Updated on 2023/12/22

写真a

 
FUJII Tasuku
 
Organization
Nagoya University Hospital Anesthesiology Lecturer of hospital
Title
Lecturer of hospital
Contact information
メールアドレス

Degree 1

  1. 博士(医学) ( 2020.3   名古屋大学 ) 

Research Interests 3

  1. 循環モニタリング

  2. Enteral ventilation

  3. Intraoperative hypotension

Research Areas 1

  1. Life Science / Anesthesiology

Current Research Project and SDGs 4

  1. Safe hemodynamic monitoring

  2. Enteral ventilation

  3. Intraoperative hypotension

  4. Perioperative glycemic control using artificial pancreas

Research History 4

  1. Nagoya University   Nagoya University Hospital Anesthesiology   Lecturer of hospital

    2021.3

  2. Nagoya University   Department of Anesthesiology, Nagoya University Hospital   Assistant professor of hospital

    2018.4 - 2021.2

  3. 国立循環器病研究センター   麻酔科

    2016.4 - 2018.3

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    Country:Japan

  4. Nagoya University   Department of Anesthesiology, Nagoya University Hospital   Assistant professor of hospital

    2013.4 - 2016.3

Education 3

  1. Nagoya University   Graduate School, Division of Medical Sciences

    2017.4 - 2020.3

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    Country: Japan

  2. Akita University   Faculty of Medicine

    2007.4 - 2011.3

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    Country: Japan

  3. Hiroshima University   Faculty of Dentistry

    1999.4 - 2005.3

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    Country: Japan

Professional Memberships 5

  1. Japanese Society of Anesthesiologists

  2. 日本心臓血管麻酔学会

  3. 日本集中治療医学会

  4. 日本区域麻酔学会

  5. 日本小児麻酔学会

 

Papers 26

  1. Intraoperative hypotension affects postoperative acute kidney injury depending on the invasiveness of abdominal surgery: A retrospective cohort study.

    Fujii T, Takakura M, Taniguchi T, Tamura T, Nishiwaki K

    Medicine   Vol. 102 ( 48 ) page: e36465   2023.12

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Medicine  

    Intraoperative hypotension (IOH) or highly invasive surgery adversely affects postoperative clinical outcomes. It is, however, unclear whether IOH affects postoperative acute kidney injury (AKI) depending on the invasiveness of abdominal surgery. We speculated that IOH in highly invasive abdominal surgery is a significant risk factor for postoperative AKI. We retrospectively reviewed the data of 448 patients who underwent abdominal surgery. Patients were divided into 3 groups: highly (such as pancreaticoduodenectomy and hepatectomy), moderately (open abdominal surgery), and minimally (laparoscopic surgery) invasive surgeries. The association between the time-weighted average (TWA) of mean arterial pressure (MAP) values (≤60 and ≤ 55 mm Hg) and AKI occurrences in each group was assessed. Postoperative AKI occurred after highly, moderately, and minimally invasive surgeries in 33 of 222 (14.9%), 14 of 110 (12.7%), and 12 of 116 (10.3%) cases, respectively (P = .526). The median [interquartile range] of TWA-MAP ≤ 60 mm Hg, as an IOH parameter, was 0.94 [0.33-2.08] mm Hg in highly, 0.54 [0.16-1.46] mm Hg in moderately, and 0.14 [0.03-0.57] mm Hg in minimally invasive surgeries (P < 0001). In addition, there was a significant association between TWA-MAP and AKI in highly invasive surgery, unlike in moderately and minimally invasive surgery, with adjusted odds ratios (95% confidence interval) for TWA-MAP ≤ 60 and ≤ 55 mm Hg associated with AKI of 1.23 [1.00-1.52] (P = .049) and 1.55 [1.02-2.36] (P = .041), respectively. Intraoperative MAP ≤ 60 mm Hg in highly invasive abdominal surgery is associated with postoperative AKI, compared to moderately and minimally invasive surgeries. Additionally, low MAP thresholds in highly invasive surgery increase postoperative AKI risk.

