• Title/Summary/Keyword: Airway evaluation

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Airway Obstruction and Respiratory Distress Owing to Sedation by use of Chloral Hydrate & Ketamine Before Extraction of the Mesiodens in Patient with Bronchial Asthma & Tonsillar Hyperplasia -A Case Report- (기관지 천식과 편도 증식증 환자에서 상악 정중부 과잉치 발치 전 포크랄과 케타민 투여 진정요법 시 발생된 기도폐쇄와 호흡장애 -증례 보고-)

  • Choi, Young-Su;Kang, Sang-Hoon;Kim, Moon-Key;Lee, Chun-Ui;Yoo, Jae-Ha
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.10 no.1
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    • pp.34-44
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    • 2010
  • The causes for airway obstruction include foreign body aspiration, congenital structural abnormalities of the airway, infection, etc. And the potential causes of acute respiratory distress contain many situations, like hyperventilation, vasodepressor syncope, asthma, etc. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Adequate pretreatment medical and dental evaluation of the prospective patient can often prevent respiratory problems from developing. The dentist can modify patient management to minimize the risk of exacerbating these conditions. When dental anxiety is a major factor, the use of psychosedative procedures and other stress-reduction techniques should also be considered. This is the report of a children case of airway obstruction and respiratory distress owing to sedation complication by use of Chloral hydrate and Ketamine before extraction of the mesiodens in a patient with bronchial asthma and tonsillar hyperplasia. After these situations, the patient was consulted & referred to the department of Pediatrics and Otorhinolaryngology.

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

  • Park, Junhyun;Ho, YeJi;Lee, Duck Hee;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.40 no.5
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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.

Evaluation of Upper Airway Depth with Different Anteroposterior Skeletal Patterns in Children (소아에서 상하악골의 위치에 따른 상기도의 시상평면상 계측값의 연관성)

  • Kim, Sookhee;Ko, Mija;Nam, Okhyung;Kim, Misun;Lee, Hyoseol;Kim, Kwangchul;Choi, Sungchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.3
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    • pp.307-313
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    • 2018
  • The respiratory function is relevant to the craniofacial growth and orthodontic diagnosis. The size of the pharyngeal airway was measured in lateral cephalometric view in children visited Kyung Hee University Hospital from January 2015 to August 2017. A total of 74 healthy children (36 boys and 38 girls) aged 7 - 11 years (mean, 8.5 years) with a normodivergent facial pattern were divided into three groups according to anteroposterior jaw relation measuring A point-Nasion-B point (ANB) angle. Lateral cephalometric data were used to measure the airway dimensions. The dimensions of the middle airway were significantly lower, reducing the upper airway space, in large ANB angle group than in other children, suggesting that children with large ANB angle have narrower airway space than others.

A Development and Effects of Simulation-based Education Program on Emergency Airway Management (시뮬레이션 기반 응급기도관리 교육 프로그램 개발 및 효과)

  • Lee, Hyun Ah;Kim, Sung Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.11
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    • pp.282-293
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    • 2019
  • Purpose: After developing and imparting knowledge of a simulation-based emergency airway management education program for nursing students, this study identified the effects of the education by evaluating emergency airway management knowledge, Clinical Performance Ability, self-efficacy, and critical thinking disposition. Method: The participants were 30 nursing students. Data were collected from October 14 to November 11, 2017, and analyzed using IBM SPSS Version 22.0. Results: The simulation-based nursing education program was developed and applied based on the ADDIE model involving five stages: analysis, design, development, implementation and evaluation. Comparing the pre-and post-education results, we observed statistically significant improvement when considering emergency airway management knowledge (t=-9.98, p<0.001), Clinical Performance Ability (t=-23.90, p<0.001), self-efficacy (t=-16.77, p<0.001), and critical thinking disposition (t=-5.04, p<0.001). Conclusions: Simulation-based emergency airway management training program is an effective educational program that enhances the emergency airway management knowledge, Clinical Performance Ability, self-efficacy, and critical thinking disposition of nursing students. We believe that the program developed in this study contributes towards improvement of patient nursing quality by enhancing the ability of nursing students to cope with emergencies in practice. Furthermore, it can be applied for educating new nursing students, and contribute to the development of nursing practices.

Relationship between Upper Airway and Sleep-Disordered Breathing in Children with Mouth Breathing (구호흡 어린이에서 수면호흡장애와 상기도와의 관계)

  • Kim, Doyoung;Lee, Daewoo;Kim, Jaegon;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.1
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    • pp.38-47
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    • 2019
  • The most common cause of mouth breathing is obstacles caused by mechanical factors in upper airway. Mouth breathing could be consequently pathological cause of sleep-disordered breathing. Sleep-disordered breathing in children can cause growth disorders and behavioral disorders. The purpose of this study was to investigate relationship between upper airway and sleep-disordered breathing in children with mouth breathing. Twenty boys between 7 - 9 years old who reported to have mouth breathing in questionnaire were evaluated with clinical examination, questionnaires, lateral cephalometric radiographs, and portable sleep testing. This study assessed apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) for the evaluation of sleep-disordered breathing and was done to investigate the correlation between these values and the upper airway width measured by lateral cephalometric radiographs. There was no significant correlation with the size of the tonsils (p = 0.921), but the adenoid hypertrophy was higher in the abnormal group than in the normal group (p = 0.008). In the classification according to AHI and ODI, retropalatal and retroglossal distance showed a statistically significant decrease in the abnormal group compared to the normal group (p = 0.002, p = 0.001). As AHI and ODI increased, upper airway width tended to be narrower. This indicates that mouth breathing could affect the upper airway, which is related to sleep quality.

