• Title/Summary/Keyword: Cuff pressure

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Long-term consistency of clinical sensory testing measures for pain assessment

  • Pablo Bellosta-Lopez;Victor Domenech-Garcia;Thorvaldur Skuli Palsson;Pablo Herrero;Steffan Wittrup Mcphee Christensen
    • The Korean Journal of Pain
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    • v.36 no.2
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    • pp.173-183
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    • 2023
  • Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs. Methods: Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated. Results: Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96-0.99; MDC, 22-55 kPa) and from good to excellent at 6 months (ICC, 0.88-0.95; MDC, 47-91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91-0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57-0.74; MDC, 24%-35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86). Conclusions: PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.

An Assessment of Allograft Function in Canine Single Lung Transplantation (일측 폐이식 실험견에서 이식폐의 기능 평가연구)

  • 박창권
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1096-1106
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    • 1995
  • We experienced 7 cases of left single lung transplantation in 14 mongrel dogs and analyzed graft lung function by hemodynamics, blood gas analysis, chest X-ray, biopsy and perfusion lung scan. We performed right pulmonary artery cuff[PA cuff for analysis of graft lung function in 3 cases. The donor lungs were flushed with modified Euro-Collins solution[n=3 or low potassium dextran glucose solution[n=4 and preserved for 4 to 5 hours[n=4 or 24 hours[n=3 at 10o C and implanted to the dogs with similar weight . Assessment of left graft lung was done by occluding the right pulmonary artery for 10 minutes using PA cuff. Assessment for graft lung function was done immediately after an operation and after 3 days, 7days and 3 weeks postoperatively. Four dogs survived for 3days, 7days[2 cases and 3 weeks respectively. Other three dogs expired within 3 hours of reperfusion. Immediate perfusion scans of left lung in four survived dogs after reperfusion were 42.1%, 36% , 11% and 5.9% respectively, and another dog with 4.8% perfusion to left lung was dead due to left atrial thrombi after 3 hours reperfusion. In one case among three acute rejections follow-up perfusion scan was done on 3rd and 11th postoperative day and the result decreased from 36% perfusion immediate postoperatively to 21% and 15% respectively. Three expired dogs postoperatively couldn`t tolerate occlusion of right pulmonary artery with above 40 mmHg of mean pulmonary artery pressure. On the other hand, three survival dogs postoperatively tolerated occlusion of right pulmonay artery with less than 30 mmHg of mean pulmonary artery pressure. and one dog couldn`t tolerate same procedure immediate postopertively but in 2 hours reperfusion later tolerated with 29 mmHg of mean pulmonary artery pressure.In conclusion we couldn`t compare the effect of two flushing solutions but low potassium dextran glucose solution showed relatively safe preservation effect in cases with preservation of more than 20 hours. Also canine left single lung transplantation model with PA cuff indicated useful method for the assessment of graft lung function with effect of lung preservation.

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Evaluating the Accuracy of Blood Pressure Measurement in General Hospital Nurses (종합병원 간호사의 혈압측정의 정확성 평가)

  • Kim Jong-Sook;Kim Sang-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.1
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    • pp.7-15
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    • 2000
  • To assess the accuracy of blood pressure measurement in general hospital nurses, 276 nurses at four hospital in Kyungju city and Pohang city were observed during the study period 20 December 1998 to 29 December 1998. The nurses measuring the blood pressure of simulated patient's were checked by the researcher or 20 items, that are recommended for consideration when doing a blood pressure measurement. Of the six items in the preparation step for measuring blood pressure, the accuracy of 'patients shouldn't talk during the procedure' had the lowest frequency(27.1%) and the other five items were above 80%. Of the ten items on blood pressure measuring technique, the accuracy of the frequency for 'inflating the cuff until the radial or brachial artery pulse is no longer palpable and then adding 30mmHg' was 0%, 'waiting $30{\sim}60$ seconds before reinflating the cuff' was alse 0%, 'rapidly deflating the cuff', 0.3%, 'rapidly and steadily inflating the cuff to the maximal level as per above-mentioned initial systolic pressure assessment step', 0.7%, 'reading the pressure to the nearest 2mmHg mark on the manometer', 10.8%, the remaining items were above 70%. Of the four items on blood pressure recording, the accuracy of 'recording the cuff size' had a frequency of 0.3%, 'recording the patient's position such as sitting, standing or lying position', 10.8%, 'recording the arm or leg which was used for measuring the blood pressure', 53.6%, and 'recording systolic/diastolic pressure', 100%. The variables significantly related to the accuracy of the blood pressure measurement were age, career position at hospital, and qualification education for blood pressure measurement(p<0.01). In the multiple regression analysis, position and qualification education were significant variables(p<0.01). In conclusion, the accuracy of blood pressure measurement was very low, thus, qualification education for blood pressure measurement should be done immediately to improve the accuracy of measurement by nurses in general hospitals.

