Background: We developed a bleeding risk scoring system (BRSS) using prophylactic anticoagulation therapy to comprehensively assess the risk of venous thromboembolism (VTE) in trauma patients. This study evaluated the usefulness of this system in trauma patients, with a focus on minimizing the rate of bleeding events associated with prophylactic anticoagulation therapy.
Methods: We retrospectively evaluated the efficacy of BRSS in trauma patients who received prophylactic anticoagulation therapy for VTE at the Kitasato University Hospital Emergency and Critical Care Center between April 1, 2015, and August 31, 2020.
Few studies have reported on the effectiveness of awake prone therapy in the clinical course of coronavirus disease (COVID-19) patients. This study aimed to investigate the effects of awake prone therapy during spontaneous breathing on the improvement of oxygenation over 3 weeks for COVID-19 acute respiratory failure. Data of consecutive COVID-19 patients with lung disorder with a fraction of inspired oxygen (FO) ≥ 0.
View Article and Find Full Text PDFWe developed a computerized clinical decision support system (CCDSS) for venous thromboembolism (VTE) risk assessment. We aimed to demonstrate its relevance and evaluate associations between risk level and VTE incidence in patients undergoing total hip/knee arthroplasty. In this case-control study, VTE was confirmed using ultrasonography/computed tomography angiography in 1098 adults at a tertiary care hospital over five years (2013-2018).
View Article and Find Full Text PDFPasteurella is a gram-negative coccobacillus that is commonly transmitted through cat and dog bites and causes various diseases in humans. In the present case, kissing an animal caused Pasteurella multocida infection, leading to sepsis and cardiogenic shock. We used venoarterial extracorporeal membrane oxygenation (VA-ECMO) to support the cardiovascular system until recovery.
View Article and Find Full Text PDFWe previously developed a computerized clinical decision support system based on national consensus guidelines and previous studies. This system was used to assess the risk of venous thromboembolism. In this study, we examined the risk factors for venous thromboembolism in patients who underwent lower limb orthopedic surgery using our risk scoring system, to investigate the association between the total risk score and the occurrence of venous thromboembolism.
View Article and Find Full Text PDFSkeletal muscle wasting in the intensive care unit (ICU) has been associated with mortality, but it is unclear whether sarcopenia, defined by skeletal muscle mass and function, is useful for detailed risk stratification after ICU discharge. In this cohort study, 72 critically ill patients with an ICU stay of ≥48 h were identified. Skeletal muscle mass was assessed from the muscle thickness (MT) of the patients' quadriceps using ultrasound images before ICU discharge.
View Article and Find Full Text PDFWe investigated whether using electrical muscle stimulation body massagers (EMS-BMs) for the passive contraction of the lower extremity muscles reduces venous stasis in the deep veins of the lower extremities. In this randomized crossover design study of 20 healthy volunteers between November 2018 and February 2019, we measured both the popliteal and femoral vein peak velocities (PV, cm/s) and blood flow volumes (BFV,mL/min), using pulsed-wave Doppler ultrasound at rest (baseline), and at 2 and 10 min after starting EMS-BM use. Two EMS types: types A (two small pads) and B (one large pad) devices respectively, were examined.
View Article and Find Full Text PDFBackground: While many patients with lower limb ischemia also have severe infections, few studies have investigated whether the presence of preoperative sepsis affects patient prognosis following lower limb amputation (LLA). Therefore, we investigated the factors (including sepsis as defined in SEPSIS-3) that contribute to the acute mortality rate in patients who underwent LLA due to arteriosclerosis obliterans (ASO) or diabetes mellitus (DM).
Methods: In this retrospective, single-center, 10-year chart review study, 122 adult patients who underwent LLA due to ASO and/or DM were identified from 56,438 surgery cases.
Background: Preoperative dehydration is one of risk factors of hypotension during spinal anesthesia (SA). We hypothesized that preoperative oral rehy- dration (POR) may help prevent hypotension during SA.
Methods: After obtaining approval from the ethics committee, patients who underwent surgery twice (urological surgery or orthopedic surgery) within 6 months were enrolled in the study.
Introduction: Graduated compression stockings (GCS) are widely used to prevent venous thromboembolism; however, GCS are slippery and a fall hazard owing to the synthetic fibers. Therefore, we investigated whether changing the sole's shape decreased slipping.
Materials And Methods: We designed four GCS types with varying sole shapes and normal slipperiness to compare with normal GCS and a barefoot model without GCS (control).
We report three cases of airway management with elective surgical cricothyroidotomy (SCT) for anesthetic management during surgical repair of maxillofacial injury involving basal skull fracture or nasal-bone fracture. In all patients, general anesthesia was induced, a supraglottic airway (SGA) device inserted, and SCT performed. Tracheal intubation was performed through SCT site, and the SGA device was removed.
View Article and Find Full Text PDFPurpose: This study aimed to examine the incidence, case fatality rate, and characteristics of perioperative symptomatic pulmonary thromboembolism (PS-PTE) throughout Japan.
