• Journal of Chest Surgery
• /
• v.25 no.3
• /
• pp.240-246
• /
• 1992

The effects of extracorporeal circulation on plateler count were studied in 120 patients. We measured platelet count before, during, after extracorporeal circulation, and postoperative 0, 1, 3, 5, 7, 9, 11th days to evaluate the effects of total extracorporeal circulation time and types of oxygenator on changes of platelet count The patients were classified into group I [extracorporeal circulation time < 100 minutes, 45 patients], II [100 < extracorporeal circulation time < 200 minutes, 48 patients], III [extracorporeal circulation time >200 minutes, 27 patients], and also all patients were classified into group B [bubble oxygenator, 84 patients] and group M [membrane oxygenator, 36 patients]. The group I, II, III were subclassified into IB, IM, IIB, IIM, IIIB and IIIM according to the types of oxygenator. The results were as follows: 1. The platelet counts were reduced throughout extracorporeal circulation and in the early postoperative periods upto postoperative third day. 2. The platelet counts after postoperative 9th to 11th day increased significantly compared with those of preoperative levels. 3. After extracorporeal circulation, the platelet recovered gradually in all groups, especially faster in group I compared with those of group II and III. 4. The effect of the type of oxygenator on the recovery of platelet count was not significant. In conclusion, extracorporeal circulation time influenced the change of platelet count. Therefore, in order to prevent of decrease of platelet count associated with extracorporeal circulation time, the extracorporeal circulation time should be shortened.

• Journal of Chest Surgery
• /
• v.22 no.4
• /
• pp.525-547
• /
• 1989

Hemorrhagic tendency observed in open heart surgery patients has been attributed, among other causes, to increased fibrinolytic activity during extracorporeal circulation. But the exact mechanism of enhanced fibrinolytic activity which occurs during extracorporeal circulation is still unknown. So, we studied and compared the changes of parameters of fibrinolytic and protein C system according to time obtained from the plasma of 31 adult open heart surgery patients[EGG group] and 10 adult general thoracic surgery patients[control group], in order to confirm the hypothesis that the activated protein C system might affect the fibrinolytic system during extracorporeal circulation. In ECC group, the nature of the enhanced fibrinolytic activity that evolved during extracorporeal circulation was characterized by significant increase in fibrin degradation products[P < 0.01] and significant decrease in plasminogen and alpha2-antiplasmin[P < 0.05, P < 0.01] in spite of adequate amount of heparin administration. These changes were most pronounced in the early phase of extracorporeal circulation and normalized after termination of extracorporeal circulation. The results of these observations were the same after volume correction with the value of hematocrit. The change of volume corrected protein C ratio during extracorporeal circulation revealed similar pattern to those of plasminogen and alpha2-antiplasmin [P < 0.01], but volume corrected ratio of free protein S showed significant increase after the commencement of extracorporeal circulation then decreased after extracorporeal circulation. Although the above mentioned changes occur similarly in both bubble type oxygenator-used and membrane oxygenator-used patients groups, but the degree of decrease was more severe in membrane oxygenator-used patients group [P < 0.01] and showed much slower recovery to reach to the preextracorporeal circulation level. These results confirm the hypothesis that the enhanced fibrinolysis during extracorporeal circulation might be caused by the activation of protein C system and the activation is possibly linked to the appearance of thrombin from contact activation of blood after wide exposure to the synthetic surfaces of extracorporeal circuit. Key words: Extracorporeal circulation, Enhanced fibrinolysis, Protein C system.

