Spatial Relationship of the Left Ventricle in the Supine Position and the Left Lateral Tilt Position (Implication for Cardiopulmonary Resuscitation in Pregnant Patients)

서지정보

· 발행기관 : 한국화재소방학회
· 수록지 정보 : 한국화재소방학회 논문지 / 27권 / 5호 / 75 ~ 79페이지
· 저자명 : 윤종근, 이병국

초록

Application of the left lateral tilt position has been recommended during cardiopulmonary resuscitation (CPR) of pregnantpatients. However, the left lateral tilt could displace the left ventricle (LV) besides the gravid uterus and may compromisethe cardiac pump mechanism of CPR. Thus, we investigated the effect of left lateral tilt on the spatial relationshipbetween the anterior-posterior axis (AP axis), which represents the direction of sternal displacement during CPR, and theLV. We retrospectively reviewed the medical records and multidetector computed tomography (MDCT) scans of 90patients who underwent virtual gastroscopy using MDCT. Virtual gastroscopy was performed with the patient both in theleft lateral tilt position and in the supine position. On an axial image showing the maximal area of the LV, the anglebetween the AP axis and the LV axis (AngleAP-LV), the shortest distance between the AP axis and the mid-point of LV cavity(DAP-MidLV) and the shortest distance between the AP axis and the LV apex (DAP-Apex) were measured. In the supinescans, the LV was situated on the left side of the AP axis in 87 patients (96.7%). On the left lateral tilt scans, the mean tiltangle was 43.4±11.0o. DAP-MidLV and DAP-Apex were significantly longer in the left lateral tilt position (p<0.001), butAngleAP-LV was comparable between the positions. This study indicates that the left lateral tilt position may compromisethe cardiac pump mechanism of chest compression in pregnant cardiac arrest patients.

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