• Title/Summary/Keyword: 양압

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Prediction of Continuous Positive Airway Pressure Level for Treatment of Obstructive Sleep Apnea (폐쇄성 무호흡의 치료시 지속적 기도 양압치의 예측)

  • Lee, Kwan Ho;Chung, Jin Hong;Lee, Hyun Woo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.755-762
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    • 1996
  • Background : Continuous positive airway pressure(CPAP) is doubtlessly using as a medical treatment of choice for patients with obstructive sleep apnea (OSA) syndrome. CPAP is effective in OSA patients as a physical "pneumatic pressure splint" mechanism. We have done this study for two purposes, first to seek for the factors to determine the optimal CPAP titer, second to predict the minimal CPAP titer using the determined factors. Methods: We studied a 72 OSA patients who were treated with CPAP. All of them were studied by using a two nights polysomnographic rests in hospital. We compared the patients requiring CPAP over $10cmH_2O$ with those who required CPAP under 5cm $H_2O$ to determine the factors affecting the minimal CPAP titer. Results : The high CPAP group is characterized by a significantly higher body mass index(BMI), apnea index(AI) and apnea and hyponea index(AHI) and significantly lower lowest $SaO_2$. Regression analysis using the optimal four variables resulted in the following prediction equation for CPAP titer. CPAPtiter=8.382 + 0.064 ${\times}$ BMI + 0.077 ${\times}$ AI - 0.004 ${\times}$ AHI - 0.077 ${\times}$ lowest $SaO_2$ When this regression equation was applied to the 72 patients, the mean CPAP titer as predicted by the above equation was $7.80{\pm}2.96$ mmHg. Compared this value with actually determined CPAPtiter, $7.93{\pm}4.00$mmHg, there was no significant difference between the two values. Conclusion: Obesity, apnea severity and lowest Sa02 were strongly correlated with CPAP titer. Linear regression equation for CPAP titer using these indices predicted very closely the actually measured values in the sleep laboratory.

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Comparison for the Optimal Pressure between Manual CPAP and APAP Titration with Obstructive Sleep Apnea Patients (한국인 폐쇄성 수면 무호흡 환자의 적정 양압을 위한 수동화 양압 측정법과 자동화 양압 측정법의 비교)

  • Kim, Dae Jin;Choi, Byoung Geol;Cho, Jae Wook;Mun, Sue Jean;Lee, Min Woo;Kim, Hyun-Woo
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.191-197
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    • 2019
  • Although auto-adjusting positive airway pressure (APAP) titration at home has several advantages over a CPAP titration in terms of convenience and time saving, there are still concerns as to whether it will show corresponding accuracy when compared to laboratory-based polysomnography (PSG) and CPAP titration. To obtain more evidence supporting home-based auto-titration, APAP titration was performed at home for patients who were presented with OSA on laboratory-based diagnostic PSG followed by CPAP titration. A total of 79 patients were included in the study. They all underwent split-night PSG with CPAP titration, and APAP titration for more than 7 days. The patients with successful titration at both situations were selected. The optimal pressure and apnea-hypopnea index (AHI) of CPAP and APAP titration were compared. The optimal pressure for CPAP and APAP titration were $7.0{\pm}1.8cmH_2O$ and $7.6{\pm}1.6cmH_2O$ (P<0.001), whereas the corresponding AHI were $1.3{\pm}1.5/h$ and $3.0{\pm}1.7/h$ (P<0.001). As a result, the achievement rates of optimal pressure for CPAP and APAP titration were 96.2% and 94.9% (r=-0.045, P=0.688), respectively. The results of this study did not differ with regard to the optimal pressure between CPAP and APAP titration. Overall, CPAP and APAP titrations should be chosen depending on a required situation.

Nasal Continuous Positive Airway Pressure Titration and Time to Reach Optima1 Pressure in Sleep Apnea Syndrome (수면 무호흡 증후군에서 지속적 양압 치료시의 최적압 및 그 도달기간)

  • Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.84-92
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    • 1995
  • Background: Nasal applied continuous positive airway pressure(CPAP) is a highly effective method of treatment for obstructive sleep apnea syndrome. More than a decade of accumulated experience with this treatment modality confirmed that it is unquestionably the medical treatment of choice for patients with obstructive sleep apnea syndrome. However it takes long time to reach optimal CPAP pressure. To save the time to reach optimal pressure, it is necessary to clarify the time to reach optimal pressure for treatment of obstructive sleep apnea syndrome. Method: CPAP pressure is titrated during an overnight study according to a standardized protocol. Just before the presleep bio-calibration procedures, the technician applies the nasal mask and switches on the clinical CPAP unit. Initial positive for pressure is typically 3.0 centimeters of water pressure. After sleep onset, the technician gradually increases the pressure until sleep-disordered breathing events disappear or become minimal. The pressure must maintain maximal airway patency during both NREM and REM sleep to be considered effective. Before recommending a final pressure setting, sleep recording and oximetry data are reviewed by an American Board of Sleep Medicine certified Sleep Specialist and a Registrered Polysomnographic Technologist. Results: We examined the time required to reach optimal pressure during routine CPAP titration in 127 consecutively evaluated individuals diagnosed with sleep-disordered breathing. Results indicate that 33% of patients required more than four hours to attain satisfactory titration. This indicates that a four-hour session is marginally enough time, at best, to determine a proper CPAP pressure setting. Moreover, 60 of 127 patients required further adjustment after optimal pressure was reached. These additional pressure trials were needed to confirm that higher pressures were not superior for eliminating sleep-disordered breathing events. Conclusions: The data presented underscore the logistical difficulty of titrating CPAP during split-night studies without modifying the titration procedure. Futhermore, the time needed to reach optimal pressure makes it improbable that proper CPAP titration can be performed during a 2-3 hour nap study.

