• Title/Summary/Keyword: Cardiopulmonary Resuscitation

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Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of Mortality

  • Byeong A Yoo;Seungmo Yoo;Eun Seok Choi;Bo Sang Kwon;Chun Soo Park;Tae-Jin Yun;Dong-Hee Kim
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.162-170
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    • 2023
  • Background: Extracorporeal cardiopulmonary resuscitation (E-CPR) plays an indispensable role when resuscitation fails; however, extracorporeal life support (ECLS) in infants is different from that in adults. The objective of this study was to evaluate the outcomes of E-CPR in infants. Methods: A single-center retrospective study was conducted, analyzing 51 consecutive patients (age <1 year) who received E-CPR for in-hospital cardiac arrest between 2010 and 2021. Results: The median age and body weight was 51 days (interquartile range [IQR], 17-111 days) and 3.4 kg (IQR, 2.9-5.1 kg), respectively. The cause of arrest was cardiogenic in 45 patients (88.2%), and 48 patients (94.1%) had congenital cardiac anomalies. The median conventional cardiopulmonary resuscitation (C-CPR) time before the initiation of ECLS was 77 minutes (IQR, 61-103 minutes) and duration of ECLS was 7 days (IQR, 3-12 days). There were 36 in-hospital deaths (70.6%), and another patient survived after heart transplantation. In the multivariate analysis, single-ventricular physiology (odds ratio [OR], 5.05; p=0.048), open sternum status (OR, 8.69; p=0.013), and C-CPR time (OR, 1.47 per 10 minutes; p=0.021) were significant predictors of in-hospital mortality. In a receiver operating characteristic curve, the optimal cut-off of C-CPR time was 70.5 minutes. The subgroup with early E-CPR (C-CPR time <70.5 minutes) showed a tendency for lower in-hospital mortality tendency (54.5% vs. 82.8%, p=0.060), albeit not statistically significant. Conclusion: If resuscitation fails in an infant, E-CPR could be a life-saving option. It is crucial to improve C-CPR quality and shorten the time before ECLS initiation.

A Novel Method of Infant Chest Compression: A Study on the Cross-Simulation of Randomization Using Manekin (새로운 영아 가슴압박법의 비교: 마네킨을 이용한 랜덤화 교차 시뮬레이션 연구)

  • Yun, Seong-Woo
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2019.05a
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    • pp.525-527
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    • 2019
  • Cardiac arrest is a series of conditions occur when the heart is stopped, regardless of the cause. one of the only ways to save a patient's life in the event of cardiac arrest is cardiopulmonary resuscitation, which is very important beacause it can maintain circulation through this technique, and high-quality CPR affects the survival rate and neurological prognosis of the patient. For infant cardiopulmonary resuscitation, use two finger to compress the chest. Hower, this method can be diffcult to reach the chest commpressions recommended by the American Heart Association because of the anatomically increased fatigue of the fingers and diffculty of vertical pressure. The study aims to verify the effects of new chest compressions in the implementation of chest compressions during infant cardiopulmonary resuscitation. The study also showed singnificant differences in chest depth and average rate of pressure(p<0.001). Based on the results of this study, we can see that the accuracy of the new chest compressions during infant cardiopulmonary resuscitation is increased, and the depth of chest compressions is improved, improving the quality index of chest compressions.

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Cardiopulmonary Resuscitation: New Concept

