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• Mechanical Power to Predict Ventilator Liberation in Patients with a Tracheostomy

  Toshiharu Nakama, Takehiro Umemura, Soukun Hoshino, Masahiro Tamashiro, Kenichi Satoh, Hiroshi Sekiguchi

  Respiratory Care     2025.01 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  Background: Mechanical power (MP) is useful for predicting the outcomes of attempts to liberate patients from mechanical ventilation. MP is computed based on measured variables derived to determine the power in joules required to breathe while on mechanical ventilation. The main objectives of this study were to calculate a cutoff value of MP that would predict successful liberation and to determine the prediction rate of liberation success based on this cutoff value. Methods: This was a single-center retrospective study. Data from 110 tracheostomized patients on mechanical ventilators were analyzed. We divided subjects on mechanical ventilation into two groups based on liberation outcome. Confounding factors in subject background were adjusted using propensity score matching (PSM). Statistically significant differences in MP at tracheostomy and liberation success between liberation success and failure groups were examined. We calculated the MP cutoff value for successful liberation using the area under the curve of the receiver operating characteristic (AUC-ROC) and its corresponding prediction rate of liberation success. Results: The number of MP of the successful liberation group was 79 and that of the failed liberation group was 31. The MP cutoff value and corresponding prediction rate for liberation success were 256.5 J/min (AUC-ROC = 0.839) and 92.2%, respectively. After PSM, the low MP group (n = 36), divided based on the MP cutoff value, had a significantly higher liberation success rate than the high MP group (n = 36), with an odds ratio of 19.95 (CI: 3.95, 91.23, P < 0.001). Conclusion: MP at tracheostomy was a strong predictor of liberation success, and the prediction rate of liberation success based on the MP cutoff value was shown to be very high. We recommend that patients with low MP be actively considered for liberation. In contrast, those with high MP should continue weaning while simultaneously making early transfer arrangements if liberation is unsuccessful.

• Feasibility and effectiveness of vertical evacuation of patients with chronic respiratory disease for tsunamis: A prospective study in a coastal area of Okinawa Prefecture, Japan

  Hoshino, S; Sekiguchi, H; Takeuchi, R; Miyagi, K; Sato, Y; Castro, JJ; Yamamoto, K; Kobayashi, J

  INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION ( International Journal of Disaster Risk Reduction )  116   2025.01 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  This study aimed to determine the feasibility of vertical evacuation of patients with chronic respiratory disease living in a tsunami inundation area in Okinawa Prefecture, Japan. The participants included 34 patients with chronic respiratory disease at Public Hospital A and Private Hospital B in Okinawa Prefecture until April 2023 and March 2024, respectively. The 6-min walk test and stair climbing test were measured to determine walking and stair ascending speeds. Walking speeds were used to determine horizontal evacuation time from home to the designated evacuation site for comparison with the estimated tsunami arrival time. The time required for vertical evacuation to suitable buildings was calculated using walking and stair ascending speeds. The mean grace time from the occurrence of the earthquake to the start of horizontal evacuation was significantly shorter than the grace time to the start of vertical evacuation time (p = 0.003). No significant difference was observed in the expected success rates when the evacuation was started immediately after the earthquake. However, when the evacuation was started later than 20 min after the earthquake, the expected success rates were significantly higher for vertical evacuation than for horizontal evacuation (20 min; p = 0.007, 25 min; p = 0.009, 30 min; p = 0.011). The results show that vertical evacuation is more effective for tsunami evacuation than horizontal evacuation and is feasible for patients with chronic respiratory disease. Thus, vertical evacuation should be included in individual evacuation plans for those who require support for tsunami evacuation.

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• Factors associated with scoliosis development in patients with congenital diaphragmatic hernia: A single-center retrospective study

  Hoshino, Tomohide Yoshida, Mayumi Tsukayama, Taro Naka1, Hiroshi Sekiguchi, Jun Kobayashi, Koichi Nakanishi

  Pediatrics & Neonatology     2024.11 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  Background: Scoliosis is the most frequent complication of musculoskeletal abnormalities in patients with congenital diaphragmatic hernia, but the factors that related to its development and severity remain largely unknown. This study aimed to investigate the clinical factors associated with the development and severity of scoliosis in patients with congenital diaphragmatic hernia. Methods: Thirty-two patients admitted to the neonatal intensive care unit for congenital diaphragmatic hernia at the University of the Ryukyus Hospital between 2004 and 2019 were retrospectively analyzed, particularly those who were discharged alive and had available chest radiographs at 4–5 years of age from medical records. The presence of scoliosis was determined using the chest radiographs. Basic and medical information was also extracted from the patients’ medical records. Results: Factors associated with scoliosis development were an Apgar score <7 points, liver prolapse, and intubation period. The Cobb angle exhibited a significant positive correlation with intubation period, hospital stay duration, and tube feeding duration. Conclusion: Patients with severe congenital diaphragmatic hernia have a high risk of developing scoliosis and may need to begin comprehensive intervention by a multidisciplinary medical team at an early stage.

