• Title/Summary/Keyword: Peripheral Catheter

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Availability of Capillary Blood Gas Analysis in Neonate (신생아에서 모세혈 가스분석 검사의 유용성)

  • Jeong, Jong Tae;Yun, Su Young;Lee, Ran;Hyun, Jae Ho;Jung, Gyu Young
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.449-453
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    • 2002
  • Purpose : Arterial blood gas analysis is frequently performed in neonatal intensive care unit (NICU) to evaluate ventilation and the metabolic state of critically ill infants. In occasions when umbilical arterial catheterization is not available, frequent arterial puncture is mandatory. This requires some technical skill and may occasionally have side effects. So we studied the validity of capillary blood gas analysis which can be performed conveniently compared with arterial blood. Methods : Twenty-four neonates admitted to NICU during April to Aug. 2001 were studied. They were more than two weeks old without indwelling arterial catheters. Thirty-six times, simultaneous arterial, and capillary blood gases were drawn by puncture and the pH, $pCO_2$ and $pO_2$ of each sample was measured. Blood pressure and body temperature was checked before sampling to rule out impaired peripheral circulation. Capillary blood was collected from warmed heels. Results : There was a strong correlation between capillary and arterial pH(r=0.91, P<0.05). The absolute value of the difference between arterial and capillary pH was less than 0.05. Also capillary $pCO_2$ showed correlation with arterial $pCO_2$(r=0.77, P<0.05). Despite a statistically significant correlation between capillary and arterial $pO_2$(r=0.68, P<0.05), the absolute value of the difference was more than 10 mmHg in 92% of cases. Conclusion : Capillary blood gases accurately reflected arterial pH and $pCO_2$ and showed a relative correlation with $pO_2$. Capillary blood gas analysis can be a useful alternative to arterial blood when continuation of the umbilical arterial catheter is no longer available.

Estimation of the Central Aortic Pulse using Transfer Function and Improvement of an Augmentation Point Detection Algorithm (전달함수를 이용한 대동맥 맥파 추정 및 증강점 검출 알고리즘 개선에 관한 연구)

  • Im, Jae-Joong
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.45 no.3
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    • pp.68-79
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    • 2008
  • Aortic AIx(augmentation index) has been used to measure aortic stiffness quantitatively and even to evaluate ventricular load. However, in order to calculate aortic AIx catheters should be inserted to the subjects' artery, which hampers its clinical usage. To overcome such limitation, aortic AIx has been indirectly calculated by estimating aortic pressure wave from the peripheral arterial pulse by applying transfer functions. In this study, central aortic pressure waves using Millar catheter and radial artery pulse waves using tonometry pressure sensor were measured to establish transfer functions for an estimation of central aortic pressure waves from radial artery pulse waves. Also, an algorithm which detects augmentation point for the calculation of AIx were developed. Developed algorithm for the detection of augmentation point gradually increases the differential order to detect inflection point rather than detects the distinctive point that appears after a specific time. Transfer functions were established using 10th order ARX model and were verified for the stability of the transfer function through residual analysis. Evaluation of an algorithm for the detection of augmentation point were performed by comparing the augmentation points obtained from developed algorithm with the known augmentation points synthesized in various conditions. In addition, developed algorithm for the AIx is proved to provide more accurate results than the ones developed by previous studies. The significance of the study was in two folds. Firstly, the results could provide the basis for the measurement of aortic stiffness using easily-measurable radial artery pulse waves, and secondly, extension of the study may enable the early diagnosis of various vascular diseases.

