• Title/Summary/Keyword: Ventilation disorders

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Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review

  • Eunhye Bae
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.4
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    • pp.179-192
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    • 2023
  • Obstructive sleep apnea (OSA) is a common sleep-breathing disorder associated with significant comorbidities and perioperative complications. This narrative review is aimed at comprehensively overviewing preoperative risk evaluation and perioperative management strategies for patients with OSA. OSA is characterized by recurrent episodes of upper airway obstruction during sleep leading to hypoxemia and arousal. Anatomical features, such as upper airway narrowing and obesity, contribute to the development of OSA. OSA can be diagnosed based on polysomnography findings, and positive airway pressure therapy is the mainstay of treatment. However, alternative therapies, such as oral appliances or upper airway surgery, can be considered for patients with intolerance. Patients with OSA face perioperative challenges due to difficult airway management, comorbidities, and effects of sedatives and analgesics. Anatomical changes, reduced upper airway muscle tone, and obesity increase the risks of airway obstruction, and difficulties in intubation and mask ventilation. OSA-related comorbidities, such as cardiovascular and respiratory disorders, further increase perioperative risks. Sedatives and opioids can exacerbate respiratory depression and compromise airway patency. Therefore, careful consideration of alternative pain management options is necessary. Although the association between OSA and postoperative mortality remains controversial, concerns exist regarding adverse outcomes in patients with OSA. Understanding the pathophysiology of OSA, implementing appropriate preoperative evaluations, and tailoring perioperative management strategies are vital to ensure patient safety and optimize surgical outcomes.

Comparison of Rehospitalization during the First Year of Life in Normal and Low Birth Weight Infants Discharged from NICU (신생아 집중치료실에서 퇴원한 정상 체중아와 저출생 체중아의 재입원에 관한 비교)

  • Min, Sae Ah;Jeon, Myung Won;Yu, Sun Hee;Lee, Oh Kyung
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1503-1511
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    • 2002
  • Purpose : Although the short- and long-term outcomes of low birth weight(LBW) neonatal intensive care unit(NICU) survivors have been extensively studied, much less information is available for normal birth weight(NBW) infants(greater than 2,500 gm) who require NICU care. Methods : We retrospectively examined the neonatal hospitalizations and one year health status of 302 NBW and 131 LBW admissions to our NICU. Information on the neonatal hospitalization was obtained from a review of medical records. Postdischarge health status was collected by using telephone surveys and medical records. Results : After initial discharge, 21.2% of the NBW infants and 23% of the LBW infants required rehospitalization during the first year of life and there was no significant difference between the two groups. The reasons for rehospitalization of the NBW infants included respiratory disorders (32.1%), G-I problems(26.2%), genitourinary problems(11.9%), surgery(10.7%), cardiac problems(7.1%), and congenital/developmental problems(1.2%). For the LBW infants, the order of frequency was the same, with the percentages slightly different. Neonatal risk factors related to the rehospitalization of the NBW infants included mechanical ventilation, duration of mechanical ventilation, and congenital anomaly. But no positive significant correlation of neonatal risk factors with rehospitalization of LBW infants was found. Conclusion : Low and normal birthweight NICU survivors were rehospitalized at similar rates. The most common cause of rehospitalization was respiratory problems. Neonatal risk factors related to rehospitalization of NBW infants were mechanical ventilation, duration of mechanical ventilation, and congenital anomaly. However, no positive significant correlation of neonatal risk factors with rehospitalization of LBW infants was found. The data suggests that NBW infant survivors, as well as LBW infant NICU survivors, require close follow up.

A Research to Decrease Airborne Microoganism the Train (전동차내 부유 미생물 저감방안에 관한 연구)

  • Choi, Sung-Ho;Choi, Soon-Gi;Son, Young-Jin
    • Proceedings of the KSR Conference
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    • 2011.10a
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    • pp.2895-2901
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    • 2011
  • SeoulMetro(line number 1 to 4) for the first half of the year. Therefore air quality in the subway is very important. It is passengers, such as sneezing and respiratory vital activities, Suspended due to skin keratin microbial action, and Microbial contaminants such as viruses. Hypersensitivity disorders, an atopic dermatitis, infectious diseases, allergic diseases, and can cause respiratory diseases. Ministry of Environment and National Institute of Environmental Research is managed so the life bacteria. It is emerging as the occupational health problems. Introduction of an appropriate ventilation system for cooling and dehumidification is needed. In line number 2, commuting and normal trains are measured in-room floating microbes. Suspended bacteria and fungi suspended in 2011 for 85 ~ 385$cfu/m^3$, 67 ~ 98$cfu/m^3$ is lower than baseline. Suspended to prevent microbial contamination and air conditioning equipment performance is a substantial improvement. Suspended micro-organisms and the impact on passenger room ventilation is increased. Electric car how to improve air quality substantially investigated.

