• Title/Summary/Keyword: 심폐기

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Variation of Cardiopulmonary Function by Use of Building Stairs (건물 계단 이용에 따른 심폐기능의 변화)

  • Yi, Seung-Ju
    • Journal of Korean Physical Therapy Science
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    • v.3 no.2
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    • pp.989-995
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    • 1996
  • This study was conducted to investigate variation of cardiopulmonary function by use of building stairs, a questionnair survey and measurement was carried out for 50 students of department of physical therapy Andong Junior College from 20th September to 3rd October, 1995. The result were as follows: The average systolic blood pressure(SBP) of stability for 50 college students who were measured was 121.3 mmHg, the average diastolic blood pressure(DBP) of stability was 78.5 mmHg, the average pulse frequency of stability was 71.8(frequency/min), the average breathing frequency of stability was 20.4(frequency/min), and the body temperature of stability was $36.8^{\circ}C$. SBP among the second, third, and fourth floors was 129.0 mmHg, 127.0 mmHg, and, 132.0 mmHg (p=0.1919), DBP was 80.1 mmHg, 76.5 mmHg, and, 82.0 mmHg (p=0.4229), the pulse frequency was 74.0, 73.1, and 74.0(frequency/min). The breathing frequency among the second, third, and fourth floors was statistically gradually increased according to 21.4, 23.1 and 24.6(frequency/min)(p=0.0071). The body temperature among the second, third, and fourth floors was statistically less and less decreased according to $36.8^{\circ}C,\;36.6^{\circ}C$ and $36.5^{\circ}C$(p=0.0040). It was revealed by this study, the breathing frequency among the second, third, and fourth floors was statistically significant increased, the body temperature was statistically significant decreased.

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Modified Ultrafiltration in Pediatric Open Heart Surgery (소아개심술에서의 변형초여과법)

  • 이정렬;임홍국;김용진;노준량;서경필
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.518-524
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    • 1999
  • Background: This study has proven the effect of modified ultrafiltration(MUF) performed after the cessation of cardiopulmonary bypass in pediatric patients who underwent open heart surgery. Material and Method: From Jan. to Dec. 1997, modified ultrafiltration was performed after cardiopulmonary bypass in 50 infants with cyanotic heart disease and the results were compared to the control group of 50 patients with cyanotic heart disease in whom modified ultrafiltration was not used. Changes of hematocrit, central venous pressure, systolic and diastolic pressure, heart rate and body weight were compared. Result: Age and body weight were not different(p=0.38, p=0.46). Disease categories were similar. Average filtering volume was 60.0$\pm$29.2cc/kg for 7.0$\pm$2.4minutes of filtration. Mean hematocrit after filtration(MUF=36.1%, control=26.4%, p=0.001) was higher in the MUF group. Systolic (p=0.0001) and diastolic blood pressure(p=0.0001) were observed to increase more and the central venous pressure(p=0.02) and the heart rate(p=0.02) were lower after filtration in the MUF group. Conclusion: This study demonstrated that modified ultrafiltration after cardiopulmonary bypass was a technically feasible option to improve the post-surgical course through the effective hemoconcentration, hemodynamic improvements, and body water control.

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End Point Temperature of Rewarming and Afterdrop After Hypothermic Cardiopulmonary Bypass in Pediatric Patients (소아에서의 저체온 심폐바이패스후 재가온 종료온도와 후하강)

  • Kim, Won-Gon;Lee, Hae-Won;Lim, Cheong
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.125-130
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    • 1997
  • Separating the patient from hypothermic cardiopulmonary bypass(CPB) before achieving adequate rewarming often results in afterdrop, which can predispose to electrolyte disturbances, arrhythmia, hemodynamic alterations, and shivering-induced increase of oxygen consumption. In an attempt to find an adequate end point temperature of rewarming after hypothermic CPB, 50 pediatric cardiac surgical patients were r ndomly assigned for end point temperature of rewarming of 35.5$^{\circ}C$ (Group 1) or 37t (Group 2), rectal temperature. Thereafter the rectal temperature was measured half, one, four, eight, and 16 hour after arrival to the intensive care unit(ICU), with heart rate and blood pressure. Additionally the rectal temperature was compared with esophageal temperature during CPB, and axillary temperature luring stay in the ICU. Nonpulsatile perfusion with a roller pump was used in all patients and a membrane or bubble oxygenator was used for oxygenation. Both groups were comparable with respect to age, sex, body surface area, total bypass time, and rewarming time. There was no afterdrop in both groups, and there were no statistical differences in the rectal temperatures between two groups. There were also no statistical dilyerences with respect to the heart rate and blood pressure between two groups. At the end of rewarming the esophageal temperature was higher than the rectal temperature. The axil ary temperature measured in ICU was always lower than the rectal temperature. No shivering was noted in all patients. In conclusion, with restoration of rectal temperature above 35.5$^{\circ}C$ at the end of CPB in pediatric patients, we did not observe an afterdrop.

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Surgical Repair of the Congenital Aneurysm of the Right Atrium (선천성 우심방 류의 수술치험 1례 보고)

  • 유양기;김정원;정성호;박정준;윤태진;서동만;김영휘;고재곤;박인숙
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.56-59
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    • 2002
  • The four most common types of congenital malformations involving the right atrium(RA) and the coronary sinus(CS) are congenital enlargement of the RA, single RA diverticulum, multiple diverticula of the RA, and aneurysm of the RA or CS. A previously healthy 6year-old child was presented with signs of upper respiratory tract infection. Chest X-ray and echocardiogram revealed a severely isolated right atrial enlargement. The abnormally dilated right atrim was widely resected under cardiopulmonary bypass. Pathology revealed multifocal myocardial loss associated with mild fibrotic changes of the endocardium and epicardium Our experience on this rare congenital disease is presented along with a review of the literature.

