• 제목/요약/키워드: cardiopulmonary

검색결과 1,410건 처리시간 0.021초

1년간의 복합 운동프로그램이 남성 치매환자의 운동능력과 인지기능에 미치는 영향 (The Effects of One Year Exercise Program on Exercise Capacity & Cognitive Function in Male Patients with Dementia)

  • 곽이섭;엄상용
    • 생명과학회지
    • /
    • 제15권2호
    • /
    • pp.220-224
    • /
    • 2005
  • 1년간의 운동이 남성 치매환자의 운동능력과 인지기능에 미치는 영향을 연구한 결과, 운동군의 경우 심폐지구력, 근력, 근지구력 및 MMSE는 운동전에 비해 운동중과 운동후 유의하게 증가하였고, 평형성과 민철성은 운동후 유의하게 증가하였으나 유연성은 유의한 차이가 없었다. 반면, 통제군은 모든 시기에서 유의한 차이가 나타나지 않았다. 이상의 결과를 볼 때, 1년간의 운동은 남성 치매환자의 운동능력과 인지기능을 향상시켜 환자들에게 자신감과 성취감을 얻을 수 있는 기회를 주었고, 나아가 독립적인 일상생활을 영위하고 삶의 질을 높이는데 크게 이바지 할 것으로 기대된다.

개심술 후 심폐소생술 실패환아에서의 체외막산소화 치험 1례 (Extracorporeal Membrane Oxygenation in the Patient with Cardiopulmonary Resuscitation Failure after Open Heart Surgery. - A case report -)

  • 전희재;성시찬;우종수;이혜경
    • Journal of Chest Surgery
    • /
    • 제32권1호
    • /
    • pp.53-57
    • /
    • 1999
  • 저자들은 심장수술 후 발생한 심정지로 심폐소생술을 시행한 신생아에서 성공적인 체외막산소화 장치(ECMO)사용 1례를 경험하였다. 환자는 울혈성 심부전과 폐동맥 고혈압을 가졌던 4.4kg의 35일된 남아로 술중에 특별한 문제없이 심실중격결손증을 첨포봉합법으로 봉합하였다. 심장 중환자실에서의 술후 경과는 junctional ectopic tachycardia (JET)가 나타나기 전까지 약 5시간 동안은 특별한 문제가 없었다. junctional ectopic tachycardia (JET)가 나타난 후 50분경과한 뒤 갑작스러운 서맥이 나타나면서 수축기 혈압이 50mmHg로 하강하여 곧 흉골절개 봉합부(sternotomy incision)를 열고 심폐소생술을 바로 시행하였으며 심폐소생술을 시행한 지 4시간 후에 상행대동맥에 동맥관을 그리고 정맥관은 우심방이에 삽관하여 체외막산소화 장치를 시작하였다. 환자의 혈액동력학은 체외막산소화 동안 안정적이었으며, 시작 후 38.5시간 만에 중지하였다. 흉골지연봉합을 시도하였고, 환자는 수술 후 7일째 인공호흡기를 제거했으며, 신경학적 합병증없이 수술 후 21일째 퇴원하였다.

  • PDF

체외 순환후 지혈에 대한 저농도의 Aprotinin 효과 (Low-Dose Aprotinin Effect on Hemostasis After Cardiopulmonary Bypass)

  • 이선희;최승호;곽문섭
    • Journal of Chest Surgery
    • /
    • 제29권2호
    • /
    • pp.185-190
    • /
    • 1996
  • The effect of low-dose aprotinin on hemostasis in patients undergoing cardiopulmonary bypass (CPB) for repeat valve replacement and coronary artery bypass operations were investigated. Thirty patients undergoing elective CPB from February 1993 through February 1995 at Catholic Medical Center were studied. the patients were randomly divided into two groups(15 patients per group) : group 1, receive 1, 000, 000 KIU/kg aprotinin in the CPB priming volume and 20, 000 KIU/kg aprotinin intravenously each hour during CPB ; group 2, without aprotinin administration served as the controls. The result showed that the early postoperative (during the first 24 hours) and mean postoperative total blood loss of the aprotinin group were significantly reduced than the control group (317.2 $\pm$ 89.6ml in the aprotinin group versus 821.3 $\pm$ 441.2rnl in the control group, p<0.01 ; 767.2 $\pm$ 214.1 ml in the aprotinin group versus 1562.5 $\pm$ 735.2 rnl in the control gorup, p<0.01). Total use of packed red ells and fresh frozen plasma was higher in control group(1.22 $\pm$ 0.3 units versus 4.21 $\pm$ 1.7units of packed red cells, p<0.01 : and 2.37 $\pm$ 0.4units versus 6.72 $\pm$ 0.88uni1s of fresh prozen plasma, p<0.05). We conclude the low-dose aprotinin was positive influence on postoperative blood loss in undergoing highly bleeding potency cardiac operation.

