1.Establishment of the Heart Failure Model in Swine for the Experiment of the Pneumatic Ventricular Assist Device.
Seongsik PARK ; Pil Won SEO ; Sang Hoon LEE ; Bong Jin KANG ; Sang Ho MOON ; Sam Hyun KIM
The Korean Journal of Thoracic and Cardiovascular Surgery 2003;36(3):123-130
BACKGROUND: In order to develop the acute heart failure model for the animal experiment of the pneumatic ventricular assist device, we decided to use young pig whose coronary artery distribution is almost the same as humans and also very cheap in price. The purpose of this study is to develop stable, reproducible acute ischemic heart failure model in swine using coronary artery ligation method. MATERIAL AND METHOD: Five young pigs whose weights are the same as adult humans are under experiment. Each pig was under endotracheal intubation and connected to a mechanical ventilator. Through left lateral thoracotomy, we exposed the heart and induced ischemic heart failure by coronary artery ligation. The ligation began at the distal part of the left anterior descending coronary artery. After 5 minutes of initial ligation we reperfused the artery and then re-ligated. Before and after each ligation-reperfusion procedure we assessed the left ventricular end-diastolic pressure, arterial pressure, and cardiac index. We also measured left ventricular end-diastolic dimension, end-systolic dimension, fractional shortening, ejection fraction using intraoperative epicardial echocardiography. After appropriate heart failure was established with sequential (from distal part of LAD to proximal location) ligation-reperfusion-ligation procedure, we inserted the ventricular assist device and operated. RESULT: We established stable acute ischemic heart failure in 3 of 5 young pigs with this sequential ligation-reperfusion-ligation procedure, and could maintained 50% less ejection fraction before the procedure according to intraoperative epicardial echocardiography. We also observed no ventricular arrhythmia usually associated with simple coronary artery ligation in large animals and no cardiac arrest associated with ventricular arrhythmia or myocardial stunning. In pathologic specimen, we observed scattered ischemic myocardium in all around the ischemic field induced by coronary artery ligation. CONCLUSION: Under the concept of ischemic preconditioning, we developed safe and reproducible acute ischemic heart failure model in swine using sequential coronary artery ligation-reperfusion-ligation method.
Adult
;
Animal Experimentation
;
Animals
;
Arrhythmias, Cardiac
;
Arterial Pressure
;
Arteries
;
Coronary Vessels
;
Echocardiography
;
Heart Arrest
;
Heart Failure*
;
Heart*
;
Heart-Assist Devices*
;
Humans
;
Intubation, Intratracheal
;
Ischemic Preconditioning
;
Ligation
;
Models, Animal
;
Myocardial Stunning
;
Myocardium
;
Swine*
;
Thoracotomy
;
Ventilators, Mechanical
;
Weights and Measures
2.Intraoperative airway obstruction caused by dissection of the internal wall of a reinforced endotracheal tube: A case report.
Yuseon CHEONG ; Beomsang HWANG ; Innam KIM ; Tsongbih CHANG ; Seongsik KANG ; Minsoo KIM
Anesthesia and Pain Medicine 2017;12(4):394-397
Endotracheal intubation is the gold standard for airway management in general anesthesia. However, airway patency is not guaranteed by keeping the endotracheal tube (ETT) in place. Sometimes, the ETT itself may become a cause of airway obstruction; there are some reports on airway obstruction related to reinforced tube malfunction. We report a rare case with an obstruction of reinforced endotracheal tubes caused by dissection of the internal wall. Recognition of the possibility of airway obstruction due to a rare cause and monitoring patients vigilantly during anesthesia is very important for patient safety.
Airway Management
;
Airway Obstruction*
;
Anesthesia
;
Anesthesia, General
;
Humans
;
Intubation, Intratracheal
;
Patient Safety
3.Intraoperative airway obstruction caused by dissection of the internal wall of a reinforced endotracheal tube: A case report.
Yuseon CHEONG ; Beomsang HWANG ; Innam KIM ; Tsongbih CHANG ; Seongsik KANG ; Minsoo KIM
Anesthesia and Pain Medicine 2017;12(4):394-397
Endotracheal intubation is the gold standard for airway management in general anesthesia. However, airway patency is not guaranteed by keeping the endotracheal tube (ETT) in place. Sometimes, the ETT itself may become a cause of airway obstruction; there are some reports on airway obstruction related to reinforced tube malfunction. We report a rare case with an obstruction of reinforced endotracheal tubes caused by dissection of the internal wall. Recognition of the possibility of airway obstruction due to a rare cause and monitoring patients vigilantly during anesthesia is very important for patient safety.
