start-ver=1.4
cd-journal=joma
no-vol=68
cd-vols=
no-issue=5
article-no=
start-page=285
end-page=290
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2014
dt-pub=201410
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=A New Classification System for Evaluating Patients with Severe Trauma Using B-type Natriuretic Peptide Levels and Estimated Glomerular Filtration Rate
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Current systems for the evaluation of trauma severity are tedious and difficult to apply in an actual emergency setting. We aimed to develop and assess the accuracy of a more efficient severity evaluation system, termed the Ugawa classification, using brain-type natriuretic peptide (BNP) measurement and the estimated glomerular filtration rate (eGFR). Two-hundred trauma patients were divided into 2 groups using an eGFR cut-off value of 90ml/min/1.73m2 as an indicator of normal renal function and 2 additional groups according to whether the BNP values were greater or less than the age in years. This resulted in 4 subject groups with different combinations of eGFR and BNP. The mean SOFA score, injury severity scores (ISS), trauma and injury severity scores (TRISS), and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores of the groups were compared by Kruskal-Wallis test, and the mortality rate after 90 days was calculated. Significant intergroup differences were found in SOFA scores, ISS scores, and APACHE II-predicted mortality rates. Although no significant differences were found in the mortality rate after 90 days or TRISS-predicted mortality rate among the 4 groups, there was a trend toward increasing trauma severity from group 1 to 4. Thus, the Ugawa classification is as accurate as existing systems, has greater efficiency, and is user-friendly.
en-copyright=
kn-copyright=
en-aut-name=MorisadaSunao
en-aut-sei=Morisada
en-aut-mei=Sunao
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=UgawaToyomu
en-aut-sei=Ugawa
en-aut-mei=Toyomu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=NosakaNobuyuki
en-aut-sei=Nosaka
en-aut-mei=Nobuyuki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=UjikeYoshihito
en-aut-sei=Ujike
en-aut-mei=Yoshihito
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
affil-num=1
en-affil=
kn-affil=Advanced Emergency and Critical Care Center of Okayama University Hospital
affil-num=2
en-affil=
kn-affil=Advanced Emergency and Critical Care Center of Okayama University Hospital
affil-num=3
en-affil=
kn-affil=Advanced Emergency and Critical Care Center of Okayama University Hospital
affil-num=4
en-affil=
kn-affil=Advanced Emergency and Critical Care Center of Okayama University Hospital
en-keyword=acute injury
kn-keyword=acute injury
en-keyword=Acute Physiology and Chronic Health Evaluation II
kn-keyword=Acute Physiology and Chronic Health Evaluation II
en-keyword=injury severity score
kn-keyword=injury severity score
en-keyword=sequential organ failure assessment
kn-keyword=sequential organ failure assessment
en-keyword=trauma and injury severity score
kn-keyword=trauma and injury severity score
END
start-ver=1.4
cd-journal=joma
no-vol=68
cd-vols=
no-issue=6
article-no=
start-page=323
end-page=329
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2014
dt-pub=201412
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Mean Lung Pressure during Adult High-Frequency Oscillatory Ventilation: An Experimental Study Using a Lung Model
en-subtitle=
kn-subtitle=
en-abstract=
kn-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/cmH2O) with or without a resistor (20cmH2O/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.
en-copyright=
kn-copyright=
en-aut-name=HirayamaTakahiro
en-aut-sei=Hirayama
en-aut-mei=Takahiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=NaganoOsamu
en-aut-sei=Nagano
en-aut-mei=Osamu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=ShibaNaoki
en-aut-sei=Shiba
en-aut-mei=Naoki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=YumotoTetsuya
en-aut-sei=Yumoto
en-aut-mei=Tetsuya
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=SatoKeiji
en-aut-sei=Sato
en-aut-mei=Keiji
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
en-aut-name=TeradoMichihisa
en-aut-sei=Terado
en-aut-mei=Michihisa
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=
en-aut-name=UgawaToyomu
en-aut-sei=Ugawa
en-aut-mei=Toyomu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=
en-aut-name=IchibaShingo
en-aut-sei=Ichiba
en-aut-mei=Shingo
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=8
ORCID=
en-aut-name=UjikeYoshihito
en-aut-sei=Ujike
en-aut-mei=Yoshihito
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=9
ORCID=
affil-num=1
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=2
en-affil=
kn-affil=Department of Disaster and Emergency Medicine, Kochi University
affil-num=3
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=4
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=5
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=6
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=7
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=8
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=9
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
en-keyword=HFOV
kn-keyword=HFOV
en-keyword=mean lung pressure
kn-keyword=mean lung pressure
en-keyword=mean airway pressure
kn-keyword=mean airway pressure
END
start-ver=1.4
cd-journal=joma
no-vol=69
cd-vols=
no-issue=4
article-no=
start-page=213
end-page=218
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2015
dt-pub=201508
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Prevalence, Risk Factors, and Short-term Consequences of Traumatic Brain Injury-associated Hyponatremia
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Hyponatremia, a common electrolyte disorder associated with traumatic brain injuries (TBIs), has high mortality and morbidity rates. The aim of this study was to identify the risk factors for hyponatremia associated with TBI. We retrospectively analyzed the cases of TBI patients who were admitted to the emergency intensive care unit at Okayama University Hospital between October 2011 and September 2014. A total of 82 TBI patients were enrolled. The incidences of hyponatremia (serum sodium level of<135mEq/L) and severe hyponatremia (serum sodium level of<130mEq/L) within the first 14 days after admission were 51オ (n=42) and 20オ (n=16), respectively. After admission, hyponatremia took a median period of 7 days to develop and lasted for a median of 3 days. Multivariate analysis demonstrated that higher fluid intake from days 1 to 3 and the presence of cranial fractures were risk factors for hyponatremia. The 58 patients with hyponatremia experienced fewer ventilator-free days, longer intensive care unit stays, and less favorable outcomes compared to the 24 patients without hyponatremia;however, these differences were not significant. Further studies are needed to determine the optimal management strategy for TBI-associated hyponatremia in the intensive care unit setting.
