• Title/Summary/Keyword: 심폐기

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Postcardiotomy Biventricular Assist Device in Adult Heart Disease. (개심술후 시행한 양심실보조장치의 성공치험 수술례)

  • 이재원;유양기;정성호;김건일;송명근
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.403-406
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    • 2001
  • 본 증례는 66세(51.8kg)된 남자에서 수술전 심한 좌심실 기능 부전과 승모판 및 삼첨판 폐쇄부전이 있어 개심술 시행후 심한 저심박출증 발생으로 인공심폐기 이탈에서 실패하고 양심실 보조장치(Centrifugal Biopump)를 사용한 후 이로부터 성공적인 이탈과 퇴원이 보고하는 바이다.

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Postcardiotomy Ventricular Assist Device (개심술후 심실 보조장치)

  • 나찬영
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.390-393
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    • 1994
  • 의료기술의 발달로 오늘날의 개심술은 대부분 성공적으로 시행되고 있지만 극히 일부분은 아직도 개심술후 심한 심실기능의 저하로 사망하는 겨우가 있다. 1960년대 중반 Spencer와 DeBakey에 의해 개심술후 심한 심실기능이 저하된 환자에게 심실보조장치를 이용하여 성공적으로 치험한 이후로 많은 발전을 거듭해 왔다. 저자들은 4개월 (6.5Kg)된 남아에서 개심술후 심한 저심박출증으로 인공심폐기의 제거를 못하여 좌심실 보조장치(Centrifugal Biopump)를 사용하여 성공적으로 치험하였기에 보고하는 바이다.

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Routine Off-pump Total Arterial Coronary Revascularization (심폐바이때스 없이 시행된 동맥 도관만를 이용한 관상동맥 완전 재관혈화)

  • Lee, Jae-Won;Park, Nam-Hee;Kang, Seong-Sik;Choo, Suk-Jung;Park, Seung-Jung;Park, Seung-Wook;Hong, Myeong-Ki;Song, Hyun;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.309-315
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    • 2003
  • Background: To avoid the adverse effects of cardiopulmonary bypass and to overcome late vein graft failure we routinely peformed off-pump total arterial coronary revascularization. Material and Method: From July 2000 to August 2001, 104 consecutive patients underwent first elective off-pump total arterial coronary revascularization. Both internal mammary, radial and gastroepiploic arteries were used. Sequential and composite grafts were used to achieve complete revascularization. Perioperative adverse events and postoperative angiograms were analyzed. Result: A total of 252 arterial conduits were used with an average of 2.47 grafts per patient. A total of 326 distal anastomosis were performed with a mean of 3.13 distal anastomosis per patient. Cross over to on-pump occurred in seven patients (6.7%). Of these 4 were due to unstable hemodynamics during lateral or posterior wall stabilization as a result of cardiomegaly and 3 were due to uncontrolled bleeding during dissection of diffusely dimunitive deeply placed intramyocardial coronary arteries. There were no opeartive deaths. Two cases of perioperative myocardial infarction and transient neurologic complications occurred, respectively. Of the 312 distal anastomoses, 308 (98.7%) were compatible with Fitz-Gibboll A or B patency grading. Conclusion: Off-pump total arterial coronary revascularization was technically feasible in most elective cases with satisfactory early results. However, on-pump coronary bypass surgery should be considered in difficult circumstances, such as cardiomegaly or unfavorable anatomy of the target coronary artery.

Out-of-Hospital Cardiac Arrest Response to a Pregnant Woman by the 119 Emergency Medical Service System: A Case Study (119구급대에 의한 병원 전 임산부 심장정지 소생환자 1례)

