研究者詳細

顔写真

サトウ　テツヤ
佐藤　哲哉
Tetsuya Sato
所属
大学院医学系研究科　医科学専攻　外科病態学講座（救急医学分野）
職名
助教
学位

  • 博士（医学） （東北大学）

論文 16

  1. Ultra-Long Polymyxin B Hemoperfusion and Its Effect on Vasopressor Dosage and Organ Dysfunction in Patients With Septic Shock Requiring High-Dose Norepinephrine: A Post Hoc Analysis of a Prospective Cohort Study. 国際誌

    Kyohei Miyamoto, Yu Kawazoe, Noriko Miyagawa, Hitoshi Yamamura, Yoshinori Ohta, Takuya Kimura, Yukitoshi Toyoda, Michihito Kyo, Tetsuya Sato, Masashi Kinjo, Masaki Takahashi, Junichi Maruyama, Hiroshi Matsuura, Kazunori Fukushima, Takeshi Morimoto

    Artificial organs　2025年10月9日

    DOI： 10.1111/aor.70025 　

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    BACKGROUND: Prolonged duration of polymyxin B hemoperfusion (PMX-HP) for septic shock is not widely investigated. METHODS: We used BEAT-SHOCK, a prospective registry including 309 adult patients with septic shock requiring high-dose norepinephrine (≥ 0.2 μg/kg/min). Our post hoc analysis included 82 patients that underwent PMX-HP, dichotomized into either the ultra-long PMX-HP group (first session duration ≥ 12 h; n = 53) or the non-ultra-long PMX-HP group (< 12 h; n = 29). The primary outcomes were changes in vasopressor/inotrope dosage, represented by vasoactive-inotropic score (VIS), and sequential organ failure assessment (SOFA) score from baseline to day 3. RESULTS: The median durations of the first PMX-HP session in the ultra-long and non-ultra-long PMX-HP groups were 1290 and 358 min, respectively. Their median baseline VIS was 38.3 (IQR 26.0-49.5) in the ultra-long group, 38.1 (IQR 30.9-55.6) in the non-ultra-long PMX-HP group. The median baseline SOFA score was 11 (IQR 9-13) in both groups. The changes in these scores from baseline to day 3 did not differ between them (adjusted difference -3.8 [95% confidence interval -9.0 to 11.3] for VIS and -0.0 [95% confidence interval -1.5 to 1.5] for SOFA score). The 90-day mortality rate was 24.7% in the ultra-long PMX-HP group and 21.1% in the non-ultra-long PMX-HP group (adjusted hazard ratio 1.35; 95% confidence interval 0.49-3.69). CONCLUSIONS: Ultra-prolonged PMX-HP for ≥ 12 h was not associated with a greater reduction in vasopressor/inotrope dosage or improvement in organ dysfunction on day 3 than PMX-HP < 12 h in our patients with septic shock without endotoxin monitoring. TRIAL REGISTRATION: UMIN Clinical Trial Registry on 1 November 2019 (registration no. UMIN000038302).

  2. 誰でも質の高い教育ができる救急初期診療シミュレーショントレーニング

    横川 裕大, 荒田 悠太郎, 小林 正和, 佐藤 哲哉, 工藤 大介, 久志本 成樹

    日本救急医学会雑誌　35　(11)　620-620　2024年11月

    出版者・発行元： (一社)日本救急医学会

    ISSN：0915-924X

    eISSN：1883-3772

  3. 多臓器不全におけるフェノタイプ解析 敗血症におけるサブクラス分類の現状と展望 Narrative review

    工藤 大介, 横川 裕大, 佐藤 哲哉, 久志本 成樹

    日本集中治療医学会雑誌　31　(Suppl.1)　S401-S401　2024年9月

    出版者・発行元： (一社)日本集中治療医学会

    ISSN：1340-7988

    eISSN：1882-966X

  4. 腎細胞癌に対する免疫チェックポイント阻害薬治療後に発症した自己免疫性後天性凝固第V因子欠乏症の1例

    庄司 孝介, 佐藤 哲哉, 久志本 成樹

    日本集中治療医学会雑誌　29　(Suppl.1)　643-643　2022年11月

    出版者・発行元： (一社)日本集中治療医学会

    ISSN：1340-7988

    eISSN：1882-966X

  5. Comparison between midazolam and propofol in acute phase for ventilated patients with sepsis: a post‐hoc analysis of the <scp>DESIRE</scp> trial

    Noriko Miyagawa, Yu Kawazoe, Tetsuya Sato, Shigeki Kushimoto, Kyohei Miyamoto, Yoshinori Ohta, Takeshi Morimoto, Hitoshi Yamamura