    DOI: 10.1097/MD.0000000000036465

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

    Fujii Tasuku, Hirai Takahiro, Tamura Takahiro, Suzuki Shogo, Nishiwaki Kimitoshi

    ARTIFICIAL ORGANS   Vol. 47 ( 6 ) page: 982 - 989   2023.6

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher: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

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  3. Accuracy of a noninvasive estimated continuous cardiac output measurement under different respiratory conditions: a prospective observational study

    Takakura Masashi, Fujii Tasuku, Taniguchi Tomoya, Suzuki Shogo, Nishiwaki Kimitoshi

    JOURNAL OF ANESTHESIA   Vol. 37 ( 3 ) page: 394 - 400   2023.6

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher: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

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  4. Enteral liquid ventilation oxygenates a hypoxic pig model. International journal

    Tasuku Fujii, Yosuke Yoneyama, Akiko Kinebuchi, Naoki Ozeki, Sho Maeda, Norikazu Saiki, Toyofumi Fengshi Chen-Yoshikawa, Hiroshi Date, Kimitoshi Nishiwaki, Takanori Takebe

    iScience   Vol. 26 ( 3 ) page: 106142 - 106142   2023.3

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    Language:English   Publishing type:Research paper (scientific journal)  

    The potential of extrapulmonary ventilation pathways remains largely unexplored. Here, we assessed the enteral ventilation approach in hypoxic porcine models under controlled mechanical ventilation. 20 mL/kg of oxygenated perfluorodecalin (O2-PFD) was intra-anally delivered by a rectal tube. We simultaneously monitored arterial and pulmonary arterial blood gases every 2 min up to 30 min to determine the gut-mediated systemic and venous oxygenation kinetics. Intrarectal O2-PFD administration significantly increased the partial pressure of oxygen in arterial blood from 54.5 ± 6.4 to 61.1 ± 6.2 mmHg (mean ± SD) and reduced the partial pressure of carbon dioxide from 38.0 ± 5.6 to 34.4 ± 5.9 mmHg. Early oxygen transfer dynamics inversely correlate with baseline oxygenation status. SvO2 dynamic monitoring data indicated that oxygenation likely originated from the venous outflow of the broad segment of large intestine including the inferior mesenteric vein route. Enteral ventilation pathway offers an effective means for systemic oxygenation, thus warranting further clinical development.

    DOI: 10.1016/j.isci.2023.106142

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

    Takakura Masashi, Fujii Tasuku, Suzuki Shogo, Nishiwaki Kimitoshi

    JOURNAL OF ARTIFICIAL ORGANS   Vol. 25 ( 2 ) page: 105 - 109   2022.6

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher: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

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  6. Incidence of intraoperative anaphylaxis caused by blood products: a 12-year single-center, retrospective study

    Amano Yasuhiro, Tamura Takahiro, Fujii Tasuku, Nishiwaki Kimitoshi

    JOURNAL OF ANESTHESIA   Vol. 36 ( 3 ) page: 390 - 398   2022.6

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Journal of Anesthesia  

    Purpose: Intraoperative anaphylaxis caused by blood products is uncommon, but it is unclear whether the rarity of this reaction is attributable to the difficulty of diagnosis, underreporting, or both. We investigated the incidence of intraoperative transfusion anaphylaxis and its reporting to the hemovigilance system. Methods: We retrospectively reviewed cases wherein general anesthesia was used at a single hospital during a 12-year period. Cases of intraoperative anaphylaxis were extracted using an electronic search strategy and determined using the recently developed grading and clinical scoring system. The causative blood products were determined by the onset duration based on literature regarding intraoperative transfusion anaphylaxis cases. Results: Among the 62,146 general anesthesia cases, 22 cases of intraoperative anaphylaxis were identified, and 11 of the 22 cases received transfusions before the onset of anaphylaxis. Intraoperative transfusion anaphylaxis was defined as occurring within 30 min of transfusion. Finally, nine cases of intraoperative transfusion anaphylaxis were analyzed. The overall incidence of intraoperative transfusion anaphylaxis was 1/3,994, with the highest incidence noted for fresh frozen plasma (1/2146; 95% confidence interval [CI] 1/6610–1/920), platelet concentrate (1/2348; 95% CI 1/92,742–1/422), and red blood cells (1/22,867; 95% CI 1/903,199–1/4,105). No evidence indicated that these cases were reported to the Japanese hemovigilance system, although all intraoperative transfusion anaphylaxis cases were diagnosed by anesthesiologists. Conclusion: The incidence of intraoperative anaphylaxis caused by blood products was higher than that reported and may be underreported to the Japanese hemovigilance system. Further research, particularly multicenter studies, is needed to confirm our results.

