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25. ARDS clinical practice guideline 2021

Author

Nakashima, Takuro, Masunaga, Aiko, Tanaka, Aiko, Inoue, Akihiko, Higashi, Akiko, Tanikawa, Atsushi, Ujiro, Atsushi, Takayama, Chihiro, Kasugai, Daisuke, Kawakami, Daisuke, Ueno, Daisuke, Satoh, Daizoh, Kai, Shinichi, Ota, Kohei, Hagiwara, Yoshihiro, Hamaguchi, Jun, Fujii, Ryo, Hongo, Takashi, Kishihara, Yuki, Masunaga, Naohisa, Yamamoto, Ryohei, Okazaki, Satoru Robert, Uchimido, Ryo, Terayama, Tetsuro, Hokari, Satoshi, Sakamoto, Hitoshi, Dongli, Nakataki, Emiko, Tabata, Erina, Okazawa, Seisuke, Kotajima, Futoshi, Ishimaru, Go, Hoshino, Haruhiko, Yoshida, Hideki, Iwai, Hidetaka, Nakagawa, Hiroaki, Sugimura, Hiroko, Narumiya, Hiromichi, Okano, Hiromu, Nakamura, Hiroshi, Sugimoto, Hiroshi, Hashimoto, Hiroyuki, Ito, Hiroyuki, Dote, Hisashi, Imahase, Hisashi, Sato, Hitoshi, Katsurada, Masahiro, Osawa, Ichiro, Kamei, Jun, Maki, Jun, Sugihara, Jun, Takeshita, Jun, Fujimoto, Junichi, Ishikawa, Junichi, Kosaka, Junko, Shibata, Junpei, Hashimoto, Katsuhiko, Nakano, Yasushi, Kikuyama, Kazuki, Shimizu, Kazushige, Okada, Kazuya, Kawano, Keishi, Anan, Keisuke, Ota, Keisuke, Kano, Ken-ichi, Asano, Kengo, Hondo, Kenichi, Ishii, Kenji, Fujita, Kensuke, Ogawa, Kenta, Ito, Kentaro, Tokunaga, Kentaro, Ishii, Kenzo, Kusumoto, Kohei, Takimoto, Kohei, Yamada, Kohei, Naito, Koichi, Yamashita, Koichi, Yoshinaga, Koichi, Yamauchi, Kota, Murata, Maki, Konda, Makiko, Hamamoto, Manabu, Aga, Masaharu, Kashiura, Masahiro, Ishikawa, Masami, Ozaki, Masayuki, Kono, Michihiko, Kyo, Michihito, Hayashi, Minoru, Abe, Mitsuhiro, Sato, Mitsunori, Sakai, Mizu, Kainuma, Motoshi, Tominaga, Naoki, Iguchi, Naoya, Nakagawa, Natsuki, Aoki, Nobumasa, Nishioka, Norihiro, Miyashita, Norihisa, Seki, Nozomu, Ikebe, Ryo, Imai, Ryosuke, Tate, Ryota, Sato, Ryuhei, Miyakawa, Sachiko, Kazuma, Satoshi, Nakano, Satoshi, Tetsumoto, Satoshi, Yoshimura, Satoshi, Yoshitake, Shigenori, Hoshi, Shin-etsu, Ohki, Shingo, Sato, Shintaro, Yoshihiro, Shodai, Ihara, Shoichi, Yamamoto, Shota, Koide, Shunichi, Kimata, Shunsuke, Saito, Shunsuke, Yasuo, Shunsuke, Sekine, Shusuke, Mimuro, Soichiro, Wada, Soichiro, Sugimura, Sosuke, Ishihara, Tadashi, Kaneko, Tadashi, Nagato, Tadashi, Maruhashi, Takaaki, Tamura, Takahiro, Ohno, Takanori, Ichiyama, Takashi, Niwa, Takashi, Ueji, Takashi, Ogura, Takayuki, Kawasaki, Takeshi, Tanaka, Takeshi, Umegaki, Takeshi, Furukawa, Taku, Omura, Taku, Nagao, Takumi, Mayumi, Takuya, Taniguchi, Takuya, Yoshida, Takuya, Shimatani, Tatsutoshi, Murata, Teppei, Sato, Tetsuya, Sawamoto, Tohru, Koukei, Yoshifumi, Takehara, Tomohiro, Ueda, Tomomi, Katsuta, Tomoya, Nishino, Tomoya, Yokoyama, Toshiki, Higashijima, Ushio, Iwanaga, Wataru, Inoue, Yasushi, Iwashita, Yoshiaki, Yamada, Yoshie, Kubota, Yoshifumi, Suido, Yoshihiro, Tomioka, Yoshihiro, Fujimoto, Yoshihisa, Fujita, Yoshihito, Yamaguchi, Yoshikazu, Nakamura, Yoshimi, Abe, Yoshinobu, Eguchi, Yoshitomo, Oshima, Yoshiyasu, Fukuda, Yosuke, Iwasaki, Yudai, Yasufuku, Yuichi, Shono, Yuji, Nakatani, Yuka, Nakamori, Yuki, Ito, Yukie, Tanabe, Yuko, Nagamine, Yusuke, Nakamura, Yuta, Kurihara, Yutaro, Tasaka, Sadatomo, Ohshimo, Shinichiro, Takeuchi, Muneyuki, Yasuda, Hideto, Ichikado, Kazuya, Tsushima, Kenji, Egi, Moritoki, Hashimoto, Satoru, Shime, Nobuaki, Saito, Osamu, Matsumoto, Shotaro, Nango, Eishu, Okada, Yohei, Hayashi, Kenichiro, Sakuraya, Masaaki, Nakajima, Mikio, Okamori, Satoshi, Miura, Shinya, Fukuda, Tatsuma, Kamo, Tetsuro, Yatabe, Tomoaki, Norisue, Yasuhiro, Aoki, Yoshitaka, Iizuka, Yusuke, Kondo, Yutaka, Narita, Chihiro, Taito, Shunsuke, Hayashi, Takuya, Terayama, Takero, Kataoka, Jun, Nishimura, Tetsuro, Yonekura, Hiroshi, Ando, Koichi, Yoshida, Takuo, Masuyama, Tomoyuki, and Sanui, Masamitsu

