研究者詳細 - 岩崎　達雄

論文 - 岩崎　達雄

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複雑心奇形を有する成人先天性心疾患患者に対するCatheter Intervention

馬場健児, 大月審一, 近藤麻衣子, 栗田佳彦, 栄徳隆裕, 重光祐輔, 平井健太, 福嶋遙佑, 岩崎達雄, 笠原真悟

日本成人先天性心疾患学会雑誌 6 ( 1 ) 118 - 118 2017年1月

大手術後の重篤な有害事象を評価・予測するための観察研究査読

Shiozaki Kyoko, Morimatsu Hiroshi, Matsusaki Takashi, Iwasaki Tatsuo

Acta Med Okayama 70 ( 6 ) 461 - 467 2016年12月

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

Many patients suffer from postoperative serious adverse events (SAEs). Here we sought to determine the incidence of SAEs, assess the accuracy of currently used scoring systems in predicting postoperative SAEs, and determine whether a combination of scoring systems would better predict postoperative SAEs. We prospectively evaluated patients who underwent major surgery. We calculated 4 scores: American Society of Anesthesiologists physical status (ASA-PS) score, the Charlson Score, the POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) score, and the Surgical Apgar Score (SAS). We assessed the occurrence of SAEs. We assessed the association between each score and SAEs. We combined these scoring systems to find the best combination to predict the occurrence of SAEs. Among 284 patients, 43 suffered SAEs. All scoring systems could predict SAEs. However, their predictive power was not high (the area under the receiver operating characteristic curves [AUROC] 0.6-0.7). A combination of the ASA-PS score and the SAS was the most predictive of postoperative SAEs (AUROC 0.714). The incidence of postoperative SAEs was 15.1 . The combination of the ASA-PS score and the SAS may be a useful tool for predicting postoperative serious adverse events after major surgery.

DOI： 10.18926/AMO/54809

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2017326186

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査読

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

日集中医誌 2016年3月

Storage duration of transfused red blood cells is not significantly associated with postoperative adverse events in pediatric cardiac surgery patients 査読国際誌

Hirokazu Kawase,Moritoki Egi,Tomoyuki Kanazawa*,Kazuyoshi Shimizu*,Yuichiro Toda,Tatsuo Iwasaki*,Kiyoshi Morita

Transfusion and Apheresis Science, Transfusion Science, Plasma Therapy and Transfusion Technology 54 ( 1 ) 111 - 116 2016年2月

Effect of the Pulsatile Extracorporeal Membrane Oxygenation on Hemodynamic Energy and Systemic Microcirculation in a Piglet Model of Acute Cardiac Failure 査読

Hideshi Itoh,Shingo Ichiba,Yoshihito Ujike,Takuma Douguchi,Hideaki Obata,Syuji Inamori, Tatsuo Iwasaki, Shingo Kasahara, Shunji Sano, Akif Undar

Artificial Organs 40 ( 1 ) 19 - 26 2016年1月

小児心臓手術後の急性腎不全の発症を尿中アルブミン値で予測する：前向き観察研究査読国際誌

J Cardiothorac Vasc Anest 30 ( 1 ) 64 - 8 2016年1月

238

Yasutoshi Kuroe, Tomoyuki Kanazawa, Naohiro Shioji, Kentaro Sugimoto, Tomohiko Suemori, Kazuyoshi Shimizu, Tatsuo Iwasaki, Hiroshi Morimatsu

Critical Care Medicine 44 136 - 136 2016年

左心低形成症候群患者における冠動脈内自家心筋前駆細胞移植：TICAP前向き第1相対照試験査読

Circulation Research 2015年9月

小児心臓手術患者における術中乳酸値変化と術後転帰の関連性：レトロスペクティブ観察研究査読国際誌

BMC Anesthesiol 15 29 - 29 2015年7月

成人先天性疾患に対するカテーテル治療成人期のSingle Ventricle PhysiologyにおけるCatheter Interventionの役割

馬場健児, 大月審一, 近藤麻衣子, 栗田佳彦, 栄徳隆裕, 重光祐輔, 福嶋遙佑, 平井健太, 佐野俊二, 笠原真悟, 岩崎達雄

日本小児循環器学会雑誌 31 ( Suppl.1 ) s1 - 130 2015年7月

筋弛緩薬投与を契機に呼吸循環不全が劇的に改善した肺高血圧症合併のFallot四徴症の一例査読

石井南穗子, 金澤伴幸, 清水一好, 戸田雄一郎, 川瀬宏和, 武藤典子, 杉本健太郎, 岩崎達雄, 森松博史, 森田潔

日本小児麻酔学会誌 20 ( 1 ) 260 - 263 2014年8月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：日本小児麻酔学会

