• Title/Summary/Keyword: Respiratory Insufficiency

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Large aspergilloma cavity treated by Cavernostomy md ometal, muscle flaps A case report (공동절개술과 유경성 대망이식술 및 근육 충진술을 이용한 거대 폐공동(폐국균증)의 치험 1례)

  • 방정희;편승환
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.936-940
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    • 1997
  • Pulmonary aspergilloma is potentially a life threatening disease resulting from the colonization of lung cavities by Aspergillus fumigatus. A case is reported: a 43-year-old man with symtomatic cavitary aspergilloma presenting with severe productive coughing, hemopt sis, occasional fever, and chilling. On preoperative plain chest radiograph and CT scan, we could find a rounded irregular opacity in a large pulmonary cavity. He received 2 separate operations for therapeutic need. At the first opertion, we performed cavernostomy and thoracoplasty because of severe pleural adhesions, tearing of cavity wall, and high risk of respiratory insufficiency. At the second operation, we performed myoplasty and omentoplasty for closure of remaining air space and complete wrapping of the BPF site. All symptoms of dyspnea and hemoptysis have since resolved. We believed that in the high risk patients who have severe respiratory symptoms, such as in aspergilloma and open cavity with a risk of respiratory insufficiency, cavernostomy followed by myoplasty or omentoplasty should be recommended.

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A Case of Respiratory Failure after Clean-up Work of the Hebei Spirit Crude Oil Spill in Taean (태안 Hebei Spirit 유출 유류 제거작업 후 발생한 호흡부전 1예)

  • Kyung, Sun Young;Chon, Su-Yeon;Kim, Yu Jin;Lee, Sang Pyo;Park, Jeong-Woong;Jeong, Sung Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.249-253
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    • 2009
  • On 7 December 2007, the Hebei Spirit ran aground near Taean and released approximately 10,900 tons of oil into the sea. Crude oil on the coastal areas and fumes in the air increased the number of health problems among the local population. We report a case of respiratory failure after the oil spill clean-up work. A 66-year-old female was admitted to hospital with cough, sputum, and dyspnea of 1-month duration after the oil spill clean-up. She was diagnosed with community-acquired pneumonia and treated with empirical antibiotics. However, she had progressive respiratory failure without identification of the pathogen. Respiratory failure due to chronic inhalation of hydrocarbons from the crude oil spill clean-up was suspected. After mechanical ventilation care, she recovered from respiratory failure and was discharged. We report a case of severe respiratory toxic effects after an oil spill clean-up. We concluded that long-term hydrocarbon inhalation during the oil spill clean-up may have induced respiratory failure in this case.

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.

Subcutaneous Emphysema as a Complication of Tonsillectomy (편도적출술후 발생한 피하기종)

  • 홍기환;조윤성;임현실;이상헌;문승현
    • Korean Journal of Bronchoesophagology
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    • v.7 no.1
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    • pp.62-65
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    • 2001
  • Subcutaneous emphysema of the head and neck are well-known sequealae of surgery and trauma to the chest airway. This occurs when air is introduced into the tissue. This can happen as a complication during, or immediately after surgery. Among the causes subcutaneous emphysema due to complication of tonsillectomy, has rarely been described. Definitive treatment will depend on the cause. Recently. we have experienced two cases of subcutaneous emphysema without respiratory and circulatory insufficiency as a complication of tonsillectomy in 38-year-old male and uvulopalatopharyngoplasty in 41- year-old male.

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One Stage Repair of Traumatic Ventricular Septal Defect and Mitral Regurgitation (외상성 심실중격결손 및 승모판막 역류증의 일차 완전정복)

  • 이재원;송태승;제형곤;송명근
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1131-1134
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    • 1999
  • After a penetrating thoracic injury early detection of intracardiac injury and early surgical repair when indicated are essential. A case presenting severe respiratory distress two weeks after a penetrating thoracic injury is reported. Transesophageal echocardiography showed massive pericardial effusion ventricular septal defect and mirtal regurgitation, The infundibular ventricular septal perforation was repaired using a Dacron patch the anterior mitral leaflet by interrupted sutures and the ruptured chordae of the posterior leaflet by a new chordae formation.

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A Case of Activated Charcoal Aspiration Treated by Early and Repeated Bronchoalveolar Lavage (기관지내시경을 통해 치료한 활성탄 흡인 1예)

  • Lee, Han-Min;Park, Jae-Seok;Kim, Jae-Yun;Lee, Ji-Yeon;Ahn, Byung-Kyu;Gil, Hyo-Wook;Choi, Jae-Sung
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.177-181
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    • 2012
  • Activated charcoal is an inert substance and it is used in standard therapy in patients with acute intoxication. Charcoal has some side effects such as pulmonary aspiration, gastrointestinal complications, and electrolyte abnormalities. Although aspiration of charcoal is a rare complication, it can cause fatal sequelae. We report a 69-year old man who developed acute respiratory failure associated with charcoal aspiration after management of glyphosate poisoning. The patient was drowsy and suffered severe vomiting during transport to our hospital. On arrival, acute respiratory failure was observed due to charcoal aspiration, but the clinical state was improved with repeated bronchoscopy with a bronchoalveolar lavage (BAL). We presumed that the aspirated charcoal was an important factor in evoking a lung injury. Early bronchoscopy with a BAL might be an effective method for eliminating charcoal from the lung, especially in the case of a large amount of aspiration, and be helpful in decreasing respiratory failure due to charcoal aspiration.

