• 제목/요약/키워드: cardiopulmonary

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만성 폐전색증의 폐동맥 색전제거및 내막 절제술;치험 2례 (Thromboendarterectomy for Chronic Pulmonary Embolism under Cardiopulmonary bypass - Report of a Cases -)

  • 이종국;윤치순;김은기
    • Journal of Chest Surgery
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    • 제24권12호
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    • pp.1201-1208
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    • 1991
  • Two successful pulmonary thromboendartectomies were performed. In the first case, it was performed under cardiopulmonary bypass with moderate hypothermia and ventricular fibrillation In the second case, it was done under deep hypothermia and intermittent circulatory arrest. The patients are recovered uneventfully without complication and discharged from the hospital on warfarin. Their symptoms were improved and the follow-up pulmonary perfusion scans revealed no evidence of residual pulmonary embolus in both cases.

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개에서 폐엽절제가 심폐기능 및 산화 스트레스 상태에 미치는 영향; 일반개흉 및 흉강경을 통한 폐엽절제술 비교 (Cardiopulmonary and Oxidative Stress Effects of Lung Lobectomy in Dogs; Comparison of Open and Thoracoscopic Surgery)

  • 이재연;김명철
    • 한국임상수의학회지
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    • 제30권6호
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    • pp.409-414
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    • 2013
  • 본 연구에서는 개에서 일반 개흉술을 통한 폐엽절제술과 흉강경을 이용한 폐엽절제술에서 심폐기능 및 생체 내 산화스트레스 상태에 미치는 영향을 비교 연구 하였다. 10 마리의 건강한 혼혈종을 사용하였고 일반 개흉술을 통한 폐엽절제술군 (group 1, n=5)과 흉강경을 이용한 폐엽절제술군 (group 2, n=5)으로 분류하였다. 심혈관계 측정 항목 및 superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx)의 농도를 측정하였다. 두 군에서 동맥혈액 가스의 유의적인 변화를 관찰 할 수 있었다. 총 마취 및 수술 시간은 개흉수술군에 비해 흉강경 폐엽 절제술군에서 유의하게 짧았다. 혈장 SOD와 CAT 수준의 증가, 그리고 GPX 수준의 감소는 수술 후 두 군 모두에서 관찰되었다. 두 군을 비교했을 때 GPX 수준에서 유의한 차이가 발견되었다. GPX 수준은 개흉 수술 군과 비교 흉강경 폐엽 절제술 군에서 유의하게 낮았다.

심정지 초기 5분간 일반간호사의 심폐소생술 수행 분석: 현장 시뮬레이션을 이용하여 (Nurses' Cardiopulmonary Resuscitation Performance during the First 5 minutes in In-Situ Simulated Cardiac Arrest)

  • 김은정;이경룡;이명현;김지영
    • 대한간호학회지
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    • 제42권3호
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    • pp.361-368
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    • 2012
  • Purpose: The purpose of this study was to analyze the cardiopulmonary resuscitation skills and teamwork of nurses in simulated cardiac arrests in the hospital. Methods: A descriptive study was conducted with 35 teams of 3 to 4 registered nurses each in a university hospital located in Seoul. A mannequin simulator was used to enact simulated cardiac arrest. Assessment included critical actions, time elapsed to initiation of critical actions, quality of cardiac compression, and teamwork which comprised leadership behavior and communication among team members. Results: Among the 35 teams, 54% recognized apnea, 43% determined pulselessness. Eighty percent of the teams compressed at an average elapsed time of $108{\pm}75$ seconds with 35%, 36%, and 67% mean rates of correct compression depth, rate, and placement, respectively. Thirty-seven percent of the teams defibrillated at $224{\pm}67$ seconds. Leadership behavior and communication among team members were absent in 63% and 69% of the teams, respectively. Conclusion: The skills of the nurses in this study cannot be considered adequate in terms of appropriate and timely actions required for resuscitation. Future resuscitation education should focus on improving the quality of cardiopulmonary resuscitation including team performance targeting the first responders of cardiac arrest.

고도의 원위부 기관협착 환자에서 경피적 심폐보조장치를 이용한 호흡보조 하에 시행한 기관절제 및 단단 문합술 (Respiratory Support by Performing Percutaneous Cardiopulmonary Support (PCPS) for Tracheal Resection and Reconstruction in Patients with Severe Distal Tracheal Stenosis)

  • 조상호;박인규;이창영;배미경;정경영
    • Journal of Chest Surgery
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    • 제42권2호
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    • pp.259-262
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    • 2009
  • 기관 및 폐문부 수술 시 기도확보가 어려운 경우나 폐실질 질환을 동반하여 저산소증 등이 우려될 경우 심폐보조장치의 도움을 받을 수 있다. 국소마취 하에 시행할 수 있는 경피적 심폐보조장치는 고전적인 심폐보조장치를 대신하여 기관호흡으로 호흡유지가 힘든 환자에게 안전하고 손쉽게 적용할 수 있다. 저자들은 고도의 하부 기관협착 환자에서 경피적 심폐보조장치를 이용한 호흡보조 하에 기관절제 및 단단 문합술을 성공하였기에 보고하는 바이다.

