• Title/Summary/Keyword: Positive expiratory pressure

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Effects of Pyengpaetang Extracts on the Acute Pulmonary Edema induced by Oleic acid in dogs (평폐탕(平肺湯)이 Oleic acid로 유발(誘發)된 가견(家犬)의 급성폐수종(急性肺水腫)에 미치는 영향(影響))

  • Chung, Jae-Woo;Han, Sang-Whan;Choe, Sun-Ho
    • The Journal of Internal Korean Medicine
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    • v.11 no.2
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    • pp.1-15
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    • 1990
  • Certain oriental medication have been shown to be effective in decreasing pulmonary vascular resistance and increasing cardiac output in primary pulmonary artery pressure secondary to pulmonary edema. So oleic acid was administered in 14 dogs in order to induce acute lung injury. And we studied the hemodynamics and blood gas changes of Pyengpaetang(50mg, 100mg) with continuous postive pressure was ventilation in pulmonary edema. The pulmonary edema group, arterial oxygenation was improved after 5 and $10cmH_2O$ PEEP(positive end expiratory pressure), but cardiovascular system was depressed. Blood pressure and cardiac output were decreased, and CVP, MP AP, PCWP were increased. In Pyengpaetang(50mg) group, mean aortic pressure was decreased and PCWP(pulmonary capillary wedge pressure) was decreased remarkably, while there was a significant increase in cardiac output. And there was improvement in $PaO_2$ and $PaCO_2$ without hemodynamic changes after applying 5cm $H_2O$ PEEP, but arterial blood gases$(PaO_2,\;PaCO_2)$ were improved, while cardiovascular effects were depressed after cm $H_2O$ PEEP. In Pyengpaetang(100mg) treated group, there was no significant hemodynamic change. But mean pulmonary arterial pressure was significantly increased, and cardiac output was decreased significantly after applying the more degree of PEEP. And blood gases were not changed significantly after applying the more degree of PEEP. The above results suggest that the effects of Pyengpaetang(50mg) group is superior to those of Pyengpaetang(100mg) group on the effects of hemodynamics and gas exchanges in acute lung injury in dogs. So we can conclude that lower degree PEEP 5cm $H_2O$ is more beneficial in Pyengpaetang(50mg) treated group.

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Effects of Pelvic Floor Muscle Exercise According to Support Surface on Maximum Inspiratory Pressure and Maximum Expiratory Pressure and Abdominal Muscle Thickness in Female College Students in Their 20s (지지면에 따른 골반 바닥 근육 운동이 20대 여대생들의 최대 들숨 압력, 최대 날숨 압력 그리고 배 근육 두께에 미치는 영향)

  • Han-Kyu Park;Yun-Hui Kim;Si-Yun Lee;Jeong-In Lee;Su-Jin Oh;Ji-Young Hwang
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.4
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    • pp.51-60
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    • 2023
  • Purpose : The purpose of this study was to determine the effect of pelvic floor muscle exercise (PFME) on an unstable support surface on maximal inspiratory pressure (MIP), maximum expiratory pressure (MEP), and abdominal muscle thickness as a method for effective PFME. Methods : This study was performed on 22 subjects. They were matched and divided into two groups based on body mass index; the experimental group (EG) performed PFME on a foam roller (n= 11), the control group (CG) performed PFME on a stable support surface (n= 11). Kegel exercise was performed with 10 seconds of contraction, 10 seconds of relaxation, and 4 sets of 10 reps per set. Both of group executed the exercise 3 times a week for 2 weeks. MIP and MEP was measured using a spirometer. Abdominal muscle thickness was measured using ultrasound. The paired t-test was used to compare difference on each group and the comparison between groups was analyzed using the independent t-test. A significance level of α= .05 was used to verify statistical significance. Results : The EG showed a significant increase in the MEP (p<.05). The CG showed a significant increase in the MEP (p<.05). There was no significant difference in the two groups (p>.05). The EG showed a significant increase in the external oblique, internal oblique and transverse abdominis (p<.05). The CG showed a significant increase in the internal oblique (p<.05). There was no significant difference in the two groups (p>.05). Conclusion : Based on the results of this study, additional research should be conducted to correct the limitations of this study to confirm that PFME performed on a foam roller has a positive effect on respiratory muscle strength and abdominal muscle thickness.

