2024/01/31 更新

写真a

スズキ サトシ
鈴木 聡
SUZUKI Satoshi
所属
岡山大学病院 助教
職名
助教
外部リンク

学位

  • 医学博士 ( 2010年9月   岡山大学 )

研究キーワード

  • 集中治療

  • 麻酔

  • 酸素療法

  • 重症患者

  • 呼吸

研究分野

  • ライフサイエンス / 麻酔科学

  • ライフサイエンス / 救急医学  / 集中治療

所属学協会

 

論文

  • Oxygen administration for postoperative surgical patients: a narrative review. 招待 査読 国際誌

    Satoshi Suzuki

    Journal of intensive care   8   79 - 79   2020年

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Most postoperative surgical patients routinely receive supplemental oxygen therapy to prevent the potential development of hypoxemia due to incomplete lung re-expansion, reduced chest wall, and diaphragmatic activity caused by surgical site pain, consequences of hemodynamic impairment, and residual effects of anesthetic drugs (most notably residual neuromuscular blockade), which may result in atelectasis, ventilation-perfusion mismatch, alveolar hypoventilation, and impaired upper airway patency. Additionally, the World Health Organization guidelines for reducing surgical site infection have recommended the perioperative administration of high-dose oxygen, including during the immediate postoperative period. However, supplemental oxygen and hyperoxemia also have harmful effects on the respiratory and cardiovascular systems, with several clinical studies having reported an association between high perioperative oxygen administration and worse clinical outcomes. Recently, the increased availability of new and short-acting anesthetic drugs, comprehensive pharmacological knowledge, postoperative multimodal analgesia, and new minimally invasive surgery options could result in lower incidences of postoperative hypoxemia. Moreover, recommendations promoting high oxygen administration to prevent surgical site infections have been challenged, considering the lack of scientific investigations, and have not been widely accepted. Given the potential harmful effects of hyperoxemia, routine postoperative oxygen administration might not be recommended. Recent clinical studies have indicated that a conservative approach to oxygen therapy, where oxygen administration is titrated to achieve slightly lower oxygen levels than usual, could be safely implemented and decrease acutely ill patients' susceptibility to hyperoxemia. Based on current evidence, appropriate monitoring, including peripheral oxygen saturation, and oxygen titration should be required during postoperative oxygen administration to avoid both hypoxemia and hyperoxemia. Future trials should therefore focus on determining the optimal oxygen target during postoperative care.

    DOI: 10.1186/s40560-020-00498-5

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  • Current Ventilator and Oxygen Management during General Anesthesia: A Multicenter, Cross-sectional Observational Study. 査読 国際誌

    Satoshi Suzuki, Yuko Mihara, Yukiko Hikasa, Shuji Okahara, Takuma Ishihara, Ayumi Shintani, Hiroshi Morimatsu, Akiko Sato, Sachio Kusume, Hidekuni Hidaka, Hidehiko Yatsuzuka, Masahiro Okawa, Makoto Takatori, Shinsei Saeki, Takeshi Samuta, Hiroaki Tokioka, Toshiaki Kurasako, Masato Maeda, Mamoru Takeuchi, Akihito Hirasaki, Michio Kitaura, Hideki Kajiki, Osamu Kobayashi, Hiroshi Katayama, Hideki Nakatsuka, Satoshi Mizobuchi, Seiji Sugimoto, Masataka Yokoyama, Kazuhito Kusudo, Kensuke Shiraishi, Toshio Iwaki, Tatsuhiko Komatsu, Yasuo Hirai, Tetsufumi Sato, Masakazu Kimura, Takeshi Yasukawa, Motonobu Kimura, Masahiro Taniguchi, Yutaka Shimoda, Yoji Kobayashi, Mitsunori Tsukioki, Nobuki Manabe, Eiji Ando, Makoto Kosaka, Takashi Tsukiji, Chika Tokura, Yasuhiro Asao, Masatoshi Sugiyama, Kozo Seto

    Anesthesiology   129 ( 1 )   67 - 76   2018年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Intraoperative oxygen management is poorly understood. It was hypothesized that potentially preventable hyperoxemia and substantial oxygen exposure would be common during general anesthesia. METHODS: A multicenter, cross-sectional study was conducted to describe current ventilator management, particularly oxygen management, during general anesthesia in Japan. All adult patients (16 yr old or older) who received general anesthesia over 5 consecutive days in 2015 at 43 participating hospitals were identified. Ventilator settings and vital signs were collected 1 h after the induction of general anesthesia. We determined the prevalence of potentially preventable hyperoxemia (oxygen saturation measured by pulse oximetry of more than 98%, despite fractional inspired oxygen tension of more than 0.21) and the risk factors for potentially substantial oxygen exposure (fractional inspired oxygen tension of more than 0.5, despite oxygen saturation measured by pulse oximetry of more than 92%). RESULTS: A total of 1,786 patients were found eligible, and 1,498 completed the study. Fractional inspired oxygen tension was between 0.31 and 0.6 in 1,385 patients (92%), whereas it was less than or equal to 0.3 in very few patients (1%). Most patients (83%) were exposed to potentially preventable hyperoxemia, and 32% had potentially substantial oxygen exposure. In multivariable analysis, old age, emergency surgery, and one-lung ventilation were independently associated with increased potentially substantial oxygen exposure, whereas use of volume control ventilation and high positive end-expiratory pressure levels were associated with decreased potentially substantial oxygen exposure. One-lung ventilation was particularly a strong risk factor for potentially substantial oxygen exposure (adjusted odds ratio, 13.35; 95% CI, 7.24 to 24.60). CONCLUSIONS: Potentially preventable hyperoxemia and substantial oxygen exposure are common during general anesthesia, especially during one-lung ventilation. Future research should explore the safety and feasibility of a more conservative approach for intraoperative oxygen therapy.

    DOI: 10.1097/ALN.0000000000002181

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  • Stroke volume variation and dynamic arterial elastance predict fluid responsiveness even in thoracoscopic esophagectomy: a prospective observational study 査読

    Yukiko Hikasa, Satoshi Suzuki, Shunsuke Tanabe, Kazuhiro Noma, Yasuhiro Shirakawa, Toshiyoshi Fujiwara, Hiroshi Morimatsu

    Journal of Anesthesia   37 ( 6 )   930 - 937   2023年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media LLC  

    DOI: 10.1007/s00540-023-03256-7

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    その他リンク: https://link.springer.com/article/10.1007/s00540-023-03256-7/fulltext.html

  • Prolonged Double-Low Time and the Incidence of Postoperative Delirium in Surgical ICU Patients 査読

    Yamanoi T, Suzuki S, Kaku R, Morimatsu H

    Acta Med Okayama   77 ( 2 )   161 - 167   2023年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Consistently low levels of histidine-rich glycoprotein as a new prognostic biomarker for sepsis: A multicenter prospective observational study 査読

    Naoya Kawanoue, Kosuke Kuroda, Hiroko Yasuda, Masahiko Oiwa, Satoshi Suzuki, Hidenori Wake, Hiroki Hosoi, Masahiro Nishibori, Hiroshi Morimatsu

    PLOS ONE   18 ( 3 )   e0283426 - e0283426   2023年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Public Library of Science (PLoS)  

    Background

    Few sepsis biomarkers accurately predict severity and mortality. Previously, we had reported that first-day histidine-rich glycoprotein (HRG) levels were significantly lower in patients with sepsis and were associated with mortality. Since the time trends of HRG are unknown, this study focused on the time course of HRG in patients with sepsis and evaluated the differences between survivors and non-survivors.

    Methods

    A multicenter prospective observational study was conducted involving 200 patients with sepsis in 16 Japanese hospitals. Blood samples were collected on days 1, 3, 5, and 7, and 28-day mortality was used for survival analysis. Plasma HRG levels were determined using a modified quantitative sandwich enzyme-linked immunosorbent assay.

    Results

    First-day HRG levels in non-survivors were significantly lower than those in survivors (mean, 15.7 [95% confidence interval (CI), 13.4–18.1] vs 20.7 [19.5–21.9] μg/mL; P = 0.006). Although there was no time × survivors/non-survivors interaction in the time courses of HRG (P = 0.34), the main effect of generalized linear mixed models was significant (P < 0.001). In a univariate Cox proportional hazards model with each variable as a time-dependent covariate, higher HRG levels were significantly associated with a lower risk of mortality (hazard ratio, 0.85 [95% CI, 0.78–0.92]; P < 0.001). Furthermore, presepsin levels (P = 0.02) and Sequential Organ Function Assessment scores (P < 0.001) were significantly associated with mortality. Harrell’s C-index values for the 28-day mortality effect of HRG, presepsin, procalcitonin, and C-reactive protein were 0.72, 0.70, 0.63, and 0.59, respectively.

    Conclusions

    HRG levels in non-survivors were consistently lower than those in survivors during the first seven days of sepsis. Repeatedly measured HRG levels were significantly associated with mortality. Furthermore, the predictive power of HRG for mortality may be superior to that of other singular biomarkers, including presepsin, procalcitonin, and C-reactive protein.

    DOI: 10.1371/journal.pone.0283426

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  • The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020). 国際誌

    Moritoki Egi, Hiroshi Ogura, Tomoaki Yatabe, Kazuaki Atagi, Shigeaki Inoue, Toshiaki Iba, Yasuyuki Kakihana, Tatsuya Kawasaki, Shigeki Kushimoto, Yasuhiro Kuroda, Joji Kotani, Nobuaki Shime, Takumi Taniguchi, Ryosuke Tsuruta, Kent Doi, Matsuyuki Doi, Taka-Aki Nakada, Masaki Nakane, Seitaro Fujishima, Naoto Hosokawa, Yoshiki Masuda, Asako Matsushima, Naoyuki Matsuda, Kazuma Yamakawa, Yoshitaka Hara, Masaaki Sakuraya, Shinichiro Ohshimo, Yoshitaka Aoki, Mai Inada, Yutaka Umemura, Yusuke Kawai, Yutaka Kondo, Hiroki Saito, Shunsuke Taito, Chikashi Takeda, Takero Terayama, Hideo Tohira, Hideki Hashimoto, Kei Hayashida, Toru Hifumi, Tomoya Hirose, Tatsuma Fukuda, Tomoko Fujii, Shinya Miura, Hideto Yasuda, Toshikazu Abe, Kohkichi Andoh, Yuki Iida, Tadashi Ishihara, Kentaro Ide, Kenta Ito, Yusuke Ito, Yu Inata, Akemi Utsunomiya, Takeshi Unoki, Koji Endo, Akira Ouchi, Masayuki Ozaki, Satoshi Ono, Morihiro Katsura, Atsushi Kawaguchi, Yusuke Kawamura, Daisuke Kudo, Kenji Kubo, Kiyoyasu Kurahashi, Hideaki Sakuramoto, Akira Shimoyama, Takeshi Suzuki, Shusuke Sekine, Motohiro Sekino, Nozomi Takahashi, Sei Takahashi, Hiroshi Takahashi, Takashi Tagami, Goro Tajima, Hiroomi Tatsumi, Masanori Tani, Asuka Tsuchiya, Yusuke Tsutsumi, Takaki Naito, Masaharu Nagae, Ichiro Nagasawa, Kensuke Nakamura, Tetsuro Nishimura, Shin Nunomiya, Yasuhiro Norisue, Satoru Hashimoto, Daisuke Hasegawa, Junji Hatakeyama, Naoki Hara, Naoki Higashibeppu, Nana Furushima, Hirotaka Furusono, Yujiro Matsuishi, Tasuku Matsuyama, Yusuke Minematsu, Ryoichi Miyashita, Yuji Miyatake, Megumi Moriyasu, Toru Yamada, Hiroyuki Yamada, Ryo Yamamoto, Takeshi Yoshida, Yuhei Yoshida, Jumpei Yoshimura, Ryuichi Yotsumoto, Hiroshi Yonekura, Takeshi Wada, Eizo Watanabe, Makoto Aoki, Hideki Asai, Takakuni Abe, Yutaka Igarashi, Naoya Iguchi, Masami Ishikawa, Go Ishimaru, Shutaro Isokawa, Ryuta Itakura, Hisashi Imahase, Haruki Imura, Takashi Irinoda, Kenji Uehara, Noritaka Ushio, Takeshi Umegaki, Yuko Egawa, Yuki Enomoto, Kohei Ota, Yoshifumi Ohchi, Takanori Ohno, Hiroyuki Ohbe, Kazuyuki Oka, Nobunaga Okada, Yohei Okada, Hiromu Okano, Jun Okamoto, Hiroshi Okuda, Takayuki Ogura, Yu Onodera, Yuhta Oyama, Motoshi Kainuma, Eisuke Kako, Masahiro Kashiura, Hiromi Kato, Akihiro Kanaya, Tadashi Kaneko, Keita Kanehata, Ken-Ichi Kano, Hiroyuki Kawano, Kazuya Kikutani, Hitoshi Kikuchi, Takahiro Kido, Sho Kimura, Hiroyuki Koami, Daisuke Kobashi, Iwao Saiki, Masahito Sakai, Ayaka Sakamoto, Tetsuya Sato, Yasuhiro Shiga, Manabu Shimoto, Shinya Shimoyama, Tomohisa Shoko, Yoh Sugawara, Atsunori Sugita, Satoshi Suzuki, Yuji Suzuki, Tomohiro Suhara, Kenji Sonota, Shuhei Takauji, Kohei Takashima, Sho Takahashi, Yoko Takahashi, Jun Takeshita, Yuuki Tanaka, Akihito Tampo, Taichiro Tsunoyama, Kenichi Tetsuhara, Kentaro Tokunaga, Yoshihiro Tomioka, Kentaro Tomita, Naoki Tominaga, Mitsunobu Toyosaki, Yukitoshi Toyoda, Hiromichi Naito, Isao Nagata, Tadashi Nagato, Yoshimi Nakamura, Yuki Nakamori, Isao Nahara, Hiromu Naraba, Chihiro Narita, Norihiro Nishioka, Tomoya Nishimura, Kei Nishiyama, Tomohisa Nomura, Taiki Haga, Yoshihiro Hagiwara, Katsuhiko Hashimoto, Takeshi Hatachi, Toshiaki Hamasaki, Takuya Hayashi, Minoru Hayashi, Atsuki Hayamizu, Go Haraguchi, Yohei Hirano, Ryo Fujii, Motoki Fujita, Naoyuki Fujimura, Hiraku Funakoshi, Masahito Horiguchi, Jun Maki, Naohisa Masunaga, Yosuke Matsumura, Takuya Mayumi, Keisuke Minami, Yuya Miyazaki, Kazuyuki Miyamoto, Teppei Murata, Machi Yanai, Takao Yano, Kohei Yamada, Naoki Yamada, Tomonori Yamamoto, Shodai Yoshihiro, Hiroshi Tanaka, Osamu Nishida

