• International Journal of Advanced Culture Technology
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• 제6권3호
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• pp.211-215
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• 2018

Ventilator-associated pneumonia (VAP) is a lung infection that develops in patients receiving mechanical ventilation. VAP contributes to about 50% of hospital-acquired pneumonia in ICU settings. One of the recommendation of the Institute of for Healthcare Improvement ventilator bundle is HOB elevation. HOB elevation affects shearing forces and makes higher risk for pressure injury development. Pressure injury (PI) is localized damage to the skin over a bony prominence. PI prevention guidelines recommend that HOB positioning should be lower to reduce risk for PI development which contradicts VAP prevention guidelines for the HOB between 30 and 45 degrees for ICU patients. This presents a care dilemma and tension. The purpose of this study was to perform a secondary data analysis using cumulative electronic health record data in order to determine the association of HOB elevation with VAP and PI in ICU patients. A secondary data analysis was conducted to determine whether HOB elevation is associated with VAP and PI. HOB elevation was not likely to be associated with VAP prevention whereas it was likely to be related to PI development. This is somewhat contrary to popular data and publications. Prospective cohort study is desired to inform us in an evidence-based fashion what actually is optimal HOB elevation for ventilated patients in ICU settings.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권2호
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• pp.202-207
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• 1995

Chylous fistula is a rare complication occurring after radical neck dissection. Previous reports on neck dissection described an incidence of about 1% to 2%. We report a case of chylous fistula that occurred after radical neck dissection for squamous cell carcinoma of left lower gingiva and mandible in a 52-year-old man. We successfully managed the fistula by the following conservative measures : bed rest with head elevation, continuation of closed suction drainage, and dietary management to decrease the rate of chyle formation.

• 중환자간호학회지
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• 제10권2호
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• pp.14-23
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• 2017

Purpose: The purpose of this study was to evaluate the effectiveness of a ventilator-associated pneumonia (VAP) bundle. Methods: This was a retrospective study that was carried out between June 2010 and October 2015. In this study, 3,224 intubated patients were included. The VAP bundle which was applied to Group 1 patients (n=470) included head-of-bed elevation to 30 degrees, cuff pressure monitorization, prophylaxis of peptic ulcer, and prophylaxis of deep vein thrombosis. The VAP bundle for Group 2 patients (n=1,914) included all the elements of the VAP bundle for Group 1 patients and one additional element which was oral care with 0.12% chlorhexidine. The VAP bundle for Group 3 patients (n=870) added sedative interruption and assessment of readiness to extubate to the VAP bundle for Group 2. Results: The numbers and incidences of VAP were significantly different among the three groups. Moreover, there were significant differences among groups in ICU length of stay and mortality. Conclusion: Three different VAP prevention bundles made different effects in patient outcomes.

• 재활복지공학회논문지
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• 제8권3호
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• pp.197-203
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• 2014

본 논문은 적절한 침상머리 각도 상승을 유지하여, 인공호흡기 관련 폐렴을 예방하기 위한 의료 보조기구인 부착형 침상머리 각도 모니터링 시스템의 개발 및 성능 분석에 대한 것이다. 개발한 침상머리 각도 모니터링 시스템의 주 기능은 가시적인 침상머리 각도 디스플레이를 통하여 효과적으로 환자의 체위를 유지하도록 도움을 주며, 데이터의 수집을 통하여 환자의 증세 호전 혹은 악화와 연관된 환자의 체위에 대한 데이터베이스를 확보하는 것이다. 시스템은 손쉬운 이동을 위하여 부착형으로 구현하였으며, 데이터베이스로 활용하기 위해 휴리스틱 기법이 혼용된 FIR Filter를 사용하여 노이즈를 제거한다. 성능 분석을 위하여 광학식 엔코더와 침상머리 각도 모니터링 시스템의 측정값을 비교한다.

• 대한한의학회지
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• 제26권3호
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• pp.66-73
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• 2005

Objectives : The purpose uf this study was to evaluate the effect of Choksmni$(ST_{36})$ moxibustion in hypertensive patients who showed sudden elevation of blood pressure. Methods : Among patients admitted to Woosuk University Hospital from June to September 2004, sixty-one patients who had shown sudden elevation in systolic blood pressure over 100mmHg were chosen by random sampling and divided into a treatment group (Choksamni moxibustion group) and a control group. In the Choksamni $(ST_{36})$ moxibustion group, moxibustion was done at the point between tibial tuberosity and head of fibula where the $ST_{36}$ is known to be located. Direct moxibustion was practiced on the patients 5 times with an increase of size from a grain of rice to a bigger cluster. Male patients were chosen to practice on the left meridian and female patients were chosen to practice on the right meridian point. Changes in blood pressure after He moxibustion were checked 4 times at tine intervals of 30 minutes. In the control group, the patients took bed rest without my medical treatment. The two groups were compared in order to demonstrate whether then were any remarkable changes in depression of blood pressure. Results : There were significant decreases in the systolic and diastolic blood pressure before and after moxibustion. We found significant decreases in systolic blood pressure at 60 minutes, 90 minutes, and 120 minutes ana diastolic blood pressure at 120 minutes in the patient group compared with the control group. Conclusions : There was a statistically significant depressing effect on blood pressure elevation observed in the group with moxibustion at $ST_{36}$ versus the control group without any medical treatment.

