• Title/Summary/Keyword: Ventilation tubing

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Home mechanical ventilation in children with chronic respiratory failure: a narrative review

  • Soyoung Kwak
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.123-135
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    • 2023
  • Advances in perinatal and pediatric intensive care and recent advances in mechanical ventilation during the last two decades have resulted in an exponential increase in the number of children undergoing home mechanical ventilation (HMV) treatment. Although its efficacy in chronic respiratory failure is well established, HMV in children is more complex than that in adults, and there are more considerations. This review outlines clinical considerations for HMV in children. The goal of HMV in children is not only to correct alveolar hypoventilation but also to maximize development as much as possible. The modes of ventilation and ventilator settings, including ventilation masks, tubing, circuits, humidification, and ventilator parameters, should be tailored to the patient's individual characteristics. To ensure effective HMV, education for the parent and caregiver is important. HMV continues to change the scope of treatment for chronic respiratory failure in children in that it decreases respiratory morbidity and prolongs life spans. Further studies on this topic with larger scale and systemic approach are required to ensure the better outcomes in this population.

Optimization of the Unducted Auxiliary Ventilation for Large-Opening Underground Limestone Mines (대단면 지하 석회석 광산내 무풍관 국부통기 최적화 연구)

  • Nguyen, Van Duc;Lee, Chang Woo
    • Tunnel and Underground Space
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    • v.29 no.6
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    • pp.480-507
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    • 2019
  • This paper aims at optimizing the auxiliary ventilation system in large-opening limestone mines with unducted fans. An extensive CFD and also site study were carried out for optimization at the blind entries. The fan location, operating mode, and layout are the parameters for optimization. Since the jet stream discharged from the auxiliary fan is flowing faster than 15 m/s in most of the cases, the stream collides with floor, sides or roof and even with the jet stream generated from the other fan placed upstream. Then, it is likely to lose a large portion of its inertial force and then its ventilation efficiency drops considerably. Therefore, the optimal fan installation interval is defined in this study as an interval that maximizes the uninterrupted flowing distance of the jet stream, while the cross-sectional installation location can be optimized to minimize the energy loss due to possible collision with the entry sides. Consequently, the optimization of the fan location will improve ventilation efficiency and subsequently the energy cost. A number of different three-dimensional computational domains representing a full-scale underground space were developed for the CFD study. The velocity profiles and the CO concentrations were studied to design and optimize the auxiliary ventilation system without duct and at the same time mine site experiments were carried out for comparison purposes. The ultimate goal is to optimize the auxiliary ventilation system without tubing to provide a reliable, low-cost and efficient solution to maintain the clean and safe work environment in local large-opening underground limestone mines.

Experimental and CFD Study on the Exhaust Efficiency of a Smoke Control Fan in Blind Entry Development Sites (맹갱도 굴진 작업공간내 방재팬의 화재연 배기효율에 관한 현장실험 및 CFD 연구)

  • Nguyen, Vanduc;Kim, Dooyoung;Hur, Wonho;Lee, Changwoo
    • Tunnel and Underground Space
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    • v.28 no.1
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    • pp.38-58
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    • 2018
  • The ventilation system plays a crucial role in underground mine safety. The main objective of the ventilation system is to supply sufficient air to dilute the contaminated air at working places and consequently provide tenable environment during the normal operation, while it also should be capable of controlling the fire propagation and facilitate rescue conditions in case of fire in mines. In this study, a smoke control fan was developed for the auxiliary ventilation as well as the fire smoke exhaust. It works as a free-standing auxiliary fan without tubing to dilute or exhaust the contaminated air from the working places. At the same time, it can be employed to extract the fire smoke. This paper aims to examine the smoke control efficiency of the fan when combined with the current ventilation system in mines. A series of the site experiments and numerical simulations were made to evaluate the fan performance in blind entry development sites. The tracer gas method with SF6 was applied to investigate the contaminant behavior at the study sites. The results of the site study at a large-opening limestone mine were compared with the CFD analysis results with respect to the airflow pattern and the gas concentration. This study shows that in blind development entry, the most polluted and risky place, the smoke fan can exhaust toxic gases or fire smoke effectively if it is properly combined with an additional common auxiliary fan. The venturi effect for smoke exhaust from the blind entry was also observed by the numerical analysis. The overall smoke control efficiency was found to be dependent on the fan location and operating method.

