• The Korean Journal of Emergency Medical Services
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• v.17 no.3
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• pp.53-60
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• 2013

Purpose: The purpose of the study is to emphasize the importance of out-of-hospital cardiac arrest resuscitation. This resuscitation by paramedic is very effectively performed under the medical direction of the doctors. Methods: The cardiac arrest victim was 4 month old infant. Informed consent from the parents of the infant was received. CPR combined with 150J defibrillation was performed to the 4 month old infant. Results: We reported that the 4 month old infant survived the cardiac arrest. Out-of-hospital cardiac arrest infant survived after 150J automated external defibrillator and CPR performance. Conclusion: Specific operative protocol is important because the paramedic can apply the proper manual defibrillator effectively. It is important to extend the work scpoe of the EMT.

• 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.

• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.107-116
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• 2020

Purpose: We compared three chest compression methods to find an efficient method for performing infant cardiopulmonary resuscitation (CPR) for single rescuers and improving chest compressions quality. Methods: Thirty new marine police trainees at the Korea Coast Guard Education Institute were tested for five sessions using three methods of single rescuer infant CPR: two-finger chest compression, two-thumb encircling chest compression, and two-finger support chest compression. Results: The depth, accuracy, and number of compressions per minute of resuscitation were analyzed for the above three methods. The depth of two-finger chest compression, two-thumb encircling chest compression, and two-finger support chest compression was 3.53±0.20cm, 4.10±0.13cm, and 4.22±0.15cm, respectively. Accuracy was 23.86±12.59%, 54.11±10.8%, 71.55±18.81%, respectively, while the time for one cycle of 30 chest compression was 16.01±10.5 seconds, 16.45±0.85 seconds, and 16.56±0.91 seconds, respectively. Chest compression interruptions were 6.59±0.78 seconds, 7.17±0.37 seconds, and 6.97±0.35 seconds, respectively. The interruptions were consistent with the range of 5-10 seconds suggested by the American Heart Association. Conclusion: When one rescuer performs CPR for an infant in cardiac arrest, a comparative analysis of three methods showed that two-thumb encircling chest compression is the best for accuracy and efficiency of chest compressions.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.323-327
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• 1987

Majority of patients with total anomalous pulmonary venous drainage [TAPVD] have severe symptoms within the first few months of life. And early in the experience with correction of TAPVD, hospital mortality was high, especially in infant. In Sejong General Hospital, we operated on 3 infants with TAPVD of cardiac type. Repair was performed under the conventional cardiopulmonary by pass in one case and by the total circulatory arrest in other 2 cases. Interatial septum between enlarged coronary sinus opening and interatrial septal defect was excised and the coronary sinus was radically unroofed to make wide opening between left atrium and common pulmonary venous channel. The defect in atrial septum was closed with redundant pericardial patch. Postoperative courses were uneventful except transient dysrrhythmia of A-V dissociation. They are doing well on follow up check.

• Journal of the Korea Society of Computer and Information
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• v.24 no.4
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• pp.153-159
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• 2019

In this paper, we propose a the effects of new chest compressions in the implementation of chest compressions during infant cardiopulmonary resuscitation, and to provide basic data for high-quality CPR. On March 12, 2019, the research target used the SPSS 22.0 Version as an experimental study using randomized cross-design of 30 emergency medical services students who completed BLS Health Care-provider. The study also showed significant differences in chest depth and average rate of pressure($34.61{\pm}1.29$, $39.40{\pm}1.08$, <0.001, $105.46{\pm}4.23$, $107{\pm}3.84$, <0.001) depending on chest compressions. There was also a significant difference in the convenience and degree of pain of chest compressions(<0.001). In addition, new chest compressions appeared close to vertical and showed statistically significant differences(p<.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. However, it will be necessary to further study the use of the new chest compressions to identify the potential for clinical use.

• The Korean Journal of Emergency Medical Services
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• v.7 no.1
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• pp.29-42
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• 2003

The purpose of this study was to development CPR training course to promote wide spread training. The course objectives was based on international Guidelines 2000. The course presents information about the AHA adult Chain of survival and signs of heart attack, cardiac arrest, stroke, and chocking in adult, and includes information about healty heart living and actions to reduce the risk of cardiovascular disease. The course also presents information about the AHA infant and chila Chain of survival, signs of breathing emergencies and chocking in infants and children, prevention of sudden infant death syndrome, and prevention of the most common fatal injuies in infants and children. Vedio-mediated instruction is the primary approach to teaching psycomotor skills.

