Publications by authors named "Shodai Yoshihiro"
Article Synopsis
- This systematic review and meta-analysis assessed how enhanced rehabilitation after hospital discharge affects the quality of life (QOL) for survivors of critical care, following PRISMA guidelines and examining data from several major health databases until January 2024.
- The review included nine randomized controlled trials (RCTs) with 573 participants, finding that enhanced rehabilitation showed no significant improvement in physical QOL but did result in a higher mental QOL score (low-certainty evidence).
- Adverse events' impact was uncertain, with mixed reports from the studies; some had no adverse events, while others noted serious incidents, indicating very low-certainty evidence on this issue.
True Effect of Fludrocortisone for Septic Shock: Baseline Risk and Transitivity Concerns.
Am J Respir Crit Care Med
November 2024
Objectives: To determine optional therapeutic strategies by comparing monotherapies and combination therapies to reduce RBC transfusion requirement for patients in the ICU.
Data Sources: MEDLINE, CENTRAL, and Embase were searched for studies published from database inception until July 2023.
Data Extraction: We included randomized controlled trials comparing erythropoiesis-stimulating agents (Epo), iron, combination therapy with iron and Epo, hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), vitamin D 3 (VD3), and placebo/no treatment.
Article Synopsis
- The study aimed to address the challenges of assessing post-intensive care syndrome (PICS) in ICU survivors by identifying effective assessment instruments through a scoping review and consensus process.
- A total of 6972 records were reviewed, leading to 20 recommended instruments spanning various domains, including physical health, cognition, and mental health.
- The findings provide a structured approach to evaluating PICS, highlighting tools like the 6-min walk test and MoCA, ensuring comprehensive assessment for ICU survivors and their families.
Providing standardized, high-quality rehabilitation for critically ill patients is a crucial issue. In 2017, the Japanese Society of Intensive Care Medicine (JSICM) promulgated the "Evidence-Based Expert Consensus for Early Rehabilitation in the Intensive Care Unit" to advocate for the early initiation of rehabilitations in Japanese intensive care settings. Building upon this seminal work, JSICM has recently conducted a rigorous systematic review utilizing the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.
View Article and Find Full Text PDFPrevious systematic review and meta-analysis indicates that rehabilitation within a week of intensive care unit (ICU) admission benefits physical function in critically ill patients. This updated systematic review and meta-analysis aim to clarify effects of initiating rehabilitation within 72 h of ICU admission on long-term physical, cognitive, and mental health. We systematically searched the MEDLINE, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi for randomized controlled trials (RCTs) between April 2019 and November 2022 to add to the previous review.
View Article and Find Full Text PDFPsychological dysfunction is one of the considerable health-related outcomes among critically-ill patients and their informal caregivers. Follow-up of intensive care unit (ICU) survivors has been conducted in a variety of different ways, with different timing after discharge, targets of interest (physical, psychological, social) and measures used. Of diverse ICU follow-up, the effects of follow-ups which focused on psychological interventions are unknown.
View Article and Find Full Text PDFObjectives: Neuromuscular electrical stimulation (NMES) is used in the rehabilitation of patients with critical illness. However, it is unclear whether NMES prevents ICU-acquired weakness (ICU-AW). For this purpose, we conducted an updated systematic review and meta-analysis.
View Article and Find Full Text PDFArticle Synopsis
- Fluid creep, primarily from fluids used as drug diluents and to keep catheters patent, significantly contributes to fluid intake in critically ill patients, particularly those with respiratory support.
- A study analyzed data from 588 ICU patients in Japan and found that fluid creep was about 25.2% of total intravenous fluid volume within the first 24 hours, with an increasing trend during their ICU stay, especially in those with severe hypoxemia.
- The research indicated that while fluid creep reduced over time in patients without hypoxemia or with mild hypoxemia, those with severe hypoxemia continued to experience a high burden of fluid creep throughout their ICU care.
Introduction: Central venous catheterization is a commonly performed procedure, accounting for approximately 8% of hospitalized patients. Based on the current literatures, the most acceptable site for central venous catheterization is inconclusive, considering various complications in hospitalized patients. Herein, we conducted a network meta-analysis to assess the clinically important complications among internal jugular, subclavian, femoral, and peripheral insertion.
View Article and Find Full Text PDFPurpose: Although the most recent systematic review and meta-analyses on acute respiratory distress syndrome (ARDS) have shown that the use of steroids decreases mortality in adult patients, its benefits and risks may differ depending on the type and dosage of the steroid. Therefore, we conducted a network meta-analysis (NMA) to compare the differences in the efficacy among different doses and types of steroids.
Methods: We searched MEDLINE, CENTRAL, ICHUSHI, ClinicalTrials.
Purpose: This study sought to describe the epidemiology of anticoagulation therapy for critically ill patients with new-onset atrial fibrillation (NOAF) according to CHA2DS2-VASc and HAS-BLED scores and to assess the efficacy of early anticoagulation therapy.
Method: Adult patients who developed NOAF during intensive care unit stay were included. We compared the patients who were treated with and without anticoagulation therapy within 48 h from AF onset.
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.
View Article and Find Full Text PDFArticle Synopsis
- - 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.
We comment on the study by Hirano et al. about the effect of steroids in patients with acute respiratory distress syndrome. It might be necessary to include only the existing randomized control trials and to reassess the certainty of evidence about the primary outcomes.
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- Recombinant human-soluble thrombomodulin (rhTM) is being investigated for its potential to improve outcomes in sepsis patients experiencing severe respiratory failure due to blood clotting issues.
- A study involving 1,180 patients from 42 ICUs in Japan compared survival rates and ventilator-free days between those treated with rhTM and those who were not.
- Results showed that rhTM treatment was linked to lower ICU and hospital mortality rates, suggesting it may be an effective therapeutic option for these patients.
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.
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.*