• Journal of Trauma and Injury
• /
• 제36권3호
• /
• pp.172-179
• /
• 2023

Purpose: Out-of-hospital traumatic cardiac arrest (TCA) often has a poor prognosis despite rescue efforts. Although the incidence and mortality of out-of-hospital cardiac arrest have increased, bystander cardiopulmonary resuscitation (CPR) has decreased in some countries during the COVID-19 pandemic. In the prehospital setting, immediate treatment of cardiac arrest is required without knowing the patient's COVID-19 status. Because COVID-19 is usually transmitted through the respiratory tract, airway management can put medical personnel at risk for infection. This study explored whether on-scene treatments involving CPR for TCA patients changed during the COVID-19 pandemic in Korea. Methods: This retrospective study used data from emergency medical services (EMS) run sheets in Gangwon Province from January 2019 to December 2021. Patients whose initial problem was cardiac arrest and who received CPR were included. Data in 2019 were classified as pre-COVID-19 and all subsequent data (from 2020 and 2021) as post-COVID-19. Age, sex, possible cause of cardiac arrest, and treatments including airway maneuvers, oropharyngeal airway (OPA) or i-gel insertion, endotracheal intubation (ETI), bag-valve mask (BVM) ventilation, intravenous (IV) line establishment, neck collar application, and wound dressing with hemostasis were investigated. Results: During the study period, 2,007 patients received CPR, of whom 596 patients had TCA and 367 had disease-origin cardiac arrest (DCA). Among the patients with TCA, 192 (32.2%) were pre-COVID-19 and 404 (67.8%) were post-COVID-19. In the TCA group, prehospital treatments did not decrease. The average frequencies were 59.7% for airway maneuvers, 47.5% for OPA, 57.4% for BVM, and 51.3% for neck collar application. The rates of ETI, i-gel insertion, and IV-line establishment increased. The treatment rate for TCA was significantly higher than that for DCA. Conclusions: Prehospital treatments by EMS workers for patients with TCA did not decrease during the COVID-19 pandemic. Instead, the rates of ETI, i-gel insertion, and IV-line establishment increased.

• Journal of Chest Surgery
• /
• 제17권2호
• /
• pp.189-196
• /
• 1984

Although the conventional methods of cardiopulmonary bypass for open heart surgery have been employed, it has been usual method to repair of congenital heart disease in infancy using deep hypother-mia and circulatory arrest technique. In 1980, we reported total correction of congenital heart disease using surface induced hypothermia-total circulatory arrest and rewarming with limited cardiopulmonary bypass. in 1981, three patients below 10 kilogram, who had ASD and PDA, and two of VSD with pulmonary hypertension were operated on using simple deep hypothermia without cardiopulmonary bypass. During surface cooling, there were no ventricular fibrillation and arrhythmia. There were no difficulties to resuscitate the heart. Postoperative respiratory and neurologic complication were not occurred. Follow up examination for two to three years gave no evidence of cerebral damage due to circulatory arrest.

• The Korean Journal of Pain
• /
• 제10권1호
• /
• pp.138-141
• /
• 1997

Rib fracture due to intense pain, may restrict patients from inadequate coughing. These conditions may produce varying degrees of complications such as atelectasis, pneumonia and arterial hypoxemia. Thoracic epidural analgesia has been used to treat pain associated multiple rib fractures because of its marked improvement in vital capacity and dynamic lung compliance. However, there are complications related to thoracic epidural analgesia which may include damage to spinal cord, perforation of dura, respiratory depression, decrease heart rate and arterial blood pressure. We experienced such a case of cardiac arrest during thoracic epidural analgesia while treating a patient for multiple rib fractures.

