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55. Development and Validation of a Clinical Score to Predict Neurological Outcomes in Patients With Out-of-Hospital Cardiac Arrest Treated With Extracorporeal Cardiopulmonary Resuscitation

Author

Okada, Yohei, primary, Kiguchi, Takeyuki, additional, Irisawa, Taro, additional, Yamada, Tomoki, additional, Yoshiya, Kazuhisa, additional, Park, Changhwi, additional, Nishimura, Tetsuro, additional, Ishibe, Takuya, additional, Yagi, Yoshiki, additional, Kishimoto, Masafumi, additional, Inoue, Toshiya, additional, Hayashi, Yasuyuki, additional, Sogabe, Taku, additional, Morooka, Takaya, additional, Sakamoto, Haruko, additional, Suzuki, Keitaro, additional, Nakamura, Fumiko, additional, Matsuyama, Tasuku, additional, Nishioka, Norihiro, additional, Kobayashi, Daisuke, additional, Matsui, Satoshi, additional, Hirayama, Atsushi, additional, Yoshimura, Satoshi, additional, Kimata, Shunsuke, additional, Shimazu, Takeshi, additional, Ohtsuru, Shigeru, additional, Kitamura, Tetsuhisa, additional, and Iwami, Taku, additional

Published
2020
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56. Serum potassium level on hospital arrival and survival after out-of-hospital cardiac arrest: The CRITICAL study in Osaka, Japan

Author

Shida, Haruka, primary, Matsuyama, Tasuku, additional, Iwami, Taku, additional, Okabayashi, Satoe, additional, Yamada, Tomoki, additional, Hayakawa, Koichi, additional, Yoshiya, Kazuhisa, additional, Irisawa, Taro, additional, Noguchi, Kazuo, additional, Nishimura, Tetsuro, additional, Uejima, Toshifumi, additional, Yagi, Yoshiki, additional, Kiguchi, Takeyuki, additional, Kishimoto, Masafumi, additional, Matsuura, Makoto, additional, Hayashi, Yasuyuki, additional, Sogabe, Taku, additional, Morooka, Takaya, additional, Sado, Junya, additional, Kishimori, Takefumi, additional, Kiyohara, Kosuke, additional, Shimazu, Takeshi, additional, Kitamura, Tetsuhisa, additional, and Kawamura, Takashi, additional

Published
2020
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58. Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: A prospective observational cohort study in Japan

Author

Okada, Yohei, primary, Kiguchi, Takeyuki, additional, Irisawa, Taro, additional, Yoshiya, Kazuhisa, additional, Yamada, Tomoki, additional, Hayakawa, Koichi, additional, Noguchi, Kazuo, additional, Nishimura, Tetsuro, additional, Ishibe, Takuya, additional, Yagi, Yoshiki, additional, Kishimoto, Masafumi, additional, Shintani, Hiroshi, additional, Hayashi, Yasuyuki, additional, Sogabe, Taku, additional, Morooka, Takaya, additional, Sakamoto, Haruko, additional, Suzuki, Keitaro, additional, Nakamura, Fumiko, additional, Nishioka, Norihiro, additional, Matsuyama, Tasuku, additional, Matsui, Satoshi, additional, Shimazu, Takeshi, additional, Koike, Kaoru, additional, Kawamura, Takashi, additional, Kitamura, Tetsuhisa, additional, and Iwami, Taku, additional

Published
2020
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59. Association Between Serum Lactate Level During Cardiopulmonary Resuscitation and Survival in Adult Out-of-Hospital Cardiac Arrest: A Multicenter Cohort Study (The Critical Study in Osaka, Japan)

Author

Nishioka, Norihiro, primary, Kobayashi, Daisuke, additional, Izawa, Junichi, additional, Irisawa, Taro, additional, Yamada, Tomoki, additional, Yoshiya, Kazuhisa, additional, Park, Changhwi, additional, Nishimura, Tetsuro, additional, Ishibe, Takuya, additional, Yagi, Yoshiki, additional, Kiguchi, Takeyuki, additional, Kishimoto, Masafumi, additional, Inoue, Toshiya, additional, Hayashi, Yasuyuki, additional, Sogabe, Taku, additional, Morooka, Takaya, additional, Sakamoto, Haruko, additional, Suzuki, Keitaro, additional, Nakamura, Fumiko, additional, Matsuyama, Tasuku, additional, Okada, Yohei, additional, Matsui, Satoshi, additional, Hirayama, Atsushi, additional, Yoshimura, Satoshi, additional, Kimata, Shunsuke, additional, Shimazu, Takeshi, additional, Kitamura, Tetsuhisa, additional, Kawamura, Takashi, additional, and Iwami, Taku, additional

Published
2020
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60. A retrospective study evaluating efficacy and safety of compassionate use of tocilizumab in 13 patients with severe-to-critically ill COVID-19: analysis of well-responding cases and rapidly-worsening cases after tocilizumab administration

Author

Hashimoto, Shoji, primary, Kitajima, Heita, additional, Arai, Tsuyoshi, additional, Tamura, Yoshitaka, additional, Nagai, Takayuki, additional, Morishita, Hiroshi, additional, Matsuoka, Hiroto, additional, Han, Yuki, additional, Minamoto, Seijiro, additional, Hirashima, Tomonori, additional, Yamada, Tomoki, additional, Kashiwa, Yozo, additional, Kameda, Makoto, additional, Yamaguchi, Seiji, additional, Uno, Kazuko, additional, Nakayama, Emi, additional, Shioda, Tatsuo, additional, Yoshizaki, Kazuyuki, additional, Kang, Sujin, additional, Kishimoto, Tadamitsu, additional, and Tanaka, Toshio, additional

Published
2020
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63. Additional file 1 of Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan

Author

Okada, Yohei, Kiguchi, Takeyuki, Irisawa, Taro, Yoshiya, Kazuhisa, Yamada, Tomoki, Hayakawa, Koichi, Noguchi, Kazuo, Nishimura, Tetsuro, Ishibe, Takuya, Yagi, Yoshiki, Kishimoto, Masafumi, Shintani, Hiroshi, Hayashi, Yasuyuki, Sogabe, Taku, Morooka, Takaya, Sakamoto, Haruko, Keitaro Suzuki, Nakamura, Fumiko, Nishioka, Norihiro, Matsuyama, Tasuku, Sado, Junya, Matsui, Satoshi, Shimazu, Takeshi, Koike, Kaoru, Kawamura, Takashi, Tetsuhisa Kitamura, and Iwami, Taku

Abstract

Additional file 1: S-Table 1. The characteristics of patients with missing BGA. S-Table 2. Original cohort (N=260). S-Table 3. Expected outcome among the excluded patients in the assumption (N=123). S-Table 4. The crude and adjusted ORs of other covariates. S-Table 5. The results of sensitivity analysis. S-Figure. Flow chart in sensitivity analysis.

