• 한국광학회지
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• 제11권4호
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• pp.294-298
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• 2000

반도체레이저로 단면 여기시킨 Nd:VAP 레이저의 내부공진기 제2고조파 출력특성을 조사하였다. 유도방출 단면적과 형광수명의 곱이 커 낮은 발진문턱 특성을 갖는 Nd:S-VAP 매질은 컴팩트한 마이크로칩 레이저에 적합하다. 내부공진기를 이용한 제2고조파 발진문턱에너지가 81 uJ로 측정되어 쉽게 발진됨을 확인하였다. 여기에너지 $2\mu\textrm{J}$에서 제2고조파 에너지 $126\mu\textrm{J}$을 얻었고, 내부공진기 제2고조파의 출력을 계산하여 이론적인 해석 근거를 제시하였다. Q-스위치된 제2고조파 출력은 펄스폭 26ns에 펄스당 에너지 $15\mu\textrm{J}$로 저출력에서도 시.공간적으로 깨끗한 펄스를 얻었으며, $M^2$도 1.47로 우수한 빔 특성을 나타내었다.

• International Journal of Advanced Culture Technology
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• 제6권3호
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• pp.211-215
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• 2018

Ventilator-associated pneumonia (VAP) is a lung infection that develops in patients receiving mechanical ventilation. VAP contributes to about 50% of hospital-acquired pneumonia in ICU settings. One of the recommendation of the Institute of for Healthcare Improvement ventilator bundle is HOB elevation. HOB elevation affects shearing forces and makes higher risk for pressure injury development. Pressure injury (PI) is localized damage to the skin over a bony prominence. PI prevention guidelines recommend that HOB positioning should be lower to reduce risk for PI development which contradicts VAP prevention guidelines for the HOB between 30 and 45 degrees for ICU patients. This presents a care dilemma and tension. The purpose of this study was to perform a secondary data analysis using cumulative electronic health record data in order to determine the association of HOB elevation with VAP and PI in ICU patients. A secondary data analysis was conducted to determine whether HOB elevation is associated with VAP and PI. HOB elevation was not likely to be associated with VAP prevention whereas it was likely to be related to PI development. This is somewhat contrary to popular data and publications. Prospective cohort study is desired to inform us in an evidence-based fashion what actually is optimal HOB elevation for ventilated patients in ICU settings.

• 대한간호학회지
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• 제40권6호
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• pp.799-807
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• 2010

Purpose: To determine whether the practice of not routinely changing ventilator circuits in patients who require prolonged mechanical ventilation is associated with ventilator-associated pneumonia (VAP). Methods: Patients were divided into two groups, ventilator circuits were routinely changed every 7 days for the control group (39) and every 14 days for the experimental group (40) over a period of 1 yr (April 1, 2009-March 31, 2010). Pediatric patients (age 17 yr or less) were not included. VAP was diagnosed by the criteria of the Centers of Disease Control and Prevention (CDC). Incidence of VAP and characteristics of infection were evaluated. Results: In the experimental group, 2 episodes of pneumonia were observed in 40 patients and 1,322 ventilator days. The rate of VAP was 1.5 per 1,000 ventilator days. There was 1 episode of pneumonia in 39 patients and 481 ventilator days for the control group. The rate of VAP was 2.1 per 1,000 ventilator days. The difference between both groups was not significant (p=.695). Conclusion: Extending ventilator circuit change interval from 7 days to 14 days does not increase the risk for VAP.

• 중환자간호학회지
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• 제4권2호
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• pp.39-46
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• 2011

Purpose: The purpose of this study was to examine the effect of oral hygiene for ventilator-associated pneumonia (VAP) incidence. Methods: This study was used a nonequivalent control group posttest design. This study was performed in two groups, experimental group and control group. The experimental group (36 patients) had performed oral care for 6 times a day. The control group (39 patients) had followed and 3 times oral care a day. Participants were patients of 20 years of age or older on mechanical ventilation more than 48 hours from July 5 to October 31 in 2007 at the medical and surgical ICU of C university hospital. Results: VAP occurred in 5 cases in the control group, while only 1 case occurred in the experimental group. Incidence for 1000 ventilator day was 12.59 in the control group and 2.18 in the experimental group. Conclusion: Nursing intervention of 6 times oral care a day proved to decrease incidence of VAP. A guideline should be made using the above nursing intervention for the critical ill patients receiving mechanical ventilation.

• Journal of applied mathematics & informatics
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• 제28권3_4호
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• pp.893-908
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• 2010

In this paper we prove the existence of spanning 3-trees in a 3-connected infinite locally finite VAP-free plane graph. Together with the results of Barnette and the author, this yields that every finite or infinite 3-connected locally finite VAP-free plane graph contains a spanning 3-tree.

