The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.

The 2024 revised edition of the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock (J-SSCG 2024) is published by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine. This is the fourth revision since the first edition was published in 2012. The purpose of the guidelines is to assist healthcare providers in making appropriate decisions in the treatment of sepsis and septic shock, leading to improved patient outcomes.

Influence of Baseline Kidney Function on Patient and Kidney Outcomes in Patients with COVID-19: A Multi-National Observational Study.

: Acute kidney injury (AKI) is a common complication of coronavirus disease-19 (COVID-19), but the impact of baseline kidney function and care processes on outcomes is not well understood. We hypothesized that baseline kidney health status may influence courses and outcomes of AKI. : This is a multinational, multicenter, retrospective cohort study.

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.

The 2024 revised edition of the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock (J-SSCG 2024) is published by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine. This is the fourth revision since the first edition was published in 2012. The purpose of the guidelines is to assist healthcare providers in making appropriate decisions in the treatment of sepsis and septic shock, leading to improved patient outcomes.

Takotsubo Syndrome Following Status Epilepticus in a Heart Transplant Recipient: A Case Report.

Introduction: Takotsubo syndrome (TTS) expresses transient wall motion abnormality of the left ventricle, reportedly induced by sympathetic overstimulation. Takotsubo syndrome is unlikely to be included in the differential diagnosis of heart transplant patients with sudden cardiac dysfunction given the complete denervation occurring during the transplantation.

Case Report: In this case report we describe the case of a female heart transplant recipient who showed apical ballooning on an echocardiogram following status epilepticus.

Impact of COVID-19 on resuscitation after hospital arrival for patients with out-of-hospital cardiac arrest: An interrupted time series analysis.

Background: In this study, we aimed to determine the effects of the coronavirus disease 2019 (COVID-19) pandemic on in-hospital cardiopulmonary resuscitation (CPR) in patients with out-of-hospital cardiac arrest (OHCA).

Methods And Results: Using the Japanese Diagnosis Procedure Combination inpatient database, we included patients with OHCA who were transported to hospitals between April 2018 and March 2021. Patients were categorized into groups, before and during the COVID-19 pandemic, according to the day of admission (before or after April 1, 2020, respectively).

Granulocyte and Monocyte Adsorption Therapy in Patients With Sepsis: A Feasibility Study.

Background: The pathogenesis of sepsis is thought to be linked to a dysregulated immune response, particularly that involving neutrophils. We have developed a granulocyte adsorption column as a "decoy organ," which relocates the massive inflammation in organs in the body to a blood purification column. This study was conducted to assess the safety and experimental effectiveness of granulocyte monocyte adsorption apheresis-direct hemoperfusion (G1-DHP) in the treatment of patients with sepsis, using a prospective, multicenter design.

Higher Processed Blood Volume of Granulocyte and Monocyte Adsorption Apheresis Ameliorates Long-Term Disease Activity in Ulcerative Colitis Patients.

Background: Granulocyte and monocyte adsorption apheresis (GMA) is a therapeutic option for remission induction in the active ulcerative colitis (UC) patients. Effects of high processed blood volume of GMA as remission induction therapy on the long-term prognosis of UC patients have remained unclear. For this study, we investigated the relation between re-exacerbation of UC and the processed blood volume of GMA performed as induction therapy.

Factors associated with activated clotting time following heparin administration in pediatric cardiopulmonary bypass: A retrospective study.

Introduction: The recently recommended activated clotting time (ACT) to be maintained at the initiation of and during cardiopulmonary bypass (CPB) is ≥480 s. However, the post-unfractionated heparin (UFH) administration ACT occasionally does not exceed 480 s. Therefore, in this study, we retrospectively evaluated the factors influencing post-heparin administration ACT before initiating CPB.

Platelet dysfunction in heatstroke-induced coagulopathy: A retrospective observational study.

Purpose: Severe heatstroke is often complicated by disseminated intravascular coagulation (DIC). The aim of this study was to evaluate platelet function assessed through thromboelastography (TEG) at the emergency department (ED) and DIC severity among patients with heatstroke.

Materials And Methods: We performed a retrospective single-tertiary hospital cohort study.

