• 대한간호학회지
• /
• 제31권1호
• /
• pp.31-42
• /
• 2001

This study was done to evaluate the effect reducing artificial dead space on intubated children. Data were collected from July 1st, 1998 to August 31st, 1999. The subjects were selected from a pediatric intensive care unit of 'S' hospital and intubated with 3.5 mm or 4.5 mm endotracheal tube after open heart surgery. They were composed of 34 patients : 17 patients were assigned to the experimental group and the rest of them were placed in the control group. The artificial airway volume was minimized in the experimental group, and the control group maintained the artificial airway volume. ETCO2, PaCO2, SPO2 were measured as indicators of pulmonary ventilation. The tools of this study were GEM-Premier and Space-Lab patient monitors. The data were analyzed using the SPSS/PC+ program. The $\chi$2 -test was used to find general characteristics. The t-test was used to test the homogenety of the pulmonary ventilation status and mechanical ventilation setting before intervention between the two groups. Also, the paired t-test was used to examine the hypothesis. The results can be summerized as : 1. CO2 can be expelled effectively from the body in case artificial dead space was decreased. 2. As the artificial dead space was reduced, the difference between ETCO2 and PaCO2 was decreased, in other words pulmonary ventilation was improved. 3. If the artificial dead space occupied above 15 percent of tidal volume, the effect of CO2 was retention revealed in the body. 4. If the artificial dead space occupied below effect. Based on the results, the following is suggested to be applied practically : 1. A kind of the ventilator circuit acting artificial dead space should be removed from the intubated children with mechanical ventilaion. 2. The endotracheal tube should not be cut because extra-body space of the endotracheal tube did not have an effect on the dead space of the intubated children. Since the researcher could not cover this aspect in the study, they recommend the following. 1. The study should be extended to the other pulmonary disease patients for the effect of improving pulmonary ventilation. 2. Also, further studying with a more narrow interval in the extra-body space of the artificial airway will be able to explain the point of artificial dead space with proper ventilation.

• 유통과학연구
• /
• 제17권7호
• /
• pp.65-76
• /
• 2019

Purpose - The purpose of this study is to investigate economical ventilation effectiveness to reduce hazardous materials exposure and damage of workers by analyzing exposure amount of noxious substances under various ventilation conditions of nail salon for indoor environments. Research design, data, and methodology - This study was carried out with cooperation of Nail shop located in SeongNam city to involve an analysis of the environmental impact indoor air quality, pollutant exposure and economical cost-effectiveness in the nail workplace. The hazardous substances were PM-10(Particulate Matter-10㎛), VOCs(Volatile Organic Compounds) and Formaldehyde, which are the major materials of nail workplace. Results - PM-10 is reduced by about 60% with air cleaner, forced artificial ventilation by 32%, and natural ventilation by about 12%. TVOCs and Formaldehyde showed similar efficiency (80~100%) after natural ventilation and ventilation after 60 minutes. The removal efficiencies of VOCs and formaldehyde were similar to those of natural ventilation and mechanical ventilation system. However, in case of dust, natural ventilation was reduced by artificial ventilation system due to inflow of external dust during natural ventilation. Conclusions - If the pollution degree of outdoor air is not high, air volume is high, and natural ventilation is performed when the air conditioning and heating system is not operated. Even at the end of the work, it keeps operating for 60 minutes to remove the pollutants generated. Results of this analysis demonstrated that the worker environment can be improved by adopting institutional legislation and guidelines for ventilation.