en-copyright=
kn-copyright=
en-aut-name=YumotoTetsuya
en-aut-sei=Yumoto
en-aut-mei=Tetsuya
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=SatoKeiji
en-aut-sei=Sato
en-aut-mei=Keiji
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=UgawaToyomu
en-aut-sei=Ugawa
en-aut-mei=Toyomu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=IchibaShingo
en-aut-sei=Ichiba
en-aut-mei=Shingo
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=UjikeYoshihito
en-aut-sei=Ujike
en-aut-mei=Yoshihito
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
affil-num=1
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=2
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=3
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=4
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=5
en-affil=
kn-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
en-keyword=traumatic brain injury
kn-keyword=traumatic brain injury
en-keyword=hyponatremia
kn-keyword=hyponatremia
en-keyword=cranial fracture
kn-keyword=cranial fracture
en-keyword=fluid intake
kn-keyword=fluid intake
END
start-ver=1.4
cd-journal=joma
no-vol=69
cd-vols=
no-issue=5
article-no=
start-page=275
end-page=278
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2015
dt-pub=201510
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Characteristics and Costs of Ladder Fall Injuries: A Report from a Single Emergency Center in Okayama
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=We sought to identify the incidence, injury patterns, and financial burden of ladder fall injuries to provide a reference for reinforcing guidelines on the prevention of such injuries. We enrolled the patients who were injured in a ladder-related fall and required intensive care between April 2012 and March 2014 at Okayama University Hospital, a tertiary care hospital in Okayama City:9 patients injured in 7 stepladder falls and 2 straight ladder falls. The median patient age was 69 years, and 8 were males. Six falls occurred in non-occupational settings. Head injuries predominated, and the injury severity score ranged from 2 to 35 (mean=21±12). At the time of discharge from the intensive care unit, one patient had died and 5 patients had some neurological disabilities. The case fatality rate was 11%. The total cost of care during the review period was ¥16,705,794, with a mean cost of
¥1,856,199 per patient. Ladder fall injuries are associated with a high rate of neurological sequelae and pose a financial burden on the health insurance system. A prevention education campaign targeting at older-aged males in non-occupational settings may be a worthwhile health service investment in this community.
en-copyright=
kn-copyright=
en-aut-name=NosakaNobuyuki
en-aut-sei=Nosaka
en-aut-mei=Nobuyuki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=GodaYu
en-aut-sei=Goda
en-aut-mei=Yu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=KnaupEmily
en-aut-sei=Knaup
en-aut-mei=Emily
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=TsukaharaKohei
en-aut-sei=Tsukahara
en-aut-mei=Kohei
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=YumotoTetsuya
en-aut-sei=Yumoto
en-aut-mei=Tetsuya
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
en-aut-name=UgawaToyomu
en-aut-sei=Ugawa
en-aut-mei=Toyomu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=
en-aut-name=UjikeYoshihito
en-aut-sei=Ujike
en-aut-mei=Yoshihito
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=
affil-num=1
en-affil=
kn-affil=Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
affil-num=2
en-affil=
kn-affil=Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
affil-num=3
en-affil=
kn-affil=Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
affil-num=4
en-affil=
kn-affil=Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
affil-num=5
en-affil=
kn-affil=Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
affil-num=6
en-affil=
kn-affil=Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
affil-num=7
en-affil=
kn-affil=Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
en-keyword=accidental falls
kn-keyword=accidental falls
en-keyword=accident prevention
kn-keyword=accident prevention
en-keyword=hospital costs
kn-keyword=hospital costs
en-keyword=injuries
kn-keyword=injuries
en-keyword=ladder
kn-keyword=ladder
END
start-ver=1.4
cd-journal=joma
no-vol=70
cd-vols=
no-issue=5
article-no=
start-page=331
end-page=337
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2016
dt-pub=201610
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=The Clinical Application of Hydrogen as a Medical Treatment
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=In recent years, it has become evident that molecular hydrogen is a particularyl effective treatment for various disease models such as ischemia-reperfusion injury; as a result, research on hydrogen has progressed rapidly. Hydrogen has been shown to be effective not only through intake as a gas, but also as a liquid medication taken orally, intravenously, or locally. Hydrogen?s effectiveness is thus multifaceted. Herein we review the recent research on hydrogen-rich water, and we examine the possibilities for its clinical application. Now that hydrogen is in the limelight as a gaseous signaling molecule due to its potential ability to inhibit oxidative stress signaling, new research developments are highly anticipated.
