• Title/Summary/Keyword: oxygenation

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The Value of Mixed Venous Oxygen Saturation during and after Cardiopulmonary Bypass (체외순환중의 중심 정맥 산소포화도의 의의)

  • 이재원
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.7-10
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    • 1995
  • Mixed Venous oxygenation saturation[SvO2 is a variable determined in part by the externally controlled factors and in part by the patient during CPB. I monitored the SvO2 and tested it as a parameter for the regulation of pump output and as a criteria for the need of inotropics after CPB. With the help of SvO2, I increased the pump flow especially during rewarming for more optimal oxygenation of cells. After CPB, the calculated cardiac index was used as an indicator for the need of inotropic support with greater accuracy and without any clinical problems. I conclude that the SvO2 is an easily checkable variable and a good indicator for optimal oxygenation at cell level, and can be used as an objective criteria for the need of postoperative inotropic support.

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Physical properties with melting temperature and holding time for $YBa_{2}$$Cu_{3}$$O_{x}$ single crystal (Y$Ba_{2}$$Cu_{3}$$O_{x}$단결정의 용융온도 및 유지시간에 따른 물리적 특성 변화)

  • 박병삼;한상철;한영희;정년호;윤희중;김경진;오제명;성태현
    • Proceedings of the Korea Institute of Applied Superconductivity and Cryogenics Conference
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    • 2003.10a
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    • pp.93-95
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    • 2003
  • YBa$_2$Cu$_3$O$_{x}$ (Y123) single crystal was grown by TSMG (top seeded melt growth) method. Physical properties of Y123 single crystal were dependent on the shape and distribution of Y2BaCuOx (Y211) in it and on the oxygenation temperature and the holding time. In this work, It was investigated to an optimal oxygenation condition and a dependence of melting temperature and holding time on physical properties. The optimal oxygenation condition was found that it was heat-treated for 30 hours at 45$0^{\circ}C$, Also it was found that the critical current density and the size of Y211 were increased with the melting temperature and the holding time.e.

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The use of extracorporeal membrane oxygenation in children with acute fulminant myocarditis

  • Heinsar, Silver;Raman, Sainath;Suen, Jacky Y.;Cho, Hwa Jin;Fraser, John F.
    • Clinical and Experimental Pediatrics
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    • v.64 no.5
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    • pp.188-195
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    • 2021
  • Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential has led to increasing use of mechanical circulatory support, especially extracorporeal membrane oxygenation (ECMO). Arrhythmias, organ failure, elevated cardiac biomarkers, and decreased ventricular function at presentation predict requirement for ECMO. In these patients, ECMO should be considered earlier as the clinical course of AFM can be unpredictable and can lead to rapid haemodynamic collapse. Key uncertainties that clinicians face when managing children with AFM such as timing of initiation of ECMO and left ventricular decompression need further investigation.

Application of Veno-venoarterial Extracorporeal Membrane Oxygenation in Multitrauma Patient with ARDS - A case report - (다발성 외상으로 유발된 급성호흡부전증후군 환자에서 정맥-정맥동맥 체외막 산화기(ECMO)의 적용 - 1예 보고 -)

  • Lee, Sung Jun;Chee, Hyun Keun;Hwang, Jae Joon;Kim, Jun Seok;Lee, Song Am;Kim, Jin Sik
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.104-107
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    • 2010
  • Acute respiratory distress syndrome (ARDS) is difficult to treat and it is often fatal. If the medical treatment for ARDS is not effective, then extracorporeal membrane oxygenation (ECMO) can be applied to the patient. A 22-year-old female who suffered multiple traumatic injuries due to a car accident presented with acute respiratory distress syndrome. Veinarterial extracorporeal membrane oxygenation (VA ECMO) was started to treat her respiratory failure. With the VA ECMO, the systemic oxygen saturation remained at only 84%, and so the ECMO system was switched to V-VA ECMO via an additional venous outflow through the right jugular vein to increase both the systemic and pulmonary oxygen saturation. After conversion to the V-VA type ECMO, the systemic oxygen saturation increased to 94% and the partial pressure of oxygen ($PaO_2$) increased to 65 mmHg. We report here on a successful case of ECMO conversion from the VA type to the V-VA type in a patient with severely hypoxic respiratory failure.

Catastrophic Bronchial Spasm Due to a Severe Anaphylactic Reaction to Protamine

  • Kim, Jae-Bum;Kim, Jae Hyun;Song, Kyung Sub
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.472-474
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    • 2016
  • Fatal anaphylactic reactions to protamine sulfate during cardiac surgery are very rare. We report a case of catastrophic bronchial spasm due to an anaphylactic reaction to protamine. The patient was managed successfully using a bronchodilator, steroid treatment, and extracorporeal membrane oxygenation.

