• Title/Summary/Keyword: Arterial tension

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Change of End-tidal PCS During Cardiopulmonary Bypass (체외순환시 호기말 이산화탄소압의 변화)

  • 오중환
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1399-1403
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    • 1992
  • The evaluation of the effectivess of ongoing cardiopulmonary resucitation efforts is dependent on the commonly used methods, such as the presence of femoral or carotid artery pulsations, arterial blood gas determinations, peripheral arterial pressure and intracardiac pressure monitoring. But recent studies suggest that end-tidal carbon dioxide tension serves as a non-invasive measurement of pulmonary blood flow and therefore cardiac output under constant ventilation. A prospective clinical study was done to determine whether end-tidal carbon dioxide monitoring in open heart surgery under cardiopulmonary bypass could be used as a prognostic indicator of bypass weaning. We monitored end-tidal PCO2 values continuously during cardiopulmonary bypass in 30 patients. "Ohmeda 5210 CO-2 monitor" under infrared absorption method were incorperated into the ventilator circuit by means of a side point adaptor between endotracheal tube and ventilator tubing. 18 patients[Group I ] were res-ucitated from partial bypass followed by aorta cross clamp off and 12 patients[Group II ] from aorta cross clamp off followed by partial bypass. But there was no difference between two groups[p>0.05]. The value of end-tidal carbon dioxide tension during ventricular fibrillation or nearly arrest state was 6.6$\pm$2.9 mmHg, and at the time of spontaneous beating was 19.3$\pm$5.6 mmHg[Mean$\pm$Standard deviation], In conclusion end-tidal carbon dioxide tension monitoring provides clinically useful, continous, noninvasive and supplementary prognostic indicator during cardiopulmonary bypass weaning procedures.rocedures.

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Changes of Cerebral Metabolism and the Related Factors during Cardiac Surgery

  • Park, Seok-Cheol
    • Biomedical Science Letters
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    • v.8 no.3
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    • pp.143-154
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    • 2002
  • The effect of cardiopulmonary bypass (CPB) on cerebral physiology during heart surgery remains incompletely understood. This study was carried out to investigate changes of cerebral metabolism and the association between the changes and clinical factors during heart surgery. Seventy adult patients (n=70) scheduled for elective cardiac surgery were participated in the present study. Middle cerebral artery blood flow velocity (V$_{MCA}$), cerebral arteriovenous oxygen content difference (C(a-v)O$_2$), cerebral oxygen extraction (COE), and modified cerebral metabolic rate for oxygen (MCMRO$_2$) were measured during six phases of the operation; Pre-CPB, CPB-10 min, Rewarm-1 (nasopharyngeal temperature 34$^{\circ}C$), Rewarm-2 (nasopharyngeal temperature 37$^{\circ}C$), CPB-off, and Post-OP (at skin closure after CPB-off). Each relationship of age, arterial blood gas parameters, or other variables to V$_{MCA}2$, C(a-v)O$_2$, COE, or MCMRO$_2$ was evaluated. V$_{MCA}$ increased (P<0.0001) whereas C(a-v)O$_2$ decreased (P<0.01) throughout the five phases of the operation compared to Pre-CPB value (control). COE diminished at CPB-10, Rewarm-1, and CPB-off (P<0.05) while MCMRO$_2$ reduced at CPB-10 and Rewarm-1 (P<0.05) compared to Pre-CPB value. Positive correlation was found between age and cerebral metabolic parameters (V$_{MCA}$, C(a-v)O$_2$, COE, or MCMRO$_2$) during CPB (range r=0.24 to 0.38, p<0.05). Four cerebral metabolic parameters had partially negative or positive correlation with arterial blood gas parameters and other variables (arterial blood pH, $O_2$ tension, $O_2$ content, $CO_2$ tension, blood pressure, blood flow, temperature, or hematocrit) during the operation. In conclusion, CPB led to marked alterations of cerebral metabolism and age, pH, and $CO_2$ tension profoundly influenced the changes during cardiac surgery.

