Time to Reset All – from Cardiovascular Monitoring and Control of Breathing to the Future
| Jazyk: | japonština |
|---|---|
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | 東邦医学会雑誌. 67(1):16-20 |
| ISSN: | 0040-8670 |
| Popis: | 最終講義 過去40年間にわたる生体情報モニターの技術革新は麻酔科の診療環境を大きく変えた.全身麻酔中には生体情報モニターからの情報をもとに全身状態を評価し,診療方針を決定し,その結果を評価するために客観的な生体情報が必須である.麻酔薬の呼吸調節機構への影響を筋電図を用いて明らかにしたことが私の第一歩.その研究手法を非侵襲的なパラメータに置き換えた臨床研究で,呼吸不全における横隔膜疲労についての定量的評価を提案できた.侵襲的手法が主体であった循環動態評価に,脈波伝搬時間という全く新しい非侵襲的パラメータを用いて新たな循環管理法を提案できたのが次の一歩.この新たなパラメータは診療コストを大幅に削減し,特に医療経済的に難しい新興国での診療環境を大きく変えつつある.新興国における新たな展開は,少子高齢化が急激に進むわが国の医療環境を解決する可能性があり,現在の医療環境をリセットするタイミングと楽しみである.During the past four decades, the extraordinary advancement made in monitoring technology of human physiology has changed anesthesia practice dramatically. It is essential to obtain various pieces of physiological information by monitoring equipment to evaluate the situation, make treatment-related decisions, and evaluate its outcome. My first step was to evaluate and elucidate the effect of anesthetics on control of breathing by means of electromyography. Later, non-invasive technique was successfully applied to evaluate the diaphragmatic dysfunction of respiratory failure. Non-invasive technology, such as pulse-wave transit time, was also applied for cardiovascular monitoring, resulting in the significant reduction of the risk and cost, thus contributing to the medical economy of emerging countries. Such experience and projects in emerging countries will help our medical economy in near future, while population distribution is expected to change dramatically in the coming decades. I would like to propose, “it is the time to reset our future." |
| Databáze: | OpenAIRE |
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