• Title/Summary/Keyword: Positive-pressure respiration

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A Study for Application of Standard and Performance Test According to Purpose and Subject of Respiratory Medical Device (호흡보조의료기기의 사용목적 및 대상에 따른 규격적용 방안 및 성능에 관한 연구)

  • Park, Junhyun;Ho, YeJi;Lee, Duck Hee;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.40 no.5
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    • pp.215-221
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    • 2019
  • The respiratory medical device is a medical device that delivers optimal oxygen or a certain amount of humidification to a patient by delivering artificial respiration to a patient through a machine when the patient has lost the ability to breathe spontaneously. These include respirators for use in chronic obstructive pulmonary disease and anesthesia or emergency situations, and positive airway pressure devices for treating sleep apnea, and as the population of COPD (chronic obstructive pulmonary disease) and elderly people worldwide surge, the market for the respiratory medical devices it is getting bigger. As the demand for both airway pressure devices, there is a problem that the ventilator standard is applied because the reference standard has not been established. Therefore, the boundaries between the items are blurred due to the purpose, intended use, and method of use overlapping similar items in a respiratory medical device. In addition, for both airway pressure devices, there is a problem that the ventilator standard is applied because the reference standard has not been established. Therefore, in this study, we propose clear classification criteria for the respiratory medical devices according to the purpose, intended use, and method of use and provide safety and performance evaluation guidelines for those items to help quality control of the medical devices. And to contribute to the rapid regulating and improvement of public health. This study investigated the safety and performance test methods through the principles of the respiratory medical device, national and international standards, domestic and international licensing status, and related literature surveys. The results of this study are derived from the safety and performance test items in the individual ventilator(ISO 80601-2-72), the International Standard for positive airway pressure device (ISO 80601-2-70), The safety and performance of humidifiers (ISO 80601-2-74) and the safety evaluation items related to home healthcare environment (IEC 60601-1-11), In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers and importers, certified test inspection institutions, academia, etc., the final guidelines were established through revision and supplementation. Therefore, in this study, we propose guidelines for evaluating the safety and performance of the respiratory medical device in accordance with growing technology development.

Cardiovascular Changes of Cat in Hypothermia (고양이에서 체표냉각에 따른 심혈관계 변동에 관한 연구)

  • Ahn, Young-Soo;Ko, Chang-Mann;Lee, Woo-Choo
    • The Korean Journal of Pharmacology
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    • v.19 no.1
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    • pp.61-69
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    • 1983
  • Hypothermia is an essential preparatory procedure for cardiac surgery, which lows the metabolic rate and myocardial oxygen demand. However, hypothermia itself is a stress enough to change the tonus of sympathoadrenal system, especially the cardiovascular responses to the catecholamines. It is reported that the positive chronotropic and inotropic response of catecholamines is exaggerated during hypothermia because of decreased norepinephrine uptake at the junctional cleft or decreased catecholamine metabolism. On the other hand, there are evidences of diminished catecholamines responses in low temperature ana further, interconversion of adrenergic receptors is also suggested. Present investigation was planned to observe the cardiovascular changes and its responses to catecholamines during surface hypothermia in cat. Healthy mongrel cats, weighing $2{\sim}3\;kg$, anesthetized with secobarbital(30 mg/kg), were permitted to hypothermia by external cooling technic. Esophageal temperature, ECG (lead II), heart rate, left ventricular pressure with dP/dt, carotid artery pressure and left ventricular contractile force were monitored with Polygragh (Model 7, Grass), and the respiration was maintained with artificial respirator (V 5 KG, Narco). Followings are summarized results. 1) Surface cooling caused progressive decrease of body temperature and reached $l8.8{\pm}0.8^{\circ}C$ and $16.9{\pm}0.6^{\circ}C$ in 120 and 150 min respectively, after immersion into ice water, and ventricular fibrillation was developed at $20.4{\pm}0.65^{\circ}C$. 2) Heart rate, blood pressure and myocardial contractility were decreased after initial increase as the body temperature falls. 3) Systolic and diastolicdd P/dt of left ventricular pressure were decreased and that the decrement of diastolic dP/dt was more marked. 4) On ECG, ST depression, Twave inversion and prolongation of PR interval were prominent in hypothermia, and moreover, the prolongation of PR interval was marked just prior to the development of ventricular fibrillation. 5) The cardiovascular responses to catecholamines, especially to isoproterenol, were suppressed under hypothermia.

