• Title/Summary/Keyword: Mechanical ventilator

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Monitoring and Interpretation of Mechanical Ventilator Waveform in the Neuro-Intensive Care Unit (신경계 중환자실에서 기계호흡 그래프 파형 감시와 분석)

  • Park, Jin
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.63-70
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    • 2018
  • Management of mechanical ventilation is essential for patients with neuro-critical illnesses who may also have impairment of airways, lungs, respiratory muscles, and respiratory drive. However, balancing the approach to mechanical ventilation in the intensive care unit (ICU) with the need to prevent additional lung and brain injury, is challenging to intensivists. Lung protective ventilation strategies should be modified and applied to neuro-critically ill patients to maintain normocapnia and proper positive end expiratory pressure in the setting of neurological closed monitoring. Understanding the various parameters and graphic waveforms of the mechanical ventilator can provide information about the respiratory target, including appropriate tidal volume, airway pressure, and synchrony between patient and ventilator, especially in patients with neurological dysfunction due to irregularity of spontaneous respiration. Several types of asynchrony occur during mechanical ventilation, including trigger, flow, and termination asynchrony. This review aims to present the basic interpretation of mechanical ventilator waveforms and utilization of waveforms in various clinical situations in the neuro-ICU.

The Incidence Rate of Ventilator Associated Pneumonia in Relation to the Exchange of Circuit Cycle (인공호흡기 튜브교환주기에 따른 인공호흡기 관련 폐렴발생률)

  • Kim, Nam-Cho;Kim, Yang-Ree
    • Korean Journal of Adult Nursing
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    • v.15 no.3
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    • pp.463-471
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    • 2003
  • Purpose: This study was aimed at providing scientific evidence for minimizing ventilator-associated pneumonia(VAP) by identifying appropriate timing of exchange of circuit for mechanical ventilator that is well suitable for the medical environment of intensive care units of hospitals in Korea. Method: This was a quasi-experimental study with a convenience sample of 19 adult subjects aged over 18 years who were admitted to the NS ICU of C university hospital, and placed on mechanical ventilator. The subjects were placed in two groups, compared on the incidence rate of VAP after they received exchange of circuit either at 1-week interval (N =10) or 2-week interval (N = 9). Result: 1) When considering 1000 days as the standard unit of analysis for incidence, the incidence rate of VAP was 7.19 cases at the 1-week cycle exchange group and 15.23 at the 2-week cycle exchange group, showing no statistically significant difference between the two groups. 2) There were a total of 3 types of bacteria isolated from the patients with VAP, including 2 cases with P. aeruginosa, 1 case with Streptococcus group F and A. baumannii. Conclusion: With thorough hand washing and strict management of tracheal tube of mechanical ventilator as well as use of tracheal intubation techniques, exchange cycle of circuit of mechanical ventilator by nurses may be changed from 1-week to 2-week interval.

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A Study on The Performance of a Heat Recovery Ventilator According to the Properties of Spacers (스페이서의 재질변화에 따른 전열교환기 성능변화에 관한 연구)

  • Lim, Tae-Kun;Jeon, Byung-Heon;Kim, Jong-Won;Jung, Sung-Hak;Lee, Seung-Kap;Ahn, Young-Chull
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.24 no.3
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    • pp.224-229
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    • 2012
  • The importance of ventilation system is being emphasized by interest of indoor air quality. Especially, heat recovery ventilation system has attracted attention as most effective ventilation plan. Because it can reduce hazardous construction materials, indoor air pollutions, and also can reduce air conditioning energy cost. In heat recovery ventilator, the element core is the most important part. The element core is composed of liner and spacer. And liner and spacer are stacked alternately. On the Liner, heat and humidity transfer are made between supply and exhaust air. And spacer plays a role as a tunnel of exhaust and supply. In this study, we investigated and analyzed the efficiency of a heat recovery ventilator, when the spacer's properties are changed. As a result, difference spacer's properties affect an efficiency of heat recovery ventilator.

Development of Ventilator without Power using Air Flow (공기흐름을 이용한 무동력 환풍장치 개발)

  • Kim, Bum-Suk;Kwon, Taek-Joo;Jeong, Ji-Hyun
    • Journal of Power System Engineering
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    • v.20 no.2
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    • pp.26-31
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    • 2016
  • The studies on the efficient ventilator to reduce fire and save energy have been proceeded actively. The purpose of this paper is to design a ventilator used in residential wood stove. The ventilator consists of rotation and support part, and it is operated by natural wind without power. The shape of rotation part of the ventilator is like airfoil to reinforce pressure drop. We designed direction controller for the rotation part to track the direction of wind continuously. The rotation and support part have point-contact each other to minimize a friction. We verify the properties of the proposed ventilator though simulation and experiment. The results show the proposed ventilator can exhaust safely combustion gas of the stove more than other ventilator.