Published
2020
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64. Additional file 1 of Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan

Author

Okada, Yohei, Kiguchi, Takeyuki, Irisawa, Taro, Yoshiya, Kazuhisa, Yamada, Tomoki, Hayakawa, Koichi, Noguchi, Kazuo, Nishimura, Tetsuro, Ishibe, Takuya, Yagi, Yoshiki, Kishimoto, Masafumi, Shintani, Hiroshi, Hayashi, Yasuyuki, Sogabe, Taku, Morooka, Takaya, Sakamoto, Haruko, Keitaro Suzuki, Nakamura, Fumiko, Nishioka, Norihiro, Matsuyama, Tasuku, Matsui, Satoshi, Shimazu, Takeshi, Koike, Kaoru, Kawamura, Takashi, Tetsuhisa Kitamura, and Iwami, Taku

Subjects
Data_FILES
Abstract

Additional file 1.

Published
2020
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66. Cardiopulmonary Resuscitation in Adults Over 80: Outcome and the Perception of Appropriateness by Clinicians

Author

Druwe, Patrick, Benoit, Dominique D., Monsieurs, Koen, Gagg, James, Nakahara, Shinji, Alpert, Evan Avraham, van Schuppen, Hans, Elo, Gabor, Huybrechts, Sofie A., Mpotos, Nicolas, Joly, Luc-Marie, Xanthos, Theodoros, Roessler, Markus, Paal, Peter, Cocchi, Michael N., Bjorshol, Conrad, Nurmi, Jouni, Salmeron, Pascual Pinera, Owczuk, Radoslaw, Svavarsdottir, Hildigunnur, Cimpoesu, Diana, Raffay, Violetta, Pachys, Gal, De Paepe, Peter, Piers, Ruth, Hill, Michael, Spottl, Peter, Gemes, Geza, Grander, Wilhelm, Rugg, Christopher, Likar, Rudolf, von Lutterotti, Theresa, Mitterndorfer, Walter, Baumgartner, Karl, Trimmel, Helmut, Sator, Florian, Pogatschnigg, Michael, Rastner, Verena, Luger, Markus, Schinnerl, Adi, Fleischmann, Wolfgang, Predl, Barbara, Aigner, Patrick, Adler, Rene, Huybrechts, Sofie, Verbeeck, Kris, Van den Broeck, Jan, Vandereyken, Frederik, Leach, Robert, De Kock, Kurt, Raveel, Geert, Van Damme, Erwin, Riahi, Sami, Meuris, David, Engels, Jorge, Fabien, Guerisse, Vranckx, Marc, Kreps, Bernard, Imbo, Filip, Vantroyen, Barbara, Maules, Yves, Sabbe, Marc, Jensen, Peter, Tabrizi, Nima Hosseinpour, Vanelderen, Pascal, Beaune, Sebastien, Ageron, Francois-Xavier, Wargon, Mathias, Roupie, Eric, Gosse, Pierre, Faour, Ali, Duncan, Gregory, Dumas, Florence, Wiel, Eric, Fort, Pierre Arnaud, Jacquin, Laurent, Duval, Arnaud Depil, Boishardy, Fabrice, Freund, Yonathan, Broche, Claire, Giolito, Didier, Herve, Thierry, Rozenberg, Alain, Jardel, Benoit, Flemming, Andreas, Wiegand, Nicolai, Hagemann, Wolfgang, Mueller, Thorsten, Selis, Melanie, Deussen, Marc, Callies, Andreas, Schiffner, Jens, Strickmann, Bernd, Schwille, Ulrich, Christenhusz, Arjan, Weijschede, Frits, Juffermans, Erwin, Nienhuis, Angelique, Breeman, Wim, Landman, Esther, Vrusch, Rob, Wouters, Sven, Winkel, Steven, den Boer, Eugene, Ketelaar, Aart, Hutten, Albert, Fokker, Katinka, van Ree, Karin, Mulder, Peter Jan, Lambregts, Rini, Deasy, Conor, Gilligan, Peadar, Breslin, Tomas, Kennedy, Una, O'Connor, Gabrielle, Doyle, Mark, Fallon, Hilary, McDaid, Fiona, Yeung, Davy, Benger, Jonathan, Stacey, Victoria, Dorrian, Susan, Haig, Stephen, Byers, Sonia, McLauchlan, Chris, Watson, David, Robinson, Maria, Kendall, Jason, Whitfield, Richard, Foster, Theresa, Truhla, Anatolij, Skulec, Roman, Smrzova, Eva, Lejsek, Jan, Gregor, Roman, Sin, Robin, Kubalova, Jana, Kratochvil, Jaroslav, Zika, Jiri, Fiala, Hynek, Koci, Jaromir, Jelen, Stanislav, Galgoczy, Peter, Szabados, Gyorgy, Temesvari, Peter, Kalman, Attila, Zubek, Laszlo, Kovacs, Eniko, Kiss, Domonkos, Valent, Mihaly, Kanizsai, Peter, Wilanowski, Tomasz, Zemojtel, Lukasz, Dubieniecki, Maciej, Ingielewicz, Anna, Wozniak, Piotr, Galazkowski, Robert, Sirbu, Fernando, Milenkovic, Dusan, Trenkler, Stefan, Dobias, Viliam, Ilavsky, Michal, Bajerovska, Lubica, Kubova, Dana, Patras, Juraj, Ioannides, Marios, Georgiou, Marios, Venetsanos, Philipos, Adamos, Georgios, Barouxis, Dimitrios, Karlis, Georgios, Chalkias, Athanasios, Lecinena, Maria Angelez, Suero, Coral, Herrero, Pablo, Sanchez, Miquel, del Castillo, Juan Gonzalez, del Arco, Carmen, Ezponda, Francisco, Llorens, Pere, Boque, Carmen, Millan, Javier, Fernandez, Pablo, Mozota, Julian, Povar, Javier, Juarez, Ricardo, Puiguriguer, Jordi, Navarro, Carmen, Aguero, Clotilde, Gorjon, Esther, Monteagudo, Tania, Saenz, Fernando, Gomez, Ignacio, Picabea, Alberto, Espinosa, Salvador, Palviainen, Jan-Erik, Tavasti, Juhani, Hallikainen, Juhana, Suonpera, Ville, Suonsyrja, Timo, Kaartinen, Johanna, Hoppu, Sanna, Carrasco, Anton Berg, Jonsdottir, Hrafnhildur Lilja, Palsson, Njall, Petursdottir, Sigrun, Palmadottir, Helga, Oskarsson, Jon Palmi, Olafsson, Oddur, Acterberg, Joseph, Blindheim-Rodal, Lillyanne, Hauge, Martin, Ytreland, Sven, Steen-Hansen, Jon Erik, Wilson, Thomas, Naess, Kristoffer, Kurland, Lisa, Malmquist, Pia, Forberg, Jakob Lundager, Djarv, Therese, Fuenzalida, Pablo Aguilera, Lara, Barbara, Zalut, Todd, Weiser, Giora, Strugo, Refael, Jaffe, Eli, Krispil, David, Schwartz, Dagan, Raitter, Ravit, Zimmerman, Deena, Tzadik, Efrat, Markowitz, Samuel, Wacht, Oren, Inagaki, Nobuhiro, Hanada, Hiroyuki, Takahoko, Ken-ichi, Negishi, Masatoshi, Matsushima, Hisao, Kano, Hideki, Koyama, Teppei, Takegami, Tetsuro, Yanagawa, Youichi, Harada, Masahiro, Yasuda, Mitsuhiro, Inaba, Kensuke, Sakamoto, Yuichiro, Yamashita, Hisashi, Honma, Masato, Tanabe, Seizan, Nachi, Sho, Nodagashira, Tatsuya, Matoh, Fumitaka, Takahashi, Tomohiro, Sode, Yoshihisa, Liu, Keibun, Yonekawa, Chikara, Inoue, Teruhiro, Sumi, Tatsunori, Kan'o, Tomomichi, Shoko, Tomohisa, Ishikura, Ken, Suzuki, Shuichi, Kishimoto, Masafumi, Katsuhara, Kazuhiro, Yumoto, Tetsuya, Nishimura, Tetsuro, Yamada, Tomoki, Otani, Takayuki, Yoshida, Kosuke, Nakamura, Motohiro, Uemura, Shuji, Umezawa, Kougaku, Nakamura, Shunsuke, Sugino, Takahiko, Tsunoyama, Taichiro, Endo, Tomoyuki, Nishida, Masamichi, Yagi, Masaharu, Fujita, Motoki, Arends, Jack, Buonadonna, Michael, Narikawa, Kenji, Sakamoto, Tetsuya, Callaway, Clifton, Goldberg, Scott, Wilcox, Susan, Gaieski, David, Sanko, Stephen, Kang, Tarina, HUS Emergency Medicine and Services, Staff Services, Clinicum, Department of Diagnostics and Therapeutics, University of Helsinki, Kimmo Kontula Research Group, Graduate School, ACS - Diabetes & metabolism, APH - Quality of Care, ACS - Heart failure & arrhythmias, ACS - Amsterdam Cardiovascular Sciences, Anesthesiology, and REAPPROPRIATE Study Grp