• 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.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.630-637
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• 2000

Backgroud: There are well-known problems in the management of low weight neonates or infants with congenital heart defects. In the past, because of a perceived high risk of operations using cardiopulmonary bypass(CPB) in these patients, there was a tendency for staged palliation without the use of CPB. However, the recent trend has been toward early reparative surgery using CPB, with acceptable mortality and good long-term survival. Therefore we reviewed our results of the operations in infants weighing less than 3kg and considered the technical aspect of conducting the CPB including myocardial protection. Material and Method: Between Jan. 1995 and Jul. 1998, 28 infants weighing less than 3kg underwent open heart surgery for many cardiac anomalies with a mean body weight of 2.7kg(range; 1.9-3.0kg) and a mean age of 41days(range; 4-110days). Preoperative management in the intensive care unit was needed in 20 infants and preoperative ventilator support therapy in 11. Total correction was performed in 23 infants and the palliative procedure in 5. Total circulatory arrest was needed in 11 infants(39%). Result: There were seven hospital deaths(25%) caused by myocardial failure(n=3), surgical failure(n=2), multiorgan failure(n=1), and sudden death(n=1). The median duration of hospital stay and intensive care unit stay were 13days(range; 6-93days) and 6days(range; 2-77days) respectively. The follow-up was achieved in 21 patients and showed three cases of late mortality(15%) and a one-year survival rate of 62%. No neurologic complications such as clinical seizure and intracranial bleeding were noticed immediately after surgery and during follow-up. Conclusion: The early and late mortality rate of open heart surgery in our infants weighing less than 3 kg stood relatively high, but the improved outcomes are expected by means of the delicate conduct of cardiopulmonary bypass including myocardial protection as well as the adequate perioperative management. Also, the longer follow-up for the neurologic development and complications are needed in infants undergoing circulatory arrest and continuous low flow CPB.

• Neonatal Medicine
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• v.18 no.2
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• pp.395-398
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• 2011

Sick sinus syndrome (SSS) is a disorder characterized by sinus node dysfunction. Although the condition is most common in the elderly, it can occur in children including neonates and its recognition and treatment are important. The diagnosis of SSS is based on the presence of sinus bradycardia, sinus arrest or exit block, combinations of sinoatrial and atrioventricular nodal conduction disturbances, and atrial tachyarrhythmias documented in the Holter recordings. In most children with SSS, previous history of congenital heart malformation or cardiac surgery is noted. SSS is also seen in the children including neonates without heart disease or other contributing factors, however SSS is most often idiopathic. The treatment of SSS depends on the basic rhythm problem, but generally involves the placement of a cardiac pacemaker. We report a case of SSS in extremely low birth weight infant without congenital heart disease and suggest that the treatment system is necessary for preterm infants with SSS.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.40-48
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• 1981

Total anomalous venous return defines a group of congenital heart disease which have in common the entire pulmonary venous drainage returning directly or indirectly to the right atrium instead of to the left atrium. Despite of recent advance in treatment, this severe malformation in its various anatomical forms has a high surgical mortality during early infancy. Because of the high mortality in the untreated infant and the surgical risk in the first year of life, the timing of the operation remains important for optimal result. Three cases of T APV R, two supracardiac types and one mixed type, were treated with extracorporeal circulation during last three years in the Dept. of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. The first one was 10 months old male with supracardiac type which drained through left innominate vein, and he was operated with profound hypothermia and total circulatory arrest but failed. The second case was 7 years old male with supracardiac type drained through left innominate vein, and he was well post operatively, and followed periodically for 12 months. The third case was 24 years old female with mixed type drainage (left upper pulmonary vein drained through left innominate vein, and the others through coronary sinus) was successfully corrected, and she was followed for 4 month without problem. All cases were diagnosed with cardiac catheterization and angiocardiogram, and also with echocardiogram in last two cases. In first two cases of supracardiac type, total circulatory arrest was used in brief period during anastomosis between common pulmonary venous trunk and left atrium. In the last case of mixed type, usual cardiopulmonary bypass with moderate hypothermia was used and total circulatory arrest was not needed.