1歳6ヵ月男児。生下時にFallot四徴症と診断され、Blalock-Taussigシャント術、狭窄に対する頻回のバルーン拡張術、狭窄解除術が施行されていた。今回、左肺動脈(PA)狭窄に対しカテーテルによるバルーン拡張術が施行された。術中にPA損傷による肺出血を来たし、術前からの低酸素血症もあるため、術後ICUで筋弛緩薬を用いた完全鎮静・抜管管理を行うこととした。ICU入室後に肺出血は消失したが、低酸素血症は遷延した。PAの著明狭窄に伴う肺高血圧症と肺出血による肺のコンプライアンス低下が問題であったため、人工呼吸器のモードは鎮静下に自発呼吸を温存することが有利と考え、ICU入室2日目に筋弛緩薬の投与を中止したところ、呼吸循環不全を生じた。ICU入室5日目に筋弛緩薬投与を再開したところ、呼吸循環動態は著明に改善し、11日目に抜管に至り、18日目には一般病棟に転棟することができた。

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チームで実践するECMO管理査読

伊藤英史, 市場晋吾, 氏家良人, 岩崎達雄, 大藤剛宏, 笠原真悟, 佐野俊二

日本小児循環器学会雑誌 30 ( Suppl. ) s392 - s392 2014年6月

胎児診断に基く周産期治療左心低形成症候群high risk症例の周産期、周術期計画胎児診断からのアプローチ

近藤麻衣子, 大月審一, 馬場健児, 大野直幹, 栗田佳彦, 栄徳隆裕, 佐野俊二, 篠原真悟, 岩崎達雄, 戸田雄一郎, 清水一好

日本小児循環器学会雑誌 30 ( Suppl. ) s154 - s154 2014年6月

複雑心奇形の周術期管理並列循環症例の管理

岩崎達雄, 戸田雄一郎, 清水一好, 金澤伴幸, 森松博史, 森田潔

日本臨床麻酔学会誌 34 ( 2 ) 169 - 176 2014年3月

記述言語：日本語出版者・発行元：日本臨床麻酔学会

先天性心疾患で最もその生理が成人と異なり管理が困難な症例は,並列循環を伴う単心室症である.これらの患児は,まず第一期姑息術を受けるが,術後にも並列循環が残存するため周術期管理ではこの並列循環の管理が大切になる.理想的な並列循環を達成するために動脈血酸素飽和度のみならず体静脈血酸素飽和度をモニタリングして循環動態を正確に把握する.また体静脈血酸素飽和度は患児の予後予測,目標指向型治療の指標としても有用である.体・肺血流のバランスをとるために心拍出量,体・肺血管抵抗を調節するが,第一期姑息術後では体血管抵抗を調節する方がより効果的で,積極的な後負荷軽減療法は並列循環を安定させ,術後合併症を低減する.(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=2014&ichushi_jid=J01620&link_issn=&doc_id=20140319200001&doc_link_id=%2Fci4jjsca%2F2014%2F003402%2F001%2F0169-0176%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fci4jjsca%2F2014%2F003402%2F001%2F0169-0176%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

[Increase in serum vecuronium concentration following sugammadex administration in a pediatric patient after prolonged sedation].

Tatsuhiko Shimizu, Yuichiro Toda, Kazuyoshi Shimizu, Tatsuo Iwasaki, Tomoyuki Kanazawa, Noriko Ishii, Kentaro Sugimoto, Hirokazu Kawase, Kiyoshi Morita

Masui. The Japanese journal of anesthesiology 62 ( 10 ) 1225 - 9 2013年10月

記述言語：日本語掲載種別：研究論文（学術雑誌）

It is known that blood concentration of rocuronium increases after administration of sugammadex, but this is not clear in the case of vecuronium. We report a pediatric case in which serum vecuronium concentration increased following sugammadex administration after prolonged sedation using vecuronium. A 19-month-old girl weighing 7.8 kg had a history of aortic valvuloplasty at 4 months of age due to truncus arteriosus. She presented again to our hospital due to aortic regurgitation. She underwent aortic valvuloplasty and then aortic valve replacement. The postoperative course was complicated with severe heart failure and acute kidney injury requiring peritoneal dialysis. For that reason she required long-term sedation including administration of a large amount of muscle relaxant due to severe low cardiac output syndrome after aortic valvuloplasty. A total of 615 mg (79 mg x kg(-1)) of vecuronium was administered over a period of 24 days. On weaning from mechanical ventilation, 125 mg (16 mg x kg(-1)) of sugammadex was given. Vecuronium concentration measured by high-performance liquid chromatography (HPLC) was 5.03 ng x ml(-1) before sugammadex administration and increase to 13.98 ng x ml(-1) after that. However, blood concentration of metabolic products of vecuronium did not exceed the lower limits of measurement in each sample. She was successfully weaned from mechanical ventilation without recurarizarion. Serum concentration of vecuronium increased after administration of sugammadex because extravascular vecuronium was redistributed to intravascular space according to the concentration gradient induced by binding and clathration of vecuronium. The measured values of vecuronium after sugammadex administration on HPLC represented the total amount of free vecuronium and vecuronium combined with sugammadex. Recurarization might occur after sugammadex reversal in patients after long-term administration of vecuronium, especially if relatively smaller doses of sugammadex were given. We experienced a pediatric case in which serum vecuronium concentration increased following sugammadex administration after prolonged sedation using vecuronium. There is a risk of recurarization after sugammadex reversal in patients after long-term administration of vecuronium.

