• Title/Summary/Keyword: respiratory failure

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Need for a safe vaccine against respiratory syncytial virus infection

  • Kim, Joo-Young;Chang, Jun
    • Clinical and Experimental Pediatrics
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    • v.55 no.9
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    • pp.309-315
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    • 2012
  • Human respiratory syncytial virus (HRSV) is a major cause of severe respiratory tract illnesses in infants and young children worldwide. Despite its importance as a respiratory pathogen, there is currently no licensed vaccine for HRSV. Following failure of the initial trial of formalin-inactivated virus particle vaccine, continuous efforts have been made for the development of safe and efficacious vaccines against HRSV. However, several obstacles persist that delay the development of HRSV vaccine, such as the immature immune system of newborn infants and the possible Th2-biased immune responses leading to subsequent vaccine-enhanced diseases. Many HRSV vaccine strategies are currently being developed and evaluated, including live-attenuated viruses, subunit-based, and vector-based candidates. In this review, the current HRSV vaccines are overviewed and the safety issues regarding asthma and vaccine-induced pathology are discussed.

Clinical Characteristics and Prognostic Factors in Patients with Pulmonary Tuberculosis Admitted to Intensive Care Units (중환자실로 입원한 폐결핵 환자의 임상 양상과 예후 인자)

  • Kang, Ji-Young;Kim, Myung-Sook;Kim, Ju-Sang;Kang, Hyeon-Hui;Kim, Seung-Soo;Kim, Yong-Hyun;Kim, Jin-Woo;Lee, Sang-Haak;Kim, Seok-Chan;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.5
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    • pp.259-266
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    • 2010
  • Background: Pulmonary tuberculosis (TB), requiring the intensive care unit (ICU) care, has been a high-mortality condition until now. In the present study, we aimed to investigate clinical features and parameters associated with TB mortality. Methods: From August 2003 to December 2008, patients with microbiologically or histologically confirmed pulmonary TB then admitted to the ICU, were retrospectively enrolled into the study. Upon enrollment, their medical records were reviewed. Results: Forty three patients (30 males, 13 females) were included and their mean age was 63.8 years (range: 17~87 years). Twelve patients died, an overall in-hospital mortality of 27.8%. The main reason for the ICU care was dyspnea or hypoxemia requiring mechanical ventilation (n=17). Other diagnoses for ICU care were hemoptysis, monitoring after procedures, neurologic dysfunction, shock, and gastrointestinal bleeding. On univariate analysis, the factors affecting the mortality were malnutrition-related parameters including low body mass index, hypoalbuminemia, lymphocytopenia, and hypocholersterolemia, as well as severity-related variables such as high acute physiology and chronic health evaluation (APACHE) score, number of involved lobes, and high C-reactive protein. In addition, respiratory failure requiring mechanical ventilation and acute respiratory distress syndrome contributed to patient fatality. It was shown on multivariate analysis that respiratory failure and hypoalbuminemia were significantly independent variables associated with the mortality. Conclusion: Acute respiratory failure is the most common reason for the ICU care and also the most important factor in predicting poor outcome. In addition, our data suggest that the parameters associated with malnutrition could be possible factors contributing to mortality.

Different Responses to Clarithromycin in Patients with Cryptogenic Organizing Pneumonia

  • Oh, Ji Hyun;Oh, Dong Jun;Koo, So-My;Kim, Yang Ki;Kim, Ki Up;Kim, Hyun Jo;Kim, Dong Won;Uh, Soo-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.401-407
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    • 2015
  • Cryptogenic organizing pneumonia (COP) is an idiopathic interstitial pneumonia characterized by a subacute course and favorable prognosis with corticosteroids. However, some patients show resistance to steroids. Macrolides have been used with success in those patients showing resistance to steroids. A few reports showed treatment failure with macrolides in patients with COP who were resistant to steroids. In this report, we described two cases of COP who showed different responses to clarithromycin. One recovered completely, but the other gradually showed lung fibrosis with clarithromycin.