    Acute Medicine &amp; Surgery　9　(1)　2022年1月

    出版者・発行元： Wiley

    DOI： 10.1002/ams2.746 　

    ISSN：2052-8817

    eISSN：2052-8817

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    Aim There are few assessments of sedatives during the acute phase under sedation protocols for patients with sepsis. We aimed to compare the influence of different sedation strategies using midazolam and propofol under light sedation on clinical outcomes of ventilated patients with sepsis. Methods This study was a post‐hoc analysis of data from the dexmedetomidine for sepsis in the ICU Randomized Evaluation (DESIRE) trial. Patients were divided into propofol and midazolam groups based on continuously used drug, and sedation control between groups compared on day three. We assessed the incidence of delirium, length of ICU stay, number of ventilator‐free days within the first 28 days, and mortality after 28 days. Results The midazolam and propofol groups consisted of 51 and 66 patients, respectively. Both groups had similar characteristics, except for age and emergency surgery. The number of well‐controlled sedation patients in the propofol group on day three was significantly higher than that in the midazolam group (odds ratio [OR] 3.9, 95% CI [1.30, 11.7]). The incidence of daily coma and delirium within the initial week was different between groups and increased with midazolam administration (P = 0.0138). The number of Confusion Assessment Method for ICU‐positive patients was significantly higher in the midazolam group than in the propofol group (OR 5.71, 95% CI [2.30, 14.2]). Conclusion In patients with sepsis required mechanical ventilation, sedation with midazolam based on a light sedation protocol may be associated with inappropriate sedation during the acute phase, with increased coma and delirium as compared to propofol.

  6. Effect of age on dexmedetomidine treatment for ventilated patients with sepsis: a post‐hoc analysis of the DESIRE trial

    Tetsuya Sato, Yu Kawazoe, Noriko Miyagawa, Yuta Yokokawa, Shigeki Kushimoto, Kyohei Miyamoto, Yoshinori Ohta, Takeshi Morimoto, Hitoshi Yamamura

    Acute Medicine & Surgery　8　(1)　2021年1月

    出版者・発行元： Wiley

    DOI： 10.1002/ams2.644 　

    ISSN：2052-8817

    eISSN：2052-8817

  7. Associations between low body mass index and mortality in patients with sepsis: A retrospective analysis of a cohort study in Japan. 国際誌

    Tetsuya Sato, Daisuke Kudo, Shigeki Kushimoto, Masatsugu Hasegawa, Fumihito Ito, Sathoshi Yamanouchi, Hiroyuki Honda, Kohkichi Andoh, Hajime Furukawa, Yasuo Yamada, Yuta Tsujimoto, Manabu Okuyama, Masakazu Kobayashi

    PloS one　16　(6)　e0252955　2021年

    DOI： 10.1371/journal.pone.0252955 　

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    BACKGROUND: The distribution of body mass in populations of Western countries differs from that of populations of East Asian countries. In East Asian countries, fewer people have a high body mass index than those in Western countries. In Japan, the country with the highest number of older adults worldwide, many people have a low body mass index. Therefore, this study aimed to determine the association between a low body mass index and mortality in patients with sepsis in Japan. METHODS: We conducted this retrospective analysis of 548 patients with severe sepsis from a multicenter prospective observational study. Multivariate logistic regression analyses determined the association between body mass index and 28-day mortality adjusted for age, sex, pre-existing conditions, the occurrence of septic shock, Acute Physiology and Chronic Health Evaluation II scores, and Sequential Organ Failure Assessment scores. Furthermore, the association between a low body mass index and 28-day mortality was analyzed. RESULTS: The low body mass index group represented 18.8% of the study population (103/548); the normal body mass index group, 57.3% (314/548); and the high body mass index group, 23.9% (131/548), with the 28-day mortality rates being 21.4% (22/103), 11.2% (35/314), and 14.5% (19/131), respectively. In the low body mass index group, the crude and adjusted odds ratios (95% confidence intervals) for 28-day mortality relative to the non-low body mass index (normal and high body mass index groups combined) group were 2.0 (1.1-3.4) and 2.3 (1.2-4.2), respectively. CONCLUSION: A low body mass index was found to be associated with a higher 28-day mortality than the non-low body mass index in patients with sepsis in Japan. Given that older adults often have a low body mass index, these patients should be monitored closely to reduce the occurrence of negative outcomes.