• The Transactions of the Korean Institute of Electrical Engineers P
• /
• v.67 no.1
• /
• pp.52-56
• /
• 2018

Extracorporeal shockwave therapy has been widely spread out showing an excellent efficacy compared to traditional medicinal treatments, interventional procedures or surgeries for diseases of tendons and musculoskeletal system. Major performance tests of extracorporeal shockwave therapy consist of pressure, energy flux, concentration, and effective amount of energy on the focus area of shockwave according to IEC 61846. Shockwave should be irradiated accurately to the lesion area to improve the performance of extracorporeal shockwave therapy, which makes it necessary to add the relevant section, IEC 60601-2-36 (12.1.101. Precision of Target Markers and Target Locations). International standards of extracorporeal shockwave therapy have been prepared based on European and western people. Thus, we need to conduct many studies on Korean patients to improve the quality of extracorporeal shockwave therapy and to develop the medical industry. In addition, the performance evaluation of extracorporeal shockwave therapy which has been prepared according to international standards should be additionally modified and supplemented corresponding to the Korean circumstances.

• Journal of Korean Medicine Rehabilitation
• /
• v.30 no.2
• /
• pp.95-103
• /
• 2020

Objectives This report aimed to review literatures using extracorporeal shock wave with syndrome differentiation theory. Methods By March 3, 2020, five foreign electronic databases (PubMed, Web of Science, Cochrane Library, EMBASE, CAJ) and six Korean medical electronic databases (KMBASE, KISTI, KISS, NDSL, DBpia, RISS) were reviewed with the key word 'extracorporeal shock wave' and 'syndrome differentiation'. We did not impose restrictions on age, gender, treatment methods, duration, results and the design of the paper. Results Twelve papers met the inclusion criteria. Seven papers used extracorporeal shock wave lithotripsy with syndrome differentiation theory and six out of seven papers treated urologic stones using extracorporeal shock wave lithotripsy. The other five papers used extracorporeal shock wave therapy with syndrome differentiation theory and four of them treated musculoskeletal disorders. However, the data of the characteristics of extracorporeal shock wave was insufficient. Conclusions After thorough review, it is considered to be meaningful to treat urologic stones and musculoskeletal disorders using extercorporeal shock wave with syndrome differentiation theory. However, some of the literatures were limited in their feasibility and reliability in terms of research design. In addition, the data regarding the strength of the extracorporeal shock wave applied on each acupoints was insufficient. Therefore, further study on the use of extracorporeal shock wave on acupoints should be conducted.

• Kosin Medical Journal
• /
• v.33 no.3
• /
• pp.477-482
• /
• 2018

Intraoperative pulmonary thromboembolism is a high mortality situation. Early mortality in patients with pulmonary thromboembolism varies from 2% in normotensive patients to 30% in patients with cardiogenic shock. The use of extracorporeal cardiopulmonary resuscitation can improve survival and neurologic outcomes of cardiac arrest. We report a case of intraoperative massive pulmonary thromboembolism with circulatory collapse and cardiac arrest during anesthesia for pelvic bone fracture surgery, which were rescued by extracorporeal membrane oxygenation.

• Journal of Chest Surgery
• /
• v.11 no.3
• /
• pp.296-302
• /
• 1978

This experiment was carried out to study the change of potassium before, during, and after extracorporeal circulation. Serum potassium and urinary potassium excretion were examined in 7 cases of patient who were taken open heart surgery using extracorporeal circulation. All of 7 cases were administered 10-25mEq of KC1 during extracorporeal circulation. Serum potassium was not changed significantly during, and after operation, but urinary potassium excretion was declined during extracorporeal circulation and tend to rise after extracorporeal circulation. This result showed no remarkable relation of serum potassium and urinary potassium excretion.

• Journal of Chest Surgery
• /
• v.7 no.1
• /
• pp.73-78
• /
• 1974

Influences on organ function were studied in animals during prolonged extracorporeal circulation with a bubble type of oxygenator. More than six hours of total cardiopulmonary bypass was performed under mild hypothermia by means of an extracorporeal circulation system in five dogs. Obtained results were summarized as follows. 1. The renal function was not so impaired seriously until four hours of extracorporeal circulation. However, there was more serious impairment of renal function in this study when extracorporeal circulation was carried out for a period of five hours or more. 2. There was gradual hepatic damage during extracorporeal circulation and the damage was more significant after bypass for a period of five to six hours. 3. There was a significant decrease in serum K during bypass, irrespective of the pump oxygenator prime with a high K solution. The reason for this is complex and due to many factors, however, it was evidently related to serum glucose levels during extracorporal circulation.

