JA Clinical Reports最新文献_第4页

Effective management of acute hemorrhage using an SL One^® rapid infusion device in a pediatric patient undergoing nephrectomy for Wilms tumor with inferior vena cava extension: a case report. SL One®快速输液器对儿童肾切除术伴下腔静脉扩张肾母细胞瘤患者急性出血的有效治疗：1例报告。

IF 0.8

JA Clinical Reports Pub Date : 2025-05-04 DOI: 10.1186/s40981-025-00788-7

Shoko Fujioka, Yusuke Miyazaki, Hinako Furuya, Chika Miyazaki, Nobuyuki Katori, Yoshie Taniguchi

{"title":"Effective management of acute hemorrhage using an SL One® rapid infusion device in a pediatric patient undergoing nephrectomy for Wilms tumor with inferior vena cava extension: a case report.","authors":"Shoko Fujioka, Yusuke Miyazaki, Hinako Furuya, Chika Miyazaki, Nobuyuki Katori, Yoshie Taniguchi","doi":"10.1186/s40981-025-00788-7","DOIUrl":"https://doi.org/10.1186/s40981-025-00788-7","url":null,"abstract":"Background: Wilms tumor is the most common pediatric renal tumor. Tumor extension into the inferior vena cava (IVC) can increase hemorrhage risk during surgical resection, necessitating rapid transfusion. Pediatric patients have lower circulating blood volume, heightening their susceptibility to hemodynamic instability.Case presentation: A 2-year-old boy with an IVC-extending Wilms tumor underwent nephrectomy. Anticipating hemorrhage, we employed an SL One® rapid infusion device via a Broviac™ central venous catheter. During a sudden, high-volume bleeding, transfusion was initiated at 23 mL/min and intermittently increased to 150 mL/min while preload was evaluated using transesophageal echocardiography, rapidly stabilizing hemodynamics. No rapid-transfusion-related complications, such as hyperkalemia or hypothermia, were observed, and the postoperative course was uneventful.Conclusions: In this pediatric case at high risk for acute blood loss, the SL One® provided effective circulatory stabilization without adverse events. Further studies are needed to validate the safety of the SL One® in pediatric patients.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"25"},"PeriodicalIF":0.8,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of intermittent and continuous renal replacement therapy for sepsis-associated AKI: a retrospective analysis of the Japanese ICU database. 间歇和连续肾替代治疗脓毒症相关AKI的比较：日本ICU数据库的回顾性分析

IF 1

JA Clinical Reports Pub Date : 2025-04-28 DOI: 10.1186/s40981-025-00787-8

Hiromu Okano, Hiroshi Okamoto, Haruna Tanaka, Ryota Sakurai, Tsutomu Yamazaki

{"title":"Comparison of intermittent and continuous renal replacement therapy for sepsis-associated AKI: a retrospective analysis of the Japanese ICU database.","authors":"Hiromu Okano, Hiroshi Okamoto, Haruna Tanaka, Ryota Sakurai, Tsutomu Yamazaki","doi":"10.1186/s40981-025-00787-8","DOIUrl":"10.1186/s40981-025-00787-8","url":null,"abstract":"Introduction: While both intermittent renal replacement therapy (IRRT) and continuous renal replacement therapy (CRRT) are used to treat sepsis-associated acute kidney injury (S-AKI), their comparative effectiveness remains unclear. We compared the outcomes between these modalities in patients with S-AKI.Methods: Data from the Japanese Intensive Care Patient Database (JIPAD) was used for this multi-center retrospective cohort study. Adult patients with S-AKI who received either IRRT or CRRT between 2015 and 2021 were included. The primary outcome was in-hospital mortality. We compared IRRT and CRRT using one-to-three propensity score matching analysis. A subgroup analysis was performed in patients with septic shock.Results: Of the 756 patients analyzed, 79 received IRRT, and 677 received CRRT. After propensity score matching, baseline characteristics were well-balanced between groups. In-hospital mortality showed no significant difference between IRRT and CRRT (48.6% vs. 38.0%; risk difference - 10.6%; 95% CI - 23.0 to 2.9; P = 0.11). In patients with septic shock, in-hospital mortality was also not different between groups (52.6% vs. 40.4%; risk difference - 12.2%; 95% CI - 28.8 to 3.7; P = 0.10).Conclusion: IRRT and CRRT may be similar in-hospital mortality in patients with S-AKI. Further studies are warranted to determine the most effective renal replacement modality for this patient population.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"24"},"PeriodicalIF":1.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe pulmonary hypertension in weaning from cardiopulmonary bypass following double Ozaki procedure: a case report. 双尾崎手术后体外循环脱机后严重肺动脉高压1例报告。

