{"created":"2023-05-15T09:06:53.215158+00:00","id":13970,"links":{},"metadata":{"_buckets":{"deposit":"c3d4a16f-d2f4-43f9-acca-7f9e934ebd74"},"_deposit":{"created_by":14,"id":"13970","owners":[14],"pid":{"revision_id":0,"type":"depid","value":"13970"},"status":"published"},"_oai":{"id":"oai:sapmed.repo.nii.ac.jp:00013970","sets":["1875:1879:2066"]},"author_link":["22475","22476","22477","22478","22479","22480","22481","22482","22483","22484","22485","22486","22487"],"control_number":"13970","item_2_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2017-10-31","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"9","bibliographicPageStart":"6","bibliographicVolumeNumber":"41","bibliographic_titles":[{"bibliographic_title":"函館医学誌 = Hakodate medical journal"},{"bibliographic_title":"Hakodate medical journal","bibliographic_titleLang":"en"}]}]},"item_2_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"急性心原性肺水腫に対する非侵襲的換気法（noninvasive ventilation；NIV）は気管挿管と並ぶ有効な治療法の１つであり，2005年以降多数のメタ解析が行われ，その有用性が報告されてきた。しかし，2008年にGrayらによって発表されたthe 3CPOtrial（Three Interventions in Cardiogenic Plumonary Oedema Trial）１）は大規模無作為化比較対象試験であったが，急性心原性肺水腫に対するNIV の使用は死亡率や気管挿管率を変えないと，これまでの見解と異なる結果となり，NIV の効果に対する医療者の認識に一石を投じた。2013年のVitalらのCochrane Database System Review and meta-analysis２）は，上記研究を含めた32の研究が対象であるが，NIV は気管挿管率を減少（relative risk：0.52）させ，院内死亡率を減少（relative risk：0.66）させる結果となっており，NIV は急性心原性肺水腫に対して有用な治療手段と考えられる。しかし，高濃度酸素投与や補助換気を必要としながら救急搬送となった重症急性心原性肺水腫症例のみを対象とした研究は少なく，そのような症例の救急外来からのNIV 施行による治療効果は明らかでない。当院では，2010年９月より救急外来でのNIV 導入を積極的に行なっている。今回，当院に救急搬送された重症急性心原性肺水腫において，救急外来におけるNIV導入がどのような効果をもたらしたか検討した。","subitem_description_type":"Abstract"}]},"item_2_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"市立函館病院"}]},"item_2_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0910-0725","subitem_source_identifier_type":"ISSN"}]},"item_2_version_type_15":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"葛西, 毅彦"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"武山, 佳洋"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"平山, 傑"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"坂脇, 園子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"坂脇, 英志"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小黒, 武雄"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"北村, 裕之"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"笹岡, 悠太"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"野田, 昇宏"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山岡, 歩"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山口, 智佳"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"上村, 修二"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"成松, 英"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-04-08"}],"displaytype":"detail","filename":"n091007254116.pdf","filesize":[{"value":"1.4 MB"}],"format":"application/pdf","licensetype":"license_11","mimetype":"application/pdf","url":{"label":"n091007254116","url":"https://sapmed.repo.nii.ac.jp/record/13970/files/n091007254116.pdf"},"version_id":"ceda3801-fbf9-4c70-8945-a4f291b2dd2b"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Noninvasive ventilation","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"emergency department","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"acute cardiogenic pulmonary edema","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal 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