• The Korean Journal of Nuclear Medicine
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• v.4 no.2
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• pp.11-27
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• 1970

Cardiac output, plasma volume and renal plasma flow were determined to evaluate hemodynamic changes in 29 patients with cirrhosis of the liver. The results obtained were as follows. 1. The mean plasma volume was 3793+895ml and it was significantly higher than the normal controls. The mean blood volume ($5266{\pm}1222ml$) and blood volume per kg body weight ($95.7{\pm}23.41ml$) were also increased significantly. The mean plasma volume per kg body weight ($69.1{\pm}19.1ml$) showed increased tendency and the mean difference between blood volume and plasma volume per kg body weight ($26.4{\pm}7.05ml$) was in lower limit of normal range. 2. The mean cardiac output was $7708{\pm}2652ml/min$ and it was significantly increased. The mean cardiac index ($4924{\pm}1998ml/min/M^2$), stroke volume ($96.2{\pm}34.2ml/beat$), stroke index ($62.3{\pm}27.34ml/M^2$) and fractional cardiac index ($1.54{\pm}0.577$) were also increased significantly. The mean total -peripheral resistance was $1664{\pm}753.8\;dynes\;sec\;cm^{-5}M^2$ and it was significantly lower than the normal controls. 3. The mean renal plasma flow was $537{\pm}146.8ml/min/1.73M^2$ and it was normal to decreased tendency. The mean endogenous creatinine clearance ($66.7{\pm}23.0ml/min/1.73M^2$) was significantly decreased. Filtration fraction was variable, but it was slightly lower than normal in most cases. The mean renal fraction of cardiac output ($11.4{\pm}6.27%$) was relatively decreased. 4. Although renal plasma flow was normal or decreased in general, it was definitely diminished in patients with creatinine clearance less than $60ml/min/1.73M^2$, resistant ascites, and signs of azotemia (elevated BUN and serum creatinine). 5. Diminished glomrular filtration rate with low filtration fraction and decreased renal fraction of cardiac output observed strongly supported increased renal afferent arteriolar resistance. 6. Renal circulatory impairment preceded azotemia or oroliguria in cirrhosis. 7. Clinical findigns and liver function were not correlated with hemodynamic changes, except for esophageal varices associated with high cardiac output obsedved. 8. No definite correlation of renal hemodynamics with plasma volume or cardiac output was found.

• The Korean Journal of Physiology and Pharmacology
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• v.4 no.3
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• pp.253-261
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• 2000

Head-out water immersion induces marked increase in the cardiac stroke volume. The present study was undertaken to characterize the stroke volume change by analyzing the aortic blood flow and left ventricular systolic time intervals. Ten men rested on a siting position in the air and in the water at $34.5^{circ}C$ for 30 min each. Their stroke volume, heart rate, ventricular systolic time intervals, and aortic blood flow indices were assessed by impedance cardiography. During immersion, the stroke volume increased 56%, with a slight (4%) decrease in heart rate, thus cardiac output increased ${\sim}50%.$ The slight increase in R-R interval was due to an equivalent increase in the systolic and diastolic time intervals. The ventricular ejection time was 20% increased, and this was mainly due to a decrease in pre-ejection period (28%). The mean arterial pressure increased 5 mmHg, indicating that the cardiac afterload was slightly elevated by immersion. The left ventricular end-diastolic volume index increased 24%, indicating that the cardiac preload was markedly elevated during immersion. The mean velocity and the indices of peak velocity and peak acceleration of aortic blood flow were all increased by ${\sim}30%,$ indicating that the left ventricular contractile force was enhanced by immersion. These results suggest that the increase in stroke volume during immersion is characterized by an increase in ventricular ejection time and aortic blood flow velocity, which may be primarily attributed to the increased cardiac preload and the muscle length-dependent increase in myocardial contractile force.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.672-674
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• 2002

A 40-years-old male with dilated cardiomyopathy(DCMP) and end-stage heart failure had undergone partial left ventriculectomy(PLV) in July 1997 and then underwent cardiac transplantation in January 1999. Three months later he showed increased ejection fraction (EF) from 26% to 42.6%, decreased left ventricular end diastolic diameter(LVEDD) from 71mm to 45mm, cardiac output(CO) 3.95 L/min and cardiac index(CI) 2.28 L/min/m$^2$echocardiographically. Eight months later, left ventriclular end diastolic and systolic diameters increased to 56 and 51 mm respectively and EF decreased to 17% in echocardiographic follow-up. He had been on maximum medication until he underwent cardiac transplantation 18 months after the PLV. Consecutive myocardial biopsies (1, 3 and 6 month later) showed ISHLT (international society of heart and lung transplantation) class la and the treatment for rejection was not needed until now on. We report a partial left ventriculectomy as a successful bridge to cardiac transplantation in a patient with DCMP and end-stage heart failure.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.353-360
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• 2019

