• 제목/요약/키워드: Respiratory insufficiency

검색결과 123건 처리시간 0.031초

공동절개술과 유경성 대망이식술 및 근육 충진술을 이용한 거대 폐공동(폐국균증)의 치험 1례 (Large aspergilloma cavity treated by Cavernostomy md ometal, muscle flaps A case report)

  • 방정희;편승환
    • Journal of Chest Surgery
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    • 제30권9호
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    • pp.936-940
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    • 1997
  • 43세 남자 환자가 기침,각혈 등의 심한 호흡기 증상을 주소로 내원하였다. 술전 단순 흉부 X-선 촬영과 단층 촬영에서 좌폐의 213를 차지하는 공동과 균종(mycetoma)을 발견할 수 있었다. 첫 수술에서 공동벽의 심한 유착과 박리증의 공동벽 파열,술전 환자의 호흡 기능을 감안하여 공동 절개술 (cavemostomy)과 흉곽 성형술(thoracoplasty)을 시행하였고 잔존하는 공간과 기관지 늑막루의 완전한 폐쇄를 흉벽 근육성형술(myoplasty)와 대망 충진술(omentoplasty)를 2차로 시행하여 추적 관찰중 좋은 결과를 보였다. 본 증례로 저자등은 심한 호흡 증상으로 전신 상태가 양호하지 못하고 만성쇠약에 빠진 좌폐의 213이상 차지할 만큼 큰 공동을 가진 폐국균증의 경우 대망이나 근육을 이용한 공동 절개술(cavemostomy)를 충분히 고려해 볼만한 수술적 방법임을 알게 되었다.

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태안 Hebei Spirit 유출 유류 제거작업 후 발생한 호흡부전 1예 (A Case of Respiratory Failure after Clean-up Work of the Hebei Spirit Crude Oil Spill in Taean)

  • 경선영;전수연;김유진;이상표;박정웅;정성환
    • Tuberculosis and Respiratory Diseases
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    • 제67권3호
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    • pp.249-253
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    • 2009
  • On 7 December 2007, the Hebei Spirit ran aground near Taean and released approximately 10,900 tons of oil into the sea. Crude oil on the coastal areas and fumes in the air increased the number of health problems among the local population. We report a case of respiratory failure after the oil spill clean-up work. A 66-year-old female was admitted to hospital with cough, sputum, and dyspnea of 1-month duration after the oil spill clean-up. She was diagnosed with community-acquired pneumonia and treated with empirical antibiotics. However, she had progressive respiratory failure without identification of the pathogen. Respiratory failure due to chronic inhalation of hydrocarbons from the crude oil spill clean-up was suspected. After mechanical ventilation care, she recovered from respiratory failure and was discharged. We report a case of severe respiratory toxic effects after an oil spill clean-up. We concluded that long-term hydrocarbon inhalation during the oil spill clean-up may have induced respiratory failure in this case.

Does the Mean Arterial Pressure Influence Mortality Rate in Patients with Acute Hypoxemic Respiratory Failure under Mechanical Ventilation?

  • Gjonbrataj, Juarda;Kim, Hyun Jung;Jung, Hye In;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • 제78권2호
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    • pp.85-91
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    • 2015
  • Background: In sepsis patients, target mean arterial pressures (MAPs) greater than 65 mm Hg are recommended. However, there is no such recommendation for patients receiving mechanical ventilation. We aimed to evaluate the influence of MAP over the first 24 hours after intensive care unit (ICU) admission on the mortality rate at 60 days post-admission in patients showing acute hypoxemic respiratory failure under mechanical ventilation. Methods: This prospective, multicenter study included 22 ICUs and compared the mortality and clinical outcomes in patients showing acute hypoxemic respiratory failure with high (75-90 mm Hg) and low (65-74.9 mm Hg) MAPs over the first 24 hours of admission to the ICU. Results: Of the 844 patients with acute hypoxemic respiratory failure, 338 had a sustained MAP of 65-90 mm Hg over the first 24 hours of admission to the ICU. At 60 days, the mortality rates in the low (26.2%) and high (24.5%) MAP groups were not significantly different. The ICU days, hospital days, and 60-day mortality rate did not differ between the groups. Conclusion: In the first 24 hours of ICU admission, MAP range between 65 and 90 mm Hg in patients with acute hypoxemic respiratory failure under mechanical ventilation may not cause significantly differences in 60-day mortality.