    Journal of intensive care   9 ( 1 )   53 - 53   2021年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members.As a result, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J-SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.

    DOI: 10.1186/s40560-021-00555-7

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  • Time Course of Histidine-Rich Glycoprotein as a New Prognostic Biomarker for Sepsis: A Multicenter Prospective Observational Study 査読

    Naoya Kawanoue, Kosuke Kuroda, Masahiko Oiwa, Satoshi Suzuki, Hidenori Wake, Masahiro Nishibori, Hiroshi Morimatsu

    ANESTHESIA AND ANALGESIA   132 ( 5S_SUPPL )   245 - 246   2021年5月

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    記述言語:英語   掲載種別:研究論文(国際会議プロシーディングス)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Intraoperative fluid therapy and postoperative complications during minimally invasive esophagectomy for esophageal cancer: a single-center retrospective study.

    Yukiko Hikasa, Satoshi Suzuki, Yuko Mihara, Shunsuke Tanabe, Yasuhiro Shirakawa, Toshiyoshi Fujiwara, Hiroshi Morimatsu

    Journal of anesthesia   34 ( 3 )   404 - 412   2020年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Compared with open thoracotomy, minimally invasive esophagectomy (MIE) methods, such as transhiatal or thoracoscopic esophagectomy, likely have lower morbidity. However, the relationship between intraoperative fluid management and postoperative complications after MIE remains unclear. Thus, we investigated the association of cumulative intraoperative fluid balance and postoperative complications in patients undergoing MIE. METHODS: This single-center retrospective cohort study examined patients undergoing thoracoscopic esophagectomy for esophageal cancer in the prone position. Postoperative complications included pneumonia, arrhythmia, thrombotic events and acute kidney injury (AKI). We compared patients with higher and lower intraoperative fluid balance (higher and lower than the median). Multivariable logistic regression analyses were performed to estimate the odds ratio of intraoperative fluid balance status on the incidence of postoperative complications. RESULTS: In total, 135 patients were included in the study. Postoperative complications occurred in 43 (32%), including cardiac arrhythmia (n = 12, 9%), thrombosis (n = 20, 15%), pneumonia (n = 13, 10%), and AKI required hemodialysis (n = 1, 1%). Patients with a higher fluid balance had higher incidence of complications than those with a lower fluid balance (46% vs. 18%, p < 0.001). After adjusting for age, ASA-PS ≥ III, blood loss, and the use of radical surgery, the higher intraoperative fluid balance group was significantly and independently associated with postoperative complications (adjusted OR 5.31, 95% CI 2.26-13.6, p < 0.0001). CONCLUSIONS: In patients undergoing thoracoscopic esophagectomy in the prone position, a greater intraoperative positive fluid balance was independently associated with a higher incidence of complications.

    DOI: 10.1007/s00540-020-02766-y

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  • Prolonged Tachycardia with Higher Heart Rate Is Associated with Higher ICU and In-hospital Mortality. 査読

    Hayashi M, Taniguchi A, Kaku R, Fujimoto S, Isoyama S, Manabe S, Yoshida T, Suzuki S, Shimizu K, Morimatsu H, Momota R

    Acta medica Okayama   73 ( 2 )   147 - 153   2019年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.18926/AMO/56650

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  • Conservative versus conventional oxygen therapy for cardiac surgical patients: A before-and-after study. 査読 国際共著 国際誌

    Glenn M Eastwood, Matthew J Chan, Leah Peck, Helen Young, Johan Mårtensson, Neil J Glassford, Hidetoshi Kagaya, Satoshi Suzuki, Sean Galvin, George Matalanis, Rinaldo Bellomo

    Anaesthesia and intensive care   47 ( 2 )   175 - 182   2019年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Avoiding hypoxaemia is considered crucial in cardiac surgery patients admitted to the intensive care unit (ICU). However, avoiding hyperoxaemia may also be important. A conservative approach to oxygen therapy may reduce exposure to hyperoxaemia without increasing the risk of hypoxaemia. Using a before-and-after design, we evaluated the introduction of conservative oxygen therapy (target SpO2 88%-92% using the lowest FiO2) for cardiac surgical patients admitted to the ICU. We studied 9041 arterial blood gas (ABG) datasets: 4298 ABGs from 245 'conventional' and 4743 ABGs from 298 'conservative' oxygen therapy patients. During mechanical ventilation (MV) and while in the ICU, compared to the conventional group, conservative group patients had significantly lower FiO2 exposure and PaO2 values ( P < 0.001 for each). Accordingly, using the mean PaO2 during MV, more conservative group patients were classified as normoxaemic (226 versus 62 patients, P < 0.01), fewer as hyperoxaemic (66 versus 178 patients, P < 0.01) and no patient in either group as hypoxaemic or severely hypoxaemic. Moreover, more ABG samples were hyperoxaemic or severely hyperoxaemic during conventional treatment ( P < 0.001). Finally, there was no difference in ICU or hospital length of stay, ICU or hospital mortality or 30-day mortality between the groups. Our findings support the feasibility and physiological safety of conservative oxygen therapy in patients admitted to ICU after cardiac surgery.

    DOI: 10.1177/0310057X19838753

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  • Perioperative Management of a Child With Glucose Transporter Type 1 Deficiency Syndrome: A Case Report. 査読 国際誌

    Yoshida T, Shimizu K, Suzuki S, Matsuoka Y, Morimatsu H

    A&A practice   11 ( 2 )   35 - 37   2018年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1213/XAA.0000000000000727

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  • 試作Tele ICUシステムの病院間使用

    清水 一好, 木村 雅一, 鈴木 聡, 林 真雄, 森松 博史

    日本集中治療医学会雑誌   25 ( Suppl. )   [O76 - 7]   2018年2月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • Associations between intraoperative ventilator settings during one-lung ventilation and postoperative pulmonary complications: A prospective observational study 査読 国際誌

    Shuji Okahara, Kazuyoshi Shimizu, Satoshi Suzuki, Kenzo Ishii, Hiroshi Morimatsu

    BMC Anesthesiology   18 ( 1 )   13 - 13   2018年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BioMed Central Ltd.  

    Background: The interest in perioperative lung protective ventilation has been increasing. However, optimal management during one-lung ventilation (OLV) remains undetermined, which not only includes tidal volume (VT) and positive end-expiratory pressure (PEEP) but also inspired oxygen fraction (FIO2). We aimed to investigate current practice of intraoperative ventilation during OLV, and analyze whether the intraoperative ventilator settings are associated with postoperative pulmonary complications (PPCs) after thoracic surgery. Methods: We performed a prospective observational two-center study in Japan. Patients scheduled for thoracic surgery with OLV from April to October 2014 were eligible. We recorded ventilator settings (FIO2, VT, driving pressure (ΔP), and PEEP) and calculated the time-weighted average (TWA) of ventilator settings for the first 2 h of OLV. PPCs occurring within 7 days of thoracotomy were investigated. Associations between ventilator settings and the incidence of PPCs were examined by multivariate logistic regression. Results: We analyzed perioperative information, including preoperative characteristics, ventilator settings, and details of surgery and anesthesia in 197 patients. Pressure control ventilation was utilized in most cases (92%). As an initial setting for OLV, an FIO2 of 1.0 was selected for more than 60% of all patients. Throughout OLV, the median TWA FIO2 of 0.8 (0.65-0.94), VT of 6.1 (5.3-7.0) ml/kg, ΔP of 17 (15-20) cm H2O, and PEEP of 4 (4-5) cm H2O was applied. Incidence rate of PPCs was 25.9%, and FIO2 was independently associated with the occurrence of PPCs in multivariate logistic regression. The adjusted odds ratio per FIO2 increase of 0.1 was 1.30 (95% confidence interval: 1.04-1.65, P =0.0195). Conclusions: High FIO2 was applied to the majority of patients during OLV, whereas low VT and slight degree of PEEP were commonly used in our survey. Our findings suggested that a higher FIO2 during OLV could be associated with increased incidence of PPCs.

    DOI: 10.1186/s12871-018-0476-x

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  • Is supplemental oxygen necessary for intraoperative lung protective ventilation?

    Shuji Okahara, Satoshi Suzuki, Hiroshi Morimatsu

    Pulmonary and Critical Care Medicine   3 ( 1 )   2018年

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Open Access Text Pvt, Ltd.  

    DOI: 10.15761/pccm.1000148

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  • 高トリグリセリド血症起因性急性膵炎にLDL(low density lipoprotein)吸着療法が奏功した妊婦の1例

    佐倉 考信, 清水 一好, 廣井 一正, 鈴木 聡, 林 真雄, 賀来 隆治, 森松 博史

    日本集中治療医学会雑誌   24 ( 1 )   26 - 30   2017年

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    記述言語:日本語   出版者・発行元:一般社団法人 日本集中治療医学会  

    妊娠中の急性膵炎は稀な疾患であるが,発症すると母体,胎児ともに予後が悪い。著明な高トリグリセリド(triglyceride, TG)血症による急性膵炎を発症した妊婦に対して,LDL(low density lipoprotein)吸着療法を施行し良好な経過をたどった症例を経験した。症例は35歳,妊娠39週の女性。TG 11,936 mg/dlの著明な高TG血症を認め,造影CTにて重症急性膵炎を疑う所見を認めた。帝王切開にて妊娠を中断の後,ICU入室となり急性膵炎,高TG血症に対する治療を開始した。高TG血症に対してLDL吸着療法を3回施行し,TG値は1,764 mg/dlまで低下した。その後,膵炎に対する保存加療が継続され,第15病日に退院した。高TG血症起因性急性膵炎において,高TG血症の治療併用は重要である。本疾患を合併した妊婦に対して,血漿交換と比較して合併症頻度の低いLDL吸着療法を選択し,安全に施行できた。

    DOI: 10.3918/jsicm.24_26

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  • A Case of Refractory Systemic Capillary Leak Syndrome (Clarkson's Disease) during Pregnancy 査読

    Yukiko Hikasa, Masao Hayashi, Satoshi Suzuki, Hiroshi Morimatsu

    ACTA MEDICA OKAYAMA   70 ( 6 )   497 - 501   2016年12月

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    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 UNIV MED SCHOOL  

    A 32-year-old woman, pregnant with twins, presented with a chief complaint of general fatigue. Her general condition had rapidly deteriorated since her last visit to the primary obstetrician; the patient was then referred to our hospital because of suspected fetal death. She underwent emergency cesarean section because fetal death had indeed occurred, and she was then admitted to the intensive care unit (ICU). On ICI: admission, she was found to he in shock. Laboratory analysis revealed extreme hemoconcentration and a low albumin level, and initially, septic shock with obstetric complications was suspected. However, because she did not respond to conventional therapy but instead, rapidly developed severe generalized edema, systemic capillary leak syndrome (SCLS) was diagnosed. The patient remained in shock for several days until undergoing plasma exchange (PE), despite some earlier empirical treatments. She eventually recovered from profound shock status and was discharged from the ICU without sequelae. Among potentially effective treatments, PE seemed to be the most reasonable choice for the treatment of her SCLS.

