In the past Toshiya Shiga has collaborated on articles with Hiroshi Hoshijima. One of their most recent publications is Original contributionProphylactic nebulized lidocaine attenuates hyperdynamic response to abrupt mask inhalation of isoflurane in adults. Which was published in journal Journal of Clinical Anesthesia.

More information about Toshiya Shiga research including statistics on their citations can be found on their Copernicus Academic profile page.

Toshiya Shiga's Articles: (6)

Original contributionProphylactic nebulized lidocaine attenuates hyperdynamic response to abrupt mask inhalation of isoflurane in adults

AbstractStudy objectivesTo examine whether prophylactic, atomized lidocaine blunts hyperdynamic responses and catecholamine release after an abrupt increase in volatile anesthetic administration.DesignProspective, randomized, double-blind, placebo-controlled study.SettingUniversity-affiliated hospital.Patients22 ASA physical status I adult patients scheduled for elective surgery.InterventionsPatients were randomly assigned to the saline or lidocaine group, and abruptly inhaled 5% isoflurane (4.3 MAC) after inhalation of ultrasonically nebulized lidocaine or saline via endoscopy mask. An esophageal Doppler probe was inserted via the mask to assess global hemodynamic performance.Measurements and main resultsImmediately after abrupt inhalation of isoflurane, heart rate (HR) in the saline group increased significantly and mean arterial pressure (MAP) remained unchanged, whereas HR in the lidocaine group remained unchanged, and MAP decreased significantly. No significant differences were noted between the saline and lidocaine groups in aortic blood flow, stroke volume in the aorta, total systemic vascular resistance in the aortic circuit, or aortic diameter. The plasma norepinephrine concentration increased in both groups after isoflurane inhalation, significantly so in the saline group but not in the lidocaine group.ConclusionProphylactic ultrasonically nebulized lidocaine (2 mg/kg) obtunds the hyperdynamic responses to abrupt inhalation of 5% isoflurane but does not completely block catecholamine release.

Original ContributionMcGrath videolaryngoscope versus Macintosh laryngoscope for tracheal intubation: A systematic review and meta-analysis with trial sequential analysis

Highlights•We evaluated not only success rate but also glottic visualization and intubation time.•We conducted a trial sequential analysis.•The McGrath is superior to the Macintosh in terms of glottic visualization.•However, it significantly extends intubation time and its success rate is not excellent•TSA suggests that further studies are necessary to confirm the results of intubation time.

Original ContributionC-MAC videolaryngoscope versus Macintosh laryngoscope for tracheal intubation: A systematic review and meta-analysis with trial sequential analysis

Highlights•We conducted a meta-analysis including more studies than the previous meta-analysis.•We conducted a trial sequential analysis.•The C-MAC is superior to the Macintosh in terms of glottic visualisation.•The C-MAC is superior to the Macintosh in terms of success rates in difficult airway.•TSA suggested that sample size were met with all outcomes.

Original articleMinor cardiac troponin t release in patients undergoing coronary artery bypass graft surgery on a beating heart

AbstractObjectives: To determine whether and to what extent coronary artery bypass graft (CABG) surgery without extracorporeal circulation is associated with cardiac troponin T (TnT) release.Design: Prospective study.Setting: A single university hospital.Participants: Twenty-three patients scheduled for minimally invasive CABG surgery. Sixteen patients received one coronary anastomosis, and seven received two.Interventions: TnT and creatine kinase-MB (CK-MB) levels were determined immediately before induction of anesthesia (baseline) and at 0, 12, and 24 hours after surgery. Hemodynamic measurements were made, and 5-lead electrocardiograms with continuous automated ST-segment trends were analyzed.Measurements and Main Results: All patients had a good cardiac outcome. Median cumulative coronary artery occlusion time was 27 minutes (range, 10 to 49 minutes). TnT levels were undetectable in 91.3% of patients at baseline when a detection limit of 0.01 ng/mL was employed. TnT and CK-MB showed significant elevations at 12 and 24 hours versus baseline. Postoperatively, TnT was detectable in 91.3% of patients, and 17.4% suffered minor myocardial damage, as evidenced by an abnormal increase in TnT greater than 0.2 ng/mL, excluding those exhibiting myocardial infarction. ST segment changes developed in seven patients, persisting for 13.0 minutes (range, 9.5 to 15.8 minutes) and disappearing immediately after coronary artery clamp release. There were no significant correlations between cumulative coronary occlusion time and peak TnT or CK-MB levels.Conclusions: TnT was detected after surgery in most patients, and significant TnT levels indicative of myocardial injury (>0.2 ng/mL) were detected in only 17% of patients, probably as a result of brief periods of coronary artery occlusion.

