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10. Neurointensive Care of Traumatic Brain Injury Patients Based on Coagulation and Fibrinolytic Parameter Monitoring

Author

NAKAE, Ryuta, primary, MURAI, Yasuo, additional, TAKAYAMA, Yasuhiro, additional, NAMATAME, Kaoru, additional, MATSUMOTO, Yoshiyuki, additional, KANAYA, Takahiro, additional, FUJIKI, Yu, additional, ONDA, Hidetaka, additional, SUZUKI, Go, additional, KANEKO, Junya, additional, ARAKI, Takashi, additional, NAOE, Yasutaka, additional, SATO, Hidetaka, additional, UNEMOTO, Kyoko, additional, MORITA, Akio, additional, YOKOTA, Hiroyuki, additional, and YOKOBORI, Shoji, additional

Published
2022
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12. Levetiracetam versus fosphenytoin as a second-line treatment after diazepam for adult convulsive status epilepticus: a multicentre non-inferiority randomised control trial

Author

Nakamura, Kensuke, primary, Marushima, Aiki, additional, Takahashi, Yuji, additional, Mochizuki, Masaki, additional, Kimura, Akio, additional, Fukuda, Yu, additional, Asami, Masahiro, additional, Nakamoto, Hidetoshi, additional, Egawa, Satoshi, additional, Kaneko, Junya, additional, Unemoto, Kyoko, additional, Kondo, Yutaka, additional, Yonekawa, Chikara, additional, Uchida, Masatoshi, additional, Hoshiyama, Eisei, additional, Yamada, Takeshi, additional, Maruo, Kazushi, additional, Ishikawa, Eiichi, additional, Matsumaru, Yuji, additional, and Inoue, Yoshiaki, additional

Published
2022
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13. Treatment of Geriatric Traumatic Brain Injury: A Nationwide Cohort Study

Author

Shoji, Yokobori, Ken, Saito, Kazuma, Sasaki, Takahiro, Kanaya, Yu, Fujiki, Masahiro, Yamaguchi, Shin, Satoh, Akihiro, Watanabe, Yutaka, Igarashi, Go, Suzuki, Junya, Kaneko, Ryuta, Nakae, Hidetaka, Onda, Saori, Ishinokami, Yasuhiro, Takayama, Yasutaka, Naoe, Hidetaka, Sato, Kyoko, Unemoto, Akira, Fuse, Hiroyuki, Yokota, Yokobori, Shoji, Saito, Ken, Sasaki, Kazuma, Kanaya, Takahiro, Fujiki, Yu, Yamaguchi, Masahiro, Satoh, Shin, Watanabe, Akihiro, Igarashi, Yutaka, Suzuki, Go, Kaneko, Junya, Nakae, Ryuta, Onda, Hidetaka, Ishinokami, Saori, Takayama, Yasuhiro, Naoe, Yasutaka, Sato, Hidetaka, Unemoto, Kyoko, Fuse, Akira, Yokota, Hiroyuki, Shoji, Yokobori, Ken, Saito, Kazuma, Sasaki, Takahiro, Kanaya, Yu, Fujiki, Masahiro, Yamaguchi, Shin, Satoh, Akihiro, Watanabe, Yutaka, Igarashi, Go, Suzuki, Junya, Kaneko, Ryuta, Nakae, Hidetaka, Onda, Saori, Ishinokami, Yasuhiro, Takayama, Yasutaka, Naoe, Hidetaka, Sato, Kyoko, Unemoto, Akira, Fuse, Hiroyuki, Yokota, Yokobori, Shoji, Saito, Ken, Sasaki, Kazuma, Kanaya, Takahiro, Fujiki, Yu, Yamaguchi, Masahiro, Satoh, Shin, Watanabe, Akihiro, Igarashi, Yutaka, Suzuki, Go, Kaneko, Junya, Nakae, Ryuta, Onda, Hidetaka, Ishinokami, Saori, Takayama, Yasuhiro, Naoe, Yasutaka, Sato, Hidetaka, Unemoto, Kyoko, Fuse, Akira, and Yokota, Hiroyuki

Abstract

source:https://www.nms.ac.jp/sh/jnms/2021/088030194.pdf

Published
2022

19. Additional file 1 of Association between mortality and age among mechanically ventilated COVID-19 patients: a Japanese nationwide COVID-19 database study

Author

Tanaka, Chie, Tagami, Takashi, Nakayama, Fumihiko, Kudo, Saori, Takehara, Akiko, Fukuda, Reo, Kaneko, Junya, Ishiki, Yoshito, Sato, Shin, Shibata, Ami, Kuno, Masamune, Unemoto, Kyoko, Hojo, Masayuki, Mizoue, Tetsuya, Asai, Yusuke, Suzuki, Setsuko, and Ohmagari, Norio

Abstract

Additional file 1: Table S1. Definition of the variables for confounding factors using multivariable analysis in Table 4.