    DOI: 10.1007/s00540-022-03059-2

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  7. Ketamine reduces the dose of remifentanil required during prolonged head and neck surgery: a propensity-matched analysis

    Fujii Tasuku, Nishiwaki Kimitoshi

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 84 ( 1 ) page: 1 - 6   2022.2

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Nagoya Journal of Medical Science  

    High-dose opioids induce hyperalgesia and tolerance, which negatively affects postoperative recovery.Prolonged surgery inevitably requires higher opioid doses. Ketamine reduces perioperative opioid consumptionand prevents opioid-induced tolerance. However, its effects in cases of prolonged surgery remainunknown. This study aimed to evaluate the dose of intraoperative remifentanil, an ultrashort-acting μ-opioidagonist, administered after an intravenous ketamine bolus during prolonged head and neck surgery. Thissingle-center, retrospective, observational study included 251 patients who underwent head and necksurgery (operation time ≥8 h) between January 2015 and December 2019. The participants were stratifiedinto two groups: those who received an intravenous bolus of ketamine and those who did not (ketaminegroup and non-ketamine group, respectively). Propensity score-matching was used to match patients in a1:1 ratio between the two groups, based on their covariates. The difference in intraoperative remifentanildose administered between the two groups was assessed. After 1:1 propensity score-matching, 89 matchedpatients were selected from each group. The mean ± standard deviation dose of remifentanil administeredwas significantly lower in the ketamine group than in the non-ketamine group before (0.15±0.05 vs0.17±0.05 μg/kg/min; P=0.01) and after matching (0.15±0.06 vs 0.17±0.05 μg/kg/min; P=0.03). In conclusion,intravenous ketamine administration may reduce the intraoperative dose of remifentanil requiredduring prolonged head and neck surgery. However, further studies are required to evaluate the effect ofthis finding on enhanced recovery after surgery

    DOI: 10.18999/nagjms.84.1.1

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  8. Non-linear regression analysis for estimating the intraoperative motor evoked potential recovery time after bolus neuromuscular blockade

    Tatsuoka Tetsuro, Fujii Tasuku, Furuhashi Takeshi, Nishiwaki Kimitoshi

    JOURNAL OF CLINICAL MONITORING AND COMPUTING   Vol. 35 ( 6 ) page: 1333 - 1339   2021.12

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Journal of Clinical Monitoring and Computing  

    The recovery time of the motor evoked potential (MEP) amplitude following a neuromuscular blockade (NMB) during surgery is useful for interpreting low-amplitude waveforms or selecting the baseline waveform. In this study, the MEP data of 195 orthopedic cases who received a bolus dose of rocuronium at the beginning of surgery, between June 2009 and January 2016 were used. A non-linear regression analysis was applied to MEP amplitude data of multiple patients. The time taken for 90% of the maximum-amplitude recovery was estimated from the identified time series model. The 90% amplitude recovery time was 88.6 min in the pharmacological model and 89.4 min in the logistic model. These results were included in the 95% confidence interval of the previous studies. Although MEP amplitude is relatively unstable because of anesthesia, the averaged time series model of MEP amplitude can be estimated by using a large number of data.

    DOI: 10.1007/s10877-020-00600-0

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  9. 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     2021.5

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Journal of Cardiothoracic and Vascular Anesthesia  

    Objectives: Perioperative hyperglycemia is associated with poor postoperative recovery, including compromised immune function and increased risk of infection. A closed-loop glycemic control system (artificial pancreas) has demonstrated strict safe perioperative glycemic control without hypoglycemia risk. The authors hypothesized that the artificial pancreas would reduce surgical site infections (SSIs) and postoperative inflammatory reactions. This study aimed to assess the effect of the artificial pancreas on SSIs and C-reactive protein (CRP) levels after cardiac surgery. Design: A single-center retrospective, propensity score–matched analysis. Setting: A university hospital. Participants: In total, 295 patients who underwent cardiovascular surgery with cardiopulmonary bypass were included. Interventions: Patients were divided into two groups: artificial pancreas (target blood glucose: 120-150 mg/dL) and intravenous insulin infusion (conventional insulin therapy, target blood glucose: <200 mg/dL). Measurements and Main Results: The differences in the incidence of SSIs and CRP levels between the two groups were assessed. After 1:1 propensity score matching based on their covariates, 101 matched patients were selected from each group. The incidence of SSIs was reduced by 3%, 5% (conventional insulin therapy), and 2% (artificial pancreas), but the reduction was not statistically significant (p = 0.45). The postoperative maximum CRP level was significantly lower in the artificial pancreas group than in the conventional insulin therapy group, mean (standard deviation)14.53 (5.64) mg/dL v 16.57 (5.58) mg/dL; p = 0.01. Conclusions: The artificial pancreas did not demonstrate a significant reduction in the incidence of SSIs. However, the artificial pancreas was safe and suppressed postoperative inflammation compared with conventional insulin therapy.

