• Title/Summary/Keyword: Acute Respiratory

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Risk Factors to Predict Acute Respiratory Failure in Patients with Acute Pesticide Poisoning (급성 농약 중독환자에서 호흡 부전 발생의 위험 인자)

  • Cho, Nam-Jun;Park, Samel;Lee, Eun Young;Gil, Hyo-Wook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.116-122
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    • 2020
  • Acute respiratory failure is an important risk factor for mortality in patients with acute pesticide poisoning. Therefore, it is necessary to investigate the risk factors to predict respiratory failure in these patients. This study retrospectively investigated the clinical features of respiratory failure among patients with acute pesticide poisoning requiring mechanical ventilation. This study included patients who were admitted with intentional poisoning by pesticide ingestion from January 2017 to December 2019. Paraquat intoxication was excluded. Among 469 patients with acute pesticide poisoning, 398 patients were enrolled in this study. The respiratory failure rate was 30.4%. The rate of respiratory failure according to the type of pesticide was carbamate (75.0%), organophosphate (52.6%), glufosinate (52.1%), glyphosate (23%), pyrethroid (8.9%), and others (17%). The mortality was 25.6% in the respiratory failure group. The risk factors for respiratory failure were old age, low body mass index, and ingestion of more than 300 mL. In conclusion, respiratory failure is a risk factor for mortality in pesticide poisoning. Old age, low body mass index, and ingestion of more than 300 mL are the risk factors for predicting respiratory failure.

Clinical characteristics of acute lower respiratory tract infections according to respiratory viruses in hospitalized children without underlying disease during the last 3 years (최근 3년간 기저질환이 없는 소아 입원 환자에서 호흡기 바이러스에 따른 급성 하기도 감염의 임상적 특징)

  • Seo, Min Hae;Kim, Hyung Young;Um, Tae Min;Kim, Hye-Young;Park, Hee-Ju
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.182-190
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    • 2017
  • Background: Respiratory viruses play a significant role in the etiology of acute respiratory infections and exacerbation of chronic respiratory illnesses. This study was conducted to identify the epidemiological and clinical characteristics of children with acute viral lower respiratory infections. Methods: This study investigated 1,168 children diagnosed with acute viral lower respiratory tract infections (RTIs) between January 2012 and December 2014. Specimens of respiratory viruses were collected using a nasopharyngeal swab and analyzed by reverse transcriptase polymerase chain reaction. We retrospectively reviewed the medical records and analyzed the clinical features of children hospitalized for acute lower respiratory infections. Results: Respiratory syncytial virus (RSV), the main cause of infection in children aged <5 years, was the most commonly detected pathogen in children with bronchiolitis and pneumonia, and resulted in high proportions of children requiring oxygen treatment and intensive care unit admission. Rhinovirus was preceded by RSV as the second most common cause of bronchiolitis and pneumonia, and was detected most frequently in the children aged ${\geq}6$ years. In addition, asthma was predominantly caused by rhinovirus in children aged ${\geq}6$ years, whereas croup was mostly caused by parainfluenza virus in those aged <5 years. Rhinovirus infection (p<0.001) and history of asthma (p=0.049) were identified as significant risk factors for readmission within a month. Conclusion: We identified the epidemiological and clinical characteristics of respiratory viruses in children with acute lower respiratory infections during the last 3 years. Our findings may provide useful clinical insight to comprehend the acute viral lower RTIs in children.

Acute Respiratory Failure during Splanchnic Nerve Block in COPD Patient (만성폐색성 폐질환 환자에서의 내장신경차단중 발생한 급성호흡부전)

  • Chang, Won-Young;Choe, Kun-Chun
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.200-204
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    • 1991
  • Neurolytic splanchnic nerve block is a relatively safe and effective method for the relief of intractable pain caused by upper abdominal cancer. We have experienced a case of severe acute respiratory failure during splanchnic nerve block under control of X-ray fluoroscopy. We think that the most likely cause of the acute respiratory failure was an asthmatic attack due to anxiety and dyspnea from the injury or stimulation of the diaphragm and pleura in this case.

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Prescription Characteristics of Antibiotics for Clinical Subjects of Acute Respiratory Infection Outpatients -Using National Health Insurance Big Data- (급성호흡기감염 환자의 표시과목별 항생제 처방특성 -국민건강보험 빅데이터를 활용하여-)

  • Gong, Mi-Jin;Hwang, Byung-Deog
    • The Korean Journal of Health Service Management
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    • v.13 no.4
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    • pp.121-132
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    • 2019
  • Objectives: This study analyzed the prescription antibiotics characteristics of Acute respiratory infection outpatients. It provides a basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods: The research data were collected from the National Health Insurance Corporation's 2014 sample cohort for Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics classification of diseases codes J00-J06, J20-J22, J40 outpatients. Results: The antibiotic prescription rate on the evaluation project for appropriate prescribing indicators of Health Insurance Review & Assessment Service was 43.54%, whereas in this study it was about 10% higher because the analysis targeted the entire acute respiratory infection diagnosis. Conclusions: There is a need to identify the correct antibiotic prescription by expanding the current assessment standard. Such standard must include acute lower respiratory infections and minor diagnosis because current evaluation projects on appropriate prescribing indicators targets only the major diagnosis of acute upper respiratory infection.