Published
2021
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20. Levetiracetam versus fosphenytoin as a second-line treatment after diazepam for adult convulsive status epilepticus: a multicentre non-inferiority randomised control trial

Author

Nakamura, Kensuke, Marushima, Aiki, Takahashi, Yuji, Mochizuki, Masaki, Kimura, Akio, Fukuda, Yu, Asami, Masahiro, Nakamoto, Hidetoshi, Egawa, Satoshi, Kaneko, Junya, Unemoto, Kyoko, Kondo, Yutaka, Yonekawa, Chikara, Uchida, Masatoshi, Hoshiyama, Eisei, Yamada, Takeshi, Maruo, Kazushi, Ishikawa, Eiichi, Matsumaru, Yuji, and Inoue, Yoshiaki

Abstract

ObjectiveStatus epilepticus (SE) is an emergency condition for which rapid and secured cessation is crucial. Although fosphenytoin (FPHT) is recommended as a second-line treatment, levetiracetam (LEV) reportedly has similar efficacy, but higher safety. Therefore, we herein compared LEV with FPHT in adult SE.MethodsWe initiated a multicentre randomised control trial in emergency departments with adult patients with convulsive SE. Diazepam was initially administered, followed intravenously by FPHT at 22.5 mg/kg or LEV at 1000–3000 mg. The primary outcome was assigned as the seizure cessation rate within 30 min of the administration of the study drug.ResultsA total of 176 adult patients with SE were enrolled (82 FPHT and 94 LEV), and 3 were excluded from the full analysis set. Seizure cessation rates within 30 min were 83.8% (67/80) in the FPHT group and 89.2% (83/93) in the LEV group. The difference in these rates was 5.5% (95% CI −4.7 to 15.7, p=0.29). The non-inferiority of LEV to FPHT was confirmed with p<0.001 by the Farrington-Manning test. No significant differences were observed in the seizure recurrence rate or intubation rate within 24 hours. Serious adverse events developed in three patients in the FPHT group and none in the LEV group (p=0.061).ConclusionThe efficacy of LEV was similar to that of FPHT for adult SE following the administration of diazepam. LEV may be recommended as a second-line treatment for SE along with phenytoin/FPHT.Trial registration numberjRCTs031190160.

Published
2023
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21. Initial Management of Traumatic Brain Injury : To Reduce Preventable Trauma Death

Author

Yokobori, Shoji, primary, Sasaki, Kazuma, additional, Shibata, Ami, additional, Kanaya, Takahiro, additional, Fujiki, Yu, additional, Yamaguchi, Masahiro, additional, Sato, Shin, additional, Watanabe, Akihiro, additional, Igarashi, Yutaka, additional, Suzuki, Go, additional, Kaneko, Junya, additional, Nakae, Ryuta, additional, Onda, Hidetaka, additional, Kitahashi, Akiko, additional, Kudo, Saori, additional, Takayama, Yasuhiro, additional, Naoe, Yasutaka, additional, Sato, Hidetaka, additional, Unemoto, Kyoko, additional, Fuse, Akira, additional, Morita, Akio, additional, and Yokota, Hiroyuki, additional

Published
2021
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22. Levetiracetam Versus Fosphenytoin as a Second-Line Treatment After Diazepam for Adult Status Epilepticus: A Multicenter Non-Inferiority Randomized Control Trial

Author

Nakamura, Kensuke, primary, Marushima, Aiki, additional, Takahashi, Yuji, additional, Mochizuki, Masaki, additional, Kimura, Akio, additional, Fukuda, Yu, additional, Asami, Masahiro, additional, Nakamoto, Hidetoshi, additional, Egawa, Satoshi, additional, Kaneko, Junya, additional, Unemoto, Kyoko, additional, Kondo, Yutaka, additional, Yonekawa, Chikara, additional, Uchida, Masatoshi, additional, Hoshiyama, Eisei, additional, Yamada, Takeshi, additional, Maruo, Kazushi, additional, Ishikawa, Eiichi, additional, Matsumaru, Yuji, additional, Inoue, Yoshiaki, additional, and Study Group, IENE ECT with the LIFE, additional

