Acute Medicine & Surgery最新文献

{"title":"A Case of Paroxysmal Sympathetic Hyperactivity due to Cardiogenic Shock","authors":"Takahito Katsuyama,&nbsp;Chiaki Toida,&nbsp;Yasuaki Maeda,&nbsp;Masao Hattori,&nbsp;Akiko Kameyama,&nbsp;Hiroshi Kamijo,&nbsp;Hiroshi Miyama,&nbsp;Yuichiro Kashima,&nbsp;Hiroshi Imamura","doi":"10.1002/ams2.70123","DOIUrl":"10.1002/ams2.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Paroxysmal sympathetic hyperactivity (PSH) is characterized by excessive autonomic activation typically seen after severe brain injury. PSH has not previously been reported in association with cardiogenic shock. Here, we report a case of PSH during the treatment of cardiogenic shock with dilated cardiomyopathy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 60-year-old man with cardiogenic shock and dilated cardiomyopathy was transferred to our hospital. He was intubated and received an Impella support. On Day 4 post-admission, paroxysmal fever, tachycardia, tachypnea, and abnormal muscle tone were observed in the extremities. Antiepileptic drugs and broad-spectrum antibiotics were ineffective, and the seizure pattern suggested PSH; therefore, gabapentin was started on Day 27 post-admission. The seizures gradually resolved and eventually resolved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case suggests that PSH may be triggered by functional disturbances in cerebral perfusion and autonomic regulation associated with cardiogenic shock, even in the absence of irreversible brain injury. When patients with cardiogenic shock present with paroxysmal tachycardia, tachypnea, and fever, PSH should be considered in the differential diagnosis. Early recognition of PSH may facilitate timely treatment and contribute to improved clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"13 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12916243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269399","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}

{"title":"Association of Level 3 Personal Protective Equipment With Intubation Success in the Emergency Department","authors":"Haruka Tsuji,&nbsp;Takashi Shiga,&nbsp;Takuyo Chiba,&nbsp;Yoshiki Fujishima,&nbsp;Yusuke Hagiwara,&nbsp;Hiroshi Okamoto,&nbsp;Hiroko Watase,&nbsp;Jin Takahashi,&nbsp;Takao Ono,&nbsp;Sakina Kadomatsu,&nbsp;Kohei Hasegawa,&nbsp;Tadahiro Goto","doi":"10.1002/ams2.70121","DOIUrl":"10.1002/ams2.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Tracheal intubation is an aerosol-generating procedure that poses a high risk of infection for healthcare workers. While Level 3 personal protective equipment (PPE) is recommended, its effect on procedural performance remains uncertain. The objective of this study was to evaluate the association among Level 3 PPE use, first-pass success, and adverse events during emergency department (ED) intubation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from the Japanese Emergency Airway Network-V, a multicenter prospective registry of 12 EDs in Japan. Adult patients, aged ≥ 18 years, who underwent emergency intubation between 2020 and 2022 were included. Level 3 PPE included disposable gloves, fluid-repellent gowns or coveralls, filtering face piece 3 respirators, and eye protection. The primary outcome was first-pass success, while secondary outcomes included major and minor adverse events, including hypotension, hypoxemia, cardiac arrest, and airway injury. Logistic regression with stabilized inverse probability of treatment weighting was performed to adjust for confounding variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 2431 patients, 1159 (47.7%) were intubated with Level 3 PPE. The unadjusted first-pass success rate was higher with PPE (83.4% vs. 79.6%; <i>p</i> = 0.02); however, adjusted first-pass success did not differ significantly (risk difference−0.4%, 95% CI–6.3 to 5.5; <i>p</i> = 0.88). After adjustment, major (0.8%, 95% CI–7.1 to 8.7) and minor (0.5%, 95% CI–2.2 to 3.2) adverse events showed no significant differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of Level 3 PPE was not associated with decreased success or increased adverse events, supporting its safe use during high-risk procedures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"13 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12913705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146224782","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}

