• Neonatal Medicine
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• v.18 no.2
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• pp.293-300
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• 2011

Purpose: The aim of the study was to investigate the change in usage and clinical outcomes of using a humidified high flow nasal cannula (HHFNC) in preterm infants. Methods: A retrospective review of patients with gestational age <32 weeks born at our neonatal intensive care unit from January 2008 to March 2011 was performed. First, data were compared between Era 1 (January 2008 to February 2009) and Era 2 (March 2009 to March 2011) to describe the increased usage of HHFNC. Second, the patients (gestational age 25-30 weeks) were divided into two groups to compare clinical outcomes. nasal continuous positive airway pressure (NCPAP) and HHFNC groups who received either NCPAP or HHFNC as a respiratory support within 14 days of birth. Results: Compared to Era 1, HHFNC usage increased from 10 to 55% in Era 2, whereas NCPAP usage decreased from 40 to 5%. No difference in pulmonary or adverse outcomes including the incidence of reintubation and bronchopulmonary dysplasia (BPD), days on oxygen and a ventilator, and other outcomes was observed between the HHFNC and NCPAP groups. Days to reach full feed (32.2${\pm}$16.7 vs. 24.7${\pm}$10.2, P=0.05) and regain birth weight (20.9${\pm}$16.9 vs. 17.2${\pm}$4.3, P=0.04) decreased in the HHFNC group. Conclusion: HHFNC was feasible and did not differ in respiratory and other outcomes, but days to reach full feed and regain birth weight decreased in the HHFNC, when compared with the NCPAP. An additional prospective multicenter designed study is needed to better define safety and efficacy of HHFNC.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.1
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• pp.73-78
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• 2012

Excessive intake of trans fats is known to be a risk factor for cardiovascular diseases. Previously, we have shown that green tea extract (GTE) lowers the intestinal absorption of lipids and lipid-soluble compounds in rats. This study was conducted to investigate a possible role of GTE on the lymphatic absorption of elaidic acid, a major trans fat in the diet. Adult male Sprague-Dawley rats with lymph duct cannula were infused via an intraduodenal catheter at 3.0 mL/hr for 8 hr with a lipid emulsion containing $180.0{\mu}mol$ elaidic acid, $400.0{\mu}mol$ triolein, $20.7{\mu}mol$ cholesterol, $3.1{\mu}mol$ ${\alpha}$-tocopherol, and $396.0{\mu}mol$ sodium-taurocholate with or without (control) GTE in a 24 mL PBS buffer (pH, 6.4). Simultaneously, lymph was collected hourly for 8 hr via the lymph duct cannula. There was a significant difference in lymph flow by GTE. Also, the lymphatic absorption of elaidic acid for 8 hr was significantly lower in rats infused with GTE than in those not infused with GTE. Similarly, GTE infusion decreased the lymphatic outputs of cholesterol, oleic acid, and phospholipids, compared with the controls. These findings provide clear evidence that GTE has an inhibitory effect on the intestinal absorption of elaidic acid and other lipids. Our work here provides the foundation for further studies to examine and evaluate dietary strategies to ameliorate dietary trans fats from the diet.

• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.319-329
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• 2018

Background: Bronchoalveolar lavage (BAL) is a necessary procedure for diagnosis of various lung diseases. High-flow nasal cannula (HFNC) oxygen delivery was recently introduced. This study aimed to investigate the safety and effectiveness of HFNC oxygen supply during BAL procedure in patients with acute respiratory failure (ARF). Methods: Patients who underwent BAL while using HFNC at a partial pressure of oxygen in arterial blood/fraction of inspired oxygen ($PaO_2/FiO_2$; PF) ratio of 300 or below among patients who had been admitted from March 2013 to May 2017 were retrospectively investigated. Results: Thirty-three BAL procedures were confirmed. Their baseline PF ratio was $166.1{\pm}46.7$. $FiO_2$ values before, during, and after BAL were $0.45{\pm}0.12$, $0.74{\pm}0.19$, and $0.57{\pm}0.14$, respectively. Flow (L/min) values before, during, and after BAL were $26.5{\pm}20.3$, $49.0{\pm}7.2$, and $40.8{\pm}14.2$, respectively. Both $FiO_2$ and flow during and after the procedure were significantly different from those before the procedure (both p<0.001). Oxygen saturation levels before, during, and after BAL measured by pulse oximeter were $94.8{\pm}2.9$, $94.6{\pm}3.5$, and $95.2{\pm}2.8%$, respectively. There were no significant differences in oxygen saturation among the three groups. Complications of BAL procedure included transient hypoxemia, hypotension, and fever. However, there was no endotracheal intubation within 24 hours. Baseline PF ratio in "without HFNC" group was significantly higher than that in "with HFNC" group. There were no differences in complications between the two groups. Conclusion: The use of HFNC during BAL procedure in ARF patients was effective and safe. However, there were no significant differences in oxygen saturation level and complications comparing "without HFNC" group in mild ARF. More studies are needed for moderate to severe ARF patients.

