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48 results on '"Kawano, Takahisa"'

10. Relationship Between Duration of Targeted Temperature Management, Ischemic Interval, and Good Functional Outcome From Out-of-Hospital Cardiac Arrest

Author

Sawyer, Kelly N., Humbert, Andrew, Leroux, Brian G., Nichol, Graham, Kudenchuk, Peter J., Daya, Mohamud R., Grunau, Brian, Wang, Henry E., Ornato, Joseph P., Rittenberger, Jon C., Aufderheide, Tom P., Wittwer, Lynn, Colella, M. Riccardo, Austin, Michael, Kawano, Takahisa, Egan, Debra, Richmond, Neal, Vithalani, Veer D., Scales, Damon, Baker, Andrew J., Morrison, Laurie J., Vilke, Gary M., and Kurz, Michael C.

Published
2020
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12. Abstract 18118: Hypothermic to Ischemic Ratio as a Predictor of Good Functional Outcome From Out-of-Hospital Cardiac Arrest in the Resuscitation Outcomes Consortium Amiodarone Lidocaine or Placebo Study

Author

Sawyer, Kelly N, Humbert, Andrew, Leroux, Brian G, Nichol, Graham, Kudenchuck, Peter J, Daya, Mohamud R, Grunau, Brian, Wang, Henry E, Ornato, Joseph P, Rittenberger, Jon C, Aufderheide, Tom P, Wittwer, Lynn, Colella, M Riccardo, Austin, Michael, Kawano, Takahisa, Egan, Debra, Richmond, Neal, Vithalani, Veer D, Scales, Damon, Baker, Andrew J, Morrison, Laurie J, and Kurz, Michael C

Published
2017

16. Emergency medical services employing intra-arrest transport less frequently for out-of-hospital cardiac arrest have higher survival and favorable neurological outcomes

Author

Grunau, Brian, primary, Kawano, Takahisa, additional, Rea, Thomas D., additional, Okubo, Masashi, additional, Scheuermeyer, Frank X., additional, Reynolds, Joshua C., additional, Heidet, Matthieu, additional, Drennan, Ian R., additional, Cheskes, Sheldon, additional, Fordyce, Christopher B., additional, Twaites, Brian, additional, and Christenson, Jim, additional

Published
2021
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20. Abstract 290: The Association of Regional Intra-arrest Transport Practices for Out-of-hospital Cardiac Arrest with Survival and Neurological Status at Hospital Discharge

Author

Grunau, Brian E, primary, Kawano, Takahisa, additional, Okubo, Masashi, additional, Reynolds, Joshua, additional, Heidet, Matthieu, additional, Scheuermeyer, Frank, additional, Cheskes, Sheldon, additional, Fordyce, Chris, additional, Drennan, Ian R, additional, Twaites, Brian J, additional, and Christenson, Jim, additional

Published
2020
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23. Public access defibrillators: Gender-based inequities in access and application

Author

Grunau, Brian, primary, Humphries, Karin, additional, Stenstrom, Robert, additional, Pennington, Sarah, additional, Scheuermeyer, Frank, additional, van Diepen, Sean, additional, Awad, Emad, additional, Al Assil, Rahaf, additional, Kawano, Takahisa, additional, Brooks, Steven, additional, Gu, Bobby, additional, and Christenson, Jim, additional

Published
2020
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28. A comprehensive validation of very early rule-out strategies for non-ST-segment elevation myocardial infarction in emergency departments: protocol for a multicentre prospective cohort study

Author

60437291, Tada, Masafumi, Azuma, Hiroyuki, Yamada, Naoki, Kano, Ken-ichi, Nagai, Hideya, Maeda, Shigenobu, Ishida, Hiroshi, Aoyama, Takahiko, Okada, Ryota, Kawano, Takahisa, Kobuchi, Taketsune, Uzui, Hiroyasu, Matano, Hideyuki, Iwasaki, Hose, Maeno, Koji, Shimada, Yoshimitsu, Yoshida, Hiroyuki, Ando, Masaki, Murakami, Yoshimasa, Iwakami, Naotsugu, Kishimoto, Sanae, Iwami, Taku, Tada, Hiroshi, Chapman, Andrew, Mills, Nicholas, Hayashi, Hiroyuki, Furukawa, Toshi A, Watanabe, Norio, 60437291, Tada, Masafumi, Azuma, Hiroyuki, Yamada, Naoki, Kano, Ken-ichi, Nagai, Hideya, Maeda, Shigenobu, Ishida, Hiroshi, Aoyama, Takahiko, Okada, Ryota, Kawano, Takahisa, Kobuchi, Taketsune, Uzui, Hiroyasu, Matano, Hideyuki, Iwasaki, Hose, Maeno, Koji, Shimada, Yoshimitsu, Yoshida, Hiroyuki, Ando, Masaki, Murakami, Yoshimasa, Iwakami, Naotsugu, Kishimoto, Sanae, Iwami, Taku, Tada, Hiroshi, Chapman, Andrew, Mills, Nicholas, Hayashi, Hiroyuki, Furukawa, Toshi A, and Watanabe, Norio

