Updated on 2025/06/20

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写真a

 
Masahide Ohtsuka
 
Organization
YCU Medical Center Intensive Care Department Associate Professor
Title
Associate Professor
Homepage
http://www.yokohama-cu.ac.jp/urahp/section/care/index.html
Profile

資格：医師、医学博士、日本専門医機構麻酔専門医、日本麻酔科学会指導医、日本集中治療医学会集中治療専門医、日本呼吸療法医学会呼吸療法専門医
専門領域：集中治療医学、呼吸生理学、人工呼吸療法
院内業務：安全管理担当兼務、RST(respiratory support team)リーダー、NST(nutrition support team)サブチェアマン

External link

Degree

  • 医学博士 ( 横浜市立大学 )

Research Interests

  • anesthesiology intensive care medicine

  • 麻酔・集中治療医学

Research Areas

  • Life Science / Anesthesiology

Education

  • Yokohama City University

    - 1985

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    Country： Japan

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Research History

  • Yokohama City University School of Medicine, Intensive Care Department, Yokohama City University Hospital   Associate Professor

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Professional Memberships

  • Japanese Society of Respiratory Care Medicine

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  • Japanese Society of Anesthesiologists

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  • The Japanese Society of Intensive Care Medicine

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Papers

  • 免疫チェックポイント阻害薬による免疫関連有害事象に伴う筋炎および重症筋無力症を発症し,急性呼吸不全に対して人工呼吸管理を必要とした1症例

    三橋 優登, 長嶺 祐介, 小林 卓雄, 林 紀子, 岸田 日帯, 澤田 侑理, 古澤 亜紀, 松宮 賢太郎, 李 賢雅, 井上 玲美, 後藤 正美, 上田 直久, 大塚 将秀

    麻酔   74 ( 2 )   104 - 107   2025.2

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    Language：Japanese   Publisher：克誠堂出版(株)  

    ＜文献概要＞がん治療の分子標的薬として使用される免疫チェックポイント阻害薬には,過度の免疫反応に起因するさまざまな病態(免疫関連有害事象)が現れることがある。ペムブロリズマブを投与後に,筋炎および重症筋無力症により人工呼吸管理を必要とした症例を経験した。換気不全および嚥下障害のため抜管困難と評価し,気管切開が必要であった。免疫関連有害事象に伴う筋炎,重症筋無力症による急性呼吸不全を呈する症例があることを集中治療医は認識しておく必要がある。

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    Other Link： https://search.jamas.or.jp/default/link?pub_year=2025&ichushi_jid=J01397&link_issn=&doc_id=20250210100012&doc_link_id=10.18916%2Fmasui.2025020011&url=https%3A%2F%2Fdoi.org%2F10.18916%2Fmasui.2025020011&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

  • Association between diaphragmatic dysfunction after adult cardiovascular surgery and prognosis of mechanical ventilation: a retrospective cohort study. International journal

    Reimi Inoue, Yusuke Nagamine, Masahide Ohtsuka, Takahisa Goto

    Journal of intensive care   11 ( 1 )   39 - 39   2023.9

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    Language：English   Publishing type：Research paper (scientific journal)  

    BACKGROUND: Diaphragmatic dysfunction often occurs after adult cardiovascular surgery. The prognostic effect of diaphragmatic dysfunction on ventilatory management in patients after cardiovascular surgery is unknown. This study aimed to investigate the association between diaphragmatic dysfunction and prognosis of ventilatory management in adult postoperative cardiovascular surgery patients. METHODS: This study was a single-center retrospective cohort study conducted at a tertiary care university hospital. This study included adult patients admitted to the intensive care unit under tracheal intubation after cardiovascular surgery. Spontaneous breathing trial was performed, and bilateral diaphragmatic motion was assessed using ultrasonography; diaphragmatic dysfunction was classified as normal, incomplete dysfunction, or complete dysfunction. The primary outcome was weaning off in mechanical ventilation. The duration of mechanical ventilation was defined as duration from the date of ICU admission to the date of weaning off in mechanical ventilation. The secondary outcomes were reintubation, death from all causes, improvement of diaphragm position assessed by chest radiographs. The subdistribution hazard ratio or hazard ratio (HR) with 95% confidence of intervals (CIs) were estimated by Fine-Gray models or Cox proportional hazard models adjusted for potential confounders. RESULTS: Of 153 patients analyzed, 49 patients (32.0%) had diaphragmatic dysfunction. Diaphragmatic dysfunction consisted of incomplete dysfunction in 38 patients and complete dysfunction in 11 patients. Diaphragmatic dysfunction groups had longer duration of mechanical ventilation (68 h [interquartile range (IQR) 39-114] vs 23 h [15-67], adjusted subdistribution HR 0.63, 95% CIs 0.43-0.92). There was a higher rate of reintubation (12.2% vs 2.9%, univariate logistic regression analysis p = 0.034, unadjusted odds ratio = 4.70, 95% CIs 1.12-19.65), and a tendency to have higher death from all causes in the diaphragmatic dysfunction group during follow-up period (maximum 6.5 years) (18.4% vs 9.6%, adjusted HR 1.64, 95% CIs 0.59-4.53). The time to improvement of diaphragm position on chest radiograph was significantly longer in the diaphragmatic dysfunction group (14 days [IQR 6-29] vs 5 days [IQR 2-10], adjusted subdistribution HR 0.54, 95% CIs 0.38-0.77). CONCLUSIONS: Diaphragmatic dysfunction after adult cardiovascular surgery was significantly associated with longer duration of mechanical ventilation and higher reintubation.