Thoracoabdominal Aortic Aneurysm Repair after Renal Transplantation (신장 이식후 발생한 해리성 흉복부 대동맥류의 외과적 치험)

  • 김대영;문광덕
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.449-453
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    • 1996
  • A successful resection of dissecting thoracoabdominal aortic aneurysm is presented in a patient who had undergone kidney transplantation 20 months previously. Because the transplanted kidney is more sensitive to ischemia than the normal kidney, a femoro-femoral bypass with a pump oxygenator was used for perfusion of the transplanted kidney during crossclamping. During the clamping time of 1)8 minutes, kidney perfusion was maintai ed with a perfusion pressure of (19 to 31) 27mmHg and the flow was 0.53 to 0.81 L/min. 32mm sized Hemashield (22 Cm in length) was interposed. The postoperative course was uncomplicated. We believe that performing the femoro- femoral bypass with a pump oxygenator is an effective and simple method for renal and spinal protection in such operations.

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Epicardial Microwave Ablation of Atrial Fibrillation (심방세동치료에 적용된 심외막극초단파차단술 -1예 보고-)

  • 박정식;이정환;안영찬;황여주;이재익;현성렬;전양빈;이창하;박철현
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.609-612
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    • 2004
  • Even though the Cox-Maze III procedure is the gold standard in the therapy for atrial fibrillation (AF) and its outcome is excellent, the complexity of the operation, longer cardiopulmonary bypass time and the risk of bleeding have tended to dissuade cardiac surgeons from its application. The recent data of the pathogenesis of AF and the development of alternative energy sources have facilitated the development of the modified Cox-Maze procedure rapidly. We reported that atrial fibrillation was conversed to sinus rhythm by the epicardial microwave ablation without cardiopulmonary bypass and the normal sinus rhythm was observed during 33 months of follow-up period.

Hybrid Procedure for Aortic Arch Repair: Arch Vessels Debranching with Supraaortic Revascularization Followed by Endovascular Aortic Stent Grafting (대동맥궁 대동맥류에서 Hybrid 수술적 치료)

  • Moon, Duk-Hwan;Chung, Cheol-Hyun;Kim, Hee-Jung
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.520-523
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    • 2009
  • Aortic arch aneurysm generally requires an urgent treatment due to the risk of catastrophic aortic rupture. However conventional surgery for aortic arch repair still carries significant risks of postoperative morbidity and mortality, especially in patients with old age. In an effort to correct the aortic pathology while minimizing the risks of complication, we performed a hybrid technique which comprises the off pump arch aortic stent grafting in an 86-old male patient with an aortic arch aneurysm.

Myocardial Hamartoma Involving the Posterior Left Ventricular Wall -Surgical Experience of One Case- (좌심실 후벽을 침범한 심근성 과오종 -수술 치험 1예-)

  • Seo Yeon-Ho;Kim Nan-Yeol;Kim Kong-Soo
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.486-489
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    • 2006
  • A 16 year-old boy was admitted to our department because of mild chest discomfort and mild dyspnea. A mass involving posterior wall of the left ventricle near posterior mitral annulus was found on echocardiography and cardiac MRI. Total excision of the mass was performed via posterior ventriculotomy under the cardiopulmonary bypass. The pathologic diagnosis revealed mature cardiac myocyte hamartoma. There was no evidence of arrhythmia and tumor recurrence during the 1 year of follow up after the surgery.

Hybrid Procedure for Aortic Arch Aneurysm: Arch Vessels Debranching andThoracic Endovascular Aortic Repair? -2 case Reports- (대동맥궁 대동맥류에서 Hybrid 술식의 적용 - 2예 보고 -)

  • Kim, Seok;Kwon, Oh-Choon;Lee, Sub;Cho, Jun-Woo;Bae, Chi-Hoon;Park, Ki-Sung
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.529-533
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    • 2010
  • Conventional surgery for aortic arch aneurysms have many postoperative complications and a high mortality rate due to prolonged cardiopulmonary bypass time, especially in high risk patients. In this report, we present two cases of a hybrid procedure that involves open brachiocephalic bypass with concomitant endovascular arch stent grafting in high risk patients with distal aortic arch aneurysm.

Coronary Artery fistula Associated with Atrial Septal Defect -Report of one case- (심방중격결손증을 동반한 관상동맥루 - 1례 보고 -)

  • 서연호;신동진;김공수
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.463-466
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    • 2002
  • We present a case of coronary artery fistula originating from the proximal left anterior descending artery draining into the main pulmonary artery, which was associated with atrial septal defect. The patient was a 56 year old male who was admitted for exertional dyspnea and abdominal distension. Echocardiogram and selective coronary arteriogram revealed a atrial septal defect and fistulous connection. The patient underwent surgery under the cardiopulmonary bypass with fibrillating heart. The pericardial patch closure of atrial septal defect and internal obliteration of the fistula termination site in the main pulmonary artery were performed. Postoperative hospital courses were uneventful without any specific complication and the patient was discharged without problem.