Abstract

Introduction: Recent advances in troponin sensitivity enabled early and accurate judgement of ruling-out myocardial infarction, especially non-ST elevation myocardial infarction (NSTEMI) in emergency departments (EDs) with development of various prediction-rules and high-sensitive-troponin-based strategies (hs-troponin). Reliance on clinical impression, however, is still common, and it remains unknown which of these strategies is superior. Therefore, our objective in this prospective cohort study is to comprehensively validate the diagnostic accuracy of clinical impression-based strategies, prediction-rules and hs-troponin-based strategies for ruling-out NSTEMIs. Methods and analysis: In total, 1500 consecutive adult patients with symptoms suggestive of acute coronary syndrome will be prospectively recruited from five EDs in two tertiary-level, two secondary-level community hospitals and one university hospital in Japan. The study has begun in July 2018, and recruitment period will be about 1 year. A board-certified emergency physician will complete standardised case report forms, and independently perform a clinical impression-based risk estimation of NSTEMI. Index strategies to be compared will include the clinical impression-based strategy; prediction rules and hs-troponin-based strategies for the following types of troponin (Roche Elecsys hs-troponin T; Abbott ARCHITECT hs-troponin I; Siemens ADVIA Centaur hs-troponin I; Siemens ADVIA Centaur sensitive-troponin I). The reference standard will be the composite of type 1 MI and cardiac death within 30 days after admission to the ED. Outcome measures will be negative predictive value, sensitivity and effectiveness, defined as the proportion of patients categorised as low risk for NSTEMI. We will also evaluate inter-rater reliability of the clinical impression-based risk estimation. Ethics and dissemination: The study is approved by the Ethics Committees of the Kyoto University Graduate School and Faculty of Medicin

Published
2019

29. In reply

Author

Kawano, Takahisa, primary, Grunau, Brian, additional, Scheuermeyer, Frank X., additional, Kawano, Takahisa, additional, and Gibo, Koichiro, additional

Published
2018
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32. A comprehensive validation of very early rule-out strategies for non-ST-segment elevation myocardial infarction in emergency departments: protocol for a multicentre prospective cohort study

Author

Tada, Masafumi, primary, Azuma, Hiroyuki, additional, Yamada, Naoki, additional, Kano, Ken-ichi, additional, Nagai, Hideya, additional, Maeda, Shigenobu, additional, Ishida, Hiroshi, additional, Aoyama, Takahiko, additional, Okada, Ryota, additional, Kawano, Takahisa, additional, Kobuchi, Taketsune, additional, Uzui, Hiroyasu, additional, Matano, Hideyuki, additional, Iwasaki, Hose, additional, Maeno, Koji, additional, Shimada, Yoshimitsu, additional, Yoshida, Hiroyuki, additional, Ando, Masaki, additional, Murakami, Yoshimasa, additional, Iwakami, Naotsugu, additional, Kishimoto, Sanae, additional, Iwami, Taku, additional, Tada, Hiroshi, additional, Chapman, Andrew, additional, Mills, Nicholas, additional, Hayashi, Hiroyuki, additional, Furukawa, Toshi A, additional, and Watanabe, Norio, additional

Published
2019
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38. Association between shelter crowding and incidence of sleep disturbance among disaster evacuees: A retrospective medical chart review study

Author

Kawano, Takahisa, Nishiyama, Kei, Morita, Hiroshi, Yamamura, Osamu, Hiraide, Atsuchi, Hasegawa, Kohei, Kawano, Takahisa, Nishiyama, Kei, Morita, Hiroshi, Yamamura, Osamu, Hiraide, Atsuchi, and Hasegawa, Kohei