Published
2021
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24. Relationship Between Institutional Volume of Out-of-Hospital Cardiac Arrest Cases and 1-Month Neurologic Outcomes: A Post Hoc Analysis of a Prospective Observational Study

Author

Kashiura, Masahiro, primary, Amagasa, Shunsuke, additional, Moriya, Takashi, additional, Sakurai, Atsushi, additional, Kitamura, Nobuya, additional, Tagami, Takashi, additional, Takeda, Munekazu, additional, Miyake, Yasufumi, additional, Inokuchi, Sadaki, additional, Masui, Yoshihiro, additional, Miura, Kunihisa, additional, Tsutsumi, Haruhiko, additional, Takuma, Kiyotsugu, additional, Atsushi, Ishihara, additional, Nakano, Minoru, additional, Tanaka, Hiroshi, additional, Ikegami, Keiichi, additional, Arai, Takao, additional, Yaguchi, Arino, additional, Oda, Shigeto, additional, Kobayashi, Kenji, additional, Suda, Takayuki, additional, Ono, Kazuyuki, additional, Morimura, Naoto, additional, Furuya, Ryosuke, additional, Koido, Yuichi, additional, Iwase, Fumiaki, additional, Nagao, Ken, additional, Kanesaka, Shigeru, additional, Okada, Yasusei, additional, Unemoto, Kyoko, additional, Sadahiro, Tomohito, additional, Iyanaga, Masayuki, additional, Muraoka, Asaki, additional, Hayashi, Munehiro, additional, Ishimatsu, Shinichi, additional, Yokokawa, Hideo, additional, Koyama, Yasuaki, additional, Tsuchiya, Asuka, additional, Kashiyama, Tetsuya, additional, Hayashi, Munetaka, additional, Oshima, Kiyohiro, additional, Kiyota, Kazuya, additional, Hamabe, Yuichi, additional, Yokota, Hiroyuki, additional, Hori, Shingo, additional, Inaba, Shin, additional, Sakamoto, Tetsuya, additional, Harada, Naoshige, additional, Kimura, Akio, additional, Kanai, Masayuki, additional, Otomo, Yasuhiro, additional, Sugita, Manabu, additional, Kinoshita, Kosaku, additional, Sakurai, Takatoshi, additional, Kitano, Mitsuhide, additional, B, Kiyoshi F., additional, Tanaka, Kotaro, additional, Yoshihara, Katsunori, additional, Yoh, Kikuo, additional, Suzuki, Junichi, additional, Toyoda, Hiroshi, additional, Mashiko, Kunihiro, additional, Shimizu, Naoki, additional, Muguruma, Takashi, additional, Shimada, Tadanaga, additional, Kobe, Yoshiro, additional, Shoko, Tomohisa, additional, Nakanishi, Kazuya, additional, Shiga, Takashi, additional, Yamamoto, Takefumi, additional, Sekine, Kazuhiko, additional, and Izuka, Shinichi, additional

Published
2020
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25. Treatment of Geriatric Traumatic Brain Injury: A Nationwide Cohort Study

Author

Shoji, Yokobori, Ken, Saito, Kazuma, Sasaki, Takahiro, Kanaya, Yu, Fujiki, Masahiro, Yamaguchi, Shin, Satoh, Akihiro, Watanabe, Yutaka, Igarashi, Go, Suzuki, Junya, Kaneko, Ryuta, Nakae, Hidetaka, Onda, Saori, Ishinokami, Yasuhiro, Takayama, Yasutaka, Naoe, Hidetaka, Sato, Kyoko, Unemoto, Akira, Fuse, Hiroyuki, Yokota, Yokobori, Shoji, Saito, Ken, Sasaki, Kazuma, Kanaya, Takahiro, Fujiki, Yu, Yamaguchi, Masahiro, Satoh, Shin, Watanabe, Akihiro, Igarashi, Yutaka, Suzuki, Go, Kaneko, Junya, Nakae, Ryuta, Onda, Hidetaka, Ishinokami, Saori, Takayama, Yasuhiro, Naoe, Yasutaka, Sato, Hidetaka, Unemoto, Kyoko, Fuse, Akira, and Yokota, Hiroyuki

