• Title/Summary/Keyword: Ventilation impairment

Search Result 21, Processing Time 0.009 seconds

Ventilation Impairment During Anesthesia in Patients with Anterior Mediastinal Mass (전 종격동 종양 환자의 마취시 발생한 환기장애)

  • Park, Ki-Bum;Park, Sang-Jin;Jee, Dae-Lim;Lee, Bo-Hyun
    • Journal of Yeungnam Medical Science
    • /
    • v.22 no.1
    • /
    • pp.104-112
    • /
    • 2005
  • Because of location, a mediastinal mass may cause complications such as a major airway obstruction, a superior vena caval obstruction, and cardiac compression during general anesthesia. The patient's condition need to be assessed by several methods to predict the risks associated with general anesthesia. The authors took computed tomographs for a preoperative evaluation of two patients with an anterior mediastinal mass, and the risk of perioperative complications was predicted by measuring the tracheal area. The patients were managed according to the preoperative evaluation but severe ventilation impairments were encountered during anesthesia. In one patient, stable ventilation could not be maintained until spontaneous breathing appeared. The operation was cancelled and the patient was brought into the ICU. In the other patient, a tracheal tube was inserted deeper in an attempt to pass the narrowed tracheal portion due to mediastinal tumor compression resulting in improved ventilation.

  • PDF

Monitoring and Interpretation of Mechanical Ventilator Waveform in the Neuro-Intensive Care Unit (신경계 중환자실에서 기계호흡 그래프 파형 감시와 분석)

  • Park, Jin
    • Journal of Neurocritical Care
    • /
    • v.11 no.2
    • /
    • pp.63-70
    • /
    • 2018
  • Management of mechanical ventilation is essential for patients with neuro-critical illnesses who may also have impairment of airways, lungs, respiratory muscles, and respiratory drive. However, balancing the approach to mechanical ventilation in the intensive care unit (ICU) with the need to prevent additional lung and brain injury, is challenging to intensivists. Lung protective ventilation strategies should be modified and applied to neuro-critically ill patients to maintain normocapnia and proper positive end expiratory pressure in the setting of neurological closed monitoring. Understanding the various parameters and graphic waveforms of the mechanical ventilator can provide information about the respiratory target, including appropriate tidal volume, airway pressure, and synchrony between patient and ventilator, especially in patients with neurological dysfunction due to irregularity of spontaneous respiration. Several types of asynchrony occur during mechanical ventilation, including trigger, flow, and termination asynchrony. This review aims to present the basic interpretation of mechanical ventilator waveforms and utilization of waveforms in various clinical situations in the neuro-ICU.

Clinical Significance of $^{99m}Tc-DPTA$ Ventilation Scan in Patient with Bronchiectasis (기관지확장증 환자에서 환기 폐주사의 임상적 의의)

  • Park, Choon-Sik;Paek, Sung-Ho;Uh, Soo-Taek;Na, Hyun;Choi, Deuk-Lin;Kim, Gi-Jeong
    • The Korean Journal of Nuclear Medicine
    • /
    • v.19 no.2
    • /
    • pp.57-63
    • /
    • 1985
  • To evaluate the clinical significance of lung ventilation scan using $^{99m}Tc-DTPA$ in patient with bronchiectasis, we compared the involovement area of bronchogram and lung ventilation scan according to lobar and segmental distribution. There were no correlation between impairment of pulmonary function test and the number of bronchiectatic lobe and segment(p>0.5). Lung ventilation scan showed 66.7% of sensivity, 100% of specificity, ana 91.7% of accuracy according to lobar distribution, and 51.9% of sensivity, 96.9% of specificity, and 88.9% of accuracy according to segmental distribution. These results suggest that lung ventilation scan can be used as diagnostic tool in patient with bronchiectasis in whom bronchogram is not tolerable.

