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生体管理医学救急・集中治療医学

研究室概要

名古屋大学救急・集中治療医学分野は，日本や世界の救急医療や集中治療の救急医学，集中治療医学，そして災害医学などの「急性期管理医学」のあり方に照らして，「急性期管理医学」の学術と仕組みを発展させ，医学および医療の発展に寄与するための講座です。当講座は，救急医学および集中治療医学について，「急性期病態医学」と「急性期管理医学」を発展させることを目標とした講座です。また，救急・集中治療の仕組みを実践し，救急・集中治療の学術を発展させ，本領域の専門家を学位（医学博士）取得の中で育てることを目的として，当講座は運営されています。

１）当講座の歴史
当講座は，1995年4月に初代武澤純教授の指導の下で立ち上がり，2010年2月より第2代松田直之教授の指導に引き継がれています。救急医学と集中治療医学の医学生，医療従事者への教育，また診療と研究として臨床指針と研究指針の下で「急性期医療」と「急性期管理医学」の発展を目標として運営されています。

２）救急医療とは
救急医療は，皆さまの身体的急変に対応する医療です。身体的急変（緊急性：emergency）に対応できるように，「急変の病態生理」を理解し，緊急性をもたらす病態の「診断」と「治療」の指針を実践します。当分野のメンバーは，この救急医療の質と安全を高めるために，名古屋大学医学部附属病院，または連携病院で，救急外来（ER：emergency room）での診療を行っています。当講座のメンバーは日本救急医学会（http://www.jaam.jp/index.htm）に所属し，中心メンバーは救急科指導医/専門医を取得しています。

３）集中治療とは
集中治療は，皆さまの身体的重症性に対応する医療です。例えば，「がん」などの病気に合併して生じた臓器傷害などに対して，集中治療室で状態をもう一度立て直すための，重症化を回避するための急性期医療です。名古屋大学大学院医学系研究科 救急・集中治療医学分野は，救急医療と集中治療を広く日本に，そして世界と連携して広めることを目標としている医学講座です。人工呼吸管理，血液浄化法，人工心肺装置（ECMO：(extracorporeal membrane oxygenation），持続脳波モニタリング，持続血圧モニタリング（観血的血圧測定）などさまざまな臓器補助管理を行います。当講座のメンバーは日本集中治療医学会（https://www.jsicm.org）に所属し，中心メンバーは集中治療専門医を取得しています。

研究プロジェクト

  1. 全身性炎症反応の病態と治療の確立（SIRS，敗血症，外傷，急性膵炎，多臓器不全，播種性血管内凝固）（臨床・基礎）
  2. 急性肺傷害の病態生理と新規創薬の解明（肺線維症の治療）（基礎）
  3. ショックおよび血管内皮細胞傷害の病態生理と治療の確立（臨床・基礎）
  4. 敗血症病態における組織修復促進の研究（基礎）
  5. インターロイキン受容体シグナルの転写因子制御の研究（基礎）
  6. 急性期栄養法の研究（臨床・基礎）
  7. 蘇生後脳症の管理の研究（臨床・基礎）
  8. 集中治療における鎮痛と鎮静の研究（臨床・基礎）
  9. 環境異常症（熱中症・偶発性低体温）の疫学と診療の研究（臨床）
  10. 急性薬物中毒の疫学と治療の研究（臨床）
  11. 小児救急医療データベースの構築と運用（臨床）
  12. 救急・集中治療領域の安全管理の研究（臨床）

教員

構成員名役職所属
松田 直之 教授 救急・集中治療医学
沼口 敦 病院講師 救急・集中治療医学
後藤 縁 病院講師 救急・集中治療医学
神宮寺成弘 病院講師 救急・集中治療医学
山本 尚範 病院助教 救急・集中治療医学
東 倫子 病院助教 救急・集中治療医学
小川広晃 病院助教 救急・集中治療医学
春日 井大介 病院助教 救急・集中治療医学
安田 祐真 専修医 救急・集中治療医学
中村 元気 専修医 救急・集中治療医学