Local blood flow in acute respiratory and metabolic acid-base distrubances in dog (급성산-염기 균형장해때의 국소 혈류량 변화)

  • Kim, Sam-Hyeon;Lee, Yeong-Gyun;Kim, U-Gyeom
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.101-109
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    • 1984
  • The influences of acute respiratory and metabolic acid-base disturbances on the carotid, renal and coronary blood flow were measured in dogs. Respiratory acidosis was induced by artificial respiration with 8% CO2 -02 gas mixture and respiratory alkalosis was induced by hyperventilation under the control of respirator. Metabolic acidosis and metabolic alkalosis were induced by intravenous infusion of 0.3N hydrochloric acid and 0.6M sodium bicarbonate solution. To observe the effect of hyperkalemia, isotonic potassium chloride solution was infused. CVI electromagnetic flowmeter probes were placed on the left common carotid artery, left renal artery and left circumflex coronary artery. Each flow was recorded on polygraph. 1. The carotid blood flow showed rapid showed rapid and marked increase in acute respiratory acidosis. Even in the cases when arterial blood pressure was lowered during the state of respiratory acidosis, carotid blood flow increased. By the infusion of hydrochloric acid, carotid blood flow increased slowly and returned to the previous label after discontinuation of the infusion. Carotid blood flow also increased by the infusion of large amount of sodium bicarbonate, but it might be the combined effect of expansion of extracellular fluid and compensatory elevation of carbon dioxide tension. 2.The renal blood flow remained unchanged during the acute acid-base disturbances, suggesting effective autoregulation. Renal blood flow, however, increased very slowly when the infusion of potassium chloride continued for a long period. 3.Although less marked than the carotid blood flow, the coronary blood flow increased in the acute respiratory and metabolic acidosis. In asphyxiated condition, coronary blood flow increased most markedly and this might be the combined effect of hypoxia, hypercapnea, and lowering of pH. In summary, the carotid blowflow showed more marked change in the acute respiratory and metabolic acidosis than the renal and coronary blood flow. Respiratory and metabolic components of acid-base disturbances may influence the local blood flow concomitantly, there being more differences in the individual responses, but respiratory component manifested more rapid and marked effect than metabolic component.

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Prescription Characteristics of Medication for Acute Respiratory Diseases before and after Pay-for-Performance -using National Health Insurance Big data- (의원 가감지급사업 실시 전후에 따른 급성호흡기계질환의 의약품 처방특성 -국민건강보험 빅데이터를 활용하여-)

  • Gong, Mi-Jin;Hwang, Byung-Deog
    • The Korean Journal of Health Service Management
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    • v.14 no.1
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    • pp.93-102
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    • 2020
  • Objectives: This study analyzed the prescription characteristics of medication for acute respiratory diseases before and after pay-for-performance to provide basic data on effective medical quality management policies. Methods: The research data were collected from the 2013-2014 sample cohort of the National Health Insurance Corporation, from Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics (classification of disease codes: J00-J06, J20-J22, J40 outpatients). Results: The antibiotics prescription rates decreased from 43.9% in 2013 to 43.5% in 2014 when the major diagnosis was for upper respiratory infections and increased from 62.0% in 2013 to 62.5% in 2014 when the major diagnosis was for lower respiratory infections. Conclusions: There is a need to identify the correct antibiotic prescription method by expanding the current assessment standards. Such standards must include acute lower respiratory infections and minor diagnoses as the current evaluation techniques focus only on the major diagnosis of acute upper respiratory infections.

