• Title/Summary/Keyword: Respiration, Artificial

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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.

National-Wide Survey on Endotracheal Suctioning in High-Risk Infants (고위험신생아를 위한 기관지흡인에 대한 실태조사)

  • Ahn Youngmee
    • Child Health Nursing Research
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    • v.5 no.2
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    • pp.198-210
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    • 1999
  • The goal of respiratory management in high risk infants is to maintain proper oxygenation by supporting respiration, therefore to minimize the secondary complications and to promote the maximum growth and development. While on artificial ventilator to achieve this goal, the infants require endotracheal suctioning(ETS) to remove lung secretions. However, the negative effects of ETS in neoates have been documented and include hypoxia, bradycardia, mucosal damage, increased intracranial pressure, and death result. The purpose of the study was to investigate how ETS is currently performed in NICU, which would be beneficial to develop the standardized ETS protocol and to apply it to these population. A national-wide survey on clinical protocol of ETS was performed to 149 neonatal nurses with the average of 3 years and 6 months experience in neonatal nursing, 34.2% of whom was bachelor in nursing. The results showed that about 89% of the nurses initiate En primarily based on the need of the subjects. The aseptic regulation on ETS was used in 83.9% of the subjects. There was no regulation on the length of catheter in 32.9% and on ID/OD ratio in 17.4%. Many nurses administered hyperoygenation/hyperinflation/hyperventilation based on personal knowhow, rather than scientific rationals (77.2%, 40.9%, 75.2%, retrospectively). About 41% of the nurse regulate subjectively the suction power, while 73.8% of them rotate the sub ject's head during suctioning and the half of the nurses was favorable in adapting the closed-suctioning protocol. With the findings of the study, the current clinical application of E% in neonates appears to be based on adult care practices, or personal preference, rather than scientific validation of the safety and effectiveness of the procedure. This study support the needs for developing and applying the standardized ETS protocolin conjunction with the consideration given to the physiologic characteristics of the neonates in respiratory distress.

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Comparative Evaluation for Seasonal CO2 Flows Tracked by GOSAT in Northeast Asia (GOSAT으로 추적된 동북아시아 이산화탄소 유동방향의 계절별 비교평가)

  • Choi, Jin Ho;Um, Jung-Sup
    • Spatial Information Research
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    • v.20 no.5
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    • pp.1-13
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    • 2012
  • This study intends to evaluate the seasonal flow direction of carbon dioxide in Northeast Asia by using GOSAT, the first Greenhouse Observing SATellite, in an attempt to overcome costly, laborious and time consuming ground observation which has been frequently pointed out in existing studies. For this purpose, missing values were supplemented by applying the Kriging interpolation and the overall flow direction of carbon dioxide was determined through anisotoropy semi-variogram. As a result, it was found that the overall spatial distribution of carbon dioxide in Northeast Asia varies depending on the latitude, and that carbon dioxide mainly flows southeast or east in spring, autumn and winter, but northeast or north in summer. Similar to the flow of monsoons in Northeast Asia, these results show that carbon dioxide flows mainly from the west to the east, which proves that carbon dioxide discharged from China is influencing even the Korean Peninsula and Japan. However, as the flow of carbon dioxide varies depending on a variety of factors such as artificial sources, plant respiration, and the absorption and discharge of the ocean, follow-up studies are requested to evaluate such variables and the correlations.

Bibliographic Studies on the Tetrodotoxin(TTX) (복어 독(Tetrodotoxin)에 관한 문헌적 고찰)

  • Hwang, Tae-Joon;Kwon, Gi-Rok;Choe, Ick-Seon
    • Journal of Pharmacopuncture
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    • v.3 no.2
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    • pp.1-25
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    • 2000
  • We were trying to study the validity of Puffer fish's poison(Tetrodotoxin- TTX) to make a traditional Korean Medical treatment. The following conclusions were made after literary studies. 1. The first record of the puffer fish dates back 2000 years ago in the Chinese text Book of Mountain and Sea and other texts from the similar period. 2. Puffer fish's poison IS known as tetrodotoxin which is an amino perhydroquinazoline compound. It has a chemical formula of $C_{11}H_{17}N_3O_8$ in the hemiacetal structure and has the molecular weight of 319. 3. Tetrodotoxin (TTX) plays a role as potent neurotransmitter blocker by blocking the $Na^+$ -gate channel which hinders the influx of $Na^+$ ion into the cell. 4. Symptoms of the puffer fish poisoning ranges from blunted sense in the lips and tongue, occasional vomiting in the first degree to sudden descending of the blood pressure, apnea, and other critical conditions in the fourth degree. Intoxication of the puffer fish poison progresses at a rapid pace as death may occur after an hour and half up to eight hours in maximum. Typical death occurs after four to six hours. 5. Ways to treat the puffer fish poisoning include gastric irrigation, induce vomiting, purgation, intravenous fluid injection, and correcting electrolytic imbalance and acidosis. In cases of dyspnea, apply oxygen inhalation and conduct artificial respiration. 6. Tetrodotoxin (TTX) may be applied in treating brain disorders, ocular pain, excess pain in the large intestine and ileum, and relieving tension of the skeletal museles, neuralgia, rheumatism, arthritis, and etc. 7. In terms of Oriental medicine, the puffer fish poison has characteristics of sweet, warm, and poisonous. It's known efficacies are to tonify weakness, dispel damp, benefit the lower back, relieve hemorrhoid, kills parasites, remove edema, and so forth. And the puffer fish eggs processed with ginger are said to be effective against tuberculosis and lung cancer, thus, it's validity must be investigated and further research should be followed.