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  • Targeted therapeutic mild hypercapnia after cardiac arrest: A phase II multi-centre randomised controlled trial (the CCC trial) 査読

    Glenn M. Eastwood, Antoine G. Schneider, Satoshi Suzuki, Leah Peck, Helen Young, Aiko Tanaka, Johan Martensson, Stephen Warrillow, Shay McGuinness, Rachael Parke, Eileen Gilder, Lianne Mccarthy, Pauline Galt, Gopal Taori, Suzanne Eliott, Tammy Lamac, Michael Bailey, Nerina Harley, Deborah Barge, Carol L. Hodgson, Maria Cristina Morganti-Kossmann, Alice Pebay, Alison Conquest, John S. Archer, Stephen Bernard, Dion Stub, Graeme K. Hart, Rinaldo Bellomo

    RESUSCITATION   104   83 - 90   2016年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER IRELAND LTD  

    Background: In intensive care observational studies, hypercapnia after cardiac arrest (CA) is independently associated with improved neurological outcome. However, the safety and feasibility of delivering targeted therapeutic mild hypercapnia (TTMH) for such patients is untested.
    Methods: In a phase II safety and feasibility multi-centre, randomised controlled trial, we allocated ICU patients after CA to 24 h of targeted normocapnia (TN) (PaCO2 35-45 mmHg) or TTMH (PaCO2 50-55 mmHg). The primary outcome was serum neuron specific enolase (NSE) and S100b protein concentrations over the first 72 h assessed in the first 50 patients surviving to day three. Secondary end-points included global measure of function assessment at six months and mortality for all patients.
    Results: We enrolled 86 patients. Their median age was 61 years (58, 64 years) and 66 (79%) were male. Of these, 50 patients (58%) survived to day three for full biomarker assessment. NSE concentrations increased in the TTMH group (p = 0.02) and TN group (p = 0.005) over time, with the increase being significantly more pronounced in the TN group (p(interaction)=0.04). S100b concentrations decreased over time in the TTMH group (p &lt; 0.001) but not in the TN group (p = 0.68). However, the S100b change over time did not differ between the groups (p(interaction)=0.23). At six months, 23 (59%) TTMH patients had good functional recovery compared with 18 (46%) TN patients. Hospital mortality occurred in 11 (26%) TTMH patients and 15 (37%) TN patients (p = 0.31).
    Conclusions: In CA patients admitted to the ICU, TTMH was feasible, appeared safe and attenuated the release of NSE compared with TN. These findings justify further investigation of this novel treatment. (C) 2016 Published by Elsevier Ireland Ltd.

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  • コントロール不良の肺動脈性肺高血圧症に合併した急性肺動脈解離の一例

    川出 健嗣, 清水 一好, 林 真雄, 谷 真規子, 鈴木 聡, 金澤 伴幸, 岩崎 達雄, 森松 博史

    日本集中治療医学会雑誌   23 ( 3 )   318 - 323   2016年5月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

    症例は29歳、男性。5年前に肺動脈性肺高血圧症(pulmonary arterial hypertension、PAH)を指摘されたが、内科的治療は行われていなかった。今回、胸痛を主訴に近医を受診し、造影CTにて肺動脈解離(pulmonary artery dissection、PAD)を指摘されたため、当院へ転院となった。当院入院後、緊急で主肺動脈人工血管置換術および左右肺動脈縫縮術が施行された。術後、PAHに対して早期に治療を開始した。未治療であったためPAHのコントロールに難渋したが、PAH治療薬の多剤併用および厳重な鎮静・挿管・人工呼吸管理を行うことで、POD21に抜管、POD29にICUを退室、POD101に退院となった。PADは非常に致死率の高い疾患であるが、早期の手術および厳重な術後管理により救命できた。(著者抄録)

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    その他リンク: https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J02874&link_issn=&doc_id=20160610390006&doc_link_id=10.3918%2Fjsicm.23.318&url=https%3A%2F%2Fdoi.org%2F10.3918%2Fjsicm.23.318&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: A retrospective nested cohort study 査読 国際誌

    Glenn M. Eastwood, Aiko Tanaka, Emilo Daniel Valenzuela Espinoza, Leah Peck, Helen Young, Johan Martensson, Ling Zhang, Neil J. Glassford, Yu-Feng Frank Hsiao, Satoshi Suzuki, Rinaldo Bellomo

    RESUSCITATION   101   108 - 114   2016年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER IRELAND LTD  

    Background: In mechanically ventilated (MV) cardiac arrest (CA) survivors admitted to the intensive care unit (ICU) avoidance of hypoxia is considered crucial. However, avoidance of hyperoxia may also be important. A conservative approach to oxygen therapy may reduce exposure to both.
    Methods: We evaluated the introduction of conservative oxygen therapy (target SpO(2) 88-92% using the lowest FiO(2)) during MV for resuscitated CA patients admitted to the ICU.
    Results: We studied 912 arterial blood gas (ABG) datasets: 448 ABGs from 50 'conventional' and 464 ABGs from 50 'conservative' oxygen therapy patients. Compared to the conventional group, conservative group patients had significantly lower PaO2 values and FiO(2) exposure (p &lt; 0.001, respectively); more received MV in a spontaneous ventilation mode (18% vs 2%; p = 0.001) and more were exposed to a FiO(2) of 0.21 (19 vs 0 patients, p = 0.001). Additionally, according to mean PaO2, more conservative group patients were classified as normoxaemic (36 vs 16 patients, p &lt; 0.01) and fewer as hyperoxaemic (14 vs 33 patients, p &lt; 0.01). Finally, ICU length of stay was significantly shorter for conservative group patients (p = 0.04). There was no difference in the proportion of survivors discharged from hospital with good neurological outcome (14/23 vs 12/22 patients, p = 0.67).
    Conclusions: Our findings provide preliminary support for the feasibility and physiological safety of conservative oxygen therapy in patients admitted to ICU for MV support after cardiac arrest (Trial registration, NCT01684124). (C) 2015 Elsevier Ireland Ltd. All rights reserved.

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  • 拡張障害型心不全治療に対して横隔膜電位(Edi)モニタリングを活用した一症例

    吉鷹 志保, 清水 一好, 岡原 修司, 落葉 佑昌, 日笠 友起子, 廣井 一正, 鈴木 聡, 林 真雄, 森松 博史

    日本集中治療医学会雑誌   23 ( Suppl. )   551 - 551   2016年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 1576: INTRAOPERATIVE FLUID THERAPY IN VIDEO-ASSISTED THORACOSCOPIC ESOPHAGECTOMY: A RETROSPECTIVE STUDY

    Yukiko Hikasa, Satoshi Suzuki, Tomoyuki Kanazawa, Masao Hayashi, Takashi Matsusaki, Kazuyoshi Shimizu, Hiroshi Morimatsu

    Critical Care Medicine   44 ( 12 )   469 - 469   2016年

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    記述言語:英語   出版者・発行元:Ovid Technologies (Wolters Kluwer Health)  

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  • Urinary Neutrophil Gelatinase-Associated Lipocalin as Predictor of Short- or Long-Term Outcomes in Cardiac Surgery Patients 査読

    Mercedes Garcia-Alvarez, Neil J. Glassford, Antoni J. Betbese, Jordi Ordonez, Victoria Banos, Marta Argilaga, Alfonso Martinez, Satoshi Suzuki, Antoine G. Schneider, Glenn M. Eastwood, M. Victoria Moral, Rinaldo Bellomo

    JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA   29 ( 6 )   1480 - 1488   2015年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

    Objectives: To determine the ability of urinary neutrophil gelatinase-associated lipocalin (uNGAL) to predict cardiac surgery-associated acute kidney injury (CSA-AKI), continuous renal replacement therapy (CRRT), mortality, and a composite outcome of major adverse kidney events at 365 days (MAKE(365)), and to investigate the influence of cardiopulmonary bypass (CPB) on NGAL release.
    Design: A prospective observational study.
    Setting: A single-center university hospital.
    Participants: A cohort of 288. adult cardiac surgery patients.
    Interventions: uNGAL was measured at baseline, immediately after surgery, and on days 1 and 2 postoperatively. The authors used the recent Kidney Disease Improving Global Outcomes consensus criteria to define CSA-AKI.
    Measurements and Main Results: CSA-AKI occurred in 36.1% of patients. uNGAL rapidly became significantly higher in patients who developed AKI, with peak value immediately after surgery (349.9 [76.6-1446.6] v 90.1 [20.8-328] ng/mg creatinine; p &lt; 0.001). No measure of uNGAL (peak, postsurgery, day 1 or 2 postsurgery) accurately predicted CSA-AKI, CRRT, mortality, or MAKE365. However, immediately after surgery, CPB induced greater uNGAL release compared with off-pump surgery (265.5 mu mol/L [71-989.6] v 48.7 ng/mg creatinine [17-129.8]; p &lt; 0.001). Moreover, such early uNGAL release correlated with CPB duration (r = 0.505; p &lt; 0.001) but not with peak serum creatinine values on day 3 or 7 after surgery.
    Conclusions: uNGAL had a limited predictive ability for CSA-AKI or other relevant clinical outcomes after cardiac surgery and appeared to be more closely related to the use and duration of CPB. Thus, its levels may represent the aggregate effect of an inflammatory response to CPB as well as a renal response to cardiac surgery and inflammation. (C) 2015 Elsevier Inc. All rights reserved.

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  • Atelectasis and mechanical ventilation mode during conservative oxygen therapy: A before-and-after study 査読 国際誌

    Satoshi Suzuki, Glenn M. Eastwood, Mark D. Goodwin, Geertje D. Noe, Paul E. Smith, Neil Glassford, Antoine G. Schneider, Rinaldo Bellomo

    JOURNAL OF CRITICAL CARE   30 ( 6 )   1232 - 1237   2015年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

    Purpose: The purpose of the study is to assess the effect of a conservative oxygen therapy (COT) (target SpO(2) of 90%-92%) on radiological atelectasis and mechanical ventilation modes.
    Materials and methods: We conducted a secondary analysis of 105 intensive care unit patients from a pilot before-and-after study. The primary outcomes of this study were changes in atelectasis score (AS) of 555 chest radiographs assessed by radiologists blinded to treatment allocation and time to weaning from mandatory ventilation and first spontaneous ventilation trial (SVT).
    Results: There was a significant difference in overall AS between groups, and COT was associated with lower time-weighted average AS. In addition, in COT patients, change from mandatory to spontaneous ventilation or time to first SVT was shortened. After adjustment for baseline characteristics and interactions between oxygen therapy, radiological atelectasis, and mechanical ventilation management, patients in the COT group had significantly lower "best" AS (adjusted odds ratio, 0.28 [95% confidence interval {CI}, 0.12-0.66]; P = .003) and greater improvement in AS in the first 7 days (adjusted odds ratio, 0.42 [95% CI, 0.17-0.99]; P = .049). Moreover, COT was associated with significantly earlier successful weaning from a mandatory ventilation mode (adjusted hazard ratio, 2.96 [95% CI, 1.73-5.04]; P &lt; .001) and with shorter time to first SVT (adjusted hazard ratio, 1.77 [95% CI, 1.13-2.78]; P = .013).
    Conclusions: In mechanically ventilated intensive care unit patients, COT might be associated with decreased radiological evidence of atelectasis, earlier weaning from mandatory ventilation modes, and earlier first trial of spontaneous ventilation. (C) 2015 Elsevier Inc. All rights reserved.

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  • Paracetamol therapy and outcome of critically ill patients: a multicenter retrospective observational study 査読 国際誌

    Satoshi Suzuki, Glenn M. Eastwood, Michael Bailey, David Gattas, Peter Kruger, Manoj Saxena, John D. Santamaria, Rinaldo Bellomo

    Critical Care   19 ( 1 )   162 - 162   2015年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BioMed Central Ltd.  

    Introduction: In this study, we aimed to examine the association between paracetamol administration in the intensive care unit (ICU) and mortality in critically ill patients. Methods: We conducted a multicenter retrospective observational study in four ICUs. We obtained information on paracetamol use, body temperature, demographic, clinical and outcome data from each hospital's clinical information system and admissions and discharges database. We performed statistical analysis to assess the association between paracetamol administration and hospital mortality. Results: We studied 15,818 patients with 691,348 temperature measurements at 4 ICUs. Of these patients, 10,046 (64%) received at least 1g of paracetamol. Patients who received paracetamol had lower in-hospital mortality (10% vs. 20%, P &lt
    0.001), and survivors were more likely to have received paracetamol (66% vs. 46%
    P &lt
    0.001). However, patients treated with paracetamol were also more likely to be admitted to the ICU after surgery (70% vs. 51%
    P &lt
    0.001) and/or after elective surgery (55% vs. 37%
    P &lt
    0.001). In multivariate logistic regression analysis including a propensity score for paracetamol treatment, we found a significant and independent association between the use of paracetamol and reduced in-hospital mortality (adjusted odds ratio =0.60 (95% confidence interval (CI), 0.53 to 0.68), P &lt
    0.001). Cox proportional hazards analysis showed that patients who received paracetamol also had a significantly longer time to death (adjusted hazard ratio =0.51 (95% CI, 0.46 to 0.56), P &lt
    0.001). The association between paracetamol and decreased mortality and/or time to death was broadly consistent across surgical and medical patients. It remained present after adjusting for paracetamol administration as a time-dependent variable. However, when such time-dependent analysis was performed, the association of paracetamol with outcome lost statistical significance in the presence of fever and suspected infection and in patients in the lower tertiles of Acute Physiology and Chronic Health Evaluation II scores. Conclusions: Paracetamol administration is common in the ICU and appears to be independently associated with reduced in-hospital mortality and time to death after adjustment for multiple potential confounders and propensity score. This association, however, was modified by the presence of fever, suspected infection and lesser illness severity and may represent the effect of indication bias.

