PURPOSE: The purpose of this study was to examine the effects of breathing exercises performed using panflutes in elderly patients undergoing spinal surgery. METHODS: The study design was a nonequivalent control group non-synchronized pre-post test. The study included 24 patients in both the experimental group and the control group. The experimental group completed a daily breathing exercise regimen using panflutes for 30minutes after meals, whereas the control group was provided standard preoperative education, including breathing exercises using incentive spirometers. After the exercise regimen, breathing exercise compliance, pulmonary infections, and life satisfaction were measured in both groups, and the data were analyzed using the SPSS/WIN program. RESULTS: The compliance rate of breathing exercises was significantly higher in the experimental group. The experimental group presented no pulmonary infections in the later period, whereas the control group presented higher pulmonary infection rates in the same period. In addition, the life satisfaction score in the experimental group significantly increased. CONCLUSION: The breathing exercise program using panflutes for elderly patients undergoing spinal surgery enhanced their breathing exercise compliance and their daily life satisfaction in addition to reducing their pulmonary infection rates.
Aged* ; Breathing Exercises ; Compliance* ; Education ; Evaluation Studies as Topic ; Humans ; Meals ; Motivation ; Patient Compliance ; Personal Satisfaction ; Postoperative Complications ; Respiration* ; Work of Breathing

No abstract available.
Positive-Pressure Respiration, Intrinsic ; Airway Resistance ; Bronchitis, Chronic ; Lung Compliance ; Vena Cava, Inferior ; Work of Breathing ; Heart Ventricles ; Blood Pressure ; Pulmonary Disease, Chronic Obstructive ; Lung ; Respiratory Muscles ; Pulmonary Emphysema ; Emphysema ; Pneumonia ; Cardiac Output ; Lung Transplantation ; Intensive Care Units ; Positive-Pressure Respiration ; Barotrauma ; Hypotension ; Korea

No abstract available.
Positive-Pressure Respiration, Intrinsic ; Airway Resistance ; Bronchitis, Chronic ; Lung Compliance ; Vena Cava, Inferior ; Work of Breathing ; Heart Ventricles ; Blood Pressure ; Pulmonary Disease, Chronic Obstructive ; Lung ; Respiratory Muscles ; Pulmonary Emphysema ; Emphysema ; Pneumonia ; Cardiac Output ; Lung Transplantation ; Intensive Care Units ; Positive-Pressure Respiration ; Barotrauma ; Hypotension ; Korea

Kyphosis is a deformity characterized by anterior flexion of the vertebral column. When severe, kyphosis may decrease lung volume and compliance, leading to increased work of breathing and deterioration of pulmonary function. Moreover, postoperative respiratory failure is a common problem for patients with severe spinal deformities. We describe the successful case of general anaesthesia in a 71-year-old male patient with severe thoracolumbar kyphosis undergoing open surgery converted from robotic surgery.
Aged ; Compliance ; Congenital Abnormalities ; Humans ; Kyphosis ; Lung ; Male ; Respiratory Insufficiency ; Robotics ; Spine ; Work of Breathing

BACKGROUND: The use of positive end expiratory pressure (PEEP) in patients with acute lung injury (ALI) improves arterial oxygenation by alleviating pulmonary shunting, helping the respiratory muscles to decrease the work of breathing, decreasing the rate of infiltrated and atelectatic tissues, and increasing functional residual capacity. In a rabbit model of saline lavage-induced ALI, we examined the effects of PEEP on gas exchange, hemodynamics, and oxygenation during high frequency jet ventilation (HFJV), and then compared these parameters with those during conventional mechanical ventilation (CMV). METHODS: Twelve rabbits underwent repeated saline lavage to create ALI. The animals were divided in 2 groups: 1) Group CMV (n = 6), and 2) Group HFJV (n = 6). In both groups, we applied 2 levels of PEEP (5 cmH2O and 10 cmH2O) and then measured the arterial blood gas, mixed venous blood gas, and hemodynamic parameters. RESULTS: With administration of PEEP of either 5 cmH2O or 10 cmH2O, the arterial oxygen content of both groups was increased, although without statistically significant differences between groups. On the contrary, the arterial carbon dioxide content was significantly decreased in the HFJV group, as compared with the CMV group, during the entire experiment. Furthermore, there was significant decreases in mean arterial pressures in both groups with a PEEP of 10 cmH2O. CONCLUSIONS: The application of PEEP in rabbits with ALI effectively improves oxygenation in either HFJV or CMV.
Acute Lung Injury ; Animals ; Arterial Pressure ; Carbon Dioxide ; Functional Residual Capacity ; Hemodynamics ; High-Frequency Jet Ventilation ; Humans ; Oxygen ; Positive-Pressure Respiration ; Rabbits ; Respiration, Artificial ; Respiratory Muscles ; Therapeutic Irrigation ; Work of Breathing

