Faculty Profiles - MORIMATSU Hiroshi

MISC - MORIMATSU Hiroshi

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小児心臓外科術後急性腎不全患者における腹膜透析の効果

森松博史, 戸田雄一郎, 江木盛時, 清水一好, 岩崎達雄, 竹内護, 中塚秀輝, 森田潔

日本集中治療医学会雑誌 14 ( Supplement ) 251 2007.1

急性疾患成人の持続血糖測定の信頼性(原標題は英語)

江木盛時, 森松博史, 戸田雄一郎, 鈴木聡, 溝渕知司, 竹内護, 中塚秀輝, 片山浩, 横山正尚, 森田潔

日本集中治療医学会雑誌 14 ( Supplement ) 303 2007.1

敗血症性ショックの治療中に好中球減少を併発した1症例

鈴木聡, 森松博史, 江木盛時, 清水一好, 佐藤哲文, 武田吉正, 中塚秀輝, 片山浩, 横山正尚, 森田潔

日本集中治療医学会雑誌 14 ( Supplement ) 257 2007.1

The mechanism of immunosuppnession in patients addmitted into ICU: the LPS nesponse and expnession of CD14/TLR-4 on monocytes

Journal of Japan Society for Surgical Infection 4 ( 2 ) 149 - 156 2007

【急性血液浄化法のnon-renal indicationの拡大】 High volume hemofiltrationの可能性と限界.

森松博史

ICUとCCU(0389-1194) 31 S60-S62 2007

A validation study for urine output criteria of RIFLE criteria

UCHINO Shigehiko, MORIMATSU Hiroshi, UEHARA Jun, MATOU Takashi

Journal of the Japanese Society of Intensive Care Medicine 14 ( 4 ) 611 - 612 2007

【集中治療・周術期管理と長期予後】 ICUにおける代謝管理と長期予後.

江木盛時, 森松博史, 片山浩, 森田潔

ICUとCCU(0389-1194) 31 527 - 534 2007

【急性腎不全の基礎と新たな治療法への期待】 HF-CHDF・HV-CHDF使用の治療戦略.

片山浩, 森松博史, 江木盛時, 佐藤哲文, 森田潔

ICUとCCU(0389-1194) 31 S12-S13 2007

Stewart Approach 新しい酸塩基平衡の考え方.

森松博史

臨床麻酔(0387-3668) 31 1281 - 1287 2007

集中治療領域における急性血液浄化法の今後の展望集中治療に役立つ血液浄化の最先端 HF,HV-CHDFに対する期待と展望.

片山浩, 森松博史, 佐藤哲文, 武田吉正, 中塚秀輝, 森田潔

日本臨床麻酔学会誌(0285-4945) 27 ( 1 ) 28 - 33 2007

Protective role of HO-1 in oxidative tissue injuries

TAKAHASHI Toru, SHIMIZU Hiroko, INOUE Kazuyoshi, MORIMATSU Hiroshi, UMEDA Kana, OMORI Emiko, AKAGI Reiko, MORITA Kiyoshi

Folia Pharmacologica Japonica 130, 252-6 ( 4 ) 252 - 256 2007

Stewart Approach : 新しい酸塩基平衡の考え方

森松博史

臨床麻酔 31, 1281-1287 2007

ﾗｯﾄ出血性ｼｮｯｸ後急性肺傷害に対するｳﾘﾅｽﾀﾁﾝの治療効果.

井上一由, 高橋徹, 井戸佳奈, 清水裕子, 森松博史, 前島亨一朗, 松三昌樹, 片山浩, 森田潔

shock学会雑誌 22 ( 2 ) 96 - 99 2007

誌上抄読会ﾚﾐﾌｪﾝﾀﾆﾙー本邦での臨床使用に際して最近の話題ー.

