• 한국임상수의학회지
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• 제33권4호
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• pp.237-242
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• 2016

A 1.86 kg, 3-year-old, female, Maltese was presented to the Veterinary Medical Teaching Hospital of Seoul National University after being hit by a car. The patient was diagnosed with urinary bladder rupture, diaphragmatic hernia and fracture of ilium, tibia and fibula. Repair surgery was performed after stabilizing treatment. During the surgery, hypoxia was identified and it worsened after positive pressure ventilation (partial pressure of oxygen in arterial blood ($PaO_2$): 52 mmHg, pulse oximetry ($SpO_2$): 87%, arterial hemoglobin oxygen saturation ($SpO_2$): 85.8%). In addition to hypoxia, blood pressure decreased to 30 mmHg. Positive pressure ventilation was discontinued because hypoxia and hypotension were aggravated. After suturing the diaphragm, air was withdrawn to form negative pressure within the thorax. However, negative pressure was not attained despite continuous withdrawal of air. A thoracostomy tube was placed because tension pneumothorax was strongly suspected. The patient recovered through close monitoring with the tube for 3 days. Due to limitation of evaluation of the lung, predicting occurrence of tension pneumothorax is difficult in patient of diaphragmatic hernia. Therefore, it is recommended that indicators of tension pneumothorax should be closely monitored during diagnosis and repair procedures of diaphragmatic hernia.

• Child Health Nursing Research
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• 제19권3호
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• pp.198-206
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• 2013

목적 본 연구는 신생아중환자실에 입원해 있는 저출생체중아를 대상으로 '어머니의 노래 들려주기 중재'의 효과를 규명하기 위해 수행되었다. 방법 서울 시내에 소재하는 일개 대학병원의 신생아중환자실에 입원한 대상자를 임의표출하여 비동등성 대조군 전후설계로 총 48명의 영아중 실험군 24명, 대조군 24명을 대상으로 하여 본 연구를 수행하였다. 결과 어머니의 노래 들려주기 중재를 제공받은 저출생체중아는 활력징후의 생리적 반응인 심박동수, 호흡수와 산소포화도에서 실험군과 대조군 사이에 통계적으로 유의한 차이가 없었다. 행동상태 점수는 두 집단 간 통계적으로 유의한 차이가 검증되었다. 즉, 노래 들려주기 중재를 제공받은 저출생체중아는 행동상태가 안정되는 결과를 보였다. 결론 본 연구를 통해 신생아중환자실에서 오랜 기간 치료를 받아야 하는 저출생체중아를 위한 긍정적인 청각자극으로서 어머니의 노래 들려주기 중재를 활용할 수 있는 객관적인 근거자료를 마련하였다는 데 의의가 있다. 또한 이러한 중재를 통해 재원기간 동안 저출생체중아의 돌봄에 어머니의 참여를 독려할 수 있을 뿐만 아니라 영아와 부모 사이의 이른 상호작용을 증진시키는 기회를 제공할 수 있다는 점에서 아동간호실무의 발전에 기여할 수 있을 것이다.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1996년도 춘계학술대회
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• pp.315-319
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• 1996

We have developed a prototype patient monitoring system including module-based bedside units, interbed network, and central stations. A bedside unit consists of a color monitor and a main CPU unit with peripherals including a module controller. It can also include up to 3 module cases and 21 different modules. In addition to the 3-channel recorder module, six different physiological parameters of ECG, respiration, invasive blood pressure, noninvasive blood pressure, body temperature, and arterial pulse oximetry with plethysmogaph are provided as parameter modules. Modules and a module controller communicate with up to 1Mbps data rate through an intrabed network based on RS-485 and HDLC protocol. Bedside units can display up to 12 channels of waveforms with any related numeric informations simultaneously. At the same time, it communicates with other bedside units and central stations through interbed network based on 10Mbps Ethernet and TCP/IP protocol. Software far bedside units and central stations fully utilizes gaphical user interface techniques and all functions are controlled by a rotate/push button on bedside unit and a mouse on central station. The entire system satisfies the requirements of AAMI and ANSI standards in terms of electrical safety and performances. In order to accommodate more advanced data management capabilities such as 24-hour full disclosure, we are developing a relational database server dedicated to the patient monitoring system. We are also developing a clinical workstation with which physicians can review and examine the data from patients through various kinds of computer networks far diagnosis and report generation. Portable bedside units with LCD display and wired or wireless data communication capability will be developed in the near future. New parameter modules including cardiac output, capnograph, and other gas analysis functions will be added.

