• 터널과지하공간
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• 제20권2호
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• pp.92-96
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• 2010

본 연구에서는 지하공간에서 화재 발생시 배연장비의 연기배출 성능을 평가하기 위하여 실험을 실시하였다. 배연장비로는 이동식 송풍기를 사용하였으며 가연물질로는 에탄올을 사용하였다. 한 변의 길이가 80cm의 정사각형 화원을 사용하였으며 최대 열방출률은 약 460 kW이다. 급기방식 배연의 영향을 평가하였다. 급기방식의 경우 실내의 가시도 향상 및 온도감소 효과를 확인할 수 있었다.

• 대한설비공학회:학술대회논문집
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• 대한설비공학회 2006년도 하계학술발표대회 논문집
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• pp.423-428
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• 2006

Twenty nine HRV models have been tested for last two years since the attestation system has been started by KARSE. It is the objective of the present study to analyze the performance test results. Uncertainty analysis has been conducted to find the effects of measured variables on the uncertainties of test results. The uncertainty of enthalpy is found to be affected by the uncertainty of wet bulb temperature significantly, but not by that of dry bulb temperature for the present range of parameters. The uncertainty of effective enthalpy efficiency is calculated to be 6%P for the cooling condition, and 3%P for the heating condition approximately. In order to reduce the uncertainty of the test results, the uncertainty of wet bulb temperature should be minimized and the indoor/outdoor test conditions should be modified so as to increase the enthalpy difference.

• 가정∙방문간호학회지
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• 제23권1호
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• pp.25-33
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• 2016

Purpose: This study aimed to survey caregivers of patients with Neuromuscular Rare and Incurable Disease (NRID) using invasive home mechanical ventilator (HMV), in order to compare the incident rate of pneumonia by tracheal suction procedures used. Method: Participants were 99 family caregivers of NRID patients using HMV. Participants were given a questionnaire consisting of 12 demographic items, 10 items about disease and HMV related characteristics, 11 items about tracheal suction procedures, and 2 items about the incidence of pneumonia. Data were analyzed using chi-square tests and t-tests. Results: The items that predicted the incidence of pneumonia were "change of irrigation saline every suction" (p=.047), "use of aseptic catheter every suction" (p=.004), and "instillation of normal saline before suction" (p=.027). In addition, these items were 47.4%, 51.4%, and 38.8% respectively. Conclusion: Family members caring for NRID patients with invasive HMV should be educated about tracheal suction, especially the necessity of changing irrigation saline after every suction, using the aseptic catheter for every suction, and instillation of normal saline before suction. Medical personnel such as home care nurses should periodically check tracheal suction procedures, and re-educate family caregivers when necessary.

• 한국산학기술학회논문지
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• 제19권5호
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• pp.593-598
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• 2018

본 연구는 혹한기 결빙 방지를 위한 열회수형 환기장치의 개발에 관한 연구로써, 개발에 필요한 내부 리턴 댐퍼를 최적화하여 적용하기 위하여 전산유체해석(Computational Fluid Dynamics)을 수행하였고 이를 바탕으로 실험을 위한 시제품을 만들어 혹한기 결로 및 결빙실험을 수행하였다. 배기 재순환 비율이 최대가 되는 최적의 내부 리턴 댐퍼를 설계하기 위하여 총 16 model의 전산유체해석을 수행하였다. 전산유체해석 결과 외기에 대한 배기 재순환 비율은 59.9% ~ 62.3%로 나타났다. 외기온도(Outdoor Air Temperature)가 $-15^{\circ}C$ 이상에서는 배기 재순환 운전과 통상 운전 모두 결로와 결빙이 발생하지 않았다. 그러나 외기온도가 $-20^{\circ}C$에서는 내부 리턴 댐퍼를 $45^{\circ}$ 열어 배기 재순환 운전을 하여야 결로와 결빙이 발생하지 않았다. 혹한기 결빙 방지를 위한 열회수형 환기장치는 외기온도에 따라 통상 운전 모드와 배기 재순환 운전 모드의 두 가지 운전모드로 운전하여야 한다. 외기온도가 $-15^{\circ}C$보다 높을 경우에는 통상 운전 모드로 작동하고 외기온도가 $-15^{\circ}C$보다 낮을 경우에는 재순환 운전 모드로 작동하는 열회수형 환기장치의 운전 알고리즘을 개발하여 적용하였다.