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  • A pilot feasibility, safety and biological efficacy multicentre trial of therapeutic hypercapnia after cardiac arrest: study protocol for a randomized controlled trial 査読

    Glenn M. Eastwood, Antoine G. Schneider, Satoshi Suzuki, Michael Bailey, Rinaldo Bellomo

    TRIALS   16   135   2015年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BIOMED CENTRAL LTD  

    Background: Cardiac arrest causes ischaemic brain injury. Arterial carbon dioxide tension (PaCO2) is a major determinant of cerebral blood flow. Thus, mild hypercapnia in the 24 h following cardiac arrest may increase cerebral blood flow and attenuate such injury. We describe the Carbon Control and Cardiac Arrest (CCC) trial.
    Methods/Design: The CCC trial is a pilot multicentre feasibility, safety and biological efficacy randomized controlled trial recruiting adult cardiac arrest patients admitted to the intensive care unit after return of spontaneous circulation. At admission, using concealed allocation, participants are randomized to 24 h of either normocapnia (PaCO2 35 to 45 mmHg) or mild hypercapnia (PaCO2 50 to 55 mmHg). Key feasibility outcomes are recruitment rate and protocol compliance rate. The primary biological efficacy and biological safety measures are the between-groups difference in serum neuron-specific enolase and S100b protein levels at 24 h, 48 h and 72 h. Secondary outcome measure include adverse events, in-hospital mortality, and neurological assessment at 6 months.
    Discussion: The trial commenced in December 2012 and, when completed, will provide clinical evidence as to whether targeting mild hypercapnia for 24 h following intensive care unit admission for cardiac arrest patients is feasible and safe and whether it results in decreased concentrations of neurological injury biomarkers compared with normocapnia. Trial results will also be used to determine whether a phase IIb study powered for survival at 90 days is feasible and justified.

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  • A pilot assessment of alpha-stat vs pH-stat arterial blood gas analysis after cardiac arrest 査読

    Glenn M. Eastwood, Satoshi Suzuki, Cristina Lluch, Antoine G. Schneider, Rinaldo Bellomo

    JOURNAL OF CRITICAL CARE   30 ( 1 )   138 - 144   2015年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

    Purpose: Resuscitated cardiac arrest (CA) patients typically receive therapeutic hypothermia, but arterial blood gases (ABGs) are often assessed after adjustment to 37 degrees C (alpha-stat) instead of actual body temperature (pH-stat). We sought to compare alpha-stat and pH-stat assessment of Pao(2) and Paco(2) in such patients.
    Materials and methods: Using ABG data obtained during the first 24 hours of intensive care unit admission, we determined the impact of measured alpha vs calculated pH-stat on Pao(2) and Paco(2) on patient classification and outcomes for CA patients.
    Results: We assessed 1013 ABGs from 120 CA patients with a median age of patients 66 years (interquartile range, 50-76). Median alpha-stat Pao(2) changed from 122 (95-156) to 107 (82-143) mm Hg with pH-stat and median Paco(2) from 39 (34-46) to 35 (30-41) mm Hg (both P &lt; .001). Using the categories of hyperoxemia, normoxemia, and hypoxemia, pH-stat estimation of Pao(2) reclassified approximately 20% of patients. Using the categories of hypercapnia, normocapnia, and hypocapnia, pH-stat estimation of Paco(2) reclassified approximately 40% of patients. The mortality of patients in different Pao(2) and Paco(2) categories was similar for pH-stat and alpha-stat.
    Conclusions: Using the pH-stat method, fewer resuscitated CA patients admitted to intensive care unit were classified as hyperoxemic or hypercapnic compared with alpha-stat. These findings suggest an impact of ABG assessment methodology on Pao(2), Paco(2), and patient classification but not on associated outcomes. (C) 2014 Elsevier Inc. All rights reserved.

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  • Pulse pressure variation-guided fluid therapy after cardiac surgery: A pilot before-and-after trial 査読

    Satoshi Suzuki, Nicholas C. Z. Woinarski, Miklos Lipcsey, Cristina Lluch Candal, Antoine G. Schneider, Neil J. Glassford, Glenn M. Eastwood, Rinaldo Bellomo

    JOURNAL OF CRITICAL CARE   29 ( 6 )   992 - 996   2014年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

    Purpose: The aim of this study is to study the feasibility, safety, and physiological effects of pulse pressure variation (PPV)-guided fluid therapy in patients after cardiac surgery.
    Materials and methods: We conducted a pilot prospective before-and-after study during mandatory ventilation after cardiac surgery in a tertiary intensive care unit. We introduced a protocol to deliver a fluid bolus for a PPV &gt;= 13% for at least &gt;10 minutes during the intervention period.
    Results: We studied 45 control patients and 53 intervention patients. During the intervention period, clinicians administered a fluid bolus on 79% of the defined PPV trigger episodes. Median total fluid intake was similar between 2 groups during mandatory ventilation (1297 mL[interquartile range 549-1968] vs 1481 mL [807-2563]; P =. 17) and the first 24 hours (3046 mL [interquartile range 2317-3982] vs 3017 mL [2192-4028]; P = .73). After adjusting for several baseline factors, PPV-guided fluid management significantly increased fluid intake during mandatory ventilation (P = .004) but not during the first 24 hours (P = .47). Pulse pressure variation-guided fluid therapy, however, did not significantly affect hemodynamic, renal, and metabolic variables. No serious adverse events were noted.
    Conclusions: Pulse pressure variation-guided fluid management was feasible and safe during mandatory ventilation after cardiac surgery. However, its advantages may be clinically small. (C) 2014 Elsevier Inc. All rights reserved.

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  • Intensive care clinicians' opinion of conservative oxygen therapy (SpO₂ 90-92%) for mechanically ventilated patients. 査読

    Eastwood GM, Peck L, Young H, Suzuki S, Garcia M, Bellomo R

    Australian critical care : official journal of the Confederation of Australian Critical Care Nurses   27 ( 3 )   120 - 125   2014年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Conservative Oxygen Therapy in Mechanically Ventilated Patients: A Pilot Before-and-After Trial 査読

    Satoshi Suzuki, Glenn M. Eastwood, Neil J. Glassford, Leah Peck, Helen Young, Mercedes Garcia-Alvarez, Antoine G. Schneider, Rinaldo Bellomo

    CRITICAL CARE MEDICINE   42 ( 6 )   1414 - 1422   2014年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Objectives: To assess the feasibility and safety of a conservative approach to oxygen therapy in mechanically ventilated ICU patients.
    Design: Pilot prospective before-and-after study.
    Setting: A 22-bed multidisciplinary ICU of a tertiary care hospital in Australia.
    Patients: A total of 105 adult (18 years old or older) patients required mechanical ventilation for more than 48 hours: 51 patients during the conventional before period and 54 after a change to conservative oxygen therapy.
    Interventions: Implementation of a conservative approach to oxygen therapy (target Spo(2) of 90-92%).
    Measurements and Main Results: We collected 3,169 datasets on 799 mechanical ventilation days. During conservative oxygen therapy the median time-weighted average Spo(2) on mechanical ventilation was 95.5% (interquartile range, 94.0-97.3) versus 98.4% (97.3-99.1) (p &lt; 0.001) during conventional therapy. The median Pao(2) was 83 torr (71-94) versus 107 torr (94-131) (p &lt; 0.001) with a change to a median Fio(2) of 0.27 (0.24-0.30) versus 0.40 (0.35-0.44) (p &lt; 0.001). Conservative oxygen therapy decreased the median total amount of oxygen delivered during mechanical ventilation by about two thirds (15,580 L [8,263-29,351 L] vs 5,122 L [1,837-10,499 L]; p &lt; 0.001). The evolution of the Pao(2)/Fio(2) ratio was similar during the two periods, and there were no difference in any other biochemical or clinical outcomes.
    Conclusions: Conservative oxygen therapy in mechanically ventilated ICU patients was feasible and free of adverse biochemical, physiological, or clinical outcomes while allowing a marked decrease in excess oxygen exposure. Our study supports the safety and feasibility of future pilot randomized controlled trials of conventional compared with conservative oxygen therapy.

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  • Mortality Related to Severe Sepsis and Septic Shock Among Critically III Patients in Australia and New Zealand, 2000-2012 査読 国際誌

    Kirsi-Maija Kaukonen, Michael Bailey, Satoshi Suzuki, David Pilcher, Rinaldo Bellomo

    JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION   311 ( 13 )   1308 - 1316   2014年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AMER MEDICAL ASSOC  

    IMPORTANCE Severe sepsis and septic shock are major causes of mortality in intensive care unit (ICU) patients. It is unknown whether progress has been made in decreasing their mortality rate.
    OBJECTIVE To describe changes in mortality for severe sepsis with and without shock in ICU patients.
    DESIGN, SETTING, AND PARTICIPANTS Retrospective, observational study from 2000 to 2012 including 101 064 patients with severe sepsis from 171 ICUs with various patient case mix in Australia and New Zealand.
    MAIN OUTCOMES AND MEASURES Hospital outcome (mortality and discharge to home, to other hospital, or to rehabilitation).
    RESULTS Absolute mortality in severe sepsis decreased from 35.0% (95% CI, 33.2%-36.8%; 949/2708) to 18.4% (95% CI, 17.8%-19.0%; 2300/12 512; P&lt;.001), representing an overall decrease of 16.7% (95% CI, 14.8%-18.6%), an annual rate of absolute decrease of 1.3%, and a relative risk reduction of 47.5% (95% CI, 44.1%-50.8%). After adjusted analysis, mortality decreased throughout the study period with an odds ratio (OR) of 0.49 (95% CI, 0.46-0.52) in 2012, using the year 2000 as the reference (P&lt;.001). The annual decline in mortality did not differ significantly between patients with severe sepsis and those with all other diagnoses (OR, 0.94 [95% CI, 0.94-0.95] vs 0.94 [95% CI, 0.94-0.94]; P = .37). The annual increase in rates of discharge to home was significantly greater in patients with severe sepsis compared with all other diagnoses (OR, 1.03 [95% CI, 1.02-1.03] vs 1.01 [95% CI, 1.01-1.01]; P&lt;.001). Conversely, the annual increase in the rate of patients discharged to rehabilitation facilities was significantly less in severe sepsis compared with all other diagnoses (OR, 1.08 [95% CI, 1.07-1.09] vs 1.09 [95% CI, 1.09-1.10]; P&lt;.001). In the absence of comorbidities and older age, mortality was less than 5%.
    CONCLUSIONS AND RELEVANCE In critically ill patients in Australia and New Zealand with severe sepsis with and without shock, there was a decrease in mortality from 2000 to 2012. These findings were accompanied by changes in the patterns of discharge to home, rehabilitation, and other hospitals.

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  • Hyperoxemia in critically mechanical ventilation patients: A factor yet to be fit for intensivists-Authors' reply 査読 国際誌

    Satoshi Suzuki, Glenn M. Eastwood, Rinaldo Bellomo

    JOURNAL OF CRITICAL CARE   29 ( 1 )   173 - 173   2014年2月

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    記述言語:英語   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

    DOI: 10.1016/j.jcrc.2013.10.002

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  • Near-infrared spectroscopy of the thenar eminence to estimate forearm blood flow 査読 国際誌

    Nicholas C. Z. Woinarski, Satoshi Suzuki, Miklos Lipcsey, Natalie Lumsden, Jaye Chin-Dusting, Antoine G. Schneider, Michael Bailey, Rinaldo Bellomo

    CRITICAL CARE AND RESUSCITATION   15 ( 4 )   323 - 326   2013年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AUSTRALASIAN MED PUBL CO LTD  

    Background: Near-infrared spectroscopy of the thenar eminence (NIRSth) can be used at the bedside to assess tissue oxygenation (Sto(2)), the reperfusion response to ischaemia and the tissue haemoglobin index (THI). Its ability to estimate forearm blood flow (FBF) has not previously been assessed.
    Objectives: We aimed to test whether short-lived venous occlusion-induced changes in NIRSth-derived THI (Delta THI/minute) correlate with strain gauge plethysmography (SGP) measurements.
    Methods: We measured FBF in nine volunteers with SGP by venous occlusion, while estimating Delta THI. Measurements were obtained in two forearm positions (elevated and horizontal) at baseline and during induced hyperaemia.
    Results: We performed 246 paired measurements at rest and after occlusion-induced hyperaemia. At rest, mean SGP-estimated FBF was 3.5-3.6 mL/dL/minute at baseline, compared with 12.9-13.6 mL/dL/minute during hyperaemia. At rest, Delta THI was 6.1-8.2/minute, compared with 29.7-32.5/minute during hyperaemia. Delta THI was a significant predictor of SGP FBF (P&lt;0.01), with stronger correlation during hyperaemia (P&lt;0.01). An equation was developed to convert Delta THI/minute into FBF at mL/dL/minute (FBF=0.362 x Delta THI/minute + 0.864).
    Conclusions: NIRSth can be used to estimate FBF. Given its portability and its ability to also measure Sto(2) and vascular reactivity, NIRSth can assist in providing a comprehensive bedside assessment of the forearm circulation in critically ill patients.

