Ventilation impairment of residents around a cement plant.

OBJECTIVES: To identify adverse health effects due to air pollution derived from a cement plant in Korea. The ventilation impairment in residents around a cement plant was compared to another group through a pulmonary function test (PFT). METHODS: From June to August of 2013, both a pre and post-bronchodilator PFT was conducted on a "more exposed group (MEG)" which consisted of 318 people who lived within a 1 km radius of a cement plant and a "less exposed group (LEG)" which consisted of 129 people who lived more than 5 km away from the same plant. The largest forced expiratory volume in a one second (FEV1) reading and a functional residual capacity (FVC) reading were recorded after examining the data from all of the usable curves that were agreed upon as valid by PFT experts of committee of National Institute of Environmental Research. The global initiative for chronic obstructive lung disease (GOLD) criteria for COPD, defined the FEV1/FVC ratio < 0.7 as the obstructive type, and the FEV1/FVC ratio ≧ 0.7 and FVC% predicted < 80% were as the restrictive type. The FVC% predicted value was estimated using Korean equation. We compared the proportion of lung function impairments between the MEG and the LEG by using a chi-square, and estimated the OR of obstructive and restrictive ventilation impairments by logistic regression. RESULTS: The obstructive type impairment proportion was 9.7% in the MEG, whereas it was 8.5% in the LEG. The restrictive type was 21.6% in the MEG which was more than the 12.4% of the LEG. The odds ratio (OR) of total ventilation impairment in the MEG was 2.63 (95% CI 1.50 ~ 4.61) compared to the LEG. The OR of obstructive type in the MEG was 1.60 (95% CI 0.70 ~ 3.65), the smoking history was 3.10 (CI 1.10 ~ 8.66) whereas OR of restrictive type in the MEG was 2.55 (95% CI 1.37 ~ 4.76), the smoking history was 0.75 (95% CI 0.35 ~ 1.60) after adjusting for sex and age. Level of exposure to particulate played a role in both types. However, it appeared to be a significant variable in restrictive type, while smoking history was also an important variable in obstructive type. CONCLUSION: Although this study is a limited cross-section study with a small number of subjects, ventilation impairment rate is higher in the MEG. There might be a possibility that it is due to long-term exposure to particulate dust generated by the cement plant.

Ventilation impairment of residents around a cement plant

OBJECTIVES: To identify adverse health effects due to air pollution derived from a cement plant in Korea. The ventilation impairment in residents around a cement plant was compared to another group through a pulmonary function test (PFT). METHODS: From June to August of 2013, both a pre and post-bronchodilator PFT was conducted on a "more exposed group (MEG)" which consisted of 318 people who lived within a 1 km radius of a cement plant and a "less exposed group (LEG)" which consisted of 129 people who lived more than 5 km away from the same plant. The largest forced expiratory volume in a one second (FEV1) reading and a functional residual capacity (FVC) reading were recorded after examining the data from all of the usable curves that were agreed upon as valid by PFT experts of committee of National Institute of Environmental Research. The global initiative for chronic obstructive lung disease (GOLD) criteria for COPD, defined the FEV1/FVC ratio == 0.7 and FVC% predicted < 80% were as the restrictive type. The FVC% predicted value was estimated using Korean equation. We compared the proportion of lung function impairments between the MEG and the LEG by using a chi-square, and estimated the OR of obstructive and restrictive ventilation impairments by logistic regression. RESULTS: The obstructive type impairment proportion was 9.7% in the MEG, whereas it was 8.5% in the LEG. The restrictive type was 21.6% in the MEG which was more than the 12.4% of the LEG. The odds ratio (OR) of total ventilation impairment in the MEG was 2.63 (95% CI 1.50 ~ 4.61) compared to the LEG. The OR of obstructive type in the MEG was 1.60 (95% CI 0.70 ~ 3.65), the smoking history was 3.10 (CI 1.10 ~ 8.66) whereas OR of restrictive type in the MEG was 2.55 (95% CI 1.37 ~ 4.76), the smoking history was 0.75 (95% CI 0.35 ~ 1.60) after adjusting for sex and age. Level of exposure to particulate played a role in both types. However, it appeared to be a significant variable in restrictive type, while smoking history was also an important variable in obstructive type. CONCLUSION: Although this study is a limited cross-section study with a small number of subjects, ventilation impairment rate is higher in the MEG. There might be a possibility that it is due to long-term exposure to particulate dust generated by the cement plant.

Ventilation impairment caused by upside-down connected unidirectional valves: A case report / 대한마취과학회지

We experienced a case of ventilation impairment resulted by the wrong-assembled unidirectional valves passed the automatic checkout of ventilator during general anesthesia. A 63-year-old man was scheduled for Ivor-Lewis operation due to esophageal cancer. After endotracheal intubation, ventilation impairment and abdominal distension were developed. No abnormal finding was found with bronchofiberoscopic examination. Suspecting anesthetic equipment failure, unidirectional valves were separated and they were proved to be connected upside-down.

Ventilation Impairment During Anesthesia in Patients with Anterior Mediastinal Mass / 영남의대학술지

Because of location, a mediastinal mass may cause complications such as a major airway obstruction, a superior vena caval obstruction, and cardiac compression during general anesthesia. The patient's condition need to be assessed by several methods to predict the risks associated with general anesthesia. The authors took computed tomographs for a preoperative evaluation of two patients with an anterior mediastinal mass, and the risk of perioperative complications was predicted by measuring the tracheal area. The patients were managed according to the preoperative evaluation but severe ventilation impairments were encountered during anesthesia. In one patient, stable ventilation could not be maintained until spontaneous breathing appeared. The operation was cancelled and the patient was brought into the ICU. In the other patient, a tracheal tube was inserted deeper in an attempt to pass the narrowed tracheal portion due to mediastinal tumor compression resulting in improved ventilation

Ventilation Impairment due to Obstruction of a Bifurcated Connector: A case report / 대한마취과학회지

Ventilation impairment sometimes developes in patients with a double-lumen tube (DLT) during thoracic anesthesia. A 27-year old man who suffered from a left pneumothorax showed ventilation impairment with right lung obstruction after the induction of anesthesia. We checked breathing sounds before and after clamping each lumen. Correct positioning was confirmed by direct visualization using a flexible fiberoptic bronchoscope and by chest X-ray. The DLT was removed and replaced by a single lumen endotracheal tube because of severe ventilation impairment. On careful examination of the DLT, manufacturing defects in a bifurcated connector were noted, and its openings were occluded with a thin plastic membrane. After replacing the DLT, the ventilation impairment was improved. It is important to test DLT prior to use, and to maintain an awareness that airway obstruction can occur due to structural defects.