研究者詳細 - 塚原　紘平

Age-specific assessment of initial hemoglobin levels and shock index for predicting life-saving interventions in pediatric blunt liver and spleen injuries. 国際誌

Tetsuya Yumoto, Takafumi Obara, Takashi Hongo, Atsuyoshi Iida, Kohei Tsukahara, Morihiro Katsura, Yutaka Kondo, Hideto Yasuda, Shigeki Kushimoto, Takashi Yorifuji, Hiromichi Naito, Atsunori Nakao

Scientific reports 15 ( 1 ) 8502 - 8502 2025年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

This study aimed to evaluate the effectiveness of combining initial hemoglobin levels with the shock index for predicting the need for life-saving interventions (LSI) in pediatric patients with blunt liver and spleen injuries (BLSI), specifically tailored to different age groups. This was a multicenter retrospective cohort study of pediatric patients with BLSI in Japan. The area under the receiver operating characteristic curve (AUROC) were used to assess predictive accuracy. The study included 1,370 patients. LSI was required in 59 of 247 (23.9%) aged 1 to 6 years, 100 of 402 (24.9%) aged 7 to 12 years, and 125 of 297 (42.1%) patients aged 13 to 16 years. Within each specific age group, the predictability was categorized as fair and appeared higher than that of the entire cohort or when using either parameter alone. Notably, in the 1 to 6-year age group, the combined values showed the highest predictability, which was statistically superior to the shock index alone (AUROC of 0.770 vs. 0.671, P = 0.025). Tailoring initial hemoglobin levels and shock index to specific age groups enhances predictability of LSI in pediatric BLSI, showing a fair level of predictive accuracy.

DOI： 10.1038/s41598-025-92673-7

Prevalence, characteristics, and outcomes of suicide-related out-of-hospital cardiac arrest among patients committing self-harm and suicide-attempts in Japan: A nationwide registry study. 国際誌

Takashi Hongo, Tetsuya Yumoto, Shunta Jinno, Yuka Yamamura, Takafumi Obara, Tsuyoshi Nojima, Kohei Tsukahara, Hiromichi Naito, Takashi Yorifuji, Atsunori Nakao

Resuscitation plus 22 100923 - 100923 2025年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Suicide-related out-of-hospital cardiac arrest (OHCA) is characterized by extremely low survival rates and represents a considerable global public health concern. This study aimed to investigate the prevalence, characteristics, and outcomes of suicide-related OHCA. METHODS: This multicenter, retrospective cohort study is an analysis of data collected from the JAPAN Registry of Self-harm and Suicide Attempts. Patients were divided into two groups, the OHCA group and the non-OHCA group. The primary outcome was death at 30 days. RESULTS: Among 1,960 self-harm and suicide attempts patients, 213 patients (10.9 %) were assigned to the OHCA group and 1,747 (89.1%) were in the non-OHCA group.Patients in the OHCA group were older (44 vs. 33 years old, p < 0.001), and the OHCA group had a higher proportion of males compared to the non-OHCA group (122 [57.3%] vs. 604 [34.6%], p < 0.001). Despite missing and unknown data, lower proportions of psychiatric consultation history (54 [30.8%] vs. 1177 [70.5%], p < 0.001), psychiatric hospitalization history (9 [5.1%] vs. 386 [23.1%], p < 0.001), and previous suicide attempts (16 [9.2%] vs. 807 [48.4%], p < 0.001) were observed in the OHCA group. Risk of death at 30 days was significantly higher in the OHCA group (200 [93.9%] vs. 31 [1.8%], p < 0.001). CONCLUSION: Suicide-related OHCA was rare and associated with poorer prognosis compared to patients without OHCA. It was more common in middle-aged men without a history of psychiatric care or prior suicide attempts, although the study was limited by missing data.

DOI： 10.1016/j.resplu.2025.100923

救急搬送件数の急増と働き方改革への対応岡山大学の取り組み

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

日本臨床救急医学会雑誌 27 ( 6 ) 765 - 771 2024年12月

記述言語：日本語出版者・発行元：(一社)日本臨床救急医学会

2024年4月から医師にも働き方改革が適用された。当院では救急搬送件数が直近3年間で3倍に急増した。これに対応するため院内外の協力・連携や下り搬送の体制強化,病院救命士の活用・育成によるタスク・シェア/シフトの促進に努めてきた。その他,徹底したシフト制など働き方改革を進めてきた。また,大学病院としての使命でもある研究・教育にも注力してきた。2023年度の院内時間外勤務時間は2022年度のそれと比較して有意に減少したものの,働き方改革前後での全体的な満足度に変化はなかった。働き方改革は労働時間もさることながら,その中身が重要であり,救急科としての専門性や役割を発揮しながら,個々がやりがいを実感できる環境づくりが重要であるが,自己研鑽という名の時間外労働の実態は反映されにくく,地域救急医療体制維持と働き方改革とのバランスも今後の課題である。(著者抄録)

COVID-19流行前後における小児院外心停止例に対するBystander CPRの変化とアウトカムの検証

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

蘇生 43 ( 3 ) 188 - 188 2024年11月

脳死下臓器提供のプロセスに関する包括的研究多機関共同後ろ向き研究J-RESPECT studyより

湯本哲也, 内藤宏道, 塚原紘平, 小原隆史, 本郷貴識, 早川峰司, 横堀將司, 西山慶, 渥美生弘, 田崎修, 中尾篤典

日本救急医学会雑誌 35 ( 11 ) 666 - 666 2024年11月

院外心停止患者における来院時体温による体温管理療法と30日後の神経学的予後

野島剛, 内藤宏道, 小原隆史, 田邉綾, 本郷貴識, 小崎吉訓, 上田浩平, 湯本哲也, 塚原紘平, 中尾篤典

蘇生 43 ( 3 ) 181 - 181 2024年11月

低体温症における来院時血中COHbの意義についての検証

三次悠哉, 湯本哲也, 本郷貴識, 小原隆史, 小崎吉訓, 野島剛, 上田浩平, 飯田淳義, 塚原紘平, 内藤宏道, 中尾篤典

日本救急医学会雑誌 35 ( 11 ) 812 - 812 2024年11月

ヘリウムガス吸入による心停止蘇生後に脳死下臓器提供に至った一例

神野駿太, 湯本哲也, 本郷貴識, 小原隆史, 野島剛, 上田浩平, 小崎吉訓, 塚原紘平, 内藤宏道, 中尾篤典

日本救急医学会雑誌 35 ( 11 ) 782 - 782 2024年11月

心停止のエピソードがあった症例の脳死下および心停止下臓器提供 ECPRの有無による比較

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

日本救急医学会雑誌 35 ( 11 ) 781 - 781 2024年11月

心肺蘇生を望まない意思表示のある院外心停止患者対応の実態と今後の展望

田邉綾, 本郷貴識, 小原隆史, 野島剛, 上田浩平, 稲葉基高, 小崎吉訓, 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 35 ( 11 ) 752 - 752 2024年11月

オール岡山での搬送困難事例を減らすための取り組み高齢者施設における急変時等相談対応事業を開始して

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

日本救急医学会雑誌 35 ( 11 ) 688 - 688 2024年11月

敗血症患者における来院時血中COHbの意義についての検証

福留将真, 湯本哲也, 薬師寺泰匡, 本郷貴識, 小原隆史, 小崎吉訓, 野島剛, 上田浩平, 塚原紘平, 内藤宏道, 中尾篤典

日本救急医学会雑誌 35 ( 11 ) 645 - 645 2024年11月

A nationwide longitudinal survey of infantile injury and its recurrence in Japan. 国際誌

Tomohiro Hiraoka, Takafumi Obara, Naomi Matsumoto, Kohei Tsukahara, Takashi Hongo, Tsuyoshi Nojima, Masaki Hisamura, Tetsuya Yumoto, Atsunori Nakao, Takashi Yorifuji, Hiromichi Naito

Scientific reports 14 ( 1 ) 24716 - 24716 2024年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Injury recurrence in young children is a significant public health concern, as it may indicate an unfavorable home environment. This study evaluates whether infantile injuries increase recurrence during preschool years, contributing to more effective prevention strategies for vulnerable families. The study included 20,191 children from "The Longitudinal Survey of Babies in the 21st Century," a representative sample of infants born in Japan between May 10 and 24, 2010. We conducted a logistic regression analysis to compare injury recurrence risk between children aged 18 months to seven years with and without infantile injury histories. The study revealed that infants with a history of injuries had a higher risk of subsequent hospital visits for injuries during preschool years (crude Odds Ratio (cOR) 1.52, 95% CI, 1.41-1.64, adjusted OR (aOR) 1.48, 95% CI 1.37-1.60). Specific injuries, such as falls (aOR 1.34, 95% CI, 1.26-1.43), pinches (aOR 1.22, 95% CI, 1.15-1.29), drowning (aOR 1.29, 95% CI, 1.19-1.40), ingestion (aOR 1.35, 95% CI, 1.17-1.55), and burns (aOR 1.47, 95% CI, 1.31-1.65), independently increased the risk of future injuries. Our findings highlight the necessity of universal safety measures in the home environment and targeted interventions for families with a history of high-risk injuries.

DOI： 10.1038/s41598-024-76403-z

Management of Obesity Hypoventilation Syndrome in Extreme Obesity: A Case Study. 国際誌

Yuya Miyoshi, Tetsuya Yumoto, Yoshinori Kosaki, Takashi Hongo, Kohei Tsukahara, Atsunori Nakao, Hiromichi Naito

The American journal of case reports 25 e945112 2024年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND Obesity hypoventilation syndrome (OHS) is characterized by hypercapnia in obese patients, with acute hypercapnic respiratory failure often worsened by various conditions. Managing super-super obese patients presents complex challenges in critical care. Our case report details the successful treatment of acute respiratory failure in a patient with a body mass index (BMI) over 80 kg/m², highlighting the importance of comprehensive, multidisciplinary care in the Intensive Care Init (ICU). CASE REPORT A 39-year-old man with a BMI of 81.1 kg/m² presented to our emergency department with respiratory distress, altered consciousness, and an inability to move independently. Arterial blood gas analysis revealed severe hypercapnia and hypoxemia, indicating decompensated OHS. Laboratory tests and computed tomography scans suggested his condition was exacerbated by pneumonia and congestive heart failure. The patient was managed in the ICU with endotracheal intubation, mechanical ventilation, and esophageal pressure monitoring. In addition to antibiotics, diuretics were used to manage fluid balance. His care included multidisciplinary support with nutritional management and active physiotherapy. After 15 days, he was weaned from the ventilator and discharged from the ICU on day 20, continuing rehabilitation until he was discharged home on day 60. CONCLUSIONS This case report describes the successful treatment of acute hypercapnic respiratory failure from decompensated OHS in a super-super obese patient. Addressing the underlying conditions and tailoring clinical practices to the patient's specific needs, especially regarding ventilatory support, fluid balance, and nutrition, were crucial. A collaborative multidisciplinary approach was essential for improving outcomes.

DOI： 10.12659/AJCR.945112

Association between signs of life and survival in traumatic cardiac arrest patients: A nationwide, retrospective cohort study. 国際誌

Takafumi Obara, Tetsuya Yumoto, Naofumi Bunya, Tsuyoshi Nojima, Tomohiro Hiraoka, Takashi Hongo, Yoshinori Kosaki, Kohei Tsukahara, Takenori Uehara, Atsunori Nakao, Hiromichi Naito

Resuscitation plus 19 100701 - 100701 2024年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The clinical impact of signs of life (SOLs) in traumatic cardiac arrest (TCA) remains to be elucidated. The aim of this study was to examine the association between SOLs and survival/neurological outcomes in TCA patients. METHODS: Retrospective data from the Japan Trauma Data Bank (2019-2021) was reviewed. TCA patients were assigned to one of two study groups based on the presence or absence of SOLs and compared. SOLs were defined as having at least one of following criteria: pulseless electrical activity >40 beats per minute, gasping, positive light reflex, or extremity/eye movement at hospital arrival. The primary outcome was survival at hospital discharge. The secondary outcome was favorable neurological status (Glasgow Outcome Scale score of 4 or 5) at hospital discharge. RESULTS: A total of 1,981 patients (114 with SOLs and 1,867 without SOLs) were included. Characteristics of patients were as follows: age (median age 60.0 years old [interquartile range: 41-80] years vs. 55.4 [38-75] years), gender (male: 76/114 (66.7%) vs. 1,207/1,867 (65.0%), blunt trauma (90/111 [81.1%] vs. 1,559/1,844 [84.5%]), Injury Severity Score (29.2 [22-41] vs. 27.9 [20-34]). Patients with SOLs showed higher survival (10/114 (8.8%) vs. 25/1,867 (1.3%), OR 1.96 [CI 1.20-2.72]) and higher favorable neurological outcomes (4/110 (3.5%) vs. 6/1,865 (0.3%), OR 2.42 [CI 1.14-3.70]) compared with patients without SOLs. CONCLUSIONS: TCA patients with SOLs at hospital arrival showed higher survival and favorable neurological outcomes at hospital discharge compared with TCA patients without SOLs.

DOI： 10.1016/j.resplu.2024.100701

移植医療における診療連携(術前、術後管理/集中治療) 岡山大学病院での脳死下臓器提供のプロセスにおける連携と取り組み救急集中治療の立場から

湯本哲也, 小原隆史, 塚原紘平, 内藤宏道, 中尾篤典

移植 59 ( 総会臨時 ) 148 - 148 2024年9月

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

ドナー管理における臓器保護に関する取り組み小児のドナー管理における多臓器不全の経時的変化単施設後方視的観察研究

小原隆史, 塚原紘平, 湯本哲也, 内藤宏道, 中尾篤典

移植 59 ( 総会臨時 ) 233 - 233 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

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

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

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

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

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

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

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

Radiation in an emergency situation: attempting to respect the patient's beliefs as reported by a minor. 国際誌

Tetsuya Yumoto, Takashi Hongo, Yasuhiro Koide, Takafumi Obara, Kohei Tsukahara, Hiromichi Naito, Atsunori Nakao

BMC medical ethics 24 ( 1 ) 80 - 80 2023年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Each individual's unique health-related beliefs can greatly impact the patient-clinician relationship. When there is a conflict between the patient's preferences and recommended medical care, it can create a serious ethical dilemma, especially in an emergency setting, and dramatically alter this important relationship. CASE PRESENTATION: A 56-year-old man, who remained comatose after out-of-hospital cardiac arrest, was rushed to our hospital. The patient was scheduled for emergency coronary angiography when his adolescent daughter reported that she and her father held sincere beliefs against radiation exposure. We were concerned that she did not fully understand the potential consequences if her father did not receive the recommended treatment. A physician provided her with in depth information regarding the risks and benefits of the treatment. While we did not want to disregard her statement, we opted to save the patient's life due to concerns about the validity of her report. CONCLUSIONS: Variations in beliefs regarding medical care force clinicians to incorporate patient beliefs into medical practice. However, an emergency may require a completely different approach. When faced with a patient in a life-threatening condition and unconscious, we should take action to prioritize saving their life, unless we are highly certain about the validity of their advance directives.