  • Lee, Kwang-Ha
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.5
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    • pp.401-408
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    • 2012
  • Cardiopulmonary resuscitation (CPR) is a series of life-saving actions that improve the chances of survival, following cardiac arrest. Successful resuscitation, following cardiac arrest, requires an integrated set of coordinated actions represented by the links in the Chain of Survival. The links include the following: immediate recognition of cardiac arrest and activation of the emergency response system, early CPR with an emphasis on chest compressions, rapid defibrillation, effective advanced life support, and integrated post-cardiac arrest care. The newest development in the CPR guideline is a change in the basic life support sequence of steps from "A-B-C" (Airway, Breathing, Chest compressions) to "C-A-B" (Chest compressions, Airway, Breathing) for adults. Also, "Hands-Only (compression only) CPR" is emphasized for the untrained lay rescuer. On the basis of the strength of the available evidence, there was unanimous support for continuous emphasis on high-quality CPR with compressions of adequate rate and depth, which allows for complete chest recoil, minimizing interruptions in chest compressions and avoiding excessive ventilation. High-quality CPR is the cornerstone of a system of care that can optimize outcomes beyond return of spontaneous circulation (ROSC). There is an increased emphasis on physiologic monitoring to optimize CPR quality, and to detect ROSC. A comprehensive, structured, integrated, multidisciplinary system of care should be implemented in a consistent manner for the treatment of post-cardiac arrest care patients. The return to a prior quality and functional state of health is the ultimate goal of a resuscitation system of care.

Nurses' Cardiopulmonary Resuscitation Performance during the First 5 minutes in In-Situ Simulated Cardiac Arrest (심정지 초기 5분간 일반간호사의 심폐소생술 수행 분석: 현장 시뮬레이션을 이용하여)

  • Kim, Eun-Jung;Lee, Kyeong-Ryong;Lee, Myung-Hyun;Kim, Ji-Young
    • Journal of Korean Academy of Nursing
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    • v.42 no.3
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    • pp.361-368
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    • 2012
  • Purpose: The purpose of this study was to analyze the cardiopulmonary resuscitation skills and teamwork of nurses in simulated cardiac arrests in the hospital. Methods: A descriptive study was conducted with 35 teams of 3 to 4 registered nurses each in a university hospital located in Seoul. A mannequin simulator was used to enact simulated cardiac arrest. Assessment included critical actions, time elapsed to initiation of critical actions, quality of cardiac compression, and teamwork which comprised leadership behavior and communication among team members. Results: Among the 35 teams, 54% recognized apnea, 43% determined pulselessness. Eighty percent of the teams compressed at an average elapsed time of $108{\pm}75$ seconds with 35%, 36%, and 67% mean rates of correct compression depth, rate, and placement, respectively. Thirty-seven percent of the teams defibrillated at $224{\pm}67$ seconds. Leadership behavior and communication among team members were absent in 63% and 69% of the teams, respectively. Conclusion: The skills of the nurses in this study cannot be considered adequate in terms of appropriate and timely actions required for resuscitation. Future resuscitation education should focus on improving the quality of cardiopulmonary resuscitation including team performance targeting the first responders of cardiac arrest.

Knowledge and Attitude about Cardiopulmonary Resuscitation for Nursing Students (간호학생의 심폐소생술에 대한 지식 및 태도)

  • Ahn, Eun-Kyong;Cho, Mee-Kyung
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.3
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    • pp.5-17
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    • 2009
  • Purpose : This study was to examine the knowledge and attitude about cardiopulmonary resuscitation(CPR) for nursing students, and to basic data with CPR education program for nursing student. Method : 128 nursing students filled out a self-administered questionnaires. The data were collected by CPR knowledge and attitude modified by the authors based on Kim's inventory (2008). Result : Nursing students weren't knowledgeable nor confident of CPR. But they had positive attitude about as a first responder. Conclusion : Intensive education by the level of knowledge should be provided for nursing students to master the knowhow of CPR, especially cardiac compression, and evaluation should be reinforced as well. And an education should be offered to enhance their confidence CPR performing CPR.

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Knowledge, attitude, confidence, and experiences of community health practitioner regarding cardiopulmonary resuscitation (보건진료 전담공무원의 심폐소생술에 대한 지식, 태도, 자신감과 수행경험)

  • Hwang, Swong-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.1
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    • pp.55-66
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    • 2014
  • Purpose : The purpose of the study is to investigate the knowledge, attitude, confidence, and experiences of community health practitioner(CHP) regarding cardiopulmonary resuscitation(CPR). Methods : The subjects were 333 CHP in G Province, C Province, and I Metropolitan City. A structured self-reported questionnaire was filled out by 209 participants from July 29, 2013 to September 30, 2013. Results : Confidence level toward CPR was intermediate, and knowledge and attitude level was very low. Seventeen participants performed CPR to cardiac arrest victim. Eleven patients among 25 patients had spontaneous recovery of circulation (ROSC). So the rate was very high. Conclusion : It is necessary to perform the efficient CPR in CHP. In order to improve the positive attitude and confidence in CHP, the renewal system must maintain every two years.

