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  1. Article ; Online: Analysis of adverse events related to extracorporeal membrane oxygenation from a nationwide database of patient-safety accidents in Japan.

    Hadano, Hiroki / Kamio, Tadashi / Fukaguchi, Kiyomitsu / Sato, Mizuki / Tsunano, Yumiko / Koyama, Hiroshi

    Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs

    2023  Volume 27, Issue 1, Page(s) 15–22

    Abstract: Although adverse events related to extracorporeal membrane oxygenation have been reported, epidemiological data on life-threatening events are insufficient to study the causes of such adverse events. Data from the Japan Council for Quality Health Care ... ...

    Abstract Although adverse events related to extracorporeal membrane oxygenation have been reported, epidemiological data on life-threatening events are insufficient to study the causes of such adverse events. Data from the Japan Council for Quality Health Care database were retrospectively analyzed. The adverse events extracted from this national database included events associated with extracorporeal membrane oxygenation reported between January 2010 and December 2021. We identified 178 adverse events related to extracorporeal membrane oxygenation. At least 41 (23%) and 47 (26%) accidents resulted in death and residual disability, respectively. The most common adverse events were cannula malposition (28%), decannulation (19%), and bleeding (15%). Among patients with cannula malposition, 38% did not undergo fluoroscopy-guided or ultrasound-guided cannulation, 54% required surgical treatment, and 18% required trans-arterial embolization. In this epidemiological study in Japan, 23% of the adverse events related to extracorporeal membrane oxygenation had fatal outcomes. Our findings suggest that a training system for cannulation techniques may be needed, and hospitals offering extracorporeal membrane oxygenation should perform emergency surgeries.
    MeSH term(s) Humans ; Extracorporeal Membrane Oxygenation/adverse effects ; Extracorporeal Membrane Oxygenation/methods ; Retrospective Studies ; Japan/epidemiology ; Catheterization/adverse effects ; Catheterization/methods ; Cannula
    Language English
    Publishing date 2023-02-16
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1463555-0
    ISSN 1619-0904 ; 1434-7229
    ISSN (online) 1619-0904
    ISSN 1434-7229
    DOI 10.1007/s10047-023-01386-z
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    Zs.A 5024: Show issues Location:
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  2. Article ; Online: Relationships between double cycling and inspiratory effort with diaphragm thickness during the early phase of mechanical ventilation: A prospective observational study.

    Itagaki, Taiga / Akimoto, Yusuke / Nakano, Yuki / Ueno, Yoshitoyo / Ishihara, Manabu / Tane, Natsuki / Tsunano, Yumiko / Oto, Jun

    PloS one

    2022  Volume 17, Issue 8, Page(s) e0273173

    Abstract: Background: Increased and decreased diaphragm thickness during mechanical ventilation is associated with poor outcomes. Some types of patient-ventilator asynchrony theoretically cause myotrauma of the diaphragm. However, the effects of double cycling on ...