Does the Mean Arterial Pressure Influence Mortality Rate in Patients with Acute Hypoxemic Respiratory Failure under Mechanical Ventilation?

  • Gjonbrataj, Juarda;Kim, Hyun Jung;Jung, Hye In;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.85-91
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    • 2015
  • Background: In sepsis patients, target mean arterial pressures (MAPs) greater than 65 mm Hg are recommended. However, there is no such recommendation for patients receiving mechanical ventilation. We aimed to evaluate the influence of MAP over the first 24 hours after intensive care unit (ICU) admission on the mortality rate at 60 days post-admission in patients showing acute hypoxemic respiratory failure under mechanical ventilation. Methods: This prospective, multicenter study included 22 ICUs and compared the mortality and clinical outcomes in patients showing acute hypoxemic respiratory failure with high (75-90 mm Hg) and low (65-74.9 mm Hg) MAPs over the first 24 hours of admission to the ICU. Results: Of the 844 patients with acute hypoxemic respiratory failure, 338 had a sustained MAP of 65-90 mm Hg over the first 24 hours of admission to the ICU. At 60 days, the mortality rates in the low (26.2%) and high (24.5%) MAP groups were not significantly different. The ICU days, hospital days, and 60-day mortality rate did not differ between the groups. Conclusion: In the first 24 hours of ICU admission, MAP range between 65 and 90 mm Hg in patients with acute hypoxemic respiratory failure under mechanical ventilation may not cause significantly differences in 60-day mortality.

A Study on the Effect of Basic Life Support Training on the First Responsive Police Officers

  • Jo, Byung-Tae;Kim, Seon-Rye
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.10
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    • pp.175-182
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    • 2019
  • The study was conducted to verify the effect of basic life support training on the skill ability of police officers. The subjects of this study were 10 experimental group and 10 comparative group with voluntary consent after explaining the theory and significance of the training experiment at the police station located in K. The education program used in this study consists of theoretical education and practical training, and the theoretical education is 60 minutes and the practical training is 30 minutes. The measurement tool for basic resuscitation performance was measured based on the 'CPR and ECG Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care' presented by the American Heart Association. The results are as follows. The experimental group showed higher performance skills than the traditional control group in field confirmation performance skills, primary evaluation performance skills (A, B, C, medical evaluation), and BLS performance skills (heart compression, artificial respiration, medical evaluation) which are the basic resuscitation performance skills. In conclusion, this study confirmed that the theory and practice education program is more effective in improving the clinical performance of police officers than the traditional lectures and practice education, so it is possible to apply this simulation education program to the cardiac arrest patient emergency treatment.

Susceptibility Weighted Imaging of the Cervical Spinal Cord with Compensation of Respiratory-Induced Artifact

  • Lee, Hongpyo;Nam, Yoonho;Gho, Sung-Min;Han, Dongyeob;Kim, Eung Yeop;Lee, Sheen-Woo;Kim, Dong-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.4
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    • pp.209-217
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    • 2018
  • Purpose: The objective of this study was to obtain improved susceptibility weighted images (SWI) of the cervical spinal cord using respiratory-induced artifact compensation. Materials and Methods: The artifact from $B_0$ fluctuations by respiration could be compensated using a double navigator echo approach. The two navigators were inserted in an SWI sequence before and after the image readouts. The $B_0$ fluctuation was measured by each navigator echoes, and the inverse of the fluctuation was applied to eliminate the artifact from fluctuation. The degree of compensation was quantified using a quality index (QI) term for compensated imaging using each navigator. Also, the effect of compensation was analyzed according to the position of the spinal cord using QI values. Results: Compensation using navigator echo gave the improved visualization of SWI in cervical spinal cord compared to non-compensated images. Before compensation, images were influenced by artificial noise from motion in both the superior (QI = 0.031) and inferior (QI = 0.043) regions. In most parts of the superior regions, the second navigator resulted in better quality (QI = 0.024, P < 0.01) compared to the first navigator, but in the inferior regions the first navigator showed better quality (QI = 0.033, P < 0.01) after correction. Conclusion: Motion compensation using a double navigator method can increase the improvement of the SWI in the cervical spinal cord. The proposed method makes SWI a useful tool for the diagnosis of spinal cord injury by reducing respiratory-induced artifact.