  • PDF

Physiological Dead Space and Shunt Following Open Heart Surgery (개심술후 폐의 Physiologic dead space 와 Shunt 의 변화상 추적)

  • 이길노
    • Journal of Chest Surgery
    • /
    • v.18 no.4
    • /
    • pp.771-779
    • /
    • 1985
  • It has been recognized that the proper matching of ventilation and perfusion within the lung is essential for the efficient exchange of gases following open heart surgery. Physiologic shunt reflects the amount of blood going to lung units with inadequate ventilation and these are also areas of the lung with adequate ventilation but inadequate blood flow. This can be quantified by measuring physiological dead space. From January to August 1985, The physiologic dead space and shunt during postoperative course had been taken in 30 patients of open heart surgery in Soonchunhyang University Hospital. Twenty cases had congenital heart disease and acquired valvular heart disease were noticed in 10 cases. The physiological dead space and shunt during postoperative periods were calculated and we made 5 items of conclusion: 1. There is high probability of ventilation-perfusion mismatch in the acquired heart disease group compared to the congenital group. 2. Duration of the CPB can exert significant influences in the physiological dead space but less in the shunt fraction. 3. There is positive relationship between Qs/Qt and Vd/Vt in the group B [CPB>90 min.] but less reliable in correlation. 4. Perfusion impairment is more significant in the diminished pulmonic blood flow group compared to the increased pulmonic blood flow [Qp/Qs>2.0] group. 5. There is no significant ventilation-perfusion mismatch within the lung during all postoperative courses.

  • PDF

Organic Solvent Exposure of Thinner-Using Occupation and Its Treatment by Means of $TiO_2$ Photocatalyst (신너사용 작업장의 유기용제 노출 및 $TiO_2$ 광촉매를 이용한 BTX처리에 관한 연구)

  • 양원호;김현용;손부순;박종안
    • Journal of environmental and Sanitary engineering
    • /
    • v.17 no.2
    • /
    • pp.26-33
    • /
    • 2002
  • Ultimate objective of industrial hygiene is the prevention of health impairment that may result from exposure to chemicals at workplace. Workers in solvent thinner-using occupation environment may be highly exposed to VOCs (volatile organic compounds) because solvent thinner has been used extensively such as painting, spraying, degreasing, coating and so on in Korea. The purpose of this study was to recognize, evaluate, and propose the control methods of VOCs from solvent thinner-using workplace. Five target volatile organic compounds (benzene, toluene, ethylbenzene, o-xylene, and m-xylene) were monitored in H company of Shiwa Industrial Complex and analyzed in perosnal, occupational indoor and outdoor during working hours simultaneously. Engineering control such as local ventilation should be made in considering the long-term exposure, though measured VOCs concentration did not exceed the workplace exposure standards. In addition, air cleaning device should be installed in local ventilation because Shiwa Industrial Complex has had the serious ambient air pollution. Currently, environmental purification using $TiO_2$ photocatalyst have attracted a great deal of attention with increasing number of recent environmental problems. In this study, $TiO_2$ sol coated on the ceramic bead was prepared by sol-gel method and the photodegradation of target compounds was investigated in gas phase by the exposure to UV-A lamp(365nm) in a batch system.

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
    • /
    • v.17 no.5
    • /
    • pp.767-773
    • /
    • 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.

Computer Models on Oxygenation Process in the Pulmonary Circulation by Gas Diffusion

  • Chang, Keun-Shik;Bae, Hwang
    • International Journal of Vascular Biomedical Engineering
    • /
    • v.4 no.1
    • /
    • pp.9-16
    • /
    • 2006
  • In this article we introduce computer models that have been developed in the past to determine the concentration of metabolic gases, the oxygen and carbon dioxide, along the pulmonary circulation. The terminal concentration of these gases in the arterial blood is related with the total change of the partial pressure of the same gases in the alveoli for the time beginning with inspiration and ending with expiration. It is affected not only by the ventilation-perfusion ratio and the gas diffusion capacity of the lung membrane but also by the pulmonary defect such as shunt, dead space, diffusion impairment and ventilation-perfusion mismatch. Some pathological pulmonary symptoms such as ARDS and CDPD can be understood through the mathematical models of these pulmonary dysfunctions. Quantitative study on the blood oxygenation process using various computer models is therefore of foremost importance in order to monitor not only the pulmonary health but also the cardiac output and cell metabolism. Reviewed in this paper include the basic and advanced methods that enable numerical study on the gas exchange and on the arterial oxygenation process, which might depend on the various heart and lung physiological conditions listed above.