  • PDF

급성심근경색 후 발생한 양심실파열로 인한 심장압전에서 체외순환의 사용없이 시행한 수술적 치료 - 1예 보고 - (Operative Treatment for Cardiac Tamponade with Ventricular Rupture of Post Myocardial Infarction without Cardiopulmonary Bypass - A case report -)

  • 최창석;김한용;박재홍
    • Journal of Chest Surgery
    • /
    • 제41권1호
    • /
    • pp.95-97
    • /
    • 2008
  • 허혈성 좌심실벽 파열은 심근경색 후에 발생하는 치명적인 합병증 중의 하나인 심장파열의 한 유형으로 빠른 진단과 수술이 필요하다. 환자는 내원 15분 전 갑작스런 의식소실을 주소로 내원한 75세 여자로 당시 의식은 반 혼수상태로 얼굴과 상하지에 청색증 소견을 보였으며 응급실에서 시행한 심초음파 검사상 심낭에 약 $1.5{\sim}2\;cm$ 두께로 삼출소견이 관찰되었으며 심장박동 수가 35회/분까지 떨어져 심장마사지 시행하면서 응급수술을 시행하였다 우심실 전벽에 1 cm정도의 파열과 좌심실 벽에 괴사성 출혈반흔을 동반한 파열부위를 확인하고 체외순환 없이 사친스키 겸자를 이용해 출혈부위를 잡은 뒤 봉합하였다. 환자는 수술 후 28일째 약간의 호흡곤란은 있으나 일상생활 가능한 상태로 퇴원하였다.

운동형태에 따른 최대 운동이 심근 산소소비량과 혈중 젖산 농도의 변화에 미치는 영향 (The effects of different exercise type for maximal exercise on RPP and blood lactate)

  • 김재성;김성수;장경모
    • 대한물리치료과학회지
    • /
    • 제10권1호
    • /
    • pp.149-157
    • /
    • 2003
  • The purpose of this study was to compare the effects of different exercise types including isokinetic, isometric, and istonic exercise of same exercise intensity on cardiopulmonary function and blood lactate level. The subjects of this study included 17 males college students. Each subjects after pretraining measurement performed isokinetic, isometric and isotonic exercise of 1 week interval using Cybex 6000 System. KBI-C and YSI 1500 were used to measure changes in cardiopulmonary function and blood lactate level respectively. First, comparing changes in RPP relative to exercise type, isokinetic group showed significant difference between before exercise ($7.08{\pm}1.12mg/kg/min$) and post exercise ($18.98{\pm}1.75mg/kg/min$). Isometric group showed that significant difference between before exercise($7.89{\pm}0.98mg/kg/min$) and post exercise($20.22{\pm}2.41mg/kg/min$). Isotonic group showed significant difference between before exercise ($8.14{\pm}0.11mg/kg/min$) and post exercise ($19.84{\pm}2.30\;mg/kg/min$). Second, comparing changes in blood lactate level relative to exercise type, isokineic group showed significant difference between before exercise ($2.99{\pm}0.65mmol$) and post exercise ($6.55{\pm}6.55mmol$). Isometric group showed significant difference between before exercise($1.71{\pm}5.48mmol$) and post exercise ($5.48{\pm}1.97mmol$). Isotonic group showed significant difference between before exercise($1.16{\pm}0.48mmol$) and post exercise($5.21{\pm}1.28mmol$). The results of this study indicate significant differences RPP in isometric exercise and significant differences blood lactate in isotonic exercise.