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Comparison between bladder urine $O_{2}$ tension and mixed venous blood $O_{2}$ tension in human (방광뇨와 혼합정맥혈의 산소분압의 비교)

  • 이두연
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.563-568
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    • 1986
  • Tissue 02 tension is an important guide in detection of the general condition in critical patients. The tissue 0, is more difficult to measure with 0, sensor in skeletal muscle and subcutaneous tissues to present. But it is much easier to measure 0, tension in bladder urine with Censini catheter in Foley catheter than in tissue. We have measured 0, tension in bladder urine, main pulmonary artery and radial artery in 16 patients in chest surgical department of Yonsei University. College of Medicine from September 26 to December 22, 1981. Six patients were male and ten patients were female. Their ages ranged from 8 to 43 years. The correlation equation between the simultaneously measured PuO2 and PvO2 was found to be Ypvo2=4.04 + 0.88 Xpuo2 [r=0.88, p<0.0001] in regression curve with computer [HP/3,000, Program: SPSS] in the Yonsei University. Measurement of 0, tension in bladder urine and MPA will be rather simple, rapid and reproducible method than that of the 0, tension in tissues. But the speed of 0, consumption in urine is fast and so the 0, tensions in bladder urine were measured as soon as possible after they were collected. They were no complications or morbidity during measurement of 0, tension in these procedures except spontaneous removal of radial arterial cannulas in 2 patients.

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The Effect of the Chest Physiotherapy in Brain Injury Patients (뇌손상 환자에게 적용한 흉부물리요법의 비교연구)

  • Hong, Hae-Sook;Choi, Young-Jin
    • Journal of Korean Biological Nursing Science
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    • v.6 no.2
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    • pp.19-30
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    • 2004
  • The purpose of this study was to compare chest percussion with chest vibration in brain injury patients. 30 patients in SICU of one general hospital in T city were randomely divided by 3 groups and the arterial oxygen tension(PaO2) and the retained secretion were measured. The chest vibration was done among the first group, the chest vibration by hand after the chest percussion was done among the second group and the mechanical chest vibration after the chest percussion was done among the third group. The data was analyzed using SPSS 7.0(5% significance) and the results are below. 1) It was adopted the hypothesis that the amount of retained secretion of endotracheal suction after stopping the actions among the first, second and the third groups is different from each other.(F=41.62, p=0.00) 2) It was rejected the hypothesis that the arterial oxygen tension(PaO2)s are different from each other among the first, second and third group.(F=1.22, p=0.31) The amount of the retained secretion after chest percussion, chest vibration by hand or mechanical chest vibration was significantly different from each other. Therefore, chest physiotherapy could be regarded as the effective nursing intervention for the unconscieus patients who have the inappropriate airway cleaness and it was more effective to be together than to be alone.

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Clinical Application and its Result of Modified Blalock-Taussig Shunt Using Polytetrafluoroethylene in Congenital Cyanotic Heart Disease (청색심기형환자에서 PTFE 인조혈관을 이용한 쇄골하-폐동맥 단락술의 임상적 적용과 그 결과)

  • 나명훈
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.55-61
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    • 1988
  • This report provides follow-up data on 116 patients with congenital cyanotic heart disease, aging 1 month to 13 years [median: 1.8 years], who underwent the modified Blalock-Taussig shunt using polytetrafluoroethylene graft at Seoul National University Hospital between September, 1984 and June, 1987. Among 116 patients complete follow-up studies were done on 95 patients. The mean preoperative arterial oxygen tension was 36 torr. Thirty-Six patients [38%] underwent operation in infancy. Conduit diameters included 4mm [15 cases], 5mm [47 cases], and 6mm [33 cases] sizes. The mean postoperative arterial oxygen tension was 52 torr [P<0.001]. The effectiveness of shunts was evaluated clinically and by shunt murmur, echocardiography and cardiac catheterization with angiography 1 to 31 months after operation. The incidence of shunt occlusion was 9.5% and the mortality was 14.8%. The actuarial patency rate was 83.1 * 6.4% and the actuarial survival rate was 82.5 * 4.5% at 30 months` follow-up for all patients. The effectiveness of the 4mm diameter conduit may be limited. Blalock-Taussig procedure is an effective alternative to the classic B-T shunt in congenital cyanotic heart disease.