Methods: From 2002 to 2011, confidential questionnaires were mailed annually to all Japanese Society of Anesthesiologists-certified training hospitals for data collection to determine the incidence and case fatality rate of PS-PTE patients. Data from 10,537 institutions in which a total of 11,786,489 surgeries had been performed were analyzed using the Mann-Whitney and Chi-square tests.
We described a case of 19-year-old female who developed re-expansion pulmonary edema (RPE) after removal of a huge ovarian tumor. Altered lung volume after the surgery was observed by chest X-ray. Preoperatively, the lung was highly compressed by the tumor.
View Article and Find Full Text PDFBackground: This study was designed to investigate the annual incidence and characteristics of perioperative pulmonary thromboembolism (PTE) in Japan from 2009 through 2011, and to compare the current trend with that observed in our previous studies conducted since 2002.
Methods: In the 3-year study period, a questionnaire was annually mailed to all institutions certified as training hospitals for anesthesiologists by the Japanese Society of Anesthesiologists (JSA). The survey included the parameters of age, sex, type of surgery, and the risk factors in patients who were operated upon.
Venous thromboembolism (VTE) is a well-recognized life-threatening complication in the intensive care unit (ICU). However, no data have been reported regarding the prevalence and methods of prevention of VTE in Japanese ICUs. This study aimed to document the current practice of VTE prevention across a broad sample of medical-surgical ICU patients in Japan.
View Article and Find Full Text PDFJ Cereb Blood Flow Metab
December 2011
In mouse hippocampal CA1 pyramidal neurons, the activity of synaptic small-conductance Ca(2+)-activated K(+) channels type 2 (SK2 channels) provides a negative feedback on N-methyl-D-aspartate receptors (NMDARs), reestablishing Mg(2+) block that reduces Ca(2+) influx. The well-established role of NMDARs in ischemia-induced excitotoxicity led us to test the neuroprotective effect of modulating SK2 channel activity following cerebral ischemia induced by cardiac arrest and cardiopulmonary resuscitation (CA/CPR). Administration of the SK channel positive modulator, 1-ethyl-benzimidazolinone (1-EBIO), significantly reduced CA1 neuron cell death and improved CA/CPR-induced cognitive outcome.
View Article and Find Full Text PDFAllopregnanolone (ALLO) is a neurosteroid that has many functions in the brain, most notably neuroprotection and modulation of gamma-amino butyric acid (GABA) neurotransmission. Using a mouse model of cardiac arrest and cardiopulmonary resuscitation, we have previously demonstrated that ALLO protects cerebellar Purkinje cells (PCs) from ischemia in a GABA(A) receptor-dependent manner. In this study we examined the effect of sex on ALLO neuroprotection, observing that low dose ALLO (2 mg/kg) provided greater neuroprotection in females compared to males.
View Article and Find Full Text PDFBackground: The Japanese Society of Anesthesiologists (JSA) has maintained records of the annual incidence and characteristics of perioperative pulmonary thromboembolism (perioperative PTE) since 2002. The aim of this paper was to provide recent results of the JSA annual study conducted in 2008, and to determine the current factors that tend to prevent perioperative venous thromboembolism (VTE) in Japan.
Methods: A comprehensive questionnaire designed by the JSA PTE working group was mailed to all institutions certified as teaching hospitals by JSA.
Background: This study aimed to investigate the annual incidence and characteristics of perioperative pulmonary thromboembolism (PTE) in Japan from 2005 through 2007, and to compare the current trend with that observed in our previous studies conducted since 2002.
Methods: In the 3-year study period, a questionnaire was annually mailed to every institution certified as a training hospital for anesthesiologists by the Japanese Society of Anesthesiologists (JSA). The survey included the parameters of age, sex, type of surgery, and the risk factors in patients who were operated upon.
Cerebellar Purkinje cells (PC) are particularly vulnerable to ischemic injury and excitotoxicity, although the molecular basis of this sensitivity remains unclear. We tested the hypothesis that ischemia causes rapid down-regulation of GABA(A) receptors in cerebellar PC, thereby increasing susceptibility to excitotoxicity. Oxygen-glucose deprivation (OGD) caused a decline in functional GABA(A) receptors, within the first hour of re-oxygenation.
View Article and Find Full Text PDFKnowledge and information were acquired from the results of the annual perioperative pulmonary thromboembolism (PPT) research from 2002 to 2004 by the Japanese Society of Anesthesiologists. Due to the popularization and use of prophylaxis, perioperative pulmonary thromboembolism (PPT) decreased significantly in 2004 compared to the years 2002 and 2003 (P < 0.001).
View Article and Find Full Text PDFThere have been no reports on acute pulmonary embolism (APE) after earthquakes. Our aim was to clarify the actual the occurrence of APE following the 2004 Mid Niigata Prefecture earthquake in Japan, and to assess the risk factors for APE after the event. We sent questionnaires to 122 hospitals in the Niigata Prefecture after the earthquake.
View Article and Find Full Text PDFBackground: The incidence of perioperative pulmonary thromboembolism (PTE) is reported not to be low in Japan. The aim of this study is to investigate the incidence and characteristics of perioperative PTE in Japan in 2004.
Methods: A questionnaire was mailed to 960 institutions registered as the teaching hospitals of the Japanese Society of Anesthesiologists (JSA).