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Experimental Study on Source Locating Technique for Transversely Isotropic Media (횡등방성 매질의 음원추적기법에 대한 실험적 연구)

  • Choi, Seung-Beum;Jeon, Seokwon
    • Tunnel and Underground Space
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    • v.25 no.1
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    • pp.56-67
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    • 2015
  • In this study, a source locating technique applicable to transversely isotropic media was developed. Wave velocity anisotropy was considered based on the partition approximation method, which simply enabled AE source locating. Sets of P wave arrival time were decided by the two-step AIC algorithm and they were later used to locate the AE sources when having the least error compared with the partitioned elements. In order to validate the technique, pencil lead break test on artificial transversely isotropic mortar specimen was carried out. Defining the absolute error as the distance between the pencil lead break point and the located point, 1.60 mm ~ 14.46 mm of range and 8.57 mm of average were estimated therefore it was regarded as thought to be 'acceptable' considering the size of the specimen and the AE sensors. Comparing each absolute error under different threshold levels, results showed small discrepancies therefore this technique was hardly affected by background noise. Absolute error could be decomposed into each coordinate axis error and through it, effect of AE sensor position could be understood so if optimum sensor position was able to be decided, one could get more precise outcome.

Emergency angioembolization performed in a hemodynamically unstable patient with grade V liver injury: The benefit of emergency angioembolization without computed tomography (혈역학적으로 불안정한 grade V 간손상에서 시행한 응급 혈관색전술: 전산화단층 촬영 없이 시행한 응급 혈관색전술의 이점)

  • Kang, Wu Seong;Park, Chan Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.235-239
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    • 2019
  • High-grade liver injury is associated with high morbidity and mortality rates. We report successful emergency angioembolization and early interventional radiology support to manage a high-grade liver injury in a 29-year-old man who presented following a fall during parachute training. Upon arrival, his blood pressure was 80/40 mmHg, and emergency ultrasonography showed a liver injury with perihepatic fluid collection. The patient's blood pressure reduced to 60/40 mmHg, and emergency angiography was performed without computed tomography (CT) (door to puncture time 36 min). After angioembolization, his blood pressure returned to 120/77 mmHg. Subsequent CT revealed no additional bleeding or hollow viscus injury. He was admitted to the Intensive Care Unit and discharged without complications 30 days after admission. In this case, emergency angioembolization (without performing CT) could successfully and safely treat a hemodynamically unstable patient with a high-grade liver injury.

Multivariate Analysis of Predictive Factors for the Severity in Stable Patients with Severe Injury Mechanism (중증 손상 기전의 안정된 환자에서 중증도 예측 인자들에 대한 다변량 분석)

  • Lee, Jae Young;Lee, Chang Jae;Lee, Hyoung Ju;Chung, Tae Nyoung;Kim, Eui Chung;Choi, Sung Wook;Kim, Ok Jun;Cho, Yun Kyung
    • Journal of Trauma and Injury
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    • v.25 no.2
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    • pp.49-56
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    • 2012
  • Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

Earthquake Monitoring : Future Strategy (지진관측 : 미래 발전 전략)

