• 제목/요약/키워드: Fluid infusion

검색결과 97건 처리시간 0.027초

말기 환자의 수액요법에 대한 간호사의 인식 (Nurses' Perception on Fluid Therapy for Terminally Ill Patients)

  • 조현숙;조옥희;유양숙
    • Journal of Hospice and Palliative Care
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    • 제13권4호
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    • pp.243-251
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    • 2010
  • 목적: 본 연구는 말기 환자에게 실시하는 수액요법에 대한 간호사들의 인식과 수액요법 실태를 파악하기 위한 서술적 조사연구이다. 방법: 대상자는 서울에 소재한 3개 대학병원의 암 병동 간호사 87명과 보건복지부의 호스피스 시범사업 지원기관으로 선정된 1개 호스피스기관의 간호사 113명, 총 200명이었다. 자료는 구조화된 설문지를 이용하여 2008년 3월 10일부터 3월 31일까지 수집하였으며, 수액요법에 대한 호스피스기관 간호사와 암 병동 간호사의 인식 차이는 $x^2test$와 ANCOVA로 알아보았다. 결과: 호스피스기관의 간호사가 암 병동 간호사에 비해 '말기 환자에게 수액을 주입하면 전신무력감이 호전되지 않는다', '수액을 주입하여도 섬망이나 안절부절함, 의식장애가 완화되지 않는다', '수액을 제한하면 폐부종이 감소되고 기침, 가래, 호흡곤란이 감소된다', '수액을 제한하면 복수가 최소화된다’고 응답한 경우가 많았다. 말기 환자에게 실시하는 수액요법에 대한 심리사회적인 측면의 인식도는 암 병동 간호사가 호스피스기관 간호사보다 높아 긍정적이었다. 호스피스기관이 암병동보다 말기 환자에게 수액을 말초정맥 혈관이나 지속적 피하 점적주사로 주입하는 경우가 많았으며, 주입하는 하루 평균 수액양이 적었다. 말기 환자에게 수액 요법을 하는 이유로 호스피스 기관은 '환자나 가족이 원해서'가 가장 많았으며, '환자 및 가족에게 치료를 지속하고 있다는 안정감을 주므로'와 '수액요법이 기본적인 처방이므로' 순이었으나 종합병원의 암 병동은 '환자나 가족에게 치료를 지속하고 있다는 안정감을 주므로', '환자나 가족이 원해서', '탈수를 교정하기 위해서' 순이었다. 결론: 종합병원의 암 병동 간호사들은 호스피스기관 간호사에 비하여 말기 환자에게 실시하는 수액요법에 대하여 긍정적이었으며, 두 기관 모두 환자나 가족이 원하여 말기 환자에게 수액요법을 시행하는 경우가 많았으므로 불필요한 수액요법을 시행하지 않도록 간호사는 물론 환자와 가족을 대상으로 교육을 하는 것이 필요하다고 생각한다.

개의 신장기능(腎臟機能)에 대(對)한 Serotonin의 작용(作用) (Action of serot9ninon the renal function in the dog.)

  • 서병철
    • 대한약리학회지
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    • 제2권1호
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    • pp.13-16
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    • 1966
  • The action of serotonin (5-Hydroxytryptamine) on the excretory function of the kidney was investigated in the dog, utilizing the clearance method and the stop-flow technique. It was shown that serotonin, $10{\mu}g/kg/min$, i. v., exerts a marked antidiuretic effects and elicits a marked hemodynamic changes in the kidney: a highly significant decrease of the glomerular filtration rate and a tendency of decrement in the renal plasma flow. Little change in the systemic blood pressure was noted, and the participation of the antidiuretic hormone in the antidiuretic action was ruled out by adding vasopressin to the infusion fluid. The stop-flow analysis showed that there is no evidence of altered activity in the tubules by serotonin. It was thus concluded that serotonin elicits anti diuresis in the dog by decreasing glomerular filtration rate, which results from the constriction of Vas afferens in the glomeruli.

