• Title/Summary/Keyword: Heart arrest

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Primary Surgical Closure of Large Ventricular Septal Defects in Small Infants (조기 영아기 심실 중격 결손의 개심술)

  • 최종범;양현웅
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.486-492
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    • 1997
  • We r viewed a policy of primary surgical closure of large ventricular septal defects in small infants. Sixty-three infants met criteria for inclusion in the study, and were divided into two groups based on age: group 1 infants aged less than 5 months(n = 31), and group 2 infants aged 5 months or more(n = 32). Both groups had similar variation in ventricular septal defect location(paramembranous versus muscular), and showed no significant difference in left to right shunt and in ratio of systemic and pulmonary vascualr resistance. Three early deaths(9.7%) occurred in group 1, but no death(0%) in group 2. The causes of death were preoperative cardiac arrest and cerebral injury followed by postoperative respiratory insufficiency in two patients, and preoperative tracheomalacia followed by laryngeal edema and respiratory arrest in one Two patients in group 1 showed postoperative low cardiac output syndrome(6.5% in group 1 versus 0% in group 2). There was no late death during the follow-up per od in both groups. No surviving patients had postoperative patch leakage, or required a second operation. These results indicate that primary surgical closure of large ventricular septal defects, if logical perioperative care is accompanied, can be saefly performed in small infants aged less than 5 months with low postoperative mortality or morbidity rates.

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Spatial Relationship of the Left Ventricle in the Supine Position and the Left Lateral Tilt Position (Implication for Cardiopulmonary Resuscitation in Pregnant Patients) (앙와위와 좌측 기울린위치에서의 좌심실의 공간적 관계 변화. 임신부 심폐소생술 측면에서)

  • Yun, Jong Geun;Lee, Byung Kook
    • Fire Science and Engineering
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    • v.27 no.5
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    • pp.75-79
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    • 2013
  • Application of the left lateral tilt position has been recommended during cardiopulmonary resuscitation (CPR) of pregnant patients. However, the left lateral tilt could displace the left ventricle (LV) besides the gravid uterus and may compromise the cardiac pump mechanism of CPR. Thus, we investigated the effect of left lateral tilt on the spatial relationship between the anterior-posterior axis (AP axis), which represents the direction of sternal displacement during CPR, and the LV. We retrospectively reviewed the medical records and multidetector computed tomography (MDCT) scans of 90 patients who underwent virtual gastroscopy using MDCT. Virtual gastroscopy was performed with the patient both in the left lateral tilt position and in the supine position. On an axial image showing the maximal area of the LV, the angle between the AP axis and the LV axis ($Angle_{AP-LV}$), the shortest distance between the AP axis and the mid-point of LV cavity ($D_{AP-MidLV}$) and the shortest distance between the AP axis and the LV apex ($D_{AP-Apex}$) were measured. In the supine scans, the LV was situated on the left side of the AP axis in 87 patients (96.7%). On the left lateral tilt scans, the mean tilt angle was $43.4{\pm}11.0^{\circ}$. $D_{AP-MidLV}$ and $D_{AP-Apex}$ were significantly longer in the left lateral tilt position (p<0.001), but $Angle_{AP-LV}$ was comparable between the positions. This study indicates that the left lateral tilt position may compromise the cardiac pump mechanism of chest compression in pregnant cardiac arrest patients.

A study of incidence and trend of unexpected sudden death of studentsin school during 17 years from 1988 to 2004 in seoul (최근 17년간(1988년-2004년) 학교내 학생 돌연사 빈도 및 추이 분석)

  • Lee, Hui-U;Sin, Seon-Mi;Hong, Yeong-Mi;Kim, Min-Hoe;Yun, Deok-Seop;O, Gyeong-Sun;Lee, Bun-Ok;Gwon, Yong-Cheol;Sin, Sang-Uk;Kim, Tae-Suk
    • Journal of the Korean Society of School Health
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    • v.19 no.1
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    • pp.1-15
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    • 2006
  • Purpose : This study was to identify the incidence, trend, and situation of the unexpected sudden death of elementary, middle, and high school students in school for 17 years from 1988 to 2004 in seoul. Methods : We used the data of The Seoul Safety Mutual aid Association in seoul. Subjects were 53 unexpected sudden death in school from elementary, middle, and high school students, and we explored the gender, month, a day of the week, year, contents of situation, and medical certificate of death. Statistic analysis were chi-square test, Cochran-Armitage trend test, and the tool was SAS 9.1.Results : There were 53 unexpected sudden death students(male 42 and female 11). The incidence of male students was higher than that of female during 16 years except in 1995. The incidence occurred in middle school students were 31 (58.5%) of 53 and were also most frequent in middle school students in both of male and female students. In 1990, the incidence was 8(15.1%) students, 6(11.3%) in 1992 , and 5(9,4%) in 2000 respectively. The frequency of unsuspected sudden death in March was 11(20.8%) of 53 students, 11 (20.8%) in September, 7(13.2%) in October. In Thursday, it was 12(22.6%) of 53 students. Only 14(26.4%) students of 53 died during general life, but 39(73.6%) were related to excercise. The diagnosis of 14 students died during general life were cardiac arrest 7(50.5%), brain disorder 3(21.4%) which were based on medical certificate. But the diagnosis of 39 students died during or after excercise were brain disorder including cerebral hemorrhage 9(23.1%), heart disease 9(23.1%), cardiac arrest 8(20.5%), and unknown 6(15.4%), respectively. Conclusion : The incidence of unexpected sudden death were more frequent in male students, in middle school, and in excercise-related situation and the trend was similar for 17 years. Therefore, to prevent the unexpected sudden death, it needs to further study substantially the risk factors of unexpected sudden death including past history, life-style, nutrition and development, family history, and learning environment.