DOI： 10.1186/s12910-023-00962-5

補助検査として4vessel studyを行った法的脳死判定の1例

塚原紘平, 内藤宏道, 萩原万龍, 野島剛, 湯本哲也, 中尾篤典, 横田裕行

移植 58 ( 総会臨時 ) 249 - 249 2023年9月

An Unusual Presentation of Chest Pain and Laryngeal Discomfort in a Pregnant Woman: A Case Report and Literature Review.

Misa Sasanami, Atsuyoshi Iida, Masaya Iwamuro, Ryousuke Hirai, Takashi Obara, Kohei Tsukahara, Tetsuya Yumoto, Hiromichi Naito, Atsunori Nakao

Acta medica Okayama 77 ( 4 ) 429 - 431 2023年8月

記述言語：英語

Intramural esophageal dissection (IED), characterized by bleeding into the submucosal space, leads to mucosal separation and dissection. The most prevalent symptoms are sudden chest or retrosternal pain, hematemesis, and dysphagia. Therefore, acute coronary syndrome and aortic dissection are among its most notable differential diagnoses. A 31-year-old pregnant woman presented with acute chest pain, laryngeal discomfort, and hematemesis. Emergency esophagogastroscopy revealed longitudinal mucosal dissection (upper esophagus to esophagogastric junction). The patient was successfully treated by avoiding the ingestion of solid foods. Clinicians should consider a diagnosis of IED for pregnant patients with acute chest pain, especially if hematemesis is present.

DOI： 10.18926/AMO/65755

アセトアミノフェン中毒におけるプロカルシトニンの有用性

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

中毒研究 36 ( 2 ) 207 - 207 2023年7月

救急医療現場における個人的信念に基づく医療行為拒否への対応放射線被曝拒否事例から考える

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

日本臨床救急医学会雑誌 26 ( 3 ) 358 - 358 2023年7月

レボチロキシン多量服薬の一例

小崎吉訓, 内藤宏道, 小出恭大, 塚原紘平, 湯本哲也, 中尾篤典

日本臨床救急医学会雑誌 26 ( 3 ) 351 - 351 2023年7月

救急医療現場における個人的信念に基づく医療行為拒否への対応放射線被曝拒否事例から考える

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

日本臨床救急医学会雑誌 26 ( 3 ) 358 - 358 2023年7月

アセトアミノフェン中毒におけるプロカルシトニンの有用性

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

中毒研究 36 ( 2 ) 207 - 207 2023年7月

集中治療領域での嚥下障害

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

日本集中治療医学会雑誌 30 ( Suppl.1 ) S269 - S269 2023年6月

当科における小児急性脳症と体温管理療法の現状

小原隆史, 塚原紘平, 平岡知浩, 本郷貴識, 湯本哲也, 内藤宏道, 中尾篤典

日本脳低温療法・体温管理学会誌 26 ( 1 ) 47 - 47 2023年6月

つなぐ命と気持ち～脳死移植における集中治療の役割～潜在的なドナーの認知から移植外科医につなげるところまで終末期の児童に対し「臓器移植の情報提供」を含めた選択肢提示を行うために当院の体制作りと現状

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

日本集中治療医学会雑誌 30 ( Suppl.1 ) S331 - S331 2023年6月

小児の院外心停止における医師の病院前救急診療は神経学的転帰を改善する

小原隆史, 湯本哲也, 塚原紘平, 野島剛, 本郷貴識, 松本尚美, 頼藤貴志, 中尾篤典, 内藤宏道

日本集中治療医学会雑誌 30 ( Suppl.1 ) S422 - S422 2023年6月

つなぐいのち～小児脳死下臓器ドナー管理小児脳死下臓器ドナー管理の特徴当センターでの経験から

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

日本集中治療医学会雑誌 30 ( Suppl.1 ) S283 - S283 2023年6月

aEEGモニタリングが診断・薬物調整に有用であったFIRESの一例

小原隆史, 平岡知浩, 山本浩継, 塚原紘平

日本小児救急医学会雑誌 22 ( 2 ) 292 - 292 2023年6月

当科における小児急性脳症と体温管理療法の現状

小原隆史, 塚原紘平, 平岡知浩, 本郷貴識, 湯本哲也, 内藤宏道, 中尾篤典

日本脳低温療法・体温管理学会誌 26 ( 1 ) 47 - 47 2023年6月

Hydrogen inhalation attenuates lung contusion after blunt chest trauma in mice. 国際誌

Kohei Ageta, Takahiro Hirayama, Toshiyuki Aokage, Mizuki Seya, Ying Meng, Tsuyoshi Nojima, Hirotsugu Yamamoto, Takafumi Obara, Atsunori Nakao, Tetsuya Yumoto, Kohei Tsukahara, Hiromichi Naito

Surgery 2023年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Lung contusion caused by blunt chest trauma evokes a severe inflammatory reaction in the pulmonary parenchyma that may be associated with acute respiratory distress syndrome. Although hydrogen gas has antioxidant and anti-inflammatory effects and is protective against multiple types of lung injury at safe concentrations, the effects of inhaled hydrogen gas on blunt lung injury have not been previously investigated. Therefore, using a mouse model, we tested the hypothesis that hydrogen inhalation after chest trauma would reduce pulmonary inflammation and acute lung injury associated with lung contusion. METHODS: Inbred male C57BL/6 mice were randomly divided into 3 groups: sham with air inhalation, lung contusion with air inhalation, and lung contusion with 1.3% hydrogen inhalation. Experimental lung contusion was induced using a highly reproducible and standardized apparatus. Immediately after induction of lung contusion, mice were placed in a chamber exposed to 1.3% hydrogen gas in the air. Histopathological analysis and real-time polymerase chain reaction in lung tissue and blood gas analysis were performed 6 hours after contusion. RESULTS: Histopathological examination of the lung tissue after contusion revealed perivascular/intra-alveolar hemorrhage, perivascular/interstitial leukocyte infiltration, and interstitial/intra-alveolar edema. These histological changes and the extent of lung contusion, as determined by computed tomography, were significantly mitigated by hydrogen inhalation. Hydrogen inhalation also significantly reduced inflammatory cytokine and chemokine mRNA levels and improved oxygenation. CONCLUSION: Hydrogen inhalation therapy significantly mitigated inflammatory responses associated with lung contusion in mice. Hydrogen inhalation therapy may be a supplemental therapeutic strategy for treating lung contusion.

DOI： 10.1016/j.surg.2023.04.029

新型コロナウイルス感染症の小児重症・中等症例発生状況(2022年上半期)

池山貴也, 井手健太郎, 岡田広, 賀来典之, 川崎達也, 黒澤寛史, 小泉沢, 齊藤修, 清水直樹, 竹内宗之, 武田充人, 田村卓也, 塚原紘平, 新津健裕, 三瓶智美, 清水一好, 辻尾有利子, 野坂クナウブ絵美里, 平井克樹, 日本集中治療医学会小児集中治療委員会日本小児集中治療連絡協議会新興再興感染症ワーキンググループ

日本集中治療医学会雑誌 30 ( 3 ) 202 - 207 2023年5月

記述言語：日本語出版者・発行元：(一社)日本集中治療医学会

日本集中治療医学会小児集中治療委員会による新型コロナウイルス関連小児重症・中等症例のオンライン登録システムでは,新型コロナウイルス感染症(COVID-19)の第6波において症例数が増加し,2022年1月から6月までの半年間に225例が登録された。第6波においては第5波では見られなかったCOVID-19関連クループが新たに報告され,登録症例の10%にのぼった。また,中枢神経系の異常を呈した症例の報告も14%から30%に増え,うち20%が小学生であることなど,臨床像に変化が見られた。本報告では第5波と第6波を比較してCOVID-19の臨床像について報告する。(著者抄録)

Association of Prehospital Physician Presence During Pediatric Out-of-Hospital Cardiac Arrest With Neurologic Outcomes. 国際誌

Takafumi Obara, Tetsuya Yumoto, Tsuyoshi Nojima, Takashi Hongo, Kohei Tsukahara, Naomi Matsumoto, Takashi Yorifuji, Atsunori Nakao, Jonathan Elmer, Hiromichi Naito

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies 2023年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: To examine the association of prehospital physician presence with neurologic outcomes of pediatric patients with out-of-hospital cardiac arrest (OHCA). DESIGN: Retrospective cohort study. SETTING: Data from the Japanese Association for Acute Medicine-OHCA Registry. INTERVENTIONS: None. PATIENTS: Pediatric patients (age 17 yr old or younger) registered in the database between June 2014 and December 2019. MEASUREMENT AND MAIN RESULTS: We used logistic regression models with stabilized inverse probability of treatment weighting (IPTW) to estimate the associated treatment effect of a prehospital physician with 1-month neurologically intact survival. Secondary outcomes included in-hospital return of spontaneous circulation (ROSC) and 1-month survival after OHCA. A total of 1,187 patients (276 in the physician presence group and 911 in the physician absence group) were included (median age 3 yr [interquartile range 0-14 yr]; 723 [61%] male). Comparison of the physician presence group, versus the physician absence, showed 1-month favorable neurologic outcomes of 8.3% (23/276) versus 3.6% (33/911). Physician presence was associated with greater odds of 1-month neurologically intact survival after stabilized IPTW adjustment (adjusted odds ratio [aOR] 1.98, 95% CI 1.08-3.66). We also found an association in the secondary outcome between physician presence, opposed to absence, and in-hospital ROSC (aOR 1.48, 95% CI 1.08-2.04). However, we failed to identify an association with 1-month survival (aOR 1.49, 95% CI 0.97-2.88). CONCLUSIONS: Among pediatric patients with OHCA, prehospital physician presence, compared with absence, was associated almost two-fold greater odds of 1-month favorable neurologic outcomes.

DOI： 10.1097/PCC.0000000000003206

Organ Donation after Extracorporeal Cardiopulmonary Resuscitation and Brain Death.

Takafumi Obara, Tetsuya Yumoto, Kenji Aoshima, Kohei Tsukahara, Hiromichi Naito, Atsunori Nakao

Acta medica Okayama 77 ( 1 ) 117 - 120 2023年2月

記述言語：英語

A 38-year-old primipara Japanese woman suffered cardiac arrest due to a pulmonary thromboembolism 1 day after undergoing a cesarean section. Extracorporeal cardiopulmonary resuscitation was initiated and extracorporeal membrane oxygenation support was needed for 24 h. Despite intensive care, the patient was diagnosed with brain death on day 6. With the family's consent, comprehensive end-of-life care including organ donation was discussed based on our hospital's policy. The family decided to donate her organs. Specific training and education are required for emergency physicians to optimize the process of incorporating organ donation into end-of-life care while respecting the patient's and family's wishes.

DOI： 10.18926/AMO/64372

Successfully treated case of severe hypothermia secondary to myxedema coma. 国際誌

Hirotsugu Yamamoto, Takashi Hongo, Tsuyoshi Nojima, Takafumi Obara, Yoshinori Kosaki, Kohei Ageta, Kohei Tsukahara, Tetsuya Yumoto, Atsunori Nakao, Hiromichi Naito

Acute medicine & surgery 10 ( 1 ) e828 2023年

記述言語：英語

BACKGROUND: Myxedema coma is an extremely rare but fatal endocrine emergency that requires urgent recognition and treatment. We describe a case of severe hypothermia that rapidly deteriorated to cardiac arrest that was attributed to myxedema coma. CASE PRESENTATION: A 52-year-old man without a history of hypothyroidism was transferred to our emergency department due to coma and profound hypothermia. The patient developed cardiac arrest immediately after hospital arrival but return of spontaneous circulation was achieved shortly after resuscitation. The patient was noted to have generalized, nonpitting edema, dry skin, severe respiratory acidosis, hyponatremia, and elevated creatinine kinase, which was indicative of hypothyroidism. Myxedema coma was confirmed by a thyroid profile. The patient was successfully treated with intravenous levothyroxine and glucocorticoid. CONCLUSION: Although myxedema coma is a rare cause of severe hypothermia, emergency physicians should be familiar with its clinical features and management.

DOI： 10.1002/ams2.828

Transcranial doppler ultrasound in a 3-month-old infant with brain death. 国際誌

Tomohiro Hiraoka, Takafumi Obara, Takashi Hongo, Tsuyoshi Nojima, Kohei Tsukahara, Tetsuya Yumoto, Atsunori Nakao

Pediatrics international : official journal of the Japan Pediatric Society 65 ( 1 ) e15587 2023年

A randomized controlled trial of teprenone in terms of preventing worsening of COVID-19 infection. 国際誌

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

PloS one 18 ( 10 ) e0287501 2023年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Some COVID-19 patients develop life-threatening disease accompanied by severe pneumonitis. Teprenone induces expression of heat-shock proteins (HSPs) that protect against interstitial pneumonia in preclinical models. We explored whether teprenone prevented worsening of COVID-19 infections. METHODS: This open-label, randomized, pilot phase 2 clinical trial was conducted at five institutions in Japan. We randomized patients hospitalized for COVID-19 with fever to teprenone or no-teprenone groups in a 1:1 ratio. We stratified patients by sex, age < and ≥ 70 years and the existence (or not) of complications (hypertension, diabetes, ischemic heart disease, chronic pulmonary disease and active cancer). No limitation was imposed on other COVID-19 treatments. The primary endpoint was the intubation rate. RESULTS: One hundred patients were included, 51 in the teprenone and 49 in the no- teprenone groups. The intubation rate did not differ significantly between the two groups: 9.8% (5/51) vs. 2.0% (1/49) (sub-hazard ratio [SHR] 4.99, 95% confidence interval [CI]: 0.59-42.1; p = 0.140). The rates of intra-hospital mortality and intensive care unit (ICU) admission did not differ significantly between the two groups: intra-hospital mortality 3.9% (2/51) vs. 4.1% (2/49) (hazard ratio [HR] 0.78, 95%CI: 0.11-5.62; p = 0.809); ICU admission 11.8% (6/51) vs. 6.1% (3/49) (SHR 1.99, 95%CI: 0.51-7.80; p = 0.325). CONCLUSION: Teprenone afforded no clinical benefit. TRIAL REGISTRATION: Japan Registry of Clinical Trials jRCTs061200002 (registered on 20/May/2020).

