잠시만 기다려 주세요. 로딩중입니다.

개심술시(開心術時) 저체온법에 관한 임상적 연구

Clinical Study of Hypothermia Technique Undergoing Open Heart Surgery

대한마취과학회지 1977년 10권 2호 p.27 ~ 40
김인세,
소속 상세정보
김인세 (  ) - 연세대학교 의과대학 마취과학교실

Abstract


Total surgical corrections of complicated heart defects with the aid of moderate hypothermic and extracorporeal circulation in conjunction with light general anesthesia were undertaken since 1963 in Yonsei Medical Center.
In order to determine the better hypothermic technique, 39 cases were divided into 2 groups.
While in group 1 we performed the cardio-pulmonary by-pass with heat exchanger using only core cooling techniques, in group 2 we used combined surface and core cooling techniques.
The results obtained are summerized as follows;
1. Mean rectal temperatures just before by-pass in group 1 and 2 were 36.5 and 33.5℃ respectively and a moderate hypothermic state after by-pass was obtained about 15 minutes earlier in group 2 than in group 1.
2. Mean arterial pressures during by-pass in group 1 were higher than in group 2. Therefore chlorpromazine was required more often in group 1.
3. Arterial oxygen and carbon dioxide tensions (uncorrected) were maintained with about 100-300 and 32-40 mmHg during by-pass in both groups.
4. Arterial pH and base excess in group 1 during by-pass were lower than in group 2, therefore sodium bicarbonate injections were required more often in group 1.
5. The incidence of use of the electrical defibrillator at the end of the main surgical procedure was higher in group 1. There were 5 post-operative intrapericardial bleeding cases in group 1 and 2 cases in group 2. There was 1 post-operative mortality case in each group.
From the above results, it may be concluded that combined surface and core cooling in conjunction with light general anesthesia, proved to be the better method to provide optimal working conditions for the surgeon.

키워드

원문 및 링크아웃 정보

 

등재저널 정보

KCI
KoreaMed
KAMS