Yuki Kotani, MD
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yukikotani.bsky.social
Yuki Kotani, MD
@yukikotani.bsky.social
Deputy Director of the Department of Intensive Care Medicine, Kameda Medical Center, Japan.
Pinned
🧠 Sedation in the ICU: are volatile anesthetics better than IV anesthetics?

Our meta-analysis of 21 RCTs (n=2,367): volatile sedation ↑ mortality (RR 1.17 [1.02–1.35]) vs. IV Sedation

⚠️ Routine use is not supported. Consider only in selected patients.

🔗 ccforum.biomedcentral.com/articles/10....
Reposted by Yuki Kotani, MD
Once again, the emperor of inductive physiological reasoning is revealed to have no clothes...
In >1,100 high-risk surgical patients, individualized periop BP targets based on pre-op nocturnal MAP were not associated with ↓ kidney or cardiac injury vs routine MAP ≥65 mm Hg

CCR Journal Watch – tracking the critical care literature daily
criticalcarereviews.com/latest-evide...
October 13, 2025 at 7:20 AM
Reposted by Yuki Kotani, MD
💧Early diuretics after cardiac surgery?
No gain, potential pain

In this post-hoc analysis of the #BROTHERstudy early IV diuresis didn’t prevent #AKI and prolonged hospitalization

🔗 www.signavitae.com/articles/10.22514/sv.2023.112

#Anesthesia #CardiacSurgery #ICU #MedEd
@yukikotani.bsky.social
July 7, 2025 at 12:15 PM
🧠 Sedation in the ICU: are volatile anesthetics better than IV anesthetics?

Our meta-analysis of 21 RCTs (n=2,367): volatile sedation ↑ mortality (RR 1.17 [1.02–1.35]) vs. IV Sedation

⚠️ Routine use is not supported. Consider only in selected patients.

🔗 ccforum.biomedcentral.com/articles/10....
June 6, 2025 at 5:16 AM
🩸 Our new meta-analysis on arterial line blood cultures

Contamination rate with arterial catheter–drawn cultures was comparable to venipuncture & lower vs venous catheter–drawn cultures

📌 In critically ill adults, arterial line sampling may be a reasonable alternative.
doi.org/10.1093/cid/...
Contamination of blood cultures drawn from arterial catheters versus venipuncture or venous catheters in critically ill patients: a systematic review and meta-analysis
AbstractBackground. Arterial catheter-drawn blood culture sampling may reduce patient discomfort and healthcare providers’ workload. Guidelines discourage
doi.org
May 27, 2025 at 8:09 AM
🆕 New RCT in JAMA: Sedation in mechanically ventilated ICU patients—Dexmedetomidine vs Clonidine vs Propofol

📕 Main takeaway: In critically ill patients, neither dexmedetomidine nor clonidine shortened time to successful extubation compared to propofol.
May 20, 2025 at 1:49 AM
Reposted by Yuki Kotani, MD
🎓 Applications are OPEN for the 1️⃣ #ESICMNEXT 𝗚𝗲𝗻𝗜𝗨𝗦 𝗙𝗲𝗹𝗹𝗼𝘄𝘀𝗵𝗶𝗽𝘀 — a 5-day hands-on training in General Intensive Care Ultrasound!

🌍 30 young intensivists will train at 7 top centres across Europe 🗓️ 𝗢𝗰𝘁 𝟭𝟯–𝟭𝟳, 𝟮𝟬𝟮𝟱

🗓️ Apply by 𝗠𝗮𝘆 𝟮𝟬 👉 www.esicm.org/newfellowshi...

#IntensiveCare #GenIUSFellowship
NEXT Fellowship in General Intensive Care Ultrasound (GenIUS) - ESICM
www.esicm.org
April 30, 2025 at 11:00 AM
Reposted by Yuki Kotani, MD
📢 Your 𝗹𝗮𝘁𝗲𝘀𝘁 𝗶𝘀𝘀𝘂𝗲 of the @intenscaremed.bsky.social with the latest articles is here! 📖 𝗙𝗼𝗹𝗹𝗼𝘄 𝘂𝘀 & stay updated with the latest research, delivered straight to you.