    DOI： 10.1186/s40560-023-00688-x

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  • 人工呼吸器関連肺炎の動向 Invited

    中橋奨, 大塚将秀

    救急・集中治療   35 ( 1 )   47 - 56   2023.1

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  • COVID-19の治療－チーム医療の観点から－ Invited

    大塚将秀, 岩下眞之

    日本臨床麻酔学会誌   42 ( 5 )   534 - 538   2022

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  • 呼吸管理FAQ－研修医からの質問270－呼吸管理とは Invited

    大塚将秀

    救急・集中治療   33 ( 4 )   1055 - 1063   2021

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    Authorship：Lead author,　Corresponding author  

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  • CT検査で大腰筋断面積の縮小を確認できたICU-acquired weaknessを合併した小児患者の1例 Reviewed

    早川翔, 折津英幸, 大塚将秀

    日本集中治療医学会雑誌   28 ( 5 )   469 - 470   2021

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  • 質の高い呼吸管理を目指して：気管チューブのカフ圧管理（再掲載） Invited

    大塚将秀

    Clinical Engineering   31 ( 9 )   760 - 765   2020.9

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  • ARDSの呼吸管理（総論） Invited

    大塚将秀

    循環制御   41 ( 1 )   3 - 4   2020.1

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  • 呼吸療法を行ううえでの臨床倫理的課題ー日本呼吸療法医学会倫理委員会アンケート調査

    久木田一朗, 公文啓二, 中川隆, 宮地哲也, 小谷透, 大塚将秀, 清水孝宏, 坪井知正, 布宮伸, 志馬伸朗

    人工呼吸   36 ( 2 )   113 - 118   2019.11

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  • 肺保護戦略の最新知識ー臨床的なアプローチ Invited

    刈谷隆之, 大塚将秀

    Clinical Engineering   30 ( 8 )   749 - 756   2019.8

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  • A case requiring intensive circulatory and metabolic perioperative management due to dapagliflozin administrated until the day before surgery Reviewed

    鴻池利枝, 大塚将秀, 出井真史

    日本集中治療医学会雑誌(Web)   26 ( 3 )   193 - 194   2019.6

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  • 集中治療における血行動態評価法：動脈圧モニターによる方法 Invited Reviewed

    大塚将秀

    ICUとCCU   43 ( 3 )   131 - 137   2019.6

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  • 気管内浸潤を伴った甲状腺腫瘍が緊急気道確保時に脱落し、その摘出が困難であった一例

    高田 一哉, 出井 真史, 高橋 紗緒梨, 大塚 将秀, 後藤 隆久

    日本集中治療医学会雑誌   26 ( 3 )   201 - 202   2019.5

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    86歳女。呼吸困難と前頸部腫脹を主訴に救急外来を受診し、頭頸部CTで気管浸潤のある甲状腺腫瘍と診断した。気管浸潤は声門の遠位20mmにある有茎性で最大径11mmの気管内腫瘍で、気管内腔の開存率は41%であった。緊急手術を行う方針でHigh care unitに入室したが2時間後に呼吸数増加、喘鳴、呼吸困難を認めた。覚醒下で内径6.0mm気管チューブを留置し、挿管後用手換気は容易であったが、気管内腫瘍が脱落した。気管チューブを腫瘍ごと抜管して摘出を試みたが、腫瘍は気管チューブから脱落した。内径8.5mm気管チューブに入れ替え、気管支鏡の処置ポートで腫瘍を吸引したまま気管支鏡を引き抜いて脱落腫瘍を回収した。その後、甲状腺腫瘍摘出術、気管切開が施行され、ICU入室を経て術後2日目に一般病棟へ転床した。

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    Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J02874&link_issn=&doc_id=20190524340013&doc_link_id=10.3918%2Fjsicm.26_201&url=https%3A%2F%2Fdoi.org%2F10.3918%2Fjsicm.26_201&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 陽陰圧体外式人工呼吸器 Invited

    大塚将秀

    救急・集中治療   31 ( 2 )   533 - 535   2019.4

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  • Ventilator associated lung injury Invited

    31 ( 2 )   373 - 374   2019.4

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  • Simulation of pressure support for spontaneous breathing trials in neonates. International journal

    Makoto Sasaki, Yoshikazu Yamaguchi, Tetsuya Miyashita, Yuko Matsuda, Masahide Ohtsuka, Osamu Yamaguchi, Takahisa Goto

    Intensive care medicine experimental   7 ( 1 )   10 - 10   2019.2

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    BACKGROUND: Endotracheal tubes used for neonates are not as resistant to breathing as originally anticipated; therefore, spontaneous breathing trials (SBTs) with continuous positive airway pressure (CPAP), without pressure support (PS), are recommended. However, PS extubation criteria have predetermined pressure values for each endotracheal tube diameter (PS 10 cmH2O with 3.0- and 3.5-mm tubes or PS 8 cmH2O with 4.0-mm tubes). This study aimed to assess the validity of these SBT criteria for neonates, using an artificial lung simulator, ASL 5000™ lung simulator, and a SERVO-i Universal™ ventilator (minute volume, 240-360 mL/kg/min; tidal volume, 30 mL; respiratory rate, 24-36/min; lung compliance, 0.5 mL/cmH2O/kg; resistance, 40 cmH2O/L/s) in an intensive care unit. We simulated a spontaneous breathing test in a 3-kg neonate after cardiac surgery with 3.0-3.5-mm endotracheal tubes. We measured the work of breathing (WOB), trigger work, and parameters of pressure support ventilation (PSV), T-piece breathing, or ASL 5000™ alone. RESULTS: WOB displayed respiratory rate dependency under intubation. PS compensating tube resistance fluctuated with respiratory rate. At a respiratory rate of 24/min, the endotracheal tube did not greatly influence WOB under PSV and the regression line of WOB converged with the WOB of ASL 5000™ alone under PS 1 cmH2O; however, at 36/min, endotracheal tube was resistant to breathing under PSV because trigger work increased exponentially with PS ≤ 9 cmH2O. The regression line of WOB under PSV converged with the WOB of T-piece breathing under PS 1 cmH2O. Furthermore, PS compensating endotracheal tube resistance was 6 cmH2O. The WOB of ASL 5000™ alone approached that of respiratory distress syndrome (RDS); however, the pressure of patient effort was normal physiological range at PS 10 cmH2O. PS equalizing WOB under PSV with that after extubation depended on the respiratory rate and upper airway resistance. If WOB after extubation equaled that of T-piece breathing, the PS was 0 cmH2O regardless of the respiratory rates. If WOB after extubation approximated  to that of ASL 5000™ alone, the PS depended on the respiratory rate. CONCLUSION: SBT strategies should be selected per neonatal respiratory rates and upper airway resistance.

