• Title/Summary/Keyword: hyperventilation

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An Acute Postoperative Intractable Hyperventilation after an Endoscopic Third Ventriculostomy

  • Lee, Hae-Mi;Shin, Kyung-Bae;Kim, Seong-Ho;Jee, Dae-Lim
    • Journal of Korean Neurosurgical Society
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    • v.51 no.3
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    • pp.173-176
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    • 2012
  • This report describes a rare case of postoperative hyperventilation attack after an endoscopic third ventriculostomy in a 46-year-old woman. About 60 min after the termination of the operation, an intractable hyperventilation started with respiratory rate of 65 breaths/min and $EtCO_2$, 16.3 mm Hg. Sedation with benzodiazepine, thiopental sodium, fentanyl, and propofol/remifentanil infusion was tried under a rebreathing mask at a 4 L/min of oxygen. With aggressive sedative challenges, ventilation pattern was gradually returned to normal during the 22 hrs of time after the surgery. A central neurogenic hyperventilation was suspected due to the stimulating central respiratory center by cold acidic irrigation solution during the neuroendoscopic procedure.

CARE OF ANXIETY DISORDER AND HYPERVENTILATION DURING REFRACTORY TOOTH EXTRACTION IN A PSYCHOLOGIC DISABLED PATIENT (정신장애 환자에서 난발치 중의 불안장애와 과환기 관리 : 증례보고)

  • Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.2
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    • pp.106-113
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    • 2014
  • Hyperventilation is produced by several distinct causes: anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The dental fears about acute pain, bleeding, needle, drill and dental surgery lead to the severe anxiety and increased blood catecholamine level. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the gentle care, a hyperventilation were occurred during the surgical extraction of impacted third molar with pericoronitis. We suggest that the dental patients with anxiety disorder must be attention for the manifestation of hyperventilation, especially in the psychologic disabled patient.

The effect on the Intracranial Pressure of the Patients Receiving Endotracheal Suction (기관내 흡인이 두개강내압에 미치는 영향에 관한 연구)

  • 김매자;이경옥
    • Journal of Korean Academy of Nursing
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    • v.23 no.2
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    • pp.245-254
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    • 1993
  • The purpose of this study was to identify effective methods to minimize increases in intracranial pressure(IICP ) during endotracheal suction by means of comparing two methods of hyperventilation and oxygen supply before and after endotracheal suction. In order to evaluate the effects of these two methods, the ICP during suctioning and the sustained time of IICP were measured. For hyperventilation, ambu-bagging was done 10 times for 30 seconds with a tidal volume of 800-900m1. For oxygen supply, 100 percent oxygen was supplied for 2 minutes before and after suction. The subjects for this study were 12 neurosurgical patients who had had a subarachnoid bolt inserted for ICP monitoring and they were all on mechanical ventilatory support in a surgical intensive care unit of Seoul National University Hospital from July 1, 1991 to March 31, 1992. In each patient hyperventilation was performed five times and oxygen supply was given five times and intracranial pressures were measured immediately before and every 30 seconds for 15 minutes after suction. For case assignments counterbalancing and repeated measure designs were combined. And so the total number of experiments were sixty for each group. The effects of hyperventilation and oxygen supply on the IICP and the sustained time of IICP after suction were analyzed by t-test. The results of study were as follows 1. There was a significant difference between the two groups in the increased ICP during suction (t=2.49, p=.014). 2. The sustained time of IICP after suctioning in the oxygen supply group was shorter than that in the hyperventilation group(t=2.35, p=.020) In summary, the Increase in the ICP during suction was lower and the time for the ICP to return to the presuction level was shorter in the oxygen supply group as compared to the hyperventilation group. Therefore, oxygen supply can be re commended before and after endotracheal suction.