Influencing Factors of Confidence in Performing Cardiopulmonary Resuscitation (CPR) among University Students (대학생의 심폐소생술 수행자신감에 영향을 미치는 요인)

  • Kim, Yu Jeong;Lee, Eun Mi
    • Journal of the Korean Society of School Health
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    • v.30 no.3
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    • pp.194-201
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    • 2017
  • Purpose: The aim of the study was to identify factors influencing confidence in performing cardiopulmonary resuscitation (CPR) of university students. Methods: Data were collected from 261 students recruited from 2 cities using a questionnaire covering confidence, knowledge and attitude in regard to CPR. Results: There was a significant positive correlation between confidence and knowledge (r=.37, p<.001), between attitude and confidence (r=.61, p<.001), and between knowledge and attitude (r=.61, p<.001). Confidence in performance increased as knowledge, attitude, grade, CPR training frequency and educational satisfaction increased. Conclusion: There is a need for CPR training programs that can improve practical training and educational satisfaction of university students.

Mallory-Weiss Tear After Cardiopulmonary Resuscitation in a Patient Suffering From Acute Myocardial Infarction

  • Yu, Jin Seok;Ko, Woo Suk;Kim, June Hyun;Bae, Kwang Uk
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.235-239
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    • 2018
  • A report of a 79 year old male patient suffering from acute myocardial infarction with Mallory-Weiss tear after successful cardiopulmonary resuscitation(CPR) by emergency medical technician in the swimming pool is presented. Successful percutaneous coronary intervention(PCI) was done after appropriate transfusion. The patient survived and discharged without major complications after admitting 11days in the hospital. Importance of CPR in AMI patient is reiterated as complication such as Mallory-Weiss tear may arise.

In-Flight Cardiopulmonary Resuscitation and COVID-19 (기내 심폐소생술과 COVID-19)

  • Kim, Jung Eon
    • Korean journal of aerospace and environmental medicine
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    • v.31 no.3
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    • pp.68-72
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    • 2021
  • As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-ofhospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

Analysis of ROSC cases for out-of-hospital cardiopulmonary resuscitation: Based on Heart Saver laureate for two area (병원 전 심폐소생술에 의한 순환회복 환자의 사례 분석: 두 지역 하트세이버 수여자를 대상으로)

  • Koh, Bong-Yeun;Lee, Jung-Eun;Hong, Sung-Gi
    • The Korean Journal of Emergency Medical Services
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    • v.19 no.3
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    • pp.7-18
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    • 2015
  • Purpose: The purpose of this study was to describe and compare the return of spontaneous circulation (ROSC) cases of out-of-hospital cardiac arrest on the basis of Heart Saver laureate. Methods: This study aimed to investigate the cardiopulmonary resuscitation (CPR) outcomes and the clinical characteristics of patients with out-of-hospital cardiac arrest by analyzing the data of two regions. The data were prehospital emergency reports of 473 patients who survived for > 72 hours after ROSC in two region from January 2012 to December 2013. Results: Among the ROSC patients, 86.8% (G), 77.9% (S) were men and 72.9% (G), 67.9% (S) were of age 41~70 years, 87.6% (G), 82.9% (S) had a witnessed cardiac arrest; and 66.7% (G), 70.6% (S) received cardiopulmonary resuscitation from bystander. Of those who performed the resuscitation, paramedics in 89.1% (G), 89.8% (S). Furthermore, 119 emergency medical technicians were involved in 69.0% of two-rescue teams in G and in 90.4% of three-rescue team in S. Conclusion: Most heart savers were qualified paramedics, and three-rescuer-teams resulted in better survival rate than two-rescuer-teams.