Publications by authors named "Shime N"
Aim: Few studies have investigated the differential effects of targeted temperature management (TTM) according to the severity of the condition in pediatric patients with post-cardiac arrest syndrome (PCAS). This study was aimed at evaluating the differential effects of TTM in pediatric patients with PCAS according to a risk classification tool developed by us, the rCAST.
Methods: We used data from a nationwide prospective registry for out-of-hospital cardiac arrest (OHCA) patients in Japan.
Aim: To determine the association between institutional experience with extracorporeal cardiopulmonary resuscitation (ECPR) and outcomes after out-of-hospital cardiac arrest (OHCA).
Methods: We analyzed data from the JAAM-OHCA registry, a nationwide multicenter database containing information on patients who experienced OHCA in Japan between June 2014 and December 2020. The study population consisted of patients with OHCA who were in cardiac arrest on hospital arrival and treated with extracorporeal membrane oxygenation (ECMO).
Objective: Previous studies have reported that the noise generated by dental equipment can interfere with the auscultation of respiratory sounds during sedation. Therefore, this study aimed to identify whether positing the acoustic sensor on the chest or cervical position would be least susceptible to interference from dental suction device noise, a prominent noise noted during respiratory sound monitoring during dental sedation.
Methods: This prospective cohort study was conducted with 30 students.
Respiratory physiotherapy for critically ill children: concern regarding a recommendation.
J Intensive Care
December 2024
The guideline entitled "Japanese Clinical Practice Guidelines for Rehabilitation in Critically Ill Patients 2023" was published by the Japanese Society of Intensive Care Medicine in 2023. However, there is an issue with the clinical question and recommendation for respiratory physiotherapy in mechanically ventilated children. Although the evidence was based on two randomized controlled trials regarding prone positioning, the recommendation may have risk of misunderstanding as a recommendation for all respiratory physiotherapy.
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- The study aimed to validate the simplified intubated COVID-19 predictive (sICOP) score for predicting outcomes in mechanically ventilated patients with COVID-19.
- It analyzed data from 146 patients across 66 hospitals in Japan, showing the sICOP score accurately predicted 28-day and in-hospital mortality with an AUC of 0.81 and 0.74, respectively.
- The sICOP score outperformed the SOFA score in both mortality predictions, indicating its potential usefulness prior to the availability of vaccines and antivirals, while suggesting that further validation with recent data is necessary.
Importance: Little is known about the epidemiology of out-of-hospital cardiac arrest (OHCA) in patients with asystole in countries where prehospital resuscitation is not withheld or terminated.
Objective: To investigate the secular trends in the patient outcomes and advanced life support (ALS) procedures and evaluate the association of ALS procedures with favorable outcomes among patients with OHCA and asystole.
Design, Setting, And Participants: This cohort study analyzed data from a nationwide prospective OHCA registry in Japan.
Background: There was no study to investigate the association between the national surge of Coronavirus disease 2019 (COVID-19) patients and the mortality of mechanically ventilated COVID-19 patients. The aim of this study was to assess the association between mortality in mechanically ventilated COVID-19 patients and two distinct national COVID-19 surge indices: (1) the daily number of newly confirmed COVID-19 cases, representing overall medical demands and (2) the total number of critically ill COVID-19 patients, reflecting critical care demands.
Methods: We analyzed the patient data registered in a national database of mechanically ventilated COVID-19 patients between February 6, 2020, and May 16, 2023, combined with the data officially published by the Japanese government.
Article Synopsis
- The translocator protein 18 kDa (TSPO) is implicated in inflammation, oxidative stress, and steroid production, and it may serve as a marker for inflammatory responses, particularly in the brain and other organs.
- This study analyzed plasma TSPO concentrations in patients with sepsis compared to healthy controls, finding that sepsis patients had significantly lower TSPO levels (0.094 ng/mL vs 0.25 ng/mL).
- Receiver operating characteristic analysis indicated that plasma TSPO may be a promising biomarker for diagnosing sepsis, with an area under the curve of 0.81; however, TSPO concentration did not correlate with the severity or prognosis of the disease.
Background: Sub-phenotyping of acute respiratory distress syndrome (ARDS) could be useful for evaluating the severity of ARDS or predicting its responsiveness to given therapeutic strategies, but no studies have yet investigated the heterogeneity of patients with severe ARDS requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO).
Methods: We conducted this retrospective multicenter observational study in adult patients with severe ARDS treated by V-V ECMO. We performed latent class analysis (LCA) for identifying sub-phenotypes of severe ARDS based on the radiological and clinical findings at the start of ECMO support.
Article Synopsis
- The study aimed to investigate the effects of tranexamic acid (TXA) on mortality and neurological outcomes in children with severe traumatic brain injuries (TBIs).
- The research analyzed data from 342 children under 18 years with severe TBIs and found that TXA use did not significantly affect in-hospital death rates or neurological outcomes at discharge.
- The authors concluded that TXA administration showed no association with improved survival or neurological status, suggesting the need for more prospective trials to evaluate its effectiveness in this population.
