研究者詳細 - 塚原　紘平

論文 - 塚原　紘平

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臓器提供支援事業の現状と課題岡山県の臓器提供施設連携体制構築事業

内藤宏道, 塚原紘平, 湯本哲也, 本郷貴織, 小崎吉訓, 小原隆史, 野島剛, 上田浩平, 飯田淳義, 久村正樹, 安田和広, 中尾篤典

移植 59 ( 総会臨時 ) 231 - 231 2024年9月

私(僕)の臨床研究、興味ありませんか? 救急集中治療の現場で臨床医が取り組む「小児」のデータベース研究の可能性

小原隆史, 内藤宏道, 塚原紘平, 本郷貴識, 野島剛, 湯本哲也, 中尾篤典

日本集中治療医学会雑誌 31 ( Suppl.1 ) S485 - S485 2024年9月

Increased Oxidative Stress and Decreased Citrulline in Blood Associated with Severe Novel Coronavirus Pneumonia in Adult Patients. 国際誌

Mitsuru Tsuge, Eiki Ichihara, Kou Hasegawa, Kenichiro Kudo, Yasushi Tanimoto, Kazuhiro Nouso, Naohiro Oda, Sho Mitsumune, Goro Kimura, Haruto Yamada, Ichiro Takata, Toshiharu Mitsuhashi, Akihiko Taniguchi, Kohei Tsukahara, Toshiyuki Aokage, Hideharu Hagiya, Shinichi Toyooka, Hirokazu Tsukahara, Yoshinobu Maeda

International journal of molecular sciences 25 ( 15 ) 2024年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

This study investigated the correlation between oxidative stress and blood amino acids associated with nitric oxide metabolism in adult patients with coronavirus disease (COVID-19) pneumonia. Clinical data and serum samples were prospectively collected from 100 adult patients hospitalized for COVID-19 between July 2020 and August 2021. Patients with COVID-19 were categorized into three groups for analysis based on lung infiltrates, oxygen inhalation upon admission, and the initiation of oxygen therapy after admission. Blood data, oxidative stress-related biomarkers, and serum amino acid levels upon admission were compared in these groups. Patients with lung infiltrations requiring oxygen therapy upon admission or starting oxygen post-admission exhibited higher serum levels of hydroperoxides and lower levels of citrulline compared to the control group. No remarkable differences were observed in nitrite/nitrate, asymmetric dimethylarginine, and arginine levels. Serum citrulline levels correlated significantly with serum lactate dehydrogenase and C-reactive protein levels. A significant negative correlation was found between serum levels of citrulline and hydroperoxides. Levels of hydroperoxides decreased, and citrulline levels increased during the recovery period compared to admission. Patients with COVID-19 with extensive pneumonia or poor oxygenation showed increased oxidative stress and reduced citrulline levels in the blood compared to those with fewer pulmonary complications. These findings suggest that combined oxidative stress and abnormal citrulline metabolism may play a role in the pathogenesis of COVID-19 pneumonia.

DOI： 10.3390/ijms25158370

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Evolution and Effects of Ad Hoc Multidisciplinary Team Meetings in the Emergency Intensive Care Unit: A Five-Year Analysis. 国際誌

Tetsuya Yumoto, Takashi Hongo, Takafumi Obara, Kohei Ageta, Toshiyuki Aokage, Kohei Tsukahara, Atsunori Nakao, Hiromichi Naito

Journal of clinical medicine 13 ( 15 ) 2024年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

Background: Multidisciplinary team meetings (MDTMs) are crucial in the ICU. However, daily rounds may not address all sensitive issues due to time constraints and the complexity of cases. This study aimed to describe detailed information and characteristics of ad hoc MDTMs in the ICU. Methods: This single-center, retrospective study analyzed adult emergency ICU admissions at Okayama University Hospital from 1 January 2019 to 31 December 2023. During this period, weekly regular multidisciplinary team ICU rounds were introduced in June 2020, and regular weekday morning MDTMs began in April 2022. A multiple logistic regression analysis was applied to determine the impact of these changes on the frequency of ad hoc MDTMs, adjusting for variables including annual changes. Results: The study analyzed 2487 adult EICU patients, with a median age of 66, and 63.3% of them male. MDTMs were held for 168 patients (6.8%), typically those with severe conditions, including higher COVID-19 prevalence and APACHE II scores, and longer ICU stays. Despite a constant total number of MDTMs, the likelihood of conducting ad hoc MDTMs increased annually (adjusted OR 1.19; 95% CI, 1.04-1.35). Of the 329 MDTMs conducted for these patients, 59.0% addressed end-of-life care, involving an average of 11 participants, mainly nurses and emergency and critical-care physicians. Conclusions: Changes in ICU round and meeting structures might be associated with a higher frequency of conducting ad hoc MDTMs, highlighting their evolving role and importance in patient care management.