📍 Read all the latest articles here 👉 www.esicm.org/icm-latest-i...

#ICM #ESICM #Research #MedicalJournals #IntensiveCare
May 2, 2025 at 12:00 PM
Guidelines for CPB in adult cardiac surgery

The CPB can only be performed through collaboration between cardiac surgeons, anesthesiologists, and perfusionists.
This European guideline covers hot topics, such as intravenous amino acid therapy for AKI prevention.
www.bjanaesthesia.org/article/S000...
2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery
Clinical practice guidelines consolidate and evaluate all pertinent evidence on a specific topic available at the time of their formulation. The goal is to assist physicians in determining the most ef...
www.bjanaesthesia.org
February 16, 2025 at 4:41 AM
Both frequentist and Bayesian approaches are important to interpret the findings of critical care research.
ccforum.biomedcentral.com/articles/10....
Death by p-value: the overreliance on p-values in critical care research - Critical Care
The p-value has changed from a versatile tool for scientific reasoning to a strict judge of medical information, with the usual 0.05 cutoff frequently deciding a study’s significance and subsequent cl...
ccforum.biomedcentral.com
February 12, 2025 at 9:52 AM
This secondary analysis of an RCT examined whether the risk of death changes between balanced crystalloids and saline depending on the Cl concentration.
The higher the Cl concentration, the more the point estimates of mortality risk favor balanced crystalloids.
link.springer.com/article/10.1...
Serum chloride concentration and outcomes in adults receiving intravenous fluid therapy with a balanced crystalloid solution or 0.9% sodium chloride - Intensive Care Medicine
Purpose To determine whether there is an interaction between baseline serum chloride concentration and pH and treatment effects in Intensive Care Unit (ICU) patients receiving intravenous fluid therap...
link.springer.com
February 12, 2025 at 9:50 AM
Pathological physiology, clinical significance, and differential diagnosis of euglycemic DKA by SGLT2 inhibitors
idp.springer.com/authorize?re...
Understanding the disease: euglycemic ketoacidosis with SGLT2 inhibitors - Intensive Care Medicine
Intensive Care Medicine -
idp.springer.com
February 4, 2025 at 10:24 AM
Recently, it has been mostly accepted that ketamine does not increase intracranial pressure. Rather, thanks to its hemodynamic tolerance, ketamine can avoid hypotension and maintain cerebral perfusion pressure when used as an induction agent for intubation.
www.bjanaesthesia.org/article/S000...
The diverse effects of ketamine, jack-of-all-trades: a narrative review
Ketamine, an N-methyl-D-aspartic acid receptor antagonist that was first discovered in 1962, has become established in anaesthesia providing dose-dependent anaesthetic, sedative, and analgesic effects...
www.bjanaesthesia.org
January 31, 2025 at 12:58 PM
Heterogeneity in the therapeutic effects of oxygen therapy in critically ill patients

Different baseline conditions, acute diseases, and concurrent interventions likely modify the optimal goals for oxygen therapy. Two large RCTs may guide future practice.
ccforum.biomedcentral.com/articles/10....
January 29, 2025 at 11:29 PM
Reposted by Yuki Kotani, MD
Induction Agents for Tracheal Intubation in Critically Ill Patients

CCR Journal Watch
criticalcarereviews.com/latest-evide...

Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at criticalcarereviews.com/newsletters/...
January 27, 2025 at 11:45 AM
What happens to hemodynamics in ARDS patients after VV ECMO initiation?

Improvements occurred in 61% at 2 h & 83% at 24 h.
The main causes seem to be improved respiratory parameters & acid-base balance and a reduction in ventilator support.
www.jcvaonline.com/article/S105...
Hemodynamic improvement in ARDS patients after VV ECMO implantation
Severe acute respiratory distress syndrome (ARDS) is often complicated by hemodynamic instability requiring pharmacological support. Venovenous extracorporeal membrane oxygenation (VV ECMO) is a well-...
www.jcvaonline.com
January 25, 2025 at 12:54 PM
Review article on AKI: Lancet