Risk Factors for Mechanical Ventilation in Patients with Scrub Typhus Admitted to Intensive Care Unit at a University Hospital

  • Moon, Kyoung Min;Han, Min Soo;Rim, Ch'ang Bum;Lee, Jun Ho;Kang, Min Seok;Kim, Ji Hye;Kim, Sang Il;Jung, Sun Young;Cho, Yongseon
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.1
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    • pp.31-36
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    • 2016
  • Background: The purpose of this study was to evaluate the risk factors for mechanical ventilation in the patients with scrub typhus admitted to intensive care unit (ICU) at a university hospital. Methods: We retrospectively selected and analyzed clinical data from the medical records of 70 patients (32 men, 38 women) admitted to the ICU with scrub typhus between 2004 and 2014. The patients had a mean${\pm}$standard deviation age of $71.2{\pm}11.1years$ and were evaluated in two groups: those who had been treated with mechanical ventilation (the MV group, n=19) and those who had not (the non-MV group, n=51). Mean ages of the MV group and the non-MV group were $71.2{\pm}8.3years$ and $71.2{\pm}11.1years$, respectively. Results: Significant differences between the two groups were observed with respect to acute respiratory failure (p=0.008), Acute Physiology and Chronic Health Evaluation (APACHE) II score (p=0.015), Sequential Organ Failure Assessment (SOFA) score (p=0.013), death (p=0.014), and ICU duration (p<0.01). Multivariate analysis indicated that the following factors were significantly associated with mechanical ventilation: acute respiratory failure (p=0.011), SOFA score (p=0.005), APACHE II score (p=0.011), platelet count (p=0.009), and lactate dehydrogenase (LDH) (p=0.011). Conclusion: Thus, five factors-acute respiratory failure, SOFA score, APACHE II score, platelet count, and LDH-can be the meaningful indicators for mechanical ventilation for the patients with scrub typhus admitted to ICU.

Comprehensive Review of Acute Respiratory Failure Following Inhalation Exposure to Waterproofing Agents (방수 스프레이 흡입 노출로 인한 급성 호흡기 중독 사례 및 원인 고찰)

  • Park, Donguk;Choi, Yeyong
    • Journal of Environmental Health Sciences
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    • v.38 no.6
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    • pp.451-459
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    • 2012
  • Background: In Korea, a healthy 36-year-old man developed acute interstitial pneumonitis soon after inhaling a waterproofing spray which he had applied at home to his outdoor jacket. Objectives: The objectives of this study were to review cases of varying degrees of respiratory toxicity and poisoning in connection with the use of waterproofing spray and summarize major reasons for cases of poisoning. Methods: We searched articles reporting on a combination of a waterproofing agent and/or respiratory symptoms, including acute respiratory syndrome, lung injury, pneumonia, pulmonary toxicity, and respiratory disease. Results: We reviewed a number of cases of varying degrees of respiratory toxicity and poisoning resulting from inhalation of waterproofing spray containing fluorocarbon co-polymer, solvents and propellants reported in a variety of countries. The literature searches concluded that among the ingredients of waterproofing agents, fluorinated polymer may cause acute respiratory health effects. Conclusion: Environmental policy should be implemented in order to prevent consumers from using household and industrial products including waterproofing agents. In addition, a national surveillance system should be created to collect cases of poisoning caused by the use of consumer products.

The Effects of Training on the Proper Use of Respiratory Rate Measurement Devices for Providing High-Quality Artificial Ventilation

  • Jae-Ran Lim;Sung-Hwan Bang;Hyo-Suk Song;Gyu-Sik Shim;Ho-Jin Park
    • Journal of the Korea Society of Computer and Information
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    • v.29 no.3
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    • pp.165-171
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    • 2024
  • This study aims to investigate the appropriate volume of artificial ventilation and success rate when Basic - emergency medical Technician administer bag valve mask(BVM) artificial ventilation to patients experiencing respiratory failure or respiratory arrest using a respiratory rate measurement device. The research was conducted from December 11th to 12th, 2023, targeting 20 Basic - emergency medical Technicians enrolled at D University. Ten participants were selected for the experimental group, receiving BVM ventilation training with the use of a respiratory rate measurement device, while the other ten were assigned to the control group, receiving BVM ventilation training without the use of a respiratory rate measurement device. The experiment involved providing artificial ventilation for 2 minutes. The results of the study indicated that the control group did not provide accurate tidal volume (p=.025). The experimental group demonstrated a higher success rate of ventilation over the 2-minute period, while the control group showed a significant difference (p=.001). Subjective perception of tidal volume and objectively measured tidal volume also exhibited a significant difference in the control group (p=.010). Therefore, training with a respiratory rate measurement device can align the subjective perception of tidal volume with objective measurements, increase the success rate of ventilation, and potentially contribute to improving survival rates in patients experiencing respiratory failure or respiratory arrest during cardiopulmonary resuscitation.