  • Chi, Heon-Cheol;Park, Jung-Ho;Kim, Geun-Young;Shin, Jin-Soo;Shin, In-Cheul;Lim, In-Seub;Jeong, Byung-Sun;Sheen, Dong-Hoon
    • Geophysics and Geophysical Exploration
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    • v.13 no.3
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    • pp.268-276
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    • 2010
  • Earthquake Hazard Mitigation Law was activated into force on March 2009. By the law, the obligation to monitor the effect of earthquake on the facilities was extended to many organizations such as gas company and local governments. Based on the estimation of National Emergency Management Agency (NEMA), the number of free-surface acceleration stations would be expanded to more than 400. The advent of internet protocol and the more simplified operation have allowed the quick and easy installation of seismic stations. In addition, the dynamic range of seismic instruments has been continuously improved enough to evaluate damage intensity and to alert alarm directly for earthquake hazard mitigation. For direct visualization of damage intensity and area, Real Time Intensity COlor Mapping (RTICOM) is explained in detail. RTICOM would be used to retrieve the essential information for damage evaluation, Peak Ground Acceleration (PGA). Destructive earthquake damage is usually due to surface waves which just follow S wave. The peak amplitude of surface wave would be pre-estimated from the amplitude and frequency content of first arrival P wave. Earthquake Early Warning (EEW) system is conventionally defined to estimate local magnitude from P wave. The status of EEW is reviewed and the application of EEW to Odesan earthquake is exampled with ShakeMap in order to make clear its appearance. In the sense of rapidity, the earthquake announcement of Korea Meteorological Agency (KMA) might be dramatically improved by the adaption of EEW. In order to realize hazard mitigation, EEW should be applied to the local crucial facilities such as nuclear power plants and fragile semi-conduct plant. The distributed EEW is introduced with the application example of Uljin earthquake. Not only Nation-wide but also locally distributed EEW applications, all relevant information is needed to be shared in real time. The plan of extension of Korea Integrated Seismic System (KISS) is briefly explained in order to future cooperation of data sharing and utilization.

Analysis of media trends related to spent nuclear fuel treatment technology using text mining techniques (텍스트마이닝 기법을 활용한 사용후핵연료 건식처리기술 관련 언론 동향 분석)

  • Jeong, Ji-Song;Kim, Ho-Dong
    • Journal of Intelligence and Information Systems
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    • v.27 no.2
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    • pp.33-54
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    • 2021
  • With the fourth industrial revolution and the arrival of the New Normal era due to Corona, the importance of Non-contact technologies such as artificial intelligence and big data research has been increasing. Convergent research is being conducted in earnest to keep up with these research trends, but not many studies have been conducted in the area of nuclear research using artificial intelligence and big data-related technologies such as natural language processing and text mining analysis. This study was conducted to confirm the applicability of data science analysis techniques to the field of nuclear research. Furthermore, the study of identifying trends in nuclear spent fuel recognition is critical in terms of being able to determine directions to nuclear industry policies and respond in advance to changes in industrial policies. For those reasons, this study conducted a media trend analysis of pyroprocessing, a spent nuclear fuel treatment technology. We objectively analyze changes in media perception of spent nuclear fuel dry treatment techniques by applying text mining analysis techniques. Text data specializing in Naver's web news articles, including the keywords "Pyroprocessing" and "Sodium Cooled Reactor," were collected through Python code to identify changes in perception over time. The analysis period was set from 2007 to 2020, when the first article was published, and detailed and multi-layered analysis of text data was carried out through analysis methods such as word cloud writing based on frequency analysis, TF-IDF and degree centrality calculation. Analysis of the frequency of the keyword showed that there was a change in media perception of spent nuclear fuel dry treatment technology in the mid-2010s, which was influenced by the Gyeongju earthquake in 2016 and the implementation of the new government's energy conversion policy in 2017. Therefore, trend analysis was conducted based on the corresponding time period, and word frequency analysis, TF-IDF, degree centrality values, and semantic network graphs were derived. Studies show that before the 2010s, media perception of spent nuclear fuel dry treatment technology was diplomatic and positive. However, over time, the frequency of keywords such as "safety", "reexamination", "disposal", and "disassembly" has increased, indicating that the sustainability of spent nuclear fuel dry treatment technology is being seriously considered. It was confirmed that social awareness also changed as spent nuclear fuel dry treatment technology, which was recognized as a political and diplomatic technology, became ambiguous due to changes in domestic policy. This means that domestic policy changes such as nuclear power policy have a greater impact on media perceptions than issues of "spent nuclear fuel processing technology" itself. This seems to be because nuclear policy is a socially more discussed and public-friendly topic than spent nuclear fuel. Therefore, in order to improve social awareness of spent nuclear fuel processing technology, it would be necessary to provide sufficient information about this, and linking it to nuclear policy issues would also be a good idea. In addition, the study highlighted the importance of social science research in nuclear power. It is necessary to apply the social sciences sector widely to the nuclear engineering sector, and considering national policy changes, we could confirm that the nuclear industry would be sustainable. However, this study has limitations that it has applied big data analysis methods only to detailed research areas such as "Pyroprocessing," a spent nuclear fuel dry processing technology. Furthermore, there was no clear basis for the cause of the change in social perception, and only news articles were analyzed to determine social perception. Considering future comments, it is expected that more reliable results will be produced and efficiently used in the field of nuclear policy research if a media trend analysis study on nuclear power is conducted. Recently, the development of uncontact-related technologies such as artificial intelligence and big data research is accelerating in the wake of the recent arrival of the New Normal era caused by corona. Convergence research is being conducted in earnest in various research fields to follow these research trends, but not many studies have been conducted in the nuclear field with artificial intelligence and big data-related technologies such as natural language processing and text mining analysis. The academic significance of this study is that it was possible to confirm the applicability of data science analysis technology in the field of nuclear research. Furthermore, due to the impact of current government energy policies such as nuclear power plant reductions, re-evaluation of spent fuel treatment technology research is undertaken, and key keyword analysis in the field can contribute to future research orientation. It is important to consider the views of others outside, not just the safety technology and engineering integrity of nuclear power, and further reconsider whether it is appropriate to discuss nuclear engineering technology internally. In addition, if multidisciplinary research on nuclear power is carried out, reasonable alternatives can be prepared to maintain the nuclear industry.

