• Title/Summary/Keyword: Cannulation

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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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Accidental Vertebral Artery Cannulation as a Complication of the Central Venous Catherization (우발적인 척추동맥으로의 중심정맥 카테터의 삽관)

  • Jeong, Ju Ho
    • Journal of Trauma and Injury
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    • v.27 no.2
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    • pp.33-37
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    • 2014
  • Central venous catheterization through a subclavian approach is indicated for some special purposes but it may cause many complications such as infection, bleeding, pneumothorax, thrombosis, air embolization, arrhythmia, myocardial perforation, and nerve injury. A case involving a mistaken central venous catheterization into the right vertebral artery through the subclavian artery is presented. A 33-year-old man who had deteriorated mentality after head injury underwent an emergency craniotomy for acute epidural hematomas on the right frontal and temporal convexities. His mentality improved rapidly, but he complained of continuous severe pain in the right posterior neck even though he had no previous symptom or past medical history of such pain. Three-dimensional cervical spine computed tomography (3D-CT) was performed first to rule out unconfirmed cervical injuries and it revealed a linear radiopaque material intrathoracically from the level of the 1st rib up to the level of C6 in the right vertebral foramen. An additional neck CT was performed, and the subclavian catheter was indwelling in the right vertebral artery through right subclavian artery. For the purpose of proper fluid infusion and central venous pressure monitoring, the subclavian vein catheterization had been performed in the operation room after general anesthesia induction before the craniotomy. Sufficient anatomical consideration and prudence is essential because inadvertent arterial cannulation at a non-compressible site is a highly risky iatrogenic complication of central venous line placement.

The effect of Arteriovenous Fistula Cannulation Direction and Puncture Distance on the Recirculation Rate of Hemodialysis Patients (혈액투석 환자의 동정맥루 천자 방향과 천자 간격이 재순환율에 미치는 영향)

  • Lim, Hyo Jeong;Choi, Eun Hee;Kim, Eun Ju;Jeong, Ji Yoon;Ban, Seung Su
    • Journal of Korean Critical Care Nursing
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    • v.11 no.1
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    • pp.28-34
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    • 2018
  • Purpose : The purpose of this study was to compare the effect of recirculation rate according to cannulation direction and interval among hemodialysis patients with arteriovenous fistula (AVF). Method : The research used repeated measures design. This study was conducted among thirty patients who received hemodialysis three times a week for longer than a year through AVF at the I University hospital. Three different types of interventions were administered to the participants each week for three weeks. Needles were placed at a different distance and in a different direction each week: 7 cm apart from each other in antegrade direction during the first week, 5 cm apart in retrograde direction in the following week, and 7 cm apart in retrograde direction in the third week. Results : No significant differences in the recirculation rate were found due to any of the three tested methods (p = 1.00). Conclusion : This finding suggests that, if the patients have well-functioned AVF, we can choose an appropriate intervention from among the three methods in consideration of the patient's diverse needs.

Clinical Analysis on Perfusion Technique (개심술시 체외순환법에 대한 임상 보고)

  • Lee, Hong Sup;Shin, He Sook;Kim, Chang Ho
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.864-870
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    • 1990
  • This study was undertaken to evaluate current technique of extracorporeal circulation by analyzing the results in 73 cases. We performed standard cardiopulmonary bypass using Polystan roller pump, bubble[Polystan] and membrane[Cobe] oxygenator. There were 42 males and 31 females. We studied the changes of hemoglobin. hemodynamics, speed of cooling and warming, methods of cannulation and ACT. Arterial cannula was inserted on ascending aorta except for 7 cases of femoral cannulation. Preoperative hemoglobin was 13.2 gm% and this value dropped to 7.5 gm% during perfusion. Blood pressure of 113 mmHg in systolic dropped 57mmHg in 10 minutes of perfusion and became 98 mmHg at the end of perfusion. Initial drop of blood pressure was marked in pediatric patient. Mean cooling time was 19.4 min[0.54 Q /min] and warming time was 34 minutes[0.25 Q /min]. During perfusion, ACT was maintained above 600 sec and 44 patient did not need additional Heparin.