    DOI： 10.1186/s40635-019-0223-8

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  • 肺保護換気の潮流 Invited

    大塚将秀

    救急・集中治療   31 ( 2 )   368 - 374   2019.2

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  • Metabolic acidosis Invited

    Masahide Ohtsuka

    Clinical Engineering   30 ( 1 )   68 - 70   2019.1

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  • Respiratory ventilator Invited

    Respica   17 ( 1 )   32 - 36   2019.1

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  • 気管挿管で血腫による上気道狭窄を回避した後天性血友病Aの1例. Reviewed

    木田達也, 出井真史, 大塚将秀

    ICUとCCU   42 ( 11 )   747 - 751   2018.11

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    Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：医学図書出版(株)  

    後天性血友病患者の気道周囲に生じた血腫による上気道狭窄に対し、気管挿管を要した1例を経験したので報告する。症例は66歳男性。後天性血友病の治療中に舌根部から喉頭蓋にかけての血腫を合併し、拡大してきたため気管挿管を施行した。後天性血友病の治療には免疫抑制療法と止血治療の併用が推奨されているが、治療開始後も出血傾向が改善するためには時間を要することが多い。後天性血友病患者において、血腫で気道狭窄を呈した場合の気管チューブ抜管のタイミングに関する明確な基準はない。本症例では、CTで血腫の拡大がないこと、内視鏡による咽頭の観察で浮腫や周囲からの圧迫像が改善したことを確認した後に抜管し、その後の上気道狭窄症状の出現はなかった。(著者抄録)

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    Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00001&link_issn=&doc_id=20190115490007&doc_link_id=%2Faa6icutc%2F2018%2F004211%2F008%2F0747-0751%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faa6icutc%2F2018%2F004211%2F008%2F0747-0751%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 麻酔 2018;67(8):866-871 Reviewed

    OHTSUKA Masahide

    67 ( 8 )   866 - 871   2018.8

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  • 気管内浸潤を伴った甲状腺腫瘍が緊急気道確保時に脱落し、その摘出が困難であった一例

    高田 一哉, 出井 真史, 佐野 友里香, 高橋 紗緒梨, 大塚 将秀, 後藤 隆久

    日本集中治療医学会雑誌   25 ( Suppl. )   [P66 - 1]   2018.2

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  • 絶食後の経腸栄養開始に伴う肝胆膵逸脱酵素と炎症反応の変動

    宮本 裕里, 大塚 将秀, 後藤 正美, 刈谷 隆之, 小倉 玲美, 村田 志乃, 早川 翔, 月永 晶人

    日本集中治療医学会雑誌   25 ( Suppl. )   [O28 - 2]   2018.2

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  • 手術直前までダパグリフロジンが投与され代謝循環管理に難渋した心臓手術の1例

    鴻池 利枝, 出井 真史, 大塚 将秀, 刈谷 隆之, 安田 さおり

    日本集中治療医学会雑誌   25 ( Suppl. )   [O15 - 6]   2018.2

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  • CABG術後の緊張性血胸及び心肺停止後、左内頸動脈血栓症及び脳梗塞を生じた一例

    内本 一宏, 安西 晃子, 安田 さおり, 横山 暢幸, 小倉 玲美, 出井 真史, 青木 真理子, 刈谷 隆之, 大塚 将秀

    日本集中治療医学会雑誌   25 ( Suppl. )   [P100 - 5]   2018.2

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  • 慢性閉塞性肺疾患患者の呼吸管理 Invited Reviewed

    大塚 将秀

    麻酔   67   485 - 493   2018

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  • 自発呼吸患者に対するマスク・カニューレによる酸素投与 Reviewed

    大塚 将秀

    Intensivist   10   423 - 432   2018

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  • 大動脈の術後に気管狭窄をきたしたマルファン症候群の一例

    林 美蓉, 出井 真史, 伊藤 慎也, 佐野 友里香, 村田 志乃, 小倉 玲美, 内本 一宏, 刈谷 隆之, 後藤 正美, 大塚 将秀

    日本集中治療医学会雑誌   24 ( Suppl. )   DP21 - 3   2017.2

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  • 開胸術後における横隔神経麻痺の発症と長期予後の検討

    小倉 玲美, 大塚 将秀, 村田 志乃, 出井 真史, 内本 宏和, 刈谷 隆之, 後藤 正美

    日本集中治療医学会雑誌   24 ( Suppl. )   DP164 - 2   2017.2

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  • Pressure Support Ventilation, Pressure Controlled Ventilation, and Dual Controlled Ventilation : Bases and Clinical Practice : Characteristics and Clinical Applications Invited Reviewed

    41 ( 1 )   13 - 20   2017.1

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  • 拘束性換気障害患者の麻酔 Invited Reviewed

    大塚 将秀

    麻酔   66 ( 1 )   46 - 51   2017.1

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  • 呼吸管理と何か Invited

    大塚 将秀

    29   641 - 648   2017

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  • 鎮静：成人の長期人工呼吸患者 Invited Reviewed

    大塚 将秀

    24   776 - 780   2017

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  • 呼吸筋疲労～呼吸不全の早期発見 Invited

    大塚 将秀

    人工呼吸   33 ( 2 )   158 - 162   2016.11

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  • 気管挿管・人工呼吸の適応 Invited

    大塚 将秀

    臨床外科   71 ( 11 )   16 - 19   2016.11

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    DOI： 10.11477/mf.1407211341

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  • 気管チューブのカフ圧管理 Invited

    大塚 将秀

    Clinical Engineering   27 ( 6 )   500 - 505   2016.6

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  • 血液ガス・酸塩基平衡のみかた Invited

    大塚 将秀

    Clinical Engineering   27 ( 4 )   294 - 298   2016.4

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    DOI： 10.15105/J02355.2016193665

