• Title/Summary/Keyword: mechanical ventilator

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A Study of the Indoor Thermal Environment in Apartment Buildings in Freezing Weather Operation of Heat Recovery Ventilator by CFD Simulation (CFD를 이용한 열회수형 환기장치 운전에 따른 혹한기 공동주택의 실내 열환경 검토)

  • Kim, Chang-Yeon;Park, Jong-Il;Kim, Dong-Gyu;Shin, Byong-Hwan;Kum, Jong-Soo
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.27 no.6
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    • pp.293-299
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    • 2015
  • In Korea, it is the law that an apartment building which consists of over 100 households must have a ventilation system installed, either natural or mechanical. The heat recovery ventilator (HRV) is great way to reduce energy consumption. In this research we confirmed that based on site's construction plan and existing diffuser form, performed purpose CFD which simulates operation in temperatures below $-5^{\circ}C$ to circumstances of installation of an HRV in an apartment. As a result of this research we found that when the diffuser's aperture area was adjusted, the distribution of air temperature and residence time of air was more equally distributed and air temperature was higher, compared to when the diffuser has an identical aperture area. We also found that we are able to increase even more air temperature and air distribution of air temperature and residence time of air was even more equally distributed when run in parallel with a splitter damper.

Risk Factors for Nosocomial Pneumonia in Patients at NS ICU (신경외과 중환자실의 병원성 폐렴 발생 위험요인)

  • Kim Nam Cho;Kim So Yeon
    • Journal of Korean Public Health Nursing
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    • v.15 no.2
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    • pp.239-248
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    • 2001
  • The purpose of this study was to analyze risk factors for nosocomial pneumonia in patients admitted to NS ICU, and to provide a basic data to decrease respiratory nosocomial infection rate engendered from medical environments in NS ICU. The study site was the NS ICU at a university hospital located in Seoul, Korea. The subjects were 31 patients diagnosed with nosocomial pneumonia, who were selected from the initial list of 300 potential subjects who had been a) admitted between September 1999 and January 2000, and September 2000 and January 2001, b) resided at the NS ICU over 72 hours. The diagnostic standard of nosocomial pneumonia was based on the nosocomial infection guides of C university hospital. The data were analyzed using frequencies and logistic regression analysis. The sputums obtained from the subjects were cultivated and causal viruses were separated. The results were as follows: 1. The nosocomial pneumonia rate was $10.3\%$. There were 7 types of causal viruses separated from the sputum. and the most prevalent type of virus was MRSA as $62.2\%$. 2. The factors significantly influencing the incidence of nosocomial pneumonia included age, the residential duration at the NS ICU, GCS scores, diabetes mellitus, insertion of tracheal tube and its duration, tracheostomy and its length of insertion, the use of artificial ventilator and the length of its use, and the insertion of naso-gastic tube. The most significant risk factor among these was the insertion of tracheal tube (odds ratio=18.684. $95\%$ CI=6.849-50.974), followed by the use of tracheostomy (odds ratio=15.419, $95\%$ CI=6.615-35.942), the insertion of naso-gastric tube (odds ratio=14.875, $95\%$ CI=6.396-34.595), and the use of artificial ventilator (odds ratio=13.000. $95\%$ CI=5.633­30.001). 3. Regarding the use of the mechanical aids, the insertion of tracheal tube resulted in 12.968 times increase of the nosocomial pneumonia rate, and the use of artificial ventilator lead 6.714 times increase of the nosocomial pneumonia rate. One point increase of the GCS score resulted in the 1.210 times increase of the nosocomial pneumonia rate. For patients who had tracheal tube, tracheostomy, and artificial ventilator, one day increase of their residential duration at NS ICU lead 1.073 times increase of the nosocomial pneumonia rate. 4. In terms of duration of the mechanical aid usage, one day increase in the use of artificial ventilator engendered 1.080 times increase in the nosocomial pneumonia rate. One day increase of the residential duration at the NS ICU lead 1.604 times increase in the nosocomial pneumonia rate. As one point of the GCS score increased, 0.876 times decrease of the nosocomial pneumonia rate was reported. These study findings show that the risk factors significantly influencing the incidence of nosocomial pneumonia include the use of tracheal tube, tracheostomy, naso-gastic tube, and artificial ventilator. It is recommended that nurses working at NS ICU should pay more attention to the patients with these factors as the risky group for the nosocomial pneumonia, and thus make more active efforts to provide nosocomial pneumonia prevention strategies for them. In further studies patients admitted to the different types of ICUs such as internal medicine or surgery unit ICU will be also included, and more wide investigation of nosocomial pneumonia risk factors will be conducted through one-year longitudinal follow up.

