• 제목/요약/키워드: Airway Pressure

검색결과 256건 처리시간 0.03초

PIV 측정 및 수치해석을 이용한 구강암 수술에 따른 기도 형상 내 유동 특성 (Flow Characteristics in a Human Airway model for Oral Cancer Surgery by PIV Experiment and Numerical Simulation)

  • 홍현지;안세현;서희림;송재민;염은섭
    • 한국가시화정보학회지
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    • 제19권3호
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    • pp.115-122
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    • 2021
  • Oral cancer surgery typically consists of resection of lesion, neck dissection and reconstruction, and it has an impact on the position of hyoid bone. Therefore, morphological change of airway can occur since the geometric parameter of airway is correlated with the hyoid bone. Airflow is affected by geometry of the airway. In this study, flow characteristics were compared between pre- and post-surgery models by both particle image velocimetry (PIV) and numerical simulation. 3D model of upper airway was reconstructed based on CT data. Velocity is accelerated by the reduced channel area, and vortex and recirculation region are observed in pre- and post-surgery models. For the post-surgery model, high pressure distribution is developed by significantly decreased hydraulic diameter, and the longitudinal flow stream is also interrupted.

호흡보조의료기기의 사용목적 및 대상에 따른 규격적용 방안 및 성능에 관한 연구 (A Study for Application of Standard and Performance Test According to Purpose and Subject of Respiratory Medical Device)

  • 박준현;호예지;이덕희;최재순
    • 대한의용생체공학회:의공학회지
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    • 제40권5호
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    • pp.215-221
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    • 2019
  • The respiratory medical device is a medical device that delivers optimal oxygen or a certain amount of humidification to a patient by delivering artificial respiration to a patient through a machine when the patient has lost the ability to breathe spontaneously. These include respirators for use in chronic obstructive pulmonary disease and anesthesia or emergency situations, and positive airway pressure devices for treating sleep apnea, and as the population of COPD (chronic obstructive pulmonary disease) and elderly people worldwide surge, the market for the respiratory medical devices it is getting bigger. As the demand for both airway pressure devices, there is a problem that the ventilator standard is applied because the reference standard has not been established. Therefore, the boundaries between the items are blurred due to the purpose, intended use, and method of use overlapping similar items in a respiratory medical device. In addition, for both airway pressure devices, there is a problem that the ventilator standard is applied because the reference standard has not been established. Therefore, in this study, we propose clear classification criteria for the respiratory medical devices according to the purpose, intended use, and method of use and provide safety and performance evaluation guidelines for those items to help quality control of the medical devices. And to contribute to the rapid regulating and improvement of public health. This study investigated the safety and performance test methods through the principles of the respiratory medical device, national and international standards, domestic and international licensing status, and related literature surveys. The results of this study are derived from the safety and performance test items in the individual ventilator(ISO 80601-2-72), the International Standard for positive airway pressure device (ISO 80601-2-70), The safety and performance of humidifiers (ISO 80601-2-74) and the safety evaluation items related to home healthcare environment (IEC 60601-1-11), In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers and importers, certified test inspection institutions, academia, etc., the final guidelines were established through revision and supplementation. Therefore, in this study, we propose guidelines for evaluating the safety and performance of the respiratory medical device in accordance with growing technology development.

폐쇄성 수면무호흡증 환자의 상하악 전진술 후 상기도 내 유동해석 (Flow Analyses of Upper Airway Before and After Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea Patient)

  • 김형호;서상호;최진영;김태윤
    • 대한기계학회논문집B
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    • 제39권5호
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    • pp.443-448
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    • 2015
  • 폐쇄성 수면무호흡증은 수면중 간헐적으로 반복되는 상기도 폐쇄 증상을 말한다. 상하악전진술은 폐쇄성 수면무호흡 치료에 가장 효과적인 외과적 수술 중 하나이다. 상하악 전진술을 통해 상기도의 부피가 증가되어 상기도의 막힘을 치료할 수 있다. 본 연구의 목적은 상하악전진술 전후의 상기도 내 유동해석을 수행하여 폐쇄성 수면무호흡증 환자의 흡기 및 호기 시의 유동현상을 분석하는 것이다. 생체내 CT 이미지로부터 상기도 모델링을 만들고, 상기도 내 상하악전진술 전 후 환자에 대한 단면적 변화 및 음압 효과에 대해 전산유체역학적 방법으로 연구하였다. 연구결과, 수술 후 SMA (section of minimum area)의 면적변화가 가장 컸으며 압력변화와 속도변화가 커진다는 것이 확인되었다. 수면무호흡증 환자에 대한 CFD 해석을 통한 연구는 치료효과에 대한 분석이 가능함을 임상적으로 확인하였다.

