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누두흉 환자에서 Nuss 금속막대 제거 전 · 후 폐 역학 변화
강규식,백남순,김천숙,안기량,권진형,김지은,유시현 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1
Nuss operation is one of the surgical procedure for pectus excavatum and it's method is the insertion of convex steel bar under the sternum through small bilateral thoracic incision. As the patients is growing, the thorax can be compressed gradually by steel bar. So Nuss bar needs to be removed two years after Nuss operation. This study was undertaken to assess the effect on the repiratory mechanics before and after the removal of the Nuss bar. Twenty patients with previous Nuss operation were allocated for the removal of Nuss bar. Lung mechanics (dynamic lung compliance, static lung compliance, and airway resistance), hemodynamic change (heart rate, systolic pressure, and diastolic pressure), and pulmonary gas exchange (arterial oxygen tension, arterial carbon dioxide tension, pulse oximeter saturation, and end tidal carbon dioxide tension) were measured before and after removal of Nuss bar. Respiratory mechanics (dynamic and static lung compliance, inspiratory airway resistance), pulmonary gas exchange and hemodynamic parameter were unchanged before and after the removal of Nuss bar. We concluded that lung mechanics were not changed before and after the removal of Nuss bar in the patients with pectus excavatum and the 95% patients were satisfied with operation.
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누두흉환자에서 Nuss 방법에 의한 수술 중 환기방법에 따른 호기 일회호흡량, 흡기 최대압력 및 활력징후의 변화
조수현,이선학,안기량,박욱,박형주,곽수달,백남순,김천숙 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.2
Changes of Vital Signs, Expired Volume and Maximal Pressure by Mode of Ventilation during a Nuss Operation in Patients with Pectus Excavatum Soo Dal Kwak, M.D., Nam Soon Baek, M.D., Su Hyun Cho, M.D. Ki Ryang Ahn, M.D., Sun Hak Lee, M.D., Chun Suk Kim, M.D. Wook Park, M.D., and Hyung Joo Park, M.D. Departments of Anesthesiology, ??Chest Surgery, College of Medicine, Soonchunhyang University, Cheonan, Korea Background: This study was undertaken in order to investigate any cardiopulmonary changes caused by the surgical procedure during a Nuss operation in patients with pectus excavatum. Methods: Thirty patients undergoing the Nuss operation were divided into two groups. The patients were randomly assigned to either Group-V (n = 15) which volume controlled ventilation was applied, or to Group-p (n = 15) where pressure controlled ventilation was applied. Mechanical ventilation provided a tidal volume to be set at approximately 10 ml/kg and a frequency set to keep ETCO_2 in range, between 32 mmHg and 38 mmHg. During the surgical procedure, we recorded expired volume (V_E) and inspired maximal pressure (Pmax) changes according to the ventilator mode, and then also recorded changes in vital signs. Results: Heart rate and blood pressure had no significant changes in either groups. In Group-V, during rotation of the metal bar, there was a significant decrease in expired volume (P < 0.001), changes of inspired maximal pressure gradually increased with the operation (P < 0.001). In Group-P, rotation of the metal bar caused a significant decrease in expired volume (P < 0.001). Conclusions: During the Nuss operation, there should be careful observation of changes in the vital signs, expired volume and maximal pressure during insertion and rotation of the metal bar. (Korean J Anesthesiol 2001; 41: 178~183)
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