• Title/Summary/Keyword: 심폐기

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Establishment of Featal Heart Surgery with an Improvement of the Placental Blood Flow in Cardiopulmonary Bypass Using Fetal Lamb Model (양태아를 이용한 심폐우회술에서의 태반혈류개선을 통한 태아심장수술의 기반기술 확립)

  • 이정렬;박천수;임홍국;배은정;안규리
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.11-18
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    • 2004
  • Background: We tested the effect of indomethacine and total spinal anesthesia on the improvement of placental flow during cardiopulmonary bypass on fetal lamb. Material and Method: Twenty fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Ten served as a control group in which placenta was worked as an oxygenator during bypass (Control group). The remainder worked as an experimental group in which pretreatment with indomethacine and total spinal anesthesia was performed before bypass with the same extracorporeal circulation technique as control group (Experimental group). Observations were made every 10 minutes during a 30-minute bypass and 30-minute post bypass period. Result: Weights of the fetuses ranged from 2.2 to 5.2 kg. In Control group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of Pa$CO_2$ increased from 61.9 to 129.6 mmHg at each time points during bypass. Flow rate was suboptimal (74.3 to 97.0 $m\ell$/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. On the contrary, in Experimental group, means of arterial pressure reamined higher (45.8 to 30 mmHg) during bypass (p<0.05). Means of Pa$CO_2$ were less ranging from 59.8 to 79.4 mmHg during bypass (P<0.05). Flow rates were higher (78.8 to 120.2 $m\ell$/kg/min) during bypass (p<0.05). There were slower deterioration of cardiac function after cessation of bypass. Conclusion: In this study, we demonstrated that the placental flow was increased during fetal cardiopulmonary bypass in the group pretreated with indomethacine and total spinal anesthesia. However, further studies with modifications of the bypass including a creation of more concise bypass circuit, and a use of axial pump are mandatory for the clinical application.

A Case Report of ROSC for Out-of Hospital Cardiopulmonary Resuscitation: Based on one Area Heart Saver (병원 전 심폐소생술에 의한 자발순환 회복 8례: 일 지역 하트세이버 수여자를 기준으로)

  • Bang, Sung-Hwan;Kim, Jee-Hee;Kim, Gyoung-Youg;Roh, Sang-Gyun
    • Fire Science and Engineering
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    • v.27 no.4
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    • pp.61-67
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    • 2013
  • This study was to investigate the cardiopulmonary resuscitation (CPR) outcomes and the clinical characteristics of outof- hospital cardiac arrest (OHCA) by analyzing date in one region. A total 8 patients, survived over 72 hours after ROSC. The cardiac arrest were caused by unknown (5 cases), cardiac disease (3 cases). The most common place of cardiac arrest was in the home (6 cases), witnessed cardiac arrest (8 cases), cardiopulmonary resuscitation by bystander was performed (4 cases), agonal respiration (3 cases). The initial electrocardiogram (ECG) showed ventricular fibrillation (VF) in 7 cases, pulseless electrical activity (PEA) other rhythms in 1 cases. Average time from call to scene arrival 6.1 minutes, call to hospital arrival 23.0 minutes, duration of total CPR was 8.7 minutes. The certificate of them were level 1 emergency medical technician (EMT) 6 cases, level 2 EMT 3 cases, total 3 members 7 cases. To improve the rate of survival for out-ofhospital cardiac arrest victims, development of continuous CPR educational program for lay rescue.

Right Heart Support in OPCAB -2 cases Report- (우심실 보조장치 하의 심장박동 상태에서 시행한 관상동맥 우회수술 -2례 보고-)

  • 조석기;김기봉
    • Journal of Chest Surgery
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    • v.33 no.11
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    • pp.906-909
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    • 2000
  • 심폐바이패스를 사용하지 않고 심장박동 상태에서 시행하는 관상동맥 우회수술은 심 비대와 좌심실 기능저하가 동반된 협증심 환자에서는 심장 뒤쪽에 위치한 관상동맥에 대한 접근이 어렵고 수술 중 혈역학적으로 불안정하여 시행하기에 어려운 경우가 많다. 우심실 보조장치 하의 심장박동 상태에서 시행하는 관상동맥 우회수술은 대동맥의 삽관을 피하고, 심폐바이패스의 합병증을 줄일 수 있으며, 심장 뒤쪽에 위치한 혈관의 문합시에도 안정된 혈역학적 상태를 유지 할 수 있어 고위험군 환자에게 도움을 줄 수 있다. 좌심실 기능저하와 심 비대가 동반된 환자에서 우심실 보조장치 하의 심장박동 상태에서 시행한 관상동맥 우회수술을 2례 시행하여 좋은 결과를 얻어 보고하고자 한다.

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Intracardiac a Aortic Foreign Body (심장 및 대동맥내 이물 치험 1례)

  • 방정희;편승환
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.932-935
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    • 1997
  • A 50-year-old male patient was admitted due to right ventricular & aortic foreign bodies with ascending aortic pseudoaneurysm. The patient had a history of Kirschner wire fixation of right sternoclavicular joint 3 months ago. Under cardiopulmonary bypass, two K-wires were removed and injured pulmonary valve leaflet and aortic wall were repaired successfully The postoperative course was uneventful and the patient was discharged on the 14th postoperative day.

