• 대한간호학회지
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• 제21권3호
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• pp.268-280
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• 1991

The nursing intervention for the prevention of the pulmonary complication and of the function lowering of pulmonary ventilation which emerge with high generation frequency during the nursing of operation patient is necessary for performing the qualitative nursing for operation patient. So, this researcher tried this study so as to obtain the data which can be utilized for the trial of nursing intervention, by grasping the effect that the deep breathing with Incentive Spirometer has on the function of pulmonary ventilation, analysing the factor to have influence on the function of pulmonary ventilation, and applying the effective method of deep breathing to the clinic. By making 42 patients who underwent the operation of upper abdomen after admitting G Hospital in Seoul from Mar. 7, 1991 to Apr.30, 1991 as the object, they were classified into the experiment group that the deep breathing was made with the use of Incentive Spiromenter and the comparison group that the deep breathing exercise was made without the use of Incentive Spirometer. And then, by measuring Tidal Volume and Forced Vital Capacity with Respirometer and $O_2$ Saturation with Pulse Oximeter at preoperation postoperation 24 hours, 72 hours, and 120 hours data were collected. The collected data were analyzed with of, average, standard deviation, x$^2$-test, t-test and ANOVA by SPSS. The result of this study is as follows : 1. As for the hypothesis that the function of pulmonary ventilation at postoperation 24 hours, 72 hours and 120 hours will be better in the experiment group that the deep breathing was made with the use of Incentive Spirometer, in comparison with the comparison group that deep breathing was made without the use of Incentive Spirometer, experiment group and comparison group didn't show the significant difference in Tidal Volume, Foreced Vital Capacity and $O_2$ Saturation at postoperation 24 hours and 72 hours. But experiment group and comparison group showed the significant difference in Tidal Volume at postoperation 120 hours (p＜0.01). So, this hypothesis was supported partially. 2. The variables that there were the significant differences about the function of pulmonary ventilation in experiment group at postoperation 24 hours stastically were smoking existence (p＜0.05), and the variables that there were not significant differences about the function of pulmonary ventilation were distinction of sex, age, anesthetic duration, smoking extent, body weight, surface area of body, existence of narcotic use, regular exercise existence, and past experience existence of respiratory disease. As above result, it appeared that the method of deep breathing with the use of the Incentive Spirometer is more effective for the function recovery of pulmonary ventilation, in comparison with the deep breathing without use of Incentive Spirometer and that smoking existence was the factor to have influence on the function of pulmonary ventilation. In the aspect of clinic, the trial of nursing intervention of deep breathing with use of Incentive Spirometer is expected. And, in the aspect of study, the study through various operative site patients about the effect of Incentive Spirometer use at the clinic will have to be confirmed.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.106-110
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• 2015

The prevalence of pneumothorax cases among Intensive Care Unit patients who require mechanical ventilation ranges from 4%-15%. A pneumothorax remains one of the most serious complications of positive pressure ventilation. It can be diagnosed in a critically ill patient through a physical examination or radiographic studies that include chest radiographs, ultrasonography, or computed tomography scanning. However, in a critically ill patient, the diagnosis of a pneumothorax is often complicated by other diseases and by difficulties in imaging sick and unconscious patients. Although electrocardiogram changes associated with a pneumothorax have been described for many years, there has been no report of such among patients who require mechanical ventilation. In this paper, we report 2 cases of a spontaneous pneumothorax with paroxysmal supraventricular tachycardia in patients who required invasive mechanical ventilation due to acute respiratory failure.

• Journal of Chest Surgery
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• 제36권7호
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• pp.527-530
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• 2003

재팽창성 페부종은 기흉이나 흉수 또는 무기폐로 인한 폐허탈을 치료할 때 생기는 매우 드문 합병증으로 때로는 중한 상태에 빠져 사망에 이르기도 한다. 재팽창성 폐부종은 오랜 기간동안 폐허탈이 있는 상태에서 빠른 속도로 많은 양의 공기나 흉수를 일시에 제거하여 발생한다 오랜 기간동안 허탈된 폐를 치료할 때에는 반드시 재팽창성 폐부종의 가능성과 합병증의 예방에 대하여 염두해 두어야 한다. 재팽창성 폐부종 환자에서 양측 폐의 기도저항과 탄성 차이가 심한 경우에, 관례적인 인공호흡기 치료법을 시행하면 정상인 한족 폐의 과폐창과 다른 한쪽 폐의 점차적인 허탈이 일어난다. 분리형 폐환기법은 이러한 문제점을 해결하는데 도움이 된다. 저자들은 두명의 남자 환자에서 심한 재팽창성 폐부종에 대하여 분리형 페환기법으로 치료하여 좋은 결과를 얻었기에, 분리형 폐환기법을 심한 재팽창성 폐부종의 치료법으로 제시한다.