편도적출술후 발생한 피하기종 (Subcutaneous Emphysema as a Complication of Tonsillectomy)

  • 홍기환;조윤성;임현실;이상헌;문승현
    • 대한기관식도과학회지
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    • 제7권1호
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    • pp.62-65
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    • 2001
  • Subcutaneous emphysema of the head and neck are well-known sequealae of surgery and trauma to the chest airway. This occurs when air is introduced into the tissue. This can happen as a complication during, or immediately after surgery. Among the causes subcutaneous emphysema due to complication of tonsillectomy, has rarely been described. Definitive treatment will depend on the cause. Recently. we have experienced two cases of subcutaneous emphysema without respiratory and circulatory insufficiency as a complication of tonsillectomy in 38-year-old male and uvulopalatopharyngoplasty in 41- year-old male.

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외상성 심실중격결손 및 승모판막 역류증의 일차 완전정복 (One Stage Repair of Traumatic Ventricular Septal Defect and Mitral Regurgitation)

  • 이재원;송태승;제형곤;송명근
    • Journal of Chest Surgery
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    • 제32권12호
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    • pp.1131-1134
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    • 1999
  • After a penetrating thoracic injury early detection of intracardiac injury and early surgical repair when indicated are essential. A case presenting severe respiratory distress two weeks after a penetrating thoracic injury is reported. Transesophageal echocardiography showed massive pericardial effusion ventricular septal defect and mirtal regurgitation, The infundibular ventricular septal perforation was repaired using a Dacron patch the anterior mitral leaflet by interrupted sutures and the ruptured chordae of the posterior leaflet by a new chordae formation.

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기관지내시경을 통해 치료한 활성탄 흡인 1예 (A Case of Activated Charcoal Aspiration Treated by Early and Repeated Bronchoalveolar Lavage)

  • 이한민;박재석;김재연;이지연;안병규;길효욱;최재성
    • Tuberculosis and Respiratory Diseases
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    • 제72권2호
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    • pp.177-181
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    • 2012
  • Activated charcoal is an inert substance and it is used in standard therapy in patients with acute intoxication. Charcoal has some side effects such as pulmonary aspiration, gastrointestinal complications, and electrolyte abnormalities. Although aspiration of charcoal is a rare complication, it can cause fatal sequelae. We report a 69-year old man who developed acute respiratory failure associated with charcoal aspiration after management of glyphosate poisoning. The patient was drowsy and suffered severe vomiting during transport to our hospital. On arrival, acute respiratory failure was observed due to charcoal aspiration, but the clinical state was improved with repeated bronchoscopy with a bronchoalveolar lavage (BAL). We presumed that the aspirated charcoal was an important factor in evoking a lung injury. Early bronchoscopy with a BAL might be an effective method for eliminating charcoal from the lung, especially in the case of a large amount of aspiration, and be helpful in decreasing respiratory failure due to charcoal aspiration.

호흡부전을 동반한 근위축성 측삭 경화증 환자의 장기적 호흡관리 1례 (A Clinical Case Study on the Long Term Respiration Management of Amyotrophic Lateral Sclerosis Patient with Respiratory Failure)

  • 이종철;정호현;차은혜;박만용;김태호;송봉근;손일홍;김성철
    • Journal of Acupuncture Research
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    • 제31권3호
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    • pp.67-73
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    • 2014
  • Objectives : Amyotrophic lateral sclerosis(ALS) is a progressive neurodegenerative disorder characterized by a selective death of motor neuron, leading to respiratory insufficiency. The purpose of this study was to assess the long term respiratory management of ALS patient with respiratory failure. Methods : One ALS patient applying a non-invasive BIPAP ventilator as well as Korean medical treatment such as acupuncture, pharmacopuncture and herbal medicine was measured on $SpO_2$, $EtCO_2$, Vte(expiratorytidalvolume) for 2 years 7 months. Results : The $SpO_2$, $EtCO_2$ of ALS patient were maintained in the normal range for 2 years 7 months. The Vte of ALS patient also wasn't worse in this study. Conclusions : In this study, the long term respiration management, combined administration of Korean medical treatment and non-invasive BIPAP ventilator, could be effective in ALS patient with respiratory failure.