• Keyword analysis of the American Heart Association Basic Life Support Guidelines using a quantitative text analysis method

  SEKIGUCHI Hiroshi, NAKAMA Toshiharu, SATO Aya, MINEI Akira, KONDO Yutaka, FUKUDA Tatsuma, UENO Eiichi, UMEMURA Takehiro, KUKITA Ichiro

  Journal of Japanese Society for Emergency Medicine ( Japanese Society for Emergency Medicine )  27 ( 1 ) 40 - 47   2024.02 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  <p><b>Background</b>: The American Heart Association (AHA) Basic Life Support (BLS) Healthcare Provider Manual was updated with new scientific evidence for resuscitation. The purpose of this study was to clarify the changes in keywords associated with guideline updates of the 2000, 2005, 2010, and 2015 AHA-BLS Healthcare Provider Manuals using a quantitative text analysis method.</p><p><b>Methods</b>: Using quantitative text analysis software (KH-coder), we analyzed the word frequency, co-occurrence network, and correspondence analysis of the AHA-BLS Japanese version of the Healthcare Provider Manual.</p><p><b>Results</b>: The top 20 extracted words were listed based on word frequency, and eight topics appeared in the co-occurrence network. Correspondence analysis extracted the following keywords: risk factors for cardiac arrest, foreign body airway obstruction, and heart massage in 2000, cardiac heart attack factors in 2005; assisted rescue breathing, agonal gasps, and CPR procedure in 2010; and team in 2015. The keyword common to all was CPR.</p><p><b>Conclusions</b>: Quantitative text analysis revealed keywords associated with the updates of the AHA-BLS guidelines in different years. </p>

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• Can Homecare Chronic Respiratory Disease Patients with Home Oxygen Treatment (HOT) in Southern Okinawa, Japan Be Evacuated Ahead of the Next Anticipated Tsunami?

  Hiroshi Sekiguchi, Rie Takeuchi, Yoko Sato, Tsuyoshi Matsumoto, Jun Kobayashi, Takehiro Umemura

  International Journal of Environmental Research and Public Health ( MDPI )    2022.05 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  Abstract: An earthquake with a magnitude of 8 or 9 is predicted to occur near the Ryukyu Islands in Japan, for which the Okinawa Prefecture is preparing countermeasures. Evacuating people to a safe shelter within the tsunami arrival time is a crucial countermeasure. This study aims to understand the vulnerabilities of patients with chronic respiratory diseases in southern parts of Okinawa during a tsunami evacuation, thereby calculating evacuation distance of vulnerable patients and creating individual evacuation plans. Data for chronic respiratory patients obtained in July 2021 from the hospitals in Okinawa Prefecture include age, gender, diagnosis, residence, nearest tsunami shelter, oxygen flow at rest and walking, and maximum walking distance for 6 min based on a 6-min walk test. A quantum geographic information system was used for mapping the data. The survival potential of patients with chronic respiratory disease was evaluated by using a tsunami inundation depth of one meter and the distance within which an evacuation can be performed until the first tsunami wave reaches the nearest evacuation shelter. Results revealed a low survival potential for respiratory disease patients under the current tsunami evacuation plan. The study suggests creating an individual evacuation plan for vulnerable patients involving families and medical staff and then conducting a drill for improving the plan.

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• Consideration of an Optimal Educational Strategy for High-Quality Cardiopulmonary Resuscitation and Chest Compression Fraction in Basic Life Support Simulation Training

  Hiroshi Sekiguchi, Ichiro Kukita

  The American Heart Association Scientific Sessions 2019  (Philadelphia, PA)  2019.11  -  2019.11 

• Verification on the possibility of evacuation of chronic respiratory disease patients in a Tsunami

  関口浩至

  The 47nd Annual Congress of The Society of Critical Care Medicine  (San Antonio, Texas, USA)  2018.02  -  2018.02 

• Verification of Changes in The Initiation Time for Chest Compressions using A Mannequin during Basic Life Support according to Modified Guidelines

  関口浩至、近藤豊、久木田一朗

  The 42nd Annual Congress of The Society of Critical Care Medicine  (San Juan, Puerto Rico, USA)  2013.02  -  2013.02 

• Verification on the possibility of evacuation of chronic respiratory disease patients in a Tsunami.

  Sekiguchi H, Kondo Y, Kukita I

  47th Annual Congress of the society of Critical Care Medicine（San Antonio, Texas, USA）  1900.01  -  1900.01 

• Consideration of an Optimal Educational Strategy for High-Quality Cardiopulmonary Resuscitation and Chest Compression Fraction in Basic Life Support Simulation Training

  関口 浩至

  American Hoeart Association Resuscitation Scientific Sessions 2019  1900.01  -  1900.01 

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• Grant-in-Aid for Scientific Research(B)

  Project Year: 2023.04  -  2026.03 

  Direct: 14,500,000 (YEN)  Overheads: 18,850,000 (YEN)  Total: 4,350,000 (YEN)

• Grant-in-Aid for Scientific Research(B)

  Project Year: 2023.04  -  2026.03 

  Direct: 14,500,000 (YEN)  Overheads: 18,850,000 (YEN)  Total: 4,350,000 (YEN)

• Grant-in-Aid for Young Scientists(A)

  Project Year: 2022.04  -  2025.03 

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• 2022.10

  　

  　

  

• 2018.03

  　

  　

• 2016.07

  　

  　

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• 2008.11

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• 琉球大学地域連携推進機構 

  2018.3