• Title/Summary/Keyword: cardiopulmonary

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Palliative Care Provided for Older Patients with Terminal Stage of Cardiopulmonary Disease Before and After Life-Sustaining Treatment Decisions (만성 심폐질환을 가진 말기 노인환자의 연명의료결정 전후 완화간호의 제공)

  • Choi, Jung-Ja;Kim, Su Hyun
    • Journal of Convergence for Information Technology
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    • v.11 no.1
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    • pp.45-53
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    • 2021
  • This study was a retrospective descriptive study to identify frequency and change of palliative care provided for older patients with terminal stage of cardiopulmonary disease before and after life-sustaining treatment (LST) decision making. As a result of chart review of 124 older patients in a university hospital, oral analgesics medication, cold and hot therapy for pain management, antibiotics medication and urine culture for urinary infection, oral care, hair wash, and partial bath were provided significantly less after LST decision making. Provision of praying and relaxation therapy for pain control, oral and nasal care, and emotional care were not changed before and after LST decision making. Spiritual care was the least provided care. Therefore, non-pharmacological pain management, emotional care, and spiritual care need to be improved for older patients with terminal cardiopulmonary disease at the end of life.

Comparison analysis of rescuer's neck muscle tone and stiffness according to cardiopulmonary resuscitation skill-level

  • Wang, Joong-San;Kim, Jeong-Ja;Jung, Ji-Yun
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.11
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    • pp.165-172
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    • 2021
  • The purpose of this study was to identify differences in the muscle tone and stiffness of neck muscles according to levels of cardiopulmonary resuscitation (CPR) skill. The subjects were 30 female students in their 20s who were divided into a skilled group (n=15) and an unskilled group (n=15). According to the results, the skilled group showed statistically significant decreases in the stiffness of the lower cervical muscle and the muscle tone of the upper trapezius on the above hand side of hand grips after CPR (p<.05). The unskilled group exhibited a statistically significant difference in both the muscle tone and stiffness of the upper trapezius muscle on both sides after CPR (p<.05). However, no statistically significant differences were found between the two groups. In addition, the non-skilled group showed statistically significant lower values than the skilled group in the mean compression rate, total number of compressions, accuracy of chest compression, and accuracy of chest relaxation (p<.05). This study confirmed that CPR has a myophysiological effect on the neck muscles of those who perform CPR. However, it found that no differences result from individual CPR skill levels that are an important element for the accuracy of CPR.

Impact of Inter-professional Attitude and Educational Burden on Clinical Nurses' Cardiopulmonary Resuscitation-related Self-efficacy Following Team-based Cardiopulmonary Resuscitation Simulation Training (팀 기반 심폐소생술 시뮬레이션 교육을 받은 임상간호사들의 전문직 간 태도 및 교육부담감이 심폐소생 관련 자기효능감에 미치는 영향)

  • Ok, Jong Sun;An, Soo Young;Kwon, Jeong Hwa
    • Journal of muscle and joint health
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    • v.31 no.1
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    • pp.22-30
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    • 2024
  • Purpose: In-hospital cardiac arrest is rare, but often results in high mortality rates. Early and effective cardiopulmonary resuscitation (CPR) is crucial for survival and nurses are often the first responders. This study aimed to investigate how inter-professional attitudes and educational burdens affect self-efficacy related to CPR performance following team-based CPR simulation training. Methods: This retrospective observational study analyzed data from a satisfaction survey conducted after team-based CPR training sessions between January and November 2022. Of the 454 nurses surveyed, 238 were included in the study after excluding those with ambiguous responses. Multiple regression analysis was performed to assess factors influencing CPR self-efficacy. The factors examined included inter-professional attitudes and educational burden. Results: Higher levels of inter-professional attitudes, particularly regarding teamwork roles and responsibilities, lower educational burden, and a positive perception of CPR competence were all associated with improved CPR-related self-efficacy. Participants who reported higher engagement in teamwork, lower task load, and greater confidence in their CPR abilities demonstrated higher self-efficacy in performing CPR. Conclusion: Enhancing the competencies of nurses who may act as initial responders in CPR situations within or outside hospital settings can help save lives and support public health.

