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진재용 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4
Acute respiratory distress syndrome(ARDS) is characterized by refractory hypoxemia due to intrapulmonary shunt. It's main pathologic feature is collapses of gas-exchange units. Mechanical ventilation with positive end-expiratory pressure has long been the most important mode of treatment of this syndrome, for which no specific treatment was proved effective. Recently, with the acknowledgement that mechanical ventilation itself can induce lung injury, the principle of ventilatory treatment of this syndrome has changed widely, which can be expressed as lung-protective strategy. The lung-protective strategy consists of two components. One is low tidal volume ventilation which is required to avoid end-inspiratory over-distension of relatively normal gas-exchange units, and the other is to address relatively high level of positive end-expiratory pressure(PEEP) (open-lung approach) which is thought to be required to prevent cyclic collapse and opening that can lead to capillary or alveolar epithelial disruptions. A decremental PEEP trial on deflation curve can give the information on optimal PEEP level for open lung state(open lung PEEP). Best oxygenation is likely to predict open-lung PEEP during a decremental PEEP trial. The determinants for oxygenation during mechanical ventilation include FiO2, PEEP level and mean airway pressure, so respiratory rate or inspiratory time can also influence oxygenation. In some patients the liberations from mechanical ventilation are tedious and pressure support mode is particularly beneficial in these patients.
Auto-PEEP이 존재하는 환자에서 호흡 일에 대한 External PEEP의 효과
진재용 ( Jae Yong Chin ),임채만 ( Chae Man Lim ),고윤석 ( Youn Suck Koh ),박평환 ( Ryung Whan Park ),최종무 ( Jong Moo Choi ),이상도 ( Sang Do Lee ),김우성 ( Woo Sung Kim ),김동순 ( Dong Soon Kim ),김원동 ( Won Dong Kim ) 대한결핵 및 호흡기학회 1996 Tuberculosis and Respiratory Diseases Vol.43 No.2
타카야수동맥염에 의한 만성 폐고혈압에서 Nitric Oxide가스와 Molsidomine의 치험 3예
진재용 ( Jin Jae Yong ),이성순 ( Lee Seong Sun ),이상수 ( Lee Sang Su ),심태선 ( Sim Tae Seon ),임채만 ( Im Chae Man ),고윤석 ( Go Yun Seog ),김우성 ( Kim U Seong ),김동순 ( Kim Dong Sun ),김원동 ( Kim Won Dong ),이상도 ( Lee Sang 대한결핵 및 호흡기학회 2000 Tuberculosis and Respiratory Diseases Vol.48 No.6