• Title/Summary/Keyword: 폐렴, 흡인

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Effects of a Dysphagia Nursing Protocol on Reducing Aspiration Pneumonia and Improving Daily Activity Dependency in Patients with Acute Stroke (급성기 뇌졸중 환자에게 적용한 '연하 장애 간호 프로토콜'이 흡인성 폐렴 발생율과 일상생활 의존율에 미치는 효과)

  • Han, Jung-Hee;Lee, Gee-Eun;Jun, Joo-Hyun;Lim, Yoo-Jin;Yoon, Eun-Jin;Kim, Yeo-Ok
    • Korean Journal of Adult Nursing
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    • v.27 no.3
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    • pp.304-313
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    • 2015
  • Purpose: Aspiration pneumonia (AP) is the major complication of dysphagia in patients with acute stroke. Nursing management for dysphagia influences on patients' health outcomes. The purpose of this study was to develop and evaluate the effects of Dysphagia Nursing Protocol (DNP) for patients with acute stroke. We aimed to examine the incidence of AP and the dependency rate at the discharge. Methods: We used a non-equivalent control group posttest only design in this study. DNP was developed with content validity index > 0.75 in all items. This protocol was composed of the evaluation, education, complication prevention, and checking phases. After training the staff nurses, we applied DNP protocol to the experimental group. The control group was enrolled from June to August 2013 (n=80), and the experimental group was June to August 2014 (n=64). Results: The incidence of AP was 16.3% in control group while 4.7% in experimental group (p=.028), and the Odds Ratio (OR) was 0.26 (p=.045). The dependency ratio was 66.3% in control group while 43.8% in experimental group (p=.011), and the OR was 0.33 (p=.011). Conclusion: DNP was beneficial for the reducing the risk of AP and the improved the functional status.

The Usefulness of Video Fluoroscopic Swallowing Study in Post-Stroke Dysphagia Patients (뇌졸중 후 연하장애 환자에서 비디오 투시 연하 조영검사의 유용성)

  • Eun, Sung-Jong;Kim, Sung-Gil;Hong, Jea-Ran
    • Journal of the Korean Society of Radiology
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    • v.4 no.3
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    • pp.19-25
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    • 2010
  • Dysphagia is common and serious problems in post-stroke patients. The post-stroke dysphagia with aspiration is associated with dehydration, malnutrition, pneumonia, sepsis and death. Up to date, gag reflex and choking history used to decide the aspiration in clinical. The purpose of this study was to evaluate the aspiration and to choice the proper meal formation using by video fluoroscpic swallowing study(VFSS) with post-stroke dysphagia patients. 58 post-stroke patients and ten normal person participated to perform the VFSS with liquid type, puding, yoplait, rice mixed with barium(Ba). Two rehabilitation medicine doctors and a radiological technologist analysed the phase(oral, pharyngeal, esophageal phase)with video film, and checked the pharyngeal transition time(PTT). 38 patients showed abnormality in pharyngeal phase, 13 patients in oral and pharyngeal phase, 3 patients in oral phase, and 2 patients in pharyngeal and esophageal phase. 43 patients(65.2%) occured the aspiration, but 23 of 43 patients improved by the chin tuck position. Aspiration occured 34 patients in liquid type, 2patients in rice gruel and nothing in boiled rice. After VFSS, 13 of 23 patients change the intaking pathway from nasogastric tube(NGT) to oral, On the contrary with 3 of 42 patients from oral to NGT. Consequently VFSS is clearly effective to evaluate the aspiration with post-stroke dysphagia patients.

A Case of Secondary Organizing Pneumonia Associated with Endobronchial Actinomycosis (기관지 방선균증과 동반된 이차성 기질화 폐렴 1예)

  • Lee, Byoung Hoon;Lee, Ki-Deok;Kim, Sang Hoon;Woo, Jeong Joo
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.3
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    • pp.227-231
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    • 2007
  • Several types of infection can cause organizing pneumonia when the inflammatory process remains active with the further organization of the intra-alveolar fibrinous exudates, despite the control of the infectious organism by antibiotics. We report a case of 37-year-old male with secondary organizing pneumonia associated with an endobronchial actinomycosis. The patient presented with a subacute cough, sputum and fever. Bronchial biopsy revealed sulfur granule to be consistent with the actinomycosis, and percutaneous needle biopsy revealed typical pattern of organizing pneumonia. The patient was treated with the appropriate antibiotics and corticosteroid. There was rapid improvement in the symptoms and radiological findings, and after six months of treatment, the corticosteroid dose was tapered off without a recurrence of the organizing pneumonia.