  • Lee, Jae-Min;Hong, Soo-Mi;An, Guk-Ki;Yun, Hyeong-Wan
    • Fire Science and Engineering
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    • v.34 no.1
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    • pp.127-134
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    • 2020
  • When a pregnant woman experiences cardiac arrest, resuscitation is of the utmost importance. Cardiac arrest in pregnant women differs from cardiac arrest in the general population since both mother and fetus need to be taken into consideration. In the event of cardiac arrest, determining whether to deliver the baby is significant. Cardiopulmonary resuscitation is not always successful, and the survival rate depends on the speed and precision of the procedure. In this study, we focus on the case of a 30-year-old pregnant woman who experienced cardiac arrest and whose family was quick to perceive her condition and call the hospital. A witness performed initial cardiopulmonary resuscitation, while rescue workers performed the advanced procedure. In this case, the patient and baby received proper treatment and left the hospital after six days. It is extremely rare for a pregnant patient to achieve return of spontaneous circulation (ROSC) or receive advanced cardiac life support before reaching the hospital. However, the woman in question in this study achieved ROSC and received both cardiopulmonary resuscitation before reaching the hospital and advanced cardiac life support at the hospital. The specifics of the case are reported in the context of a literature review.

Effects of Combined Exercise on Body Composition and Cardiovascular fitness in Sarcopenic Obesity Elderly Women (16주간 복합운동이 Sarcopenic Obesity 여성고령자의 신체조성 및 심폐체력에 미치는 영향)

  • Jung, Joo-Ha;Yang, Jum-Hong
    • 한국노년학
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    • v.32 no.3
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    • pp.703-714
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    • 2012
  • The purpose of this study was to analyze the effects of combined exercise on body composition and cardiovascular disease risk factors in sarcopenic obesity elderly women. The subjects for the study were 21 obesity elderly women over 65 years old . They were divided into two groups, the sarcopenic obesity group(n=9) and non-sarcopenic obesity group(n=12). The variables of body composition and cardiovascular fitness were measured in all the subjects before and after 16-week combined exercise. All data was analyzed by two-way ANOVA with repeated measures, and paired t-test by using SPSS 18.0. The findings of this study were as follows; 1. Effects on body composition The relationship between sarcopenia and body composition were only significant for the group ${\times}$ time interaction in FFM. In the sarcopenic obesity elderly women, % body fat significantly decreased and sarcopenia reduced by 30%, but there were no significant changes in the FFM and ASM. On the other hand, the non-sarcopenic obesity elderly women significantly decreased % body fat and significantly increased FFM and ASM. 2. Effects on cardiovascular fitness Both groups significantly increased V˙ O2peak. The most important finding in this study was that sarcopenic obesity elderly women showed delayed effects of a 16-week combined exercise on FFM and ASM compared to the non-sarcopenic obesity elderly women. However, the further studies might need to confirm these results with both genders, different age groups, and various exercise types.

Preparation and Self-Confidence to Response to Emergent, Acute or Life-threatening Health Crisis among School Nurses in South Korea (학교내 응급상황에 대한 준비 실태와 보건교사의 응급처치 수행자신감)

  • Kim, Ji-yeon;Jeong, Ihn Sook
    • The Journal of Korean Society for School & Community Health Education
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    • v.21 no.3
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    • pp.21-34
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    • 2020
  • 배경 및 목적: 본 연구는 학교 내 응급상황(천식 위기, 알레르기 반응, 저혈당 위기, 발작, 심폐정지, 출혈/골절, 머리/목 상해, 열성질환, 중독, 질식)에 대한 행정 차원과 물품구비 차원에서의 준비 실태, 그리고 응급처치 수행자신감을 파악하는데 목적이 있다. 방법: 단면조사연구로 274명의 보건교사를 대상으로 하였으며, 자가보고형 조사지를 이용하여 대상자와 학교의 일반적 특성, 학교 내 응급상황에 대한 행정·물품 준비 실태, 그리고, 응급처치 수행자신감 등 3개 영역의 자료를 수집하였다. 자료수집은 2018년 2월 1일부터 2018년 7월 31일까지 실시하였고, 자료분석은 기술통계, t-검정과 분산분석을 이용하였다. 결과: 대부분의 학교에서 응급상황 관리계획이 있었으나, 응급상황별로 천식 위기는 46.7%, 알레르기 반응은 58.4%에서만 관리계획을 갖추고 있었다. 산소, 혈당측정기, 자동제세동기, 경추고정장치 등은 85% 이상의 학교에서 보유하고 있었으나, 기관확장제 흡입기, 에피네프린 주사제, 흡인기 등은 거의 갖추고 있지 않았다. 응급상황 수행자신감은 5점 만점에 2.67점 (발작관리) 에서 3.55점 (심폐정지관리)이었으며, 일부 응급상황에 대해서 의료기관 근무경력이 증가함에 따라 수행자신감이 증가하였다. 결론: 대부분의 학교에서 응급관리계획을 수립하고 있었으나, 응급상황별 관리계획을 수립한 경우는 반 정도에 불과하였다. 보건교사의 학교 내 응급상황에 대한 응급처치 수행자신감은 전체적으로 낮게 나타남에 따라, 이들의 역량강화를 위한 체계적인 교육과 멘토링 프로그램이 요구된다.