Subjects
Male, medicine.medical_specialty, Traumatic brain injury, medicine.medical_treatment, Glasgow Outcome Scale, Targeted temperature management, Logistic regression, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Brain Injuries, Traumatic, Humans, Medicine, Geriatric Assessment, Aged, Retrospective Studies, Intracranial pressure, Aged, 80 and over, business.industry, Mortality rate, General Medicine, Prognosis, medicine.disease, Treatment Outcome, Intraventricular hemorrhage, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, business, Cohort study
Abstract

BACKGROUND Because of the aging of the Japanese population, traumatic brain injuries (TBI) have increased in elderly adults. However, the effectiveness and prognosis of intensive treatment for geriatric TBI have not yet been determined. Thus, we used nationwide data from the Japan Neurotrauma Data Bank (JNTDB) projects to analyze prognostic factors for intensive and aggressive treatments. METHODS We analyzed 1,879 geriatric TBI cases (age ≥65 years) registered in four JNTDB projects: Project 1998 (P1998) to Project 2015 (P2015). Clinical features, use of aggressive treatment, and 6-month outcomes on the Glasgow Outcome Scale (GOS) were compared among study projects. Logistic regression was used to identify prognostic factors in aggressively treated patients. RESULTS The percentage of geriatric TBI cases significantly increased with time-P1998: 30.1%; Project 2004 (P2004): 34.6%; Project 2009 (P2009): 43.9%; P2015: 53.6%, p

Published
2020
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26. Treatment for Geriatric Traumatic Brain Injury: A Nationwide Cohort Study

Author

Yokobori, Shoji, primary, Saito, Ken, additional, Sasaki, Kazuma, additional, Kanaya, Takahiro, additional, Fujiki, Yu, additional, Yamaguchi, Masahiro, additional, Satoh, Shin, additional, Watanabe, Akihiro, additional, Igarashi, Yutaka, additional, Suzuki, Go, additional, Kaneko, Junya, additional, Nakae, Ryuta, additional, Onda, Hidetaka, additional, Ishinokami, Saori, additional, Takayama, Yasuhiro, additional, Noae, Yasutaka, additional, Sato, Hidetaka, additional, Unemoto, Kyoko, additional, Fuse, Akira, additional, and Yokota, Hiroyuki, additional

Published
2020
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28. Disaster and Mass Casualty Incident Responses by Doctor Car

Author

Kuno, Masamune, primary, Suzuki, Kensuke, additional, Unemoto, Kyoko, additional, Tagami, Takashi, additional, Nakayama, Fumihiko, additional, Kaneko, Junya, additional, Saito, Ken, additional, Sato, Shin, additional, Tanaka, Chie, additional, Fukuda, Reo, additional, Kudo, Saori, additional, and Kitahashi, Akiko, additional

Published
2019
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31. Head positioning in suspected patients with acute stroke from prehospital to emergency department settings: a systematic review and meta‐analysis.

Author

Hifumi, Toru, Yamakawa, Kazuma, Shiba, Daiki, Okazaki, Tomoya, Kobata, Hitoshi, Gotoh, Jun, Unemoto, Kyoko, Kondo, Yutaka, Yokobori, Shoji, Ajimi, Yasuhiko, Iwase, Masaaki, Kumasawa, Junji, Goto, Jun, Sawamura, Atsushi, Hoshiyama, Eisei, Honda, Mitsuru, Norisue, Yasuhiro, Matsumoto, Shoji, Miyake, Yasufumi, and Moriya, Takashi

Published
2021
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32. Effects of hypertonic saline versus mannitol in patients with traumatic brain injury in prehospital, emergency department, and intensive care unit settings: a systematic review and meta-analysis.

Author

Miyoshi, Yukari, Kondo, Yutaka, Suzuki, Hidetaka, Fukuda, Tatsuma, Yasuda, Hideto, Yokobori, Shoji, for the Japan Resuscitation Council (JRC) Neuroresuscitation Task Force and the Guidelines Editorial Committee, Ajimi, Yasuhiko, Iwase, Masaaki, Unemoto, Kyoko, Kumasawa, Junji, Goto, Jun, Kobata, Hitoshi, Sawamura, Atsushi, Hifumi, Toru, Hoshiyama, Eisei, Honda, Mitsuru, Norisue, Yasuhiro, Matsumoto, Shoji, and Miyake, Yasufumi

Subjects
HYPERTONIC saline solutions, BRAIN injuries, INTENSIVE care units, HOSPITAL emergency services, META-analysis
Abstract

