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Kondo, Yutaka

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Kondo

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Yutaka

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Kondo, Yutaka

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2015 - 20173

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Author's Publications: search.filters.isAuthorOfPublication.c7b40259-f083-4c21-9931-7fb7fce87ed8

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    Meta-analysis of the efficacies of amiodarone and nifekalant in shock-resistant ventricular fibrillation and pulseless ventricular tachycardia
    (Nature Publishing Group UK, 2017) Sato, Shiho; Zamami, Yoshito; Imai, Toru; Tanaka, Satoshi; Koyama, Toshihiro; Niimura, Takahiro; Chuma, Masayuki; Koga, Tadashi; Takechi, Kenshi; Kurata, Yasuko; Kondo, Yutaka; Izawa-Ishizawa, Yuki; Sendo, Toshiaki; Nakura, Hironori; Ishizawa, Keisuke
    Amiodarone (AMD) and nifekalant (NIF) are used in the treatment of ventricular fibrillation or tachycardia; however, only few studies have been conducted on their efficacies. Therefore, a meta-analysis was conducted. Relevant sources were identified from PubMed, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi. The outcomes were short-term and long-term survival in patients with shock-resistant ventricular fibrillation /pulseless ventricular tachycardia. Thirty-three studies were analysed. The results showed that, compared to the control treatment, AMD did not improve short-term survival (odds ratio (OR): 1.25, 95% confidence interval (CI): 0.91–1.71) or long-term survival (OR: 1.00, 95% CI: 0.63–1.57). However, compared to the control treatment, NIF significantly improved short-term survival (OR: 3.23, 95% CI: 2.21–4.72) and long-term survival (OR: 1.88, 95% CI: 1.36–2.59). No significant difference was observed in short-term survival (OR: 0.85, 95% CI: 0.63–1.15) or long-term survival (OR: 1.25, 95% CI: 0.67–2.31) between AMD- and NIF-treated patients. The results suggest that NIF is beneficial for short-term and long-term survival in shock-resistant ventricular fibrillation/pulseless ventricular tachycardia; however, the efficacy of AMD in either outcome is not clear.
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    Epidemiology, Risk Factors, and Outcomes of Out-of-Hospital Cardiac Arrest Caused by Stroke: A Population-Based Study
    (Wolters Kluwer Health, 2016) Fukuda, Tatsuma; Ohashi-Fukuda, Naoko; Kondo, Yutaka; Sera, Toshiki; Doi, Kent; Yahagi, Naoki
    Abstract Limited information is available regarding stroke-related out-of-hospital cardiac arrest (OHCA). We aimed to assess the clinical characteristics of stroke-related OHCA and to identify the factors associated with patient outcomes. We conducted a nationwide population-based study of adult OHCA patients in Japan from January 1, 2006 to December 31, 2009. We examined the epidemiology, risk factors, and outcomes of stroke-related OHCA compared with cardiogenic OHCA. The primary outcome was neurologically favorable survival. Of the 243,140 eligible patients, 18,682 (7.7%) were diagnosed with stroke-related OHCA. Compared to OHCA with a presumed cardiac etiology, stroke-related OHCA patients had a greater chance of prehospital return of spontaneous circulation (ROSC) (9.9% vs 5.9%, P < 0.0001) but a reduced chance of 1-month survival (3.6% vs 4.9%, P < 0.0001) or favorable neurological outcomes (1.2% vs 2.6%, P < 0.0001). After adjusting for a variety of confounding factors, the prehospital ROSC rates were higher (adjusted OR 2.47, 95% confidence interval [CI] 2.34–2.62), but the neurologically favorable survival rates were lower (adjusted OR 0.66, 95%CI 0.57–0.76), among the stroke-related OHCA patients. In stroke-related OHCA cases, having a younger age, witness, and shockable 1st documented rhythm were associated with improved outcomes. Men had more favorable neurological outcomes. Seasonal or circadian factors had no critical impact on favorable neurological outcomes. Prehospital advanced life support techniques (i.e., epinephrine administration or advanced airway management) were not associated with favorable neurological outcomes. Although stroke-related OHCA had lower 1-month survival rates and poorer neurological outcomes than cardiogenic OHCA, the rates were not considered to be medically futile. Characteristically, sex differences might impact neurologically favorable survival.
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    Indication for mild therapeutic hypothermia based on an initial Glasgow Coma Scale motor score
    (BioMed Central, 2015) Hifumi, Toru; Kawakita, Kenya; Okazaki, Tomoya; Egawa, Satoshi; Kondo, Yutaka; Natsukawa, Tomoaki; Sawano, Hirotaka
    Although neurological evaluation using the Glasgow Coma Scale motor score is mandatory for post-cardiac arrest patients, further study is required to determine if this score can be used as an indicator for mild therapeutic hypothermia. Although the current study conducted by Natsukawa et al. presents interesting data, there are some critical issues regarding study design, selection bias, and interpretation of study results that should be pointed out.