Minimized Priming Volume for Open Heart Surgery in Neonates and Infants (신생아와 유아 심장 수술 시 심폐기회로 충진액의 최소화)

  • Kim, Woong-Han;Chang, Hyoung-Woo;Yang, Sung-Won;Cho, Jae-Hee;Lee, Kyung-Hoon;Baek, In-Hyuk;Kwak, Jae-Gun;Park, Chun-Soo;Lee, Jeong-Ryul;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.418-425
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    • 2009
  • Background: Cardiopulmonary bypass (CPB) involves use of an initial priming volume which can cause side effects such as hemodilution, transfusion, inflammatory reaction and edema. Hence, there have been efforts made tore-duce the initial priming volume. We compared this traditional method to a CPB method that uses a minimized priming volume (MPV). Material and Method: For 97 patients who underwent congenital cardiac surgery between July 2007 to June 2008, we discussed each case and decided which method to use. We reviewed the medical records and cardiopulmonary bypass sheets of the patients. Result: We used a MPV method for 46 patients, and a traditional method for the other 51. There were no significant differences in preoperative and intraoperative characteristics between the two groups, such as body weight, age, cardiopulmonary bypass time, lowest body temperature, etc. However, the priming volume was much smaller in the MPV group than the traditional group (p<0.001). The volume of initially mixed packed RBC was also much smaller in the MPV group (p<0.001). There were no significant differences in postoperative mortality and neurologic complications. Conclusion: We could significantly reduce the initial priming volume and initially mixed pRBC volume with the revised CPB method. We suggest that this method be used more widely for congenital cardiac surgery.

Responses of Health Physical Fitness and Arterial Stiffness through Cigarette Smoking (흡연습관이 성인 남성의 건강관련체력 및 동맥경직도에 미치는 영향)

  • Jung, Min-Kyung;Park, Eun-Kyung;Yoo, Jae-Hyun
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.2
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    • pp.197-205
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    • 2019
  • This study was to compare arterial stiffness and hemodynamic responses between male smokers and non-smokers. This study also investigates the influences of smoking before exercise on arterial stiffness and hemodynamic responses. 24 male subjects of age 20-29 without history of cardiorespiratory disease were divided into smokers and non-smokers. Smokers had more than 5 years of smoking experience. In order to evaluate the effects of pre-exercise smoking, smokers were tested twice, once with a cigarette before the exercise and the other once without one. Data was collected from bio-impedance analysis, SphygmoCor XCEL, graded exercise test, and fitness test. Main results of this study are as follows: First, there are differences between smokers and non-smokers in cardiorespiratory and hemodynamic response functions, as shown by maximal oxygen consumption, exercise duration, and heart rate. Second, the although the arterial stiffness between smokers and non-smokers showed statistically significant differences in the speed of the pulse wave velocity and augmentation index, smoker had a faster rate. It shows that smoking behavior has a negative impact on the cardiovascular system. Third, pre-exercise smoking behavior does have an impact on cardiorespiratory and hemodynamic response functions, as shown by exercise duration and heart rate. Lastly, arterial stiffness between smokers and non-smokers showed statistically not significant in the speed of the pulse wave velocity and augmentation index. However, the difference was not statistically significant. Brachial systolic pressure, a component of pulse wave analysis, on the other hand, was significantly dependent on pre-exercise smoking behavior. Subjects who participated in this study are college students in early 20s. Given their relatively short history of smoking, it is possible that their smoking habits are not severe enough to develop into cardiorespiratory or cardiovascular diseases. But Smokers showed lower levels of cardiopulmonary functions, as maximal oxygen consumption and exercise duration than nonsmokers.

