研究者詳細 - 鈴木　章悟

論文 - 鈴木　章悟

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Risk markers for postoperative reintubation of intensive care unit patients: A retrospective multicentre study of the National Intensive Care Registry Open Access

Masaki, H; Suzuki, S; Nakayama, N; Kobayashi, E; Fujii, A; Nishiwaki, K; Mizuno, M; Nakatochi, M

INTENSIVE AND CRITICAL CARE NURSING 87 巻頁： 103956 2025年4月

記述言語：英語出版者・発行元：Intensive and Critical Care Nursing

Objectives: To evaluate postoperative reintubation incidence and identify risk markers to expedite the identification of high-risk patients after ICU admission. Methods: We performed this retrospective multicentre study that included postoperative adult patients admitted to Japanese ICUs between April 2015 and March 2022 using the Japanese Intensive care PAtient Database (JIPAD). Data regarding the patients treated in included ICUs were accumulated by the JIPAD, which we received for research use. Logistic regression analysis with generalised estimating equations was used to estimate odds ratios (ORs) of 1-standard deviation increments and 95 % confidence intervals (CIs) for the association of each variable available within 24 h after ICU admissions with reintubation. Results: Among 13,219 admissions during the study period, 828 patients were postoperatively reintubated (incidence = 6.26 %, 95 % CI: 5.86–6.69). Maximum partial pressure of carbon dioxide (PaCO2), bilirubin, and blood urea nitrogen (adjusted OR = 1.138, 95 % CI: 1.055–1.228; adjusted OR = 1.101, 95 % CI: 1.018–1.191; and adjusted OR = 1.105, 95 % CI: 1.016–1.203, respectively) and body mass index (BMI) and minimum white blood cells counts (adjusted OR = 0.867, 95 % CI: 0.797–0.944; and adjusted OR = 0.878, 95 % CI: 0.815–0.946, respectively) were significantly associated with postoperative reintubation. Conclusions: Postoperative reintubation incidence in Japanese ICUs was estimated to be 6.26%. BMI, maximum PaCO2, clinical laboratory data reflecting surgical invasiveness, and immunosuppression may be risk markers for postoperative reintubation. Implications for clinical practice: Our study will help identify high-risk patients for postoperative reintubation early post-ICU admission, enabling early and focused nursing care to prevent reintubation, such as early mobilisation and ambulation.

DOI： 10.1016/j.iccn.2025.103956

Prevention of central venous catheter occlusion by saline with or without heparin in intensive care unit after surgical intervention: a double-blind, randomized trial

Nakamoto M., Tamura T., Kobayashi E., Kawaguchi M., Matsuoka Y., Fujii A., Ando M., Kubo Y., Miyagawa Y., Inagaki T., Suzuki S., Nishiwaki K.

Nagoya Journal of Medical Science 87 巻 ( 1 ) 頁： 51 - 59 2025年

出版者・発行元：Nagoya Journal of Medical Science

Heparinized saline is used to prevent catheter obstruction; however, it is associated with concerns regarding the incidence of heparin-induced thrombocytopenia and the accuracy of the blood test results. This study compared the impact of saline with and without heparin on central venous catheter occlusion rates in post-surgical intensive care unit patients using a prospective, double-blinded, randomized, controlled design. Patients aged 20–90 years planned to experience central venous catheter insertion and postoperative intensive care unit admission were enrolled and were randomly assigned to either the heparin group (administered normal saline with heparin) or the control group (administered normal saline alone), based on a 1:1 ratio. Nurses blinded to patient allocation performed the occlusion assessment (every 24 h). The Kaplan–Meier curve was used to assess the time to occlusion or removal of each catheter. Central venous catheter insertion results of 136 patients showed no significant variation in occlusion rates between the heparin and control groups within the first 3 days. There was no significant difference between normal saline with and without heparin in preventing central venous occlusion in the intensive care unit up to 3 days post-surgery. The results of this study suggest that it is not necessary to use normal saline with heparin in the management of central venous catheter occlusion, at least when moving from the operating room to the intensive care unit.

