• Title/Summary/Keyword: Cardiopulmonary disease

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Reliable Prognostic Cardiopulmonary Function Variables in 110 Patients With Acute Ischemic Heart Disease

  • Lee, Jeong Jae;Park, Chan-hee;You, Joshua (Sung) Hyun
    • Physical Therapy Korea
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    • v.29 no.3
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    • pp.200-207
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    • 2022
  • Background: The oxygen uptake efficiency slope (OUES) is the most important index for accurately measuring cardiopulmonary function in patients with acute ischemic heart disease. However, the relationship between the OUES variables and important cardiopulmonary function parameters remain unelucidated for patients with acute ischemic heart disease, which accounts for the largest proportion of heart disease. Objects: The present cross sectional clinical study aimed to determine the multiple relationships among the cardiopulmonary function variables mentioned above in adults with acute ischemic heart disease. Methods: A convenience sample of 110 adult inpatients with ischemic heart disease (age: 57.4 ± 11.3 y; 95 males, 15 females) was enrolled at the hospital cardiac rehabilitation center. The correlation between the important cardiopulmonary function indicators including peak oxygen uptake (VO2 peak), minute ventilation (VE)/carbon dioxide production (VCO2) slope, heart rate recovery (HRR), and ejection fraction (EF) and OUES was confirmed. Results: This study showed that OUES was highly correlated with VO2 peak, VE/VCO2 slope, and HRR parameters. Conclusion: The OUES can be used as an accurate indicator for cardiopulmonary function. There are other factors that influence aerobic capacity besides EF, so there is no correlation with EF. Effective cardiopulmonary rehabilitation programs can be designed based on OUES during submaximal exercise in patients with acute ischemic heart disease.

"Off-Pump" Coronary rtery bypass Grafting in Multi-vessel Coronary Disease -Two Cases- (다중 혈관질환에서 심폐바이패스를 이용하지 않은 관상동맥 우회술)

  • 유원희;김기봉
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1123-1126
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    • 1999
  • Coronary artery bypass grafting (CABG) technique has been much developed but CABG under cardiopulmonary bypass has the unavoidable deficits such as generalized inflammatory reaction from cardiopulmonary bypass and myocardial ischemia from aortic-cross clamp. There has been remarkable advancement of CABG without cadiopulmonary bypass. We performed CABG successfully without cardiopulmonary bypass. We performed CABG successfully without cardiopulmonary bypass in two patients with multivessel coronary disease who were failed to intervene with percutaneous transluminal coronary angioplasty. We herein report the two cases.

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Effect of Cardiopulmonary Bypass on Platelet (체외순환이 혈소판에 미치는 영향)

  • Choe, Jun-Yeong;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.26-35
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    • 1988
  • The effect of cardiopulmonary bypass on platelet count, platelet function, and bleeding time was studied in 60 patients. Platelet count was significantly reduced during and after cardiopulmonary bypass. Platelet function also had a reduced aggregation response to adenosine diphosphate. Bleeding time was prolonged to over 30 minutes during cardiopulmonary bypass and not returned to normal level until postbypass 1 hour. The amount of postoperative bleeding was proportional to the degree of decrease in platelet count and function, degree of decrease in platelet count and function. There was no significant correlation between duration of cardiopulmonary bypass and platelet count, platelet function, bleeding time, or amount of postoperative bleeding. Patients with cyanotic congenital heart disease showed a larger amount of postoperative bleeding than patients with acyanotic congenital heart disease [P<0.01], and this difference was due to the fact that platelet function was more significantly affected by cardiopulmonary bypass in cyanotic group. Patients using membrane oxygenator showed a less amount of postoperative bleeding than patients using bubble oxygenator [p<0.005] reflecting better preservation of platelet count and function by membrane oxygenator.

