Acute Medicine & Surgery最新文献

{"title":"Association between the severity of hypothermia and in-hospital mortality in patients with infectious diseases: The J-Point registry","authors":"Tadaharu Shiozumi,&nbsp;Yuki Miyamoto,&nbsp;Sachiko Morita,&nbsp;Naoki Ehara,&nbsp;Nobuhiro Miyamae,&nbsp;Yohei Okada,&nbsp;Takaaki Jo,&nbsp;Yasuyuki Sumida,&nbsp;Nobunaga Okada,&nbsp;Makoto Watanabe,&nbsp;Masahiro Nozawa,&nbsp;Ayumu Tsuruoka,&nbsp;Yoshihiro Fujimoto,&nbsp;Yoshiki Okumura,&nbsp;Tetsuhisa Kitamura,&nbsp;Tasuku Matsuyama","doi":"10.1002/ams2.964","DOIUrl":"https://doi.org/10.1002/ams2.964","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Hypothermia is associated with poor prognosis in patients with sepsis. However, no studies have explored the correlation between the severity of hypothermia and prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the Japanese accidental hypothermia network registry (J-Point registry), we examined adult patients aged ≥18 years with infectious diseases whose initial body temperature was ≤35°C from April 1, 2011 to March 31, 2016, in 12 centers. Patients were divided into three groups according to their body temperature: Tertile 1 (T1) (32.0–35.0°C), Tertile 2 (T2) (28.0–31.9°C), and Tertile 3 (T3) (&lt;28.0°C). In-hospital mortality was employed as a metric to assess outcomes. We conducted a multivariate logistic regression analysis to investigate the relationship between the three categories and the occurrence of in-hospital mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 572 patients were registered, and 170 eligible patients were identified. Of these patients, 55 were in T1 (32.0–35.0°C), 76 in T2 (28.0–31.9°C), and 39 in T3 (&lt;28.0°C) groups. The overall in-hospital mortality rate in accidental hypothermia (AH) patients with infectious diseases was 34.1%. The in-hospital mortality rates in the T1, T2, and T3 groups were 34.5%, 36.8%, and 28.2%, respectively. The multivariable analysis demonstrated no significant differences regarding in-hospital mortality among the three groups (T2 vs. T1, adjusted odds ratio [OR]: 1.29; 95% confidence interval [CI]: 0.58–2.89 and T3 vs. T1, adjusted OR: 0.83; 95% CI: 0.30–2.31).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this multicenter retrospective observational study, hypothermia severity was not associated with in-hospital mortality in AH patients with infectious diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.964","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140949192","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":"Characteristics and outcomes of out-of-hospital cardiac arrest in a hilly area: Utstein Registry data from the Nagasaki Medical Region, Japan","authors":"Valeryia Zmushka,&nbsp;Goro Tajima,&nbsp;Keita Iyama,&nbsp;Koichi Hayakawa,&nbsp;Kazunori Yamashita,&nbsp;Takamitsu Inokuma,&nbsp;Hiroo Izumino,&nbsp;Takanobu Otaguro,&nbsp;Eri Uemura,&nbsp;Tomohiro Ueki,&nbsp;Shimon Murahashi,&nbsp;Shuhei Yamano,&nbsp;Kensuke Takahashi,&nbsp;Yoshihiro Aoki,&nbsp;Atsuko Tachikawa,&nbsp;Osamu Tasaki","doi":"10.1002/ams2.966","DOIUrl":"https://doi.org/10.1002/ams2.966","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To analyze characteristics and investigate prognostic indicators of out-of-hospital cardiac arrest (OHCA) in a hilly area in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective population-based study was conducted using the Utstein Registry for 4280 OHCA patients in the Nagasaki Medical Region (NMR) registered over the 10-year period from 2011 to 2020. The main outcome measure was a favorable cerebral performance category (CPC 1–2). Sites at which OHCA occurred were classified into “sloped places (SPs)” (not easily accessible by emergency medical services [EMS] personnel due to slopes) and “accessible places (APs)” (EMS personnel could park an ambulance close to the site). The characteristics and prognosis based on CPC were compared between SPs and APs, and multivariable analysis was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant improvement in prognosis occurred in the NMR from 2011 to 2020. Prognosis in SPs was significantly worse than that in APs. However, multivariable analysis did not identify SP as a prognostic indicator. The following factors were associated with survival and CPC 1–2: age group, witness status, first documented rhythm, bystander-initiated cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use, use of mechanical CPR (m-CPR) device or esophageal obturator airway (EOA), and year. Both m-CPR and EOA use were associated with a poor prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a hilly area, OHCA patients in SPs had a worse prognosis than those in APs, but SPs was not significantly associated with prognosis by multivariable analysis. Interventions to increase bystander-initiated CPR and AED use could potentially improve outcomes of OHCA in the NMR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.966","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140949191","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":"Significance