• Journal of Chest Surgery
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• 제57권3호
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• pp.281-288
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• 2024

Background: Venoarterial extracorporeal membrane oxygenation (ECMO) is a key treatment method used with patients in cardiac arrest who do not respond to medical treatment. A critical step in initiating therapy is the insertion of ECMO cannulas. Peripheral ECMO cannulation methods have been preferred for extracorporeal cardiopulmonary resuscitation (ECPR). Methods: Patients who underwent ECPR at Daegu Catholic University Medical Center between January 2017 and May 2023 were included in this study. We analyzed the impact of 2 different peripheral cannulation strategies (surgical cutdown vs. percutaneous cannulation) on various factors, including survival rate. Results: Among the 99 patients included in this study, 66 underwent surgical cutdown, and 33 underwent percutaneous insertion. The survival to discharge rates were 36.4% for the surgical cutdown group and 30.3% for the percutaneous group (p=0.708). The ECMO insertion times were 21.3 minutes for the surgical cutdown group and 10.3 minutes for the percutaneous group (p<0.001). The factors associated with overall mortality included a shorter low-flow time (hazard ratio [HR], 1.045; 95% confidence interval [CI], 1.019-1.071; p=0.001) and whether return of spontaneous circulation was achieved (HR, 0.317; 95% CI, 0.127-0.787; p=0.013). Low-flow time was defined as the time from the start of cardiopulmonary resuscitation to the completion of ECMO cannula insertion. Conclusion: No statistically significant difference in in-hospital mortality was observed between the surgical and percutaneous groups. However, regardless of the chosen cannulation strategy, reducing ECMO cannulation time was beneficial, as a shorter low-flow time was associated with significant benefits in terms of survival.

• 한국양식학회지
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• 제16권1호
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• pp.1-7
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• 2003

무지개송어의 대동맥에 삽입관을 부착한 후 스트레스와 관련된 생리화학적 반응을 조사하였고, 실험사료의 위내 강제공급 후 혈장내 유리 아미노산의 농도변화를 비교하였다. 무지개 송어에 있어 아미노산의 요구량 설정 모델 개발을 위한 기초연구로서 사료 영양학적 연구를 위한 새로운 사료공급 및 혈액채취 방법의 개발을 위하여, 강제투여 및 대동맥 삽입방법의 적용 가능성을 조사하였다. 스트레스와 관련된 생리화학적 반응조사에 있어서 혈액내 헤마토크리트(Ht)는 6시간에 최대치를 보였고, 12시간에 최초수준으로 돌아와 48시간까지 유지되었고 혈장내 코티졸과 글루코스는 3시간에 증가하기 시작하여 6시간에 최대치를 보였으며(P<0.05), 48시간에 최초수준으로 돌아왔다. 혈장내 총 단백질 함량, 삼투압, Na농도, K농도, Cl농도, 헤모글로빈(Hb)수와 적혈구수(red blood cell, RBC)는 48시간동안 큰 변화를 보이지 않았다. 실험사료의 위내 강제 공급 후 혈장내 유리 아미노산의 농도 변화는, arginine, histidine, Iysine, methionine, threonine. valine, glutamic acid. isoleucine, leucine, phenylalanine과 tryptophan이 사료공급 후 4시간에 최대치를 보였고, 8~24시간사이에 최초수준 또는 감소하고, 48시간까지 일정하게 유지되었다. glycine은 사료공급 후 4~8사이에 감소하여 12시간에 최대치를 보였고 24시간에 최초수준으로 돌아왔다. alanine과 aspartic acid의 농도는 사료공급 후 4시간에 최대치를 보였고, 48시간에 기본농도로 돌아왔다. 상기 결과를 토대로, 위내 강제 공급 방법과 대동맥 삽입방법을 무지개 송어의 사료 영양학적 연구에 적용 가능하였고, 유리아미노산의 농도 측정으로 필수 아미노산 요구량 추정이 가능함을 보여주었다.