  8. A Novel Type of Stem Cells Double-Positive for SSEA-3 and CD45 in Human Peripheral Blood

    Tetsuya Sato, Shohei Wakao, Yoshihiro Kushida, Kazuki Tatsumi, Masaaki Kitada, Takatsugu Abe, Kuniyasu Niizuma, Teiji Tominaga, Shigeki Kushimoto, Mari Dezawa

    Cell Transplantation　29　096368972092357-096368972092357　2020年1月1日

    出版者・発行元： SAGE Publications

    DOI： 10.1177/0963689720923574 　

    ISSN：0963-6897

    eISSN：1555-3892

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    Peripheral blood (PB) contains several types of stem/progenitor cells, including hematopoietic stem and endothelial progenitor cells. We identified a population positive for both the pluripotent surface marker SSEA-3 and leukocyte common antigen CD45 that comprises 0.04% ± 0.003% of the mononuclear cells in human PB. The average size of the SSEA-3(+)/CD45(+) cells was 10.1 ± 0.3 µm and ∼22% were positive for CD105, a mesenchymal marker; ∼85% were positive for CD19, a B cell marker; and ∼94% were positive for HLA-DR, a major histocompatibility complex class II molecule relevant to antigen presentation. These SSEA-3(+)/CD45(+) cells expressed the pluripotency markers Nanog, Oct3/4, and Sox2, as well as sphingosine-1-phosphate (S1P) receptor 2, and migrated toward S1P, although their adherence and proliferative activities in vitro were low. They expressed NeuN at 7 d, Pax7 and desmin at 7 d, and alpha-fetoprotein and cytokeratin-19 at 3 d when supplied to mouse damaged tissues of the brain, skeletal muscle and liver, respectively, suggesting the ability to spontaneously differentiate into triploblastic lineages compatible to the tissue microenvironment. Multilineage-differentiating stress enduring (Muse) cells, identified as SSEA-3(+) in tissues such as the bone marrow and organ connective tissues, express pluripotency markers, migrate to sites of damage via the S1P-S1P receptor 2 system, and differentiate spontaneously into tissue-compatible cells after homing to the damaged tissue where they participate in tissue repair. After the onset of acute myocardial infarction and stroke, patients are reported to have an increase in the number of SSEA-3(+) cells in the PB. The SSEA-3(+)/CD45(+) cells in the PB showed similarity to tissue-Muse cells, although with difference in surface marker expression and cellular properties. Thus, these findings suggest that human PB contains a subset of cells that are distinct from known stem/progenitor cells, and that CD45(+)-mononuclear cells in the PB comprise a novel subpopulation of cells that express pluripotency markers.

  9. The impact of organ dysfunctions on mortality in patients with severe sepsis: A multicenter prospective observational study. 国際誌

    Daisuke Kudo, Shigeki Kushimoto, Noriko Miyagawa, Tetsuya Sato, Masatsugu Hasegawa, Fumihito Ito, Sathoshi Yamanouchi, Hiroyuki Honda, Kohkichi Andoh, Hajime Furukawa, Yasuo Yamada, Yuta Tsujimoto, Manabu Okuyama

    Journal of critical care　45　178-183　2018年6月

    DOI： 10.1016/j.jcrc.2018.03.011 　

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    PURPOSE: Disseminated intravascular coagulations (DIC), acute respiratory distress syndrome (ARDS), and acute kidney injury (AKI) are major organ dysfunctions that occur in patients with sepsis. This study aimed to elucidate the impact of these organ dysfunctions on mortality in patients with severe sepsis. MATERIAL AND METHODS: A prospective observational study was performed in 10 ICUs to obtain data from patients with severe sepsis. Multivariate analyses to examine in-hospital mortality were performed. RESULTS: Data of 573 patients were analyzed. In-hospital mortality rate was 19.4% (111/573). The incidences of DIC, ARDS, and AKI were 58.4%, 18.7%, and 41.7%, while the associated mortality rates were 28.9%, 36.4%, and 31.8%, respectively. In multiple regression model, DIC (odds ratio 2.71, 95% confidence interval [CI] 1.45-5.27) and AKI stage 3 (odds ratio 1.98, 95% CI 1.07-3.63) were significantly associated with higher in-hospital all-cause mortality. DIC (hazard ratio 2.58, 95% CI 1.53-4.55) and AKI stage 3 (hazard ratio 1.73, 95% CI 1.07-2.80) were also significantly associated with longer survival durations. However, severe ARDS was not associated with these outcomes. CONCLUSIONS: DIC and AKI are frequent complications in patients with severe sepsis. In this study, DIC, and AKI stage 3 were independent risk factors of in-hospital mortality.

