A5011522137- Intensive Care Unit Cognitive Disorders
- Family and Patient Care in Intensive Care Units
- Healthcare Decision-Making and Restraints
- Atrial Fibrillation Management and Outcomes
- Anesthesia and Sedative Agents
- Respiratory Support and Mechanisms
- Cardiac electrophysiology and arrhythmias
- Sepsis Diagnosis and Treatment
- Vascular Procedures and Complications
- Abdominal Trauma and Injuries
- Infections and bacterial resistance
- Renal function and acid-base balance
- Kawasaki Disease and Coronary Complications
- Cardiac, Anesthesia and Surgical Outcomes
- Appendicitis Diagnosis and Management
- Hemodynamic Monitoring and Therapy
- Abdominal vascular conditions and treatments
- Cardiac Arrhythmias and Treatments
- Endometriosis Research and Treatment
- Orthopedic Surgery and Rehabilitation
- Heart Failure Treatment and Management
- Frailty in Older Adults
- Tracheal and airway disorders
- Inflammasome and immune disorders
- COVID-19 Clinical Research Studies
Wakayama Medical University
2017-2025
Abstract Background Dexmedetomidine has been reported to improve organ dysfunction in critically ill patients. In a recent randomized controlled trial (Dexmedetomidine for Sepsis Intensive Care Unit (ICU) Randomized Evolution [DESIRE]), we demonstrated that dexmedetomidine was associated with reduced mortality risk among patients severe sepsis. We performed this exploratory sub-analysis examine the mechanism underlying improved survival sedated dexmedetomidine. Methods The DESIRE compared...
ABSTRACT Necrotizing pneumonia has a high mortality rate of approximately 50%. Its computed tomography findings lack enhancement in areas consolidation. These should be interpreted as potentially indicative severe clinical course. Hypermucovisous strains Klebsiella pneumoniae are often hypervirulent and may cause fatal necrotizing pneumonia.
Lactate clearance is useful to guide initial resuscitation of patients with septic shock. We conducted this study evaluate whether dexmedetomidine increases lactate in This was a randomized controlled trial that involved post hoc subgroup analysis. Adult shock under ventilation were receive sedation strategy or without (60 the and 51 nondexmedetomidine groups). The primary outcome at 6 h, defined as percent decrease from randomization h after. median Acute Physiology Chronic Health...
In post-intensive care syndrome (PICS), long-term survivors of critical illness present various physical and mental symptoms that can persist for years after discharge. Post-intensive in Japan has not been well described, so this study aims to elucidate its epidemiology.We undertook a single-center prospective longitudinal cohort mixed intensive unit (ICU) Japanese tertiary hospital. Adult patients emergently admitted the ICU were eligible inclusion study. To assess activity daily living...
Background: We aimed to determine risk factors associated with worsened activity of daily living (ADL) status three months after intensive care unit (ICU) discharge. Methods: In this prospective, observational study, we enrolled critically ill adult patients that were emergently admitted an ICU. assessed ADL by Barthel index score prior ICU admission and The primary outcome was status, defined as a ≥10 decrease in score. Results: 102 (median age 72 years old, 55% male, 87% received...
Aim Tracheostomy is widely performed in critically ill patients who require prolonged mechanical ventilation. Long‐term morbidity (post‐intensive care syndrome) tracheostomized not reported, however, so we evaluate it here. Methods This a sub‐analysis of single center prospective longitudinal study, which assessed activities daily living (ADL) and psychiatric symptoms adult emergently admitted to the intensive unit (ICU). We evaluated association between these tracheostomy by posting...
Delirium frequently develops in patients with sepsis during their intensive care unit (ICU) stay, which is associated increased morbidity and mortality. A prediction model for delirium ICU, PRE-DELIRIC, has been utilized overall ICU patients, but its utility uncertain among sepsis. This study aims to examine the of PRE-DELIRIC predict mechanically ventilated sepsis.This a post hoc analysis randomized clinical trial eight Japanese ICUs, aimed evaluate sedative strategy with/without...
Many nonsurgical techniques have been reported for the removal of intravascular foreign bodies. The percutaneous approach is widely perceived as best technique to retrieve bodies (1-3). This minimally invasive has a high success rate and low morbidity, it avoids complications associated with surgical interventions. However, approaches are commonly used remove intramuscular bodies, no cases an body reported. Here, we report two successful image-guided using biopsy forceps.
Abstract Background Electrical cardioversion (ECV) is widely used to restore sinus rhythm in critically ill adult patients with atrial fibrillation, although its prognostic value uncertain. This study aims elucidate the clinical meaning of successful ECV. Methods a sub-analysis AFTER-ICU study, multicenter prospective cohort 423 non-cardiac new-onset fibrillation (AF). Patients that underwent ECV within 7 days after initial onset AF were included sub-analysis. We compared intensive care unit...
Abstract Aim Psychiatric problems are common in critically ill patients after discharge from an intensive care unit (ICU). The effect of (ICU) diaries on psychiatric symptoms ICU was investigated this prospective study. Methods Enrolled were adult who emergently admitted to and expected stay for at least 2 days. These received filled out by healthcare professionals family members. Comparison made with a historical cohort previous trial conducted the same but without diaries. primary outcome...
The arc of Riolan (AOR) is an anastomosis between the middle and left colic arteries. Aneurysms AOR are very rare visceral artery aneurysms. A 44-year-old man presented with abdominal pain loss consciousness. Computed tomography angiography showed hemorrhagic ascites around liver spleen. An irregularly dilated was visible within a hematoma in upper region abdomen, consistent ruptured pseudoaneurysm AOR. Transcatheter arterial embolization performed microcoils. patient's disappeared after...
Multisystem inflammatory syndrome in adults (MIS-A) is a rare and emerging after coronavirus disease 2019 (COVID-19). To the best of our knowledge, Japanese cases MIS-A are rarely reported. Here, we describe case 44-year-old woman presenting with multiorgan dysfunction (i.e., cardiovascular mucocutaneous involvement) markedly elevated markers 2 weeks recovery from COVID-19. Treatment intravenous immunoglobulins corticosteroids resolved her symptoms. On 13th day, she was discharged hospital...
The aim of this study was to evaluate the effect prolonged direct hemoperfusion using polymyxin B immobilized fiber cartridges (PMX-DHP) on interleukin-6 (IL-6) concentration in patients with septic shock. A total 16 received a 26 sessions 12-h PMX-DHP (PMX-DHP-12h group) and 7 11 2-h (PMX-DHP-2h group). We compared serum IL-6 concentrations other secondary outcomes between two treatment groups. were measured at 0, 2, 5, 8, 12 h. median age 78 years (interquartile range [IQR] 60–84)...
Angioembolization for traumatic pancreaticoduodenal artery injury with unstable circulation, which characteristically requires a prolonged procedure time, does not yet have standardized strategy damage control interventional radiology.We encountered two cases of rare wherein the patients were saved by multidisciplinary team shared goal clinical success, rather than procedural success angioembolization. Both treated angioembolization had residual pseudoaneurysm or faint extravasation in...
Traumatic pancreaticoduodenal arterial injury (TPDAI) with unstable circulation rarely occurs immediately after abdominal trauma. Angioembolization is more frequently chosen for urgent hemostasis in patients TPDAI involving hemorrhagic shock. However, characterized by traumatic hemorrhage from the artery supplied both celiac and superior mesenteric artery, leading to prolonged angioembolization procedure time. Moreover, there are no standardized strategies time-conscious damage control...