• 제목/요약/키워드: oxygenation

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성인의 선천성 심질환 수술 후 발생한 폐동맥 고혈압 위기증에서 체외막 산소화 장치를 이용한 치험 - 1례 보고 - (Treatment of Pulmonary Hypertensive Crisis Using ECMO - A Case Report -)

  • 최재성;김기봉
    • Journal of Chest Surgery
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    • 제35권9호
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    • pp.664-667
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    • 2002
  • 선천성 심질환에 대한 개심술후 발생한 폐동맥 고혈압 위기증이 혈관확장제 등의 내과적 치료에 반응하지 않는 경우에 체외막 산소화 장치를 사용함으로써, 안정적인 산소공급의 확보를 통한 폐혈관 저항의 상승 방지, 심박출량의 상당 부분의 바이패스를 통한 폐관류압의 감소, 우심실의 용적 부하 감소 및 심실보조 기능을 통한 우심부전 및 저심박출의 예방 등의 치료 효과를 기대할 수 있다. 본 증례의 경우, 동맥관 개존증과 이차성 폐동맥 고혈압이 합병되어 있었던 37세 남자에서 수술후 발생한 폐동맥 고혈압 위기증에 대한 치료시 체외막 산소화 장치를 함께 사용하여 좋은 결과를 얻었기에 보고하는 바이다.

Cytomegalovirus Myocarditis Required Extracorporeal Membrane Oxygenation Support Followed by Ganciclovir Treatment in Infant

  • Kim, Bong Jun;Jung, Jo Won;Shin, Yu Rim;Park, Han Ki;Park, Young Hwan;Shin, Hong Ju
    • Journal of Chest Surgery
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    • 제49권3호
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    • pp.199-202
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    • 2016
  • A 7-month-old girl with no medical history was treated with mechanical circulatory support due to myocarditis. Her cardiac contractility did not improve despite more than one week of extracorporeal membrane oxygenation treatment. Thus, we planned a heart transplant. However, a high level of cytomegalovirus was found in blood laboratory results by quantitative polymerase chain reaction. The patient's heart contractility recovered to normal range four days after ganciclovir treatment. She was discharged with slightly decreased cardiac contractility with a left ventricular ejection fraction of 45%.

Intracardiac Thrombosis Involving All Four Cardiac Chambers after Extracardiac Membranous Oxygenation Associated with MTHFR Mutations

  • Kim, Bong Jun;Song, Seung Hwan;Shin, Yu Rim;Park, Han Ki;Park, Young Hwan;Shin, Hong Ju
    • Journal of Chest Surgery
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    • 제49권3호
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    • pp.207-209
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    • 2016
  • A 4-month-old boy diagnosed with acute myocarditis was treated with extracorporeal membrane oxygenation (ECMO). Follow-up echocardiography eight hours after ECMO revealed intracardiac thrombosis involving all four heart chambers. Because of the high risk of systemic embolization due to a pedunculated thrombus of the aortic valve, we performed an emergency thrombectomy. After the operation, the patient had a minor neurologic sequela of left upper arm hypertonia, which had almost disappeared at the last outpatient clinic two months later. He was diagnosed with a major mutation in MTHFR (methylenetetrahydrofolate reductase), which is related to thrombosis.

Left Atrial Decompression by Percutaneous Left Atrial Venting Cannula Insertion during Venoarterial Extracorporeal Membrane Oxygenation Support

  • Kim, Ha Eun;Jung, Jo Won;Shin, Yu Rim;Park, Han Ki;Park, Young Hwan;Shin, Hong Ju
    • Journal of Chest Surgery
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    • 제49권3호
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    • pp.203-206
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    • 2016
  • Patients with venoarterial extracorporeal membrane oxygenation (ECMO) frequently suffer from pulmonary edema due to left ventricular dysfunction that accompanies left heart dilatation, which is caused by left atrial hypertension. The problem can be resolved by left atrium (LA) decompression. We performed a successful percutaneous LA decompression with an atrial septostomy and placement of an LA venting cannula in a 38-month-old child treated with venoarterial ECMO for acute myocarditis.

Computer Models on Oxygenation Process in the Pulmonary Circulation by Gas Diffusion

  • Chang, Keun-Shik;Bae, Hwang
    • International Journal of Vascular Biomedical Engineering
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    • 제4권1호
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    • pp.9-16
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    • 2006
  • In this article we introduce computer models that have been developed in the past to determine the concentration of metabolic gases, the oxygen and carbon dioxide, along the pulmonary circulation. The terminal concentration of these gases in the arterial blood is related with the total change of the partial pressure of the same gases in the alveoli for the time beginning with inspiration and ending with expiration. It is affected not only by the ventilation-perfusion ratio and the gas diffusion capacity of the lung membrane but also by the pulmonary defect such as shunt, dead space, diffusion impairment and ventilation-perfusion mismatch. Some pathological pulmonary symptoms such as ARDS and CDPD can be understood through the mathematical models of these pulmonary dysfunctions. Quantitative study on the blood oxygenation process using various computer models is therefore of foremost importance in order to monitor not only the pulmonary health but also the cardiac output and cell metabolism. Reviewed in this paper include the basic and advanced methods that enable numerical study on the gas exchange and on the arterial oxygenation process, which might depend on the various heart and lung physiological conditions listed above.

