Publications by authors named "Kohkichi Andoh"
Article Synopsis
- Sepsis is a leading cause of death in ICUs and contributes to long-term physical, cognitive, and mental health problems (collectively known as post-intensive care syndrome, or PICS) for both patients and their families.
- A multicenter study across 26 ICUs will follow patients over five years after their ICU stay to analyze the effectiveness of the ABCDEF care bundle on survival rates and the incidence of PICS.
- The study has received ethical approvals, and findings will be shared in peer-reviewed journals and at scientific conferences, ensuring transparency and dissemination of results.
The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock.
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- - The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020) were developed to help healthcare professionals effectively treat sepsis and septic shock, building on the previous guidelines from 2016.
- - The guidelines cover 22 areas including important new topics such as patient-centered care and ICU-acquired weakness, and detail 118 clinical questions that address various aspects of sepsis management.
- - In creating these guidelines, a diverse group of 226 medical professionals used the GRADE method for recommendations, resulting in 79 GRADE-based recommendations and 5 Good Practice Statements.
Article Synopsis
- * The initial cuff pressure was set at 26 cmHO, with fluctuations observed; pressures exceeded 30 cmHO in all patients and dropped below 20 cmHO in 69% of cases.
- * Overall, while cuff pressure varied significantly during surgery, serious complications were rare, highlighting the need for better pressure management during procedures.
Article Synopsis
- The study investigates the link between low body mass index (BMI) and mortality in older adults with sepsis in Japan, highlighting differences in body mass distributions between East Asian and Western populations.
- An analysis of 548 patients reveals that those with low BMI had a significantly higher 28-day mortality rate (21.4%) compared to those with normal (11.2%) and high BMI (14.5%).
- The findings indicate that low BMI is associated with a higher risk of mortality in sepsis patients, suggesting the need for careful monitoring of older adults with low BMI to improve their health outcomes.
Purpose: Disseminated intravascular coagulations (DIC), acute respiratory distress syndrome (ARDS), and acute kidney injury (AKI) are major organ dysfunctions that occur in patients with sepsis. This study aimed to elucidate the impact of these organ dysfunctions on mortality in patients with severe sepsis.
Material And Methods: A prospective observational study was performed in 10 ICUs to obtain data from patients with severe sepsis.
Background: To compare the efficacy of three antiseptic solutions [0.5%, and 1.0% alcohol/chlorhexidine gluconate (CHG), and 10% aqueous povidone-iodine (PVI)] for the prevention of intravascular catheter colonization, we conducted a randomized controlled trial in patients from 16 intensive care units in Japan.
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- * 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.
Article 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.
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.*
Many studies have suggested that neutrophil elastase (NE) may contribute to multiple organ failure (MOF) and acute injury of lung endothelial cells. It is therefore conceivable that NE inhibitors may improve the outcome of MOF patients. A synthetic NE inhibitor, sivelestat, which was developed and released in Japan, inhibited inflammatory reactions in various animal models.
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