Differences in Treatment Outcomes According to the Insertion Method Used in Extracorporeal Cardiopulmonary Resuscitation: A Single-Center Experience

  • Han Sol Lee;Chul Ho Lee;Jae Seok Jang;Jun Woo Cho;Yun-Ho Jeon
    • Journal of Chest Surgery
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    • v.57 no.3
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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.

Minimized Priming Volume for Open Heart Surgery in Neonates and Infants (신생아와 유아 심장 수술 시 심폐기회로 충진액의 최소화)

  • Kim, Woong-Han;Chang, Hyoung-Woo;Yang, Sung-Won;Cho, Jae-Hee;Lee, Kyung-Hoon;Baek, In-Hyuk;Kwak, Jae-Gun;Park, Chun-Soo;Lee, Jeong-Ryul;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.418-425
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    • 2009
  • Background: Cardiopulmonary bypass (CPB) involves use of an initial priming volume which can cause side effects such as hemodilution, transfusion, inflammatory reaction and edema. Hence, there have been efforts made tore-duce the initial priming volume. We compared this traditional method to a CPB method that uses a minimized priming volume (MPV). Material and Method: For 97 patients who underwent congenital cardiac surgery between July 2007 to June 2008, we discussed each case and decided which method to use. We reviewed the medical records and cardiopulmonary bypass sheets of the patients. Result: We used a MPV method for 46 patients, and a traditional method for the other 51. There were no significant differences in preoperative and intraoperative characteristics between the two groups, such as body weight, age, cardiopulmonary bypass time, lowest body temperature, etc. However, the priming volume was much smaller in the MPV group than the traditional group (p<0.001). The volume of initially mixed packed RBC was also much smaller in the MPV group (p<0.001). There were no significant differences in postoperative mortality and neurologic complications. Conclusion: We could significantly reduce the initial priming volume and initially mixed pRBC volume with the revised CPB method. We suggest that this method be used more widely for congenital cardiac surgery.

Effects of Exercise Intervention on Physical Fitness and Health-relalted Quality of Life in Hemodialysis Patients (운동요법이 혈액투석 환자의 체력과 건강관련 삶의 질에 미치는 효과)

  • Jang, Eun-Joung;Kim, Hee-Seung
    • Journal of Korean Academy of Nursing
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    • v.39 no.4
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    • pp.584-593
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    • 2009
  • Purpose: The purpose of this study was to investigate the effect of stretching, muscle strengthening, and walking exercise on the cardiopulmonary function and health-related quality of life in hemodialysis patients. Methods: Twenty-one patients in the intervention and the control group participated in the exercise respectively on maintenance hemodialysis at four university hospitals. The exercise was composed of 20 to 60 min per session, 3 sessions a week for 12 weeks. The effect of exercise was assessed by cardiopulmonary function (peak oxygen uptake, peak ventilation, peak respiration rate, maximal heart rate, and exercise duration) using a cycle ergometer. Grip strength was measured by dynamometer, and flexibility was measured by sit and reach measuring instrument. Health-related quality of life was measured using Medical Outcomes Study Short Form-36. Results: Peak oxygen uptake, peak ventilation, peak respiration rate, exercise duration, grip strength, flexibility, and physical component scale were significantly improved in the intervention group after 12 week's exercise compared to the control group. Conclusion: These findings indicate the exercise can improve cardiopulmonary function, grip strength, flexibility, and physical component scale of health-related quality of life in hemodialysis patients.

Effect of Simulation-based Advanced Cardiopulmonary Life Support Education for Nursing Students Hospitals (간호학생을 대상으로 한 시뮬레이션기반 전문심장소생술 교육의 효과)

  • Jung, Hyo-Ju;Chae, Min-Jeong
    • The Korean Journal of Health Service Management
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    • v.9 no.3
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    • pp.127-143
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    • 2015
  • Objectives : This study is a quasi-experiment with a pre-post design and a nonequivalent control group performed from May 1 to June 2, 2013 to verify the effects of a simulation based education program on nursing students' self-confidence, and clinical performance ability. Methods : The subjects of the study were a total of 60 students in their fourth year of a nursing program at a university located in G city and they were assigned to an experimental group of 30 students and a control group of 30 students by convenience sampling. Results : After being offered education, self-confidence, and clinical performance ability were significantly more improved than before in each group. In the comparison of the two groups, the self-confidence (t=3.00, p=.004) and clinical performance ability(t=3.14, p=.003) of the experiment group were significantly higher than those of the control group. Conclusions : The results indicated that instructional methods using a simulation-based emergency care program should be adopted maximize the effects of advanced cardiopulmonary life support education.

