• Title/Summary/Keyword: Ventilation disorders

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Clinical Application of Nasal Intermittent Positive Pressure Ventilation with Bi-level Positive Airway Pressure(BiPAP) (기도 이중 양압(BiPAP)을 이용한 비강 간헐 양압환기의 임상적 적용)

  • Cho, Jae-Youn;Lee, Sang-Youb;Lee, Sang-Hwa;Park, Sang-Myun;Suh, Jung-Kyung;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.723-730
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    • 1995
  • Background: Noninvasive ventilation has been used extensively for the treatment of patients with neuromuscular weakness or restrictive chest wall disorders complicated by hypoventilatory respiratory failure. Recently, noninvasive positive pressure ventilation has been used in patients with alveolar hypoventilation, chronic obstructive pulmonary disease(COPD), and adult respiratory distress syndrome. Sanders and Kern reported treatment of obstructive sleep apnea with a modification of the standard nasal CPAP device to deliver seperate inspiratory positive airway pressure(IPAP) and expiratory positive airway pressure(EPAP). Bi-level positive airway pressure(BiPAP) unlike nasal CPAP, the unit delivers a different pressure during inspiration from that during expiration. The device is similar to the positive pressure ventilator or pressure support ventilation. Method and purpose: Bi-level positive airway pressure(BiPAP) system(Respironics, USA) was applied to seven patients with acute respiratory failure and three patients on conventional mechanical ventilation. Results: 1) Two of three patients after extubation were successfully achieved weaning from conventional mechanical ventilation by the use of BiPAP ventilation with nasal mask. Five of seven patients with acute respiratory failure successfully recovered without use of conventional mechanical ventilation. 2) $PaO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients significantly improved more than baseline values(p<0.01). $PaCO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients did not change significantly more than baseline values. Conclusion: Nasal mask BiPAP ventilation can be one of the possible alternatives of conventional mechanical ventilation in acute respiratory failure and supportive method for weaning from mechanical ventilation.

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Effects of Nutrient Solution Application Methods and Rhizospheric Ventilation on Vegetative Growth of Young Moth Orchids without a Potting Medium in a Closed-Type Plant Factory

  • Min, Sang Yoon;Oh, Wook
    • Journal of People, Plants, and Environment
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    • v.23 no.5
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    • pp.545-554
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    • 2020
  • Background and objective: Moth orchids in the vegetative stage are suitable for a multi-layer growing environment in a closed-type plant factory which can be a good alternative that can reduce production costs by reducing cultivation time and energy cost per plant. This study was conducted to find out the optimal rhizospheric environment for different irrigation methods without a potting medium and rhizospheric ventilation for the vegetative growth of young Phalaenopsis hybrid 'Blanc Rouge' (P. KV600 × P. Kang 1) and Phalaenopsis Queen Beer 'Mantefon' in a closed-type plant factory system. Methods: The one-month-old clonal micropropagules with bare roots rapped with a sponges were fixed on the holes of styrofoam plates above growth beds, and were watered using the ebb-and-flow (EBB) and aeroponic (AER) methods with Ichihashi solution (0.5 strength) once a day at 06:00 (P) or 18:00 (S), and both (PS). Rhizospheric ventilation (V) was also applied to change the temperature, relative humidity, and CO2 concentration of the beds. Plants potted into sphagnum moss and watered once a week were used as the control group. Results: After 12 months of treatment, the growth characteristics of the EBB groups were the best among the treatment groups without a medium, but no effect of irrigation timing was observed. V reduced the temperature, relative humidity and CO2 concentration of the beds. Whereas, EBB+V (ebb-and-flow with ventilation) improved plant growth and reduced the occurrence of disorders and withering. Especially, EBB+V showed a similar performance to the control group. Conclusion: The results indicated that the optimal irrigation method without a potting medium for producing middle-aged potted moth orchids was the EBB system with forced rhizospheric ventilation. Therefore, further studies on the optimal ventilation method and moisture control of the crown need to be carried out to develop the irrigation system without a potting medium for vertical farming in closed-type plant factories.

Significance Evaluation of Lung Volume and Pulmonary Dysfunction (폐용적과 폐기능 환기장애에 대한 유의성 평가)