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  • Current oxygen management in mechanically ventilated patients: A prospective observational cohort study 査読 国際誌

    Satoshi Suzuki, Glenn M. Eastwood, Leah Peck, Neil J. Glassford, Rinaldo Bellomo

    JOURNAL OF CRITICAL CARE   28 ( 5 )   647 - 654   2013年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

    Purpose: Oxygen (O-2) is the most common therapy in mechanically ventilated patients, but targets and dose are poorly understood. We aimed to describe current O-2 administration and titration in such patients in an academic intensive care unit.
    Materials and Methods: In consecutive ventilated (&gt; 48 hours) patients we prospectively obtained fraction of inspired O-2 (FIO2), pulse oximetry O-2 saturation (SpO(2)) and arterial O-2 tension (PaO2) every 6 hours. We calculated the amount of excess O-2 delivery and the intensivists' response to hyperoxemia (SpO(2) &gt; 98%).
    Results: During 358 mechanical ventilation days in 51 critically ill patients, median calculated excess O-2 delivery was 3472 L per patient. Patients spent most of their time with their SpO(2) &gt; 98% (59% [29-83]) and PaO2 between 80 and 120 mm Hg (59% [38-72]). In addition, 50% of all observations showed hyperoxemia and 4% severe hyperoxemia (PaO2 &gt; 202.5 mm Hg). Moreover, 71% of the calculated total excess 263,841 L of O-2 was delivered when the FIO2 was 0.3 to 0.5. When hyperoxemia occurred with an FIO2 between 0.3 and 0.4, for 88% of episodes, no FIO2 adjustments were made.
    Conclusions: Excess O-2 delivery and liberal O-2 therapy were common in mechanically ventilated patients. Current O-2 therapy practice may be suboptimal and further investigations are warranted. (C) 2013 Elsevier Inc. All rights reserved.

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  • Hypophosphatemia in critically ill patients 査読 国際誌

    Satoshi Suzuki, Moritoki Egi, Antoine G. Schneider, Rinaldo Bellomo, Graeme K. Hart, Colin Hegarty

    Journal of Critical Care   28 ( 4 )   536 - e19   2013年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Purpose: The aim of this study was to assess the association of phosphate concentration with key clinical outcomes in a heterogeneous cohort of critically ill patients. Materials and Methods: This was a retrospective observational study at a general intensive care unit (ICU) of an Australian university teaching hospital enrolling 2730 adult critically ill patients. Results: We studied 10 504 phosphate measurements with a mean value of 1.17 mmol/L (measurements every 28.8 hours on average). Hyperphosphatemia (inorganic phosphate [iP] concentration &gt
    1.4 mmol/L) occurred in 45% and hypophosphatemia (iP ≤ 0.6 mmol/L) in 20%. Among patients without any episodes of hyperphosphatemia, patients with at least 1 episode of hypophosphatemia had a higher ICU mortality than those without hypophosphatemia (P = .004). In addition, ICU nonsurvivors had lower minimum phosphate concentrations than did survivors (P = .009). Similar results were seen for hospital mortality. However, on multivariable logistic regression analysis, hypophosphatemia was not independently associated with ICU mortality (adjusted odds ratio, 0.86 [95% confidence interval, 0.66-1.10]
    P = .24) and hospital mortality (odds ratio, 0.89 [0.73-1.07]
    P = .21). Even when different cutoff points were used for hypophosphatemia (iP ≤ 0.5, 0.4, 0.3, or 0.2 mmol/L), hypophosphatemia was not an independent risk factor for ICU and hospital morality. In addition, timing of onset and duration of hypophosphatemia were not independent risk factor for ICU and hospital mortality. Conclusions: Hypophosphatemia behaves like a general marker of illness severity and not as an independent predictor of ICU or in-hospital mortality in critically ill patients. © 2013 Elsevier Inc.

    DOI: 10.1016/j.jcrc.2012.10.011

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  • Normothermic extracorporeal human liver perfusion following donation after cardiac death 査読

    Rinaldo Bellomo, Bruno Marino, Graham Starkey, Bhao Zhong Wang, Michael A. Fink, Nan Zhu, Satoshi Suzuki, Shane Houston, Glenn Eastwood, Paolo Calzavacca, Neil Glassford, Brenton Chambers, Alison Skene, Antoine G. Schneider, Daryl Jones, Andrew Hilton, Helen Opdam, Stephen Warrillow, Nicole Gauthier, Lynne Johnson, Robert Jones

    CRITICAL CARE AND RESUSCITATION   15 ( 2 )   78 - 82   2013年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AUSTRALASIAN MED PUBL CO LTD  

    Liver transplantation is a major life-saving procedure and donation after cardiac death (DCD) has increased the pool of potential liver donors.
    However, livers procured after DCD are at increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to protect, evaluate and, in future, transplant DCD livers.
    We conducted a proof-of-concept experiment using a human liver procured by DCD (deemed not suitable for liver donation) to assess the short-term (3 hours) feasibility,, histological effects and functional efficacy of NELP.
    We used an extracorporeal membrane oxygenation circuit with separate hepatic artery and portal vein perfusion to achieve physiological perfusion pressures, and coupled this with parenteral nutrition and an insulin infusion. We achieved NELP with evidence of liver function (bile production, paracetamol removal and control of ammonia, bilirubin and lactate levels) for 3 hours. There was essentially normal liver and biliary tract histology after 8 hours of perfusion.
    Our experiment justifies further investigation of the feasibility and efficacy of human DCD liver preservation by NELP.

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  • Normothermic extracorporeal perfusion of isolated porcine liver after warm ischaemia: a preliminary report 査読

    Rinaldo Bellomo, Satoshi Suzuki, Bruno Marino, Graeme K. Starkey, Brenton Chambers, Michael A. Fink, Bao Zhong Wang, Shane Houston, Glenn Eastwood, Paolo Calzavacca, Neil Glassford, Alison Skene, Daryl A. Jones, Robert Jones

    CRITICAL CARE AND RESUSCITATION   14 ( 3 )   173 - 176   2012年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AUSTRALASIAN MED PUBL CO LTD  

    Liver transplantation is a major life-saving procedure, and donation after cardiac death (DCD) has increased the pool of potential liver donors.
    However, DCD livers are at increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to protect, evaluate and, in future, transplant DCD livers.
    We conducted proof-of-concept experiments using a DCD model in the pig to assess the short-term (4 hours) feasibility and functional efficacy of NELP. Using extracorporeal membrane oxygenation, parenteral nutrition, separate hepatic artery and portal vein perfusion, and physiological perfusion pressures, we achieved NELP and evidence of function (bile production, paracetamol removal, maintenance of normal ammonia and lactate levels) for 4 hours in pig livers subjected to 15 and 30 minutes of cardiac arrest before explantation.
    Our experiments justify further investigations of the feasibility and efficacy of human DCD liver preservation by ex-vivo perfusion.

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  • Effect of tranexamic acid on blood loss in pediatric cardiac surgery: a randomized trial 査読

    Kazuyoshi Shimizu, Yuichiro Toda, Tatsuo Iwasaki, Mamoru Takeuchi, Hiroshi Morimatsu, Moritoki Egi, Tomohiko Suemori, Satoshi Suzuki, Kiyoshi Morita, Shunji Sano

    JOURNAL OF ANESTHESIA   25 ( 6 )   823 - 830   2011年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER TOKYO  

    Purpose The benefit of tranexamic acid (TXA) in pediatric cardiac surgery on postoperative bleeding has varied among studies. It is also unclear whether the effects of TXA differ between cyanotic patients and acyanotic patients. The aim of this study was to test the benefit of TXA in pediatric cardiac surgery in a well-balanced study population of cyanotic and acyanotic patients.
    Methods A total of 160 pediatric patients undergoing cardiac surgery with cardiopulmonary bypass (81 cyanotic, 79 acyanotic) were included in this single-blinded, randomized trial at a tertiary care university-affiliated teaching hospital. Eighty-one children (41 cyanotic, 40 acyanotic) were randomly assigned to a TXA group, in which they received 50 mg/kg of TXA as a bolus followed by 15 mg/kg/h infusion and another 50 mg/kg into the bypass circuit. The other 79 patients were randomly assigned to a placebo group. The primary end point was the amount of 24-h blood loss.
    Results The amount of 24-h blood loss was significantly less in the TXA group than in the placebo group [mean (95% confidence interval): 18.6 (15.8-21.4) vs. 23.5 (19.4-27.5) ml/kg, respectively; mean difference -4.9 (-9.7 to -0.01) ml/kg; p = 0.049]. This effect of TXA was already significant at 6 h [9.5 (7.5-11.5) vs. 13.2 (10.6-15.9) ml/kg, respectively; mean difference -3.47 (-7.0 to -0.4) ml/kg; p = 0.027]. However, there was no significant difference in the amount of blood transfusion between the groups. There was also no statistical difference in the effect of TXA in each cyanotic and acyanotic subgroup.
    Conclusion TXA can reduce blood loss in pediatric cardiac surgery but not the transfusion requirement (http://ClinicalTrials.gov number NCT00994994).

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  • Postoperative coil embolization of residual MAPCAs greatly improved left heart failure in a patient after corrective surgery for pulmonary atresia, ventricular septal defect and MAPCAs 査読

    Masako Kinoshita, Kazuyoshi Shimizu, Yuichiro Toda, Satoshi Suzuki, Tomohiko Suemori, Tatsuo Iwasaki, Toru Takahashi, Kiyoshi Morita

    Japanese Journal of Anesthesiology   59 ( 11 )   1441 - 1445   2010年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A male child, aged 1 year, with pulmonary atresia, ventricular septal defect and major aorto-pulmonary collateral arteries (PA, VSD, MAPCA) underwent corrective surgery including MAPCA ligation uneventfully. A few hours after admission to the ICU, severe heart failure, refractory to aggressive cardiac support including epinephrine infusion, became worse. Emergent cardiac catheterization on postoperative day 5 demonstrated the residual MAPCA and its occlusion by coil embolization dramatically resolved heart failure, indicating that the primary cause of this hemodynamic instability was likely excessive left-to-right shunt due to MAPCA. Residual LR shunt should be kept in mind to be a rare but significant cause of postoperative serious heart failure.

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  • Successful use of intravenous amiodarone for refractory ventricular fibrillation just after releasing aortic cross-clamp 査読

    Satoshi Suzuki, Tatsuo Iwasaki, Hiroshi Morimatsu, Nagisa Yokoi, Mayuko Matsuoka, Tomohiko Suemori, Tomoyuki Kanazawa, Kazuyoshi Shimizu, Yuichiro Toda, Kiyoshi Morita

    Japanese Journal of Anesthesiology   59 ( 10 )   1266 - 1270   2010年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Amiodarone is widely used in Europe and the United States for refractory ventricular fibrillation (VF) in various situations, such as VF after myocardial infarction or out-of-hospital cardiac arrest. We report a case of successful treatment with amiodarone of refractory VF immediately after releasing aortic cross-clamp in cardiac surgery. A 66-year-old man suffering from severe aortic stenosis underwent aortic valve replacement (AVR). General anesthesia was induced with propofol and remifentanil, and subsequently AVR was performed under cardiopulmonary bypass. Just after releasing aortic cross-clamp, VF occurred, and it continued despite multiple trials of cardioversion with direct current (DC) shocks of 20 J or 30 J. Furthermore, some DC shocks of 30 J or 50 J after administering lidocaine 60 mg and 0.5 mol·l-1 magnesium sulfate 20 ml were also ineffective. Then, nifekalant 20 mg was administered and DC shocks of 50 J were repeated intermittently, but VF still persisted. Eventually, VF disappeared after a final DC shock of 50 J with intravenous amiodarone 125 mg. Overall duration of VF was 60 minutes. The patient's trachea was extubated three days after the surgery without any complications. Intravenous amiodarone may be one of the most useful remedies for some types of arrhythmias including persistent VF.

