Poor Environmental Conditions Created the Acute Health Deteriorations in Evacuation Shelters after the 2016 Kumamoto Earthquake.

When disasters occur, affected people in evacuation shelters may experience health problems, such as exacerbation of chronic diseases or development of new diseases. This study examined the factors contributing to sudden illness in evacuation shelters used for the 2016 Kumamoto Earthquake. The subjects were evacuees of the Kumamoto Earthquake who were transported to hospitals from evacuation shelters by ambulance.

Development, implementation, and refinement of a comprehensive postcardiac arrest care training course in Japan.

Aim: In Japan, no training course is dedicated to postcardiac arrest care (PCAC), including venoarterial extracorporeal membrane oxygenation (VA-ECMO); thus, faculty members of the Japanese Circulation Society developed an original, comprehensive PCAC training course. This report reviews the development, implementation, and refinement of this PCAC training course.

Methods: We examined the preserved data from the Japanese Circulation Society PCAC training courses between 2014 and 2020.

Exploration of autonomic regulation reflecting on pathophysiological change of sepsis: a prospective observational study.

Aim: It remains unclear how autonomic regulation modulates pathophysiological changes of sepsis. This study aims to analyze and clarify those in patients with suspected sepsis.

Methods: In this single-centered, prospective, observational study, adult patients who had an infection, a quick Sequential Organ Failure Assessment score of 2 or more at the emergency department, and underwent intensive care were screened.

Factors Affecting Human Damage in Heavy Rains and Typhoon Disasters.

Floods due to heavy rains or typhoons are frequent annual hazards in Japan. This study aims to reduce disaster fatalities and contribute to disaster risk reduction. This retrospective observational study analyzed fatalities caused by heavy rains or typhoons.

An Autopsy Case of Fulminant, Suppurative Bacterial Myocarditis Caused by Group B Streptococcus.

A 61-year-old woman was admitted to our hospital with a fever, nausea, diarrhea, and back pain. Her condition rapidly deteriorated, and she was transferred to the intensive-care unit for mechanical circulatory support and antibiotics, but she died 40 hours after admission. Autopsy findings showed necrotic and suppurative myocardial changes due to group B Streptococcus (GBS).

Impact of Induced Therapeutic Hypothermia by Intravenous Infusion of Ice-Cold Fluids After Hospital Arrival in Comatose Survivors of Out-of-Hospital Cardiac Arrest With Initial Shockable Rhythm.

Background: The effect of in-hospital rapid cooling by intravenous ice-cold fluids for comatose survivors of out-of-hospital cardiac arrest (OHCA) is unclear.

Methods and results: From the J-PULSE-HYPO study registry, data for 248 comatose survivors with return of spontaneous circulation (ROSC) who were treated with therapeutic hypothermia (34℃ for 12-72 h) after witnessed shockable OHCA were extracted. Patients were divided into 2 groups by the median collapse-to-ROSC interval (18 min), and then into 2 groups by cooling method (rapid cooling by intravenous ice-cold fluids vs.

Cluster Randomized Trial of Duration of Cooling in Targeted Temperature Management After Resuscitation for Cardiac Arrest.

The 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care recommend that comatose patients with return of spontaneous circulation after cardiac arrest have targeted temperature management (TTM). However, the duration of TTM remains to be elucidated. We conducted a cluster randomized trial in 10 hospitals to compare 12-24 vs.

Clinical Features of Disaster-Associated Direct Deaths during Recent Inland Earthquakes in Japan.

Natural disasters, including earthquakes, cause disaster-associated direct deaths due to hazards and disaster-related deaths. This study was a retrospective and observational study that explored the effect of natural disasters on direct death. Although research reports on disaster-related deaths are common, there are few reports of disaster-associated direct death caused by events, such as house collapses, fires, and sediment-related factors.

Clinical Features of Patients With Acute Aortic Dissection After an Earthquake: Experience from the Kumamoto Earthquake 2016.

Background: While there is a concern about the increase in the occurrence of acute aortic dissection (AAD) caused by the worsening of hypertension, mental stress, etc., there is a lack of data regarding the influence of disasters on this event. The aim of this study was to address this issue in the acute-subacute phase after the Kumamoto Earthquake occurred on 14 April 2016.

Association between rewarming duration and neurological outcome in out-of-hospital cardiac arrest patients receiving therapeutic hypothermia.

Aim: The European Resuscitation Council guidelines recommend a slow rate of rewarming of 0.25 °C/h-0.5 °C/h for out-of-hospital cardiac arrest (OHCA) patients receiving therapeutic hypothermia (TH).

Slow rewarming improved the neurological outcomes of prolonged mild therapeutic hypothermia in patients with severe traumatic brain injury and an evacuated hematoma.

Mild therapeutic hypothermia (MTH) is expected to improve the neurological outcomes of patients with severe traumatic brain injury (TBI). However, there are no standard protocols for managing the temperature of patients with severe TBI in order to improve their neurological outcomes. We conducted a post hoc analysis of the B-HYPO study, a randomized controlled trial of MTH in patients with TBI in Japan.

The Impact of Heart Rate Response During 48-Hour Rewarming Phase of Therapeutic Hypothermia on Neurologic Outcomes in Out-of-Hospital Cardiac Arrest Patients.