• Journal of Hospice and Palliative Care
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• 제22권4호
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• pp.198-206
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• 2019

목적: 호스피스 및 완화치료 환자 또는 임종단계 환자를 위한 연명 치료 결정에 관한 법안은 2016년에 제정되어 2018년 2월부터 시행 되었다. 이 법안의 취지와 내용은 미국의 POLST에 근거한다. 이 연구의 목적은 미국의 POLST를 변형하여 만든 MK-POLST를 호스피스 병동 환자들에게 적용을 한 뒤 각 항목에 대한 선호도 및 시행 일치율을 조사하는 것이다. 방법: 2017년 2월 1일부터 2019년 4월 30일까지 경상대학교병원의 부속 호스피스 병동의 모든 입원 환자의 MK-POLST에 대한 의무기록을 후향적으로 분석하였다. 결과: 총 387명의 연구대상자 중 295명의 환자가 MK-POLST를 작성했다. MK-POLST는 환자 자신이 133건(44.1%), 배우자가 84건(28.5 %), 자녀가 75건(25.4%) 작성했다. MK-POLST가 작성된 295 명의 환자 중 단 13명(4.4%)이 주사 영양제를 거부하였으며, 5명(1.7%)은 완화적 진정을 거부하였지만, 대다수인 288명(97.6%)이 심폐소생술 및 인공호흡기 치료를 원하지 않았고, 226명(76.9%)이 승압제 사용을 원하지 않았다. 인공호흡기, 심폐소생술 및 완화적 진정을 제외한 모든 MK-POLST 항목의 시행 일치율에 대한 Kappa 값은 낮았다. 결론: 호스피스 환자들은 심폐소생술, 인공호흡기 및 승압제 사용은 거부 했지만, 대조적으로 항생제, 주사 영양제 및 완화적 진정은 대다수 또는 절대적인 경우에 선호했다.

• The Korean journal of internal medicine
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• 제39권1호
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• pp.160-171
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• 2024

Background/Aims: The effectiveness of remdesivir treatment in reducing mortality and the requirement for mechanical ventilation (MV) remains uncertain, as randomized controlled trials (RCTs) have produced conflicting results. Methods: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and other data resources to find RCTs published prior to April 10, 2023. The selection of studies, assessment of risk of bias, and meta-analysis were conducted according to PRISMA guidelines. The primary outcomes were all-cause mortality and the need to initiate MV. Results: A total of 5,068 articles were screened, from eight RCTs comprising 11,945 patients. The meta-analysis found that, compared to standard care or placebo, remdesivir treatment provided no significant all-cause mortality benefit (pooled risk ratio [RR], 0.93; 95% confidence interval [CI], 0.85-1.02; 8 studies; high certainty evidence), while subgroup analyses revealed a trend towards reduced mortality among patients requiring oxygen but not MV (pooled RR, 0.88; 95% CI, 0.77-1.00; 6 studies; I² = 4%). The need to initiate MV (pooled RR, 0.74; 95% CI, 0.59-0.94; 7 studies; moderate certainty evidence) in remdesivir-treated patients was also reduced compared to controls. Remdesivir significantly increased clinical improvement and discharge and significantly reduced serious adverse events. Conclusions: In this systematic review and meta-analysis of RCTs, it was found that remdesivir treatment did not show a substantial decrease in the risk of mortality. However, it was linked to a reduction in the necessity for additional ventilator support, suggesting remdesivir could be beneficial for COVID-19 patients, particularly those who are not on MV.

