JaLCDOI 10.18926/AMO/53021
FullText URL 68_6_323.pdf
Author Hirayama, Takahiro| Nagano, Osamu| Shiba, Naoki| Yumoto, Tetsuya| Sato, Keiji| Terado, Michihisa| Ugawa, Toyomu| Ichiba, Shingo| Ujike, Yoshihito|
Abstract In adult high-frequency oscillatory ventilation (HFOV), stroke volume (SV) and mean lung pressure (PLung) are important for lung protection. We measured the airway pressure at the Y-piece and the lung pressure during HFOV using a lung model and HFOV ventilators for adults (R100 and 3100B). The lung model was made of a 20-liter, airtight rigid plastic container (adiabatic compliance: 19.3ml/cmH<sub>2</sub>O) with or without a resistor (20cmH<sub>2</sub>O/l/sec). The ventilator settings were as follows: mean airway pressure (MAP), 30cmH2O;frequency, 5-15Hz (every 1Hz);airway pressure amplitude (AMP), maximum;and % of inspiratory time (IT), 50% for R100, 33% or 50% for 3100B. The measurements were also performed with an AMP of 2/3 or 1/3 maximum at 5, 10 and 15Hz. The PLung and the measured MAP were not consistently identical to the setting MAP in either ventilator, and decreasing IT decreased the PLung in 3100B. In conclusion, we must pay attention to the possible discrepancy between the PLung and the setting MAP during adult HFOV.
Keywords HFOV mean lung pressure mean airway pressure
Amo Type Original Article
Published Date 2014-12
Publication Title Acta Medica Okayama
Volume volume68
Issue issue6
Publisher Okayama University Medical School
Start Page 323
End Page 329
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25519026
Web of Sience KeyUT 000346882200002
Related Url http://ousar.lib.okayama-u.ac.jp/metadata/53132
JaLCDOI 10.18926/AMO/49040
FullText URL 66_6_443.pdf
Author Ugawa, Toyomu| Sakurama, Kazufumi| Yorifuji, Takashi| Takaoka, Munenori| Fujiwara, Yasuhiro| Kabashima, Narutoshi| Azuma, Daisuke| Hirayama, Takahiro| Tsukahara, Kohei| Morisada, Sunao| Iida, Atsuyoshi| Tada, Keitaro| Shiba, Naoki| Sato, Nobuo| Ichiba, Shingo| Kino, Koichi| Fukushima, Masaki| Ujike, Yoshihito|
Abstract The functioning of an arteriovenous fistula (AVF) used for vascular access during hemodialysis has been assessed mainly by dilution methods. Although these techniques indicate the immediate recirculation rate, the results obtained may not correlate with Kt/V. In contrast, the clearance gap (CL-Gap) method provides the total recirculation rate per dialysis session and correlates well with Kt/V. We assessed the correlation between Kt/V and CL-Gap as well as the change in radial artery (RA) blood flow speed in the fistula before percutaneous transluminal angioplasty (PTA) in 45 patients undergoing continuous hemodialysis. The dialysis dose during the determination of CL-Gap was 1.2 to 1.4 Kt/V. Patients with a 10% elevation or more than a 10% relative increase in CL-Gap underwent PTA (n=45), and the values obtained for Kt/V and CL-Gap before PTA were compared with those obtained immediately afterward. The mean RA blood flow speed improved significantly (from 52.9 to 97.5cm/sec) after PTA, as did Kt/V (1.07 to 1.30) and CL-Gap (14.1% to -0.2%). A significant correlation between these differences was apparent (r=-0.436 and p=0.003). These findings suggest that calculating CL-Gap may be useful for determining when PTA is required and for assessing the effectiveness of PTA, toward obtaining better dialysis.
Keywords hemodialysis recirculation clearance gap vascular access percutaneous transluminal angioplasty
Amo Type Original Article
Published Date 2012-12
Publication Title Acta Medica Okayama
Volume volume66
Issue issue6
Publisher Okayama University Medical School
Start Page 443
End Page 447
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2012 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 23254578
Web of Sience KeyUT 000312966100003
JaLCDOI 10.18926/AMO/48688
FullText URL 66_4_335.pdf
Author Shiba, Naoki| Nagano, Osamu| Hirayama, Takahiro| Ichiba, Shingo| Ujike, Yoshihito|
Abstract In adult high-frequency oscillatory ventilation (HFOV) with an R100 artificial ventilator, exhaled gas from patientʼs lung may warm the temperature probe and thereby disturb the humidification of base flow (BF) gas. We measured the humidity of BF gas during HFOV with frequencies of 6, 8 and 10Hz, maximum stroke volumes (SV) of 285, 205, and 160ml at the respective frequencies, and, BFs of 20, 30, 40l/min using an original lung model. The R100 device was equipped with a heated humidifier, HummaxⅡ, consisting of a porous hollow fiber in circuit. A 50-cm length of circuit was added between temperature probe (located at 50cm proximal from Y-piece) and the hollow fiber. The lung model was made of a plastic container and a circuit equipped with another HummaxⅡ. The lung model temperature was controlled at 37℃. The HummaxⅡ of the R100 was inactivated in study-1 and was set at 35℃ or 37℃ in study-2. The humidity was measured at the distal end of the added circuit in study-1 and at the proximal end in study-2. In study-1, humidity was detected at 6Hz (SV 285ml) and BF 20l/min, indicating the direct reach of the exhaled gas from the lung model to the temperature probe. In study-2 the absolute humidity of the BF gas decreased by increasing SV and by increasing BF and it was low with setting of 35℃. In this study setting, increasing the SV induced significant reduction of humidification of the BF gas during HFOV with R100.
Keywords HFOV humidification
Amo Type Original Article
Published Date 2012-08
Publication Title Acta Medica Okayama
Volume volume66
Issue issue4
Publisher Okayama University Medical School
Start Page 335
End Page 341
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2012 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22918206
Web of Sience KeyUT 000307918900006
Author Ichiba, Shingo|
Published Date 2012-04-01
Publication Title 岡山医学会雑誌
Volume volume124
Issue issue1
Content Type Journal Article
JaLCDOI 10.18926/AMO/47266
FullText URL 65_6_403.pdf
Author Waseda, Koichi| Tanimoto, Yasushi| Ichiba, Shingo| Miyahara, Nobuaki| Murakami, Toshi| Ochi, Nobuaki| Terado, Michihisa| Nagano, Osamu| Maeda, Yoshinobu| Kanehiro, Arihiko| Ujike, Yoshihito| Tanimoto, Mitsune|
Abstract Bronchiolitis obliterans (BO) is a disease with a poor prognosis, and a key factor that limits long-term survival after allogeneic hematopoietic stem cell transplantation (HSCT). We here report a case of a 31-year woman with acute lymphatic leukemia, which was treated by chemotherapy and HSCT, and consequently developed BO 2 years after HSCT. A non-tuberculous mycobacterial infection occurred and showed gradual exacerbation. She started taking anti-mycobacterial drugs, but lost appetite, felt tired and finally lost consciousness one month after beginning medication. Arterial blood gas revealed marked hypercapnia. Using extracorporeal life support (ECLS), the carbon dioxide concentration was reduced and her consciousness recovered. To our knowledge, this is the first case in which ECLS was successfully used for hypercapnia in a patient with BO.
Keywords extracorporeal life support hypercapnia bronchiolitis obliterans noninvasive positive pressure ventilation
Amo Type Case Report
Published Date 2011-12
Publication Title Acta Medica Okayama
Volume volume65
Issue issue6
Publisher Okayama University Medical School
Start Page 403
End Page 406
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22189481
Web of Sience KeyUT 000298516900007