  • PDF

출동 거리에 따른 병원 전 심장정지 환자의 자발순환회복률 분석 (Return of spontaneous circulation rate according to dispatch distance in out-of-hospital cardiac arrest)

  • 김종호;전윤철;문준동
    • 한국응급구조학회지
    • /
    • 제21권2호
    • /
    • pp.51-61
    • /
    • 2017
  • Purpose: This study measured return of spontaneous circulation (ROSC) in relation to dispatch distance in patients with out-of-hospital cardiac arrest. Methods: Of 2,347 out-of-hospital cardiac arrest patients transported by emergency medical technicians in J Province between January 1 and December 31, 2015, those under age 18, those with reserved resuscitation, and those with traumatic cardiac arrest, leaving 855 patients in the study sample. ROSC was compared between those with dispatch distance ${\leq}4km$ (short dispatch distance, 465 patients) and those with dispatch distance >4 km (long dispatch distance, 390 patients). Results: The mean was 2.17 km in the short dispatch group and 9.87 km in the long dispatch group (p=.000). Mean distance from was 6.49 km and 13.39 km in the two groups, respectively (p=.000). ROSC differed significantly between the short and long dispatch distance groups (7.1% for short dispatch distance, 3.6% for long dispatch distance, p=.025). The length of time from to cardiopulmonary resuscitation also differed significantly between the short and long dispatch distance groups (8.77 minutes and 14.63 minutes, respectively, p=.000). Conclusion: ROSC was lower in areas of long dispatch distance compared to those of short dispatch distance. We expect this was most likely due to differences in response time by age and dispatch distance to the scene of cardiac arrest. However, no significant differences were found between the groups in the factors affecting ROSC.

심폐소생술 시 구조자의 hand technique에 따른 가슴압박의 질 및 피로도 비교 (Comparisons of the quality of chest compression and fatigue levels of the rescuer for different hand techniques used in cardiopulmonary resuscitation)

  • 박유진;정지원;김병우
    • 한국응급구조학회지
    • /
    • 제23권3호
    • /
    • pp.67-81
    • /
    • 2019
  • Purpose: The purpose of this study was to compare the difference in compression quality and fatigue levels in a rescuer for three different hand techniques used in cardiopulmonary resuscitation (CPR). Methods: The participants were paramedic students at the basic life support provider level. The hands-only CPR was performed for 10 minutes for each of the three hand techniques without disruption, and the quality of chest compressions and fatigue levels were analyzed. Results: There was no difference between the sexes in the chest compression quality and the physiologic parameters before and after compression. Among the quality indexes of chest compression with each of the techniques performed for 10 minutes, the mean depth (p<.01) and mean accuracy (p=.000) of the compression were found to be higher in the five finger fulcrum technique, while the mean compression rate and relaxation accuracy showed no significant differences. Regarding fatigue levels, the five finger fulcrum technique caused lesser subjective fatigue as compared to other techniques (p<.05), although the heart rate and blood pressure revealed no difference. Conclusion: The five finger fulcrum technique was found to be better than the other techniques in terms of chest compression quality and subjective levels of fatigue, indicating that it should be used in CPR education.

요양보호사 교육생을 위한 기본심폐소생술 교육프로그램 개발 및 효과 (Development and effects of basic cardiopulmonary resuscitation education program for trainee care workers)

  • 이성희;최정실
    • 가정간호학회지
    • /
    • 제23권2호
    • /
    • pp.224-232
    • /
    • 2016
  • Purpose: This study set out to use a one-group pretest-posttest experimental design to develop a highly motivating CPR program for help care workers who lack CPR education, and to evaluate its effects on their knowledge about program application, attitude, and self-efficacy. Methods: For this purpose, 140 questionnaires were administered to subjects who underwent training at an educational institution for care workers in S city and G province. The program was developed from April, 25 to May, 15 in 2016, and the evaluation period was from May to July, 15. The collected data were analyzed through SPSS version 23, and a paired t-test was conducted. Results: The program spanned 240 minutes, including 80 minutes on theoretical education and 160 minutes on practical education. Knowledge of CPR in the post-test proved to be higher than that in the pre-test, from 6.4 to 9.2 (t=-15.72, p<.001),; the score on attitude increased from 38.4 to 41.7 (t=-5.89, p<.001),; and self-efficacy increased from 41.0 to 66.7 (t=-21.83, p<.001). Conclusion: The basic CPR education program emphasizing motivation was effective for the care worker trainees and could be used for other curriculum by expanding the scope of the subject.

