• Title/Summary/Keyword: Inspiratory pressure

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Relationship Between Trunk Control and Respiratory Function in Stroke Patients (뇌졸중 환자의 체간조절과 호흡기능의 관계)

  • Lee, Kyeong-Jin;Kim, Nan-Soo
    • Archives of Orthopedic and Sports Physical Therapy
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    • v.14 no.2
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    • pp.25-32
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    • 2018
  • Purpose: This study aimed to investigate the relationship between trunk control and pulmonary function and respiratory muscle strength in stroke patients. Methods: This study included 30 patients who had been clinically diagnosed with strokes, and trunk control abilities were measured using the trunk impairment scale (TIS). The subjects were classified into a group with high trunk control ability (TIS score ${\geq}20$) and a group with low trunk control ability (TIS score < 20). The patients' forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were measured. To compare the pulmonary function and respiratory muscle strength between the two groups, the measurement data were analyzed using an independent T-test, and the relationship between TIS and respiratory function was analyzed using a Pearson correlation. Results: The high trunk control ability group had significantly higher pulmonary function and respiratory muscle strength than the low trunk control ability group. Significant positive correlations were found between trunk control and FVC, FEV1, PEF, MIP, and MEP. Conclusions: This study demonstrated that trunk control affects pulmonary function and respiratory muscle strength in stroke patients.

A Prospective Clinical Study of Crystalloid and Colloid Solutions as Priming Additive Fluids for Cardiopulmonary bypass of the Small Children (소아에서 인공심폐기 충전액의 첨가용액으로서 사용한 crystalloid와 colloid 용액에 관한 임상연구)

  • Han, Jae-Jin;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.25 no.5
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    • pp.469-479
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    • 1992
  • Searching for the clinical effects of colloid solutions that used to increasing the oncotic pressure of priming solutions at the cardiopulmonary bypass, 29 patients [who were diagnosised as simple VSD around 10kg of body weight and scheduled to be operated from June 1990 to December 1990 at Sejong General Hospital] were divided randomly and prospectively to the two groups: A group [15] was received 4gm% albumin as addition to the priming solutions and B Group [14] the same amount of Ringer`s lactated solution. 34 clinical parameters [Body weight, sex, age, body surface area, Qp/Qs, pulmonary arterial pressure, cardiopulmonary bypass time, anesthetic time, intraoperatively infused crystalloid and colloid amount, hemoglobin, hematocrit, serum sodium concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum protein, serum albumin concentration, urine output, central venous pressure, postoperatively infused colloid amount, immedediate post-operative peak inspiratory pressure, cardiac index, blood pressure and pump flow during cardiopulmonary bypass, inotro-pic assist, diuretics, extubation period, total drain amount, duration of ICU] were measured and compaired between the two groups. There were no differences of preoperative and operative clinical parameters. And postoper-atively, practically there were no nearly differences at the clinical outcomes between the two groups, but some parameters [cardiac index, PIP, BP and pumpflow during CPB, etc] contributed to being preferable to the Group A at certain times [P<0.05]. Conclusively, it might be thought that the priming solution of cardiopulmonary bypass added by colloid solution had some beneficial effects on the patients, especially younger and associated with complex anomaly to be expected taken longer time of cardiopulmonary bypass, and more studies about the neonatal and complex anomaly cases were needed in that points.

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Effects of Personalized Complex Aerobic Training Programs using Wearable Device on Cardiovascular and Respiratory Functions of Female Elderly