溝渕知司, 佐藤健治, 花崎元彦, 中塚秀輝, 大西藍, 大西淳司, 那須敬, 脇有紀, 谷真規子, 金澤伴幸, 鈴木聡, 林真雄

臨床麻酔 31 93 - 100 2007

腹膜透析を要した小児心臓周術期患者の過血糖(原標題は英語)

江木盛時, 森松博史, 戸田雄一郎, 岩崎達雄, 清水一好, 竹内護, 松崎孝, 鈴木聡, 横山正尚, 森田潔

日本集中治療医学会雑誌 14 ( Supplement ) 2007

The effects of saline or albumin resuscitation on acid-base status and serum electrolytes

Rinaldo Bellomo, Hiroshi Morimatsu, Craig French, Louise Cole, David Story, Shigehiko Uchino, Toshio Naka

CRITICAL CARE MEDICINE 34 ( 12 ) 2891 - 2897 2006.12

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

Objective: To test whether fluid resuscitation with normal saline or 4% albumin is associated with differential changes in acid-base status and serum electrolytes.
Design: Nested cohort study.
Setting. Three general intensive care units.
Patients: Six hundred and ninety-one critically ill patients.
Interventions: Randomization of patients to receive blinded solutions of either 4% human albumin or normal saline for fluid resuscitation.
Measurements and Main Results. Albumin was given to 339 patients and saline to 352. At baseline, both groups had a similar serum bicarbonate, albumin, and base excess levels. After randomization, bicarbonate and base excess increased significantly and similarly over time (p <.0001). On multivariate analysis, fluid resuscitation with albumin predicted a smaller increase in pH (p =.0051), bicarbonate (p =.034), and base excess (p =.015). The amount of fluid was an independent predictor of pH (p <.0001), serum chloride (p <.0001), calcium (p =.0001), bicarbonate (p =.0002), and base excess (p <.0001) on the first day of treatment. In patients who received >3 L of fluids in the first 24 hrs, albumin administration was associated with a significantly greater increase in serum chloride (p =.0026). Acute Physiology and Chronic Health Evaluation II score and the presence of sepsis also independently predicted changes in several electrolytes and acid-base variables.
Conclusions. When comparing albumin and saline, the choice and amount of resuscitation fluid are independent predictors of acid-base status and serum electrolytes. When large volumes are given, albumin administration leads to a higher chloride concentration. However, overall differences between the types of fluid are minor, whereas the volume of fluid administered is a much stronger predictor of such changes, which are also influenced by illness severity and the passage of time.

DOI： 10.1097/01.CCM.0000242159.32764.86

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Effect of low-dose vasopressin infusion on vital organ blood flow in the conscious normal and septic sheep

D. Di Giantomasso, H. Morimatsu, R. Bellomo, C. N. May

ANAESTHESIA AND INTENSIVE CARE 34 ( 4 ) 427 - 433 2006.8

Language：English Publisher：AUSTRALIAN SOC ANAESTHETISTS

The effect of low-dose vasopressin (AVP) on vital regional circulations may be clinically relevant but has not been fully described. We sought to determine the effect of low-dose AVP on systemic haemodynamics, coronary, mesenteric and renal circulations in the conscious normal and septic mammal.
We studied seven Merino sheep using a prospective randomized cross-over double-blind placebo-controlled animal design. We inserted flow probes around aorta, coronary, mesenteric and renal arteries and, three weeks later, we infused low-dose AVP (0.02 IU/min) or placebo in the normal and septic state induced by intravenous E. coli. In normal sheep, AVP (0. 02 IU/min) induced a 17% decrease in mesenteric blood flow (393.0 +/- 134.9 vs 472.1 +/- 163.8 ml/min, P<0.05) and a 14% decrease in mesenteric conductance (P<0.05). In septic sheep, APT decreased heart rate and cardiac output by 28% and 22%, respectively (P<0.05). It also decreased mesenteric blood flow and mesenteric conductance by 23% (flow: 468.5 +/- 159.7 vs 611.3 +/- 1363 ml/min, P<0.05; conductance: 63 +/- 2.7 vs 8.2 +/- 2.7 ml/min/mmHg; P<0.05). Renal blood flow was unchanged but urine output and creatinine clearance increased (P < 0.05). We conclude that low-dose AVP infusion has similar effects in the normal and septic mammalian circulation: bradycardia, decreased cardiac output, decreased mesenteric blood flow and conductance and increased urine output and creatinine clearance. This information is important to clinicians considering its administration in humans.

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Hyperchloremic acidosis in the critically ill: One of the strong-ion acidoses?