  10. Postoperative changes in presepsin level and values predictive of surgical site infection after spinal surgery: A single-center, prospective observational study 査読有り

    Tomoaki Koakutsu, Tetsuya Sato, Toshimi Aizawa, Eiji Itoi, Shigeki Kushimoto

    Spine　43　(8)　578-584　2018年4月15日

    出版者・発行元： Lippincott Williams and Wilkins

    DOI： 10.1097/BRS.0000000000002376 　

    ISSN：1528-1159 0362-2436

  11. Mortality Effects of Prolonged Hemoperfusion Therapy Using a Polymyxin B-Immobilized Fiber Column for Patients with Septic Shock: A Sub-Analysis of the DESIRE Trial

    Yu Kawazoe, Tetsuya Sato, Noriko Miyagawa, Yuta Yokokawa, Shigeki Kushimoto, Kyohei Miyamoto, Yoshinori Ohta, Takeshi Morimoto, Hitoshi Yamamura

    BLOOD PURIFICATION　46　(4)　309-314　2018年

    DOI： 10.1159/000491744 　

    ISSN：0253-5068

    eISSN：1421-9735

  12. 脊椎外科周術期におけるプレセプシンの動態―術後創傷感染症早期診断における有用性―

    小圷知明, 佐藤哲哉, 桑原功行, 工藤大介, 相澤俊峰, 橋本功, 井樋栄二, 久志本成樹

    Journal of Spine Research　7　(3)　409-409　2016年3月25日

    出版者・発行元： (一社)日本脊椎脊髄病学会

    ISSN：1884-7137

    eISSN：2435-1563

  13. 来院時に急性冠症候群を疑う所見に乏しく低体温療法後に緊急経皮的冠動脈形成術を要した院外心停止の1例

    佐藤哲哉, 佐藤哲哉, 鈴木秀明, 鈴木秀明, 工藤大介, 工藤大介, 浅沼敬一郎, 久志本成樹, 久志本成樹

    日本臨床救急医学会雑誌　18　(5)　669-674　2015年10月

    出版者・発行元： Japanese Society for Emergency Medicine

    DOI： 10.11240/jsem.18.669 　

    ISSN：1345-0581

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    急性冠症候群を原因とする心停止蘇生後患者に対する緊急冠動脈造影/経皮的冠動脈形成術が推奨されているが，適応判断とタイミングは明確ではない。今回，院外心停止蘇生直後には急性冠症候群を疑わせる所見に乏しく，低体温療法を施行，その後，再度心停止となり緊急冠動脈造影を要した症例を経験したので報告する。症例は60歳代の男性。血液透析へ行く準備中に心肺停止となった。救急隊到着時初期波形は心室細動であり，除細動を施行し，波形は無脈性電気活動へと変化，その後自己心拍が再開した。来院時，明らかな虚血を疑わせる心電図所見，心筋逸脱酵素の上昇はなく，心エコー上は全周性心筋肥大を認め，局所性収縮異常所見はなく，肥大型心筋症による心室細動と診断した。第6病日，再度心室細動となり，心エコーにおける前壁壁運動低下，広範なST低下を伴う心電図所見から急性冠症候群を疑い緊急冠動脈造影を施行し，冠動脈狭窄を認めた。来院時に急性冠症候群を示唆する所見に乏しい心停止蘇生後患者に対する緊急冠動脈造影の適応・施行時期に関し，さらなる検討が必要である。

