Updated on 2025/04/02

写真a

 
OKAHARA Shuji
 
Organization
Scheduled update Assistant Professor
Position
Assistant Professor
External link

Degree

  • Doctor of Philosophy in Medical Science ( 2018.6   Okayama University )

 

Papers

  • イソフルラン,プロポフォールを投与し鎮静薬を計画的に減量しえた長期人工呼吸管理の小児重症心不全例

    成谷 俊輝, 黒田 浩佐, 岡原 修司, 鈴木 聡, 金澤 伴幸, 清水 一好, 岩崎 達雄, 森松 博史

    日本集中治療医学会雑誌   31 ( 4 )   261 - 265   2024.7

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    Language:Japanese   Publisher:(一社)日本集中治療医学会  

    小児の長期にわたる鎮静は,薬剤耐性や医原性離脱症候群(iatrogenic withdrawal syndrome,IWS)を引き起こし,管理に難渋する場合がある。患者は14歳,男児。劇症型心筋炎と診断され左心補助人工心臓を必要とし,鎮痛鎮静薬は高用量かつ長期間投与となった。抜管に向けてIWS発症回避のため薬剤漸減の必要があったが,その過程での安全な管理のために抜管までは鎮静度の維持が必要と考えた。ミダゾラムとフェンタニルは12時間ごとに5%ずつ減量し,その間は適応外使用としてケタミン,イソフルラン,プロポフォールを順に投与し,鎮静度を維持した。プロポフォール中止後は速やかに覚醒が得られたため抜管し,ミダゾラム,フェンタニル中止後にデクスメデトミジンを漸減終了した。経過中はプロポフォール注入症候群,IWS,悪性高熱症を疑う所見を認めなかった。(著者抄録)

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    Other Link: https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J02874&link_issn=&doc_id=20240719470006&doc_link_id=20240719470001&url=http%3A%2F%2Fsearch.jamas.or.jp%2Flink%2Fbc%2F20240719470001&type=jamaslink&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F99999_1.gif

  • Postoperative Complications in Living Donors for Lung Transplantation. International journal

    Shin Tanaka, Kento Fujii, Megumi Ishihara, Haruki Choshi, Kei Matsubara, Kohei Hashimoto, Shuji Okahara, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Hiromasa Yamamoto, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka

    Transplantation direct   10 ( 5 )   e1617   2024.5

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    Language:English   Publishing type:Research paper (scientific journal)  

    BACKGROUND: Living donor lobar lung transplantation is a life-saving procedure for critically ill patients. This requires 2 healthy donors exposed to risks and without medical benefit. Therefore, the donor's safety and minimal postoperative complications are crucial. This study aimed to investigate the short-term outcomes and identify the risk factors affecting these outcomes. METHODS: The data of 175 living donors enrolled between 1998 and 2022 were analyzed. Donors were divided into era 1 (1998-2009) and era 2 (2010-2022). RESULTS: The overall incidence of postoperative complications was 39%, of which 7% were major complications. Donors who underwent surgery on the right side had a higher incidence of delayed pulmonary fistulae (P = 0.01) and elevated liver enzyme levels (P = 0.028). Living donor surgery on the right side (P = 0.01), era 2 (P = 0.01), and the need for plasty (P = 0.04) were predictors of postoperative complications. CONCLUSIONS: Updated data on complications and their correlation with postoperative quality of life from this study could aid in the selection of potential donors and facilitate informed consent.

