Publications by authors named "Kazuhiro Sugiyama"
Aim: The optimal arterial partial pressure of carbon dioxide (PaCO) for patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) remains unknown. We aimed to investigate the association between post-resuscitation PaCO and neurological outcomes.
Methods: This retrospective cohort study analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan, a multicenter registry study across 36 hospitals in Japan, including patients with out-of-hospital cardiac arrest (OHCA) admitted to intensive care units (ICU) after ECPR between 2013 and 2018.
Article Synopsis
- This study aimed to explore the characteristics and outcomes of patients who experience out-of-hospital cardiac arrest (OHCA) due to hanging, comparing them with other causes of OHCA.
- It analyzed data from a Japanese OHCA registry for individuals aged 18 and older, finding that hanging-induced OHCA accounted for about 3% of cases, with affected patients generally being younger and less likely to have witnessed events or shockable heart rhythms.
- The results showed a significantly lower likelihood of favorable neurological outcomes after one month for hanging-induced cases, emphasizing that while certain factors like younger age and initial non-asystole rhythm can improve chances, the overall prognosis remains poor.
Background: Dementia is a common comorbidity in older patients with traumatic brain injury (TBI), potentially affecting their care processes and outcomes. However, the impact of pre-existing dementia on TBI remains unclear as research on TBI often excludes older adults with comorbidities. This study aimed to investigate the association between pre-existing dementia and outcomes in older patients admitted to hospitals after TBI.
View Article and Find Full Text PDFBackground: A subset of patients with traumatic cardiac arrest is salvageable when the reversible causes of cardiac arrest are promptly treated. However, prognosis and risk factors of survivors upon hospital admission after traumatic cardiac arrest remain unclear. We aimed to describe the outcomes, identify risk factors, and develop a simple risk-scoring model for patients resuscitated from traumatic cardiac arrest.
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- Atomoxetine, a medication for ADHD, can cause serious cardiac complications if overdosed, leading to cases like the one presented here involving venoarterial extracorporeal membrane oxygenation (VA-ECMO) for life-threatening cardiogenic shock.
- A 30-year-old male experienced seizures and severe circulatory failure after a significant atomoxetine overdose, requiring emergency VA-ECMO for resuscitation, alongside other treatments like medication removal and intravenous lipid emulsion.
- The case highlights the need for healthcare providers to be aware of the potentially severe cardiac effects of atomoxetine overdose and underscores the importance of close monitoring and intensive care for patients in critical condition.
Article Synopsis
- The study evaluates the impact of trauma on patients undergoing Extracorporeal Cardiopulmonary Resuscitation (ECPR) for out-of-hospital cardiac arrest, hypothesizing that trauma would negatively affect survival and neurological outcomes.
- A total of 189 patients were analyzed, finding that while 2.1% had head trauma (with all dying during treatment), 16.4% had torso trauma, which did not significantly affect 30-day survival or neurological outcomes compared to those without trauma.
- The findings highlight that while trauma from patient collapse or resuscitation can occur, its effects on survival and neurological health vary, with serious head injuries leading to high mortality rates.
Aim: Patients with the return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) are unstable and often experience rearrest, after which ROSC may be reattained. This study investigated the incidence and risk factors of post-ROSC events (rearrest and subsequent reattainment of ROSC) and their impact on outcomes in patients with prehospital ROSC following OHCA.
Methods: Patients with OHCA and prehospital ROSC were identified from the Tokyo Fire Department database between 1 January 2018 and 31 December 2022.
A new nondestructive inspection method, the magnetic hammer test (MHT), which uses a compact and highly sensitive tunnel magnetoresistance (TMR) sensor, is proposed. This method complements the magnetic flux leakage method and eliminates the issues of the hammer test. It can therefore detect weak magnetic fields generated by the natural vibration of a pipe with a high signal-to-noise ratio.
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- FibCare is a new testing device designed to quickly measure fibrinogen levels in patients, and this study aimed to evaluate its accuracy in an emergency department setting.* -
- The study analyzed blood samples from 147 patients and found that while FibCare and the traditional Clauss method had a moderate correlation in results, FibCare missed a significant number of hypofibrinogenemia cases.* -
- The findings suggest that although FibCare is compatible with existing methods, healthcare providers should be cautious of its potential to underestimate fibrinogen levels, particularly in trauma patients and severe cases.*
Background: Whether and how the transfusion volume should be limited in resuscitation after trauma remains unclear. We investigated the association between transfusion volume and survival outcome following trauma.
Methods: Using the Japan Trauma Data Bank (2019-2021), we identified patients 18 years or older who received balanced blood transfusion within the first 24 hours of injury.
Article Synopsis
- Left ventricular free wall rupture is a severe complication of heart attacks that can lead to cardiac tamponade, which is life-threatening.
- ECMO is often used to manage heart instability, but increased pressure can cause problems with blood flow and brain perfusion.
- A case study of a 65-year-old man highlights how combining ECMO with pericardial drainage helped stabilize his condition temporarily, though he ultimately faced a poor neurological outcome and passed away.
Article Synopsis
- The study's aim was to create a scoring model to identify individuals who could still benefit from resuscitation efforts after out-of-hospital cardiac arrest, despite meeting termination of resuscitation rules.
- Researchers analyzed data from the All-Japan Utstein Registry between 2010 and 2019, focusing on patients who met basic and advanced life support termination rules and used statistical methods to find factors linked to favorable neurological outcomes.