This is a must-read paper that covers not only the epidemiology, pathophysiology, and management of AKI, but also crosstalk with other organs during the acute phase and long-term adverse effects on other organs.
www.thelancet.com/journals/lan...
Acute kidney injury
Acute kidney injury (AKI) is a common, heterogeneous, multifactorial condition, which is part of the overarching syndrome of acute kidney diseases and disorders. This condition's incidence highest in ...
www.thelancet.com
January 21, 2025 at 1:39 AM
Narrative review on vasoplegic shock

Regarding the dosage of norepinephrine used as a guideline for starting vasopressin therapy, there are an increasing number of publications stating "0.2 µg/kg/min" rather than "0.25 µg/kg/min."
www.bjaed.org/article/S205...
Management of vasoplegic shock
Vasoplegic shock is common, contributing up to two-thirds of cases of shock admitted to the ICU.1,2 For the two most common causes of vasoplegic shock—septic shock and vasoplegic shock after cardiopul...
www.bjaed.org
January 21, 2025 at 1:38 AM
US assessment of LV function in septic shock

EF does not represent LV contractility but the relationship between LV contractility and afterload. For example, if there is too much vasopressor, the afterload will increase and EF may appear relatively low.
link.springer.com/article/10.1...
How we could use critical care echocardiography in the assessment of and management of cardiovascular phenotypes in septic shock: the good, the bad, and the ugly profiles - Intensive Care Medicine
Intensive Care Medicine -
link.springer.com
January 21, 2025 at 1:36 AM
Reposted by Yuki Kotani, MD
A review article on hemodynamic management in septic shock has been published in Burns & Trauma!
It covers a wide range of topics, including fluids, vasopressors, steroids, and resuscitation goals!
Open access👇
academic.oup.com/burnstrauma/...
Haemodynamic management of septic shock
Abstract. Septic shock is a significant challenge in the management of patients with burns and traumatic injuries when complicated by infection, necessitat
academic.oup.com
January 19, 2025 at 2:53 AM
A review article on hemodynamic management in septic shock has been published in Burns & Trauma!
It covers a wide range of topics, including fluids, vasopressors, steroids, and resuscitation goals!
Open access👇
academic.oup.com/burnstrauma/...
Haemodynamic management of septic shock
Abstract. Septic shock is a significant challenge in the management of patients with burns and traumatic injuries when complicated by infection, necessitat
academic.oup.com
January 19, 2025 at 2:43 AM
Our SR of angiotensin II published in JCVA is now available to read with free access until March 2!
authors.elsevier.com/c/1kQEu3lSIP...
authors.elsevier.com
January 11, 2025 at 12:54 PM
Reposted by Yuki Kotani, MD
CCR Journal Watch

#NAVIGATEtrial from #CCR24 is now published in @bjajournals.bsky.social

NIV for early resp failure on general wards

@yukikotani.bsky.social et al

criticalcarereviews.com/latest-evide...

CCR Newsletter - subscribe at criticalcarereviews.com/newsletters/...
January 3, 2025 at 8:43 PM
🆕Publication: RCT to assess NIV for acute respiratory failure in general wards
@bjajournals.bsky.social

Most NIV trials were conducted in ICUs. Only two small, single-center RCTs evaluated NIV in general wards. Here are the results of the first multicenter RCT👇
authors.elsevier.com/c/1kNDs1dCDu...
authors.elsevier.com
January 3, 2025 at 3:22 AM
Last publication in 2024🍾
We assessed the effects of non-adrenergic vasopressors in three populations (sepsis, cardiac surgery, and non-cardiac surgery).
Our findings justify future RCTs comparing these agents with usual care based on noradrenaline alone.
ccforum.biomedcentral.com/articles/10....
December 30, 2024 at 3:20 PM
Intravenous amino acid infusion in cardiac surgery patients with CKD: secondary analysis of PROTECTION trial
AKI prevention was confirmed in CKD, and the treatment effect was similar regardless of baseline eGFR, although renal functional reserve declines in CKD.
journals.lww.com/anesthesiolo...
Amino Acid Infusion for Kidney Protection in Cardiac... : Anesthesiology
kidney disease (CKD) have diminished renal functional reserve, and AA may be less protective in such patients. Thus, a separate investigation of such patients is warranted. Methods: We defined CKD ...
journals.lww.com
December 29, 2024 at 12:57 AM