Subjects
Male, medicine.medical_specialty, Resuscitation, media_common.quotation_subject, medicine.medical_treatment, education, 030204 cardiovascular system & hematology, Out of hospital cardiac arrest, 03 medical and health sciences, 0302 clinical medicine, AGE, Older patients, Japan, Perception, Physicians, Hospital discharge, Medicine, Humans, Cardiopulmonary resuscitation, media_common, Resuscitation Orders, Aged, 80 and over, business.industry, OF-LIFE, HOSPITAL CARDIAC-ARREST, 030208 emergency & critical care medicine, CARE, inappropriate care, Cardiopulmonary Resuscitation, United States, 3. Good health, Nursing Homes, Europe, Cross-Sectional Studies, 3121 General medicine, internal medicine and other clinical medicine, Emergency medicine, SURVIVAL, Female, Human medicine, Geriatrics and Gerontology, adults 80 and older, business, Nursing homes, ETHICS, Out-of-Hospital Cardiac Arrest
Abstract

OBJECTIVES: To determine the prevalence of clinician perception of inappropriate cardiopulmonary resuscitation (CPR) regarding the last out‐of‐hospital cardiac arrest (OHCA) encountered in an adult 80 years or older and its relationship to patient outcome. DESIGN: Subanalysis of an international multicenter cross‐sectional survey (REAPPROPRIATE). SETTING: Out‐of‐hospital CPR attempts registered in Europe, Israel, Japan, and the United States in adults 80 years or older. PARTICIPANTS: A total of 611 clinicians of whom 176 (28.8%) were doctors, 123 (20.1%) were nurses, and 312 (51.1%) were emergency medical technicians/paramedics. RESULTS AND MEASUREMENTS: The last CPR attempt among patients 80 years or older was perceived as appropriate by 320 (52.4%) of the clinicians; 178 (29.1%) were uncertain about the appropriateness, and 113 (18.5%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the “appropriate” subgroup was 8 of 265 (3.0%), 1 of 164 (.6%) in the “uncertain” subgroup, and 2 of 107 (1.9%) in the “inappropriate” subgroup (P = .23); 503 of 564 (89.2%) CPR attempts involved non‐shockable rhythms. CPR attempts in nursing homes accounted for 124 of 590 (21.0%) of the patients and were perceived as appropriate by 44 (35.5%) of the clinicians; 45 (36.3%) were uncertain about the appropriateness; and 35 (28.2%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the nursing home patients was 0 of 107 (0%); 104 of 111 (93.7%) CPR attempts involved non‐shockable rhythms. Overall, 36 of 543 (6.6%) CPR attempts were undertaken despite a known written do not attempt resuscitation decision; 14 of 36 (38.9%) clinicians considered this appropriate, 9 of 36 (25.0%) were uncertain about its appropriateness, and 13 of 36 (36.1%) considered this inappropriate. CONCLUSION: Our findings show that despite generally poor outcomes for older patients undergoing CPR, many emergency clinicians do not consider these attempts at resuscitation to be inappropriate. A professional and societal debate is urgently needed to ensure that first we do not harm older patients by futile CPR attempts. J Am Geriatr Soc 68:39–45, 2019