    DOI: 10.1097/TXD.0000000000001617

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  • Donor's long-term quality of life following living-donor lobar lung transplantation. International journal

    Kento Fujii, Shin Tanaka, Megumi Ishihara, Kei Matsubara, Kohei Hashimoto, Shuji Okahara, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Shinji Otani, Hiromasa Yamamoto, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka

    Clinical transplantation   37 ( 4 )   e14927   2023.2

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    Language:English   Publishing type:Research paper (scientific journal)  

    INTRODUCTION: Living-donor lobar lung transplantation is an alternative procedure to deceased donation lung transplantation. It involves graft donation from healthy donors; however, only a few reports have discussed its long-term prognosis in living lung donors and their associated health-related quality of life. This study aimed to examine living lung donors' health-related quality of life. METHODS: In our cross-sectional survey of living lung donors, we assessed health-related quality of life based on three key aspects (physical, mental, and social health) using the 36-Item Short Form Health Survey. We also evaluated chronic postoperative pain and postoperative breathlessness using the numeric rating scale and the modified Medical Research Council Dyspnea scale, respectively. RESULTS: We obtained consent from 117 of 174 living lung donors. The average scores of the living lung donors on the 36-Item Short Form Health Survey were higher than the national average. However, some donors had poorer physical, mental, and social health, with lower summary scores than the national averages. Low mental component summary predictors included donor age (<40 years; odds ratio = 10.2; p<.001) and recipient age (<18 years; odds ratio = 2.73; p<.032). Low role-social component summary predictors included high lung allocation score (≥50; odds ratio = 3.94, p<.002) and recipient death (odds ratio = 3.64; p = .005). There were no predictors for physical component summary. Additionally, many donors did not complain of pain or dyspnea. CONCLUSIONS: Living lung donors maintained acceptable long-term health-related quality of life after surgery. Potential donors should be informed of relevant risk factors, and high-risk donors should receive appropriate support. This article is protected by copyright. All rights reserved.

    DOI: 10.1111/ctr.14927

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  • A prediction model to determine the untapped lung donor pool outside of the DonateLife network in Victoria International journal

    Shuji Okahara, Gregory I Snell, Bronwyn J Levvey, Mark McDonald, Rohit D’Costa, Helen Opdam, David V Pilcher

    Anaesthesia and Intensive Care   50 ( 5 )   380 - 387   2022.9

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:SAGE Publications  

    Lung transplantation is limited by a lack of suitable lung donors. In Australia, the national donation organisation (DonateLife) has taken a major role in optimising organ donor identification. However, the potential outside the DonateLife network hospitals remains uncertain. We aimed to create a prediction model for lung donation within the DonateLife network and estimate the untapped lung donors outside of the DonateLife network. We reviewed all deaths in the state of Victoria’s intensive care units using a prospectively collected population-based intensive care unit database linked to organ donation records. A logistic regression model derived using patient-level data was developed to characterise the lung donors within DonateLife network hospitals. Consequently, we estimated the expected number of lung donors in Victorian hospitals outside the DonateLife network and compared the actual number. Between 2014 and 2018, 291 lung donations occurred from 8043 intensive care unit deaths in DonateLife hospitals, while only three lung donations occurred from 1373 ICU deaths in non-DonateLife hospitals. Age, sex, postoperative admission, sepsis, neurological disease, trauma, chronic respiratory disease, lung oxygenation and serum creatinine were factors independently associated with lung donation. A highly discriminatory prediction model with area under the receiver operator characteristic curve of 0.91 was developed and accurately estimated the number of lung donors. Applying the model to non-DonateLife hospital data predicted only an additional five lung donors. This prediction model revealed few additional lung donor opportunities outside the DonateLife network, and the necessity of alternative and novel strategies for lung donation. A donor prediction model could provide a useful benchmarking tool to explore organ donation potential across different jurisdictions, hospitals and transplanting centres.

    DOI: 10.1177/0310057x211070011

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    Other Link: http://journals.sagepub.com/doi/full-xml/10.1177/0310057X211070011

  • 血液粘弾性検査によりヘパリン残存が術後止血困難の原因と特定できた心臓外科緊急手術の一症例

    森松 尭, 金澤 伴幸, 岡原 修司, 越智 聡子, 佐倉 考信, 清水 一好, 森松 博史

    臨床モニター   33 ( Suppl. )   117 - 117   2022.6

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    Language:Japanese   Publisher:医学図書出版(株)  