研究実績

  • 2021年
    1. Yasuda Y, Nishikimi M, Matsui K, Numaguchi A, Nishida K, Emoto R, Matsui S, Matsuda N. The rCAST score is useful for estimating the neurological prognosis in pediatric patients with post-cardiac arrest syndrome before ICU admission: External validation study using a nationwide prospective registry. Resuscitation. 2021;168:103-109.
    2. Nishikimi M, Ogura T, Nishida K, Hayashida K, Emoto R, Matsui S, Matsuda N, Iwami T. Outcome Related to Level of Targeted Temperature Management in Postcardiac Arrest Syndrome of Low, Moderate, and High Severities: A Nationwide Multicenter Prospective Registry. Crit Care Med. 2021;49:e741-e750.
    3. Nishikimi M, Nishida K, Shindo Y, Shoaib M, Kasugai D, Yasuda Y, Higashi M, Numaguchi A, Yamamoto T, Matsui S, Matsuda N. Failure of non-invasive respiratory support after 6 hours from initiation is associated with ICU mortality. PLoS One. 2021;16:e0251030.
    4. Kasugai D, Ozaki M, Nishida K, Goto Y, Takahashi K, Matsui S, Matsuda N. Relative platelet reductions provide better pathophysiologic signatures of coagulopathies in sepsis. Sci Rep. 2021;11:14033.
    5. Hiraiwa H, Kasugai D, Ozaki M, Goto Y, Jingushi N, Higashi M, Nishida K, Kondo T, Furusawa K, Morimoto R, Okumura T, Matsuda N, Matsui S, Murohara T. Clinical impact of visually assessed right ventricular dysfunction in patients with septic shock. Sci Rep. 2021;11:18823.
    6. Suzuki T, Yamashita S, Hattori K, Matsuda N, Hattori Y. Impact of a long-term high-glucose environment on pro-inflammatory responses in macrophages stimulated with lipopolysaccharide. Naunyn Schmiedebergs Arch Pharmacol. 2021;394:2129-2139.
  • 2020年
    1. Yasuda Y, Nishikimi M, Nishida K, Takahashi K, Numaguchi A, Higashi M, Matsui S, Matsuda N. Relationship Between Serum Norepinephrine Levels at ICU Admission and the Risk of ICU-Acquired Delirium: Secondary Analysis of the Melatonin Evaluation of Lowered Inflammation of ICU Trial. Crit Care Explor. 2020;2:e0082.
    2. Kakinaha Y, Nishida O, Taniguchi T, Okajima M, Morimatsu H, Ogura H, Yamada Y, Nagano T, Morishita E, Matsuda N. Efficacy and safety of landiolol, an ultra-short-acting β1-selective antagonist, for treatment of sepsis-related tachyarrhythmia (J-Land 3S): a multicentre, open-label, randomised controlled trial. Lancet Respir Med. 2020;S2213-2600(20)30037-0.
    3. Matsuda N. Pathophysiological approaches in the critical care of COVID-19: COVID-19 management bundles. Chinese Trad med J 2020;3:1-9.
    4. Omote N, Matsuda N, Hashimoto N, Nishida K, Sakamoto K, Ando A, Nakahara Y, Nishikimi M, Higashi M, Matsui S, Hasegawa Y. High-flow nasal cannula therapy for acute respiratory failure in patients with interstitial pneumonia: a retrospective observational study. Nagoya J Med Sci. 2020;82:301-313.
    5. Matsuda N, Nishida O, Taniguchi T, Okajima M, Morimatsu H, Ogura H, Yamada Y, Nagano T, Ichikawa A, Kakihana Y; J-Land 3S Study Group. Impact of patient characteristics on the efficacy and safety of landiolol in patients with sepsis-related tachyarrhythmia: Subanalysis of the J-Land 3S randomised controlled study. EClinicalMedicine. 2020;28:100571.
    6. Imbaby S, Matsuda N, Tomita K, Hattori K, Palikhe S, Yokoo H, Hattori Y. Beneficial effect of STAT3 decoy oligodeoxynucleotide transfection on organ injury and mortality in mice with cecal ligation and puncture-induced sepsis. Sci Rep. 2020;10:15316.
