Publications by authors named "Tetsuya Sakamoto"
Article Synopsis
- - ECPR can enhance survival and neurological recovery for patients suffering from out-of-hospital cardiac arrest (OHCA), but elevated levels of arterial oxygen can hinder these outcomes, particularly in the context of targeted temperature management (TTM).
- - This study analyzed data from a larger registry of ECPR cases, focusing on the impact of prolonged hyperoxemia, defined as a partial pressure of arterial oxygen (PaO) of 300 mmHg or higher, during the initial days of intensive care.
- - Findings indicate that prolonged hyperoxemia negatively affects both survival and neurological recovery post-ECPR, with factors such as age and initial heart rhythm also playing critical roles in patient outcomes.
Article Synopsis
- Previous studies suggest that women have better outcomes than men when undergoing extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA), but detailed research on this is limited.
- This study analyzed data from the SAVE-J II registry, examining the sex differences and outcomes in ECPR patients, focusing on neurological recovery at hospital discharge.
- Findings showed that while there were more male patients, women had a higher adjusted odds ratio for favorable neurological outcomes (1.60), indicating better recovery compared to men, especially given the differences in cardiac rhythms presented at the time of treatment. *
Article Synopsis
- The study investigated what factors contribute to better neurological outcomes in patients initially experiencing pulseless electrical activity (PEA) who received extracorporeal cardiopulmonary resuscitation (ECPR).
- Data from the SAVE-J II registry, which included 36 hospitals in Japan, showed that only 8.2% of patients had favorable neurological outcomes, while 16.9% survived to hospital discharge.
- Key factors linked to better outcomes included absence of cardiac rhythm conversion to asystole, presence of signs of life, pupil size, and temporary return of circulation, with certain causes of cardiac arrest like acute coronary syndrome having higher favorable outcomes.
Article Synopsis
- This study investigates the link between rewarming durations and neurological outcomes in patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR) with targeted temperature management (TTM) after experiencing out-of-hospital cardiac arrest (OHCA).
- The research is a secondary analysis of data from the Advanced Life Support Study Registry in Japan, focusing on patients with either a TTM of 34°C or below.
- Findings show that a shorter rewarming duration (<24 hours) was not significantly associated with better neurological outcomes or survival rates compared to longer durations (24 hours or >24 hours).
Aim: Extracorporeal cardiopulmonary resuscitation (ECPR) is used to resuscitate patients with cardiac arrest; however, its effect in treating hypothermic cardiac arrest has not been well studied. Therefore, in this study, we aimed to examine the characteristics and outcomes of patients with hypothermic cardiac arrest who underwent ECPR, using a multicenter out-of-hospital cardiac arrest (OHCA) registry in Japan.
Methods: Baseline characteristics of patients with hypothermic OHCA and body temperature below 32 °C were assessed.
Although patients who underwent night-time resuscitation for out-of-hospital cardiac arrest (OHCA) had worse clinical outcomes than those who underwent day-time resuscitation, the differences between the outcomes of patients with OHCA who underwent extracorporeal cardiopulmonary resuscitation (ECPR) in the day-time and night-time remain unclear. We analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan. Patients were categorized according to whether they received treatment during the day-time or night-time.
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- A study in Japan examined pediatric patients aged 0-19 who died from SARS-CoV-2 infection between January and September 2022, identifying 62 cases and analyzing detailed medical information from 53 of those patients.
- Of the patients with internal causes of death, 15% were infants under 1 year old, 59% had no underlying health conditions, and 88% of those eligible for vaccination had not been vaccinated.
- Key findings showed that 46% experienced out-of-hospital cardiac arrest, nonrespiratory symptoms were more prevalent than respiratory symptoms, and the primary suspected causes of death were central nervous system and cardiac abnormalities; the study emphasizes close monitoring of pediatric patients in the week following symptom onset
Article Synopsis
- In a study of out-of-hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR), researchers explored how low-flow time affects survival outcomes, focusing on those with accidental hypothermia (AH).
- Out of 1,252 enrolled patients, 8.4% had AH, and those patients showed a higher survival discharge rate (44.8%) compared to those without AH (25.4%).
- The findings suggest that low-flow time does not significantly impact survival in AH patients, unlike non-AH patients where longer low-flow times negatively affect survival rates.
Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for refractory cardiac arrest, and immediate initiation after indication is recommended. However, the practical goals of ECPR preparation (such as the door-to-needle time) remain unclear. This study aimed to elucidate the association between the door-to-needle time and neurological outcomes of out-of-hospital cardiac arrest.
View Article and Find Full Text PDFObjective: The association between fluid balance and outcomes in patients who underwent out-of-hospital cardiac arrest (OHCA) and received extracorporeal cardiopulmonary resuscitation (ECPR) remains unknown. We aimed to examine the above relationship during the first 24 h following intensive care unit (ICU) admission.
Methods: We performed a secondary analysis of the SAVE-J II study, a retrospective multicenter study involving OHCA patients aged ≥ 18 years treated with ECPR between 2013 and 2018 and who received fluid therapy following ICU admission.
Article Synopsis
- A study investigated the survival rates of adult patients with out-of-hospital cardiac arrest (OHCA) who received extracorporeal cardiopulmonary resuscitation (ECPR) at different medical centers in Japan.
- The research divided centers into high, medium, and low-volume categories based on the number of ECPR sessions they performed annually, finding that higher-volume centers had significantly better survival rates for patients at discharge.
