Acute and Critical Care

In Byung Kim

4 Articles

A Simulation Study for Quality of Chest Compression Provided by Health Personnel: Jun Mo Yeo, Min Hong Choa, Sang Won Chung, In Byung Kim, Ji Hoon Kang, Kyung Wuk Kim, Jai Woog Ko; Korean J Crit Care Med. 2011;26(2):64-68.; DOI: https://doi.org/10.4266/kjccm.2011.26.2.64

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BACKGROUND
Effective chest compression may improve the return of spontaneous circulation and neurologic outcome in arrest victims. For fear of rescuer's fatigue, guidelines for cardiopulmonary resuscitation (CPR) recommended that chest compression (CC) should be switched every 2 minutes, but there is little evidence. We investigated whether health personnel could provide consistent quality of CC for 2 minutes.
METHODS
We recruited prospectively health personnel working on one university hospital. On the day assigned randomly, CPR performance data was collected with use of CPR recording technology. Quality of CPR was calculated every 30 seconds interval. To identify the quality decay, we used repeated measure analysis of variance with SPSS 17.0 for analysis.
RESULTS
We analyzed 8,485 CCs performed by 41 subjects. Total number of CC decayed between 90 to 120 seconds (51.6 +/- 3.3 to 50.8 +/- 3.5, p = 0.020) within recommended range. The ratio of correct depth CC decayed between 90 to 120 seconds, falling from 83.4 +/- 24.9% to 68.3 +/- 38.4% (p = 0.002). The ratio of low depth CC increased significantly over time (10.2 +/- 20.7% to 31.3 +/- 38.5%, p < 0.001).
CONCLUSIONS
Health personnel may provide adequate number of CC for 2 minutes. But, the number of correct depth CC may decay between 90 to 120 seconds. Also the number of low depth CC may increase over time.

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Comparisons of the qualities of chest compression according to various positions of rescuer to patient at the in-hospital cardiopulmonary resuscitation model
Geon-Nam Kim, Seong-Woo Choi, Jin-Yeong Jang, So-Yeon Ryu
The Korean Journal of Emergency Medical Services.2014; 18(1): 7. CrossRef
Comparison on the Quality and fatigue of hands-Only CPR According to the Presence or Absence of Verbal counting by Some Middle-aged Women
Geon-Nam Kim, Sung-Soo Choi, Seong-Woo Choi
Journal of the Korea Academia-Industrial cooperation Society.2013; 14(3): 1320. CrossRef

Variations in Pulse Oximetry Plethysmographic Waveform Amplitude and Hemodynamic Assessment Induced by Passive Leg Raising in Spontaneously Breathing Adult Volunteers: Jai Woog Ko, Sang Weon Chung, Yo Seob Park, Kyo Joon Lee, Dong Seok Moon, In Byung Kim; Korean J Crit Care Med. 2008;23(1):6-12.; DOI: https://doi.org/10.4266/kjccm.2008.23.1.6

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Abstract PDF: BACKGROUND
In hemodynamically unstable patients with spontaneous breathing activity, predicting volume responsivenss is a difficult challenge. Our objective was to test whether the respiratory changes in pulse oxymetry plethysmographic waveform amplitude (POP) and in stroke volume (deltaSV) could predict fluid responsiveness to passive leg raising (PLR) in normal volunteers.
METHODS
We investigated 25 normal volunteers. We assessed hemodynamic status (HR, SBP, MAP, CI and SVI) and calculated the respiratory variation in pulse oximetry plethysmographic waveform amplitude at supine and after PLR. We attached a pulse oximeter of 25 spontaneously breathing volunteers as several time points: after 1 min and 5 min in supine position and during PLR at 60degrees. Heart rate, non-invasive blood pressures (mean arterial pressure, systolic blood pressure), maximal POP (POPmax), minimal POP (POPmin) and deltaPOP defined as (POPmax-POPmin)/[(POPmax+POPmin)/2] were recorded using monitor.
RESULTS
Comparing to supine and PLR, systolic blood pressure and mean arterial pressure were not different, but the change in cardiac index, stroke volume and respiratory variation in POP were significant different. In response group (> or =10% in deltaCI), the change in cardiac index, stroke volume and respiratory variation in POP were significant greater.
CONCLUSION
PLR induces a significant decrement of variation in POP amplitude among spontaneouely breathing volunteers. We suppose that the changes in stroke volume and the respiratory variation in pulse oximetry plethysmographic waveform amplitude induced by PLR predict fluid responsiveness in spontaneous breathing patients.

Factors of Cardiopulmonary Resuscitation Outcome for In-hospital Adult Patients: In Byung Kim, Sang Won Chung, Dong Seok Moon, Ki Hyun Byun; Korean J Crit Care Med. 2007;22(2):83-90.

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Abstract PDF: BACKGROUND
The purpose of this study was to evaluate the factors of cardiopulmonary resuscitation (CPR) outcome for in-hospital adult patients, acquiring data with standardized reporting guideline of in-hospital cardiopulmonary resuscitation in Korea.
METHODS
All adult cardiac arrest patients from July 2004 to December 2006 in this general hospital were included. Their clinical spectrums were reviewed retrospectively using Utstein-style based template.
RESULTS
For the study time period, one hundred and forty-two patients underwent cardiac arrest in this hospital. 136 patients were performed CPR. Return of spontaneous circulation (ROSC) occurred in 42 cases, and 15 patients were survived to hospital discharge. A shorter CPR time and a lower Simplified Acute Physiology Score II (SAPS II) were significant for survivor to hospital discharge (p<0.01). Sex, age, and location in cardiac arrest were not attributed to survival to hospital discharge.
CONCLUSIONS
In-hospital CPR patients, the high rate of ROSC and survival to hospital discharge were associated to the cause of arrest, shorter time of CPR, and lesser severity of disease (SAPS II). This result can be a great implication of survivor from CPR in-hospital adult patients in Korea. Further evaluation with consistent data acquisition of CPR using Utstein-style would contribute to improve CPR practice and outcome.

Comparison of Impedance Cardiography with Thermodilution of Hemodynamic Parameters in Critically Ill Patients: Hyung Goo Kang, Sang Won Chung, Ki Hyun Byun, In Byung Kim; Korean J Crit Care Med. 2006;21(2):77-82.

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Abstract PDF: BACKGROUND
To evaluate the feasibility of noninvasive hemodynamic monitoring (impedance cardiography, ICG) in critically ill patients, we compared this technique with simultaneous invasive monitoring with a pulmonary artery thermodilution catheter.
METHODS
A prospective observational study was done comparing invasive monitoring and noninvasive monitoring in 12 critically ill patients. The cardiac output (CO), the stroke volume (SV) and the systemic vascular resistance (SVR) measured by using a standard thermodilution pulmonary artery catheter technique were compared with the corresponding measurements simultaneously using an ICG.
RESULTS
The value of CO, SV and SVR measured by ICG were closely correlated to those by the thermodilution methods [r: 0.659 (p<0.01), 0.536 (p<0.01), 0.738 (p<0.01)].
CONCLUSIONS
ICG can provide hemodynamic information previously available only by invasive monitoring with a thermodilution catheter.

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