A Case of Pneumocystis carinii Pneumonia in an Infant with Failure to Thrive (성장 장애를 보인 영아에서 발현된 주폐포자충 폐렴 1례)

  • Kong, Sun Hui;Lee, Ho Jun;Kim, Soo Yeon;Kim, Hak Sung;Lee, Dong Woo;Kim, Jae Yoon
    • Pediatric Infection and Vaccine
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    • v.12 no.1
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    • pp.95-99
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    • 2005
  • Pneumocystis carinii pneumonia is an infectious disease which is highly prevalent in the group of immunosuppressed patients, particularly with hematologic tumors as lymphomas and acquired immune deficiency syndrome(AIDS), severe malnutrition, organ transplantations, high dose corticosteroid therapy. Some cases of Pneumocystis carinii pneumonia in infants with primary immune deficiency were already reported. The authors present a case of Pneumocystis carinii pneumonia developed in an infant who suffered from 10 days of poor feeding and failure to thrive and not included in the risk groups listed above. He had bilateral interstitial infiltrations on the chest radiography, diagnosed as Pneumocystis carinii pneumonia after Gomori-methenamine silver staining of his sputum that was taken through tracheal intubation. He improved after administering Trimethoprim-sulfamethoxazole for 14 days.

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Implementation of Multi-frame Medical Image Labeling Web Application for Swallowing Disorder Analysis (삼킴장애 분석을 위한 멀티프레임 의료영상 라벨링 웹 애플리케이션 구현)

  • Dong-Wook Lim;Chung-sub Lee;Si-Hyeong Noh;Chul Park;Min Su Kim;Hee-Kyung Moon;Chang-Won Jeong
    • Annual Conference of KIPS
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    • 2023.05a
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    • pp.8-10
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    • 2023
  • 삼킴장애는 음식물이 입에서 식도로 가지않고 걸리거나 기도(Trachea)로 흡입되는 문제를 갖는 상태이다. 특히 노인이나 신경계 질환을 앓는 환자의 경우 기도로 흡입된 음식덩이가 폐렴을 일으키고 결국에는 사망으로 이어지기에 적절한 치료와 관리가 요구된다. 보통 영상으로 판단할 수 있는 삼킴단계는 구강준비단계(Oral Preparatory Phase), 구강단계(Oral Phase), 인두단계(Pharyngeal Phase), 식도단계(Esophageal Phase) 4가지로 분류하고 삼킴장애는 침습(Penetration)과 흡인(Aspiration)으로 크게 2가지로 분류한다. 본 논문에서는 이러한 6가지 클래스를 가지는 삼킴장애 환자 비디오 파일을 라벨링하기 위한 웹 애플리케이션을 제안한다. 이를 구현하기 위해서 대용량 멀티프레임 이미지를 수신해서 분리하여 저장하도록 개발하였다. 또한 음식덩이를 정교하게 분할할 수 있도록 GrabCut 알고리즘을 적용하여 라벨링할 수 있도록 하였다. 차후 라벨러와 전문의 간의 협업이 가능하도록 라벨링 데이터의 상태를 관리할 수 있도록 개발하고자 한다.

Severe Exogenous Lipoid Pneumonia Following Ingestion of Large Dose Squalene : Successful Treatment with Steroid (다량의 스쿠알렌 복용 후 발생한 중증 지방성 폐렴 -스테로이드 치료로 호전된 1예-)

  • Choi, Hyo Sun;Kwang, Hyon Joo;Chae, Seung Wan;Lim, Si Young;Lim, Seong Yong
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.235-238
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    • 2006
  • Exogenous lipoid pneumonia (ELP) is an uncommon condition resulting from aspiration or inhalation of vegetable, animal or mineral oil. It results in foreign body type inflammatory reaction of the lung and can show various clinical presentations from asymptomatic incidental finding to severe pneumonia leading to acute respiratory failure. Although many cases have been reported, severe ELP requiring steroid or whole lung lavage for treatment is rare. We report a case of 51-year old man with esophageal cancer who developed severe ELP following ingestion of large dose shark oil (Squalene) and successfully treated with prednisolone.