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  • Perioperative management for open balloon atrial septostomy immediately after caesarean section in a baby with hypoplastic left heart syndrome and intact atrial septum 査読

    Nagisa Yokoi, Yuichiro Toda, Satoshi Suzuki, Tomoyuki Kanazawa, Tomohiko Suemori, Kazuyoshi Shimizu, Tatsuo Iwasaki, Kiyoshi Morita

    Japanese Journal of Anesthesiology   59 ( 10 )   1308 - 1310   2010年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Hypoplastic left heart syndrome (HLHS) with intact atrial septum (IAS) is an extreme type of single ventricle physiology among congenital heart diseases, in which a baby cannot supply oxygenated blood into systemic circulation without alternative pathway. We report the case of the neonate undergoing open balloon atrial septostomy (BAS) and bilateral pulmonary artery banding (PAB) soon after scheduled caesarean sections (C/S). A 35-year-old female was pregnant and fetal echocardiography at 32 weeks revealed one of the twins as HLHS/IAS. Severe hypoxia soon after birth was suspected. Thus, scheduled C/S followed by open BAS was planned. At 36 weeks of gestation, the mother was anesthetized with spinal bupivacaine and the female baby with HLHS/IAS was delivered. After diagnosed definitely by pediatric cardiologists, her trachea was intubated by anesthegiologists and umbilical catheters were placed by neonatologists. Then the baby was transferred to neighboring operating theater for BAS 68 minutes after the birth, while her SpO2 was maintained around 75-85% through serial procedures. Open BAS and PAB were performed under general anesthesia without any hemodynamic instability or severe hypoxia. Cooperation among anesthegiologists, neonatologists, pediatric cardiologists, and cardiac surgeons is mandatory in order to successfully complete such a rushed procedure.

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  • Responses to surgical stress after esophagectomy: Gene expression of heat shock protein 70, toll-like receptor 4, tumor necrosis factor-α and inducible nitric oxide synthase. 査読

    Suzuki S, Morimatsu H, Omori E, Shimizu H, Takahashi T, Yamatsuji T, Naomoto Y, Morita K

    Molecular medicine reports   3 ( 5 )   765 - 769   2010年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.3892/mmr.2010.335

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  • RACHS-1 CATEGORYは小児心臓手術において術後経過の予測因子となる

    末盛 智彦, 戸田 雄一郎, 岩崎 達雄, 清水 一好, 鈴木 聡, 森田 潔, 笠原 真悟, 佐野 俊二, 岡本 吉生, 大野 直幹, 大月 審一

    日本小児循環器学会雑誌   26 ( Suppl. )   s282 - s282   2010年6月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 小児先天性心疾患術後の急性腎障害 pRIFLEクライテリアによる検討

    戸田 雄一郎, 清水 一好, 末盛 智彦, 岩崎 達雄, 森田 潔, 鈴木 聡, 笠原 真悟, 佐野 俊二, 岡本 吉生, 大野 直幹, 大月 審一

    日本小児循環器学会雑誌   26 ( Suppl. )   s205 - s205   2010年6月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • Acid-base variables in patients with acute kidney injury requiring peritoneal dialysis in the pediatric cardiac care unit 査読

    Hiroshi Morimatsu, Yuichiro Toda, Moritoki Egi, Kazuyoshi Shimizu, Takashi Matsusaki, Satoshi Suzuki, Tatsuo Iwasaki, Kiyoshi Morita

    JOURNAL OF ANESTHESIA   23 ( 3 )   334 - 340   2009年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER TOKYO  

    We aimed to clarify the acid-base abnormalities of patients with acute kidney injury (AKI) requiring peritoneal dialysis (PD) in pediatric cardiac care units.
    A retrospective observational study was conducted in a pediatric cardiac care unit in a tertiary care university hospital. The subjects were 40 patients with AKI requiring PD between 2003 and 2005, and controls matched by type of surgery and body weight. Acid-base variables, including blood gas data and electrolytes, were assessed. The Stewart-Figge variables, including strong ion difference apparent (SIDa), strong ion difference effective (SIDe), and strong ion gap (SIG), were calculated.
    Blood gas analyses showed that the PD group was more acidemic, with a lower mean bicarbonate and a lower mean base excess, typical features of metabolic acidosis. The strong ion analyses revealed that the PD group had lower mean sodium and albumin concentrations. Based on the Stewart-Figge methodology, SIDa was smaller in the PD group than in the control group, but SIG was similar in the two groups. Receiver-operating characteristic curve analyses showed that serum albumin was the only prognostic factor associated with PCCU mortality, even after adjustment for PD treatment.
    Patients with AKI requiring PD in a pediatric cardiac care unit had significant metabolic acidosis compared to controls matched by the type of surgery and body weight. Hyponatremia and hypoalbuminemia were characteristics of these patients. The calculated SIDa was smaller in the PD than in the control group. Only the serum albumin had a significant prognostic value.

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  • ASDの麻酔・術後管理

    岩崎 達雄, 戸田 雄一郎, 清水 一好, 末盛 智彦, 鈴木 聡, 森田 潔

    Cardiovascular Anesthesia   13 ( 1 )   43 - 48   2009年5月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓血管麻酔学会  

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  • Non-overt disseminated intravascular coagulation scoring for critically ill patients: The impact of antithrombin levels 査読 国際誌

    Moritoki Egi, Hiroshi Morimatsu, Christian J. Wiedermann, Makiko Tani, Tomoyuki Kanazawa, Satoshi Suzuki, Takashi Matsusaki, Kazuyoshi Shimizu, Yuichiro Toda, Tatsuo Iwasaki, Kiyoshi Morita

    THROMBOSIS AND HAEMOSTASIS   101 ( 4 )   696 - 705   2009年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SCHATTAUER GMBH-VERLAG MEDIZIN NATURWISSENSCHAFTEN  

    Validation of a scoring algorithm for non-overt disseminated intravascular coagulation (DIC) proposed by the International Society on Thrombosis and Haemostasis (ISTH) is still incomplete. It was the objective of this study to assess the impact of including AT to non-overt DIC scoring on the predictability for intensive care unit (ICU) death and the later development of overt-DIC defined by the Japanese Ministry of Health and Welfare (JMHW) or the ISTH. We performed a retrospective observational study conducted in 364 patients in critical care. Coagulation parameters obtained daily for DIC screening were utilised for scoring. There were 194 and 196 patients scored as positive non-overt DIC with and without AT, respectively; diagnostic agreement between the two was 78%. As compared with patients without non-overt DIC, these non-overt DIC patients had significantly higher mortality. In 37 ICU non-survivors, positive non-overt DIC scoring with AT preceded ICU death by a median of 6.8 days, which was significantly earlier as compared with a median of 5.4 days for non-overt DIC without AT (p=0.022). In patients who developed overt-DIC after admission, the time period from positive non-overt DIC to positive overt-DIC was significantly longer when AT was utilised (overt-DIC ISTH; 1.3 days vs. 0.1 days, p=0.004, overt-DIC JMHW; 2.5 days vs. 2.0 days, p=0.04, with AT vs. without AT, respectively). Non-overt DIC scoring predicted a high risk of death in critically ill patients. When information on AT levels was included, non-overt DIC scoring was found to predict development of overt-DIC significantly earlier than non-overt DIC scoring without AT.

    DOI: 10.1160/TH08-07-0448

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  • Anesthetic management of pediatric patients with insulinoma using continuous glucose monitoring 査読

    Motoko Manabe, Hiroshi Morimatsu, Moritoki Egi, Satoshi Suzuki, Ryuji Kaku, Masaki Matsumi, Kiyoshi Morita

    Japanese Journal of Anesthesiology   58 ( 6 )   757 - 759   2009年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Insulinomas are rare tumors, the incidence of which is 1-2 per million. Patients with insulinomas present with symptoms of hypoglycemia secondary to insulin hypersecretion. Surgical resection is a treatment of choice and offers the only chance of cure. The important points in anesthesia are the precaution against hypoglycemia until tumor resection and the control of rebound hyperglycemia soon after tumor resection. We report the anesthetic management of a 5-year-old patient with insulinoma. Soon after the induction of anesthesia, the continuous glucose monitoring was commenced. Until the tumor resection, 10% glucose infusion was required to avoid hypoglycemia. Then, insulin infusion was continued to maintain blood glucose level around 150 mg·dl-1. All glucose management was guided with continuous glucose monitoring. This is a first case report to show the feasibility and usefulness of continuous glucose monitoring in management of pediatric insulinoma patients. As the blood glucose was dramatically altered during perioperative period, frequent blood glucose measurements or continuous glucose monitoring is mandatory during perioperative period of insulinoma resection.

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  • 危篤患者に対する非顕性DICスコアの妥当性検証(A validation of non-overt disseminated intravascular coagulation score for critically ill patients)

    江木 盛時, 森松 博史, Wiedermann Christian J., 谷 真規子, 金澤 伴幸, 鈴木 聡, 松崎 孝, 清水 一好, 戸田 雄一郎, 岩崎 達雄, 森田 潔

    日本集中治療医学会雑誌   15 ( Suppl. )   223 - 223   2008年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 高血糖と予後 Hyperglycemia in Pediatric Cardiac Surgery Patients Requiring Peritoneal Dialysis

    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 ( Suppl. )   211 - 211   2007年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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書籍等出版物

  • LiSA

    鈴木 聡( 担当: 分担執筆 ,  範囲: 酸素化の功罪について 「いつもの」FIO2で,本当に大丈夫?)

    メディカル・サイエンス・インターナショナル  2023年4月 

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    記述言語:日本語 著書種別:学術書

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  • 麻酔 2021年9月号 査読

    ( 担当: 分担執筆 ,  範囲: 周術期酸素投与,周術期体温管理と術後予後(手術部位感染を中心に))

    克誠堂出版  2021年8月 

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    記述言語:日本語 著書種別:学術書

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  • 心臓血管麻酔Positive and Negativeリスト25 : その麻酔管理方法にエビデンスはあるのか?

    山蔭, 道明, 平田, 直之, 吉川, 裕介(麻酔科学)( 担当: 分担執筆 ,  範囲: 心臓血管手術後の呼吸管理)

    中外医学社  2020年9月  ( ISBN:9784498055469

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    総ページ数:iii,199p   記述言語:日本語 著書種別:教科書・概説・概論

    CiNii Books

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  • 人工呼吸管理・NPPVの基本、ばっちり教えます

    西村匡司( 担当: 分担執筆 ,  範囲: 酸素療法)

    羊土社  2019年8月 

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    記述言語:日本語 著書種別:教科書・概説・概論

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  • Clinical Engineering 2019年8月号 Vol.30 No.8 (クリニカルエンジニアリング)

    ( 担当: 分担執筆 ,  範囲: 酸素療法のいま)

    学研メディカル秀潤社  2019年7月  ( ISBN:4780906199

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    総ページ数:120   著書種別:教科書・概説・概論

    ASIN

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  • 救急医学 2019年3月号 救急医学研究 入門!

    ( 担当: 分担執筆 ,  範囲: 研究課題の見つけ方(医師編))

    2019年2月 

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    記述言語:日本語 著書種別:教科書・概説・概論

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MISC

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

    成谷俊輝, 黒田浩佐, 岡原修司, 鈴木聡, 清水一好, 森松博史

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

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  • 集中治療領域におけるTele ICUシステムの試作・検討

    清水 一好, 林 真雄, 鈴木 聡, 森松 博史

    日本集中治療医学会雑誌   24 ( Suppl. )   DP74 - 5   2017年2月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • コントロール不良の肺動脈性肺高血圧症に合併した急性肺動脈解離の一例

    川出健嗣, 清水一好, 林真雄, 谷真規子, 鈴木聡, 金澤伴幸, 岩崎達雄, 森松博史

    日本集中治療医学会雑誌(Web)   23 ( 3 )   2016年

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  • 上顎癌術直後にAeromonas属による治療抵抗性の敗血症性ショックをきたし、急激な経過をたどった症例

    塩路 直弘, 清水 一好, 林 真雄, 金澤 伴幸, 鈴木 聡, 岡原 修司, 日笠 友起子, 森松 博史

    ICUとCCU   39 ( 7 )   431 - 435   2015年7月

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    記述言語:日本語   出版者・発行元:医学図書出版(株)  

    症例は71歳、男性。上顎癌に対して放射線、化学療法を先行した後、根治術を施行した。術後ICUに予定入室したが、入室約6時間後から血圧低下、代謝性アシドーシスが出現した。輸液負荷とノルアドレナリン持続投与にも抵抗性で敗血症性ショックを疑い、抗菌薬を変更、バソプレシン、アドレナリン、ハイドロコルチゾンを追加、CHDFを開始した。入室2日目に血液培養でグラム陰性桿菌が陽性となった。循環・呼吸不全と肝不全が進行したため、血漿交換、VA ECMOを導入した。その後も左心不全が急速に進行しIABPも挿入した。経過中2度、開創し皮弁を確認したが皮弁の血流は保たれていた。あらゆる治療に反応なく入室4日目に永眠した。後日、血液培養の結果がAeromonas属であることが判明した。免疫抑制の背景をもつ患者の場合、Aeromonas属による敗血症性ショックは重篤化し、急激に進行する可能性がある。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J00001&link_issn=&doc_id=20150811310006&doc_link_id=%2Faa6icutc%2F2015%2F003907%2F007%2F0431-0435%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faa6icutc%2F2015%2F003907%2F007%2F0431-0435%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • Conservative Oxygen Therapy in Mechanically Ventilated Patients Reply

    Rinaldo Bellomo, Satoshi Suzuki, Glenn M. Eastwood

    CRITICAL CARE MEDICINE   42 ( 9 )   E631 - E631   2014年9月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1097/CCM.0000000000000472

    Web of Science

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  • Letter by Eastwood et al Regarding Article, "Association Between Postresuscitation Partial Pressure of Arterial Carbon Dioxide and Neurological Outcome in Patients With Post-Cardiac Arrest Syndrome"

    Glenn M. Eastwood, Satoshi Suzuki, Rinaldo Bellomo

    CIRCULATION   129 ( 1 )   E9 - E9   2014年1月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1161/CIRCULATIONAHA.113.004554

    Web of Science

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  • 食道癌術後の難治性発作性心房細動に対して塩酸ランジオロールを使用した7例の検討.