Background: Complications during veno-venous extracorporeal membrane oxygenation (VV-ECMO) are associated with in-hospital mortality. Asian patients on extracorporeal membrane oxygenation (ECMO) have higher risks of bleeding and in-hospital mortality than Caucasian patients. This study aimed to characterize and identify bleeding complications and their associated factors related to in-hospital mortality in patients with severe coronavirus disease 2019 (COVID-19) requiring VV-ECMO in Japan.
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- A systematic review was conducted to assess the safety of infusing vasoactive agents like epinephrine and norepinephrine through peripheral venous catheters or intraosseous access in critically ill children, as previous analyses had mostly focused on dopamine and had a limited number of patients.
- The review included twelve observational studies and one randomized controlled trial, ultimately calculating the incidence rates of local adverse events associated with these infusions.
- The findings showed a low incidence of such adverse events, at 2.1% overall, suggesting that peripheral infusion of vasoactive agents may be safe and viable in critical situations.
Article Synopsis
- A nationwide study in Japan analyzed the relationship between intensive care unit (ICU) case volume and outcomes for sepsis patients using data from 2010 to 2017.
- The study found that patients in higher-volume ICUs had significantly lower in-hospital mortality rates compared to those in lower-volume ICUs, indicating that more experience in treating sepsis correlates with better patient outcomes.
- However, higher-volume ICUs also incurred higher daily medical costs, suggesting a trade-off between cost and quality of care, especially for patients requiring advanced therapies like mechanical ventilation.
Background And Objectives: Victims of natural disasters are exposed to air pollution, changes in living conditions, and physical/emotional stress, which leads to exacerbation of asthma. The study aimed to examine the association between being victims of a natural disaster and asthma medication prescriptions among children and adolescents by comparing those affected and unaffected by the 2018 Japan floods.
Methods: Within the most severely impacted regions, a 1-year postdisaster retrospective cohort study was conducted on the basis of the National Health Insurance Claims Database.
We thank the authors of the Letter to the Editor for their astute points raised in reference to our original study [...
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- Traditional stethoscope auscultation is inadequate for continuous monitoring, prompting the development of a new acoustic monitoring system for respiratory sounds.
- The system was tested on a 24-week-old infant with extremely low birth weight who developed pulmonary atelectasis, allowing for early and noninvasive diagnosis through sound analysis.
- After treatment with surfactant lavage, the system showed significant improvement in lung sounds and the patient's condition, highlighting its potential to enhance neonatal respiratory care.
Article Synopsis
- This study investigated how different out-of-hospital cardiac arrest (OHCA) patients with a shockable rhythm respond to amiodarone treatment using machine learning techniques.
- The analysis included data from 2,333 OHCA patients, revealing that certain factors like age and pre-hospital interventions predict the effectiveness of amiodarone on neurological outcomes.
- Ultimately, approximately 47% of patients showed significant benefits from amiodarone, while 53% did not, highlighting the need for tailored treatment strategies in OHCA cases.
Article Synopsis
- Early identification of patients at high risk for PIVC-related phlebitis is crucial to prevent complications associated with medical devices.
- The study developed and validated four machine learning models to predict phlebitis incidence in critically ill patients, using a large dataset of 3429 PIVCs.
- Results showed that the Random Survival Forest (RSF) model had the best performance for predicting phlebitis, while key predictive factors included insertion site, catheter material, age, and medication use.
Article Synopsis
- A study investigated the effects of carbapenems as initial antibiotics on mortality rates in critically ill patients with bacterial infections, utilizing data from 268 patients across 31 Japanese ICUs.
- Results showed no significant difference in 28-day mortality between patients treated with carbapenems and those who were not (18% vs 16%).
- However, a longer duration of carbapenem use was associated with an increased risk of detecting multidrug-resistant pathogens.
Background: Patients who receive invasive mechanical ventilation (IMV) in the intensive care unit (ICU) have exhibited lower in-hospital mortality rates than those who are treated outside. However, the patient-, hospital-, and regional factors influencing the ICU admission of patients with IMV have not been quantitatively examined.
Methods: This retrospective cohort study used data from the nationwide Japanese inpatient administrative database and medical facility statistics.
Article Synopsis
- - A study analyzed over 73 million hospitalized patients in Japan from 2010 to 2019 to explore the prevalence of community-acquired infections (CAI) and nosocomial infections (NI), finding increases in both types of infections, particularly among those aged 85 and older.
- - The research indicated that 9.7% of patients had CAI and 4.7% had NI, with NI having a higher in-hospital mortality rate (14.5% vs. 8.3%) and resulting in longer hospital stays and greater medical costs.
- - Despite the overall decline in mortality rates for both infections over the years, the data highlights the significant impact of NI on older patients, undersc
Hypercalcemia is generally treated conservatively, including massive fluid administration. However, in cases of acute respiratory distress syndrome (ARDS) associated with drowning, excessive fluid administration may worsen respiratory status. An 81-year-old female was found drowned in a hot spring at an accommodation facility and urgently transported to our hospital.
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