Comparison of the Effect of Inhalation and Exhalation Breathing Exercises on Pulmonary Function of Patients With Cervical Cord Injury (경수손상환자들의 폐기능 향상을 위한 흡기 및 호기 호흡운동 방법의 효과 비교)

  • Jean, Yong-Jin;Oh, Duck-Won;Kim, Kyung-Mo;Lee, Young-Jung
    • Physical Therapy Korea
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    • v.17 no.1
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    • pp.9-16
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    • 2010
  • This study aimed to compare 2 protocols recommended to patients with chronic cervical cord injury: each protocol included breathing exercises (inhalation-oriented or exhalation-oriented) and facilitation maneuver for the accessory respiratory muscles. Seventeen patients with chronic cervical cord injury volunteered to participate in this study, and we randomized these patients into 2 groups: the inhalation-oriented breathing exercise group (IOBEG) and exhalation-oriented breathing exercise group (EOBEG), consisting of 8 and 9 patients, respectively. Patients in the IOBEG performed inspiratory exercises using intermittent positive pressure breathing devices, while those in the EOBEG performed expiratory exercises using incentive spirometry. All exercises were performed by the subjects twice a day for 4 weeks, with each session lasting an average of 20 min. The outcomes were assessed on the basis of the pre- and post-treatment values of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC. In the IOBEG, no significant differences were observed between the pre- and post-treatment values of any of the measured variables (p>.05); however, in the EOBEG, significant improvement was noted in the VC, FVC, FEV1 measured (p<.05) after the treatment. In addition, the rates of change in the values of VC, FVC, and FEV1 differed significantly between the 2 groups (p<.05). These findings suggest that the EOBEs can enhance respiratory function and are clinically feasible in patients with chronic cervical cord injury. Further studies will be undertaken to evaluate the clinical application of these findings.

Influence of the lung mechanical ventilation with injurious parameters on 7-ketocholesterol synthesis in Sus Scrofa

  • Klimenko, Oxana V.;Vobruba, Vaclav;Martasek, Pavel
    • BMB Reports
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    • v.43 no.4
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    • pp.257-262
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    • 2010
  • The aim of work was to investigate changes of 7-ketocholesterol synthesis in alveolar macrophages in the dynamic of lung mechanical ventilation with injurious parameters. The goal of in vitro part of work was to observe influence of 7-ketocholesterol on iNOS and MIP1 $\beta$ production in bronchoalveolar lavage fluid (BALF) cells. We used 17 healthy domestic pigs randomly assigned into two treatment groups: group I with mechanical ventilation with physiological parameters; group II underwent injurious ventilation with high volume tidal (VT) and low positive end expiratory pressure (PEEP). Cells were analyzed for CYP27A1 protein and gene expression levels, 7-ketocholesterol production. In alveolar macrophages of group II, we obtained increase of production of CYP27A1 protein and 7-ketocholesterol, as well as the expression of the CYP27A1 gene at the 2nd hour of ventilation. In the in vitro experiments we show dose-dependent increase of MIP1 $\beta$ and decrease of CYP27A1, iNOS protein production after 7-ketocholesterol treatment.