PubMed

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新生児・乳児心臓手術の周術期管理総肺静脈還流異常(TAPVC)

戸田雄一郎, 岩崎達雄, 清水一好, 金澤伴幸, 杉本健太郎, 川瀬宏和, 石井典子, 森田潔

Cardiovascular Anesthesia 17 ( 1 ) 61 - 63 2013年8月

LVOTOを伴うTGAに対するPulmonary root translocationの有用性について

栄徳隆裕, 大月審一, 馬場健児, 大野直幹, 近藤麻衣子, 栗田佳彦, 小寺亜矢, 佐野俊二, 笠原真悟, 岩崎達雄, 戸田雄一郎

日本小児循環器学会雑誌 29 ( Suppl. ) s284 - s284 2013年6月

General anesthesia for pediatric cardiac catheterization - Effects of anesthetics on blood pressure, heart rate, oxygen saturation, and carbon dioxide 査読

Yuichiro Toda, Mamoru Takeuchi, Naoyuki Taga, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tomohiko Suemori, Kiyoshi Morita

Japanese Journal of Anesthesiology 61 ( 12 ) 1312 - 1315 2012年12月

記述言語：日本語掲載種別：研究論文（学術雑誌）

Background : There are limited data about the correlations between amount of anesthetics and variations in vital signs during pediatric cardiac catheterization. Methods : Data in 80 children with congenital heart disease undergoing cardiac catheterization with/without interventional cardiology in 2004 were examined in this retrospective cohort study. Data on blood pressure, heart rate, oxygen saturation, partial tension in end tidal carbon dioxide (PETCO2), and total amount of anesthetics given during general anesthesia were obtained from anesthetic charts. The correlations between amount of anesthetics and those vital signs were analyzed. Results : Median age of the patients was 14 months and median body weight was 8.8 kg. Median rates of variation in heart rate, blood pressure, oxygen saturation and PETCO2 were 22.8%, 29.3%, 5.9% and 10.8%, respectively. Although there were no statistical correlations between those vital signs and amounts of anesthetics such as fentanyl, vecuronium and sevoflurane, rates of variation in heart rate was smaller in patients for whom the amount of fentanyl given was more than 4 μg·kg-1·hr-1. Conclusions : There were no associations between amount of anesthetics and variations in vital signs in pediatric cardiac catheterization.

Scopus

PubMed

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Pacing lead extraction using an excimer laser sheath under general anesthesia 査読

Satoshi Kimura, Yuichiro Toda, Kentaro Sugimoto, Noriko Ishii, Kazuyoshi Shimizu, Tomohiko Suemori, Tatsuo Iwasaki, Kiyoshi Morita

Japanese Journal of Anesthesiology 61 ( 11 ) 1277 - 1280 2012年11月

記述言語：日本語掲載種別：研究論文（学術雑誌）

An excimer laser sheath has recently been used for extraction of pacing and ICD leads. By using this technique, leads are removed more easily and it has to take a shorter time to extract leads. Although lead extraction with this method can cause fatal complications such as large vessel injury, little has been reported regarding anesthetic management during the lead extraction. We experienced two cases of pacing lead extraction using an excimer laser sheath under general anesthesia. The procedures were mainly performed by cardiologists in the operating theater. A wide area was prepared with sterile drapes as for cardiac surgery with cardiovascular surgeons standing by. Vascular access catheters were placed in the right femoral artery as well as vein, and in the right internal jugular vein so that immediate PCPS introduction could be performed in case of sudden hemodynamic collapse by massive bleeding. In the first case, lead extraction was completed without any complication, but in the second case sternotomy was performed by cardiac surgeons for safe separation of leads from vessels. There were also no bleeding episodes in the second case. Preparation for bleeding and cooperation among cardiologists, cardiovascular surgeons, medical engineers and anesthesiologists are necessary from the safety point of view of this procedure under general anesthesia.

Scopus

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先天性心疾患に対する姑息手術中に発生しうる危険な出来事

清水一好, 戸田雄一郎, 金澤伴幸, 石井典子, 杉本健太郎, 川瀬宏和, 岩崎達雄, 森田潔

Cardiovascular Anesthesia 16 ( 1 ) 131 - 136 2012年8月

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