{"title":"Comment on “Fulminant Myocarditis in Immune-Mediated Thrombotic Thrombocytopenic Purpura: A Case Report”","authors":"Prajnasini Satapathy,&nbsp;Rachana Mehta,&nbsp;Ranjana Sah","doi":"10.1002/ams2.70122","DOIUrl":"10.1002/ams2.70122","url":null,"abstract":"<p>We commented on a recent case report of fulminant myocarditis in immune-mediated thrombotic thrombocytopenic purpura (iTTP). While the authors attributed cardiac dysfunction to myocarditis, we caution that microvascular ischemia remains a plausible mechanism, given the clinical context and nonspecific imaging. Diagnostic clarity is essential because therapeutic strategies may differ from one another. We advocated for a rigorous cardiac evaluation in patients with iTTP to inform appropriate management.</p>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"13 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218306","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}

{"title":"Validation of the PECARN Abdominal Rule and FAST-AST/ALT Criteria in Pediatric Blunt Abdominal Trauma: A Retrospective Cohort Study","authors":"Ryo Kamidani,&nbsp;Takashi Araki,&nbsp;Yoshihiro Tada,&nbsp;Ikuya Ueta","doi":"10.1002/ams2.70116","DOIUrl":"10.1002/ams2.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Rapid and accurate diagnosis of intra-abdominal injuries (IAIs) is crucial for pediatric patients with blunt abdominal trauma. However, clinical assessments can be challenging in children. We evaluated several clinical decision instruments (CDIs) designed to identify children with low risk of IAI who required acute intervention (IAI-I) at a Japanese pediatric hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study was conducted between April 2021 and March 2024 and included 259 pediatric patients with torso trauma. We used clinical and imaging data to compare the Pediatric Emergency Care Applied Research Network (PECARN) abdominal rule with a combination of focused assessment with sonography in trauma (FAST) with elevated aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels rule.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 259 pediatric patients assessed, 20 (7.7%) developed IAI. Of these, one required intervention. The PECARN abdominal rule had a sensitivity of 100% and a specificity of 65.1% for identifying IAI-I, whereas FAST with elevated AST/ALT had a sensitivity of 100% and a specificity of 82.2%. For IAI, the PECARN abdominal rule had a sensitivity of 90% and a specificity of 69.5%, whereas FAST with elevated AST/ALT had a sensitivity of 65.0% and a specificity of 88.7%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The PECARN abdominal rule had high sensitivity but moderate specificity for identifying IAI, whereas FAST with elevated AST/ALT had a higher specificity. These findings suggest that CDIs can minimize unnecessary computed tomography scans in this context. Further validation of these findings in other healthcare settings and patient populations is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"13 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218372","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}