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Books

  • 臨床麻酔科学書

    岡原 修司, 森松 博史( Role: Contributor ,  移植外科の麻酔 肺移植手術の麻酔)

    中山書店  2022.7  ( ISBN:9784521749495

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    Total pages:xvi, 783p   Language:Japanese

    CiNii Books

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  • Challenge緊急手術の麻酔

    岡原 修司, 小林 求( Role: Contributor ,  臓器移植 肺移植)

    文光堂  2021.11  ( ISBN:9784830628528

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    Total pages:323p   Language:Japanese

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MISC

  • 肺移植術後の気管支狭窄解除術において、Electrical Impedance Tomographyを治療効果判定に使用した一例

    木村 貴一, 岡原 修司, 清水 一好, 森松 博史

    臨床モニター   34 ( Suppl. )   62 - 62   2023.4

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    Language:Japanese   Publisher:医学図書出版(株)  

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  • 【2023のシェヘラザードたち】(第6夜)どんなデバイスも使い手次第 肺動脈カテーテルの光と影

    岡原 修司

    LiSA 別冊   30 ( 別冊'23春号 )   31 - 34   2023.4

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    Language:Japanese   Publisher:(株)メディカル・サイエンス・インターナショナル  

    <文献概要>肺動脈カテーテルは心臓血管外科麻酔において,麻酔科医が重症例に適切な治療介入の判断を行ううえで重要な役割を担っている。その一方で,不適切な操作を行った場合には致死的な合併症が起こり得る。以前に比べて挿入する機会が減少した中,われわれにとって循環の切り札となる肺動脈カテーテルを安全かつ有効に使いこなすため,私の周りで起きた恐ろしいトラブル症例を共有したい。

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  • 肺移植の麻酔管理と海外の動向

    岡原 修司

    日本臨床麻酔学会誌   42 ( 4 )   355 - 359   2022.7

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    Language:Japanese   Publisher:日本臨床麻酔学会  

    本邦の肺移植は臓器提供の少なさゆえ,待機期間が長く,レシピエントの病状の進行へとつながり,厳重な周術期管理が必要である.術前評価では術中に体外循環が必要かどうか,必要な場合には導入のタイミングを検討する.麻酔導入時は肺血管抵抗の上昇を回避し,体血管抵抗を保ち,灌流圧の維持に努める.再灌流時には早期グラフト機能不全を軽減するために,緩徐な再灌流に加えて,制限的輸液管理や肺保護換気を実践する.世界的にはドナー不足に対してマージナル肺を体外循環下で評価するEx vivo lung perfusionや心停止ドナーからの肺移植に取り組んでおり,移植医療の発展には臓器提供システムの整備が重要である.(著者抄録)

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    Other Link: https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J01620&link_issn=&doc_id=20220725330008&doc_link_id=10.2199%2Fjjsca.42.355&url=https%3A%2F%2Fdoi.org%2F10.2199%2Fjjsca.42.355&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

  • 適応外薬を併用し鎮静薬を計画的に減量しえた小児長期人工呼吸管理の一症例

    成谷俊輝, 黒田浩佐, 岡原修司, 鈴木聡, 清水一好, 森松博史

    日本集中治療医学会中国・四国支部学術集会プログラム・抄録集(Web)   6th   2022

  • オーストラリアでの肺移植の臨床・研究から学んだ日本の肺移植の課題とこれから進むべき道

    岡原 修司

    日本臨床麻酔学会誌   41 ( 6 )   S128 - S128   2021.10

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    Language:Japanese   Publisher:日本臨床麻酔学会  

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Research Projects

  • Utilizing inspiratory reduction in central venous pressure to assess respiratory efforts

    Grant number:22K16627  2022.04 - 2025.03

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research Grant-in-Aid for Early-Career Scientists  Grant-in-Aid for Early-Career Scientists

    岡原 修司

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    Grant amount:\4030000 ( Direct expense: \3100000 、 Indirect expense:\930000 )

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Class subject in charge

  • Anesthesiology and Resuscitology (2024academic year) special  - その他