• The Korean journal of internal medicine
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• 제39권2호
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• pp.295-305
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• 2024

Background/Aims: The prognosis of patients with idiopathic pulmonary fibrosis (IPF) and respiratory failure requiring mechanical ventilation is poor. Therefore, mechanical ventilation is not recommended. Recently, outcomes of mechanical ventilation, including those for patients with IPF, have improved. The aim of this study was to investigate changes in the use of mechanical ventilation in patients with IPF and their outcomes over time. Methods: This retrospective, observational cohort study used data from the National Health Insurance Service database. Patients diagnosed with IPF between January 2011 and December 2019 who were placed on mechanical ventilation were included. We analyzed changes in the use of mechanical ventilation in patients with IPF and their mortality using the Cochran-Armitage trend test. Results: Between 2011 and 2019, 1,227 patients with IPF were placed on mechanical ventilation. The annual number of patients with IPF with and without mechanical ventilation increased over time. However, the ratio was relatively stable at approximately 3.5%. The overall hospital mortality rate was 69.4%. There was no improvement in annual hospital mortality rate. The overall 30-day mortality rate was 68.7%, which did not change significantly. The overall 90-day mortality rate was 85.3%. The annual 90-day mortality rate was decreased from 90.9% in 2011 to 83.1% in 2019 (p = 0.028). Conclusions: Despite improvements in intensive care and ventilator management, the prognosis of patients with IPF receiving mechanical ventilation has not improved significantly.

• 중환자간호학회지
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• 제3권1호
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• pp.53-65
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• 2010

Purpose: The purpose of this study was to identify the intensity and types of discomfort caused by an endotracheal tube in patients during ventilator therapy after cardiac surgery, and to analyze the differences in the intensity and types of discomfort by sociodemographic and clinical characteristics and characteristics related to endotracheal tubes. Methods: The intensity of discomfort was measured using an 11-point numeric rating scale and the types of discomfort were measured using a 4-point numeric rating scale. Sociodemographic and clinical characteristics and characteristics related to endotracheal tube were collected by observation and the electronic medical chart using a structured questionnaire. Results: The mean intensity of discomfort in patients due to endotracheal tubes was 6,91 points, 84% of patients reported discomfort over 5 points, The most severe discomfort was pain during endotracheal suctioning, and dry mouth and breathing difficulties were also found to induce discomfort. Patients who had more severe surgical site pain, longer duration of intubation and higher cuff pressure demonstrated more severe discomfort due to the endotracheal tube. Conclusion: These results can be used as basic data for developing nursing intervention to relieve the discomfort caused by endotracheal tubes in patients during ventilator therapy.

• KIEAE Journal
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• 제8권1호
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• pp.11-18
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• 2008

The purpose of this study is to analyze application methods and structural characteristics of each element of environment-friendly European housing through classification of skin types. The results of the study are following. 1) The skins are classified by three types; single skin with multi layers, double skin with single layer and double skin with multi layers. 2) Most single skins with multi-layer are composed with wooden louvers, sun blinds and insulating windows. There are introduction of atrium and balcony, and variation sectional space composition according to cases. 3) There are two types of double skins; to put cavity between inner skin and outer skin and more extensional spaces such as balconies, corridors and stair halls. Solar walls and mechanical ventilators are often introduced to double skins with multi-layer. 4) The functions of the latest environment-friendly skins are vary from controllers and buffers of indoor environmental elements such as temperature, light, air and sound to equipments to perform essential functions to efficiently operate HVAC systems.

• Journal of Korean Biological Nursing Science
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• 제20권4호
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• pp.228-235
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• 2018

Purpose: This study aimed to investigate the clinical alarm occurrence and management of nurses toward clinical alarms in the intensive care unit (ICU). Methods: This observational study was conducted with 40 patients and nurses cases in two ICUs of a university hospital. This study divided 24 hours into the unit of an hour and conducted two times of direct observation per unit hour for 48 hours targeting the medical devices applied to 40 patients. Data were analyzed using IBM SPSS Statistics 23. Results: On average, 3.8 units of medical devices were applied for each patient and the ranges of alarm settings were wide. During 48 hours, 184 cases of clinical alarm were occurred by four types of medical devices including physiological monitors, mechanical ventilators, infusion pumps, and continuous renal replacement therapy. Among them, false alarm was 110 cases (59.8%). As for the alarm management by ICU nurses, two-minute alarm mute took up most at 38.0% (70 cases), and no response was second most at 32.6% (60 cases). When valid alarm sounded, nurses showed no response at 43.2%. Conclusion: The findings suggest that a standard protocol for alarm management should be developed for Korean ICU settings. Based on the protocol, continuous training and education should be provided to nurses for appropriate alarm management.