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  • アミオダロン投与中に低血圧と徐脈となり、濃度測定で有効血中濃度上限を超えていたことが判明した症例

    小倉 玲美, 月永 晶人, 早川 翔, 宮本 裕里, 鈴木 ちえ子, 村田 志乃, 刈谷 隆之, 後藤 正美, 倉橋 清泰, 大塚 将秀

    日本集中治療医学会雑誌   23 ( Suppl. )   449 - 449   2016.1

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  • 気管チューブ抜管の実際 Invited

    大塚 将秀

    Clinical Engineering   26 ( 12 )   1145 - 1150   2015.12

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    DOI： 10.15105/J02355.2016219342

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  • 人工呼吸のウィーニング－スムーズで安全な呼吸管理をめざして Invited

    大塚 将秀

    日本臨床麻酔学会誌   35 ( 1 )   106 - 111   2015.1

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    DOI： 10.2199/jjsca.35.106

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  • 呼吸器外科手術における人工呼吸療法 Invited

    坪井正博, 大塚 将秀

    MEDICAL TORCH   11 ( 2 )   34 - 37   2015

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  • 呼吸管理と体位 Invited

    大塚 将秀

    人工呼吸   31 ( 1 )   24 - 30   2014.5

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  • 安静換気フローボリューム曲線の臨床的意義‐コンピュータシミュレーションによる解析 Reviewed

    大塚 将秀

    麻酔   63 ( 4 )   462 - 467   2014.4

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  • 肺保護戦略的人工呼吸管理 Invited

    大塚 将秀

    ICUとCCU   38 ( 4 )   229 - 234   2014.4

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  • Clinical application of the tidal flow-volume curve - A computer simulation Reviewed

    Masahide Ohtsuka

    Japanese Journal of Anesthesiology   63 ( 4 )   462 - 467   2014

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    Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Kokuseido Publishing Co. Ltd  

    Background: Since the tidal flow-volume (V-V) curve obtained during mechanical ventilation is difficult to interpret there have been few reports on how to interpret it. Methods: The tidal V̇-V curve during mechanical ventilation was analyzed using a computer simulation. Ventilatory modes, the time constant of a patient's respiratory system (TC), spontaneous breathing during mechanical ventilation, airway obstructions, and circuit leakage were simulated. Results: The inspiratory shape depended on ventilatory modes and was affected by TC only in pressure-regulated breathing. The expiratory shape was not dependent on ventilatory modes and was influenced by TC. Spontaneous breathing synchronized with the mandatory ventilatory phase increased the flow rate. Characteristic double expiratory flow pattern was observed in spontaneous expiration during the inspiratory phase of the ventilator. A dip in the expiratory tidal V̇-V curve was observed with a peripheral airway obstruction model. A central airway obstruction attenuated the slope of the expiratory phase. In circuit leakage, the tidal V̇-V curve did not return to the origin at the end of the expiration. Conclusions: New findings on the tidal V̇-V curve were observed and this systematic analysis will be helpful in clinical respiratory care.

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  • フロー・ボリュームカーブから見る呼吸病態生理学 Invited

    大塚 将秀

    ICUとCCU   37 ( 6 )   455 - 460   2013.6

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  • Clinical trial of a method for confirming the effects of spinal anesthesia in patients with spinal cord injury Reviewed

    Akiko Takatsuki, Masahide Ohtsuka

    JOURNAL OF ANESTHESIA   26 ( 6 )   914 - 917   2012.12

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

    In this case series study, we prospectively examined whether it might be possible to check the effect of spinal anesthesia (SA), based on the disappearance of lower extremity reflexes and spasticity, in patients with spinal cord injury (SCI), in whom the effect cannot be confirmed by the pinprick test or by using the Bromage scale. In 40 patients with chronic, clinically complete cervical SCI who were scheduled to receive SA, pre-anesthetic examination revealed that the Babinski sign, patellar tendon reflex, and spasticity (assessed using the Ashworth scale) were all positive in 31 patients, while two of these three pre-anesthetic assessment parameters were positive in eight patients. The effect of SA in these 39 patients (97.5 %) was confirmed by demonstrating the absence of both the Babinski sign and patellar tendon reflex and loss of spasticity after SA. Our results suggested that the effect of SA can be confirmed by the disappearance of the Babinski sign and patellar tendon reflex and loss of spasticity in most patients with complete cervical SCI, although determination of the level of the block is difficult. In conclusion, loss of the Babinski sign, patellar tendon reflex, and spasticity might be useful for checking the effect of SA in cervical SCI patients.

    DOI： 10.1007/s00540-012-1429-z

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  • やさしいグラフィックモニター Invited

    大塚 将秀

    人工呼吸   29 ( 1 )   50 - 55   2012.5

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  • A case of laryngopharyngeal edema after a spinal tumor resection in prone position with extensive neck flexion Reviewed

    Junko Ito, Masahide Ohtsuka, Kiyoyasu Kurahashi

    Japanese Journal of Anesthesiology   61 ( 2 )   189 - 192   2012.2

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    A 63-year-old woman developed laryngopharyngeal edema after a cervical spinal tumor resection in prone position. The tracheal tube was removed after 11 hours of general anesthesia and nasal airway was inserted because stridor was audible. Blisters were found on the skin of the anterior neck of the patient. Examinations at 3 h after the extubation suggested upper airway stenosis including stridor, increased work of breathing, oxygenation impairment, and hypercapnia. The trachea of the patient was intubated and the examination of the upper airway by inserting a fiberoptic bronchoscope through the patient's mouth revealed laryngopharyngeal edema. It was considered that the disturbance of venous and/or lymphatic flow of anterior neck due to extensive neck anteflexion during the surgery in prone position had induced the laryngopharyngeal edema
    however, we could not verify the cause of the edema. The edema persisted for weeks. We conclude that we should avoid extensive neck anteflexion during surgery in prone position and it is recommended to observe the upper airway for a few hours after extubation because there could be airway obstruction due to delayed and/or progressive laryngopharyngeal edema.