Background: Intracranial pressure control has long been recognized as an important requirement for patients with severe traumatic brain injury. Hypertonic saline has drawn attention as an alternative to mannitol in this setting. The aim of this study was to assess the effects of hypertonic saline versus mannitol on clinical outcomes in patients with traumatic brain injury in prehospital, emergency department, and intensive care unit settings by systematically reviewing the literature and synthesizing the evidence from randomized controlled trials. Methods: We searched the MEDLINE database, the Cochrane Central Register of Controlled Trials, and the Igaku Chuo Zasshi (ICHUSHI) Web database with no date restrictions. We selected randomized controlled trials in which the clinical outcomes of adult patients with traumatic brain injury were compared between hypertonic saline and mannitol strategies. Two investigators independently screened the search results and conducted the data extraction. The primary outcome was all-cause mortality. The secondary outcomes were 90-day and 180-day mortality, good neurological outcomes, reduction in intracranial pressure, and serum sodium level. Random effects estimators with weights calculated by the inverse variance method were used to determine the pooled risk ratios. Results: A total of 125 patients from four randomized trials were included, and all the studies were conducted in the intensive care unit. Among 105 patients from three trials that evaluated the primary outcome, 50 patients were assigned to the hypertonic saline group and 55 patients were assigned to the mannitol group. During the observation period, death was observed for 16 patients in the hypertonic saline group (32.0%) and 21 patients in the mannitol group (38.2%). The risks were not significant between the two infusion strategies (pooled risk ratio, 0.82; 95% confidence interval, 0.49–1.37). There were also no significant differences between the two groups in the other secondary outcomes. However, the certainty of the evidence was rated very low for all outcomes. Conclusions: Our findings revealed no significant difference in the all-cause mortality rates between patients receiving hypertonic saline or mannitol to control intracranial pressure. Further investigation is warranted because we only included a limited number of studies [ABSTRACT FROM AUTHOR]

Published
2020
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33. Efficacy and safety of tranexamic acid administration in traumatic brain injury patients: a systematic review and meta-analysis.

Author

Yokobori, Shoji, Yatabe, Tomoaki, Kondo, Yutaka, Kinoshita, Kosaku, for the Japan Resuscitation Council (JRC) Neuroresuscitation Task Force and the Guidelines Editorial Committee, Ajimi, Yasuhiko, Iwase, Masaaki, Unemoto, Kyoko, Kumasawa, Junji, Goto, Jun, Kobata, Hitoshi, Sawamura, Atsushi, Hifumi, Toru, Hoshiyama, Eisei, Honda, Mitsuru, Norisue, Yasuhiro, Matsumoto, Shoji, Miyake, Yasufumi, Moriya, Takashi, and Yasuda, Hideto

Abstract

Background: The exacerbation of intracranial bleeding is critical in traumatic brain injury (TBI) patients. Tranexamic acid (TXA) has been used to improve outcomes in TBI patient. However, the effectiveness of TXA treatment remains unclear. This study aimed to assess the effect of administration of TXA on clinical outcomes in patients with TBI by systematically reviewing the literature and synthesizing evidence of randomized controlled trials (RCTs). Methods: MEDLINE, the Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (ICHUSHI) Web were searched. Selection criteria included randomized controlled trials with clinical outcomes of adult TBI patients administered TXA or placebo within 24 h after admission. Two investigators independently screened citations and conducted data extraction. The primary "critical" outcome was all-cause mortality. The secondary "important" outcomes were good neurological outcome rates, enlargement of bleeding, incidence of ischemia, and hemorrhagic intracranial complications. Random effect estimators with weights calculated by the inverse variance method were used to report risk ratios (RRs). Results: A total of 640 records were screened. Seven studies were included for quantitative analysis. Of 10,044 patients from seven of the included studies, 5076 were randomly assigned to the TXA treatment group, and 4968 were assigned to placebo. In the TXA treatment group, 914 patients (18.0%) died, while 961 patients (19.3%) died in the placebo group. There was no significant difference between groups (RR, 0.93; 95% confidence interval, 0.86–1.01). No significant differences between the groups in other important outcomes were also observed. Conclusions: TXA treatment demonstrated a tendency to reduce head trauma-related deaths in the TBI population, with no significant incidence of thromboembolic events. TXA treatment may therefore be suggested in the initial TBI care. [ABSTRACT FROM AUTHOR]

Published
2020
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34. Feasibility and Safety of Intravascular Temperature Management for Severe Heat Stroke