Abstract

Objectives: We determined whether crowding at emergency shelters is associated with a higher incidence of sleep disturbance among disaster evacuees and identified the minimum required personal space at shelters. Design: Retrospective review of medical charts. Setting: 30 shelter-based medical clinics in Ishinomaki, Japan, during the 46 days following the Great Eastern Japan Earthquake and Tsunami in 2011. Participants: Shelter residents who visited eligible clinics. Outcome measures: Based on the result of a locally weighted scatter-plot smoothing technique assessing the relationship between the mean space per evacuee and cumulative incidence of sleep disturbance at the shelter, eligible shelters were classified into crowded and non-crowded shelters. The cumulative incidence per 1000 evacuees was compared between groups, using a Mann-Whitney U test. To assess the association between shelter crowding and the daily incidence of sleep disturbance per 1000 evacuees, quasi-least squares method adjusting for potential confounders was used. Results: The 30 shelters were categorised as crowded (mean space per evacuee <5.0 m2, 9 shelters) or noncrowded (≥5.0 m2, 21 shelters). The study included 9031 patients. Among the eligible patients, 1079 patients (11.9%) were diagnosed with sleep disturbance. Mean space per evacuee during the study period was 3.3 m2 (SD, 0.8 m2) at crowded shelters and 8.6 m2 (SD, 4.3 m2) at non-crowded shelters. The median cumulative incidence of sleep disturbance did not differ between the crowded shelters (2.3/1000 person-days (IQR, 1.6-5.4)) and non-crowded shelters (1.9/1000 person-days (IQR, 1.0-2.8); p=0.20). In contrast, after adjusting for potential confounders, crowded shelters had an increased daily incidence of sleep disturbance (2.6 per 1000 person-days; 95% CI 0.2 to 5.0/1000 person-days, p=0.03) compared to that at non-crowded shelters. Conclusions: Crowding at shelters may exacerbate sleep disruptions in disaster evacuees; therefore, app

Published
2016

40. Gains of Continuing Resuscitation in Refractory Out-of-hospital Cardiac Arrest: A Model-based Analysis to Identify Deaths Due to Intra-arrest Prognostication.

Author

Grunau, Brian, Puyat, Joseph, Wong, Hubert, Scheuermeyer, Frank X., Reynolds, Joshua C., Kawano, Takahisa, Singer, Joel, Dick, William, and Christenson, James

Subjects
CARDIAC arrest, THERAPEUTICS, ATTITUDE (Psychology), CONFIDENCE intervals, CARDIOPULMONARY resuscitation, EMERGENCY medical services, EMERGENCY medicine, LONGITUDINAL method, MEDICAL personnel, PROBABILITY theory, REGRESSION analysis, STATISTICS, DATA analysis, TERMINATION of treatment, DATA analysis software, DESCRIPTIVE statistics, PROGNOSIS
Abstract

Objective: Prognostication bias, in which a clinician predicts a negative outcome and terminates resuscitation (TR) thereby ensuring a poor outcome, is a rarely identified limitation of out-of-hospital cardiac arrest (OHCA) research. We sought to estimate the number of deaths due to intra-arrest prognostication in a cohort of OHCA's, and use this data to estimate the incremental benefit of continuing resuscitation. Methods: This study examined a cohort of consecutive non-traumatic EMS-treated OHCAs from a provincial ambulance service, between 2007 and 2011 inclusive. We used Cox and logistic regression modeling, adjusting for Utstein covariates, to estimate the probability of ROSC, survival, and favorable neurological outcomes as a function of resuscitation time, and applied these models to estimate the number of missed survivors in those who had TR (prior to 20, 30, or 40 minutes). We determined the time juncture at which (1) the likelihood of survival fell below 1%, and (2) the proportion of survivors who had achieved ROSC exceeded 99%. Results: Of 5674 adult EMS-treated cases, 46% achieved ROSC, and 12% survived. The median time of TR was 27.0 minutes (IQR 19.0-35.0). Continuing resuscitation until 40 minutes yielded an estimated 17 additional survivors (95% CI 13-21), 10 (95% CI 7-13) with favorable neurological outcomes. The probability of survival of those in refractory arrest decreased below 1% at 28 minutes (95% CI 24-30 minutes). At 36 minutes (95% CI 34-38 minutes) >99% of survivors had achieved ROSC. Conclusion: We identified possible deaths due to intra-arrest prognostication. Resuscitation should be continued for a minimum of 30 minutes in all patients, however for those with initial shockable rhythms 40 minutes appears to be warranted. Interventional trials and observational studies should standardize or adjust for duration of resuscitation prior to TR. [ABSTRACT FROM AUTHOR]

Published
2018
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46. Author Correction: Association of ketamine use with lower risks of post-intubation hypotension in hemodynamically-unstable patients in the emergency department.

Author

Ishimaru, Tadayoshi, Goto, Tadahiro, Takahashi, Jin, Okamoto, Hiroshi, Hagiwara, Yusuke, Watase, Hiroko, Hasegawa, Kohei, Japanese Emergency Medicine Network Investigators, Morita, Hiroshi, Kawano, Takahisa, Kamikawa, Yohei, Nagai, Hideya, Matsumoto, Takashi, Nonami, Suguru, Miyoshi, Yusuke, Segawa, Sho, Kitai, Yuya, Tanaka, Kenzo, Minami, Saburo, and Yakushiji, Hiromasa

Subjects
KETAMINE, HYPOTENSION
Abstract

An amendment to this paper has been published and can be accessed via a link at the top of the paper. [ABSTRACT FROM AUTHOR]

Published
2020
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47. Abstract 12074: Door-To-Targeted Temperature Management Initiation Time and Outcomes in Out-Of-Hospital Cardiac Arrest: Insights From the CCC Trial.

