• Title/Summary/Keyword: 자발호흡

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Surgical Repair of Abdominal Aortic Aneurysm under Epidural Anesthesia in Patient with Chronic Obstructive Pulmonary Disease -A case report- (만성 폐쇄성 폐질환 환자에서 자발 호흡를 유지한 상태하의 복부 대동맥류 수술 -1예 보고-)

  • Park Sung-Yong;Hong You-Sun;Lee Gi-Jong;Yu Song-Hyeon
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.782-785
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    • 2006
  • Chronic pulmonary obstructive disease is known to be a significant risk factor for mortality in patients who under-went operation for abdominal aortic aneurysm. To decrease perioperative respiratory complication in these patients, maintenance of self respiration as possible is one of the better method. A seventy-seven year old male patient complained of abdominal pain and he was diagnosed for 9 cm sized abdominal aortic aneurysm. But he had severe chronic obstructive pulmonary disease which was expected to increase surgical mortality. So we introduced epidural anesthesia with maintenance of self respiration and performed surgical resection and graft replacement of abdominal aorta, and he recovered without any complication.

Simultaneous Bilateral Spontaneous Pneumothorax (동시에 발생한 양측성 자발성 기흉)

  • Kim Eung-Soo;Sohn Sang-Tae;Kang Jong-Yael
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.475-478
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    • 2006
  • Background: The simultaneous bilateral spontaneous pneumothorax is a rare clinical event. Contrary to the unilateral pneumothorax, the patients with simultaneous bilateral spontaneous pneumothorax sometimes complains of severe respiratory distress, cyanosis and chest pain without tention pneumothorax. It is often dangerous; therefore, the chest drain should be inserted immediately. Material and Method: Between March 1994 and February 2004, 802 patients were treated in our department for spontaneous pneumothorax. Among these, the simultaneous bilateral spontaneous pneumothorax developed in 14 patients (1.7%). Result: Out of fourteen patients, two females and twelve males presented with simultaneous bilateral spontaneous pneumothorax. The patient age ranged between 0 and 79 years with mean age of 31.2 years. In eleven patients, this was the first episode of pneumothorax. One patient had combined hemopneumothorax and two patients had combined pyopneurnothorax. Six patients had smoking history (42.8%, average 17.3 p-y). Five patients had pulmonary tuberculosis history and among these, two patients had active pulmonary tuberculosis. Three patients were died due to meconium-aspiration pneumonia (1 patient) and ARDS (Acute Respiratory Distress Syndrome) with pneumonia (2 patients). We treated these patients with nasal oxygen inhalation, chest drain insertion, thoracotomy, VATS (Video-Assisted Thoracoscopic Surgery) and chemical pleurodesis. Conclusion: The simultaneous bilateral spontaneous pneumothorax developed in 14 patients (1.7%) among 802 patients. Prompt insertion of chest drain is needed for a relief of severe symptoms, and to reduce the risk of recurrence, early thoracotomy or VATS should be performed rather than chest drain insertion only.

Sevoflurane Insufflation Sedation for the Dental Treatment of a Patient with Pulmonary Arterial Hypertension : A Case Report (폐동맥 고혈압 환자의 치과치료에서 세보플루란 흡입 진정의 사용 : 증례보고)

  • Chi, Seongin;Kim, Seungoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.1
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    • pp.75-79
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    • 2015
  • Pulmonary arterial hypertension (PAH) is a common complication of Congenital heart defects (CHD) with left-to-right shunts, and PAH with increased pulmonary vascular resistance (PVR) is associated with considerable morbidity and mortality. General anesthesia (GA) can be life-threatening in patients with PAH, because the positive pressure ventilation during GA increases pulmonary arterial pressure and decreases pulmonary blood flow. This may also lead to hypoxia. Therefore, spontaneous ventilation may be safer than positive pressure ventilation in patients with PAH. A five-year-old male child, weighing 11 kg, with medical history showing a total correction of Tetralogy of Fallot (TOF) in 2009 and ongoing treatment with hypertension (HTN) medicine since 2007, visited the Dankook University Dental Hospital. He had multiple dental caries, and the treatment was completed under sevoflurane insufflation sedation via nasal cannula. The patient remained sedated throughout the operation while maintaining normal vital signs and spontaneous respiration. In conclusion, sevoflurane insufflation sedation may be a safer alternative to GA for the dental treatment of patients with PAH.

