University of the Ryukyus · Graduate School of Health Sciences / Department of Health Sciences · 准教授

Research keywordsCongenital・Mechanical Power・Patients・Predict Ventilator Liberation・Scoliosis・Single・diaphragmatic・hernia

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• Mechanical Power to Predict Ventilator Liberation in Patients with a Tracheostomy2025 · Background: Mechanical power (MP) is useful for predicting the outcomes of attempts to liberate patients from mechanical ventilation. MP is computed based on measured variables derived to determine the power in joules required to breathe while on mechanical ventilation. The main objectives of this study were to calculate a cutoff value of MP that would predict successful liberation and to determine the prediction rate of liberation success based on this cutoff value. Methods: This was a single-center retrospective study. Data from 110 tracheostomized patients on mechanical ventilators were analyzed. We divided subjects on mechanical ventilation into two groups based on liberation outcome. Confounding factors in subject background were adjusted using propensity score matching (PSM). Statistically significant differences in MP at tracheostomy and liberation success between liberation success and failure groups were examined. We calculated the MP cutoff value for successful liberation using the area under the curve of the receiver operating characteristic (AUC-ROC) and its corresponding prediction rate of liberation success. Results: The number of MP of the successful liberation group was 79 and that of the failed liberation group was 31. The MP cutoff value and corresponding prediction rate for liberation success were 256.5 J/min (AUC-ROC = 0.839) and 92.2%, respectively. After PSM, the low MP group (n = 36), divided based on the MP cutoff value, had a significantly higher liberation success rate than the high MP group (n = 36), with an odds ratio of 19.95 (CI: 3.95, 91.23, P < 0.001). Conclusion: MP at tracheostomy was a strong predictor of liberation success, and the prediction rate of liberation success based on the MP cutoff value was shown to be very high. We recommend that patients with low MP be actively considered for liberation. In contrast, those with high MP should continue weaning while simultaneously making early transfer arrangements if liberation is unsuccessful.
• COVID-19流行初期のリハビリテーション介入体制における取組みと一報告2025 · 大城徹也, 関口浩至, 嶺井陽 他
• Feasibility and effectiveness of vertical evacuation of patients with chronic respiratory disease for tsunamis: A prospective study in a coastal area of Okinawa Prefecture, Japan2023 · This study aimed to determine the feasibility of vertical evacuation of patients with chronic respiratory disease living in a tsunami inundation area in Okinawa Prefecture, Japan. The participants included 34 patients with chronic respiratory disease at Public Hospital A and Private Hospital B in Okinawa Prefecture until April 2023 and March 2024, respectively. The 6-min walk test and stair climbing test were measured to determine walking and stair ascending speeds. Walking speeds were used to determine horizontal evacuation time from home to the designated evacuation site for comparison with the estimated tsunami arrival time. The time required for vertical evacuation to suitable buildings was calculated using walking and stair ascending speeds. The mean grace time from the occurrence of the earthquake to the start of horizontal evacuation was significantly shorter than the grace time to the start of vertical evacuation time (p = 0.003). No significant difference was observed in the expected success rates when the evacuation was started immediately after the earthquake. However, when the evacuation was started later than 20 min after the earthquake, the expected success rates were significantly higher for vertical evacuation than for horizontal evacuation (20 min; p = 0.007, 25 min; p = 0.009, 30 min; p = 0.011). The results show that vertical evacuation is more effective for tsunami evacuation than horizontal evacuation and is feasible for patients with chronic respiratory disease. Thus, vertical evacuation should be included in individual evacuation plans for those who require support for tsunami evacuation.
• Factors associated with scoliosis development in patients with congenital diaphragmatic hernia: A single-center retrospective study2004 · Background: Scoliosis is the most frequent complication of musculoskeletal abnormalities in patients with congenital diaphragmatic hernia, but the factors that related to its development and severity remain largely unknown. This study aimed to investigate the clinical factors associated with the development and severity of scoliosis in patients with congenital diaphragmatic hernia. Methods: Thirty-two patients admitted to the neonatal intensive care unit for congenital diaphragmatic hernia at the University of the Ryukyus Hospital between 2004 and 2019 were retrospectively analyzed, particularly those who were discharged alive and had available chest radiographs at 4–5 years of age from medical records. The presence of scoliosis was determined using the chest radiographs. Basic and medical information was also extracted from the patients’ medical records. Results: Factors associated with scoliosis development were an Apgar score <7 points, liver prolapse, and intubation period. The Cobb angle exhibited a significant positive correlation with intubation period, hospital stay duration, and tube feeding duration. Conclusion: Patients with severe congenital diaphragmatic hernia have a high risk of developing scoliosis and may need to begin comprehensive intervention by a multidisciplinary medical team at an early stage.

• 沖縄県の医療的ケア児が地域の学校で共に学ぶことを支える看護職育成を目指して2024 · 研究助成：令和６年度 琉球大学SDGs研究プロジェクト助成
• 伊是名中学校生徒に対する津波や地震・台風災害に関する 島嶼地域防災リーダー育成・教育支援プロジェクト2024 · 研究助成 事業名: 令和６年度戦略的地域連携推進経費地域協働プロジェクト 推進事業
• ウェアラブルカメラなどICTを用いた遠隔授業による伊是名中学校の生徒 に対する防災教育支援プロジェクト2023 · 研究助成 事業名: ２０２３（令和５）年度「つながる離島・広がる沖縄」教育未来基金 事業
• 働き方改革時代の救急医療における救急救命士および看護師への実効的タスクシフト2023 · 基盤研究(B)

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