• KSII Transactions on Internet and Information Systems (TIIS)
• /
• 제17권8호
• /
• pp.2016-2029
• /
• 2023

Accurate prediction of critical illness is significant for ensuring the lives and health of patients. The selection of indicators affects the real-time capability and accuracy of the prediction for critical illness. However, the diversity and complexity of these indicators make it difficult to find potential connections between them and critical illnesses. For the first time, this study proposes an indicator analysis model to extract key indicators from the preoperative and intraoperative clinical indicators and laboratory results of critical illnesses. In this study, preoperative and intraoperative data of heart failure and respiratory failure are used to verify the model. The proposed model processes the datum and extracts key indicators through four parts. To test the effectiveness of the proposed model, the key indicators are used to predict the two critical illnesses. The classifiers used in the prediction are light gradient boosting machine (LightGBM) and eXtreme Gradient Boosting (XGBoost). The predictive performance using key indicators is better than that using all indicators. In the prediction of heart failure, LightGBM and XGBoost have sensitivities of 0.889 and 0.892, and specificities of 0.939 and 0.937, respectively. For respiratory failure, LightGBM and XGBoost have sensitivities of 0.709 and 0.689, and specificity of 0.936 and 0.940, respectively. The proposed model can effectively analyze the correlation between indicators and postoperative critical illness. The analytical results make it possible to find the key indicators for postoperative critical illnesses. This model is meaningful to assist doctors in extracting key indicators in time and improving the reliability and efficiency of prediction.

• 한국임상약학회지
• /
• 제34권3호
• /
• pp.194-201
• /
• 2024

Background: Asthma is a chronic inflammatory airway disease associated with systemic inflammation and increased prevalence of various comorbid conditions. This study investigates the prevalence of non-respiratory comorbidities among adult asthma patients in South Korea, aiming to elucidate potential correlations and impacts of asthma on overall health, thereby affecting patients' quality of life and healthcare systems. Methods: This retrospective cohort study utilized the National Health Insurance Service data (HIRA-NPS-2020) and included adults diagnosed with asthma. Non-respiratory diseases were identified using the Korean Standard Disease Classification (KCD-8) codes, with exclusions applied for other respiratory conditions. The prevalence of comorbidities was analyzed and compared between asthma and non-asthma patients, adjusting for confounders such as age, gender, and insurance status through inverse probability treatment weighting (IPTW). Results: The analysis revealed that asthma patients exhibit significantly higher rates of cardiovascular diseases, metabolic disorders, gastrointestinal conditions, and mental health issues compared to the control group. Notably, conditions such as heart failure, gastroesophageal reflux disease, and anxiety were more prevalent, with odds ratios (OR) ranging from 1.18 to 3.90. These results demonstrate a substantial burden of comorbidities associated with asthma, indicating a broad impact on health beyond the respiratory system. Conclusion: The findings highlight the systemic nature of asthma and the interconnectedness of inflammatory processes across different organ systems. This comprehensive analysis confirms previous research linking asthma with an increased risk of various non-respiratory diseases, providing insights into the multifaceted impact of asthma on patient health.

• 대한소아치과학회지
• /
• 제42권4호
• /
• pp.327-330
• /
• 2015

어린이와 청소년을 대상으로 한 치과 진정법에서 환자 안전과 성공의 열쇠는 호흡기 상태와 밀접하게 연관되어 있다. 소아치과의 특별한 상황 - 똑바로 누운 자세에서 러버댐으로 구강 측 기도가 제한 된 상태-하에서 코로 호흡함을 고려해야 한다. 따라서 소아치과의사는 의과적 자문이나 평가와 별도로, 스스로 이러한 상황하에서 환자의 호흡기적 평가를 할 필요가 있다. 특히, 아데노이드 비대, 코막힘, 후비루와 기도과민 등의 상황을 평가하는 것이 중요하다. 부비동염, 알레르기 비염, 천식, 코골이와 폐쇄성 수면 무호흡 증후군 등이 있는 환자는 진정 실패를 초래할 가능성이 있으므로, 질환이나 증상에 대한 확실한 조절을 통하여 치과 진정법의 안전성을 더욱 증진 시킬 수 있을 것이다.