DOI： 10.3390/jcm13154324

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後頭部可逆性白質脳症を合併した肢端紅痛症の1例

武川真也, 鈴木健吾, 宇田和宏, 茂原研司, 荒川恭佑, 齋藤有希惠, 宮原宏幸, 長谷川高誠, 小原隆史, 塚原紘平, 八代将登, 津下充, 塚原宏一

日本小児科学会雑誌 128 ( 7 ) 1004 - 1005 2024年7月

amplitude-integrated electroencephalogram(aEEG)によるモニタリングを行った敗血症性ショックの乳児症例

松尾逸平, 小原隆史, 塚原紘平, 竹中暁, 土屋弘樹, 小林勝弘

日本小児救急医学会雑誌 23 ( 2 ) 250 - 250 2024年7月

救命救急センターにおける小児のICU入室数は救急応需に影響するのか?

小原隆史, 塚原紘平, 松尾逸平, 湯本哲也, 内藤宏道, 中尾篤典

日本小児救急医学会雑誌 23 ( 2 ) 267 - 267 2024年7月

来院時低体温症例における甲状腺ホルモンと復温速度の検討

野島剛, 内藤宏道, 本郷貴識, 小原隆史, 小崎吉訓, 薬師寺泰匡, 湯本哲也, 塚原紘平, 久村正樹, 中尾篤典

日本脳低温療法・体温管理学会誌 27 ( 1 ) 45 - 45 2024年7月

amplitude-integrated EEG/SEFモードを用いた小児急性脳症の体温管理療法中の脳波変化

小原隆史, 塚原紘平, 内藤宏道, 湯本哲也, 中尾篤典

日本脳低温療法・体温管理学会誌 27 ( 1 ) 47 - 47 2024年7月

県内の重症小児救急患者に関する集約化の現状と課題

小原隆史, 平岡知浩, 松尾逸平, 塚原紘平

日本小児科学会雑誌 128 ( 7 ) 1004 - 1004 2024年7月

後頭部可逆性白質脳症を合併した肢端紅痛症の1例

武川真也, 鈴木健吾, 宇田和宏, 茂原研司, 荒川恭佑, 齋藤有希惠, 宮原宏幸, 長谷川高誠, 小原隆史, 塚原紘平, 八代将登, 津下充, 塚原宏一

日本小児科学会雑誌 128 ( 7 ) 1004 - 1005 2024年7月

アセトアミノフェンと鉄剤を大量内服し、血漿交換を行った肝障害の一例

小崎吉訓, 松尾逸平, 薬師寺泰匡, 野島剛, 塚原紘平, 内藤宏道, 中尾篤典

中毒研究 37 ( 2 ) 252 - 252 2024年7月

Successful Diagnosis of Neuroleptic Malignant Syndrome in an Unconscious Patient Using Amplitude-Integrated Electroencephalography: A Case Report

Shunsuke Nakamura, Atsuyoshi Iida, Kohei Tsukahara, Hiromichi Naito

Cureus 2024年6月

Organ donation after extracorporeal cardiopulmonary resuscitation: a nationwide retrospective cohort study. 国際誌

Tetsuya Yumoto, Kohei Tsukahara, Takafumi Obara, Takashi Hongo, Tsuyoshi Nojima, Hiromichi Naito, Atsunori Nakao