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The Relationship between Arterial and End-tidal Partial Pressures of CO$_{2}$ in Halothane-anesthetized Heavy Breed Horses with respect to Operative Positions and the Modes of Ventilation (Halothane으로 마취된 거대말에서 수술자세와 호흡방법에 따른)

  • 안경아;권오경;산권명부;권구청;산안칙부
    • Journal of Veterinary Clinics
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    • v.14 no.2
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    • pp.238-243
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    • 1997
  • 체중이 700-750kg 인 4마리의 중종마에 70분동안 마취를 실시하여 동맥혈의 이 산화탄소 분압과 호기말 가스내의 이산화탄소 분압 사이의 관계를 관찰하였다. 마취도중 자발 호흡, 인공호흡 1(흡기시간 2.0초), 인공호흡 2(흡기시간 2.5초)를 각각 30분,20분,20분씩 실시하였으며 매 10분마다 동맥혈가스분석과 호기말 가스내 이산화탄소분압 측정을 실시하 였다. 동시에 혈압, 심전도, 체온측정을 실시하여 마취된 환축의 상태를 관찰하였다. 2주후에 자세를 달리하여(앙와에서 측와로) 같은 방법으로 재 실험하였다. 호기말 이산화탄소분압은 동맥혈에서보다 평균 10 mmHg 정도 낮은 양상을 보였으나 높은 상관관계를 보였으며 자세에 따른 유의적 차이는 업었다(앙와자세; r=0.949, 측와자세; r=0.920, P<0.01). 이러한 결과를 토 대로 조직에 창상을 줄 수 있는 동맥혈 가스분석 대신 비침습적방법인 호기말 가스내 이산화 탄소 분압을 측정하는 것이 환축의 모니터링에 효과적으로 사용 가능하다는 것을 알 수 있었다.

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Design of Capacitive Sensors for Blood Vessel Condition Using FEA Simulation; For Developing of an Implantable Telemetry System to Monitoring the Arterial Change (FEA 시뮬레이션을 이용한 혈관 상태 측정용 커패시티브 센서 설계; 체내 동맥 혈관 변화 모니터링이 가능한 이식형 텔레메트리 시스템 개발을 위한)

  • Kang, So Myoung;Lee, Jae Ho;Wei, Qun
    • Journal of Korea Multimedia Society
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    • v.22 no.11
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    • pp.1280-1287
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    • 2019
  • For developing a wireless implantable device to monitoring the artery variation in real-time. The concept of a special vessel variation measurement capacitive sensor is presented in this paper. The sensor consists of two part; main sensor to measuring the arterial variation, and reference sensor is used to improve the accuracy of the capacitance value variation. Before sensor manufacture, a model of the sensor attached on the artery was designed in 3D to conduct in the FEA simulation to validate the validity and feasibility of the idea. The artery model was designed as layered structures and made of collagenous soft tissues with intima inside, followed by the media and the adventitia. Also, a grease layer was designed in the inner of the arterial wall to imitate the clogged arteries. The simulation was divided into two parts; sensor performance test by changing the diameter of the grease layer, and arterial wall tension test by changing the blood pressure. As the simulation results, the capacitance value measured by the proposed sensor is decreased follow the diameter of the grease increased. Also, large elastic deformation of the arterial wall since changing the blood pressure has been observed.

The Effect of Positioning with Mechanically Ventilatory Acute Respitatory Failure Patients on Arterial Oxygen Partial Pressure and Alveolar-arterial Oxygen tension (인공호흡기를 부착한 급성 호흡부전 환자에서 폐병변 부위에 따른 체위적용이 동맥혈 가스분압 및 폐포동맥간 산소 분압차에 미치는 영향)

