Publications by authors named "U Higashijima"
Background: Patients undergoing liver transplantation are in a state of coagulopathy before surgery because of liver failure. Intraoperative hemorrhage, massive transfusions, and post-reperfusion syndrome further contribute to coagulopathy, acidosis, and hypothermia. In such situations, temporary cessation of surgery with open abdominal management and resuscitation in the intensive care unit (ICU), which is commonly used as a damage control strategy in trauma care, may be effective.
View Article and Find Full Text PDFBackground: Sodium-glucose cotransporter (SGLT) 2 inhibitors partially inhibit SGLT1 expression; however, whether a clinical dose of SGLT2 inhibitor abrogates ischemic preconditioning (IPC) is unknown, and the pharmacological cardioprotective effect under SGLT1 inhibition has not been examined. In this study, we investigated whether a clinical dose of tofogliflozin abrogates IPC and whether pharmacological preconditioning with olprinone has cardioprotective effects under SGLT1 inhibition.
Methods: Male Wistar rats were divided into seven groups (seven rats per group) and subjected to the following treatments before inducing ischemia/reperfusion (I/R; 30 minutes of coronary artery occlusion followed by 120 minutes of reperfusion): saline infusion control treatment (Con); ischemic preconditioning (IPC); IPC after phlorizin infusion (IPC+Phl); IPC after low-dose tofogliflozin infusion (IPC+L-Tof); IPC after high-dose tofogliflozin infusion (IPC+H-Tof); olprinone infusion (Olp); and Olp infusion after phlorizin infusion (Olp+Phl).
Article Synopsis
- Amniotic fluid embolism (AFE) is a serious condition that can cause respiratory and circulatory failure during pregnancy, complicating treatment with issues like bleeding tendencies due to disseminated intravascular coagulation (DIC).
- A 39-year-old patient with AFE underwent emergency cesarean section and required massive blood transfusions; when she developed critical respiratory and circulatory failure, venoarterial extracorporeal membrane oxygenation (VA-ECMO) was implemented without initial anticoagulation.
- The patient's condition stabilized after five days on VA-ECMO, allowing her to be weaned off the machine and ultimately discharged home in good health, highlighting the importance of managing bleeding tendencies effectively in such cases.
Rationale: Streptococcal toxic shock syndrome (STSS) rapidly leads to refractory shock and multiple organ failure. The mortality rate among patients with STSS is 40%; however, most deaths occur within a few days of onset. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) may help avoid acute death in adult patients with STSS.
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- Diagnosing mesenteric ischemia (AMI) in critically ill patients can be tough, but the "aquarium sign" seen on echocardiograms can help identify it via ultrasound.
- A 65-year-old woman with lymphoma was admitted with shock and showed an aquarium sign on an echocardiogram, indicating potential AMI despite normal lactate levels initially.
- After further imaging confirmed AMI, she underwent urgent surgery and her condition improved, highlighting the importance of monitoring for symptoms like the aquarium sign regardless of other indicators.