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  • 成人における気管チューブの抜管基準 Invited Reviewed

    大塚 将秀

    日本集中治療医学会雑誌   19 ( 3 )   340 - 345   2012

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    DOI： 10.3918/jsicm.19.340

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  • The effect of dexmedetomidine in a child with intractable supraventricular tachyarrythmia after total cavopulmonary connection Reviewed

    60 ( 4 )   493 - 495   2011.4

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  • Tracheal intubation using Airway Scope(A (R)) in two patients with difficult airway during cardiopulmonary resuscitation Reviewed

    Mariko Baba, Junichi Fujimoto, Kenji Mizutani, Kyota Nakamura, Yoshitaka Kamiya, Masahide Ohtsuka, Takahisa Goto

    JOURNAL OF ANESTHESIA   24 ( 4 )   618 - 620   2010.8

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER TOKYO  

    The Airway Scope AWS-S100(A (R)) (AWS, Pentax, Tokyo), a rigid video laryngoscope with integrated tube guidance that has recently become commercially available, helped the authors to establish airways in two patients with in-hospital cardiopulmonary arrest, after failed attempts to intubate the patients using the Macintosh laryngoscope (that only commanded the Cormack-Lehane grade 4 glottic views), the laryngeal mask airway, and even surgical cricothyroidotomy for the second case. This showed the utility of the AWS in the management of difficult airway cases even in emergency settings.

    DOI： 10.1007/s00540-010-0955-9

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  • 集中治療の最新技術：栄養管理の最前線 Invited

    大塚 将秀

    臨床麻酔   34 ( 3 )   547 - 554   2010.3

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  • 血液ガス Invited

    大塚 将秀

    人工呼吸   26 ( 2 )   197 - 202   2009.11

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  • CENTRAL AIRWAY OCCLUSION UNDERESTIMATES INTRINSIC POSITIVE END-EXPIRATORY PRESSURE: A NUMERICAL AND PHYSICAL SIMULATION Reviewed

    Kiyoyasu Kurahashi, Masahide Ohtsuka, Yutaka Usuda

    EXPERIMENTAL LUNG RESEARCH   35 ( 9 )   756 - 769   2009

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：TAYLOR & FRANCIS INC  

    Intrinsic positive end-expiratory pressure (PEEP) occurs when airway outflow is higher than zero at end-expiration. Differences in the time constant among alveolar units may result in an uneven distribution of intrinsic PEEP. The authors conducted a computer simulation of a 2-compartment respiratory system and calculated intrinsic PEEP for each alveolar unit and confirmed it with a test-lung experiment. Ventilator settings, including respiratory rate, inspiratory time, pause time, and external PEEP, were tested at various values in combination with various airway resistance and alveolar compliance values. The simulation was performed by calculating the flow, pressure, and volume every millisecond. The data demonstrated that the larger the difference of time constant between 2 respiratory units, the greater the difference in intrinsic PEEP between the units. A higher respiratory frequency and a larger percentage of inspiratory time resulted in an increase in the intrinsic PEEP at the central airway, as well as a wide difference in the intrinsic PEEP between airway units. These phenomena were confirmed by a 2-compartment test-lung study. The authors demonstrated and verified an uneven distribution of intrinsic PEEP in 2 different experiments, which raised a warning that some respiratory units might have much higher intrinsic PEEP than the intrinsic PEEP measured clinically.

    DOI： 10.3109/01902140902878496

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  • 胸部外傷性疾患と麻酔 Invited

    大塚 将秀

    臨床麻酔   32 ( 1 )   53 - 58   2008.1

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  • 人工呼吸管理のための教育の標準化

    大塚 将秀

    人工呼吸   24 ( 2 )   178 - 178   2007.11

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  • A simple technique for bedside insertion of transpyloric enteral feeding tubes ; without special devices or drugs

    OKUTANI Keisuke, HAYAMI Hajime, OHKI Hiroshi, KOKAWA Atsuko, NAGAI Shoichiro, OHTSUKA Masahide, YAMAGUCHI Osamu, USUDA Yutaka

    Journal of the Japanese Society of Intensive Care Medicine   14 ( 2 )   177 - 185   2007.4

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    Language：Japanese   Publisher：The Japanese Society of Intensive Care Medicine  

    <b>Objective</b>: To assess the validation of the simple technique to insert enteral feeding tube (EFT) transpylorically without using supporting devices or drugs. <b>Patients</b>: Critically ill patients who entered intensive care units of two hospitals of Yokohama City University since April 1st 2003 to May 31st 2005, and needed nutritional support via transpyloric tube. <b>Method</b>: We used ARGYLE™ "New Enteral Feeding Tube". Every advance 3 cm was followed by confirmation if it loops back or not, abdominal auscultation was done at many sites. If changes in resistance of insertion was felt, or pitch or duration of the sound was heard differently, we considered tube proceeded beyond pylorus, and withdraw the stylet to end the procedure. Tube tip was confirmed by radiographically. <b>Results</b>: We inserted 71 times in 64 patients, and succeeded 56 times (78.9%). Although the duration of procedure was shorter in success cases (21.6 ± 4.8 min) than in failure cases (51.3 ± 33), the difference was not significant (<i>P</i> = 0.050). There were no critical complications. <b>Conclusion</b>: This simple technique is practical in success rate, duration of procedure.