en-copyright=
kn-copyright=
en-aut-name=IidaAtsuyoshi
en-aut-sei=Iida
en-aut-mei=Atsuyoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=NosakaNobuyuki
en-aut-sei=Nosaka
en-aut-mei=Nobuyuki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=YumotoTetsuya
en-aut-sei=Yumoto
en-aut-mei=Tetsuya
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=KnaupEmily
en-aut-sei=Knaup
en-aut-mei=Emily
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=NaitoHiromichi
en-aut-sei=Naito
en-aut-mei=Hiromichi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
en-aut-name=NishiyamaChihiro
en-aut-sei=Nishiyama
en-aut-mei=Chihiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=
en-aut-name=YamakawaYasuaki
en-aut-sei=Yamakawa
en-aut-mei=Yasuaki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=
en-aut-name=TsukaharaKohei
en-aut-sei=Tsukahara
en-aut-mei=Kohei
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=8
ORCID=
en-aut-name=TeradoMichihisa
en-aut-sei=Terado
en-aut-mei=Michihisa
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=9
ORCID=
en-aut-name=SatoKeiji
en-aut-sei=Sato
en-aut-mei=Keiji
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=10
ORCID=
en-aut-name=UgawaToyomu
en-aut-sei=Ugawa
en-aut-mei=Toyomu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=11
ORCID=
en-aut-name=NakaoAtsunori
en-aut-sei=Nakao
en-aut-mei=Atsunori
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=12
ORCID=
affil-num=1
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=2
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=3
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=4
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=5
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=6
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=7
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=8
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=9
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=10
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=11
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=12
en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
en-keyword=hydrogen
kn-keyword=hydrogen
en-keyword=antioxidant effect
kn-keyword=antioxidant effect
en-keyword=medical gas
kn-keyword=medical gas
en-keyword=gaseous signaling molecule
kn-keyword=gaseous signaling molecule
en-keyword=clinical tests
kn-keyword=clinical tests
END
start-ver=1.4
cd-journal=joma
no-vol=71
cd-vols=
no-issue=2
article-no=
start-page=179
end-page=180
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2017
dt-pub=201704
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Intracranial Pressure Monitoring for Pediatric Acute Encephalopathy
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Newly published clinical practice guidelines recommend intracranial pressure (ICP) monitoring in critical care for the management of pediatric acute encephalopathy (pAE), but the utility of ICP monitoring for pAE has been poorly studied. We recently performed direct ICP monitoring for two patients. We observed that although the direct ICP monitoring had clinical benefits with less body weight gain and no vasopressor use in both cases, this monitoring technique is still invasive. Future studies should determine the utility of non-invasive ICP monitoring systems in pAE to further improve the quality of intensive-care management.