  • Ji-Yul Kim;Soo-Young Ye
    • Journal of the Korean Society of Radiology
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    • v.17 no.5
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    • pp.767-773
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    • 2023
  • To In this study, we sought to evaluate related factors affecting lung volume and their significance in pulmonary function and ventilation disorders. As experimental subjects, 206 normal adult men and women who underwent a low-dose chest CT scan and a spirometry test were selected at the same time. The experimental method was to measure lung volume using lung CT images obtained through a low-dose chest CT scan using deep learning-based AVIEW. Measurements were made using the LCS automatic diagnosis program. In addition, the results of measuring lung function were obtained using a spirometer, and gender and BMI were selected as related factors that affect lung volume, and significance was evaluated through an independent sample T-test with lung volume. As a result of the experiment, it was confirmed that in evaluating lung volume according to gender, all lung volumes of men were larger than all lung volumes of women. he result of an independent samples T-test using the respective average values for gender and lung volume showed that all lung volumes were larger in men than in women, which was significant (p<0.001). And in the evaluation of lung volume according to BMI index, it was confirmed that all lung volumes of adults with a BMI index of 24 or higher were larger than all lung volumes of adults with a BMI index of less than 24. However, the independent samples T-test using the respective average values for BMI index and lung volume did not show a significant result that all lung volumes were larger in BMI index 24 or higher than in BMI index less than 24 (p<0.055). In the evaluation of lung volume according to the presence or absence of pulmonary ventilation impairment, it was confirmed that all lung volumes of adults with normal pulmonary function ventilation were larger than all lung volumes of adults with pulmonary ventilation impairment. And as a result of the independent sample T-test using the respective average values for the presence or absence of pulmonary ventilation disorder and lung volume, the result was significant that all lung volumes were larger in adults with normal pulmonary function ventilation than in adults with pulmonary function ventilation disorder (p <0.001). Lung volume and spirometry test results are the most important indicators in evaluating lung health, and using these two indicators together to evaluate lung function is the most accurate evaluation method. Therefore, it is expected that this study will be used as basic data by presenting the average lung volume for adults with normal ventilation and adults with impaired lung function and ventilation in similar future studies on lung volume and vital capacity testing.

The diagnosis of sleep related breathing disorders and polysomnography (수면호흡장애의 진단과 수면다원검사)

  • Park, Ji Woon
    • The Journal of the Korean dental association
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    • v.53 no.4
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    • pp.238-248
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    • 2015
  • Sleep related breathing disorders(SRBDs) are a group of diseases accompanied by difficulties in respiration and ventilation during sleep. Central sleep apnea, obstructive sleep apnea(OSA), sleep-related hypoventilation, and hypoxemia disorder are included in this disease entity. OSA is known to be the most common SRBDs and studies show its significant correlation with general health problems including hypertension, arrhythmia, diabetes, and metabolic syndrome. The diagnostic process of OSA is composed of physical examinations of the head and neck area and also the oral cavity. Radiologic studies including cephalography, CT, MRI, and fluoroscopy assist in identifying the site of obstruction. However, polysomnography(PSG) is still considered the gold standard for the diagnosis of OSA since it offers both qualitative and quantitative recording of the events during a whole night's sleep. The dentist who is trained in sleep medicine can easily identify patients with the risk of OSA starting from simple questions and screening questionnaires. Diagnosis is the first step to treatment and considering the high rate of under-diagnosis for OSA the dentist may play a substantial role in the diagnosis and treatment of OSA which will eventually lead to the well-being of the patient as a whole person. So the objective of this article is to assist dental professionals in gaining knowledge and insight of the diagnostic measures for OSA including PSG.

Congenital central hypoventilation syndrome combined with Hirschsprung disease diagnosed in the neonatal period (신생아에서 진단된 Hirschsprung 병을 동반한 congenital central hypoventilation syndrome 1례)

  • Choi, Jin Hyun;Oh, Jin Hee;Kim, Jong-Hyun;Koh, Dae Kyun;Hong, Seung-Chul
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.446-450
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    • 2006
  • Congenital central hypoventilation syndrome (CCHS) or Ondine's curse is a very rare sleep disorder that is the result of a congenital failure of the autonomic control of ventilation caused by insensitivity of the chemoreceptor to hypercapnea during sleep. Gastrointestinal motility disorders, particularly a congenital megacolon (Hirschsprung disease) is often combined with CCHS. This combination can be explained by a defect in the migration of neuronal cells from the neural crest (neurocristopathy) during the intrauterine period. A diagnosis of CCHS is made by confirming the failure of adequate ventilation in response to hypercapnea and hypoxia during sleep and the exclusion of other diseases. Young infants frequently show atypical clinical courses, and their conditions are frequently complicated with the long-term sequela of hypoxemic episodes. Therefore, a high index of suspicion and active treatment with mechanical ventilation are important for reducing recurrent hypoxemic episodes in the neonatal period. This paper reports the follow up of a case of CCHS in a neonate who showed frequent intractable apnea and cyanosis and was given artificial mechanical ventilation during sleep.