of perioperative inter-departmental collaboration for obstetric emergency response: A mini-review","authors":"Nobuyasu Komasawa","doi":"10.1002/ams2.962","DOIUrl":"https://doi.org/10.1002/ams2.962","url":null,"abstract":"<p>This review underscores the crucial role of interdisciplinary collaboration in managing obstetric emergencies such as crisis bleeding. Prompt clinical judgment and coordinated interventions involving various departments are emphasized for the well-being of both the mother and newborn. The review explores the importance of emergency response infrastructure in obstetric facilities and delves into the 2022 Obstetric Crisis Bleeding Guidelines, emphasizing the relevance of a DIC score for severity assessment. The collaborative efforts within the operating room, involving different healthcare professionals, are detailed, stressing meticulous coordination during emergencies like massive bleeding. The necessity of interprofessional collaboration for building a responsive perioperative management team is discussed, with a focus on leadership, followership, and effective communication. The abstract also proposes simulation-based education for inter-departmental training, emphasizing a modified non-technical skill evaluation tool tailored to the unique characteristics of obstetric crisis management in the operating room. Continuous formative assessment of these factors is deemed essential for effective training in various obstetric emergency situations.</p>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.962","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140881031","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":"Carbazochrome sodium sulfonate and tranexamic acid combination therapy to reduce blood transfusions after 24 h of injury: A retrospective study","authors":"Hiroki Nagasawa,&nbsp;Kazuhiko Omori,&nbsp;Soichirou Ota,&nbsp;Ken-ichi Muramatsu,&nbsp;Ikuto Takeuchi,&nbsp;Hiromichi Ohsaka,&nbsp;Youichi Yanagawa","doi":"10.1002/ams2.961","DOIUrl":"https://doi.org/10.1002/ams2.961","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Reducing the blood transfusion volume is important in severe trauma. We hypothesized that carbazochrome sodium sulfonate (CSS) combined with tranexamic acid (TXA) would reduce blood transfusions in severe trauma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From April 2017 to March 2023, data were collected from patients (aged ≥16 years) admitted to our hospital for trauma and administered packed red blood cells (pRBC) and plasma transfusions within 12 h postinjury. Patients infused with CSS and TXA (CSS + TXA group) were compared with those infused with TXA alone (TXA group). The outcomes were blood product transfusion volumes within and after 24 h, the number of patients receiving &gt;6 units of pRBC transfusion after 24 h, duration of intensive care unit and in-hospital stays, and 28-day in-hospital mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 138 patients were included in the study. In the univariate analyses, the CSS + TXA group (<i>n</i> = 62) showed a significant reduction in the total pRBC transfusion volume, in-hospital days, and number of patients receiving &gt;6 units of pRBCs in the delayed phase. Based on the multivariate logistics regression analysis, only the CSS + TXA group had a significantly lower adjusted odds ratio for receiving &gt;6 units of pRBC transfusion after 24 h. During the in-hospital days, the CSS + TXA group did not experience an increased incidence of major complications when compared with the TXA group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with trauma, treatment with CSS with TXA may reduce the requirement for blood transfusion after 24 h. Moreover, this treatment can improve admission outcomes without increasing complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.961","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140844703","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":"Acute alcohol intoxication presenting acquired lesion of the corpus callosum in a young healthy woman: A case of possible Marchiafava–Bignami disease","authors":"Makoto Watanabe,&nbsp;Nobuhito Atagi,&nbsp;Yosuke Makino,&nbsp;Kunihiko Kooguchi,&nbsp;Bon Ohta","doi":"10.1002/ams2.960","DOIUrl":"https://doi.org/10.1002/ams2.960","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Marchiafava–Bignami disease is a rare neurological disease characterized by acquired lesions of the corpus callosum. Although the major causative etiology is chronic alcoholism, a case caused by acute alcohol intoxication has not yet been reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 19-year-old female with no known medical history or a history of chronic alcohol consumption was brought to the emergency department in a coma after binge alcohol consumption. Even after an overnight observation, she remained comatose. After a thorough examination including magnetic resonance imaging, which showed lesions of the corpus callosum, she was treated with thiamine for Marchiafava–Bignami disease. She recovered completely and at the follow-up, the callosum lesion had resolved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is a rare case within the spectrum of Marchiafava–Bignami disease caused by acute consumption of alcohol. Clinicians should be aware of this potentially devastating critical condition among patients with severe alcohol intoxication, which might have been overlooked.