consistency of predominant microorganisms according to collection method were 86.7% of aspiration, 78.3% of canular, 74.3% of incision, and 63.6% of oral. In conclusion, the aspiration trap method fur the sputum collection from the patients with intubation of tracheostomy showed the lower contamination rate of the specimens and it was helpful for rapid, accurated interpretation of the lower respiratory tract infection and hospital infection.

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Bronchogenic Cyst Rupture and Pneumonia after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Case Report

  • Hong, Goohyeon;Song, Junwhi;Lee, Kyung-Jong;Jeon, Kyeongman;Koh, Won-Jung;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.4
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    • pp.177-180
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    • 2013
  • We report a 54-year-old woman who presented with a well-defined, homogeneous, and non-enhancing mass in the retrobronchial region of the bronchus intermedius. The patient underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histological confirmation. Serous fluid was aspirated by EBUS-TBNA. Cytological examination identified an acellular smear with negative microbiological cultures. The patient was finally diagnosed with bronchogenic cysts by chest computed tomography (CT) and EBUS-TBNA findings. However, 1 week after EBUS-TBNA, the patient developed bronchogenic cyst rupture and pneumonia. Empirical antibiotics were administered, and pneumonia from the bronchogenic cyst rupture had resolved on follow-up chest CT. To our knowledge, this is the first reported case of pneumonia from bronchogenic cyst rupture after EBUS-TBNA.

The Type Analysis for Safety Accident of Water Sports Happening in River

  • Kim, Nam Eui;Ahn, Moo Eob;Seo, Jeong Yeol;Kim, Dong Won;Kim, Jeong Hyeok;Kim, Hyung Ki;Han, Jae Hyun;Lee, Tae Hun
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.186-191
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    • 2017
  • Purpose: Recently, as the number of people who enjoy water sports life in river or lake easy to accessible are increasing, that of the patients who are injured in water sports also does gradually. We intend to investigate the type of the injured patients of water sports and the riskiness of the sports in this study. Methods: We retrospectively looked into the medical records of the patients who were injured in water sports and visited a general hospital in Gangwondo-province from 2010 to 2015. Results: Total 146 patients came to the hospital during six years. Patients mostly occurred at younger ages, in summer, and on holidays, rather than weekdays. The most common lesions of injuries were faces (53 patients). The most common types of injuries were contusions (62 patients), followed by fractures (32 patients) and lacerations (26 patients). The most frequent fracture sites were the upper extremities (11 patients). Most of the trauma patients were mild, but a small number of patients with aspiration pneumonia occurred and their severity was higher than trauma patients. Conclusions: In this study, facial injuries were most frequent in water sports injuries. In the fractures, upper extremities were the most common fractured lesions. In addition, even if there is no direct trauma, aspiration pneumonia is serious, so caution should be taken with protective equipment suitable for water sports.