Published
2022
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27. Steroid treatment in patients with acute respiratory distress syndrome: a systematic review and network meta-analysis

Author

Yoshihiro, Shodai, Hongo, Takashi, Ohki, Shingo, Kaneko, Tadashi, Ishikawa, Junichi, Ihara, Shoichi, and Taito, Shunsuke

Subjects
Methylprednisolone -- Comparative analysis -- Health aspects, Medical research -- Comparative analysis -- Health aspects, Medicine, Experimental -- Comparative analysis -- Health aspects, Steroids -- Health aspects -- Comparative analysis, Respiratory distress syndrome -- Care and treatment, Mortality -- Japan -- United Kingdom -- Canada, Dexamethasone -- Comparative analysis -- Health aspects, Acute respiratory distress syndrome -- Care and treatment, Health
Abstract

Purpose Although the most recent systematic review and meta-analyses on acute respiratory distress syndrome (ARDS) have shown that the use of steroids decreases mortality in adult patients, its benefits and risks may differ depending on the type and dosage of the steroid. Therefore, we conducted a network meta-analysis (NMA) to compare the differences in the efficacy among different doses and types of steroids. Methods We searched MEDLINE, CENTRAL, ICHUSHI, ClinicalTrials.gov, and WHO ICTRP databases from the earliest records to March 2021 for randomized control trials, which compared steroids with placebo or conventional therapy for ARDS. Using the random-effects model, we compared various categories of steroids (high-dose methylprednisolone, low-dose methylprednisolone, hydrocortisone, dexamethasone, and no steroid) concerning hospital mortality, incidence of infection, and ventilator-free days (VFD). Results We analyzed nine studies involving adult patients (n = 1212). Although there were no significant differences between the groups in terms of the mortality and incidence of infection, the number of VFD were greater when using low-dose methylprednisolone than when not using any steroids (Mean difference: 6.06; 95% confidence intervals: [2.5, 10.5]). Moreover, the rank probability showed that low-dose methylprednisolone might be the optimal treatment, whereas using no steroid or high-dose methylprednisolone may be inferior to other treatments in terms of mortality, infection, and VFD. Conclusion This NMA suggested that the effect of steroids on the outcome in patients with ARDS might depend on the type of the steroid drug administered. Moreover, further studies are needed to identify the optimal type and dosage., Author(s): Shodai Yoshihiro [sup.1], Takashi Hongo [sup.2], Shingo Ohki [sup.3], Tadashi Kaneko [sup.4], Junichi Ishikawa [sup.5], Shoichi Ihara [sup.6], Shunsuke Taito [sup.7], Masahiko Sakaguchi [sup.8], Tomoaki Yatabe [sup.9] Author Affiliations: [...]

