• Title/Summary/Keyword: Fluid therapy

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Treatment of Refractory Chylous Ascites with an Innovative Peritoneovenous Shunt: Temporary Usage of a Continuous Renal Replacement System: A Case Report

  • Park, Jiyoun;Lee, Jae Jun;Lee, Jung Hee;Shim, Young Mog
    • Journal of Chest Surgery
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    • v.55 no.1
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    • pp.81-84
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    • 2022
  • Esophagectomy and esophageal reconstruction are commonly chosen as surgical options for esophageal cancer. However, prolonged untreated chyle leakage is associated with a poor prognosis. We report the case of a patient with refractory chylous ascites. To limit the ongoing fluid loss, we utilized the chylous ascites as an additional fluid source in a renal replacement therapy system. A continuous renal replacement therapy (CRRT) drainage system was modified to drain both the chylous ascites and venous blood. The ascites drainage rate was determined empirically and regulated by a dial-flow extension set. The CRRT mode was set to continuous venovenous hemodiafiltration and maintained for 7 days. After the patient was weaned from CRRT, ascites did not reaccumulate, and the patient's general condition improved dramatically. No infections related to the system occurred. This procedure temporarily alleviates symptoms and provides more time for alternative treatment strategies.

Relationship between Nursing Task Overload and Aseptic Technique Performance in Clinical Nursing Skills (임상 간호사의 역할과부담과 기본간호술 수행 시의 무균술 이행의 관계)

  • Lee, Sun-Ok;Park, Kyung-Yeon
    • Journal of East-West Nursing Research
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    • v.15 no.1
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    • pp.18-25
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    • 2009
  • Purpose: The study was investigated to identify the relationship between nursing workload and aseptic technique performance by clinical nurses, and to decrease the incidence rate of nosocomial infection. Methods: Participants (N=283) were recruited in B city from April to June 2007. The data were collected by a structured questionnaire and analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation coefficient. Results: Nursing workload was rated 9.85 out of a total score of 15. The level of aseptic technique performance as the basis for insertion of a Foley catheter was 42.72 out of a total score of 50, and as basis for insertion of intravenous catheter for fluid therapy was 40.11 out of a total score of 55. There was not a significant relationship between aseptic technique performance and nursing workload. There was a significant positive relationship between the aseptic technique performance in insertion of Foley catheter and that of intravenous catheter for fluid therapy (r=.279, p<.001). Conclusions: Attention to asepsis by nurses is crucial in nosocomial infection-related clinical nursing skills.

The Effect of Warming Methods on the Vital Signs and Thermal Discomfort of the Patient with Gastrectomy (가온요법이 위암수술 환자의 활력징후와 체온불편감에 미치는 효과)

  • Hong, Sung-Jung;Lee, Ji-Min;Kim, Yun-Kyung
    • Journal of Korean Biological Nursing Science
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    • v.12 no.2
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    • pp.81-88
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    • 2010
  • Purpose: The purpose of this study was to compare effects of intravenous fluid warming and forced-air warming on perioperative body temperature, Blood Pressure, Pulse and thermal discomfort after gastrectomy under general anesthesia. Methods: Data collection was performed from October, 2009 to February, 2010. The intravenous fluid warming group (27) was warmed through an IV line by an Animec set to $37^{\circ}C$. The forced-air warming group (27) was warmed by Bair Hugger System. The warming continued from induction of general anesthesia to two hours after completion of surgery. The data was analyzed by t-test, $X^2$, repeated measures ANOVA using SPSS/WIN 17.0. Results: There was a significant difference of body temperature and thermal discomfort between the intravenous fluid warming group and the forced-air warming group. Conclusion: We need to explore the effects combination of the intravenous fluid warming and the forced-air warming, and other warming therapy and the efficiency of modalities with regards to cost benefit is also needed.