Objectives: Bradycardia during therapeutic hypothermia has been reported to be a predictor of favorable neurologic outcomes in out-of-hospital cardiac arrests. However, bradycardia occurrence rate may be influenced by the target body temperature. During therapeutic hypothermia, as part of the normal physiologic response, heart rate decreases in the cooling phase and increases during the rewarming phase.

Acute Effects of Ambient PM on All-Cause and Cause-Specific Emergency Ambulance Dispatches in Japan.

Short-term health effects of ambient PM have been established with numerous studies, but evidence in Asian countries is limited. This study aimed to investigate the short-term effects of PM on acute health outcomes, particularly all-cause, cardiovascular, respiratory, cerebrovascular and neuropsychological outcomes. We utilized daily emergency ambulance dispatches (EAD) data from eight Japanese cities (2007-2011).

Evolved role of the cardiovascular intensive care unit (CICU).

Cardiovascular intensive care refers to special systemic management for the patients with severe cardiovascular disease (CVD), which consists of heart disease and vascular disease. CVD is one of the leading causes of death in the world. In order to prevent death due to CVDs, an intensive care unit for severe CVD patients, so-called cardiovascular intensive care unit (CICU), has been developed in many general hospitals.

Serum neutrophil gelatinase-associated lipocalin levels predict the neurological outcomes of out-of-hospital cardiac arrest victims.

Background: Serum neutrophil gelatinase-associated lipocalin (NGAL) is a well-known biomarker of acute kidney injury. Serum NGAL was recently proposed as a potential predictor of mortality in post cardiac arrest syndrome (PCAS) patients following out-of-hospital cardiac arrest (OHCA). However, the potential predictive value of NGAL for neurological outcomes is unknown.

Effectiveness of lower target temperature therapeutic hypothermia in post-cardiac arrest syndrome patients with a resuscitation interval of ≤30 min.

Background: Therapeutic hypothermia (TH) is a standard strategy to reduce brain damage in post-cardiac arrest syndrome (PCAS) patients. However, it is unknown whether the target temperature should be adjusted for PCAS patients in different states.

Methods: Participants in the J-PULSE-Hypo study database were divided into lower (32.

Comparison of the McGrath MAC video laryngoscope and the Pentax Airwayscope during chest compression: a manikin study.

We tested the utility of the McGrath MAC(®) (McG) video laryngoscope during chest compression compared with the Pentax Airwayscope(®) (AWS). We recruited 59 participants into the simulation study. The difference in the time to intubation (TTI [sec]) between without and with chest compression was significant for the AWS attempts (median 13, range 6-28 vs.

An analysis of the relationship between Glasgow Coma Scale score and plasma glucose level according to the severity of hypoglycemia.

Background: The Glasgow Coma Scale (GCS) score of an individual with hypoglycemia is expected to be low due to an insufficient glucose supply to the brain. However, we sometimes encounter hypoglycemic patients with high GCS scores. This study was undertaken to analyze the relationship between the GCS score and the plasma glucose level.

Comparison of the conventional Macintosh laryngoscope, the Pentax Airwayscope, and the McGrath MAC video laryngoscope under restricted cervical motion: a manikin study.

Aim: We compared the utility of the conventional Macintosh laryngoscope, the Pentax Airway Scope, and the McGrath MAC video laryngoscope under restricted cervical motion using a manikin.

Methods: We recruited 36 participants into the simulation study. The manikin's cervical motion was restricted with a cervical collar and a head immobilizer, as occurs in trauma cases.

Effects of uninterrupted chest compressions on the rescuer's physical condition.

Study Objective: Recent guidelines have emphasized the need for uninterrupted chest compressions. The purpose of this study was to evaluate the rescuer's tolerability of uninterrupted chest compressions.

Methods: Twenty-five healthy subjects performed uninterrupted chest compressions for 7 minutes at a rate of 100 compressions per minute using a training manikin.

Electrocardiogram findings of patients with serum potassium levels of nearly 10.0 mmol/L: a report of two cases.

Cases: In Case 1, a 63-year-old woman was admitted with muscular weakness. She had hypertension, diabetes mellitus, and chronic renal failure on hemodialysis. She was taking a beta-blocker.

Comparison of the utility of the Pentax Airway Scope (AWS) with that of the conventional Macintosh laryngoscope during chest compression: is the AWS an easy-to-use device for a novice?

Aim: The Pentax Airway Scope occasionally contacts the arm of the chest compressor at insertion because of its large body. Here, we test the Airway Scope's ease of use compared to that of the conventional Macintosh laryngoscope during chest compression, when operated by a novice.

Methods: We recruited 73 participants into this simulation study.

Neurological benefit of therapeutic hypothermia following return of spontaneous circulation for out-of-hospital non-shockable cardiac arrest.

Background: Although therapeutic hypothermia is an effective therapy for comatose adults experiencing out-of-hospital shockable cardiac arrest, there is insufficient evidence that is also applicable for those with out-of-hospital non-shockable cardiac arrest.

Methods And Results: Of 452 comatose adults treated with therapeutic hypothermia after return of spontaneous circulation (ROSC) subsequent to an out-of-hospital cardiac arrest of cardiac etiology, 372 who had a bystander-witnessed cardiac arrest, target core temperature of 32-34°C and cooling duration of 12-72 h were eligible for this study (75 cases of non-shockable cardiac arrest, 297 cases of shockable cardiac arrest). The median collapse-to-ROSC interval was significantly longer in the non-shockable group than in the shockable group (30 min vs.