{"title":"RE: Utility of Plasma Myostatin as a Predictive Biomarker for Post-Intensive Care Syndrome in Patients With Sepsis","authors":"Hinpetch Daungsupawong,&nbsp;Viroj Wiwanitkit","doi":"10.1002/ams2.70119","DOIUrl":"10.1002/ams2.70119","url":null,"abstract":"&lt;p&gt;The publication on “Utility of Plasma Myostatin as a Predictive Biomarker for Post-Intensive Care Syndrome in Patients With Sepsis [&lt;span&gt;1&lt;/span&gt;]” is interesting. The intriguing hypothesis that plasma myostatin levels may be a predictor of Post-Intensive Care Syndrome (PICS) in patients with severe sepsis is brought up by this study. However, there are a number of limitations to the study that need to be taken into account. First, given the high mean patient age of 71 years, it is a single-center prospective study, which restricts extrapolation to other groups. Confounding variables that have not been sufficiently controlled could include frailty or sarcopenia. Additionally, there is a considerable danger of statistical instability and large confidence intervals due to the small sample size of 77 patients, especially in logistic regression. This could result in “significant” results that are less definite than claimed.&lt;/p&gt;&lt;p&gt;In terms of statistics, even though multivariable logistic regression was employed, no information was given on control variables such baseline muscle mass, nutritional status, inflammation indicators, the severity of delirium, or drugs that impact the system. Neuromuscular levels are significant confounders of PICS results as well as myostatin dynamics. Additionally, even though the AUC values of 0.70 and 0.76 indicate “fair discrimination” prediction abilities, they are not yet appropriate for use as clinical biomarkers, particularly as the biomarker to be utilized should have an AUC of ≥ 0.80 or higher for dependability. Additionally, the sample was only measured three times, which might not accurately represent the sepsis response's myostatin kinetics, which exhibit a more complicated pattern than a linear change over a single day.&lt;/p&gt;&lt;p&gt;From a discussion standpoint, a number of issues need extensive discussion such as (1) Do lower myostatin levels indicate muscle catabolism or an adaptive response of the inflammatory–metabolic axis? (2) are the links shown to be causative or just epiphenomena of the severity of the disease? (3) for years, there has been discussion in the literature on whether myostatin measures can actually be differentiated from structurally identical proteins, such as GDF-11, and (4) whether a more potent multibiomarker panel can be produced by combining myostatin with other biomarkers such as IL-6, NGAL, or neurofilament light chain.&lt;/p&gt;&lt;p&gt;In the future, generalizability will be confirmed by multicenter trials with a variety of sample groups, especially in younger patients or those without sarcopenia. The biological consequences will also be clarified by longitudinal studies that monitor myostatin trajectories on a daily basis or connect them to imaging-based muscle measurements like CT or ultrasound muscle mass. To improve predictive power, myostatin data could be combined with other variables using machine learning models. In order to translate biomarkers into specific intervention paths, it wi","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"13 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211927","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}

{"title":"Response to “RE: Utility of Plasma Myostatin as a Predictive Biomarker for Post Intensive Care Syndrome in Patients With Sepsis”","authors":"Ayaki Shirahata,&nbsp;Nobuto Nakanishi,&nbsp;Yuko Ono,&nbsp;Shigeaki Inoue,&nbsp;Joji Kotani","doi":"10.1002/ams2.70118","DOIUrl":"10.1002/ams2.70118","url":null,"abstract":"&lt;p&gt;We sincerely thank Drs. Daungsupawong and Wiwanitkit for their thoughtful and constructive comments on our article, “Utility of Plasma Myostatin as a Predictive Biomarker for Post-Intensive Care Syndrome (PICS) in Patients with Sepsis.” Their insights provide an important opportunity to clarify several aspects of our study.&lt;/p&gt;&lt;p&gt;First, we acknowledge that this was a single-center, exploratory study that predominantly included elderly patients. As stated in the manuscript, our findings should be regarded as hypothesis-generating, and confirmation in larger, multicenter cohorts is necessary. Major limitations include the small sample size, potential selection bias, and limited adjustment for confounding variables.&lt;/p&gt;&lt;p&gt;Second, regarding the assessment of sarcopenia, skeletal muscle mass was evaluated using the psoas muscle index at the third lumbar vertebral level on computed tomography. Previous studies have demonstrated that computed tomography-derived psoas muscle index correlates with whole-body skeletal muscle mass and serves as a reasonable surrogate marker for sarcopenia in critically ill patients [&lt;span&gt;1&lt;/span&gt;]. Sarcopenia was included as a covariate in our multivariable model, and lower plasma myostatin levels remained independently associated with long-term functional impairment. Because of the retrospective study design, muscle assessment was limited to a single time point. Future prospective studies should incorporate longitudinal muscle evaluation using ultrasound, which has been shown to detect low muscularity at ICU admission [&lt;span&gt;1&lt;/span&gt;]. Serial ultrasound measurements combined with myostatin kinetics may better capture dynamic muscle changes after sepsis.&lt;/p&gt;&lt;p&gt;Third, the predictive performance of plasma myostatin, with area-under-the-curve values ranging from 0.70 to 0.76, indicates fair discrimination. According to commonly accepted criteria, an AUC of 0.70–0.79 reflects fair accuracy, 0.80–0.89 good accuracy, and ≥ 0.90 excellent accuracy [&lt;span&gt;2&lt;/span&gt;]. Therefore, although statistically significant, our findings should be interpreted cautiously and require external validation before clinical application.&lt;/p&gt;&lt;p&gt;Finally, low plasma myostatin levels may reflect enhanced muscle catabolism or compensatory adaptation within the inflammatory–metabolic axis. In critically ill populations, lower circulating myostatin has been associated with systemic inflammation and unfavorable outcomes [&lt;span&gt;3&lt;/span&gt;]. Experimental studies suggest that interleukin-6 may modulate myostatin expression via the JAK/STAT3 signaling pathway, providing a mechanistic link between inflammation and muscle atrophy. Although myostatin (GDF-8) and GDF-11 share substantial sequence homology, they are distinct gene products with different tissue distributions. Myostatin is primarily expressed in skeletal muscle and the central nervous system, whereas GDF-11 is more prominent in neural and cardiovascular tissues [&lt;span&gt;4&lt;/span&gt;]. This difference may par","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"13 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12907249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211905","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}

