• Title/Summary/Keyword: respiratory management

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A Case of Activated Charcoal Aspiration Treated by Early and Repeated Bronchoalveolar Lavage (기관지내시경을 통해 치료한 활성탄 흡인 1예)

  • Lee, Han-Min;Park, Jae-Seok;Kim, Jae-Yun;Lee, Ji-Yeon;Ahn, Byung-Kyu;Gil, Hyo-Wook;Choi, Jae-Sung
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.177-181
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    • 2012
  • Activated charcoal is an inert substance and it is used in standard therapy in patients with acute intoxication. Charcoal has some side effects such as pulmonary aspiration, gastrointestinal complications, and electrolyte abnormalities. Although aspiration of charcoal is a rare complication, it can cause fatal sequelae. We report a 69-year old man who developed acute respiratory failure associated with charcoal aspiration after management of glyphosate poisoning. The patient was drowsy and suffered severe vomiting during transport to our hospital. On arrival, acute respiratory failure was observed due to charcoal aspiration, but the clinical state was improved with repeated bronchoscopy with a bronchoalveolar lavage (BAL). We presumed that the aspirated charcoal was an important factor in evoking a lung injury. Early bronchoscopy with a BAL might be an effective method for eliminating charcoal from the lung, especially in the case of a large amount of aspiration, and be helpful in decreasing respiratory failure due to charcoal aspiration.

Development of a Respiratory Infection Prevention Program for the Rural Elderly in the Post COVID-19 Era: A Study Using Delphi Method of Community Health Practitioners (포스트 코로나 시기 농촌 거주 노인의 호흡기감염 예방 프로그램 개발: 보건진료 전담공무원 대상 델파이 기법)

  • Kwon, Myung Soon;Yu, Jeong Soon;Jang, Ji Hye
    • Journal of Korean Public Health Nursing
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    • v.36 no.3
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    • pp.417-430
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    • 2022
  • Purpose: The purpose of this study was to develop a respiratory infection prevention program for the rural elderly in the post-coronavirus disease 2019 (COVID-19) era. Methods: The Delphi method was used to validate the contents of the program. Two rounds of Delphi surveys and one individual interview were conducted on four subjects and 16 categories with nine experts. Content validity was calculated using the content validity ratio (CVR) and coefficient of variation (CV). Results: This study verified the content validity of the existing program components, such as respiratory infection prevention characteristics, cough etiquette, correct hand washing, oral hygiene, correct tooth brushing, and exercise by walking. The study comprised 28 categories covering seven subjects, including the provision of knowledge and information about COVID-19, environmental management for respiratory infection prevention, and exercise training for immunity enhancement. Conclusion: This Delphi study examined the respiratory infection prevention program that was redesigned for the post-COVID-19 era and confirmed the validity of the educational contents. The findings of this study suggest that the program can be used practically for the prevention of respiratory infection among the rural elderly.

A Study on Nursing Needs and Respiratory Self-care Practice Degree in Elderly Chronic Obstructive Pulmonary Disease (만성폐쇄성 폐질환 노인의 호흡기 자가간호 실천정도와 간호요구)