    DOI: 10.1053/j.jvca.2021.04.047

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  10. Comparing oscillometric noninvasive and invasive intra-arterial blood pressure monitoring in term neonates under general anesthesia: A retrospective study

    Fujii Tasuku, Nishiwaki Kimitoshi

    PEDIATRIC ANESTHESIA   Vol. 30 ( 12 ) page: 1396 - 1401   2020.12

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Paediatric Anaesthesia  

    Background: Oscillometric noninvasive blood pressure and/or invasive intra-arterial blood pressure are commonly used to measure the systolic, diastolic, and mean components of blood pressure. Agreement between the two methods has been reported in adults, children, and infants, but rarely in neonates, especially under general anesthesia. Aims: This retrospective study compared the agreement of each measured blood pressure value (oscillometric noninvasive or invasive intra-arterial blood pressure monitoring) in term neonates under general anesthesia. Methods: Data were collected from neonates born at ≥36 weeks of gestation whose body weight was ≥2500 g and who underwent abdominal or noncardiac thoracic surgery with both oscillometric noninvasive and invasive intra-arterial blood pressure measurements from January 2015 to March 2020. The primary outcome was the agreement of systolic, diastolic, and mean blood pressure values between the two methods using Bland-Altman analysis. Results: Paired blood pressure measurements (n = 1193) from 67 cases were compared. In Bland-Altman analysis, bias (standard deviation), 95% limits of agreement, and percentage error were −9.3 (8.4), −26.1-7.6, and 26.9% for systolic; 1.6 (6.5), −11.3-14.6, and 38.7% for diastolic; and −1.3 (5.8), −13.0-10.3, and 26.9% for mean blood pressure, respectively. During low blood pressure (intra-arterial mean blood pressure ≤30 mm Hg), the biases (standard deviation) of systolic, diastolic, and mean blood pressure were −11.4 (5.7), −0.7 (3.7), and −5.1 (4.2), whereas during high blood pressure (intra-arterial mean blood pressure ≥60 mm Hg), the values were 0.1 (9.7), 5.6 (9.4), and 6.4 (7.4), respectively. Conclusions: Based on the bias and percentage error, the mean blood pressure exhibited the most acceptable agreement between oscillometric noninvasive and invasive intra-arterial blood pressure monitoring in term neonates under general anesthesia. However, during hypertension or hypotension, there was a large discrepancy between the two methods.

    DOI: 10.1111/pan.14020

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  11. Sizing of mitral annuloplasty rings using real-time three-dimensional transesophageal echocardiography and the difference between patients with and without recurrent mitral regurgitation: retrospective cohort study

    Fujii Tasuku, Yoshitani Kenji, Kanemaru Eiki, Nakai Michikazu, Nishimura Kunihiro, Ohnishi Yoshihiko, Nishiwaki Kimitoshi

    JOURNAL OF ECHOCARDIOGRAPHY   Vol. 18 ( 3 ) page: 169 - 174   2020.9

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s12574-020-00465-x

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  12. Transverse vs. parasagittal in-plane approaches in ultrasound-guided paravertebral block using a microconvex probe: A randomised controlled trial.

