• 기본간호학회지
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• 제16권2호
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• pp.214-222
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• 2009

Purpose: The purpose of this study was to evaluate the effects of a walking-support program on the pulmonary ventilatory functions of elderly people who had undergone upper-abdominal surgery. Method: The study was a quasi-experimental research design. There were 26 partcipants who were admitted for upper-abdominal surgery to P University Hospital in B city. Walking exercise education was provided individually to the experimental group the day before their operation and 20 minutes a day for five days after the surgery using the 'Walking Exercise Guide Document'. Pulmonary ventilatory function was with FVC (Forced Vital Capacity), PEF (Peak Expiratory Flow), FEVI (Forced Expiratory Volume in 1 Second), FER (Forced Expiratory Ratio), Oxygen Saturation, and VAS (Visual Analog Scale). Results: The objective indexes of pulmonary ventilatory function were not significantly different between the two groups, but the subjective index was significantly different. Conclusion: With the above results, the walking support program could be an effective nursing intervention for improving pulmonary ventilatory function of surgical patients.

• Journal of Korean Biological Nursing Science
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• 제15권4호
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• pp.247-256
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• 2013

Purpose: This study aimed to determine the effects of listening to music on pain and vital signs of critically ill patients with ventilatory support in intensive care units during nursing treatment (changes of posture and tracheal suction). Methods: The experimental treatment was to use an mp3 player and a speaker to let them listen to classical music by Mozart during nursing treatment. To determine the effects of music intervention, pain (Critical-Care Pain Observation Tool-K) was used. The data analysis was carried out by using PASW Statistics 20.0. Results: Hypothesis "The scores for pain would differ between the experimental group provided with music intervention during nursing treatment, and the control group" was supported. Conclusion: Application of music intervention during nursing treatment for critically ill patients with ventilatory support in intensive care units was found to be effective in reducing pain. Therefore, music intervention during nursing treatment for critically ill patients with ventilatory support can be used as non-pharmaceutical nursing intervention to reduce pain for the patients.

• Clinical and Experimental Pediatrics
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• 제46권2호
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• pp.192-194
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• 2003

가정분만으로 태어난 후 생후 6일된 신생아에서 전신성 강직-간대 경련이 발생하여 내원한 환아에서, 병력과 진찰 소견상 신생아 파상풍으로 진단하여 근이완제 및 인공환기요법으로 치료한 1례를 경험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제43권6호
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• pp.804-807
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• 2010

둔상에 의한 기관지 손상은 소아에서 드물게 발생하나 치명적일 수 있으며 성공적인 치료를 위해서는 호흡 유지가 중요하다. 외상에 의해 기관지가 절단된 소아 환자에게 기도 유지에 어려움이 었었으나 응급실에서 체외막형 산화기를 이용한 환기 보조 하에 성공적으로 수술적 치료를 시행하였기에 이를 보고하고자 한다. 체외막형 산화기 보조 기간 동안 전신적 헤파린 투여는 필요하지 않았으며, 혈전성 합병증도 발생하지 않았다. 결론적으로 헤파린 사용 여부와 상관없이 선택적인 둔상 환자에게서 환기 보조를 위한 체외막형 산화기는 유용하다 할 수 있겠다.

• Tuberculosis and Respiratory Diseases
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• 제61권3호
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• pp.265-272
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• 2006

연구 배경: 척추후측만증, 흉곽성형술, 섬유흉 등과 같은 흉곽변형에 따른 질환들은 비슷한 환기장애의 형태로서 결과적으로 만성호흡부전에 이를 수 있으며, 경과 중 흔히 적인 급성호흡부전이 합병하게 되고 사망의 위험에 놓이게 된다. 저자들은 이러한 환자들에서 급성호흡부전의 빈도와 결과, 생리적 상태, 그리고 장기적 예후 등의 특성을 알아보고자 하였다. 대상 및 방법: 경북대학교병원에서 급성호흡부전으로 첫 환기보조를 받게 된 29명의 흉벽질환자를 대상으로 초기 사망률, 이후의 급성호흡부전의 재발빈도, 동맥혈가스검사 및 폐기능검사, 재택 산소 치료의 효과, 그리고 장기 생존율을 조사하였다. 결 과: 1) 첫 급성호흡부전시의 사망률은 24.1%였으며, 생존자 중 72.7%에서 급성호흡부전이 1회 이상 재발하였고 전체적인 급성호흡부전에 대한 이탈 성공률은 73.2%였다. 2) 첫 급성호흡부전으로부터 회복된 22명은 평균 FVC 및 TLC가 각각 추정 정상치의 37.2, 62.4%인 제한성 환기장애와 평균 $PaCO_{2}$가 57mmHg인 만성적 과탄산혈증 호흡부전소견을 보였으며, $PaCO_{2}$와 VC 및 FVC 사이에 유의한 연관성을 보였다. 3) 보존적 약물치료만 받은 군과 상대적으로 유의한 저산소혈증에 의해 보존적 치료와 재택 산소치료를 함께 받은 군의 비교 시에, 재 급성호흡부전 환자수와 생존율에서 두 군 간에 유의한 차이가 없었다. 4) 첫 급성호흡부전으로부터 생존한 22명의 경과에서 재택 NIV를 받은 2명을 제외한 20명의 1년, 3년, 5년 생존율은 각각 75%, 66%, 57%였으며, 사망자의 88%가 심폐부전으로 사망하였다. 결 론: 흉벽질환자의 급성호흡부전에 대해 적극적으로 환기보조치료가 시도될 만하나, 이들 만성적 호흡부전자에서 재택 산소 치료만으로는 그 효과가 미약하여 삶의 질 및 생존율의 향상을 위해서는 재택 NIV가 필요할 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제62권9호
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• pp.344-352
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• 2019