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A Pilot Study on the Psychological and Physical Responses of Breath - Counting Meditations (수식관 명상의 심리적 신체적 반응 연구 - 단일군)

  • Lee, Jae-Hyok
    • Journal of Oriental Neuropsychiatry
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    • v.25 no.1
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    • pp.47-54
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    • 2014
  • Objectives: The purpose of this research was to analyze the responses of breath-counting meditations with the psychological test and the physical index. Methods: Breath-counting meditation was applied to 10 normal adults. Then, clinical research State-Trait Anxiety Inventory (STAI), State-Trait Anger eXpression Inventory (STAXI), Psychosocial Well-being Index Short Form (PWI-SF), Brief Encounter Psychosocial Instrument-Korean version (BEPSI-K), Heart Rate Variability (HRV), and Vital Signs (V/S) were carried out to analyze the responses of breath-counting meditations. Results: 1) Systolic Blood Pressure (SBP) decreased on the fifteenth day of breath-counting meditation, and Body Temperature (BT) increased on the fifteenth day. In addition, respiration decreased throughout the period of breath-counting meditation. 2) Standard deviations of N-N interval and Total Power (TP) of HRV all significantly increased on the fifteenth day of breath-counting meditation. 3) Scores of STAI1, STAXI1, STAXI2, and PWI-SF decreased after the breath-counting meditation. Conclusions: The results suggested that breath-counting meditations have positive responses to anger, anxiety and stress.

The Effect of EEG And Physiological Changes To Participation in Progressive Relaxation Technique Of The University Archery players (호흡을 통한 신체적 이완이 대학 양궁선수의 뇌파 및 생리적 변인에 미치는 영향)

  • Nam, Sang-Nam;Park, Soo-Woong
    • Journal of Digital Convergence
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    • v.12 no.1
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    • pp.467-473
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    • 2014
  • The purpose of this study is to monitor the physiological changes by measuring EEG, blood pressure, heart rate, etc after applying progressive relaxation technique to university archery players in order to verify the effect of progressive relaxation through respiration, and, ultimately, improve an athlete's archery performance. This study chose 13 female archery athletes. The EEG, blood pressure, and heart rate of the athletes were measured before applying Jacobson's progressive relaxation technique for 12 weeks, during which the EEG, blood pressure, and heart rate were measured 3 times a week after 15 to 20 minutes of training before every measurement. We used the SPSS18.0 program for technical analysis to check the general features of the athletes and carried out the paired t-test to examine the changes made to the EEG, blood pressure, and heart rate of a single test group before and after the experiment. All statistical level of significance was maintained at ${\alpha}=0.5$. The results are as follows. First, after 12 weeks of appliance, between the targets' relative ${\alpha}$ wave and ${\beta}$ wave, the relative ${\alpha}$ wave showed a statistically significant increase while the relative ${\beta}$ wave showed no changes. Second, after 12 weeks of appliance, in terms of blood pressure, the systolic pressure showed no changes while the diastolic pressure showed a statistically significant change. Third, there was no statistically significant change to the heart rate. In conclusion, progressive relaxation through breathing has a positive effect on the archery athletes.

Comparison of Vital Sign and Respiratory Functions According to the Points of Time to Nebulize Bronchodilator to Operated Adult Patients through Mechanical Ventilator (인공호흡기를 통하여 기관지 확장제를 분무한 시점에 따른 심장수술환자의 활력징후와 폐기능의 비교)

  • Kang, Jee Young;Yoo, Yang Sook;Seong, So Young;Seo, Ji Won;Koo, Seul A;Park, Kyoung Won;Choi, Eun Ju
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.73-85
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    • 2008
  • Purpose: To examine effects of application of bronchodilators after endotracheal suction on peak air way pressure (PAP), lung compliance (Cdyn), oxygen saturation ($SpO_2$), heart rate (HR), blood pressure (BP), and respiration rate (RR) in cardiac surgery patients. Method: Data were collected from October 2007 to March 2008. Participants were patients who were treated with bronchodilators through mechanical ventilators in the SICU. At each suctioning, bronchodilators were applied immediately, and at 5, 10, and 15 minutes after suctioning. Besides PAP, Cdyn, $SpO_2$, HR, BP, RR, data on the frequency of side effects were also collected at 15, 30, 60 minutes after nebulization. Data were analyzed using the SAS program. Results: For application of bronchodilator right after suctioning and after, 5, 10 and 15 minutes, PAP and Cdyn did not show any significant differences although PAP was persistently decreased for 15 to 30 minutes and Cdyn increased at 15 minutes and decreased gradually after nebulization. Besides $SpO_2$, HR, BP, and RR, frequency of side effects did not show any significant difference. Conclusion: Bronchodilators can be applied at any time. However, the positive effects of bronchodilation right after suctioning on PAP and Cdyn, as also shown in previous reports, indicate it is a more efficient clinical process to maintain an adequate airway.