DOI： 10.18999/nagjms.87.1.51

Scopus

Effect of intensive insulin therapy on inflammatory response after cardiac surgery using bedside artificial pancreas: A propensity score-matched analysis 査読有り

Fujii, T; Hirai, T; Tamura, T; Suzuki, S; Nishiwaki, K

ARTIFICIAL ORGANS 47 巻 ( 6 ) 頁： 982 - 989 2023年6月

記述言語：英語出版者・発行元：Artificial Organs

Background: Perioperative hyperglycemia leads to poor postoperative clinical outcomes, including compromised immune function, cardiovascular events, and mortality. The optimal perioperative blood glucose levels during cardiac surgery remain unclear. A closed-loop glycemic control system (artificial pancreas, target blood glucose range:120–150 mg/dl) prevents postoperative inflammatory response more effectively than conventional insulin therapy (<200 mg/dl). However, the clinical effects of intensive insulin therapy with strict glycemic control (80–110 mg/dl) are controversial. This study aimed to determine whether intensive insulin therapy would further suppress postoperative inflammatory reactions. Methods: This study analyzed 262 patients who underwent cardiovascular surgery with cardiopulmonary bypass. The patients were divided into two groups according to their target blood glucose range: 80–110 mg/dl and 120–150 mg/dl. The primary outcome was the difference in the C-reactive protein levels between the two groups. Results: Propensity score matching resulted in 95 patients in each group based on their covariates. There was no difference in the postoperative maximum C-reactive protein levels between the two groups (14.81 ± 5.93 mg/dl vs. 14.34 ± 5.52 mg/dl; p = 0.571) following propensity score matching. Hypoglycemia did not occur during intensive insulin therapy. Conclusions: Intensive insulin therapy following cardiac surgery with cardiopulmonary bypass did not demonstrate significant advantages in the suppression of postoperative inflammatory reactions compared to that with mild glycemic control. However, intensive insulin therapy using an artificial pancreas was found to be safe, with no hypoglycemic events.

DOI： 10.1111/aor.14418

Web of Science

Scopus

PubMed

Accuracy of a noninvasive estimated continuous cardiac output measurement under different respiratory conditions: a prospective observational study 査読有り

Takakura, M; Fujii, T; Taniguchi, T; Suzuki, S; Nishiwaki, K

JOURNAL OF ANESTHESIA 37 巻 ( 3 ) 頁： 394 - 400 2023年6月

記述言語：英語出版者・発行元：Journal of Anesthesia

Purpose: The estimated continuous cardiac output (esCCO) system was recently developed as a noninvasive hemodynamic monitoring alternative to the thermodilution cardiac output (TDCO). However, the accuracy of continuous cardiac output measurements by the esCCO system compared to TDCO under different respiratory conditions remains unclear. This prospective study aimed to assess the clinical accuracy of the esCCO system by continuously measuring the esCCO and TDCO. Methods: Forty patients who had undergone cardiac surgery with a pulmonary artery catheter were enrolled. We compared the esCCO with TDCO from mechanical ventilation to spontaneous respiration through extubation. Patients undergoing cardiac pacing during esCCO measurement, those receiving treatment with an intra-aortic balloon pump, and those with measurement errors or missing data were excluded. In total, 23 patients were included. Agreement between the esCCO and TDCO measurements was evaluated using Bland–Altman analysis with a 20 min moving average of the esCCO. Results: The paired esCCO and TDCO measurements (939 points before extubation and 1112 points after extubation) were compared. The respective bias and standard deviation (SD) values were 0.13 L/min and 0.60 L/min before extubation, and − 0.48 L/min and 0.78 L/min after extubation. There was a significant difference in bias before and after extubation (P < 0.001); the SD before and after extubation was not significant (P = 0.315). The percentage errors were 25.1% before extubation and 29.6% after extubation, which is the criterion for acceptance of a new technique. Conclusion: The accuracy of the esCCO system is clinically acceptable to that of TDCO under mechanical ventilation and spontaneous respiration.