A Study on the Development of a Infusion Pump based on an Active Muscle Pump (능동형 근육펌프 구조의 수액 주입 펌프 개발에 관한 연구)

  • Lee, Jeong-Whan;Lee, Sang-Yeob;Lee, Jung-Eun;Ahn, Ihn-Seok
    • Journal of the Korean Society of Industry Convergence
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    • v.25 no.3
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    • pp.443-449
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    • 2022
  • In this study, in order to improve the disadvantages of the environmental error of the infusion set that performs infusion therapy in the existing clinical practice and to maximize the user's convenience by miniaturizing the existing infusion pump system, the structure of the muscle pump of the human vein was imitated. As a double check valve method, a method for preventing the backflow of fluid and discharging a constant fluid in one direction by external pressure was proposed. The proposed bio-mimic muscle pump uses a check valve that controls the flow of fluid in one direction and a silicone tube with elasticity, and a chamber is constructed. A peristaltic pump for applying intermittent pressure to the tube chamber was constructed using a multi-cam structure roller. In order to verify the performance of the proposed pump, optimization was performed while changing the number of multi-cam rollers and adjusting the speed of the roller driving motor, and the reproducibility of the instantaneous discharge amount and the continuous discharge amount of the pump was compared and tested. The performance of the muscle pump proposed in this study was verified through experiments that it can inject up to 1L of fluid within 12 hours, and that it is possible to inject the fluid with an accuracy of ±0.1ml. Real-time monitoring of the fluid injection volume through the bio-mimic muscle pump proposed in this study not only increases the convenience of the administrator, but also provides a precise fluid administration environment to more patients at a low cost, and additionally applies bubble detection and occlusion detection technology If so, it is believed that a safer medical environment can be provided to patients.

Resuscitation Fluids for Patients at High Risk of Multiple Organ Dysfunction Syndromes: A Systematic Review and Meta-analysis

  • Nam, Jae Hyun;Kwack, Hee Jin;Ha, Woo Seob;Chung, Jee-Eun
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.251-259
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    • 2022
  • Background: Intravenous fluid therapy is one of the most common interventions in critically ill patients. Normal saline is frequently used, but there have been some concerns about hyperchloremia. Due to closer to plasma composition, crystalloids have been used as alternatives to normal saline. However, the optimal choice of resuscitative fluids remains controversial. Methods: MEDLINE, EMBASE, and CENTRAL were comprehensively searched until July 2021 to compare balanced crystalloids with normal saline in critically ill patients with the risk factors for multiple organ dysfunction syndromes (MODS).The primary endpoint was composite mortality. Secondary outcomes were acute kidney injury (AKI)/acute renal failure (ARF), and new receipt of renal replacement therapy (RRT). Results: A total of 1,240 studies were searched, and finally, 8 randomized controlled trials and 5 cohort studies were included. In the meta-analysis of composite mortality of 30,710 patients, balanced crystalloids compared to normal saline were significantly associated with reduced mortality (OR 0.80, 95% CI 0.68-0.95). In AKI/ARF, balanced crystalloids had a lower risk than normal saline (OR 0.91, 95% CI 0.84-0.99). There was no difference between balanced crystalloids and normal saline in risk of new receipt of RRT (OR 0.91, 95% CI 0.80-1.04). Conclusion: In fluid resuscitation for patients at high risk of MODS, the use of balanced crystalloids showed a significantly lower incidence of mortality compared to normal saline.

The Experiences of Alternative Therapy with the Menopausal Symptom in middle-aged Women (중년여성의 갱년기 증상완화를 위한 대체요법 경험)

