• Title/Summary/Keyword: 자발적 순환 회복

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Factors influencing the return of spontaneous circulation of patients with out-of-hospital cardiac arrest (병원외 심정지 환자의 자발적 순환 회복에 영향을 미치는 요인)

  • Park, Il-Su;Kim, Eun-Ju;Sohn, Hae-Sook;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.11 no.9
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    • pp.229-238
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    • 2013
  • Out-of-hospital cardiac arrest is a major public health problem in Korea. The survival rate to discharge remains at approximately 3.5% and only 1% have good neurological function. To increase the survival rate, prehospital care should restore spontaneous circulation. The purpose of this study was to analyze the factors associated with return of spontaneous circulation(ROSC) after out-of-hospital cardiac arrest. Data used for this study were collected from KCDC Out-of-Hospital Cardiac Arrest Surveillance 2009. As for the results of decision tree analysis, it is clear that prehospital CPR, cardiac arrest witness, activity, past history(cancer/heart disease/stroke), place, bystander CPR, response time, age, etc are significant contributing factors in ROSC. Among 16 cardiac arrest types from decision tree classification, the ROSC rate of type 1 is the highest(29.6%). Also notable is the fact that bystander CPR was strongly correlated with ROSC of patents with cardiac arrest occurring in non-public places. Community resources should be concentrated on increasing bystander CPR and early prehospital emergency care.

Postoperative Atrial Fibrillation after Isolated Coronary Artery Bypass Graft Surgery (단독관상동맥우회로술 후 발생한 심방세동)

  • Suh, Jong-Hui;Park, Chan Beom;Moon, Mi-Hyoung;Kweon, Jong Bum;Kim, Young-Du;Jin, Ung;Moon, Seok-Whan;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.14-21
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    • 2009
  • Background: Postoperative atrial fibrillation (AF) is a common complication after coronary artery bypass graft (CABG) surgery. Although postoperative AF is regarded as benign, transient and self-limited, it has been associated with increased morbidity, thromboembolic events and an increased duration and cost of hospitalization. Material and Method: From January 1994 to December 2007, 190 patients that had isolated CABG surgery were divided into two groups. Group 1 (n=139) involved those who had postoperative atrial fibrillation, and group 2 (n=51) did not have any such events. We reviewed the medical records retrospectively including the incidence of postoperative AF, patient characteristics, surgery related factors and the outcome of the patients with postoperative AF. Result: The frequency of postoperative AF was 26.8%, the conversion rate to regular sinus rhythm before discharge was 82.4%; 82.4% of the AF developed within the first three postoperative days. Although the postoperative AF group was significantly older and had a prolonged postoperative Intensive care unit (ICU) stay, there was no difference in the aortic crossclamp time or duration of hospitalization. No spontaneous defibrillation at declamping, and longer duration of cardiopulmonary bypass were significantly related to the development of postoperative AF. However, postoperative treatment with a beta blocker was associated with a decreased incidence of postoperative AF. The multivariate analysis showed that age and ICU stay were significantly associated with the development of POAF. Spontaneous defibrillation and postoperative beta blocker treatment were significantly associated with a decreased frequency of POAF. Conclusion: AF after CABG surgery is a common complication associated with increased morbidity and a longer ICU stay. Therefore, various strategies aimed at reducing AF, and its complications, such as postoperative treatment with a beta blocker should be considered.