2022/10/02 更新

写真a

コバヤシ アキラ
小林 玲
KOBAYASHI Akira
所属
医歯学総合病院 総合周産期母子医療センター 講師
職名
講師
外部リンク

学位

  • 博士(医学) ( 2018年9月   新潟大学 )

研究分野

  • ライフサイエンス / 胎児医学、小児成育学

経歴(researchmap)

  • 新潟大学医歯学総合病院   総合周産期母子医療センター   講師

    2021年6月

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経歴

  • 新潟大学   医歯学総合病院 総合周産期母子医療センター   講師

    2021年6月 - 現在

学歴

  • 新潟大学   大学院医歯学総合研究科

    - 2018年9月

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  • 新潟大学   医学部   医学科

    - 2001年3月

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論文

  • Randomized Controlled Trial of High-Flow Nasal Cannula in Preterm Infants After Extubation. 国際誌

    Atsushi Uchiyama, Kaoru Okazaki, Masatoshi Kondo, Shuntaro Oka, Yukiko Motojima, Fumihiko Namba, Nobuhiko Nagano, Kayo Yoshikawa, Kazunori Kayama, Akira Kobayashi, Yoshiki Soeno, Osamu Numata, Hideyo Suenaga, Ken Imai, Hidehiko Maruyama, Hideshi Fujinaga, Hiroyuki Furuya, Yushi Ito

    Pediatrics   146 ( 6 )   2020年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: Our aim is to compare the efficacy and safety of high-flow nasal cannula (HFNC) against those of nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive-pressure ventilation (NIPPV) after extubation in preterm infants. METHODS: This prospective, randomized, noninferiority trial was conducted in 6 tertiary NICUs. Infants born at <34 weeks who needed noninvasive ventilation after extubation were enrolled. We randomly assigned infants to an HFNC group when HFNC was used or to an NCPAP/NIPPV group when NCPAP or NIPPV was used. The primary outcome was treatment failure within 7 days after extubation. We then examined clinical aspects of treatment failure with HFNC use. RESULTS: In total, 176 and 196 infants were assigned to the HFNC and NCPAP/NIPPV groups, respectively. The HFNC group showed a significantly higher rate of treatment failure than that of the NCPAP/NIPPV group, with treatment failure occurring in 54 infants (31%) compared with 31 infants (16%) in the NCPAP/NIPPV group (risk difference, 14.9 percentage points; 95% confidence interval, 6.2-23.2). Histologic chorioamnionitis (P = .02), treated patent ductus arteriosus (P = .001), and corrected gestational age at the start of treatment (P = .007) were factors independently related to treatment failure with HFNC use. CONCLUSIONS: We found HFNC revealed a significantly higher rate of treatment failure than NCPAP or NIPPV after extubation in preterm infants. The independent factors associated with treatment failure with HFNC use were histologic chorioamnionitis, treated patent ductus arteriosus, and a younger corrected gestational age at the start of treatment.

    DOI: 10.1542/peds.2020-1101

    PubMed

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  • Thyroid function in asphyxiated newborns who received hypothermia therapy. 国際誌

    Akira Kobayashi, Touhei Usuda, Masaki Wada, Takayuki Kaneko, Kinuko Kojima, Akihiko Saitoh

    Pediatrics international : official journal of the Japan Pediatric Society   60 ( 5 )   433 - 437   2018年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Thyroid function in asphyxiated newborns who received hypothermia therapy and its relation to neurological outcome are not well described. METHODS: We performed a prospective study to measure thyroid function in 12 asphyxiated newborns who received hypothermia therapy. We measured serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) on admission, at 24, 72, and 96 h after birth, and at discharge (range, 17-54 days). The 12 newborns were divided into two groups based on the presence of brain injury on head magnetic resonance imaging (six in the abnormal imaging group and six in the normal imaging group), and thyroid function was compared between the two groups. RESULTS: Serum TSH was within the normal range in the 12 newborns. Serum FT3 and FT4 remained low at 24, 72, and 96 h after birth, and returned to normal range at discharge in the 12 newborns. There was no significant difference in serum TSH between the two groups, but serum FT3 at 96 h after birth, and serum FT4 at 72 and 96 h after birth, were significantly lower in the abnormal imaging group than in the normal imaging group (P = 0.02; P = 0.03; and P = 0.01, respectively). CONCLUSIONS: Asphyxiated newborns have transient low thyroid hormone levels at 24-96 h after birth. Serum FT3 and FT4 between 72 and 96 h after birth may predict brain injury in asphyxiated newborns.

    DOI: 10.1111/ped.13534

    PubMed

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