Background: Controlled hypotension (CH) provides a better surgical environment and reduces operative time. However, there are some risks related to organ hypoperfusion. The EV1000/FloTrac system can provide continuous cardiac output monitoring without the insertion of pulmonary arterial catheter. The present study investigated the efficacy of this device in double jaw surgery under CH. Methods: We retrospectively reviewed the medical records of patients who underwent double jaw surgery between 2010 and 2015. Patients were administered conventional general anesthesia with desflurane; CH was performed with remifentanil infusion and monitored with an invasive radial arterial pressure monitor or the EV1000/FloTrac system. We allocated the patients into two groups, namely an A-line group and an EV1000 group, according to the monitoring methods used, and the study variables were compared. Results: Eighty-five patients were reviewed. The A-line group reported a higher number of failed CH (P = 0.005). A significant correlation was found between preoperative hemoglobin and intraoperative packed red blood cell transfusion (r = 0.525; P < 0.001). In the EV1000 group, the mean arterial pressure (MAP) was significantly lower 2 h after CH (P = 0.014), and the cardiac index significantly decreased 1 h after CH (P = 0.001) and 2 h after CH (P = 0.007). Moreover, venous oxygen saturation (ScVO₂) decreased significantly at both 1 h (P = 0.002) and 2 h after CH (P = 0.029); however, these values were within normal limits. Conclusion: The EV1000 group reported a lower failure rate of CH than the A-line group. However, EV1000/FloTrac monitoring did not present with any specific advantage over the conventional arterial line monitoring when CH was performed with the same protocol and same mean blood pressure. Preoperative anemia treatment will be helpful to decrease intraoperative transfusion. Furthermore, ScVO₂ monitoring did not present with sufficient benefits over the risk and cost.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.274-280
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• 1977

As a major cause for postoperative hypoxia, the importance of increased physiological shunting is increasingly emphasized. This study is a review and analysis of postoperative physiological shunting following open heart surgery with the aid of extracorporeal circulation. Sixteen patients were selected from among 21 patients who underwent elective open heart surgery at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University, School of Medicine, from December, 1975 to September, 1977. The results were as follows: 1. The degree of postoperative physiological shunt was progressively increased from 18.8% mean value one hour after surgery to 22.7% mean value, reaching a peak on the second postoperative days. 2. For up to one week, large physiological shunt[15%] was persisted in one patient. 3. Comparing long[more than 90 minutes] with short[less than 90 minutes] perfusion time group using pump oxygenator, it was found that the physiological shunt increased about 3% in the long as compared with the short perfusion time group. 4. The mean blood pressure was 70-80 mmHg without a remarkable causal relationship between physiological shunt and mean blood pressure. 5. On elevated $PaO_2$[>200 torr], the physiological shunt was decreased less than 20% of cardiac output, but on diminished $PaO_2$[102 torr] after two days, it was 22.7% of cardiac output. From above results, a contrary causal relationship between $PaO_2$ and physiological shunt was obtained. Co Reviewing chest X-rays postperfusion, it was demonstrated that no remarkable causal relationship between roentgen-ray evidence and physiological shunt could be obtained.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.336-339
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• 1996

Stellate ganglion block which usually practiced in pain clinics may combined with hemodynamic changes because it blocks sympathetic nerve chains. We measured the hemodynamic changes with NCCOM3-$R7^{(R)}$ (BOMED, U.S.A.) which applicated bioimpedance method in twenty-two patients. Mean arterial pressure, heart rate, cardiac output, ejection fraction and left ventricle end diastolic volume (LEDV) were measured before stellate ganglion block (control), 1, 3, 5, 10 and 20 minutes after stellate ganglion block with 8 ml of 0.25% bupivacaine. The results were as follows: Mean arterial pressure decreased significantly (p<0.05) in 10, 20 minutes after stellate ganglion block comparing to control, but not clinically significant. Heart rate, cardiac output, ejection fraction and LVEDV showed no significant change compared to control value. These results showed that stellate ganglion block is a safe technique without significant hemodynamic changes.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.38 no.2
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• pp.106-111
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• 2005