    7. Kazama S, Hiraiwa H, Kimura Y, Ozaki R, Shibata N, Arao Y, Oishi H, Kato H, Kuwayama T, Yamaguchi S, Kondo T, Furusawa K, Morimoto R, Okumura T, Bando YK, Sato T, Shimada K, Kiyoi H, Nakamura G, Yasuda Y, Kasugai D, Ogawa H, Higashi M, Yamamoto T, Jingushi N, Ozaki M, Numaguchi A, Goto Y, Matsuda N, Murohara T. A case of reexpansion pulmonary edema and acute pulmonary thromboembolism associated with diffuse large B-cell lymphoma treated with venovenous extracorporeal membrane oxygenation. J Cardiol Cases. 2020;23:53-56.
    8. Hiraiwa H, Goto Y, Nakamura G, Yasuda Y, Sakai Y, Kasugai D, Jinno S, Tanaka T, Ogawa H, Higashi M, Yamamoto T, Jingushi N, Ozaki M, Numaguchi A, Kondo T, Morimoto R, Okumura T, Matsuda N, Murohara T. Relative bradycardia as a clinical feature in patients with coronavirus disease 2019 (COVID-19): A report of two cases. J Cardiol Cases. 2020;22:260-264.
  • 2019年
    1. Nishikimi M, Ogura T, Nishida K, Takahashi K, Nakamura M, Matsui S, Matsuda N, Iwami T. External validation of a risk classification at the emergency department of post-cardiac arrest syndrome patients undergoing targeted temperature management. Resuscitation. 2019;140:135-141.
    2. Kasugai D, Nishikimi M, Nishida K, Higashi M, Yamamoto T, Numaguchi A, Takahashi K, Matsui S, Matsuda N. Timing of administration of epinephrine predicts the responsiveness to epinephrine in norepinephrine-refractory septic shock: a retrospective study. J Intensive Care. 2019;7:20.
    3. Nakajima H, Nishikimi M, Shimizu M, Hayashi K, Inoue T, Nishida K, Takahashi K, Matsui S, Nishida Y, Matsuda N. Clinical Frailty Scale Score Before ICU Admission Is Associated With Mobility Disability in Septic Patients Receiving Early Rehabilitation. Crit Care Explor. 2019;1:e0066.
    4. Funahashi Y, Kato N, Masuda T, Nishio F, Kitai H, Ishimoto T, Kosugi T, Tsuboi N, Matsuda N, Maruyama S, Kadomatsu K. miR-146a targeted to splenic macrophages prevents sepsis-induced multiple organ injury. Lab Invest. 2019;99:1130-1142.
    5. Kondo T, Morimoto R, Yokoi T, Yamaguchi S, Kuwayama T, Haga T, Hiraiwa H, Sugiura Y, Watanabe N, Kano N, Ichii T, Fukaya K, Sawamura A, Okumura T, Yoshizumi T, Mutsuga M, Fujimoto K, Matsuda N, Usui A, Murohara T. Hemodynamics of cardiac tamponade during extracorporeal membrane oxygenation support in a patient with fulminant myocarditis. J Cardiol Cases. 2018;19:22-24.
  • 2018年
    1. Hattori Y, Hattori K, Suzuki T, Palikhe S, Matsuda N. Nucleic-acid based gene therapy approaches for sepsis. Eur J Pharmacol. 2018;833:403-410.
    2. Imaizumi T, Matsuda N, Tomita K, Palikhe S, Ohashi W, Hattori K, Hattori Y. Activator Protein-1 Decoy Oligodeoxynucleotide Transfection Is Beneficial in Reducing Organ Injury and Mortality in Septic Mice. Crit Care Med. 2018;46:e435-e442.
    3. Takatani Y, Ono K, Suzuki H, Inaba M, Sawada M, Matsuda N. Inducible nitric oxide synthase during the late phase of sepsis is associated with hypothermia and immune cell migration. Lab Invest.  2018;98:629-639.
    4. Kawakami M, Hattori M, Ohashi W, Fujimori T, Hattori K, Takebe M, Tomita K, Yokoo H, Matsuda N, Yamazaki M, Hattori Y. Role of G protein-coupled receptor kinase 2 in oxidative and nitrosative stress-related neurohistopathological changes in a mouse model of sepsis-associated encephalopathy.  J Neurochem. 2018;145:474-488.
    5. Nishikimi M, Numaguchi A, Takahashi K, Miyagawa Y, Matsui K, Higashi M, Makishi G, Matsui S, Matsuda N. Effect of Administration of Ramelteon, a Melatonin Receptor Agonist, on the Duration of Stay in the ICU: A Single-Center Randomized Placebo-Controlled Trial. Crit Care Med. 2018;128:11-15.