• Journal of Veterinary Clinics
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• v.31 no.5
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• pp.371-375
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• 2014

This article describes the use of laparoscopic-assisted cystoscopy for removal of urinary calculi in five dogs. All dogs had micturition disorder due to urinary calculi. The surgical technique used was same in all cases. A urethral catheter passed into the urinary bladder through the urethra preoperatively. A 5-mm diameter cannula was placed in the ventral midline, 1 to 2 cm cranial to the umbilicus, and the 5-mm laparoscope was introduced via the cannula. A 10-mm diameter cannula was placed adjacent to the apex of the bladder under the visual guidance of laparoscopy. The bladder was then partially exteriorized through the 10-mm portal site, and a stab incision was performed on the bladder wall. The incisional margin of the bladder was sutured to the skin of the second portal site in $360^{\circ}$ simple continuous suture. A 2.7-mm diameter cystoscope with a sheath was introduced into the bladder lumen. The cystic and urethral calculi were removed under the visual guidance of cystoscopy with continuous fluid flushing. No major postoperative complications were identified. During the follow up period (range 7 to 21 months), no episodes of urinary dysfunction or recurrence of clinical signs were observed.

• Journal of Biomedical Engineering Research
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• v.25 no.6
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• pp.489-496
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• 2004

Insertion of cannulae into vessels may disturb the blood flow doing non-physiological load and stress on blood cells such that ADP may increase and result in hemolysis. Authors used the computational method to simulate the 3-dimensional blood flow inside of the cannula using numerical method. We limited the research to within the drainage cannulae with side holes inserted through the human vein. In this paper, 9 different cannulae with side holes categorized by the number of side holes of 4, 12, and 20, and also categorized by the array type of side holes of staggered array, in-line array, and alternative in-line array were studied and compared to the cannula with no side holes by using CFD analysis. We evaluated the flow rate, the wall shear stress, and the shear rate and compared them with one another to estimate the effect of the side holes. The flow rate is not proportional to the number of the side holes. However, larger number of side holes can reduce the mean shear rate. Both the number and the array type of side holes play an important role on the fluid dynamics of the blood flow in cannulae.

• Journal of Chest Surgery
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• v.44 no.1
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• pp.9-17
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• 2011

Background: A peripheral extracorporeal membrane oxygenator (p-ECMO) has been developed to support patients who are dying due to a serious cardiopulmonary condition. This analysis was planned to define the clinical situation in which the patient benefits most from a p-ECMO. Material and Methods: Between June 2007 and Aug 2009, a total of 41 adult patients used the p-ECMO. There were 23 males and 18 females (mean age $54.4{\pm}15.1$ years). All patients had very unstable vital signs with hypoxia and complex cardiac problems. We divided the patients into 4 groups. In the first group, a p-ECMO was used as a bridge to cardiac operation. In the second group, patients did not have the opportunity to undergo any cardiac procedures; nevertheless, they were treated with a p-ECMO. In the third group, patients mostly had difficulty in weaning from CPB (cardiopulmonary bypass) after cardiac operation. The fourth group suffered from many complications, such as pneumonia, bleeding, infections, and LV dysfunction with underlying cardiac problems. All cannulations were performed by the Seldinger technique or cutting down the femoral vessel. A long venous cannula of $DLP^{(R)}$ (Medtronic Inc, Minneapolis, MN) or $RMI^{(R)}$ (Edwards Lifesciences LLC, Irvine, CA) was used together with a 17~21 Fr arterial cannula and a 21 Fr venous cannula. As a bypass pump, a Capiox emergency bypass system ($EBS^{(R)}$; Terumo, Tokyo, Japan) was used. We attempted to maintain a flow rate of $2.4{\sim}3.0\;L/min/m^2$ and an activated clotting time (ACT) of around 180 seconds. Results: Nine patients survived by the use of the p-ECMO. Ten patients were weaned from a p-ECMO but they did not survive, and the remainder had no chance to be weaned from the p-ECMO. The best clinical situation to apply the p-ECMO was to use it as a bridge to cardiac operation and for weaning from CPB after cardiac operation. Conclusion: Various clinical results were derived by p-ECMO according to the clinical situation. For the best results, early adoption of the p-ECMO for anatomical correction appears important.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.2
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• pp.102-107
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• 2019