  • Lee, Hea-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.10 no.1
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    • pp.149-160
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    • 2004
  • The primary purpose of this study was to describe psychological aspects of menopausal women who have experiences on alternative therapies, such as pomegranate tree fluid, life pack, evening primerose, zacro syrup, zacro pill, multi-vitamin, oriental medicine instead of estrogen. In order to have insights on the participants behaviors, this qualitative research was conducted. The participants in this study were six women who have been taking at least one of the alternative therapies to relieve the menopausal symptom. Data had been collected from November 2002 to May 2003. The interview questions were about motivations to seek the alternative therapy, menopausal symptoms, feelings or positive effects after the treatment. The interviews were recorded and transcribed into written documents. The method described by Giorgi was utilized for data analysis. The study results were as follows : 1. The participants sought the alternative therapy based on their own information or by friends' recommendations. The motivations of taking the therapy were to live younger and healthier by reliving menopausal symptoms including somatic symptoms, such as irregular menstruation, flushing sense, cold sweating, insomnia, dull headache, vagina dryness, cystitis after sexual intercourse, joint pain, nervousness, depression, skin dryness, and suppression of activity. 2. The participants expressed that they became more active and felt better with disappearing menopausal symptoms after about 2 to 3 weeks treatment. 3. The participants did not want to accept the fact that they had menopause, which caused avoidance of having medical diagnosis and medical treatment. They also did not want to let their spouses know about their symptoms. 4. The major reason of taking the alternative therapy was to avoid the side effects of estrogen therapy in spite of high costs of the alternative way. 5. The participants suggested that menopausal women needed to be educated about physical and psychological symptoms of menopause. They also needed to be informed about how to manage it. In conclusion, accurate information about foods and drugs utilized for the alternative therapy was needed. Medically proved methods to recognize positive effects and side effects were also necessary. These goals could be achieved by continuous medical observations and further research.

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Comparative evaluation of low-level laser therapy and ultrasound heat therapy in reducing temporomandibular joint disorder pain

  • Khairnar, Sanyukta;Bhate, Kalyani;Santhosh, Kumar S.N.;Kshirsagar, Kapil;Jagtap, Bhagyashree;Kakodkar, Pradnya
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.5
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    • pp.289-294
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    • 2019
  • Background: Pain, limitations in opening, asymmetrical jaw movements, and temporomandibular joint (TMJ) sounds are the most common findings in temporomandibular joint disorders (TMDs), which causes excruciating pain, inflammation of the surrounding muscles, posterior fibers, and synovial fluid. This study aimed to evaluate and compare the effects of ultrasound heat therapy and low-level laser therapy (LLLT) in reducing TMD-related pain. Methods: This prospective study included 42 patients (age range, 25-45 years), who were divided into two groups of 21 patients each. All patients were prescribed a non-steroidal anti-inflammatory drug (NSAID) twice a day for 5 days for temporary relief of pain prior to the commencement of treatment. Patients were kept on a soft diet and asked to restrict mouth opening during the same period. Fifteen sessions of LLLT (Group A) or ultrasound therapy (Group B) were administered to the affected side. Results: Post-therapy, the mean visual analog scale score for group A and group B was 4.81 (2.01) and 6.19 (1.20), respectively; the difference was statistically significant and favoring the LLLT group. Similarly, the mean mouth opening for group A and group B was 3.99 (0.40) and 3.65 (0.41), respectively; the difference was statistically significant and favoring the LLLT group. Conclusion: Our study recommends LLLT for treating TMD-related pain with no underlying bony pathology.

Efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors for patient with leptomeningeal metastasis of epidermal growth factor receptor mutant non-small cell lung cancer

  • Lee, Jong Sik;Lee, Kyung Ann;Lee, Kang Hoon;Moon, Sun Young;Kim, In Ae;Jeon, Sung Jin;Min, Jae Ki;Kim, Hee Joung;Lee, Kye Young
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.64-67
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    • 2016
  • We report on a 64-year-old man with leptomeningeal metastasis (LM) from an epidermal growth factor receptor (EGFR)-mutated adenocarcinoma of the lung. He was treated with paclitaxel, cisplatin. After completion of chemotherapy, he complained of headache, nausea, and vomiting. EGFR-mutated tumor cells were identified from the cerebrospinal fluid (CSF). Second-line therapy with gefitinib, methotrexate was started. After receiving gefitinib for 4 weeks, he had no more headaches or vomiting. Eleven months after initiation of gefitinib, he developed headache and nausea. Chest computed tomography showed aggravation of bone metastasis. Third-line therapy was started with gemcitabine and carboplatin. Two weeks later, he experienced disorientation. After a fourth relapse within the central nervous system, the therapy was switched to erlotinib and significant improvement of LM was achieved. This case shows that LM can be diagnosed by detecting EGFR mutation in CSF and EGFR tyrosine kinase inhibitors are effective for LM from EGFR mutant non-small cell lung cancer.