Regulation of depth and composition of airway surface liquid

  • J. H. Widdicombe;S. J. Bastacky;D. X.Y. Wu;Lee, C. Y.
    • 한국응용약물학회:학술대회논문집
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    • 한국응용약물학회 1996년도 춘계학술대회
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    • pp.119-130
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    • 1996
  • We review the factors which regulate the depth and composition of the human airway surface liquid (ASL). These include secretion from airway submucosal glands, ion and fluid transport across the surface epithelium, goblet cell discharge, surface tension and transepithelial gradients in osmotic and hydrostatic pressure. We describe recent experiments in which we have used low temperature scanning electron microscopy of rapidly frozen specimens to detect changes in depth of ASL in response to submucosal gland stimulation. We also present preliminary data in which X-ray microanalysis of frozen specimens has been used to determine the elemental composition of ASL.

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수면무호흡 중에 관찰된 다양한 기도협착의 형태:상기도 CT 및 상기도 압력 측정법 (Airway Narrowing Patterns during Obstructive Sleep Apnea : Airway CT and Multi-level Airway Pressure Monitoring)

  • 정승철;홍승봉;경승현;김후원
    • 수면정신생리
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    • 제7권1호
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    • pp.18-26
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    • 2000
  • 목적 및 방법 : 수면무호흡증 환자들에서 상기도 압력 측정법을 이용하여 수면 중 기도협착의 형태를 연구하고, 각성시와 수면 중에 실시한 상기도 CT scan의 수면무호흡 중 기도 협착 부위의 예측도를 평가하기 위하여, 11명의 수면무호흡증 환자에서 4 압력 센서 또는 2 압력 센서가 달린 도관을 상기도로 삽입하여 상기도의 압력을 측정하면서 수면다원검사를 시행하고, 이 환자들에서 각성시와 수면 중에 상기도의 다섯 곳(high-retropalatal, low-retropalatal, retroglossal, hypopharynx, esophagus)에서 cine CT를 시행한 후 각 방법에 의하여 기도 협착 부위를 진단하고, 수면 중 상기도 압력 측정 결과에 의거하여 상기도 cine CT의 정확도를 평가하였다. 결 과: 상기도 압력 측정 결과 4명(36%)만이 수면 중에 단일 형태의 기도 협착을 보였고, 나머지 7명(64%)은 여러 가지 형태의 기도 협착을 보였다. Velopharynx가 수면무호흡시에 가장 흔히 관찰되는 기도 협착 부위였다(63.6%). 그러나, 상기도 cine CT결과는 수면무호흡 중에 8명이 단일 형태의 기도 협착을 보였다(72.7%). Apneic CT에서도 Velopharynx가 가장 흔한 기도 협착 부위였다. 상기도 압력 측정법과 상기도 CT 촬영법 사이의 기도 협착 진단의 일치율은 단 5명에서만 잘 일치하였고(high-concordant), 5명은 잘 일치하지 않았으며(low-concordant), 나머지 1명은 전혀 일치하지 않았다. 결 론: 대부분의 수면무호흡증 환자는 수면 중 여러 번 발생하는 수면무호흡에서 2가지 또는 그 이상의 기도 협착 형태를 보이므로, 단 1회의 수면무호흡의 상태만을 반영하는 상기도 CT는 수면무호흡의 기도 협착 부위를 적절히 반영하지 못한다고 생각된다.

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폐쇄성수면무호흡증(Obstructive Sleep Apnea)의 치료에 대한 치과의사의 임상적 접근 (Clinical approach for treatment modality of obstructive sleep apnea: focus on the role of dentists)

  • 신원철;이덕원;정유진;김태경
    • 대한치과의사협회지
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    • 제53권1호
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    • pp.47-56
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    • 2015
  • Obstructive sleep apnea (OSA), most common respiratory disorder of sleep, is characterized by intermittent partial or complete occlusions of the upper airway due to loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxemia, which leads to poor quality of sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences Untreated OSAS can cause various problems such as hypertension, diabetes, stroke, cardiac disease, daytime sleepiness. Various treatments are available, including non-surgical treatment such as medication or modification of life style, surgical treatment, continuous positive airway pressure (CPAP) and oral appliance (OA). Oral appliance is known to be effective in mild to moderate OSA, also genioglossus muscle advancement (GA) or maxillomandibluar advancement (MMA) is a good option for OSA patients with muscular or skeletal problems. Although the prevalence of OSA is increasing, the proportion of the patient treated by dentist is still very law. Dentists need to understand the mechanism of OSA and develop abilities to treat OSA patients with dental problems. The purpose of this paper is to give a brief overview about OSA and the dentist's role in OSA patients.

