• Journal of Chest Surgery
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• 제51권4호
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• pp.277-279
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• 2018

A 68-year-old man presented with a posterior tracheal wall injury caused by percutaneous dilatational tracheostomy. The wound was immediately covered with an absorbable polyglycolic acid sheet. Ten days after the injury, the perforation was closed with knotless sutures using a Castroviejo needle-holder through the tracheostomy. The successful repair in this case indicates the feasibility of the knotless suture technique for perforations. The technique is described in detail in this report. The patient was weaned from the mechanical ventilator on postoperative day 25. In cases of posterior tracheal posterior wall perforation, every effort should be made to repair the perforation through an existing opening.

• Journal of Chest Surgery
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• 제45권3호
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• pp.186-188
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• 2012

Status asthmaticus is a rare, fatal condition, especially in children. Sometimes respiratory support is insufficient with a mechanical ventilator or medical therapy for patients with status asthmaticus. In such situations, early extracorporeal membrane oxygenation application is a useful method for treating refractory respiratory failure. We report on a case of a six-year-old, male child who underwent venovenous extracorporeal membrane oxygenation support for refractory status asthmaticus.

• International Journal of Air-Conditioning and Refrigeration
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• 제13권2호
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• pp.83-88
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• 2005

This study investigates the air leakage and heat transfer characteristics of a commercially available rotary-type air-to-air heat exchanger with a fiber polyester matrix. Crossover leakage between the exhaust and supply air is measured using a tracer gas method for various ventilation rates and rotational speeds of the wheel. A correlation equation for the leakage is obtained by summing up pressure leakage and carryover leakage. The pressure leakage is observed to be a function of ventilation rate only, and the carryover leakage is found to be a linear function of wheel speed. The real efficiency of the heat exchanger can be obtained from its apparent efficiency by taking into account the leakage ratio. The heat recovery efficiency decreases, as the ventilation rate increases. As the wheel speed increases, however, the efficiency increases initially but reaches a constant value for the speeds over 10rpm.

• 설비공학논문집
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• 제19권2호
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• pp.175-182
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• 2007

The objective of the present study is to investigate the heat storage characteristics of a packed bed according to periodically oscillating flows. Experiments have been performed to measure transient temperature distributions in solid and fluid Phases of the porous media. A simplified analytical model has been developed with intra-particle and dispersion effects neglected, and non-dimensional parameters have been derived. The transient temperature distributions according to the simplified numerical model agree well with the experimental results. Heat storage efficiencies defined in two different ways are obtained for various time periods and face velocities.

• Tuberculosis and Respiratory Diseases
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• 제77권1호
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• pp.6-12
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• 2014

Severe sepsis is the most common cause of death among critically ill patients in non-coronary intensive care units. In 2002, the guideline titled "Surviving Sepsis Campaign" was published by American and European Critical Care Medicine to decrease the mortality of severe sepsis and septic shock patients, which has been the basis of the treatment for those patients. After the first revised guidelines were published on 2008, the most current version was published in 2013 based on the updated literature of until fall 2012. Other important revised guidelines in critical care field such as 'Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit' were revised in 2013. This article will review the revised guidelines and several additional interesting published papers of until March 2014, including the part of ventilator-induced lung injury and the preventive strategies.

• 터널과지하공간
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• 제20권2호
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• pp.92-96
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• 2010

본 연구에서는 지하공간에서 화재 발생시 배연장비의 연기배출 성능을 평가하기 위하여 실험을 실시하였다. 배연장비로는 이동식 송풍기를 사용하였으며 가연물질로는 에탄올을 사용하였다. 한 변의 길이가 80cm의 정사각형 화원을 사용하였으며 최대 열방출률은 약 460 kW이다. 급기방식 배연의 영향을 평가하였다. 급기방식의 경우 실내의 가시도 향상 및 온도감소 효과를 확인할 수 있었다.

• 대한설비공학회:학술대회논문집
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• 대한설비공학회 2006년도 하계학술발표대회 논문집
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• pp.423-428
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• 2006

Twenty nine HRV models have been tested for last two years since the attestation system has been started by KARSE. It is the objective of the present study to analyze the performance test results. Uncertainty analysis has been conducted to find the effects of measured variables on the uncertainties of test results. The uncertainty of enthalpy is found to be affected by the uncertainty of wet bulb temperature significantly, but not by that of dry bulb temperature for the present range of parameters. The uncertainty of effective enthalpy efficiency is calculated to be 6%P for the cooling condition, and 3%P for the heating condition approximately. In order to reduce the uncertainty of the test results, the uncertainty of wet bulb temperature should be minimized and the indoor/outdoor test conditions should be modified so as to increase the enthalpy difference.