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미숙아의 기관지흡인 전 흉곽진동 간호중재가 산소포화도, 심박동수와 기도분비물의 양에 미치는 영향 (The Effects of Chest Vibration Prior to Endotracheal Suctioning on Oxygen Saturation, Heart Rate and Lung Secretions in Premature Infants)

  • 안영미
    • Child Health Nursing Research
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    • 제4권2호
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    • pp.245-254
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    • 1998
  • Prematurity is the main cause for respiratory disorders in neonates. The goal in respiratory management is to maintain respiration with adequate oxygenation. Chest vibration(CV) prior to on dotracheal suctioning(ETS) has been arbitrarily applied to ventilated premature infants without the scientific evaluation of its safety and efficacy. A repeated measure within subjects experimental study was conducted to investigate the effects of CV prior to 875 on oxygenation and lung secretions in twenty-one ventilated premature infants. The independent variable was the type of research protocol, the control type (275 without C.V) and t he intervention(ETS with CV). The dependent variables were oxygen saturation(SpO₂), heart rate (HR), measured by pulse oximeter, and the amount of lung secretions measured in gram. The results showed there was no difference in SpO₂ responses regardless CV employed before ETS. But there was a significant difference in HR responses between the control and the intervention, even without clinical significance. There was a significant difference in the amount of lung secretions retrieved during ETS with CV, compared to ETS without CV. This study suggested the safety of CV by demonstrating no clinically significant changes in SpO₂ and HR in premature infants. The efficacy of CV could be supported by the increases in the amount of sputum during ETS with CV compared to ETS without CV in premature infants.

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2009 H1N1 influenza virus infection and necrotizing pneumonia treated with extracorporeal membrane oxygenation

  • Ji, Sun-Tae;Lee, Ok-Jeong;Yang, Ji-Hyuk;Ahn, Kang-Mo;Cho, Joong-Bum;Jeong, Soo-In;Han, Woo-Sik;Kim, Yae-Jean
    • Clinical and Experimental Pediatrics
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    • 제54권8호
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    • pp.345-349
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    • 2011
  • A 3-year-old girl with acute respiratory distress syndrome due to a H1N1 2009 influenza virus infection was complicated by necrotizing pneumonia was successfully treated with extracorporeal membrane oxygenation (ECMO). This is the first reported case in which a pediatric patient was rescued with ECMO during the H1N1 influenza epidemic in Korea in 2009.

Life-Threatening Acute on Chronic Pulmonary Thromboembolism Requiring Extracorporeal Membrane Oxygenation

  • Lee, Heemoon;Kim, Min Soo;Kim, Wook Sung;Kim, Yong Han;Cho, Sung Ho;Lee, Jae Jin
    • Journal of Chest Surgery
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    • 제51권3호
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    • pp.205-208
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    • 2018
  • A 71-year-old female patient was admitted to the emergency department with sudden aggravation of chest pain and severe dyspnea. Computed tomography showed extensive pulmonary thromboembolism. Venoarterial extracorporeal membrane oxygenation (ECMO) was instituted due to sudden bradycardia and hypotension. An emergency operation was performed. However, chronic pulmonary thromboembolism combined with an acute pulmonary embolism was detected in the operating room. Embolectomy and endarterectomy were performed. ECMO was then discontinued. The patient was discharged on postoperative day 13 with warfarin for anticoagulation. The patient was followed up for 46 months as an outpatient without further thromboembolic events.

Successful Left-Heart Decompression during Extracorporeal Membrane Oxygenation in an Adult Patient by Percutaneous Transaortic Catheter Venting

  • Hong, Tae Hee;Byun, Joung Hun;Yoo, Byung Ha;Hwang, Sang Won;Kim, Han Yong;Park, Jae Hong
    • Journal of Chest Surgery
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    • 제48권3호
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    • pp.210-213
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    • 2015
  • Venoarterial extracorporeal membrane oxygenation (VA ECMO) is widely used in patients with cardiogenic shock. Insufficient decompression of the left ventricle (LV) is considered a major factor preventing adequate LV recovery. A 40-year-old male was diagnosed with acute myocardial infarction, and revascularization was performed using percutaneous stenting. However, cardiogenic shock occurred, and VA ECMO was initiated. Severe LV failure developed, and percutaneous transaortic catheter venting (TACV) was incorporated into the venous circuit of VA ECMO under transthoracic echocardiography guidance. The patient was successfully weaned from VA ECMO. Percutaneous TACV is an effective, relatively noninvasive, and rapid method of LV decompression in patients undergoing VA ECMO.

고압산소요법시(高壓酸素療法時) 약물요법병행(藥物療法倂行)의 효과에 관(關)한 연구(硏究) (A study on the Effects of Hyperbaric Oxygenation Combined with the Drug Administration in the Treatment of CO poisoning)

  • 윤덕로;김익수
    • Journal of Preventive Medicine and Public Health
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    • 제6권1호
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    • pp.71-76
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    • 1973
  • 1) The oxygen consumption was studied with albino rats under normal environment after they were given Cytochrome C intravenously (10mg/kg). The cosumption was 74.6cc/kg min. with that of control, 75.4cc/kg. min. The difference of the consumptions was not statistically significant. However, under 0.5% CO environment, the oxygen consumption of the Cytochrome C treated rats (62.5cc/kg min) was significantly greater than the control (42.1cc/kg min.) 2) The recovery time of rat acutely poisoned by 1% CO was studied. The recovery time of the Cytochrome C treated group was 37.2 minutes and in control group it was 52.2 minutes. Also significant difference of fatality was noted between the treated group (21.8%) and the untreated group (49.7%) 3) The combined effects of the hyperbaric oxygenation (100% $O_2$ at 3 atmospheric pressures) and the Cytochrome C administration was compared with the effect of the simple hyperbaric oxygenation. There was no significant difference of recovery time between the experimental group while the fatality of the experiment group was lower than control group.

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