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.960","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140818954","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":"Respiratory-like movements during an apnea test","authors":"Shinichi Kida,&nbsp;Isao Nagata,&nbsp;Tetsuhiro Takei,&nbsp;Kazuhiro Yoshizawa,&nbsp;Taketo Suzuki,&nbsp;Hiroyuki Yamada,&nbsp;Yusuke Nakayama","doi":"10.1002/ams2.959","DOIUrl":"https://doi.org/10.1002/ams2.959","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the possible occurrence of spontaneous movements during an apnea test, respiratory-like movements are rare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 51-year-old man was transferred to our hospital when a sudden disturbance of consciousness developed into cardiac arrest. After spontaneous circulation returned, we diagnosed bilateral cerebellar hemorrhage. He remained comatose with dilated pupils, absent brainstem reflexes, spontaneous breathing, and electrocerebral activity. After being considered brain dead, his family opted for organ donation. The first legal brain death examination on day 5 was aborted because of respiratory-like movements mimicking repetitive abdominal respiration during the apnea test. However, an enhanced magnetic resonance image of the head indicated no blood flow and somatosensory evoked potential testing revealed no brain-derived potentials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Respiratory-like movements can occur during the apnea test in patients considered brain dead. Further research is required to understand this phenomenon.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.959","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140641846","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":"Emergency resuscitative thoracotomy in severe trauma: Analysis of the nation-wide registry data in Japan","authors":"Hiromu Okano,&nbsp;Takero Terayama,&nbsp;Hiroshi Okamoto,&nbsp;Tsutomu Yamazaki","doi":"10.1002/ams2.958","DOIUrl":"https://doi.org/10.1002/ams2.958","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Emergency resuscitative thoracotomy is a potentially lifesaving procedure for patients with cardiac pulmonary arrest and profound circulatory failure resulting from a severe injury. However, survival rate post-emergency resuscitative thoracotomy shows considerable variation, with many studies constrained by limited sample sizes and ambiguous criteria for inclusion. Herein, we assessed the outcomes of emergency resuscitative thoracotomy and identified predictors of futility using Japan Trauma Data Bank data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data of patients aged ≥18 years between 2004 and 2019 were analyzed. The primary outcome measure was survival at discharge. Descriptive statistics were used to compare the survivor and nonsurvivor groups. A multivariable logistic regression analysis was conducted to identify predictors of survival in patients undergoing emergency resuscitative thoracotomy while adjusting for confounding factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among patients who underwent emergency resuscitative thoracotomy, 684/5062 (13.5%) survived. Age &lt;65 years (adjusted odds ratio, 1.351; 95% confidence interval, 1.130–1.615; <i>p</i> &lt; 0.001), absence of cardiac pulmonary arrest on emergency department arrival (adjusted odds ratio, 1.694; 95% confidence interval, 1.280–2.243; <i>p</i> &lt; 0.01), Injury Severity Score &lt;16 (adjusted odds ratio, 2.195; 95% confidence interval, 1.611–2.992; <i>p</i> &lt; 0.01), and penetrating injury (adjusted odds ratio, 1.834; 95% confidence interval, 1.384–2.431; <i>p</i> &lt; 0.01) were identified as factors associated with survival at discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The survival rate for emergency resuscitative thoracotomy in Japan stands at approximately 13.5%. Factors contributing to survival include younger age, absence of cardiopulmonary arrest at emergency department arrival, lack of severe trauma, and sustaining penetrating injuries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.958","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140639649","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":"Veno-venous extracorporeal membrane oxygenation for acute respiratory distress syndrome caused by nitrogen dioxide inhalation: A case report","authors":"Tomoya Nishimura,&nbsp;Makoto Aoki,&nbsp;Hiroyuki Suzuki,&nbsp;Hiroya Hagiwara,&nbsp;Akira Kawauchi,&nbsp;Kenji Fujizuka,&nbsp;Mitsunobu