Author

Yokobori, Shoji, primary, Koido, Yuichi, additional, Shishido, Hajime, additional, Hifumi, Toru, additional, Kawakita, Kenya, additional, Okazaki, Tomoya, additional, Shiraishi, Shinichirou, additional, Yamamura, Eiji, additional, Kanemura, Takashi, additional, Otaguro, Takanobu, additional, Matsumoto, Gaku, additional, Kuroda, Yasuhiro, additional, Miyake, Yasufumi, additional, Naoe, Yasutaka, additional, Unemoto, Kyoko, additional, Kato, Hiroshi, additional, Matsuda, Kiyoshi, additional, Matsumoto, Hisashi, additional, and Yokota, Hiroyuki, additional

Published
2018
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35. A Patient with a Dural Arteriovenous Fistula at the Craniocervical Junction in Whom Endovascular Treatment Was Initially Performed, Followed by Surgical Management

Author

Kaneko, Junya, primary, Shibata, Ami, additional, Kitahashi, Akiko, additional, Kudo, Saori, additional, Unemoto, Kyoko, additional, Yamaguchi, Hidenori, additional, Yamazaki, Michio, additional, Tamaki, Tomonori, additional, Matsumoto, Gaku, additional, Yokota, Hiroyuki, additional, and Hyodo, Akio, additional

Published
2018
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37. A New Rule for Terminating Resuscitation of Out-of-Hospital Cardiac Arrest Patients in Japan: A Prospective Study

Author

Inokuchi, Sadaki, primary, Masui, Yoshihiro, additional, Miura, Kunihisa, additional, Tsutsumi, Haruhiko, additional, Takuma, Kiyotsugu, additional, Atsushi, Ishihara, additional, Nakano, Minoru, additional, Tanaka, Hiroshi, additional, Ikegami, Keiichi, additional, Arai, Takao, additional, Yaguchi, Arino, additional, Kitamura, Nobuya, additional, Oda, Shigeto, additional, Kobayashi, Kenji, additional, Suda, Takayuki, additional, Ono, Kazuyuki, additional, Morimura, Naoto, additional, Furuya, Ryosuke, additional, Koido, Yuichi, additional, Iwase, Fumiaki, additional, Nagao, Ken, additional, Kanesaka, Shigeru, additional, Okada, Yasusei, additional, Unemoto, Kyoko, additional, Sadahiro, Tomohito, additional, Iyanaga, Masayuki, additional, Muraoka, Asaki, additional, Hayashi, Munehiro, additional, Ishimatsu, Shinichi, additional, Miyake, Yasufumi, additional, Yokokawa, Hideo, additional, Koyama, Yasuaki, additional, Tsuchiya, Asuka, additional, Kashiyama, Tetsuya, additional, Hayashi, Munetaka, additional, Oshima, Kiyohiro, additional, Kiyota, Kazuya, additional, Hamabe, Yuichi, additional, Yokota, Hiroyuki, additional, Hori, Shingo, additional, Inaba, Shin, additional, Sakamoto, Tetsuya, additional, Harada, Naoshige, additional, Kimura, Akio, additional, Kanai, Masayuki, additional, Otomo, Yasuhiro, additional, Sugita, Manabu, additional, Kinoshita, Kosaku, additional, Sakurai, Takatoshi, additional, Kitano, Mitsuhide, additional, Matsuda, Kiyoshi, additional, Tanaka, Kotaro, additional, Yoshihara, Katsunori, additional, Yoh, Kikuo, additional, Suzuki, Junichi, additional, Toyoda, Hiroshi, additional, Mashiko, Kunihiro, additional, Shimizu, Naoki, additional, Muguruma, Takashi, additional, Shimada, Tadanaga, additional, Kobe, Yoshiro, additional, Shoko, Tomohisa, additional, Nakanishi, Kazuya, additional, Shiga, Takashi, additional, Yamamoto, Takefumi, additional, Sekine, Kazuhiko, additional, and Izuka, Shinichi, additional

Published
2017
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40. Retrospective study of the effectiveness of Intra-Aortic Balloon Occlusion (IABO) for traumatic haemorrhagic shock

Author

30409205, Irahara, Takayuki, Sato, Norio, Moroe, Yuuta, Fukuda, Reo, Iwai, Yusuke, Unemoto, Kyoko, 30409205, Irahara, Takayuki, Sato, Norio, Moroe, Yuuta, Fukuda, Reo, Iwai, Yusuke, and Unemoto, Kyoko

