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Development and Experimental Evaluation of Respiratory Assist Device by Use of Right Thoracic Negative Pressure Ventilation
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Joong Hwan Oh, Sang Hun Lee, Hyun Kyo Lim, Young Hee Lee, Sung Hoon Kim
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Korean J Crit Care Med. 2005;20(2):165-169.
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 Abstract
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- BACKGROUND
A diaphragm pacing with electrical stimulation is a new respiratory assist device which has advantages over mechanical ventilation. Unilateral phrenic nerve stimulation makes uneven distribution of intrathoracic negative pressure and most likely relates to paradoxical motion of the diaphragm. Our purpose is to investigate a respiratory effect of right phrenic nerve pacing after thoracotomy compared with bilateral pacing. METHODS: Five dogs were examined under the general anesthesia. Right 5th intercostal space was opened. Two pacing leads were placed around the phrenic nerve and connected to the stimulator. Chest wall was closed after chest tube insertion. Ventilator was off without self respiration. Swan-Ganz catheter was introduced to the pulmonary artery, cardiac output, central venous pressure (CVP), pulmonary capillary wedge pressure (PCWP).
Arterial blood gases (PO2 & PCO2), end-tidal PCO2 (PETCO2) and tidal volume were measured with nerve stimulation. Left phrenic nerve was managed as the same manner. RESULTS: Right phrenic nerve pacing resulted in a tidal volume of 186+/-5 ml, PETCO2 of 55.0+/-2.3 mmHg, Arterial PO2 of 115+/-12 mmHg, PCO2 of 59+/-4 mmHg, Cardiac output of 2.3+/-0.5 L/min, CVP of 12.0+/-2.3 mmHg, PCWP of 14.2+/-2.5 mmHg.
Bilateral phrenic nerve pacing resulted in a tidal volume of 418+/-3 ml, PETCO2 of 47.0+/-2.7 mmHg, PO2 of 289+/-10 mmHg, PCO2 of 42+/-3 mmHg, Cardiac output of 3.1+/-0.4 L/min, CVP of 10.2+/-2.5 mmHg, PCWP of 14.5+/-2.7 mmHg. Right phrenic nerve pacing showed significantly lower tidal volume, PO2 and higher PETCO2 and arterial blood PCO2 (p<0.05).
CONCLUSIONS
Right phrenic nerve pacing plays a role to develop respiratory assist. However the effect is less than the bilateral pacing.
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Hemodynamic Effect of Pulmonary Artery Ligation during Pneumonectomy
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Kwang Ho Lee, Hyun Kyo Lim, Eun Sung Jun, Young Bok Lee, Kyung Bong Yoon, Jae Chan Choi, Soon Yul Kim, Ryung Choi
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Korean J Crit Care Med. 2000;15(2):88-92.
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Abstract
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- BACKGROUND
Pulmonary artery ligation during pneumonectomy increase the pulmonary blood flow of dependent lung and may increase the pulmonary arterial pressure and pulmonary vascular resistance. The purpose of this study is to evaluate the hemodynamic effect of pulmonary artery ligation during pneumonectomy.
METHODS
Nine patients who were supposed to receive pneumonectomy were studied. Hemodynamic measurements were performed following two lung ventilation (TLV), one lung ventilation (OLV), after pulmonary artery ligation and after pneumonectomy.
RESULTS
There is no significant differences in heart rate, systemic arterial pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, cardiac index and pulmonary vascular resistance index. Arterial oxygen tension significantly reduced during OLV and increased after pulmonary artery ligation and after pneumonectomy.
CONCLUSIONS
These results suggest that pulmonary artery ligation during pneumonectomy may not affect the cardiopulmonary hemodynamics.
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Delayed Development of Pulmonary Embolism after Total Hip Replacement: A case report
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Hyun Kyo Lim, Young Bok Lee, Kwang Ho Lee, Chun Gyung Kim, Kyoung Min Lee, Chong Kweon Chung
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Korean J Crit Care Med. 1998;13(2):239-242.
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Abstract
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- Though anticoagulant therapy has been shown to improve outcomes dramatically, pulmonary embolism is a potentially fatal disease. A 82 years old female underwent elective operation for left femur neck fracture under general anesthesia. At the twenty-two postoperative days, she suddenly developed cyanosis with hypotension. She was transferred to intensive care unit and pulmonary embolism was diagnosed by pulmonary perfusion scan and echocardiography. Despite of diagnosis and treatment of pulmonaly embolism, she expired 29 hours after onset of symptom.
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