Ryo Ueno

ICU Trainee ☕🎾🥃🍛🍖🇯🇵🇦🇺

[Ryo Ueno @Intensive_Ryo]

🧵 FRAILTY after surgery: Does it still matter in the ICU?

We studied 216,922 postop ICU patients across 🇦🇺 to find out.
Here’s what we learned 👇
#ICU #Frailty #PerioperativeCare #CriticalCare

[Ryo Ueno @Intensive_Ryo]

@so_flat @YukiKotani5 点滴のマシンにmg/kg/h表示のオプションがデフォルトでついていたので大丈夫でした　笑

[Ryohei Yamamoto@物価3倍の国 @so_flat]

ICUの酸素療法95～95%くらいがいいかも、というSRをAJRCCMに出版できました。

今井先生おめでとうございます。

Comparison of Oxygenation Targets in Critically Ill Adults: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials https://t.co/LtCDTHR8CQ

[Ryo Ueno @Intensive_Ryo]

For those interested in ICU ethics & real-world practice

@jsicm_org @ANZICS @ESICM @SCCM @yourICM @CritCareReviews @IntensiveNXT @jseptic @ATSCritCare @ISICEM @JaamSNS @WICSBottomLine @ATSBlueEditor @Crit_Care

[Ryo Ueno @Intensive_Ryo]

What constitutes End-of-Life practice in Australia?

"Culture, ethics and clinical practicefor intensivists managing end of life care:an Australian perspective"

🆓🔓https://t.co/lN10atw4v2

[Ryohei Yamamoto@物価3倍の国 @so_flat]

下痢の研究第二弾。

いったいどの下痢の定義がICUでは良いんでしょうか。

死亡との関連から定義の妥当性を評価しました。

https://t.co/BaDr86kDlt

[David Pilcher @IntensiveDave]

30 years & 3 million ICU admissions in 🇦🇺 🇳🇿
Is this as good as it gets? @anzics https://t.co/NSU2M8b8VI
Great work by @JuliaPilowsky @Intensive_Ryo #JoshMclarty #MichaelBailey @AlastairBrown21 #anzicscore

[テニスゴリラ @Tennis_P_C]

こんなんウソやん…

マッチに当ててへし折るくらいならまだ現実味ある。

[小谷祐樹 Yuki Kotani｜集中治療医 @YukiKotani5]

🧠 Sedation in the ICU – are volatile anaesthetics a better option?

In recent years, volatile anaesthetics (e.g., sevoflurane) have gained attention as alternatives to intravenous (IV) sedation in ICU patients.
They offer some theoretical advantages:
✅ Rapid awakening (exhaled via lungs)
✅ Possibly protective for lungs and diaphragm
But are they safe? Do they really improve outcomes?

Our team conducted a meta-analysis of 21 RCTs (n = 2,367) comparing volatile vs. IV sedation in critically ill adults receiving mechanical ventilation.
We found that volatile sedation was associated with increased mortality: RR 1.17 [95% CI 1.02–1.35]

⚠️ While volatile agents may facilitate faster extubation, current evidence does not support routine use in ICU patients.

Use should be limited to selected patients where benefits are likely to outweigh potential risks.

🔗 Open-access paper @Crit_Care:
https://t.co/yirDfWM7y8

[亀田総合病院集中治療科 @kameda_icu]

当科の興梠貴俊先生を筆頭に、
📄「重症患者における動脈カテーテルと静脈穿刺または静脈カテーテルから採取した血液培養のコンタミネーション：系統的レビューおよびメタ解析」
が Clinical Infectious Diseasesに掲載されました！

リンクはこちら👇
🔗 [https://t.co/75idpS8szO]

[Ryo Ueno @Intensive_Ryo]

Dexmed as primary sedatives:
- SPICE-III ➡️ No mortality benefit, ?merit in older MV patient
- 🆕A2B no difference in early extubation

Dexmed as an adjunct:
- DahLIA➡️early extubation in agitated MV pt
- DESIRE ➡️ no mortality benefit in septic pt on MV

[Eddy J. Gutierrez, MD @eddyjoemd]

Is renin the next big thing in ICU patient management? The concepts are intriguing, and I look forward to implementing them in my patient management one day. 🎩 tip to the authors including @YukiKotani5, @giovannilandoni, and @KhannaAshishCCM.
https://t.co/wtiQFg1wGN

[Ryohei Yamamoto@物価3倍の国 @so_flat]

🆕 Published in Intensive Care Medicine 📘
What do older adults truly value after critical illness?
A survey of 3,410 seniors in Japan found many care more about reducing burden on family, financial impact, and dignity — not just survival.

🔗 https://t.co/kfMGtc7MW9

[Ryo Ueno @Intensive_Ryo]

@so_flat おめです！

[Ryo Ueno @Intensive_Ryo]

今後の日本のicu研究で大事になる研究。winratioにせよcomposite outcomeにせよ、patient centredなアウトカムとは実際問題何なのか知らないといけない、税金を使った研究なら尚更。

[Ryohei Yamamoto@物価3倍の国 @so_flat]

新しい論文をだしました。

高齢者における重症疾患罹患後に大事だと思うアウトカムは何か？

価値観がわからずICU入室し、判断に困るケースが多いため、事前にアウトカムの好みを知っておいたら良くね？という研究です。

高齢者が大事にしているアウトカムは
↓↓
https://t.co/JdIpf4mTPx

[Ryo Ueno @Intensive_Ryo]

1. Caregiver’s burden
2. Financial impact
3. Toileting function
4. Independent daily activity
5. Normal swallowing

🧑‍🔬A survey of healthy volunteers (>75yo) from Japan

💡Identified top 5 pt-centred outcomes post ICU discharge

🆕 letter at @yourICM
https://t.co/EjwihyEjlb

[Ryo Ueno @Intensive_Ryo]

@so_flat きれいにKMが分かれた時はまじで驚きました。CFS 4-6の差なんて正確に記録できないんじゃないかと当初思ってたんですよね。

[Ryo Ueno @Intensive_Ryo]

🧓🏽🛌 Frailty matters—even after surgery.

In this multicentre ICU cohort 🇦🇺(n=216k), frailty (CFS 5–8) was associated with significantly shorter 4-year survival 🕰️💔

🚨 New in BJA:
🔗 https://t.co/IGJ7uXL2YO

@BJAJournals

[Ryo Ueno @Intensive_Ryo]

@catchdrash @ryanryling @jones_daza @IntensiveDave @anzicrc 🚨 New in BJA:
🔗 https://t.co/IGJ7uXL2YO

@BJAJournals

[Ryo Ueno @Intensive_Ryo]

🧵 FRAILTY after surgery: Does it still matter in the ICU?

We studied 216,922 postop ICU patients across 🇦🇺 to find out.
Here’s what we learned 👇
#ICU #Frailty #PerioperativeCare #CriticalCare

[Ryo Ueno @Intensive_Ryo]

Grateful to work with an amazing team @catchdrash @ryanryling @jones_daza @IntensiveDave @anzicrc