A Clinical Case Study on the Long Term Respiration Management of Amyotrophic Lateral Sclerosis Patient with Respiratory Failure (호흡부전을 동반한 근위축성 측삭 경화증 환자의 장기적 호흡관리 1례)

  • Lee, Jong Cheol;Jeong, Ho Hyun;Cha, Eun Hye;Park, Man Yong;Kim, Tae Ho;Song, Bong Keun;Son, Il Hong;Kim, Sung Chul
    • Journal of Acupuncture Research
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    • v.31 no.3
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    • pp.67-73
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    • 2014
  • Objectives : Amyotrophic lateral sclerosis(ALS) is a progressive neurodegenerative disorder characterized by a selective death of motor neuron, leading to respiratory insufficiency. The purpose of this study was to assess the long term respiratory management of ALS patient with respiratory failure. Methods : One ALS patient applying a non-invasive BIPAP ventilator as well as Korean medical treatment such as acupuncture, pharmacopuncture and herbal medicine was measured on $SpO_2$, $EtCO_2$, Vte(expiratorytidalvolume) for 2 years 7 months. Results : The $SpO_2$, $EtCO_2$ of ALS patient were maintained in the normal range for 2 years 7 months. The Vte of ALS patient also wasn't worse in this study. Conclusions : In this study, the long term respiration management, combined administration of Korean medical treatment and non-invasive BIPAP ventilator, could be effective in ALS patient with respiratory failure.

A Study on Infant Respiratory Diseases Diagnosis using Frequency Bandwidth Analysis of Crying Waveform (울음소리의 주파수 대역폭 분석을 이용한 소아호흡기 질환 진단에 관한 연구)

  • Kim, Bong-Hyun;Cho, Dong-Uk
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.33 no.12B
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    • pp.1123-1130
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    • 2008
  • Baby's diseases diagnosis has inconvenient for received direct coming to help that order expression ability was insufficiency which consciousness situation concern about the infant health because of birth rate and decrease the marriage rate and divorce rate. So in this paper through the infant crying sound about home a foundation which infant diseases develop the system comparison normal infant with take a infant that analysis the extract the voice analytics component. Especially this paper propose about the methodology for development system that infant cold, infant pneumonia, infant asthma among extract the crying sound feature part for infant respiratory diseases discussion the most easy has involved the infant. So infant respiratory put case stimulus diseases about all voice organs and experiment the analysis method through the bandwidth about phonetics analysis component that comparison normal infant with take a respiratory infant. Through these method, we were extracted to results that infant's frequency bandwidth suffering from respiratory diseases than a normal infant is short.

Anesthetic Management of an Amyotrophic Lateral Sclerosis Patient Undergoing Dental Care in Daysurgery Center (외래치료실에서의 근위축성 측삭경화증 환자(ALS)의 전신마취 하치과 치료시 마취관리)

  • Kim, Han-Su;Lee, Suk-Yung;Choi, Eun-Hye;Kim, Seung-Oh
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.4
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    • pp.195-201
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    • 2013
  • Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease caused by the degeneration of upper and lower motor neurons. The disorder causes muscle weakness and atrophy in airway muscles including pharyngeal, laryngeal and other respiratory muscles. The response to muscle realxant is also altered in patients with ALS. Because of the inherent muscle weakness and associated respiratory insufficiency, particular attentions are needed in anesthetic management of ALS patients. We used proper doses of inhalation anesthetics and opioids under EEG-entropy (electroencephalography-entropy)-monitoring without the use of muscle realxants in the anesthetic management of a patient with ALS. The patient early recovered and was discharged on the same day without any respiratory complications.

Rigid Bronchoscopy for Post-tuberculosis Tracheobronchial Stenosis

  • Hojoong Kim
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.4
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    • pp.245-250
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    • 2023
  • The healing process of tracheobronchial tuberculosis (TB) results in tracheobronchial fibrosis causing airway stenosis in 11% to 42% of patients. In Korea, where pulmonary TB is still prevalent, post-TB tracheobronchial stenosis (PTTS) is one of the main causes of benign airway stenosis causing progressive dyspnea, hypoxemia, and often life-threatening respiratory insufficiency. The development of rigid bronchoscopy replaced surgical management 30 years ago, and nowadays PTTS is mainly managed by bronchoscopic intervention in Korea. Similar to pulmonary TB, tracheobronchial TB is treated with combination of anti-TB medications. The indication of rigid bronchoscopy is more than American Thoracic Society (ATS) grade 3 dyspnea in PTTS patients. First, the narrowed airway is dilated by multiple techniques including ballooning, laser resection, and bougienation under general anesthesia. Then, most of the patients need silicone stenting to maintain the patency of dilated airway; 1.5 to 2 years after indwelling, the stent could be removed, this has shown a 70% success rate. Acute complications without mortality develop in less than 10% of patients. Subgroup analysis showed successful removal of the stent was significantly associated with male sex, young age, good baseline lung function and absence of complete one lobe collapse. In conclusion, rigid bronchoscopy could be applied to PTTS patients with acceptable efficacy and tolerable safety.