User experience of MV2000-MT (SU:M2)® as a Mechanical Ventilator: A Comparative Clinical Study on Usability, Safety, and Medical Staff Satisfaction

  • Jeon, Soeun;Kim, Hae Kyu;Lee, Dowon;Kim, Hyae Jin;Park, Eun Ji
    • Journal of Biomedical Engineering Research
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    • v.40 no.6
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    • pp.260-267
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    • 2019
  • In the present study, we aimed to demonstrate that MV2000-MT(SU:M2)® (MV, MEK-ICS, Paju, Korea), a domestic ventilator, is not inferior in terms of usability, safety, and medical staff satisfaction as compared to Hamilton G5 (G5, Hamilton Medical AG, Rhäzuns, Switzerland). A total of 39 patients who applied MV (group M) or G5 (group H) were included in the study sample. Usability was evaluated by the following factors: the number of alarm errors, replacement requirement of breathing circuit, replacement requirement of a right-angle connector, and ease of ventilator weaning. For safety evaluation, the number of ventilator replacements due to malfunction of the ventilator was evaluated. Items for medical staff satisfaction survey were as follows: the number of MV and G5 uses, hardware, and software assessment. In the usability evaluation, the replacement requirement of the right-angle connector was lower in Group M than in Group H (mean ± standard deviation, Group M: 7.39 ± 6.72, Group H: 14.19 ± 10.24, p = 0.021); however, the evaluations of other parts were not significantly different between the two groups. The number of ventilator replacements due to a malfunction of the ventilator did not differ between two groups. The number of MV and G5 uses was 3.0 [3.0-4.0] and 10.0 [5.0-10.0] (median [interquartile range], p < 0.001). Overall, the mean medical staff satisfaction score of Hamilton G5 was higher than that of MV2000-MT(SU:M2)®. The usability of MV is comparable to that of G5. However, medical staff satisfaction with Hamilton G5 was higher than that with MV2000-MT(SU:M2)®, and this difference could be due to the difference in the number of uses. In order to improve the penetration rate of the domestic mechanical ventilator, it is necessary to find ways to increase familiarity of medical staff with domestic mechanical ventilators.

Clinical experience of ventilator therapy in chest trauma (인공호흡기 치료를 받은 흉부외상 환자의 임상적 고찰)

  • 서강석
    • Journal of Chest Surgery
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    • v.26 no.1
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    • pp.59-63
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    • 1993
  • A clinical evaluation was performed with a population of 49 patients of chest trauma, who were diagnosed to undergo ventilator therapy, and had gone through ventilator therapy at the Department of Thoracic and Cardiovascular Surgery, Kyungpook University Hospital. One of most common causes of chest trauma was vehicle accidents [77.5%] with the prevalent age group being their forties. The common findings were multiple rib fractures [89.8%], hemopneumothrax [81.6%], lung contusion [61.2%] and flail chest [44.9%]. Their common combined injuries were the orthopedics and neurosugical injuries [86.7%]. Complications caused by chest trauma were pneumonia, respiratory failure, atelectasis, barotrauma and empyema. Pulmonary infections were commonly associated with mechanical ventilation in the long term group and were best prevented by using bronchial hygiene therapy.The mortality rate was 5.8% of the total patients and that was 38.8% of the patients, who needed ventilator therapy. The causes of death were pneumonia, respiratory failure, acute renal failure and hypovolemic shock. Mechanical ventilation has an important place in the treatment of patients with severe chest trauma.

