Proper fluid management is crucial for the management of critically ill patients. However, there is a continuing debate about the choice of the fluid, i.e., crystalloid vs. colloid. Colloid solution is theoret...
Authors: Daisuke Toyoda, Shigeo Shinoda and Yoshifumi Kotake
Disorders of the urea cycle are secondary to a defect in the system that converts ammonia into urea, resulting in accumulation of ammonia and other products. This results in encephalopathy, coma, and death if ...
Authors: MarcelCerqueira Cesar Machado and Fabiano Pinheiro da Silva
Infusion fluids may be contaminated with different types of particulates that are a potential health hazard. Particulates larger than microvessels may cause an embolism by mechanical blockage and inflammation;...
Disseminated intravascular coagulation (DIC) has a common pathogenesis in terms of persistent widespread activation of coagulation in the presence of underlying disease, but the degree of fibrinolytic activati...
Yamakagashi (Rhabdophis tigrinus) is a species of pit viper present throughout Russia and Eastern Asia. Although R. tigrinus venom is known to induce life-threatening hemorrhagic symptoms, the clinical characteri...
We tested the utility of the McGrath MAC® (McG) video laryngoscope during chest compression compared with the Pentax Airwayscope® (AWS). We recruited 59 participants into the simulation study. The difference in t...
Tracheotomy is an indispensable component in intensive care management. Doctors in charge of the intensive care unit (ICU) usually decide whether tracheotomy should be performed. However, long-term follow-up o...
Authors: Yukihiro Ikegami, Ken Iseki, Chiaki Nemoto, Yasuhiko Tsukada, Jiro Shimada and Choichiro Tase
Supplemental landiolol administration (20 or 40 μg kg-1 min-1) effectively diminished harmful hemodynamic changes during bronchoscopic endotracheal suctioning compared to normal saline. However, inappropriate use...
Authors: Toru Hifumi, Hiroshi Kato, Yuichi Koido, Kenya Kawakita and Yasuhiro Kuroda
Disseminated intravascular coagulation (DIC) is categorized into bleeding, organ failure, massive bleeding, and non-symptomatic types according to the sum of vectors for hypercoagulation and hyperfibrinolysis....
Authors: Hideo Wada, Takeshi Matsumoto and Yoshiki Yamashita
Body temperature abnormalities, which occur because of several infectious and non-infectious etiologies, are among the most commonly noted symptoms of critically ill patients. These abnormalities frequently tr...
Here, we report a case of a 41-year-old male diagnosed as septic shock with purpura fulminans (PF) infection. The causative organism was β-lactamase-negative ampicillin-resistant Hemophilus influenzae. He develop...
Active cytomegalovirus infection is not uncommon in critically ill non-immunosuppressed patients. We conducted a preliminary observational study to determine the prevalence of active cytomegalovirus infection ...
Hypothermia and acidosis are secondary causes of trauma-related coagulopathy. Here we report the case of a 72-year-old patient with severe trauma who suffered near-severe hypothermia despite the initiation of ...
Pseudomonas aeruginosa is the most common gram-negative pathogen causing pneumonia in immunocompromised patients. Acute lung injury induced by bacterial exoproducts is associated with a poor outcome in P. aerugin...
In Japan, the continuation of critical care at the end of life is a common practice due to the threat of legal action against physicians that may choose a palliative care approach. This is beginning to change ...
Authors: Jun Makino, Shigeki Fujitani, Bridget Twohig, Steven Krasnica and John Oropello
The aim of the study was to understand the current status of intensive care unit (ICU) in order to optimize the resources achieving the best possible care.
During mechanical ventilation, endotracheal tube cuff pressure should be maintained within proper range. We investigated the effect of frequent adjustment on cuff pressure in 27 mechanically ventilated patient...
Landiolol is an ultra-short-acting β1-selective antagonist developed in Japan that was recently approved for the treatment of tachycardia in intensive care units (ICUs). This study investigated the protective eff...
Authors: Junpei Tochikubo, Yushi U Adachi, Tadashi Ejima, Atsushi Numaguchi, Naoyuki Matsuda, Shigehito Sato and Norihiko Shiiya
It remains to be clarified if the application of noninvasive positive pressure ventilation (NPPV) is effective after extubation in patients with hypoxemic respiratory failure who require the sufficient level o...