Published
2019

71. Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan

Author

30724380, 10252230, 60437291, Okada, Yohei, Kiguchi, Takeyuki, Irisawa, Taro, Yoshiya, Kazuhisa, Yamada, Tomoki, Hayakawa, Koichi, Noguchi, Kazuo, Nishimura, Tetsuro, Ishibe, Takuya, Yagi, Yoshiki, Kishimoto, Masafumi, Shintani, Hiroshi, Hayashi, Yasuyuki, Sogabe, Taku, Morooka, Takaya, Sakamoto, Haruko, Suzuki, Keitaro, Nakamura, Fumiko, Nishioka, Norihiro, Matsuyama, Tasuku, Sado, Junya, Matsui, Satoshi, Shimazu, Takeshi, Koike, Kaoru, Kawamura, Takashi, Kitamura, Tetsuhisa, Iwami, Taku, the CRITICAL Study Group Investigators, 30724380, 10252230, 60437291, Okada, Yohei, Kiguchi, Takeyuki, Irisawa, Taro, Yoshiya, Kazuhisa, Yamada, Tomoki, Hayakawa, Koichi, Noguchi, Kazuo, Nishimura, Tetsuro, Ishibe, Takuya, Yagi, Yoshiki, Kishimoto, Masafumi, Shintani, Hiroshi, Hayashi, Yasuyuki, Sogabe, Taku, Morooka, Takaya, Sakamoto, Haruko, Suzuki, Keitaro, Nakamura, Fumiko, Nishioka, Norihiro, Matsuyama, Tasuku, Sado, Junya, Matsui, Satoshi, Shimazu, Takeshi, Koike, Kaoru, Kawamura, Takashi, Kitamura, Tetsuhisa, Iwami, Taku, and the CRITICAL Study Group Investigators

Abstract

Background: We aimed to identify the association of pH value in blood gas assessment with neurological outcome among out-of-hospital cardiac arrest (OHCA) patients treated by extracorporeal cardiopulmonary resuscitation (ECPR). Methods: We retrospectively analyzed the database of a multicenter prospective observational study on OHCA patients in Osaka prefecture, Japan (CRITICAL study), from July 1, 2012 to December 31, 2016. We included adult OHCA patients treated by ECPR. Patients with OHCA from external causes such as trauma were excluded. We conducted logistic regression analysis to identify the odds ratio (OR) and 95% confidence interval (CI) of the pH value for 1 month favorable neurological outcome adjusted for potential confounders including sex, age, witnessed by bystander, CPR by bystander, pre-hospital initial cardiac rhythm, and cardiac rhythm on hospital arrival. Results: Among the 9822 patients in the database, 260 patients were finally included in the analysis. The three groups were Tertile 1: pH ≥ 7.030, Tertile 2: pH 6.875–7.029, and Tertile 3: pH < 6.875. The adjusted OR of Tertiles 2 and 3 compared with Tertile 1 for 1 month favorable neurological outcome were 0.26 (95% CI 0.10–0.63) and 0.24 (95% CI 0.09–0.61), respectively. Conclusions: This multi-institutional observational study showed that low pH value (< 7.03) before the implementation of ECPR was associated with 1 month unfavorable neurological outcome among OHCA patients treated with ECPR. It may be helpful to consider the candidate for ECPR.

Published
2020

72. Poor long-term survival of out-of-hospital cardiac arrest in children a multicenter, prospective registry in osaka, japan

Author

Matsui, Satoshi, 1000050270674, Sobue, Tomotaka, 1000050379202, Irisawa, Taro, 1000040623434, Yamada, Tomoki, 1000060403086, Hayakawa, Koichi, 1000040379201, Yoshiya, Kazuhisa, Noguchi, Kazuo, Nishimura, Tetsuro, Ishibe, Takuya, Yagi, Yoshiki, 1000030724380, Kiguchi, Takeyuki, Kishimoto, Masafumi, Shintani, Hiroshi, Hayashi, Yasuyuki, Sogabe, Taku, Morooka, Takaya, Sakamoto, Haruko, Suzuki, Keitaro, Nakamura, Fumiko, Nishioka, Norihiro, Okada, Yohei, 1000050829025, Matsuyama, Tasuku, Sado, Junya, 1000050196474, Shimazu, Takeshi, Tanaka, Ryojiro, Kurosawa, Hiroshi, 1000060437291, Iwami, Taku, 1000030639810, 0000-0003-0107-0580, Kitamura, Tetsuhisa, Matsui, Satoshi, 1000050270674, Sobue, Tomotaka, 1000050379202, Irisawa, Taro, 1000040623434, Yamada, Tomoki, 1000060403086, Hayakawa, Koichi, 1000040379201, Yoshiya, Kazuhisa, Noguchi, Kazuo, Nishimura, Tetsuro, Ishibe, Takuya, Yagi, Yoshiki, 1000030724380, Kiguchi, Takeyuki, Kishimoto, Masafumi, Shintani, Hiroshi, Hayashi, Yasuyuki, Sogabe, Taku, Morooka, Takaya, Sakamoto, Haruko, Suzuki, Keitaro, Nakamura, Fumiko, Nishioka, Norihiro, Okada, Yohei, 1000050829025, Matsuyama, Tasuku, Sado, Junya, 1000050196474, Shimazu, Takeshi, Tanaka, Ryojiro, Kurosawa, Hiroshi, 1000060437291, Iwami, Taku, 1000030639810, 0000-0003-0107-0580, and Kitamura, Tetsuhisa