  • Noh, Hyun-Sook;Min, Hye-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.9 no.1
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    • pp.17-29
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    • 2003
  • This study investigated the degree of self-care practice to maintain the stable respiratory function and the required respiratory nursing needs upon the elderly with chronic obstructive pulmonary diseases. The research subjects were 115 elderly people over 60 years old, who were diagnosed to have chronic obstructive pulmonary diseases (the mixed type, chronic bronchitis, bronchial asthma, emphysema) and were hospitalized in 3 university hospitals in Busan or treated as outpatient, and the data was collected over the period between June 1, 2002 and September 30, 2002. In order to measure the respiratory self-care practice degree and nursing needs of the subjects, the instrument on the self-care practice and the instrument on nursing needs were developed by the researcher. The research results are as follows: 1. The mean of respiratory self-care practice degree by the subjects was 2.41 out of 4 for each clause, and the degree of practicing general management was the highest(2.70), and nutrition control(2.66), respiratory exercise(2.65), expectoration of sputum (2.63), oxygen therapy(2.60), environment control(2.50), and medication control(2.36) succeeded. 2. The degree of self-care practice had a significant difference depending on age(F=2.82, P=0.02), frequency of hospitalization(F=3.11, P=0.01), and diagnosed disease(F=15.66, P=0.00). 3. The subjects nursing needs of respiratory system were 3.07 on the average out of 4.00, and 'I want to know how to prevent the infection of respiratory system such as cold scored the highest 3.83, while the clauses like 'want to know how to face the respiratory disorder properly'(3.77) and 'want the specific explanation of the symptoms of my disease'(3.66) also had scored high points. 4. The nursing needs of the respiratory system had a significant difference depending on diagnosed disease such as mixed type of chronic obstructive pulmonary diseases, emphysema, bronchitis, and asthma (F=6.70, P=0.00). The research showed that the subjects degree of self-care practice of respiratory system was low on the whole, while the nursing needs for managing respiratory organ were relatively high. Therefore, specific education concerning the nursing of the disease and self-care upon the elderly having chronic obstructive pulmonary disease is necessary.

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Chronic Obstructive Pulmonary Disease: Respiratory Review of 2014

  • Lee, Young-Min
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.4
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    • pp.155-160
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    • 2014
  • Chronic obstructive pulmonary disease (COPD) is characterized by a diverse array of pulmonary and nonpulmonary manifestations, but our understanding of COPD pathogenesis and the factors that influence its heterogeneity in disease presentation is poor. Despite this heterogeneity, treatment algorithms are primarily driven by a single measurement, forced expiratory volume in 1 second ($FEV_1$) as a percentage of its predicted value ($FEV_1%$). In 2011, a major shift in Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment recommendations was proposed that stratifies patients with COPD on the basis of symptoms and exacerbation history. This article reviews the work reported in 2013 that enlightens our understanding of COPD with respect to COPD classification systems, phenotype, biomarker, exacerbation, and management for patients with COPD.

The Role of Bronchodilators in Preventing Exacerbations of Chronic Obstructive Pulmonary Disease

  • Beeh, Kai M.
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.241-247
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    • 2016
  • Bronchodilators are the cornerstone of symptomatic chronic obstructive pulmonary disease (COPD) treatment. They are routinely recommended for symptom reduction, with a preference of long-acting over short-acting drugs. Bronchodilators are classified into two classes based on distinct modes of action, i.e., long-acting antimuscarinics (LAMA, once-daily and twice-daily), and long-acting ${\beta}2$-agonists (LABA, once-daily and twice-daily). In contrast to asthma management, evidence supports the efficacy of both classes of long-acting bronchodilators as monotherapy in preventing COPD exacerbations, with greater efficacy of LAMA drugs versus LABAs. Several novel LAMA/LABA fixed dose combination inhalers are currently approved for COPD maintenance treatment. These agents show superior symptom control to monotherapies, and some of these combinations have also demonstrated superior efficacy in exacerbation prevention versus monotherapies, or combinations of inhaled corticosteroids plus LABA. This review summarizes the current data on clinical effectiveness of bronchodilators alone or in combination to prevent exacerbations of COPD.

Tuberculosis Infection and Latent Tuberculosis

  • Lee, Seung Heon
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.201-206
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    • 2016
  • Active tuberculosis (TB) has a greater burden of TB bacilli than latent TB and acts as an infection source for contacts. Latent tuberculosis infection (LTBI) is the state in which humans are infected with Mycobacterium tuberculosis without any clinical symptoms, radiological abnormality, or microbiological evidence. TB is transmissible by respiratory droplet nucleus of $1-5{\mu}m$ in diameter, containing 1-10 TB bacilli. TB transmission is affected by the strength of the infectious source, infectiousness of TB bacilli, immunoresistance of the host, environmental stresses, and biosocial factors. Infection controls to reduce TB transmission consist of managerial activities, administrative control, engineering control, environmental control, and personal protective equipment provision. However, diagnosis and treatment for LTBI as a national TB control program is an important strategy on the precondition that active TB is not missed. Therefore, more concrete evidences for LTBI management based on clinical and public perspectives are needed.