Influence of Sleep-Related Breathing Disorders on Changes of Cardiovascular Function (수면과 관련된 호흡장애가 심혈관계의 기능 변화에 미치는 영향)

  • Moon, Hwa-Sik
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.129-139
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    • 1997
  • The data collected to date indicate that sleep-related breathing disorders, including sleep-disordered breathing(sleep apnea) and underlying respiratory system diseases, are one of the important risk factors for cardiovascular dysfunction. Sleep-disordered breathing(sleep apnea) is now recognized as one of the leading causes of systemic hypertension, cardiac arrhythmias, coronary heart disease, pulmonary hypertension, right heart failure, and stroke. Sleep may exert a profound effect on breathing in patients with underlying respiratory system disease including bronchopumonary diseases, chest wall abnormalities, central alveolar hypoventilation syndromes or respiratory neuromuscular disorders. Chronic hypoxia and hypercapnia in these patients may accelerate the development of long term cardiovascular complications such as cardiac arrhythmias, pulmonary hypertension, and right heart failure(cor pulmonale). Several recent studies reported that sleep-related breathing disorders are associated with long-term cardiovascular morbidity and mortality. Careful assessment of respiratory and cardiovascular function in these patients is critical. Aggressive and highly effective treatment of sleep-related breathing disorders using tracheostomy, mechanical ventilation, nasal continuous positive airway pressure therapy(nCPAP), intercurrent oxygen therapy or other interventions can reduce the prevalence of cardiovascular dysfunction and the long-term mortality.

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Fatigue and related factors in cervicobrachial disorders (경견완장애의 피로자각증상과 관련요인)

  • Kang, Jeom-Deok
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.8 no.1
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    • pp.5-14
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    • 2002
  • Objectives : In order to investigate industrial fatigue due to visual display terminal (VDT) work of post office. Methods : The questionnaire survey for subjective symptoms of fatigue was carried out on 39 post office clerks who had been engaged in VDT work for various length of work hours. The questionnaire comprised three groups of 10 items each, representing dullness and sleepiness, difficulty in concentration and bodily projection of fatigue. Results : The scores of dullness and sleepiness was 16.62, scores of concentration difficulty was 16.35, those of bodily fatigue was 16.23, and total scores was 49.21. Fatigue scores was significantly associated with age and work duration, VDT of work hours, ventilation, illumination, nosie. Conclusions : Data from this study support a statistically significant association between age and scores of dullness, scores of concentration difficulty, between work duration and scores of dullness, scores of bodily fatigue, between VDT of work hours and scores of bodily fatigue.

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Chronic Obstructive Pulmonary Disease and Sleep Disorder (만성폐쇄성폐질환과 수면장애)

  • Kim, Sei Won;Kang, Hyeon Hui
    • Sleep Medicine and Psychophysiology
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    • v.27 no.1
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    • pp.8-15
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    • 2020
  • Sleep disorder in chronic obstructive pulmonary disease (COPD) is common and typically is associated with oxygen desaturation. The mechanisms of desaturation include hypoventilation and ventilation to perfusion mismatch. Despite the importance of sleep in patients with COPD, this topic is under-assessed in clinical practice. Impaired sleep quality is associated with more severe COPD and may contribute to worse clinical outcomes. Recent data have indicated that specific respiratory management of patients with COPD and sleep disordered breathing improves clinical outcomes. Clinicians managing patients with COPD should pay attention to and actively manage symptoms of comorbid sleep disorders. Management of sleep-related problems in COPD should particularly focus on minimizing sleep disturbance.

Anesthetic Experiences of Myasthenia Gravis: Report of two cases (중증근무력증 환자의 마취 2례 보고)

  • Park, Dae-Pal;Lee, Kyung-Chul
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.287-292
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    • 1985
  • Myasthenia gravis is usually defined as a state of abnormal fatigability. The cause of myasthenia gravis is not known. Several disorders tend to occur more frequently in patients with myasthenia gravis, such as hyperthyroidism or other thyroidal disorder. Anesthetic experience with thymectomies for two patients with myasthenia gravis has been reported. Both of them tolerated the surgical procedures under endoteracheal Nitrous oxide-Oxygen-Halothane anesthesia well. Diagnosis and clinical features including choice of preanesthetic medication, anesthetic agents, techniques and of neuromuscular blocking agents for myasthenic patients have been discussed. Paramount importance of rigid attention to ventilation, the maintenance of a patent airway and the removal of secretions whenever necessary for the patient safety throughout operative and postoperative period has been stressed.

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Analysis of Characteristics and Prognostic Factors in Adult Patients Receiving Mechanical Ventilation in the Medical Intensive Care Unit of a University Hospital (한 대학병원 내과계 중환자실의 기계환기 시행 환자의 현황 및 예후인자의 분석)

  • Song, Jin Woo;Choi, Chang-Min;Hong, Sang-Bum;Oh, Yeon-Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.292-300
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    • 2008
  • Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit. Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation for more than 48 hours in the medical ICU of one tertiary referral hospital. Results: The mean age of the patients was $60.3{\pm}15.6$ years and 34.0% were female. The initial mean APACHE III score was $72.3{\pm}25$. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score >70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality. Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly associated with the outcome of mechanical ventilatory support in patients with respiratory failure.