Chronic ; Intermittent Positive-Pressure Breathing

This patient had received antihypertensive therapy, which was followed by severe acute hypertension (300/260 mmHg), due to inadequate ventilation after anesthesia. Acute hypertensive treatment was performed successfully by lowering blood pressure with chlorpromazine, 25 mg and valium, 10 mg by intravenous injection, with intermittent positive pressure breathing.
Anesthesia ; Blood Pressure ; Chlorpromazine ; Diazepam ; Humans ; Hypertension ; Injections, Intravenous ; Intermittent Positive-Pressure Breathing ; Postoperative Period* ; Ventilation

A case of Mendelson's syndrome during induction of anesthesia has been reported. The patient was treated with hydrocortisone IV, oxygen c IPPB, aminophylline and antibiotics. The patient recovered completely 3 days after aspiration. We must take the preventive measure for aspiration into the lung during anesthesia, especially obstetric patient.
Aminophylline ; Anesthesia* ; Anti-Bacterial Agents ; Humans ; Hydrocortisone ; Intermittent Positive-Pressure Breathing ; Lung ; Oxygen ; Pneumonia, Aspiration

Post-operative pulmonary complications have been discussed as to causes and preventive methods for a long time. One of these methods is intermittent positive pressure breathing(IPPB) which has been widely advocated, but there are many debates now. We studied the relationship of post-operative pulmonary complications with patient's age, general condition and operation site & duration of IPPB. The results were as follows: 1. The rate of IPPB was 8. 4% of general anesthetic patients. 2. The ratio of medical to surgical patients on in IPPB was 1: 10. 3. We had 13 post-op. pulm. complications with prophylactic IPPB and 4 cases without IPPB. 4. The incidence of post-operative, pulmonary complications increased with the patients age, operative time, number of class in physical status (by ASA) and increased particularly after upper abdominal surgery more than lower abdomen or other sites.
Abdomen ; Anesthesia, General* ; Humans ; Incidence ; Intermittent Positive-Pressure Breathing* ; Operative Time

BACKGROUND/AIMS: Immediate postpolypectomy bleeding (IPPB) increases the procedure time and it may disturb performing a safe polypectomy. The purpose of this study is to investigate whether clipping before snare polypectomy of large pedunculated polyps is useful for the prevention of IPPB. METHODS: This is a single arm, pilot study. We enrolled patients with pedunculated colorectal polyps that were 1 cm in size or more from 4 university hospitals between June 2009 and June 2010. Clips were applied at the stalk and snare polypectomy was then performed. The complications, including IPPB, were investigated. RESULTS: Fifty six pedunculated polyps in 47 patients (Male:Female=36:11; age, 56+/-11 years) were included. The size of the polyp heads was 17+/-8 mm. Tubular adenoma was most common (57%). The number of clips used before snare polypectomy was 2+/-0.5. The procedure was successful in all cases. IPPB occurred in 2 cases (3.6%), and both of these were managed by additional clipping. Delayed bleeding occurred in another one case (1.8%), which improved with conservative treatment. No perforation occurred. CONCLUSIONS: We suggest that clipping before snare polypectomy of pedunculated polyps may be an easy and effective technique for the prevention of IPPB, and this should be confirmed in large scale, prospective, controlled studies.
Adenoma ; Arm ; Head ; Hemorrhage ; Hospitals, University ; Humans ; Intermittent Positive-Pressure Breathing ; Pilot Projects ; Polyps ; SNARE Proteins

OBJECTIVETo evaluate the efficacy of targeted tidal volume ventilation in the treatment of severe neonatal respiratory distress syndrome (RDS).

METHODSEighty-four neonates with severe RDS between June 2008 and January 2010 were randomly assigned to 3 groups according to the ventilation mode: synchronized intermittent positive pressure ventilation plus volume guarantee (SIPPV+VG; n=31), high frequency oscillation ventilation (HFOV; n=23) and intermittent mandatory ventilation (IMV; n=30). The oxygenation status, the durations of oxygen exposure and ventilation and the incidence of complications were observed.

RESULTSThe oxygenation status (P/F and a/APO2) in the SIPPV+VG and the HFOV groups was improved significantly 12 hrs after ventilation (P<0.05). While in the IMV group, the oxygenation status was not improved until 24 hrs after ventilation. The durations of oxygen exposure and ventilation in the SIPPV+VG and the HFOV groups were shorter than in the IMV group (P<0.05). The incidences of air leak syndrome and ventilation-associated pneumonia (VAP) were lower in the SIPPV+VG and the HFOV groups than in the IMV group (P<0.05). The incidence of severe intracranial hemorrhage in the HFOV group was higher than in the other two groups (P<0.05).

CONCLUSIONSCompared with IMV, SIPPV+VG and HFOV can improve the oxygenation status more quickly, shorten the ventilation duration and decrease the incidences of air leak syndrome and VAP in neonates with severe RDS.