Author

Stanger, Dylan, Kawano, Takahisa, Malhi, Navraj, Grunau, Brian, Tallon, John, Wong, Graham C, Christenson, James, and Fordyce, Christopher B

Subjects
*CARDIAC arrest, *TIME management, *LOGISTIC regression analysis, *HOSPITAL admission & discharge, *HOSPITAL patients
Abstract

Introduction: Targeted temperature management (TTM) is a recommended treatment modality to improve neurologic outcomes in patients with out-of-hospital cardiac arrest (OHCA). The impact of the duration from hospital admission to TTM initiation (Door-to-TTM; DTT) on clinical outcomes has not been well elucidated. We hypothesized that shorter DTT initiation intervals would be associated with improved survival with favorable neurologic outcome. Methods: We performed a post hoc analysis of patients from British Columbia (BC) who were enrolled in the Trial of Continuous or Interrupted Chest Compressions during CPR (CCC) Trial, which included non-traumatic paramedic-treated OHCAs. We excluded those who died prior to hospital admission or were not treated with TTM. The primary outcome was favorable neurological status (modified Rankin scale of 0-3) at hospital discharge, with a secondary outcome of survival to discharge. We fit a logistic regression analysis to determine the association of early versus delayed DTT, dichotomized by the median DTT duration. We performed the same analysis within the a priori defined subgroups by initial cardiac rhythm. Results: Of 3805 patients enrolled in the CCC Trial in BC, 570 (68% shockable initial rhythm) were included. There was substantial variation in DTT among patients receiving TTM (Figure). The median DTT duration was 122 minutes (IQR 35-218). Favourable neurological outcomes in the early and late DTT groups were 48% and 38%, respectively. Compared to delayed DTT (IQR 167 - 319 minutes), early DDT (IQR 20 - 81 minutes) was associated with survival (adjusted OR 1.56, 95% CI 1.02-2.38) but not favourable neurological outcomes (adjusted OR 1.45, 95% CI, 0.94-2.22) at hospital discharge. Among those with initial shockable rhythms, DTT was associated with survival (adjusted OR 1.82, 95% CI 1.10-3.00) and favorable neurological outcomes (adjusted OR 1.79, 95% CI, 1.09-2.95). Conclusions: Initiation of TTM within 122 minutes of hospital admission was associated with improved survival. Among those with initial shockable rhythms, early TTM initiation was associated with improved survival and neurological outcomes. These results support in-hospital efforts to achieve early DTT among OHCA patients admitted to hospital. [ABSTRACT FROM AUTHOR]

Published
2018

48. [First death case of serotonin syndrome in Japan induced by fluvoxamine and tandospirone].

Author

Kawano T, Kosuge T, Takagi S, Shimoyama A, Harunari N, Tahara Y, and Suzuki N

Subjects
Adolescent, Anti-Anxiety Agents blood, Drug Overdose, Fatal Outcome, Fluvoxamine blood, Heart Arrest chemically induced, Humans, Isoindoles blood, Japan, Male, Piperazines blood, Pyrimidines blood, Serotonin Receptor Agonists blood, Selective Serotonin Reuptake Inhibitors blood, Severity of Illness Index, Shock chemically induced, Syndrome, Anti-Anxiety Agents adverse effects, Fever chemically induced, Fluvoxamine adverse effects, Isoindoles adverse effects, Muscle Hypertonia chemically induced, Piperazines adverse effects, Pyrimidines adverse effects, Serotonin Receptor Agonists adverse effects, Selective Serotonin Reuptake Inhibitors adverse effects
Abstract

We experienced the first death case of the serotonin syndrome in Japan caused by fluvoxamine and tandospirone. A 15-year-old man was transported to our hospital for shock, muscle hypertonia and hyperthermia after cardiopulmonary arrest. His serum concentrations of fluvoxamine and tandospirone were 3,554 ng/mL and 698 ng/mL respectively after 24 hours from oral intake. He was dead in spite of intensive treatments. The progress of the serotonin syndrome is usually rapid. So, it should be monitored appropriately a patient with serotonin syndrome. If he has hyperthermia, immediate paralysis should be induced. We should aware of the serotonin syndrome a case of overdose on a serotonergic agent.

Published
2011

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