• 성인간호학회지
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• 제28권6호
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• pp.628-636
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• 2016

Purpose: This study examined the effects of a program designed to prevent ventilator-associated pneumonia (VAP) on VAP rate and endotracheal colonization. The program focused on aspiration prevention and oral care. Methods: A nonequivalent control group post-test only design was utilized. One hundred patients admitted to a medical intensive care unit (MICU) or coronary care unit (CCU) were assigned to either a experimental group (n=50) or a control group (n=50). The participants were selected 48 hours following an endotracheal intubation. VAP prevention program given to the experimental group includes keeping the head of the bed to $30^{\circ}{\sim}45^{\circ}$ high, maintaining continuous endotracheal cuff pressure at 25 cm $H_2O$, performing endotracheal suction before change position, and providing oral care with 0.1% chlorhexidine every four hours. The control group received usual care. Data were analyzed using t-test, $x^2$ test, Mantel-Haenszel $x^2$ and Cox proportional harzard regression model. Results: The experimental group showed a lower VAP rate than the control group although the difference was not statistically significant ($x^2=0.79$, p=.375). The experimental group showed lower colonization in tracheal secretion than the control group ($x^2=14.59$, p<.001). Conclusion: Results showed that a VAP prevention program is effective in reducing colonization of tracheal secretion. Therefore, VAP prevention programs are recommended as an ICU nursing intervention.

• 대한수의학회지
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• 제59권3호
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• pp.141-149
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• 2019

From 1996 to 2014, 14 foals from nine farms in Jeju were diagnosed with a Rhodococcus equi infection. Clinically, most foals showed characteristic respiratory signs, including hyperthermia and dyspnea. The seasonal occurrence of R. equi infection in foals was higher in summer, such as June (eight foals; 57.1%) and July (four foals; 28.6%), than in the other seasons. The major cases of R. equi infections were observed among two-month-old (eight foals; 57.1%) and three-month-old (three foals; 21.4%) foals. Histopathologically, bronchopneumonia, abscess, and granulomatous pneumonia were the most prevalent lesions in the lungs of foals. Colonic ulcers and submucosal abscesses were found in a foal. Some foals showed granulomatous lymphadenitis and abscesses in the mesenteric and other lymph nodes. According to the polymerase chain reaction using 10 tissue samples of foals and nine R. equi isolates, the vapA gene was detected in 11/11 (100%) foals. Immunohistochemical staining using the anti-VapA monoclonal antibody was applied to detect the R. equi VapA antigen in the organs of foals. R. equi VapA antigens were demonstrated in most lungs and some mesenteric and hilar lymph nodes of 13 foals. Isolated virulent R. equi VapA bacteria showed high sensitivity to gentamicin, quinolones, rifampin, and vancomycin.

• 중환자간호학회지
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• 제3권2호
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• pp.13-22
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• 2010

Purpose: This study was intended to examine the effects of educating the Ventilator-Associated Pneumonia (VAP) control for the nurses working in the intensive care unit (ICU). Methods: The study was conducted using one group pre-post test research design. The education on infection control was provided to 31 nurses working at the medical and surgical ICUs. A comparison was then made in terms of the degree of performing infection control a month before, two weeks after, and three months after the education respectively. The incidences of VAP at the medical and surgical ICUs were compared for 3 months before and after the education. Results: The average performance scores between before and after the education showed statistically significant differences. Compared to three months before, the incidence of VAP after the education was decreased slightly from 5.48 to 1.88 per 1,000 ventilator days. Conclusion: It is necessary to continue the VAP education, specifically on infection prevention and control methods and the consistent evaluation of its effects as well as the development of standardized educational program should be approached extensively in further studies.

• 가정∙방문간호학회지
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• 제25권3호
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• pp.224-231
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• 2018

Purpose: This study was to analyze the factors affecting ventilator-associated pneumonia with severe trauma patients. Methods: This study conducted from May 1, 2018 to May 31, 2018 based on the medical records of the intensive care unit of a university hospital from May 1, 2017 to April 30, 2018 in Gangwon province. The inclusion criteria were 1) Trauma intensive care unit patient, 2) older than 19 years 3) without pneumonia at the time of admission. The collected data were analyzed using descriptive, correlation analysis, ANOVA, t-tests, $x^2$-tests and regression. Results: The severe trauma patients had a total of 2,877 days receiving ventilator, and nine VAP cases. The overall infection rate was 4.0%, and the VAP incidence rate was 3.13 per 1000 ventilator days. VAP in severe trauma patient affected ICU stay(OR=1.03), mechanical ventilator applied day(OR=1.04). Conclusion: Therefore, the development of an individualized VAP prevention bundle and nursing intervention for patients with trauma will be needed and further studies. In addition, there were no findings regarding the relationship between VAP occurrence and the severity of multiple traumatic injuries, so further studies of these factors should be performed.

• Tuberculosis and Respiratory Diseases
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• 제73권1호
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• pp.32-37
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• 2012

Background: This study evaluates the bacterial pathogens of Ventilator-associated pneumonia (VAP) in a tertiary referral hospital. Methods: A total of 109 bacterial pathogens from 91 adult patients with VAP, who were admitted to the medical intensive care unit from January 2008 to December 2009, were examined. Clinical characteristics, bacterial pathogens, and resistance profiles were analyzed. Results: Staphylococcus aureus (44%) was the most frequently isolated. Acinetobacter baumanii (30%), Pseudomonas aeruginosa (12%), Stenotrophomonas maltophilia (7%), Klebsiella pneumoniae (6%), and Serratia marcescens (2%) were isolated from the transtracheal aspirates or bronchoalveolar lavage in patients with VAP. There was no significant difference of bacterial pathogens between early and late onset VAP. All isolated S. aureus were methicillin resistant S. aureus; the imipenem resistance rate of A. baumanii was 69%. Conclusion: The two most frequent pathogens of VAP were S. aureus and A. baumanii. There were no pathogenic differences between early and late onset VAP.