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Survey on the Care Burden and Quality of Life in Family Caregivers of Patients Using Home Mechanical Ventilator in Yeongnam Region, Korea (영남권역에서 가정용 인공호흡기를 사용하는 환자 가족간병인의 간병 부담과 삶의 질)

  • Son, Ju-Hyun;Moon, Myung-Hoon;Cho, Mi-Kyung;Yun, Ra-Yu;Huh, Sung-Chul;Min, Ji-Hong;Moon, Jung-In;Kim, Soo-Yeon
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.1
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    • pp.39-49
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    • 2020
  • Objective : The aim of this study was to investigate the care burden and life quality in family caregivers of community-dwelling patients using home mechanical ventilator(HMV) in Yeognam region. Methods : Survey performed to family caregivers of the patients using HMV in Yeognam region, Korea. The questionnaire is composed with patient care and the burden on caring. Korean version of Short Form Zarit Burden Interview(K-ZBI-12) and 3-Level version of EuroQol-5 Dimension applying Korean weight(KEQ-5D-3L) were also investigated. Statistical significance was accepted for p<.05. Results : A total 98 out of 150 questionnaires were analyzed. The K-ZBI-12(33.08±10.34) had a correlation with KEQ-5D-3L(0.71±0.25) negatively(p=.038). Patients' age, duration of HMV, financial burden and professional caregivers' care time had correlations with K-ZBI-12 positively(p<.05). KEQ-5D-3L correlated duration of HMV negatively(p=.017). Invasive ventilator group had lower KEQ-5D-3L than the non-invasive ventilator group(p=.008). K-ZBI-12 was lower in more than one caregiver care of patients than in one(p=.001). Conclusion : This study revealed high care burden and low quality of life in family caregivers of the patients with HMV in Yeongnam region, Korea. Efforts are needed to continually identify the needs of patients and their families, and the socioeconomic support and medical services associated with HMV.

Control Method to Ensure Uniform Exhaust Function by Household of Apartment House (공동주택의 세대별 균등 배기량을 확보 하는 제어방법에 관한 연구)

  • Kwon, Yong-Il
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.29 no.12
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    • pp.628-637
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    • 2017
  • This study was conducted to present an effective control method for the common duct system to uniformly discharge volume flow rate exhausted from the kitchen and bathroom of each household in an apartment regardless of the position of household. Since the common duct system is installed vertically and the ventilator is installed in the terminal, the static pressure of each household decreases when vertical height increases. Therefore, the volume flow rate exhausted from each household is different. In order to improve such a phenomenon, a constant air volume damper shall be installed in a branch duct coupled with a common vertical duct system. The selected ventilator should also be able to handle the maximum volume flow rate considering diversity factor. Therefore, a uniform volume flow rate must be exhausted from all households where the hood is operated. This paper mainly focuses on suggestion of an optimum exhaust control method by comparing exhaust performance of each household according to the presence or absence of a constant air volume damper.

Respiratory Review of 2013: Critical Care Medicine

  • Choi, Hye Sook
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.1
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    • pp.1-8
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    • 2013
  • Several papers on respiratory and critical care published from March 2012 to February 2013 were reviewed. From these, this study selected and summarized ten articles, in which the findings were notable, new, and interesting: effects of high-frequency oscillation ventilation on acute respiratory distress syndrome (ARDS); safety and efficacy of hydroxyethyl starch as a resuscitation fluid; long-term psychological impairments after ARDS; safety and efficacy of dexmedetomidine for sedation; B-type natriuretic peptide-guided fluid management during weaning from mechanical ventilation; adding of daily sedation interruptions to protocolized sedations for mechanical ventilation; unassisted tracheostomy collar of weaning from prolonged mechanical ventilations; and effects of nighttime intensivist staffing on the hospital mortality rates.

Two Cases of Falciparum Malaria with Acute Respiratory Distress Syndrome (중증 열대열 말라리아에 동반된 급성호흡곤란증후군 2예)

  • Park, Joo-Hun;Shin, Eun-Sug;Woo, Jun-Hee;Kim, Yeun-Ok;Bae, In-Gyu;Jang, Jae-Jeong;Chi, Hyun-Sook;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.888-895
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    • 1998
  • Malaria is one of the most common infectious diseases in the world. Plasmodium falciparum, accounting for nearly all malaria mortality, kills an estimated 1 to 2 million persons yearly and has several features that make it deadlist of malarias. While cerebral malaria is the most common presentation of severe disease, acute lung injury associated with malaria is uncommon but serious and fatal complication. We report two cases of severe malaria with ARDS and multi-organ failure. All two patients traveled to foreign countries, Kenya, Papua New Guinea where choroquine-resistant malaria is distributed. The first case, which developed cerebral malaria, hypoglycemia, multi-organ failure, and ARDS, treated with quinine and mechanical ventilator, but expired due to oxygenation failure. Autopsy showed acute necrotizing infiltration, diffuse eosinophilic fibrinoid deposits along the alveolar space, and alveolar macrophage with malaria pigment The second case also developed multi-organ failure, followed by ARDS, and was treated with quinine, exchange transfusion, plasmapheresis, and mechanical ventilator. He recovered with residual restrictive lung change after treatment.