{"title":"Pediatric ECPR as Bridge to Surgery: Successful Management of Refractory Cardiac Arrest in High-Risk ICD Lead Extraction","authors":"Jessy Steve Masso-Bueso,&nbsp;Gian Manuel Jiménez-Rodríguez,&nbsp;Kevin Alexis Fierros-Chablé,&nbsp;David Jacobo Sánchez-Amaya,&nbsp;Gustavo Rojas-Velasco,&nbsp;Daniel Manzur-Sandoval","doi":"10.1002/ams2.70117","DOIUrl":"10.1002/ams2.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Refractory cardiac arrest remains a major challenge in children, with poor survival despite advances in cardiopulmonary resuscitation (CPR). Extracorporeal cardiopulmonary resuscitation (ECPR), defined as rapid deployment of extracorporeal membrane oxygenation (ECMO) during ongoing CPR, provides circulatory and respiratory support and can serve as a bridge to definitive interventions. While increasingly reported in adults, pediatric use remains limited due to anatomical and physiological challenges, with evidence largely restricted to case reports and small series.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 14-year-old female with dilated cardiomyopathy, severe left ventricular dysfunction (LVEF 12.5%), and prior implantable cardioverter-defibrillator placement underwent elective lead extraction and generator replacement. During the procedure, pericardial effusion with hemodynamic collapse occurred, requiring emergent pericardiocentesis. Despite transient return of spontaneous circulation, refractory cardiac arrest developed after 24 min of CPR. ECPR was initiated via percutaneous femoral veno-arterial ECMO, restoring systemic perfusion. Transesophageal echocardiography revealed right atrial perforation, which was surgically repaired. Hemodynamic stability was achieved with combined ECMO and intra-aortic balloon pump support. The patient was successfully decannulated on postoperative Day 1, extubated on Day 4 without neurological deficits, and discharged to a heart transplant program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights the pivotal role of ECPR as a bridge to definitive repair in pediatric patients experiencing refractory arrest during high-risk interventions. Early initiation, skilled cannulation, and multidisciplinary coordination were critical for survival. Pediatric experiences such as these are essential to refine selection criteria, inform procedural planning, and expand the limited evidence supporting ECPR as a transformative strategy in resuscitation for this vulnerable population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"13 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12907257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211914","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}