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Derivations of Positive Pressure Condition for Development of Foldable Safe Pathway in Railway Tunnel Fires (철도터널화재용 접이식 대피통로 개발을 위한 양압 조건 도출)

  • Kim, JiTae;Ro, Kyoungchul
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.1
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    • pp.284-289
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    • 2019
  • The Korea Foldable safe pathway system is an evacuation support system to get temporary evacuation route in railway tunnel and large space fires. A prevention smoke screen is unfolded in fires and it is needed to prevent heat and smoke from fire source. Therefore, ventilation system for positive pressure condition is equipped with foldable safe pathway system. Numerical analyses of temperature and pressure distribution with distance from fire source were performed considering fire scenario of new train vehicle. The smoke temperatures did not exceed $200^{\circ}C$ that distance from the fire source was more than 20 m and smoke pressure was reduced with distance from fire source. Maximum smoke pressure was 14 Pa and average pressure was 6 Pa in position of prevention smoke screen. As results, to install foldable safe pathway system, ventilation system is need to maintain 6 Pa positive pressure condition.

Assessment of Computed Tomographic Lung Density in Beagle and Shihtzu Dogs : Influence of Position and Positive End Expiratory Pressure (비글과 시츄견에서 호기말 양압에 따른 전산화 단층촬영상의 폐밀도의 평가)

  • Kim, Tae-Hun;Chang, Jin-Hwa;Yun, Seok-Ju;Yoon, Jung-Hee;Chang, Dong-Woo
    • Journal of Veterinary Clinics
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    • v.27 no.3
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    • pp.273-283
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    • 2010
  • The objective of this study was to measure densities in various areas of the normal canine lung with computed tomography (CT) depending on influences of gravity and the degree of lung inflation and to determine optimal positions and positive end expiratory pressure of canine lung for CT scanning. In each eight normal Beagle and Shihtzu dogs, a respiratory breathhold maneuver without spontaenous breathing at different positive end expiratory pressure (PEEP) of 0 mmHg, 10 mmHg and 20 mmHg was applied with the position of right and left lateral recumbency, sternal recumbency, and dorsal recumbency and spiral-CT scans of the total lung were acquired. Slices were selected at three levels through the apex, middle and basal lung at the aortic arch, carina and just above the diaphragm and lung density was measured in the dorsal, ventral, and lateral portions of the peripheral lung field. Lung density in dependent areas was higher than in nondependent areas (p < 0.05) regardless of species, positions, anatomic locations at the PEEP of 0 mmHg and 10 mmHg. However, no significant difference of lung density was found at PEEP of 20 mmHg in both species except the dorsal recumbency in Shihtzu dogs. This density gradient in the dependent areas is strongly influenced by PEEP (p < 0.05). In the four positions on the CT gantry, the lung density at the dependent and nondependent location of the lung was greater at the aortic arch than at the base (p < 0.05). Lung density decreased on identical location according to increase of PEEP (p < 0.05). There was no significant difference between right and left lung density at sternal and dorsal recumbency and no significant difference of the dorsal, ventral, and lateral portions of lung density at the right and left recumbency under identical pressure. It is implied that during chest CT scan with 20 mmHg of positive end expiratory pressure with right or left lateral recumbency, canine lung density do not influenced by gravity or anatomic location.

Study on the Gas Tight Shut-off Valve of NBC Shelter using Positive Pressure Measurement and Chemical Detection Module (양압측정 및 화학탐지 모듈을 적용한 화생방 방호시설의 가스차단밸브에 관한 연구)

  • Park, Hyoung-Keun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.417-422
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    • 2017
  • One of the most frightening aspects of weapons of mass destruction (WMD) is their ability to cause death in very small quantities without being visible to the public. The military authorities are making considerable effort to ensure the survivability of the combatants in the event of NBC(Nuclear, Biological and Chemical) contamination. Therefore, in this study, modules were developed for the measurement of the positive pressure and for the detection of the chemicals used for the control of the various shut-off valves used in an NBC shelter. In addition, a high performance gas tight shut-off valve was developed that can overcome the disadvantages associated with manual manufacturing, such as the occurrence of defective products and high manufacturing cost. By applying the positive pressure measurement and chemical detection modules, this valve was able to be used to control the facility. The developed gas-tight shut-off valve maintained airtight characteristics at a pressure loss of 28[Pa] at the prescribed wind velocity and an internal pressure of 30[kPa]. It is expected to be possible to control the gas-tight shut-off valve through the remote measurement of the positive pressure, thereby ensuring the foreign independence of import substitution and defense related technology in the future. In addition, by installing these valves in all of the intake ports or exhaust ports connected to the outside of the NBC shelter, it is possible to prevent the damage resulting from the rapid inflow of the storm pressure caused by conventional weapons and nuclear explosions, thereby protecting the people and equipment in the shelter.