Abstract

The effect of post-cardiac arrest care in children with out-of-hospital cardiac arrest (OHCA) has not been adequately established, and the long-term outcome after pediatric OHCA has not been sufficiently investigated. We describe here detailed in-hospital characteristics, actual management, and survival, including neurological status, 90 days after OHCA occurrence in children with OHCA transported to critical care medical centers (CCMCs). We analyzed the database of the Comprehensive Registry of Intensive Care for OHCA Survival (CRITI-CAL) study, which is a multicenter, prospective observational data registry designed to accumulate both pre-and in-hospital data on OHCA treatments. We enrolled all consecutive pediatric patients aged <18 years who had an OHCA and for whom resuscitation was attempted and who were transported to CCMCs between 2012 and 2016. A total of 263 pediatric patients with OHCA were enrolled. The average age of the patients was 6.3 years, 38.0% were aged < 1 year, and 60.8% were male. After hospital arrival, 4.9% of these pediatric patients re-ceived defibrillation; 1.9%, extracorporeal life support; 6.5%, target temperature management; and 88.2% adrenaline administration. The proportions of patients with 90-day survival and a pediatric cerebral performance category (PCPC) score of 1 or 2 were 6.1% and 1.9%, respectively. The proportion of patients with a PCPC score of 1 or 2 at 90 days after OHCA occurrence did not significantly improve during the study period. The proportion of pediatric patients with a 90-day PCPC score of 1 or 2 transported to CCMCs was ex-tremely low, and no significant improvements were observed during the study period.

Published
2020

74. Clustering out‐of‐hospital cardiac arrest patients with non‐shockable rhythm by machine learning latent class analysis.

Author

Okada, Yohei, Komukai, Sho, Kitamura, Tetsuhisa, Kiguchi, Takeyuki, Irisawa, Taro, Yamada, Tomoki, Yoshiya, Kazuhisa, Park, Changhwi, Nishimura, Tetsuro, Ishibe, Takuya, Yagi, Yoshiki, Kishimoto, Masafumi, Inoue, Toshiya, Hayashi, Yasuyuki, Sogabe, Taku, Morooka, Takaya, Sakamoto, Haruko, Suzuki, Keitaro, Nakamura, Fumiko, and Matsuyama, Tasuku

Published
2022
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76. Association between pH and neurological outcome among cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan

Author

OKADA, YOHEI, primary, Kiguchi, Takeyuki, additional, Irisawa, Taro, additional, Yoshiya, Kazuhisa, additional, Yamada, Tomoki, additional, Hayakawa, Koichi, additional, Noguchi, Kazuo, additional, Nishimura, Tetsuro, additional, Ishibe, Takuya, additional, Yagi, Yoshiki, additional, Kishimoto, Masafumi, additional, Shintani, Hiroshi, additional, Hayashi, Yasuyuki, additional, Sogabe, Taku, additional, Morooka, Takaya, additional, Sakamoto, Haruko, additional, Suzuki, Keitaro, additional, Nakamura, Fumiko, additional, Nishioka, Norihiro, additional, Matsuyama, Tasuku, additional, Sado, Junya, additional, Matsui, Satoshi, additional, Shimazu, Takeshi, additional, Koike, Kaoru, additional, Kawamura, Takashi, additional, Kitamura, Tetsuhisa, additional, and Iwami, Taku, additional

Published
2020
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81. Characteristics of suicide attempters with family history of suicide attempt: a retrospective chart review

Author

Nakagawa Makiko, Kawanishi Chiaki, Yamada Tomoki, Iwamoto Yoko, Sato Ryoko, Hasegawa Hana, Morita Satoshi, Odawara Toshinari, and Hirayasu Yoshio

Subjects
Psychiatry, RC435-571
Abstract

Abstract Background Family history of suicide attempt is one of the risks of suicide. We aimed at exploring the characteristics of Japanese suicide attempters with and without a family history of suicide attempt. Methods Suicide attempters admitted to an urban emergency department from 2003 to 2008 were interviewed by two attending psychiatrists on items concerning family history of suicide attempt and other sociodemographic and clinical information. Subjects were divided into two groups based on the presence or absence of a family history of suicide attempt, and differences between the two groups were subsequently analyzed. Results Out of the 469 suicide attempters, 70 (14.9%) had a family history of suicide attempt. A significantly higher rate of suicide motive connected with family relations (odds ratio 2.21, confidence interval 1.18–4.17, p < .05) as well as a significantly higher rate of deliberate self-harm (odds ratio 2.51, confidence interval 1.38–4.57, p < .05) were observed in patients with a family history of suicide compared to those without such history. No significant differences were observed in other items investigated. Conclusion The present study has revealed the characteristics of suicide attempters with a family history of suicide attempt. Further understanding of the situation of such individuals is expected to lead to better treatment provision and outcomes, and family function might be a suitable focus in their treatment.

Published
2009
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82. Psychiatric assessment of suicide attempters in Japan: a pilot study at a critical emergency unit in an urban area

Author

Kishida Ikuko, Furuno Taku, Kato Daiji, Konishi Akiko, Sato Ryoko, Hasegawa Hana, Kawanishi Chiaki, Yamada Tomoki, Odawara Toshinari, Sugiyama Mitsugi, and Hirayasu Yoshio

Subjects
Psychiatry, RC435-571
Abstract

Abstract Background The incidence of suicide has increased markedly in Japan since 1998. As psychological autopsy is not generally accepted in Japan, surveys of suicide attempts, an established risk factor of suicide, are highly regarded. We have carried out this study to gain insight into the psychiatric aspects of those attempting suicide in Japan. Methods Three hundred and twenty consecutive cases of attempted suicide who were admitted to an urban emergency department were interviewed, with the focus on psychosocial background and DSM-IV diagnosis. Moreover, they were divided into two groups according to the method of attempted suicide in terms of lethality, and the two groups were compared. Results Ninety-five percent of patients received a psychiatric diagnosis: 81% of subjects met the criteria for an axis I disorder. The most frequent diagnosis was mood disorder. The mean age was higher and living alone more common in the high-lethality group. Middle-aged men tended to have a higher prevalence of mood disorders. Conclusion This is the first large-scale study of cases of attempted suicide since the dramatic increase in suicides began in Japan. The identification and introduction of treatments for psychiatric disorders at emergency departments has been indicated to be important in suicide prevention.