Reduction Rate of Uric Acid in Blood during Continuous Renal Replacement Therapy for Acute Kidney Injury: A Multicenter Retrospective Observational Study.

Introduction: Continuous renal replacement therapy (CRRT) eliminates these small solutes with equal efficacy under the same conditions. However, variations in the reduction rates of these solutes observed in patients with CRRT are likely influenced by factors other than removal through CRRT. This study evaluated the reduction rates of these small solutes during CRRT and their possible association with mortality.

Association Between IV Contrast Media Exposure and Acute Kidney Injury in Patients Requiring Emergency Admission: A Nationwide Observational Study in Japan.

Objective: This study aimed to elucidate the association between IV contrast media CT and acute kidney injury (AKI) and in-hospital mortality among patients requiring emergency admission.

Design: In this retrospective observational study, we examined AKI within 48 hours after CT, renal replacement therapy (RRT) dependence at discharge, and in-hospital mortality in patients undergoing contrast-enhanced CT or nonenhanced CT. We performed 1:1 propensity score matching to adjust for confounders in the association between IV contrast media use and outcomes.

In Pursuit of Transformational Clinical Solutions.

It gives me great pleasure to introduce myself as the new Co-Editor-in-Chief of the (JCM) [...

Tachycardia and Acute Kidney Injury among Critically Ill Patients with Sepsis: A Prospective Observational Study.

Introduction: Tachycardia caused by sympathetic overactivity impairs myocardial function and raises septic patients' mortality. This study examined whether tachycardia is associated with acute kidney injury (AKI) period-prevalence among critically ill patients with and without sepsis.

Methods: In 328 patients (119 sepsis and 209 non-sepsis) admitted to our intensive care unit (ICU), we assessed heart rate at ICU admission, plasma neutrophil gelatinase-associated lipocalin (NGAL) and N-terminal pro-B-type natriuretic peptide, and urinary L-type fatty acid-binding protein and N-acetyl-β-d-glucosaminidase (NAG) at 0 and 48 h after admission.

Trajectory pattern of serially measured acute kidney injury biomarkers in critically ill patients: a prospective observational study.

Background: The clinical value of the trajectory of temporal changes in acute kidney injury (AKI) biomarkers has not been well established among intensive care unit (ICU) patients.

Methods: This is a single-center, prospective observational study, performed at a mixed ICU in a teaching medical institute in Tokyo, Japan. Adult ICU patients with an arterial line and urethral catheter were enrolled from September 2014 to March 2015.

Heterogeneity in the definition of major adverse kidney events: a scoping review.

Acute kidney injury (AKI) is associated with persistent renal dysfunction, the receipt of dialysis, dialysis dependence, and mortality. Accordingly, the concept of major adverse kidney events (MAKE) has been adopted as an endpoint for assessing the impact of AKI. However, applied criteria or observation periods for operationalizing MAKE appear to vary across studies.

Serum Myostatin at Dialysis Initiation May Predict 1-Year Mortality and Hospitalization.

Objective: Myostatin, which is known as a negative skeleton muscle regulator, is associated with mortality in maintenance hemodialysis patients. However, the significance of serum myostatin concentrations at dialysis initiation has not been established. We investigated the relation between serum myostatin concentrations and mortality or hospitalization within 1 year in incident dialysis patients.

Dose of nafamostat mesylate during continuous kidney replacement therapy in critically ill patients: a two-centre observational study.

Background: Nafamostat mesylate is an anticoagulant used for critically ill patients during continuous kidney replacement therapy (CKRT), characterised by its short half-life. However, its optimal dosage remains unclear. This study aimed to explore the optimal dosage of nafamostat mesylate during CKRT.

Impact of renal dysfunction on the diagnosis of acute pancreatitis using urinary trypsinogen-2: A retrospective study.

Aim: Early diagnosis of acute pancreatitis is crucial, and urinary trypsinogen has been recently reported as a useful biomarker for diagnosing acute pancreatitis. We aimed to evaluate the impact of renal dysfunction on the diagnostic performance of urinary trypsinogen-2 for acute pancreatitis.

Methods: We conducted a retrospective study using the clinical data of patients who visited the Department of Emergency and Critical Care at the University of Tokyo Hospital between 1 October, 2021, and 30 June, 2022.