• 한국임상수의학회지
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• 제32권4호
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• pp.380-384
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• 2015

The relationships between end-tidal partial pressure of carbon dioxide ($P_{ET}CO_2$) and arterial partial pressure of carbon dioxide ($P_aCO_2$), and between $P_{ET}CO_2$ and blood pH in isoflurane-anesthetized cinereous vultures were evaluated. Nine cinereous vultures (weighing 7.3-9.5 kg) were anesthetized via mask with isoflurane, intubated, and connected to a mechanical ventilator. By mechanical ventilator, respiratory rate was altered to achieve a $P_{ET}CO_2$ randomly selected among 30 to 35 mmHg. $P_aCO_2$ and blood pH were determined in serial arterial samples and compared with concurrent $P_{ET}CO_2$ measured with a sidestream capnography. Thirty six samples, nine cinereous vultures were tested 4 times each, were used to determine correlations coefficients between $P_aCO_2$ and $P_{ET}CO_2$, and between $P_{ET}CO_2$ and blood pH. Strong correlations were observed between $P_aCO_2$ and $P_{ET}CO_2$ (r = 0.951, P = 0.000, y = 1.679x - 30.236, $R^2=0.905$) as well as between $P_{ET}CO_2$ and blood pH (r = -0.728, P = 0.000, y = -0.024x + 8.389, $R^2=0.530$) with Pearson's correlation coefficient and simple linear regression. These results suggest that the capnography used provided a sufficiently accurate estimation of $P_aCO_2$ and blood pH. Thus, the monitoring of $P_{ET}CO_2$ can be useful method to prevent hypoventilation for cinereous vultures receiving mechanical ventilation.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권2호
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• pp.97-103
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• 2018

Background: Respiration monitoring is necessary during sedation for dental treatment. Recently, acoustic respiration rate ($RRa^{TM}$), an acoustics-based respiration monitoring method, has been used in addition to auscultation or capnography. The accuracy of this method may be compromised in an environment with excessive noise. This study evaluated whether noise from the ultrasonic scaler affects the performance of RRa in respiratory rate measurement. Methods: We analyzed data from 49 volunteers who underwent scaling under intravenous sedation. Clinical tests were divided into preparation, sedation, and scaling periods; respiratory rate was measured at 2-s intervals for 3 min in each period. Missing values ratios of the RRa during each period were measuerd; correlation analysis and Bland-Altman analysis were performed on respiratory rates measured by RRa and capnogram. Results: Respective missing values ratio from RRa were 5.62%, 8.03%, and 23.95% in the preparation, sedation, and scaling periods, indicating an increased missing values ratio in the scaling period (P < 0.001). Correlation coefficients of the respiratory rate, measured with two different methods, were 0.692, 0.677, and 0.562 in each respective period. Mean capnography-RRa biases in Bland-Altman analyses were -0.03, -0.27, and -0.61 in each respective period (P < 0.001); limits of agreement were -4.84-4.45, -4.89-4.15, and -6.18-4.95 (P < 0.001). Conclusions: The probability of missing respiratory rate values was higher during scaling when RRa was used for measurement. Therefore, the use of RRa alone for respiration monitoring during ultrasonic scaling may not be safe.

• 대한치과마취과학회지
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• 제11권1호
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• pp.32-37
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• 2011

Pulsus paradoxus has been defined as a decrease in systolic blood pressure (SBP) of 10 mmHg or more during inspiration. This report describes pulsus paradoxus detected by pulse oximetry during dental procedure. Case: A 10 years old boy who had impacted mandibular premolar with malformation scheduled for extraction under intravenous sedation with Fentanyl and Propofol. The patient showed upper airway obstruction with stridor and pulsus paradoxus. Though pulsus paradoxus is generally critical condition, in this case, respiration and other vital sign was maintained comparatively well with care in administering oxygen and considerate monitoring of pulse oximetry and capnography. Discussion: Noninvasive continuous monitoring of pulse oximetry allows recognition of pulsus paradoxus which can lead to serious problems. Clinicians should know very well about it and be able to manage of this kind of situation.