    鈴木 聡, 森松博史, 江木盛時, 清水一好, 松崎 孝, 佐藤哲文, 片山 浩, 森田 潔

    日本集中治療医学会雑誌   18 ( 2 )   215 - 220   2011年

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

    術後の発作性心房細動の発生は、ICUや病院滞在日数、医療費の増加につながることが報告されており、その管理は重要である。我々は、食道癌術後に難治性の発作性心房細動を合併し、短時間作用型β1選択的遮断薬である塩酸ランジオロールを使用した7例を経験した。症例は51〜87歳で、いずれも男性であった。複数の抗不整脈薬が無効であり、塩酸ランジオロール投与を開始した。初期の急速投与は行わず、4.3〜33.5μg/kg/minと低用量の範囲で開始し、投与前と投与1時間後の心拍数は平均153[140、167][95%信頼区間]/minから101[88、116]/min(P<0.0001)と有意な低下を認めた。平均血圧は88[78、94]mmHgから82[74、89]mmHg(P=0.37)と有意な変化を認めず、重症な低血圧に陥る症例もなかった。6例では投与開始24時間以内に洞調律に回復した。複数の抗不整脈薬に抵抗性の食道癌術後発作性心房細動に対する低用量の塩酸ランジオロール投与は、大きな血圧の低下なく心拍数の安定をもたらした。(著者抄録)

    DOI: 10.3918/jsicm.18.215

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J02874&link_issn=&doc_id=20110422460012&doc_link_id=20110422460001%2C20111017450026&url=http%3A%2F%2Fsearch.jamas.or.jp%2Flink%2Fbc%2F20110422460001%2C20111017450026&type=jamaslink&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F99999_1.gif

  • 低血糖は先天性心疾患の術後経過に影響を及ぼすか?

    岩崎 達雄, 戸田 雄一郎, 清水 一好, 末盛 智彦, 鈴木 聡, 杉本 健太郎, 森田 潔

    日本小児麻酔学会誌   16 ( 1 )   75 - 75   2010年8月

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    記述言語:日本語   出版者・発行元:日本小児麻酔学会  

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  • 集中治療室での先天性心疾患におけるベクロニウム持続投与 挿管時間との関係

    清水 一好, 森松 博史, 戸田 雄一郎, 鈴木 聡, 金澤 伴幸, 末盛 智彦, 岩崎 達雄, 森田 潔

    日本集中治療医学会雑誌   17 ( 3 )   353 - 354   2010年7月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

    2006年12月〜2007年6月に、ICU入室後に筋弛緩薬を持続投与された先天性心疾患40例(6.3〜15.8ヵ月・平均11ヵ月)を対象に、挿管時間への影響因子について検討した。40例のうち37例(92.5%)は心臓手術後患者で、施行術式はRACHS-1カテゴリーで2.8〜3.6(平均3.2)、人工心肺時間92〜140分(平均116分)、大動脈遮断時間49〜82分(平均65分)、人工心肺中の冷却温度は24.8〜28.4℃(平均26.6℃)であった。ICU入室中に投与したベクロニウムの総投与量は3.3〜11.7mg・kg-1(平均7.5mg・kg-1)、持続投与中止から抜管までの時間は48.4〜153.9時間(平均101.1時間)と4日間を要していた。そのうち約80%の症例は100時間以内に抜管可能であった。5例は抜管まで200時間以上と長時間を要した。挿管時間と各因子の比例ハザードモデルによる単変量解析の結果、ベクロニウム総投与量と人工心肺冷却温度が有意に独立した危険因子であった。

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J02874&link_issn=&doc_id=20100730590017&doc_link_id=10.3918%2Fjsicm.17.353&url=https%3A%2F%2Fdoi.org%2F10.3918%2Fjsicm.17.353&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 小児心臓手術における下垂体ホルモンの変動 年齢による相違

    清水 一好, 森松 博史, 戸田 雄一郎, 江木 盛時, 末盛 智彦, 鈴木 聡, 岩崎 達雄, 森田 潔

    日本集中治療医学会雑誌   17 ( Suppl. )   279 - 279   2010年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 食道癌術後患者に対する栄養プロトコール導入の効果

    濱田 暁, 江木 盛時, 竹野内 志保, 鈴木 聡, 清水 一好, 松崎 孝, 戸田 雄一郎, 森松 博史, 佐藤 健治, 森田 潔

    日本集中治療医学会雑誌   17 ( Suppl. )   369 - 369   2010年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 小児心疾患集中治療室における鎮静薬の人工呼吸・ICU滞在への影響

    戸田 雄一郎, 清水 一好, 岩崎 達雄, 末盛 智彦, 鈴木 聡, 森松 博史, 江木 盛時, 森田 潔

    日本集中治療医学会雑誌   17 ( Suppl. )   291 - 291   2010年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 重症患者における低AT3血症と患者死亡の関係

    竹野内 志保, 江木 盛時, 森松 博史, 戸田 雄一郎, 清水 一好, 松崎 孝, 鈴木 聡, 森田 潔

    日本集中治療医学会雑誌   17 ( Suppl. )   312 - 312   2010年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • REAL TIME HOST&apos;S RESPONSES TO SURGICAL STRESS AFTER ESOPHAGECTOMY: GENE EXPRESSIONS OF HEAT SHOCK PROTEIN 70, TOLL-LIKE RECEPTOR 4, TUMOR NECROSIS FACTOR-ALPHA, AND INDUCIBLE NITRIC OXIDE SYNTHASE

    Satoshi Suzuki, Hiroshi Morimatsu, Emiko Omori, Hiroko Shimizu, Toru Takahashi, Kiyoshi Morita

    CRITICAL CARE MEDICINE   37 ( 12 )   A58 - A58   2009年12月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

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  • ALTERATIONS OF PITUITARY HORMONES AFTER PEDIATRIC CARDIAC SURGERY

    Kazuyoshi Shimizu, Hiroshi Morimatsu, Yuichiro Toda, Moritoki Egi, Tomohiko Suemori, Satoshi Suzuki, Tatsuo Iwasaki, Kiyoshi Morita

    CRITICAL CARE MEDICINE   37 ( 12 )   A113 - A113   2009年12月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

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  • 小児用パーカー気管チューブ、経鼻挿管の使用経験

    戸田 雄一郎, 岩崎 達雄, 清水 一好, 末盛 智彦, 鈴木 聡, 森田 潔

    日本小児麻酔学会誌   15 ( 1 )   105 - 105   2009年9月

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    記述言語:日本語   出版者・発行元:日本小児麻酔学会  

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  • ファロー四徴症根治手術後左右シャント残存により心不全に陥ったが、コイル塞栓により著明に改善した一症例

    木下 真佐子, 清水 一好, 戸田 雄一郎, 鈴木 聡, 末盛 智彦, 岩崎 達雄, 高橋 徹, 森田 潔

    日本臨床麻酔学会誌   29 ( 6 )   S344 - S344   2009年9月

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    記述言語:日本語   出版者・発行元:日本臨床麻酔学会  

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  • 周術期集中治療での新しい試み トラネキサム酸投与は小児心臓手術周術期の出血量を減少させる

    清水 一好, 戸田 雄一郎, 末盛 智彦, 鈴木 聡, 岩崎 達雄, 森田 潔, 大野 直幹, 岡本 吉生, 大月 審一, 笠原 真悟, 佐野 俊二

    日本小児循環器学会雑誌   25 ( 3 )   351 - 351   2009年5月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • チアノーゼ性疾患は出血量が多い トロンボモデュリン、プロテインCとの関連

    戸田 雄一郎, 岩崎 達雄, 清水 一好, 末盛 智彦, 鈴木 聡, 森田 潔, 佐野 俊二, 笠原 真悟, 大月 審一, 竹内 護

    日本小児循環器学会雑誌   25 ( 3 )   566 - 566   2009年5月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 小児先天性心疾患術後における急性腎障害(Acute Kidney Injury)の影響 pediatric RIFLEの応用

    戸田 雄一郎, 岩崎 達雄, 清水 一好, 末盛 智彦, 鈴木 聡, 金澤 伴幸, 森松 博史, 江木 盛時, 森田 潔

    日本集中治療医学会雑誌   16 ( Suppl. )   247 - 247   2009年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 先天性心疾患の筋弛緩持続投与症例における挿管時間に関係する因子

    清水 一好, 森松 博史, 戸田 雄一郎, 鈴木 聡, 金澤 伴幸, 末盛 智彦, 江木 盛時, 岩崎 達雄, 森田 潔

    日本集中治療医学会雑誌   16 ( Suppl. )   247 - 247   2009年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 先天性心疾患の術後管理 小児心臓手術術後心不全に対する軽度低体温管理

    岩崎 達雄, 戸田 雄一郎, 清水 一好, 末盛 智彦, 鈴木 聡, 金澤 伴幸, 森田 潔

    日本集中治療医学会雑誌   16 ( Suppl. )   173 - 173   2009年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 侵襲期の輸液栄養管理 周術期急性高血糖に対するパラチノース含有糖質調節流動食 Randomized Cross-Over Trial

    江木 盛時, 鈴木 聡, 松崎 孝, 清水 一好, 森松 博史, 戸田 雄一郎, 溝渕 知司, 片山 浩, 横山 正尚, 森田 潔

    日本集中治療医学会雑誌   16 ( Suppl. )   186 - 186   2009年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 術後呼吸管理に難渋した、cornelia de lange症候群を伴う総動脈管症患者に対する麻酔経験

    金澤 伴幸, 鈴木 聡, 末盛 智彦, 清水 一好, 戸田 雄一郎, 岩崎 達雄, 森田 潔

    Cardiovascular Anesthesia   12 ( Suppl. )   133 - 133   2008年11月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓血管麻酔学会  

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  • ASDの麻酔・術後管理 Amplatzerを含む

    岩崎 達雄, 戸田 雄一郎, 清水 一好, 金澤 伴幸, 末盛 智彦, 鈴木 聡, 森田 潔

    Cardiovascular Anesthesia   12 ( Suppl. )   66 - 66   2008年11月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓血管麻酔学会  

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  • 先天性副腎低形成患者のVSD閉鎖術の麻酔管理

    末盛 智彦, 松岡 舞夕子, 鈴木 聡, 金澤 伴幸, 清水 一好, 戸田 雄一郎, 岩崎 達雄, 森田 潔

    Cardiovascular Anesthesia   12 ( Suppl. )   107 - 107   2008年11月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓血管麻酔学会  

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  • 大動脈遮断解除直後の難治性心室細動に対して塩酸アミオダロン静脈内投与が奏功した1症例

    鈴木 聡, 清水 一好, 金澤 伴幸, 末盛 智彦, 戸田 雄一郎, 岩崎 達雄, 森田 潔

    Cardiovascular Anesthesia   12 ( Suppl. )   159 - 159   2008年11月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓血管麻酔学会  

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  • 小児心臓手術におけるトラネキサム酸投与は術中及び術後の出血量を減少させる

    清水 一好, 岩崎 達雄, 森松 博史, 鈴木 聡, 金澤 伴幸, 江木 盛時, 戸田 雄一郎, 森田 潔

    Cardiovascular Anesthesia   12 ( Suppl. )   162 - 162   2008年11月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓血管麻酔学会  

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  • HLHS/IASと診断された胎児に対し、予定帝王切開後に緊急BAS・PABを施行した1症例の麻酔経験

    横井 渚, 戸田 雄一郎, 鈴木 聡, 金澤 伴幸, 末盛 智彦, 清水 一好, 岩崎 達雄, 森田 潔

    日本臨床麻酔学会誌   28 ( 6 )   S231 - S231   2008年10月

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    記述言語:日本語   出版者・発行元:日本臨床麻酔学会  

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  • 先天性心疾患患者、非心臓手術時の麻酔管理 先天性心疾患患者、非心臓手術時の麻酔管理 repaired heart

    岩崎 達雄, 戸田 雄一郎, 清水 一好, 金澤 伴幸, 末盛 智彦, 鈴木 聡, 森田 潔

    Cardiovascular Anesthesia   12 ( 1 )   47 - 50   2008年5月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓血管麻酔学会  

