ORCID Profile
0000-0002-9532-2859
Current Organisations
Vita-Salute San Raffaele University
,
Faculdade de Medicina da Universidade de São Paulo
,
Kameda Medical Center
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Publications
Del Nido Cardioplegia in Adult Cardiac Surgery: Meta-Analysis of Randomized Clinical Trials
Publisher: Elsevier BV
Date: 07-2023
Response to: norepinephrine formulation for equivalent vasopressive score
Publisher: Springer Science and Business Media LLC
Date: 28-03-2023
Modification of sequential organ failure assessment score using acute kidney injury classification
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.JCRC.2019.02.026
Abstract: To assess the predictive validity of a modified Sequential Organ Failure Assessment (SOFA) score, of which the renal component was replaced with Kidney Disease Improving Global Outcomes (KDIGO) classification of Acute Kidney Injury (AKI). Using a prospective cohort study on AKI in Japan, we replaced the renal component of SOFA score with AKI stages according to the KDIGO criteria except that initiation of renal replacement therapy was assigned four points. We assessed the predictive validity of KDIGO-based SOFA score for hospital and ICU mortality by comparing the areas under the receiver operating characteristic curve (AUC) derived from logistic regression models with that of the original SOFA score. 2292 patients were registered. Overall hospital mortality was 11.6%, and ICU mortality was 5.1%. KDIGO-based SOFA score was moderately correlated with APACHE II score (rho = 0.476). The AUC for hospital and ICU mortality of KDIGO-based and the original SOFA score were 0.749 vs 0.745 (p = .393) and 0.790 vs 0.791 (p = .900). The prognostic performance of KDIGO-based SOFA score was not superior but comparable to that of the original SOFA score.
Risk factors for peripheral intravascular catheter-related phlebitis in critically ill patients: analysis of 3429 catheters from 23 Japanese intensive care units
Publisher: Springer Science and Business Media LLC
Date: 08-04-2022
DOI: 10.1186/S13613-022-01009-5
Abstract: Phlebitis is an important complication occurring in patients with peripheral intravascular catheters (PIVCs). The risk factors for phlebitis in the intensive care unit (ICU) was examined. A secondary analysis of a prospective multicenter cohort study was conducted, involving 23 ICUs in Japan—the AMOR–VENUS study. Consecutive patients aged ≥ 18 years admitted to the ICU with newly inserted PIVCs after ICU admission were enrolled. Characteristics of the ICU, patients, PIVCs, and the drugs administered via PIVCs were recorded. A marginal Cox regression model was used to identify the risk factors associated with phlebitis. A total of 2741 consecutive patients from 23 ICUs were reviewed for eligibility, resulting in 1359 patients and 3429 PIVCs being included in the analysis population. The median dwell time was 46.2 h (95% confidence interval [CI], 21.3–82.9). Phlebitis occurred in 9.1% (95% CI, 8.2–10.1%) of catheters (3.5 cases/100 catheter days). The multivariate analysis revealed that the only factors that increased the risk of developing phlebitis were drugs administered intravenously. This study included 26 drugs, and 4 were associated with increased phlebitis: nicardipine (HR, 1.85 95% CI, 1.29–2.66), noradrenaline (HR, 2.42 95% CI, 1.40–4.20), amiodarone (HR, 3.67 95% CI, 1.75–7.71) and levetiracetam (HR, 5.65 95% CI, 2.80–11.4). Alternatively, factors significantly associated with a reduced risk of phlebitis were: standardized drug administration measures in the ICU (HR, 0.35 95% CI, 0.17–0.76), 30≤ BMI (HR, 0.43 95% CI, 0.20–0.95), catheter inserted by a doctor as nurse reference (HR, 0.55 95% CI, 0.32–0.94), and upper arm insertion site as forearm reference (HR, 0.52 95% CI, 0.32–0.85). The nitroglycerin was associated with a reduced phlebitis risk (HR, 0.22 95% CI, 0.05–0.92). Various factors are involved in the development of phlebitis caused by PIVCs in critically ill patients, including institutional, patient, catheter, and drug-induced factors, indicating the need for appropriate device selection or models of care in the ICU. Trial registration: UMIN-CTR, the Japanese clinical trial registry (registration number: UMIN000028019, July 1, 2017).
Occurrence and incidence rate of peripheral intravascular catheter-related phlebitis and complications in critically ill patients: a prospective cohort study (AMOR-VENUS study)
Publisher: Springer Science and Business Media LLC
Date: 06-01-2021
DOI: 10.1186/S40560-020-00518-4
Abstract: The lack of precise information on the epidemiology of peripheral intravascular catheter (PIVC)-related phlebitis and complications in critically ill patients results in the absence of appropriate preventive measures. Therefore, we aimed to describe the epidemiology of the use of PIVCs and the incidence/occurrence of phlebitis and complications in the intensive care unit (ICU). This prospective multicenter cohort study was conducted in 23 ICUs in Japan. All consecutive patients aged ≥ 18 years admitted to the ICU were enrolled. PIVCs inserted prior to ICU admission and those newly inserted after ICU admission were included in the analysis. Characteristics of the ICU, patients, and PIVCs were recorded. The primary and secondary outcomes were the occurrence and incidence rate of PIVC-related phlebitis and complications (catheter-related blood stream infection [CRBSI] and catheter failure) during the ICU stay. We included 2741 patients and 7118 PIVCs, of which 48.2% were inserted in the ICU. PIVC-related phlebitis occurred in 7.5% (95% confidence interval [CI] 6.9–8.2%) of catheters (3.3 cases / 100 catheter-days) and 12.9% (95% CI 11.7–14.2%) of patients (6.3 cases / 100 catheter-days). Most PIVCs were removed immediately after diagnosis of phlebitis (71.9%). Grade 1 was the most common phlebitis (72.6%), while grade 4 was the least common (1.5%). The incidence rate of CRBSI was 0.8% (95% CI 0.4–1.2%). In cases of catheter failure, the proportion and incidence rate per 100 intravenous catheter-days of catheter failure were 21% (95% CI 20.0-21.9%) and 9.1 (95% CI 8.7–10.0), respectively. PIVC-related phlebitis and complications were common in critically ill patients. The results suggest the importance of preventing PIVC-related complications, even in critically ill patients. UMIN-CTR, the Japanese clinical trial registry (registration number: UMIN000028019 , July 1, 2017).
Related Organisations
Faculdade De Medicina Da Universidade De São Paulo
Location: No location found
Related Funding Activities
No related grants have been discovered for Yuki Kotani.