• 한국임상약학회지
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• 제24권1호
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• pp.9-14
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• 2014

Background: It is known to reduce the mortality when glutamine is supplied to patients during the surgery or in intensive care unit through intravenous nutrition supply. The purpose of this study is to establish the appropriate basis for use of glutamine and guidelines of nutrition supply for critically ill patients in the hospital by examining the clinical effects of administration of glutamine with subjects of elderly critically ill patients receiving intravenous nutrition in one hospital in Korea. Method: Among elderly patients with age of 60 or more hospitalized in Yeuido St. Mary's Hospital from August 2012 to July 2013, those who stayed in the intensive care unit for more than a week and received TPN (Total Parenteral Nutrition) for more than 3 days during staying in the intensive care unit were classified to a test group using glutamine and a control group without glutamine. Duration of use of mechanical ventilator, duration of hospitalization, occurrence of infectious disease and death were compared between two groups. We would like to identify the clinical test figures affected by the use of glutamine by examining changes in SCr, Total Protein, Albumin, AST, ALT, TB, DB and GFR at the time of admission and discharge. Results: At the time of admission to intensive care unit, gender, physical measurement information and clinical test figures did not show any significant difference between 72 subjects in a test group and 24 subjects in a control group. Thus, two groups began in the same condition. There were no significant difference in duration of hospitalization, duration of intensive care unit, use of mechanical ventilator, occurrence of infectious disease and death. As the results of statistical analysis of the average changes of clinical test figures at the time of admission and discharge of intensive care unit, SCr and GFR were significantly changed in the test group. GFR was significantly changed in a control group. As the result of analysis of the clinical test figures at the time of discharge with reflection of average changes after clinical test figures were corrected at the time of admission of intensive care unit, TB and GFR were significantly increased in a test group compared with those in a control group. Other clinical test figures were not significantly changed. Conclusion: If glutamine is administered to critically ill patients over age 60 receiving TPN and careful monitoring for total bilirubin is made in the future, it is expected to give the positive effect on renal function andminimize the side effect of arise in total bilirubin.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.170-174
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• 2013

Purpose: A flail chest is one of most challenging problems for trauma surgeons. It is usually accompanied by significant underlying pulmonary parenchymal injuries and mayled to a life-threatening thoracic injury. In this study, we evaluated the treatment result for a flail chest to determine the effect of trauma localization on morbidity and mortality. Methods: Between 2004 and 2011, 46 patients(29 males/17 females) were treated for a flail chest. The patients were divided into two group based on the location of the trauma in the chest wall; Group I contained patients with an anterior flail chest due to a bilateral costochondral separation (n=27) and Group II contained patients with a single-side posterolateral flail chest due to a segmental rib fracture (n=19). The location of the trauma in the chest wall, other injuries, mechanical ventilation support, prognosis and ISS (injury severity score) were retrospectively examined in the two groups. Results: Mechanical ventilation support was given in 38 patients(82.6%), and 7 of these 38 patients required a subsequent tracheostomy. The mean ISS for all 46 patients was $19.08{\pm}10.57$. Between the two groups, there was a significant difference in mean ventilator time (p<0.048), but no significant difference in either trauma-related morbidity (p=0.369) or mortality (p=0.189). Conclusion: An anterior flail chest frequently affects the two underlying lung parenchyma and can cause a bilateral lung contusion, a hemopneumothorax and lung hemorrhage. Thus, it needs longer ventilator care than a lateral flail chest does and is more frequently associated with pulmonary complications with poor outcome than a lateral flail chest is. In a severe trauma patient with a flail chest, especially an anterior flail chest, we must pay more attention to the pulmonary care strategy and the bronchial toilet.

• Journal of Trauma and Injury
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• 제21권2호
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• pp.115-119
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• 2008

Purpose: Abrupt abstinence from alcohol in cause of chronic alcohol addiction can trigger alcohol withdrawal syndrome. The authors studied the effect of post-operative alcohol withdrawal syndrome in patients who require intensive care due to trauma. Methods: For the study group, we selected 70 patients who had undergone emergency surgery from May 2003 to March 2007 due to trauma and who had been treated with prophylactic thiamine. Data was collected retrospectively. We excluded those who extended their hospital stay for other than traumatic causes, those who died within 3 days of surgery after trauma, those who transferred to other institutions, and those who received a psychiatric diagnosis. Patient groups were determined by the existence or the non-existence of withdrawal syndrome. Age, sex, injury mechanism, mortality, complications, durations of hospital stay and intensive care, use of mechanical ventilator, and sedative use were investigated. A Chi-square test and The Mann-Whitney method were used for statistical analysis in this study. Results: Twenty-four (24) patients from the 58 who had an ISS of 16 or more showed alcohol withdrawal syndrome, and men were shown to be affected with the syndrome significantly more than women. Although ISS was higher in the group with alcohol withdrawal syndrome, statistically, the difference was not significant (P<0.08). The total hospital stay in the patient group with alcohol withdrawal syndrome was on average 10 days longer. However, the difference was not significant (P<0.054). The duration of intensive care in the patient group with alcohol withdrawal syndrome was significantly longer (P<0.029). The patients with alcohol withdrawal syndrome showed no significant difference in the duration of mechanical ventilator use (P<0.783), or in the duration of sedative use (P<0.284). Respiratory distress, pneumonia, upper airway infection, sepsis, acute renal failure, and mortality in the alcohol withdrawal syndrome group were investigated, but no statistically significant difference were noted. Conclusion: We found that the duration of intensive care in chronic alcohol abusers was longer due to the development of alcohol withdrawal syndrome. We also discovered that, when the patients overcame the symptoms of alcohol withdrawal syndrome after intensive care, no difference was found in the frequency of developing complications, the morbidity, and the mortality. Therefore, we conclude that intensive care in trauma patients who are chronic alcohol abusers decreases the incidence of complications found in patients with post-operative alcohol withdrawal syndrome and does not adversely impact the prognoses for those patients.