DOI： 10.1007/s00540-023-03176-6

Web of Science

Scopus

PubMed

Interference of a ventricular assist device with magnetic navigation during insertion of Sherlock 3CG (TM), a bedside peripherally inserted central catheter 査読有り

Takakura Masashi, Fujii Tasuku, Suzuki Shogo, Nishiwaki Kimitoshi

JOURNAL OF ARTIFICIAL ORGANS 25 巻 ( 2 ) 頁： 105 - 109 2022年6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：Journal of Artificial Organs

Recently, the Sherlock 3CG™ Tip Confirmation System, including a magnetic tracking system and an intracavitary electrocardiography guidance system, has been introduced for bedside peripherally inserted central catheter (PICC) insertion. Magnetic field sources interfere with the magnetic tracking system. Electromagnetic interference of the ventricular assist device (VAD) has already been reported with various devices but not on Sherlock 3CG™. We assessed the availability of the magnetic tracking system in patients with and without a VAD during Sherlock 3CG™ insertion and evaluated the rate of optimal PICC tip position. We retrospectively reviewed 99 patients who had undergone PICC insertion using Sherlock 3CG™ on the bedside at our institutional intensive care unit from February 2018 to December 2020. Patients were divided into groups with and without a VAD. The availability of magnetic navigation and the success rate of optimal catheter tip position in each group were assessed. Among 87 cases analyzed, there were 12 and 75 cases with a VAD and without a VAD, respectively. The availability of magnetic navigation during Sherlock 3CG™ insertion was significantly lower in the group with a VAD [4/12 (33%) with VAD vs. 72/75 (96%) without VAD, P < 0.001]. In addition, the rate of optimal PICC tip position was also significantly lower in the group with a VAD [6/12 (50%) vs. 63/75 (84%), P = 0.015] The VAD significantly led to magnetic tracking system failure due to its electromagnetic interference during Sherlock 3CG™ insertion and significantly reduced the success rate of PICC insertions in the optimal position.

DOI： 10.1007/s10047-021-01293-1

Web of Science

Scopus

PubMed

Lidocaine inhibits vascular endothelial growth factor-A-induced angiogenesis 査読有り

Suzuki Shogo, Mori Atsushi, Fukui Aya, Ema Yoshiaki, Nishiwaki Kimitoshi

JOURNAL OF ANESTHESIA 2020年7月

Fibrinogen levels measured by the dry hematology method are lower than those measured by the Clauss method under a high concentration of heparin 査読有り

Suzuki Shogo, Tamura Takahiro, Hasegawa Kazuko, Maeda Sho, Mori Reona, Kainuma Motoshi, Adachi Yushi, Nishiwaki Kimitoshi

NAGOYA JOURNAL OF MEDICAL SCIENCE 81 巻 ( 2 ) 頁： 259 - 267 2019年5月

*Different effects of dibutyryl cAMP on monolayer permeability in human aortic and coronary arterial endothelial cells 査読有り

Nan, YS, Nan, Yong-Shan, Li, SY (Li, Shao-Yan, Kang, JL, Kang, Ji-Lon, Suzuki, S, Suzuki, Shogo, Ema, Y, Ema, Yoshiaki, Nishiwaki, K, Nishiwaki, Kimitosh

AFRICAN JOURNAL OF MICROBIOLOGY RESEARCH 5 巻 ( 6 ) 頁： 897-903 2012年2月

Effects of midazolam, diazepam, propofol and dexmedetomidine on endothelial cell proliferation and angiogenesis induced by VEGF 査読有り