Minimally Invasive Coronary Artery Bypass Grafting (소침습적 관상동맥우회술)

  • Na, Chan-Young;Lee, Young-Tak;Park. Joong-Won;Chung, Do-Hyun;Jung, Ill-Sang;Jung, Yoon-Seup;Kim, Ok-Sung;Bang, Jung-Hyun;Lee, Sub;Chung, Chul-Hyun;KIM, Woong-Han;Park, Young-Kwan;Kim, Chong-Whan;Hong, Sung-Nok;Han, Jae-Jin;Lee, Gun
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.118-124
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    • 1998
  • Minimally invasive coronary artery bypass grafting without using cardiopulmonary bypass (CPB) is a recently accepted modality of myocardial revascularization prcedures which is particularly suitable to the patients with lesions in the left anterior descending(LAD) and the right coronary arteries. Of the consecutive 35 patients of coronary artery bypass grafting performed at Sejong General Hospital from March to August 1996, six patients underwent minimally invasive coronary artery bypass grafting without CPB. All had stenotic lesions of the LAD more than 90%. Bypass grafting of the LAD was approached through midline sternotomy in one, through ministernotomy in two, and through limited left anterior thoracotomy in three patients, respectively. The internal mammary arteries were prepared without the use of thoracoscope. The mobilized mammary arteries were connected directly to the LAD in 5 patients, and the anastomosis required interposition of a segment of the radial artery in the remaining one. The diagonal branch was revascularized with the saphenous vein graft at the same time in one patient. No blood transfusion was necessary in 2 patients, and average blood required during surgery was 800ml in 4 patients. All patients were extubated from 4 to 14 hours(mean 9 hours) after operation. Early postoperative coronary angiography in 5 patients between 7 and 10 days after surgery has proved full patency of the grafts. With these limited clinical experiences, the clinical results demonstrated that minimally invasive coronary artery bypass grafting without CPB is an useful procedure especially in patients with isolated lesion in the proximal LAD.

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Comparative Analysis of Medical Terminology Among Korea, China, and Japan in the Field of Cardiopulmonary Bypass (한.중.일 의학용어 비교 분석 - 심폐바이패스 영역를 중심으로 -)

  • Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.159-167
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    • 2007
  • Background: Vocabularies originating from Chinese characters constitute an important common factor in the medical terminologies used 3 eastern Asian countries; Korea, China and Japan. This study was performed to comparatively analyze the medical terminologies of these 3 countries in the field of cardiopulmonary bypass (CPB) and; thereby, facilitate further understanding among the 3 medical societies. Material and Method: A total of 129 English terms (core 85 and related 44) in the field of CPB were selected and translated into each country's official terminology, with help from Seoul National University Hospital (Korea), Tokyo Michi Memorial Hospital(Japan), and Yanbian Welfare Hospital and Harbin Children Hospital (China). Dictionaries and CPB textbooks were also cited. In addition to the official terminology used in each country, the frequency of use of English terms in a clinical setting was also analyzed. Result and Conclusion: Among the 129 terms, 28 (21.7%) were identical between the 3 countries, as based on the Chinese characters. 86 terms were identical between only two countries, mostly between Korea and Japan. As a result, the identity rate in CPB terminology between Korea and Japan was 86.8%; whereas, between Korea and China and between Japan and China the rates were both 24.8%. The frequency of use of English terms in clinical practices was much higher in Korea and Japan than in China. Despite some inherent limitations involved in the analysis, this study can be a meaningful foundation in facilitating mutual understanding between the medical societies of these 3 eastern Asian countries.