2024/03/18 更新

写真a

タカクラ マサシ
高倉 将司
TAKAKURA Masashi
所属
医学部附属病院 麻酔科 病院助教
職名
病院助教

学位 2

  1. 博士(医学) ( 2023年12月   名古屋大学 ) 

  2. 学士(医学) ( 2014年3月   奈良県立医科大学 ) 

 

論文 9

  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   102 巻 ( 48 ) 頁: e36465   2023年12月

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    記述言語:英語   出版者・発行元:Medicine (United States)  

    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

    Web of Science

    Scopus

    PubMed

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

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

    JOURNAL OF ANESTHESIA     2023年3月

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    担当区分:筆頭著者   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

  3. mRNA COVID-19ワクチン接種の副反応として難治性心原性ショックを呈し,機械的補助循環を要した一例 査読有り

    高倉 将司, 藤井 祐, 佐藤 威仁, 鈴木 章悟, 西脇 公俊

    日本集中治療医学会雑誌   30 巻 ( 1 ) 頁: 32 - 33   2023年1月

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    担当区分:筆頭著者, 責任著者   記述言語:日本語   出版者・発行元:一般社団法人 日本集中治療医学会  

    DOI: 10.3918/jsicm.30_32

    CiNii Research

  4. 投稿論文 症例報告 ミニトラック挿入後にボールバルブ血餅によって重篤な気道閉塞合併症を生じた1症例

    高倉 将司, 藤井 祐, 喜多 桂, 谷口 智哉, 天野 靖大, 鈴木 章悟, 西脇 公俊

    麻酔   71 巻 ( 11 ) 頁: 1201 - 1204   2022年11月

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    出版者・発行元:克誠堂出版(株)  

    DOI: 10.18916/j01397.2023016077

    CiNii Research

  5. 周術期重症高血糖に対して36時間の人工膵臓STG<sup>®</sup>-55の使用によりその後良好な血糖管理を行い得た感染性腹部大動脈瘤の1例

    谷口 智哉, 平井 昂宏, 藤井 祐, 高倉 将司, 喜多 桂, 鈴木 章悟, 西脇 公俊

    日本集中治療医学会雑誌   29 巻 ( 6 ) 頁: 601 - 602   2022年11月

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    記述言語:日本語   出版者・発行元:一般社団法人 日本集中治療医学会  

    DOI: 10.3918/jsicm.29_601

    CiNii Research

  6. ミニトラック挿入後にボールバルブ血餅によって重篤な気道閉塞合併症を生じた1症例 査読有り

    高倉 将司

    麻酔   71 巻 ( 11 ) 頁: 1201 - 1204   2022年11月

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    担当区分:筆頭著者, 責任著者   記述言語:日本語  

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

    蘇生   41 巻 ( 1 ) 頁: 38 - 39   2022年6月

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    記述言語:日本語   出版者・発行元:日本蘇生学会  

    DOI: 10.11414/jjreanimatology.41.1_38

    CiNii Research

  8. 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     2021年9月

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    記述言語:日本語   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

  9. 巨大心臓腫瘍に対する経静脈的ペースメーカー植え込み術において,経食道心エコーが術中麻酔管理とリード留置に有用であった一例

    高倉 将司, 佐藤 威仁, 藤井 祐, 竹田 道宏, 西脇 公俊

    Cardiovascular Anesthesia   24 巻 ( 1 ) 頁: 173 - 177   2020年

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    出版者・発行元:一般社団法人 日本心臓血管麻酔学会  

    <p> 今回,巨大な心臓原発性悪性リンパ腫の患者に対し経静脈的ペースメーカー植え込み術の麻酔管理を経食道心エコー(TEE)を用いて,ペーシングリードをエコー下に誘導することで安全に行いえた症例を経験したため報告する。症例は70歳代男性。右心系を占拠する巨大な心臓原発性悪性リンパ腫と診断された。経過中にⅢ度房室ブロックをきたしたため全身麻酔下でのペースメーカー留置術を施行された。循環虚脱に備え体外循環のスタンバイを行った上で慎重に麻酔導入を行った。術中ペーシングリードの位置決めに際して透視下のみでは適切な位置に誘導することが困難だったが,同時にTEEを併用する事で誘導が可能であり有用性が高かった。</p>

    DOI: 10.11478/jscva.2020-2-006

▼全件表示

MISC 1

  1. Aspiration of massive free air from a large bore intravenous catheter sheath: A case report.

    Tamura T, Takakura M, Adachi YU, Satomoto M  

    Radiology case reports15 巻 ( 10 ) 頁: 1777 - 1780   2020年10月

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    出版者・発行元:Radiology Case Reports  

    DOI: 10.1016/j.radcr.2020.07.023

    Scopus

    PubMed