Postoperative atelectasis should be avoided in surgical patients with impaired pulmonary function. Nasal high-flow (NHF) therapy delivered by the Optiflow™ system (Fisher & Paykel Healthcare Ltd., Auckland, Ne...
Acute respiratory distress syndrome (ARDS) is characterized by permeability pulmonary edema and refractory hypoxemia. Recently, the new definition of ARDS has been published, and this definition suggested seve...
The Glasgow Coma Scale (GCS) score of an individual with hypoglycemia is expected to be low due to an insufficient glucose supply to the brain. However, we sometimes encounter hypoglycemic patients with high G...
Sepsis is a major risk factor for the development of thrombocytopenia, but few studies have specifically evaluated prognostic importance of thrombocytopenia in patients with sepsis. We investigated the inciden...
Authors: Chakradhar Venkata, Rahul Kashyap, J Christopher Farmer and Bekele Afessa
Dexmedetomidine is a highly selective central α2-agonist with anesthetic and analgesic properties for patients in intensive care units. There is little information about the relationship between dosage and plasma...
Limited studies are available on prevalence and severity of vitamin D deficiency in a critically ill population. To the best of our knowledge, this the first study of its kind in an Indian intensive care set-up.
Authors: Afzal Azim, Armin Ahmed, Subhash Yadav, Arvind K Baronia, Mohan Gurjar, Madan M Godbole, Banani Poddar and Ratender K Singh
Neutrophil is a major player in the pathophysiology of severe sepsis. Recent studies have revealed that the cell death mechanism of neutrophils directly relates to the development of organ dysfunction during s...
Authors: Toshiaki Iba, Naoyuki Hashiguchi, Isao Nagaoka, Yoko Tabe and Miwa Murai
Epinephrine administration has been advocated for cardiopulmonary resuscitation (CPR) for decades. Despite the fact that epinephrine administration during CPR is internationally accepted, the effects of the pr...
In patients with severe sepsis, depression of cardiac performance is common and is often associated with left ventricular (LV) dilatation to maintain stroke volume. Although it is essential to optimize cardiac...
Methicillin-resistant Staphylococcus aureus is still a great concern, and recognition of the carrier is essential for appropriate infection control in intensive care units. The utility of wet swab compared to dry...
Subcutaneous emphysema is not a rare complication in intensive care unit patients. Recently, ultrasound guidance for central venous puncture is becoming popular; however, the information on imaging for subcuta...
Authors: Toshi Kubodera, Yushi U Adachi, Toshiyuki Hatano, Tadashi Ejima, Atsushi Numaguchi and Naoyuki Matsuda
Strongyloidiasis is a parasitic infection that occurs in tropical regions. Hyperinfection, which is an accelerated autoinfection, is often associated with an immunosuppressive state, such as HTLV-1 infection o...
Although heated humidifiers (HHs) are the most efficient humidifying device for mechanical ventilation, some HHs do not provide sufficient humidification when the inlet temperature to the water chamber is high...
Authors: Yusuke Chikata, Mutsuo Onodera, Hideaki Imanaka and Masaji Nishimura
The Fundamental Critical Care Support (FCCS) course has been introduced after minimal adaptation according to Japanese clinical settings. The original course in the USA is often used to prepare residents for r...
Although some studies conducted outside of Japan have addressed the effectiveness of intravenous immunoglobulins (IVIG) in treating infections, the dosing regimens and amounts used in Japan are very different ...
Treatment of infections caused by multidrug-resistant Pseudomonas species is difficult because few antibiotics active against such organisms are available. Arbekacin, a relatively new aminoglycoside, is effective...
Authors: Yoshiaki Iwashita, Tomoyuki Enokiya, Kei Suzuki, Kazuto Yokoyama, Akitaka Yamamoto, Ken Ishikura, Masahiro Okuda and Hiroshi Imai
Semi-quantitative Gram stain and culture methods are still commonly used for diagnosing ventilator-associated pneumonia (VAP), due to its convenience. Only a few studies, however, have assessed the reliability...