  • Song, Jun-Young;Park, Sam-Ho;Kim, Byeong-Soo;Ha, Tae-Won;Son, Jin-Kyu;Lee, Myung-Mo
    • Physical Therapy Rehabilitation Science
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    • v.10 no.4
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    • pp.421-429
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    • 2021
  • Objective: The purpose of this study was to examine the effect of personalized complex aerobic training programs using wearable device on cardiovascular and respiratory functions in community based female elderly. Design: One group pre-post intervention study. Methods: Twenty-one older female participants lived in 'D' city were included. The personalized complex aerobic training program using wearable devices was applied to all participants for 4 weeks, 3 times a week, 30 minutes for per session. The participants' blood pressure, heart rate, oxygen saturation, respiration rate, submaximal exercise stress test, pulmonary function test and respiratory muscle strength test were evaluated before and after the complex training program. Results: After intervention, resting diastolic blood pressure, resting systolic blood pressure and the systolic blood pressure after submaximal exercise stress test were significantly decreased over time (p<0.05), and the submaximal exercise stress test duration were significantly increased over time (p<0.05). The maximal inspiratory pressure (MIP) was significantly increased compare to before the intervention (p<0.05). Conclusions: This study showed that personalized complex training program using wearable device can provide personalized exercise intensity according to cardiopulmonary function that give feedback, and these interventions have a significant effect on improving the cardiovascular and respiratory system functions of the female elderly in the community dwelling.

Oxygenation Index in the First 24 Hours after the Diagnosis of Acute Respiratory Distress Syndrome as a Surrogate Metric for Risk Stratification in Children

  • Kim, Soo Yeon;Kim, Byuhree;Choi, Sun Ha;Kim, Jong Deok;Sol, In Suk;Kim, Min Jung;Kim, Yoon Hee;Kim, Kyung Won;Sohn, Myung Hyun;Kim, Kyu-Earn
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.222-229
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    • 2018
  • Background: The diagnosis of pediatric acute respiratory distress syndrome (PARDS) is a pragmatic decision based on the degree of hypoxia at the time of onset. We aimed to determine whether reclassification using oxygenation metrics 24 hours after diagnosis could provide prognostic ability for outcomes in PARDS. Methods: Two hundred and eighty-eight pediatric patients admitted between January 1, 2010 and January 30, 2017, who met the inclusion criteria for PARDS were retrospectively analyzed. Reclassification based on data measured 24 hours after diagnosis was compared with the initial classification, and changes in pressure parameters and oxygenation were investigated for their prognostic value with respect to mortality. Results: PARDS severity varied widely in the first 24 hours; 52.4% of patients showed an improvement, 35.4% showed no change, and 12.2% either showed progression of PARDS or died. Multivariate analysis revealed that mortality risk significantly increased for the severe group, based on classification using metrics collected 24 hours after diagnosis (adjusted odds ratio, 26.84; 95% confidence interval [CI], 3.43 to 209.89; P=0.002). Compared to changes in pressure variables (peak inspiratory pressure and driving pressure), changes in oxygenation (arterial partial pressure of oxygen to fraction of inspired oxygen) over the first 24 hours showed statistically better discriminative power for mortality (area under the receiver operating characteristic curve, 0.701; 95% CI, 0.636 to 0.766; P<0.001). Conclusions: Implementation of reclassification based on oxygenation metrics 24 hours after diagnosis effectively stratified outcomes in PARDS. Progress within the first 24 hours was significantly associated with outcomes in PARDS, and oxygenation response was the most discernable surrogate metric for mortality.

Mechanical Ventilation of the Children (소아의 기계적 환기요법)

