Publications by authors named "Shu Utsumi"
Background: Tranexamic acid (TXA) has been used to treat traumatic brain injury (TBI); however, no definitive conclusions have been drawn regarding its effectiveness or dosage. This study evaluated the optimal TXA dose for treating TBI using a network meta-analysis (NMA).
Methods: Five databases were searched for peer-reviewed randomized controlled trials (RCTs) published from inception to May 2024.
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 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 [...
View Article and Find Full Text PDFIntracranial pressure (ICP) monitoring and monitoring of brain tissue oxygen (Pbto2) in addition to ICP have been used in the management of traumatic brain injury (TBI). However, the optimal monitoring method is inconclusive. We searched 4 databases with no language restrictions through January 2024 for peer-reviewed randomized controlled trials (RCTs) comparing ICP monitoring with combined Pbto2 and ICP monitoring in patients with traumatic brain injury.
View Article and Find Full Text PDFBackground: The aim of this systematic review was to assess the estimated incidence of pseudoaneurysm (PSA) with follow-up computed tomography (CT) for adult splenic injury with nonoperative management (NOM).
Methods: A systematic literature search was conducted in MEDLINE, Central, CINAHL, Clinical Trials, and ICTRP databases between January 1, 2010, and December 31, 2023. Quality assessment was performed using the Risk of Bias in Non-randomized Studies of Exposures (ROBINS-E) tool.
Article Synopsis
- The study aimed to analyze moderate traumatic brain injury (TBI) epidemiology and factors linked to poor neurological outcomes among adults using data from the Japan Trauma Data Bank (2019-2022).
- It involved 1,638 patients, predominantly male with a median age of 73, and found that falls were the most common cause of injury, with notable rates of subdural hematomas and cerebral contusions.
- Key factors such as older age, higher comorbidity, lower Glasgow Coma Scale scores, severe trauma, and the need for mechanical ventilation or craniotomy were linked to worse outcomes, while treatments like tranexamic acid and ICU admission correlated with better results.
Article Synopsis
- Out-of-hospital cardiac arrest (OHCA) varies significantly in causes and severity, affecting outcomes and treatment effectiveness.
- There has been limited research specifically addressing these differences in OHCA.
- This literature review aims to examine prognosis and treatment efficacy based on CA-related waveforms, patient age, and post-cardiac arrest syndrome severity to identify better treatment strategies for improved outcomes.
Kounis syndrome is an acute coronary syndrome (ACS) caused by an allergic reaction that almost always occurs immediately and simultaneously with allergic symptoms. We present a case of Kounis syndrome type III that developed after complete resolution of contrast-induced anaphylaxis in a 60-year-old man with a coronary stent placed in the proximal left anterior descending (LAD) artery branch for ischemic heart disease. Contrast-enhanced computed tomography revealed anaphylactic shock.
View Article and Find Full Text PDFContext: Nonpharmacologic distraction (NPD) during medical procedures in children is known to be beneficial to patients; however, no reviews have assessed their benefits to medical providers.
Objectives: We aimed to assess the benefits of NPD to medical providers.
Data Sources: We searched 5 databases for relevant articles.
Article Synopsis
- The study aimed to explore whether the number of pediatric patients treated for severe traumatic brain injury (TBI) at a hospital affects in-hospital mortality rates.
- It analyzed data from 1,148 pediatric patients treated across 141 hospitals in Japan, categorizing hospitals as low, middle, or high volume based on patient numbers.
- The findings indicated no significant link between hospital volume and in-hospital mortality, suggesting that the number of severe TBI cases treated by a hospital may not impact patient survival outcomes.
We report a case of post-extubation respiratory failure due to insufficient airway mucus expectoration that was successfully treated using mechanical insufflation-exsufflation (MI-E). A 32-year-old woman with a long-term history of steroid therapy for Blau syndrome was admitted to our intensive care unit with refractory hypoxemia due to pneumonia associated with the novel coronavirus disease 2019. Mechanical ventilation with veno-venous extracorporeal membrane oxygenation (VV-ECMO) was required due to severe hypoxemia.
View Article and Find Full Text PDFBackground: We aimed to synthesize published data on and identify factors associated with healthcare providers' satisfaction with end-of-life care for critically ill adults.
Methods: Electronic databases were searched from inception to January 23, 2023. We included trials involving adults admitted to intensive care units (ICUs) or high-dependency units to evaluate palliative care interventions.
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.
Objective: Pain in pediatric musculoskeletal (MSK) injuries can lead to increased anxiety, fear, and avoidance of medical care, making analgesic management critical. Therefore, we evaluated analgesic efficacy and adverse effects to select the optimal analgesic agent in pediatric patients with MSK injuries.
Methods: Four databases were searched from inception to March 2023 for peer-reviewed, open randomized controlled trials (RCTs).
The mortality rate of patients with COVID-19 pneumonia requiring mechanical ventilation remains high. This study determined the percentage and characteristics of patients who developed lung abscesses or pyothorax and their mortality rates among adult patients with COVID-19 admitted to the ICU who required mechanical ventilation. Of the 64 patients with COVID-19 assessed, 30 (47%) developed ventilator-associated pneumonia (VAP), of whom 6 (20%) developed pyothorax or lung abscess.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the effectiveness of different airway management techniques (bag-mask ventilation, endotracheal intubation, and supraglottic airway) during prehospital resuscitation in children who experience cardiac arrest.
- The analysis included five studies with a total of 4,852 pediatric patients, revealing that bag-mask ventilation was associated with better survival rates compared to endotracheal intubation, although the certainty of these results is low.
- The findings indicate that bag-mask ventilation may be the most effective airway management option for pediatric out-of-hospital cardiac arrest, but the overall evidence from the studies is limited and not definitive.
Background: The efficacy of targeted temperature management, including the appropriate length of time, in pediatric traumatic brain injury is inconclusive. We aimed to compare the efficacy of normothermia and therapeutic hypothermia administered for various durations.
Methods: We searched four databases without language limitations until December 2021 and included peer-reviewed published randomized controlled trials comparing normothermia (>35.
The benefits of introducing a systematic lung-protective protocol for coronavirus disease 2019 (COVID-19) pneumonia requiring invasive ventilation in the intensive care unit (ICU) are unknown. Herein, we aimed to evaluate the clinical effects of introducing such a protocol in terms of mortality, duration of ventilation, and length of ICU stay. In this single-centre, retrospective, quality comparison study, we identified patients with COVID-19 pneumonia who received invasive ventilation in our ICU between February 2020 and October 2021.
View Article and Find Full Text PDFWe report the first case of airway obstruction due to toxin-producing Corynebacterium ulcerans, successfully managed with venovenous extracorporeal membrane oxygenation (V-V ECMO). A woman aged 73 years who was living with companion animals was intubated for pneumonia of unknown origin and treated with an empirical antimicrobial agent. Corynebacterium species were detected in the sputum and treated as commensal bacteria.
View Article and Find Full Text PDFRepeat head computed tomography (RHCT) is common and routine for pediatric traumatic brain injury (TBI) patients. In mild (Glasgow Coma Scale; GCS 13-15) to moderate (GCS 9-12) TBI, recent studies have shown that RHCT without clinical deterioration does not alter management. However, the effectiveness of routine RHCT for pediatric TBI patients under 2 years has not been investigated.
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