DOI： 10.1371/journal.pone.0287501

智の探求:プレホスピタルと医療機関における心肺蘇生を望まない患者への対応 DNAR指示を有する院外心停止の特徴、病院前処置、転機に関する検討

臓器移植におけるドナー管理(臓器保護の観点から) 6歳未満おける臓器移植ドナー管理の特徴

小原隆史, 内藤宏道, 塚原紘平, 青景聡之, 野島剛, 上田浩平, 小崎吉訓, 山田太平, 藤崎宣友, 中尾篤典

日本集中治療医学会雑誌 29 ( Suppl.1 ) 297 - 297 2022年11月

脳死の状態判断に補助検査として脳血流シンチグラフィを施行した1例

庵谷紘美, 内藤宏道, 小原隆史, 青景聡之, 塚原紘平, 中尾篤典

日本集中治療医学会雑誌 29 ( Suppl.1 ) 667 - 667 2022年11月

臓器移植におけるドナー管理(臓器保護の観点から) 6歳未満おける臓器移植ドナー管理の特徴

小原隆史, 内藤宏道, 塚原紘平, 青景聡之, 野島剛, 上田浩平, 小崎吉訓, 山田太平, 藤崎宣友, 中尾篤典

日本集中治療医学会雑誌 29 ( Suppl.1 ) 297 - 297 2022年11月

デジタル田園健康特区における救急救命士の権限・役割の拡大による救急体制の充実への取り組み

上田浩平, 本郷貴識, 小原隆史, 野島剛, 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 33 ( 10 ) 872 - 872 2022年10月

産科情報共有システム「iPicss」により迅速な対応ができた出産中の脳出血の搬送例

佐々並三紗, 小崎吉訓, 塚原紘平, 牧尉太, 中尾篤典, 内藤宏道, 湯本哲也, 上田浩平, 小原隆史, 本郷貴識, 平岡知浩

日本救急医学会雑誌 33 ( 10 ) 806 - 806 2022年10月

組織の体制整備による持続可能な「臓器提供」

塚原紘平, 平岡知浩, 薬師寺泰匡, 小原隆史, 小崎吉訓, 野島剛, 湯本哲也, 山本浩継, 青景聡之, 内藤宏道, 中尾篤典

日本救急医学会雑誌 33 ( 10 ) 847 - 847 2022年10月

医学生による女性型シミュレーターを用いた蘇生実習の検討

久保卓也, 本郷貴識, 塚原紘平, 野島剛, 小崎吉訓, 内藤宏道, 中尾篤典

日本救急医学会雑誌 33 ( 10 ) 875 - 875 2022年10月

地域枠制度・地域医療に対する持続的発展を担う救急医療教育

野島剛, 湯本哲也, 小崎吉訓, 長谷川徹, 塚原紘平, 内藤宏道, 小川弘子, 佐藤勝, 忠田正樹, 中尾篤典

日本救急医学会雑誌 33 ( 10 ) 850 - 850 2022年10月

キノコ中毒におけるプロカルシトニンによる診断は有用か

野島剛, 湯本哲也, 小崎吉訓, 小原隆史, 上田浩平, 塚原紘平, 山田太平, 内藤宏道, 中尾篤典

中毒研究 35 ( 2 ) 153 - 153 2022年7月

前頸部の腫脹によるICP上昇に対し厳密な体位保持が有用であった重症頭部外傷の小児例

小原隆史, 塚原紘平, 山本浩継, 内藤宏道, 中尾篤典

日本小児救急医学会雑誌 21 ( 2 ) 287 - 287 2022年6月

智の探究:標準的教育コースのオンライン化小児病院前救護トレーニングコース(PPMEC)のオンライン化

問田千晶, 六車崇, 賀来典之, 塚原紘平, 安達晋吾, 光銭大裕, 新田雅彦, 野坂宜之, 林卓郎, 松浦治人, 守谷俊, 日本臨床救急医学会小児救急委員会

日本臨床救急医学会雑誌 25 ( 2 ) 306 - 306 2022年5月

勇の探求:小児傷病者への病院前診療～救急診療の現況～小児病院前救護トレーニングコース(PPMEC)岡山県地域主催型の報告

塚原紘平, 問田千晶, 六車崇, 賀来典之, 安達晋吾, 光銭大裕, 野坂宜之, 林卓郎, 松浦治人, 新田雅彦, 守谷俊, 日本臨床救急医学会小児救急委員会

日本臨床救急医学会雑誌 25 ( 2 ) 294 - 294 2022年5月

田邉綾, 内藤宏道, 野島剛, 塚原紘平, 山田太平, 中尾篤典

日本臨床救急医学会雑誌 25 ( 2 ) 275 - 275 2022年5月

脳卒中様症状を呈した急性大動脈解離の1例

加藤篤之, 野島剛, 小原隆史, 塚原紘平, 内藤宏道, 中尾篤典

日本臨床救急医学会雑誌 25 ( 2 ) 329 - 329 2022年5月

岡山市における重症熱傷患者搬送とコロナウイルス感染症の影響

上田浩平, 内藤宏道, 塚原紘平, 中尾篤典

熱傷 48 ( 1 ) 39 - 39 2022年3月

当院高度救命救急センターにおける小児の熱傷と感染に関するまとめ

小原隆史, 塚原紘平, 野島剛, 上田浩平, 山本浩継, 内藤宏道, 中尾篤典

熱傷 48 ( 1 ) 41 - 41 2022年3月

集学的アプローチを用いた小児外傷患者に対する保護活動の実際

上原健敬, 依光正則, 福岡史朗, 佐藤浩平, 畑利彰, 島村安則, 塚原紘平, 中尾篤典, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S311 - S311 2022年3月

当院EICUにおいて、熱傷患者の熱傷面積が広いほど緑膿菌は検出されるかの検証

木口隆, 加藤湖月, 野島剛, 小崎吉訓, 藤崎宣友, 塚原紘平, 内藤宏道, 中尾篤典

熱傷 48 ( 1 ) 40 - 40 2022年3月

日本外傷学会データバンクを用いた熱傷症例の検討

野島剛, 内藤宏道, 小原隆史, 小崎吉訓, 上田浩平, 塚原紘平, 中尾篤典

熱傷 48 ( 1 ) 38 - 39 2022年3月

新型コロナウイルス感染症の小児重症・中等症例発生数と重症小児の診療体制

黒澤寛史, 池山貴也, 賀来典之, 川崎達也, 小泉沢, 齊藤修, 竹内宗之, 武田充人, 田村卓也, 塚原紘平, 西村奈穂, 清水直樹, 三瓶智美, 清水一好, 辻尾有利子, 西村奈穂, 新津健裕, 平井克樹, 志馬伸朗, 日本集中治療医学会小児集中治療委員会日本小児集中治療連絡協議会COVID-19ワーキンググループ

日本集中治療医学会雑誌 29 ( 2 ) 177 - 180 2022年3月

記述言語：日本語出版者・発行元：(一社)日本集中治療医学会

日本集中治療医学会小児集中治療委員会日本小児集中治療連絡協議会COVID-19ワーキンググループは,新型コロナウイルスの国内流行のいわゆる第5波で,その初期の段階で20歳未満の患者数が増加していることを把握した。小児科学会との協力体制のもと,小児重症・中等症例発生状況をまとめた。登録症例数は46例。COVID-19肺炎は20例であり,その他の入室理由が過半数を占めた。また,重症症例の診療体制について整理した。(著者抄録)

一酸化炭素中毒に対して高気圧酸素療法を施行した2例

浦田奈生子, 土屋弘樹, 柴田敬, 塚原紘平, 嶋泰樹, 小林勝弘

日本小児科学会雑誌 126 ( 2 ) 337 - 337 2022年2月

Reusable Medical Isolation Gowns with a Liquid Barrier: Washing Gowns in the Coronavirus Disease 2019 Pandemic Era?

Hiromichi Naito, Kohei Tsukahara, Soshi Takao, Takashi Yorifuji, Atsunori Nakao

JMA journal 5 ( 1 ) 107 - 108 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

Healthcare providers are at risk of exposure to SARS-CoV-2 via droplets, respiratory secretions, and contact with contaminated surfaces. Personal protective equipment (PPE) is necessary for primary reliable prevention to treat patients with coronavirus disease 2019 (COVID-19). However, PPE shortages have had a significant impact on every medical facility, and outpatient clinics are especially vulnerable to shortages of medical supplies. During the first stage of the pandemic, efforts were made to reduce the use of medical supplies. Guidance and strategies were proposed to ration the use of PPE, including reusing it. However, reuse (wash) of isolation gowns has not been practically promoted despite these suggestions. Further, reusable products may have advantages for economic and ecologic reasons. We developed an adult universally sized, long-sleeved, 100% polyester, reusable/washable gown with liquid barrier protection. The isolation gown can be worn repeatedly through washing and subsequent disinfection, and it can withstand washing in 80°C hot water for 10 min and/or immersion in 0.05%-0.1% sodium hypochlorite for 30 min and then dried. This new gown's liquid barrier performance is at Association for the Advancement of Medical Instrumentation level 1, even after 20 repeated uses with low cost. The choice of barrier level for gowns should be made based on the risk of contamination. However, the healthcare setting for COVID-19 patients varies greatly with not fully elucidated transmissibility. The newly made reusable isolation gown can be one option for treating COVID-19 patients especially in low-risk settings with economical advantage. Further, preparedness for reuse may have critical implications in extreme shortage. Reconsideration should be focused on reusable gowns with liquid barrier performance and their appropriate use.

DOI： 10.31662/jmaj.2021-0075

蘇生実習における性差教育が与えるインパクト

谷田貴, 折田沙穂, 塚原紘平, 中村俊介, 久保卓也, 小崎吉訓, 野島剛, 内藤宏道, 中尾篤典

日本救急医学会雑誌 32 ( 12 ) 2703 - 2703 2021年11月

Association between emergency medical service transport time and survival in patients with traumatic cardiac arrest: a Nationwide retrospective observational study. 国際誌

Hiromichi Naito, Tetsuya Yumoto, Takashi Yorifuji, Tsuyoshi Nojima, Hirotsugu Yamamoto, Taihei Yamada, Kohei Tsukahara, Mototaka Inaba, Takeshi Nishimura, Takenori Uehara, Atsunori Nakao

BMC emergency medicine 21 ( 1 ) 104 - 104 2021年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Patients with traumatic cardiac arrest (TCA) are known to have poor prognoses. In 2003, the joint committee of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma proposed stopping unsuccessful cardiopulmonary resuscitation (CPR) sustained for > 15 min after TCA. However, in 2013, a specific time-limit for terminating resuscitation was dropped, due to the lack of conclusive studies or data. We aimed to define the association between emergency medical services transport time and survival to demonstrate the survival curve of TCA. METHODS: A retrospective review of the Japan Trauma Data Bank. Inclusion criteria were age ≥ 16, at least one trauma with Abbreviated Injury Scale score (AIS) ≥ 3, and CPR performed in a prehospital setting. Exclusion criteria were burn injury, AIS score of 6 in any region, and missing data. Estimated survival rate and risk ratio for survival were analyzed according to transport time for all patients. Analysis was also performed separately on patients with sustained TCA at arrival. RESULTS: Of 292,027 patients in the database, 5336 were included in the study with 4141 sustained TCA. Their median age was 53 years (interquartile range (IQR) 36-70), and 67.2% were male. Their median Injury Severity Score was 29 (IQR 22-41), and median transport time was 11 min (IQR 6-17). Overall survival after TCA was 4.5%; however, survival of patients with sustained TCA at arrival was only 1.2%. The estimated survival rate and risk ratio for sustained TCA rapidly decreased after 15 min of transport time, with estimated survival falling below 1%. CONCLUSION: The chances of survival for sustained TCA declined rapidly while the patient is transported with CPR support. Time should be one reasonable factor for considering termination of resuscitation in patients with sustained TCA, although clinical signs of life, and type and severity of trauma should be taken into account clinically.

DOI： 10.1186/s12873-021-00499-z

Short or Irregular Sleep Duration in Early Childhood Increases Risk of Injury for Primary School-Age Children: A Nationwide Longitudinal Birth Cohort in Japan. 国際誌

Takafumi Obara, Hiromichi Naito, Kohei Tsukahara, Naomi Matsumoto, Hirotsugu Yamamoto, Takashi Yorifuji, Atsunori Nakao

International journal of environmental research and public health 18 ( 18 ) 2021年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

The aim of this study was to investigate the longitudinal relationship between shorter or irregular sleep duration (SD) in early childhood and increased risk of injury at primary school age using data from a nationwide survey in Japan. We categorized SD into seven groups: 6 h, 7 h, 8 h, 9 hrs, 10 or 11 h, >12 h, and irregular, based on questionnaire responses collected at 5.5 years old. The relationship between SD and incidence of injury at 5.5-nine years of age is shown. In addition, we completed a stratified analysis on children with or without problematic behavior at eight years old. We included 32,044 children, of which 6369 were classified as having an injury and 25,675 as not having an injury. Logistic regression model showed that shorter or irregular SD categories were associated with an increased adjusted odds ratio (aOR) for injuries (6 h: aOR 1.40, 95% confidence interval (CI) 1.19-1.66, 7 h: aOR 1.10, 95% CI, 0.98-1.23, 8 h: aOR 1.13, 95% CI, 1.02-1.26, irregular: aOR 1.26, 95% CI 1.10-1.43). The same tendency was observed with shorter or irregular SD in subgroups with or without behavioral problems. Shorter or irregular sleep habits during early childhood are associated with injury during primary school age.

DOI： 10.3390/ijerph18189512

Off the Job Trainingがコロナ禍で生き残る道小児病院前救護トレーニングコース(PPMEC)のコロナ禍での取組み

問田千晶, 六車崇, 賀来典之, 塚原紘平, 安達晋吾, 光銭大裕, 新田雅彦, 野坂宜之, 林卓郎, 松浦治人, 守谷俊, 日本臨床救急医学会小児救急委員会

日本臨床救急医学会雑誌 24 ( 2 ) 207 - 207 2021年5月

Plastic Bronchitis in a Five-Year-Old Boy Treated Using Extracorporeal Membrane Oxygenation; a Case Report. 国際誌

Tsuyoshi Nojima, Hiromichi Naito, Takafumi Obara, Kohei Tsukahara, Atsunori Nakao

Archives of academic emergency medicine 9 ( 1 ) e16 2021年

記述言語：英語

Plastic bronchitis is an uncommon disorder marked by the production of bronchial casts and acute respiratory failure development. In pediatric cases, influenza infection sometimes results in the obstruction of bronchi and leads to this potentially life-threatening condition. We report the case of a five-year-old boy with plastic bronchitis related to influenza A infection, which could only be recovered by the use of extracorporeal membrane oxygenation (ECMO). ECMO could effectively provide sufficient oxygenation for patients suffering from severe reversible acute respiratory failure. If patients infected with the influenza virus present acute respiratory distress with total lung atelectasis, clinicians should consider the diagnosis of plastic bronchitis and the subsequent treatment interventions with ECMO in a severe cases.