• Clinical Endoscopy
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• 제56권4호
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• pp.490-498
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• 2023

Background/Aims: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common and serious complication of endoscopic retrograde cholangiopancreatography. To prevent this event, a unique precutting method, termed opening window fistulotomy, was performed in patients with a large infundibulum as the primary procedure for biliary cannulation, whereby a suprapapillary laid-down H-shaped incision was made without touching the orifice. This study aimed to assess the safety and feasibility of this novel technique. Methods: One hundred and ten patients were prospectively enrolled in this study. Patients with a papillary roof size ≥10 mm underwent opening window fistulotomy for primary biliary access. In addition, the incidence of complications and success rate of biliary cannulation were evaluated. Results: The median size of the papillary roof was 6 mm (range, 3-20 mm). Opening window fistulotomy was performed in 30 patients (27.3%), none of whom displayed PEP. Duodenal perforation was recorded in one patient (3.3%), which was resolved by conservative treatment. The cannulation rate was high (96.7%, 29/30 patients). The median duration of biliary access was 8 minutes (range, 3-15 minutes). Conclusions: Opening window fistulotomy demonstrated its feasibility for primary biliary access by achieving great safety with no PEP complications and a high success rate for biliary cannulation.

• 한국가금학회지
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• 제24권2호
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• pp.91-95
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• 1997

This study was conducted to establish a colostomy technique using cannulation in white Leghorn male chicks. A everted rectum method was used for colostomy from 3 to 20 months old roosters. After 2 or 3 days of operation, blood clots were taken off. At this time, a cannula was also inserted into artificisal annus to keep it open. The cannula was regularly exchanged at every 7 to 10 days. Polyethylene bag and plastic beaker were used for feces and urine collection, respect-ively. The present paper describes the methods of operation, cannulation after colostomy recturn and post-operation management. This method has succeeded in colostomising chickens that survive as long as their normal counterparts.

• Clinical and Experimental Pediatrics
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• 제45권9호
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• pp.1120-1125
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• 2002

목 적: 소아에서 장기간의 정맥유지, 고단위 영양 수액투여, 혈액채취, 중심정맥압 측정 등을 위해 중심 정맥 도관 삽입술을 시행하고 있다. 그런데 소아는 경부의 해부학적 구조의 구별이 어려워 중심정맥에 도관 삽입이 상당히 어렵고, 여러 가지 심각한 합병증을 초래할 수가 있다. 저자들은 소아에서 audible Doppler ultrasound(8 MHz)를 이용하여 쉽게 중심정맥을 확인하여 카테타를 삽입할 수 있는지 알아보고자 하였다. 방 법: 2001년 4월에서 7월까지 서울아산병원 소아과에 입원한 환아 중 중심정맥 삽입술을 시행한 46명을 대상으로 하였다. 휴대용, 8 MHz Doppler ultrasound device(Pocket-Dop II, iMex, USA)를 이용하여 중심정맥 삽입술을 시행하였고, 이들 환아에서 삽입술의 성공률과 천자시간, 천자횟수, 합병증 등을 조사하였다. 결 과 : 1) 대상 환아는 46례로 남아 20례, 여아 26례였고 평균연령은 3세(범위 1-156개월)였으며, 특히 영아는 18명이었으며 평균연령은 6.3개월이었다. 2) 중심정맥에 도관을 삽입한 가장 흔한 부위는 우측내경정맥(63%)이며, 다음으로 좌측내경정맥, 대퇴정맥, 쇄골하정맥 순이었다. 3) 중심정맥 도관 삽입술의 성공률은 96%(46례 중 44례)였으며, 소아는 96%였고, 영아는 94%였다. 4) 평균 천자시간은 5.2분이었고, 소아는 3.7분, 영아는 7.5분 소요되었다. 5) 46례 중 6례에서 합병증이 발생했으며, 혈종 4례, 동맥천자 1례, 기흉 1례 등이었다. 6) 1회 시도 성공률은 전체 환아는 59%였으며, 소아는 71%, 영아는 39%였다. 중심정맥 삽입 과거력이 없을 경우 전체 환아의 1회 시도 성공률은 70%였고, 있을 경우는 48%였다. 결 론 : 소아나 영아에서 휴대용, 8 MHz Doppler ultrasound device를 이용하여 쉽게 중심정맥의 위치를 확인하여 중심정맥 도관 삽입술의 성공률을 높이고, 심각한 합병증을 줄일 수 있어서, audible Doppler ultrasound를 이용하여 중심정맥 도관 삽입술을 시행하는 것이 유용할 것으로 생각한다.