체외순환후 fructose-1,6-diphosphatate[FDP]가 적혈구에 미치는 영향 (Effect of Fructose-1,6-diphosphate[FDP] on Red Blood Cells after Extracorporeal Circulation)

  • 이정렬
    • Journal of Chest Surgery
    • /
    • 제25권7호
    • /
    • pp.693-701
    • /
    • 1992
  • Extracorporeal cardiopulmonary bypass[CPB] has been associated with a wide variety of hematologic derangements, including a transient deformation and hemolysis of red blood cells[RBCs], which is supposed to be due to mechanical trauma and/or metabolic alterations. Since membrane integrity is, in part, maintained by energy requiring process, inadequate function of erythrocyte glycolytic pathway, which is inevitalble during CPB, may cause depletion of high energy phosphate pool and result in hemolysis. The authors performed an investigation to assess whether administration of Fructose-l, 6-diphsphate [FDP], which has been known to enhance intracellular glycolytic activities, could counteract erythrocyte hemolytic events caused by CPB. Sixty pateints with cyanotic congenital heart diseases, who underwent open heart surgery under CPB longer than 60 minutes, were randomly divided into two groups depending on whether use of FDP[Group FDP] or not[Group Control]. The age, sex, CPB time, preoperative hemoglobin level, disease entities were all similar[Table 1], and membrane type oxygenators were used in all patients. In Group, FDP, a dose of 250mg/kg body weight of FDP was administered by intravenous dripping every 12 hours from the morning of the operation to postoperative 48 hours, To demonstrate the degree and pattern of hemolysis of erythrocyte, reticulocyte count, indirect /direct bilirubin, haptoglobin, plasma hemoglobin, lactate dehydrogenase were measured every 12 hours from the time of cessation of CPB to 48 hours and RBC morphologic study, osmotic fragility test were done every 24 hours. All parameters revealed less hemolytic in group FDP [Fig. 1~5], though the differences between two groups were not significant, except plasma hemoglobin, lactate dehydrogenase changes. A pattern of sequential changes of plasma hemoglobin, lactate deh-ydrogenase showed the highest level at the time of CPB stop and abrupt decrease in following 24 hours in both groups, and statistically significant differences were demonstrated in group FDP at least for the first 12 hours postoperatively[p<0.05]. The authors conclude that they can expect the benificial effect of FDP on the maintenance of membrane stability of RBC probably by energy enhancement during the shock status of CPB, but FDP could not completely prevent the damaging effect on RBC by cardiopulmonary bypass

  • PDF

개심술 치험 50례 (Clinical Experiences of Open Heart Surgery [50 Cases])

  • 임진수
    • Journal of Chest Surgery
    • /
    • 제18권4호
    • /
    • pp.692-699
    • /
    • 1985
  • Fifty cases of Open Heart Surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 1985. 1. The age of the congenital heart disease was from 7 to 29 years, the mean age was 14.5 years. In the acquired heart disease, the age was from 14 to 48 years, and the mean age was 22.3 years. The ratio of male to female was about 1.8:1. 2. The number of congenital cyanotic heart disease were 7 patients, congenital acyanotic heart disease were 17 patients and acquired valvular heart disease were 26 patients. All of the acquired heart disease was one or more valve disease. 3. Preoperative symptoms of the congenital heart disease were exertional dyspnea [cyanotic 100%, acyanotic 70.6%] and palpitation [cyanotic 28.6%, acyanotic 76.1%], and the acquired heart diseases were exertional dyspnea [92.3%], palpitation [34.1 %], and chest discomfort [30.8%]. 4. The method of the myocardial protection during the cardiopulmonary bypass were mild or moderate hypothermia, intermittent coronary perfusion of the cardioplegic solution, topical myocardial hypothermia with 4oC Hartmann`s solution. 5. In the cases of the valve replacement, postoperative oral anticoagulant therapy was started at oral intake of food using the warfarin and persantin, and the prothrombin time was maintained 30-50% of control value during 3-6 months for tissue valve replacement and permanently for metal valve replacement. 6. The postoperative complications were appeared in 24 cases and the complications were wound infection, occipital alopecia, hemorrhage etc. 7. The mortality after open heart surgery was 8 percents and the cause of death was low cardiac output syndrome, right heart failure, DIC, and Left ventricle rupture.

  • PDF