• 한국응급구조학회지
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• 제17권3호
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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.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2019년도 춘계학술대회
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• pp.525-527
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• 2019

심정지(Cardiac arrest)는 원인과 관계없이 심장의 박동이 정지되어 발생하는 일련의 상태를 말한다. 심정지 발생 시 환자의 생명을 구하기 위한 유일한방법 중 하나는 심폐소생술이며 이 술기를 통하여 순환을 유지 시킬 수 있고, 고품질의 심폐소생술은 환자의 생존률과 신경학적 예후에 영향을 미치기 때문에 매우 중요한 술기이다. 영아 심폐소생술의 경우 두 손가락으로 가슴을 압박하는 방법을 사용한다. 하지만 이 방법은 해부학적으로 손가락의 피로도가 가중되고 수직압박이 힘들어 미국심장협회에서 권장한 가슴압박깊이에 도달하기 힘들 수 있다. 이 연구는 영아 심폐소생술 중 가슴압박 시행 시 새로운 가슴압박법의 효과를 검증하고, 고품질의 심폐소생술을 위한 기초자료를 제공하고자 한다. 연구결과 가슴압박 방법에 따라 가슴의 평균압박깊이 및 평균압박 속도가 유의한 차이가 있었다(p<0.001) 또한 가슴압박의 편리성 및 통증정도에서 유의한 차이를 보였다. 본 연구의 결과를 종합해 볼 때 영아 심폐소생술 중 새로운 가슴압박법 시행 시 정확도가 높아지고, 가슴압박 깊이가 나아져 가슴압박의 질적 지표가 개선되었음을 알 수 있었다.

• 한국응급구조학회지
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• 제24권3호
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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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• 제20권2호
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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.

• 한국컴퓨터정보학회논문지
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• 제24권4호
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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.

• 한국응급구조학회지
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• 제7권1호
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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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• 제56권3호
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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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• 제33권8호
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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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• 제18권2호
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• pp.395-398
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• 2011

굴기능부전증후군은 매우 드물지만 신생아에서도 발생할 수 있으며 소아 환자의 경우 대부분 선천심장병이 있거나 심장수술 후에 발생한다. 그러나 이와 같은 심질환의 선행 요인이 없는 신생아에서도 발생할 수 있기 때문에 이에 대한 인지가 필요하다. 굴기능부전증후군은 대부분 특발성으로 발생하며 증상도 다양하고 24시간 심전도 검사상에서도 다양한 형태로 관찰된다. 본 증례에서는 초극소저체중출생아에서 선천심장병 없이 발생한 굴기능부전증후군에 대해 보고하였다. 환아는 심전도상 굴느린맥과 함께 심방세동이 동반된 느린맥과 빠른맥이 반복되어 관찰되었으며 무호흡, 산소포화도의 저하, 청색증의 징후를 나타냈다. 증상이 있는 굴기능부전증후군의 경우 대부분 심장박동조율기의 삽입이 필요하나 본 환아는 당시 체중 750 g으로 심장박동조율기의 삽입에 실패하여 약물 치료를 시작하였다. Isoproterenol과 atropine으로 치료하면서 환아의 체중이 1,500 g을 넘어서자 증상과 심전도상의 호전을 보였다. 향후 본 환아에서처럼 심장박동조율기의 삽입이 어려운 소아 환자의 경우에 대한 치료 체계에 대해 많은 연구가 필요하다.

• Journal of Chest Surgery
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• 제14권1호
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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.