Unrecognized Orbital Images Cause Diagnostic Confusion: Silicone Oil and Implanted Silicone Encircling Bands. 国際誌

Tsuyoshi Nojima, Takafumi Obara, Kohei Tsukahara, Atsunori Nakao, Hiromichi Naito

Case reports in emergency medicine 2021 9940395 - 9940395 2021年

記述言語：英語

Introduction: Most physicians are not familiar with postoperative changes to the orbit, so radiologists and clinicians may sometimes find it challenging to conduct a proper radiological assessment of the globe of the eye and orbital abnormalities. We present a patient with head trauma who had surgery for retinal detachment with implantation of silicone encircling bands. This case report may help clinicians recognize imaging characteristics after ophthalmic surgery to prevent misdiagnosis and unnecessary workup. Case Report. An 18-year-old man with severe head trauma was admitted to our hospital. Initial computed tomography (CT) revealed a high attenuation of intraocular silicone that could be mistaken for a hemorrhage. Ophthalmological examination and detailed ophthalmic history confirmed silicone oil in his eye for treatment of retinal detachment. Knowledge of the anatomical changes and radiological appearance of postsurgical findings following retinal detachment, including the surgical materials of silicone oil or bands, can prevent unnecessary alarm. Conclusion: Implanted ophthalmic devices, for example, silicone oil, appear similar to hemorrhages on CT and magnetic resonance imaging and cause diagnostic confusion. When in doubt, it is useful to assess the clinical presentation and obtain an accurate medical history.

DOI： 10.1155/2021/9940395

Incidence and characteristics of medical emergencies related to dental treatment: a retrospective single-center study. 国際誌

Kyoichi Obata, Hiromichi Naito, Hiromasa Yakushiji, Takafumi Obara, Kisho Ono, Tsuyoshi Nojima, Kohei Tsukahara, Taihei Yamada, Akira Sasaki, Atsunori Nakao

Acute medicine & surgery 8 ( 1 ) e651 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

AIM: Although uncommon, medical emergencies arise in general dental practice. Inadequate data on their severity and frequency makes targeting medical education for general dental practitioners difficult. This also makes planning for unexpected events challenging for practitioners and makes collaborating with emergency physicians burdensome. We aimed to clarify the incidence and characteristics of a dental outpatient department's medical emergencies. METHODS: This single-center, retrospective, observational study was undertaken with patients who visited the dental outpatient department of Okayama University Hospital during the 8-year period. The primary outcome of the study was to identify the incidence and characteristics of medical emergencies in the dental outpatient department. Then we examined the timing of medical emergencies, administered medications, and final disposition (home/admission). RESULTS: During the period, 1,146,929 patients were enrolled. Forty-two patients (0.0037%) were consulted as medical emergencies. More than 60% of the incidents were vasovagal syncope, and dehydration and hypoglycemia were the second most prevalent at 9.5%. The most common types of dental treatments were tooth extraction (45.2%), followed by general dental treatment (28.6%), and other dental surgery such as implant placement (14.3%). Types of medical emergencies occurred equally before, during, and after dental treatment. Antihypertensive agents, sedatives, or glucose were used. For patients with emergencies, 90.5% recovered during the day and returned home, and 9.5% were hospitalized. CONCLUSION: The incidence of medical emergencies was low in our dental outpatient department. Knowledge of basic management principles, regular education for emergency care, and practicing first aid skills are mandatory for safe patient management.

DOI： 10.1002/ams2.651

Delay in Emergency Medical Service Transportation Responsiveness during the COVID-19 Pandemic in a Minimally Affected Region 査読

Acta Med. Okayama 74 ( 6 ) 513 - 520 2020年12月

インフルエンザウイルス感染を契機に上気道閉塞、意識障害を呈した甲状腺クリーゼ一例

佐々並三紗, 塚原紘平, 小崎吉訓, 小原隆史, 野島剛, 上田浩平, 山本浩継, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 31 ( 11 ) 1075 - 1075 2020年11月

COVID-19影響下における救急・集中治療関連医療従事者の心理的健康度

久保卓也, 小崎吉訓, 藤崎宣友, 青景聡之, 塚原紘平, 山田太平, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 31 ( 11 ) 1035 - 1035 2020年11月

amplitude-integrated EEGが意識障害患者の診断・早期治療に有効であった悪性症候群の1例

中村俊介, 内藤宏道, 野島剛, 小崎吉訓, 山本浩継, 藤崎宣友, 青景聡之, 塚原紘平, 山田太平, 尾迫貴章, 中尾篤典

日本救急医学会雑誌 31 ( 11 ) 1105 - 1105 2020年11月

当院における産科救急の現状

藤崎宣友, 山本浩継, 野島剛, 小崎吉訓, 青景聡之, 塚原紘平, 山田太平, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 31 ( 11 ) 1921 - 1921 2020年11月

食事に関する詳細な問診を必要とした壊血病の一例

小出恭大, 山田太平, 小崎吉訓, 野島剛, 塚原紘平, 藤崎宣友, 尾迫貴章, 内藤宏道, 城端慧, 高岡諒, 中尾篤典

日本救急医学会雑誌 31 ( 11 ) 2105 - 2105 2020年11月

mobile ECMOシステムの構築に向けての現状と問題点臨床工学技士の立場から

平山隆浩, 落葉佑昌, 堂口琢磨, 岡田真澄, 川田将弘, 青景聡之, 塚原紘平, 小崎吉訓, 内藤宏道, 中尾篤典

日本集中治療医学会雑誌 27 ( Suppl. ) 625 - 625 2020年9月

静脈-静脈体外式膜型人工肺療法(VV ECMO)ラットモデルの構築

青景聡之, 岡田真澄, 平山隆浩, 塚原紘平, 内藤宏道, 中尾篤典

日本集中治療医学会雑誌 27 ( Suppl. ) 471 - 471 2020年9月

当院の救急集中治療室における、急性腎障害の持続的腎代替療法の導入時期と予後を検討する

岡田真澄, 平山隆浩, 落葉佑昌, 塚原紘平, 青景聡之, 藤崎宣友, 山田太平, 内藤宏道, 中尾篤典

日本集中治療医学会雑誌 27 ( Suppl. ) 506 - 506 2020年9月

一酸化炭素中毒に対し高気圧酸素療法を行った妊婦の一例

小崎吉訓, 小出恭大, 野島剛, 藤崎宣友, 青景聡之, 塚原紘平, 山田太平, 尾迫貴章, 内藤宏道, 中尾篤典

中毒研究 33 ( 2 ) 162 - 162 2020年9月

Comparison of Two Different Intensive Care Unit Systems for Severely Ill Children in Japan: Data from the JaRPAC Registry.

Kohei Tsukahara, Hiromichi Naitou, Takashi Yorifuji, Nobuyuki Nosaka, Hirotsugu Yamamoto, Takaaki Osako, Atsunori Nakao

Acta medica Okayama 74 ( 4 ) 285 - 291 2020年8月

担当区分：筆頭著者記述言語：英語掲載種別：研究論文（学術雑誌）

The importance of centralizing treatment services for severely ill children has been well established, but such entralization remains difficult in Japan. We aimed to compare the trauma and illness severity and mortality of children admitted to two common types of ICUs for children. According to the type of management and disposition of the medical provider, we classified ICUs as pediatric ICUs [PICUs] or general ICUs, and analyzed differences in endogenous and exogenous illness settings between them. Overall, 1,333 pediatric patients were included, with 1,143 patients admitted to PICUs and 190 patients to general ICUs. The Pediatric Cerebral Performance Category score (PCPC) at discharge was significantly lower in the PICU group (adjusted OR: 0.45; 95%CI: 0.23-0.88). Death and unfavorable neurological outcomes occurred less often in the PICU group (adjusted OR: 0.29; 95%CI: 0.14-0.60). However, when limited to exogenous illness, PCPC scores (adjusted OR: 0.38; 95%CI: 0.07-1.99) or death/unfavorable outcomes (adjusted OR: 0.72; 95%CI: 0.08-6.34) did not differ between the groups. PCPC deterioration and overall sequelae/death rates were lower in PICUs for children with endogenous illnesses, although the outcomes of exogenous illness were similar between the 2 unit types. Further studies on the necessity of centralization are warranted.

DOI： 10.18926/AMO/60365

救急隊活動における小児傷病者対応のポイント(第3回) 小児傷病者への対応(1)

塚原紘平, 問田千晶, 六車崇, 日本臨床救急医学会小児救急委員会

プレホスピタル・ケア 33 ( 2 ) 44 - 47 2020年4月

Pediatric airway compromise due to thyroid storm associated with influenza A infection: A case report. 国際誌

Taiki Higaki, Kohei Tsukahara, Takafumi Obara, Tsuyoshi Nojima, Hirotsugu Yamamoto, Takaaki Osako, Hiromichi Naito, Atsunori Nakao

Respiratory medicine case reports 31 101182 - 101182 2020年

記述言語：英語

Thyroid storm is a potentially fatal intensification of thyrotoxicosis normally marked by tachycardia, hyperthermia, impaired mental status, and severe agitation. It can be initiated by numerous causes. Failure to promptly diagnose the condition may lead to high mortality. Early diagnosis and treatment of thyroid storm are essential to prevent further life-threatening complications. A 10-year-old girl was admitted to our emergency center for intensive care. The patient presented tachypnea with stridor, paradoxical abdominal breathing, and "barking" cough. The patient was diagnosed as upper airway obstruction complicated by thyroid storm associated with influenza infection. Following immediate airway management, the patient was administered a short-acting beta-blocker, hydrocortisone, thiamazole, and saturated solution of potassium iodide was initiated. The patient was extubated on day 8 and transferred to a local hospital on day 11 without adverse complications. When examining patients with influenza infection, emergency doctors should be more attentive not to miss other critical diagnoses. The present case was initially diagnosed as croup due to influenza infection. Sharing our experience may help emergency physicians treat similar cases of pediatric airway compromise due to thyroid storm.

DOI： 10.1016/j.rmcr.2020.101182

Extracorporeal membrane oxygenation in Stenotrophomonas maltophilia pneumonia during acute myeloid leukemia: A case report. 国際誌

Kenki Saito, Toshiyuki Aokage, Takayuki Sato, Kohei Tsukahara, Fumiaki Tokioka, Takanao Otake, Hiromasa Irie, Yasunori Ueda

Respiratory medicine case reports 31 101224 - 101224 2020年

記述言語：英語

Stenotrophomonas maltophilia (S. maltophilia) is a Gram-negative, multidrug-resistant organism that both opportunistically infects the bloodstream and leads to pneumonia in immunosuppressed patients, including those with hematologic malignancies. In patients with severe respiratory failure, venovenous extracorporeal membrane oxygenation (VV ECMO) can stabilize the respiratory status. However, whether ECMO in patients with hematologic malignancies improves the clinical outcomes is still controversial because ECMO increases the risk of the exacerbation of sepsis and bleeding. We report a case of a 46-year-old man with Stenotrophomonas maltophilia hemorrhagic pneumonia acquired during consolidation chemotherapy for acute myeloid leukemia in whom VV ECMO lead to a good clinical outcome. The stabilization of his respiratory status achieved with VV ECMO allowed time for trimethoprim-sulfamethoxazole antibiotic therapy to improve the pneumonia. We suggest the background of patients, including comorbidities and general conditions, should be taken into account when considering the clinical indications of ECMO.

DOI： 10.1016/j.rmcr.2020.101224

Therapeutic strategies for ischemia reperfusion injury in emergency medicine. 国際誌

Hiromichi Naito, Tsuyoshi Nojima, Noritomo Fujisaki, Kohei Tsukahara, Hirotsugu Yamamoto, Taihei Yamada, Toshiyuki Aokage, Tetsuya Yumoto, Takaaki Osako, Atsunori Nakao

Acute medicine & surgery 7 ( 1 ) e501 2020年

記述言語：英語掲載種別：研究論文（学術雑誌）

Ischemia reperfusion (IR) injury occurs when blood supply, perfusion, and concomitant reoxygenation is restored to an organ or area following an initial poor blood supply after a critical time period. Ischemia reperfusion injury contributes to mortality and morbidity in many pathological conditions in emergency medicine clinical practice, including trauma, ischemic stroke, myocardial infarction, and post-cardiac arrest syndrome. The process of IR is multifactorial, and its pathogenesis involves several mechanisms. Reactive oxygen species are considered key molecules in reperfusion injury due to their potent oxidizing and reducing effects that directly damage cellular membranes by lipid peroxidation. In general, IR injury to an individual organ causes various pro-inflammatory mediators to be released, which could then induce inflammation in remote organs, thereby possibly advancing the dysfunction of multiple organs. In this review, we summarize IR injury in emergency medicine. Potential therapies include pharmacological treatment, ischemic preconditioning, and the use of medical gases or vitamin therapy, which could significantly help experts develop strategies to inhibit IR injury.