    DOI： 10.3918/jsicm.14.177

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  • プレッシャーサポート換気時の二段呼吸現象のコンピュータシミュレーションによる解析 Reviewed

    大塚 将秀

    麻酔   53 ( 12 )   1369 - 1376   2004.12

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    Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：克誠堂出版  

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    Other Link： http://search.jamas.or.jp/link/ui/2005118994

  • Analysis by computer simulation of double breathing during pressure support ventilation Reviewed

    Masahide Ohtsuka, Yutaka Usuda, Osamu Yamaguchi, Yoshitsugu Yamada

    Japanese Journal of Anesthesiology   53 ( 12 )   1369 - 1376   2004.12

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    Language：Japanese   Publishing type：Research paper (scientific journal)  

    Background: Pressure support ventilation (PSV) usually provides good patient-ventilator synchrony, but asynchrony is sometimes encountered. Double breathing is one form of asynchrony in which the ventilator assists two or more times during a single inspiration of the patient. Methods: Double breathing was analyzed using a computer simulation. Results: In an obstructive lung model, inspiratory support was terminated just after the beginning of the inspiration lasting until inspiratory effort triggering the ventilator again. One of the causes of this premature termination was that the compressed and consumed volume in the circuit created a high peak inspiratory flow setting. The other cause was oscillation of the airway pressure. Reducing the circuit volume, slowing the inspiratory rise time, or decreasing the termination criteria could prevent this phenomenon. In a restrictive lung model, the time-constant of the lung was so short that the inspiratory flow finished early and double breathing occurred. It was difficult to prevent this phenomenon by adjusting the circuit assembly or respiratory parameters. Conclusions: Double breathing during PSV was considered to be closely associated with obstructive or restrictive lung. If the problem arises and cannot be resolved by adjusting ventilatory parameters, the ventilatory mode must be changed.

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  • Visually adjusted Fowler position is not accurate in angle

    KUGENUMA Yuki, KAGEYAMA Yoshie, OHTSUKA Masahide

    Journal of the Japanese Society of Intensive Care Medicine   11 ( 1 )   47 - 48   2004.1

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    Language：Japanese   Publisher：The Japanese Society of Intensive Care Medicine  

    DOI： 10.3918/jsicm.11.47

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    Other Link： http://search.jamas.or.jp/link/ui/2004146658

  • 人工呼吸器の回路交換と経鼻挿管が，人工呼吸器関連肺炎の発生頻度に及ぼす影響

    山口 修, 速水 元, 谷口 英喜, 磯田 晋, 神谷 紀之, 上向 伸幸, 後藤 正美, 大塚 将秀

    日本集中治療医学会雑誌   11 ( 1 )   49 - 51   2004

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    Language：Japanese   Publisher：The Japanese Society of Intensive Care Medicine  

    DOI： 10.3918/jsicm.11.49

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  • Ultrasonography and lung mechanics can diagnose diaphragmatic paralysis quickly Reviewed

    Takahiro Manabe, Masahide Ohtsuka, Yutaka Usuda, Kiyotaka Imoto, Michio Tobe, Yoshinori Takanashi

    Asian Cardiovascular and Thoracic Annals   11 ( 4 )   289 - 292   2003

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：Asia Publishing Exchange Pte Ltd  

    Diaphragmatic paralysis after cardiovascular surgery requires early diagnosis prior to extubation. The effectiveness of ultrasonography and a lung mechanics assessment was evaluated. Paralysis of the diaphragm was diagnosed when the diaphragm failed to move or moved in a cephalad direction during inspiration. It was diagnosed in 3 of 40 patients (7.5%) who underwent cardiovascular surgery from 1998 to 1999. Patients were extubated when all parameters met the extubation criteria, irrespective of the presence or absence of diaphragmatic paralysis. One patient required prolonged assisted ventilation and died from mediastinitis on the 35th postoperative day. The other 2 patients required assisted ventilation for an additional 1-3 days. Ultrasonography and a lung mechanics assessment are effective tools for the early diagnosis of diaphragmatic paralysis and assessment of respiratory function after cardiovascular surgery.

    DOI： 10.1177/021849230301100404

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  • Influence of blood sample oxygen tension on blood glucose concentration measured using an enzyme-electrode method Reviewed

    K Kurahashi, H Maruta, Y Usuda, M Ohtsuka

    CRITICAL CARE MEDICINE   25 ( 2 )   231 - 235   1997.2

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILLIAMS & WILKINS  

    Objective: To determine the accuracy of a bedside glucometer with an enzyme-electrode sensor based on enzyme oxidation by glucose oxidase.
    Design: Prospective, cross sectional clinical study.
    Setting: Operating room in a public hospital.
    Patients: Fifty-four patients undergoing surgical procedures for a derivation (n = 17) and a validation (n = 37) study. interventions: Arterial blood samples were obtained via a 2-gauge cannula inserted into each patient's radial artery.
    Measurements and Main Results: Glucose measurements and arterial blood gas analyses were concurrently performed, using 48 blood samples for the derivation study and 45 blood samples for the Validation study of this technique. Blood glucose concentrations were measured with both a bedside glucometer using an enzyme-electrode method and a laboratory glucometer based on the colorimetric method. The bedside glucometer consistently underestimated the glucose concentrations and the underestimation was related to the sample oxygen tension but not to hematocrit, plasma protein, creatinine, uric acid, or bilirubin. The present investigation used the following correction formula: (corrected glucose value) = (glucose concentration obtained by a bedside glucometer) + 0.1 x (sample oxygen tension) + 16. The corrected data were in agreement with the laboratory-determined glucose values (i.e., the mean difference and precision were 0.4 and 7.1 mg/dL, respectively). A validation study confirmed the generalization of the present correction formula which facilitates a more accurate estimation of brood glucose concentrations.
    Conclusions: Brood glucose values measured using a bedside glucometer in this study were influenced by the sample oxygen tension. We used a corrective equation which improved the accuracy of estimating blood glucose values to a clinically acceptable range.