Survey of observer variation in transesophageal echocardiography: comparison of anesthesiology and cardiology literature

AbstractObjective: Transesophageal echocardiographic examination tends to be somewhat observer and experience dependent, and observer bias can arise easily when data are calculated and interpreted by unskilled, nonblinded, or single observers. The study plan was to see whether authors have adequately described how observer bias is minimized in their studies. Thus, a study was conducted systematically reviewing methods reported in transesophageal echocardio graphy articles in peer-reviewed anesthesiology journals versus those reported in peer-reviewed cardiology journals.Interventions: After MEDLINE searches of the literature published from 1997 through 1999, the authors investigated 56 anesthesiology reports and 56 randomly selected, year-matched cardiology reports. An 8-item questionnaire was developed that examined several factors: the number of observers and their experience levels, whether observers were blind to clinical data, whether low-quality images were excluded, the use of on-line or off-line analysis, and observer variability.Main results: The analysis revealed inadequacies in reporting of important information that relates to bias and quality in 91.1% of anesthesiology and 98.2% of cardiology articles. Observer variability was not reported in 50.0% of the anesthesiology reports and 67.9% of the cardiology reports; however, difference between the 2 bodies of literature was not significant. The journal impact factor was significantly higher for the cardiology literature than for the anesthesiology literature (2.42 [0.386–10.893] v 1.07 [0.664–3.439]; median [range], p < 0.001).Conclusion: Articles reviewed had at least some inadequacies in reporting the methods to minimize observer bias in both the anesthesiology and cardiology literature. Reporting methodology standards in TEE examinations remain to be established.

Original articleEffects of oral hygiene using chlorhexidine on preventing ventilator-associated pneumonia in critical-care settings: A meta-analysis of randomized controlled trials

AbstractBackground/purposeVentilator-associated pneumonia (VAP) is one of the most frequent causes of morbidity and mortality among mechanically ventilated patients in critical care. Previous meta-analyses demonstrated that oral chlorhexidine (CHX) is beneficial in preventing VAP. Several new studies on oral hygiene as a preventive measure for VAP have been published. Considering all the currently available evidence together, an updated meta-analysis was conducted to evaluate the efficacy of oral CHX in preventing VAP.Materials and methodsA comprehensive literature search was conducted to identify clinical trials comparing oral hygiene care using CHX with conventional care in terms of the incidence of VAP. Two reviewers independently assessed each report to confirm that all reports met the inclusion criteria. The data from each trial were combined using the Mantel–Haenszel fixed-effects model to calculate the pooled relative risk and the corresponding 95% confidence intervals. Funnel plots were used to assess publication bias.ResultsNine randomized controlled trials met our inclusion criteria. Overall, 1623 patients received oral hygiene with CHX and 1662 received a placebo. The heterogeneity of the data was statistically refuted. Oral hygiene using CHX resulted in a reduced incidence of VAP (relative risk = 0.59; 95% confidence interval, 0.47–0.73; P < 0.001; I2 = 27.8%) according to a fixed-effects model. Publication bias was not apparent in the funnel plots.ConclusionThe analysis showed that oral CHX decontamination significantly reduced the incidence of VAP but not the mortality rate.

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