• Clinical and Experimental Pediatrics
• /
• 제59권10호
• /
• pp.389-394
• /
• 2016

The incidence of bronchopulmonary dysplasia (BPD) has not decreased over the last decade. The most important way to decrease BPD is by weaning the patient from the ventilator as soon as possible in order to reduce ventilator-induced lung injury that underlies BPD, and by using a noninvasive ventilator (NIV). Use of a heated, humidified, high flow nasal cannula (HHHFNC), which is the most recently introduced NIV mode for respiratory support in preterm infants, is rapidly increasing in many neonatal intensive care units due to the technical ease of use without sealing, and the attending physician's preference compared to other NIV modes. A number of studies have shown that nasal breakdown and neonatal complications were lower when using a HHHFNC than when using nasal continuous positive airway pressure (nCPAP), or nasal intermittent positive pressure ventilation. The rates of extubation failure during respiratory support were not different between patients who used HHHFNC and nCPAP. However, data from the use of HHHFNC as the initial respiratory support "after birth", particularly in extremely preterm infants, are lacking. Although the HHHFNC is efficacious and safe, large randomized controlled trials are needed before the HHHFNC can be considered an NIV standard, particularly for extremely preterm infants.

• 생명과학회지
• /
• 제11권3호
• /
• pp.259-265
• /
• 2001

Mercury vapor inhalation-induced acute respiratory failure(ARF) has been reported to be fatal. This study was designed to observe the possible mechanism of inhaled mercury vapor poisoning in the respiratory system. Sixty percent of rats(12/20) exposed to mercury vapor were dead within 72 hours of exposure whereas all the rats(20/20) exposed to mercury vapor combined with dithiothreitol(DTT) vapor survived. The histological observation showed that ARF was a direct cause of the death induced by mercury vapor inhalation, which was significantly circumvented by DTT vapor. Cyclic AMP mediated chloride secretion was inhibited by luminal side but not serosal side sulfhydryl blocking agents (Hf$^{2+}$ $\rho$-chloromercuribenzoic acid or $\rho$-chloromercuriphenyl sulfonic acid) in a dose-dependent manner in a primary cultured rat airway monolayer. The inhibitory component of cAMP induced chloride secretion was completely restored by luminal side DTT(0.5mM). these results suggest that the oxidized form(Hg$^{2+}$) of mercury vapor(Hg0) contribute to ARF and subsequent death. The finding is important as it can provide important information regarding emergency manipulation of ARF patients suffering from by mercury vapor poisoning.ing.

• Tuberculosis and Respiratory Diseases
• /
• 제83권2호
• /
• pp.132-140
• /
• 2020

In human immunodeficiency virus (HIV)-infected patients, Pneumocystis jirovecii pneumonia (PCP) is a well-known opportunistic infection and its management has been established. However, PCP is an emerging threat to immunocompromised patients without HIV infection, such as those receiving novel immunosuppressive therapeutics for malignancy, organ transplantation, or connective tissue diseases. Clinical manifestations of PCP are quite different between patients with and without HIV infections. In patients without HIV infection, PCP rapidly progresses, is difficult to diagnose correctly, and causes severe respiratory failure with a poor prognosis. High-resolution computed tomography findings are different between PCP patients with HIV infection and those without. These differences in clinical and radiological features are due to severe or dysregulated inflammatory responses that are evoked by a relatively small number of Pneumocystis organisms in patients without HIV infection. In recent years, the usefulness of polymerase chain reaction and serum β-D-glucan assay for rapid and non-invasive diagnosis of PCP has been revealed. Although corticosteroid adjunctive to anti-Pneumocystis agents has been shown to be beneficial in some populations, the optimal dose and duration remain to be determined. Recent investigations revealed that Pneumocystis colonization is prevalent and that asymptomatic carriers are at risk for developing PCP and can serve as the reservoir for the spread of Pneumocystis by airborne transmission. These findings suggest the need for chemoprophylaxis in immunocompromised patients as well as infection control measures, although the indications remain controversial. Because a variety of novel immunosuppressive therapeutics have been emerging in medical practice, further innovations in the diagnosis and treatment of PCP are needed.

• Tuberculosis and Respiratory Diseases
• /
• 제80권4호
• /
• pp.351-357
• /
• 2017

In 2011, a cluster of peripartum patients were admitted to the intensive care unit of a tertiary hospital in Seoul with signs and symptoms of severe respiratory distress of unknown etiology. Subsequent epidemiological and animal studies suggested that humidifier disinfectant (HD) might represent the source of this pathology. Epidemiological studies, animal studies, and dose-response analysis demonstrated a strong association between HD use and lung injuries. The diagnostic criteria for HD-associated lung injury (HDALI) was defined on the basis of the clinical, pathological, and radiological attributes of the patients. The clinical spectrum of HDALI appears to range from asymptomatic to full-blown acute respiratory failure, and some patients have required actual lung transplantation for survival. The overall mortality of the exposed population was not significant, although peripartum patients and children who were admitted to the intensive care unit did show high mortality rates. Persistent clinical findings such as diffuse ill-defined centrilobular nodules and restrictive lung dysfunction were observed in some of the survivors. The findings of this review emphasize the importance of assessment of the level of toxicity of chemical inhalants utilized in a home setting, as well as the need to identify and monitor afflicted individuals after inhalational injury.