A Study on Abdomen MRI Scan Using Metronome (메트로놈을 이용한 복부 MRI 검사에 대한 연구)

  • Park, Ho-Sung;Kim, Jae-Seok
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.24 no.9
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    • pp.1138-1143
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    • 2020
  • MRI scans in the abdominal area are difficult to achieve optimal images due to artificial respiration. Among 45 patients (male:female = 30:15) who underwent abdominal MRI examination, a metronome-based examination method was studied for patients whose breathing is difficult and difficult to examine. The images examined without using a metronome were divided into group A, and the images examined using a metronome were divided into group B. Image quality improvement (30%) and inspection time (approximately 50 seconds) were reduced in images using metronome. During abdominal magnetic resonance imaging (ABD MRI), the images examined using a metronome had differences in quality and examination time compared to the unused images. It is more effective to use a metronome brace that controls the patient's respiratory rate during abdominal magnetic resonance imaging under respiratory induction in patients with difficulty in respiratory-gated.

Post Harvest Technology for High Quality Rice (고품질 쌀 생산을 위한 수확 후 관리기술)

  • 김동철
    • Proceedings of the Korean Society of Postharvest Science and Technology of Agricultural Products Conference
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    • 2002.08a
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    • pp.54-63
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    • 2002
  • Post-harvest technology for rice was focused on in-bin drying system, which consists of about 100, 000 facilities in 1980s. The modernized Rice Processing Complex (RPC) and Drying Storage Center (DSC) became popular for rice dry, storage, process and distribution from 1990s. However, the percentage of artificial drying for rice is 48% (2001) and the ability of bulk storage is about 15%. Therefore it is necessary to build enough drying and bulk storage facilities. The definition of high quality rice is to satisfy both good appearance and good taste. The index for good taste in rice is a below 7% of protein, 17-20% of amylose, 15.5-16.5% of moisture contents and high concentration of Mg and K. To obtain a high quality rice, it is absolutely needed to integrate high technologies including breeding program, cropping methods, harvesting time, drying, storing and processing methodologies. Generally, consumers prefer to rice retaining below b value of 5 in colorimetry, and the whiteness, the hardness and the moisture contents of rice are in order of consumer preference in rice quality. By selection of rice cultivars according to acceptable quality, the periods between harvesting time and drying reduced up to about 20 days. Therefore it is necessary to develop a low temperature grain drying system in order to (1) increase the rate of artificial rice drying up to 85%, (2) keep the drying temperature of below 45C, (3) maintain high quality in rice and (4) save energy consumption. Bulk storage facilities with low temperature storage system (7-15C) for rice using grain cooler should be built to reduce labor for handling and transportation and to keep a quality of rice. In the cooled rice, there is no loss of grain quality due to respiration, insect and microorganism, which results in high quality rice containing 16% of moisture contents all year round. In addition, introducing a low temperature milling system reduced the percentage of broken rice to 2% and increased the percentage of head rice to 3% because of proper hardness of grain. It has been noted that the broken rice and cracking reduced significantly by using low pressure milling and wet milling. Our mission for improving rice market competitiveness goes to (1) produce environment friendly, functional rice cultivars, (2) establish a grade standard of rice quality, (3) breed a new cultivar for consumer oriented and (4) extend the period of storage and shelf life of rice during postharvest.

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Systemic Corticosteroid Treatment in Severe Community-Acquired Pneumonia Requiring Mechanical Ventilation: Impact on Outcomes and Complications (기계환기가 요구된 중증 지역사회획득 폐렴에서 전신 스테로이드의 투여가 예후와 합병증의 발생에 미치는 영향)

  • Lee, Seung-Jun;Lee, Seung-Hun;Kim, You-Eun;Cho, Yu-Ji;Jeong, Yi-Yeong;Kim, Ho-Cheol;Lee, Jong-Deog;Kim, Jang-Rak;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.149-155
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    • 2012
  • Background: This study is to evaluate the effect of systemic corticosteroid on the clinical outcomes and the occurrence of complications in mechanical ventilated patients with severe community-acquired pneumonia (CAP). Methods: We retrospectively assessed the clinical outcomes and complications in patients with severe CAP admitted to ICU between March 1, 2003 and July 28, 2009. Outcomes were measured by hospital mortality after ICU admission, duration of mechanical ventilation (MV), ICU, and hospital stay. Complications such as ventilator associated pneumonia (VAP), catheter related-blood stream infection (CR-BSI), and upper gastrointestinal (UGI) bleeding during ICU stay were assessed. Results: Of the 93 patients, 36 patients received corticosteroids over 7 days while 57 patients did not receive corticosteroids. Age, underlying disease, APACHE II, PSI score, and use of vasopressor were not different between two groups. In-hospital mortality was 30.5% in the steroid group and 36.8% in the non-steroid group (p>0.05). The major complications such as VAP, CR-BSI and UGI bleeding was significantly higher in the steroid group than in the non-steroid group (19.4% vs. 7%, p<0.05). The use of steroids and the duration of ICU stay were significantly associated with the development of major complications during ones ICU stay (p<0.05). Conclusion: Systemic corticosteroid in patients with severe CAP requiring mechanical ventilation may have no beneficial effect on clinical outcomes like duration of ICU stay and in-hospital mortality but may contribute to the development of ICU acquired complications.