• 대한간호학회지
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• 제31권1호
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• pp.31-42
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• 2001

This study was done to evaluate the effect reducing artificial dead space on intubated children. Data were collected from July 1st, 1998 to August 31st, 1999. The subjects were selected from a pediatric intensive care unit of 'S' hospital and intubated with 3.5 mm or 4.5 mm endotracheal tube after open heart surgery. They were composed of 34 patients : 17 patients were assigned to the experimental group and the rest of them were placed in the control group. The artificial airway volume was minimized in the experimental group, and the control group maintained the artificial airway volume. ETCO2, PaCO2, SPO2 were measured as indicators of pulmonary ventilation. The tools of this study were GEM-Premier and Space-Lab patient monitors. The data were analyzed using the SPSS/PC+ program. The $\chi$2 -test was used to find general characteristics. The t-test was used to test the homogenety of the pulmonary ventilation status and mechanical ventilation setting before intervention between the two groups. Also, the paired t-test was used to examine the hypothesis. The results can be summerized as : 1. CO2 can be expelled effectively from the body in case artificial dead space was decreased. 2. As the artificial dead space was reduced, the difference between ETCO2 and PaCO2 was decreased, in other words pulmonary ventilation was improved. 3. If the artificial dead space occupied above 15 percent of tidal volume, the effect of CO2 was retention revealed in the body. 4. If the artificial dead space occupied below effect. Based on the results, the following is suggested to be applied practically : 1. A kind of the ventilator circuit acting artificial dead space should be removed from the intubated children with mechanical ventilaion. 2. The endotracheal tube should not be cut because extra-body space of the endotracheal tube did not have an effect on the dead space of the intubated children. Since the researcher could not cover this aspect in the study, they recommend the following. 1. The study should be extended to the other pulmonary disease patients for the effect of improving pulmonary ventilation. 2. Also, further studying with a more narrow interval in the extra-body space of the artificial airway will be able to explain the point of artificial dead space with proper ventilation.

• Asian-Australasian Journal of Animal Sciences
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• 제10권3호
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• pp.318-323
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• 1997

In order to assess the effect of solar exposure on pulmonary functions and evaporative losses from skin and pulmonary surfaces, in six healthy Sahiwal (S) and six Sahiwal ${\times}$ Holstein ($S{\times}H$) cattle were exposed to direct sun during summer. Breed differences were observed during exposure. Increase in sweating rate was higher in crossbreds (222%) than in Sahiwal (125%). Pre-exposure (ambient temperature, $32.6{\pm}0.85^\circ}C$, solar radiation, $0.9cal\;cm^{-2}min^{-1}$) evaporative loss from skin accounted for about 90% of the losses and remaining losses were contributed by pulmonary surfaces in Sahiwal. The contribution of evaporation through skin increased to 92% (ambient temperature $39.4{\pm}0.68^\circ}C$, solar radiation, $1.35cal\;cm^{-2}min^{-1}$). In crossbreds 80% of the evaporative losses were through skin before exposure which increased to 87% after exposure to solar radiations. Rectal temperature increase was higher in crossbreds ($1.5^{\circ}C$) than in Sahiwal ($0.8^{\circ}C$). With the increase in pulmonary evaporative losses, respiratory frequency increased to 2 fold in Sahiwal and pulmonary ventilation increased 1.6 times the resting value in Sahiwal due to solar exposure. In $S{\times}H$ crossbreds the respiratory frequency increased 3.5 times and pulmonary ventilation increased only to 1.8 times due to decrease in tidal volume. There was about 2 fold increase in alveolar ventilation in both the breeds, the increase in dead space ventilation was more in crossbreds than in Sahiwal. Behavioral symptoms exhibited by animals after exposure were profuse salivation, open mouth panting, tongue protrusion and general restlessness.

• Tuberculosis and Respiratory Diseases
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• 제81권3호
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• pp.247-255
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• 2018

Background: Patients with acute respiratory failure secondary to tuberculous destroyed lung (TDL) have a poor prognosis. The aim of the present retrospective study was to develop a mortality prediction model for TDL patients who require mechanical ventilation. Methods: Data from consecutive TDL patients who had received mechanical ventilation at a single university-affiliated tertiary care hospital in Korea were reviewed. Binary logistic regression was used to identify factors predicting intensive care unit (ICU) mortality. A TDL on mechanical Ventilation (TDL-Vent) score was calculated by assigning points to variables according to ${\beta}$ coefficient values. Results: Data from 125 patients were reviewed. A total of 36 patients (29%) died during ICU admission. On the basis of multivariate analysis, the following factors were included in the TDL-Vent score: age ${\geq}65$ years, vasopressor use, and arterial partial pressure of oxygen/fraction of inspired oxygen ratio <180. In a second regression model, a modified score was then calculated by adding brain natriuretic peptide. For TDL-Vent scores 0 to 3, the 60-day mortality rates were 11%, 27%, 30%, and 77%, respectively (p<0.001). For modified TDL-Vent scores 0 to ${\geq}3$, the 60-day mortality rates were 0%, 21%, 33%, and 57%, respectively (p=0.001). For both the TDL-Vent score and the modified TDL-Vent score, the areas under the receiver operating characteristic curve were larger than that of other illness severity scores. Conclusion: The TDL-Vent model identifies TDL patients on mechanical ventilation with a high risk of mortality. Prospective validation studies in larger cohorts are now warranted.