We studied the cardio-respiratory properties in the Japanese amberjack (Seriola quinqueradiata) during acute hypoxia exposure. Fish were exposed to three levels of hypoxia (80, 60 or 50 mmHg) for 60 min at $25^{\circ}C$. Cardiovascular parameters (cardiac output; Q, heart rate; HR, stroke volume; SV, blood pressure; $P_{DA}$) changed little from pre-exposure values during both 80 and 60 mmHg of hypoxia. During 50 mmHg of hypoxia, the fish showed a bradycardia which significantly affected Q, whereas no change in SV. $P_{DA}$ increased transiently. Arterial oxygen partial pressure ($PaO_2$) immediately reduced along with a decrease of the water oxygen partial pressure ($P_WO_2$). Arterial $O_2$ content ($CaO_2$) decreased significantly only after 60 min of 50 mmHg of hypoxia. Arterial pH (pHa) and hematocrit value (Hct) did not change significantly. Comparing the effects of different levels of hypoxia, oxygen delivery to the tissues ($Q\;{\times}\;CaO_2$) should be maintained a constant over a broad range of $P_WO_2$, however, severely depressed below 50 mmHg of hypoxia.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.664-667
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• 2002

Extracorporeal membrane oxygenation(ECMO) provides stable oxygenation to prevent elevation of pulmonary vascular resistance and bypasses a significant part of cardiac output to the pulmonary vascular bed to reduce pulmonary perfusion pressure. In addition, ECMO prevents right heart failure and low cardiac output by means of ventricular assist and reduction in volume load to right ventricle. As a result, ECMO can be used for the treatment of pulmonary hypertensive crisis after surgery for congenital heart disease, especially when it is refractory to conventional measures. We report a case of postoperative pulmonary hypertensive crisis, developed in a 37-year-old male with patent ductus arteriosus with secondary pulmonary hypertension, which was successfully managed including ECMO.

• Journal of Korean Clinical Nursing Research
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• v.14 no.3
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• pp.141-151
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• 2008

Purpose: This study aimed at applying a standardized nursing process to adult surgery patients of post anesthetic care unit, and examining the validity of linkages in the measuring index of nursing outcome by which nursing outcome was applied. Method: The subjects were 184 surgery adult patients admitted at the post anesthetic care unit of Y university hospital. This study was used the measured tool developed by Choi et al.(2004) and by Lee (2004) who had already verified a validity based on Johnson and Bulechek's study(2001). Results: The nursing diagnosis of an acute pain, an urinary retention, a nausea, a decreased cardiac output, an ineffective airway clearance and an ineffective airway clearance were used in taking care for patients. The related factors according to the main nursing diagnosis were as the following: an injurious physical factor in an acute pain, reflex are inhibition in an urinary retention, post surgical anesthesia in a nausea, stroke volume change in a decreased cardiac output, secretory stasis in an ineffective airway clearance, pain in an ineffective breathing pattern. Conclusion: The study results could be facilitated in nursing process application for nurses at post anesthetic care unit. Also this study would provide basic data to develop a computerized program for the improvement of nursing process application.

• Journal of Korean Academy of Nursing
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• v.41 no.2
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• pp.191-196
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• 2011

Purpose: We investigated the effects of group III mechanoreceptors to cardiovascular responses in both pre-menopausal woman and post-menopausal woman during passive ankle dorsiflexion (PAD). Methods: Twenty healthy volunteers (10 post-menopausal women and 10 pre-menopausal women) were recruited for this study. Stroke volume (SV), heart rate (HR), cardiac output (CO), and total vascular conductances (TVC) were measured continuously throughout the experiment. To stimulate the group III mechanoreceptors, PAD was performed for one minute. Results: The results showed that mean arterial pressure (MAP) mediated by the mechanoreflex activation was significantly increased in both groups. However, this pressor response was significantly higher in post-menopausal women. This reflex significantly increased both SV and CO in pre-menopausal women, while there were no differences in post-menopausal women. There was no difference in HR in either group. The mechanoreflex significantly decreased TVC in post-menopausal woman, while there was no difference in pre-menopausal woman. Conclusion: The results indicate that the excessive pressor response mediated by the mechanoreflex occurs due to overactivity of group III mechanorecptors and the mechanism is produced mainly via peripheral vasoconstriction in post-menopausal women.