• Title/Summary/Keyword: Respiratory arrest technique

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Respiratory Arrest during Cervical Epidural Block -A case report- (경부 경막외 차단중 발생한 호흡정지 -2예 보고-)

  • Kim, Deog-Jae;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.264-267
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    • 1996
  • Cervical epidural block can be useful in the management of acute and chronic pain of the head, neck, shoulder, and arm, for selected patients. In spite of the widespread use of cervical epidural blocks for pain, there is limited published data on the specific technique and complications regarding the procedure. High levels of epidural block do not appear to be associated with clinically significant circulatory or ventilatory changes unless the concentrations of local anesthetics used are great enough to produce paralysis of intercostal and phrenic nerves. However, high level of epidural block is associated with sympathetic block which may affect responses of circulatory and ventilatory systems. Accordingly, the possibility of major complications of cervical epidural block must be borne in mind. We experienced two cases of respiratory arrest during cervical epidural block with bupivacaine. This is a report regarding complications of cervical epidural block.

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Repair of intracardiac defect under simple deep hypothermia in infancy without cardiopulmonary bypass: report of 3 cases (단순 초저온법에 의한 개심술: 3례 보)

  • 조범구
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.189-196
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    • 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.

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Aortopulmonary Window -Report of A Case- (폐동맥 대동맥 중격결손증 1례 보고)

  • 박기진
    • Journal of Chest Surgery
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    • v.28 no.7
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    • pp.721-725
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    • 1995
  • One case of surgical correction of a large aortopulmonary window in a 4 months old female is reported in detail. Clinical symptoms consisted of fatigue when feeding and recurrent upper respiratory tract infection. Under cardiopulmonary bypass with moderate hypothermia and cardioplegic arrest of the heart, the aortopulmonary window was approached through a vertical incision at the anterior wall of window itself. The defect was closed with pericardial patch using continuous suture posteriorly and sandwitch technique anteriorly. The patient was weaned from the cardiopulmoanry bypas without hemodynamic problem and postoperative course was uneventful. This surgical technique is recommandable as it provides good exposure of the defect and can be performed easily and safely.

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Evaluation of the Usefulness of Ancillary Devices for Patients with Acute Lumbar Pain During Magnetic Resonance Imaging (자기공명영상검사 시 급성 요추 통증 환자를 위한 보조기구의 유용성 평가)

  • Park, Hee-Wang;Lee, Moo-Sik;Kim, Yong-Kwon;Bae, Seok-Hwan
    • Journal of radiological science and technology
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    • v.41 no.3
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    • pp.193-199
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    • 2018
  • The purpose of this study was to evaluate the convenience and image quality of patients with acute lumbar pain patients at a general hospital in Daejeon using ancillary devices for postural changes and correction. The results of the study are summarized as follows. First, the Turbo S pin Echo technique(TS E) using ancillary equipment has the highest image evaluation rating with an average score of 4.440, which is highly valuable on a diagnosis. Second, the average score for patient the questionnaire 'When using ancillary equipment, I feel that my body is calibrated to side without bias.' was shown as 4.440, which is very useful for the correction of the patient's body when using ancillary equipment. Finally, Breath Hold technique(BH) is very effective in shortening test time of acute lumbar pain patients, because it can reduce test time 86.4% faster than Turbo Spin Echo technique(TSE). The results of the study showed that the use of ancillary equipment to perform the test through the side lying postures helped to reduce the pain and control the patient's breathing, and the diagnostic value of the image was high.

Variation of Cardiac Output and Blood Pleasure after Flooding Water into Lungs (폐 침수시의 심장 박출량과 혈압의 변동)

  • Cho, Sung-Doo;Nam, Kee-Yong
    • The Korean Journal of Physiology
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    • v.1 no.1
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    • pp.57-66
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    • 1967
  • Cold $(0^{\circ}C)$ or warm $(25^{\circ}C)$ fresh and sea water were flooded into the lungs of rabbits through tracheal canule. Respiratory arrest ensued in 19.5 minutes in the warm fresh water flooded rabbits and was the longest survival time among the experimental groups. The survival times in the other groups were: 2.32 minutes in cold fresh water group, 2.75 minutes in .warm sea water group, and 4.57 minutes in cold sea water group. Cardiac output was measured by means of T-1824 dilution technique after 2 or 3 minutes of flooding in 27 rabbits. Blood pressure was observed by mercury manometer throughout the survival time in 40 rabbits. The following results were obtained. 1. Cardiac output in the warm fresh water flooded and sea water flooded animal was smaller than that of control rabbits. In the cold fresh water flooded animal cardiac output was greater than that of the control animal. 2. Time constants of T-1824 dilution curve of experimental group were elongated than the normal curve. 3. Central blood volume showed an increase in the fresh water group, a decrease in cold sea water group and no change in warm sea water group. 4. In all of the experimental groups arterial blood Pressure showed an abrupt and great variations after flooding of lungs and lasted about 30 seconds. Thereafter, arterial pressure remained at a plateau level until the sudden fall to zero and this was almost coincided with the time of respiratory arrest. The Plateau level of arterial Pressure in fresh water group was about 10 mmHg higher than the control value, and it was lower than the control value in warm sea water group. In cold sea water group the plateau was made up by fluctuations around the control value. 5. Osmosis of water through the lung alveolar membrane occured in all animals. Fresh water caused hemodilution and sea water caused hemoconcentration. 6. In sea water flooded animal more volume of water was recovered through the tracheal canule than the volume injected into trachea. This was interpreted as the consequence of the shift of water from plasma to alveolar sac. 7. Relative freight of lung was greater in fresh water group than sea water group. In all animal lung edema ensued. 8. The mechanisms of cardiac output variations were discussed.

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Surgical Result of the Modified Blalock-Taussig Shunt in Early Infancy (조기 영아기에서의 변형 블라록-타우시히 단락술의 수술 결과)

  • 이정렬;곽재건;최재성
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.573-579
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    • 2002
  • Background: In this study, the role and the surgical outcome of the modified Blalock-Taussig shunt in the treatment of the infants with cyanotic complex congenital heart diseases were investigated. Material and Method: Over the last 12 years, 105 modified BT shunts were performed in 100 infants. Postoperative course, shunt patency rate, complications, mortality and its risk factors were reviewed restrospectively. Result: The mean age at operation was 43.0$\pm$36.6 days. Sex ratio was 60:40(M:F). The postoperative oxygen saturations were lowest after mean duration of 11 hours after the shunt procedure. The operative mortality was 8%(8) with 3 late deaths. Causes of operative death included failure of maintenance of minimum oxygenation during the procedure(2), immediate postoperative shunt occlusion(2), respiratory failure(2), low cardiac output due to heart failure and pericardial effusion(2) and sepsis(2). Late deaths resulted from acute cardiac arrest during the follow up cardiac catheterization, hypoxic myocardial failure, and arrhythmia. Year of surgery, shunt size, age at operation, and complexity of the anomalies were not the risk factors for mortality. Six month shunt patency rate was 97% and overall patency rate was 96%. Postoperative complications comprised of shunt occlusion(6), phrenic nerve palsy(3), and wound infection(2). Conclusion: We demonstrated that modified Blalock-Taussig shunt was a useful tool to palliate the infants with complex cyanotic heart disease in whom early complete repair was not feasible with acceptable mortality and patency rate. An adequate postoperative management and a meticulous surgical technique may be key factors for the better results.