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The Study on Risk Factors Analysis and Improvement of VDT Syndrome in Nuclear Medicine (핵의학과 Video Display Terminals Syndrome 유해 요인 조사 및 개선에 관한 연구)

  • Kim, Jung-Soo;Kim, Seung-Jeong;Lee, Hong-Jae;Kim, Jin-Eui;Kim, Hyun-Joo;Han, In-Im;Joo, Yung-Soo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.61-66
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    • 2010
  • Purpose: Recently, Department of Nuclear Medicine have an interest in Video Display Terminals (VDT) syndrome including musculoskeletal disorders, ophthalmologic disorders, trouble of electromagnetic waves and stress disorders occur to VDT workers as the growing number of users and rapid pace of service period supply in large amount. This study research on the actual condition for VDT syndrome in Nuclear Medicine, Seoul National University Hospital (SNUH), discover the problem and draw a plan of upcoming improvement. The aim of this study establish awareness about VDT syndrome and is to prevent for it in the long run. Materials and Methods: Department of Nuclear Medicine, SNUH is composed Principle part, Pediatric part and PET center. We estimated risk factors visit in each part directly. Estimation method use "Check list for VDT work" of Wonjin working environment health laboratory and check list is condition of VDT work, condition of work tables, condition of chairs, condition of keyboards, condition of monitors, working position, character of health management and other working environment. Analysis result is verified in Department of Occupational and Environment, Hallym University Sacred Heard Hospital. Results: As a result of analysis, VDT condition of Department of Nuclear Medicine, SNUH is rule good. In case of work tables, recent of things are suitable to users upon the ergonomical planning, but 15% of existing work tables are below the standard value. In case of chairs are suitable, but 5% of theirs lost optimum capacity become superannuated. The keyboards are suitable for 98% of standard value. In case of monitors, angle control of screen is possible of all, but positioning control is impossible for 38%. In case of working position, 10% is fixed positioning for long time and some of the items researched unsuitable things for standard. At health management point, needed capable of improvement. Also, other working condition as lighting, temperature, noise and ventilation, discovered the problem, but is sufficient to advice value. Conclusion: VDT syndrome is occurrences of possibility continuously, come economical expensive about improvement, is inherent in various causes and originate without your knowledge. So, there is need systematic management system. In Nuclear Medicine, VDT syndrome make it better that constant interest and effort as improvement of ergonomical working environment, improvement of working procedure, regular exercise and steady stretching, and can be prevented fairly. This promote physical and mental condition of worker in top form in comfortable working environment, so this is judged by enlargement of operations efficiency and rising of satisfaction ratings of the inside client.

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A Clinical Report about Hiccup and Eructation from Emotional Stress (칠정(七情) 자극 후 발생한 해역(咳逆).희기(噫氣) 환자 치혐 1례)

  • Kim, Kyong-Soo;Lee, Dong-Won
    • Journal of Oriental Neuropsychiatry
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    • v.13 no.1
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    • pp.127-132
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    • 2002
  • This case show that emotional stress and wekness of gastrointestinal function occur a chronic hiccup and eructation(during 3 months), oriental medical therapy can cure completely this symptom. Seven emotional stress(anger, delight, sadness, thinking, worry, fear, horror) occur various pathologic changes. Hiccup is caused by CNS, psychologic, thoracic, abdominal factor etc. In oriental medicine, GI trouble regarded as a very importent factor that occur hiccup and eructation. Besides, emotional stress is a very important factor as well. This patient have an introvert personality ordinary times. One day, she had a miscarriage by hers husband's assault. After that time, she suffered from very serious GI trouble(dyspepsia, epigastric pain, anorexia). And then hiccup, eructation, weight loss(10kg/3months) is occured. This patient diagnosed only gastritis. This symptom did not stop during 3 months, regardless of western medical therapy(some western drugs medication, fluid supply etc). After oriental medical therapy(herb medicine;Yukunjatang, acupuncture;CV12, CV6, S36, CV17, H7, SP6, P6, moxibustion;VI2, CV6, S36, negative therapy;back area and traditional oriental medical psychotherapy;ventilation, support, desensitization and family interview) put in operation during 15 days, patient completely recover from hiccup, eructation and anxiety disorders.