• 한국컴퓨터정보학회논문지
• /
• 제29권3호
• /
• pp.165-171
• /
• 2024

본 연구는 2급 응급구조사가 호흡부전 및 호흡정지 환자에게 백-밸브 마스크(BVM) 인공호흡 시 호흡량 측정기를 사용하여 적정량의 호흡량과 및 성공률을 알아보고자 한다. 연구는 2023년 12월 11일부터 12일까지 D 대학교에 재학 중인 2급 응급구조사를 대상으로 20명을 선정하여 10명은 호흡량 측정기를 이용하여 BVM 인공호흡을 교육한 실험군으로, 다른 10명은 호흡량 측정기 없이 BVM 인공호흡을 교육한 대조군으로 선정하여 2분간 인공호흡을 제공하는 실험을 하였다. 연구 결과, 대조군에서는 정확한 호흡량을 제공하지 못하였고(p=.025), 호흡 성공률 역시 실험군에서는 2분간 호흡 성공률이 높았으나 대조군에서는 유의한 차이를 보였으며(p=.001), 주관적 호흡량과 측정된 객관적 호흡량이 대조군에서 유의한 차이를 보였다(p=.010). 따라서 호흡량 측정기를 사용한 교육은 2급 응급구조사가 느끼는 주관적 호흡량을 객관적 호흡량과 일치시키고 호흡 성공률을 높여 호흡부전 및 호흡정지와 심폐소생술 시 심장정지 환자의 생존율을 높이는 데 도움이 될 것이다.

• 한국터널지하공간학회 논문집
• /
• 제17권2호
• /
• pp.153-166
• /
• 2015

일반적인 장대 철도터널에 비해 해저터널은 환기 및 방재를 위한 별도의 연직갱 또는 경사갱 설치에 공간상 많은 제약을 받게 되므로, 인공섬을 건설하여 환기를 수행할 필요가 있다. 그러나, 인공섬 설치에는 시공상의 문제 뿐만 아니라 건설비용이 증가하게 되므로, 인공섬 설치를 최소화하여 환기구간 거리를 늘려야 한다. 이에 따른 환기거리의 증가시, 누풍에 의한 신선공기 공급량이 커지게 된다. 공급풍량이 과대해지면, 구조물 한계에 의해 설치가능한 덕트직경이 제한적이므로, 팬 정압 및 동력도 상당히 증가하게 된다. 따라서, 초장대 해저터널을 건설하기 위해서는 이러한 현실적인 문제를 극복하고, 시공중 터널내 환경을 쾌적한 상태로 유지할 수 있는 기술력이 필요하다. 본 논문에서는 이러한 초장대 해저터널에 적합한 공사중 환기 방식을 개발하기 위한 기본연구로써, 국내외의 공사중 환기용량 산정방법 비교를 통해, 스위스의 SIA 196 코드가 초장대 해저터널계획에 적합함을 확인하였다. 또한, 덕트 접속부의 누출에 관한 실험을 통해, 국내의 덕트 접속방식은 100 m당 누풍율이 1.5~3.0% 사이임을 확인하였다. S등급 덕트의 경우 환기가능거리가 10.2 km 이므로, 덕트의 접속방법을 개선한다면, 환기가능거리는 더 길어질 수 있다. 따라서, 공사중 덕트의 누풍개선이 초장대 해저터널의 공사중 환기의 주요 이슈임을 확인하였다.

• Journal of Chest Surgery
• /
• 제25권12호
• /
• pp.1523-1529
• /
• 1992

This report decribes our experience with operative stabilization of flail chest with the use of Judet`s struts. In a series of 56 patients with flail chest, the method allowed shorter duration of artificial ventilation and decreased functional sequale. We find this technique to be better than previously published methods, since it provides better stabilization and immobilazation of the ribs and thus obviates the need for artificial ventilation and prevents post-traumatic chest deformity.

• Journal of Chest Surgery
• /
• 제24권4호
• /
• pp.366-370
• /
• 1991

This report describes our experience with the operative stabilization of flail chest with the use of Judet`s struts. In a series of 14 patients with flail chest, the method allowed shorter duration of artificial ventilation and decreased functional sequale. We find this technique to be better than previously published methods, since it provides better stabilization and immobilization of the ribs and thus obviates the need for artificial ventilation and prevents post-traumatic chest deformity.

