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심윤수,( So Young Park ),( Kwang Ha Yoo ),( Yong Bum Park ),( Jinkyeong Park ),( Hye Yun Park ),( Yong Il Hwang ),( Dong Ah Park ) 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.-
Backgrounds: Although noninvasive positive pressure ventilation (NIPPV) treatment for acute respiratory failure improves the outcome in COPD patients the results of studies in which COPD chronic respiratory distress was treated with NIPPV vary widely. We aimed to evaluate the long-term effect of domiciliary NIPPV. Methods: We performed an extensive search of the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases to identify randomized controlled trials (RCTs) pertaining to the long-term treatment of COPD with NIPPV ventilation over a period of more than 1 year. Results: The eight trials included in this study comprised data from 913 patients. The mortality rates for the NIPPV and control groups, were 29% (118/414) and 36% (151/419). This difference was statistically significant (RR, 0.79; 95% CI, 0.65-0.95, p = 0.01). The mortality rates in the four trials that included stable COPD patients were reduced on application of NIPPV (RR 0.71, 95% CI 0.56-0.91, p = 0.006). In a further subgroup analysis, mortality was reduced when the mean baseline PaCO2 level was high (RR 0.71, 95% CI 0.55-0.93, p = 0.01). The results of the subgroup analysis according to the mean IPAP level showed that the mortality rates in the NIPPV group in three trials were reduced (RR 0.72, 95% CI 0.54-0.96, p = 0.03). There was no difference in QOL between NIPPV and control groups (SMD -0.037, 95% CI -0.34-0.29, p = 0.85). There was no significant difference in the dropout rate between the two groups. (RR 0.99, 95% CI 0.72-1.36, p = 0.94). Conclusion: Domiciliary NIPPV should be considered in COPD patients especially when used in patients with a stable status and relatively higher PaCO2 level, and among those with a higher IPAP level.
이재범 ( Jae Beom Lee ),심윤수 ( Yun Su Sim ),노영욱 ( Young Wook Noh ),박혜성 ( Hye Sung Park ),태정현 ( Chung Hyun Tae ),임소연 ( So Yeon Lim ),전윤희 ( Yoon Hee Jun ),류연주 ( Yon Ju Ryu ),천은미 ( Eun Mi Chun ),이진화 ( Jin Hw 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.1
Antiphospholipid syndrome (APS) causes recurrent thromboses and morbidity during pregnancy, including fetal loss. This malady is associated with the persistent presence of anticardiolipin antibody or lupus anticoagulant. The pulmonary manifestations of antiphospholipid syndrome include pulmonary thromboembolism, pulmonary hypertension, acute respiratory distress syndrome, etc. Pulmonary thromboembolism is often the initial manifestation of antiphospholipid syndrome and a timely diagnosis is critical due to the high mortality rate. We herein report on a 19-year-old man with pulmonary thromboembolism that was caused by primary antiphospholipid syndrome. He presented with blood-tinged sputum, fever and epigastric pain, and his chest computerized tomography showed pulmonary thromboembolism. The other possible causes of pulmonary thromboembolism were excluded and the diagnosis of primary antiphospholipid syndrome was confirmed by the lupus anticoagulant that was present on two occasions six weeks apart. We also discuss the nature and management of antiphospholipid syndrome, along with a brief review of the relevant literatures. (Tuberc Respir Dis 2007; 63: 72-77)