Publications by authors named "Jin Takahashi"
Aims: Guidelines recommend non-invasive positive pressure ventilation (NPPV) for patients with acute decompensated heart failure (ADHF) with an inadequate response to initial oxygen therapy. During Japan's coronavirus disease 2019 pandemic, NPPV use in emergency departments (EDs) was limited due to aerosol-spreading concerns. This study compared the respiratory management and clinical outcomes of patients with ADHF in EDs before and during the pandemic.
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- - The study investigated the safety of the "Holding-up uterus" technique during cesarean hysterectomy for patients with placenta accreta spectrum under shock conditions (shock index > 1.5).
- - Among 12 patients, those with higher shock index had more complications, though none were severe, and preoperative uterine artery embolization showed no significant risks.
- - The findings suggest that the "Holding-up uterus" approach is safe in severe cases, but complications like thrombosis can occur, and certain pregnancy factors may increase risks.
Background: Door to balloon time is a crucial factor of mortality in patients with ST-segment elevation myocardial infarction. However, the factors that contribute to failure of achieving door to balloon time ≤ 90 min in an electrocardiogram triage system remain unknown.
Methods: This single-center retrospective observational study collected data from consecutive patients with ST-segment elevation myocardial infarction from April 2016 to March 2021.
Aim: Capnography is recommended for use in procedural sedation and analgesia (PSA); however, limited studies assess its impact on recovery time. We investigated the association between capnography and the recovery time of PSA in the emergency department (ED).
Methods: This study was a secondary analysis of a multicenter PSA patient registry including eight hospitals in Japan.
Article Synopsis
- Airway obstruction is a critical emergency condition, and a study analyzed its impact on intubation success and related complications in the emergency department (ED) over a 9-year period.
- Out of 7,349 patients, 272 (4%) required tracheal intubation for airway obstruction, showing a lower first-pass success rate (63%) compared to non-obstruction cases (74%).
- The study found that patients with airway obstruction not only had a significantly reduced chance of successful intubation but also a higher risk of experiencing adverse events during the process.
Aim: Patients with head trauma who take antiplatelet or anticoagulant (APAC) agents have a higher rate of mortality. However, the association between these agents and mortality among blunt torso trauma patients without severe traumatic brain injury remains unclear.
Methods: Using the Japanese nationwide trauma registry, we conducted a retrospective cohort study including adult patients with blunt torso trauma without severe head trauma between January 2019 and December 2020.
Introduction: Cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) patients during the coronavirus disease 2019 (COVID-19) pandemic carries an added risk of COVID-19 infection for healthcare workers. However, because of the shortage of medical supplies and limited evidence of COVID-19 in the initial stages of the pandemic, strategies for the management of OHCA patients may have varied across hospitals.
Method: A web-based questionnaire was used.
Background: While the older population accounts for an increasing proportion of emergency department (ED), little is known about intubation-related adverse events in this high-risk population. We sought to determine whether advanced age is associated with a higher risk of intubation-related adverse events in the ED.
Methods: This is an analysis of data from a prospective, 15-centre, observational study-the second Japanese Emergency Airway Network (JEAN-2) study.
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
View Article and Find Full Text PDFTo determine whether ketamine use for tracheal intubation, compared to other sedative use, is associated with a lower risk of post-intubation hypotension in hemodynamically-unstable patients in the emergency department (ED), we analyzed the data of a prospective, multicenter, observational study-the second Japanese Emergency Airway Network (JEAN-2) Study-from February 2012 through November 2017. The current analysis included adult non-cardiac-arrest ED patients with a pre-intubation shock index of ≥0.9.
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- The study aimed to establish a new D-dimer threshold for diagnosing pulmonary embolism (PE) specific to the Japanese population, as the existing thresholds were based on data from Western countries where PE incidence is much higher.
- Conducted in a Japanese emergency department, the retrospective study analyzed 395 patients and found that a D-dimer threshold of 1100 μg/L resulted in a 0% failure rate for PE detection, suggesting safer exclusions of unnecessary imaging tests.
- The findings indicate that the new threshold could effectively reduce CTPA use in Japanese patients, with potential applicability to other Asian populations, but further research is required to confirm these results.
Aim: Little evidence on Japanese frequent presenters (FPs) is available. Therefore, this retrospective cohort study compared characteristics between FPs and non-frequent presenters (NFPs) in emergency departments (EDs) in Japan.
Methods: Frequent presenters included those who presented to an ED ≥4 times during the study period from August 1, 2012 to July 21, 2013.
Introduction: Although the implementation of simulation-based education (SBE) is essential for emergency medicine residency programs (EMRPs), little is known about the factors associated with its degree of SBE implementation in EMRPs. Therefore, this study aimed to investigate factors associated with SBE implementation in EMRPs. We hypothesized that the number of the simulation faculty was associated with the degree of SBE implementation.
View Article and Find Full Text PDFBackground: The anesthesia literature has reported that pre-intubation fentanyl use is associated with post-intubation hypotension which is a risk factor of poor post-emergency department (ED) prognosis. However, little is known about the relations between fentanyl use for intubation and post-intubation hypotension in the ED. We aimed to determine whether pretreatment with fentanyl was associated with a higher risk of post-intubation hypotension in the ED.
View Article and Find Full Text PDFBackground: Nontraumatic Stanford type A acute aortic dissection is a life-threatening condition; thus, the ability to make a precise diagnosis of nontraumatic Stanford type A acute aortic dissection is essential for the emergency physician. Several reports have shown that the mediastinal widening on a chest radiograph is useful for the diagnosis of nontraumatic Stanford type A acute aortic dissection; however, the exact cutoff value of the mediastinal width on plain radiographs is rarely defined.
Methods: A single-center retrospective case-control study was conducted between October 1, 2013, and March 31, 2015.
Objectives: We evaluated the vascularity of retained products of conception (RPOC) using arterial spin-labeling magnetic resonance imaging (ASL-MRI) to clarify the clinical feasibility of this approach.
Materials And Methods: A pulsed-continuous ASL sequence with echo-planar imaging (EPI) acquisitions was used. Ten consecutive patients with RPOC were enrolled.
Objectives: Acute alcohol intoxication is often treated in emergency departments by intravenous crystalloid fluid (IVF), but it is not clear that this shortens the time to achieving sobriety. The study aim was to investigate the association of IVF infusion and length of stay in the ED.
Methods: This single-center retrospective cohort study was conducted in Japan and included patients aged ≥20years of age and treated for acute alcohol intoxication without or with IVF.
Background: Coins are made of metal, which is generally radiopaque, and so physicians often have the misconception that all coins are detectable by radiography. Here, we report a case of intentionally swallowed coins in the oesophagus of an adult; the coins could not be detected on chest radiography but were detected using computed tomography (CT).
Case Presentation: A 46-year-old woman with a history of depression presented to the emergency department after an intentional medication overdose and ingestion of two Japanese 1-yen coins.
Objective: Severe motor vehicle accidents involving pregnant women can result in fetal and neonatal death. We describe a case in which fetal death occurred due to relatively mild seatbelt injuries and present the characteristic magnetic resonance imaging (MRI) findings of the placenta.
Case Report: A 26-year-old primigravid woman at 20 weeks gestation was involved in an automobile accident.