Legal Relations of the Contract of International Carriage of Goods by Air (국제항공화물운송계약(國際航空貨物運送契約)의 법률관계(法律關係) -화주(貨主)의 권리의무(權利義務)를 중심(中心)으로-)

  • Lee, Kang-Bin
    • The Korean Journal of Air & Space Law and Policy
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    • v.1
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    • pp.193-222
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    • 1989
  • The purpose of this study is to review the rights and duties of cargo owners, the party to the contract of international carriage of goods by air under the Warsaw Convention System and the IATA conditions. It is generally known that air freight is the most-cost mode of transportation. However, should there be considerations of total distribution cost, the use of air freight leads exporters to be advantageous in physical distribution. The Warsaw Convention System defined and limited the rights and duties of cargo owners and air carriers paticipating in the international carriage of goods, but it does not regulate every aspect of air transportation. Therefore, the unregulated parts are governed by national laws and by individual contracts of carriage. The International Air Transport Association(lATA), a worldwide organization of airlines, has formulated model conditions of contract for the carriage of cargo. These models are not uniformly followed but they serve as a basis for many of the individual standard form of contracts prepared by air carriers. The contract of air carriage of goods is a contract of adhesion, 'the consignor recognizing and accepting the conditions laid down by the carrier'. There are consignors and carriers as the parties to the contract of international carriage of goods. In addition to his basic right, implied in Warsaw Convention Article 18 and 19, to require devery of the goods in good condition and at the date agreed upon, the consignor has the right to dispose the goods in the course of the journey up to the moment when the consignee is entitled to require delivery. If it is impossible to carry out the orders of the consignor, the carrier must so inform him forthwith. The right conferred on the consignor ceases at the moment when that of the consignee begins in accordance with Warsaw Convention Article 13. Nevertheless, if the consignee declines to accept the air waybill or the goods, or if he cannot be communicated with, the consignor resumes his right of disposition. Unless it is otherwise agreed, it is the duty of the carrier to give notice to the consignee as soon as the goods arrive. The consignee is entitled, on arrival of the goods at the place of destination, to require the carrier to hand over to him the air waybill and to deliver the goods to him, on payment of the charges due and on complying with the conditions of carriage set out in the air waybill. The air waybill is supposed to be made out by the consignor. If the carrier makes it out, he is deemed, subject to proof to the contrary, to have done so on behalf of the consignor, whether there is one air waybill or several, each must be made out in three original parts. The first is for the carrier, the second is for the consignee, and the the third is handed to the consignor when the shipment has been accepted. The consignor is responsible for the correctness of the particulars and statement concerning the cargo appearing in the air waybill. Each of the original parts of the air waybill has evidential value and possession of his part is a condition for the exercise by the consignor or consignee of his rights under the contract of carriage. Hague Protocol set forth in Article 9 that nothing in this. Convention prevents the issue of a negotiable air waybill, but Montreal Additional Protocol No. 4 deleted this article. All charges applicable to a shipment are payable in cash at the time of acceptance thereof by the carrier in case of a prepaid shipment or at the time of delivery thereof by the carrier in case of a collect shipment. The carrier shall have lien the cargo for unpaid charges and, in the event of non-payment thereof, shall have the right to dispose of the cargo at public or private sale and pay itself out of the proceeds of such sale any and all such amounts. In conclusion, the Warsaw Convention System has the character of ambiguity in various respects, not only in the part of the forms of documents but also in conditions of contract. Accordingly, the following propositions might be considered: (1) If the carrier does not obey the orders of the consignor for the disposition of the goods without proper reasons, he will be liable strictly for any damage which may be caused thereby to the cargo owner. The special agreement and carrier's conditions of carriage which limit unreasonably the consignor's right of disposition of the goods will be nullified. (2) The instrument of the Warsaw Convention System which is not yet in force(Montreal Additional Protocol No. 4) would considerably simplfy the processing and keeping of computerized records of the carriage. Until this instrument enters into force, the airlines will be faced with practical problems preventing them to substitute computerized data processing techniques for the formal issuance of the documents. Accordingly, Montreal Additional Protocol No. 4 should become effective as soon as posisble. From a practical point of view in the international trade, the issuance of negotiable air waybill should be permitted for the security of the bank.