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Sevoflurane Insufflation Sedation for the Dental Treatment of a Patient with Pulmonary Arterial Hypertension : A Case Report (폐동맥 고혈압 환자의 치과치료에서 세보플루란 흡입 진정의 사용 : 증례보고)

  • Chi, Seongin;Kim, Seungoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.1
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    • pp.75-79
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    • 2015
  • Pulmonary arterial hypertension (PAH) is a common complication of Congenital heart defects (CHD) with left-to-right shunts, and PAH with increased pulmonary vascular resistance (PVR) is associated with considerable morbidity and mortality. General anesthesia (GA) can be life-threatening in patients with PAH, because the positive pressure ventilation during GA increases pulmonary arterial pressure and decreases pulmonary blood flow. This may also lead to hypoxia. Therefore, spontaneous ventilation may be safer than positive pressure ventilation in patients with PAH. A five-year-old male child, weighing 11 kg, with medical history showing a total correction of Tetralogy of Fallot (TOF) in 2009 and ongoing treatment with hypertension (HTN) medicine since 2007, visited the Dankook University Dental Hospital. He had multiple dental caries, and the treatment was completed under sevoflurane insufflation sedation via nasal cannula. The patient remained sedated throughout the operation while maintaining normal vital signs and spontaneous respiration. In conclusion, sevoflurane insufflation sedation may be a safer alternative to GA for the dental treatment of patients with PAH.

Comparison and evaluation of treatment plans using Abdominal compression and Continuous Positive Air Pressure for lung cancer SABR (폐암의 SABR(Stereotactic Ablative Radiotherapy)시 복부압박(Abdominal compression)과 CPAP(Continuous Positive Air Pressure)를 이용한 치료계획의 비교 및 평가)

  • Kim, Dae Ho;Son, Sang Jun;Mun, Jun Ki;Park, Jang Pil;Lee, Je Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.35-46
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    • 2021
  • Purpose : By comparing and analyzing treatment plans using abdominal compression and The Continuous Positive Air Pressure(CPAP) during SABR of lung cancer, we try to contribute to the improvement of radiotherapy effect. Materials & Methods : In two of the lung SABR patients(A, B patient), we developed a SABR plan using abdominal compression device(the Body Pro-Lok, BPL) and CPAP and analyze the treatment plan through homogeneity, conformity and the parameters proposed in RTOG 0813. Furthermore, for each phase, the X, Y, and Z axis movements centered on PTV are analyzed in all 4D CTs and compared by obtaining the volume and average dose of PTV and OAR. Four cone beam computed tomography(CBCT) were used to measure the directions from the center of the PTV to the intrathoracic contacts in three directions out of 0°, 90°, 180° and 270°, and compare the differences from the average distance values in each direction. Result : Both treatment plans obtained using BPL and CPAP followed recommendations from RTOG, and there was no significant difference in homogeneity and conformity. The X-axis, Y-axis, and Z-axis movements centered on PTV in patient A were 0.49 cm, 0.37 cm, 1.66 cm with BPL and 0.16 cm, 0.12 cm, and 0.19 cm with CPAP, in patient B were 0.22 cm, 0.18 cm, 1.03 cm with BPL and 0.14 cm, 0.11 cm, and 0.4 cm with CPAP. In A patient, when using CPAP compared to BPL, ITV decreased by 46.27% and left lung volume increased by 41.94%, and average dose decreased by 52.81% in the heart. In B patient, volume increased by 106.89% in the left lung and 87.32% in the right lung, with an average dose decreased by 44.30% in the stomach. The maximum difference of A patient between the straight distance value and the mean distance value in each direction was 0.05 cm in the a-direction, 0.05 cm in the b-direction, and 0.41 cm in the c-direction. In B patient, there was a difference of 0.19 cm in the d-direction, 0.49 cm in the e-direction, and 0.06 cm in the f-direction. Conclusion : We confirm that increased lung volume with CPAP can reduce doses of OAR near the target more effectively than with BPL, and also contribute more effectively to restriction of tumor movement with respiration. It is considered that radiation therapy effects can be improved through the application of various sites of CPAP and the combination with CPAP and other treatment machines.

