| Project/Area Number |
17K11596
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Emergency medicine
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| Research Institution | Nippon Medical School |
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Principal Investigator |
Hidetaka Onda 日本医科大学, 医学部, 助教 (30521603)
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| Co-Investigator(Kenkyū-buntansha) |
布施 明 日本医科大学, 医学部, 教授 (80238641)
増野 智彦 日本医科大学, 医学部, 講師 (00318528)
横堀 将司 日本医科大学, 医学部, 准教授 (70449271)
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| Project Period (FY) |
2017-04-01 – 2024-03-31
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| Project Status |
Completed (Fiscal Year 2023)
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| Budget Amount *help |
¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000)
Fiscal Year 2020: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2018: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000)
Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | 嚥下 / 挿管 / 集中治療 / 嚥下評価 / 抜管 / 食事 / 評価 / 肺炎 / 再挿管 / 経口摂取 |
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| Outline of Final Research Achievements |
The removal of an endotracheal tube is an invasive procedure, necessitating a protocol. Swallowing evaluations were implemented to prevent dangerous extubations and achieve more accurate assessments. Based on risk factors, patients were divided into two groups: one started oral intake as planned, while the other followed usual practices. We compared re-intubation and aspiration pneumonia rates between the groups. Cases of aspiration pneumonia and re-intubation were objectively evaluated to determine the effectiveness of initiating oral intake timing. High-risk patients included those using vasopressors, aged 65 or older, or with aspiration pneumonia as an underlying condition. Recognizing the importance of thorough swallowing evaluations and risk management is crucial for effective treatment.
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| Academic Significance and Societal Importance of the Research Achievements |
本介入研究により、抜管後に、誤嚥性肺炎の合併や、再挿管となる症例が、どのように異なるかを客観的に評価し、経口摂取開始時期決定の有効性を検討した。昇圧剤の使用、高齢者の65歳以上、および原疾患が誤嚥性肺炎である症例は、抜管自体にリスクが認められ、またその後の経口摂取に関しても他症例のようにスムーズに進まなかった。嚥下評価やリスクを熟知して治療、嚥下を進めていく必要性が認められた。
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