DOI： 10.1002/ams2.501

大規模地震時医療活動訓練における医療資機材の空輸航空会社との連携と今後の課題

三木真彩菜, 三橋乙矢, 加藤湖月, 平山隆浩, 野島剛, 山田太平, 塚原紘平, 尾迫貴章, 中尾篤典

Japanese Journal of Disaster Medicine 24 ( 3 ) 338 - 338 2019年12月

災害時、都道府県庁には、いつ、だれが行く?西日本豪雨災害を経験した岡山県の取り組み

山田太平, 小崎吉訓, 塚原紘平, 内藤宏道, 高田洋介, 渡邉暁洋, 大川恭昌, 加藤湖月, 中尾篤典

Japanese Journal of Disaster Medicine 24 ( 3 ) 242 - 242 2019年12月

岡山大学病院における多数傷病者受入れの現状と課題(続報)

高田洋介, 渡邉暁洋, 山田太平, 小崎吉訓, 塚原紘平, 内藤宏道, 中尾博之, 中尾篤典

Japanese Journal of Disaster Medicine 24 ( 3 ) 246 - 246 2019年12月

平時に全県下で使用している妊産婦緊急搬送補助アプリシステムの災害時使用への応用

牧尉太, 塚原紘平, 早田桂, 福原健, 山下範之, 杉原弥香, 増山寿

Japanese Journal of Disaster Medicine 24 ( 3 ) 303 - 303 2019年12月

集中治療中に胃壁内気腫症を発症し保存的に治療しえた1例

庵谷紘美, 湯本哲也, 小崎吉訓, 山本浩継, 青景聡之, 藤崎宣友, 山田太平, 塚原紘平, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 30 ( 9 ) 777 - 777 2019年9月

エチレングリコール中毒、「早期介入」が功を奏した一症例

佐々並三紗, 山田太平, 庵谷紘美, 小崎吉訓, 湯本哲也, 山本浩継, 藤崎宣友, 塚原紘平, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 30 ( 9 ) 639 - 639 2019年9月

開腹止血術と同時に経腹部大動脈アプローチでTEVARを行った1例

山川泰明, 小崎吉訓, 山本浩継, 藤崎宣友, 青景聡之, 塚原紘平, 山田太平, 万代康弘, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 30 ( 9 ) 826 - 826 2019年9月

積極的な画像診断により救命した特発性腸間膜血腫の1例

山田太平, 小崎吉訓, 湯本哲也, 山本浩継, 藤崎宣友, 青景聡之, 塚原紘平, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 30 ( 9 ) 838 - 838 2019年9月

VV-ECMOを駆使して他院に収容された超重症呼吸不全をECMOで救命するチーム派遣・ECMO導入・搬送まで担う高度ECMO搬送システムの構築

青景聡之, 小崎吉訓, 塚原紘平, 内藤宏道, 中尾篤典

日本救急医学会雑誌 30 ( 9 ) 557 - 557 2019年9月

Increase in the incidence of dermatitis after flood disaster in Kurashiki area possibly due to calcium hydroxide. 国際誌

Taihei Yamada, Takaaki Osako, Atsuyoshi Iida, Tetsuya Yumoto, Kohei Tsukahara, Akihiro Watanabe, Hiromichi Naito, Atsunori Nakao

Acute medicine & surgery 6 ( 2 ) 208 - 209 2019年4月

高度救命救急センターにおける重症患者への蛋白質投与について

皆尾望, 藤崎宣友, 庵谷紘美, 小崎吉訓, 山川泰明, 飯田淳義, 湯本哲也, 山本浩継, 山田太平, 青景聡之, 塚原紘平, 万代康弘, 尾迫貴章, 内藤宏道, 中尾篤典

日本臨床外科学会雑誌 80 ( 3 ) 608 - 608 2019年3月

平成30年7月豪雨水害時の消毒用消石灰散布が及ぼす健康被害

山田太平, 小崎吉訓, 飯田淳義, 塚原紘平, 内藤宏道, 高田洋介, 渡邉暁洋, 大川恭昌, 名倉弘哲, 三木真彩菜, 三橋乙矢, 井上智美, 加藤湖月, 中尾博之, 中尾篤典

Japanese Journal of Disaster Medicine 23 ( 3 ) 423 - 423 2019年2月

豪雨水害に対する岡山県下の対応と課題

中尾博之, 渡邉暁洋, 高田洋介, 山田太平, 内藤宏道, 飯田淳義, 小崎吉訓, 塚原紘平, 名倉弘哲, 大川恭昌, 三橋乙矢, 三木真彩菜, 井上智美, 加藤湖月, 中尾篤典

Japanese Journal of Disaster Medicine 23 ( 3 ) 331 - 331 2019年2月

岡山大学病院における多数傷病者受入れの現状と課題

高田洋介, 渡邉暁洋, 山田太平, 小崎吉訓, 塚原紘平, 内藤宏道, 中尾博之, 中尾篤典

Japanese Journal of Disaster Medicine 23 ( 3 ) 533 - 533 2019年2月

平成30年7月豪雨災害時の病院避難における現場救護所での活動報告

三橋乙矢, 三木真彩菜, 西尾拓真, 加藤湖月, 大川恭昌, 小崎吉訓, 飯田淳義, 塚原紘平, 山田太平, 内藤宏道, 中尾篤典, 高田洋介, 渡邉暁洋, 中尾博之

Japanese Journal of Disaster Medicine 23 ( 3 ) 363 - 363 2019年2月

「病院避難において関係機関が認識するべき役割とは〜受援施設と支援機関それぞれの立場から〜」平成30年7月豪雨におけるまび記念病院の病院避難の経験から DMAT派遣要請基準の考察

中尾篤典, 稲葉基高, 山田太平, 内藤宏道, 塚原紘平, 渡邉暁洋, 中尾博之

Japanese Journal of Disaster Medicine 23 ( 3 ) 311 - 311 2019年2月

「地域包括ケアシステムと地域災害医療体制のあり方」 BCPに基づく地域包括ケアシステムの構築

中尾博之, 渡邉暁洋, 高田洋介, 飯田淳義, 塚原紘平, 中尾篤典

Japanese Journal of Disaster Medicine 23 ( 3 ) 273 - 273 2019年2月

「小児周産期領域における災害対策」平成30年7月豪雨での岡山県災害時小児周産期リエゾンの活動報告

塚原紘平, 小崎吉訓, 飯田淳義, 山田太平, 内藤宏道, 渡邉暁洋, 高田洋介, 中尾博之, 中尾篤典

Japanese Journal of Disaster Medicine 23 ( 3 ) 314 - 314 2019年2月

「平成30年7月豪雨」での岡山大学病院の活動・傷病者受け入れ

内藤宏道, 小崎吉訓, 飯田淳義, 山田太平, 塚原紘平, 渡邉暁洋, 高田洋介, 中尾博之, 中尾篤典

Japanese Journal of Disaster Medicine 23 ( 3 ) 364 - 364 2019年2月

A patient presenting painful chest wall swelling: Tietze syndrome. 国際誌

Kohei Sawada, Hiromi Ihoriya, Taihei Yamada, Tetsuya Yumoto, Kohei Tsukahara, Takaaki Osako, Hiromichi Naito, Atsunori Nakao

World journal of emergency medicine 10 ( 2 ) 122 - 124 2019年

Heat-not-burn cigarettes induce fulminant acute eosinophilic pneumonia requiring extracorporeal membrane oxygenation. 国際誌

Toshiyuki Aokage, Kohei Tsukahara, Yasushi Fukuda, Fumiaki Tokioka, Akihiko Taniguchi, Hiromichi Naito, Atsunori Nakao

Respiratory medicine case reports 26 87 - 90 2019年

記述言語：英語

Background: Although the cause of acute eosinophilic pneumonia (AEP) has not yet been fully clarified, cigarette smoking is reported to be a risk factor for developing AEP. The heat-not-burn cigarette (HNBC) was developed to reduce the adverse effects of smoke on the user's surroundings. However, the health risks associated with HNBCs have not yet been clarified. We report a successfully treated case of fatal AEP presumably induced by HNBC use. Presentation of case: A 16-year-old man commenced HNBC smoking two weeks before admission and subsequently suffered from shortness of breath that gradually worsened. The patient was transferred to emergency department and immediately intubated because of respiratory failure. Computed tomography showed mosaic ground-glass shadows on the distal side of both lungs with a PaO2/FIO2 ratio of 76. The patient required veno-venous extracorporeal membrane oxygenation (ECMO) for severe respiratory failure. He was diagnosed with AEP by clinical course and detection of eosinophils in sputum; thus, methylprednisolone was administrated. The patient was weaned off ECMO four days after initiation and extubated the day after. He fully recovered without sequelae. Conclusion: As far as we know, our patient is the first case of AEP induced by HNBC use successfully treated with ECMO. Emergency physicians must be aware that HNBCs can induce fatal AEP.

DOI： 10.1016/j.rmcr.2018.12.002

Emphysematous cystitis successfully treated with hyperbaric oxygen therapy: case report

Hirotaka Yasuhara, Hiromichi Naito, Yoshinori Kosaki, Yasuaki Yamakawa, Atsuyoshi Iida, Tetsuya Yumoto, Hirotsugu Yamamoto, Taihei Yamada, Kohei Tsukahara, Takaaki Osako, Yasuhiro Mandai, Atsunori Nakao

UNDERSEA AND HYPERBARIC MEDICINE 45 ( 6 ) 701 - 703 2018年11月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：UNDERSEA & HYPERBARIC MEDICAL SOC INC

Emphysematous cystitis is an uncommon acute infection of the underlying bladder musculature and mucosa, caused by gas-producing organisms. Here we describe an 87-year-old woman with diabetes mellitus and emphysematous cystitis who was successfully treated with hyperbaric oxygen (HBO2) therapy. Her predisposition of diabetes and infection with gas-producing bacteria was considered to precede the development of emphysematous cystitis. Computed tomography revealed gas accumulation in the bladder wall and lumen. Antibiotics and HBO2 therapy were administered. HBO2 therapy may be beneficial due to the improvement in oxygenation of the tissues affected by the disease. HBO2 is a useful adjunct therapy for the management of severe emphysematous cystitis.

Web of Science

右内頸静脈穿刺による脱血での体外膜型肺を併用した心肺蘇生脱血カニューレに関して

内藤宏道, 平山隆浩, 塚原紘平

日本集中治療医学会雑誌 25 ( 6 ) 467 - 468 2018年11月

熱性けいれん重積状態後に半球性の著明な脳血流低下を示し、その後典型的なけいれん重積型急性脳症に至った1歳女児

土屋弘樹, 井上拓志, 原成未, 西村佑真, 竹内章人, 塚原紘平, 山本浩継, 八代将登, 佐藤剛史, 久保俊英

脳と発達 50 ( 6 ) 444 - 444 2018年11月

腹部CTからみた薬物過量内服

浅田遼, 塚原紘平, 内藤宏道, 飯田淳義, 小崎吉訓, 山川泰明, 湯本哲也, 山本浩継, 山田太平, 尾迫貴章, 中尾篤典

日本救急医学会雑誌 29 ( 10 ) 444 - 444 2018年10月

大動脈のCT値を利用した重症外傷患者における新規大量輸血予測ツールの開発

庵谷紘美, 湯本哲也, 小崎吉訓, 山川泰明, 飯田淳義, 山本浩継, 山田太平, 塚原紘平, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 29 ( 10 ) 473 - 473 2018年10月

学会開催日とその前後で外傷患者の死亡率に差はあるか? 日本外傷データバンクより

湯本哲也, 内藤宏道, 庵谷紘美, 小崎吉訓, 山川泰明, 飯田淳義, 山本浩継, 山田太平, 塚原紘平, 尾迫貴章, 中尾篤典

日本救急医学会雑誌 29 ( 10 ) 473 - 473 2018年10月

本人・家族からの申告のなかった農薬中毒例の検討

有吉雪乃, 内藤宏道, 萩岡信吾, 小崎吉訓, 飯田淳義, 湯本哲也, 山田太平, 塚原紘平, 尾迫貴章, 森本直樹, 中尾篤典

日本救急医学会雑誌 29 ( 10 ) 446 - 446 2018年10月

アンモニアガス曝露による気管狭窄・肺胞障害を認めた症例

沢田孝平, 小崎吉訓, 山本浩継, 藤崎宣友, 青景聡之, 山田太平, 塚原紘平, 万代康弘, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 29 ( 10 ) 437 - 437 2018年10月

腹筋運動が誘因となったと思われる特発性腹直筋血腫の1症例

山田太平, 小崎吉訓, 湯本哲也, 飯田淳義, 山本浩継, 藤崎宣友, 青景聡之, 塚原紘平, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 29 ( 10 ) 553 - 553 2018年10月

ANCA関連血管炎による重症呼吸不全に対しV-V ECMO管理中に血漿交換を並列で施行し人工肺の圧上昇を認めた1症例

宮本綾子, 高寛, 堂口琢磨, 西村まどか, 高浪大地, 塚原紘平, 青景聡之

日本急性血液浄化学会雑誌 9 ( Suppl. ) 127 - 127 2018年9月

他院にてV-V ECMOを導入した患者に対して生体両肺移植を施行した1例

宮本綾子, 高浪大地, 西村まどか, 堂口琢磨, 高寛, 塚原紘平, 笠原真悟, 大藤剛宏

体外循環技術 45 ( 3 ) 310 - 310 2018年9月

当院5年6ヵ月の小児の熱傷における挿管症例の検討

小崎吉訓, 山本浩継, 山川泰明, 内藤宏道, 飯田淳義, 湯本哲也, 山田太平, 塚原紘平, 尾迫貴章, 中尾篤紀

熱傷 44 ( 2 ) 104 - 104 2018年6月

Ictal Cardiorespiratory Arrest Associated with Status Epilepticus in Panayiotopoulos Syndrome.

Hirotsugu Yamamoto, Hiromichi Naito, Takaaki Osako, Kohei Tsukahara, Taihei Yamada, Tetsuya Yumoto, Atsuyoshi Iida, Yoshinori Kosaki, Makio Oka, Fumika Endo, Akira Gochi, Atsunori Nakao

Acta medica Okayama 72 ( 3 ) 297 - 300 2018年6月

記述言語：英語

A healthy 10-year-old boy vomited during sleep and later complained of abdominal pain; he became drowsy and uncommunicative. At the nearby hospital E.R., he deteriorated rapidly, and his respiratory movements were absent with cardiac arrest. He was immediately resuscitated. Brain MRI showed no abnormalities. EEG revealed an abnormal pattern with recurrent multifocal epileptiform activity over the bilateral occipital and frontal regions during sleep. Based on the clinical/radiological findings we diagnosed Panayiotopoulos syndrome (PS), a benign form of early-onset pediatric epilepsy characterized by autonomic symptoms. Lifethreating cardiopulmonary arrest is rare in PS, but long seizure duration of PS may associate with apnea and bradycardia.

DOI： 10.18926/AMO/56076

Hyperammonemic encephalopathy in a patient receiving fluorouracil/oxaliplatin chemotherapy

前頸部熱傷のため気管切開前に同部の植皮を先行させた4例についての検討

高見優男, 飯田淳義, 小崎吉訓, 山川泰明, 湯本哲也, 山田太平, 山本浩継, 塚原紘平, 尾迫貴章, 内藤宏道, 中尾篤典

熱傷 44 ( 2 ) 103 - 103 2018年6月

Raoultella planticola bacteremia-induced fatal septic shock following burn injury 査読

Tetsuya Yumoto*,Hiromichi Naito*,Hiromi Ihoriya,Kohei Tsukahara*,Tomoyuki Ota,Toshiyuki Watanabe,Atsunori Nakao*

Annals of Clinical Microbiology and Antimicrobials 17 ( 1 ) 2018年5月

Hiromi Ihoriya, Hirotsugu Yamamoto, Taihei Yamada, Kohei Tsukahara, Kanae Inoue, Tetsuya Yumoto, Hiromichi Naito, Atsunori Nakao

Clinical Case Reports 6 ( 4 ) 603 - 605 2018年4月

Portal Venous Gas Following Ingestion of Hydrogen Peroxide Successfully Treated with Hyperbaric Oxygen Therapy.