South Korean and Japanese intention to use automated external defibrillators in out-of-hospital cardiac arrest situations (일반인의 AED 사용에 관한 한·일 비교 연구)

  • Leem, Seung-Hwan
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.1
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    • pp.17-27
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    • 2014
  • Purpose : The purpose of the study is to investigate the factors influencing using AED use in South Korea and Japan. Methods : I conducted a questionnaire survey from February 25 to March 4, 2013, receiving responses from 517 people in Korea and 520 people in Japan. The questionnaire included sociodemographic factors, history of heart disease, AED knowledge, and other variables. A logistic regression analysis was conducted. Results : Among the 517 Korean respondents, 220 (42.6%) intended to use AEDs. Among the 520 Japanese respondents, 384 (74.4%) had similar intentions. Multiple logistic regression analysis found the following significant predictors of intent to use AEDs: gender (odds ratio [OR] = 0.419), household income (OR = 0.991), and AED knowledge (OR = 2.833) in Korea; and gender (OR = 0.582), age (OR = 0.968), cardiac disease history (OR = 2.099), and AED knowledge (OR = 2.984) in Japan. Conclusion : It would be helpful to teach AED use to encourage performing public access defibrillation. In addition, it is necessary to design AED education programs based on country-specific factors.

Evaluating the Quality of Basic Life Support Information for Primary Korean-Speaking Individuals on the Internet (국내 인터넷 웹 페이지에 나타난 기본심폐소생술 정보의 질 평가)

  • Kang, Hee Do;Moon, Hyung Jun;Lee, Jung Won;Choi, Jae Hyung;Lee, Dong Wook;Kim, Hyun Su;Kang, In Gu;Kim, Doh Eui;Lee, Hyung Jung;Lee, Han You
    • Health Communication
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    • v.13 no.2
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    • pp.125-132
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    • 2018
  • Purpose: The aim of this study is to investigate the quality of basic life support (BLS) information for primary Korean-speaking individuals on the internet. Methods: Using the $Google^{(C)}$ search engine, we searched for the terms 'CPR', 'cardiopulmonary resuscitation (in Korean)' and 'cardiac arrest (in Korean)'. The accuracy, reliability and accessibility of web pages was evaluated based on the 2015 American heart association(AHA) guidelines for CPR & emergency cardiovascular care, the health on the net foundation code of conduct and Korean web content accessibility guidelines 2.1, respectively. Results: Of the 178 web pages screened, 50 met criteria for inclusion. The overall quality of BLS information was not enough (median 5/7, IQR 4.75-6). 23(36%) pages were created in accordance with 2010 AHA guidelines. Only 24(48%) web pages educated on how to use the automated electrical defibrillator. The attribution and transparency of the reliability of pages was relatively low, 20(40%) and 16(32%). The web accessibility score was relatively high. Conclusion: A small of proportion of internet web pages searched by Google have high quality BLS information for a Korean-speaking population. Web pages based on past guideline were still being searched. The notation of the source of CPR information and the transparency of the author should be improved. The verification and evaluation of the quality of BLS information exposed to the Internet are continuously needed.

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.

Percutaneous Cardiopulmonary Support (PCPS) for Patients with Cardioppulmonary Bypass Weaning Failure during Open Heart Surgery (개심술 중 심폐기 이탈에 실패한 환자에게 적용한 경피적 심폐순환 보조장치)

  • Ryu, Kyoung-Min;Park, Seong-Sik;Seo, Pil-Won;Ryu, Jae-Wook;Kim, Seok-Kon
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.604-609
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    • 2009
  • Background: Recently, percutaneous cardiopulmonary support (PCPS) has been widely used to rescue patients in cardiogenic shock or cardiac arrest. However, patients with cardiopulmonary bypass (CPB) weaning failure during open heart surgery still have very poor outcomes after PCPS. We investigated clinical results and prognostic factors for patients who underwent PCPS during open heart surgery. Material and Method: From January 2005 to December 2008, 10 patients with CPB weaning failure during open heart surgery underwent PCPS using the CAPIOX emergency bypass system ($EBS^{(R)}$, Terumo Inc, Tokyo, Japan). We retrospectively reviewed the medical records of those 10 patients. Result: The average age of the patients was $60.2{\pm}16.5$ years (range, $19{\sim}77$ years). The mean supporting time was $48.7{\pm}64.7$ hours (range, $4{\sim}210$ hours). Of the 10 patients, 6(60%) were successfully weaned from the PCPS While 5 (50%) were able to be discharged from the hospital. Complications were noted in 5 patients (50%). In univariate analysis, long aortic cross clamp time during surgery, mediastinal bleeding during PCPS and high level of Troponin-I before PCPS were significant risk factors. All of the discharged patients are still surviving $34{\pm}8.6$ months (range, $23{\sim}48$ months) post-operatively. Conclusion: The use of PCPS for CPB weaning failure during open heart surgery can improve the prognosis. More experience and additional clinical studies are necessary to improve survival and decrease complications.

