• Journal of Chest Surgery
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• v.39 no.6 s.263
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• pp.490-494
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• 2006

Lung transplantation is the choice of treatment for selected patients with end-stage pulmonary disease. However, retransplantation of the lung due to primary graft failure carries a high risk of morbidity and mortality. This is a case of a 52 year old male with emphysema who continuously needed a ventilator care and a tracheostomy. He underwent a left single lung transplantation but were not able to wean from the ventilator due to primary graft failure, and therefore we decided to do a retransplantation. Bilateral sequential single lung transplantation was performed under the cardiopulmonary bypass. The patient recovered quite well and was discharged and fully active with his work. Retransplantation although it carries a high risk, is a very effective treatment in patients with primary graft failure.

• Korean Journal of Adult Nursing
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• v.26 no.2
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• pp.191-202
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• 2014

Purpose: This study was aimed to survey the actual caregiving conditions of family caregivers who are caring patients with rare and incurable diseases using home ventilators at home, and to clarify any factors affecting their burdens and quality of life. Methods: A questionnaire survey was performed by the 159 subjects, and the questionnaires contained the actual conditions of caregiving activities, and caregiver's burdens and quality of life. The collected data was analyzed by ANOVA, Pearson's correlation, and stepwise linear regressions. Results: The mean of burden scores was 3.55 out of 5, and influencing variables included the relationships with patient (spouse), respite (moderate), health status, and diagnosis (non ALS), with the explanatory power of 30.0%. The mean of the quality of life was 2.58 point, and the influencing variables included burdens, health status, and respite (enough), with the explanatory power of 39.0%. Conclusion: In order to improve the quality of life among family caregivers caring for patients with using a home ventilator, it is required to develop strategies for reducing caregiving burdens as well as to introduce family respite welfare systems to family caregivers.

• Fire Science and Engineering
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• v.30 no.1
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• pp.6-11
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• 2016

This study analyzed the performance of smoke exhaustion installed to secure the life safety from the smoke each opening modes, as performing the simulation on the Jeju regions generating to strong windy using CONTAM. We assessed the effectiveness of the system under conditions of high external winds as well as an ambient wind conditions. It also assessed the relative effectiveness of opening all vents versus opening only those vents which served rooms in which the fire was located. This study revealed external winds exerted a substantial impact on the performance of the smoke ventilation system. It was found that opening the ventilation system in the room containing the fire resulted in a greater performance than opening vents in both fire in all rooms. The reduced performance of the smoke ventilation system upon the opening of all vents is thought to be due to the intrusion of outside air, and the establishment of unfavorable air circulation, caused by the negative pressure generated in the building.

• Tuberculosis and Respiratory Diseases
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• v.83 no.2
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• pp.167-174
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• 2020

Background: The purpose of this study was to investigate the effect of early tracheostomy on clinical outcomes in patients requiring prolonged acute mechanical ventilation (≥96 hours). Methods: Data from 575 patients (69.4% male; median age, 68 years), hospitalized in the medical intensive care unit (ICU) of a university-affiliated tertiary care hospital March 2008-February 2017, were retrospectively evaluated. Early and late tracheostomy were designated as 2-10 days and >10 days after translaryngeal intubation, respectively. Results: The 90-day cumulative mortality rate was 47.5% (n=273) and 258 patients (44.9%) underwent tracheostomy. In comparison with the late group (n=115), the early group (n=125) had lower 90-day mortality (31.2% vs. 47.8%, p=0.012), shorter stays in hospital and ICU, shorter ventilator length of stay (median, 43 vs. 54; 24 vs. 33; 23 vs. 28 days; all p<0.001), and a higher rate of transfer to secondary care hospitals with post-intensive care settings (67.2% vs. 43.5% p<0.001). Also, the total medical costs of the early group were lower during hospital stays than those of the late group (26,609 vs. 36,973 USD, p<0.001). Conclusion: Early tracheostomy was associated with lower 90-day mortality, shorter ventilator length of stay and shorter lengths of stays in hospital and ICU, as well as lower hospital costs than late tracheostomy.

• Perspectives in Nursing Science
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• v.14 no.1
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• pp.1-9
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• 2017

Purpose: To study the internal psychological conflicts among nursing students during an infection control protocol carried out in the hospital by measuring their observation skills and performance during clinical training. Methods: Investigation of both pre- and post- infection control was conducted using questionnaires for clinical infection practices. We identified and evaluated the students' observation skills, clinical performance, clinical perception, and internal conflict regarding clinical infection control. We also interviewed the students as part of our study. Results: Among parameters such as clinical performance, observation skills, clinical perception, and internal conflict, the average observation skills (t=5.49, p<.001) were significantly lower, while internal conflict among students (t=-7.23, p<.001) was significantly higher than expected prior to clinical training. Generally, there was a negative correlation between observation skills and internal conflict in every aspect of infection control practice (r=-.281, p=.031). Internal conflict was significantly higher than expected in the context of hand hygiene (t=-2.135, p=.037), personal hygiene (t=-3.48, p=.002), and ventilator management (t=-3.69, p<.001). Clinical performance of students in the context of hand hygiene (t=4.69, p<.001), personal hygiene (t=2.06, p=.044), and ventilator management (t=2.68, p<.001) was significantly lower than expected prior to clinical training. Conclusion: Our findings showed that internal psychological conflict is higher when infection control practices are observed or performed to a lesser degree. Therefore, reinforcing education regarding infection control among students, such as developing a systematic program, or consecutive training and monitoring, is suggested.