Airway Management
;
Airway Obstruction*
;
Anesthesia
;
Anesthesia, General
;
Humans
;
Intubation, Intratracheal
;
Patient Safety
4.Drug overdose due to malfunction of a patient-controlled analgesia machine: A case report.
Yuri YI ; Seongsik KANG ; Byeongmun HWANG
Korean Journal of Anesthesiology 2013;64(3):272-275
Patient-controlled analgesia (PCA) provides excellent pain control and high stability, thereby minimizing the incidence of adverse effects. However, one of our patients experienced respiratory depression and hypotension within 30 minutes of initiation of PCA therapy. We discovered that machine malfunction caused continuous activation of the PCA button, resulting in a drug overdose. The PCA machine was sent to the manufacturer, who found an electrical short in the PCA button. All PCA units of the same make and model were immediately removed from hospitals and replaced with redesigned units without defects in the PCA button. We have used the improved machines without any problems. The purpose of this report is to raise awareness of this type of malfunction in PCA units in order to help prevent adverse events in the future.
Analgesia, Patient-Controlled
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Drug Overdose
;
Humans
;
Hypotension
;
Incidence
;
Passive Cutaneous Anaphylaxis
;
Respiratory Insufficiency
5.Comparison between GlideRite® rigid stylet and Parker Flex-It™ stylet to facilitate GlideScope intubation in simulated difficult intubation: a randomized controlled study
Ji Won BAK ; Yeonji NOH ; Juyoun KIM ; Byeongmun HWANG ; Seongsik KANG ; Heejeong SON ; Minsoo KIM
Anesthesia and Pain Medicine 2022;17(1):104-111
The GlideScope® videolaryngoscope (GVL) is widely used in patients with difficult airways and provides a good glottic view. However, the acute angle of the blade can make insertion and advancement of an endotracheal tube (ETT) more difficult than direct laryngoscopy, and the use of a stylet is recommended. This randomized controlled trial compared Parker Flex-It™ stylet (PFS) with GlideRite® rigid stylet (GRS) to facilitate intubation with the GVL in simulated difficult intubations. Methods: Fifty-four patients were randomly allocated to undergo GVL intubation using either GRS (GRS group) or PFS (PFS group). The total intubation time (TIT), 100-mm visual analog scale (VAS) for ease of intubation, success rate at the first attempt, use of laryngeal manipulation, tube advancement rate by assistant, and complications were recorded. Results: There was no significant difference between the GRS and PFS groups regarding TIT (50.3 ± 12.0 s in the GRS group and 57.8 ± 18.8 s in the PFS group, P = 0.108). However, intubation was more difficult in the PFS group than in the GRS group according to VAS score (P = 0.011). Cases in which the ETT was advanced from the stylet by an assistant, were more frequent in the GRS group than in the PFS group (P = 0.002). The overall incidence of possible complications was not significantly different. Conclusions: In patients with a simulated difficult airway, there was no difference in TIT using either the PFS or GRS. However, endotracheal intubation with PFS is more difficult to perform than GRS.
6.Quality of Anticoagulation and Treatment Satisfaction in Patients with Non-Valvular Atrial Fibrillation Treated with Vitamin K Antagonist: Result from the KORean Atrial Fibrillation Investigation II.
Seil OH ; June Soo KIM ; Yong Seog OH ; Dong Gu SHIN ; Hui Nam PAK ; Gyo Seung HWANG ; Kee Joon CHOI ; Jin Bae KIM ; Man Young LEE ; Hyung Wook PARK ; Dae Kyeong KIM ; Eun Sun JIN ; Jaeseok PARK ; Il Young OH ; Dae Hee SHIN ; Hyoung Seob PARK ; Jun Hyung KIM ; Nam Ho KIM ; Min Soo AHN ; Bo Jeong SEO ; Young Joo KIM ; Seongsik KANG ; Juneyoung LEE ; Young Hoon KIM
Journal of Korean Medical Science 2018;33(49):e323-
BACKGROUND: Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction. METHODS: We conducted a multicenter, prospective, non-interventional study. Patients with CHADS2 ≥ 1 and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up. RESULTS: A total of 877 patients (age, 67; male, 60%) were enrolled and followed up for one year. More than half of patients (56%) had CHADS2 ≥ 2 and 83.6% had CHA2DS2-VASc ≥ 2. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain. CONCLUSION: INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.
Atrial Fibrillation*
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Drug Interactions
;
Follow-Up Studies
;
Humans
;
International Normalized Ratio
;
Male
;
Prospective Studies
;
Risk Factors
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Stroke
;
Thromboembolism
;
Vitamin K*
;
Vitamins*