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Anti-Alzheimer′s drug, taurine transport through the blood-brain barrier in mice and pharmacokinetics

  • Kim, You-Jung;Kang, Young-Sook
    • 한국응용약물학회:학술대회논문집
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    • 한국응용약물학회 1998년도 Proceedings of UNESCO-internetwork Cooperative Regional Seminar and Workshop on Bioassay Guided Isolation of Bioactive Substances from Natural Products and Microbial Products
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    • pp.193-194
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    • 1998
  • Recently, evaluation of brain transport of taurine which is possible to effect on Alzheimer's disease has investigated in rats. Also, internal carotid artery perfusion (ICAP) method is very useful for measuring of blood-brain barrier (BBB) permeability in rats. But ICAP has difficulties to evaluate of BBB permeability in mice especially. In the present study examines neuropharmaceutials permeability through the BBB in mice by common carotid artery perfusion (CCAP) method that modify ICAP method and require simple surgery. The external carotid artery (ECA) is cannulated with coagulating pterygopalatine artery (PPA) on ICAP method, while CCA is cannulated without coagulating PPA on CCAP method. The CCAP method require 4-5 fold higher infusion rate than ICAP method because an additional factor of 2 must be incorporated to adjust for fluid loss to the extracerebral circulation.

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이상성 경과를 보이고 정맥면역글로불린 치료 후 호전된 일본뇌염 (Japanese-B Viral Encephalitis with a Biphasic Illness Pattern and Recovery after Intravenous Immunoglobulin Therapy)

  • 이병찬;전지예;문혜진;임정근;조용원
    • Annals of Clinical Neurophysiology
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    • 제16권1호
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    • pp.35-38
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    • 2014
  • Japanese-B viral encephalitis (JE) usually has a monophasic illness pattern. A 45-year-old woman in an altered mentality had improved over 1 month. About 1 week after the initial improvement, the patient became comatose with aggravated EEG and MRI findings. Assays of cerebrospinal fluid and serum were positive for the IgM antibody to Japanese-B virus. After intravenous immunoglobulin (IVIG) infusion, the patient recovered. We report a patient with JE who showed a biphasic illness pattern and recovered after IVIG therapy.

혈장 삼투질 농도 변동에 따른 항이뇨 호르몬과 Aldosterone 분비조절 : 한국청년 (Role of Plasma Osmolality in AVP and Aldosterone Release in Korean Young Men)

  • 이원정;주영은;구자훈
    • The Korean Journal of Physiology
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    • 제21권2호
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    • pp.297-304
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    • 1987
  • A study was carried out to find out the relationship between arginine vasopressin (AVP) release and plasma osmolality in 15 young men (age: 21.4 yr). After an overnight fasting, wale. (20 ml/kg) was imbibed, and venous blood and urine samples were collected every 30 min for 90 min. then 5% saline was infused (0.06 ml/min/kg) for 120 min. AVP was extracted on Sep-Pak column and measured by radioimmunoassay. Under basal condition, plasma osmolality (pOsm), AVP (pAVP) and aldosterone (pAldo) levels were 286.5 mOsm/kg, 1.1 pg/ml, and 140 pg/ml, respectively. pAVP became undetectable during maximum water diuresis, and increased in response to hypertonic saline infusion. pAVP level began to increase when pOsm was above 280 mOsm/kg. Changes in urinary AVP excretion (uAVP) was parallel to pAVP levels. The fall in pAVP was followed by a decrease in uAVP, uOsm and an increase in free water clearance, while the later rise in pAVP was followed by an increase in uAVP, uOsm and a decrease in free water clearance. When pooling all data together, relationships between pAVP and pOsm, and uAVP and uOsm were best expressed by an exponential relationship (r=0.78, 0.86, respectively). pAldo level decreased to 71 pg/ml after water ingestion, and decreased further to 30 pg/ml 2 hr after 5% saline infusion. Even at the same pNa, pAldo level during dehydration state was significantly higher than during hydration state. Negative exponential relation (r=-0.59) was observed between pAldo and pNa. Response to change in body fluid volume was greater in aldosterone than in AVP release.