Acoustic Analysis of Respiration and Phonation Method

  • 문영일;정성민;김문정
    • Proceedings of the KSLP Conference
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    • 1998.11a
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    • pp.180-180
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    • 1998
  • 목소리를 많이 사용하는 사람들에서 발생되는 음성장애는 대부분 잘못된 발성방법으로 인한 후두의 과긴장으로 인해 야기되는 것으로, 흡기 및 호기를 자발적으로 조절할 수 있는 호흡방법과 성대 및 주변 근육의 긴장을 줄이도록 하는 훈련하는 음성치료가 주된 치료 방법으로 대두되고 있다. 지금까지 음성치료의 효과는 주로 청음인지적(perceptual) 측면에서 많이 논의되어 왔으며 객관적인 자료는 아직까지 별로 없는 상태이다. 더욱이 호흡 및 발성 방법에 따른 음성 분석은 미진한 상황이다. (중략)

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Symptomatic Spontaneous Pneumothorax in the Newborn : Comorbidities and Outcomes (증상이 있는 신생아 자발성 기흉의 관련 질환과 예후)

  • Joo, Ji-Won;Yang, Eun-Mi;Sohn, Young-Jun;Kim, Mi-Jeong;Song, Eun-Song;Choi, Young-Youn;Byun, Hyung-Suck
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.166-171
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    • 2008
  • Purpose : This study was performed to determine the rate of neonatal symptomatic spontaneous pneumothorax, and the corresponding clinical characteristics, co-morbidities, and outcomes. Methods : The demographic characteristics, clinical symptoms and signs, associated abnormalities, methods of treatment, and outcomes were investigated in 22 neonates with symptomatic spontaneous pneumothorax in the neonatal intensive care unit (NICU) of Chonnam University Hospital between March 2003 and February 2008. Results : The rate of spontaneous pneumothorax was 0.55%. Among the 22 neonates, the number of outborns was 15 (68.2%) and the number of males was 12 (54.5%). The main symptoms and signs were chest retraction, tachypnea, and cyanosis. The pneumothoraces were more frequent on the right side (59.1%) and all cases were diagnosed within 3 days of life. Four cases (18.2%) had urologic abnormalities and 7 cases (31.8%) had cranial abnormalities by ultrasonography. The treatments included oxygen (81.8%) and oxygen with chest tube drainage (18.2%). All of the infants survived and the overall outcomes were favorable. Conclusion : When respiratory symptoms and signs are develop abruptly in otherwise healthy newborns, the clinician should suspect a spontaneous pneumothorax and check a chest x-ray as soon as possible. Although the outcome of neonatal symptomatic spontaneous pneumothorax is favorable, renal and cranial ultrasonography are needed because of the higher possibility of urologic abnormalities and germinal matrix/intraventricular hemorrhage than in newborns without a pneumothorax.

Decreased heart sound in a healthy newborn: Spontaneous multiseptated cystic pneumomediastinum with delayed respiratory distress (자발성 종격동 기흉: 작게 청진된 심음을 주소로 내원한 신생아)

  • Choe, Young June;Kim, Eun Sun;Kim, Ee-Kyung;Kim, Han-Suk;Chun, Jung-Eun;Kim, Woo Sun;Kim, In-One;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.244-247
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    • 2010
  • Spontaneous pneumomediastinum in the absence of predisposing risk factors has been rarely observed in full-term neonates. A 3-day-old neonate, delivered vaginally at term without any perinatal complications or signs of respiratory difficulty, was referred to the Seoul National University Children's Hospital because of reduced heart sound detected during routine neonatal examination. Chest computed tomography (CT) showed air collection in the anterior mediastinum. The baby developed respiratory distress on the fourth day and required supplemental oxygen. On the seventh day, there was no sign of respiratory difficulty, and x-ray examination showed no demonstrable pneumomediastinum. Hence, careful neonatal physical examination is essential during the postnatal assessment of newborns, and spontaneous pneumomediastinum should be considered when a healthy newborn presents with reduced heart sound.