The variation of elapsed time on fatigue and quality of single rescuer cardiopulmonary resuscitation (시간 경과에 따른 1인 심폐소생술의 질과 피로도의 변화)

  • Jang, Mun-Sun;Tak, Yang-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.1
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    • pp.9-19
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    • 2013
  • Purpose : The purpose of this study was to investigate the variation of elapsed time in the cardiopulmonary resuscitation (CPR) quality and the fatigue in continuous CPR by single rescuer. This study will provide basic data about the time for the alternation of the CPR providers. Methods : The volunteer students having healthcare provider certification were recruited from the department of emergency medical service. The students performed 30:2 CPR for 20 minutes, and the data were recorded and analyzed. Metrics were based on the 2010 American Heart Association (AHA) Guidelines, and the CPR continued without any feedback. Results : Among the indicators of CPR, the accuracy and the depth of chest compressions decreased after about 5.3 minutes, and the rate increased approximately after 6.8 minutes. Changes in clinical indicators appeared, and fatigue increased after about 3 minutes. According to the increase in fatigue level, the changes in the CPR indicators and clinical indicators showed up, and these results proved to be statistically significant. However, there were no associations among the time, fatigue, and gender. Conclusion : Even though the times of changes in the indicators appeared differently, the times of changes in fatigue and CPR quality were able to be confirmed.

Perception and Attitude of Emergency Medical Staff to Family Presence During Cardiopulmonary Resuscitation (심폐소생술 시 가족 입회에 대한 응급의료센터 의료인의 태도와 인식)

  • Koo, Hyun-Jung;Yoo, Yang-Sook
    • Korean Journal of Adult Nursing
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    • v.23 no.6
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    • pp.624-632
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    • 2011
  • Purpose: This study was performed to determine the perception and attitude of emergency medical staff by the presence of family members while performing Cardiopulmonary Resuscitation (CPR). Methods: Data were collected from June and August in 2010 using questionnaire. The participants were 187 doctors and nurses who were working at emergency medical centers located at eight hospitals. Results: Approximately half of the medical emergency staff had previous experience of having requests from a patient's family members to remain present at the time of performing CPR. Most of the subjects did not know that the 2005 American Heart Association (AHA) guideline recommended including willing family members' during CPR. Doctors were more likely than nurses to recognize that the positive effects of family members being present during CPR. Conclusion: This study indicates that health professionals are not aware of the AHA guidelines for including family members during CPR of a patient and further that more doctors than nurses recognized the value of including willing family members during CPR.

Risk Factors Associated with Difficult Reversal of Heparin by Protamine Sulfate in Cardiopulmonary Bypass: An Ignored Issue

  • Ku, Min Jung;Kim, Su Wan;Lee, Seogjae;Chang, Jee Won;Lee, Jonggeun
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.258-262
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    • 2020
  • Background: The aim of this study was to evaluate risk factors associated with difficult heparin reversal by protamine after cardiopulmonary bypass. Methods: Data from 120 consecutive patients who underwent open heart surgery from 2009 to 2017 were retrospectively reviewed. Patients were divided into 2 groups: (1) those in whom complete heparin reversal was achieved after a single infusion of protamine (group A, n=89); and (2) those who required more protamine for heparin reversal (group B, n=31). Results: Female sex, prolonged bypass time (>200 min), long aortic cross-clamping time (>120 min), and a lowest rectal temperature <26℃ were significant predictors of difficult heparin reversal. Larger amounts of fresh frozen plasma and platelet concentrate were transfused in group B than in group A. Conclusion: Surgeons' efforts to reduce operative time and avoid deep hypothermia may be helpful for increasing the likelihood of easy heparin reversal, especially in female patients.