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Clinical Impact of Supplementation of Vitamins B1 and C on Patients with Sepsis-Related Acute Respiratory Distress Syndrome

  • Yoo, Jung-Wan;Kim, Rock Bum;Ju, Sunmi;Lee, Seung Jun;Cho, Yu Ji;Jeong, Yi Yeong;Lee, Jong Deog;Kim, Ho Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.3
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    • pp.248-254
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    • 2020
  • Background: Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. Methods: Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018-May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017-May 2018 (the control group). Results: Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. Conclusion: Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.

Factors Influencing Stress of Nurse who care for patients using a Home Mechanical Ventilator in General Ward (병동 간호사의 가정용 인공호흡기 적용 환자 간호 스트레스 영향요인)

  • Min, Hyun Ju;Kwon, Hee Young;Shin, Chae Won;Ha, Young Jin;Kim, Hyun Jeong
    • Journal of Home Health Care Nursing
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    • v.26 no.1
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    • pp.91-101
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    • 2019
  • Purpose: The purpose of this study was to identify factors associated with stress related to home mechanical ventilator (HMV) care in general ward nurses. Methods: The study participants were 110 general ward nurses. Data on participant characteristics, level of knowledge, education needs, coping ability in emergency situations, confidence, and stress were collected from August 1 to 30, 2018 using a structured questionnaire by web-based surveys. Data were analyzed using SPSS/WIN 20.0 for descriptive statistics and independent t-test, one-way analysis of variance, Pearson's correlation coefficient, and multiple regression analysis. Results: Significant factors associated with stress related to HMV care were ward career, intensive care unit (ICU) career, intensive care room (ICR) career, education experience, and satisfaction level of HMV education. Stress had negative correlations with confidence and positive correlations with education needs. The determining factors affecting stress related to HMV care in the general ward were confidence (${\beta}=-.31$, p=.004), ICR career (${\beta}=-.27$, p<.001), education needs (${\beta}=.24$, p=.005), education frequency (${\beta}=-.18$, p=.040), and ICU career (${\beta}=-.18$, p=.025); their explanation power was about 41.8%. Conclusions: It is necessary to develop HMV care training manuals and guidelines and consider ICU or ICR careers for patient safety.

Clinical and Epidemiological Characteristics of Severe Poisoning Patients and Analysis of Prognostic Factors (중증 중독환자의 임상 역학적 특징과 예후에 영향을 주는 요인분석)

  • Jung, Young Yun;Ha, Chul Min;Jung, Sung Tae;Lee, Hyoung Ju
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.94-101
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    • 2020
  • Purpose: This study examined the clinical and epidemiological characteristics of intensive care unit (ICU) patients admitted or died in the emergency medical center with acute-poisoning to investigate the variables related to the prognosis. Methods: The data were collected from poisoning patients admitted or died in the emergency medical center of a general hospital located in Seoul, from January 2014 to February 2020. The subjects of this study were 190 patients. The medical records were screened retrospectively, and the clinical and epidemiological characteristics of the patients in the emergency room (ER) and ICU were examined to investigate the contributing factors that influence the poor prognosis. Results: The study analyzed 182 patients who survived after being admitted to the intensive care unit (ICU). The results are as follows. The mental change (87.4%) was the most common symptom. Sedative poisoning (49.5%) was the commonest cause. For most patients, pneumonia (26.9%) was the most common complication. Hypotension (23.7%), tachycardia (42.1%), fever (15.8%), seizures (10.5%), dyspnea (2.6%), high poisoning severity score (PSS), type of toxic material, mechanical ventilator application (39.5%), inotropes application (39.5%), and pneumonia (55.3%) were correlated the LOS over 5 days in the ICU. 8 patients died. In the case of death pesticides and carbon monoxide were the main toxic materials; tachycardia, bradycardia, and hypotension were the main symptoms, and a mechanical ventilator and inotropes were applied. Conclusion: Patients with unstable vital signs, high PSS, and non-pharmaceutical poisoning had a prolonged LOS in the ICU and a poor prognosis.