    先天性心疾患患者への腸回転異常修復術における麻酔を経験した。症例は2歳9ヵ月男児で、生後すぐに心雑音を指摘された。生後10日目に心エコー検査で無脾症、単心房、共通房室弁孔、両大血管右室起始、総肺静脈還流異常(TAPVC)、superior-inferior ventricleと診断され、TAPVC修復術、肺動脈絞扼術が施行された。生後7ヵ月で両方向性グレン手術とvertical vein ligationが施行された。今回、両大静脈肺動脈吻合法予定で入院したが、腸回転異常が認められ、入院後17日目に待機的に腸回転異常修復術を施行した。本症例の麻酔経過を述べ、このような患児の麻酔を安全に行うためには原疾患の血行動態を把握する必要があることを指摘した。非心臓手術の対象となる疾患の理解も必要である。

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  • 小児重症患者のスコアリングシステムの小児先天性心疾患患者でのvalidation PIM,PRISM,PELODを用いて

    戸田 雄一郎, 岩崎 達雄, 清水 一好, 金澤 伴幸, 森田 潔, 鈴木 聡, 赤木 禎治, 佐野 俊二, 笠原 真悟, 大月 審一, 岡本 吉生

    日本小児循環器学会雑誌   24 ( 3 )   293 - 293   2008年5月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 岡山大学病院における新生児心臓手術後のステロイド使用の検討

    清水 一好, 竹内 護, 岩崎 達雄, 森松 博史, 戸田 雄一郎, 江木 盛時, 金澤 伴幸, 鈴木 聡, 森田 潔

    日本集中治療医学会雑誌   15 ( Suppl. )   179 - 179   2008年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 食道癌術後の発作性心房細動の発生とその危険因子

    鈴木 聡, 森松 博史, 江木 盛時, 清水 一好, 金澤 伴幸, 谷 真規子, 戸田 雄一郎, 岩崎 達雄, 片山 浩, 森田 潔

    日本集中治療医学会雑誌   15 ( Suppl. )   182 - 182   2008年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 小児ICUのスコアリングシステムの心疾患患者でのvalidation PIM,PRISM,PELODを用いて

    戸田 雄一郎, 森松 博史, 岩崎 達雄, 清水 一好, 江木 盛時, 鈴木 聡, 金澤 伴幸, 森田 潔

    日本集中治療医学会雑誌   15 ( Suppl. )   179 - 179   2008年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • Hyperglycemia and the outcome of pediatric cardiac surgery patients requiring peritoneal dialysis.

    Egi M, Morimatsu H, Toda Y, Matsusaki T, Suzuki S, Shimizu K, Iwasaki T, Takeuchi M, Bellomo R, Morita K

    Int J Artif Organs   31 ( 4 )   309 - 316   2008年

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  • Validation of PIM, PRISM, and PELOD for children with congenital heart disease in pediatric cardiac care unit

    Yuichiro Toda, Hiroshi Morimatsu, Moritoki Egi, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tionloyuki Kanazawa, Satoshi Suzuki, Kiyoshi Morita

    CRITICAL CARE MEDICINE   35 ( 12 )   A7 - A7   2007年12月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

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  • 【ケース別救急診療のための緊急麻酔法 安全に!確実に!】新生児期緊急手術の麻酔と注意点 先天性心疾患

    岩崎 達雄, 戸田 雄一郎, 清水 一好, 鈴木 聡, 末盛 智彦, 金澤 伴幸, 森田 潔

    救急・集中治療   19 ( 11-12 )   1492 - 1498   2007年12月

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    記述言語:日本語   出版者・発行元:(株)総合医学社  

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  • 小児心臓手術の術後出血の危険因子

    戸田 雄一郎, 岩崎 達雄, 清水 一好, 金澤 伴幸, 鈴木 聡, 森田 潔, 竹内 護

    日本小児麻酔学会誌   13 ( 1 )   115 - 115   2007年11月

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    記述言語:日本語   出版者・発行元:日本小児麻酔学会  

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  • 小児先天性心疾患患者における腹膜透析の予後と予測因子

    戸田 雄一郎, 森松 博史, 江木 盛時, 清水 一好, 鈴木 聡, 岩崎 達雄, 竹内 護, 横山 正尚, 森田 潔

    日本集中治療医学会雑誌   14 ( Suppl. )   222 - 222   2007年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 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年

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  • 小児心臓手術15年の経験

    竹内 護, 岩崎 達雄, 戸田 雄一郎, 清水 一好, 末盛 智彦, 鈴木 聡, 森田 潔

    Cardiovascular Anesthesia   10 ( Suppl. )   121 - 121   2006年9月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓血管麻酔学会  

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  • 小口径(5mm)プローベを用いた新生児乳児に対する術中経食道心エコーの使用経験

    岩崎 達雄, 竹内 護, 戸田 雄一郎, 清水 一好, 鈴木 聡, 森田 潔

    Cardiovascular Anesthesia   10 ( Suppl. )   116 - 116   2006年9月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓血管麻酔学会  

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▼全件表示

講演・口頭発表等

  • 集中治療における至適酸素化 招待

    鈴木 聡

    日本臨床麻酔学会 第41回大会  2021年11月5日 

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    開催年月日: 2021年11月5日 - 2021年11月6日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 酸素の功罪と適切な酸素化 招待

    鈴木 聡

    日本麻酔科学会第67回学術集会 WEB開催  2020年6月 

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    開催年月日: 2020年7月1日 - 2020年8月31日

    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 麻酔科医が行う術後集中治療の魅力 Postoperative respiratory complications; Can we prevent? Can we treat? 招待

    鈴木 聡

    日本麻酔科学会第66回学術集会  2019年6月1日 

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    開催年月日: 2019年5月30日 - 2019年6月1日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 麻酔管理における酸素投与~それでも高濃度酸素投与を続けますか?~ 招待

    鈴木 聡

    日本麻酔科学会第69回学術集会  2022年6月16日 

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    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 目標酸素濃度はいくつに設定していますか? 招待

    鈴木 聡

    第41回日本呼吸療法医学会学術集会  2019年8月3日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 心拍再開後の呼吸管理が神経学的転帰に及ぼす影響

    鈴木 聡, 田中 愛子, Glenn Eastwood, Rinaldo Bellomo

    第46回日本集中治療医学会学術集会  2019年3月3日 

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    会議種別:シンポジウム・ワークショップ パネル(公募)  

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  • Current oxygen management during general anesthesia: a multicenter cross-sectional study.

    Satoshi Suzuki

    29th Annual Congress of the European Society of Intensive Care Medicine  2016年10月5日 

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    記述言語:英語   会議種別:口頭発表(一般)  

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  • 酸素化の目標はいくらにすべきか? 招待

    鈴木 聡

    第43回日本集中治療医学会学術集会  2016年2月13日 

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    記述言語:日本語   会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 周術期データの一元管理を可能にする患者情報管理システムの構築~当院におけるシステムリプレースの経験~ 招待

    鈴木 聡

    日本麻酔科学会第66回学術集会  2019年5月31日 

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    開催年月日: 2019年5月30日 - 2019年6月1日

    記述言語:日本語   会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 周術期チームによる術後せん妄管理 招待

    鈴木 聡

    日本麻酔科学会第69回学術集会  2022年6月18日 

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    記述言語:日本語   会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • SSI 予防として高濃度酸素を投与する 「Con: SSI予防として高濃度酸素投与を推奨しない」 招待

    鈴木 聡

    第34回日本外科感染症学会総会学術集会  2021年12月17日 

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    会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 周術期管理に必要な基本手技のコツとピットフォール ~日常的なものから特定行為まで~

    鈴木 聡

    2021年度日本麻酔科学会支部周術期管理チームセミナー WEB開催  2021年9月 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • Pros&Cons 周術期患者の目標 SpO2 「Pros:高めの SpO2を目標とする」 招待

    鈴木 聡

    第43回日本呼吸療法医学会学術集会  2021年7月4日 

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    会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 集中治療患者の SpO2の目標値 「高濃度酸素の弊害」 招待

    鈴木 聡

    第43回日本呼吸療法医学会学術集会  2021年7月4日 

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    会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 「外傷患者の hyperoxia は許容できるか?」 Cons:酸素療法は諸刃の剣 招待

    鈴木 聡

    第34回日本外傷学会総会・学術集会  2020年12月8日 

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    会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 周術期管理チームセミナー 「周術期医療の質向上を目指す体温管理」 招待

    鈴木 聡

    日本麻酔科学会中国・四国支部第56回学術集会  2019年9月7日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 解熱・鎮痛のABC 招待

    鈴木 聡

    第28回日本医療薬学会年会  2018年11月25日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 臨床研究テーマの選び方(医師向け) 招待

    鈴木 聡

    日本集中治療医学会 第3回 臨床研究セミナー  2018年10月7日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 周術期管理チームセミナー「術直後の患者管理 ~回復室の役割~」 招待

    鈴木 聡

    九州麻酔科学会第56回大会  2018年9月8日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 鎮痛のABC 招待

    鈴木 聡

    日本集中治療医学会第2回東海北陸支部学術集会  2018年6月9日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • ここが知りたい!解熱薬としてのアセトアミノフェン静注液の素朴な疑問 招待

    鈴木 聡

    第45回日本集中治療医学会学術集会  2018年2月23日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • Pros & Cons 人工呼吸中の目標 SaO2 Con: CONVENTIONAL (SaO2 97-100%) 招待

    鈴木 聡

    第45回日本集中治療医学会学術集会  2018年2月22日 

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    会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 敗血症患者の体温管理 ―明日から役立つ基礎知識― 招待

    鈴木 聡

    第45回日本集中治療医学会学術集会  2018年2月22日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 周術期管理チームセミナー「術中呼吸管理(SpO2モニタ・人工呼吸)」 招待

    日本麻酔科学会中国・四国支部第54回学術集会  2017年9月2日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 敗血症:議論の分かれる治療法(Pro-Con 形式による PBLD) 招待

    鈴木 聡

    日本麻酔科学会第 64 回学術集会  2017年6月8日 

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    会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 観察研究を計画しよう「アウトカム;How to define meaningful outcome」 招待

    鈴木 聡

    第44回日本集中治療医学会学術集会  2017年3月11日 

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    会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 集中治療室におけるアセトアミノフェン静注液 ~ 3 年目で見えてきた課題と展望~ 招待

    鈴木 聡

    第44回日本集中治療医学会学術集会  2017年3月9日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • ICU における解熱剤としてのアセトアミノフェン静注液 招待

    鈴木 聡

    日本小児麻酔学会 第22回大会  2016年10月8日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 周術期管理チームセミナー「術中管理・モニタリング」 招待

    鈴木 聡

    日本麻酔科学会中国・四国支部第53回学術集会  2016年9月10日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • ICU における解熱剤としてのアセトアミノフェン静注液 招待

    鈴木 聡

    第24回 日本集中治療医学会 東海北陸地方会 総会・学術集会  2016年6月25日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • SpO2のピットフォール 招待

    鈴木 聡

    日本麻酔科学会第63回学術集会  2016年5月27日 

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    会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 重症患者の発熱に対するアセトアミノフェン静注液の可能性を探る 招待

    鈴木 聡

    2016年2月13日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 臨床研究を行う際のデータベースの作成法 招待

    鈴木 聡

    第43回日本集中治療医学会学術集会  2016年2月12日 

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    会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 集中治療最新文献厳選 42 ─最新知見をうまく臨床応用するには─ 呼吸 招待

    鈴木 聡

    第42回日本集中治療医学会学術集会  2015年2月11日 

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    会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • Conservative oxygen therapy(酸素制限療法)の呼吸器モードと放射線画像所見に対する影響

    鈴木 聡, Eastwood G, Bellomo R

    第42回日本集中治療医学会学術集会  2015年2月10日 

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    会議種別:シンポジウム・ワークショップ パネル(公募)  

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  • 海外集中治療分野におけるアセトアミノフェン静注液の活用 招待

    鈴木 聡

    日本臨床麻酔学会 第34回大会  2014年11月1日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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▼全件表示

共同研究・競争的資金等の研究

  • 周術期酸素療法における高酸素血症に関する研究

    研究課題/領域番号:16K20097  2016年04月 - 2020年03月

    日本学術振興会  科学研究費助成事業  若手研究(B)

    鈴木 聡

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    配分額:4030000円 ( 直接経費:3100000円 、 間接経費:930000円 )

    本研究の目的は、全身麻酔時の人工呼吸管理中の酸素療法と、術後合併症、患者予後との関連を明らかにすることである。国内43施設1498人を対象とした横断的な研究では、80%以上で高酸素血症が発生し、特に肺手術で用いられる分離肺換気中に過剰な酸素投与に曝されるリスクが大きいことが分かった。この結果は、次の介入研究を正当化するものであり、分離肺換気を必要とする全身麻酔中において、酸素の使用を厳重に管理する方法と、酸素の使用を制限していない従来の管理方法を比較するランダム化比較試験を計画し、倫理委員会の承認を得たところである。

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