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초저체온하 대동맥수술 환자에서 완전 순환차단의 안전한 체온 및 기간에 대한 연구

Other Titles
 Clinical Application of Compressed Spectral Array During Deep Hypothermia 
Authors
 장병철  ;  유선국  ;  김선호  ;  송재성  ;  박성제  ;  문준호  ;  김정택  ;  곽영란  ;  홍용우 
Citation
 Korean Journal of Thoracic and Cardiovascular Surgery (대한흉부외과학회지), Vol.30(8) : 752-759, 1997 
Journal Title
 Korean Journal of Thoracic and Cardiovascular Surgery (대한흉부외과학회지) 
ISSN
 0301-2859 
Issue Date
1997
Abstract
Profound hypothermia protects . cerebral function during total circulatory arrest(TCA) in the surgical treatment of a variety of cardiac and aortic diseases. Despite its importance, there is no ideal technique to monitor the brain injury from ischemia. Since 1994, we have developed compressed spectral array(CSA) of electroencephalography(EEG) and monitored cerebral activity to reduce ischemic injury. The purposes of this study are to analyse the efficacy of CSA and to establish objective criteria to consistently identify the safe level of temperature and arrest time. We studied 6 patients with aortic dissection(AD, n=3) or aortic arch aneurysm(n=3, ruptured in 2). Body temperatures from rectum and esophagus and the EEG were monitored continuously during cooling and rewarming period. TCA with cerebral ischemia was performed in 3 patients and TCA with selective cerebral perfusion was performed in 3 patients. Total ischemic time was 30, 36 and 56 minutes respectively for TCA group and selective perfusion time was 41, 56 and 92 minutes respectively for selective perfusion group. The rectal temperatures for flat EEG were between 16.1 and 22. 1℃ (mean: 18.4 ± 2.0): the esophageal temperatures between 12.7 and 16.4℃ (mean 14.7±1.6). The temperatures at which EEG reappeared 5∼15.4℃ for esophagus. There was no neurological defic t and no surgical mortality in this series. In summary, the electrical cerebral activity Teappeared within 23 minutes at the temperature less than 16℃ for rectum. It seemed that 15℃ of esophageal temperature was not safe for 20 minutes of TCA and continuous monitoring the EEG with CSA to identify the electrocerebral silence was useful.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Medical Engineering (의학공학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Yoo, Sun Kook(유선국) ORCID logo https://orcid.org/0000-0002-6032-4686
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/177953
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