    Abstract Background: Increased and decreased diaphragm thickness during mechanical ventilation is associated with poor outcomes. Some types of patient-ventilator asynchrony theoretically cause myotrauma of the diaphragm. However, the effects of double cycling on structural changes in the diaphragm have not been previously evaluated. Hence, this study aimed to investigate the relationship between double cycling during the early phase of mechanical ventilation and changes in diaphragm thickness, and the involvement of inspiratory effort in the occurrence of double cycling.
    Methods: We evaluated adult patients receiving invasive mechanical ventilation for more than 48 h. The end-expiratory diaphragm thickness (Tdiee) was assessed via ultrasonography on days 1, 2, 3, 5 and 7 after the initiation of mechanical ventilation. Then, the maximum rate of change from day 1 (ΔTdiee%) was evaluated. Concurrently, we recorded esophageal pressure and airway pressure on days 1, 2 and 3 for 1 h during spontaneous breathing. Then, the waveforms were retrospectively analyzed to calculate the incidence of double cycling (double cycling index) and inspiratory esophageal pressure swing (ΔPes). Finally, the correlation between double cycling index as well as ΔPes and ΔTdiee% was investigated using linear regression models.
    Results: In total, 19 patients with a median age of 69 (interquartile range: 65-78) years were enrolled in this study, and all received pressure assist-control ventilation. The Tdiee increased by more than 10% from baseline in nine patients, decreased by more than 10% in nine and remained unchanged in one. The double cycling indexes on days 1, 2 and 3 were 2.2%, 1.3% and 4.5%, respectively. There was a linear correlation between the double cycling index on day 3 and ΔTdiee% (R2 = 0.446, p = 0.002). The double cycling index was correlated with the ΔPes on days 2 (R2 = 0.319, p = 0.004) and 3 (R2 = 0.635, p < 0.001).
    Conclusions: Double cycling on the third day of mechanical ventilation was associated with strong inspiratory efforts and, possibly, changes in diaphragm thickness.
    MeSH term(s) Adult ; Aged ; Diaphragm/diagnostic imaging ; Humans ; Positive-Pressure Respiration ; Respiration, Artificial ; Retrospective Studies ; Ventilators, Mechanical
    Language English
    Publishing date 2022-08-17
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0273173
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  3. Article ; Online: Effect of controlled ventilation during assist-control ventilation on diaphragm thickness : a post hoc analysis of an observational study.

    Itagaki, Taiga / Nakanishi, Nobuto / Takashima, Takuya / Ueno, Yoshitoyo / Tane, Natsuki / Tsunano, Yumiko / Nunomura, Toshiyuki / Oto, Jun

    The journal of medical investigation : JMI

    2020  Volume 67, Issue 3.4, Page(s) 332–337

    Abstract: Background : Since diaphragm passivity induces oxidative stress that leads to rapid atrophy of diaphragm, we investigated the effect of controlled ventilation on diaphragm thickness during assist-control ventilation (ACV). Methods : Previously, we ... ...

    Abstract Background : Since diaphragm passivity induces oxidative stress that leads to rapid atrophy of diaphragm, we investigated the effect of controlled ventilation on diaphragm thickness during assist-control ventilation (ACV). Methods : Previously, we measured end-expiratory diaphragm thickness (Tdiee) of patients mechanically ventilated for more than 48 hours on days 1, 3, 5 and 7 after the start of ventilation. We retrospectively investigated the proportion of controlled ventilation during the initial 48-hour ACV (CV48%). Patients were classified according to CV48% : Low group, less than 25% ; High group, higher than 25%. Results : Of 56 patients under pressure-control ACV, Tdiee increased more than 10% in 6 patients (11%), unchanged in 8 patients (14%) and decreased more than 10% in 42 patients (75%). During the first week of ventilation, Tdiee decreased in both groups : Low (difference, -7.4% ; 95% confidence interval [CI], -10.1% to -4.6% ; p < 0.001) and High group (difference, -5.2% ; 95% CI, -8.5% to -2.0% ; p = 0.049). Maximum Tdiee variation from baseline did not differ between Low (-15.8% ; interquartile range [IQR], -22.3 to -1.5) and High group (-16.7% ; IQR, -22.6 to -11.1, p = 0.676). Conclusions : During ACV, maximum variation in Tdiee was not associated with proportion of controlled ventilation higher than 25%. J. Med. Invest. 67 : 332-337, August, 2020.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Diaphragm/pathology ; Humans ; Middle Aged ; Positive-Pressure Respiration ; Respiration, Artificial/adverse effects ; Retrospective Studies ; Young Adult
    Language English
    Publishing date 2020-11-04
    Publishing country Japan
    Document type Journal Article ; Observational Study
    ZDB-ID 1435233-3
    ISSN 1349-6867 ; 1343-1420
    ISSN (online) 1349-6867
    ISSN 1343-1420
    DOI 10.2152/jmi.67.332
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    Zs.A 264: Show issues Location:
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  4. Article: Effect of High-Flow Nasal Cannula on Sleep-disordered Breathing and Sleep Quality in Patients With Acute Stroke.