• 한국산업보건학회지
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• 제34권1호
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• pp.57-66
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• 2024

Objective: Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction that is only partly reversible, inflammation in the airways, and systemic effects. This study aimed to investigate the association between low peripheral oxygen saturation levels (SpO₂), and composite indices predicting death in male patients with (COPD). Method: A total of 140 participants with post-bronchodilator FEV₁/FVC ratio less than 0.7 were included. Three composite indices (ADO, DOSE, BODEx) were calculated using six variables such as age (A), airflow obstruction (O), body mass index (B), dyspnea (D), exacerbation history (E or Ex), and smoking status (S). Severity of airflow limitation was classified according to Global Initiative for Obstructive Lung Disease (GOLD) guidelines. SpO₂ was measured by pulse oximetry, and anemia and iron deficiency were assessed based on blood hemoglobin levels and serum markers such as ferritin, transferrin saturation, or soluble transferrin receptor. Results: Participants with low SpO₂ (<95%) showed significantly lower levels of %FEV₁ predicted (p=0.020) and %FEV₁/FVC ratio (p=0.002) compared to those with normal SpO₂ levels. The mMRC dyspnea scale (p<0.001) and GOLD grade (p=0.002) showed a significant increase in the low SpO₂ group. Receiver Operating Characteristic analysis revealed higher area under the curve for %FEV₁ (p=0.020), %FEV₁/FVC(p=0.002), mMRC dyspnea scale (p=0.001), GOLD grade (p=0.010), ADO (p=0.004), DOSE (p=0.002), and BODEx (p=0.011) in the low SpO₂ group. Conclusion: These results suggest that low SpO₂ levels are related to increased airflow limitation and the composite indices of COPD.

• Tuberculosis and Respiratory Diseases
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• 제52권4호
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• pp.385-394
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• 2002

연구배경: 굴곡성 기관지내시경 검사는 검사로 인한 합병증 및 치명률이 적어 각종 폐질환의 진단 및 치료에 널리 사용되고 있다. 그러나 심, 폐기능이 심하게 저하된 환자에서도 기관지경검사가 필요한 경우가 많고, 기관지 내시경 시술중의 저산소혈증이 심각한 심부정맥을 초래할 수도 있기 때문에 저산소혈증의 조기발견 및 적절한 처치는 임상적으로 중요하다. 방 법: 1997년 1월3일부터 1997년 6월 30일까지 경북대학교병원 호흡기내과에서 경기관지폐생검과 기관지 폐포 세척술을 제외한 진단 목적을 기관지내시경 검사를 시행한 379예의 환자를 대상으로 pulse oxmetry를 이용하여 기관지내시경검사를 시행하는 동안과 시술전후에 동맥혈 산소포화도를 지속적으로 감시하였다. 결 과: 1) 남자가 263명, 여자가 116명으로 평균연령은 55세였다. 검사전 시행한 폐기능검사 성적 가운데 FVC는 추정정상치의 백분율의 평균이 $78.9{\pm}20.01%$, $FEV_1$는 추정정상치의 백분율의 평균이 $72.58{\pm}23.89%$, 그리고 $FEV_1/FVC%$는 $66.4{\pm}14.05%$ 이었다. 2) 시술전 기저 동맥혈 산소포화도는 평균 $96.9{\pm}2.85%$였으며, 379예 가운데 62예(16.4%)에서 저산소혈증($SaO_2$ <90%)이 발생하였다. 저산소혈증이 발생한 시기는 기관지경 시술전, 중, 후 각각 12, 37, 13예이었다. 3) 저산소혈증이 있었던 환자들의 성별분포 및 흡연력은 저산소혈증이 없었던 대조군과 유의한 차이가 없었으나, 평균연령은 $59.3{\pm}13.52$세로 정상군의 $54.8{\pm}16.52$세 보다 유의하게 많았고, 기저 산소포화도는 $93.7{\pm}4.29%$로 정상군의 $97.5{\pm}1.89%$에 비해 유의하게 낮았다. 시술시간은 저산소혈증이 있었던 군은 $17.6{\pm}8.93$ 분으로 대조군의 $12.0{\pm}6.30$ 분에 비해 유의하게 길었다. 4) 저산소혈증이 있었던 군의 $FEV_1$은 추정정상치의 백분율의 평균이 $63.6{\pm}22.79%$로 대조군의 $73.9{\pm}23.83%$ 보다 유의하게 낮았고, FVC 및 $FEV_1/FVC%$도 저산소혈증이 있었던 군에서 대조군보다 낮은 경향이었다. 5) 시술전에 저산소혈증이 있었던 12예 가운데 10예는 저농도의 산소투여로 시술을 무사히 진행하였고, 2예는 지속적인 저산소혈증으로 검사를 중단하였다. 시술동안 저산소혈증이 발생한 37예 가운데 27예는 산소투여로, 9예는 깊은 호흡으로 저산소혈증이 소실되었고 1예는 시술을 중단하였다. 시술 후에 저산소혈증이 발생한 13예의 경우 11예는 저산소혈증이 즉시 소실되었으며 2예는 산소투여가 필요하였다. 결 론: 이상의 결과로 기관지 내시경검사시 지속적인 동맥혈 산소포화도의 감시가 필요하며, 특히 저산소혈증의 빈도가 높은 폐기능이 저하된 환자에서는 저산소혈증의 조기발견과 적절한 조치를 위해 반드시 시행해야 할 것으로 생각된다.