Background: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients. Purpose: We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care. Methods: Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients. Results: Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery. Conclusion: The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children.

• Tuberculosis and Respiratory Diseases
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• 제50권6호
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• pp.740-746
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• 2001

Background : A 35-year-old woman was admitted to the emergency room with sudden dyspnea that developed one day prior. The initial Chest X-ray showed multiple bullous changes at the right middle and lower lung field and long standing fibrotic tuberculous changes at the right upper lung field. The left lung field was totally collapsed by an fibrotic old tuberculous lesion. In spite of supportive medical care with oxygen therapy after admission, the radiographic lesions were no significant change but the respiratory distress had worsened. The patient suffered respiratory failure and received mechanical ventilatory support. The HRCT showed a localized tension pneumothorax mimicking multiple giant bullae at the right lower lung field. Immediately after a closed thoracostomy with a 32 French chest tube and air drainage, her vital signs and dyspnea were gradually improved. The patient was successfully weaned from mechanical ventilation after 5 days of mechanical ventilatory support. The patient had received talc pleurodesis through a chest tube to prevent the recurrence of the life-threatening localized pneumothorax. The patient was discharged without recurrence of the pneumothorax.

• Clinical and Experimental Pediatrics
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• 제46권9호
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• pp.930-933
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• 2003

저자들은 신나 흡인 후 발생한 구토와 보챔을 주소로 내원한 환아에서 발생한 폐출혈을 동반한 화학성 폐렴 1례를 경험하였기에 문헌 고찰과 함께 이를 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.149-155
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• 2015

Extracorporeal life support (ECLS) is a type of cardiopulmonary bypass. It is an artificial means of supplying oxygen and removing $CO_2$ on behalf of damaged lungs while patients are recovering from underlying diseases. Recently, the use of ECLS is rapidly increasing as this machine becomes smaller, less invasive and easier to use. In addition, the improvement of clinicians' technique and outcome is increasing their application to patients with acute respiratory distress. In this regard, the purpose of this review is to introduce the physiological principles, risk factors, and advantages of ECLS, clinical rationale for using ECLS, ventilatory strategy during ECLS, which are still causing different opinions, the weaning from ECLS, and the use of anticoagulant.

• Journal of Chest Surgery
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• 제46권6호
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• pp.444-448
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• 2013

Background: We aimed to investigate the preoperative, operative, and postoperative factors affecting intra-aortic balloon pump (IABP) insertion in patients undergoing isolated on-pump coronary artery bypass grafting (CABG). We also investigated factors affecting morbidity, mortality, and survival in patients with IABP support. Methods: Between January 2002 and December 2009, 1,657 patients underwent isolated CABG in Izmir Katip Celebi University Ataturk Training and Research Hospital. The number of patients requiring support with IABP was 134 (8.1%). Results: In a multivariate logistic regression analysis, prolonged cardiopulmonary bypass time and prolonged operation time were independent predictive factors of IABP insertion. The postoperative mortality rate was 35.8% and 1% in patients with and without IABP support, respectively (p=0.000). Postoperative renal insufficiency, prolonged ventilatory support, and postoperative atrial fibrillation were independent predictive factors of postoperative mortality in patients with IABP support. The mean follow-up time was $38.55{\pm}22.70$ months and $48.78{\pm}25.20$ months in patients with and without IABP support, respectively. The follow-up mortality rate was 3% (n=4) and 5.3% (n=78) in patients with and without IABP support, respectively. Conclusion: The patients with IABP support had a higher postoperative mortality rate and a longer length of intensive care unit and hospital stay. The mid-term survival was good for patients surviving the early postoperative period.