DA Story, H Morimatsu, R Bellomo

ANESTHESIA AND ANALGESIA 103 ( 1 ) 144 - 148 2006.7

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

Decreases in plasma bicarbonate are associated with hyperchloremic acidosis and lactic acidosis. According to the Stewart approach to acid-base physiology, the strong-ion difference regulates plasma bicarbonate, with chloride and lactate being the only strong anions routinely measured in clinical chemistry. We hypothesized that the plasma strong-ion difference, both with and without lactate, would have a stronger association with plasma bicarbonate than plasma chloride alone would have with bicarbonate. We used plasma acid-base data from 300 critically ill patients. The correlation with bicarbonate became progressively weaker (P < 0.001): all measured strong ions, r = 0.60; measured strong ions without lactate, r = 0.42; chloride alone, r = -0.27. In a subgroup of 26 patients with traditional hyperchloremic acidosis (base excess < -2mmol/L and anion gap < 17 mmol/L), the measured strong-ion difference (without lactate) had a stronger correlation (P < 0.001) with bicarbonate than chloride had: r = 0.85 versus r = -0.60. We conclude that hyperchloremic acidosis and lactic acidosis are strong-ion acidoses. Hyperchloremia should be viewed relative to the plasma strong cations. A practical conclusion is that both managing and preventing acid-base disorders with IV fluid therapy involves manipulating each of the plasma strong ions, particularly sodium and chloride.

DOI： 10.1213/01.ane.0000221449.67354.52

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Acid-base balance during continuous veno-venous hemofiltration: The impact of severe hepatic failure

T. Naka, R. Bellomo, H. Morimatsu, J. Rocktaschel, L. Wan, P. Gow, P. Angus

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS 29 ( 7 ) 668 - 674 2006.7

Language：English Publisher：WICHTIG EDITORE

Background: Continuous renal replacement therapy (CRRT) affects acid-base balance but the influence of severe hepatic failure (SHF) on this effect is unknown.
Aim: To assess the effect of SHF on acid-base balance in patients receiving CVVH.
Design: Retrospective laboratory investigation.
Subjects: Forty patients with SHF and acute renal failure (ARF) treated with CVVH and 42 critically ill patients with severe ARF but no liver disease also treated with CVVH (controls).
Intervention: Retrieval of clinical and laboratory data from prospective unit and laboratory databases.
Methods: Quantitative acid-base status assessment using the Stewart-Figge methodology. Comparison of findings between the two groups.
Results: Although CVVH had a major effect on acid base balance in both groups, patients with SHF had a higher mean lactate concentrations (4.8 vs. 3.1 mmol/L; p < 0.0005), a greater base deficit compared to controls (-1 vs. 4.1 mEq/L; p < 0.0001) and a lower PaCO2 tension (36.8 vs. 42.5 mmHg; p < 0.0001), despite the use of bicarbonate replacement fluid. The acidifying effect of hyperlactatemia was slightly worsened by an increased strong ion gap (9.3 vs. 4.9 mEq/L; p < 0.0001). It was, however, attenuated by an increased strong ion difference apparent (SIDa) (43.6 vs. 41.9 mEq/L; p < 0.05) secondary to hypochloremia (96 vs. 100 mmol/L; p < 0.0001) and by hypoalbuminemia, although hypoalbuminemia in SHF patients (26 vs. 23; p < 0.005) was less pronounced than in controls.
Conclusion: The use of CVVH does not fully correct the independent acidifying effect of liver failure on acid-base status. Increased lactate and strong ion gap values maintain a persistent base deficit despite the alkalinizing effects of hypoalbuminemia and hypochloremia. The correction of acidosis in SHF patients may require more intensive CVVH.

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General anesthesia in a patient with dystrophic epidermolysis bullosa

Yuichiro Toda, Masataka Yokoyama, Hiroshi Morimatsu, Hideki Nakatsuka, Mamoru Takeuchi, Hiroshi Katayama, Kiyoshi Morita

Journal of Anesthesia 20 ( 2 ) 138 - 140 2006.5

Language：English

A 13-year-old boy with epidermolysis bullosa underwent a repair of pseudosyndactyly. He had a long history of bullae formation in the oral cavity and on the pharynx and body surface, and some were active at the time of surgery. We chose inhalational general anesthesia with tracheal intubation using sevoflurane and nitrous oxide. The trachea was successfully extubated after the surgery, and no major bulla formation was observed. General anesthesia with tracheal intubation may be chosen as anesthesia for patients with epidermolysis bullosa. © JSA 2006.

DOI： 10.1007/s00540-006-0388-7

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