JaLCDOI 10.18926/AMO/56645
フルテキストURL 73_2_101.pdf
著者 Iida, Atsuyoshi| Naito, Hiromichi| Yorifuji, Takashi| Zamami, Yoshito| Yamada, Akane| Koga, Tadashi| Imai, Toru| Sendo, Toshiaki| Nakao, Atsunori| Ichiba, Shingo|
抄録 Sedatives are administered during extracorporeal membrane oxygenation (ECMO) therapy to ensure patient safety, reduce the metabolic rate and correct the oxygen supply-demand balance. However, the concentrations of sedatives can be decreased due to absorption into the circuit. This study examined factors affecting the absorption of a commonly used sedative, midazolam (MDZ). Using multiple ex vivo simulation models, three factors that may influence MDZ levels in the ECMO circuit were examined: polyvinyl chloride (PVC) tubing in the circuit, use of a membrane oxygenator in the circuit, and heparin coating of the circuit. We also assessed changes in drug concentration when MDZ was re-injected in a circuit. The MDZ level decreased to approximately 60% of the initial concentration in simulated circuits within the first 30 minutes. The strongest factor in this phenomenon was contact with the PVC tubing. Membrane oxygenator use tended to increase MDZ loss, whereas heparin circuit coating had no influence on MDZ absorption. Similar results were obtained when a second dose of MDZ was injected to the second-use circuits.
キーワード sedatives ECMO polyvinyl chloride pharmacokinetics pharmacodynamics
Amo Type Original Article
発行日 2019-04
出版物タイトル Acta Medica Okayama
73巻
2号
出版者 Okayama University Medical School
開始ページ 101
終了ページ 107
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31015744
JaLCDOI 10.18926/AMO/56076
フルテキストURL 72_3_297.pdf
著者 Yamamoto, Hirotsugu| Naito, Hiromichi| Osako, Takaaki| Tsukahara, Kohei| Yamada, Taihei| Yumoto, Tetsuya| Iida, Atsuyoshi| Kosaki, Yoshinori| Oka, Makio| Endo, Fumika| Gochi, Akira| Nakao, Atsunori|
抄録 A healthy 10-year-old boy vomited during sleep and later complained of abdominal pain; he became drowsy and uncommunicative. At the nearby hospital E.R., he deteriorated rapidly, and his respiratory movements were absent with cardiac arrest. He was immediately resuscitated. Brain MRI showed no abnormalities. EEG revealed an abnormal pattern with recurrent multifocal epileptiform activity over the bilateral occipital and frontal regions during sleep. Based on the clinical/radiological findings we diagnosed Panayiotopoulos syndrome (PS), a benign form of early-onset pediatric epilepsy characterized by autonomic symptoms. Lifethreating cardiopulmonary arrest is rare in PS, but long seizure duration of PS may associate with apnea and bradycardia.
キーワード pediatric epilepsy autonomic symptom cardiac arrest afebrile seizure EEG
Amo Type Case Report
発行日 2018-06
出版物タイトル Acta Medica Okayama
72巻
3号
出版者 Okayama University Medical School
開始ページ 297
終了ページ 300
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29926008
JaLCDOI 10.18926/AMO/55859
フルテキストURL 72_2_181.pdf
著者 Tsuboi, Chika| Naito, Hiromichi| Hagioka, Shingo| Hanafusa, Hiroaki| Hirayama, Takahiro| Kosaki, Yoshinori| Iida, Atsuyoshi| Yumoto, Tetsuya| Tsukahara, Kohei| Morimoto, Naoki| Nakao, Atsunori|
抄録 The primary toxicity of hydrogen peroxide results from its interaction with catalase, which liberates water and oxygen. We report the case of a 14-year-old Japanese girl with portal venous gas that was caused by oxygen liberated from intentionally ingested hydrogen peroxide. Although she had a past history of atrial septal defect, recovery without cardiac or neurological sequelae was achieved using hyperbaric oxygen therapy. Emergency physicians must be aware of the danger of liberated oxygen due to hydrogen peroxide ingestion.
キーワード air embolism ASD breaching agent HBO intoxication
Amo Type Case Report
発行日 2018-04
出版物タイトル Acta Medica Okayama
72巻
2号
出版者 Okayama University Medical School
開始ページ 181
終了ページ 183
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29674767
JaLCDOI 10.18926/AMO/55583
フルテキストURL 71_6_467.pdf
著者 Obata, Kengo| Yumoto, Tetsuya| Fuke, Soichiro| Tsukahara, Kohei| Naito, Hiromichi| Iida, Atsuyoshi| Takahashi, Tetsuya| Ujike, Yoshihito| Nakao, Atsunori|
抄録 Early mobilization is advocated to prevent intensive care unit-acquired physical weakness, but the patient's workload and its changes in response to body position changes have not been established. We used indirect calorimetry to determine the energy expenditure (EE) in response to body position changes, and we assessed EE's correlation with respiratory parameters in healthy volunteers: 8 males and 8 females, mean age 23.4±1.3 years. The subjects started in the resting supine position followed by a 30° head-up position, a 60° head-up position, an upright sitting position, a standing position, and the resting supine position. EE was determined in real time by indirect calorimetry monitoring the subject’s respiratory rate, tidal volume (VT), and minute volume (MV). The highest values were observed immediately after the subjects transitioned from standing to supine, and this was significantly higher compared to the original supine position (1,450±285 vs. 2,004±519 kcal/day, p<0.01). Moderate correlations were observed between VT and EE (r=0.609, p<0.001) and between MV and EE (r=0.576, p<0.001). Increasing VT or MV indicates an increasing patient workload during mobilization. Monitoring these parameters may contribute to safe rehabilitation. Further studies should assess EE in critically ill patients.
キーワード early mobilization energy expenditure indirect calorimetry rehabilitation body position
Amo Type Original Article
発行日 2017-12
出版物タイトル Acta Medica Okayama
71巻
6号
出版者 Okayama University Medical School
開始ページ 467
終了ページ 473
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29276219
JaLCDOI 10.18926/AMO/49040
フルテキストURL 66_6_443.pdf
著者 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|
抄録 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.
キーワード hemodialysis recirculation clearance gap vascular access percutaneous transluminal angioplasty
Amo Type Original Article
発行日 2012-12
出版物タイトル Acta Medica Okayama
66巻
6号
出版者 Okayama University Medical School
開始ページ 443
終了ページ 447
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2012 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23254578
Web of Sience KeyUT 000312966100003