Patients with chronic obstructive pulmonary disease (COPD) frequently complain of dyspnea on exertion and reduced exercise capacity, which has been attributed to an increase in the work of breathing and in impaired of gas exchange. Although COPD primarily affects the pulmonary system, patients with COPD exhibit significant systemic manifestations of disease progression. These manifestations include weight loss, nutritional abnormalities, skeletal muscle dysfunction (SMD), cardiovascular problems, and psychosocial complications. It has been documented that SMD significantly contributes to a reduced exercise capacity in patients with COPD. Ventilatory and limb muscle in these patients show structural and functional alteration, which are influenced by several factors, including physical inactivity, hypoxia, smoking, aging, corticosteroid, malnutrition, systemic inflammation, oxidative stress, apoptosis, and ubiquitin-proteasome pathway activation. This article summarizes briefly the evidence and the clinical consequences of SMD in patients with COPD. In addition, it reviews contributing factors and therapeutic strategies.
Aging ; Anoxia ; Apoptosis ; Disease Progression ; Dyspnea ; Exercise Tolerance ; Extremities ; Humans ; Inflammation ; Malnutrition ; Muscle, Skeletal ; Muscles ; Oxidative Stress ; Pulmonary Disease, Chronic Obstructive ; Smoke ; Smoking ; Weight Loss ; Work of Breathing

In order to improve synchrony between a ventilator and its patient, a new method for triggering a ventilator based on diaphragmatic electromyogram (EMG) is introduced. The methods to extract and process diaphragmatic EMG signals are studied. It has been shown that the characteristic parameters of a respiration activity, such as inspiratory beginning point, expiratory beginning point and respiration period, can be detected from diaphragmatic EMG envelop instead of traditional flux curve. A new parameter, designated as diaphragmatic "Intensity of EMG" for short "IEMG", is defined. Repeat respiration tests have disclosed that there is relatively high correlation between the diaphragmatic IEMG curve and its corresponding cubage curve. These results primarily demonstrate that the new synchronization method may be feasible.
Diaphragm ; physiology ; Electromyography ; Humans ; Positive-Pressure Respiration ; methods ; Respiration ; Respiration, Artificial ; methods ; Respiratory Insufficiency ; therapy ; Respiratory Muscles ; physiology ; Work of Breathing ; physiology

Kyphoscoliosis is a deformity of the costovertebral skeletal structures characterized by an anterior flexion (kyphosis) and lateral curvature (scoliosis) of the patient's vertebral column.(1)) In kyphoscoliosis, lung volume and compliance is reduced due to the change of vertebral column. The work of breathing is increased by abnormal mechanism of the thorax and by increased airway resistance resulting from small lung volume. Airway management and respiratory problems are common and spinal deformities can cause difficulties with regional anesthesia. We had experienced a successful spinal anesthesia for closed reduction and internal fixation (CRIF) and proximal femoral nail (PFN) of fractured intertrochanteric femur in a patient with extremely severe thoracolumbar kyphoscoliosis.
Airway Management ; Airway Resistance ; Anesthesia ; Anesthesia, Conduction ; Anesthesia, Spinal ; Compliance ; Congenital Abnormalities ; Femur ; Humans ; Kyphosis ; Lung ; Nails ; Scoliosis ; Spine ; Thorax ; Work of Breathing

A mechanical ventilation trigger way is set forth and a technical analysis on the pressure trigger way and flow trigger way is made in this paper. And it is pointed out that the PEEPi's influence on the human organism is the reason for the latter two kinds of trigger ways' notable differences in the measured values of the inspiration time and breath work.
Humans ; Positive-Pressure Respiration ; Respiration, Artificial ; methods ; Work of Breathing

OBJECTIVETo investigate the effect of non-invasive positive pressure ventilation (NIPPV) on the work of breathing (WOB) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).

METHODSEleven patients with acute exacerbation of COPD received pressure support ventilation (PSV) at different levels during NIPPV. The changes of inspiratory muscle effort and breathing pattern of the patients were observed.

RESULTSThe average minute ventilation (VE, P<0.01) and tidal volume (VT, P<0.05) of the patients were significantly higher during routine PSV and high pressure support (H-PS) than those during spontaneous breathing (SB), and the breathing pattern of the patients did not undergo significant changes during high positive end expiratory pressure (H-PEEP). The WOB of the inspiratory muscles was reduced significantly during PSV as compared with that measured in SB (P<0.01), while the WOB of exspiratory muscle increased significantly (P<0.01).

CONCLUSIONNIPPV can relieve the load of the inspiratory muscles in patients with acute exacerbation of COPD, and the WOB of the inspiratory muscles can be reduced by PSV, H-PEEP and H-PS (by 75%, 71% and 76%, respectively), but higher PSV during NIPPV can cause higher WOB of the exspiratory muscles.

Aged ; Exhalation ; physiology ; Humans ; Inhalation ; physiology ; Male ; Middle Aged ; Pressure ; Pulmonary Disease, Chronic Obstructive ; pathology ; physiopathology ; therapy ; Pulmonary Ventilation ; Work of Breathing ; physiology