Published
2022
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32. Evolution and Effects of Ad Hoc Multidisciplinary Team Meetings in the Emergency Intensive Care Unit: A Five-Year Analysis.

Author

Yumoto, Tetsuya, Hongo, Takashi, Obara, Takafumi, Ageta, Kohei, Aokage, Toshiyuki, Tsukahara, Kohei, Nakao, Atsunori, and Naito, Hiromichi

Subjects
*HEALTH care teams, *MULTIPLE regression analysis, *EMERGENCY nurses, *TIME complexity, *LOGISTIC regression analysis, *EMERGENCY nursing
Abstract

Background: Multidisciplinary team meetings (MDTMs) are crucial in the ICU. However, daily rounds may not address all sensitive issues due to time constraints and the complexity of cases. This study aimed to describe detailed information and characteristics of ad hoc MDTMs in the ICU. Methods: This single-center, retrospective study analyzed adult emergency ICU admissions at Okayama University Hospital from 1 January 2019 to 31 December 2023. During this period, weekly regular multidisciplinary team ICU rounds were introduced in June 2020, and regular weekday morning MDTMs began in April 2022. A multiple logistic regression analysis was applied to determine the impact of these changes on the frequency of ad hoc MDTMs, adjusting for variables including annual changes. Results: The study analyzed 2487 adult EICU patients, with a median age of 66, and 63.3% of them male. MDTMs were held for 168 patients (6.8%), typically those with severe conditions, including higher COVID-19 prevalence and APACHE II scores, and longer ICU stays. Despite a constant total number of MDTMs, the likelihood of conducting ad hoc MDTMs increased annually (adjusted OR 1.19; 95% CI, 1.04–1.35). Of the 329 MDTMs conducted for these patients, 59.0% addressed end-of-life care, involving an average of 11 participants, mainly nurses and emergency and critical-care physicians. Conclusions: Changes in ICU round and meeting structures might be associated with a higher frequency of conducting ad hoc MDTMs, highlighting their evolving role and importance in patient care management. [ABSTRACT FROM AUTHOR]

Published
2024
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38. Collapse-related traumatic intracranial hemorrhage following out-of-hospital cardiac arrest: A multicenter retrospective cohort study

Author

Inoue, Fumiya, primary, Hongo, Takashi, additional, Ichiba, Toshihisa, additional, Otani, Takayuki, additional, Naito, Hiroshi, additional, Kosaki, Yoshinori, additional, Murakami, Yuya, additional, Iida, Atsuyoshi, additional, Yumoto, Tetsuya, additional, Naito, Hiromichi, additional, and Nakao, Atsunori, additional

Published
2023
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40. Successfully treated case of severe hypothermia secondary to myxedema coma

Author

Yamamoto, Hirotsugu, Hongo, Takashi, Nojima, Tsuyoshi, Obara, Takafumi, Kosaki, Yoshinori, Ageta, Kohei, Tsukahara, Kohei, Yumoto, Tetsuya, Nakao, Atsunori, Naito, Hiromichi, Yamamoto, Hirotsugu, Hongo, Takashi, Nojima, Tsuyoshi, Obara, Takafumi, Kosaki, Yoshinori, Ageta, Kohei, Tsukahara, Kohei, Yumoto, Tetsuya, Nakao, Atsunori, and Naito, Hiromichi

Abstract

Background: Myxedema coma is an extremely rare but fatal endocrine emergency that requires urgent recognition and treatment. We describe a case of severe hypothermia that rapidly deteriorated to cardiac arrest that was attributed to myxedema coma. Case Presentation: A 52-year-old man without a history of hypothyroidism was transferred to our emergency department due to coma and profound hypothermia. The patient developed cardiac arrest immediately after hospital arrival but return of spontaneous circulation was achieved shortly after resuscitation. The patient was noted to have generalized, nonpitting edema, dry skin, severe respiratory acidosis, hyponatremia, and elevated creatinine kinase, which was indicative of hypothyroidism. Myxedema coma was confirmed by a thyroid profile. The patient was successfully treated with intravenous levothyroxine and glucocorticoid. Conclusion: Although myxedema coma is a rare cause of severe hypothermia, emergency physicians should be familiar with its clinical features and management.