    Nakanishi, Nobuto / Suzuki, Yasuhiro / Ishihara, Manabu / Ueno, Yoshitoyo / Tane, Natsuki / Tsunano, Yumiko / Itagaki, Taiga / Oto, Jun

    Cureus

    2020  Volume 12, Issue 7, Page(s) e9303

    Abstract: Introduction Sleep-disordered breathing (SDB) is common after stroke. Although the standard treatment of SDB is continuous positive airway pressure (CPAP) ventilation, the patient's intolerance and discomfort result in low adherence rates. Alternatively, ...

    Abstract Introduction Sleep-disordered breathing (SDB) is common after stroke. Although the standard treatment of SDB is continuous positive airway pressure (CPAP) ventilation, the patient's intolerance and discomfort result in low adherence rates. Alternatively, high-flow nasal cannula (HFNC) may be useful as it reduces upper airway collapse with low level of positive pressure and well tolerability. The aim of this study was to investigate whether HFNC therapy reduces SDB and improves sleep quality with higher compliance rate. Methods We included acute stroke patients with SDB for the assessment of apnea-hypopnea index (AHI) >5/h using WatchPAT 200 (Itamar Medical Ltd, Caesarea, Israel). Patients who met inclusion criteria received HFNC therapy (40 L/min) with monitoring by WatchPAT. AHI, oxygen desaturation index (ODI), sleep efficiency, and rapid eye movement (REM) sleep were compared in patients with and without HFNC therapy. We also evaluated the patient's comfort of HFNC therapy (discomfort or not). Results Among 17 patients assessed for AHI, 12 received HFNC therapy. HFNC therapy was not adhered in two patients due to intolerance. Eight patients remained for final analysis. There were no differences in SDB and sleep quality with and without HFNC therapy as follows: HFNC therapy vs control; AHI 24.9 ± 20.1 vs 21.3 ± 15.0/h (p = 0.63), ODI 16.2 ± 16.5 vs 12.9 ± 12.3/h (p = 0.54), sleep efficiency 80.4 ± 12.9 vs 87.1 ± 6.2 (p = 0.28), percentage of REM sleep 19.4% ± 9.6% vs 27.6% ± 8.9% (p = 0.07). Two patients (17%) complained of discomfort among eight patients. Conclusion HFNC therapy did not improve SDB and sleep quality. Nonadherence and discomfort were observed in HFNC therapy. We need a large trial to confirm this result.
    Language English
    Publishing date 2020-07-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.9303
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  5. Article ; Online: Incidence of bacterial contamination in infusion set needles.

    Nakataki, Emiko / Oto, Jun / Hata, Michiko / Tsunano, Yumiko / Okuda, Nao / Imanaka, Hideaki / Nishimura, Masaji

    American journal of infection control

    2013  Volume 41, Issue 3, Page(s) 273–274

    Abstract: We examined the incidence and types of bacterial contamination in 265 infusion set needles in adult critically ill patients. Bacterial contamination was detected in 15 samples (5.7%), and a total of 17 organisms were isolated. Ten were coagulase-negative ...

    Abstract We examined the incidence and types of bacterial contamination in 265 infusion set needles in adult critically ill patients. Bacterial contamination was detected in 15 samples (5.7%), and a total of 17 organisms were isolated. Ten were coagulase-negative staphylococci (CNS) and Staphylococcus aureus, and the remainder were α-Streptococcus, Corynebacterium, and gram-negative rods. Although the contamination was not directly related to catheter-related bloodstream infections exchanging infusion bottles can cause intraluminal contamination and is a possible route of these infections.
    MeSH term(s) Adult ; Bacteria/classification ; Bacteria/isolation & purification ; Catheter-Related Infections/etiology ; Humans ; Incidence ; Needles/microbiology
    Language English
    Publishing date 2013-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392362-9
    ISSN 1527-3296 ; 0196-6553
    ISSN (online) 1527-3296
    ISSN 0196-6553
    DOI 10.1016/j.ajic.2012.02.028
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  6. Article: Acute Cardiac Failure in a Pregnant Woman due to Thyrotoxic Crisis.