en-copyright=
kn-copyright=
en-aut-name=NosakaNobuyuki
en-aut-sei=Nosaka
en-aut-mei=Nobuyuki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=TsukaharaKohei
en-aut-sei=Tsukahara
en-aut-mei=Kohei
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=KnaupEmily
en-aut-sei=Knaup
en-aut-mei=Emily
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=YabuuchiToshihiko
en-aut-sei=Yabuuchi
en-aut-mei=Toshihiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=KikkawaTomonobu
en-aut-sei=Kikkawa
en-aut-mei=Tomonobu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
en-aut-name=FujiiYosuke
en-aut-sei=Fujii
en-aut-mei=Yosuke
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=
en-aut-name=YashiroMasato
en-aut-sei=Yashiro
en-aut-mei=Masato
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=
en-aut-name=YasuharaTakao
en-aut-sei=Yasuhara
en-aut-mei=Takao
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=8
ORCID=
en-aut-name=OkadaAyumi
en-aut-sei=Okada
en-aut-mei=Ayumi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=9
ORCID=
en-aut-name=UgawaToyomu
en-aut-sei=Ugawa
en-aut-mei=Toyomu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=10
ORCID=
en-aut-name=NakaoAtsunori
en-aut-sei=Nakao
en-aut-mei=Atsunori
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=11
ORCID=
en-aut-name=TsukaharaHirokazu
en-aut-sei=Tsukahara
en-aut-mei=Hirokazu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=12
ORCID=
en-aut-name=DateIsao
en-aut-sei=Date
en-aut-mei=Isao
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=13
ORCID=
affil-num=1
en-affil=Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
kn-affil=
affil-num=2
en-affil=Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
kn-affil=
affil-num=3
en-affil=Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
kn-affil=
affil-num=4
en-affil=Department of Pediatrics, Okayama University Hospital
kn-affil=
affil-num=5
en-affil=Department of Pediatrics, Okayama University Hospital
kn-affil=
affil-num=6
en-affil=Department of Pediatrics, Okayama University Hospital
kn-affil=
affil-num=7
en-affil=Department of Pediatrics, Okayama University Hospital
kn-affil=
affil-num=8
en-affil=Department of Neurological Surgery, Okayama University Hospital
kn-affil=
affil-num=9
en-affil=Department of Pediatrics, Okayama University Hospital
kn-affil=
affil-num=10
en-affil=Advanced Emergency and Critical Care Center of Okayama University Hospital
kn-affil=
affil-num=11
en-affil=Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
kn-affil=
affil-num=12
en-affil=Department of Pediatrics, Okayama University Hospital
kn-affil=
affil-num=13
en-affil=Department of Neurological Surgery, Okayama University Hospital
kn-affil=
en-keyword=cerebral perfusion
kn-keyword=cerebral perfusion
en-keyword=encephalopathy
kn-keyword=encephalopathy
en-keyword=child
kn-keyword=child
en-keyword=intracranial pressure
kn-keyword=intracranial pressure
en-keyword=neurological intensive care
kn-keyword=neurological intensive care
END
start-ver=1.4
cd-journal=joma
no-vol=127
cd-vols=
no-issue=3
article-no=
start-page=203
end-page=207
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2015
dt-pub=20151201
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=Non-high-output cardiac failure in patients undergoing hemodialysis through an arteriovenous shunt
kn-title=透析シャント心不全―非過大シャント心不全 “Non-High-Output Cardiac Failure”の病態―
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Background: Hemodialysis-related heart failure has been considered to be associated with excessive blood flow through the arteriovenous (AV) shunt used for vascular access. However, some patients undergoing dialysis have heart failure in the absence of an increase in cardiac output (CO) related to shunt blood-flow loading because the loading cannot be compensated for by increasing CO. This condition may be challenging to manage ; thus, early diagnosis is important.
Methods and Results: Twelve patients (mean age, 71 years ; 9 men) with end-stage renal disease, dialysis-related heart failure, a high brain natriuretic peptide (BNP) level, and a mean New York Heart Association (NYHA) class of II underwent AV shunt closure. Their cardiac index (CI), pre- and post-dialysis BNP levels, and several cardiac variables were assessed pre- and postoperatively. All patients achieved relief of heart failure symptoms and a reduction in NYHA class after AV closure, but six patients had a postoperative increase in CI (the "non-high-output" cardiac failure group), whereas the other six had a decrease in CI (the "high-output" cardiac failure group). The high-output patients had greater improvements in BNP levels and most cardiac variables compared to the non-high-output group ;
therefore, the heart failure in the non-high-output patients was considered more serious than that in the high-output group.
Conclusions: The selection of effective strategies for treating dialysis-related heart failure may depend partly on identifying which patients have non-high-output failure. Such identification requires serial measurements of BNP levels and evaluations of cardiac variables other than the ejection fraction.
en-copyright=
kn-copyright=
en-aut-name=UgawaToyomu
en-aut-sei=Ugawa
en-aut-mei=Toyomu
kn-aut-name=鵜川豊世武
kn-aut-sei=鵜川
kn-aut-mei=豊世武
aut-affil-num=1
ORCID=
affil-num=1
en-affil=
kn-affil=岡山大学大学院医歯薬学総合研究科
en-keyword=心拍出量(cardiac output)
kn-keyword=心拍出量(cardiac output)
en-keyword=心不全(heart failure)
kn-keyword=心不全(heart failure)
en-keyword=脳性ナトリウム利尿ペプチド(brain natriuretic peptide)
kn-keyword=脳性ナトリウム利尿ペプチド(brain natriuretic peptide)
en-keyword=非過大シャント心不全(non-high-output cardiac failure)
kn-keyword=非過大シャント心不全(non-high-output cardiac failure)
en-keyword=腎臓(kidney)
kn-keyword=腎臓(kidney)
END