Comparison of the effects of different-sized airways in inspiratory trainers on maximal inspiratory pressure and rating of perceived exertion scale in healthy young people

  • Hwang, Young-In;Kim, Ki-Song
    • Physical Therapy Rehabilitation Science
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    • 제7권1호
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    • pp.18-22
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    • 2018
  • Objective: This study aimed to investigate the effect of different-sized airways of the inspiratory muscle trainer (IMT) on maximal inspiratory pressure (MIP) and the rating of perceived exertion, as measured by the modified Borg scale (m-Borg). Design: Cross-sectional study. Methods: Twenty healthy subjects (10 men, 10 women) volunteered for the study. The spirometry was used to measure MIP. The trial order of the three spirometry conditions was chosen randomly. After measuring the MIP and before taking the final break, each of the conditions were immediately measured using the m-Borg. All subjects used the IMT with an airway diameter of 5-, 6-, and 7-mm. Results: The MIP significantly decreased with the decreasing airway diameter of the IMT (p<0.001), and the differences in all three conditions (7- and 6-mm, 6- and 5-mm, and 7- and 5-mm airways) were significant (p<0.05). The RPE significantly increased with the decreasing airway diameter of the IMT (p<0.001), and the differences in all three conditions (7- and 6-mm, 6- and 5-mm, and 7- and 5-mm airways) were significant (p<0.05). Conclusions: Decreasing the airway diameter of the IMT decreased the MIP and increased the m-Borg. In regards to physical exercise within the clinical setting, the m-Borg could be a useful as a prior monitoring method to prevent dyspnea for patients with narrowed airways (blocked with secretion or sputum in pulmonary disease) and the different-sized airways of the IMT could be applied as a useful tool to improve MIP for prevention of pulmonary disease.

Clinical assessment of the efficacy of supraglottic airway devices compared with endotracheal tubes in cats during volume-controlled ventilation

  • Niyatiwatchanchai, Nutawan;Thengchaisri, Naris
    • Journal of Veterinary Science
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    • 제21권2호
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    • pp.27.1-27.10
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    • 2020
  • The efficacies of a supraglottic airway device (SGAD) and an endotracheal tube (ETT) in cats under general anesthesia with volume-controlled ventilation (VCV) were compared. Thirty healthy cats were randomly allocated for airway control using either an SGAD or an ETT. Five tidal volumes (6, 8, 10, 12, and 14 mL/kg) were randomly tested, and respiratory rates were adjusted to achieve a minute ventilation of 100 mL/kg/min. The dose of propofol necessary to insert the SGAD or ETT, the static respiratory pressure, leakage during VCV, and end tidal CO2 (ETCO2) were recorded. Dosages of propofol and static respiratory measurements for the SGAD and ETT groups were compared using a t-test. The distribution of leakages and hypercapnia (ETCO2 > 45 mmHg) were compared using Fisher's exact test. A significance level of p < 0.05 was established. No significant difference in dose of propofol was observed between the SGAD and ETT groups (7.1 ± 1.0, 7.3 ± 1.7 mg/kg; p = 0.55). Static resistance pressure of the SGAD (22.0 ± 8.1 cmH2O/L/sec) was significantly lower than that of the ETT (36.6 ± 12.9 cmH2O/L/sec; p < 0.01). Of the 75 trials, leakage was more frequent when using an SGAD (8 events) than when using an ETT (1 event; p = 0.03). Hypercapnia occurred more frequently with SGAD (18 events) than with ETT (3 events; p < 0.01). Although intubation with an ETT is the gold standard in small animal anesthesia, the use of an SGAD can reduce airway resistance and the work of breathing. Nonetheless, SGAD had more dead space and the tidal volume for VCV needs adjustment.

소아에서 후두 마스크를 이용한 기관지이물 제거 경험 1예 보고 (A Case of Bronchial Foreign Body Removal During Trans-Laryngeal Mask Airway Fiberoptic Bronchoscopy)

  • 서지원;김종렬;박규호;강준구;최진
    • Tuberculosis and Respiratory Diseases
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    • 제44권6호
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    • pp.1433-1439
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    • 1997
  • 소아에서 기관지내 이물은 드물지 않게 접하는 질환이 나 본 예의 환자의 경우와 같이 소아에서 후두 마스크를 사용하여 기관절개술(tracheostomy)을 회피하고 기관지 이물을 제거한 경험예는 현재까지 아직 발표된 바 없고, 아직까지도 마취과의사를 제외한 다른 진료분야의 의사들에게는 후두 마스크가 널리 알려져 있지 않기에 저자들은 후두 마스크를 사용하여 굴곡성 기관지경으로 기관지 이물을 성공적으로 제거한 1례를 문헌고찰과 함께 보고하는 바이다.

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