Published
2007
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83. Ultrasound Measurement of Septic Shock‐induced Acute Skeletal Muscle Atrophy in Intensive Care Unit.

Author

Tanaka, Kohei and Yamada, Tomoki

Subjects
MUSCULAR atrophy, INTENSIVE care units, SKELETAL muscle, ULTRASONIC imaging, RECTUS femoris muscles
Abstract

Background: Skeletal muscle wasting progresses rapidly during critical care. However, the effect of skeletal muscle changes on physical function during intensive care remain poorly understood. Objective: To examine the changes in skeletal muscle thickness of patients admitted to the intensive care unit (ICU) for septic shock and the relationship between skeletal muscle thickness and physical function following intensive care. Design: Longitudinal observational study. Setting: Single emergency hospital. Patients: Ten septic shock patients who were mechanically ventilated in the ICU were recruited. Interventions: Not applicable. Methods: Ultrasound measurements of thickness of rectus femoris (RF) were conducted within 24 hours after admission and repeated every two days until the 14th hospital day. The correlations between TRF and various parametric data (i.e., age, severity classification, mechanically ventilated period, length of stay (LOS) at the ICU, and physical function) correlations were assessed with Pearson's product moment coefficient of correlation. Main Outcome Measure(s): Curve estimation for best fit for chronological changes in TRF with respect to the HD and the correlation between TRF and clinical indicators. Results: Eight septic shock patients were observed completely for 14 days. TRF decreased linearly by 30.6% (IQR: 23.9‐45.7) during the first 14 days. The correlation between TRF at admission and physical function at the 30th hospital day was close to significant. The TRF at the 14th hospital day was negatively correlated with disease severity and age. A positive correlation was observed between the decrease in rate of TRF and LOS at the ICU. Conclusion: Skeletal muscle thickness of septic shock patients rapidly decreased in a linear manner over 14 days and may predict physical function after critical care. [ABSTRACT FROM AUTHOR]

Published
2021
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84. Association between serum lactate level during cardiopulmonary resuscitation and survival in adult out-of-hospital cardiac arrest: a multicenter cohort study.

Author

Nishioka, Norihiro, Kobayashi, Daisuke, Izawa, Junichi, Irisawa, Taro, Yamada, Tomoki, Yoshiya, Kazuhisa, Park, Changhwi, Nishimura, Tetsuro, Ishibe, Takuya, Yagi, Yoshiki, Kiguchi, Takeyuki, Kishimoto, Masafumi, Inoue, Toshiya, Hayashi, Yasuyuki, Sogabe, Taku, Morooka, Takaya, Sakamoto, Haruko, Suzuki, Keitaro, Nakamura, Fumiko, and Matsuyama, Tasuku

Subjects
SERUM, LACTATES, CARDIOPULMONARY resuscitation, CARDIAC arrest, BIOLOGICAL rhythms
Abstract

We aimed to investigate the association between serum lactate levels during cardiopulmonary resuscitation (CPR) and survival in patients with out-of-hospital cardiac arrest (OHCA). From the database of a multicenter registry on OHCA patients, we included adult nontraumatic OHCA patients transported to the hospital with ongoing CPR. Based on the serum lactate levels during CPR, the patients were divided into four quartiles: Q1 (≤ 10.6 mEq/L), Q2 (10.6–14.1 mEq/L), Q3 (14.1–18.0 mEq/L), and Q4 (> 18.0 mEq/L). The primary outcome was 1-month survival. Among 5226 eligible patients, the Q1 group had the highest 1-month survival (5.6% [74/1311]), followed by Q2 (3.6% [47/1316]), Q3 (1.7% [22/1292]), and Q4 (1.0% [13/1307]) groups. In the multivariable logistic regression analysis, the adjusted odds ratio of Q4 compared with Q1 for 1-month survival was 0.24 (95% CI 0.13–0.46). 1-month survival decreased in a stepwise manner as the quartiles increased (p for trend < 0.001). In subgroup analysis, there was an interaction between initial rhythm and survival (p for interaction < 0.001); 1-month survival of patients with a non-shockable rhythm decreased when the lactate levels increased (p for trend < 0.001), but not in patients with a shockable rhythm (p for trend = 0.72). In conclusion, high serum lactate level during CPR was associated with poor 1-month survival in OHCA patients, especially in patients with non-shockable rhythm. [ABSTRACT FROM AUTHOR]

Published
2021
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93. Impact of age on survival of patients with out‐of‐hospital cardiac arrest transported to tertiary emergency medical institutions in Osaka, Japan.