    DOI： 10.1097/00003246-199702000-00006

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Books

  • 理学療法士集中治療テキスト

    岡村正嗣, 大塚将秀（ Role： Joint author運動と感覚の神経学的評価を実践する能力、痛みを評価する能力、痛みの評価を実践する能力）

    真興交易(株)医書出版部  2023.3  （ ISBN:9784880039466 ）

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    Total pages：451p   Language：Japanese  

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  • 入門新呼吸療法

    大塚将秀（ Role： Joint author酸素療法）

    克誠堂出版  2023.3  （ ISBN:9784771905726 ）

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    Total pages：viii, 249p   Language：Japanese  

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  • 集中治療医学レビュー : 最新主要文献と解説

    岡元, 和文, 大塚, 将秀, 佐藤, 直樹 (医師), 松田, 直之（ Role： Edit）

    総合医学社  2022.5  （ ISBN:9784883787333 ）

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    Total pages：348p   Language：Japanese  

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  • ECMO・PCPSバイブル

    大塚将秀（ Role： ContributorECMO中の医療介入：人工呼吸器設定）

    メディカ出版  2021 

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  • 重症患者管理指針

    岡元和文, 久志本茂樹, 黒田泰弘, 大塚将秀, 佐藤直樹, 土井研人, 真弓俊彦（ Role： Joint editor陽陰圧体外式人工呼吸）

    総合医学社  2020 

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  • 呼吸管理2020-21ーガイドライン、スタンダード、論点そして私見

    大塚将秀（ Role： Editl呼吸管理とは）

    総合医学社  2020 

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  • 重症患者管理指針

    岡元和文, 久志本茂樹, 黒田泰弘, 大塚将秀, 佐藤直樹, 土井研人, 真弓俊彦（ Role： Joint editor肺保護戦略の潮流）

    2020 

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  • 第47回日本集中治療医学会学術集会テキスト集

    大塚将秀（ Role： Contributor優しく理解ー人工呼吸の換気モード）

    日本集中治療医学会  2020 

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  • 救急集中治療レビュー

    大塚将秀（ Role： Edit）

    総合医学社  2020 

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  • 救急集中治療レビュー

    大塚将秀（ Role： Contributorl呼吸管理とは）

    総合医学社  2020 

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  • 麻酔科医に必要な周術期呼吸管理

    大塚将秀（ Role： Contributor抜管の基準）

    2020 

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  • 重症患者管理指針

    岡元和文, 久志本茂樹, 黒田泰弘, 大塚将秀, 佐藤直樹, 土井研人, 真弓俊彦（ Role： Joint editor人工呼吸器関連肺障害）

    総合医学社  2020 

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  • 救急集中治療アドバンス 急性循環不全

    大塚将秀（ Role： Contributor心原性ショック）

    中山書店  2019 

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  • 臨床工学技士集中治療テキスト

    大塚将秀（ Role： Contributor気道確保）

    克誠堂  2019 

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  • 集中治療、ここだけの話. 田中竜馬編

    大塚 将秀（ Role： Contributor酸塩基平衡の解釈方法）

    医学書院  2018 

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  • 集中治療医学レビュー 最新主要文献と解説 2018-19

    大塚 将秀（ Role： Edit呼吸管理）

    総合医学社  2018 

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  • 人体のメカニズムから学ぶ臨床工学－呼吸治療学

    大塚 将秀（ Role： Edit）

    MEDIVAL VIEW  2017.3 

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  • ARDSーその常識は正しいか？

    大塚 将秀（ Role： Edit）

    総合医学社  2017 

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  • 麻酔科医として必ず知っておきたい周術期の呼吸管理

    小倉玲美, 大塚 将秀（ Role： Contributor麻酔中のモニタリングと血液ガス分析）

    羊土社  2017 

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  • 救急・集中治療のための輸液管理Q&A 第3版

    大塚 将秀（ Role： Contributor重症喘息発作患者の輸液管理）

    総合医学社  2017 

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  • 臨床工学技士のための人工呼吸療法

    大塚 将秀（血液ガス分析）

    MEDICAL VIEW  2017 

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  • 救急・集中治療アドバンス 急性呼吸不全

    大塚 将秀（ Role： Contributor間欠的強制換気）

    中山書店  2016 

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  • 理学療法MOOK18

    大塚 将秀（ Role： Contributor循環管理）

    三輪書店  2015.12 

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  • 呼吸療法Up Date

    大塚 将秀（ Role： Contributor人工呼吸療法に関連したインシデントとその対策）

    真興交易医書出版部  2015 

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  • 人工呼吸器離脱のための標準テキスト

    大塚 将秀（ Role： Contributor換気モード（換気様式））

    学研メディカル秀潤社  2015 

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  • まれな疾患A to Z

    大塚 将秀（ Role： Contributorバンコマイシン耐性腸球菌感染症）

    文光堂  2015 

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  • クリティカルケアにおける呼吸管理

    大塚 将秀（ Role： Contributor人工呼吸器とその基本設定）

    克誠堂出版  2013 

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  • 麻酔科で学びたい技術

    大塚 将秀（ Role： Contributor病態の知識の整理：喘息）

    羊土社  2013 

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  • ここから始める人工呼吸ケア

    大塚 将秀（ Role： Contributorアラームへの対応、回路のリークチェック、酸塩基平衡の基礎、モニタリングと検査値）

    照林社  2013 

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  • Dr大塚の血液ガスのなぜ？がわかる～基礎から学ぶ酸塩基平衡と酸素化の評価

    大塚 将秀（ Role： Sole author）

    学研メディカル秀潤社  2012.12 

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  • 人工呼吸器換気モード超入門

    大塚 将秀（ Role： Contributorこれだけは押さえておきたい基本の換気モード：CMV/AV/IMV/SIMV, PCV, VCV）

    メディカ出版  2012 

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  • イラストでわかる人工呼吸器合併症の予防＆ケア

    大塚 将秀（ Role： ContributorALI/ARDS患者）

    メディカ出版  2012 

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  • ナーシングケアQ&A41号 呼吸管理とケア－病態生理から学ぶ臨床のすべて