• Journal of Korean Academy of Nursing
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• v.38 no.6
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• pp.874-880
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• 2008

Purpose: The purpose of this study was to identify muscle atrophy in critically ill patients on ventilators. A comparison was made between limb circumferences and muscle areas on the day of admission to an intensive care unit (ICU) and on the 8th day after admission. Methods: The data were collected from 30 critically ill patients using ventilators at S hospital ICU in Seoul during the period from October 2005 to April 2006. Limb circumferences and skinfold thickness were measured on the day of admission and on the 8th day after admission to the ICU. Limb circumferences and skinfold thickness were measured on the right mid-arm, right mid-thigh, and right mid-calf using a measuring tape and a skinfold calipers. Limb muscle areas were calculated by an equation after measuring limb circumferences and skinfold thickness. The data were analyzed by paired t-test and independent t-test. Results: 1) Mid-arm circumference, mid-thigh circumference and mid-calf circumference on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 2) Mid-arm muscle area, mid-thigh muscle area and mid-calf muscle area on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 3) Steroid and vecuronium medication didn't affect changes in limb circumferences (mid-arm, mid-thigh, mid-calf) and muscle areas (mid-arm, mid-thigh, mid-calf on the 8th day after admission to the ICU compared to the day of admission. Conclusion: Limb muscle atrophy may occur on the 8th day after admission to the ICU in critically ill patients using ventilator.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.888-895
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• 1998

Malaria is one of the most common infectious diseases in the world. Plasmodium falciparum, accounting for nearly all malaria mortality, kills an estimated 1 to 2 million persons yearly and has several features that make it deadlist of malarias. While cerebral malaria is the most common presentation of severe disease, acute lung injury associated with malaria is uncommon but serious and fatal complication. We report two cases of severe malaria with ARDS and multi-organ failure. All two patients traveled to foreign countries, Kenya, Papua New Guinea where choroquine-resistant malaria is distributed. The first case, which developed cerebral malaria, hypoglycemia, multi-organ failure, and ARDS, treated with quinine and mechanical ventilator, but expired due to oxygenation failure. Autopsy showed acute necrotizing infiltration, diffuse eosinophilic fibrinoid deposits along the alveolar space, and alveolar macrophage with malaria pigment The second case also developed multi-organ failure, followed by ARDS, and was treated with quinine, exchange transfusion, plasmapheresis, and mechanical ventilator. He recovered with residual restrictive lung change after treatment.

• Tuberculosis and Respiratory Diseases
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• v.83 no.3
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• pp.248-254
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• 2020

Background: Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. Methods: Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018-May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017-May 2018 (the control group). Results: Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. Conclusion: Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.

• Korean Journal of Air-Conditioning and Refrigeration Engineering
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• v.29 no.4
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• pp.175-184
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• 2017

With the improvement of living standards, the ventilation for the mitigation of indoor or outdoor air-pollution problems has recently attracted a lot of attention. Consequently, the ventilation for the supply of outdoor fresh air into a room is treated as an important building-design factor. The ventilation is generally divided into the forced and natural types; here, the former can control the ventilation rate by using mechanical devices, but it has the disadvantages of the equipment costs, maintenance costs, and noise generation, while the latter is applied to most workshops due to the absence of noise and the low installation and maintenance costs. In this experimental study, the ventilation performance of a typical rotating-type natural ventilator, which is called a "wind turbine," was investigated with the outdoor-wind velocity and the indoor/outdoor-temperature difference. From the experiment results, it was confirmed that the temperature difference of $10^{\circ}C$ corresponds to the ventilation driving force with an outdoor-wind velocity of 1.0 m/s. Additionally, the intake-opening area of a building also exerts a great effect on the ventilation rates.

• Journal of Chest Surgery
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• v.49 no.5
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• pp.337-343
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• 2016

Background: Recent developments in surgical techniques and hospital care have led to improved outcomes following total anomalous pulmonary venous return (TAPVR) repair. However, the surgical repair of TAPVR remains associated with a high risk of mortality and need for reoperation. We conducted this retrospective study to evaluate mid-term outcomes following in situ TAPVR repair without total circulatory arrest (TCA), and to identify the risk factors associated with surgical outcomes. Methods: We retrospectively reviewed 29 cases of surgical intervention for TAPVR conducted between April 2000 and July 2015. All patients were newborns or infants who underwent in situ TAPVR repair without TCA. Results: Four anatomic subtypes of TAPVR were included in this study: supracardiac (20 cases, 69.0%), cardiac (4 cases, 13.8%), infracardiac (4 cases, 13.8%), and mixed (1 case, 3.4%). The median follow-up period for all patients was 42.9 months. Two (6.9%) early mortalities occurred, as well as 2 (6.9%) cases of postoperative pulmonary venous obstruction (PVO). Preoperative ventilator care (p=0.027) and preoperative PVO (p=0.002) were found to be independent risk factors for mortality. Conclusion: In situ repair of TAPVR without TCA was associated with encouraging mid-term outcomes. Preoperative ventilator care and preoperative PVO were found to be independent risk factors for mortality associated with TAPVR repair.