Author

Nakamura, Fumiko, Kajino, Kentaro, Kitamura, Tetsuhisa, Daya, Mohamud R, Ong, Marcus EH, Matsuyama, Tasuku, Yamada, Tomoki, Hayakawa, Koichi, Irisawa, Taro, Yoshiya, Kazuhisa, Noguchi, Kazuo, Nishimura, Tetsuro, Uejima, Toshifumi, Yagi, Yoshiki, Kiguchi, Takeyuki, Kishimoto, Masafumi, Matsuura, Makoto, Hayashi, Yasuyuki, Sogabe, Taku, and Morooka, Takaya

Subjects
AGE distribution, CARDIAC arrest, CONFIDENCE intervals, HOSPITAL emergency services, LONGITUDINAL method, MULTIVARIATE analysis, SCIENTIFIC observation, SURVIVAL, TERTIARY care, ODDS ratio
Abstract

Aim: The purpose of this study was to evaluate the out‐of‐hospital cardiac arrest (OHCA) characteristics of patients stratified by age who had resuscitation attempted and were transported to tertiary emergency medical institutions in Osaka Prefecture, Japan; especially those of advanced age. Methods: A prospective, population‐based, observational review was carried out of consecutive OHCA patients with emergency responder resuscitation attempts from July 2012 to December 2016 in Osaka, Japan. Patients were classified into four groups: (i) 18–64 years; (ii) 65–74 years; (iii) 75–84 years; and (iv) ≥85 years. Patient, event and treatment characteristics were examined for patients with presumed cardiac etiology of OHCA. The primary outcome was the 1‐month survival with a neurologically favorable outcome. Results: A total of 4636 patients with OHCA of presumed cardiac origin were transported to tertiary emergency medical institutions. The number of patients in the four groups was as follows: (i) 1290 (27.8%); (ii) 1102 (23.8%); (iii) 1420 (30.6%); and (iv) 824 (17.8%). The 1‐month survival with a neurologically favorable outcome was: (i) 207 (16.0%); (ii) 96 (8.7%); (iii) 60 (4.2%); and (iv) seven (0.85%). In a multivariate analysis for 1‐month survival with a neurologically favorable outcome, increased age was a significant prognostic factor (≥85 years; adjusted odds ratio 0.08, 95% confidence interval 0.03–0.23) for poor outcomes. Conclusions: In this population, advanced age (≥85 years) was strongly associated with poor outcomes. Further discussion of policies directed at resuscitation of very elderly OHCA patients is required, considering limited medical resources and the rapidly aging population in Japan. Geriatr Gerontol Int 2019; 19: 1088–1095. [ABSTRACT FROM AUTHOR]

Published
2019
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94. Structural and thermodynamic analyses reveal critical features of glycopeptide recognition by the human PILR alpha immune cell receptor

Author

Furukawa, Atsushi, Kakita, Kosuke, Yamada, Tomoki, Ishizuka, Mikihiro, Sakamoto, Jiro, Hatori, Nanao, Maeda, Naoyoshi, Ohsaka, Fumina, Saitoh, Takashi, Nomura, Takao, Kuroki, Kimiko, Nambu, Hisanori, Arase, Hisashi, Matsunaga, Shigeki, Anada, Masahiro, Ose, Toyoyuki, Hashimoto, Shunichi, Maenaka, Katsumi, Furukawa, Atsushi, Kakita, Kosuke, Yamada, Tomoki, Ishizuka, Mikihiro, Sakamoto, Jiro, Hatori, Nanao, Maeda, Naoyoshi, Ohsaka, Fumina, Saitoh, Takashi, Nomura, Takao, Kuroki, Kimiko, Nambu, Hisanori, Arase, Hisashi, Matsunaga, Shigeki, Anada, Masahiro, Ose, Toyoyuki, Hashimoto, Shunichi, and Maenaka, Katsumi

Abstract

Before entering host cells, herpes simplex virus-1 uses its envelope glycoprotein B to bind paired immunoglobulin-like type 2 receptor alpha (PILR alpha) on immune cells. PILR alpha belongs to the Siglec (sialic acid (SA)-binding immunoglobulin-like lectin)- like family, members of which bind SA. PILR alpha is the only Siglec member to recognize not only the sialylated O-linked sugar T antigen (sTn) but also its attached peptide region. We previously determined the crystal structure of PILR alpha complexed with the sTn-linked glycopeptide of glycoprotein B, revealing the simultaneous recognition of sTn and peptide by the receptor. However, the contribution of each glycopeptide component to PILR alpha binding was largely unclear. Here, we chemically synthesized glycopeptide derivatives and determined the thermodynamic parameters of their interaction with PILR alpha. We show that glycopeptides with different sugar units linking SA and peptides (i.e. "GlcNAc-type" and "deoxy-GlcNAc-type" glycopeptides) have lower affinity and more enthalpy-driven binding than the wild type (i.e. GalNAc-type glycopeptide). The crystal structures of PILR alpha complexed with these glycopeptides highlighted the importance of stereochemical positioning of the O4 atom of the sugar moiety. These results provide insights both for understanding the unique O-glycosylated peptide recognition by the PILR alpha and for the rational design of herpes simplex virus-1 entry inhibitors.

Published
2017

96. Rationale, design, and profile of Comprehensive Registry of In-Hospital Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan.

Author

30724380, 10252230, 60437291, Yamada, Tomoki, Kitamura, Tetsuhisa, Hayakawa, Koichi, Yoshiya, Kazuhisa, Irisawa, Taro, Abe, Yoshio, Ishiro, Megumi, Uejima, Toshifumi, Ohishi, Yasuo, Kaneda, Kazuhisa, Kiguchi, Takeyuki, Kishi, Masashi, Kishimoto, Masafumi, Nakao, Shota, Nishimura, Tetsuro, Hayashi, Yasuyuki, Morooka, Takaya, Izawa, Junichi, Shimamoto, Tomonari, Hatakeyama, Toshihiro, Matsuyama, Tasuku, Kawamura, Takashi, Shimazu, Takeshi, Iwami, Taku, 30724380, 10252230, 60437291, Yamada, Tomoki, Kitamura, Tetsuhisa, Hayakawa, Koichi, Yoshiya, Kazuhisa, Irisawa, Taro, Abe, Yoshio, Ishiro, Megumi, Uejima, Toshifumi, Ohishi, Yasuo, Kaneda, Kazuhisa, Kiguchi, Takeyuki, Kishi, Masashi, Kishimoto, Masafumi, Nakao, Shota, Nishimura, Tetsuro, Hayashi, Yasuyuki, Morooka, Takaya, Izawa, Junichi, Shimamoto, Tomonari, Hatakeyama, Toshihiro, Matsuyama, Tasuku, Kawamura, Takashi, Shimazu, Takeshi, and Iwami, Taku