The New International Guidelines for Cardiopulmonary Resuscitation (심폐소생술의 최신지침 소개)

  • 우건화
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.451-455
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    • 2003
  • In August 2000, the American Heart Association and the European Resuscitation Council published the conclusions of tile International Guidelines 2000 Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care which contains both the new recommendations and an in-depth review. The most important changes in the recommendations according to the authors are discontinuation of the pulse-check for lay people, 500 ml instead of 800∼1,200 ml tidal volume during bag-valve-mask ventilation (FiO2 > 0.4) of a patient with an unprotected airway, unifying correct endotracheal intubation size as 8.0 mm, vasopressin (40 units) and epinephrine (1 mg) as comparable drugs to treat patients with ventricular fibrillation, early prehospital survey and intravenous lysis for patients who have suffered coronary artery syndrome and stroke.

cDNA Cloning, Tissue Expression and Association of Porcine Pleiomorphic Adenoma Gene-like 1 (PLAGL1) Gene with Carcass Traits

  • Zhang, F.W.;Cheng, H.C.;Deng, C.Y.;Xiong, Y.Z.;Li, F.E.;Lei, M.G.
    • Asian-Australasian Journal of Animal Sciences
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    • v.19 no.9
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    • pp.1257-1261
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    • 2006
  • Pleiomorphic adenoma gene-like1 (PLAGL1) encodes a zinc-finger (ZF) protein with seven ZFs of the C2H2-type which is a regulator of apoptosis and cell cycle arrest, and also regulates the secretion of insulin. In both human and mouse, PLAGL1 is a candidate gene for tumor suppressor and transient neonatal diabetes mellitus (TNDM). In this study, a 2,238 bp fragment covering the complete coding region was obtained and deposited to GenBank (accession number: DQ288899). The reverse transcriptase-polymerase chain reaction (RT-PCR) indicated that PLAGL1 was expressed almost equally in heart, liver, spleen, lung, kidney, stomach, small intestine, skeletal muscle, fat, uterus and ovary. Comparing the sequences of Large White and Meishan pigs, a C-T transition in exon 6 was found. The polymorphism could be detected by TaqI and was genotyped in five purebreds (Large White, Landrace, Meishan, Tongcheng and Bamei). Association analysis was performed between the polymorphism and carcass traits in 276 pigs of a "Large White${\times}$Meishan" F2 resource population. As a consequence, significant associations of the genotypes with shoulder backfat thickness (SFT) and internal fat rate (IFR) were observed. Pigs with TT genotype had low SFT and high IFR compared with TC or CC genotypes.

Simulation Nursing Education Research Topics Trends Using Text Network Analysis (텍스트네트워크분석을 적용하여 탐색한 국내 시뮬레이션간호교육 연구주제 동향)

  • Park, Chan Sook
    • Journal of East-West Nursing Research
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    • v.26 no.2
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    • pp.118-129
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    • 2020
  • Purpose: The purpose of this study was to analyze the topic trend of domestic simulation nursing education research using text network analysis(TNA). Methods: This study was conducted in four steps. TNA was performed using the NetMiner (version 4.4.1) program. Firstly, 245 articles from 4 databases (RISS, KCI, KISS, DBpia) published from 2008 to 2018, were collected. Secondly, keyword-forms were unified and representative words were selected. Thirdly, co-occurrence matrices of keywords with a frequency of 2 or higher were generated. Finally, social network-related measures-indices of degree centrality and betweenness centrality-were obtained. The topic trend over time was visualized as a sociogram and presented. Results: 178 author keywords were extracted. Keywords with high degree centrality were "Nursing student", "Clinical competency", "Knowledge", "Critical thinking", "Communication", and "Problem-solving ability." Keywords with high betweenness centrality were "CPR", "Knowledge", "Attitude", "Self-efficacy", "Performance ability", and "Nurse." Over time, the topic trends on simulation nursing education have diversified. For example, topics such as "Neonatal nursing", "Obstetric nursing", "Pediatric nursing", "Blood transfusion", "Community visit nursing", and "Core basic nursing skill" appeared. The core-topics that emerged only recently (2017-2018) were "High-fidelity", "Heart arrest", "Clinical judgment", "Reflection", "Core basic nursing skill." Conclusion: Although simulation nursing education research has been increasing, it is necessary to continue studies on integrated simulation learning designs based on various nursing settings. Additionally, in simulation nursing education, research is required not only on learner-centered educational outcomes, but also factors that influence educational outcomes from the perspective of the instructors.