    Fujii T, Shibata Y, Shinya S, Nishiwaki K

    European journal of anaesthesiology   Vol. 37 ( 9 ) page: 752 - 757   2020.9

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/EJA.0000000000001223

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  13. Clarification on chronic pain - a painfully persistent problem? A reply

    Fujii T, Nishiwaki K

    ANAESTHESIA   Vol. 75 ( 3 ) page: 408 - 409   2020.3

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    DOI: 10.1111/anae.14960

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  14. Chronic pain after breast surgery - still many unanswered questions: a reply

    Fujii T, Nishiwaki K

    ANAESTHESIA   Vol. 75 ( 3 ) page: 416 - 417   2020.3

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    DOI: 10.1111/anae.14982

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  15. Efficacy of pectoral nerve block type-2 (Pecs II block) versus serratus plane block for postoperative analgesia in breast cancer surgery: a retrospective study

    Kubodera Kazumi, Fujii Tasuku, Akane Akiko, Aoki Wakana, Sekiguchi Akiko, Iwata Keiko, Ban Makiko, Ando Reiko, Nakamura Nozomi, Shibata Yasuyuki, Nishiwaki Kimitoshi

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 82 ( 1 ) page: 93 - 99   2020.2

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    DOI: 10.18999/nagjms.82.1.93

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  16. A single paravertebral injection via a needle vs. a catheter for the spreading to multiple intercostal levels: a randomized controlled trial

    Fujii Tasuku, Shibata Yasuyuki, Ban Yasutaka, Shitaokoshi Akira, Takahashi Kunihiko, Matsui Shigeyuki, Nishiwaki Kimitoshi

    JOURNAL OF ANESTHESIA   Vol. 34 ( 1 ) page: 72 - 78   2020.2

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Springer Science and Business Media LLC  

    DOI: 10.1007/s00540-019-02713-6

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  17. Comparison of Right Ventricular Function Between Patients With and Without Pulmonary Hypertension Owing to Left-Sided Heart Disease: Assessment Based on Right Ventricular Pressure-Volume Curves. International journal

    Eiki Kanemaru, Kenji Yoshitani, Shinya Kato, Tasuku Fujii, Akito Tsukinaga, Yoshihiko Ohnishi

    Journal of cardiothoracic and vascular anesthesia   Vol. 34 ( 1 ) page: 143 - 150   2020.1

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    OBJECTIVES: Right ventricular (RV) failure with pulmonary hypertension (PH) is frequently encountered in patients with advanced left-sided heart disease (LHD). However, RV energetics in patients with postcapillary PH because of LHD has not been well studied. The authors investigated intraoperative RV energetics in patients with PH due to LHD based on pressure-volume curves with three-dimensional transesophageal echocardiography and pulmonary artery catheterization. DESIGN: Exploratory study. SETTING: National center. PARTICIPANTS: Thirty-three patients who underwent cardiac surgery for LHD were enrolled. Ten patients had PH (mean pulmonary artery pressure ≥ 25 mmHg). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: RV stroke work index (RVSWI) was calculated by integrating the area bounded by the pressure-volume curve. RV minute work index (RVMWI) was calculated as RVSWI × heart rate. Right ventriculo-arterial coupling was estimated as stroke volume divided by end-systolic volume (SV/ESV). The authors compared RV energetics between patients with and without PH because of LHD. RVSWI and RVMWI were significantly higher in patients with PH (690.7 mmHg·mL/m2 [601.6-737.1] v 440.9 mmHg·mL/m2 [330.8-585.3], p = 0.015, and 60,068 mmHg·mL/m2/min [35,547-68,741] v 26,351 mmHg·mL/m2/min [17,316-32,517], p = 0.011, respectively), although cardiac index was nearly identical. SV/ESV was significantly lower in patients with PH (0.520 [0.305-0.810] v 0.820 (0.650-1.090), p = 0.007). CONCLUSIONS: Although cardiac index was similar, RVSWI and RVMWI were significantly higher and SV/ESV was significantly lower in patients with PH because of LHD, suggesting that patients with postcapillary PH have inefficient RV performance.