• 한국컴퓨터정보학회논문지
• /
• 제29권3호
• /
• pp.165-171
• /
• 2024

본 연구는 2급 응급구조사가 호흡부전 및 호흡정지 환자에게 백-밸브 마스크(BVM) 인공호흡 시 호흡량 측정기를 사용하여 적정량의 호흡량과 및 성공률을 알아보고자 한다. 연구는 2023년 12월 11일부터 12일까지 D 대학교에 재학 중인 2급 응급구조사를 대상으로 20명을 선정하여 10명은 호흡량 측정기를 이용하여 BVM 인공호흡을 교육한 실험군으로, 다른 10명은 호흡량 측정기 없이 BVM 인공호흡을 교육한 대조군으로 선정하여 2분간 인공호흡을 제공하는 실험을 하였다. 연구 결과, 대조군에서는 정확한 호흡량을 제공하지 못하였고(p=.025), 호흡 성공률 역시 실험군에서는 2분간 호흡 성공률이 높았으나 대조군에서는 유의한 차이를 보였으며(p=.001), 주관적 호흡량과 측정된 객관적 호흡량이 대조군에서 유의한 차이를 보였다(p=.010). 따라서 호흡량 측정기를 사용한 교육은 2급 응급구조사가 느끼는 주관적 호흡량을 객관적 호흡량과 일치시키고 호흡 성공률을 높여 호흡부전 및 호흡정지와 심폐소생술 시 심장정지 환자의 생존율을 높이는 데 도움이 될 것이다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권8호
• /
• pp.3695-3700
• /
• 2012

Mammalian mediator (MED) is a multi-protein coactivator that has been identified by several research goups. The involvement of the MED complex subunit 19 (MED 19) in the metastasis of lung adenocarcinoma cell line (H1299), which expresses the MED 19 subunit, was here investigated. When MED 19 expression was decreased by RNA interference H1299 cells demonstrated reduced clone formation, arrest in the S phase of the cell cycle, and lowered metastatic capacity. Thus, MED 19 appears to play important roles in the biological behavior of non-small cell lung carcinoma cells. These findings may be important for the development of novel lung carcinoma treatments.

• Tuberculosis and Respiratory Diseases
• /
• 제82권2호
• /
• pp.133-142
• /
• 2019

Background: Idiopathic pulmonary fibrosis involves irreversible alveolar destruction. Although alveolar epithelial type II cells are key functional participants within the lung parenchyma, how epithelial cells are affected upon bleomycin (BLM) exposure remains unknown. In this study, we determined whether BLM could induce cell cycle arrest via regulation of Schlafen (SLFN) family genes, a group of cell cycle regulators known to mediate growth-inhibitory responses and apoptosis in alveolar epithelial type II cells. Methods: Mouse AE II cell line MLE-12 were exposed to $1-10{\mu}g/mL$ BLM and $0.01-100{\mu}M$ baicalein (Bai), a G1/G2 cell cycle inhibitor, for 24 hours. Cell viability and levels of pro-inflammatory cytokines were analyzed by MTT and enzyme-linked immunosorbent assay, respectively. Apoptosis-related gene expression was evaluated by quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR). Cellular morphology was determined after DAPI and Hoechst 33258 staining. To verify cell cycle arrest, propidium iodide (PI) staining was performed for MLE-12 after exposure to BLM. Results: BLM decreased the proliferation of MLE-12 cells. However, it significantly increased expression levels of interleukin 6, tumor necrosis factor ${\alpha}$, and transforming growth factor ${\beta}1$. Based on Hoechst 33258 staining, BLM induced condensation of nuclear and fragmentation. Based on DAPI and PI staining, BLM significantly increased the size of nuclei and induced G2/M phase cell cycle arrest. Results of qRT-PCR analysis revealed that BLM increased mRNA levels of BAX but decreased those of Bcl2. In addition, BLM/Bai increased mRNA levels of p53, p21, SLFN1, 2, 4 of Schlafen family. Conclusion: BLM exposure affects pulmonary epithelial type II cells, resulting in decreased proliferation possibly through apoptotic and cell cycle arrest associated signaling.

• 한국응급구조학회지
• /
• 제23권3호
• /
• pp.29-40
• /
• 2019

Purpose: This study was conducted to identify the effects of educational intervention on pre-test and post-test tidal volume, endotracheal peak pressure, and ventilation interval measurements during single-rescuer respiratory-assistant therapy by paramedic students. Methods: The present study, with a quasi-experimental design, included a pre-test and post-test nonequivalent control group. A total of 62 paramedic students (31, experimental group; 31, control group) participated in this study. The intervention lasted 80 minutes. Data were collected from each student before the intervention and two weeks after the intervention, between September 3 and 21, 2018. The collected data were analyzed using IBM SPSS Statistics for Windows, Version 25.0. Results: Tidal volume (p<.001) and endotracheal peak pressure (p=.002) measurements after the intervention were significantly different between the two groups. Analysis of covariance was used to control the variance (the pretest value of endotracheal peak pressure) in order to identify the effect of the intervention in the two groups. Endotracheal peak pressure was not significantly different between the two groups. Conclusion: Education and training of paramedic students in emergency medical services on single-rescuer respiratory-assistant therapy is necessary for the emergency care of patients with respiratory arrest.