• Transactions on Electrical and Electronic Materials
• /
• v.16 no.1
• /
• pp.25-28
• /
• 2015

In this study, a basic research on artificial liver was performed for its application to people on the waiting list of liver transplant or patients with hepatic insufficiency. Artificial livers are generally classified into mechanic type, bioartificial type, and hybrid type. An extracorporeal circulation device was examined herein, which is indispensable in the application of an artificial liver, for its effectiveness in supporting the recovery of liver functions. Extracorporeal circulation system is a treatment and life-support system which sends out the patient's blood, removes toxicity by various methods, and then sends the blood back to the interior of the body. This study used an extracorporeal circulation system which enables the Plasma Perfusion by CVVH method, and applied the program of Bioateco corp. Animals with acute hepatic insufficiency were produced to apply the extracorporeal circulation device. As a result, their ammonia, bilirubin, SGOT, SGPT, and bile acid levels rose, confirming the liver function restoration in the experimental animals.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.7 no.2
• /
• pp.150-155
• /
• 2009

Purpose: Extracorporeal elimination of drugs is a critical part of managing poisonings, although the indications and optimal method remain a matter of debate. The aim of this study is to report our clinical experiences with continuous renal replacement therapy (CRRT), as performed by emergency room physicians, as method of extracorporeal drug elimination in patients with poisoning. Methods: This study was a retrospective study of the consecutive patients who underwent CRRT, as performed by an emergency room physician, for acute poisoning. The patient characteristics, the kinds of drugs and the method of extracorporeal elimination were analyzed by reviewing the patients' charts. Results: During eleven months, 26 patients with acute poisoning underwent extracorporeal elimination (2 patients; intermittent hemodialysis, 24 patients; CRRT). The mean time from the decision to performing extracorporeal elimination was $206.0{\pm}36.8$ minutes for intermittent hemodialysis, $62.9{\pm}8.5$ minutes for continuous venoveno-hemodiafiltration (CVVHDF) and $56.6{\pm}6.8$ minutes for charcoal hemoperfusion. For the patients with CRRT, CVVHDF was conducted in 10 patients (3 patients; valproic acid, 2 patients; Lithium, 1 patient; salicylates, 1 patient; methanol) and charcoal hemoperfusion by using CRRT was done in 14 patients (13 patients; paraquat, 1 patient; dapsone). For the 12 patients who required hemodialysis due to severe poisoning, 7 patients underwent CRRT because of their unstable vital signs. Conclusion: CRRT was an effective method of extracorporeal drug elimination in patients with acute poisoning, and especially for the cases with unstable vital sign and for those patients who required an early start of extracorporeal elimination according to the characteristics of the drug. (ED note: the writing of the abstract was not clear. Check it carefully.)

• Tuberculosis and Respiratory Diseases
• /
• v.72 no.1
• /
• pp.1-7
• /
• 2012

Extracorporeal Membrane Oxygenation (ECMO) support to tissue oxygenation has been shown to improve survival in patients with life threatening respiratory distress syndrome or cardiac failure. Extracorporeal life support such as ECMO, including extracorporeal $CO_2$ removal ($ECCO_2R$), is used as temporary support until successful recovery of organs. A recently published multicentre randomized controlled trial, known as the CESAR (conventional ventilation or extracorporeal membrane oxygenation for severe adult respiratory failure) trial, was the first trial to demonstrate the utility of ECMO in acute respiratory distress syndrome (ARDS). During the 2009 influenza A (H1N1) pandemic, there were many reports of patients with severe ARDS related to H1N1 infection treated with ECMO. These reports revealed a high survival rate and effectiveness of ECMO. In this review, we explain the indication of ECMO clinical application, the practical types of ECMO, and complications associated with ECMO. In addition, we explain recent new ECMO technology and management of patients during ECMO support.