• Title/Summary/Keyword: ARRHYTHMIA

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Factors Influencing Length of Stay at the Recovery Room among Elderly Patients Undergone General Anesthesia (노인 수술 환자의 회복실 체류시간에 영향을 미치는 요인)

  • Kim, Sun-Mi;So, Hee-Young;Lee, Mi-Hyang;Park, Myou-Yun;Kwon, Myoung-Jin
    • Korean Journal of Adult Nursing
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    • v.23 no.1
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    • pp.87-99
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    • 2011
  • Purpose: The study was designed to identify the factors that influence the length of stay of elderly people in the recovery room. Methods: The design of the study was descriptive correlation. The subjects were 196 general anesthesia patients. The data were analyzed by SPSS/WIN 17.0 program. Results: The average length of stay in the recovery room was 62.62 minutes. The length of stay in the recovery room was influenced by age (27.50%); number of diseases (12.97%) and albumin level (6.75%). Other related post operative factors (30.98%) were abnormal ABGA, shivering, PAR score, pain, arrhythmia, amount of bleeding, cardiovascular complication, hypertension and delirium. Those factors explained 78.2% out of the total variance of the length of stay. The strongest effector was the abnormal ABGA (${\beta}$=.226) and then shivering (${\beta}$=.222). Conclusion: The influencing factors should be assessed and monitored for the aged before and after surgery. Further research is needed to find the exact factors for ICU transfer elderly from recovery room and emergency surgery target.

The Relationship and Mechanism Underlying the Effect of Conscious Breathing on the Autonomic Nervous System and Brain Waves (의식적 호흡이 자율신경과 뇌파에 영향을 미치는 기전에 관하여)

  • Kang, Seung Wan
    • Perspectives in Nursing Science
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    • v.14 no.2
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    • pp.64-69
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    • 2017
  • Purpose: Breathing can be controlled either unconsciously or consciously. In Asian countries, various conscious breathing-control techniques have been practiced for many years to promote health and wellbeing. However, the exact mechanism underlying these techniques has not yet been established. The purpose of this study is to explore the physiological mechanism explaining how conscious breathing control could affect the autonomic nervous system, brain activity, and mental changes. Methods: The coupling phenomenon among breathing rhythm, heart rate variability, and brain waves was explored theoretically based on the research hypothesis and a review of the literature. Results: Respiratory sinus arrhythmia is a well-known phenomenon in which heart rate changes to become synchronized with breathing: inhalation increases heart rate and exhalation decreases it. HRV BFB training depends on conscious breathing control. During coherent sinusoidal heart rate changes, brain ${\alpha}$ waves could be enhanced. An increase in ${\alpha}$ waves was also found and the synchronicity between heart beat rhythm and brain wave became strengthened during meditation. Conclusion: In addition to the effect of emotion on breathing patterns, conscious breathing could change heart beat rhythms and brainwaves, and subsequently affect emotional status.

Clinical Characteristics of Patients after Aryloxyphenoxy Propionate Herbicide Ingestion (Aryloxyphenoxy propionate 계열 제초제 중독환자의 임상 양상)

  • Lim, Junyeong;Moon, Jeongmi;Chun, Byeongjo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.71-77
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    • 2016
  • Purpose: No studies have been conducted to investigate the acute toxicity of aryloxyphenoxypropionate herbicides in humans following ingestion. Therefore, this study was conducted to investigate the clinical characteristics of aryloxyphenoxypropionate herbicide poisoning and provide guidance for physicians treating patients who have ingested these types of herbicides. Methods: A retrospective observational case series was conducted using ten patients with history of aryloxyphenoxy propionate herbicide. Data were collected for clinical manifestation, management and final outcome. Results: The most common symptoms were gastrointestinal irritation and an altered mental state (Glasgow Coma Scale<15). An elevated lactate level was a common laboratory abnormality, and prolonged QTc interval was commonly observed. These clinical features normalized within one day of supportive treatment. Conclusion: The acute toxicity of aryloxyphenoxypropionate herbicides in humans is manageable with supportive treatment. However, physicians should take into account depressed consciousness, the possibility of arrhythmia, and an elevated lactate level when planning their treatment strategy.