• The Korean Journal of Pain
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• 제12권1호
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• pp.81-86
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• 1999

Background: Essential hyperhidrosis is a condition with excessive sweating, which may be localized in any parts of the body. Thoracic sympathectomy has been a surgical procedure for the management of hyperhidrosis. Methods: We studied 30 ASA I and II patients suffering from severe hyperhidrosis. Bilateral upper thoracoscopic sympathectomy of $T_{2-4}$ was performed in 30 patients under general anesthesia. Anesthesia was induced with 2.5% thiopental sodium 5 mg/kg and succinylcholine chloride 1 mg/kg and was maintained with enflurane 1~2 Vol% and $N_2O-O_2$ mixture adjusted to maintain $SpO_2$ greater than 96%. During anesthesia, invasive arterial pressure, heart rate, EKG, $SpO_2$ and capnography were monitored. Skin temperature was measured with thermister probes attached to the index finger of each hand. An increase in temperature after cautery confirmed success of the sympathectomy. Results: There were 14 men and 16 women whose ages ranged from 16 to 46 years old (mean age 22.2). Of these patients, 13 patients had complained of palm-sole hyperhidrosis, 9 of palm-sole-axilla hyperhidrosis, 4 of palm-sole-face hyperhidrosis and 4 of palm-sole-axilla-face hyperhidrosis. The provocative factors of excessive sweating were tension and stress from interpersonal relationships. There was positive familial history in 37%. The most common complication was compensatory hyperhidrosis in 23 patients comprising 76%. Other complication included peumothorax (4 patients), hemothorax (1 patient), ipsilateral Horner's syndrome (1 patient) and paresthesia of right arm (1 patient). The degree of satisfaction was graded as good, fair and poor with 15, 12 and 3 patients, respectively. Conclusions: Thoracoscopic sympathectomy with VATS is an efficient, safe and minimally invasive surgical procedure for essential hyperhidrosis.

• 국제물리치료학회지
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• 제10권2호
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• pp.1750-1755
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• 2019

Background: Most of the previous researches on the abnormality of breathing pattern have focused on the silence of functional movements owing to such abnormality, however, have not been clearly identified the relationship between the abnormal breathing pattern on one hand and kinesiophobia and flexion relaxation phenomenon (FRP) on the other hand. Objective: To compare patients with chronic low back pain (CLBP) and healthy person in the abnormality of breathing pattern, kinesiophobia, and FRP during flexion and extension of the trunk. Design: Case-control study. Methods: The research subjects consisted of a group of 15 healthy adults and another group of 15 patients with CLBP. Capnography was used to measure the endtidal $CO_2$ ($EtCO_2$) and respiratory quotient (RQ). The muscle activity of multifidus and erector spinae of the subjects was measured during flexion and extension of the trunk to identify their FRP. The Nijmegen Questionnaire (NQ) and Tampa Scale of Kinesiophobia (TSK) were utilized to measure their breathing patterns and kinesiophobia, respectively. The Kolmogorov-Smirnov (K-S) test was conducted in order to analyze the normal distribution of the measured data. Their general characteristics were identified by the descriptive statistics and the independent t-test was performed to identify the differences between the two groups in terms of abnormality of breathing pattern, kinesiophobia, and FRP. The level of significance was set at ${\alpha}=.05$. Results: The patients with CLBP had significantly less $EtCO_2$ and shorter breathing hold time (BHT) than normal healthy person (p<.05). The patient with CLBP also had significantly greater kinesiophobia than healthy person (p<.05), and had less FRP than the healthy person (p<.01). Conclusions: These results suggest that the CLBP had greater abnormality of breathing pattern and kinesiophobia with less FRP than healthy person.

• Journal of Acupuncture Research
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• 제29권5호
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• pp.187-195
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• 2012

Objectives : Amyotrophic lateral sclerosis(ALS) is a progressive and incurable disease that causes degeneration of the motor neurons of the brain stem and spinal cord. The purpose of this study was to report the effectiveness of Sa-am acupuncture treatment on ALS patient. Methods : Following the stabilization period, a ALS patient respiratory figures(Et $C_{O2}$, Sp $_{O2}$, RR, pulse) were measured by using capnography & pulse oximetry for 30 minutes before acupuncture treatment. Acupuncture treatment such as lung tonification($SP_3(+){\cdot}LU_9(+){\cdot}HT_8(-){\cdot}LU_{10}(-)$), heart tonification($HT_9(+){\cdot}LR_1(+){\cdot}SI_8(-){\cdot}KI_{10}(-)$), liver tonification ($KI_{10}(+){\cdot}LR_8(+){\cdot}LU_8(-){\cdot}LR_4(-)$) were conducted for 5 days. Each Sa-am acupuncture treatment conducted at AM 7 : 00, AM 11 : 00, PM 4 : 30 of the day. During acupuncture treatment, the patient respiratory figures were measured equally for 30 minutes. The patient was treated by using Dong-bang acupuncture needles($0.30{\times}4.0$) and also stimulated using infra red. Results : The value of Et $C_{O2}$ has decreased more after Sa-am acupuncture lung tonification treatment than others. The value of pulse has decreased more after Sa-am acupuncture heart tonification treatment than others. The value of raspiration rate has decreased more after Sa-am acupuncture liver tonification treatment than others. And the value of Sp $O_2$ has increased more after Sa-am acupuncture liver tonification treatment than others. Conclusions : Although this study was subject to a few limitations, but it shows that Sa-am acupuncture treatment for ALS patients has a meaningful effect. This study needs to be developed further using a larger sample size to obtain more valuable and meaningful data.

