• 제목/요약/키워드: Patient circulation

검색결과 284건 처리시간 0.022초

심장 부정맥을 동반한 하악 전돌증 환자의 술전준비와 악교정수술

  • 유정택;김철;송선헌
    • 대한치과의사협회지
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    • 제40권9호통권400호
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    • pp.703-708
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    • 2002
  • Cardiac arrhythmia is irregular heart rate. It's one of the reason of unpredictable sudden death. Accurate diagnosis and management of cardiac arrhythmia are the most important factors for the life of patient. To obtain a good prognosis, Dentist should be know and manage the multi-types of cardiac arrhythmia during dental treatment with the cooperation of medical doctor majored in cardiac circulation medicine. We casually found the cardiac arrhythmia in mandible prognathism patient during preparation for orthognathic surgery. Orthognathic surgery for cardiac arrhythmia patient was done successfully under general anesthesia with the temporary cardiac pace-maker.

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심실중격결손이 없는 폐동맥페쇄증 환아에서 체외순환 없이 시행한 고식적 수술치험 1례 (Surgical Treatment of Pulmonary Atresia with Intact Ventricular Septum without Extracorporeal Circulation - Report of One Case -)

  • 박철현;이신영;김창호
    • Journal of Chest Surgery
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    • 제24권7호
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    • pp.719-724
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    • 1991
  • A case of pulmonary atresia with intact ventricular septum was presented in a 10-month-old cyanotic female patient, which was congenitally rare. Infant with pulmonary atresia and intact ventricular septum usually require urgent surgical intervention. Angiogram showed the pulmonary atresia at the level of the pulmonary valve, the hypoplasia of tricuspid valve and atrial septal defect without patent ductus arteriosus. We performed the pericardial patch graft on the right ventricular outflow tract and pulmonary artery after ventriculotomy using pacemaker wire as electrical saw and main pulmonary arteriotomy and then modified Waterston shunt from the ascending aorta to patch on the right ventricular outflow tract without extracorporeal circulation. Patient was postoperatively good condition.

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국내 종합병원의 리모델링에 나타난 공간구성방안에 관한 연구 - 부문별 재배치 및 동선연결방안을 중심으로 - (A Study on the Spatial Composition Strategy in the Remodeling of General Hospitals - Focused on the Departmental Relocation and Circulation System -)

  • 김하진;양내원
    • 한국실내디자인학회논문집
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    • 제13권6호
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    • pp.123-131
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    • 2004
  • The hospitals built In the seventies and eighties have gone through many different extensions and renovations. However, as there had been no prior projections of the future extensions, irrational processes in terms of interdepartmental functional relocations and space availability have recurred. As well, areas and departments are located in several wings, which bring about a decrease in interdepartmental functional linkage, causing a lot of confusion and trouble in hospital management. Through this research we acquire concluding remarks. 1) To restore functional linkage in the whole hospital, strategy of interdepartmental relocation with the clinic-in-the clinic concept is the measure to minimize the problems of the increase in interdepartmental functional linkage since the clinic-in-the clinic concepts minimize circulation and maximizes efficiency of hospital management by making all the dispersed wings as professional as possible. 2) The measure of smooth circulation in order to resolve the problems of patients' difficulty in identifying directions and in decrease in staff's work performance, which arises from the extensions without considering the traffic systems of the whole hospital involves introduction of linear circulation systems in which connections between departments or areas can be made centering main axes of circulation. It is also a responsive measure to enhance the functional linkage between buildings and efficiency of patient's ease in identification of directions.

최근 한국에 건립된 혼자 중심적 병동부의 건축계획적 특징에 관한 연구 (A Study on the Character of Architectural Planning of Ward in the resently Built Patient-centered Hospitals)

  • 박남규;양내원;유영민
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제1권2호
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    • pp.63-72
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    • 1996
  • A syudy on hospital architecture was as a circulation effective work as most amount and function at the view of nurse, staff until now. The architect do not have a data about planning patient-centered hospital, do not reflect a demand of patient at the planning step. This study arrange what is concept of patient-centered, recently concept of patient-centered hospital is importantly raised, at centering around a ward that a life of patient is the most influenced. This study make clear character of patient-centered hospital at home, the problem and demand of patient through the P.O.E.

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급성심근경색 환자에게 적용된 정맥-정맥 체외막산화기의 임상 효과 (Clinical effects of veno-venous extra-corporeal membrane oxygenation for acute myocardial infarction)

  • 김수완;성길명;이재근
    • Journal of Medicine and Life Science
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    • 제15권2호
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    • pp.108-111
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    • 2018
  • Extra-corporeal membrane oxygenation (ECMO) has the potential to rescue patients in cardiac arrest or respiratory failure. ECMO has two systems such as veno-arterial and veno-venous circulation. In cardiac arrest resulting from acute myocardial infarction, veno-arterial ECMO is mandatory for systemic circulation and oxygenation. A 75-year old female patient underwent primary coronary intervention for acute myocardial infarction. Despite successful revascularization, recurrent ventricular tachycardia and heart failure were progressing. We performed a veno-arterial ECMO through the femoral artery and vein, then the patient seemed to be stable clinically. However, laboratory studies, echocardiography, and vital signs indicated multi-organ failure and decreasing cardiac function. We found out an error that we performed veno-venous ECMO instead of veno-arterial ECMO. We added a femoral artery cannula and exchange the circuit system to veno-arterial ECMO. While the systemic circulation seemed to be recovered, the left ventricular function was decreased persistently. A hypovolemia resulting from pulmonary hemorrhage was occurred, which lead to ECMO failure. The patient died of cardiac arrest and multi-organ failure 23 hours after ECMO. Because the color of arterial and venous circuits represent the position and efficacy of ECMO, if unexpected or abnormal circuit colors are detected, prompt and aggressive evaluation for ECMO function is mandatory.