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Factors Affecting the Survivals of Out-of-hospital Cardiac Arrests by 119 Fire Service (119구급대원의 심폐소생술 성적 분석 - 병원전 심정지를 중심으로 -)

  • Kang, Byung-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.2
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    • pp.111-128
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    • 2005
  • Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

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Monitoring North Korea Nuclear Tests: Comparison of 1st and 2nd Tests (북한 핵실험 모니터링 : 1, 2차 비교)

  • Chi, Heon-Cheol;Park, Jung-Ho;Kim, Geun-Young;Che, Il-Young;Sheen, Dong-Hoon;Shin, Jin-Soo;Cho, Chang-Soo;Lee, Hee-Il
    • Geophysics and Geophysical Exploration
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    • v.13 no.3
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    • pp.243-248
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    • 2010
  • Two suspicious events, which were claimed as underground nuclear tests by North Korea, were detected in the northern Korean Peninsula on October 9, 2006 and May 25, 2009. The KIGAM and Korea-China Joint seismic stations are distributed uniformly along the boundaries between North Korea and adjacent countries. In this study, the data from broadband stations with the distance of 200 to 550 km from the test site are used to analyze and compare two nuclear tests of North Korea. By comparing the time differences of the Pn-wave arrival times of 1st and 2nd tests at multiple stations, the relative locations of two test sites could be calculated precisely. From the geometrical calculation with the velocity of Pn wave $V_{Pn}$ = 8 km/s, the 2nd test site is estimated to move in the WNW direction from 1st one with the distance of 2 km. Body wave magnitude, mb of the 2nd test, which was announced officially as the network average of 4.5, varies widely with the directional location of stations from 4.1 to 5.2. The magnitude obtained from Lg wave, $m_b$(Lg), shows less variation between 4.3 to 4.7 with the average of 4.6. The moving-window spectra of time traces of 1st and 2nd tests show very similar pattern with different scale level. In addition, the corner frequencies of P wave of 1st and 2nd tests at each station show no or negligible difference. This indicates the burial depths of two tests might be very similar. The relative yield amount of the 2nd test is estimated 8 times larger than that of the 1st from the weighted average of ground-velocity amplitude ratios.