Chika Tsuboi, Hiromichi Naito, Shingo Hagioka, Hiroaki Hanafusa, Takahiro Hirayama, Yoshinori Kosaki, Atsuyoshi Iida, Tetsuya Yumoto, Kohei Tsukahara, Naoki Morimoto, Atsunori Nakao

Acta medica Okayama 72 ( 2 ) 181 - 183 2018年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

The primary toxicity of hydrogen peroxide results from its interaction with catalase, which liberates water and oxygen. We report the case of a 14-year-old Japanese girl with portal venous gas that was caused by oxygen liberated from intentionally ingested hydrogen peroxide. Although she had a past history of atrial septal defect, recovery without cardiac or neurological sequelae was achieved using hyperbaric oxygen therapy. Emergency physicians must be aware of the danger of liberated oxygen due to hydrogen peroxide ingestion.

DOI： 10.18926/AMO/55859

Cushing's sign and severe traumatic brain injury in children after blunt trauma 査読国際誌

Tetsuya Yumoto*,Hiromichi Naito*,Takashi Yorifuji*,Hiroki Maeyama,Yoshinori Kosaki*,Hirotsugu Yamamoto*,Kohei Tsukahara*,Takaaki Osako*,Atsunori Nakao*

BMJ Open 8 ( 3 ) e020781 2018年3月

院外心停止患者の搬送先病院と予後の検討

内藤宏道, 小崎吉訓, 山川泰明, 飯田淳義, 湯本哲也, 山本浩継, 山田太平, 塚原紘平, 尾迫貴章, 中尾篤典

日本集中治療医学会雑誌 25 ( Suppl. ) [O85 - 2] 2018年2月

Portal venous gas following ingestion of hydrogen peroxide successfully treated with hyperbaric oxygen therapy 査読

Chika Tsuboi,Hiromichi Naito*,Shingo Hagioka,Hiroaki Hanafusa,Takahiro Hirayama (T. Hirayama),Yoshinori Kosaki*,Atsuyoshi Iida*,Tetsuya Yumoto*,Kohei Tsukahara*,Naoki Morimoto,Atsunori Nakao*

Acta Medica Okayama, Acta. Medica Okayama, Acta medicinae Okayama, Acta medica Okayama 72 ( 2 ) 181 - 183 2018年1月

Serum Procalcitonin Levels in Acute Encephalopathy with Biphasic Seizures and Late Reduced Diffusion 査読国際誌

Yosuke Fujii,Masato Yashiro*,Mutsuko Yamada,Tomonobu Kikkawa,Nobuyuki Nosaka,Yukie Saito,Kohei Tsukahara*,Masanori Ikeda*,Tsuneo Morishima,Hirokazu Tsukahara*

Disease Markers, Disease markers 2018 4025694 - 4025694 2018年1月

Usefulness of 3-D computed tomography for diagnosis of abusive head trauma 査読

Kazumasa Zensho,Hirotsugu Yamamoto*,Kohei Tsukahara*,Takaaki Osako*,Atsunori Nakao*

Pediatrics International, Acta Paediatrica Japonica, Paediatria Japonica, Acta Paediatrica Japonica (Overseas Edition) 2018年1月

Medical equipment deployment in pediatric emergency prehospital medical units in Japan 査読

Noriyuki Kaku,Masahiko Nitta,Takashi Muguruma,Yuichiro Hirata,Kohei Tsukahara*,Emily Knaup (E. Knaup),Nobuyuki Nosaka,Yuki Enomoto

Pediatrics International, Acta Paediatrica Japonica, Paediatria Japonica, Acta Paediatrica Japonica (Overseas Edition) 60 ( 1 ) 93 - 95 2018年1月

Ictal cardiorespiratory arrest associated with status epilepticus in panayiotopoulos syndrome 査読

Hirotsugu Yamamoto*,Hiromichi Naito*,Takaaki Osako*,Kohei Tsukahara*,Taihei Yamada*,Tetsuya Yumoto*,Atsuyoshi Iida*,Yoshinori Kosaki*,Makio Oka*,Fumika Endoh*,Akira Gochi,Atsunori Nakao*

Acta Medica Okayama, Acta. Medica Okayama, Acta medicinae Okayama, Acta medica Okayama 72 ( 3 ) 297 - 300 2018年1月

Serum Procalcitonin Levels in Acute Encephalopathy with Biphasic Seizures and Late Reduced Diffusion. 国際誌

Yosuke Fujii, Masato Yashiro, Mutsuko Yamada, Tomonobu Kikkawa, Nobuyuki Nosaka, Yukie Saito, Kohei Tsukahara, Masanori Ikeda, Tsuneo Morishima, Hirokazu Tsukahara

Disease markers 2018 2380179 - 2380179 2018年

記述言語：英語掲載種別：研究論文（学術雑誌）

Procalcitonin (PCT) is used as a biomarker in severe infections. Here, we retrospectively investigated levels of serum PCT, C-reactive protein (CRP), and inflammatory cytokines (IL-6, TNF-α, and IFN-γ) in the second phase of patients with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). Nine AESD pediatric patients (4 men, 5 women; AESD group) admitted to Okayama University Hospital from 2010 to 2016 were compared with 10 control patients with febrile seizures (FS) (3 men, 7 women; FS group). Mean PCT concentrations (ng/mL) in the AESD and FS groups were significantly different, at 9.8 ± 6.7 and 0.8 ± 0.9, respectively (p = 0.0011). CRP (mg/dL) were 0.79 ± 0.89 and 1.4 ± 1.0 (p = 0.21), respectively; IL-6 (pg/mL) were 449.7 ± 705.0 and 118.3 ± 145.4 (p = 0.20), respectively; TNF-α (pg/mL) were 18.6 ± 12.5 and 16.6 ± 6.0 (p = 0.67), respectively; and IFN-γ (pg/mL) were 79.6 ± 158.5 and 41.9 ± 63.7 (p = 0.56), respectively. Ratios of PCT to CRP were 27.5 ± 34.2 and 3.2 ± 6.8 (p < 0.0001), respectively. The sensitivity and specificity in the diagnosis of AESD using a cutoff of PCT/CRP ratio of 1.0 were 100% and 80%, respectively. These results suggest that PCT and the PCT/CRP ratio are useful in auxiliary diagnosis of the second stage of AESD, and in AESD, PCT is likely to increase through a different mechanism.

DOI： 10.1155/2018/2380179

非もやもや病小児脳梗塞・脳虚血症例の治療におけるチーム医療の重要性査読

Indirect Calorimetry Measurement of Energy Expenditure Related to Body Position Changes in Healthy Adults. 査読

Obata K, Yumoto T, Fuke S, Tsukahara K, Naito H, Iida A, Takahashi T, Ujike Y, Nakao A.

Acta Med Okayama 71 ( 6 ) 467 - 473 2017年12月

安原隆雄, 菱川朋人, 亀田雅博, 平松匡文, 杉生憲志, 野坂宜之, 塚原紘平, 八代将登, 林裕美子, 伊達勲

脳卒中の外科 45 ( 6 ) 476 - 482 2017年11月

記述言語：日本語出版者・発行元：(一社)日本脳卒中の外科学会

症例1:9歳女児。左片麻痺で発症し、右内包後脚脳梗塞と診断された。aspirin内服を行い、24ヵ月再発なく外来加療中である。症例2:13歳男児。けいれん発作、意識障害、左片麻痺が生じ、動脈炎として加療開始された。右中大脳動脈領域に脳梗塞を認めたため外減圧術を施行したが、第62病日に頭蓋骨形成術を施行後に意識障害が生じ、けいれん重積状態となった。barbitalを用いた2週間にわたる鎮静・呼吸循環管理にて徐々に改善したが、左不全麻痺の悪化、右不全麻痺を生じた。17ヵ月経過現在、両杖をついた歩行訓練を行っている。症例3:10ヵ月女児。左不全片麻痺で発症し、3日後に意識障害が生じた。右側の血栓性脳梗塞と考えaspirin内服を開始したが、脳梗塞の再発、左側に新規の脳梗塞を来たした。warfarinとaspirinの内科加療を開始し、16ヵ月再発なく経過している。症例4:2歳女児。Klippel-Trenaunay症候群として経過観察されていた。繰り返す左片麻痺とけいれん発作が生じ、右内頸動脈の閉塞ないし狭窄に伴う脳虚血と診断し、aspirin内服加療を開始した。16ヵ月間再発なく経過している。

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J02079&link_issn=&doc_id=20171211180009&doc_link_id=%2Fcp4strok%2F2017%2F004506%2F009%2F0476-0482%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcp4strok%2F2017%2F004506%2F009%2F0476-0482%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Occult Sources of Bleeding in Blunt Trauma : A Narrative Review.

Tetsuya Yumoto, Yoshinori Kosaki, Yasuaki Yamakawa, Atsuyoshi Iida, Hirotsugu Yamamoto, Taihei Yamada, Kohei Tsukahara, Hiromichi Naito, Takaaki Osako, Atsunori Nakao

Acta medica Okayama 71 ( 5 ) 363 - 368 2017年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Worldwide, hemorrhagic shock in major trauma remains a major potentially preventable cause of death. Controlling bleeding and subsequent coagulopathy is a big challenge. Immediate assessment of unidentified bleeding sources is essential in blunt trauma patients with hemorrhagic shock. Chest/pelvic X-ray in conjunction with ultrasonography have been established classically as initial diagnostic imaging modalities to identify the major sources of internal bleeding including intra-thoracic, intra-abdominal, or retroperitoneal hemorrhage related to pelvic fracture. Massive soft tissue injury, regardless of whether isolated or associated with multiple injuries, occasionally causes extensive hemorrhage and acute traumatic coagulopathy. Specific types of injuries, including soft tissue injury or retroperitoneal hemorrhage unrelated to pelvic fracture, can potentially be overlooked or be considered "occult" causes of bleeding because classical diagnostic imaging often cannot exclude such injuries. The purpose of this narrative review article is to describe "occult" or unusual sources of bleeding associated with blunt trauma.

DOI： 10.18926/AMO/55433

Venous thromboembolism in major trauma patients: a single-center retrospective cohort study of the epidemiology and utility of D-dimer for screening

Tetsuya Yumoto, Hiromichi Naito, Yasuaki Yamakawa, Atsuyoshi Iida, Kohei Tsukahara, Atsunori Nakao

Acute Medicine & Surgery 4 ( 4 ) 394 - 400 2017年10月

過酸化水素摂取後の門脈内ガスに対する高圧酸素療法による治療の成功(Portal venous gas following ingestion of hydrogen peroxide successfully treated with hyperbaric oxygen therapy)

高尾賢一朗, 内藤宏道, 湯本哲也, 小崎吉訓, 飯田淳義, 塚原紘平, 山本浩継, 山川泰明, 山田太平, 尾迫貴章, 中尾篤典

日本救急医学会雑誌 28 ( 9 ) 526 - 526 2017年9月

指切創処置時における私の工夫

山川泰明, 小崎吉訓, 山本浩継, 飯田淳義, 湯本哲也, 山田太平, 塚原紘平, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 28 ( 9 ) 502 - 502 2017年9月

マムシ咬傷における入院期間にかかわる因子の検討

小崎吉訓, 内藤宏道, 山田太平, 塚原紘平, 尾迫貴章, 溝上良一, 川西進, 萩岡信吾, 繁光薫, 中尾篤典, 森本直樹

日本救急医学会雑誌 28 ( 9 ) 726 - 726 2017年9月

重度呼吸性アシドーシスを合併したPanayiotopoulos syndrome(Panayiotopoulos syndrome associated with severe respiratory acidosis)

西野貴大, 飯田淳義, 塚原紘平, 内藤宏道, 山田太平, 湯本哲也, 尾迫貴章, 小崎吉訓, 山本浩継, 山川泰明, 中尾篤典

日本救急医学会雑誌 28 ( 9 ) 518 - 518 2017年9月

クモ膜下出血術後、スパイナルドレナージの合併症として、血腫による急性閉塞性水頭症を発症した1例

内藤宏道, 山川泰明, 塚原紘平, 湯本哲也, 飯田淳義, 小崎吉訓, 山本浩継, 山田太平, 尾迫貴章, 中尾篤典

日本救急医学会雑誌 28 ( 9 ) 625 - 625 2017年9月

確定診断に時間を要したStanford A型急性大動脈解離患者の特徴

華房宏成, 内藤宏道, 小崎吉訓, 塚原紘平, 尾迫貴章, 溝上良一, 川西進, 萩岡信吾, 繁光薫, 中尾篤典, 森本直樹

日本救急医学会雑誌 28 ( 9 ) 512 - 512 2017年9月

救急医として地域、社会全体でリーダーになるということ(To be a regional and global leader as an emergency physician)

湯本哲也, 小崎吉訓, 山川泰明, 飯田淳義, 山本浩継, 山田太平, 塚原紘平, 内藤宏道, 尾迫貴章, 中尾篤典

日本救急医学会雑誌 28 ( 9 ) 471 - 471 2017年9月

小児領域における緊急度判定基準の確立に向けた現状理解査読

野坂宜之, クナウプ絵美里, 塚原紘平, 六車崇

日本臨床救急医学会雑誌 20 ( 4 ) 577 - 580 2017年8月

記述言語：日本語出版者・発行元：(一社)日本臨床救急医学会

多数の軽症患者受診に紛れ少数の重症例が生じる小児救急診療において、緊急度判定の重要性は高い。有用性ならびに汎用性の高い小児の緊急度判定法の確立が喫緊の課題である。(1)成長によりさまざまなパラメーターが著しく変化し、自己表現能力が未成熟である患者群の特徴、(2)多くの救急疾患が一般小児科外来を受診する現状、(3)小児人口の絶対的減少という社会的背景を踏まえ、救急科のみならず小児科・内科・耳鼻咽喉科などを含めた領域横断的な研究を通して、家庭-病院前-初療の各時相における緊急度判定の体系を構築する必要がある。(著者抄録)

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J03405&link_issn=&doc_id=20170925540003&doc_link_id=10.11240%2Fjsem.20.577&url=https%3A%2F%2Fdoi.org%2F10.11240%2Fjsem.20.577&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Multiple liver abscesses caused by streptococcus constellatus. 査読

Takeuchi N, Naito H, Yumoto T, Tsukahara K, Yamada T, Osako T, Soneda J, Nakao A.