• 대한치과마취과학회지
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• 제14권1호
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• pp.17-27
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• 2014

Background: Various medical emergency situations can occur during dental practices. Cardiac arrest is known to comprise approximately 1% of emergency situation. Thus, it is necessary for dentists to be able to perform cardiopulmonary resuscitation (CPR) to increase the chance of saving patient's life in emergency situation. In this paper, we conducted a survey study to evaluate to what extent dentists actually understood CPR practice and if they had experience in handling emergency situations in practice. Method: The survey was done for members of the Korean Dental Society of Anesthesiology (KDSA), who had great interest in CPR and for whom survey-by-mail was convenient. We had selected 472 members of the KDSA with a dental license and whose office address and contact information were appropriate, and sent them a survey questionnaire by mail asking about the degree of their CPR understanding and if they had experience of handling emergency questions before. Statistical analyses -frequency analysis, chi-square test, ANOVA, and so on- were performed by use of IBM SPSS Statistics 19 for each question. Result: Among 472 people, 181 responded (38.4% response rate). Among the respondents were 134 male and 47 female dentists. Their average age was $40.4{\pm}8.4$. In terms of practice type, there were 123 private practitioners (68.0%), 20 professors (11.0%), 16 dentists-in-service (8.8%), 13 residents (specialist training) (7.2%) and 9 military doctors (5%). There were 125 dentists (69.1%) who were specialists or receiving training to be specialist, most of whom were oral surgeon (57, 31.5%) and pediatric dentists (56, 30.9%). There were 153 people (85.0%) who received CPR training before, and 65 of them (35.9%) were receiving regular training. When asked about the ratio of chest pressure vs mouth-to-mouth respiration when conducting CPR, 107 people (59.1%) answered 30:2. However, only 27.1% of them answered correctly for a question regarding CPR stages, C(Circulation)- A(Airway)- B(Breathing)- D(Defibrillation), which was defined in revised 2010 CPR practice guideline. Dentists who had experience of handling emergency situations in their practice were 119 (65.6%). The kinds of emergency situations they experienced were syncope (68, 37.6%), allergic reactions to local anesthetic (44, 24.3%), hyperventilation (43, 23.8%), seizure (25, 13.8%), hypoglycemia (15, 8.3%), breathing difficulty (14, 7.8%), cardiac arrest (11, 6.1%), airway obstruction (6, 3.3%), intake of foreign material and angina pectoris (4, 2.2%), in order of frequency. Most respondents answered that they handled the situation appropriately under the given emergency situation. In terms of emergency equipment they had blood pressure device (70.2%), pulse oximetry (69.6%), Bag-Valve-Mask (56.9%), emergency medicine (41.4%), intubation kit (29.8%), automated external defibrillator (23.2%), suction kit (19.3%) and 12 people (6.6%) did not have any equipment. In terms of confidence in handling emergency situation, with 1-10 point scale, their response was $4.86{\pm}2.41$ points. The average point of those who received regular training was $5.92{\pm}2.20$, while those who did not was $4.29{\pm}2.29$ points (P<0.001) Conclusion: The result showed they had good knowledge of CPR but the information they had was not up-to-date. Also, they were frequently exposed to the risk of emergency situation during their dental practice but the level of confidence in handling the emergency situation was intermediate. Therefore, regular training of CPR to prepare them for handling emergency situation is deemed necessary.