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.

Efficacy of near-infrared spectroscopy in diagnosing skin and soft tissue infections: A single-center retrospective study.

Aim: Skin and soft tissue infection (SSTI) is classified as necrotizing fasciitis (NF) or cellulitis based on the invasion depth of the lesion. Cellulitis has a good prognosis and improves with conservative treatment, whereas NF has a poor prognosis with rapid progression requiring prompt debridement of the wound and intensive care control. Therefore, they should be differentiated quickly and accurately; however, a useful diagnostic method, except for the surgical test incision, remains to be established.

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.

Advance Care Planning Initiatives in Critical Care Centers in Japan: A Case Report.

This report examines the promotion of advance care planning (ACP) for patients admitted to critical care centers and discharged to home. Emergency transport experience allows patients and their families to realistically discuss her ACP.

Carbon dioxide angiography during angioembolization for trauma patients increases the detection of active bleeding and leads to reliable hemostasis: a retrospective, observational study.

Background: Angiography with carbon dioxide (CO) has long been used as an alternative when iodine contrast media (ICM) cannot be used due to allergy to iodine or renal dysfunction. Conversely, CO angiography is also known as a provocation method for active bleeding. In this study, we examined the efficacy of CO angiography in angioembolization (AE) for trauma patients.

Carnitine Deficiency in Intensive Care Unit Patients Undergoing Continuous Renal Replacement Therapy: A Single-center Retrospective Study.

Introduction: Carnitine deficiency is common in patients undergoing intermittent hemodialysis and may also occur during continuous renal replacement therapy (CRRT). We evaluated intensive care unit (ICU) patients undergoing CRRT for carnitine deficiency and its associated risk factors.

Methods: This was a single-center, retrospective, observational study performed between June 2019 and March 2020.

Distal radial approach for arterial pressure monitoring with a long catheter provides safe and stable monitoring in the intensive care unit: A single-center retrospective study.

Background: To compare the distal radial artery approach (DRA) with a longer catheter to DRA with a shorter catheter in arterial catheter (AC) placement in the intensive care unit (ICU).

Methods: This was a single-center retrospective cohort study of DRA with a long catheter (60 mm) for arterial catheterization in the ICU. DRA with a short catheter (25-30 mm) was used in the control group, and the groups were compared using multivariate regression analysis.

Evaluation of a new insertion site for arterial pressure line in intensive care unit management: a prospective study.

The arterial pressure line (A-line) is primarily inserted through the radial artery. However, accidental removal due to joint movement can be problematic in the intensive care unit (ICU). This study aimed to evaluate the safety and effectiveness of A-line insertion in the ICU through the distal radial approach (DRA), which is used in cardiac catheterization.

Hybrid surgery for blunt aortic injury with rupture: a case report.

Background: Blunt thoracic aortic injury is one of the most lethal traumatic injuries. Ruptured cases often result in cardiac arrest before arrival at the hospital, and survival is rare.

Case Presentation: A female patient in her 30 s was struck by an automobile while she was walking across an intersection.

Efficacy of median sacral artery embolization for treating severe pelvic fractures: a retrospective study.

Objective: Transcatheter arterial embolization (TAE) of bilateral internal iliac arteries (IIAs) in patients with a hemodynamically unstable pelvic fracture is associated with a low mortality rate. The persistence of unstable hemodynamics after IIA embolization indicates the involvement of other arteries, such as the median sacral artery (MSA). This study aimed to evaluate the efficacy of MSA embolization.

Advanced do-not-attempt-resuscitation directives and emergency medical services for out-of-hospital cardiopulmonary arrest patients in Japan: a pilot study.

Aims: We investigated how do-not-attempt-resuscitation (DNAR) orders are currently used, and we examined the emergency medical team responses for out-of-hospital cardiac arrest (OHCA) cases in Japan.

Methods: The sample for this prospective study comprised all OHCA cases attended to by the Sagamihara Municipal Fire Department emergency medical services between May 30, 2019 and February 15, 2020. Data were recorded by the responding emergency medical team.

Diagnosis of skin and soft tissue infections using near-infrared spectroscopy.

Aim: Skin and soft tissue infections are classified into cellulitis and necrotizing fasciitis, which are difficult to distinguish. Necrotizing fasciitis has a poor prognosis and requires immediate intensive care. The diagnostic gold standard is to incise the lesion to determine whether necrosis has reached the fascia.

Safety of arterial catheterization using the distal radial approach in intensive care unit management: A pilot study.

Background: Arterial catheter (A-line) is essential for managing severely ill patients, and the radial artery is the most common insertion site in the intensive care unit (ICU). However, many accidental removals occur because the insertion site of A-line in the traditional radial approach (TRA) overlaps with the joint flexion. Recent reports have shown no significant difference in the complication rates between coronarography using the distal radial approach (DRA) and that using TRA.

Life-threatening traumatic epistaxis due to massive bleeding into the maxillary sinus.

A 77-year-old woman with no medical history fell, and her face was strongly impacted on the ground. On arrival at our hospital, her initial vital signs were stable. She underwent an endoscopy to stop the bleeding.

Pancreatitis in a Patient with Severe Coronavirus Disease Pneumonia Treated with Veno-venous Extracorporeal Membrane Oxygenation.

Severe coronavirus disease (COVID-19) can induce serious complications, including acute respiratory distress syndrome, septic shock, and acute kidney injury. However, few reports have associated COVID-19 with pancreatitis. We herein report the case of a 55-year-old patient who developed acute pancreatitis associated with severe COVID-19 pneumonia and was successfully treated with veno-venous extracorporeal membrane oxygenation (ECMO).

Intravascular treatment for ruptured facial artery aneurysm via percutaneous cardiopulmonary support device: A case report.

Even in cases of cardiac arrest caused by hemorrhagic shock, when reliable control of the bleeding source is possible, ECPR may be an effective treatment option if anticoagulant therapy is well-managed and is withdrawn early.

Use of Multimodal Interventional Radiology with an Intracerebral Artery Stent Retriever for Acute Superior Mesenteric Artery Thrombosis: A Case Report.

Acute superior mesenteric artery thrombosis is usually fatal; however, early intravascular treatment using a mechanical thrombectomy device can be an effective intervention. A 70-year-old man with atrial fibrillation presented with sudden abdominal pain; superior mesenteric artery thrombosis was confirmed using contrast-enhanced computed tomography. Thrombolysis, mechanical fragmentation, aspiration, and thrombectomy were successfully performed using the Trevo® XP ProVue stent retriever via a brachial approach, and intestinal necrosis was avoided.