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Emergency and Critical Care Medicine

Prof. Nobuaki Shime

¡¾Research Keyword¡¿
Infection, sepsis, antibiotics, pediatric intensive care, acute respiratory failure/acute respiratory distress syndrome (ARDS), mechanical ventilation, respiratory physiology, extracorporeal membrane oxygenation (ECMO), COVID-19, respiratory sound monitoring, telemedicine, prehospital emergency care, medical control, doctor helicopter, encephalopathy

¡¾Recent highlights¡¿
We are in the process of extending the cloud-based database established during the COVID-19 pandemic and improving it to include acute respiratory distress syndrome (ARDS) and unknown emerging and re-emerging infectious diseases. We are also developing a novel algorithm to predict exacerbations of acute respiratory failure using machine learning (AMED research project). The automated respiratory sound analysis system, cooperatively developed with Pioneer (now Air Water Inc.), has been improved into an attachable device that can be used in operating rooms and intensive care units (AMED research project) and a remote monitoring device that can be applied in COVID-19 hotel care (AMED research project).
At the G7 Hiroshima Summit, as the hospital for the Prime Ministers and other relevant leaders, we prepared our hospital to treat the most critically ill patients and to provide medical care for the many wounded and sick due to bombings and chemical terrorism. In addition, as the medical coordination headquarters for all of Hiroshima, we commanded the safety confirmation and emergency transport routes for the Prime Ministers and other relevant leaders.
In the Noto Peninsula Earthquake, we dispatched several medical teams to the disaster site to rescue and support the victims. In the disaster area, we served as the medical coordination headquarters, leading the participating DMATs, and we ourselves were dispatched to the disaster site to evacuate all patients from a near-collapsed hospital and to reconstruct a collapsed welfare facility for the elderly.
We are constructing a critical care transport system to safely centralize critically ill patients requiring mechanical ventilation and extracorporeal circulation.
Using a rabbit model of severe respiratory failure, we are investigating the mechanisms of lung injury caused by mechanical ventilation and spontaneous breathing. We are also analyzing the mechanisms of septic encephalopathy and multi-organ failure in collaboration with neuroanatomy. 
In the Japanese sepsis guideline and ARDS practical guideline, we are both chairing and leading the development of these guidelines. We have presented several symposiums and educational lectures (including overseas) in the fields of sepsis, mechanical ventilation, and ECMO, and disseminated information in the form of papers and books.

¡¾·¡»å³Ü³¦²¹³Ù¾±´Ç²Ô¡¿
We have adopted a roof-tile educational system, whereby senior doctors educate younger doctors and younger doctors educate residents and medical students, thus creating a sustainable educational system. Because they are educated by physicians close in age, they have the advantage of being able to easily ask questions. We provide clinical instruction as well as teaching through basic and clinical research on what improvements can be made to save lives that cannot be saved.
Regarding sepsis, infectious diseases, severe respiratory failure, and mechanical ventilation, we have established an integrated research system that ranges from basic research using animal models to clinical research using patient data.
In addition, we collaborate with a wide variety of medical institutions in and outside of Hiroshima, and we also offer the opportunity to study in Japan and abroad if desired.

Collaborating institutions in Hiroshima: Hiroshima Prefectural Hospital, Hiroshima Municipal Hospital, Hiroshima Red Cross Hospital, JA Hiroshima General Hospital, JA Onomichi General Hospital, Asa Municipal Hospital, NHO Kure Medical Center, Chugoku Rosai Hospital, Kure Kyosai Hospital, NHO Higashi-Hiroshima Medical Center, Kosei General Hospital, Ochi Public Hospital, Hamawaki Hospital.
Collaborating institutions outside Hiroshima:
1) Specialist training: Kyoto Prefectural University, NHO Kyoto Medical Center, Kyoto Second Red Cross Hospital, Kyoto First Red Cross Hospital, Fukuchiyama Municipal Hospital, Nagahama Red Cross Hospital, Kurashiki Central Hospital, Shimane Central Hospital, Kawaguchi Cardio Respiratory Hospital, Industrial Medical University
2) Collaborative research: Kyoto Prefectural University, Shinshu University, National Institute of Biomedical Innovation
3) Overseas training: Children's hospital of Philadelphia, Children's hospital of Los Angeles

¡¾¸é±ð²õ±ð²¹°ù³¦³ó¡¿
1. Investigation of mechanisms of respiratory, circulatory, and infection control in emergency and critical care medicine (basic and clinical research): Septic shock, acute respiratory distress syndrome (ARDS), emerging and re-emerging infectious diseases
2. Development of novel medical devices for emergency and critical care medicine: automated breath sound analysis system, cloud-based critical care database, machine learning algorithm to predict exacerbations
3. Research on improvement of pre-hospital care using big data (social epidemiology research): emergency transport database, doctor helicopter database
 

Prof. Shime giving a lecture for young doctors

Medical procedure for starting ECMO

Dr. Ohshimo and Dr. Sadamori presenting a novel technology of computer-assisted electronic stethoscope at a press conference


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School of Medicine

1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, Japan 734-8553
TEL: +81-82-257-1705