Publications by authors named "Kohei Takimoto"
Article Synopsis
- - A middle-aged woman developed acute compartment syndrome (ACS) in all four extremities after overdosing on multiple medications, including nifedipine and olmesartan, which led to severe swelling and skin necrosis.
- - Her condition required emergency intubation due to haemodynamic instability, and despite initial stabilization, escalating limb swelling was noted, with compartment pressures exceeding 30 mm Hg.
- - The case suggests that the ACS was likely triggered by drug-induced angio-oedema from the medications, highlighting the need for careful monitoring for ACS in patients experiencing significant limb swelling after such overdoses.
Since the start of the coronavirus disease 2019 (COVID-19) pandemic, it has remained unknown whether conventional risk prediction tools used in intensive care units are applicable to patients with COVID-19. Therefore, we assessed the performance of established risk prediction models using the Japanese Intensive Care database. Discrimination and calibration of the models were poor.
View Article and Find Full Text PDFBackground: The Acute Physiology and Chronic Health Evaluation (APACHE) III-j model is widely used to predict mortality in Japanese intensive care units (ICUs). Although the model's discrimination is excellent, its calibration is poor. APACHE III-j overestimates the risk of death, making its evaluation of healthcare quality inaccurate.
View Article and Find Full Text PDFWe examined the institutional variations in anticoagulation therapy for sepsis-induced disseminated intravascular coagulation (DIC) and their effects on patient outcomes. This post hoc analysis of a cohort study included 3195 patients with severe sepsis across 42 intensive care units. To evaluate differences in the intensity of anticoagulation therapy, the proportion of patients receiving anticoagulation therapy and the total number of patients with sepsis-induced DIC were compared.
View Article and Find Full Text PDFSepsis is a syndrome with physiologic, pathologic, and biochemical abnormalities induced by infection. Sepsis can induce the dysregulation of systemic coagulation and fibrinolytic systems, resulting in disseminated intravascular coagulation (DIC), which is associated with a high mortality rate. Although there is no international consensus on available treatments for sepsis-induced DIC, DIC diagnosis and treatment are commonly performed in Japanese clinical settings.
View Article and Find Full Text PDFPurpose: We investigated the epidemiology and outcome of disseminated intravascular coagulation (DIC) in patients with sepsis.
Materials And Methods: We analyzed data from a multicenter observational study (Japan Septic Disseminated Intravascular Coagulation [JSEPTIC-DIC] study) conducted in 42 intensive care units in Japan. DIC scores were calculated using two scoring systems: the International Society on Thrombosis and Haemostasis (ISTH) and Japanese Association for Acute Medicine (JAAM) criteria.
Background And Purpose: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English-language version of these guidelines was created based on the contents of the original Japanese-language version.
Methods: Members of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members.
Article Synopsis
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016) were created to address specific needs in Japan and are a joint effort by two medical societies, reflecting localized clinical practices.
- The guidelines were developed with input from various medical professionals, utilizing a structured method that included public commentary and a peer review system to ensure quality and transparency in the drafting process.
- In total, 87 clinical questions were identified across 19 areas of focus, including new topics relevant to pediatric care, with important revisions made since the previous version in 2012.
Article Synopsis
- * Results showed that while patients receiving IVIgG were generally more severely ill and had higher ICU mortality, the overall in-hospital mortality rates were similar between those treated with IVIgG and those who were not.
- * The final analysis indicated that IVIgG administration did not significantly influence ICU or in-hospital mortality, suggesting it may not be an effective adjunctive treatment for sepsis in this context.
Complicated skin and soft tissue infections (cSSTIs) are skin and soft tissue infections (SSTIs) that involve deep soft tissue. cSSTIs often require surgical intervention and/or hospitalization. cSSTIs are associated with significant mortality and morbidity, and carry a significant burden on health care systems.
View Article and Find Full Text PDFArticle Synopsis
- Supplemental doses of antithrombin (AT) are commonly used in Japan to treat sepsis-induced disseminated intravascular coagulation (DIC), but the evidence supporting their effectiveness is limited.
- A large retrospective study analyzed data from 3,195 patients, finding a statistically significant association between AT supplementation and lower in-hospital mortality rates for patients with DIC, although further analyses questioned the strength of this link.
- The study concluded that AT supplementation may help reduce mortality in sepsis-induced DIC, but the evidence is not definitive, and while patients needing AT had more transfusions, they did not experience increased severe bleeding complications.
Background: With the development of invasive medical procedures, an increasing number of healthcare-associated infective endocarditis cases have been reported. In particular, non-nosocomial healthcare-associated infective endocarditis in outpatients with recent medical intervention has been increasingly identified.
Case Presentation: A 66-year-old man with diabetes mellitus and a recent history of intermittent urethral self-catheterization was admitted due to a high fever.
Article Synopsis
- * The average age of the patients was 70 years, and their health status, measured by the Acute Physiology and Chronic Health Evaluation II score, indicated a moderate level of severity.
- * Survival rates were estimated at 73.6% and 56.3% for patients at 28 days and 90 days post-ICU admission, respectively.*
Recombinant human soluble thrombomodulin (rhTM) is a novel class of anticoagulants for treating disseminated intravascular coagulation (DIC). Although rhTM is widely used in clinical settings throughout Japan, there is limited clinical evidence supporting the use of rhTM in patients with sepsis-induced DIC. Furthermore, rhTM is not approved for DIC treatment in other countries.
View Article and Find Full Text PDFIntroduction: Sivelestat is neutrophil elastase inhibitor, which is widely used in Japan for the treatment of acute lung injury. However, the clinical efficacy of the medication has not been convincingly demonstrated.
Methods: We conducted a systematic review and meta-analysis of randomized controlled trials on sivelestat for the treatment of acute lung injury and acute respiratory distress syndrome.