Successful High Flow Nasal Oxygen Therapy for Excessive Dynamic Airway Collapse: A Case Report

  • Park, Jisoo;Lee, Yeon Joo;Kim, Se Joong;Park, Jong Sun;Yoon, Ho Il;Lee, Jae Ho;Lee, Choon-Taek;Cho, Young-Jae
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.455-458
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    • 2015
  • Excessive dynamic airway collapse (EDAC) is a disease entity of excessive reduction of the central airway diameter during exhalation, without cartilage collapse. An 80-year-old female presented with generalized edema and dyspnea at our hospital. The patient was in a state of acute decompensated heart failure due to pneumonia with respiratory failure. We accordingly managed the patient with renal replacement therapy, mechanical ventilation and antibiotics. Bronchoscopy confirmed the diagnosis of EDAC. We scheduled extubation after the improvement of pneumonia and heart condition. However, extubation failure occurred due to hypercapnic respiratory failure with poor expectoration. Her EDAC was improved in response to high flow nasal oxygen therapy (HFNOT). Subsequently, the patient was stabilized and transferred to the general ward. HFNOT, which generates physiologic positive end expiratory pressure (PEEP) effects, could be an alternative and effective management of EDAC. Further research and clinical trials are needed to demonstrate the therapeutic effect of HFNOT on EDAC.

A Study on the Pulmonary Hemodynamic Changes before and after PEEP in ARDS (호흡부전증에세 호기말 양압호흡법 치료 전후의 폐혈류역학적 변화에 관한 연구)

  • Chung, June-Key;Shin, Seong-Hae;Khang, Shin-Kwang;Park, Sung-Ki;Lee, Myung-Chul;Cho, Bo-Youn;Koh, Chang-Soon;Kim, Yong-Lack;Kim, Kwang-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.18 no.1
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    • pp.45-53
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    • 1984
  • The purpose of this study is to observe the changes of pulmonary capillary permeability and various hemodynamic parameters before and after Positive End-Expiratory Pressure(PEEP) in Adult Respiratory Distress Syndrome (ARDS). Using a canine oleic acid induced ARDS model, we measured the pulmonary capillary permeability with a slope of lung: heart radioactivity ratio, hemodynamic parameters with Swan-Ganz catheter and blood gas tensions. 1) In normal and ARDS dogs, the PEEP didn't significantly influence the slope of lung: heart radioactivity ratio. But in ARDS group the slope index was increased compaired with that of control group (p<0.05). 2) Also in ARDS group, $PaO_2$ was significantly decreased, and $PaCO_2,\;PvCO_2$, MPAP, $AaDO_2$, Qs/Qt were significantly increased compared with those of control group (p<0.05). 3) In normal dogs, the PEEP didn't influence blood pH or gas tension, $AaDO_2$, Qs/Qt, or hemodynamics. 4) In ARDS dogs, however, the PEEP significantly increased $PaO_2$ and decreased $AaDO_2$, Qs/Qt (p<0.05).

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Changes in Pulmonary Functioning After Respiratory Excercise Treatment in Patients With Progressive Muscular Dystrophy (간헐적 양압호흡기를 이용한 호흡운동치료 후 근 이영양증 환자의 폐기능 변화)

  • Kim, Ki-Song;Lee, Gyu-Wan;Oh, Duck-Won
    • Physical Therapy Korea
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    • v.6 no.3
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    • pp.72-81
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    • 1999
  • The purpose of this study was to identify the differences in pulmonary functioning after respiratory exercise with IPPB (Intermittent Positive Pressure Breather) in patients with progressive muscular dystrophy (PMD). The subjects were 46 patients with PMD who were admitted to the Rehabilitation Medicine Department of Youngdong Severance Hospital. The subjects were assigned into one of 2 groups. The control group received comprehensive treatments such as ROM exercise, deep breathing exercise, moist hot packs, and ultrasound twice a day while admitted at the Rehabilitation Medicine Department. Unlike the control group, the subjects at the experimental group received respiratory exercise treatment with IPPB. The subjects were admitted for 10~19 days, and the average length of hospital stay was 12.2 days. Pulmonary functioning was evaluated at admission and discharge by SENSOR MEDICS. The data were analyzed by a paired t-test and a independent t-test. The results were as follows: 1) The change of each parameter of pulmonary function tests were significantly improved in all groups after respiratory exercise treatment during admission (p<0.05). 2) By comparing the change of each parameter of pulmonary function tests between the experimental group and control group, the parameters of vital capacity (VC), forced vital capacity, forced vital capacity predicted (FVCP) and forced expiratory volume in 1 second (FEV1) were significantly improved in the experimental group which had received the pulmonary exercise treatment with IPPB (p<0.05). In conclusion, this study suggests that the pulmonary exercise treatments with IPPB facilitated improvement in the pulmonary functioning for the PMD patients during their hospital stay.