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병원가정간호사업 운영 현황 및 서비스 만족도에 관한 연구 (A Study for the Present Conditions and the Service Satisfaction with Hospital Home Care Service)

  • 홍춘실;오경옥;박미영;심희숙;차영남
    • 가정∙방문간호학회지
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    • 제8권2호
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    • pp.121-134
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    • 2001
  • The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).

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Effects of Intraruminal Saliva Flow on Feed Intake in Goats Fed on Alfalfa Hay Cubes

  • Sunagawa, Katsunori;Nakatsu, Yoshifumi;Nishikubo, Yoriko;Ooshiro, Takeshi;Naitou, Kouta;Nagamine, Itsuki
    • Asian-Australasian Journal of Animal Sciences
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    • 제15권12호
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    • pp.1738-1746
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    • 2002
  • Research was carried out to ascertain whether or not the volume of saliva flowing into the rumen regulates dry forage intake in ruminants. Goats with a parotid fistula were fed roughly crushed alfalfa hay cubes, concentrated beef cattle feed and $NaHCO_3$ wice daily (10:00-12:00, 16:00-18:00). Except for the days on which experiments were conducted, the animals were free access to drinking water. The animals were intraruminally infused every day prior to the morning feeding period with parotid saliva collected from the parotid fistula over a 24 h period. The present experiment consisted of three treatments, non-infusion (NI), intraruminal infusion of parotid saliva (RSI), and intraruminal infusion of warm water (RWI). In the RSI treatment, approximately 4-5 kg of parotid saliva (280-290 mOsm/l) collected over a 24 h period was intraruminally infused 1 h prior to the commencement of morning feeding. In the RWI treatment, parotid saliva was substituted for warm water ($36^{\circ}C$). After infusions, the animals were fed on roughly crushed alfalfa hay cubes for 2 h. During feeding, eating and saliva secretion rates were measured. Blood samples were also periodically collected from the jugular vein. After 2 h feeding, water intake was measured for 30 min. These measurements were used to define thirst levels. On the day of the experiment, the animals were not access to drinking water during the morning feeding. It is thought that rumen fill in RSI and RWI treatments was higher than the NI treatment. In comparison with the NI treatment however, cumulative feed intake increased by 39.3% with RSI treatment and by 45.9% with RWI treatment after completion of the 2 h feeding period. After 2 h feeding, thirst level in the RSI treatment showed only a 10% decrease compared to the NI treatment, but thirst level in the RWI treatment decreased 49.8%. Despite the significant differences in thirst levels between RSI and RWI treatments, the cumulative feed intake in both treatments was similar. When comparing accumulated saliva secretion volumes 2 h after feeding, volumes in the RSI treatment were significantly 35.9% lower than the NI treatment while volumes in the RWI treatment were unchanged. However, the volumes of saliva and fluid flowing into the rumen were greater in both RSI and RWI treatments when compared to the NI treatment. The results indicate that the amount of saliva flowing into the rumen is a factor regulating feed intake in ruminants fed on dry forage.

복강내 확산성 물질의 부위별 흡수속도 (Regional Differences of Entry Rate of Freely Diffusible Substances from Peritoneal Cavity)