대형 민간병원의 사례분석에 의한 사용자별 면적배분 현황에 대한 연구 (A research on User-focused Space analysis of representing large Corporate hospitals)

  • 이정만;최아현
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제1권2호
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    • pp.39-51
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    • 1996
  • Design scheme drawings of the two major corporate hospitals - Asan Medical Center and Samsung Medical Center - are analysed in the aspect of floor area distributions and their proportions for various users and user-functions. Primary users of hospitals are categorized into three ; patients, employees and others. Then, patient spaces are subdivided into patient private, patient/medical, patient/support staff, patient/nursing, patient/guardian, patient common ; employee spaces into doctors, trainees, doctors common, nurses, support staffs, non-medical staffs, employee common ; others spaces into subcontractors, general publics, non-living, and internal circulation. The purpose of this research is to develop a user-focused insight into hospital spaces and a new method of hospital programming and design.

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근무형태 및 피폭선량에 따른 PET/CT실의 운영 효율성 평가 (Operation Efficiency Estimation of PET/CT Center by Work Form and Exposure Dose)

  • 권오진;정서희;백승찬;김경호
    • 핵의학기술
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    • 제13권1호
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    • pp.93-97
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    • 2009
  • 2006년~2008년 2사분기까지의 2.5년간의 환자 건수는 14,674건이었으며, $^{18}F$-FDG 평균 주사량은 461.5 MBq 였다. 2.5년간 순환근무는 3회 이루어졌고, 10명의 방사선사 중 PET과 Gamma 영역별 1인을 제외한 8명의 순환근무가 시행되었다. 추가로 2008년 3인의 신입인력이 야간에 투입되어 이에 대한 평가도 이루어졌다. 방사선사의 근무연한은 15년 이상이 2인, 10~15년이 3인, 5~10년이 1인, 5년 미만이 3인이었다. 이들의 개인별 피폭선량은 먼저 PET실에 근무를 하고 있을 때가 Gamma 영역에 근무하고 있을 때 보다 더 높게 나왔다. 가장 큰 원인으로는 일일 처리 건수 면에서 PET과 Gamma영역의 차이가 거의 없는 상태에서 $^{99m}Tc$보다는 상대적으로 에너지가 높은 $^{18}F$-FDG를 사용하는데 있다고 본다. 특히 개인별 피폭선량도 근무연한에 따른 분기별 평가에서 서로 다르게 나타났다. 또한 순환근무 초기 1개월째보다는 업무의 연속성을 익힌 3개월째에 더 낮은 피폭선량을 보여 주고 있다. 이는 PET 실의 근무연한이 길수록 업무의 숙달도가 증가하여 개인별 피폭선량은 감소하는 것으로 보인다. 예약실에 근무하는 간호사의 피폭선량은 $^{18}F$-FDG 주사 후 짧은 시간에 환자와의 접촉이 이루어지고 있어 그리 큰 문제점을 보이지는 않았다. 그러나 임신 가능성이 있는 간호사일 경우는 이를 재고해 보아야할 필요가 있다. 순환 근무를 통한 장시간 PET/CT실을 벗어난 상황이 될 경우 대부분의 근무자가 초기 1개월에서 업무의 연속성 결여 및 개인별 피폭선량 증가라는 위험성을 내포하였다. PET/CT 환자의 증가에 따른 PET/CT실 전체의 과도한 피폭을 분산하기 위한 순환 근무제의 도입이 또 다른 문제점을 갖고 있음을 알 수 있다.5,6) 이를 해결하기 위해서는 근무자의 업무재교육과 순환 및 고정 근무제의 적절한 병행을 시행할 필요가 있다고 본다. 또한 고정 근무자는 순환 근무 인력들의 이런 문제점을 해결하기 위해 업무영역에서 표준화된 업무지침서 등을 만들어야 한다.

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Deleterious Effects of Hyperoxemic Extracorporeal Circulation during Cardiovascular Surgery

  • Park, Seok-Cheol
    • 대한의생명과학회지
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    • 제7권1호
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    • pp.7-15
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    • 2001
  • Although extracorporeal circulation (ECC) has been routinely used for cardiovascular surgery, hyperoxemia during ECC may produce oxygen toxicity and cellular injury. This study was performed to investigate the clinical influences of hyperoxemic ECC during cardiovascular operation. 40 adult patients scheduled for elective cardiovascular surgery were classified into normoxemic (arterial oxygen tension: 115 mmHg, n=20) and hyperoxemic (arterial oxygen tension: 380 mmHg, n=20) ECC. At preoperative and postoperative period, total leukocyte and neutrophil counts, platelet counts, iron, glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine in peripheral arterial blood, malondialdehyde (MDA) and troponin-T concentration (TnT) in coronary sinus blood, pulmonary vascular resistance (PVR), and postoperative blood loss volume (BLS) were measured and compared between groups. Hyperoxemic group had postoperatively higher total leukocyte and neutrophil counts, MDA, TnT, PVR total BLS, iron, glucose, AST, ALT, BUN, and creatinine than normoxemic group (p<0.05).0 conclusion, hyperoxemic ECC results in greater inflammatory response and oxidative damaging effects on the heart lung, liver and kidney, probably being adverse to postoperative patient recovery. For reducing these deleterious effects and improving postoperative outcomes, management lowering oxygen tension during ECC is recommended.

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