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Re-Expansion Pulmonary Edema Associated with Resection of Ruptured Hlediastinal Thymic Cyst -A Case Report (파열된 종격동 흉선낭종의 절제술후 동반된 재팽창성 폐부종 -1례 보고-)

  • Jo, Deok-Geun;Lee, Jong-Ho;Gwak, Mun-Seop
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1149-1153
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    • 1997
  • Unilateral reexpansion pulmonary edema(RPE) is generally considered a rare complication occurring when a chronically atelectatic lung is rapidly reexpanded by tube thoracostomy or thoracentesis. It can also take place when the lung collapse is of short duration or when the lung is reexpanded without intrapleural sucti n. We experienced a case of RPE following surgical resection in mediastinal thymic cyst A 26 year old female patient suffered from long-standing atelectasis of the right lung due to a huge mediastinal cyst that was misrecognized as tuberculous pleural effusion. Empyema developed after iatrogenic rupture of mediastinal cyst by pig-tailed tube thoracostomy. We successfally managed the ruptured mediastinal thymic cyst, empyema and postoperatively developed RPE following reexpansion of the collapsed lung. The patient was treated with drugs and mechanical ventilation with positive end-expiratory pressure for RPE. The remainder of her hospital course was uneventful.

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Comparison of Two Methods of Recruiting the Acutely Injured Lung (급성 폐손상에서 폐를 Recruit시키는 방법간의 비교 연구)

  • Suh, Gee-Young;Kang, Kyeong-Woo;Park, Sang-Joon;Kim, Ho-Choel;Young, Lim-Si;Chung, Man-Pyo;Han, Jeong-Ho;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.500-512
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    • 2000
  • Background : To evaluate the efficacy of two methods of obtaining lung recruitment to reduce ventilator-induced lung injury(VILI). Methods : Fifteen New-Zealand white rabbits were ventilated in the pressure-controlled mode while maintaining constant tidal volume(10 ml/kg) and fixed respiration rate. Lung injury was induced by repeated saline lavage (PaO2<100 mmHg), and the pressure-volume curve was drawn to obtain Pflex. The animals were then randomly assigned to three groups and ventilated for 4 hours. In the control group(n=5), positive end-expiratory pressure(PEEP) less than that of Pflex by 3 mmHg was applied throughout the study. In the recruitment maneuver(RM) group(n=5), RM(CPAP of 22.5 mmHg, for 45 seconds) was performed every 15 minutes in addition to PEEP level less than Pflex by 3 mmHg This phrase is unclear. In the Pflex group, PEEP of Pflex was given without RM. Gas exchange, lung mechanics, and hemodynamics parameters as well as pathology were examined. Results : 1) Both the control and RM groups showed decreasing tendency in PaO2 with time. There was significantly decreased PaO2 at 4 hr compared to Ihr(p<0.05). But in the Pflex group, PaO2 did not decrease with time(p<0.05 vs other groups at 3, 4 hr). PaCO2 did not show significant difference among the three groups. 2) There was no significant difference in static compliance and plateau pressure. Mean blood pressure and heart rate also did not show any significant difference among the three groups. 3) The pathologic exam showed significantly less neutrophil infiltration in the Pflex group than in the control group(p<0.05). There was borderline significant difference in hyaline membrane score among the groups (p= 0.0532). Conclusion : Although recruitment maneuver of the injured lung may be important in decreasing VILI, it alone may not be sufficient to minimize VILI.

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