@Intensive_Ryo

ICU Trainee ☕🎾🥃🍛🍖🇯🇵🇦🇺 https://xitter.cf/t.co/hYOd7at9On

 Melbourne, Victoria
Joined January 2019
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🧵 FRAILTY after surgery: Does it still matter in the ICU? We studied 216,922 postop ICU patients across 🇦🇺 to find out. Here’s what we learned 👇 #ICU #Frailty #PerioperativeCare #CriticalCare
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EN中で下痢のあるICU患者で、ENを減らしたり止めたら 本当に下痢止まるの？ という疑問の研究が Nutrition in Clinical Practice に排出されました。 経腸栄養の減量は1日あたり90g程度の下痢量の減少と600kcalのエネルギー減少とのトレードオフでした。 っていうかEN止めても下痢そんなに減らなくない？という怒りに満ちた研究です。 読むときはマスクと手袋をして読んでください 😷🧤💩💩 Association of enteral nutrition reduction or discontinuation with diarrhea volume and caloric delivery in critically ill adults with diarrhea: A retrospective cohort study - Yamamoto - Nutrition in Clinical Practice - Wiley Online Library aspenjournals.onlinelibrary.…

Association of enteral nutrition reduction or discontinuation with diarrhea volume and caloric...

Background When critically ill patients receiving enteral nutrition (EN) develop diarrhea, clinicians often reduce or discontinue EN, although evidence supporting this practice is limited. We...

aspenjournals.onlinelibrary.wiley.com
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半年働いて感じた、日本と違うオーストラリアICUの5つの特徴｜Taku F | 研究＆臨床@メルボルン @TakuF_J note.com/taku_melb/n/ncc2007…

半年働いて感じた、日本と違うオーストラリアICUの5つの特徴｜Taku F | 研究＆臨床@メルボルン

オーストラリア・メルボルンンの三次医療機関（tertiary hospital）のICUで勤務を始めて半年が経ちました。 この記事では、特に印象に残った「日本のICUとの違い」を紹介していきます。 もちろん、どちらのシステムが優れているという話ではありません。 ひとつの比較材料として読んでいただければ嬉しいです。 1. 役職による給与・責任・業務が明確に分かれている オーストラリアのICUで...

note.com
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ICUの酸素療法95～95%くらいがいいかも、というSRをAJRCCMに出版できました。 今井先生おめでとうございます。 Comparison of Oxygenation Targets in Critically Ill Adults: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials academic.oup.com/ajrccm/arti…
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What constitutes End-of-Life practice in Australia? "Culture, ethics and clinical practicefor intensivists managing end of life care:an Australian perspective" 🆓🔓rdcu.be/e4NCe
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For those interested in ICU ethics & real-world practice @jsicm_org @ANZICS @ESICM @SCCM @yourICM @CritCareReviews @IntensiveNXT @jseptic @ATSCritCare @ISICEM @JaamSNS @WICSBottomLine @ATSBlueEditor @Crit_Care
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下痢の研究第二弾。 いったいどの下痢の定義がICUでは良いんでしょうか。 死亡との関連から定義の妥当性を評価しました。 link.springer.com/10.1186/s4…

Classifying diarrhea in critically ill patients through various criteria: a cohort study

Journal of Intensive Care - The absence of consensus criteria for diarrhea in critically ill patients poses challenges, including an uncertain prevalence and inconsistent findings regarding the...