    6. Nishikimi M, Ogura T, Nishida K, Takahashi K, Fukaya K, Liu K, Nakamura M, Matsui S, Matsuda N. Differential effect of mild therapeutic hypothermia depending on the findings of hypoxic encephalopathy on early CT images in patients with post-cardiac arrest syndrome. Resuscitation. 2018;128:11-15.
    7. Nishikimi M, Ogura T, Matsui K, Takahashi K, Fukaya K, Liu K, Morita H, Nakamura M, Matsui S, Matsuda N. Accuracy of the first interpretation of early brain CT images for predicting the prognosis of post-cardiac arrest syndrome patients at the emergency department. J Intensive Care. 2018;6:26.
    8. Yamashita S, Suzuki T, Iguchi K, Sakamoto T, Tomita K, Yokoo H, Sakai M, Misawa H, Hattori K, Nagata T, Watanabe Y, Matsuda N, Yoshimura N, Hattori Y. Cardioprotective and functional effects of levosimendan and milrinone in mice with cecal ligation and puncture-induced sepsis. Naunyn Schmiedebergs Arch Pharmacol. 2018;391:1021-1032.
    9. Sakamoto T, Ohashi W, Tomita K, Hattori K, Matsuda N, Hattori Y. Anti-inflammatory properties of cilostazol: Its interruption of DNA binding activity of NF-κB from the Toll-like receptor signaling pathways.Int Immunopharmacol. 2018;62:120-131.
    10. Suzuki T, Sakata K, Mizuno N, Palikhe S, Yamashita S, Hattori K, Matsuda N, Hattori Y. Different involvement of the MAPK family in inflammatory regulation in human pulmonary microvascular endothelial cells stimulated with LPS and IFN-γ. Immunobiology. 2018;223:777-785.
    11. Endo S, Shimazaki R, Antithrombin Gamma Study Group. An open-label, randomized, phase 3 study of the efficacy and safety of antithrombin gamma in patients with sepsis-induced disseminated intravascular coagulation syndrome. J Intensive Care. 2018;6:75.
    12. Nishikimi M, Numaguchi A, Takahashi K, Matsui S, Matsuda N. The authors' reply. Crit Care Med. 2018;46:e1010-e1011.
    13. Nishikimi M, Numaguchi A, Takahashi K, Matsui S, Matsuda N. The authors' reply. Crit Care Med. 2018;46:e1225-e1226.
    14. Kondo T, Sawamura A, Okumura T, Kano N, Morimoto R, Watanabe N, Hiraiwa H, Kuwayama T, Sugiura Y, Haga T, Yamaguchi S, Fukaya K, Yokoi T, Fujimoto K, Mutsuga M, Yoshizumi T, Matsuda N, Usui A, Murohara T.  Promising method for management of venoarterial extracorporeal membrane oxygenation: A case of severe heart failure successfully stabilized by "high-flow/vasodilation method”. J Cardiol Cases. 2018;18:81-84.
    15. Kondo T, Morimoto R, Yokoi T, Yamaguchi S, Kuwayama T, Haga T, Hiraiwa H, Sugiura Y, Watanabe N, Kano N, Ichii T, Fukaya K, Sawamura A, Okumura T, Yoshizumi T, Mutsuga M, Fujimoto K, Matsuda N, Usui A, Murohara T. Hemodynamics of cardiac tamponade during extracorporeal membrane oxygenation support in a patient with fulminant myocarditis. J Cardiol Cases. 2018;19:22-24. 
    16. Nishida O, Ogura H, Egi M, Fujishima S, Hayashi Y, Iba T, Imaizumi H, Inoue S, Kakihana Y, Kotani J, Kushimoto S, Masuda Y, Matsuda N, Matsushima A, Nakada TA, Nakagawa S, Nunomiya S, Sadahiro T, Shime N, Yatabe T, Hara Y, Hayashida K, Kondo Y, Sumi Y, Yasuda H, Aoyama K, Azuhata T, Doi K, Doi M, Fujimura N, Fuke R, Fukuda T, Goto K, Hasegawa R, Hashimoto S, Hatakeyama J, Hayakawa M, Hifumi T, Higashibeppu N, Hirai K, Hirose T, Ide K, Kaizuka Y, Kan'o T, Kawasaki T, Kuroda H, Matsuda A, Matsumoto S, Nagae M, Onodera M, Ohnuma T, Oshima K, Saito N, Sakamoto S, Sakuraya M, Sasano M, Sato N, Sawamura A, Shimizu K, Shirai K, Takei T, Takeuchi M, Takimoto K, Taniguchi T, Tatsumi H, Tsuruta R, Yama N, Yamakawa K, Yamashita C, Yamashita K, Yoshida T, Tanaka H, Oda S. The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016). J Intensive Care. 2018;6:7. Acute Med Surg. 2018;5:3-89.