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Determination of the dietary lysine requirement by measuring plasma free lysine concentrations in rainbow trout Oncorhynchus mykiss after dorsal aorta cannulation

  • Yun, Hyeonho;Park, Gunjun;Ok, Imho;Katya, Kumar;Hung, Silas SO;Bai, Sungchul C.
    • Fisheries and Aquatic Sciences
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    • v.19 no.1
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    • pp.4.1-4.7
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    • 2016
  • This study evaluated the dietary lysine requirement by measuring the plasma free lysine concentrations in rainbow trout, Oncorhynchus mykiss after dorsal aorta cannulation. A basal diet containing 36.6 % crude protein (29.6 % crystalline amino acids mixture, 5 % casein and 2 % gelatin) was formulated to one of the seven L-amino acid based diets containing graded levels of lysine (0.72, 1.12, 1.52, 1.92, 2.32, 2.72 or 3.52 % dry diet). A total of 35 fish averaging $512{\pm}6.8g$ ($mean{\pm}SD$) were randomly distributed into seven groups with five fish in each group. After 48 h of feed deprivation, each group of fish was fed one of the experimental diets by intubation at 1 % body weight. Blood samples were taken at 0, 5 and 24 h after intubation. Post-prandial plasma free lysine concentrations (PPlys, 5 h after intubation) of fish fed diets containing ${\geq}2.32%$ lysine were higher than those of fish fed diets containing ${\leq}1.92%$ lysine. Post-absorptive free lysine concentrations (PAlys, 24 h after intubation) of fish fed diets containing 2.32 and 3.52 % lysine were higher than those of fish fed diets containing ${\leq}1.52%$ lysine. The brokenline regression analysis on the basis of PPlys and PAlys indicated that the lysine requirement of rainbow trout could be 2.34 and 2.20 % in diet. Therefore, these results strongly suggested that the dietary lysine requirement based on the broken-line model analyses of PPlys and PAlys could be greater than 2.20 % but less than 2.34 % (corresponding to be $6.01%{\leq},but{\leq}6.39%$ in dietary protein basis, respectively) in rainbow trout. Also, these results shown that the quantitative estimation of lysine requirement by using PPlys and PAlys could be an acceptable method in fish.

A regression for estimating metabolizable glucose in diets of weaned piglets for optimal growth performance

  • Lv, Liangkang;Feng, Zhi;Zhang, Dandan;Lei, Long;Zhang, Hui;Liu, Zhengya;Ren, Ying;Zhao, Shengjun
    • Animal Bioscience
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    • v.34 no.10
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    • pp.1643-1652
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    • 2021
  • Objective: Two experiments were conducted to provide a new approach for evaluating feed nutritional value by metabolizable glucose (MG) in piglet diets with different levels of starch and crude fiber. In Exp 1, a regression equation for MG was generated. In Exp 2, the equation was verified, and the optimal growth performance of piglets under appropriate MG levels was tested. Methods: In Exp 1, 20 weaned piglets (7.74±0.81 kg body weight [BW]) were randomly assigned to 1 of 4 treatments, including the basal diet containing different levels of MG (starch, 25.80%, 31.67%, 45.71%, 49.36%; crude fiber, 1.23%, 1.35%, 1.80%, 1.51%). The piglets were implanted with an ileal fistula, cannulation of the carotid artery, portal vein, and mesenteric artery. The chyme from the ileum fistula and blood samples were collected. In Exp 2, 30 weaned piglets (8.96±0.50 kg BW) were randomly assigned to 1 of 5 treatments, including the experimental diets with different levels of MG (37.6, 132.5, 300.0, 354.3, and 412.5 g/kg). The piglets' BW, and feed consumption were recorded to calculate growth performance during the 28-d experiment. Results: In Exp 1, the MG levels in 4 diets were 239.62, 280.68, 400.79, and 454.35 g/kg. The regression equation for the MG levels and dietary nutrients was: Y (MG) = 12.13×X1 (starch)+23.18×X2 (crude fiber)-196.44 (R2 = 0.9989, p = 0.033). In Exp 2, treatments with 132.5 and 300.0 g/kg MG significantly (p<0.05) increased average daily gain and feed conversion efficiency of weaned piglets, increased digestibility of crude fat, and had no effect on digestibility of crude protein compared to 300.0 to 412.5 g/kg MG. Conclusion: The pig model combining the ileum fistula and cannulation of blood vessels was successfully used to determine the dietary MG levels. The recommended MG level in weaned pig diets is 132.5 to 300.0 g/kg.