link.springer.com
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30 years & 3 million ICU admissions in 🇦🇺 🇳🇿 Is this as good as it gets? @anzics journals.lww.com/ccmjournal/… Great work by @JuliaPilowsky @Intensive_Ryo #JoshMclarty #MichaelBailey @AlastairBrown21 #anzicscore
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こんなんウソやん… マッチに当ててへし折るくらいならまだ現実味ある。
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🧠 Sedation in the ICU – are volatile anaesthetics a better option? In recent years, volatile anaesthetics (e.g., sevoflurane) have gained attention as alternatives to intravenous (IV) sedation in ICU patients. They offer some theoretical advantages: ✅ Rapid awakening (exhaled via lungs) ✅ Possibly protective for lungs and diaphragm But are they safe? Do they really improve outcomes? Our team conducted a meta-analysis of 21 RCTs (n = 2,367) comparing volatile vs. IV sedation in critically ill adults receiving mechanical ventilation. We found that volatile sedation was associated with increased mortality: RR 1.17 [95% CI 1.02–1.35] ⚠️ While volatile agents may facilitate faster extubation, current evidence does not support routine use in ICU patients. Use should be limited to selected patients where benefits are likely to outweigh potential risks. 🔗 Open-access paper @Crit_Care: ccforum.biomedcentral.com/ar…
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当科の興梠貴俊先生を筆頭に、 📄「重症患者における動脈カテーテルと静脈穿刺または静脈カテーテルから採取した血液培養のコンタミネーション：系統的レビューおよびメタ解析」 が Clinical Infectious Diseasesに掲載されました！ リンクはこちら👇 🔗 [doi.org/10.1093/cid/ciaf260]

Contamination of Blood Cultures Drawn From Arterial Catheters Versus Venipuncture or Venous...

Arterial catheter–drawn blood cultures exhibit contamination rates comparable to venipuncture and may have lower contamination rates than venous catheter–d

academic.oup.com
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Dexmed as primary sedatives: - SPICE-III ➡️ No mortality benefit, ?merit in older MV patient - 🆕A2B no difference in early extubation Dexmed as an adjunct: - DahLIA➡️early extubation in agitated MV pt - DESIRE ➡️ no mortality benefit in septic pt on MV
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Is renin the next big thing in ICU patient management? The concepts are intriguing, and I look forward to implementing them in my patient management one day. 🎩 tip to the authors including @YukiKotani5, @giovannilandoni, and @KhannaAshishCCM. eddyjoemd.com/foamed/
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🆕 Published in Intensive Care Medicine 📘 What do older adults truly value after critical illness? A survey of 3,410 seniors in Japan found many care more about reducing burden on family, financial impact, and dignity — not just survival. 🔗 rdcu.be/emfHV
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今後の日本のicu研究で大事になる研究。winratioにせよcomposite outcomeにせよ、patient centredなアウトカムとは実際問題何なのか知らないといけない、税金を使った研究なら尚更。
Ryohei Yamamoto@物価3倍の国
@so_flat16 May 2025
新しい論文をだしました。 高齢者における重症疾患罹患後に大事だと思うアウトカムは何か？ 価値観がわからずICU入室し、判断に困るケースが多いため、事前にアウトカムの好みを知っておいたら良くね？という研究です。 高齢者が大事にしているアウトカムは ↓↓ doi.org/10.1007/s00134-025-0…

Unraveling important outcomes for elderly patients facing critical illness: a vignette-based survey

Intensive Care Medicine -

link.springer.com
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@so_flat おめです！
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1. Caregiver’s burden 2. Financial impact 3. Toileting function 4. Independent daily activity 5. Normal swallowing 🧑‍🔬A survey of healthy volunteers (>75yo) from Japan 💡Identified top 5 pt-centred outcomes post ICU discharge 🆕 letter at @yourICM rdcu.be/emfHV
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🧓🏽🛌 Frailty matters—even after surgery. In this multicentre ICU cohort 🇦🇺(n=216k), frailty (CFS 5–8) was associated with significantly shorter 4-year survival 🕰️💔 🚨 New in BJA: 🔗 authors.elsevier.com/c/1k~Co… @BJAJournals
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Grateful to work with an amazing team @catchdrash @ryanryling @jones_daza @IntensiveDave @anzicrc
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🚨 New in BJA: 🔗 authors.elsevier.com/c/1k~Co… @BJAJournals
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