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Nationwide Analysis of Mortality Rates and Related Surgical Procedures in Hearing Disability Patients in South Korea

  • Han, Hye Min;Kwak, Ji Won;Kim, Hyeon Geun;Lee, Hoyoung;Kim, Young-Chan;Park, Euyhyun;Jung, Hak Hyun;Im, Gi Jung
    • Korean Journal of Audiology
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    • v.24 no.4
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    • pp.204-209
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    • 2020
  • Background and Objectives: Hearing loss (HL) and its repercussions are major problems in today's society. There are limited data on the relationship between degree of HL and otologic disorders. The aim of this study is to estimate mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures in hearing disability patients in South Korea. Subjects and Methods: Retrospective medical data for 160,205 patients with hearing disability was extracted. Mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures were compared with a normal control group consisting of 865,475 people; approximately 5 times the number of hearing disability patients. Results: According to the Korean National Disability Registry (NDR), 0.458% of the population in South Korea suffered from hearing disability in 2015. Higher rates of mortality and sudden idiopathic HL were reported in hearing disability patients, increasing up to a maximum of 1.594 times and 1,039.695 times, respectively, compared to the normal control group. Mastoidectomy surgery was 2.5 times more frequently performed and pressure equalizing (PE) tube insertion was about 15 times more frequently performed in hearing disability patients. Conclusions: Hearing disability is related to higher risks of mortality, sudden idiopathic HL and otologic surgical procedures, including mastoidectomy and PE tubing.

Nationwide Analysis of Mortality Rates and Related Surgical Procedures in Hearing Disability Patients in South Korea

  • Han, Hye Min;Kwak, Ji Won;Kim, Hyeon Geun;Lee, Hoyoung;Kim, Young-Chan;Park, Euyhyun;Jung, Hak Hyun;Im, Gi Jung
    • Journal of Audiology & Otology
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    • v.24 no.4
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    • pp.204-209
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    • 2020
  • Background and Objectives: Hearing loss (HL) and its repercussions are major problems in today's society. There are limited data on the relationship between degree of HL and otologic disorders. The aim of this study is to estimate mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures in hearing disability patients in South Korea. Subjects and Methods: Retrospective medical data for 160,205 patients with hearing disability was extracted. Mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures were compared with a normal control group consisting of 865,475 people; approximately 5 times the number of hearing disability patients. Results: According to the Korean National Disability Registry (NDR), 0.458% of the population in South Korea suffered from hearing disability in 2015. Higher rates of mortality and sudden idiopathic HL were reported in hearing disability patients, increasing up to a maximum of 1.594 times and 1,039.695 times, respectively, compared to the normal control group. Mastoidectomy surgery was 2.5 times more frequently performed and pressure equalizing (PE) tube insertion was about 15 times more frequently performed in hearing disability patients. Conclusions: Hearing disability is related to higher risks of mortality, sudden idiopathic HL and otologic surgical procedures, including mastoidectomy and PE tubing.

Long-term Prognosis and Physiologic Status of Patients Requiring Ventilatory Support Secondary to Chest wall Disorders (흉벽질환에 의한 급성호흡부전 환자의 생리적 특성과 장기적인 예후)

  • Yoon, Seok Jin;Jun, Hee Jung;Kim, Yong Joo;Lee, Seung Jun;Kim, Eun Jin;Cha, Seung Ick;Park, Jae Yong;Jung, Tae Hoon;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.265-272
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    • 2006
  • Background: Chest wall deformities such as kyphoscoliosis, thoracoplasty, and fibrothorax cause ventilatory insufficiency that can lead to chronic respiratory failure, with recurrent fatal acute respiratory failure(ARF). This study evaluated the frequency and outcome of ARF, the physiologic status, and the long-term prognosis of these patients. Methods: Twenty-nine patients with chest wall disorders, who experienced the first requirement of ventilatory support from ARF were examined. The mortality and recurrence rate of ARF, the pulmonary functions with arterial blood gas analysis, the efficacy of home oxygen therapy, and the long-term survival rate were investigated. Results: 1) The mortality of the first ARF was 24.1%. ARF recurred more than once in 72.7% of the remaining 22 patients, and overall rate of successful weaning was 73.2%. 2) Twenty-two patients who recovered from the first ARF showed a restrictive ventilatory impairment with a mean FVC and TLC of 37.2% and 62.4 % of predicted value, respectively, and a mean $PaCO_{2}$ of 57mmHg. Among the parameters of pulmonaty functions. the FVC(p=0.01) and VC(p=0.02) showed a significant correlation with the $PaCO_{2}$ level. 3) There were no significant differences between the patients treated with conservative medical treatment only and those with additional home oxygen therapy due to significant hypoxemia in the patients with recurrent ARF and the mortality. 4) The 1, 3, 5-year survival rates were 75%, 66%, and 57%, respectively, in the 20 patients who had recovered from the first ARF, excluding the two patients managed by non-invasive nocturnal ventilatory support. Conclusion: These results suggest that active ventilatory support should be provided to patients with ARF and chest wall disorders. However, considering recurrent ARF and weak effect of home oxygen therapy, non-invasive domiciliary ventilation is recommended in those patients with these conditions to achieve a better long-term prognosis.