IF 0.8

JA Clinical Reports Pub Date : 2025-04-21 DOI: 10.1186/s40981-025-00785-w

Jin Sato, Hideki Hino, Ryota Watanabe, Takashi Mori

{"title":"Severe pulmonary hypertension in weaning from cardiopulmonary bypass following double Ozaki procedure: a case report.","authors":"Jin Sato, Hideki Hino, Ryota Watanabe, Takashi Mori","doi":"10.1186/s40981-025-00785-w","DOIUrl":"https://doi.org/10.1186/s40981-025-00785-w","url":null,"abstract":"Background: Ozaki surgery, which reconstructs cardiac valves using autologous pericardium, is commonly performed for aortic valve replacement and offers benefits such as avoiding anticoagulation and reducing valve degeneration. However, its application to pulmonary valve replacement remains rare, and anesthetic management for such cases is not well documented.Case presentation: A 71-year-old woman with severe aortic and pulmonary valve stenosis underwent double valve replacement using the Ozaki procedure and coronary artery bypass grafting. Post-cardiopulmonary bypass, she developed severe pulmonary hypertension and systemic hypotension. Norepinephrine exacerbated pulmonary hypertension, while arginine vasopressin effectively stabilized systemic pressure without worsening pulmonary pressure.Conclusions: This is the first reported case of anesthetic management for double valve replacement using the Ozaki procedure. Adequate use of vasopressin led to ameliorating pulmonary hypertension after cardiopulmonary bypass. Assessing preoperative right ventricular pressure and selecting appropriate vasopressors are crucial in mitigating perioperative pulmonary hypertension.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"23"},"PeriodicalIF":0.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High-flow oxygenation therapy for a sedated elderly frail patient with hiccups undergoing transcatheter aortic valve implantation. 高流量氧合治疗经导管主动脉瓣植入术中镇静的老年虚弱打嗝患者。

IF 0.8

JA Clinical Reports Pub Date : 2025-04-21 DOI: 10.1186/s40981-025-00784-x

Ryosuke Osawa, Takero Arai, Takashi Asai

{"title":"High-flow oxygenation therapy for a sedated elderly frail patient with hiccups undergoing transcatheter aortic valve implantation.","authors":"Ryosuke Osawa, Takero Arai, Takashi Asai","doi":"10.1186/s40981-025-00784-x","DOIUrl":"https://doi.org/10.1186/s40981-025-00784-x","url":null,"abstract":"Background: Transcatheter aortic valve implantation (TAVI) can be performed under sedation, but body movements may lower the efficacy of the procedure and may increase the risk of complications, such as cardiac tamponade. Additional sedatives and analgesics may be required to prevent body movements; this would increase the risk of upper airway obstruction and of respiratory depression. We report a frail patient with hypoxemia and hiccups, in whom high-flow nasal oxygenation facilitated TAVI by effectively inhibiting body movements and respiratory complications.Case presentation: In an 82-year-old patient with severe aortic stenosis, heart failure, hypoxemia, and hiccups, TAVI was planned under sedation with dexmedetomidine, fentanyl, and ketamine. High-flow nasal oxygenation effectively prevented hiccups and associated body movements, and prevented upper airway obstruction and respiratory depression, during TAVI.Conclusions: High-flow nasal oxygenation therapy is potentially useful during cardiac catheterization procedure under monitored anesthesia care, in elderly frail patients with reduced cardiopulmonary function.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"22"},"PeriodicalIF":0.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anesthetic management of coronary artery reconstruction in a patient with myocardial ischemia caused by an anomalous origin of the right coronary artery running between the great vessels: a case report. 右冠状动脉在大血管之间异常起始引起心肌缺血的冠状动脉重建的麻醉处理：1例报告。