• 대한물리의학회지
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• 제14권1호
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• pp.43-51
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• 2019

PURPOSE: To prevent secondary complications from decreased pulmonary functions and promote neurological recovery, identification of respiratory capacity change patterns depending on different postures of stroke patients and investigation of their properties are needed for active rehabilitation. Therefore, this study was conducted to investigate the changes in vital capacity in response to different positions and to implement the results as clinical data. METHODS: A respiratory function test was administered to 52 patients with stroke in the sitting, supine, paretic side lying, and non-paretic side lying positions. Pulmonary function indexes used for comparison were forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), forced expiratory flow 25-75% (FEF 25-75%), and maximum voluntary ventilation (MVV). One-way repeated ANOVA was used for analysis, and post hoc analysis was conducted using least significant difference (LSD). RESULTS: All pulmonary function indexes were measured in the order of sitting, paretic side lying, supine, and non-paretic side lying positions. Excluding the FEF25-75% and MVV of the supine compared with the paretic side lying position, all other pulmonary function indexes differed significantly (p<.05). CONCLUSION: There are differences in pulmonary function indexes depending on different postures of stroke patients, and the study showed that the non-paretic side lying position yielded the greatest effect on lung ventilation mechanisms. Based on these results, appropriate postures need to be considered during physical therapy interventions for stroke patients.

• Journal of Chest Surgery
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• 제6권1호
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• pp.7-14
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• 1973

Ventilatory functions and arterial respiratory gases were studied in 24 patients who underwent resectional surgery for pulmonary tuberculosis. Postoperative measurements were made 24 hours, 72 hours and 7 days after surgery and the results were compared to preoperative values. Twenty-four hours postoperatively, there occurred striking increase in respiratory rate, minute ventilation, dead space ventilation and dead space tidal volume ratio, and the increase in minute ventilation was caused primarily by the increase in respiratory rate. However, alveolar ventilation, oxygen consumption, carbon dioxide elimination and respiratory quotient showed no significant postoperative changes although two of the last values showed slight decreases 24 hours after surgery. The lowest arterial oxygen saturation level was obtained 24 hours postoperatively followed by gradual rises but not to the preoperative levels until 7 days after surgery. A decreased arterial carbon dioxide tension with elevated pit was noted 24 hours after surgery, which returned to the preoperative level on the following measurement.

• Tuberculosis and Respiratory Diseases
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• 제86권2호
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• pp.133-141
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• 2023

Background: The present study evaluated the association between participation in a rehabilitation program during a hospital stay and 1-year survival of patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]) with various respiratory diseases as their main diagnoses that led to mechanical ventilation. Methods: Retrospective data of 105 patients (71.4% male, mean age 70.1±11.3 years) who received PMV in the past 5 years were analyzed. Rehabilitation included physiotherapy, physical rehabilitation, and dysphagia treatment program that was individually provided by physiatrists. Results: The main diagnosis leading to mechanical ventilation was pneumonia (n=101, 96.2%) and the 1-year survival rate was 33.3% (n=35). One-year survivors had lower Acute Physiology and Chronic Health Evaluation (APACHE) II score (20.2±5.8 vs. 24.2±7.5, p=0.006) and Sequential Organ Failure Assessment score (6.7±5.6 vs. 8.5±2.7, p=0.001) on the day of intubation than non-survivors. More survivors participated in a rehabilitation program during their hospital stays (88.6% vs. 57.1%, p=0.001). The rehabilitation program was an independent factor for 1-year survival based on the Cox proportional hazard model (hazard ratio, 3.513; 95% confidence interval, 1.785 to 6.930; p<0.001) in patients with APACHE II scores ≤23 (a cutoff value based on Youden's index). Conclusion: Our study showed that participation in a rehabilitation program during hospital stay was associated with an improvement of 1-year survival of PMV patients who had less severe illness on the day of intubation.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.47-55
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• 2022

Background: We evaluated the long-term effects of domiciliary noninvasive positive-pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD). Methods: Databases were searched to identify randomized controlled trials of COPD with NIPPV for longer than 1 year. Mortality rates were the primary outcome in this meta-analysis. The eight trials included in this study comprised data from 913 patients. Results: The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419), suggesting a statistically significant difference (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65-0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR, 0.99; 95% CI, 0.72-1.36; p=0.94). Conclusion: Maintaining long-term nocturnal NIPPV for more than 1 year, especially in patients with stable COPD, decreased the mortality rate, without increasing the withdrawal rate compared with long-term oxygen treatment.