The Survival Rate of Korean Patients with COPD with or without Acute Exacerbations

  • Uh, Soo-Taek;Lee, Ji-Yeon;Koo, So-Mi;Kim, Yang-Ki;Kim, Ki-Up;Park, Jong-Sook;Park, Sung-Woo;Jang, An-Soo;Kim, Do-Jin;Choi, Jae-Sung;Na, Joo-Ok;Suh, Ki-Hyun;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.6
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    • pp.474-481
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    • 2011
  • Background: Chronic obstructive pulmonary disease (COPD) is characterized by air low limitation, which is one of the leading causes of mortality worldwide. There have been many studies on survival rates in the world literature, but there have been few reports regarding the survival rate in Korean patients with COPD. Acute exacerbation is regarded as a risk factor for mortality in patients with COPD. The purpose of this study was to investigate the survival rate and the effect of acute exacerbations on the survival rate of Korean patients with COPD. Methods: A total of 502 COPD patients who were diagnosed on the basis of history and lung function tests were enrolled in this study. The frequency of acute exacerbations, body mass index (BMI), C-reactive protein (CRP) and pulmonary hypertension were analyzed. Results: The 3- and 5-year survival rates were 98% and 83%, respectively. The median survival time was 78 months. The median survival time was 55 months in 322 patients with one or more acute exacerbations. The 3- and 5-year survival rates were significantly lower in the 322 patients with one or more acute exacerbations than in those without any. The mortality rate was significantly higher in patients with CRP>3 mg/L than in those with CRP ${\leq}3$ mg/L (p<0.005); it was significantly higher in patients with pulmonary hypertension than in those without it (p<0.01). Conclusion: Because the 5-year survival rate is 83% in Korean patients with COPD, the management of stable patients with COPD should focus on the prevention of acute exacerbations.

Acute Respiratory Insufficiency Following Blunt Chest Trauma -2 Case Report- (흉부손상에 병발한 급성호흡부전증 -2예 보고-)

  • Wang, Young Pil;Lee, Hong Kyun
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.148-156
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    • 1976
  • Acute respiratory failure has become an increasingly frequent cause of death following shock or trauma. Interstitial or diffuse alveolar edema, as chief pathophysiologic change of acute respiratory insufficiency, can be the result of sepsis, fat embolism, cardiac failure, lung congestion, and oxygen toxicity. These pulmonary problems are extremely difficult to treat without early recognition of their development and aggressive management. If the treatment is delayed, the progressive respiratory failure is almost uniformly fatal. Authors have experienced two cases of acute respiratory insufficiency following the blunt chest trauma, which were healed uneventfully. Literatures were briefly reviewed.

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A Rare Case of Acute Obstructive Laryngitis in a Cat with Severe Respiratory Distress

  • Hyeona Bae;Dongbin Lee;DoHyeon Yu
    • Journal of Veterinary Clinics
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    • v.40 no.2
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    • pp.124-129
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    • 2023
  • A 5-year-old neutered male domestic short-haired cat presented with acute dyspnea characterized by open-mouth breathing and stridor for 2 days. Direct visualization via laryngoscopy revealed diffuse laryngeal swelling and severe thickening of the vocal folds bilaterally; thus, the upper respiratory tract was obstructed owing to severe edema. Neutrophil infiltration was found on fine needle aspiration of the larynx cytology, and no discrete mass with polyp or neoplasia was identified on diagnostic imaging. The cat was diagnosed with acute obstructive laryngitis, and a tracheostomy tube was immediately installed. After 17 days of treatment with steroids, doxycycline and azithromycin, the swollen larynx gradually improved, and there was no recurrence of laryngitis or respiratory obstruction. A feline upper respiratory polymerase chain reaction panel revealed Mycoplasma felis infection; however, it could not be determined whether it was pathogenic or opportunistic. Herein, we report a case of obstructive laryngitis in a cat. When respiratory obstruction due to acute laryngitis is identified, a good prognosis is expected with rapid and appropriate treatment.

Comprehensive Review of Acute Respiratory Failure Following Inhalation Exposure to Waterproofing Agents (방수 스프레이 흡입 노출로 인한 급성 호흡기 중독 사례 및 원인 고찰)

  • Park, Donguk;Choi, Yeyong
    • Journal of Environmental Health Sciences
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    • v.38 no.6
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    • pp.451-459
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    • 2012
  • Background: In Korea, a healthy 36-year-old man developed acute interstitial pneumonitis soon after inhaling a waterproofing spray which he had applied at home to his outdoor jacket. Objectives: The objectives of this study were to review cases of varying degrees of respiratory toxicity and poisoning in connection with the use of waterproofing spray and summarize major reasons for cases of poisoning. Methods: We searched articles reporting on a combination of a waterproofing agent and/or respiratory symptoms, including acute respiratory syndrome, lung injury, pneumonia, pulmonary toxicity, and respiratory disease. Results: We reviewed a number of cases of varying degrees of respiratory toxicity and poisoning resulting from inhalation of waterproofing spray containing fluorocarbon co-polymer, solvents and propellants reported in a variety of countries. The literature searches concluded that among the ingredients of waterproofing agents, fluorinated polymer may cause acute respiratory health effects. Conclusion: Environmental policy should be implemented in order to prevent consumers from using household and industrial products including waterproofing agents. In addition, a national surveillance system should be created to collect cases of poisoning caused by the use of consumer products.