A Study on the Implementation and Development of Image Processing Algorithms for Vibes Detection Equipment (정맥 검출 장비 구현 및 영상처리 알고리즘 개발에 대한 연구)

  • Jin-Hyoung, Jeong;Jae-Hyun, Jo;Jee-Hun, Jang;Sang-Sik, Lee
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.15 no.6
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    • pp.463-470
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    • 2022
  • Intravenous injection is widely used for patient treatment, including injection drugs, fluids, parenteral nutrition, and blood products, and is the most frequently performed invasive treatment for inpatients, including blood collection, peripheral catheter insertion, and other IV therapy, and more than 1 billion cases per year. Intravenous injection is one of the difficult procedures performed only by experienced nurses who have been trained in intravenous injection, and failure can lead to thrombosis and hematoma or nerve damage to the vein. Nurses who frequently perform intravenous injections may also make mistakes because it is not easy to detect veins due to factors such as obesity, skin color, and age. Accordingly, studies on auxiliary equipment capable of visualizing the venous structure of the back of the hand or arm have been published to reduce mistakes during intravenous injection. This paper is about the development of venous detection equipment that visualizes venous structure during intravenous injection, and the optimal combination was selected by comparing the brightness of acquired images according to the combination of near-infrared (NIR) LED and Filter with different wavelength bands. In addition, an image processing algorithm was derived to threshehold and making blood vessel part to green through grayscale conversion, histogram equilzation, and sharpening filters for clarity of vein images obtained through the implemented venous detection experimental module.

A Study on the Comparison of Detected Vein Images by NIR LED Quantity of Vein Detector (정맥검출기의 NIR LED 수량에 따른 검출된 정맥 이미지 비교에 관한 연구)

  • Jae-Hyun, Jo;Jin-Hyoung, Jeong;Seung-Hun, Kim;Sang-Sik, Lee
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.15 no.6
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    • pp.485-491
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    • 2022
  • Intravenous injection is the most frequent invasive treatment for inpatients and is widely used for parenteral nutrition administration and blood products, and more than 1 billion procedures are used for peripheral catheter insertion, blood collection, and other IV therapy per year. Intravenous injection is one of the difficult procedures to be performed only by trained nurses with intravenous injection training, and failure can lead to thrombosis and hematoma or nerve damage to the vein. Accordingly, studies on auxiliary equipment capable of visualizing the vein structure of the back of the hand or arm are being published to reduce errors during intravenous injection. This study is a study on the performance difference according to the number of LEDs irradiating the 850nm wavelength band on a vein detector that visualizes the vein during intravenous injection. Four LED PCBs were produced by attaching NIR filters to CCD and CMOS camera lenses irradiated on the skin to acquire images, sharpen the acquired images using image processing algorithms, and project the sharpened images onto the skin. After that, each PCB was attached to the front end of the vein detector to detect the vein image and create a performance comparison questionnaire based on the vein image obtained for performance evaluation. The survey was conducted on 20 nurses working at K Hospital.

Embolectomy of Arteries of Extremities -Clinical analysis of 26 cases (사지동맥의 색전제거술 -26례의 분석-)

  • 강종렬;구본일
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.172-178
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    • 1997
  • We present a etrospective analysis of arterial embolectomies performed at the Inje University Seoul Paik Hospital. During the period of March 1987 Feburary 1996 twenty-six patients underwent embolectomies, eighteen patients were male and eight patients were female, mean age of patients was 56.8 years. Rest pain was the chief complaint in 24 patients, the remaining two patients complained of long term history of claudication after recovery of acute symtoms. But only 10 patients had sensBrylmotor symtoms. Heart was the most common source of embolization and frequent predisposing factor of embolism was ischemic heart disease in 8 cases and valvular heart disease in 11 cases. The sites of embolization were upper extremities artery in 6 cases, saddle embolism in 2 cases, lower extremities artery in 18 cases and the most common site of embolism was femoral artery in 1 1 cases. Preoperative angiography was taken in the diagnosis and planning of the embolectomy in 1) patients while in the other patient p eoperative angiography was not taken. Only two cases were operated within the golden period of 6 hours and other cases were operated in more than 6 hours after embolization. In all patients, the Fogarty embolectomy catheter was used without bypass surgery via bachial ateriotomy in the embolism of upper extremities artery, bilateral groin approaches in the saddle embolism and transfemoral approach in the embolism of lower extremities artery. However 3 patients were re-operated via transpopliteal approach in the distal poplitiotibial embolism. Eighteen patients received perioperative anticoagulation therapy by heparin or fraxiparine and wafarin was used in 17 patients at the time of discharge and the indication of anticogulation was patients of valvular heat disease andfor atrial fibrillation, peripheral artery atherosclerosis and recurrent embolism. Postoperative results of the embolectomy were as follows: fouteen pateints had excellent results, five cases had symtom improvement after re-operation, B. K. amputation in 1 case who had severe atherosclerosis of lower extremities, recurrent embolism in 1 case and death in 2 cases the cause of death were acute renal failure and cerebral artery embolism, respectively. The complications of the embolectomy were reperfusion syndrome, pseudoaneurysm and intimal dissection in one case each. Conclusively the problems of embolism is delayed diagnosis and increasing number of old aged patient who had suffered from ischemic heart diease. Preoperative angiography was not always needed for embol ectomy. Selective anticoagulation therapy can decrease incidence of re-embolism. In the distal poplitiotibial embolism, embolectomy of tibial artery was difficult.