• 대한소아치과학회지
• /
• 제44권2호
• /
• pp.243-255
• /
• 2017

심폐소생술(cardiopulmonary resuscitation, CPR)은 심장의 기능이 정지하거나 호흡이 멈추었을 때 인공적으로 혈액을 순환시키고 호흡을 보조해 주는 응급처치이다. 심폐소생술은 기본생명구조술(basic life support, BLS)과 전문소생술(advanced life support, ALS)로 나눌 수 있다. 기본생명구조술은 주요 조직으로 혈류 공급을 강제적으로 하기 위한 흉부압박과 호흡정지 환자에게 구조호흡(rescue breathing) 그리고 심실세동을 개선해 주기 위한 자동제세동기(automated external defibrillator, AED)이 포함된다. 전문소생술의 범주는 성인을 대상으로 하는 고급생명구조술(advanced cardiovascular life support, ACLS)과 소아를 대상으로 하는 소아고급생명구조술(pediatric advanced life support, PALS)이 있다. 치과 치료에 극심한 공포를 가지며, 여러 이유로 치과 진료에 협조를 얻기 어려운 소아를 대상으로 하는 치료환경에서는 약물을 이용한 진정법이 고려된다. 이는 심정지를 포함한 응급상황이 발생할 가능성이 증가하는 이유가 된다. 소아고급생명구조술은 기본생명구조술을 포함하며, 심정지에 이를 수 있는 원인을 호흡, 순환장애 그리고 심인성으로 나누어 대처하는 체계적인 방법을 제시한다. 소아는 성인에 비해 심인성의 원인은 낮지만, 해부학적인 약점으로 인해 호흡이나, 순환장애에 의한 심정지의 가능성은 높다. 따라서, 스트레스를 많이 받은 아이를 치료하거나 진정법을 시행하는 소아치과의사는 소아고급생명구조술을 익힘으로써 응급상황에 적절히 대처할 수 있는 역량을 갖출 수 있으리라 사료된다.

• Journal of Chest Surgery
• /
• 제49권3호
• /
• pp.151-156
• /
• 2016

Background: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. Methods: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. Results: Twelve children, median age 6.6 months (range, 1 day to 11.7 years), required ECPR. patients' diseases spanned several categories: congenital heart disease (n=5), myocarditis (n=2), respiratory failure (n=2), septic shock (n=1), trauma (n=1), and post-cardiotomy arrest (n=1). Cannulation sites included the neck (n=8), chest (n=3), and neck to chest conversion (n=1). Median duration of extracorporeal membrane oxygenation was five days (range, 0 to 14 days). Extracorporeal membrane oxygenation was successfully discontinued in 10 (83.3%) patients. Nine patients (75%) survived more than seven days after support discontinuation and four patients (33.3%) survived and were discharged. Causes of death included ischemic brain injury (n=4), sepsis (n=3), and gastrointestinal bleeding (n=1). Conclusion: ECPR plays a valuable role in children experiencing refractory cardiac arrest. The weaning rate is acceptable; however, survival is related to other organ dysfunction and the severity of ischemic brain injury. ECPR prior to the emergence of end-organ injury and prevention of neurologic injury might enhance survival.

• Journal of Chest Surgery
• /
• 제33권5호
• /
• pp.436-439
• /
• 2000

Tracheo-innominate artery fistula is a rare, but it is one of the gravest complications next to tracheostromy. Early recognition and prompt surgical management is mandatory. The patient was a 66 year old women with MCA infarct who maintained tracheostomy for lyear. She had respiratory arrest due to the excessive bleeding through the tracheostomy site. We report an successful experience for control of bleeding by an innominate artery fistula division and primay suture closure under direct digital compression.