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Airway Partial Obstruction by Internal Hermiation of Armored Endotracheal Tube: A case report
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Mijeung Gwak, Hyun Sook Hwang, Eun Ha Suk, Pyung Hwan Park
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Korean J Crit Care Med. 2002;17(1):29-33.
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 Abstract
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- During general anesthesia, intubation with kink-resistant armored tubes permit the anesthesiologist to work some distance from the surgical field during operation on the head and neck or with patients whose unusual position may kink and obstruct a tube not so reinforced. But armored tubes are still subject to number of hazards, including herniation of the intra-luminal cuff or layer into the lumen of the tube. So extra care is required in their use. We report a case of intraluminal herniation of armored tube accompanied with peak inspiratory pressure during general anesthesia.
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The Distribution of Medical Personnel and Medical Equipments in the Intensive Care Units in Korea
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Shin Ok Koh, Pyung Hwan Park, Myoung Hoon Kong, Yong Lak Kim
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Korean J Crit Care Med. 2001;16(2):138-143.
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Abstract
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- BACKGROUND
Not much of the fund is invested in the intensive care unit (ICU) in Korean hospitals since the cost of ICU care is set too low compared to the other medical fields as well as to the other part of the world. This study is designed to support the base of an ICU standard guideline in Korea.
METHODS
The questionnaire were sent to 73 ICUs and 24 neonatal ICUs (NICU) of 30 hospitals. Twenty-two of them were teaching hospitals and 8 of them were general hospitals.
RESULTS
The ratios of ICU bed number to total bed number were 5.0% and 6.0% in teaching hospital and general hospital respectively. The ratios of NICU bed to total bed were 3.4% and 2.0% in teaching hospital and general hospital respectively. Intensivists were kept in 24.6% of ICU and 36.4% of NICU. Residents were kept in 43.1% of ICU and 45.5% of NICU. The utilization of ICU service was 90% for teaching hospital and 86% for general hospital. The utilization of NICU was 89% for teaching hospital and 3% of general hospital. Nurse to patient ratios varied widely. Most ICUs in teaching hospital showed the nurse to patients ratio of 1 : 4 which was about 32% of total ICU. Most NICUs in teaching hospital showed the nurse to patients ratio of 1 : 5 which was around 20% of total NICU. Most of the ICUs were equipped with central piping system for oxygen and compressed air supply, vacuum system and all the necessary medical gadgets such as mechanical ventilators, ECG monitors, defibrillators, pulse oximeters and infusion pumps.
CONCLUSIONS
The distribution of medical personnel as well as medical equipments were varied widely. The variation existed between teaching hospital and general hospital as well as within the teaching hospitals. We need to establish a standard, which grades the level of ICU according to the number of keeping physician, nurse-patients ratio, and the types of medical equipments they have.
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Effects of Mg2+ Intravenous Pretreatment on Brain Energy Metabolism in Acute Ischemic-Reperfusion Model in Cats: 31P and 1H Magnetic Resonance Spectroscopic Study
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Eun Ha Suk, Ji Young Kang, Sung Kwan Chun, Pyung Hwan Park, Kun Ho Lim, Jung Hee Lee, Tae Hwan Lim
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Korean J Crit Care Med. 1999;14(2):132-136.
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Abstract
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- BACKGOUND: This study was purposed to evaluate the effects of Mg2+ pretreatment on cerebral ischemic injury in cats.
METHODS
Global cerebral ischemia was induced by ligation of both innominate arteries following ligation of inferior vena cava under lowered mean blood pressure for 20 minutes followed by 3 hrs of reperfusion. Ten cats were divided into 2 groups: Group 1 (n=5) is the control group, for group 2 (n=5) (Mg2+ group), the animals were pretreated with 90 mg/kg of Mg2+ intravenously before subjected to ischemia.