• 한국농공학회지
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• 제20권1호
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• pp.4592-4598
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• 1978

The purpose of this research is to find out mathemetically an economical intake water depth in the design of head works through the derivation of some formulas. For the performance of the purpose the following formulas were found out for the design intake water depth in each flow type of intake sluice, such as overflow type and orifice type. (1) The conditional equations of !he economical intake water depth in .case that weir body is placed on permeable soil layer ; (a) in the overflow type of intake sluice, {{{{ { zp}_{1 } { Lh}_{1 }+ { 1} over {2 } { Cp}_{3 }L(0.67 SQRT { q} -0.61) { ( { d}_{0 }+ { h}_{1 }+ { h}_{0 } )}^{- { 1} over {2 } }- { { { 3Q}_{1 } { p}_{5 } { h}_{1 } }^{- { 5} over {2 } } } over { { 2m}_{1 }(1-s) SQRT { 2gs} }+[ LEFT { b+ { 4C TIMES { 0.61}^{2 } } over {3(r-1) }+z( { d}_{0 }+ { h}_{0 } ) RIGHT } { p}_{1 }L+(1+ SQRT { 1+ { z}^{2 } } ) { p}_{2 }L+ { dcp}_{3 }L+ { nkp}_{5 }+( { 2z}_{0 }+m )(1-s) { L}_{d } { p}_{7 } ] =0}}}} (b) in the orifice type of intake sluice, {{{{ { zp}_{1 } { Lh}_{1 }+ { 1} over {2 } C { p}_{3 }L(0.67 SQRT { q} -0.61)}}}} {{{{ { ({d }_{0 }+ { h}_{1 }+ { h}_{0 } )}^{ - { 1} over {2 } }- { { 3Q}_{1 } { p}_{ 6} { { h}_{1 } }^{- { 5} over {2 } } } over { { 2m}_{ 2}m' SQRT { 2gs} }+[ LEFT { b+ { 4C TIMES { 0.61}^{2 } } over {3(r-1) }+z( { d}_{0 }+ { h}_{0 } ) RIGHT } { p}_{1 }L }}}} {{{{+(1+ SQRT { 1+ { z}^{2 } } ) { p}_{2 } L+dC { p}_{4 }L+(2 { z}_{0 }+m )(1-s) { L}_{d } { p}_{7 }]=0 }}}} where, z=outer slope of weir body (value of cotangent), h1=intake water depth (m), L=total length of weir (m), C=Bligh's creep ratio, q=flood discharge overflowing weir crest per unit length of weir (m3/sec/m), d0=average height to intake sill elevation in weir (m), h0=freeboard of weir (m), Q1=design irrigation requirements (m3/sec), m1=coefficient of head loss (0.9∼0.95) s=(h1-h2)/h1, h2=flow water depth outside intake sluice gate (m), b=width of weir crest (m), r=specific weight of weir materials, d=depth of cutting along seepage length under the weir (m), n=number of side contraction, k=coefficient of side contraction loss (0.02∼0.04), m2=coefficient of discharge (0.7∼0.9) m'=h0/h1, h0=open height of gate (m), p1 and p4=unit price of weir body and of excavation of weir site, respectively (won/㎥), p2 and p3=unit price of construction form and of revetment for protection of downstream riverbed, respectively (won/㎡), p5 and p6=average cost per unit width of intake sluice including cost of intake canal having the same one as width of the sluice in case of overflow type and orifice type respectively (won/m), zo : inner slope of section area in intake canal from its beginning point to its changing point to ordinary flow section, m: coefficient concerning the mean width of intak canal site,a : freeboard of intake canal. (2) The conditional equations of the economical intake water depth in case that weir body is built on the foundation of rock bed ; (a) in the overflow type of intake sluice, {{{{ { zp}_{1 } { Lh}_{1 }- { { { 3Q}_{1 } { p}_{5 } { h}_{1 } }^{- {5 } over {2 } } } over { { 2m}_{1 }(1-s) SQRT { 2gs} }+[ LEFT { b+z( { d}_{0 }+ { h}_{0 } )RIGHT } { p}_{1 }L+(1+ SQRT { 1+ { z}^{2 } } ) { p}_{2 }L+ { nkp}_{5 }}}}} {{{{+( { 2z}_{0 }+m )(1-s) { L}_{d } { p}_{7 } ]=0 }}}} (b) in the orifice type of intake sluice, {{{{ { zp}_{1 } { Lh}_{1 }- { { { 3Q}_{1 } { p}_{6 } { h}_{1 } }^{- {5 } over {2 } } } over { { 2m}_{2 }m' SQRT { 2gs} }+[ LEFT { b+z( { d}_{0 }+ { h}_{0 } )RIGHT } { p}_{1 }L+(1+ SQRT { 1+ { z}^{2 } } ) { p}_{2 }L}}}} {{{{+( { 2z}_{0 }+m )(1-s) { L}_{d } { p}_{7 } ]=0}}}} The construction cost of weir cut-off and revetment on outside slope of leeve, and the damages suffered from inundation in upstream area were not included in the process of deriving the above conditional equations, but it is true that magnitude of intake water depth influences somewhat on the cost and damages. Therefore, in applying the above equations the fact that should not be over looked is that the design value of intake water depth to be adopted should not be more largely determined than the value of h1 satisfying the above formulas.