Chronic obstructive pulmonary diseases are being increased every year by many factors. But there are two important factors. First of all the atmospheric contamination is due to modern civilization, secondarily, the increase of old age population which is the result of prolonged life span by contribution of modern medicine. For these reasons increasing chronic obstructive pulmonary disease, anesthesiologists have had increased problems to administer anesthesia, because these patients are most difficult to manage for anesthesia. Author have studied for if it could be diminished these problems by comparing of the complications during period of anesthesia induction, maintenance, recovery and 5 postoperative days, with IPPB therapy and other physical therapy. The results of the study are as follows: 1) Pre and postoperative IPPB therapy is more useful to diminish anesthesia problems compared with other physical therapy. 2) Other physical therapy is useful when compared with controlled group. 3) IPPB therapy is the choice of treatment for postoperative atelectasis. Statistical significance was assessed by using student t test.
Anesthesia ; Civilization ; History, Modern 1601- ; Humans ; Intermittent Positive-Pressure Breathing* ; Lung Diseases, Obstructive ; Pulmonary Atelectasis ; Pulmonary Disease, Chronic Obstructive

The authors have experienced five cases of general anesthesia for repair of diaphragmatic hernia in children, and following results were obtained. Whether it was congenital or traumatic in origin, prompt reduction and repair is desirable if accurate diagnosis was made and patients condition was acceptable, for increased postoperative survival rate and prevention of possible complications. When the intermittent positive pressure breathing was needed during preoperative, intraoperative or postoperative period, the greatest concern of anesthetist is that excessive positive ventilation should be avoid. The most important factors in this situation probably are the use of chest drainage, daily Roentgen-ray examination, and better use of postoperative ventilatory assistance, for prevention of postoperative atelectasis and other pulmonary complications.
Anesthesia, General* ; Child* ; Diagnosis ; Drainage ; Hernia, Diaphragmatic* ; Humans ; Intermittent Positive-Pressure Breathing ; Postoperative Period ; Pulmonary Atelectasis ; Survival Rate ; Thorax ; Ventilation

Thirty six pediatric patients who were diagnosed as pulmonary atelectasis by chest radiography were managed with one of the following techniques for the treatment of atelectasis: 1) intermittent positive pressure breathing (IPPB) with extrathoracic chest percussion and vibration, 2) IPPB and intrapulmonary percussive ventilation (IPV) and 3) IPV only. Chest X-ray films and arterial pH, Pco, and Po, were obtained for all patients in the morning and the afternoon. And systolic and diastolic blood pressure and heart rate were measured at that time. Alveolar arterial oxygen tension difference was calculated from inspired oxygen fracton and arterial oxygen tension. The rate of treatment of atelectasis was significantly low in the patients with IPPB and chest physiotherpy. But the durations for the treatment were not significantly different among the three groups. There were no significant differences in blood pressures, heart rates and artrial blood gases between pre-treatment and post- treatment states in all groups.
Blood Pressure ; Critical Illness* ; Gases ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Intermittent Positive-Pressure Breathing ; Oxygen ; Percussion ; Pulmonary Atelectasis* ; Radiography ; Thorax ; Ventilation* ; Vibration ; X-Ray Film

BACKGROUND: Respiratory care for patients in intensive care units(ICUs) has been performed mainly by nurses in Korea. However, the current status of respiratory care i the Korea ICUs is not well known. Respiratory care and the methods of delivery in ICUs were surveyed. METHOD: A confidential questionnaire was distributed to the head nurses working the ICUs at 117 hospitals in Korea. One hundred hospitals returned the questionnaires, for a response rate of 85%. The hospitals were divided into three groups : Main university hospitals(MUH), university associated hospitals(UAH), and general hospitals(GH) RESULT: Eighteen units of 66 units in MUH and 35 units of 58 units in GH were organized as a general ICUs. The percentage of ICUs with full-time doctors was 47.1%. The nurses usually delivered respiratory care spending from 1 to 4 h during their 8 h of working time. Although the respondents felt that respiratory care should be delivered by trained respiratory therapists, these therapists were not found at the hospitals. Most of the units performed percussion, tracheal suctioning, and positional changes. However, vibration and IPPB were less frequently performed in GH. Among oxygen supply apparatus, venturi mask and T-piece were not frequently used in GH. GH applied a noninvasive ventilator mode less frequently than MUH and UAH. The percentage of Swan-Ganz catheter monitoring was only 21.4% in GH. CONCLUSION: Respiratory care for patients in the Korean ICUs was provided by nurses on the whole. In addition, there were many differences in the level of respiratory care according to the type of hospital. To overcome the current problems revealed, an effective in-hospital training program for the development of full-time respiratory care therapists should be established urgently in Korea.
Catheters ; Data Collection ; Education ; Humans ; Intensive Care Units* ; Intensive Care* ; Intermittent Positive-Pressure Breathing ; Korea ; Masks ; Nursing, Supervisory ; Oxygen ; Percussion ; Suction ; Ventilators, Mechanical ; Vibration