- The resulting scoring model, particularly for those under the basic life support category, utilized age, cardiac rhythm, and transport time to predict outcomes, revealing that patients with higher scores had a slightly increased probability of favorable outcomes, although most scored below the threshold needed for a meaningful chance.
Article Synopsis
- This study investigated blunt traumatic diaphragmatic injury (BTDI) in Japan using data from a national trauma registry covering patients aged 18 and older from 2004 to 2019.
- Out of over 305,000 analyzed patients, only 868 were diagnosed with BTDI, resulting in a stable prevalence of about 0.3% and a high in-hospital mortality rate of nearly 47%.
- Key factors associated with BTDI included the injury mechanism, Glasgow Coma Scale score, hypotension, specific organ injuries, and certain bone fractures.
Background: Whether and how bystander cardiopulmonary resuscitation (CPR) modifies the cardiac rhythm after out-of-hospital cardiac arrest (OHCA) over time remains unclear. We investigated the association between bystander CPR and the likelihood of ventricular fibrillation (VF) or ventricular tachycardia (VT) as the first documented cardiac rhythm.
Methods: We identified individuals with witnessed OHCA of cardiac origin from a nationwide population-based OHCA registry in Japan between 1 January 2005 and 31 December 2019.
Study Objective: To elucidate the clinical utility of the Clinical Frailty Scale score for predicting poor neurologic functions in patients resuscitated from out-of-hospital cardiac arrest (OHCA).
Methods: This was a prospective, multicenter, observational study conducted between 2019 and 2021. The study included adults with nontraumatic OHCA admitted to the intensive care unit after return of spontaneous circulation (ROSC).
Aims: Optimal sedation regimens for patients after extracorporeal cardiopulmonary resuscitation (ECPR) remain unclear. This study compared the outcomes of patients who received propofol and midazolam for sedation post-ECPR for out-of-hospital cardiac arrest (OHCA).
Methods And Results: A retrospective cohort study analysed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan, including patients admitted to 36 intensive care units (ICUs) in Japan post-ECPR for OHCA of cardiac aetiology between 2013 and 2018.
A magnetocardiograph that enables the clear observation of heart magnetic field mappings without magnetically shielded rooms at room temperatures has been successfully manufactured. Compared to widespread electrocardiographs, magnetocardiographs commonly have a higher spatial resolution, which is expected to lead to early diagnoses of ischemic heart disease and high diagnostic accuracy of ventricular arrhythmia, which involves the risk of sudden death. However, as the conventional superconducting quantum interference device (SQUID) magnetocardiographs require large magnetically shielded rooms and huge running costs to cool the SQUID sensors, magnetocardiography is still unfamiliar technology.
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- - Central nervous system (CNS) infections can sometimes occur as a complication of invasive liver abscess syndrome, but they are infrequently linked to CNS infections without liver abscesses.
- - The text focuses on three fatal cases of CNS infections caused by a certain pathogen that didn't involve liver abscesses.
- - These cases highlight the rarity and potential severity of CNS infections connected to the pathogen when there are no detectable liver abscesses.
Article Synopsis
- Streptococcus suis is a gram-positive bacterium that can cause serious infections like bacterial meningitis and sepsis in humans, often transmitted through raw pork or exposure to pigs.
- A case study highlights a 38-year-old woman who developed septic shock after consuming raw pork, and although medical interventions were aggressive, her condition worsened rapidly.
- The report emphasizes the importance of timely recognition of such zoonotic pathogens and suggests that peripheral blood smears can help diagnose infections even before blood culture results are available.
Purpose: Thoracolumbar spine injury is frequently seen with high-energy trauma but dislocation fractures are relatively rare in spinal trauma, which is often neurologically severe and requires urgent treatment. Therefore, it is essential to understand other concomitant injuries when treating dislocation fractures. The purpose of this study is to determine the differences in clinical features between thoracolumbar spine injury without dislocation and thoracolumbar dislocation fracture.
View Article and Find Full Text PDFFifteen-year secular changes in the care and outcomes of patients with out-of-hospital cardiac arrest in Japan: a nationwide, population-based study.
Eur Heart J Qual Care Clin Outcomes
September 2023
Article Synopsis
- A study was conducted to examine the changes in outcomes for patients with out-of-hospital cardiac arrest (OHCA) in Japan over a 15-year period (2005-2019).
- Researchers analyzed data on 1,764,440 patients, focusing on those who received resuscitation, and found significant improvements in favorable neurological outcomes, particularly among younger patients and those with initial shockable rhythms.
- The study concluded that while collaborative initiatives have positively impacted OHCA care in Japan, further efforts are required to enhance outcomes across different patient demographics.
Article Synopsis
- The study aimed to analyze characteristics of trauma patients who self-referred to the emergency department and later died, focusing on identifying factors that predict mortality.
- Researchers examined data from a nationwide registry in Japan between 2004 and 2019, comparing the traits of patients who died to those who survived, using logistic regression to assess the impact of various factors on in-hospital death.
- Key findings indicated that older age, male sex, higher comorbidity scores, specific injury circumstances, lower neurological scores, and severe injuries significantly increased the likelihood of mortality in these patients, suggesting early identification and targeted treatment could improve outcomes.
Article Synopsis
- Ruptured umbilical hernias can lead to serious health issues, particularly in cirrhotic patients who develop fluid build-up (ascites).
- A case study details a 42-year-old woman with liver cirrhosis and schizophrenia who suffered from intestinal evisceration and bacteremia after her umbilical hernia ruptured.
- The timely use of antibiotics targeting skin bacteria, along with surgical intervention and managing her ascites, significantly improved her health.