Published
2023

41. Association between prehospital advanced life support by emergency medical services personnel and neurological outcomes among adult out-of-hospital cardiac arrest patients treated with extracorporeal cardiopulmonary resuscitation: A secondary analysis of the SAVE-J II study

Author

Yumoto, Tetsuya, Hongo, Takashi, Hifumi, Toru, Inoue, Akihiko, Sakamoto, Tetsuya, Kuroda, Yasuhiro, Yorifuji, Takashi, Nakao, Atsunori, Naito, Hiromichi, SAVE-J II study group, Yumoto, Tetsuya, Hongo, Takashi, Hifumi, Toru, Inoue, Akihiko, Sakamoto, Tetsuya, Kuroda, Yasuhiro, Yorifuji, Takashi, Nakao, Atsunori, Naito, Hiromichi, and SAVE-J II study group

Abstract

Study Objective: Early deployment of extracorporeal cardiopulmonary resuscitation (ECPR) is critical in treating refractory out-of-hospital cardiac arrest (OHCA) patients who are potential candidates for ECPR. The effect of prehospital advanced life support (ALS), including epinephrine administration or advanced airway, compared with no ALS in this setting remains unclear. This study's objective was to determine the association between any prehospital ALS care and outcomes of patients who received ECPR with emergency medical services-treated OHCA. Methods: This was a secondary analysis of data from the Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J) II study. Patients were separated into 2 groups-those who received prehospital ALS (ALS group) and those did not receive prehospital ALS (no ALS group). Multiple logistic regression analysis was used to investigate the association between prehospital ALS and favorable neurological outcomes (defined as Cerebral Performance Category scores 1-2) at hospital discharge. Results: A total of 1289 patients were included, with 644 patients in the ALS group and 645 patients in the no ALS group. There were fewer favorable neurological outcomes at hospital discharge in the ALS group compared with the no ALS group (10.4 vs 19.8%, p <0.001). A multiple logistic regression analysis revealed that any prehospital ALS care (adjusted odds ratios 0.47; 95% confidence interval 0.34-0.66; p <0.001) was associated with unfavorable neurological outcomes at hospital discharge. Conclusion: Prehospital ALS was associated with worse neurological outcomes at hospital discharge in patients treated with ECPR for OHCA. Further prospective studies are required to determine the clinical implications of these findings.

Published
2023

44. Heat stroke management during the COVID‐19 pandemic: Recommendations from the experts in Japan (2nd edition)

Author

Kanda, Jun, primary, Wakasugi, Masahiro, additional, Kondo, Yutaka, additional, Ueno, Satoru, additional, Kaneko, Hitoshi, additional, Okada, Yohei, additional, Okano, Yuichi, additional, Kishihara, Yuki, additional, Hamaguchi, Jun, additional, Ishihara, Tadashi, additional, Igarashi, Yutaka, additional, Nakae, Ryuta, additional, Miyamoto, Sohma, additional, Yamada, Eri, additional, Ikechi, Daisuke, additional, Yamazaki, Maiko, additional, Tanaka, Daiki, additional, Sawada, Yusuke, additional, Suda, Chiaki, additional, Yoshimura, Satoshi, additional, Onodera, Ryuta, additional, Kano, Kenichi, additional, Hongo, Takashi, additional, Endo, Kaori, additional, Iwasaki, Yohei, additional, Kodaira, Hiroshi, additional, Yasuo, Shunsuke, additional, Seki, Nozomu, additional, Okuda, Hiroshi, additional, Nakajima, Satoshi, additional, Nagato, Tadashi, additional, Terazumi, Keiko, additional, Nakamura, Satoshi, additional, and Yokobori, Shoji, additional

Published
2023
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49. A hyperechoic mass in femoral vein

Author

Kaku, Naoko, primary, Sugiyama, Hiroki, additional, Nakamura, Kazufumi, additional, Furutani, Tomoki, additional, Hongo, Takashi, additional, and Ito, Hiroshi, additional

Published
2022
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