A Surgical Experience of Adult TOF with Anomalous Systemic Venous Return (체정맥 이상환류를 동반한 성인 활로씨 4증후군의 치험 1례)

  • 유환국
    • Journal of Chest Surgery
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    • v.24 no.11
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    • pp.1154-1159
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    • 1991
  • Anomalous systemic venous return to the right atrium is clinically innocuous and cause no functional disturbances or physiologic abnormalities by themselves and consequently require no treatment but may be surgical importance. We experienced a case of adult TOF combined with anomalous systemic venous drainage. Rudimentary right SVC with draining left sided vertical vein and IVC with separately drained left vein was revealed at operation time. With the bicaval cannulation, large sucker was used for drainage of blood from the left hepatic vein. Postoperative angiocardiogram showed above findings and combined double inferior vena cava at lumbar level.

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Reconstruction of tracheal stenosis: report of one case (기관협착증 치험 1)

  • 윤갑진
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.492-496
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    • 1984
  • For the treatment of acute respiratory failure and emergency care of an urgent patient, tracheostomy in itself may have been a life saving procedure. But, tracheal stenosis gives serious clinical manifestation which can only be corrected by surgical intervention in many occasions. We experienced one case of tracheal stenosis following tracheostomy for assisted ventilation. Tracheogram showed a 4.0 cm segmental narrowing below the tracheostoma. Before reconstruction, we tried to T-tube cannulation, but the result was not satisfactory. So we resected the narrowed segment and tracheal reconstruction was performed with uneventful result.

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Determination of Valine requirements by usging plasma free amino acid concentrations in rainbow trout(Oncorhynchus mykiss) with dorsal aorta cannulation

  • Sungchul C. Bai;Park, Gunjun;Im ho Ok;Kim, Youngchul
    • Proceedings of the Korean Aquaculture Society Conference
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    • 2003.10a
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    • pp.67-67
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    • 2003
  • Dorsal aorta cannulated rainbow trout averaging 505 $\pm$ 6.5g (Mean $\pm$ SD) were divided into 7 groups (5 fish per group). Twenty four hour post feeding, cannulated fish were intubated with one of seven L-amino acid diets containing graded levels of Valine (Val. : 0.45, 0.95, 1.20, 1.45, 1.70, 1.95 or 2.45%) at 1% of body weight. Blood samples were taken at 0, 5 and 24hr after feeding the experimental diets. Post-prandial (5h after feeding) plasma-free Valine concentrations (PPval.) increased linearly from fish fed diets containing Valine between 0.45 and 1.45%, but the concentration remained constant from fish fed diets containing valine between 1.45 and 2.45%. Post-absorptive (24h after feeding) plasma free valine concentrations (PAval) increased linearly from fish fed diets containing valine between 0.45 and 1.45%, but the concentration remained constant from fish fed diets containing valine between 1.45 and 1.95%. Using the broken-line model analysis, the dietary valine requirement by PPval and PAval could be 1.44 and 1.50% in rainbow trout, respectively. These results supported that the estimated dietary valine requirement by PP(val.) and PA(val.) could be in close agreement with the values obtained from the previous conventional feeding method. Thus, the use of PFAA concentrations for determining essential amino acid requirements could be possible in rainbow trout with dorsal aorta cannulation.

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Veno-venous Extracorporeal Membrane Oxygenation with a Double Lumen Catheter for Pediatric Pulmonary Support (급성호흡부전 환아에게 이중관 캐뉼라로 시행한 정맥간 체외막형산화장치)

  • Choi, Min-Suk;Yang, Ji-Hyuk;Jun, Tae-Gook;Lee, Young-Tak;Ahn, Kang-Mo
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.168-171
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    • 2010
  • The number of cases of extracorporeal membrane oxygenation (ECMO) has rapidly increased all over Korea since the introduction of peripheral cannulation catheters. However, the application of ECMO to children has been limited due to the shortage of pediatric equipment and difficulty in maintaining an ECMO system with peripheral cannulation. For this reason, there have been only few reports of pediatric ECMO in Korea, and most of them pertained to the veno-arterial type ECMO for supporting the cardiac system in postcardiotomy patients. We report here on the successfully performing veno-venous ECMO, with using a double lumen percutaneous catheter, in a child with acute respiratory distress syndrome.