• Journal of Trauma and Injury
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• 제31권1호
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• pp.16-18
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• 2018

Delayed esophageal rupture due to blunt injury is not new. However, rupture due to suspected barotrauma is very rare. We describe a case of esophageal rupture in a male 24-year-old patient after diving in shallow waters. The patient was quadriplegic and could not experience the typical chest pain related to rupture and resulting mediastinitis. The rupture was discovered 4 days after emergency decompressive laminectomy and fusion for his cervical spine. The rupture was evidently caused by barotrauma and was discovered four days after admission. He underwent primary closure and pericardial flap as a life-saving procedure.

• 한국응급구조학회지
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• 제17권3호
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• pp.21-28
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• 2013

Purpose: The purpose of this study is to get basic user guidelines of safe and efficient bag-valve-mask application on patients having abnormal pathophysiological pulmonary conditions. Methods: This study was performed by pre-qualified 35 EMS junior and senior students. Participants were instructed to compress ambulatory bag randomly about half, one-third, one-fourth within different airway resistance and pulmonary compliance. Resultant tidal volume and pulmonary wedge pressures on RespiTranier monitor were analysed in relation to pulmonary physiologic index. Results: At least over half compression of bag guaranteed minimal tidal volume regardless of pulmonary conditions. There was no increase of pulmonary wedge pressure above the level of barotrauma on half compression at any pulmonary conditions. Conclusion: Assisted ventilation with ambulatory bag on patients with pathological pulmonary conditions should be over half compressed regardless of respiratory disease entity.

• Journal of Chest Surgery
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• 제53권1호
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• pp.34-37
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• 2020

Cerebral air embolism combined with cardiomyopathy secondary to pulmonary barotrauma is rare. Here, we report an unusual case of cerebral air embolism combined with transient cardiomyopathy secondary to large bulla rupture during a pulmonary function test after lung cancer surgery. The patient experienced loss of consciousness. Computed tomography and magnetic resonance imaging suggested a cerebral air embolism. Electrocardiography showed ST-segment elevation and abnormally high plasma levels of cardiac enzymes. Echocardiography and coronary angiography suggested cardiomyopathy. The patient was discharged with no sequelae.

• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.142-144
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• 2013

A 49-year-old female with a history of several neurosurgical and otolaryngologic procedures for occipital meningioma and cerebrospinal fluid leaks was diagnosed with pneumocephalus after a one hour flight on a domestic jet airliner. Despite multiple operations, the air appeared to enter the cranium through a weak portion of the skull base due to the low atmospheric pressure in the cabin. The intracranial air was absorbed with conservative management. The patient was recommended not to fly before a definite diagnostic work up and a sealing procedure for the cerebrospinal fluid leak site had been performed. Recent advances in aviation technology have enabled many people to travel by air, including individuals with medical conditions. Low cabin pressure is not dangerous to healthy individuals; however, practicing consultant neurosurgeons should understand the cabin environment and prepare high risk patients for safe air travel.

• 대한의용생체공학회:의공학회지
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• 제11권2호
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• pp.203-208
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• 1990

A possible asymmetry in airway inertance was modeled based on previously reported radiographic visualization data of the airway wall fluctuation in intact dogs. Effects of asymmetric Inertance on mean lung volume during high frequency ventilation (HFV) were evaluated in terms of mean inertive pressure drop across the airways. It was found that a negligible inertlve pressure drop was expected ($<1{\;}cmH_20$) in normal subjects, while a sig- nificant rise in mean alveolar pressure compared to mean mouth pressure by approximately $3{\;}cmH_20$ was resulted for about 40% airway fluctuation representing bronchoconstriction state by Histamine induction. These results demonstrate that asymmetric Inertance could lead patients with airway diseases to a significant lung hyperinflation (LHI), and bronchodilation treatment is recommended prior to applying HFV to prevent those patients from a possible barotrauma.