Surgical Infections Case Reports 2 ( 1 ) 61 - 64 2017年7月

Burst Suppression in Hypothermia after Cardiac Arrest because of Drowning Treated with Targeted Temperature Management 査読

Tomoya Okazaki,Toru Hifumi,Satoshi Egawa,Hideyuki Hamaya,Natsuyo Shinohara,Shohei Kawamoto,Takuma Iwaki,Kohei Tsukahara*,Kenya Kawakita,Takashi Kusaka,Yasuhiro Kuroda

Therapeutic hypothermia and temperature management, Therapeutic Hypothermia and Temperature Management 7 ( 2 ) 107 - 110 2017年6月

Venous thromboembolism in major trauma patients: a single-center retrospective cohort study of the epidemiology and utility of D-dimer for screening. 査読

Yumoto T, Naito H, Yamakawa Y, Iida A, Tsukahara K, Nakao A.

Acute Med Surg 19 ( 4(4) ) 394 - 400 2017年6月

New age-based weight estimation formulae for Japanese children.

Nosaka N, Yorifuji T, Knaup , Tsukahara K, Muguruma T, Okada A, Tsukahara H, Doi H.

Pediatr Int 59 ( 6 ) 727 - 732 2017年6月

Intracranial Pressure Monitoring for Pediatric Acute Encephalopathy.

Nosaka N, Tsukahara K, Knaup E, Yabuuchi T, Kikkawa T.

Acta Med Okayama 71 ( 2 ) 179 - 180 2017年4月

記述言語：英語出版者・発行元：Okayama University Medical School

Newly published clinical practice guidelines recommend intracranial pressure (ICP) monitoring in critical care for the management of pediatric acute encephalopathy (pAE), but the utility of ICP monitoring for pAE has been poorly studied. We recently performed direct ICP monitoring for two patients. We observed that although the direct ICP monitoring had clinical benefits with less body weight gain and no vasopressor use in both cases, this monitoring technique is still invasive. Future studies should determine the utility of non-invasive ICP monitoring systems in pAE to further improve the quality of intensive-care management.

DOI： 10.18926/AMO/54987

Pneumatosis cystoides intestinalis presenting as pneumoperitoneum in a patient with chronic obstructive pulmonary disease 査読

A Successfully Treated Case of Criminal Thallium Poisoning. 査読

Yumoto T, Tsukahara K, Naito H, Iida A, Nakao A.

case Rep Infect Dis 11 ( 4 ) 2017年4月

A Successfully Treated Case of Criminal Thallium Poisoning. 査読国際誌

Yumoto T, Tsukahara K, Naito H, Iida A, Nakao A.

case Rep Infect Dis 11 ( 4 ) OD01-OD02 2017年4月

A case of traumatic cardiopulmonary arrest with good neurological outcome predicted by amplitude-integrated electroencephalogram. 査読

Harada K, Tsukahara K, Yumoto T, Yamakawa Y, Iida A, Naito H, Nakao A.

Int J Surg Case Rep 36 42 - 45 2017年3月

Recurrent apnea in an infant with pertussis due to household transmission. 国際誌

Motoharu Ochi, Nobuyuki Nosaka, Emily Knaup, Kohei Tsukahara, Tomonobu Kikkawa, Yousuke Fujii, Masato Yashiro, Keiji Sato, Toyomu Ugawa, Ayumi Okada, Hirokazu Tsukahara

Clinical case reports 5 ( 3 ) 241 - 245 2017年3月

Atsuyoshi Iida*,Hiromichi Naito*,Kohei Tsukahara*,Tetsuya Yumoto*,Nobuyuki Nosaka*,Shinnichi Kawana,Keiji Sato*,Nobuhiro Takeuchi,Jyunichi Soneda,Atsunori Nakao*

Journal of Medical Case Reports 11 ( 1 ) 1 - 10 2017年2月

Intraocular silicone oil masquerading as eye hemorrhage. 査読

Yamakawa Y, Naito H, Tsukahara K, Iida A, Yumoto T, Yamada T, Osako T, Nakao A.

J Trauma Treat 6 ( 1 ) 360 - 361 2017年2月

A successfully treated case of penetrating facial trauma. 査読

Yumoto T, Iida A, Tsukahara K, Naito H, Terado M, Sato K, Date I, Nakao A.

Int J Case Rep Images 8 ( 2 ) 120 - 123 2017年2月

AN69ST膜はナファモスタットメシル酸塩のほとんどを吸着する

平山隆浩, 大川恭昌, 鵜川豊世武, 林久美子, 野坂宜之, 湯本哲也, 塚原紘平, 内藤宏道, 佐藤圭路, 中尾篤典

日本集中治療医学会雑誌 24 ( Suppl. ) AW - 2 2017年2月

早期リハビリテーションを始めようチームビルディングの実際高度救命救急センターにおける理学療法士の関わり方

大塚貴久, 塚原紘平, 湯本哲也, 佐藤圭路, 鵜川豊世武, 中尾篤典

日本集中治療医学会雑誌 24 ( Suppl. ) PD7 - 6 2017年2月

Successfully-treated asymptomatic celiac artery aneurysm 査読

Nobuhiro Takeuchi,Junichi Soneda,Hiromichi Naito*,Atsuyoshi Iida*,Tetsuya Yumoto*,Kohei Tsukahara*,Atsunori Nakao*

International Journal of Surgery Case Reports 33 115 - 118 2017年1月

Inhaled hydrogen ameliorates endotoxin-induced bowel dysfunction

Hiroyuki Sakata, Ayana Okamoto, Michiko Aoyama-Ishikawa, Hayato Yamashita, Keisuke Kohama, Noritomo Fujisaki, Taihei Yamada, Joji Kotani, Kohei Tsukahara, Atsuyoshi Iida, Atsunori Nakao

Acute Medicine & Surgery 4 ( 1 ) 38 - 45 2017年1月

Bacteremia or pseudobacteremia? Review of pseudomonas fluorescens infections. 査読国際誌

Takeshi Nishimura, Kenji Hattori, Akihiko Inoue, Taiji Ishii, Tetsuya Yumoto, Kohei Tsukahara, Astunori Nakao, Satoshi Ishihara, Shinichi Nakayama

World journal of emergency medicine 8 ( 2 ) 151 - 154 2017年

Impact of Cushing's sign in the prehospital setting on predicting the need for immediate neurosurgical intervention in trauma patients 査読

Tetsuya Yumoto*,Toshiharu Mitsuhashi*,Yasuaki Yamakawa*,Atsuyoshi Iida*,Nobuyuki Nosaka*,Kohei Tsukahara*,Hiromichi Naito*,Atsunori Nakao*

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 24 ( 1 ) 2016年12月

国立大学病院の災害管理マニュアルの分析プロジェクト(DMMH-A project)報告書の概要査読

中尾博之, 中島康, 吉矢和久, 塚原紘平, 大友康裕, 嶋津, 岳士, 氏家良人

日本集団災害医学会雑誌 21 ( 2 ) 293 - 300 2016年11月

Donor pretreatment with carbon monoxide prevents ischemia/reperfusion injury following he Recurrent apnea art transplantation in rats. 査読

Fujisaki N, Kohama K, Nishimura T, Yamashita H, Ishikawa M, Kanematsu A, Yamada T, Lee S, Yumoto T, Tsukahara K, Kotani J, Nakao A.

Med Gas Res. 14 ( 6 ) 122 - 129 2016年10月

The Clinical Application of Hydrogen as a Medical Treatment. 査読

Iida A, Nosaka N, Yumoto T. Knaup E. Naito H. Nishiyama C. Yamakawa Y. Tsukahara K. Terado M. Sato K. Ugawa T. Nakao A.

Acta Med Okayama 70 ( 5 ) 331 - 337 2016年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Okayama University Medical School

In recent years, it has become evident that molecular hydrogen is a particularyl effective treatment for various disease models such as ischemia-reperfusion injury; as a result, research on hydrogen has progressed rapidly. Hydrogen has been shown to be effective not only through intake as a gas, but also as a liquid medication taken orally, intravenously, or locally. Hydrogenʼs effectiveness is thus multifaceted. Herein we review the recent research on hydrogen-rich water, and we examine the possibilities for its clinical application. Now that hydrogen is in the limelight as a gaseous signaling molecule due to its potential ability to inhibit oxidative stress signaling, new research developments are highly anticipated.

DOI： 10.18926/AMO/54590

Targeted age, device deployment, and problems associated with pediatric defibrillation in pediatric prehospital emergency medical care settings in Japan. 査読国際誌

Noriyuki Kaku, Masahiko Nitta, Takashi Muguruma, Kohei Tsukahara, Emily Knaup, Nobuyuki Nosaka, Yuki Enomoto

Acute medicine & surgery 3 ( 4 ) 356 - 359 2016年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Aim: The use of automated external defibrillators was expanded to include infants according to the 2010 cardiopulmonary resuscitation guidelines in Japan. However, deployment has been slower for pediatric patients in Japan, because there are fewer appropriate pediatric patients for automated external defibrillators than adults. This study aimed to investigate the targeted age range for pediatric defibrillation and device deployment of defibrillators for pediatric patients in prehospital emergency medical care settings in Japan, and present the issues associated with automated external defibrillators. Methods: We administered a web-based survey to the fire defense headquarters in Japan regarding prehospital emergency medical care for pediatric patients in June 2013. We extracted and analyzed some parts of the data related to pediatric defibrillation. Results: Eighty-eight percent of the fire defense headquarters responded to the survey. Sixty-two percent of the fire defense headquarters applied the expanded indication protocol for pediatric defibrillation, which included infants. Forty-three percent of the fire defense headquarters replied that their emergency medical service personnel were using semi-automatic defibrillators without a pediatric mode, whereas 21% of them were using automated external defibrillators that were not equipped with pediatric attenuators. Moreover, many of the semi-automatic defibrillators are not designed for pediatric defibrillation in patients aged <8 years. Conclusions: Pediatric prehospital emergency medical care in Japan is inadequately equipped for pediatric defibrillation. It will be necessary to use age-appropriate defibrillators as the targeted age range for automated external defibrillators rapidly expands to include infants.

DOI： 10.1002/ams2.194

A successfully treated case of iliopsoas abscess affecting urinary tract infection caused by streptococcus sanguis. 査読

Takeuchi N, Emori K, Yoshitani M, Soneda J, Naito H, Yumoto T, Tsukahara K, Nakao A.

Surg Infect Case Rep. 1 ( 1 ) 123 - 125 2016年9月

Intraperitoneally administered, hydrogen-rich physiologic solution protects against postoperative ileus and is associated with reduced nitric oxide production. 査読

Okamoto A, Kohama K, Aoyama-Ishikawa M, Yamashita H, Fujisaki N, Yamada T, Yumoto T, Nosaka N, Naito H, Tsukahara K, Iida A, Sato K, Kotani J, Nakao A.

Surgery. 160 ( 3 ) 623 - 631 2016年9月

A case of cricothyroidotomy for facial trauma in a patient taking antiplatelet agents after a simple ground-level fall. 査読国際誌

Yumoto T, Matsumura T, Tsukahara K, Sato K, Ugawa T, Ujike Y.

Int J Surg Case Rep. 27 87 - 89 2016年8月

Soft tissue hematoma of the neck due to thyroid rupture with unusual mechanism. 査読

Tsukahara K, Sato K, Yumoto T, Iida A, Nosaka N, Terado M, Naito H, Orita Y, Naito T, Miki K, Sugihara M, Nagao S, Ugawa T, Nakao A.

Int J Surg Case Rep. 26 217 - 220 2016年8月

Validity of Mothers' Reports of Children's Weight in Japan. 査読

Nosaka N, Fujiwara T, Knaup E, Okada A, Tsukahara H.

Acta Med Okayama. 70 ( 4 ) 255 - 259 2016年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Okayama University Medical School

Estimation methods for pediatric weight have not been evaluated for Japanese children. This study aimed to assess the accuracy of mothersʼ reports of their childrenʼs weight in Japan. We also evaluated potential alternatives to the estimation of weight, including the Broselow tape (BT), Advanced Pediatric Life Support (APLS), and Parkʼs formulae. We prospectively collected cross-sectional data on a convenience sample of 237 children aged less than 10 years who presented to a general pediatric outpatient clinic with their mothers. Each weight estimation method was evaluated using Bland-Altman plots and by calculating the proportion within 10 and 20 of the measured weight. Mothersʼ reports of weight were the most accurate method, with 94.9 within 10 of the measured weight, the lowest mean difference (0.27kg), and the shortest 95 limit of agreement (－1.4 to 1.9kg). The BT was the most reliable alternative, followed by APLS and Parkʼs formulae. Mothersʼ reports of their children ʼs weight are more accurate than other weight estimation methods. When no report of a childʼs weight by the mother is available, BT is the best alternative. When an aged-based formula is the only option, the APLS formula is preferred.

DOI： 10.18926/AMO/54500

Development of a Japanese scale for assessment of aediatric normal weight. 査読

Nosaka N, Yorifuji T, Knaup E, Muguruma T, Okada A, Tsukahara H, Doi H.

Resuscitation. 105 A1 - A8 2016年8月

複数の原因が考えられた乳児期突発性危急事態の1例

越智元春, 野坂宜之, 塚原紘平, 佐藤圭路, 鵜川豊世武, 氏家良人, 渡邉宏和, 吉川知伸, 藤井洋輔, 八代将登, 塚原宏一

日本小児科学会雑誌 120 ( 7 ) 1128 - 1128 2016年7月

病院前の小児声門上気道デバイスの配備状況．査読

塚原紘平、賀来典之、六車崇、クナウプ絵美里、野坂宜之、榎本有希.