Effects of Full Body Massage on Labor Pain and Delivery Stress Reaction for Primipara during Labor (분만 중 전신마사지가 초산부의 분만진통과 분만스트레스 반응에 미치는 효과)

  • Lee, Kun-Ja;Chang, Chun-Ja;Jo, Hyun-Sook
    • Women's Health Nursing
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    • v.9 no.3
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    • pp.224-234
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    • 2003
  • Purpose: This study was to test the effects of a full body massage on labor pain and delivery stress reaction for primipara during labor. Method: This study employed a quasi- experimental method(nonequivalent control group, pre-post test design). The subjects of this study were 57 primipara hospitalized at the U OB & GYN hospital in Inchon from November 1. 2001 to July 31, 2002. 28 women were assigned to the experimental group and 29 to the control group. The experimental group was given 20 minutes full body massage for each of three delivery phases. The control group was given conventional delivery care. The levels of labor pain were measured by the Visual Analogue Scale and the expression scores of the labor pain and the levels of delivery stress reaction were measured by pulse rate, respiration rate, and blood pressure, and State-Anxiety Scale. Data were analyzed using the repeated measures analysis of covariance(ANCOVA), t-test, $X^2$- test, simple ANCOVA with SPSS program. Result: There was no interaction effect between time and group(F=.370, p=.693), but significant time effects were found for subjective labor pain(F=3.840, p=.028). There was no interaction effect between time and group(F=.112, p=.894), but significant group effects were found for objective labor pain(F=12.299, p=.001). There was no interaction effect between time and group for PR(F=.172, p=.843), RR(F=.626, p=.539), SBP(F=.089, p=.915), DBP(F=.748, p=.479), but significant group effects were found for SBP(F=7.547, p=.008). The level of status anxiety of the experimental group was significantly lower than the control group(F=11.787, p=.001). Conclusion: This study showed that the full body massage has partially positive effect on labor pain and delivery stress reaction. Therefore this study suggested that the full body massage might be used clinically to help primipara during labor.

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Mechanical ventilation-associated pneumothorax presenting with paroxysmal supraventricular tachycardia in patients with acute respiratory failure

  • Eom, Jeong Ho;Lee, Myung Goo;Lee, Chang Youl;Kwak, Kyong Min;Shin, Won Jae;Lee, Jung Wook;Kim, Seong Hoon;Choi, Sang Hyeon;Park, So Young
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.106-110
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    • 2015
  • The prevalence of pneumothorax cases among Intensive Care Unit patients who require mechanical ventilation ranges from 4%-15%. A pneumothorax remains one of the most serious complications of positive pressure ventilation. It can be diagnosed in a critically ill patient through a physical examination or radiographic studies that include chest radiographs, ultrasonography, or computed tomography scanning. However, in a critically ill patient, the diagnosis of a pneumothorax is often complicated by other diseases and by difficulties in imaging sick and unconscious patients. Although electrocardiogram changes associated with a pneumothorax have been described for many years, there has been no report of such among patients who require mechanical ventilation. In this paper, we report 2 cases of a spontaneous pneumothorax with paroxysmal supraventricular tachycardia in patients who required invasive mechanical ventilation due to acute respiratory failure.

Comparison of Two Methods of Recruiting the Acutely Injured Lung (급성 폐손상에서 폐를 Recruit시키는 방법간의 비교 연구)

  • Suh, Gee-Young;Kang, Kyeong-Woo;Park, Sang-Joon;Kim, Ho-Choel;Young, Lim-Si;Chung, Man-Pyo;Han, Jeong-Ho;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.500-512
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    • 2000
  • Background : To evaluate the efficacy of two methods of obtaining lung recruitment to reduce ventilator-induced lung injury(VILI). Methods : Fifteen New-Zealand white rabbits were ventilated in the pressure-controlled mode while maintaining constant tidal volume(10 ml/kg) and fixed respiration rate. Lung injury was induced by repeated saline lavage (PaO2<100 mmHg), and the pressure-volume curve was drawn to obtain Pflex. The animals were then randomly assigned to three groups and ventilated for 4 hours. In the control group(n=5), positive end-expiratory pressure(PEEP) less than that of Pflex by 3 mmHg was applied throughout the study. In the recruitment maneuver(RM) group(n=5), RM(CPAP of 22.5 mmHg, for 45 seconds) was performed every 15 minutes in addition to PEEP level less than Pflex by 3 mmHg This phrase is unclear. In the Pflex group, PEEP of Pflex was given without RM. Gas exchange, lung mechanics, and hemodynamics parameters as well as pathology were examined. Results : 1) Both the control and RM groups showed decreasing tendency in PaO2 with time. There was significantly decreased PaO2 at 4 hr compared to Ihr(p<0.05). But in the Pflex group, PaO2 did not decrease with time(p<0.05 vs other groups at 3, 4 hr). PaCO2 did not show significant difference among the three groups. 2) There was no significant difference in static compliance and plateau pressure. Mean blood pressure and heart rate also did not show any significant difference among the three groups. 3) The pathologic exam showed significantly less neutrophil infiltration in the Pflex group than in the control group(p<0.05). There was borderline significant difference in hyaline membrane score among the groups (p= 0.0532). Conclusion : Although recruitment maneuver of the injured lung may be important in decreasing VILI, it alone may not be sufficient to minimize VILI.

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