IF 0.8

JA Clinical Reports Pub Date : 2025-04-17 DOI: 10.1186/s40981-025-00786-9

Riki Kuzuno, Shuji Kawamoto, Kenichiro Tatsumi, Chikashi Takeda, Moritoki Egi

{"title":"Anesthetic management of coronary artery reconstruction in a patient with myocardial ischemia caused by an anomalous origin of the right coronary artery running between the great vessels: a case report.","authors":"Riki Kuzuno, Shuji Kawamoto, Kenichiro Tatsumi, Chikashi Takeda, Moritoki Egi","doi":"10.1186/s40981-025-00786-9","DOIUrl":"https://doi.org/10.1186/s40981-025-00786-9","url":null,"abstract":"Background: Coronary artery origin anomalies, though often incidentally detected, can lead to sudden death. Comprehensive perioperative management is essential. We report a case of an anomalous right coronary artery (RCA) arising from the left main coronary artery (LMCA) and coursing between the aorta and pulmonary artery, discovered after myocardial infarction, in which intraoperative management ensured successful coronary reconstruction.Case presentation: A 49-year-old woman presented with chest pain and ST segment elevation. Coronary angiography revealed an anomalous RCA demonstrating compressive ischemia by the aorta and pulmonary artery. Preoperatively, blood pressure was stabilized with an isosorbide dinitrate patch. Under cardiopulmonary bypass, the RCA was transected and reanastomosed to its physiological aortic position. Intraoperatively, nicorandil was administered to suppress vascular smooth muscle contraction, while five-lead ECG, transesophageal echocardiography, and operative ultrasound monitoring enabled early detection of ischemia and prevented hypertension. Postoperative ventricular premature contractions resolved by the next day, with uneventful recovery.Conclusions: Targeted pharmacologic blood pressure control and multimodal monitoring are vital for safe perioperative outcomes in anomalous coronary artery origin cases.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"21"},"PeriodicalIF":0.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of swallowing function during the perioperative period using fiberoptic endoscopy in a patient with myasthenia gravis: a case report. 纤维内镜对重症肌无力患者围手术期吞咽功能的评价：1例报告。

IF 0.8

JA Clinical Reports Pub Date : 2025-04-02 DOI: 10.1186/s40981-025-00783-y

Kunihiro Mitsuzawa, Takashi Ishida, Mariko Ito, Satoshi Tanaka, Mikito Kawamata

{"title":"Evaluation of swallowing function during the perioperative period using fiberoptic endoscopy in a patient with myasthenia gravis: a case report.","authors":"Kunihiro Mitsuzawa, Takashi Ishida, Mariko Ito, Satoshi Tanaka, Mikito Kawamata","doi":"10.1186/s40981-025-00783-y","DOIUrl":"10.1186/s40981-025-00783-y","url":null,"abstract":"Background: General anesthesia causes postoperative dysphagia, and myasthenia gravis also impairs swallowing function. Thus, managing general anesthesia in patients with myasthenia gravis requires special attention to swallowing function. Fiberoptic endoscopic evaluation of swallowing (FEES) has the potential to provide precise perioperative assessment and management of swallowing in these patients.Case presentation: A 35-year-old woman with myasthenia gravis was scheduled for laparoscopic ileocolic resection. FEES was performed before anesthesia, after extubation, and on postoperative day 1. General anesthesia was performed with endotracheal intubation, and extubation was performed uneventfully. Post-extubation FEES revealed salivary pooling, decreased glottal closure reflex, and redness of right arytenoid, likely caused by the endotracheal intubation and nasogastric tube. However, FEES performed on postoperative day 1 showed improvement of these findings.Conclusions: FEES effectively identified transient swallowing impairments related to intubation and confirmed the absence of dysphagia specific to myasthenia gravis, thereby contributing to safe perioperative care.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"20"},"PeriodicalIF":0.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of preoperative anxiety and depression with quality of recovery after caesarean delivery: a prospective observational study. 术前焦虑和抑郁与剖宫产后恢复质量的关系：一项前瞻性观察研究。