• Journal of Chest Surgery
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• 제26권1호
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• pp.59-63
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• 1993

A clinical evaluation was performed with a population of 49 patients of chest trauma, who were diagnosed to undergo ventilator therapy, and had gone through ventilator therapy at the Department of Thoracic and Cardiovascular Surgery, Kyungpook University Hospital. One of most common causes of chest trauma was vehicle accidents [77.5%] with the prevalent age group being their forties. The common findings were multiple rib fractures [89.8%], hemopneumothrax [81.6%], lung contusion [61.2%] and flail chest [44.9%]. Their common combined injuries were the orthopedics and neurosugical injuries [86.7%]. Complications caused by chest trauma were pneumonia, respiratory failure, atelectasis, barotrauma and empyema. Pulmonary infections were commonly associated with mechanical ventilation in the long term group and were best prevented by using bronchial hygiene therapy.The mortality rate was 5.8% of the total patients and that was 38.8% of the patients, who needed ventilator therapy. The causes of death were pneumonia, respiratory failure, acute renal failure and hypovolemic shock. Mechanical ventilation has an important place in the treatment of patients with severe chest trauma.

• 대한기관식도과학회지
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• 제1권1호
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• pp.109-115
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• 1995

High frequency Jet ventilation (HFJV) via cricothyroid membrane puncture contols frequency of ventilation as 20-200/min and persuits adequate gas exchange. HFJV was known to have advantages such as improvement of PaO$_2$, lesser barotrauma, stable hemodynamic effects, good operative field and lesser movement of head. The purpose of this study was to clarify the advantages of HFJV in cases of microlaryngeal surgery which operating time was expected even within 30 minutes. Twenty-eight patients were divided two groups : 1)control group : general endotracheal Intubation anesthesia. 2)experimental group : HFJV via cricothyroid membrane puncture with intravenous anesthesia, frequency 40/min, I/E ratio 40%, driving pressure 40 psi. We analyzed blood pressure, arterial blood gas, score of general condition and recovery time after operation. In conclusion, HFJV via cricothyroid membrane puncture had a good score of general condition and rapid recovery of consciousness, although some accumulation of P$CO_2$and elevation of blood pressure.

• Journal of Yeungnam Medical Science
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• 제19권2호
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• pp.92-98
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• 2002

Emergency medicine(EM) is the specialty of evaluating, stabilizing and initiating treatment for patients with life or limb-threatening illnesses or injuries. Techniques unique to the specialty of EM are the triage systems, quick stabilization methods, and emergency surgery procedures. The field of EM encompasses areas such as emergency department management, disaster planning and management, the management of emergency medical service(EMS) systems, research into such areas as brain and heart resuscitation, trauma and disaster management, survival medicine, and environmental emergencies(cold and heat injuries, poisioning, decompression sickness and barotrauma). Today, in addition to providing emergency care, the emergency specialists have moral and legal obligations to assess and report probable cases of child and spouse abuse, sexual assault, and alcohol and drug abuse. Future, the EM should provide surveillance, identification, intervention, and evaluation of injury and disease, therefore EM will remain as a key component of evolving community health care system.

• 대한두개안면성형외과학회지
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• 제20권3호
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• pp.199-202
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• 2019

Traumatic subcutaneous emphysema, which is the infiltration of air into subcutaneous tissues due to trauma, is caused by various factors such as chest and/or abdominal trauma, facial fractures, and barotrauma caused by mechanical ventilation. In this case report, a 32-year-old woman developed traumatic subcutaneous emphysema after undergoing abdominal liposuction at a local clinic. She was subsequently admitted to Busan Paik Hospital, and with early diagnosis and conservative treatment, she was discharged on the seventh day of hospitalization with no complications. However, because traumatic subcutaneous emphysema may accompany other injuries for various reasons, radiological examination and various tests should be performed to prevent serious complications and sequelae.

• 항공우주의학회지
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• 제29권3호
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• pp.93-95
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• 2019

Middle-ear barotrauma is a common problem reported by aircrew members and passengers. Studies have shown that 20~50% of passengers report ear complaints during the flight or after landing. Barotitis media is defined as an acute or chronic inflammation caused by a pressure differential between the tympanic cavity and the surrounding atmosphere. The Problems caused by otitis media or sinusitis of aircrew during landing and take-off can be a threat to aviation safety. Therefore, the aviation medical examiner should know about barotitis media of aircrews. In this paper, we aimed to learn what is barotitis media and how much it could affect aircrews. Also, we aimed to evaluate how barotitis media could make an impact on crews during flight, and how to manage these problems.