The Characteristics of Dolmen Culture and Related Patterns during the End Phase in the Gyeongju Region (경주 지역 지석묘 문화의 특징과 종말기의 양상)

  • Lee, Soohong
    • Korean Journal of Heritage: History & Science
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    • v.53 no.4
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    • pp.216-233
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    • 2020
  • This study set out to review tomb culture in the Gyeongju region during the Bronze Age, and also examine the patterns of dolmens during their end phase. For these purposes, the study analyzed 18 tomb relics from the Bronze Age and nine from the early Iron Age. Gyeongju belongs to the Geomdan-ri cultural zone. Approximately 120 tombs from the Bronze Age have been excavated in the Gyeongju region. There are fewer tombs than dwellings in the region, which is a general characteristic of the Geomdan-ri cultural zone. Although the number of tombs is small, the detailed structure of the dead body is varied. During the Bronze Age, tombs in the Gyeongju region were characterized by more prolific construction of pit tombs, dolmens with boundaries, and stacked stone altars than were the cases in other areas. There is a great possibility that the pit tombs in the Gyeongju region were influenced by their counterparts in the northeastern parts of North Korea, given the spindle whorl artifacts buried at the Dongsan-ri sites. Dolmens with boundaries and stacked stone altars are usually distributed in the Songguk-ri cultural zone, and it is peculiar that instances of these are found in large numbers in the Gyeongju region as part of the Geomdanri cultural zone. Even in the early Iron Age, the building of dolmens with boundaries and stacked stone altars continued in the Gyeongju region under the influence of the Bronze Age. A new group of people moved into the area, and they crafted ring-rimmed pottery and built wooden coffin tombs. In the early Iron Age, new rituals performed in high places also appeared, and were likely to provide venues for memorial services for heavenly gods in town-center areas. The Hwacheon-ri Mt. 251-1 relic and the Jukdong-ri relic are ruins that exhibit the aspect of rituals performed in high places well. In these rituals performed in high places, a stacked stone altar was built with the same form as the dolmens with boundaries, and a similar rock to the cover stone of a dolmen was used. People continued to build and use dolmens with boundaries and stacked stone altars while sustaining the Bronze Age traditions, even into the early Iron Age, because the authority of dolmens was maintained. Some dolmens with boundaries and stacked stone altars, known as being Bronze Age in origin, would have continued to be used in ritual practices until the early Iron Age. Entering the latter half of the second century B.C., wooden coffin tombs began to propagate. This was the time when the southern provinces, including the Gyeongju region, were included in the East Asian network, with the spread of ironware culture and the arrival of artifacts from central China. Around this time, dolmen culture faded into history with a new era beginning in its place.

End Point Temperature of Rewarming and Afterdrop After Hypothermic Cardiopulmonary Bypass in Pediatric Patients (소아에서의 저체온 심폐바이패스후 재가온 종료온도와 후하강)

  • Kim, Won-Gon;Lee, Hae-Won;Lim, Cheong
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.125-130
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    • 1997
  • Separating the patient from hypothermic cardiopulmonary bypass(CPB) before achieving adequate rewarming often results in afterdrop, which can predispose to electrolyte disturbances, arrhythmia, hemodynamic alterations, and shivering-induced increase of oxygen consumption. In an attempt to find an adequate end point temperature of rewarming after hypothermic CPB, 50 pediatric cardiac surgical patients were r ndomly assigned for end point temperature of rewarming of 35.5$^{\circ}C$ (Group 1) or 37t (Group 2), rectal temperature. Thereafter the rectal temperature was measured half, one, four, eight, and 16 hour after arrival to the intensive care unit(ICU), with heart rate and blood pressure. Additionally the rectal temperature was compared with esophageal temperature during CPB, and axillary temperature luring stay in the ICU. Nonpulsatile perfusion with a roller pump was used in all patients and a membrane or bubble oxygenator was used for oxygenation. Both groups were comparable with respect to age, sex, body surface area, total bypass time, and rewarming time. There was no afterdrop in both groups, and there were no statistical differences in the rectal temperatures between two groups. There were also no statistical dilyerences with respect to the heart rate and blood pressure between two groups. At the end of rewarming the esophageal temperature was higher than the rectal temperature. The axil ary temperature measured in ICU was always lower than the rectal temperature. No shivering was noted in all patients. In conclusion, with restoration of rectal temperature above 35.5$^{\circ}C$ at the end of CPB in pediatric patients, we did not observe an afterdrop.

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