Familial Sick Sinus Syndrome (가족성 동기능 장애 증후군 1례)

  • Nam, In-Hye;Cheon, Sung-Hee;Kil, Hong-Ryang
    • Clinical and Experimental Pediatrics
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    • v.46 no.2
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    • pp.195-197
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    • 2003
  • Sick sinus syndrome(SSS) constitutes a spectrum of cardiac arrhythmia, including sinus bradycardia, sinus pause-arrest, sinoatrial block, slow escape rhythm, bradyarrhythmia and tachyarrhythmia. SSS is relatively uncommon in children but its exact incidence is unknown because diagnostic criteria are not uniform and most children with SSS, in general are asymptomatic. SSS may be primary(organic sinus node disease) or secondary(cardiac surgery comprises much of SSS in children and adolescents), but it can hardly be caused by familial relations as well. We reports an occurrence of familial sick sinus syndrome. Mother was diagnosed as SSS, which was presented by symptoms of dizziness and treated by permanent pacemaker(DDD). Also, two daughters revealed SSS with non-compacted cardiomyopathy on neonatal screening and fetal echocardiography respectively. We concluded that familial SSS may occur, so familial screening should be suggested.

Congenital LQT Syndromes: From Gene to Torsade de Pointes

  • Carmeliet, Edward
    • The Korean Journal of Physiology and Pharmacology
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    • v.6 no.1
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    • pp.1-7
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    • 2002
  • Congenital Long QT syndrome (LQTs) is a relatively rare pathologic disorder but results frequently in sudden cardiac death. Of the six LQTs that have been clinically described, five have been worked out for their genetic and biophysical profile. Most are generated by mutations which cause a loss of function in two delayed $K^+$ currents, $i_{Ks}\;and\;i_{Kr}.$ One syndrome is generated by mutations in the $Na^+$ channel which causes essentially a gain of function in the channel. Clinically the syndromes are characterized by slowed repolarization of the cardiac ventricular action potential and the occurrence of typical arrhythmias with undulating peaks in the electrocardiogram, called Torsade de Pointes. Arrhythmias are initiated by early or delayed afterdepolarizations and continue as reentry. Triggers for cardiac events are exercise (swimming; LQT1), emotion (arousal; LQT2) and rest/sleep (LQT3). ${\beta}-blockers$ have a high efficacy in the treatment of LQT1 and LQT2. In LQT3 their use is questionable. The study of congenital LQTsyndromes is a remarkable example of how basic and clinical science converge and take profit of each other's contribution.

Relationships between Symptom Experience and Quality of Life in Patients with Atrial Fibrillation (심방세동 환자의 증상경험 및 삶의 질간의 관계)

  • Baek, Kyung-Hwa;Son, Youn-Jung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.4
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    • pp.485-494
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    • 2008
  • Purpose: In this study, relationships between symptom experience and quality of life in a cross-sectional sample of patients with Atrial Fibrillation (AF) were investigated. Methods: This descriptive study involved a convenience sample of AF patients from S university hospital, C city. One hundred and two AF patients completed psychometric validated measures of AF related symptoms and quality of life. Descriptive statistics and Pearson correlation coefficients with SPSS WIN 14.0 were used for data analysis. Results: Of 16 atrial arrhythmia-related symptoms, the patients reported 'tiredness' as the most frequent and 'shortness of breath' as the most severe. The level of overall quality of life for patients with AF was 53.92. There were significant differences in symptom frequency according to religion, New York Heart Association (NYHA) classification and left ventricular ejection fraction ; symptom severity according to monthly income and stroke ; quality of life according to age, job, alcohol intake, NYHA class and stroke. Quality of life for these patients was positively correlated with symptom frequency and symptom severity. Conclusions: This study demonstrated that patients with more frequent and severe symptoms perceive poorer quality of life than patients with less frequent and less severe symptoms. Symptom experience should be assessed early to improve quality of life for patients.

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Electrocardiogram Signal Compression with Reconstruction via Radial Basis Function Interpolation Based on the Vertex

  • Ryu, Chunha;Kim, Tae-Hun;Kim, Jungjoon;Choi, Byung-Jae;Park, Kil-Houm
    • International Journal of Fuzzy Logic and Intelligent Systems
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    • v.13 no.1
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    • pp.31-38
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    • 2013
  • Patients with heart disease need long-term monitoring of the electrocardiogram (ECG) signal using a portable electrocardiograph. This trend requires the miniaturization of data storage and faster transmission to medical doctors for diagnosis. The ECG signal needs to be utilized for efficient storage, processing and transmission, and its data must contain the important components for diagnosis, such as the P wave, QRS-complex, and T wave. In this study, we select the vertex which has a larger curvature value than the threshold value for compression. Then, we reconstruct the compressed signal using by radial basis function interpolation. This technique guarantees a lower percentage of root mean square difference with respect to the extracted sample points and preserves all the important features of the ECG signal. Its effectiveness has been demonstrated in the experiment using the Massachusetts Institute of Technology and Boston's Beth Israel Hospital arrhythmia database.