• Journal of Microbiology and Biotechnology
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• 제28권10호
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• pp.1700-1705
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• 2018

We evaluated the influence of sampling technique (cannulation vs. stomach tube) and site (dorsal sac vs. ventral sac) on the rumen microbiome and fermentation parameters in Hanwoo steers. Rumen samples were collected from three cannulated Hanwoo steers via both a stomach tube and cannulation, and 16S rRNA gene amplicons were sequenced on the MiSeq platform to investigate the rumen microbiome composition among samples obtained via 1) the stomach tube, 2) dorsal sac via rumen cannulation, and 3) ventral sac via rumen cannulation. A total of 722,001 high-quality 16S rRNA gene sequences were obtained from the three groups and subjected to phylogenetic analysis. There was no significant difference in the composition of the major taxa or alpha diversity among the three groups (p>0.05). Bacteroidetes and Firmicutes represented the first and second most dominant phyla, respectively, and their abundances did not differ among the three groups (p>0.05). Beta diversity principal coordinate analysis also did not separate the rumen microbiome based on the three sample groups. Moreover, there was no effect of sampling site or method on fermentation parameters, including pH and volatile fatty acids (p>0.05). Overall, this study demonstrates that the rumen microbiome and fermentation parameters are not affected by different sampling techniques and sampling sites. Therefore, a stomach tube can be a feasible alternative method to collect representative rumen samples rather than the standard and more invasive method of rumen cannulation in Hanwoo steers.

• Clinical and Experimental Pediatrics
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• 제58권4호
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• pp.136-141
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• 2015

Purpose: Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure. Methods: Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications. Results: Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, $6.54{\pm}1.06$ years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was $1.57{\pm}0.34$ and $14.07{\pm}1.91$ minutes, respectively, the mean catheter dwell time was $14.73{\pm}2.5$ days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%). Conclusion: The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients.

• Journal of Yeungnam Medical Science
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• 제4권1호
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• pp.145-149
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• 1987

경피요골동맥삽관후 수지괴사가 발생되어 손목을 절단한 1례를 보고하며, 동맥삽관후 수지괴사가 유발될 수 있는 요인으로는 사용된 카테터의 크기, 종류, 천자횟수, 삽관거치기간 및 카테터삽관후 유지방법외에도 환자의 혈액구성성분변화, 혈액응고장애, 심박출량감소상태, 성별 등을 들 수 있으며, 본원에서 발생된 예에서는 수술후 환자가 심히 움직여 끈으로 동맥삽관된 손목을 침대에 묶어 놓음으로써 카테터에 의한 혈관손상이 심했음이 가장 큰 원인일 것으로 추측되며 그 외에도 혈액성분변화 및 응고장애에 의해 심한 혈전형성이나 heparin용액의 간헐적 관류시 발생될 수 있는 혈전의 전색도 가능성이 있을 것으로 사료된다.

• Perspectives in Nursing Science
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• 제11권2호
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• pp.144-152
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• 2014

Purpose: The purpose of the study is to offer necessary data to develop nursing interventions to reduce intravenous injection pain and uneasiness among hospitalized children. Methods: A total of 200 patients aged 1-72 months were selected. Pain during intravenous cannulation was assessed using the Procedural Behavior Checklist (PBCL) and the Faces Pain Rating Scale (FPRS). Data were analyzed by t-test and ANOVA using the SPSS/WIN 12.0. Results: Younger patients showed higher pain response than older patients (F=33.87, p<.001). Children with respiratory diseases showed higher responses in FPRS and PBCL than children without respiratory disease (F=4.17, p=.017; F=25.31, p<.001, respectively). Children of preschool age showed higher pain response during IV cannulation than the comparison group (t=2.04, p=.045). Children who had previous experiences with hospitalization and injections showed higher response to pain than those without these experiences (t=2.05, p=.045). In regards to FPRS, patients who were recannulated showed more painful restarts compared with patients injected just once (t=-3.60, p<.001). In regards to PBCL, infants and toddlers (t=-4.88, p<.001) and preschoolers (t=-3.86, p<.001) showed high pain scores during recannulation. Conclusion: A sick child's response to pain may be worse as they feel more pain over time. These characteristics should be considered for development of nursing interventions.

• Journal of Chest Surgery
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• 제51권4호
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• pp.283-285
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• 2018

A 73-year-old woman who underwent combined bioprosthetic mitral valve replacement, tricuspid ring annuloplasty, and coronary artery bypass grafting 12 years previously visited our clinic due to aggravated dyspnea caused by structural valve deterioration of the mitral prosthesis. Because aortic or femoral artery cannulation and cross-clamping would have a high risk of stroke owing to severe calcification of the ascending aorta and ilio-femoral vessels, and because there was a risk of redo sternotomy due to the patent bypass grafts, a comprehensive approach including axillary artery cannulation, a minimally invasive right thoracotomy approach, and a clampless hypothermic fibrillatory arrest technique was used during redo mitral valve replacement.