Characterization and Differentiation of Synovial Fluid Derived Mesenchymal Stem Cells from Dog (개 관절 윤활액 유래 중간엽 줄기세포의 특성과 분화능 분석)

  • Lee, Jeong-Hyeon;Lee, Sung-Lim
    • Journal of Embryo Transfer
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    • v.27 no.3
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    • pp.175-181
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    • 2012
  • The synovial tissues are a valuable MSCs source for cartilage tissue engineering because these cells are easily obtainable by the intra-articular biopsy during diagnosis. In this study, we isolated and characterized the canine MSCs derived from synovial fluid of female and male donors. Synovial fluid was flushed with saline solution from pre and post-puberty male (cM1-sMSC and cM2-sMSC) and female (cF1-sMSC and cF2-sMSC) dogs, and cells were isolated and cultured in advanced-DMEM (A-DMEM) supplemented with 10% FBS in a humidified 5% $CO_2$ atmosphere at $38.5^{\circ}C$. The cells were evaluated for the expression of the early transcriptional factors, such as Oct3/4, Nanog and Sox2 by RT-PCR. The cells were induced under conditions conductive for adipogenic, osteogenic, and chondrogenic lineages, then evaluated by specific staining (Oil red O, von Kossa, and Alcian Blue staining, respectively) and analyzed for lineage specific markers by RT-PCR. All cell types were positive for alkaline phosphatase (AP) activity and early transcriptional factors (Oct3/4 and Sox2) were also positively detected. However, Nanog were not positively detected in all cells. Further, these MSCs were observed to differentiate into mesenchymal lineages, such as adipocytes (Oil red O staining), osteocytes (von Kossa staining), and chondrocytes (Alcian Blue staining) by cell specific staining. Lineage-specific genes (osteocyte; osteonectin and Runx2, adipocytes; PRAR-${\gamma}2$, FABP and LEP, and chondrocytes; collagen type-2 and Sox9) were also detected in all cells. In this study, we successfully established synovial fluid derived mesenchymal stem cells from female and male dogs, and determined their basic biological properties and differentiation ability. These results suggested that synovial fluid is a valuable stem cell source for cartilage regeneration therapy, and it is easily accessible from osteoarthritic knee.

The Halliwick Method (할리윅 치료)

  • Kim, Tae-Youl;Yoon, Hee-Jong;Lambeck, Johan
    • Journal of Korean Physical Therapy Science
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    • v.5 no.3
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    • pp.625-631
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    • 1998
  • The Halliwick method was developed by Mr. James McMillan, a Canadian engineer of fluid mechanics. In 1949 he started to teach physically handicapped girls to swim at the "Halliwick school for crippled Girls" in London. The Halliwick method has four important basic units, as is shown in Fig 1. This constribution only deals with the structures or the practical part of the method. This part is also known as the 10-point programme. Before the characteristics of the 10 points are dealt with seperately, a few general remarks about these ponits have to be discussed. Of all things happening in the water, fun is the most important one. Swimming is fun! Swimming is taught in an order McMillan describes as: mental Adjustment(M.A), balance restoratiion(B.R.), inhibition(Inh.), and facilitation(Fac.). The 10 points of structure are linked to each other as well as to the learning process as is shown in Fig 3. The Halliwick method, which was devised by James McMillan, has proved to be a very successful way of establishing the basic principles as they have described in this article.

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