Seiya Kato

Plasmapheresis therapy has no triglyceride-lowering effect in patients with hypertriglyceridemic pancreatitis.

Kyohei Miyamoto, Masayasu Horibe, Masamitsu Sanui, Mitsuhito Sasaki, Daisuke Sugiyama, Seiya Kato, Takahiro Yamashita, Takashi Goto, Eisuke Iwasaki, Kunihiro Shirai, Kyoji Oe, Hirotaka Sawano, Takuya Oda, Hideto Yasuda, Yuki Ogura, Kaoru Hirose, Katsuya Kitamura, Nobutaka Chiba, Tetsu Ozaki, Taku Oshima, Tomonori Yamamoto, Keiji Nagata, Tetsuya Mine, Koji Saito, Motohiro Sekino, Tomoki Furuya, Naoyuki Matsuda, Mineji Hayakawa, Takanori Kanai and Toshihiko Mayumi

Outcomes of abdominal trauma patients with hemorrhagic shock requiring emergency laparotomy: efficacy of intra-aortic balloon occlusion

The aims of this study were to investigate outcomes of abdominal trauma in patients with hemorrhagic shock requiring emergency laparotomy and clarify the beneficial effects of intra‐aortic balloon occlusion (IABO) for intra‐abdominal hemorrhage in patients with critically uncontrollable hemorrhagic shock (CUHS).

The Association Between Sequential Organ Failure Assessment Scores and Mortality in Patients With Sepsis During the First Week: The JSEPTIC DIC Study:

Objective: Predicting prognosis is a complex process, particularly in patients with severe sepsis or septic shock. This study aimed to determine the relationship between the Sequential Organ Failure Assessment (SOFA) scores for individual organs during the first week of admission and the in-hospital mortality in patients with sepsis. Methods: This study was a post hoc evaluation of the Japan Septic Disseminated Intravascular Coagulation study and included patients admitted to 42 intensive care units in Japan for severe sepsis or septic shock, between January 2011 and December 2013. We assessed the relationship between the organ and total SOFA scores on days 1, 3, and 7 following admission and the in-hospital mortality using logistic regression analysis. Results: We evaluated 2732 patients and found the in-hospital mortality rate was 29.1%. The mean age of the patients (standard deviation) was 70.5 (14.1) years, and the major primary site of infection was the abdomen (33.6%). The central nervous system (CNS) SOFA score exhibited the strongest relationship with mortality on days 1 (adjusted odds ratio [aOR]: 1.49, 95% confidence interval [CI]: 1.40-1.59), 3 (aOR: 1.75, 95% CI: 1.62-1.89), and 7 (aOR: 1.93, 95% CI: 1.77-2.10). The coagulation SOFA scores showed a weak correlation with mortality on day 1, but a strong correlation with mortality on day 7 (aOR: 2.04, 95% CI: 1.87-2.24). Conclusions: The CNS SOFA scores were associated with mortality in patients with severe sepsis on days 1, 3, and 7 following hospitalization. The coagulation SOFA score was associated with mortality on day 7. In clinical situations, the CNS SOFA scores during the acute phase and the CNS SOFA and coagulation SOFA scores during the subsequent phases should be evaluated in order to determine patient prognosis.

Prehospital quick sequential organ failure assessment as a tool to predict in-hospital mortality

Objective This study aimed to evaluate the predictive ability of quick sequential organ failure assessment (qSOFA) score for in‐hospital mortality among patients transported by physician‐staffed helicopters. Methods We conducted a single‐center, retrospective observational study using the physician‐staffed helicopter registry data between 2003 and 2016. We calculated the qSOFA scores based on the patients’ vital signs, which were measured on the scene. The tools discriminatory ability was determined using the area under the curve of the receiver operating characteristic. Results A total of 1849 patients with a mean age of 63.0 (standard deviation [SD], 18.4) years were included in this study. The diagnostic categories included were trauma and nontrauma cases (1038 [56%] and 811 [44%], respectively). In‐hospital mortality was documented in 169 (9%) patients. Meanwhile, the in‐hospital mortality rates among patients with qSOFA scores of 0, 1, 2, and 3 were 5/411 (1%), 69/797 (9%), 71/541 (13%), and 24/100 (24%), respectively (P < 0.0001 for trend). If the cutoff point is ≥1, the sensitivity and specificity of the qSOFA scores were 0.97 and 0.24, respectively. The area under the curve of the qSOFA scores was 0.67 for all patients, whereas that for trauma patients was 0.75. Conclusion An increase in the qSOFA score is associated with a gradual increase in the in‐hospital mortality rate among all patients. In particular, a very low mortality rate was observed among patients with a qSOFA score of 0. The qSOFA score predicted the in‐hospital mortality of patients with trauma well.

Adherence rate of quality-of-care indicators for Staphylococcus aureus bacteremia is extremely low in Japanese emergency and critical care departments: a multicenter retrospective observational study

Staphylococcus aureus bacteremia causes significant morbidity and mortality and requires specific management to prevent complications. Most studies evaluating quality of care have been carried out in Europe and North America, and accurate epidemiological data are lacking in Asia. We aimed to describe the epidemiology and evaluate the quality of care for S. aureus bacteremia in Japan.

Additional file 1: Table S1. of Prolonged direct hemoperfusion using a polymyxin B immobilized fiber cartridge provides sustained circulatory stabilization in patients with septic shock: a retrospective observational before-after study

The catecholamine usage and dosing within 12 h from starting PMX-DHP. Table S2. Time course of the urine output within 12 h after starting PMX-DHP. Table S3. Time course of the serum lactate and PaO2/FiO2 ratio within 12 h after starting PMX-DHP. Table S4. The SOFA score during one week after the first PMX-DHP session. (DOCX 27 kb)

Early enteral levetiracetam in diazepam-resistant convulsive status epilepticus

Levetiracetam is used intravenously as an emergent initial and urgent control therapy for acute convulsive status epilepticus. However, the efficacy of early enteral levetiracetam has not been confirmed in cases of benzodiazepine‐resistant convulsive status epilepticus.