Influence of Negative-Pressure Wound Therapy on Tissue Oxygenation of the Foot

  • Shon, Yoo-Seok;Lee, Ye-Na;Jeong, Seong-Ho;Dhong, Eun-Sang;Han, Seung-Kyu
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.668-672
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    • 2014
  • Background Negative-pressure wound therapy (NPWT) is believed to accelerate wound healing by altering wound microvascular blood flow. Although many studies using laser Doppler have found that NPWT increases perfusion, recent work using other modalities has demonstrated that perfusion is reduced. The purpose of this study was to investigate the influence of NPWT on tissue oxygenation of the foot, which is the most sensitive region of the body to ischemia. Methods Transcutaneous partial pressure of oxygen ($TcpO_2$) was used to determine perfusion beneath NPWT dressings of 10 healthy feet. The sensor was placed on the tarso-metatarsal area of the foot and the NPWT dressing was placed above the sensor. $TcpO_2$ was measured until it reached a steady plateau state. The readings obtained at the suction-on period were compared with the initial baseline (pre-suction) readings. Results $TcpO_2$ decreased significantly immediately after applying NPWT, but gradually increased over time until reaching a steady plateau state. The decrease in $TcpO_2$ from baseline to the steady state was 2.9 to 13.9 mm Hg (mean, $9.3{\pm}3.6$ mm Hg; $13.5{\pm}5.8%$; P<0.01). All feet reached a plateau within 20 to 65 minutes after suction was applied. Conclusions NPWT significantly decrease tissue oxygenation of the foot by 2.9 to 13.9 mm Hg. NPWT should be used with caution on feet that do not have adequate tissue oxygenation for wound healing.

Clinical effects of veno-venous extra-corporeal membrane oxygenation for acute myocardial infarction (급성심근경색 환자에게 적용된 정맥-정맥 체외막산화기의 임상 효과)

  • Kim, Su Wan;Seong, Gil Myeong;Lee, Jae-Geun
    • Journal of Medicine and Life Science
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    • v.15 no.2
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    • pp.108-111
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    • 2018
  • Extra-corporeal membrane oxygenation (ECMO) has the potential to rescue patients in cardiac arrest or respiratory failure. ECMO has two systems such as veno-arterial and veno-venous circulation. In cardiac arrest resulting from acute myocardial infarction, veno-arterial ECMO is mandatory for systemic circulation and oxygenation. A 75-year old female patient underwent primary coronary intervention for acute myocardial infarction. Despite successful revascularization, recurrent ventricular tachycardia and heart failure were progressing. We performed a veno-arterial ECMO through the femoral artery and vein, then the patient seemed to be stable clinically. However, laboratory studies, echocardiography, and vital signs indicated multi-organ failure and decreasing cardiac function. We found out an error that we performed veno-venous ECMO instead of veno-arterial ECMO. We added a femoral artery cannula and exchange the circuit system to veno-arterial ECMO. While the systemic circulation seemed to be recovered, the left ventricular function was decreased persistently. A hypovolemia resulting from pulmonary hemorrhage was occurred, which lead to ECMO failure. The patient died of cardiac arrest and multi-organ failure 23 hours after ECMO. Because the color of arterial and venous circuits represent the position and efficacy of ECMO, if unexpected or abnormal circuit colors are detected, prompt and aggressive evaluation for ECMO function is mandatory.

Iatrogenic Iliac Vein Injury Following Extracorporeal Membrane Oxygenation Cannulation in a Patient with May-Thurner Syndrome: A Case Report and Literature Review (May-Thurner 증후군 환자에서 체외막산소공급 삽관 중 발생한 의인성 장골 정맥 손상: 증례 보고 및 문헌고찰)

  • Seok Jin Hong;Sang Min Lee;Jung Ho Won
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.244-249
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    • 2021
  • A 53-year-old woman presented with dyspnea. She had undergone extended thymectomy for an invasive thymoma two months prior. CT revealed numerous small nodules in the lung. After that, she deteriorated owing to acute respiratory distress syndrome (ARDS), and the vascular surgeon planned veno-venous extracorporeal membrane oxygenation (ECMO). During percutaneous cannulation through the left femoral vein, a vascular injury was suspected, and the patient's vital signs became unstable. Diagnostic angiography showed a ruptured left common iliac vein, and the bleeding was stopped by placement of a stent-graft. May-Thurner syndrome was diagnosed on abdominal CT. Here, we report a rare case of ECMO-related vascular injury in a patient with an unrecognized anatomical variant, May-Thurner syndrome.

Surgical Repair of a Traumatic Tracheobronchial Injury in a Pediatric Patient Assisted with Venoarterial Extracorporeal Membrane Oxygenation

  • Suh, Jee Won;Shin, Hong Ju;Lee, Chang Young;Song, Seung Hwan;Narm, Kyoung Sik;Lee, Jin Gu
    • Journal of Chest Surgery
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    • v.50 no.5
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    • pp.403-406
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    • 2017
  • Tracheobronchial rupture due to blunt chest trauma is a rare but life-threatening injury in the pediatric population. Computed tomography (CT) is not always reliable in the management of these patients. An additional concern is that ventilation may be disrupted during surgical repair of these injuries. This report presents the case of a 4 -year-old boy with an injury to the lower trachea and carina due to blunt force trauma that was missed on the initial CT scan. During surgery, he was administered venoarterial extracorporeal membrane oxygenation (ECMO). Although ECMO is not generally used in children, this case demonstrated that the short-term use of ECMO during pediatric surgery is safe and can prevent intraoperative desaturation.