A Case of Fatal Hyperinfective Strongyloidiasis with Acute Respiratory Failure and Intestinal Perforation in Lung Cancer Patient (폐암환자에서 급성호흡부전과 장천공을 동반한 분선충 감염증 1예)

  • Kim, Hyeon-Sik;Kim, Yu-Eun;Yun, Eun-Young;Ju, Ji-Hyun;Ma, Jeong-Eun;Lee, Gi-Dong;Cho, Yu-Ji;Kim, Ho-Cheol;Lee, Jong-Deok;Hwang, Young-Sil;Jeong, Yi-Yeong
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.1
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    • pp.29-33
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    • 2010
  • Strongyloides stercoralis is an intestinal nematode that is a parasite to humans. The infecting filariform larvae of S. stercoralis enters the host body via the bloodstream, passes through the lungs, penetrates the alveoli, and then ascends the airway to transit down the esophagus into the small bowel. The infection can persist for decades without causing major symptoms and can elicit eosinophilia of varying magnitudes. Of note, this infection can also develop into a disseminated, often fatal, disease (hyperinfection) in patients receiving immunosuppressive corticosteroids. A 65-year-old man who was receiving corticosteroid therapy for the treatment of spinal stenosis was admitted to the emergency room with complaints of abdominal pain and severe dyspnea. We detected many S. stercoralis larvae in the sputum and in the bronchoalveolar-lavage sample collected by bronchoscopy. Here, we report a fatal case of strongyloidiasis with acute respiratory failure and intestinal perforation. In addition, we provide a brief review of the relevant medical literature.

A Case of the Localized Tension Pneumothorax Mimicking Giant Bullae (거대 폐기포 (giant bulla)로 오진된 국소형 긴장성 자발 기흉)

  • Ko, Hyuk;Park, Sung-Ho;Kim, Su-Hee;Park, Wan;Park, Chong-Bin;Kim, Jong-Wook;Ryu, Dae-Sik;Jung, Bock-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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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.

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Endobronchial ALK-Positive Anaplastic Large Cell Lymphoma Presenting Massive Hemoptysis

  • Kim, Hee Kyung;Kim, Bo Hye;Kim, Sae Ahm;Shin, Jae Kyoung;Song, Ji-Hyun;Kwon, Ah-Young;Kim, Jung-Hyun;Kim, Eun-Kyung;Lee, Ji-Hyun;Kim, Gwaung-Il;Jeong, Hye Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.390-395
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    • 2015
  • Primary anaplastic large cell lymphoma (ALCL) of the lung is highly aggressive and quite rare. We report here a case of anaplastic lymphoma kinase-positive endobronchial ALCL, that was initially thought to be primary lung cancer. A 68-year-old woman presented with hemoptysis, dyspnea, and upper respiratory symptoms persisting since 1 month. The hemoptysis and and bronchial obstruction lead to respiratory failure, prompting emergency radiotherapy and steroid treatment based on the probable diagnosis of lung cancer, although a biopsy did not confirm malignancy. Following treatment, her symptoms resolved completely. Chest computed tomography scan performed 8 months later showed increased and enlarged intra-abdominal lymph nodes, suggesting lymphoma. At that time, a lymph node biopsy was recommended, but the patient refused and was lost to follow up. Sixteen months later, the patient revisited the emergency department, complaining of persistent abdominal pain since several months. A laparoscopic intra-abdominal lymph node biopsy confirmed a diagnosis of ALCL.

A Case of Infantile Hemangioendothelioma of the Liver Treated with Hepatic Embolization and Lobectomy (간동맥 색전술과 간엽 절제술로 치료한 영아 간내 혈관내피종 1례)

  • Kim, Jae Seon;Moon, Soo Kyung;Yoon, Hye Seon;Lee, Tae Seok
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.660-664
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    • 2005
  • Infantile hemangioendothelioma(IHE) of the liver is the most common vascular tumor in infants before the age of 6 months. It is a histologically benign tumor with potentially life-threatening complications. The clinical manifestations are variable, ranging from asymptomatic forms to intractable high-output heart failure. In addition, abdominal mass, intraperitoneal hemorrhage due to rupture of mass, respiratory distress, hematologic abnormalities and jaundice can occur. Diagnostic work-up is through doppler ultrasound sonography, computed tomography scan, magnetic resonance imaging and angiography. Treatment consists of medical treatment, interventional therapy, surgical resection and liver transplantation. We experienced symptomatic IHE in a premature neonate who presented with high output heart failure and respiratory distress. Initial medical treatment and steroid therapy failed to improve his condition. Coil embolization of left hepatic artery resulted in improvement of respiratory symptoms. However, a left lobectomy was performed because the mass size was not decreased with development of collateral vessels. The infant was well, after a successful discharge from the hospital.