Nakamura","doi":"10.1002/ams2.957","DOIUrl":"https://doi.org/10.1002/ams2.957","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nitrogen dioxide (NO₂) is known to cause lung injury, but there is no established treatment for acute respiratory distress syndrome (ARDS) caused by NO₂ inhalation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 35-year-old man was accidentally exposed to NO₂ fumes and presented to the emergency department. On admission, his oxygen saturation was 87% on ambient air and he was diagnosed with ARDS caused by NO₂ inhalation and immediately intubated; however, hypoxemia and hypercapnia were not ameliorated. Hence, veno-venous extracorporeal membrane oxygenation (V-V ECMO) was introduced and the ventilator settings were set for lung-protective ventilation. Methylprednisolone was also administered. After the initiation of these treatments, oxygenation gradually improved. Therefore, ECMO was weaned off on day 11 and he was extubated on day 12.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lung injury caused by NO₂ inhalation can cause ARDS, and lung-protective ventilation with V-V ECMO induction, as well as glucocorticoid administration, may be effective for this condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.957","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140641848","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":"Survival of a hemodynamically unstable pediatric liver trauma patient with aortic balloon occlusion catheter during air transport: A case report","authors":"Yuichi Miyake,&nbsp;Yuko Okishio,&nbsp;Naoaki Shibata,&nbsp;Shuji Kawashima,&nbsp;Toru Nasu,&nbsp;Kentaro Ueda","doi":"10.1002/ams2.955","DOIUrl":"https://doi.org/10.1002/ams2.955","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The utility of resuscitative endovascular balloon occlusion of the aorta (REBOA) in children remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>An 11-year-old patient with liver trauma with massive extravasation was transported to a local hospital, where an emergency trauma surgery was unavailable. Following the placement of REBOA as a bridge to hemostasis, she was transferred to our hospital by a firefighting helicopter with balloon occlusion. Immediately, she underwent damage control laparotomy and transcatheter arterial embolization. She was subsequently discharged from the hospital 6 months after the accident without complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>REBOA as a bridge to hemostasis may be useful for pediatric patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140633763","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":"Usefulness of the Yokohama Advanced Cardiopulmonary Help Team in patients with acute respiratory distress syndrome","authors":"Shusuke Utada,&nbsp;Hayato Taniguchi,&nbsp;Hiroshi Honzawa,&nbsp;Tomoaki Takeda,&nbsp;Takeru Abe,&nbsp;Ichiro Takeuchi","doi":"10.1002/ams2.953","DOIUrl":"https://doi.org/10.1002/ams2.953","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate whether establishing an extracorporeal membrane oxygenation (ECMO) specialist team, termed the Yokohama Advanced Cardiopulmonary Help Team (YACHT), affected the outcomes and centralization of patients requiring ECMO in Yokohama-Yokosuka regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study included patients aged ≥18 years and treated with venovenous-ECMO for severe acute respiratory distress syndrome (ARDS) from 2014 to 2023. The primary outcome was intensive care unit (ICU) mortality. The secondary outcomes included ICU-, mechanical ventilator-, and ECMO-free days and complications during the first 28 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 46 (12 without- and 34 with-YACHT) patients. Among with-YACHT patients, 24 were transferred to our hospital from other hospitals, 14 were assessed by dispatched ECMO physicians, and 9 were transferred after ECMO introduction. No without-YACHT patients were transferred from other hospitals. With-YACHT patients experienced coronavirus disease 2019-associated respiratory failure more frequently (0 vs. 27, <i>p</i> &lt; 0.001) and had higher Acute Physiology and Chronic Health Evaluation II scores (19 vs. 24, <i>p</i> = 0.037) and lower Respiratory Extracorporeal Membrane Oxygenation Survival Prediction scores (4 vs. 2, <i>p</i> = 0.021). ICU mortality was not significantly different between the groups (2 vs. 4, <i>p</i> = 0.67). ICU- (14 vs. 9, <i>p</i> = 0.10), ventilator- (11 vs. 5, <i>p</i> = 0.01), and ECMO-free days (20 vs. 14, <i>p</i> = 0.038) were higher before YACHT establishment. The incidences of complications were not significantly different between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Mortality was not significantly different pre- and post-YACHT establishment; however, it helped promote regionalization and centralization in Yokohama-Yokosuka areas. We will collect more cases to demonstrate YACHT's usefulness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140633789","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}