  • Park, June Dong
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1310-1316
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    • 2005
  • Mechanical ventilation in children has some differences compared to in neonates or in adults. The indication of mechanical ventilation can be classified into two groups, hypercapnic respiratory failure and hypoxemic respiratory failure. The strategies of mechanical ventilation should be different in these two groups. In hypercapnic respiratory failure, volume target ventilation with constant flow is favorable and pressure target ventilation with constant pressure is preferred in hypoxemic respiratory failure. For oxygenation, fraction of inspired oxygen($FiO_2$) and mean airway pressure(MAP) can be adjusted. MAP is more important than FiO2. Positive end expiratory pressure(PEEP) is the most potent determinant of MAP. The optimal relationship of $FiO_2$ and PEEP is PEEP≒$FiO_2{\times}20$. For ventilation, minute volume of ventilation(MV) product of tidal volume(TV) and ventilation frequency is the most important factor. TV has an maximum value up to 15 mL/kg to avoid the volutrauma, so ventilation frequency is more important. The time constant(TC) in children is usually 0.15-0.2. Adequate inspiratory time is 3TC, and expiratory time should be more than 5TC. In some severe respiratory failure, to get 8TC for one cycle is impossible because of higher frequency. In such case, permissive hypercapnia can be considered. The strategy of mechanical ventilation should be adjusted gradually even in the same patient according to the status of the patient. Mechanical ventilators and ventilation modes are progressing with advances in engineering. But the most important thing in mechanical ventilation is profound understanding about the basic pulmonary mechanics and classic ventilation modes.

Clinical Application of Nasal Intermittent Positive Pressure Ventilation with Bi-level Positive Airway Pressure(BiPAP) (기도 이중 양압(BiPAP)을 이용한 비강 간헐 양압환기의 임상적 적용)

  • Cho, Jae-Youn;Lee, Sang-Youb;Lee, Sang-Hwa;Park, Sang-Myun;Suh, Jung-Kyung;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.723-730
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    • 1995
  • Background: Noninvasive ventilation has been used extensively for the treatment of patients with neuromuscular weakness or restrictive chest wall disorders complicated by hypoventilatory respiratory failure. Recently, noninvasive positive pressure ventilation has been used in patients with alveolar hypoventilation, chronic obstructive pulmonary disease(COPD), and adult respiratory distress syndrome. Sanders and Kern reported treatment of obstructive sleep apnea with a modification of the standard nasal CPAP device to deliver seperate inspiratory positive airway pressure(IPAP) and expiratory positive airway pressure(EPAP). Bi-level positive airway pressure(BiPAP) unlike nasal CPAP, the unit delivers a different pressure during inspiration from that during expiration. The device is similar to the positive pressure ventilator or pressure support ventilation. Method and purpose: Bi-level positive airway pressure(BiPAP) system(Respironics, USA) was applied to seven patients with acute respiratory failure and three patients on conventional mechanical ventilation. Results: 1) Two of three patients after extubation were successfully achieved weaning from conventional mechanical ventilation by the use of BiPAP ventilation with nasal mask. Five of seven patients with acute respiratory failure successfully recovered without use of conventional mechanical ventilation. 2) $PaO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients significantly improved more than baseline values(p<0.01). $PaCO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients did not change significantly more than baseline values. Conclusion: Nasal mask BiPAP ventilation can be one of the possible alternatives of conventional mechanical ventilation in acute respiratory failure and supportive method for weaning from mechanical ventilation.

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Pressure-Loss Characteristics of an Asymmetric Bifurcation Model of Human Lung Airways (비대칭 인체 기관지 분지관의 압력손실 특성)

  • Kang, Min-Yeong;Lee, Jin-Won
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.36 no.3
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    • pp.301-307
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    • 2012
  • The characteristics of pressure loss in an asymmetric bifurcating tube were investigated numerically for steady inspiratory conditions. The loss coefficient K calculated for various asymmetry and flow-distribution ratios found in human lung airways showed a power-law dependence on the Reynolds number (Re) and length-to-diameter ratio (L/d), with different exponents for Re $\geq$ 100 and Re < 100. The fundamental characteristics of the asymmetric bifurcation are similar to the case of symmetric bifurcation. In addition, the effect of skewed inlet velocity profiles on the pressure loss was weak, and decreased with an increasing number of bifurcations.