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Development of An Actuator-Based Blood Pressure Simulator for Automatic Blood Pressure Monitor (자동혈압계 점검을 위한 액추에이터 기반의 혈압 시뮬레이터 개발)

  • Soo Hong Kim;Seung Jun Lee;Mun Hyeok Lim;Hye Min Park;Min Seok Gang;Gun Ho Kim;Kyoung Won Nam
    • Journal of Biomedical Engineering Research
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    • v.45 no.1
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    • pp.49-55
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    • 2024
  • Accurate measurement of blood pressure is essential for classifying an individual's disease, identifying blood pressure-related risks, and managing health. Due to the environmental and health hazards of mercury sphygmomanometers, automatic sphygmomanometers using the oscillometric method are widely used in hospitals as well as in general homes, and have established themselves as a practical standard sphygmomanometer. In this study, we developed a blood pressure simulator using an actuator that provides simulated pressure to an automatic blood pressure cuff. The developed blood pressure simulator adopts an arm-shaped cylindrical shape similar to the situation in which a person measures blood pressure with an automatic blood pressure monitor, and implements a method of transmitting pressure to the cuff using a pressure plate. Accuracy was evaluated through the mean and standard deviation of the difference with the commercialized blood pressure simulator BP PUMP 2, and reproducibility was confirmed using two automatic blood pressure monitors. The developed blood pressure simulator enables automatic blood pressure monitoring in a simple manner and also meets the evaluation standards for accuracy and reproducibility. In the future, as a standardized blood pressure simulator, it is expected to be of great help in evaluating and verifying the performance of automatic blood pressure monitors by supplementing precise hardware and software and building a blood pressure database.

The Effect of Intracuff Pressure Adjustment on Postoperative Sore Throat and Hoarseness after Nitrous Oxide and Air Anesthesia (아산화질소(N2O)와 공기(Air)를 사용한 마취 수술의 기낭압 조정이 수술 후 인후통과 쉰목소리에 미치는 영향)

  • Gu, An Na;Yu, Mi
    • Journal of Korean Academy of Nursing
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    • v.49 no.2
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    • pp.215-224
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    • 2019
  • Purpose: To investigate the differences in postoperative sore throat and hoarseness by adjustment of endotracheal tube cuff pressure (CP) during nitrous oxide ($N_2O$) and air anesthesia. Methods: A one-equivalent control group pretest-posttest design was used. Data were collected from August 8 to October 19, 2017 and analyzed using the independent t-test and repeated measures ANOVA. Eighty-four participants were enrolled and divided into three groups: 28 in the Control Group (CP adjusted every 30 minutes using $N_2O$), 28 in Experimental Group 1 (CP adjusted every 10 minutes using $N_2O$), and 28 in Experimental Group 2 (non-adjusted CP using air), all of whom underwent urologic, gynecologic, and orthopedic surgeries at the G University hospital. Sore throat was assessed using a numeric rating scale; hoarseness was evaluate using the Stout classification at 1, 6, and 24 hours after surgery. Results: Scores for sore throat and hoarseness were significantly different between the groups at each measurement time, and scores were consistently higher in the control group. During subsequent measurements, sore throat and hoarseness scores were significantly lower at 6 hours. Cuff pressure changed significantly using air anesthesia (${\chi}^2=10.41$, p=.015) up to 2 hours after induction. Severe sore throat and hoarseness was observed for up to 6 hours after surgery. Conclusion: Cuff pressure adjustment at short time intervals would be helpful in reducing postoperative sore throat and hoarseness. Nursing intervention focused on prevention of sore throat and hoarseness should be required up to 6 hours postoperatively in patients undergoing endotracheal intubation.