    DOI: 10.1053/j.jvca.2019.05.025

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  18. A randomised controlled trial of pectoral nerve‐2 ( PECS 2) block vs. serratus plane block for chronic pain after mastectomy

    T. Fujii, Y. Shibata, A. Akane, W. Aoki, A. Sekiguchi, K. Takahashi, S. Matsui, K. Nishiwaki

    Anaesthesia   Vol. 74 ( 12 ) page: 1558 - 1562   2019.12

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Wiley  

    DOI: 10.1111/anae.14856

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    Other Link: https://onlinelibrary.wiley.com/doi/full-xml/10.1111/anae.14856

  19. Measurement of the Aortic Annulus Area and Diameter by Three-Dimensional Transesophageal Echocardiography in Transcatheter Aortic Valve Replacement. International journal

    Keigo Ebuchi, Kenji Yoshitani, Eiki Kanemaru, Tasuku Fujii, Akito Tsukinaga, Yusuke Shimahara, Yoshiniko Ohnishi

    Journal of cardiothoracic and vascular anesthesia   Vol. 33 ( 9 ) page: 2387 - 2393   2019.9

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    OBJECTIVES: Sizing of the aortic valve is crucial for transcatheter aortic valve replacement (TAVR). Multidetector computed tomography (MDCT) is used for sizing. Recently, three-dimensional transesophageal echocardiography (3DTEE) has enabled accurate measurement of the aortic annulus area and diameter in cases that are difficult to measure. The authors compared measurements of aortic annulus areas and diameters acquired by MDCT and 3DTEE. DESIGN: Retrospective observational study. SETTING: Single national center. PARTICIPANTS: Sixty-eight patients who underwent TAVR replacement between September 2015 and March 2017. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The authors extracted and compared preoperative measurements of the aortic annulus area, as well as the long- and short-axis diameter, measured by MDCT and 3DTEE. There was no significant difference in the aortic annulus area (409 ± 74 v 414 ± 70 mm2, p = 0.15) or short-axis diameter (20.4 ± 2.0 v 20.6 ± 1.9 mm, p = 0.103) between 3DTEE and MDCT, but the long-axis diameter differed significantly (25.0 ± 2.4 v 25.8 ± 2.0 mm, p < 0.001), respectively. Prosthesis sizes based on 3DTEE and MDCT were the same, except in 3 patients who could not stay still during MDCT measurement; in those cases, prosthesis sizes based on 3DTEE were adopted. CONCLUSIONS: Measurements of the aortic annulus area and diameter in TAVR were similar between 3DTEE and MDCT. Patients who have difficulty remaining still during MDCT measurement because of dementia should have their prostheses sized based on 3DTEE measurements.

    DOI: 10.1053/j.jvca.2019.04.025

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  20. Catheterization in an ultrasound-guided thoracic paravertebral block using thoracoscopy

    T. Fujii, Y. Shibata, Y. Ban, A. Shitaokoshi, K. Nishiwaki

    Asian Journal of Anesthesiology   Vol. 55 ( 1 ) page: 24 - 25   2017.3

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Taiwan Society of Anesthesiologists  

    Thoracic paravertebral block (TPVB) is an efficient alternative to epidural anesthesia. The location of a catheter within the thoracic paravertebral space (TPVS) has been examined in the human cadaver studies, but it is unclear how it goes into the TPVS during catheterization. In this report, thoracoscopy was used to observe the thoracic cavity in real-time during a parasagittal in-plane approach of ultrasound-guided TPVB. During thoracoscopy, we observed whether a paravertebral catheter could be advanced caudally beyond the ribs into the neighboring TPVS. Our result demonstrated that the catheter was difficult to be advanced beyond the ribs and confined within the same level of TPVS as where it was inserted. In the previous thoracoscopic observation of the paravertebral spread, we assumed that the local anesthetic acts most strongly at the intercostal level of the injection. Therefore, we recommend to insert the catheter for TPVB at the level corresponding to the incision site of thoracotomy.

    DOI: 10.1016/j.aja.2017.05.004

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    PubMed

  21. [Acute Subdural Hematoma due to the Breakage of an Epidural Catheter Left for a Long Time].

    Fujii T, Suzuki K, Shibata Y, Nishiwaki K

    Masui. The Japanese journal of anesthesiology   Vol. 66 ( 1 ) page: 65-69   2017.1

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    PubMed

  22. Intravenous cibenzoline improved the systolic anterior motion of the mitral valve after mitral valvuloplasty : a case report

    Fujii Tasuku, Aoyama Tadashi, Ishida Yuki, Shinya Sonoe, Kainuma Motoshi, Nishiwaki Kimitoshi