Abstract

[Introduction] Intra-aortic balloon occlusion (IABO) is useful for proximal vascular control, by clamping the descending aorta, in traumatic haemorrhagic shock. However, there are limited clinical studies regarding its effectiveness. This study aimed at investigating the effectiveness of IABO for traumatic haemorrhagic shock. [Methods] This retrospective, observational study included trauma patients who underwent IABO at the Emergency and Critical Care Center of Nippon Medical School Tama-Nagayama Hospital between January 2009 and March 2013. 14 patients were included to this study who were in shock on arrival (systolic blood pressure [SBP] <90 mmHg or shock index ≥1), underwent IABO for resuscitation and temporary haemostasis, and subsequently underwent haemostatic intervention (operation or transcatheter arterial embolization). Patient characteristics, physiological status, SBP, heart rate (HR), initial fluid and blood transfusion, time course, and total occlusion time were compared before and after IABO as well as between the survived (n = 5) and non-survived (n = 9) groups. [Results] The majority of patients experienced blunt injuries, with an average injury severity score of 29.5. The liver, pelvis, spleen, and mesenterium represented the majority of injured organs. SBP, but not HR, was significantly higher after IABO than before IABO (123.1 vs. 65.5 mmHg, P = 0.0001). The revised trauma score and probability of survival were significantly different between the survived and non-survived groups (both, P = 0.04). The survived group required significantly less blood transfusion volume than the non-survived group (20 vs. 33.7 red blood cell units, P = 0.04). In addition, the survived group required a significantly shorter total occlusion time than the non-survived group (46.2 vs. 224.1 min, P = 0.002). [Conclusions] IABO was used for relatively severe trauma patients. SBP was significantly higher after IABO, but was not related to survival. However, blood transfusi

Published
2015

43. Clinical course of patients with ALI/ARDS treated with sivelestat: comparison of effects on direct and indirect lung injury using high-resolution CT and clinical parameters

Author

Soma, Kazui, primary, Imai, Hiroshi, additional, Inokuchi, Sadaki, additional, Nakagawa, Yoshihide, additional, Sugiyama, Mitsugi, additional, Arata, Shinju, additional, Nakazawa, Akio, additional, Niimi, Hiroshi, additional, Seki, Ippei, additional, Nishimaki, Horoshi, additional, Sasaki, Jun, additional, Narihara, Kentaro, additional, Kurokawa, Akira, additional, and Unemoto, Kyoko, additional

Published
2013
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49. Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic Out‐of‐Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS‐KANTO [Survey of Survivors after Out‐of‐Hospital Cardiac Arrest in Kanto Area] 2012 Study)

Author

Hayashida, Kei, Tagami, Takashi, Fukuda, Tatsuma, Suzuki, Masaru, Yonemoto, Naohiro, Kondo, Yutaka, Ogasawara, Tomoko, Sakurai, Atsushi, Tahara, Yoshio, Nagao, Ken, Yaguchi, Arino, Morimura, Naoto, Kitamura, Nobuya, Nomura, Tomohisa, Shimizu, Naoki, Akashi, Akiko, Inokuchi, Sadaki, Masui, Yoshihiro, Miura, Kunihisa, Tsutsumi, Haruhiko, Takuma, Kiyotsugu, Atsushi, Ishihara, Nakano, Tanaka, Hiroshi, Ikegami, Keiichi, Arai, Takao, Oda, Shigeto, Kobayashi, Kenji, Suda, Takayuki, Ono, Kazuyuki, Furuya, Ryosuke, Koido, Yuichi, Iwase, Fumiaki, Kanesaka, Shigeru, Okada, Yasusei, Unemoto, Kyoko, Sadahiro, Tomohito, Iyanaga, Masayuki, Muraoka, Asaki, Hayashi, Munehiro, Miyake, Yasufumi, Yokokawa, Hideo, Koyama, Yasuaki, Tsuchiya, Asuka, Kashiyama, Tetsuya, Hayashi, Munetaka, Oshima, Kiyohiro, Kiyota, Kazuya, Hamabe, Yuichi, Yokota, Hiroyuki, Hori, Shingo, Inaba, Shin, Sakamoto, Tetsuya, Harada, Naoshige, Kimura, Akio, Kanai, Masayuki, Otomo, Yasuhiro, Sugita, Manabu, Kinoshita, Kosaku, Sakurai, Takatoshi, Kitano, Mitsuhide, Matsuda, Kiyoshi, Tanaka, Kotaro, Yoshihara, Katsunori, Yoh, Kikuo, Suzuki, Junichi, Toyoda, Hiroshi, Mashiko, Kunihiro, Muguruma, Takashi, Shimada, Tadanaga, Kobe, Yoshiro, Shoko, Tomohisa, Nakanishi, Kazuya, Shiga, Takashi, Yamamoto, Takefumi, Sekine, Kazuhiko, and Izuka, Shinichi