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Effect of Cardiopulmonary Physiotherapy on Patients With Percutaneous Coronary Intervention - Systematic Review and Meta-Analysis (경피적 관상동맥 중재술을 받은 환자를 대상으로 심장호흡물리치료에 대한 효과 - 체계적 고찰과 메타분석)

  • Kang, Na-yoon;Park, Beom-seok;Kim, Min-hee
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.1
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    • pp.63-73
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    • 2019
  • PURPOSE: This study examined the effects of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). METHODS: Electronic bibliographic databases of a regional information sharing system (RISS) and PubMed were searched to identify studies with randomized and non-randomized controlled trials. As the final outcome, 320 publications were identified and 18 studies met the inclusion and exclusion criteria. All studies were assessed for the quality of study using Cochrane's risk of bias. RESULTS: Sixteen studies met the inclusion criteria, in which meta-analysis had been conducted to examine the effectiveness of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI. Meta-analysis based on a random effect model showed that the cardiopulmonary physiotherapy was beneficial in improving the cardiopulmonary function, metabolism, inflammatory markers, and quality of life. In particular, there was a significant effect on the peak oxygen uptake (effect size 5.30%; 95% confidence interval 3.62~6.97). Cardiopulmonary physiotherapy for a during period of 6 weeks or more was effective in significantly improving the cardiopulmonary function and metabolism function in a subgroup analysis, but cardiopulmonary physiotherapy for less than 6 weeks was not effective. CONCLUSION: Cardiopulmonary physiotherapy has positive effects on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI.

Reversals in Decisions about Life-Sustaining Treatment and Associated Factors among Older Patients with Terminal Stage of Cardiopulmonary Disease (만성 심폐질환을 가진 말기 노인 환자의 연명의료 의사결정의 번복 및 관련 요인)

  • Choi, Jung-Ja;Kim, Su Hyun;Kim, Shin-Woo
    • Journal of Korean Academy of Nursing
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    • v.49 no.3
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    • pp.329-339
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    • 2019
  • Purpose: The purpose of this study was to investigate the frequency, patterns, and factors of reversals in decisions about life-sustaining treatment (LST) among older patients with terminal-stage chronic cardiopulmonary disease. Methods: This was a retrospective correlational descriptive study based on medical chart review. De-identified patient electronic medical record data were collected from 124 deceased older patients with terminal-stage cardiopulmonary disease who had made reversals of LST decisions in an academic tertiary hospital in 2015. Data were extracted about the reversed LST decisions, LST treatments applied before death, and patients' demographic and clinical factors. Multivariate logistic regression analysis was used to identify the factors associated with the reversal to higher intensity of LST treatment. Results: The use of inotropic agents was the most frequently reversed LST treatment, followed by cardiopulmonary resuscitation, intubation, ventilator therapy, and hemodialysis. Inconsistency between the last LST decisions and actual treatments occurred most often in hemodialysis. One-third of the reversals in LST decisions were made toward higher intensity of LST treatment. Patients who had lung diseases (vs. heart diseases); were single, divorced, or bereaved (vs. married); and had an acquaintance as a primary decision maker (vs. the patients themselves) were significantly more likely to reverse the LST decisions to higher intensity of LST treatment. Conclusion: This study demonstrated the complex and turmoil situation of the LST decision-making process among older patients with terminal-stage cardiopulmonary disease and suggests the importance of support for patients and families in their LST decision-making process.

The Change of Derum and Urine Amylase Level Following Cardiopulmonary Bypass in the Patients with Congenital heart disease (선천성 심기형 환아에서 체외순환후 혈청 및 소변 Amylase치의 변화)