Results of Extracorporeal Cardiopulmonary Resuscitation in Children

  • Shin, Hong Ju;Song, Seunghwan;Park, Han Ki;Park, Young Hwan
    • Journal of Chest Surgery
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    • 제49권3호
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    • pp.151-156
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    • 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.

Cardiopulmonary function and scoliosis severity in idiopathic scoliosis children

  • Huh, Seokwon;Eun, Lucy Yougmin;Kim, Nam Kyun;Jung, Jo Won;Choi, Jae Young;Kim, Hak Sun
    • Clinical and Experimental Pediatrics
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    • 제58권6호
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    • pp.218-223
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    • 2015
  • Purpose: Idiopathic scoliosis is a structural lateral curvature of the spine of unknown etiology. The relationship between degree of spine curvature and cardiopulmonary function has not yet been investigated. The purpose of this study was to determine the association between scoliosis and cardiopulmonary characteristics. Methods: Ninety children who underwent preoperative pulmonary or cardiac evaluation at a single spine institution over 41 months were included. They were divided into the thoracic-dominant scoliosis (group A, n=78) and lumbar-dominant scoliosis (group B, n=12) groups. Scoliosis severity was evaluated using the Cobb method. In each group, relationships between Cobb angles and cardiopulmonary markers such as forced vital capacity (FVC), forced expiratory volume in one second ($FEV_1$), $FEV_1$/FVC, left ventricular ejection fraction, pulmonary artery flow velocity, and tissue Doppler velocities (E/E', E'/A') were analyzed by correlation analysis linear regression. Results: In group A, 72 patients (92.3%) underwent pulmonary function tests (PFTs), and 41 (52.6%) underwent echocardiography. In group B, 9 patients (75.0%) underwent PFT and 8 (66.7%) underwent echocardiography. Cobb angles showed a significant negative correlation with FVC and $FEV_1$ in group A (both P<0.05), but no such correlation in group B, and a significant negative correlation with mitral E/A ratio (P<0.05) and tissue Doppler E'/A' (P<0.05) in group A, with a positive correlation with mitral E/A ratio (P<0.05) in group B. Conclusion: Pulmonary and cardiac function was significantly correlated with the degree of scoliosis in patients with thoracic-dominant scoliosis. Myocardial diastolic function might be impaired in patients with the most severe scoliosis.

Effects of High-intensity Intermittent Training and Moderate-intensity Training on Cardiopulmonary Capacity in Canoe and Kayak Paddlers during 8 Weeks

  • Kim, Ah-Ram;Shin, Won-Seob
    • 대한물리의학회지
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    • 제9권3호
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    • pp.307-314
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    • 2014
  • PURPOSE: The purpose of this study was to investigate the effects of high intensity intermittent training on cardiopulmonary capacity in canoe and kayak paddlers. METHODS: A total of 16 canoe and kayak paddlers were participated in this study. Experimental group(n=8) was performed high-intensity intermittent training and control group(n=8) was moderate intensity training. All subjects performed a treadmill test in order to compare the difference before and after the intervention. Finishing the test, all subjects were measured to their heart rate(HR), forced vital capacity(FVC), forced expiratory volume in one second (FEV1) and forced expiratory ratio(FEV1/FVC). Recovery of heart rate(RHR) was calculated using the HR. HR and pulmonary flow values was measured before and during the intervention period per 2, 4, 6 and 8 weeks. To compare the differences over time between experimental group and the control group, used(time${\times}$group) two-way repeated measures ANOVA. One-way repeated ANOVA was performed to determine where differences over time within-group. RESULTS: One-way repeated ANOVA revealed a significant difference in the experimental and control group. In experimental group, %RHR3min and FEV1 were significantly increased after 4 weeks(p<.05). Also, %RHR1min, FVC and FEV1/FVC were significantly increased after 6 weeks(p<.05). In control group, %RHR1min, %RHR3min, FVC, FEV1 and FEV1/FVC were significantly increased after 6 weeks(p<.05). CONCLUSION: Not only moderate training but also high-intensity intermittent training contributes to cardiopulmonary capacity in canoe and kayak paddlers. Although high-intensity intermittent training is very short time, the training has high degree of efficiency. Therefore, developed this training in the future, it will be better to improve the cardiopulmonary capacity for athletes and healthy people.