  • 2017年
    1. Hattori Y, Hattori K, Suzuki T, Matsuda N. Recent advances in the pathophysiology and molecular basis of sepsis-associated organ dysfunction: Novel therapeutic implications and challenges. Pharmacol Ther. 2017;177:56-66.
    2. Nishikimi M, Matsuda N, Matsui K, Takahashi K, Ejima T, Liu K, Ogura T, Higashi M, Umino H, Makishi G, Numaguchi A, Matsushima S, Tokuyama H, Nakamura M, Matsui S. A novel scoring system for predicting the neurologic prognosis prior to the initiation of induced hypothermia in cases of post-cardiac arrest syndrome: the CAST score. Scand J Trauma Resusc Emerg Med.2017;25:49.
    3. Sakai M, Suzuki T, Tomita K, Yamashita S, Palikhe S, Hattori K, Yoshimura N, Matsuda N, Hattori Y. Diminished responsiveness to dobutamine as an inotrope in mice with cecal ligation and puncture-induced sepsis: attribution to phosphodiesterase 4 upregulation. Am J Physiol Heart Circ Physiol. 2017;31:H1224-H1237.
    4. Miyamoto K, Horibe M, Sanui M, Sasaki M, Sugiyama D, Kato S, Yamashita T, Goto T, Iwasaki E, Shirai K, Oe K, Sawano H, Oda T, Yasuda H, Ogura Y, Hirose K, Kitamura K, Chiba N, Ozaki T, Oshima T, Yamamoto T, Nagata K, Mine T, Saito K, Sekino M, Furuya T, Matsuda N, Hayakawa M, Kanai T, Mayumi T. Plasmapheresis therapy has no triglyceride-lowering effect in patients with hypertriglyceridemic pancreatitis. Intensive Care Med. 2017;43:949-951.
    5. Yamamoto S, Muramatsu M, Azuma E, Ikutani M, Nagai Y, Sagara H, Koo BN, Kita S, O'Donnell E, Osawa T, Takahashi H, Takano KI, Dohmoto M, Sugimori M, Usui I, Watanabe Y, Hatakeyama N, Iwamoto T, Komuro I, Takatsu K, Tobe K, Niida S, Matsuda N, Shibuya M, Sasahara M. A subset of cerebrovascular pericytes originates from mature macrophages in the very early phase of vascular development in CNS. Sci Rep. 2017;7:3855.
    6. Hattori Y, Hattori K, Matsuda N. Regulation of the Cardiovascular System by Histamine. Handb Exp Pharmacol. 2017;241:239-258.
  • 2016年
    1. Matsuda N. Alert cell strategy in SIRS-induced vasculitis: sepsis and endothelial cells. J Intensive Care  2016;4:21.
    2. Matsuda N, Yamada S, Hinoshita T, Sasaki J, Ikeda H, Harunari N, Sakamoto T. The International Activities in Taiwan by the Joint Burn Care Assistance Team of Physicians from Japan Medical Association and Three Medical Societies. Japan Med Assoc J. 59:12-16，2016.
    3. Hattori Y, Hattori K, Matsuda N. Regulation of the Cardiovascular System by Histamine. Handb Exp Pharmacol. 2016;241:239-258.
    4. Nishikimi M, Matsuda N, Matsui K, Takahashi K, Ejima T, Liu K, Ogura T, Higashi M, Umino H, Makishi G, Numaguchi A, Matsushima S, Tokuyama H, Nakamura M, Matsui S. CAST: a new score for early prediction of neurological outcomes after cardiac arrest before therapeutic hypothermia with high accuracy. Intensive Care Med 2016;42:2106-2107.
    5. Inaba M, Matsuda N, Banno H, Jin W, Wachino JI, Yamada K, Kimura K, Arakawa Y. In vitro reduction of antibacterial activity of tigecycline against multidrug-resistant Acinetobacter baumannii with host stress hormone norepinephrine. Int J Antimicrob Agents 2016;48:680-689.
    6. Hattori M, Yamazaki M, Ohashi W, Tanaka S, Hattori K, Todoroki K, Fujimori T, Ohtsu H, Matsuda N, Hattori Y. Critical role of endogenous histamine in promoting end-organ tissue injury in sepsis. Intensive Care Med Exp 2016;4:36.

研究キーワード

救急医学、集中治療医学、急性期管理、急性肺傷害、ショック、急性腎傷害、急性肝不全、播種性血管内凝固、血管内皮細胞傷害、蘇生後低酸素性脳症、環境異常症、敗血症、全身性炎症、細胞内情報伝達、転写因子

その他

救急医学あるいは集中治療医学に従事されている皆さんの大学院進学を支援しています。本領域の研究希望につきまして，お問い合わせ下さい。