울음소리의 주파수 대역폭 분석을 이용한 소아호흡기 질환 진단에 관한 연구 (A Study on Infant Respiratory Diseases Diagnosis using Frequency Bandwidth Analysis of Crying Waveform)

  • 김봉현;조동욱
    • 한국통신학회논문지
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    • 제33권12B호
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    • pp.1123-1130
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    • 2008
  • 출산율, 결흔율 감소 및 이혼을 증가 등의 사회적 현상으로 인해 태어나면서부터 건강에 대한 관심이 증대되고 있는 실정이다. 특히 의사 표현 능력이 부족한 소아의 질환 진단은 직접 내원해서 진단을 받아야 하는 불편함을 가지고 있다. 이를 위해 본 연구에서는 재택 기반으로 소아 울음소리를 통해 음성 분석학적 요소를 추출하여 정상 소아와 질환을 앓고 있는 소아와의 비교, 분석을 통해 소아 질환을 진단할 수 있는 시스템을 개발하고자 한다. 특히, 본 논문은 소아에게 가장 쉽게 걸릴 수 있는 소아호흡기 질환 중 소아감기, 소아폐렴 및 소아천식을 대상으로 실험을 수행하였으며 울음소리의 특징 요소를 추출하여 진단기기로 개발하고자 한다. 이를 위해 소아호흡기 질환이 인체의 음성 기관을 자극하는 질환임을 가정하고 음성학적 분석 요소 중 조음기관과 관련된 주파수대역폭분석을 통한 방법을 실험하였으며 이를 정상 소아와 소아호흡기 질환을 앓고 있는 환자를 비교, 분석하였다. 이와같은 방법을 통해 정상 소아에 비해 호흡기 질환을 앓고 있는 소아가 주파수 대역폭이 짧게 형성되는 결과를 추출하였다.

외래치료실에서의 근위축성 측삭경화증 환자(ALS)의 전신마취 하치과 치료시 마취관리 (Anesthetic Management of an Amyotrophic Lateral Sclerosis Patient Undergoing Dental Care in Daysurgery Center)

  • 김한수;이숙영;최은혜;김승오
    • 대한치과마취과학회지
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    • 제13권4호
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    • pp.195-201
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    • 2013
  • Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease caused by the degeneration of upper and lower motor neurons. The disorder causes muscle weakness and atrophy in airway muscles including pharyngeal, laryngeal and other respiratory muscles. The response to muscle realxant is also altered in patients with ALS. Because of the inherent muscle weakness and associated respiratory insufficiency, particular attentions are needed in anesthetic management of ALS patients. We used proper doses of inhalation anesthetics and opioids under EEG-entropy (electroencephalography-entropy)-monitoring without the use of muscle realxants in the anesthetic management of a patient with ALS. The patient early recovered and was discharged on the same day without any respiratory complications.

Rigid Bronchoscopy for Post-tuberculosis Tracheobronchial Stenosis

  • Hojoong Kim
    • Tuberculosis and Respiratory Diseases
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    • 제86권4호
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    • pp.245-250
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    • 2023
  • The healing process of tracheobronchial tuberculosis (TB) results in tracheobronchial fibrosis causing airway stenosis in 11% to 42% of patients. In Korea, where pulmonary TB is still prevalent, post-TB tracheobronchial stenosis (PTTS) is one of the main causes of benign airway stenosis causing progressive dyspnea, hypoxemia, and often life-threatening respiratory insufficiency. The development of rigid bronchoscopy replaced surgical management 30 years ago, and nowadays PTTS is mainly managed by bronchoscopic intervention in Korea. Similar to pulmonary TB, tracheobronchial TB is treated with combination of anti-TB medications. The indication of rigid bronchoscopy is more than American Thoracic Society (ATS) grade 3 dyspnea in PTTS patients. First, the narrowed airway is dilated by multiple techniques including ballooning, laser resection, and bougienation under general anesthesia. Then, most of the patients need silicone stenting to maintain the patency of dilated airway; 1.5 to 2 years after indwelling, the stent could be removed, this has shown a 70% success rate. Acute complications without mortality develop in less than 10% of patients. Subgroup analysis showed successful removal of the stent was significantly associated with male sex, young age, good baseline lung function and absence of complete one lobe collapse. In conclusion, rigid bronchoscopy could be applied to PTTS patients with acceptable efficacy and tolerable safety.