著者

Ryuta Nakashima Toru Hifumi Kenya Kawakita Tomoya Okazaki Satoshi Egawa Akihiko Inoue Ryutaro Seo Nobuhiro Inagaki Yasuhiro Kuroda

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-16-1006, (Released:2017-02-24)

参考文献数

133

被引用文献数

13

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The discussion of neurocritical care management in post-cardiac arrest syndrome (PCAS) has generally focused on target values used for targeted temperature management (TTM). There has been less attention paid to target values for systemic and cerebral parameters to minimize secondary brain damage in PCAS. And the neurologic indications for TTM to produce a favorable neurologic outcome remain to be determined. Critical care management of PCAS patients is fundamental and essential for both cardiologists and general intensivists to improve neurologic outcome, because definitive therapy of PCAS includes both special management of the cause of cardiac arrest, such as coronary intervention to ischemic heart disease, and intensive management of the results of cardiac arrest, such as ventilation strategies to avoid brain ischemia. We reviewed the literature and the latest research about the following issues and propose practical care recommendations. Issues are (1) prediction of TTM candidate on admission, (2) cerebral blood flow and metabolism and target value of them, (3) seizure management using continuous electroencephalography, (4) target value of hemodynamic stabilization and its method, (5) management and analysis of respiration, (6) sedation and its monitoring, (7) shivering control and its monitoring, and (8) glucose management. We hope to establish standards of neurocritical care to optimize brain function and produce a favorable neurologic outcome.

著者

Ryuta Nakashima Toru Hifumi Kenya Kawakita Tomoya Okazaki Satoshi Egawa Akihiko Inoue Ryutaro Seo Nobuhiro Inagaki Yasuhiro Kuroda

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.81, no.4, pp.427-439, 2017-03-24 (Released:2017-03-24)

参考文献数

133

被引用文献数

13

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The discussion of neurocritical care management in post-cardiac arrest syndrome (PCAS) has generally focused on target values used for targeted temperature management (TTM). There has been less attention paid to target values for systemic and cerebral parameters to minimize secondary brain damage in PCAS. And the neurologic indications for TTM to produce a favorable neurologic outcome remain to be determined. Critical care management of PCAS patients is fundamental and essential for both cardiologists and general intensivists to improve neurologic outcome, because definitive therapy of PCAS includes both special management of the cause of cardiac arrest, such as coronary intervention to ischemic heart disease, and intensive management of the results of cardiac arrest, such as ventilation strategies to avoid brain ischemia. We reviewed the literature and the latest research about the following issues and propose practical care recommendations. Issues are (1) prediction of TTM candidate on admission, (2) cerebral blood flow and metabolism and target value of them, (3) seizure management using continuous electroencephalography, (4) target value of hemodynamic stabilization and its method, (5) management and analysis of respiration, (6) sedation and its monitoring, (7) shivering control and its monitoring, and (8) glucose management. We hope to establish standards of neurocritical care to optimize brain function and produce a favorable neurologic outcome.

著者

黒田 康弘 クロダ ヤスヒロ Yasuhiro Kuroda

雑誌

史苑

巻号頁・発行日

vol.65, no.2, pp.89-118, 2005-03-19

著者

Toshifumi Kikuchi Yasuhiro Kuroda

出版者

Japan Concrete Institute

雑誌

Journal of Advanced Concrete Technology (ISSN:13473913)

巻号頁・発行日

vol.9, no.1, pp.115-124, 2011-02-23 (Released:2011-02-22)

参考文献数

12

被引用文献数

28 78

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One of the largest contributors of the greenhouse gas emission is the production of cement for use in concrete. However, concrete is well-known for its carbon dioxide (CO2) uptake by carbonation. The purpose of this study was to consider the CO2 uptake in demolished and crushed concrete. In this study, three kinds of experiments and survey were carried out, including (1) an experiment using mortar specimens made in the laboratory so as to identify the conditions that accelerate CO2 uptake, (2) an experiment using concrete obtained from the demolition site and (3) a survey on the CO2 uptake in recycled crusher-run stone obtained from recycling plants. The experiment on new mortar and demolished concrete pointed out that the CO2 uptake in cement hydrate increases significantly when the particles are relatively small and when they are alternately wetted and dried. Furthermore, the survey on concrete at recycling plants found the amount of CO2 uptake in one ton of recycled crusher-run stone to be approximately 11 kilograms. Finally, using this value, the life cycle of CO2 of concrete structures was calculated and shown to be approximately 5.5% less when the CO2 uptake is taken into account compared to when it is not taken into account.