  • Hwang, Hee Joung;Park, Hye Ja
    • Korean Journal of Adult Nursing
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    • v.12 no.2
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    • pp.234-244
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    • 2000
  • It is widely recognized that manipulation of body position takes advantage of the influences of gravity for improving oxygenation. The study aims to determine the effects of positioning(supine, prone, right lateral decubitus and left lateral decubitus positions) applied to the mechanically ventilatory acute respiratory failure patients on arterial oxygen partial pressure($PaO_2$), alveolar arterial oxygen tension difference($AaDO_2$), mean aterial pressure, peak inspiratory pressure and plateau pressure. Thirty two acute respiratory failure patients admitted to the medical intensive care unit at Kangnam St. Mary's Hospital, The Catholic University of Korea from March 1997 to January 1998, were divided into three groups by radiographic evidence of unilateral or bilateral lung disease. In group 1 with dominant right lung disease were twelve subjects, group 2 with dominant left lung disease had eight subjects and group 3 had twelve subjects with bilateral lung disease. The variables were measured in 30 minutes after each position of supine, prone, good lung down lateral decubitus and sick lung down lateral decubitus position. The position order was done at random by Latin squre design. The results are as follows; 1) With group 1 patients, the $PaO_2$ in the left lateral decubitus and prone position were $126.8{\pm}30.8$ mmHg and $106.7{\pm}36.8$ mmHg, respectively(p=0.0001). 2) With group 2 patients, the $PaO_2$ in the prone and the right lateral decubitus position were $121.7{\pm}44.7$ mmHg and $118.5{\pm}31.7$ mmHg, respectively (p=0.0018). 3) With group 3 patients, the $PaO_2$ was $143.6{\pm}36.6$ mmHg in the prone position (p=0.0001). 4) With group 1 patients, the $AaDO_2$ in the left lateral decubitus and the right lateral decubitus position were $178.1{\pm}29.7$ mmHg and $233.1{\pm}24.4$ mmHg, respectively(p=0.0001). 5) With group 2 patients, the $AaDO_2$ in the prone and the left lateral decubitus postion were $184.0{\pm}39.5$ mmHg and $231.0{\pm}23.9$ mmHg, respectively(p=0.0019). 6) With group 3 patients, the $AaDO_2$ in the prone and the supine postion were $377.1{\pm}35.6$ mmHg and $435.7{\pm}13.1$ mmHg, respectively (p=0.0001). 7) There were no differences among the mean arterial pressure, peak inspiratory pressure and plateau pressure for each of the supine, prone, left lateral decubitus and right lateral decubitus position. The results suggest that oxygenation may improve in mechanically ventilatory patients with unilateral lung disease when the position is good lung dependent and prone, and patients with bilateral lung disease when the position is prone without any effects on the mean arterial pressure and airway pressure. It is suggested that body positions improve ventilation/perfusion matching and oxygenation need to be specified in patient care plans.

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Role of Endogenous Nitric Oxide in the Vasorelaxation Induced by High Calcium Environment in vitro

  • Lee, Jong-Eun;Lee, Byung-Kook;Ahn, Hyun-Taek;Ahn, Byoung-Hee;Kang, Jung-Chaee
    • The Korean Journal of Physiology
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    • v.26 no.2
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    • pp.123-128
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    • 1992
  • The present study was undertaken to examine if endogenous nitric oxide is partly responsible for the high calcium induced vasorelaxation in vitro. Isolated porcine coronary arterial rings were suspended in the tissue chamber and their changes in isometric tension were recorded. KCI little affected the vascular tension in the calcium free media, but subsequent addition of cumulative doses of $CaCl_3$ from 1 to 40 mM caused a contraction followed by complete relaxation. The maximum tension was noted at the calcium concentration in the media of 5 mM, and then the tension progressively declined at 10-40 mM. The relaxation was slightly attenuated in the endothelium-denuded preparation. The relaxation was converted into a contraction by the addition of methylene blue. The relaxation response was not affected in the presence of indomethacin, but was significantly attenuated by $N^w-nitro-L-arginine$ methyl ester pretreatment. These results suggest that the calcium induced vasorelaxation is in part attributable to the release of endogenous nitric oxide.

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Reconstruction of Wrist and Forearm with use of Anterolateral Thigh Free Flap in High Tension Electrical Burn Patients (전기 화상 환자에서 수근부 및 전완부의 전외측 대퇴근막 유리 피판술을 이용한 재건)

  • Yun, Hyung-No;Lee, Jun-Hyup;Lee, Tae-Seop;Lee, Dong-Eun
    • Archives of Reconstructive Microsurgery
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    • v.11 no.2
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    • pp.179-185
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    • 2002
  • The wrist and forearm are a frequently damaged area in high tension electrical injury as an input or output of the current. Electrical burns affecting the wrist and forearm may produce full thickness necrosis of the skin and damage deep vital structures beneath the eschar, affecting the local tendons, nerves, even bones and joints which result in serious dysfunction of the hand. From January 1997 to December 2001, we had treated 20 patients with high tension electrical burn in the wrist and forearm using anterolateral thigh free flap. Average follow up period were 24 months and we get satisfactory results both in functional and aesthetic aspects. This flap is considered useful in one-stage reconstruction of wide and large soft tissue defect combined with arterial injuries.

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