RESULTS
Phosphocreatine/inorganic phosphate (Pcr/Pi) and pH decreased after ischemia and did not recovered during reperfusion. And there were no significant differences between the two groups. The ratios of lactate/N-acetyl aspartate (Lac/NAA) and lactate/creatine (Lac/Cr) increased after ischemia and not recovered during reperfusion. But the ratios were higher for the group 2 than the group 1 during reperfusion (p<0.05). For the Mg2+ group, blood pressure during reperfusion was lower than the control group.
CONCLUSIONS
Mg2+ intravenous pretreatment had no protective effect on this global cerebral ischemia animal model. Even it deteriorated brain energy metabolism by lowering blood pressure.
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Number of Beds and Types of Intensive Care Unit (ICU) in University and Non-University Hospitals in Korea
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Shin Ok Koh, Pyung Hwan Park, Myoung Hoon Kong, Chang Young Jeung, Woong Mo Lim, Yong Lak Kim
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Korean J Crit Care Med. 1998;13(2):212-217.
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Abstract
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- BACKGOUND: The number of ICU beds related to the number of general acute care beds provides a broad measure of intensive care, but it has obvious limitations and underestimates extreme regional differences. As a first step, we evaluated the number of ICU beds or the ratio of ICU beds to hospital beds in university and non-university hospitals in Korea.
METHODS
The number of ICU beds and hospital beds, the ratio of the number of ICU beds to hospital beds, and the types of ICU in each range of ICU beds and hospital beds in the university and non-university hospital were analyzed as well.
RESULTS
Thirty university hospitals had 1,824 ICU beds out of 25,966 hospital beds, an average of 7.0%. The number of ICU beds ranged from 17 to 159 beds and hospital beds ranged from 400 to 2,000 beds in university hospitals. Fourteen non-university hospitals had 377 ICU beds out of 6,121 hospital beds, an average of 6.2%. In non-university hospitals, the number of ICU beds ranged from 6 to 67 beds with 50 to 700 hospital beds. If there was only one ICU, e.g. multidisciplinary, or more than one, the director of a multidisciplinary and surgical ICU was usually filled by an anesthesiologist, while the directors of other ICUs were usually specialists according to each specific ICU.
CONCLUSIONS
There was a large disparity in the number of ICU beds and in the ratio of ICU beds to hospital beds between university and non-university hosptials, and even between university hospitals.
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The Effect of Brain Hypothermia on Brain Edema Formation after Transient Ischemia
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Seung Sig Kang, Kyu Taek Choi, Chung Gill Leem, In Hea Cho, Sung Lyang Chung, Pyung Hwan Park
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Korean J Crit Care Med. 1998;13(1):43-48.
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Abstract
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- BACKGOUND: When ischemia reduces blood supply, hypothermia remains the sine qua non for reducing demand. An alternative to whole body deep hypothermia is an isolated cerebral hypothermia via perfusion of cooled blood through one internal carotid artery. The goal of this study was to evaluate the effect of isolated cold hemisphere perfusion during the cerebral ischemia on the formation of brain edema.
METHODS
The studies were designed to perfuse a saline solution into both carotid arteries with a different temperature (left 15degreesC, right 38degreesC) in the same animal. Cerebral ischemia was produced by a combination of the both carotid artery saline perfusion and systemic hypotension to a mean arterial blood pressure of 40 mmHg for 10 minutes. Ninety minutes after reperfusion, brain water contents were measured using the kerosene/bromobenzene density gradient and compared with warm saline perfusion and normal control group.
RESULTS
Brain water content of cold saline perfusion hemisphere measured at 90 minutes after ischemia showed decreased water content compared to warm saline perfusion hemisphere (p<0.05).
CONCLUSIONS
Cerebral cold saline perfusion during the ischemia decreased the formation of brain edema. These results showed hypothemia is one of the most effective ways to protect brain from the ischemia.
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Respiratory Dynamics in Acute Respiratory Distress Syndrome
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Pyung Hwan Park
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Korean J Crit Care Med. 1997;12(2):121-124.
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Abstract
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- No abstract available.
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