• Journal of Chest Surgery
• /
• 제28권12호
• /
• pp.1150-1154
• /
• 1995

Pneumomediastinum[Mediastinal emphysema is characterized by the presence of air in the mediastinum, and classified as spontaneous[occurring without obvious cause or secondary[caused by a trauma or artificial ventilation . To study the clinical evaluation of pneumomediastinum, data were obtained from 20 patients. The incidences of spontaneous pneumomedisastinum were 5 and those of secondary pneumomedistinum were 15 cases. The mean age was 21.2$\pm$3.4 years[$\pm$SD in spontaneous pneumomediastinum and 44.1$\pm$20.0 years[$\pm$SD in secondary pneumomediastinum. There were 16 male and 4 female patients. The common presenting compliants were retrosternal pain in 19 patients[95% , dyspnea in 12[60% , and hoarsness in 2[10% . The predisposing factors were asthma,excessive exercise and vomiting in spontaneous pneumomediastinum;trauma, artificial ventilation, tracheostomy, the rupture of trachea or esophagus in secondary pneumomediastinum. The physical findings were subcutaneous emphysema in 17 patients[85% , Hamman`s sign in 11 patients[55% and decreased cardiac dullness in 2 patients[10% . Spontaneous pneumomediastinums were managed conservatively, however, surigical procedures were needed in secondary pneumomediastinums. There was no recurrence, but one patinet died of tension pneumomedistinum. We concluded that spontaneous pneumomediastinum is uncommon, usually benign, and self-limited and secondary pneumomedistinum due to trauma or artificial ventilation is more increasing, and necessitates the early, aggressive intervention.

• 화약ㆍ발파
• /
• 제24권2호
• /
• pp.9-22
• /
• 2006

길이가 대단히 짧은 터널을 제외하고는 터널을 시공하는 경우 일반적으로 인위적인 환기시스템이 필요하다. 특히 장대터널의 경우 굴착 진행에 따라 적절한 환기시스템을 조합해서 사용하는 것이 효과적이다. 터널 연장이 4,580m인 능동터널은 본래 송기식을 사용하는 것으로 설계를 했지만, 굴착이 진행됨에 따라 송기식만으로 환기하는 데에는 한계가 예상되어 별도의 방식 검토를 수행하였다. 굴착중 터널의 소요환기량을 산정하고 이 소요환기량과 선택가능한 여러 가지 경우의 환기조합방식을 사례볕로 구성한 뒤 환기량과 유동성을 해석하고 비교함으로써 경제적으로도 우수한 최적의 환기조합안을 도출하였다. 환기시스템을 결정하기 위하여 각 환기시스템에 대한 경제적 효율성 평가를 수행하였다.

• 한국응급구조학회지
• /
• 제19권2호
• /
• pp.7-17
• /
• 2015

Purpose: This study aimed to compare the effects of rescue ventilation maneuvers on the quality of two-rescuer cardiopulmonary resuscitation (CPR). Methods: We implemented mouth to mouth (MMV), mouth to pocket mask (MPV) and bag-valve mask ventilation (BMV) maneuvers. Each team of two-nurses was randomized to perform three consecutive sessions of two-rescuer CPR by using three artificial ventilation maneuvers. Results: The subjects were 26 teams of nurses (female: 96.2%, male: 3.8%, age: 26.6 years). Failed ventilation was more frequent in BMV ($2.23{\pm}2.21$, p <.001) than MMV ($0.31{\pm}0.74$) and MPV ($0.38{\pm}0.64$). BMV had more compressions per minute ($93.7{\pm}5.7$) than MMV ($87.0{\pm}7.2$, p = .001) and shorter total compression pause time ($46.1{\pm}5.8sec$) and compression pause fraction ($23.3{\pm}2.2%$) than MMV ($54.8{\pm}10.3sec$, p = .001, $25.5{\pm}3.5%$, p = .001, respectively) and MPV ($53.1{\pm}7.1sec$, p =. 006 and $25.8{\pm}2.6%$, p = .006, respectively). Conclusion: In our simulation study, BMV reduced the compression pause time and increased the number of compressions per minute, thus indicating CPR provided to patients was effective. However, considering the high rate of ventilation failure, we recommend periodic training.

• 대한신경집중치료학회지
• /
• 제11권2호
• /
• 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.