BENIGN TUMORS IN THE ALVEOLAR RIDGE OF NEWBORNS (신생아의 치조제에 발생한 양성 종물)

  • Lee, Jae-Ho;Kim, So-Hwa;Yun, Jung-Hun;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.2
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    • pp.310-315
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    • 2001
  • The soft tissue tumors that occur commonly in newborn infants include palatal and gingival cyst of the newborn, congenital epulis, hemangioma, teratoma, pyogenic granuloma, and irritation fibroma. Such soft tissue tumors in the alveolar ridge of newborns are usually treated by surgical excision. If untreated, they can cause airway obstruction and breathing difficulty due to aspiration. They also cause discomfort during oral feeding. If nasal feeding is tried, since vomitting is impossible, there is a risk of aspiration pneumonia. In this case, a newborn infant visited our hospital with soft tissue tumor as chief complaint, and the infant was treated by surgical excision. It appeared to be similar to pyogenic granuloma and irritation fibroma upon histologic exam. However, it was different from those diseases since multinucleated giant cells were observed and it was congenital. The pathologic process of this neoplasm is not clear. This case is reported, since it is difficult to classify it as a specific disease.

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A Case of Exogenous Lipoid Pneumonia after Ingestion of Squalene in Patients with Achalasia (식도이완불능증 환자에서 스쿠알렌 복용 후 발생한 지방성 폐렴 1예)

  • Park, Jung Chul;Jung, Chi Young;Lee, Jae Kwang;Lee, Yu Jin;Park, Seung Chan;Seo, Hye Jin;Kim, Yeon Jae;Lee, Byung Ki;Huh, Dong Myung;Sohn, Kyung Rak
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.5
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    • pp.421-425
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    • 2008
  • Exogenous lipoid pneumonia (ELP) is a chronic inflammatory reaction of the lungs resulting from the aspiration of vegetable, animal or mineral oils. Squalene, is a derivative of shark liver oil that is taken as a traditional remedy in some Asian countries, and is used widely also in cosmetics. Similar to the symptoms in most cases of oil aspiration, the symptoms of squalene-induced lipoid pneumonia are either absent or nonspecific. Hence, the disease is generally detected incidentally. Although many cases with predisposing factors have been reported, ELP with achalasia is quite rare. We report a 47-year old woman with achalasia who developed ELP after ingesting squalene. The patient was treated successfully by supportive care and surgical treatment of the achalasia.

Aspiration Pneumonia after General Anesthesia Using Laryngeal Mask Airway -A case report- (후두 마스크를 이용한 전신 마취 후 발생된 흡인성 폐렴)

  • Lee, Deok-Hee;Park, Ki-Ho
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.127-131
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    • 2004
  • A laryngeal mask airway (LMA) has many advantages in the management of airway emergencies or the treatment of patients in whom intubation is difficult, but the use of LMA during positive ventilation may seem inappropriate to protect the airway because of the risk of pulmonary aspiration of regurgitated gastric contents. We experienced aspiration pneumonia after general anesthesia using LMA in patient who suffered from panperitonitis. It is considered that the main reason for aspiration pneumonia was a leakage of gastric content through the space surrounding the nasogastric tube while under high airway inflation pressure. We concluded that when LMA or the Proseal laryngeal mask airway (PLMA) is chosen for the use in difficult intubations, careful patient-suitability selection and the correct knowledge of LMA and PLMA are needed to protect the airway against aspiration.

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A Case of Sandifer Syndrome (Sandifer 증후군 1례)

  • Lee, Mira;Kim, Soo Hyun;Kim, Yong Joo;Seol, In Joon
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1036-1039
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    • 2003
  • Sandifer syndrome is a rare manifestation of gastroesophageal reflux in children, occurring in association with abnormal movement of the head and neck and recurrent episodes of seizure after feeding. This syndrome may be misdiagnosed as infantile seizure and musculoskeletal disorder and may be associated with failure to thrive, anemia, aspiration pneumonia, and esophagitis. In this paper, Sandifer syndrome in a four months old male with recurrent aspiration pneumonia, apnea, and seizure after feeding is presented.