Tracheoesophageal Fistula Associated with Endotracheal Intubation (기관삽관과 관련된 경부 기관의 기관식도루)

  • Hah, J. Hun
    • Korean Journal of Bronchoesophagology
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    • v.18 no.2
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    • pp.41-44
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    • 2012
  • Acquired tracheoesophageal fistula (TEF) can occur rarely from various causes. Recently, cuff-related tracheal injury after endotracheal intubation with the orotracheal tube and tracheostomy cannula is the most common etiology of nonmalignant TEF. Since cuff-related TEF is usually preventable with proper selection of the cuffed tube and close monitoring of cuff pressure. Although most patients present increased secretions, recurrent pneumonia, or coughing after swallowing, a high index of suspicion is required in patients at risk for developing a TEF. Surgical correction for the defectis required. In most cases, primary closure of the esophageal defect and tracheal resection and end-to-end anastomosis give the best results.

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Effect of Extracorporeal Shock Wave Therapy on Pain and Function in Patients with Rotator Cuff Tendinitis (체외충격파치료가 회전근개 건염 환자의 통증 및 기능에 미치는 영향)

  • Seo, Hyung-Seok;Sung, Youn-Bum;Lee, Jung-Ho;Park, Young-Han
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.7
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    • pp.3132-3139
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    • 2012
  • The purpose of this study was to evaluate whether extracorporeal shock wave (ESWT) is an effective treatment for rotator cuff tendinitis. Study subjects included 32 patients (16 in the experimental group and 16 in the control group). The patients were evaluated by assessing pain and function using visual analog scale (VAS), pressure pain threshold (PPT), Constant and Murley Scale (CMS), and simple shoulder test (SST). The results of this study indicated that ESWT after the subjects in the experimental group experienced significant changes in pain, range of motion, muscle strength, and function when compared to the control group. These results indicate that ESWT could be considered as an effective and efficient treatment for rotator cuff tendinitis.

A New Method for Artifact Reduction Based on Capacitive Sensor and Adaptive Filter in Oscillometric Blood Pressure Measurement (오실로메트릭 혈압 측정에서 커패시턴스 센서와 적응필터를 이용한 새로운 잡음제거방법에 관한 연구)

  • Choi, Hyun-Seok;Park, Ho-Dong;Lee, Kyoung-Joung
    • Journal of Biomedical Engineering Research
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    • v.29 no.3
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    • pp.239-248
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    • 2008
  • In this study, a new method using a capacitive sensor and an adaptive filter was proposed to deal with artifacts contaminating an oscillation signal in oscilometric blood pressure measurement. The proposed method makes use of a variation of the capacitance between an electrode fixed to a cuff and an external object to detect artifacts caused by the external object bumping into the cuff. The proposed method utilizes the adaptive filter based on linear prediction to remove the detected artifacts. The conventional method using linear interpolation and the proposed method using the adaptive filter were applied to three types of the artifact-contaminated oscillation signals(no overlap, non-consecutive overlap, and consecutive overlap between artifacts and oscillations) to compare them in terms of the artifact reduction performance. The proposed method was more robust than the conventional method in the case of consecutive overlap between artifacts and oscillations. The proposed method could be useful for measuring blood pressure in such a noisy environment that the subject is being transported.

A Case of Acquired Tracheomalacia of prolonged intubated patient (장기간 기관삽관 환자에게서 발견된 기관 연화증 1례)

  • Kim, Dong-Wook;Choi, Ik-Joon;Jin, Hong-Ryul;Park, Min-Hyun
    • Korean Journal of Bronchoesophagology
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    • v.14 no.1
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    • pp.34-37
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    • 2008
  • Although prolonged periods of intubation, chronic respiratory infection and inflammation have been reported to cause tracheomalacia. it is of relatively low incidence in adults, The clinical suspicion should be high when there has been a history of prolonged intubation with high cuff pressure and air leakage. When this clinical situation is encountered, rather than increasing the cuff pressure, the diagnosis of tracheomalacia should be considered.

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