Transient Repiratory Dysfunction after Percutaneous Cordotomy -A case report- (경피적 척수시상로절단술 후 발생한 호흡부전 -증례 보고-)

  • Lee, Jun Seog;Sinn, Yoo Sik;Park, Chan Hong
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.275-278
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    • 2005
  • Percutaneous cordotomy is a useful method for cancer pain management. Candidates for cervical cordotomy include those patients with unilateral cancer pain below the shoulder, with a life expectancy of less than 1 year, who can not be adequately treated by other less invasive methods. However, various complications can occur following a cordotomy, with the most serious being respiratory dysfunction. Herein, we report a case of transient respiratory dysfunction following a percutaneous cervical cordotomy.

Respiratory Arrest during Cervical Epidural Block -A case report- (경부 경막외 차단중 발생한 호흡정지 -2예 보고-)

  • Kim, Deog-Jae;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.264-267
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    • 1996
  • Cervical epidural block can be useful in the management of acute and chronic pain of the head, neck, shoulder, and arm, for selected patients. In spite of the widespread use of cervical epidural blocks for pain, there is limited published data on the specific technique and complications regarding the procedure. High levels of epidural block do not appear to be associated with clinically significant circulatory or ventilatory changes unless the concentrations of local anesthetics used are great enough to produce paralysis of intercostal and phrenic nerves. However, high level of epidural block is associated with sympathetic block which may affect responses of circulatory and ventilatory systems. Accordingly, the possibility of major complications of cervical epidural block must be borne in mind. We experienced two cases of respiratory arrest during cervical epidural block with bupivacaine. This is a report regarding complications of cervical epidural block.

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Clinical Aspect of MicroRNA in Lung Cancer

  • Jeong, Hye Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.2
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    • pp.60-64
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    • 2014
  • MicroRNAs (miRNAs) are a class of small noncoding RNAs that modulate target gene activity, and are aberrantly expressed in most types of cancer as well in lung cancer. A miRNA can potentially target a diverse set of mRNAs; further, it plays a critical role in lung tumorigenesis as well as affects patient outcome. Previous studies focused mainly on abnormal miRNAs expressions in lung cancer tissues. Interestingly, circulating miRNAs were identified in human plasma and serum in 2008. Since then, considerable effort has been directed to the study of circulating miRNAs as one of the biomarkers of lung cancer. miRNAs expression of tissues and blood in lung cancer patients is being analyzed by more researchers. Recently, to overcome the high false-positivity of low-dose chest computed tomography scan, miRNAs in lung cancer screening are being investigated. This article summarizes the recent researches regarding clinical applications of miRNAs in the diagnosis and management of lung cancer.

Recent Advances in Idiopathic Pulmonary Fibrosis

  • Park, Sanghoon;Lee, Eun Joo
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.1
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    • pp.1-6
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    • 2013
  • The concept on idiopathic pulmonary fibrosis (IPF) pathogenesis has progressed from chronic inflammation to aberrant wounding healing and even more to the current paradigms of a multifactorial and heterogeneous disease process. Despite the growth of clinical trials for IPF, most of the results, including N-acetylcysteine combination, warfarin, and bosentan, were disappointing. On the other hand, there have been a number of important developments; the foremost is the licensing of pirfenidone in Europe and Asia. In this article, we briefly review the recent knowledge of pathogenesis of IPF. We also summarize the recent clinical trials regarding the management of IPF.