ICU
研究活動の概要

当院の特性から集中治療科病棟は、病院全体で87床（開院時64床）/一般病棟550床（開院時498床）で全体の16%を占めております。
ここ外科系集中治療科病棟（ICU病棟）は、成人の心臓および血管に疾患をもつ患者の、主に手術後を担当する集中治療科病棟で、全部で24床ありますが、現在16床で運用している為、増床に向け準備を進めております。

主な対象疾患として、成人心疾患では、心移植・心筋梗塞・狭心症・弁膜症・重症心不全などです。
大血管疾患では、大動脈瘤・大動脈解離・慢性肺動脈血栓塞栓症などです。
緊急症例も多く、約30%程度は緊急手術です。
年間症例は1200例、心臓移植手術が2021年度は7例、総計146例です。
2021年度の入室患者の年齢分布は80～90歳が20.0%、90～100歳が2.0%を占め、高齢化も見られます。

研究課題は術後合併症の予防、治療に関しての研究が中心ですが、特に重症心不全の病態に関しての研究を進めています。また、早期診断、加療に向けての取り組みに関しても検討中です。

今年も新型コロナウイルス感染症（COVID-19）の重症患者の受け入れの要請を受け、COVID-19の治療法、ならびに急性呼吸不全に対する人工呼吸管理とECMO管理に関して知見を深めました。またICU施設内の改装、並びにゾーニングを行い、安全に患者受け入れ、加療を行いました（2021年47症例、延べ55症例）。

研究業績
  1. Yamada T, Ogawa T, Minami K, Kusaka Y, Hoshiga M, Ukimura A, Sano T, Kitai T, Yonetsu T, Torii S, Kohsaka S, Kuroda S, Node K, Matsue Y, Matsumoto S. Multiple Cardiovascular Diseases or Risk Factors Increase the Severity of Coronavirus Disease 2019. Circulation Journal. 85, 2111-2115, 2021.
  2. Shijo T, Matsuda H, Yokawa K, Inoue Y, Seike Y, Uehara K, Takahara M, Sasaki H. The impact of vascularized tissue flap coverage on aortic graft infection with and without infected graft excision. European Journal of Cardio-Thoracic Surgery. 60, 1043-1050, 2021.
  3. Tadokoro N, Fukushima S, Minami K, Taguchi T, Saito T, Kawamoto N, Kakuta T, Seguchi O, Watanabe T, Nakajima Doi S, Kuroda K, Suzuki K, Yanase M, Asaumi Y, Shimizu H, Fukushima N, Fujita T. Efficacy of central extracorporeal life support for patients with fulminant myocarditis and cardiogenic shock. European Journal of Cardio-Thoracic Surgery. 60, 1184-1192, 2021.
  4. Inoue Y, Matsuda H, Matsuo J, Shijo T, Omura A, Seike Y, Uehara K, Sasaki H, Kobayashi J. Efficacy of entry exclusion strategy for DeBakey type III retrograde Stanford type A acute aortic dissection. European Journal of Cardio-Thoracic Surgery. 59, 481-489, 2021.
  5. Tadokoro N, Fukushima S, Shimahara Y, Saito T, Kawamoto N, Kakuta T, Minami K, Fujita T. Comparison of safety and haemodynamic performance between the AvalusTM stented aortic valve bioprosthesis and MagnaTM valve in Japanese patients. General Thoracic and Cardiovascular Surgery. 69, 1060-1069, 2021.
  6. Seike Y, Fukuda T, Yokawa K, Horinouchi H, Inoue Y, Shijo T, Uehara K, Sasaki H, Matsuda H. Severe intraluminal atheroma and iliac artery access affect spinal cord ischemia after thoracic endovascular aortic repair for degenerative descending aortic aneurysm. General Thoracic and Cardiovascular Surgery. 69, 1367-1375, 2021.
  7. Uehara K, Matsuda H, Yokawa K, Inoue Y, Shijo T, Seike Y, Sasaki H. Open anatomical repair for primary coarctation of the aorta in adults. General Thoracic and Cardiovascular Surgery. 69, 1532-1538, 2021.
  8. Minami K, Kabata D, Kakuta T, Fukushima S, Fujita T, Shintani A, Yoshitani K, Ohnishi Y. U-Shaped Association Between Intraoperative Net Fluid Balance and Risk of Postoperative Recurrent Atrial Tachyarrhythmia Among Patients Undergoing the Cryo-Maze Procedure: An Observational Study. Journal of Cardiothoracic and Vascular Anesthesia. 35, 2392-2396, 2021.
  9. Minami K, Kabata D, Kakuta T, Fukushima S, Fujita T, Yoshitani K, Ohnishi Y. Association Between Sternotomy Versus Thoracotomy and the Prevalence and Severity of Chronic Postsurgical Pain After Mitral Valve Repair: An Observational Cohort Study. Journal of Cardiothoracic and Vascular Anesthesia. 35, 2937-2944, 2021.
  10. Maekawa M, Minami K, Yoshitani K, Watanabe K, Kanazawa H, Tadokoro N, Fukushima S, Fujita T, Ohnishi Y. Correlation Between Intraventricular Pressure Difference and Indexed Flow of a Left Ventricular Assist Device. Journal of Cardiothoracic and Vascular Anesthesia. 35, 3626-3630, 2021.
  11. Taguchi H, Tanaka T, Nishiofuku H, Fukuoka Y, Minamiguchi K, Taiji R, Takayama K, Takeda M, Hatakeyama K, Inoue T, Ohbayashi C, Kichikawa K. A Rat Model of Frozen Shoulder Demonstrating the Effect of Transcatheter Arterial Embolization on Angiography, Histopathology, and Physical Activity. Journal of Vascular and Interventional Radiology. 32, 376-383, 2021.
  12. Kakuta T, Fukushima S, Minami K, Saito T, Kawamoto N, Tadokoro N, Ikuta A, Kobayashi J, Fujita T. Novel risk score for predicting recurrence of atrial fibrillation after the Cryo-Maze procedure. European Journal of Cardio-Thoracic Surgery. 59, 1218-1225, 2021.
  13. Kakuta T, Fukushima S, Minami K, Kawamoto N, Tadokoro N, Saiki Y, Fujita T. Incidence of and risk factors for pacemaker implantation after the modified Cryo-Maze procedure for atrial fibrillation. The Journal of Thoracic and Cardiovascular Surgery. Epub, 2021.