Critical care (London, England) 28 ( 1 ) 160 - 160 2024年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Limited data are available on organ donation practices and recipient outcomes, particularly when comparing donors who experienced cardiac arrest and received extracorporeal cardiopulmonary resuscitation (ECPR) followed by veno-arterial extracorporeal membrane oxygenation (ECMO) decannulation, versus those who experienced cardiac arrest without receiving ECPR. This study aims to explore organ donation practices and outcomes post-ECPR to enhance our understanding of the donation potential after cardiac arrest. METHODS: We conducted a nationwide retrospective cohort study using data from the Japan Organ Transplant Network database, covering all deceased organ donors between July 17, 2010, and August 31, 2022. We included donors who experienced at least one episode of cardiac arrest. During the study period, patients undergoing ECMO treatment were not eligible for a legal diagnosis of brain death. We compared the timeframes associated with each donor's management and the long-term graft outcomes of recipients between ECPR and non-ECPR groups. RESULTS: Among 370 brain death donors with an episode of cardiac arrest, 26 (7.0%) received ECPR and 344 (93.0%) did not; the majority were due to out-of-hospital cardiac arrests. The median duration of veno-arterial ECMO support after ECPR was 3 days. Patients in the ECPR group had significantly longer intervals from admission to organ procurement compared to those not receiving ECPR (13 vs. 9 days, P = 0.005). Lung graft survival rates were significantly lower in the ECPR group (log-rank test P = 0.009), with no significant differences in other organ graft survival rates. Of 160 circulatory death donors with an episode of cardiac arrest, 27 (16.9%) received ECPR and 133 (83.1%) did not. Time intervals from admission to organ procurement following circulatory death and graft survival showed no significant differences between ECPR and non-ECPR groups. The number of organs donated was similar between the ECPR and non-ECPR groups, regardless of brain or circulatory death. CONCLUSIONS: This nationwide study reveals that lung graft survival was lower in recipients from ECPR-treated donors, highlighting the need for targeted research and protocol adjustments in post-ECPR organ donation.

DOI： 10.1186/s13054-024-04949-5

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法的脳死判定時にCPAPモードを用いた無呼吸テストを実施した小児2例

平岡知浩, 小原隆史, 塚原紘平, 難波宏太, 岡田真澄, 平山隆浩, 湯本哲也, 内藤宏道, 中尾篤典

日本小児科学会雑誌 128 ( 2 ) 361 - 361 2024年2月

法的脳死判定時にCPAPモードを用いた無呼吸テストを実施した小児2例

平岡知浩, 小原隆史, 塚原紘平, 難波宏太, 岡田真澄, 平山隆浩, 湯本哲也, 内藤宏道, 中尾篤典

日本小児科学会雑誌 128 ( 2 ) 361 - 361 2024年2月

Successful Cardiac, Lung, and Kidney Transplantation from a Methanol-poisoned Donor.

Takashi Hongo, Tetsuya Yumoto, Yoshinori Kosaki, Tomohiro Hiraoka, Kohei Tsukahara, Tsuyoshi Nojima, Takafumi Obara, Kohei Ageta, Yukie Yamasaki, Kaori Taniguchi, Masanobu Miura, Satoru Miyaishi, Hiromichi Naito, Atsunori Nakao

JMA journal 7 ( 1 ) 133 - 135 2024年1月

記述言語：英語

Massive methanol exposure can lead to severe and detrimental effects that can result in death or brain death. As organs from patients with brain death after methanol ingestion are less likely to be recovered, these patients have been considered marginal donors. We present a case of successful multiple organ transplantation (heart, lungs, and kidneys) from a methanol-poisoned patient. Our experience illustrates that donor death from methanol intoxication does not preclude organ transplantation.

DOI： 10.31662/jmaj.2023-0081

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バルプロ酸徐放剤とオランザピン過量内服により遅発性に高アンモニア血症を生じた1例

萩原万瀧, 野島剛, 本郷貴識, 小原隆史, 小崎吉訓, 湯本哲也, 塚原紘平, 内藤宏道, 中尾篤典

日本救急医学会雑誌 34 ( 12 ) 798 - 798 2023年12月

EICUでのドナー管理と救急応需率との関係

湯本哲也, 本郷貴識, 小崎吉訓, 小原隆史, 上田浩平, 野島剛, 飯田淳義, 青景聡之, 塚原紘平, 内藤宏道, 中尾篤典

日本救急医学会雑誌 34 ( 12 ) 855 - 855 2023年12月

メタノール中毒患者での脳死下臓器提供の一例

小崎吉訓, 薬師寺泰匡, 野島剛, 飯田淳義, 塚原紘平, 湯本哲也, 内藤宏道, 中尾篤典

日本救急医学会雑誌 34 ( 12 ) 856 - 856 2023年12月

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