• 대한통합의학회지
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• 제7권2호
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• pp.1-10
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• 2019

Purpose : To investigate the relationship between breathing pattern disorder and joint position error (JPE) in patients with chronic low back pain (CLBP). Methods : Thirty nine patients with CLBP participated. End-tidal $CO_2$ and respiration rate (RR) were measured using a capnography. Breathing-hold time (BHT) and Nijmegen Questionnaire (NQ) were investigated. Thoracic excursion was measured with a cloth tape measurement technique. Joint position error were measured using a small laser point mounted on a lightweight headband. they were asked to relocate the head, after the neck movement on the horizontal plane. Pearson 's test was used for correlation analysis between respiratory variables and JPE in patients with CLBP. Independent t-test was used to verify the difference between thoracic and diaphragm breathing pattern in patients with CLBP. The significance level was set at 0.05. Results : There was a significant correlation between JPE (LR) and JPE (RR, EX) (r=.639, r=.813) (p<.001) and a low negative correlation with end-tidal $CO_2$ (r=-.357) (p<.05). There was a significant correlation between RR and JPE (EX) (r=.750) (p<.001). There was a low correlation between JPE (EX) and NQ (r=.333) (p<.05). There was a somewhat high negative correlation between NQ and thoracic excursion (r=-.528) (p<.001). There was a somewhat high negative correlation between thoracic excursion and JPE (LR, RR, EX) (r=-.470, r=-.484, r=-.602) (p<.001). There were no significant differences in the RR, BHT, NQ, and thoracic excursion between the thoracic and diaphragmatic breathing (p>.05). There was a significant difference in the JPE (EX), end - tidal $CO_2$, and VAS values between the thoracic and diaphragm breathing (p<.05). Conclusion : There was a correlation between JPE (EX) and NQ in patients with CLBP, and correlation between thoracic excursion and JPE (LR, RR, EX) and NQ. There was a significant difference in the JPE (EX), end-tidal $CO_2$ level, and VAS value in the comparison of thoracic breathing and diaphragm breathing. The results showed that breathing patterns and JPE were related to each other.

• 한국엔터테인먼트산업학회논문지
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• 제14권4호
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• pp.355-363
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• 2020

이 연구는 만성요통환자의 호흡패턴이상과 통증관의 상관관계를 알아보기 위해 실시하였다. 104명의 만성요통환자의 날숨끝 이산화탄소농도(EtCO₂)와 호흡률을 카프노그래프를 통해 측정하였고, 호흡유지시간과 Nijmegen Questionnaire, 가슴우리 움직임거리, 시각적사상척도를 추가로 평가하였다. Pearson's 검사로 상관관계를 분석하였으며, 결과는 EtCO₂와 BHT, 가슴우리 움직임거리에서 통계적으로 유의한 상관관계를 보였으며(r=.302, r=.281)(p<.01), RR과 VAS에서 낮은 음의 상관관계(r=-.253,-.200)(p <.05)를 보였다. RR과 NQ에서도 유의한 상관관계를 보였으며(r=.237)(p<.05). 가슴우리 움직임거리와 VAS사이에서는 낮은 음의 상관관계를 보였다(r=-.370)(p<.01). 가슴 호흡과 가로막호흡 사이의 EtCO₂, RR, BHT, 가슴우리 움직임거리, 그리고 VAS에서 통계적으로 유의한 차이가 있었으며(p<.05), NQ에서는 유의한 차이가 없었다(p>.05). 만성요통환자의 EtCO₂, BHT, 가슴우리움직임거리, RR, 그리고 VAS 사이에는 상관관계가 있었다. 또한, RR과 NQ, 흉부 소풍과 VAS 사이에는 상관관계를 보였다. 결과적으로 호흡패턴이상과 통증 사이에는 밀접한 관계가 있었으며, 가슴호흡과 가로막호흡의 비교에서 EtCO₂, RR, BHT, 가슴우리 움직임거리 및 VAS에서 유의한 차이가 있었다. 이것은 만성요통환자의 재활 및 통증 관리에서 호흡패턴중재가 기초자료로 사용될 수 있을 것으로 사료된다.