  • PDF

Successful Removal of Endobronchial Blood Clots Using Bronchoscopic Cryotherapy at Bedside in the Intensive Care Unit

  • Lee, Hongyeul;Leem, Cho Sun;Lee, Jae Ho;Lee, Choon-Taek;Cho, Young-Jae
    • Tuberculosis and Respiratory Diseases
    • /
    • v.77 no.4
    • /
    • pp.193-196
    • /
    • 2014
  • Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

A case of combined lung cancer squamo-adeno-undifferentiated carcinoma (혼합형 원발성 폐암 1례 보고)

  • 김송명
    • Journal of Chest Surgery
    • /
    • v.16 no.3
    • /
    • pp.368-374
    • /
    • 1983
  • Combined type of primary lung cancer is a very rare form in clinical experience, which is 3 histologically different variants of bronchogenic carcinoma. These type had a well differentiated squamous carcinoma forming keratin pearls, well differentiated adenocarcinoma and pleomorphic undifferentiated cell carcinoma, usually small cell carcinoma. The patient, a male, 49-Y-0, was complaint coughing, mild dyspnea, blood tinged sputum and chest pain. Under diagnosis of lung cancer preoperatively, the right total pneumonectomy was performed with very difficulty such as arrhythmia, ventilation impairment during post operation course. The histology of specimen was disclose as 3 different histological type, combined lung cancer as squamoadenoundifferentiated carcinoma. The mediastinal nodes were freed from metastasis but the parietal pleural metastatic loci was found. The radio & chemotherapy were performed post-operatively. The patient had been experienced empyema at post-pneumonectomy space and then open drainage procedure and thoracoplasty had been added for treatment course. The patient is alive recently.

  • PDF

Ventilatory Dynamics in Bronchiectasis (기관지확장증의 환기역학)

  • Kim, Yeon-Jae;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
    • /
    • v.40 no.5
    • /
    • pp.548-557
    • /
    • 1993
  • Background: Bronchiectasis is a irreversible disease, a lot of cases of which are associated with chronic bronchitis, pulmonary emphysema and bronchial asthma due to chronic recurrent pulmonary infection. Therefore, pulmonary functions in bronchiectasis may also vary with associated diseases or involved segments. Methods: For the evaluation of ventilatory dynamics in bronchiectasis with respect to the pathoanatomic types of bronchiectasis and the degree of dyspnea, a total of 93 cases comprising 45 cases of tubular, 30 saccular and 18 mixed type of bronchiectasis whose clinical diagnosis was confirmed by bronchography were analyzed retrospectively. They were also divided into two groups: those with Hugh-Jones dyspnea grade 1 & 2 (group I) and those with Hugh-Jones dyspnea grade 3 & 4 (group II). Pulmonary functions tested in this study were analyses of curves of forced expiratory volume and flow-volume, and determinations of maximal voluntary ventilation and closing volumes. Results: The results were as follows; 1) The vital capacity and parameters reflecting expiratory flow rate except PEF were significantly reduced in saccular and mixed type than that in tubular type of bronchiectasis. 2) In saccular and mixed type, the maximal voluntary ventilation tended to decrease while CV/VC tended to increase. 3) As the degree of dyspnea became serious, the involved segments were progressively increased. In contrast, ventilatory functions were significantly reduced in proportion to the severity of dyspnea. Conclusion: These findings suggest that in bronchiectasis, there be obstructive ventilatory impairment combined with mild restrictive ventilatory impairment, which becomes more prominent in saccular and mixed type and also as the degree of dyspnea progresses.

  • PDF