Estimation of THI Index to Evaluate Thermal Stress of Animal-occupied Zone in a Broiler House Using BES Method (BES 기법을 이용한 육계사 내부 고온 스트레스 평가를 위한 THI 지수 모의)

  • Ha, Taehwan;Kwon, Kyeong-seok;Hong, Se-Woon;Choi, Hee-chul;Lee, Jun-yeob;Lee, Dong-hyun;Woo, Saemee;Yang, Ka-young;Kim, Rack-woo;Yeo, Uk-hyeon;Lee, Sangyeon;Lee, In-bok
    • Journal of The Korean Society of Agricultural Engineers
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    • v.60 no.2
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    • pp.75-84
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    • 2018
  • Thermal stress of livestock has been issued due to recent climate change trends and this causes reproductive disorders, decreased feed consumption, immunosuppression, and increased mortality of animals. Concept of THI has been widely used to quantitatively evaluate the degree of thermal stress for animals, however use of this concept is restricted for animals living in the enclosed facilities such as mechanically ventilated broiler houses. In this study, time-based internal energy flow and variation trends of temperature and humidity were analyzed based on BES technique. Local weather data, insulation characteristics of building materials, heat and moisture generation rate from broilers according to age, algorithm of ventilation operation were adopted for boundary condition of the model to accurately compute THI values inside the mechanically ventilated broiler house. From the BES computation, excess frequency of THI threshold in Jeju city was highest on the assumption that air conditioning equipments were not installed. When general raising density ($39kg\;m^{-2}$) was adopted, total 2,191 hours were exceeded. Excess hours of THI threshold were strongly related to the cumulative air temperature ($R^2=0.87$).

The Association between Pulmonary Function Test Result and Combustible Cigarette Smoking or Electrical Cigarette Smoking in Korean Adults : Using the 2014-2019 Korean national health and nutrition examination survey data (한국 성인에서 일반담배 또는 가열 전자담배를 이용한 흡연 형태와 폐 기능 검사 결과와의 관련성: 2014-2019년도 국민건강영양조사 자료를 이용하여)

  • Il-hwan Kim;Il-Hyun Lee;Sae-Ron Shin
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.1
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    • pp.27-39
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    • 2024
  • Purpose : Smoking is a major factor in chronic obstructive pulmonary disease (COPD), but the effect of electrical cigarette smoking on COPD development is still uncertain. This study aimed to compare the functions of airways and lungs exposed to combustible cigarettes and electrical cigarettes based on the pulmonary function test (PFT) results from the Korean National Health and Nutrition Examination Survey (NHANES). Methods : This study used data from 8,942 participants with PFT results out of 47,309 total subjects from the 6th to 8th Korean NHANES (2014-2015, 2016-2018, and 2019, respectively). Individuals with diseases such as cancer, ex-smokers, and dual tobacco users were excluded. The PFT results were analyzed according to the COPD diagnostic criteria. After adjusting for confounding variables, a complex sample generalized linear model ANOVA test was performed to investigate the association between PFT results and combustible smoker or electrical cigarette user groups. Results : In an analysis based on the obstructive ventilatory disorders (forced expiratory volume in 1 second[FEV1]/forced vital capacity[FVC]<.7), combustible cigarette smokers showed a 3.46 times higher risk of COPD compared to non-smokers, while electrical cigarette smokers exhibited no significant difference in terms of COPD-related risks compared to non-smokers. FEV1 showed a negative relation with combustible cigarette smokers as reported elsewhere (B=-.07, p<.001). FEV1/FVC was negatively related to both combustible cigarette smokers (B=-.03, p<.001) and electrical cigarette smokers (B=-.02, p<.001). Conclusion : FEV1/FVC decreases were observed in the long-term exposure to both combustible and electrical cigarettes. The lower FEV1 in the combustible cigarette group implies the worsening of the severity of COPD, suggesting more damage to the airways and lungs in the short term. Therefore, the temporary electrical cigarettes use for the transition period in order to smoking cessation potentially aids to reduce the harmful effect of combustible cigarettes in COPD development.