{"title":"Evaluating the Efficacy of Hyperbaric Oxygen Therapy for Acute Carbon Monoxide Poisoning: A Systematic Review and Meta-Analysis","authors":"Motoki Fujita,&nbsp;Masaki Todani,&nbsp;Yasuhiko Ajimi,&nbsp;Tomoaki Yatabe,&nbsp;Shoji Yokobori,&nbsp;Manabu Araki,&nbsp;Norio Chihara,&nbsp;Masao Nagayama,&nbsp;Tetsuya Samkamoto,&nbsp;Ryosuke Tsuruta,&nbsp;the Japan Resuscitation Council (JRC) Neuroresuscitation Task Force and the Guidelines Editorial Committee","doi":"10.1002/ams2.70114","DOIUrl":"10.1002/ams2.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To reassess the efficacy of hyperbaric oxygen (HBO) therapy for acute carbon monoxide (CO) poisoning through a systematic review and meta-analysis, including a subgroup analysis of treatment pressures exceeding 2.5 atm absolute (ATA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating HBO therapy for acute CO poisoning. A literature search was performed in MEDLINE, CENTRAL, and Ichushi-Web databases, focusing on RCTs published up to June 2024. Only adult patients (≥ 18 years) were included, and studies were screened following PRISMA guidelines. Data extraction and quality assessment were conducted by two independent reviewers using the Cochrane risk of bias tool and the GRADE approach. Statistical analysis used a random effects model, with outcomes expressed as odds ratios (OR) and 95% confidence intervals (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six studies were included, and no significant benefit of HBO therapy was observed in terms of reducing mortality or improving neurological outcomes. The subgroup analysis of HBO at ≥ 2.5 ATA also showed no significant advantage over control treatments. Moderate to significant heterogeneity was found across included studies, and the quality of evidence was rated as low to very low.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The efficacy of HBO therapy, even at ≥ 2.5 ATA, for improving outcomes in acute CO poisoning remains unproven. Despite these findings, HBO therapy may still hold potential benefits that require further exploration. High-quality, multicenter RCTs are necessary to better define its role in the treatment of CO poisoning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>UMIN Clinical Trials Registry: UMIN000054641</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"13 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103556","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}

{"title":"Delayed Respiratory Failure After Sulfuric Acid Mist Inhalation From a Foaming Lead-Acid Battery","authors":"Rio Saruta,&nbsp;Yuya Suzuki,&nbsp;Kasumi Satoh,&nbsp;Komei Kameyama,&nbsp;Manabu Okuyama,&nbsp;Hajime Nakae","doi":"10.1002/ams2.70115","DOIUrl":"10.1002/ams2.70115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sulfuric acid inhalation can cause respiratory tract injury and life-threatening respiratory failure. Reports of delayed hypoxemia after exposure to acid aerosols generated from foaming lead–acid batteries are rare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>An 80-year-old auto mechanic inhaled an odorless aerosol for seconds while leaning over a foaming lead–acid battery in an enclosed garage, and presented with dyspnea and type I respiratory failure (PaO₂/FiO₂ ratio = 195) after 13 days. Chest computed tomography showed bilateral ground-glass opacities with superimposed right lung consolidation. Microbiological tests and autoantibody panel results were negative. High-flow nasal cannula oxygen and intravenous systemic corticosteroids were initiated, with rapid improvement. Antibiotics were discontinued on day 8 and corticosteroids were tapered over 40 days followed by the patient's discharge on day 43.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sulfuric acid inhalation can follow a subacute and progressive course. In severe cases, multimodal supportive care and selective systemic corticosteroids may be considered post-assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"13 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049530","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}

{"title":"Delayed-Onset Infected Perirenal Hematoma Following Trauma: A Case Report","authors":"Yuta Nakamura,&nbsp;Tomoki Wada,&nbsp;Ryota Inokuchi,&nbsp;Kent Doi","doi":"10.1002/ams2.70109","DOIUrl":"10.1002/ams2.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Perirenal hematomas are commonly observed in patients with renal trauma; however, secondary infections are uncommon and often underdiagnosed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>An 82-year-old woman with a history of diabetes mellitus and liver cirrhosis presented to our emergency department with intermittent fever, malaise, and lower back pain 1 month after sustaining a fall. Contrast-enhanced computed tomography (CT) showed an 8-cm gas-containing left perirenal hematoma without urinary extravasation, and blood culture revealed <i>Klebsiella pneumoniae</i>. The patient was initially treated with intravenous antibiotics; however, CT-guided percutaneous drainage was eventually required for clinical and radiologic resolution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Delayed-onset infection in traumatic perirenal hematoma needs to be considered in high-risk patients for early definitive source control.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"13 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12808811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996977","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}