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Family Caregivers of Korean Patients on Ventilators at Home: A Penomenological Study

  • Kim, Ki-Ryeon;Kim, Young-Soon
    • Journal of Korean Clinical Health Science
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    • v.3 no.1
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    • pp.290-298
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    • 2015
  • Purpose. This study aimed to explore family caregivers' experiences with ventilator-dependent patients at home. Methods. The number of patients using mechanical ventilators at home is expected to increase and family caregivers must be able to care for them. However, few studies focus on the experiences of family caregivers. We conducted in-depth interviews with 11 family caregivers who cared for a ventilator-dependent patient at home in South Korea. Data were analyzed using phenomenological method of enquiry. Results. Statements generated from the interviews on the meaning of the family caregiver's experiences were organized into 27 themes, 5 theme clusters, and 2 categories. The theme clusters included endurance under the burden situation, role strain as a caregiver, separation from others, trying to find coping methods, and oriental ethnical customs. Family caregivers of patients using domestic mechanical ventilators need systematic education and emotional support to cope with the challenges of managing ventilator equipment and learning new ways of communicating with patients on the ventilators. Conclusion. These findings may contribute to family caregivers' knowledge and competence, thereby allowing them to better support their ventilator-dependent family members.

A Study of The Related Factors to Successful Weaning from Mechanical Ventilation in leu Patients (인공호흡기 치료환자의 이탈(weaning) 성공 관련 요인에 대한 연구)

  • Kim, Eun-Sung;Choi, S-Mi
    • Journal of Korean Biological Nursing Science
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    • v.9 no.1
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    • pp.71-84
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    • 2007
  • Purpose : The Purpose of this study was to identify the physiological, psychological factors to successful weaning of mechanical ventilation in ICU patients. Method: Data was collected by interview with the use of questionnaires from 70 ICU patients, who were mechanically ventilated more than 3days at Y university medical center. Data was analyzed with descriptive statics, t-test, and $x^2$ test, and Pearson Coefficient Correlation using SPSS WIN 12.0 program. Result: ICU patients with mechanical ventilator during weaning period reported high levels of anxiety, moderate levels of stress, and fatigue. The physiological, psychological factors influencing ventilator weaning success were RSBI(p=0.007), stress(p=0.009), anxiety(p=0.020), depression(p=0.040), fatigue(p=0.001), and dyspnea(p=0.010). The RSBI factor was shown to have positive correlations with ventilator care periods, $PaCO_2$, and fatigue. Dyspnea was also positively correlated with stress, anxiety, depression, and fatigue. Conclusion: This study suggests that RSBI, stress, anxiety, depression, fatigue, and dyspnea are significant factors to successful weaning from mechanical ventilation.

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Ventilator-associated Pneumonia with Circuit Changes Every 7 Days versus Every 14 Days (회로 교환주기에 따른 인공호흡기 관련 폐렴발생률 차이)

  • Choi, Jeong-Sil;Yeon, Jeong-Haw
    • Journal of Korean Academy of Nursing
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    • v.40 no.6
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    • pp.799-807
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    • 2010
  • Purpose: To determine whether the practice of not routinely changing ventilator circuits in patients who require prolonged mechanical ventilation is associated with ventilator-associated pneumonia (VAP). Methods: Patients were divided into two groups, ventilator circuits were routinely changed every 7 days for the control group (39) and every 14 days for the experimental group (40) over a period of 1 yr (April 1, 2009-March 31, 2010). Pediatric patients (age 17 yr or less) were not included. VAP was diagnosed by the criteria of the Centers of Disease Control and Prevention (CDC). Incidence of VAP and characteristics of infection were evaluated. Results: In the experimental group, 2 episodes of pneumonia were observed in 40 patients and 1,322 ventilator days. The rate of VAP was 1.5 per 1,000 ventilator days. There was 1 episode of pneumonia in 39 patients and 481 ventilator days for the control group. The rate of VAP was 2.1 per 1,000 ventilator days. The difference between both groups was not significant (p=.695). Conclusion: Extending ventilator circuit change interval from 7 days to 14 days does not increase the risk for VAP.

A Study on the Dew Condensation According to the Operational Conditions of a Heat-Recovery Ventilator (전열교환 환기시스템의 운전 상태에 따른 결로 발생에 관한 연구)

  • Jeon, Byung-Heon;Kim, Jong-Won;Lee, Seung-Kap;Lee, Young-Ju;Ahn, Young-Chull
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.25 no.10
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    • pp.529-533
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    • 2013
  • Heat-recovery ventilators are being adopted in most newly built apartment houses for energy reduction and indoor environment improvement. In winter, however, the dew condensation resulting from the difference between the indoor and outdoor temperatures may reduce the ventilator's performance and threaten the health of indoor residents. This study analyzes the occurrence of dew condensation according to the ventilator's operational conditions and the changes of temperature and products. The experimental results show that condensations is formed at $26^{\circ}C$ and 60%R.H, which is an unfavorable climatic condition, and when the damper is not closed tightly. Therefore it is important to ensure damper performance to prevent back flow.