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The Effect of the Simple Fogarty Thromboembolectomy (단순 Fogarty 혈전색전 제거술의 효과)

  • Oh, Joong-Hwan;Park, Il-Hwan;Lee, Chong-Kookk
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.480-486
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    • 2009
  • Background: The Fogarty thromboembolectomy catheter technique was devised to extract distal arterial emboli and it represents a milestone for the treatment of patients with acute arterial occlusion since the 1960s. The major causes of arterial occlusion have changed from emboli of a heart origin to atherosclerosis over the past 30 years. Accordingly, questions have been raised about the effectiveness of simple Fogarty thromboembolectomy. Material and Method: During the period from March 1990 through August 2008, 156 patients who requiring Fogarty thromboembolectomy were analyzed. The patients were divided into two groups: those with simple Fogarty thromboembolectomy (Group 1, 79 patients) and those with additional vascular bypass graft surgery (Group 2, 77 patients). The duration of symptoms, the cause of thrombi, admission via the emergency room, a history of acupuncture or misdiagnosis, combined diseases, the anatomic occlusion site and the cause of death were analyzed using T-tests, cross tab tests, Chi square tests and Kaplan-Meier tests, respectively. Result: The mean age was 64$\pm$10 years in the 2 groups. The duration of symptoms (pain) in Group 1 vs Group 2 was 12$\pm$4 days vs 71$\pm$14 days (p=0.001). 50 (63%) patients in Group 1 were admitted via the emergency room vs 18 (23%) patients in Group 2 (p=0.005). Misdiagnosis and the treatment for herniated intervertebral disc or acupuncture were given to, 20 (25%) patients in Group 1 vs 30 (39%) patients in Group 2. Anticoagulation treatment before admission was performed in 22 (28%) patients in Group 1 vs 11 (14%) patients in Group 2. The causes of thrombi were heart disease in, 24 (30%) patients in Group 1 vs 6 (8%) patients in Group 2 (p=0.001), atherosclerosis in 46 (58%) patients in Group 1 vs 67 (87%) patients in Group 2 (p=0.001) and trauma in 9 (11%) patients in Group 1 vs 6 (8%) patients in Group 2. The combined diseases were cerebrovascular accident, hypertension and diabetes mellitus in 22 $\sim$ 37% of the total patients. The occlusion sites were mainly in the iliac and femoral arteries. Endarterectomy was performed in 7 (9%) patients in Group 1 vs 18 (23%) patients in Group 2 (p=0.012). Treatment was successful in 27 (34%) patients in Group 1 and in 40 (52%) patients in Group 2 (p=0.019). Reocclusion occurred in 37(47%) patients in Group 1 vs 20 (26%) patients in Group 2 (p=0.000), Amputation was done in 4 (5%) patients in Group 1 vs 12 (16%) patients in Group 2 (p=0.012) and death occurred in 10 (13%) patients (Group 1) vs 3(4%) patients (Group 2) (p=0.044). Conclusion: The recent past has shown a decline in the effectiveness of simple Fogarty thromboembolectomy with a changing pattern of acute arterial occlusion from a rheumatic heart origin to atherosclerosis. Additional bypass procedures play a role for the treatment of arterial occlusion instead of always performing simple Fogarty thromboembolectomy.