    Cardiovascular Anesthesia   Vol. 21 ( 1 ) page: 69-74   2017

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    <p> In this case, hemodynamic collapse occurred due to the systolic anterior motion (SAM) of the mitral valve after a mitral valvuloplasty (MVP). Intravenous administration of cibenzoline, a sodium (Na<sup>+</sup>)-channel blocker, reduced left ventricular outflow tract (LVOT) obstruction and the mitral regurgitation (MR) resulting from the SAM, and the hemodynamic condition was improved.</p><p> SAM is a well-known complication after MVP. The Venturi effect created by increasing the blood flow velocity at the narrowed LVOT causes the anterior leaflet of the mitral valve to be drawn into the LVOT. Effective perioperative management suppresses the left ventricular contraction, and increases the pre-load and after-load. This requires discontinuation of inotropic drugs, administration of vasoconstrictors, and expansion of intravascular volume. Considering the pathogenesis of SAM, therapies for hypertrophic obstructive cardiomyopathy, such as a beta (β)-blocker, a calcium antagonist, or a Na<sup>+</sup>-channel blocker, can be effective for treatment of SAM after MVP. A short-acting β-blocker is convenient, and commonly used for the perioperative management of SAM. The essential cause of SAM after MVP is myocardial hypercontraction rather than tachycardia. A Na<sup>+</sup>-channel blocker is effective for attenuation of the left ventricular pressure gradient (LVPG) because it has more of a negative inotropic effect than a negative chronotropic effect. Therefore, we suggest that if a β-blocker is unavailable, or is insufficient for decreasing the LVPG, cibenzoline is effective for SAM after MVP.</p>

    DOI: 10.11478/jscva.2016-3-022

  23. Breakage and retention of thoracic paravertebral catheter: a case report

    Fujii Tasuku, Shibata Yasuyuki, Nishiwaki Kimitoshi

    JA CLINICAL REPORTS   Vol. 3 ( 1 ) page: 4   2017

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    Language:English   Publishing type:Research paper (scientific journal)  

    DOI: 10.1186/s40981-016-0074-1

    Web of Science

    PubMed

  24. Observation of ultrasound-guided thoracic paravertebral block using thoracoscopy. Reviewed

    Fujii T, Shibata Y, Nishiwaki K

    Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists   Vol. 54 ( 3 ) page: 101-102   2016.9

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    DOI: 10.1016/j.aat.2016.05.004

    PubMed

  25. Radicular cyst in a deciduous tooth: a case report and literature review. Reviewed

    Nagata T, Nomura J, Matsumura Y, Yanase S, Fujii T, Oka T, Uno S, Tagawa T

    Journal of dentistry for children (Chicago, Ill.)   Vol. 75 ( 1 ) page: 80-84   2008.1

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  26. Synergistic interaction of 5-aminolevulinic acid-based photodynamic therapy with simultaneous hyperthermia in an osteosarcoma tumor model. Reviewed

    Yanase S, Nomura J, Matsumura Y, Nagata T, Fujii T, Tagawa T

    International journal of oncology   Vol. 29 ( 2 ) page: 365-373   2006.8

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Research Project for Joint Research, Competitive Funding, etc. 2

  1. 腸換気法を用いた酸素化補助・救急療法の市販用投与機器開発に関する研究開発

    2023.8 - 2027.3

    医療機器等研究成果展開事業  

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    Authorship:Coinvestigator(s)  Grant type:Competitive

    Direct Cost: \12000000 )

  2. 腸換気法を用いた革新的呼吸補助技術の開発

    2022.7 - 2023.3

    新興・再興感染症に対する革新的医薬品等開発推進研究事業 (AMED)

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    Authorship:Coinvestigator(s)  Grant type:Competitive

    Grant amount:\7800000 ( Direct Cost: \6000000 、 Indirect Cost:\1800000 )

KAKENHI (Grants-in-Aid for Scientific Research) 2

  1. 革新的な呼吸補助手段「腸換気法」の臨床開発への薬理機序の解明

    Grant number:23H03009  2023.4

    科学研究費助成事業  基盤研究(B) 

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    Authorship:Principal investigator  Grant type:Competitive

    Direct Cost: \13800000 )

  2. 脳死関連肺障害の病態解明と予防・治療法の開発ーNPY,VEGFと腸換気法の検討

    2022.4 - 2025.3

    科学研究費助成事業  基盤研究(C) 

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    Authorship:Coinvestigator(s)  Grant type:Competitive