The Relationship between Arterial and End-tidal Partial Pressures of CO$_{2}$ in Halothane-anesthetized Heavy Breed Horses with respect to Operative Positions and the Modes of Ventilation (Halothane으로 마취된 거대말에서 수술자세와 호흡방법에 따른)

  • 안경아;권오경;산권명부;권구청;산안칙부
    • Journal of Veterinary Clinics
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    • v.14 no.2
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    • pp.238-243
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    • 1997
  • 체중이 700-750kg 인 4마리의 중종마에 70분동안 마취를 실시하여 동맥혈의 이 산화탄소 분압과 호기말 가스내의 이산화탄소 분압 사이의 관계를 관찰하였다. 마취도중 자발 호흡, 인공호흡 1(흡기시간 2.0초), 인공호흡 2(흡기시간 2.5초)를 각각 30분,20분,20분씩 실시하였으며 매 10분마다 동맥혈가스분석과 호기말 가스내 이산화탄소분압 측정을 실시하 였다. 동시에 혈압, 심전도, 체온측정을 실시하여 마취된 환축의 상태를 관찰하였다. 2주후에 자세를 달리하여(앙와에서 측와로) 같은 방법으로 재 실험하였다. 호기말 이산화탄소분압은 동맥혈에서보다 평균 10 mmHg 정도 낮은 양상을 보였으나 높은 상관관계를 보였으며 자세에 따른 유의적 차이는 업었다(앙와자세; r=0.949, 측와자세; r=0.920, P<0.01). 이러한 결과를 토 대로 조직에 창상을 줄 수 있는 동맥혈 가스분석 대신 비침습적방법인 호기말 가스내 이산화 탄소 분압을 측정하는 것이 환축의 모니터링에 효과적으로 사용 가능하다는 것을 알 수 있었다.

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The Diagnosis and Ancillary Tests of Brain Death (뇌사의 진단과 진단을 위한 보조적 검사)

  • Kim, Cheon-Sik
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.1
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    • pp.64-68
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    • 2004
  • Brain death is defined as the irreversible cessation of all brain function. The diagnosis of brain death is primarily based on a careful neurological examination demonstrating unresponsiveness, absent of brain stem reflexes, and no respiratory activity. Several conditions which may mimic brain death must be excluded. In some cases investigations such as electroencephalography, angiography, transcranial doppler or evoked potentials can contribute to the diagnosis. The brief review will introduce medical technologist and clinician to the key issues in the definition and management of brain death.

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Symptomatic Pneumothorax in the Full-term Neonate (만삭 신생아의 기흉)

  • Choi, Woo-Kyoung;Hong, Chan-Eui;Lee, Dong-Jin;Hur, Nam-Jin;Lee, Young-Hwan
    • Journal of Yeungnam Medical Science
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    • v.22 no.2
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    • pp.183-190
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    • 2005
  • Background: This study was performed to evaluate the incidence and clinical characteristics of symptomatic pneumothorax in the full-term neonate. Materials and Methods: We retrospectively reviewed the medical records of 32 symptomatic pneumothorax patients in the full term neonates who admitted to the neonatal intensive care unit in Ulsan Dong Kang General Hospital from January, 2000 to December, 2004. The subjects were divided into two groups according to underlying causes; spontaneous pneumothorax group and secondary pneumothorax group, then each clinical characteristics were assessed. Results: Spontaneous pneumothorax patients were 10(31%) and secondary pneumothorax patients were 22(69%). Overall incidence of spontaneous pneumothorax was 0.4%. Most common cause of secondary pneumothorax was pneumonia. Twelve cases(54.5%) among secondary pneumothorax patients were associated with mechanical ventilator care. Clinical characteristics, courses and managements were similar between two groups, but more shorter duration of admission and chest-tube insertion in spontaneous pneumothorax group Conclusion: The patient with symptomatic pneumothorax needs careful observation and proper management with or without underlying respiratory diseases.

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The Treatment of Massive Spontaneous Subcutaneous Emphysema by Multiple Intravenous Catheter and Continuous Suction Drainage (다수의 정맥용 도관의 피하삽입과 지속흡인을 이용한 다량의 자발성 피하공기증 치료 1예)

  • Kim, Sun Young;Uom, Kwang Seok;Lee, Young Seok;Huh, Kyung Rim;Kwon, Chin Woo;Jang, Seung Hun;Kim, Dong Gyu;Jung, Ki Suck
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.2
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    • pp.178-183
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    • 2006
  • A-61-year-old COPD patient was hospitalized due to dyspnea and was diagnosed with acute exacerbation of COPD. During the hospital stay, the patient's dyspnea was aggravated by massive spontaneous subcutaneous emphysema. Multiple 16 gauge intravenous catheters were inserted at the midclavicular line for drainage. Although subcutaneous catheter drainage was carried out, respiratory failure developed with an increased in massive subcutaneous emphysema. Continuous suction drainage with wall suction was applied resulting in the rapid resolution of the subcutaneous emphysema. We report a case of the that effective management of massive subcutaneous emphysema using multiple 16 gauge intravenous catheters with continuous suction.