    Okuda, Nao / Onodera, Mutsuo / Tsunano, Yumiko / Nakataki, Emiko / Oto, Jun / Imanaka, Hideaki / Nishimura, Masaji

    Case reports in cardiology

    2012  Volume 2012, Page(s) 393580

    Abstract: Introduction. Cardiac failure during pregnancy is usually related to preeclampsia/eclampsia, rarely to hyperthyroidism. While hyperthyroidism can easily lead to hypertensive cardiac failure and may harm the fetus, it is sometimes difficult to distinguish ...

    Abstract Introduction. Cardiac failure during pregnancy is usually related to preeclampsia/eclampsia, rarely to hyperthyroidism. While hyperthyroidism can easily lead to hypertensive cardiac failure and may harm the fetus, it is sometimes difficult to distinguish hyperthyroidism from normal pregnancy. Case Presentation. We encountered a case of 41-year-old pregnant woman with hypertensive cardiac failure. Because we initially diagnosed as pre-eclampsia/eclampsia, Caesarian section was performed. However, her symptoms still persisted after delivery. After thyroid function test results taken on the day of admission were obtained on the fourth day, we could diagnose that her cardiac failure was caused by thyrotoxic crisis. Conclusions. Hypertensive cardiac failure due to hyperthyroidism during pregnancy is rare and difficult to diagnose because of similar presentation of normal pregnancy. However, physicians should be aware of the risks posed by hyperthyroidism during pregnancy.
    Language English
    Publishing date 2012-07-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2627627-6
    ISSN 2090-6412 ; 2090-6404
    ISSN (online) 2090-6412
    ISSN 2090-6404
    DOI 10.1155/2012/393580
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  7. Article ; Online: Comparison of bacterial contamination of blood conservation system and stopcock system arterial sampling lines used in critically ill patients.

    Oto, Jun / Nakataki, Emiko / Hata, Michiko / Tsunano, Yumiko / Okuda, Nao / Imanaka, Hideaki / Nishimura, Masaji

    American journal of infection control

    2012  Volume 40, Issue 6, Page(s) 530–534

    Abstract: Background: Commonly placed to monitor blood pressure and to aspirate blood, arterial lines frequently cause complications. The blood conservation system (BCS) forms a closed infusion line and may be expected to reduce complications caused by ... ...

    Abstract Background: Commonly placed to monitor blood pressure and to aspirate blood, arterial lines frequently cause complications. The blood conservation system (BCS) forms a closed infusion line and may be expected to reduce complications caused by intraluminal contamination. We compared microbial contamination resulting from use of BCS and 3-way stopcock catheterization.
    Methods: Patients who required arterial catheterization for at least 24 hours in our intensive care unit were randomly assigned to receive an arterial pressure monitoring system either with the BCS (test group) or with a 3-way stopcock (comparator group). To evaluate arterial line contamination, we qualitatively assessed the contamination of the catheter tip and intraluminal fluid.
    Results: We analyzed microbial contamination for a total of 216 arterial catheters: 109 in the test group and 107 in the comparator group. We found no difference in the incidence of catheter tip colonization in the 2 groups (test group, 8/109 vs comparator group, 11/107; P = .48). There was a statistically significant correlation between catheter tip colonization and duration of arterial line utilization. We found statistically significantly lower intraluminal fluid contamination in the test group (test group, 2/109 vs comparator group, 9/107; P = .03). There was no relationship between intraluminal fluid contamination and catheter tip contamination.
    Conclusion: There was less microbial contamination of intraluminal fluid when BCS was used for arterial catheterization.
    MeSH term(s) Adult ; Aged ; Catheter-Related Infections/prevention & control ; Critical Illness ; Cross Infection/prevention & control ; Equipment Contamination/prevention & control ; Equipment Design/methods ; Female ; Humans ; Incidence ; Intensive Care Units ; Male ; Middle Aged ; Vascular Access Devices/adverse effects ; Vascular Access Devices/microbiology
    Language English
    Publishing date 2012-08
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 392362-9
    ISSN 1527-3296 ; 0196-6553
    ISSN (online) 1527-3296
    ISSN 0196-6553
    DOI 10.1016/j.ajic.2011.08.006
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  8. Article: [Delayed discharge from the intensive care unit].