Abstract

[Background] We established a multi-center, prospective cohort that could provide appropriate therapeutic strategies such as criteria for the introduction and the effectiveness of in-hospital advanced treatments, including percutaneous coronary intervention (PCI), target temperature management, and extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) patients. [Methods] In Osaka Prefecture, Japan, we registered all consecutive patients who were suffering from an OHCA for whom resuscitation was attempted and who were then transported to institutions participating in this registry since July 1, 2012. A total of 11 critical care medical centers and one hospital with an emergency care department participated in this registry. The primary outcome was neurological status after OHCA, defined as cerebral performance category (CPC) scale. [Results] A total of 688 OHCA patients were documented between July 2012 and December 2012. Of them, 657 were eligible for our analysis. Patients’ average age was 66.2 years old, and male patients accounted for 66.2 %. The proportion of OHCAs having a cardiac origin was 50.4 %. The proportion as first documented rhythm of ventricular fibrillation/pulseless ventricular tachycardia was 11.6 %, pulseless electrical activity 23.4 %, and asystole 54.5 %. After hospital arrival, 10.5 % received defibrillation, 90.8 % tracheal intubation, 3.0 % ECPR, 3.5 % PCI, and 83.1 % adrenaline administration. The proportions of 90-day survival and CPC 1/2 at 90 days after OHCAs were 5.9 and 3.0 %, respectively. [Conclusions] The Comprehensive Registry of In-hospital Intensive Care for OHCA Survival (CRITICAL) study will enroll over 2000 OHCA patients every year. It is still ongoing without a set termination date in order to provide valuable information regarding appropriate therapeutic strategies for OHCA patients (UMIN000007528).

Published
2016

97. Rationale, design, and profile of Comprehensive Registry of In-Hospital Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan

Author

1000040623434, Yamada, Tomoki, 1000030639810, Kitamura, Tetsuhisa, 1000060403086, Hayakawa, Koichi, 1000040379201, Yoshiya, Kazuhisa, 1000050379202, Irisawa, Taro, Abe, Yoshio, Ishiro, Megumi, Uejima, Toshifumi, Ohishi, Yasuo, Kaneda, Kazuhisa, 1000030724380, Kiguchi, Takeyuki, Kishi, Masashi, Kishimoto, Masafumi, Nakao, Shota, Nishimura, Tetsuro, Hayashi, Yasuyuki, Morooka, Takaya, Izawa, Junichi, 1000010828411, Shimamoto, Tomonari, Hatakeyama, Toshihiro, 1000050829025, Matsuyama, Tasuku, 1000010252230, Kawamura, Takashi, 1000050196474, Shimazu, Takeshi, 1000060437291, Iwami, Taku, 1000040623434, Yamada, Tomoki, 1000030639810, Kitamura, Tetsuhisa, 1000060403086, Hayakawa, Koichi, 1000040379201, Yoshiya, Kazuhisa, 1000050379202, Irisawa, Taro, Abe, Yoshio, Ishiro, Megumi, Uejima, Toshifumi, Ohishi, Yasuo, Kaneda, Kazuhisa, 1000030724380, Kiguchi, Takeyuki, Kishi, Masashi, Kishimoto, Masafumi, Nakao, Shota, Nishimura, Tetsuro, Hayashi, Yasuyuki, Morooka, Takaya, Izawa, Junichi, 1000010828411, Shimamoto, Tomonari, Hatakeyama, Toshihiro, 1000050829025, Matsuyama, Tasuku, 1000010252230, Kawamura, Takashi, 1000050196474, Shimazu, Takeshi, 1000060437291, and Iwami, Taku

Abstract

Yamada, T., Kitamura, T., Hayakawa, K. et al. Rationale, design, and profile of Comprehensive Registry of In-Hospital Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan. j intensive care 4, 10 (2016). https://doi.org/10.1186/s40560-016-0128-5, Background: We established a multi-center, prospective cohort that could provide appropriate therapeutic strategies such as criteria for the introduction and the effectiveness of in-hospital advanced treatments, including percutaneous coronary intervention (PCI), target temperature management, and extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) patients. Methods: In Osaka Prefecture, Japan, we registered all consecutive patients who were suffering from an OHCA for whom resuscitation was attempted and who were then transported to institutions participating in this registry since July 1, 2012. A total of 11 critical care medical centers and one hospital with an emergency care department participated in this registry. The primary outcome was neurological status after OHCA, defined as cerebral performance category (CPC) scale. Results: A total of 688 OHCA patients were documented between July 2012 and December 2012. Of them, 657 were eligible for our analysis. Patients' average age was 66.2 years old, and male patients accounted for 66.2 %. The proportion of OHCAs having a cardiac origin was 50.4 %. The proportion as first documented rhythm of ventricular fibrillation/pulseless ventricular tachycardia was 11.6 %, pulseless electrical activity 23.4 %, and asystole 54.5 %. After hospital arrival, 10.5 % received defibrillation, 90.8 % tracheal intubation, 3.0 % ECPR, 3.5 % PCI, and 83.1 % adrenaline administration. The proportions of 90-day survival and CPC 1/2 at 90 days after OHCAs were 5.9 and 3.0 %, respectively. Conclusions: The Comprehensive Registry of In-hospital Intensive Care for OHCA Survival (CRITICAL) study will enroll over 2000 OHCA patients every year. It is still ongoing without a set termination date in order to provide valuable information regarding appropriate therapeutic strategies for OHCA patients (UMIN000007528).

Published
2016

100. Effect of Histone Acetylation on N-Methyl-D-Aspartate 2B Receptor Subunits and Interleukin-1 Receptors in Association with Nociception-Related Somatosensory Cortex Dysfunction in a Mouse Model of Sepsis

Author

Imamura, Yukio, primary, Yoshikawa, Nao, additional, Murkami, Yuki, additional, Mitani, Satoko, additional, Matsumoto, Naoya, additional, Matsumoto, Hisatake, additional, Yamada, Tomoki, additional, Yamakawa, Kazuma, additional, Nakagawa, Junichiro, additional, Ogura, Hiroshi, additional, Shimazu, Takeshi, additional, and Jin, Takashi, additional

Published
2016
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