  • 조병득;신동훈
    • The Korean Journal of Physiology
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    • 제1권2호
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    • pp.157-168
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    • 1967
  • The entry of antipyrine and urea from the peritoneal cavity of rabbit into organ tissue and blood plasma was studied. Two hundred mg of antipyrine plus 300 mg of urea in 10 ml Ringer's solution was injected into the peritoneal cavity of anesthetized rabbit. The injection was made from above of a rabbit kept tying right side down and it enabled part of the abdominal organs (liver, intestine, kidney) was immersed in the injected solution and kept high concentration gradient throughout the experimental period. The remaining part of the organs was revered only by a thin film of the test solution. Subsequently, in this part of the organs the concentration gradient of the diffusible substances during entry was presumed to decrease as time elapsed. Four pieces of the liver tissue were taken namely, the right superficial, right deep, left superficial and left deep portions. Two were taken from the small intestine, one from the portion which was immersed in. the fluid and the other from that above the fluid mass. Both kidneys were separately analyzed. As a remote organ the gastrocnemius muscle was taken from the right leg of the animal. The intervals which were the time periods elapsed after injections were 5,7,10,15 or 30 minutes. At each point 5 animals were sacrificed and the concentrations of the test substances in the tissue water were measured. The results obtained were as follows. 1. In the liver the right portion which was immersed in the fluid showed higher concentration if the test substances than the left portion and the superficial region exceeded the deep region. The concentrations diminished as the time elapsed after infusion, particulary in the case of antipyrine, suggesting circulatory removal of the substances. In urea such decreasing tendency of the concentration was not obvious, and suggested slower removal rate of it as compared with that of antipyrine. 2. In the small intestine there was no regional difference in the concentration of the test substances. Because of the intestinal motility different portions of the intestine were seemed to have bathed in the fluid of the same concentration. In general the concentrations in the intestinal wall exceeded those of the liver, suggesting a slower removal rate than in the latter. 3. In the kidney the accumulation of the endogenous urea was predominant, and the accumulating mechanism in the renal tissue went on during the period of the experiment. Therefore it revealed increasing tendencies as the time elapsed. The penetration of the test substances in this organ from the peritoneal cavity seemed to be slower than in other abdominal organs, namely liver or small intestine. Part of the test substances in the kidney were obviously brought by the blood stream. 4. Rapid exponential decay of the concentration of antipyrine and of the osmolality of the peritoneal fluid was attributed to the extensive removal through the whole dimension of the peritoneal surface, and the remote organ such as the gastrocnemius muscle attained a fairly close value to that of the abdominal organs in less than 30 minutes. The factors which related to the absorption rate were discussed. They were the concentration gradient, permeability and the regional perfusion rate.

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거대 농흉으로 발견된 폐방선균증 1예 (A Case of Huge Empyema Caused by Pulmonary Actinomycosis)

  • 김덕룡;최윤희;이승환;이종신;김민재;이승숙;최두환;김철현;이재철
    • Tuberculosis and Respiratory Diseases
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    • 제57권6호
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    • pp.579-583
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    • 2004
  • 환자는 지속적인 객담을 동반한 기침 및 발열이 있었고, 방사선학적 검사에서 좌측폐에 air-fluid level을 동반한 거대한 공동이 관찰되었다. 임상 양상이 폐농양에 부합되어 항생제 투여와 배농을 시행 하였으나 호전이 없어 개흉술을 시행하였다. 수술 소견상 폐농양이 아닌 농흉이 관찰되었으며, 조직병리검사에서 폐방선균증으로 진단되었다.

레이저 형광여기법(LIF)를 이용한 복잡 난류유동장의 혼합특성에 관한 연구 (A Study on the Mixing Characteristics in Complex Turbulent Flow by a Laser Induced Fluorescence Method)

  • 김경천;정은호
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2001년도 춘계학술대회논문집E
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    • pp.542-547
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    • 2001
  • A non-intrusive Planar Laser-Induced Fluorescence(PLIF) technique was applied to study the turbulent mixing process in a Rushton turbine reactor. Instantaneous and ensemble averaged concentration fields are obtained by measuring the fluorescence intensity of Rhodamine B tracer excited by a thin Nd:Yag laser sheet illuminating the whole center plane of the stirred tank. The gray level images captured by a 14-bit cooled CCD camera can be transformed to the local concentration values using a calibration matrix. The dye injection point was selected at the tank wall with three quarter height (3/4H) from the tank bottom to observe the mixing characteristics in upper bulk flow region. There exist distinct two time scales: the rapid decay of mean concentration in each region after the dye infusion reflects the large scale mixing while the followed slow decay reveals the small scale mixing. The temporal change of concentration probability functions conjectures the two sequential processes in the batch type mixing. An inactive column of water existed above the impeller disk, in which the fluid rotates with the shaft but is isolated from the mean bulk flow.

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