  14. 硫化水素中毒によるCPA蘇生例に対する治療アプローチ

    佐藤 哲哉, 大村 拓, 小林 道生, 古川 宗, 山内 聡, 久志本 成樹

    日本救急医学会雑誌　23　(10)　667-667　2012年10月

    出版者・発行元： (一社)日本救急医学会

    ISSN：0915-924X

    eISSN：1883-3772

  15. 偶発性低体温症によるCPA蘇生の一例 rSO2とPCPSと体温

    佐藤 哲哉, 遠藤 智之, 大村 拓, 古川 宗, 山内 聡, 久志本 成樹

    東北救急医学会総会・学術集会プログラム・抄録集　26回　89-89　2012年6月

    出版者・発行元： 東北救急医学会

  16. ミトコンドリアDNAの重症敗血症・敗血症性ショック患者における病態および重症度との関係

    工藤 大介, 山内 聡, 遠藤 智之, 古川 宗, 宮川 乃理子, 佐藤 哲哉, 久志本 成樹

    東北救急医学会総会・学術集会プログラム・抄録集　26回　96-96　2012年6月

    出版者・発行元： 東北救急医学会

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MISC 7

  1. ドクターヘリにおける自動式胸骨圧迫装置使用時の新たな工夫

    勝田賢, 佐藤哲哉, 岡崎綾子, 中田貴史, 谷河篤, 宮坂矩博, 宮川乃理子, 工藤大介, 工藤大介, 山田康雄, 久志本成樹, 久志本成樹

    日本航空医療学会雑誌　25　(2)　2024年

    ISSN： 1346-129X

  2. 敗血症におけるサブクラス分類の現状と展望:Narrative review

    工藤大介, 工藤大介, 横川裕大, 佐藤哲哉, 久志本成樹, 久志本成樹

    日本集中治療医学会学術集会(Web)　51st　2024年

  3. プレセプシンの整形外科周術期における動態と基準値策定の試み 単一施設前向き観察研究

    小圷 知明, 佐藤 哲哉, 相澤 俊峰, 井樋 栄二, 久志本 成樹

    日本整形外科学会雑誌　92　(3)　S774-S774　2018年3月

    出版者・発行元： (公社)日本整形外科学会

    ISSN： 0021-5325

  4. 頭部外傷診療でのデータサイエンスの取り組み:体制構築,意義,今後の展望

    中川敦寛, 入野田崇, 神戸茂雄, 佐藤哲哉, 小林正和, 工藤大介, 野村亮介, 西澤松彦, 久志本成樹, 冨永悌二, 冨永悌二

    日本救急医学会雑誌　28　(9)　433-433　2017年9月15日

    出版者・発行元： (一社)日本救急医学会

    ISSN： 0915-924X

    eISSN： 1883-3772

  5. 脊椎手術後のプレセプシン値の推移―術後創傷感染症早期診断における有用性―

    小圷知明, 佐藤哲哉, 桑原功行, 工藤大介, 相澤俊峰, 橋本功, 井樋栄二, 久志本成樹

    日本整形外科学会雑誌　90　(2)　S86-S86　2016年3月4日

    出版者・発行元： (公社)日本整形外科学会

    ISSN： 0021-5325

  6. Body temperature abnormalities in non-neurological critically ill patients: A review of the literature

    Shigeki Kushimoto, Satoshi Yamanouchi, Tomoyuki Endo, Takeaki Sato, Ryosuke Nomura, Motoo Fujita, Daisuke Kudo, Taku Omura, Noriko Miyagawa, Tetsuya Sato

    Journal of Intensive Care　2　(1)　2014年2月18日

    出版者・発行元： BioMed Central Ltd.

    DOI： 10.1186/2052-0492-2-14 　

    ISSN： 2052-0492

  7. 血栓性血小板減少性紫斑病に対する抗ADAMTS13抗体価の測定とリツキシマブ投与の標準化の必要性

    佐藤 哲哉, 小林 道生, 榎本 純也, 遠山 昌平, 小林 正和, 石橋 悟, 久志本 成樹

    日本集中治療医学会雑誌　21　(Suppl.)　[DP-5]　2014年1月

    出版者・発行元： (一社)日本集中治療医学会

    ISSN： 1340-7988

    eISSN： 1882-966X

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共同研究・競争的資金等の研究課題 2

  1. 病態に強固な関連がある敗血症新規サブクラス分類の開発

    工藤 大介, 田宮 元, 早川 峰司, 菱沼 英史, 久志本 成樹, 成田 暁, 山川 一馬, 佐藤 哲哉, 小柴 生造, 湯本 哲也, 後藤 匡啓, 近藤 豊, 石原 唯史, 佐藤 幸男, 錦見 満曉, 堤 悠介, 高山 渉, 鈴木 浩大, 春日井 大介

    提供機関：Japan Society for the Promotion of Science

    制度名：Grants-in-Aid for Scientific Research

    研究種目：Grant-in-Aid for Scientific Research (B)

    研究機関：Tohoku University

    2024年4月1日 ～ 2026年3月31日

  2. 病態に強固な関連がある敗血症新規サブクラス分類の開発

    工藤 大介, 田宮 元, 早川 峰司, 菱沼 英史, 久志本 成樹, 成田 暁, 山川 一馬, 佐藤 哲哉, 小柴 生造, 後藤 匡啓

    提供機関：Japan Society for the Promotion of Science

    制度名：Grants-in-Aid for Scientific Research

    研究種目：Grant-in-Aid for Scientific Research (B)

    研究機関：Tohoku University

    2023年4月1日 ～ 2026年3月31日