Subjects
cardiopulmonary resuscitation, emergency department, mechanical chest compression device, Cardiopulmonary Resuscitation and Emergency Cardiac Care
Abstract

Background: Mechanical cardiopulmonary resuscitation (mCPR) for patients with out‐of‐hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes. Methods and Results: In a prospective, multicenter, observational study, adult patients with out‐of‐hospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified. The primary outcome was survival to hospital discharge. The secondary outcomes included a return of spontaneous circulation and successful hospital admission. Multivariate analyses adjusted for potential confounders and within‐institution clustering effects using a generalized estimation equation were used to analyze the association of the mCPR with outcomes. Between January 1, 2012 and March 31, 2013, 6537 patients with out‐of‐hospital cardiac arrest were eligible; this included 5619 patients (86.0%) in the manual CPR group and 918 patients (14.0%) in the mCPR group. Of those patients, 28.1% (1801/6419) showed return of spontaneous circulation in the emergency department, 20.4% (1175/5754) had hospital admission, 2.6% (168/6504) survived to hospital discharge, and 1.2% (75/6419) showed a favorable neurological outcome at 1 month after admission. Multivariate analyses revealed that mCPR was associated with a decreased likelihood of survival to hospital discharge (adjusted odds ratio, 0.40; 95% confidence interval, 0.20–0.78; P=0.005), return of spontaneous circulation (adjusted odds ratio, 0.71; 95% confidence interval, 0.53–0.94; P=0.018), and hospital admission (adjusted odds ratio, 0.57; 95% confidence interval, 0.40–0.80; P=0.001). Conclusions: After accounting for potential confounders, the mCPR in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic out‐of‐hospital cardiac arrest. Further studies are needed to clarify circumstances in which mCPR may benefit these patients.

Published
2017
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50. Changes Over 7 Years in Temperature Control Treatment and Outcomes After Out-of-Hospital Cardiac Arrest: A Japanese, Multicenter Cohort Study.

Author

Tanaka C, Tagami T, Nakayama F, Kuno M, Kitamura N, Yasunaga H, Aso S, Takeda M, and Unemoto K

Abstract

Temperature control is the only neuroprotective intervention suggested in current international guidelines for patients with return of spontaneous circulation after cardiac arrest, but the prevalence of temperature control therapy, temperature settings, and outcomes have not been clearly reported. We aimed to investigate changes over 7 years in provision of temperature control treatment among out-of-hospital cardiac arrest (OHCA) patients in Kanto region, Japan. Data of all adult OHCA patients who survived for more than 24 hours in the prospective cohort studies, SOS-KANTO 2012 (conducted from 2012 to 2013) and SOS-KANTO 2017 (conducted from 2019 to 2021), in Japan were included. We compared the prevalence of temperature control and the proportion of mild (≥35°C) and moderate (from 32°C to 34.9°C) hypothermia between the two study groups. We also performed a Cox regression analysis to evaluate 30-day mortality adjusted by temperature control therapy (none, moderate hypothermia, or mild hypothermia), age, sex, past medical history, witnessed status, bystander cardiopulmonary resuscitation, initial rhythm, location of arrest, and dataset (SOS-KANTO 2012 or 2017). We analyzed data from 2936 patients ( n  = 1710, SOS-KANTO 2012; n  = 1226, SOS-KANTO 2017). Use of temperature control was lower (45.3% vs. 41.4%, p  = 0.04), moderate hypothermia was lower ( p  < 0.01), and mild hypothermia was higher ( p  < 0.01) in SOS-KANTO 2017 compared with SOS-KANTO 2012. The survival rate was significantly higher for patients with mild ( p  < 0.01) and moderate ( p  < 0.01) hypothermia compared with those who did not receive temperature control therapy. Overall, the incidence of moderate hypothermia decreased and that of mild hypothermia increased and the use of temperature control decreased between the two studies conducted 7 years apart in the Kanto area, Japan. Temperature control management might improve survival of patients with OHCA.

Published
2024
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