Nan, YS; Li, SY; Kang, JL; Suzuki, S; Ema, ; Nishiwaki, K

AFRICAN JOURNAL OF MICROBIOLOGY RESEARCH 4 巻 ( 23 ) 頁： 2549-2555 2010年12月

集中治療室における経管投与で使用する薬剤の投与方法の標準化への試み査読有り

稲垣孝行, 宮川泰宏, 中井剛, 鈴木章悟, 鈴木輝彦, 阪井祐介, 森智子, 梅村朋, 長尾能雅, 山田清文

日本臨床救急医学会雑誌 26 巻 ( 6 ) 頁： 694 - 702 2023年12月

Hypopharyngeal Injury by Transesophageal Echocardiography During Cardiac Surgery

Aoki, Y; Tamura, T; Uchida, W; Morioka, H; Yamamoto, M; Yuhara, S; Nishio, N; Mutsuga, M; Furune, S; Suzuki, S; Nishiwaki, K

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA 37 巻 ( 10 ) 頁： 2027 - 2031 2023年10月

Thromboelastographic evaluation after cardiac surgery optimizes transfusion requirements in the intensive care unit: a single-center retrospective cohort study using an inverse probability weighting method 査読有り

Tamura Takahiro, Suzuki Shogo, Fujii Tasuku, Hirai Takahiro, Imaizumi Takahiro, Kubo Yoko, Shibata Yasuyuki, Narita Yuji, Mutsuga Masato, Nishiwaki Kimitoshi

頁： 1 - 9 2023年5月

Successful perioperative management of extended right hemihepatectomy in a trisomy 18 infant with coarctation of the aorta after pulmonary artery banding 査読有り

蘇生 41 巻 ( 1 ) 頁： 38 - 39 2022年6月

Surgical Site Infections and Inflammatory Reaction After Cardiac Surgery; Bedside Artificial Pancreas Versus Conventional Insulin Therapy: A Propensity Score-Matched Analysis.

Fujii T, Hirai T, Suzuki S, Nishiwaki K

Journal of cardiothoracic and vascular anesthesia 2021年5月

Impact of Perioperative Steroid Administration in Patients Undergoing Major Hepatectomy with Extrahepatic Bile Duct Resection: A Randomized Controlled Trial 査読有り

Onoe Shunsuke, Yokoyama Yukihiro, Ebata Tomoki, Igami Tsuyoshi, Mizuno Takashi, Yamaguchi Junpei, Watanabe Nobuyuki, Suzuki Shogo, Nishiwaki Kimitoshi, Ando Masahiko, Nagino Masato

ANNALS OF SURGICAL ONCOLOGY 2020年6月

血小板抗HLA抗体陽性症例においてランダムマッチ血小板輸血で血小板数の増加を認めた経験査読有り

森玲央那, 貝沼関志, 鈴木章悟, 西脇公俊

麻酔 67 巻 ( 6 ) 頁： 642-646 2018年6月

[Comparison of Perioperative Outcomes for Esophageal Cancer: Thoracoscopic Versus Thoracotomic Esophagectomy]. 査読有り

Mori R, Suzuki S, Nishtwai K

Masui. The Japanese journal of anesthesiology 66 巻 ( 3 ) 頁： 287-290 2017年3月

大血管手術後にプロポフォール注入症候群による横紋筋融解を発症したと考えられる一症例査読有り

平井昂宏, 貝沼関志, 林智子, 長谷川和子, 青山正, 水野祥子, 鈴木章悟, 西脇公俊

日本集中治療医学会雑誌 23 巻 ( 6 ) 頁： 647-650 2016年11月

Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation. 査読有り

Hori T, Ogura Y, Onishi Y, Kamei H, Kurata N, Kainuma M, Takahashi H, Suzuki S, Ichikawa T, Mizuno S, Aoyama T, Ishida Y, Hirai T, Hayashi T, Hasegawa K, Takeichi H, Ota A, Kodera Y, Sugimoto H, Iida T, Yagi S, Taniguchi K, Uemoto S.

world journal of hepatology 8 巻 ( 25 ) 頁： 1047-1060 2016年9月

再膨張性肺水腫にともなう高度低酸素血症に対して一酸化窒素吸入療法を行った1症例査読有り

鈴木克尚,貝沼関志, 水野祥子, 萩原伸昭, 青山正, 市川崇, 高橋英夫, 鈴木章悟

日本集中治療医学会雑誌 21 巻 ( 4 ) 頁： 350-353 2014年7月

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