    Okuda, Nao / Tsunano, Yumiko / Kohata, Hisakazu / Nakataki, Emiko / Itagaki, Taiga / Onodera, Mutsuo / Imanaka, Hideaki / Nishimura, Masaji

    Masui. The Japanese journal of anesthesiology

    2014  Volume 63, Issue 10, Page(s) 1164–1166

    Abstract: Background: Delayed discharge from ICU to the general ward can exert an adverse effect. We researched whether patients are discharged smoothly from our ICU to the general ward.: Methods: We defined that patients were eligible for discharge if they ... ...

    Abstract Background: Delayed discharge from ICU to the general ward can exert an adverse effect. We researched whether patients are discharged smoothly from our ICU to the general ward.
    Methods: We defined that patients were eligible for discharge if they are without administration of catecholamine, being assisted by mechanical ventilation and having blood purification therapy.
    Results: Average time from actual discharge to the time patient was considered eligible for discharge was fifteen hours. This study was retrospective.
    Conclusions: We need to investigate further the reasons why delayed discharge occurred. It is im portant that patients are discharged from the ICU to the general ward properly. Delayed discharge can delay the recovery and expose the patient to multi-resistant microorganisms. We studied whether patients are discharged smoothly from the ICU to the general ward.
    MeSH term(s) Adult ; Aged ; Assisted Circulation ; Catecholamines ; Cross Infection/prevention & control ; Female ; Hemofiltration ; Humans ; Intensive Care Units/statistics & numerical data ; Male ; Middle Aged ; Patient Discharge/statistics & numerical data ; Patients' Rooms/statistics & numerical data ; Respiration, Artificial ; Retrospective Studies ; Time Factors
    Chemical Substances Catecholamines
    Language Japanese
    Publishing date 2014-10
    Publishing country Japan
    Document type English Abstract ; Journal Article
    ZDB-ID 391878-6
    ISSN 0021-4892
    ISSN 0021-4892
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  9. Article ; Online: Effect of high-flow nasal cannula on thoraco-abdominal synchrony in adult critically ill patients.

    Itagaki, Taiga / Okuda, Nao / Tsunano, Yumiko / Kohata, Hisakazu / Nakataki, Emiko / Onodera, Mutsuo / Imanaka, Hideaki / Nishimura, Masaji

    Respiratory care

    2014  Volume 59, Issue 1, Page(s) 70–74

    Abstract: Background: High-flow nasal cannula (HFNC) creates positive oropharyngeal airway pressure and improves oxygenation. It remains unclear, however, whether HFNC improves thoraco-abdominal synchrony in patients with mild to moderate respiratory failure. ... ...