Respiratory Air Flow Transducer Applicable to Cardiopulmonary Resuscitation Procedure (인공심폐소생술에 활용 가능한 호흡기류센서)

  • Kim, Kyung-Ah;Lee, In-Kwang;Lee, You-Mi;Yu, Hee;Kim, Young-Il;Han, Sang-Hyun;Cha, Eun-Jong
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.62 no.6
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    • pp.833-839
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    • 2013
  • Cardiopulmonary resuscitation (CPR) is performed by thoracic compression and artificial ventilation for the patient under emergent situation to maintain at least the minimum level of respiration and blood circulation for life survival. Good quality CPR requires monitoring respiration, however, traditional respiratory air flow transducers cannot be used because the transducer elements are facing the whole area perpendicular to the flow axis. The present study developed a new air flow transducer conveniently applicable to CPR. Specially designed "sensing rod" samples the air velocity at 3 different locations of the flow cross-section, then transforms into average dynamic pressure by the Bernoulli's law. The symmetric structure of the sensing holes of the sensing rod enables bi-directional measurement simply by taking the difference in pressure by a commercial differential pressure transducer. Both inspiratory and expiratory flows were obtained with symmetric measurement characteristics. Quadratic curve fitting provided excellent calibration formula with a correlation coefficient>0.999 (P<0.0001) and the mean relative error<1%. The present results can be usefully applied to accurately monitor the air flow rate during CPR.

A Clinical Case Report on the Improvement of Respiratory Function of a Fascioscapulohumeral Muscular Dystrophy Patient after Korean Medical Treatment (안면견갑상완형 근이영양증 환자에 대한 한의학적 치료 이후 호흡기능 호전에 대한 임상 증례)

  • Lee, Sang Hyun;Jeong, Ju Yong;Cho, Myoung Rae
    • Journal of Acupuncture Research
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    • v.32 no.4
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    • pp.195-201
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    • 2015
  • Objectives : The purpose of this study is to report on the improvement of respiratory function of a fascioscapulohumeral muscular dystrophy patient after receiving Korean medical treatment. Methods : This study was carried out on a 60 year-old male patient who suffered from fascioscapulohumeral muscular dystrophy. While we carried out Korean medical treatment, we observed $EtCO_2$ (end-tidal carbon dioxide), Vte (exhaled tidal volume) and PIP (peak inspiratory pressure). Results : $EtCO_2$ count decreased from 34 mmHg to 24 mmHg during the treatment period, and PIP count became stable. Vte count also did not worsen in this study. Conclusions : Based on this study, we concluded that Korean medical treatment could be effective in treating fascioscapulohumeral muscular dystrophy patients with respiratory failure.

Nasal Diseases and Its Impact on Sleep Apnea and Snoring (코질환과 수면무호흡증)

  • Kim, Chang-Hee;Rhee, Chae-Seo
    • Sleep Medicine and Psychophysiology
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    • v.11 no.1
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    • pp.17-21
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    • 2004
  • Nasal congestion is one of the most common symptoms of medical complaints. Snoring is caused by vibration of the uvula and the soft palate. Nasal obstruction may contribute not only to snoring and obstructive sleep apnea (OSA) but also impair application of continuous nasal positive airway pressure (CPAP), which is the most widely employed treatment for OSA. Total or near-total nasal obstruction leads to mouth breathing and has been shown to cause increased airway resistance. However, the exact role of the nasal airway in the pathogenesis of OSA is not clear and there is no consensus about the role of nasal obstruction in snoring and sleep apnea. Some reports have failed to demonstrate any correlation between snoring and nasal obstruction. On the other hand, opposing reports suggest that nasal disease may cause sleep disorders and that snoring can be improved after nasoseptal surgery. Reduced cross-sectional area causes increased nasal resistance and predisposes the patient to inspiratory collapse of the oropharynx, hypopharynx, or both. Discrete abnormalities of the nasal airway, such as septal deformities, nasal polyps, and choanal atresia and with certain mucosal conditions such as sinusitis, allergic rhinitis and inferior turbinate hypertrophy can cause snoring or OSA. Thus, these sources of nasal obstruction should be corrected medically or surgically for the effective management of OSA and adjunctive for CPAP.

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