  • Baek, Hui-Jong;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.892-899
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    • 1995
  • Pancreatitis is a known complication of cardiac surgery with cardiopulmonary bypass. Although ischemia is believed to be a factor, the exact cause of pancreatitis after cardiopulmonary bypass remains unknown.We prospectively studied 67 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass for evaluation of the pancreatic injury after cardiopulmonary bypas. Serial measurement of amylase level in serum and urine was done postoperatively. Hyperamylasemia was detected in 15 patients[22.4% , of whom no patient had pancreatitis. There was no significant difference between serum amylase level and parameters such as cardiopulmonay bypass time, aortic cross clamp time, mean blood pressure, rectal temperature, flow rate, and use of circulatory arrest during cardiopulmonary bypass. Hyperamylasuria was detected in 8 patients[11.9% , and urine amylase level was elevated significantly in the groups with prolonged cardiopulmonary bypass, mean blood pressure more than 40mmHg, and rectal temperature more than 20 $^{\circ}$C. We recommend that serum amylase level and/or amylase-creatinine clearance ratio is measured for ealy detection and management of pancreatitis after cardiopulmonary bypass.

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Repair of intracardiac defect under simple deep hypothermia in infancy without cardiopulmonary bypass: report of 3 cases (단순 초저온법에 의한 개심술: 3례 보)

  • 조범구
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.189-196
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    • 1984
  • Although the conventional methods of cardiopulmonary bypass for open heart surgery have been employed, it has been usual method to repair of congenital heart disease in infancy using deep hypother-mia and circulatory arrest technique. In 1980, we reported total correction of congenital heart disease using surface induced hypothermia-total circulatory arrest and rewarming with limited cardiopulmonary bypass. in 1981, three patients below 10 kilogram, who had ASD and PDA, and two of VSD with pulmonary hypertension were operated on using simple deep hypothermia without cardiopulmonary bypass. During surface cooling, there were no ventricular fibrillation and arrhythmia. There were no difficulties to resuscitate the heart. Postoperative respiratory and neurologic complication were not occurred. Follow up examination for two to three years gave no evidence of cerebral damage due to circulatory arrest.

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Serum and Urine Potassium Changes during, and after Extracorporeal Circulation in Open Heart Surgery (체외순환 전후의 혈청및 소변 칼륨의 변화)

  • 조창훈
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.17-22
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    • 1992
  • The alterations in serum and urine potassium were studied in twenty two patients who underwent open heart surgery using extracorporeal circulation from June 1990 to August 1990 at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kei-myung University. There were fifteen cases congenital heart disease and seven acquired heart disease. The serum and urine potassium levels were measured pre-, intra- and postoperatively until seventh postoperative day using ionic selective electrode measuring method. After general anesthesia, the serum potassium level decreased significantly but slowly increased during.cardiopulmonary bypass and returned preoperative level after operation. The urine potassium level decreased slowly from general anesthesia to cardiopulmonary bypass weaning but returned preoperative level following operation. During cardiopulmonary bypass, serum and urine potassium levels in diuretic group were lower than that of non diuretic group. There was no remarkable difference in the serum potassium level between single RA cannulation group and bicaval cannulation group preoperatively, but the serum potassium level in single RA cannulation group was much higher than that of bicaval cannulation group. There was no significant difference in the urine potassium level between single RA can-nulation group and bicaval cannulation group postoperatively.

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Palliative Care Provided for Older Patients with Terminal Stage of Cardiopulmonary Disease Before and After Life-Sustaining Treatment Decisions (만성 심폐질환을 가진 말기 노인환자의 연명의료결정 전후 완화간호의 제공)

  • Choi, Jung-Ja;Kim, Su Hyun
    • Journal of Convergence for Information Technology
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    • v.11 no.1
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    • pp.45-53
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    • 2021
  • This study was a retrospective descriptive study to identify frequency and change of palliative care provided for older patients with terminal stage of cardiopulmonary disease before and after life-sustaining treatment (LST) decision making. As a result of chart review of 124 older patients in a university hospital, oral analgesics medication, cold and hot therapy for pain management, antibiotics medication and urine culture for urinary infection, oral care, hair wash, and partial bath were provided significantly less after LST decision making. Provision of praying and relaxation therapy for pain control, oral and nasal care, and emotional care were not changed before and after LST decision making. Spiritual care was the least provided care. Therefore, non-pharmacological pain management, emotional care, and spiritual care need to be improved for older patients with terminal cardiopulmonary disease at the end of life.