Result of Surgical Repair of Intracardiac Defects Associated with Corrected Transposition - 33 cases - (교정형 대혈관 전위증에 동반된 심장기형의 수술 성적에 대한 보고)

  • 김성호
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.16-21
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    • 1990
  • From November 1978 through June 1989, 33 patients aged 3 months to 27 years [mean 9.7 years] underwent repair of intracardiac defects associated with corrected transposition. Five patients had had previous palliative surgery. Operation were performed in 31 for ventricular septal defect, 22 for pulmonary outflow tract obstruction, 16 for atrial septal defect, and 5 for anatomical tricuspid valve regurgitation. Pulmonary outflow tract obstruction was relieved by pulmonary valvotomy in 9, Rastelli procedure in 5, modified Fontan procedure in 3, and by REV procedure in 5 patients recently. Early mortality was 21.2%[7/33] and no late mortality during follow up period. Two had residual pulmonary outflow tract obstruction and one residual VSD. In eight patients, transient arrhythmia was found but soon returned to sinus rhythm. Five patients developed complete heart block and 2 were given permanent pacemaker insertion. There were 8 RBBB, 1 LBBB and one second degree atrioventricular block patients, but all showed no clinical significance. This report suggests that surgical repair of intracardiac defects associated with corrected transposition can be achieved with acceptable low risk. Though the mortality is still high, we can improved the result by advancing surgical technique, knowledge of the special conduction system, and by improving postoperative care.

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Clinical and Hemodynamic Investigation of Atrial Septal Defect (심방중격결손증의 혈류역학적 상관관계 및 임상적 고찰)

  • 정상조
    • Journal of Chest Surgery
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    • v.24 no.5
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    • pp.445-450
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    • 1991
  • Forty eight patients diagnosed as atrial septal defect, had been operated from April 1986 to December 1990 at the Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, were analysed retrospectively. Of the 48 patients, 12 patients, were male and 36 patients were female, Their ranged from 8 months to 51 years old, and the mean was 18.0 years old. The proceeding two symptoms were exertional dyspnea and frequent upper respiratory infection. But 10 patients [20.8%] were asymptomatic. Electrocardiographic findings were regular sinus rhythm in 100.0%, RVH in 29.2%, incomplete RBBB in 27.1%, and first degree AV block in 2.1%. Hemodynamic studies were performed in 38 of 48 patients. Significant pulmonary hypertension[over 50mmHg in systolic pulmonary arterial pressure], which is the most serious risk factor, was developed in 4 patients[8.3%]. There was statistical significance between size of defect[cm2/BSA-M2] and systolic pulmonary arterial pressure[sPAP] retrospectively[p=0.036]. We could not find the correlationship between age and Qs % size. Anatomically, secundum type constituted 97.9%, in which 43 patients were PFO type[91.6%] and 3 patients were IVC type[6.3%]. 38 of 48 ASD patients were repaired with patch closure[72.9%] and remains were repaired with direct closure[27.1%]. The operative result was excellent except two cases of transient postoperative arrhythmia. There was no operative mortality.

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A Comparative Study of Antegrade Cardioplegia Versus Retrograde Cardioplegia for Myocardial Protection during the Open Heart Surgery (순행성 관관류법과 역행성 관관류법의 임상적 비교연구)

  • 조완재
    • Journal of Chest Surgery
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    • v.22 no.4
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    • pp.609-619
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    • 1989
  • During aortic valve surgery, cardioplegic solution is delivered through direct cannulation of both coronary ostia. Since this approach may cause an intimal injury leading to acute dissection or late ostial stenosis, this study was undertaken to evaluate myocardial protective effect of retrograde perfusion of cardioplegia [RCSP <% RRAP] in 18 clinical cases, which were compared with antegrade perfusion of cardioplegia in 27 clinical cases. This study were investigated 1] cease and return of electromechanical activity after cardioplegia infusion 2] the myocardial temperature during operation 3] the aortic cross clamping time and total bypass time 4] frequency of DC shock for defibrillation 5] need for inotropic drugs after operation 6] electrocardiographic evidence of myocardial infarction or ventricular arrhythmia after operation 7] the enzymes activity during preoperative and postoperative period as an evaluation of myocardial ischemic injury and 8] operative mortality rate The combination of retrograde cardioplegia and topical cooling with ice slush yielded promptly hypothermia of myocardium and shorter aortic cross-clamping time compared with antegrade cardioplegia [P < 0.05]. The temperature of the interventricular septum was maintained below 20oC by continuous perfusion or intermittent perfusion of cold blood cardioplegia and other results were no statistically significant difference between the two methods [P >0.05]. This technique provides clear operative field and avoids some serious complications which are caused by coronary ostial cannulation. These results suggested that the retrograde perfusion of cardioplegia is a simple, safe, and effective means of myocardial protection during open heart surgery.

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