Development of Auto-titrating Algorithm for Auto-titrating Positive Airway Pressure (자동형 양압유지기의 자동적정 알고리즘 개발)

  • Park, Jong-Uk;Urtnasan, Erdenebayar;Kim, Yoon-Ji;Lee, Kyoung-Joung;Lee, Sang-hag
    • Journal of Biomedical Engineering Research
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    • v.40 no.4
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    • pp.132-136
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    • 2019
  • This study proposes an auto-titrating algorithm for auto-titrating positive airway pressure (APAP). The process of the proposed algorithm is as follows. First, sleep apnea-hypopnea and snoring events were detected using nasal pressure. Second, APAP base pressure and SDB events were used for automatic titration of optimal pressure. And, auto-titrating algorithm is built into M3 (MEK-ICS CO. Ltd., Republic of Korea) for evaluation. The detection results of SDB showed mean sensitivity (Sen.) and positive predictive value (PPV.) of 85.7% and 87.8%, respectively. The mean pressure and apnea-hypopnea index (AHI) of auto-titrating algorithm showed $13.0{\pm}5.2cmH_2O$ and $3.0{\pm}2.4$ events/h, respectively. And, paired t-test was conducted to verify whether the performance of our algorithm has no significant difference with AutoSet S9 (p>0.05). These results represent better or comparable outcomes compared to those of previous APAP devices.

Post-operative Continuous Positive Airway Pressure (CPAP) Therapy in Velopharyngeal Insufficiency Patient (지속성 양압 치료법을 이용한 구개인두기능부전증의 치료)

  • Kim, Kyu Nam;Koh, Kyung Suck;Jung, Seung Eun;Ha, Seung Hee;Park, Mi Kyung
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.73-76
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    • 2010
  • Purpose: There are several surgical methods for correcting a velopharyngeal insufficiency (VPI) but in some cases, it is not possible to achieve complete recovery of the velopharyngeal function. This paper introduces a new therapy for treating hypernasality without further surgery using continuous positive airway pressure (CPAP). Methods: CPAP therapy was applied to seven VPI patients for eight weeks from April of 2007 to September of 2009. All patients underwent palatoplasty for the cleft palate and six patients underwent palatal lengthening for VPI before CPAP therapy. A speech pathologist performed an auditory perceptual evaluation to evaluate the improvement in hypernasality after 8-week CPAP therapy. Results: Six patients showed an improvement in hypernasality after CPAP therapy according to the auditory perceptual evaluation. One patient with severe hypernasality responded to the early part of therapy but the hypernasality did not improve after therapy. Conclusion: CPAP therapy might be effective in reducing the hypernasality in patients with VPI by providing resistance training to strengthen the velopharyngeal closure muscles. In particular, CPAP therapy could be more effective for patients who show mild to moderate hypernasality after surgery.

Treatment of Snoring and Obstructive Sleep Apnea with Dental Orthosis (구강내 장치를 이용한 코골이 및 폐쇄성 수면무호흡증의 치료효과)

  • 안홍균
    • Journal of Oral Medicine and Pain
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    • v.22 no.2
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    • pp.383-394
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    • 1997
  • The purpose of this study was to examine the anatomic changes in the upper airway with a dental orthosis. the effectiveness and side effects of orthosis in the treatment of snoring and obstructive sleep apnea. To meet this puppose a dental orthosis, designed to increase the size of the upper airway by advancing the mandible, was used in 42 patients (30 M, 12 F), aged 29 - 69 years, to treat snoring and varying decrees of obstructive sleep apnea. Cephalometric study of anatomic featured was made with and without a dental orthosis, and the evaluation of the effectiveness and side effects of orthosis was done by questionnaires. The obtained results were as follows : 1. All subjects were habitual snorers and 32 patients comp1ained the loudness of snoring as severe as be heard outside of the patient's room. 2. According to the degree of respiratory distirbance index(RDI) and aprea index(Al) from the polysomnograph in 34 patient, mild obstructive sleep apnea patients were 5, moderate 6 and severe 16. 3. Various anatomic changes in the upper airway with denta1 orthosis were as follows : (1) More superioly positioned hyoid bone ( p<0.001) (2) Enlarged oropharyngeal (superior p<0.01, middle p<0.01. inferior p<0.01) and hypopharyngeal (P<0.05) airway space. 4. According to the results of the changes of clinical syptoms after the usage of the dental orthosis acquired from questionnaires, there was significant improvement in the frequently, the loudness and the severity of snoring, cessation of breathing and awakening from the difficulty of breathing during sleep. 5. The effectiveness and side effects of dental orthosis by questionnaires were as follows ; (1) Dental orthosis satisfied almost all the patients (68±20%). (2) Snoring was improved in all the patients (73±19%). (3) Obstructive sleep aphea was improved in all the patients (61 ± 37%) (4) Sleepiness in the daytime was significantly improved (61 ±37%). (5) The sleep quality was significantly improved (61±37%). (6) The discomfort of the dental orthosis was minor (33±18%) and no serious complications were observed. 6. The dental orthosis is an effective treatment for the symptom of snoring, and it can also effectively treat varying degrees of obstructive sleep apnea.

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