日本臨床救急医学会雑誌. 19 ( 3 ) 489 - 492 2016年6月

担当区分：筆頭著者記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本臨床救急医学会

背景：わが国の消防本部における小児の病院前救護の声門上気道デバイスの使用基準や配備状況は明らかではない。目的・方法：小児の病院前救護における声門上気道デバイスの配備状況を把握し，問題点の抽出を行う。2013年6月に，わが国の消防本部を対象に小児病院前救護に関するウェブアンケートを施行し，声門上気道デバイスに関する部分を解析した。結果：適応年齢は「規定なし」が63%，次いで「全年齢」が最も多く23％であった。また，60％のメディカルコントロール協議会で適応年齢の統一がされていなかった。ラリンゲルチューブ（LT）は98％，ラリンゲルマスク（LM）は59％の消防本部が配備していると回答したが，回答した適応年齢と一致していない現状が明らかになった。結論：小児病院前救護の声門上デバイスの配備状況を調査した。配備状況，適応，教育に関して課題は多く，現状解決のための方策が必要である。

DOI： 10.11240/jsem.19.489

小児病院前救護における静脈路確保と薬剤投与の施行体制の現況．査読

その他リンク： https://jlc.jst.go.jp/DN/JLC/20022985567?from=CiNii

Letter to the Editor regarding the paper by Sun G et al: Elevated serum levels of neutrophil elastase in patients with influenza virus-associated encephalopathy. 査読

Nosaka N, Hatayama K, Fujii Y, Yashiro M, Tsukahara H, Morishima T.

J Neuro Sci. 364 188 - 188 2016年5月

A Close Call: Lucky Man Survives Penetrating Chest Trauma. 査読

Terado M, Iida A, Tsukahara K, Sato K, Takagaki M, Hirayama T, Nakao A.

Med Case Rep. 2 ( 2:20 ) 1 - 1 2016年4月

クナウプ絵美里、賀典之、野坂宜之、塚原紘平、榎本有希、六車崇.

日本臨床救急医学会雑誌. 19 ( 1 ) 35 - 40 2016年2月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本臨床救急医学会

背景：病院前救護での小児への救命処置は，地域メディカルコントロール協議会（以下，MCと略す）ごとに業務プロトコールが定められている。目的・方法：小児への静脈路確保と薬剤投与の基準の調査のため，全国767消防本部の救急責任者にメールでウェブアンケートを実施した。結果：アンケート回収率は87.5％。適応年齢は，静脈路確保で「規定なし」56％，薬剤投与で「8歳以上」82％が最多であった。小児を処置の対象と回答したものの，1割の消防本部では小児には不適切な太い留置針のみが配備されていた。複数の消防本部が所属するMCのうち，静脈路確保は60％，薬剤投与は24％で年齢基準が統一されていなかった。救命救急センターが少ない地域では，8割以上が小児を薬剤投与の適応としていた。小児CPR教育への充足度は低いが需要は高かった。結論：事後検証を行う体制の整備，地域に合った年齢基準の策定と徹底，基準にあった装備と教育が必要である。

DOI： 10.11240/jsem.19.35

その他リンク： https://jlc.jst.go.jp/DN/JLC/20021061934?from=CiNii

外傷患者における冷汗の意義?多施設共同前向き観察研究より?. 査読

湯本哲也、塚原紘平、飯田淳義、寺戸通久、佐藤圭路、鵜川豊世武、氏家良人、西村哲郎、定光大海、土谷飛鳥、植木浜一、高間辰雄、真弓俊彦.

日本外傷学会雑誌. 30 ( 1 ) 1 - 8 2016年1月

Donor pretreatment with carbon monoxide prevents ischemia/reperfusion injury following heart transplantation in rats

Atsunori Nakao, Noritomo Fujisaki, Keisuke Kohama, Takeshi Nishimura, Hayato Yamashita, Michiko Ishikawa, Akihiro Kanematsu, Taihei Yamada, Sungsoo Lee, Tetsuya Yumoto, Kohei Tsukahara, Joji Kotani

Medical Gas Research 6 ( 3 ) 122 - 122 2016年

Suoerior ophthalmic Vein thrombosis associated with severe facial trauma :a case report. 査読

J Med Case Rep. 2015年12月

小児の病院前救護に関する教育の現状査読

榎本有希, 賀来典之, 六車崇, クナウプ絵美里, 野坂宜之, 塚原紘平

日本臨床救急医学会雑誌 18 ( 6 ) 723 - 728 2015年12月

記述言語：日本語出版者・発行元：(一社)日本臨床救急医学会

目的:わが国の小児病院前救護に関する教育の実態は不明である。小児病院前救護に関する教育の課題を抽出するために本研究を行った。方法:2013年6月にわが国の消防本部を対象に小児病院前救護に関するアンケートを施行し、そのうち教育に関する部分を抽出し解析した。結果:多くの項目で小児病院前救護に関する教育の必要性は認識されていた。一方で、教育が必要量の50%以上行われている(充足している)との回答は半数未満であった。また、救命救急センターの少ない地域では、多い地域に比べて教育の充足度が有意に低い分野が複数みられた。考察:小児病院前救護に関する教育の必要性は認識されているが、十分な教育がなされていない可能性がある。教育内容を再検討のうえで、処置基準や装備デバイスと一貫性をもった、効率的なoff the job trainingを行う必要がある。(著者抄録)

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J03405&link_issn=&doc_id=20160120510005&doc_link_id=10.11240%2Fjsem.18.723&url=https%3A%2F%2Fdoi.org%2F10.11240%2Fjsem.18.723&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Superior ophthalmic vein thrombosis associated with severe facial trauma: a case report 査読国際誌

Mishima M, Yumoto T, Hashimoto H, Yasuhara T, Iida A, Tsukahara K, Sato K, Ugawa T, Otsuka F and Ujike Y

J. Med. Case Rep 9 244 - 244 2015年10月

病院前の小児声門上気道デバイスの配備状況査読

臨床救急医学会雑誌 2015年10月

Characteristics and costs of ladder fall injuries: a report from a single emergency center in Okayama 査読

Nosaka Nobuyuki, Goda Yu, Knaup Emily, Tsukahara Kohei, Yumoto Tetsuya, Ugawa Toyomu, Ujike Yoshihito

Acta Medica Okayama 69 ( 5 ) 275 - 278 2015年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Okayama University Medical School

We sought to identify the incidence, injury patterns, and financial burden of ladder fall injuries to provide a reference for reinforcing guidelines on the prevention of such injuries. We enrolled the patients who were injured in a ladder-related fall and required intensive care between April 2012 and March 2014 at Okayama University Hospital, a tertiary care hospital in Okayama City:9 patients injured in 7 stepladder falls and 2 straight ladder falls. The median patient age was 69 years, and 8 were males. Six falls occurred in non-occupational settings. Head injuries predominated, and the injury severity score ranged from 2 to 35 (mean＝21±12). At the time of discharge from the intensive care unit, one patient had died and 5 patients had some neurological disabilities. The case fatality rate was 11%. The total cost of care during the review period was ￥16,705,794, with a mean cost of￥1,856,199 per patient. Ladder fall injuries are associated with a high rate of neurological sequelae and pose a financial burden on the health insurance system. A prevention education campaign targeting at older-aged males in non-occupational settings may be a worthwhile health service investment in this community.

DOI： 10.18926/AMO/53673

その他リンク： http://search.jamas.or.jp/link/ui/2016310201

Abnormal ranges of vital signs in children in Japanese prehospital settings. 国際誌

Nobuyuki Nosaka, Takashi Muguruma, Emily Knaup, Kohei Tsukahara, Yuki Enomoto, Noriyuki Kaku

Acute medicine & surgery 2 ( 4 ) 267 - 270 2015年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Aim: The revised Fire Service Law obliges each prefectural government in Japan to establish a prehospital acuity scale. The Foundation for Ambulance Service Development (FASD) created an acuity scale for use as a reference. Our preliminary survey revealed that 32 of 47 prefectures directly applied the FASD scale for children. This scale shows abnormal ranges of heart rate and respiratory rate in young children. This study aimed to evaluate the validity of the abnormal ranges on the FASD scale to assess its overall performance for triage purposes in paediatric patients. Methods: We evaluated the validity of the ranges by comparing published centile charts for these vital signs with records of 1,296 ambulance patients. Results: A large portion of the abnormal ranges on the scale substantially overlapped with the normal centile charts. Triage decisions using the FASD scale of vital signs properly classified 22% (n = 287) of children. The sensitivity and specificity for high urgency were as high as 91% (95% confidence interval, 82-96%) and as low as 18% (95% confidence interval, 16-20%). Conclusion: We found there is room for improvement of the abnormal ranges on the FASD scale.

DOI： 10.1002/ams2.139

IMPROVED SURVIVAL WITH AN INNOVATIVE APPROACH TO THE TREATMENT OF SEVERELY BURNED PATIENTS: DEVELOPMENT OF A BURN TREATMENT MANUAL. 査読

Annals of Burns and Fire Disasters. 2015年9月

Ditch-related falls: Need for preventive educational campaigns．査読

Acute Medicine and Surgery 2015年8月

Abnormal ranges of vital signs in children in Japanese prehospital settings．査読

Acute Medicine and Surgery 2015年7月

Three cases of heparin-induced thrombocytepenia associated with polytrauma 査読

ACUTE MEDICINE & SURGERY 2015年5月

Acute respiratory distress syndrome in a child with severe epileptic disorder treated successfully by extracorporeal membrane oxygenation: a case report．査読

BMC Pediatrics 2015年5月

Acute respiratory distress syndrome in a child with severe epileptic disorder treated successfully by extracorporeal membrane oxygenation: a case report. 国際誌

Nobuyuki Nosaka, Shingo Ichiba, Kohei Tsukahara, Emily Knaup, Kumiko Hayashi, Shingo Kasahara, Yoshinori Kobayashi, Makio Oka, Katsuhiro Kobayashi, Harumi Yoshinaga, Yoshihito Ujike

BMC pediatrics 15 29 - 29 2015年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is now a candidate therapy for children with acute respiratory failure. CASE PRESENTATION: We report our experience of using central ECMO therapy for acute respiratory distress syndrome followed by seizure in a 15-month-old girl with a severe epileptic disorder. Her respiratory distress was refractory to standard medical treatment and mechanical ventilatory support. Her condition was complicated by development of a pneumothorax. The patient was successfully weaned off ECMO and discharged without deterioration of her neurological status. CONCLUSION: The successful outcome in this case resulted from the central ECMO, which enabled "lung rest" and adequate cerebral blood flow. In skilled ECMO facilities, early implementation of ECMO would give some advantages to patients such as the one presented here. Given the invasiveness and the ease of the procedure, introduction of dual-lumen catheters adequately sized for pediatric patients in Japan is required.

DOI： 10.1186/s12887-015-0348-1

乳児期から特異な経過を示すDravet症候群の1例

人工呼吸管理中における食道内圧測定の使用経験

平山隆浩, 平山敬浩, 林久美子, 井口浩貴, 湯本哲也, 塚原紘平, 飯田淳義, 山内英雄, 佐藤圭路, 鵜川豊世武, 市場晋吾, 氏家良人

日本臨床工学技士会会誌 ( 54 ) 196 - 196 2015年4月

血中一酸化炭素ヘモグロビン(CO-Hb)濃度が0%であった一酸化炭素中毒死の1症例

神原由依, 飯田淳義, 湯本哲也, 平山敬浩, 塚原紘平, 佐藤圭路, 鵜川豊世武, 氏家良人, 三浦雅布, 宮石智

中毒研究 28 ( 1 ) 72 - 72 2015年3月

敗血症性ショック患者における動脈圧波形変化の解析による血管状態の推定

平山隆浩, 北脇知己, 林久美子, 佐藤圭路, 平山敬浩, 湯本哲也, 塚原紘平, 鵜川豊世武, 市場晋吾, 氏家良人

日本集中治療医学会雑誌 22 ( Suppl. ) [MO2 - 1] 2015年1月

小林由典, 岡牧郎, 小林勝弘, 吉永治美, 野坂宜之, 塚原紘平, 鵜川豊世武, 笠原真悟

脳と発達 47 ( 1 ) 60 - 60 2015年1月

Septic shock due to Aeromonas hydrophila bacteremia in a patient with alcoholic liver cirrhosis: a case report. 査読国際誌

J Med Case Rep 8 402 - 402 2014年12月

Current experience and limitations of extracorporeal cardiopulmonary resuscitation for cardiac arrest in children: a single-center retrospective study

Kohei Tsukahara, Chiaki Toida, Takashi Muguruma

Journal of Intensive Care 2 ( 1 ) 2014年12月

Immediate screening method for predicting the necessity of massive transfusions in trauma patients: a retrospective single-center study. 査読国際誌

J Intensive Care 2 ( 1 ) 54 - 54 2014年9月

岡山大学病院高度救命救急センターにおける薬剤経管投与方法への薬剤師の介入症例

座間味義人, 名倉弘哲, 飯田淳義, 塚原紘平, 寺戸通久, 鵜川豊世武, 芝直基, 山内英雄, 市場晋吾, 氏家良人

日本集中治療医学会雑誌 20 ( Suppl. ) 413 - 413 2013年1月

Evaluating the Need for and Effect of Percutaneous Transluminal Angioplasty on Arteriovenous Fistulas by Using Total Recirculation Rate per Dialysis Session ("Clearance Gap")

Ugawa Toyomu, Sakurama Kazufumi, Yorifuji Takashi, Takaoka Munenori, Fujiwara Yasuhiro, Kabashima Narutoshi, Azuma Daisuke, Hirayama Takahiro, Tsukahara Kohei, Morisada Sunao, Iida Atsuyoshi, Tada Keitaro, Shiba Naoki, Sato Nobuo, Ichiba Shingo, Kino Koichi, Fukushima Masaki, Ujike Yoshihito

Acta Medica Okayama 66 ( 6 ) 443 - 447 2012年12月

記述言語：英語出版者・発行元：Okayama University Medical School

The functioning of an arteriovenous fistula (AVF) used for vascular access during hemodialysis has been assessed mainly by dilution methods. Although these techniques indicate the immediate recirculation rate, the results obtained may not correlate with Kt/V. In contrast, the clearance gap (CL-Gap) method provides the total recirculation rate per dialysis session and correlates well with Kt/V. We assessed the correlation between Kt/V and CL-Gap as well as the change in radial artery (RA) blood flow speed in the fistula before percutaneous transluminal angioplasty (PTA) in 45 patients undergoing continuous hemodialysis. The dialysis dose during the determination of CL-Gap was 1.2 to 1.4 Kt/V. Patients with a 10% elevation or more than a 10% relative increase in CL-Gap underwent PTA (n＝45), and the values obtained for Kt/V and CL-Gap before PTA were compared with those obtained immediately afterward. The mean RA blood flow speed improved significantly (from 52.9 to 97.5cm/sec) after PTA, as did Kt/V (1.07 to 1.30) and CL-Gap (14.1% to －0.2%). A significant correlation between these differences was apparent (r＝－0.436 and p＝0.003). These findings suggest that calculating CL-Gap may be useful for determining when PTA is required and for assessing the effectiveness of PTA, toward obtaining better dialysis.

DOI： 10.18926/AMO/49040