    大塚 将秀（ Role： Contributor体位が呼吸機能に及ぼす影響は？ 腹臥位療法の意味と方法は？）

    総合医学社  2012 

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  • 麻酔科レビュー：最新主要文献集2012

    大塚 将秀（ Role： Contributor麻酔中の気道管理）

    総合医学社  2012 

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  • はじめての人工呼吸管理

    大塚 将秀（ Role： Contributorどの換気モードを用いるか）

    中外医学社  2012 

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  • 新呼吸療法テキスト

    大塚 将秀（ Role： ContributorALI/ARDS）

    アトムス  2012 

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  • 全科に必要な重症患者ケアQ&A

    大塚 将秀（ Role： Contributor心拍出量は何のために測るの？ Swan-Ganzカテーテルは何のために入れるの？）

    総合医学社  2011 

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  • 重症患者の呼吸器ケア

    大塚 将秀（ Role： Contributor鎮痛・鎮静の理解）

    日総研出版  2011 

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  • もう怖くない！ 人工呼吸器マスターガイド

    大塚 将秀（ Role： Edit）

    メディカ出版  2011 

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  • 急性期呼吸理学療法

    大塚 将秀（ Role： Contributor循環管理）

    メヂカルビュー  2010 

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  • ナースのための人工呼吸Q&A

    大塚 将秀（ Role： Edit）

    メディカ出版  2010 

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  • 人工呼吸器とケア

    大塚 将秀（ Role： Contributor人工呼吸器で呼吸筋の疲れが治せるの？ 予防的に人工呼吸器を使用することがあるの？）

    総合医学社  2010 

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  • 理学療法MOOK4

    大塚 将秀（ Role： ContributorICUのモニタリングとリスク管理－呼吸器を中心に）

    三輪書店  2009 

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  • 呼吸管理の知識と実際

    大塚 将秀（ Role： Edit）

    メディカ出版  2009 

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  • 人工呼吸管理実践ガイド

    大塚 将秀（ Role： Contributor画像診断）

    照林社  2009 

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  • Curves and Loops in Mechanical Ventilation－人工呼吸中のグラフィックモニタリング

    ドレ－ゲルメディカルジャパン  2003 

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  • 呼吸療法の基礎-呼吸療法で使用される薬物

    基礎から学ぶ 呼吸療法  2001 

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  • 周術期管理-大血管

    集中治療医学  2001 

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  • 急患室における、呼吸困難患者の鑑別診断と診断の進め方

    エクセルナース6救急医学編 メディカルビュー社  1999 

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  • 14章.心臓手術術後の管理 A-L項.

    心臓・血管麻酔ハンドブック.奥村福一郎 編 南江堂.東京.  1998 

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  • 横浜市立大学医学部麻酔科-術後の鎮痛鎮静法.

    -救急・ICU・外科系病棟における-ベッドサイドの鎮痛・鎮静管理.田上恵 編 真興交易 医書出版部.東京.  1998 

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  • 4章.モニタリング A-O項.

    心臓・血管麻酔ハンドブック.奥村福一郎 編 南江堂.東京.  1998 

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  • 外科手術後の管理-消化管術後

    新版図説ICU 呼吸管理編  1996 

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  • 救急処置

    新版図説ICU 呼吸管理編  1996 

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  • 3.人工呼吸器と附属機器 加湿器・ネブライザ・フィルタ(共編)

    人工呼吸療法  1996 

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  • 急性中毒症

    新版図説ICU 呼吸管理編  1996 

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  • ICUで使用される主な薬剤

    新版図説ICU 呼吸管理編  1996 

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  • 検査の正常値

    新版図説ICU 呼吸管理編  1996 

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  • 12.ICU (]G0002[).患者管理の実際 G.(共編)

    麻酔ハンドブック  1995 

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  • Do Not resuscitate(DNR)

    1995 

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  • 12.ICU (]G0002[).患者管理の実際 F.精神管理(共編)

    麻酔ハンドブック  1995 

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  • Computing and Monitoring in Anesthesia and Intensive Care(共編)

    Springer-Verlag  1992 

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  • Ventilation-A New Automated Weaning System with Pressure Support Ventilation(共編)

    Excerpta Medica-International Congress Series 885-Intensive and Critical Care Medicine  1990 

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  • Ventilation-Effects of PEEP on FRC in Patients with Acute Respiratory Failure(共編)

    Excerpta Medica-International Congress Series 885-Intensive and Critical Care Medicine  1990 

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  • Ventilation-Techniques in Weaning from Ventilators-Factors Influencing the Process of Weaning(共編)

    Excerpta Medica-International Congress Series 885-Intensive and Critical Care Medicine  1990 

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  • 定常流型人工呼吸器の問題点(共著)

    ICUとCCU  1988 

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MISC

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Industrial property rights

  • Humidifier with Humidity Sensor

    Masahide Ohtsuka

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    Applicant：Masahide Ohtsuka

    Application no：特願平4-156044  Date applied：1992.5

    Announcement no：特開平5-317428  Date announced：1993.12

    Patent/Registration no：特許第2654887号  Date registered：1997.5 

    No 2654887 Japan

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Research Projects

  • Basic research to prevent delirium in ICU: examination on effects of a newly-developed anti-insomnia drug, Suvorexant.

    Grant number：16K11415  2016.4 - 2019.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    KARIYA Takayuki

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    Grant amount：\4030000 （ Direct Cost: \3100000 、 Indirect Cost：\930000 ）

    It has been well documented that the occurrence of delirium during intensive care unit (ICU) stay correlate with mortality, duration in the ICU, and other morbidities. We tested a preventive effect of a newly developed anti-insomnia drug, suvorexant, against delirium on patients who undergo cardiac surgery. We conducted a double-blinded controlled trial and randomly assigned patients to either suvorexant or placebo group. Delirium was observed 4 out of 5 patients and 3 out of 5 patients in suvorexant and placebo groups, respectively. Lack of power is the limitation; however, we didn’t see any preventive effect of suvorexant on delirium in the setting tested.

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  • 多臓器不全

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    Grant type：Competitive

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  • 人工呼吸

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    Grant type：Competitive

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  • respiratory physiology

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    Grant type：Competitive

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  • mechanical ventilation

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    Grant type：Competitive

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  • multiple organ failure

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    Grant type：Competitive

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  • 呼吸生理学

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    Grant type：Competitive

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