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A Clinical Case Report of a Cervical Herniated Intervertebral Disc Patient with Hyperventilation Syndrome Developed after Magnetic Resonance Imaging (자기공명영상 촬영 후 발생한 경추 추간판탈출증 환자의 과호흡증후군 호전 1례)

  • Jeong, Hoon;Kim, Dong-Sub;Kim, Mi-Riong;Kim, Eun-Soo;Kim, Tae-Hun;Park, Ji-Yong;Park, Hyun-Min;Cho, Nam-Hoon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.7 no.1
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    • pp.75-83
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    • 2012
  • Objectives : The purpose of this study is to investigate the clinical application of acupuncture treatment to a cervical herniated intervertebral disc patient with hyperventilation syndrome developed after magnetic resonance imaging(MRI). Methods : A patient with cervical herniated intervertebral disc got hyperventilation syndrome after taking magnetic resonance imaging. To relieve symptoms, we took paperbag breathing first aid, but it had no effect. So we used acupuncture therapy with strong stimulation. To measure the outcome of the patient's improvement, we observed change of vital sign and verbal numerical rating scale(VNRS). Results : After 8 minutes of acupuncture treatment, the patient had significant improvement in change of vital sign and verbal numerical rating scale(VNRS). Conclusions : In emergency situation, acupuncture treatment as a first aid has a positive effect to control hyperventilation syndrome.

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Hyperventilation due to Incision & Drainage under Inadequate Psychosedation & Local Anesthesia in Advanced Odontogenic Infectious Lesion (진행성 치성 감염병소에서 부적절한 진정요법과 국소마취 시행하 절개 배농술에 따른 과환기증)

  • Oh, Ji-Hyeon;Son, Jeong-Seog;Yoo, Jae-Ha;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.1
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    • pp.63-71
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    • 2014
  • Extension of advanced odontogenic infection from deep neck fascial spaces into the mediastinum is heralded by chest pain, dyspnea, fever, and radiographic demonstration of mediastinal widening. The critical care should be done in a team approach by multiple medical and dental departments, such as, oral & maxillofacial surgery, otolaryngology, anesthesiology, chest surgery, and infection medicine. Especially, fluid & drug therapy, adequate incision & drainage and systemic supportive psychosedation care are important. But, acute hyperventilation can be produced by several distinct causes: severe anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The orofacial fears about acute pain, trismus, dysphagia, swelling and oral surgical treatment lead to the severe anxiety and increased blood catecholamine level by stress. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the care, hyperventilation was occurred during psychosedation and local anesthesia for incision and drainage of the masticatory fascial space abscess with deep neck infection & mediastinitis. We suggest that the dental patient with advanced odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

Hyperventilation During Local Anesthesia in Acute Odontogenic Infectious Lesion - Report of two cases - (급성 치성감염 병소에서 국소마취 중 유발된 과환기 -증례 보고-)

  • Yoo, Jae-Ha;Kim, Hyun-Sil;Baek, Sung-Hum;Yoo, Tae-Min;Lee, Ji-Woong;Chung, Won-Gyun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.2 s.3
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    • pp.107-113
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    • 2002
  • Hyperventilation is defined as ventilation in excess of that required to maintain normal blood $PaO_2$ and $PaCO_2$. It is produced by several distinct causes: anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The dental fears about acute pain, needle, drill and dental surgery lead to the severe anxiety and increased blood catecholamine level. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the gentle care, two cases of hyperventilation were occurred during local anesthesia for incision and drainage of acute odontogenic infectious lesions. We suggest that the dental patients with acute odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

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A Case Report of Medically Unexplained Dyspnea (원인불명의 호흡곤란을 호소한 증례 보고 1례)

  • Kim, Hyun-Ji;Lee, Hai-Ja;Park, Eun-Jung
    • The Journal of Pediatrics of Korean Medicine
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    • v.21 no.3
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    • pp.97-107
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    • 2007
  • Objectives The purpose of this study is to report a case showed significant consult in treating Idiopathic chronic hyperventilation patient with oriental medicine. Methods The patient had suffered from dysypnea for 7 months, so we treated her with herbal medicine, acupuncture, laser, CEP nebulizer and cupping. Results and Conclusions This study shows that oriental medicine works for treating Idiopathic chronic hyperventilation. For more accurate studies, further studies are needed with more clinical cases.

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Effects of the Selective Management for Increased Intracranial Pressure with Obstruction of Internal Carotid Artery in Rabbits (선택적 뇌압하강치료가 내경동맥 폐쇄에 따른 뇌압변동에 미치는 효과)