Purpose: Acute carbon monoxide (CO) poisoning is one of the most common types of poisoning and a major health problem worldwide. Treatment options are limited to normobaric oxygen therapy, administered using a non-rebreather face mask or hyperbaric oxygen. Compared to conventional oxygen therapy, high-flow nasal cannula oxygen (HFNC) creates a positive pressure effect through high-flow rates. The purpose of this human pilot study is to determine the effects of HFNC on the rate of CO clearance from the blood, in patients with mild to moderate CO poisoning. Methods: CO-poisoned patients were administered 100% oxygen from HFNC (flow of 60 L/min). The fraction of COHb (fCOHb) was measured at 30-min intervals until it decreased to under 10%, and the half-life time of fCOHb (fCOHb t_1/2) was subsequently determined. Results: At the time of ED arrival, a total of 10 patients had fCOHb levels ≥10%, with 4 patients ranging between 10% and 50%. The mean rate of fCOHb elimination patterns exhibits logarithmic growth curves that initially increase quickly with time (HFNC equation, Y=0.3388*X+11.67). The mean fCOHbt_1/2 in the HFNC group was determined to be 48.5±12.4 minutes. Conclusion: In patients with mild to moderate CO poisoning, oxygen delivered via high flow nasal cannula is a safe and comfortable method to treat acute CO toxicity, and is effective in reducing the COHb half-life. Our results indicate HFNC to be a promising alternative method of delivering oxygen for CO toxicity. Validating the effectiveness of this method will require larger studies with clinical outcomes.

• Tuberculosis and Respiratory Diseases
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• v.82 no.1
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• pp.81-85
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• 2019

Background: Bronchoscopy is a useful diagnostic and therapeutic tool. However, the clinical use of high-flow nasal cannula (HFNC) in adults with acute respiratory failure for diagnostic and invasive procedures has not been well evaluated. We present our experiences of well-tolerated diagnostic bronchoscopy as well as cases of improved saturation in hypoxaemic patients after a therapeutic bronchoscopic procedure. Methods: We retrospectively reviewed data of hypoxaemic patients who had undergone bronchoscopy for diagnostic or therapeutic purposes from October 2015 to February 2017. Results: Ten patients (44-75 years of age) were enrolled. The clinical purposes of bronchoscopy were for diagnosis in seven patients and for intervention in three patients. For the diagnoses, we performed bronchoalveolar lavage in six patients. One patient underwent endobronchial ultrasonography with transbronchial needle aspiration of a lymph node to investigate tumour involvement. Patients who underwent bronchoscopy for therapeutic interventions had endobronchial mass or blood clot removal with cryotherapy for bleeding control. The mean saturation ($SpO_2$) of pre-bronchoscopy in room air was 84.1%. The lowest and highest mean saturation with HFNC during the procedure was 95% and 99.4, respectively. The mean saturation in room air post-bronchoscopy was 87.4%, which was 3.3% higher than the mean room air $SpO_2$ pre-bronchoscopy. Seven patients with diagnostic bronchoscopy had no hypoxic event. Three patients with interventional bronchoscopy showed improvement in saturation after the procedure. Bronchoscopy was well tolerated in all 10 cases. Conclusion: This study suggests that the use of HFNC in hypoxaemic patients during diagnostic and therapeutic bronchoscopy procedures has clinical effectiveness.

• Journal of Korean Academy of Nursing
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• v.53 no.4
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• pp.468-479
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• 2023

Purpose: This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit. Methods: A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ² test, Mann-Whitney U test, and area under the curve (AUC). Results: Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption. Conclusion: The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1997.04a
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• pp.92-92
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• 1997

Stereotaxic apparatus를 이용하여 흰쥐의 두개골을 천공하여 periaqueductal gray matter에 정확히 cannula를 삽입하여 1일 이상의 방치후 여기로 약물을 투여하여 일군의 동물들은 행동의 변화를 관찰하고, 일군의 동물들은 경동맥에서의 혈압과 심박수의 변화를 관찰한다. 결과: ET-1에 의해 유발된 barrel-rolling은 NMDA receptor-selective antagonist인 MK-801에 의해 유의성있게 억제되었으며, NOS antagonist인 L-NAME과 NO scavenger인 Hemoglobin에 의해서도 유의성 있게 억제되었다.