- Results indicated that patients treated at high-volume centers were more likely to survive than those at medium or low-volume centers, suggesting that higher experience and expertise could lead to improved outcomes and fewer complications in ECPR procedures.
The prognosis for patients with out-of-hospital cardiac arrest (OHCA) has been reported to be worse in the cold season. On the other hand, it is unclear whether a similar trend exists in OHCA patients who are treated with extracorporeal cardiopulmonary resuscitation (ECPR). This study was a retrospective multicenter registry study.
View Article and Find Full Text PDFBackground: In some cases of patients with out-of-hospital cardiac arrest (OHCA) who underwent extracorporeal cardiopulmonary resuscitation (ECPR), negative pupillary light reflex (PLR) and mydriasis upon hospital arrival serve as common early indicator of poor prognosis. However, in certain patients with poor prognoses inferred by pupil findings upon hospital arrival, pupillary findings improve before and after the establishment of ECPR. The association between these changes in pupillary findings and prognosis remains unclear.
View Article and Find Full Text PDFObjectives: Serial evaluations of lactate concentration may be more useful in predicting outcomes in patients with out-of-hospital cardiac arrest (OHCA) than a single measurement. This study aimed to evaluate the impact of lactate clearance (LC) on clinical and neurologic outcomes in patients with OHCA who underwent extracorporeal cardiopulmonary resuscitation (ECPR).
Design: Retrospective multicenter observational study.
Article Synopsis
- Out-of-hospital cardiac arrest (OHCA) is critical, and implementing effective "chain of survival" strategies is crucial for improving patient survival rates; monitoring these processes is essential for quality assurance.
- In Japan, various OHCA registries such as the All-Japan Utstein registry and regional projects like the Osaka-CRITICAL study have been established to collect and analyze extensive data on OHCA cases, enhancing emergency medical services.
- Each registry has unique strengths and challenges but collectively contributes to improving emergency response systems and advancing resuscitation science in Japan.
Background: Bleeding is the most common complication in out-of-hospital cardiac arrest (OHCA) patients receiving extracorporeal cardiopulmonary resuscitation (ECPR). No studies comprehensively described the incidence rate, timing of onset, risk factors, and treatment of bleeding complications in OHCA patients receiving ECPR in a multicenter setting with a large database. This study aimed to analyze the risk factors of bleeding during the first day of admission and to comprehensively describe details of bleeding during hospitalization in patients with OHCA receiving ECPR in the SAVE-J II study database.
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- The study aimed to compare the effectiveness of mechanical versus manual chest compressions in patients experiencing out-of-hospital cardiac arrest before receiving extracorporeal cardiopulmonary resuscitation (ECPR).
- It analyzed data from the SAVE-J II registry, focusing on patient outcomes such as mortality at hospital discharge and cerebral performance category scores.
- Results revealed that patients receiving mechanical chest compressions had a significantly higher mortality rate than those receiving manual compressions, suggesting that mechanical compressions may be linked to worse outcomes in this context.
Purpose: The effect of a prophylactic distal perfusion catheter (DPC) after extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) remains unclear. Therefore, we aimed to clarify the association between prophylactic DPC and prognosis in patients with OHCA undergoing ECPR.
Materials And Methods: A secondary analysis of the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J II) database was performed to compare groups of patients with and without prophylactic DPCs.
Background: Risk stratification is important in patients with post-cardiac arrest syndrome. The Post-Cardiac Arrest Syndrome for Therapeutic Hypothermia (CAST) and revised CAST (rCAST) scores have been well validated for predicting neurological outcomes, particularly for conventionally resuscitated patients with post-cardiac arrest syndrome. However, no studies have evaluated patients undergoing extracorporeal cardiopulmonary resuscitation.
View Article and Find Full Text PDFBackground: This study evaluated the association between intra-aortic balloon pump (IABP) use in patients with out-of-hospital cardiac arrest (OHCA) caused by acute coronary syndrome (ACS) who received extracorporeal cardiopulmonary resuscitation (ECPR) and 30-day outcomes.
Methods: This study was a secondary analysis of data from the SAVE-J II study, a retrospective, multicenter registry study involving 36 participating institutions in Japan. Patients with cardiac arrest caused by ACS who received ECPR were divided into two groups depending on whether or not they received IABP.
Background: We examined the association between body mass index (BMI) and outcomes in patients with out-of-hospital cardiac arrest (OHCA) undergoing extracorporeal cardiopulmonary resuscitation (ECPR).
Methods: We retrospectively analyzed the database of an observational multicenter cohort in Japan. Adult patients with OHCA of cardiac etiology who received ECPR between 2013 and 2018 were categorized as follows: underweight, BMI < 18.
Wider Dissemination of Simplified Chest Compression-Only Cardiopulmonary Resuscitation Training Combined With Conventional Cardiopulmonary Resuscitation Training and 10-Year Trends in Cardiopulmonary Resuscitation Performed by Bystanders in a City.
Circ J
July 2024
Background: Little is known about how to effectively increase bystander cardiopulmonary resuscitation (CPR), so we evaluated the 10-year trend of the proportion of bystander CPR in an area with wide dissemination of chest compression-only CPR (CCCPR) training combined with conventional CPR training.
Methods and results: We conducted a descriptive study after a community intervention, using a prospective cohort from September 2010 to December 2019. The intervention consisted of disseminating CCCPR training combined with conventional CPR training in Toyonaka City since 2010.