  • Kim, Bum-Dae;Lee, Kyoung-Yeob;Kim, Seong-Ho;Han, Dong-Ro;Bae, Jang-Ho;Kim, Oh-Lyong;Choi, Byung-Yearn;Cho, Soo-Ho;Shin, Hyun-Jin
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.167-180
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    • 1994
  • In order to inquire the most effective management of increased intracranial pressure(ICP), mannitol, steroid and hyperventilation were used in rabbits after ligation or non-ligation of the carotid artery. Mannitol was more effective than steroid and hyperventilation in the degree of the reduction of ICP. The intracranial pressure was decreased 43~45% for 25~30 minutes after injection of mannitol. Steroid was less effective than mannitol in the degree of the reduction of ICP. But the time of reduction of ICP was longer, that is, the degree of reduction was 24~60 minutes after injection of steroid. Hyperventilation is effective in the initial time only, for 10 minutes after hyperventilation. The degree of ICP reduction was 13.5~16.7% for 10 minutes after hyperventilation. The combined group, that is three kinds of mangenent were used, is the most effective treatment to reduce ICP of ICP. The degree of the reduction of ICP was 42.1~49.3% for 20 minutes, 47.7~52.5% for 30minnutes. There was no significant difference between ligation and non-ligation group.

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A Study on the Relationships between Breathing Disorders and Pathological Patterns Based on the Cold-Heat, Phlegm-, Yin Deficiency-, Lao Juan (勞倦)-Pattern Questionnaires and the Nijmegen Questionnaire (호흡실조와 증형간 연관성 연구: 한열, 담음, 음허, 노권 및 네이메헨 설문을 중심으로)

  • Hong, Hanna;Oh, Hwan-Sup;Park, Young-Bae;Park, Young-Jae
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.4
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    • pp.215-221
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    • 2016
  • Objectives: The purpose of this study was to examine the relationship between pathological patterns and hyperventilation syndrome, using pathological pattern and Nijmegen questionnaires. Methods: 33 healthy adults were asked to complete the Cold-Heat-, Phlegm-, Yin deficiency, and Lao Juan (勞倦)-pattern questionnaires, the Chalder fatigue scale, and the Nijmegen questionnaire at Kyung Hee University Hospital. We performed Pearson correlation analyses between the pathological pattern questionnaires and the Nijmegen questionnaire. The questionnaires were composed of several factors. Therefore, each factor and Nijmegen questionnaire score were also analyzed. Results: All of the pattern questionnaire scores had a positive correlation with the Nijmegen questionnaire score. The phlegm pattern, in particular, and the LaoJuan (勞倦) questionnaire scores had high correlation coefficients. The coefficient for the phlegm pattern was 0.856 and the coefficient for the LaoJuan (勞倦) pattern questionnaire was 0.855. Conclusions: The results mean that the pathological pattern questionnaires could be one of the reference materials to evaluate hyperventilation syndrome. Furthermore, improvement of pathological patterns may be helpful for treating hyperventilation syndrome, together with conventional therapies including breathing training.

The comparison between normal and cerebral infarction subject;using Transcranial Doppler (경두개 도플러(TCD)를 이용한 정상군과 뇌경색군의 상호비교연구)

  • Choi, Jae-Young;Lee, Dong-Won;Jeong, Sung-Hyun;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.157-167
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    • 1998
  • Background and Purpose : Cerebrovascular reactivity(CVR) can be estimated by measuring the change of cerebral blood flow that occurs during vasostimulation. To estimate the cerebrovascular reactivity, we investigated the change of flow velocity of the middle cerebral artery(MCA) during hyperventilation and hypoventilation with the transcranial doppler. So we studied whether the CVR measured by this method could show a significant difference between the normal and the cerebral infarction subjects and whether the CVR may decrease with age in normal subjects. Methods : Using transcranial doppler, we measured the mean velocity(Vm), the pulsatility index(P.I.) at the resting state, the end of breath-holding and the end of hyperventilation in 36 normal and 10 cerebral infarction subjects, so we calculated the percentile change of mean velocity(%${\Delta}$Vm) and P.I.(%${\Delta}$P.I.) after the vasostimulation. We estimated the change of Vm, P.I., %${\Delta}$Vm and %${\Delta}$P.I. by the age group and compared those parameters between the age-matched normal control and cerebral infarction subjects. Results : The Vm in MCA significantly decreased with age(p<0.05), but there was no significant difference in Vm and P.I. between normal and cerebral infarction subjects. The %${\Delta}$Vm and %${\Delta}$P.I. in response to hyperventilation significantly decreased with age in MCA and there was significant difference in $%{\Delta}Vm$ of MCA after breath-holding between the normal and cerebral infarction subjects. Conclusion : The breath-holding and hyperventilation tests could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied in the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.

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