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Axillocoronary Bypass as Coronary Reoperation via Minimally Invasive Procedure-A Report of One Case- (관상동맥 재수술로서의 최소 침습 수기를 통한 액와 -관상동맥 우회술 -1례 보고-)

  • 백완기;윤용한;김정택;김광호;임현경
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.399-402
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    • 2001
  • 최근 심폐기를 사용하지 않는 최소침습성 직접 관상동맥우회술(MIDCAB procedure)은 심장수술 분야에서 급속도로 발전을 거듭하고 있다. 금번 저자들은 전에 만들어 준 좌전하행지 이식편이 막혀 관상동맥 재수술을 필요로 하였으나 좌내 유동맥의 혈류량의 불충분하였다고 생각되었다. 1례에서 최소 침습 수기를 통한 액와-관상동맥 우회술을 시행하여 만족스러운 결과를 얻었기에 문헌고찰과 함께 보고하고자 한다.

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Surgical Repair of Atrial Septal Defect Using Extracorporeal Circulation: One Case Report (심폐기를 이용한 심방중격결손의 외과적 교정: 1례 보고)

  • 이동준
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.143-147
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    • 1977
  • Atrial septal defect is the most common of the congenital heart disease in the adult. Since the first description of atrial septal defect by Rokitansky in 1857, this anomaly has been studied by many workers in past one century. In 1953, Lewis had first corrected the atrial septal defect under direct vision with deep hypothermia, and Gibbon [1954] had first done the atrial septal defect under direct vision with extracorporeal circulation. In our college [May 2’ 1977], we have first repaired the A.S.D. under direct vision with artificial heart-lung machine and, the defect was 4x5cm in size which was closed by Dacron patch. This patient was 12 year old girl who is well now. [postoperative 13 days]

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Numerical study for fluid-structure interaction of blood flow in TPLS (박동형 인공심폐기에서의 혈류의 고체-유체 상호작용에 대한 수치적 연구)

  • Jung G. S.;Seong H. C.;Shim E. B.;Ko H. J.;Min B. G.
    • Proceedings of the KSME Conference
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    • 2002.08a
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    • pp.705-706
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    • 2002
  • Hemodynamics of the TPLS(Twin Pulse Life Support System) is numerically investigated to delineate the possibility of hemolysis in blood. Computational method employing finite element algorithm is utilized to solve the blood flow of the sac squeezed by moving actuator. We assume that the blood flow interacts with the sac material which is activated by the rigid body motion of the actuator. Valve dynamics at the ends of the sac is simplified as on/off type motion. We compute the transient viscous flow in the two-dimensional geometry of the blood sac. Incompressible laminar flow is simulated on the assumption of Newtonian fluid. Blood velocity has a step gradient near the throat of the sac formed by the moving actuator. According to the decrease of the gap size of blood passage, the magnitude of shear stress in the blood is dramatically increased. Numerical solutions show that the maximum value of shear stress in the blood flow in TPLS is relatively smaller than that of the roller type ECLS.

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Surgical Treatment of Aortic Valve Injury after Blunt Chest Trauma (흉부 둔상 후 생긴 대동맥판 폐쇄부전증의 외과적 치료)

  • Yoon, Soo-Young;Park, Sang-Soon;Na, Myung-Hoon;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.968-970
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    • 2000
  • 26세 남자가 길가다 버스에 치어, 다발성 늑골골절, 흉골골절, 우견갑골골절, 좌쇄골하동맥 폐색, 외상성 기관식도루로 입원 치료 중 이완기 심잡읍이 생겼다. 심초음파 검사에서 심한 대동맥판 폐쇄 부전과 증식물로 진단하였다. 심폐기 운영 하에 좌 우 관상 동맥 첨판에 10mm, 7mm 파열을 발견 5-0 Prolene 연속 봉합하여 좋은 수술 결과를 얻고 환자는 수술 14일에 퇴원하였다.

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노년기 운동

  • KOREA ASSOCIATION OF HEALTH PROMOTION
    • 건강소식
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    • v.30 no.1 s.326
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    • pp.12-13
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    • 2006
  • 노년기에 나타나는 신체적인 특징은 일반적인'노화 현상'이라고 볼 수 있다. 체력의 저하로 운동 기능이 둔화되고, 심폐 기능과 면역 능력이 저하되어 쉽게 병에 걸리고 주위 환경에 대한 적응력이 저하되는 현상이나타난다. 정신적인 노화도 나타나는데 일반적으로 감각, 지각, 지능 등과 같은 정신 및 신경기능의 저하와불안 또는 우울 등의 정서 및 성격의 변화를 나타내기도 한다.그러나 이러한 변화는 노화 과정에서 초래되는 것이기도 하지만 젊더라도 운동을 거의 하지 않는 사람들에게도 똑같이 일어나고 있다. 따라서 노화 현상이라기 보다는 근육의 불용성 위축으로 초래되는 것이기에 적절한 운동으로 예방 또한 가능하다.

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The Remedial Effect Measurement of an Obesity Remedy Machine for Home Use (새로운 가정용 비만치료기의 비만치료효과 측정)

  • Lee Jae-Hoon;Lee Dong-Hyung
    • Science of Emotion and Sensibility
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    • v.8 no.1
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    • pp.37-45
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    • 2005
  • This paper reports the remedial effect measurement of an obesity remedy machine for home use which has been developed by H Co. and the authors. It is expected that the machine enhances it's remedial effect and usability by utilizing medium frequency and thermotherapy belt etc. In order to measure it's remedial effect, a clinical experiment, which participates eight young female subjects, has been conducted for one month. The experiment includes the measurements on the changes of Gas-Exchange Responses of subjects through Cardio-Pulmonary Exercise Testing. The experimental results show that the obesity remedy machine helps the subjects to reduce their weights, fat rates, and $VCO_2s$. Thus, it turns out that the machine can be a good candidate for medical treatment on the obesity.

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