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1. 成人における一次救命処置 basic life support bls in adults
2. 急性下肢虚血の臨床的特徴と診断 clinical features and diagnosis of acute lower extremity ischemia
3. 小児蘇生法における灌流評価 assessment of perfusion in pediatric resuscitation
4. 小児における足骨折（中足骨または指節骨を除く） foot fractures other than metatarsal or phalangeal in children
5. 小児における中足骨および足趾骨折 metatarsal and toe fractures in children

English Journal

The characteristics of patients having ankylosing spondylitis associated with Takayasu's arteritis.

Gan FY, Fei YY, Li MT, Wang Q, Xu D, Hou Y, Zeng XF, Zhang FC.SourceDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China, 100730.
Clinical rheumatology.Clin Rheumatol.2013 Dec 6. [Epub ahead of print]
Both ankylosing spondylitis (AS) and Takayasu's arteritis (TA) are infrequent, and their association is even more rare. Our objective was to assess their association and characteristics in our patients. We conducted retrospective analysis of our hospital inpatients from June 2000 to July 2011 who ha
PMID 24310108

A rare anomalous origin of left subclavian artery from the circle of Willis in combination with right sided aortic arch: A case report.

Ahmadi A, Sonbolestan SA.SourceAssistant Professor, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
ARYA atherosclerosis.ARYA Atheroscler.2013 Sep;9(5):303-305.
BACKGROUND: One of the rare aortic congenital abnormalities is right sided aortic arch which is occurred in approximately 0.1% of the population. The anomalous origin of the subclavian arteries has also been reported.CASE REPORT: In this study, a case of a right-sided aortic arch with anomalous left
PMID 24302940

No-touch time in donors after cardiac death (nonheart-beating organ donation).

Rady MY, Verheijde JL.SourceDepartment of Critical Care Medicine, Mayo Clinic Hospital, Mayo Clinic, Phoenix, Arizona, USA. rady.mohamed@mayo.edu
Current opinion in organ transplantation.Curr Opin Organ Transplant.2013 Apr;18(2):140-7. doi: 10.1097/MOT.0b013e32835e29a8.
PURPOSE OF REVIEW: To evaluate arterial pulselessness and the no-touch time of 5 min in defining irreversible cessation of cardiorespiratory functions in nonheart-beating donation (NHBD).RECENT FINDINGS: Experimental NHBD studies identified compensatory neurohumoral mechanisms elicited in controll
PMID 23334256

Japanese Journal

Immunohistochemical Studies on Annexin I and II in Takayasu Arteritis

Ohkawara Miho,Numano Fujio
Acta histochemica et cytochemica 35(1), 1-10, 2002-00-00
… It causes the stenotic and/or obstructive changes of the arterial wall leading to the characteristic clinical feature of pulselessness. …
NAID 110003150866

Takayasu Arteritis-beyond Pulselessness-

Numano Fujio,Kobayashi Yasushi
Internal medicine 38(3), 226-232, 1999-03-00
NAID 10005896527

Takayasu's Arteritis in Prepulseless Stage Manifesting Lymph Node Swelling and Hepatosplenomegaly

YOTSUYANAGI Hiroshi,CHIKATSU Norio,KANEKO Yoshiyasu,KUROKAWA Kiyoshi
Internal medicine 34(5), 455-459, 1995-05-00
… Lymph node swelling and hepatosplenomegaly subsided gradually, while vascular murmur and pulselessness appeared. …
NAID 10006804154

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★リンクテーブル★

リンク元	「ショック」「区画症候群」「動脈損傷」「脈拍触知不能」

「ショック」

　　[★]

英: shock
同: 虚脱状態
関: 産科ショック

メジャー

心原性ショック cardiogenic shock

心筋梗塞、致死的不整脈、心不全

閉塞性ショック

心タンポナーデ、収縮性心膜炎、肺血栓塞栓症、緊張性気胸

低容量性ショック hypovolemic shock = 循環血液量減少性ショック

出血性ショック、体液喪失(熱傷)・脱水

敗血症性ショック septic shock ⊆　血管分布異常性ショック

マイナー

神経原性ショック neurogenic shock ⊆　血管分布異常性ショック
アナフィラキシーショック anaphylactic shock ⊆　血管分布異常性ショック

ショックの5P

以下の所見がそろったときにショックと判断する
1. 蒼白(pallor)
2. 虚脱(prostration)
3. 脈拍を触れない(pulselessness)
4. 冷汗(perspiration)
5. 呼吸不全(pulmonary deficiency)

ショックの判断

簡便

収縮期血圧 90 mmHg以下

循環モニターのためのデバイス・検査項目

血圧・脈拍
心電図
心エコー
呼吸・血ガス
血液検査・尿検査
バルーンカテーテル：残尿を排泄し、30分ごとに尿量、血圧、脈拍を測定する
中心静脈圧
スワン・ガンツカテーテル
PiCCO
胃トノメトリー

治療

心原性ショック		原疾患の治療
低容量性ショック		輸液、輸血、止血、昇圧剤は原則使用しない
敗血症性ショック		抗菌薬、昇圧薬、エンドトキシン吸着カラム、輸血、血糖コントロール、低容量ステロイド
神経原性ショック		輸液、昇圧薬
アナフィラキシーショック		エピネフリン、輸液、抗ヒスタミン剤、ステロイド、昇圧薬、H2ブロッカー
閉塞性ショック	緊張性気胸	胸腔穿刺、胸腔ドレナージ
	心タンポナーデ	心嚢穿刺、心膜開窓
	肺塞栓	塞栓除去術、血栓溶解術