Change of End-tidal PCS During Cardiopulmonary Bypass (체외순환시 호기말 이산화탄소압의 변화)

  • 오중환
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1399-1403
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    • 1992
  • The evaluation of the effectivess of ongoing cardiopulmonary resucitation efforts is dependent on the commonly used methods, such as the presence of femoral or carotid artery pulsations, arterial blood gas determinations, peripheral arterial pressure and intracardiac pressure monitoring. But recent studies suggest that end-tidal carbon dioxide tension serves as a non-invasive measurement of pulmonary blood flow and therefore cardiac output under constant ventilation. A prospective clinical study was done to determine whether end-tidal carbon dioxide monitoring in open heart surgery under cardiopulmonary bypass could be used as a prognostic indicator of bypass weaning. We monitored end-tidal PCO2 values continuously during cardiopulmonary bypass in 30 patients. "Ohmeda 5210 CO-2 monitor" under infrared absorption method were incorperated into the ventilator circuit by means of a side point adaptor between endotracheal tube and ventilator tubing. 18 patients[Group I ] were res-ucitated from partial bypass followed by aorta cross clamp off and 12 patients[Group II ] from aorta cross clamp off followed by partial bypass. But there was no difference between two groups[p>0.05]. The value of end-tidal carbon dioxide tension during ventricular fibrillation or nearly arrest state was 6.6$\pm$2.9 mmHg, and at the time of spontaneous beating was 19.3$\pm$5.6 mmHg[Mean$\pm$Standard deviation], In conclusion end-tidal carbon dioxide tension monitoring provides clinically useful, continous, noninvasive and supplementary prognostic indicator during cardiopulmonary bypass weaning procedures.rocedures.

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Nationwide Analysis of Mortality Rates and Related Surgical Procedures in Hearing Disability Patients in South Korea

  • Han, Hye Min;Kwak, Ji Won;Kim, Hyeon Geun;Lee, Hoyoung;Kim, Young-Chan;Park, Euyhyun;Jung, Hak Hyun;Im, Gi Jung
    • Korean Journal of Audiology
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    • v.24 no.4
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    • pp.204-209
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    • 2020
  • Background and Objectives: Hearing loss (HL) and its repercussions are major problems in today's society. There are limited data on the relationship between degree of HL and otologic disorders. The aim of this study is to estimate mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures in hearing disability patients in South Korea. Subjects and Methods: Retrospective medical data for 160,205 patients with hearing disability was extracted. Mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures were compared with a normal control group consisting of 865,475 people; approximately 5 times the number of hearing disability patients. Results: According to the Korean National Disability Registry (NDR), 0.458% of the population in South Korea suffered from hearing disability in 2015. Higher rates of mortality and sudden idiopathic HL were reported in hearing disability patients, increasing up to a maximum of 1.594 times and 1,039.695 times, respectively, compared to the normal control group. Mastoidectomy surgery was 2.5 times more frequently performed and pressure equalizing (PE) tube insertion was about 15 times more frequently performed in hearing disability patients. Conclusions: Hearing disability is related to higher risks of mortality, sudden idiopathic HL and otologic surgical procedures, including mastoidectomy and PE tubing.

Nationwide Analysis of Mortality Rates and Related Surgical Procedures in Hearing Disability Patients in South Korea

  • Han, Hye Min;Kwak, Ji Won;Kim, Hyeon Geun;Lee, Hoyoung;Kim, Young-Chan;Park, Euyhyun;Jung, Hak Hyun;Im, Gi Jung
    • Journal of Audiology & Otology
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    • v.24 no.4
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    • pp.204-209
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    • 2020
  • Background and Objectives: Hearing loss (HL) and its repercussions are major problems in today's society. There are limited data on the relationship between degree of HL and otologic disorders. The aim of this study is to estimate mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures in hearing disability patients in South Korea. Subjects and Methods: Retrospective medical data for 160,205 patients with hearing disability was extracted. Mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures were compared with a normal control group consisting of 865,475 people; approximately 5 times the number of hearing disability patients. Results: According to the Korean National Disability Registry (NDR), 0.458% of the population in South Korea suffered from hearing disability in 2015. Higher rates of mortality and sudden idiopathic HL were reported in hearing disability patients, increasing up to a maximum of 1.594 times and 1,039.695 times, respectively, compared to the normal control group. Mastoidectomy surgery was 2.5 times more frequently performed and pressure equalizing (PE) tube insertion was about 15 times more frequently performed in hearing disability patients. Conclusions: Hearing disability is related to higher risks of mortality, sudden idiopathic HL and otologic surgical procedures, including mastoidectomy and PE tubing.

Colonization Rate and Control of Vancomycin-Resistant Enterococci in the Neonatal Intensive Care Unit (일개 신생아중환자실 반코마이신 저항 장구균(VRE)의 유행 양상과 조절)

  • Seo, Jung Ho;Nam, Ga Yeon;Park, Kyung Hee;Byun, Shin Yun;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • v.17 no.1
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    • pp.1-8
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    • 2010
  • Purpose : Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). Methods : We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. Results : The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. Conclusion : VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.