• 한국동물위생학회지
• /
• 제47권2호
• /
• pp.95-100
• /
• 2024

An 11-year-old neutered male Dachshund dog weighing 7 kg presented with acute onset of respiratory distress after subcutaneous administration of cytosine arabinoside (CA). The patient previously diagnosed with meningoencephalitis of unknown origin and was being treated with oral prednisolone, levetiracetam, potassium bromide, gabapentin, and periodic subcutaneous CA administration (50 mg/m², q 12 h, subcutaneous, 4 times, every 3 weeks). The patient developed tachypnea with labored respiratory effort after 9th CA administration. Thoracic radiograph revealed bilateral diffuse interstitial to alveolar pulmonary opacities, and echocardiogram indicated no evidence of left-sided heart failure. Based on the onset coinciding with the administration of CA, low possibility of other pulmonary disease, remission of symptom showed after discontinuation of CA, we suspected CA-induced interstitial lung disease. The patient's pulmonary opacities on the radiograph improved to a similar degree as before the adverse event over time, but respiratory symptoms were not fully resolved. Sildenafil (2 mg/kg, per oral, q 12 h) was given as therapeutic trial to manage possible pulmonary hypertension, suspected a sequela of the lung disease, based on an echocardiographic evidence and clinical signs. The patient's respiratory symptom was well managed since, and achieved discontinuation of sildenafil.

• 대한소아치과학회지
• /
• 제44권2호
• /
• pp.243-255
• /
• 2017

심폐소생술(cardiopulmonary resuscitation, CPR)은 심장의 기능이 정지하거나 호흡이 멈추었을 때 인공적으로 혈액을 순환시키고 호흡을 보조해 주는 응급처치이다. 심폐소생술은 기본생명구조술(basic life support, BLS)과 전문소생술(advanced life support, ALS)로 나눌 수 있다. 기본생명구조술은 주요 조직으로 혈류 공급을 강제적으로 하기 위한 흉부압박과 호흡정지 환자에게 구조호흡(rescue breathing) 그리고 심실세동을 개선해 주기 위한 자동제세동기(automated external defibrillator, AED)이 포함된다. 전문소생술의 범주는 성인을 대상으로 하는 고급생명구조술(advanced cardiovascular life support, ACLS)과 소아를 대상으로 하는 소아고급생명구조술(pediatric advanced life support, PALS)이 있다. 치과 치료에 극심한 공포를 가지며, 여러 이유로 치과 진료에 협조를 얻기 어려운 소아를 대상으로 하는 치료환경에서는 약물을 이용한 진정법이 고려된다. 이는 심정지를 포함한 응급상황이 발생할 가능성이 증가하는 이유가 된다. 소아고급생명구조술은 기본생명구조술을 포함하며, 심정지에 이를 수 있는 원인을 호흡, 순환장애 그리고 심인성으로 나누어 대처하는 체계적인 방법을 제시한다. 소아는 성인에 비해 심인성의 원인은 낮지만, 해부학적인 약점으로 인해 호흡이나, 순환장애에 의한 심정지의 가능성은 높다. 따라서, 스트레스를 많이 받은 아이를 치료하거나 진정법을 시행하는 소아치과의사는 소아고급생명구조술을 익힘으로써 응급상황에 적절히 대처할 수 있는 역량을 갖출 수 있으리라 사료된다.

• Journal of Chest Surgery
• /
• 제43권1호
• /
• pp.104-107
• /
• 2010

급성호흡부전증후군은 치료가 어렵고 치명율이 높다. 인공호흡기 치료에 반응하지 않는 중증의 경우 체외막 산화기(Extracorporeal membrane oxygenation, ECMO)가 적용되고 있다. 교통사고로 다발성 외상을 받은 21세 여자가 흉부 방사선상 양측폐에 심한 침윤 소견과 동맥혈가스 검사상 급성호흡부전증후군(Acute respiratory distress syndrome, ARDS)으로 판단되어 정맥동맥 체외산화기(Veno- arterial Extracorporeal Membrane Oxygenation, VA ECMO) 치료를 시작하였다. ECMO 적용 2일째 흉부 방사선상 폐 침윤 소견 악화되면서 동맥혈 산소 포화도(Systemic oxygen saturation, $SaO_2$)가 85% 미만으로 저하되었다. 이에 중추신경계와 폐의 산소화를 향상시키기 위해 ECMO의 유출로에 곁회로를 이용하여 우측 경정맥에 연결하여 정맥-정맥동맥 ECMO (Veno-venoarterial ECMO, V-VA ECMO)로 전환하였고 이후 동맥혈 산소 분압($PaO_2$) 65 mmHg, $SaO_2$ 94%로 향상되었다. V-VA ECMO로의 전환은 전신에 산소 공급을 늘리기 위해 고려해 볼 수 있는 방법으로 생각된다.