    Abstract Background: High-flow nasal cannula (HFNC) creates positive oropharyngeal airway pressure and improves oxygenation. It remains unclear, however, whether HFNC improves thoraco-abdominal synchrony in patients with mild to moderate respiratory failure. Using respiratory inductive plethysmography, we investigated the effects of HFNC on thoraco-abdominal synchrony.
    Methods: We studied 40 adult subjects requiring oxygen therapy in the ICU. Low-flow oxygen (up to 8 L/min) was administered via oronasal mask for 30 min, followed by HFNC at 30-50 L/min. Respiratory inductive plethysmography transducer bands were circumferentially placed: one around the rib cage, and one around the abdomen. We measured the movement of the rib-cage and abdomen, and used the sum signal to represent tidal volume (V(T)) during mask breathing, and at 30 min during HFNC. We calculated the ratio of maximum compartmental amplitude (MCA) to V(T), and the phase angle. We assessed arterial blood gas and vital signs at each period, and mouth status during HFNC. We used multiple regression analysis to identify factors associated with improvement in thoraco-abdominal synchrony.
    Results: During HFNC, breathing frequency significantly decreased from 25 breaths/min (IQR 22-27 breaths/min) to 21 breaths/min (IQR 18-24 breaths/min) (P < .001), and MCA/VT (P < .001) and phase angle (P = .047) significantly improved.
    Conclusions: HFNC improved thoraco-abdominal synchrony in adult subjects with mild to moderate respiratory failure.
    MeSH term(s) Abdomen/physiopathology ; Aged ; Catheters ; Critical Illness ; Female ; Humans ; Male ; Middle Aged ; Movement/physiology ; Noninvasive Ventilation/instrumentation ; Noninvasive Ventilation/methods ; Nose ; Oxygen Inhalation Therapy/instrumentation ; Oxygen Inhalation Therapy/methods ; Prospective Studies ; Respiratory Insufficiency/physiopathology ; Respiratory Insufficiency/therapy ; Respiratory Mechanics ; Thorax/physiopathology
    Language English
    Publishing date 2014-01
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.02480
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  10. Article ; Online: ESICM LIVES 2016: part three: Milan, Italy. 1–5 October 2016

    Velasquez, T. / Mackey, G. / Lusk, J. / Kyle, U. G. / Fontenot, T. / Marshall, P. / Shekerdemian, L. S. / Coss-Bu, J. A. / Nishigaki, A. / Yatabe, T. / Tamura, T. / Yamashita, K. / Yokoyama, M. / Ruiz-Rodriguez, J. C. / Encina, B. / Belmonte, R. / Troncoso, I. / Tormos, P. / Riveiro, M. /
    Baena, J. / Sanchez, A. / Bañeras, J. / Cordón, J. / Duran, N. / Ruiz, A. / Caballero, J. / Nuvials, X. / Riera, J. / Serra, J. / Rutten, A. M. F. / van Ieperen, S. N. M. / Der Kinderen, E. P. H. M. / Van Logten, T. / Kovacikova, L. / Skrak, P. / Zahorec, M. / Akcan-Arikan, A. / Silva, J. C. / Goldsworthy, M. / Wood, D. / Harrison, D. / Parslow, R. / Davis, P. / Pappachan, J. / Goodwin, S. / Ramnarayan, P. / Chernyshuk, S. / Yemets, H. / Zhovnir, V. / Pulitano’, S. M. / De Rosa, S. / Mancino, A. / Villa, G. / Tosi, F. / Franchi, P. / Conti, G. / Patel, B. / Khine, H. / Shah, A. / Sung, D. / Singer, L. / Haghbin, S. / Inaloo, S. / Serati, Z. / Idei, M. / Nomura, T. / Yamamoto, N. / Sakai, Y. / Yoshida, T. / Matsuda, Y. / Yamaguchi, Y. / Takaki, S. / Yamaguchi, O. / Goto, T. / Longani, N. / Medar, S. / Abdel-Aal, I. R. / El Adawy, A. S. / Mohammed, H. M. E. H. / Mohamed, A. N. / Parry, S. M. / Knight, L. D. / Denehy, L. / De Morton, N. / Baldwin, C. 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    Intensive Care Med Exp

    Keywords covid19
    Publisher PMC
    Document type Article ; Online
    DOI 10.1186/s40635-016-0100-7
    Database COVID19

    Kategorien

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