IF 0.8

JA Clinical Reports Pub Date : 2025-03-29 DOI: 10.1186/s40981-025-00782-z

Ayu Ishida, Mitsuru Ida, Akane Kinomoto, Yusuke Naito, Masahiko Kawaguchi

{"title":"Association of preoperative anxiety and depression with quality of recovery after caesarean delivery: a prospective observational study.","authors":"Ayu Ishida, Mitsuru Ida, Akane Kinomoto, Yusuke Naito, Masahiko Kawaguchi","doi":"10.1186/s40981-025-00782-z","DOIUrl":"10.1186/s40981-025-00782-z","url":null,"abstract":"Introduction: To investigate the association between the presence of both anxiety and depression and the quality of recovery after caesarean delivery.Methods: This secondary analysis of a prospective observational study included 137 patients aged ≥ 18 years who underwent elective and urgent caesarean delivery under spinal anesthesia and completed the Obstetric Quality of Recovery-11 scale at least once postoperatively. Before caesarean delivery, patients were screened for anxiety and depression using the Hospital Anxiety and Depression Scale. A total score of ≥ 8 in each subscale was considered positive screening. Postpartum quality of recovery was assessed using the Obstetric Quality of Recovery-11 at three time points, with a higher score indicating better recovery.Results: Among the eligible patients, 17.5% (24/137) screened positive for both anxiety and depression. No significant difference was found in the Obstetric Quality of Recovery-11 score 24 h after caesarean delivery (p = 0.13, Cohen's d = 0.33), but differences were observed on postoperative day 3 (p = 0.004, Cohen's d = 0.67) and postoperative day 5 (p = 0.01, Cohen's d = 0.58). In the multiple regression analysis, after adjusting for prominent clinical factors, the presence of both anxiety and depression was associated with the Obstetric Quality of Recovery-11 score on postoperative day 3 (p = 0.01) and postoperative day 5 (p = 0.01), but not 24 h after delivery (p = 0.19).Conclusions: Positive Hospital Anxiety and Depression Scale screening for both anxiety and depression was associated with a poor quality of recovery, measured using the Obstetric Quality of Recovery-11 scores on PODs 3 and 5.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"19"},"PeriodicalIF":0.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Low molecular weight heparin-induced thrombocytopenia management during hemodialysis and cardiac surgery: a case report and literature review. 血液透析和心脏手术期间低分子肝素诱导的血小板减少症的处理：一个病例报告和文献复习。

IF 0.8

JA Clinical Reports Pub Date : 2025-03-28 DOI: 10.1186/s40981-025-00781-0

Shuto Takada, Shogo Suzuki, Takahiro Tamura

{"title":"Low molecular weight heparin-induced thrombocytopenia management during hemodialysis and cardiac surgery: a case report and literature review.","authors":"Shuto Takada, Shogo Suzuki, Takahiro Tamura","doi":"10.1186/s40981-025-00781-0","DOIUrl":"10.1186/s40981-025-00781-0","url":null,"abstract":"Background: Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin therapy, including low molecular weight heparins (LMWHs) like dalteparin. While LMWHs reduces the risk of HIT compared to unfractionated heparin, vigilance remains essential.Case presentation: An 82-year-old male with chronic kidney disease (CKD) developed HIT during hemodialysis anticoagulation with dalteparin, resulting in a platelet count of 17,000/µL and positive HIT antibodies. Dalteparin was replaced with nafamostat mesilate. Following confirmed HIT antibody seronegativity, elective aortic valve replacement was performed under cardiopulmonary bypass using heparin. Postoperative dialysis was managed using nafamostat mesilate, preventing HIT recurrence. His platelet count recovered after dalteparin replacement, and no recurrence of HIT was observed.Conclusions: Even LMWHs, such as dalteparin, pose a HIT risk, necessitating vigilant monitoring. Confirming HIT antibody seronegativity and appropriately timing surgery are critical for patients with a history of HIT. Proper postoperative follow-up and alternative anticoagulation strategies can prevent HIT recurrence.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"18"},"PeriodicalIF":0.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efforts to prevent surgical sponge retention: check X-ray on the big screen. 防止手术海绵滞留的措施：在大屏幕上检查x光片。

IF 0.8

JA Clinical Reports Pub Date : 2025-03-14 DOI: 10.1186/s40981-025-00780-1

Kengo Ito, Shotaro Ishimoto, Chiaki Nemoto, Keisuke Yoshida, Satoki Inoue

引用次数: 0

Difficult diagnosis of tetanus in a sedated patient after ileal resection. 回肠切除术后镇静患者破伤风的难诊断。

IF 0.8

JA Clinical Reports Pub Date : 2025-03-08 DOI: 10.1186/s40981-025-00779-8

Satoko Noguchi, Junichi Saito, Eiji Hashiba

引用次数: 0