Emergency and Critical Care Medicine

Prof. Nobuaki Shime

【Research Keyword】
critical care medicine, intensive care medicine, pediatric intensive care medicine, sepsis, septic encephalopathy, infectious diseases, extracorporeal membrane oxygenation (ECMO), mechanical ventilation, pneumonia, COVID-19, disaster medicine, telemedicine、information and communication technology (ICT), aeromedical service

【Recent highlights】
We have developed an electronic stethoscope with automatic analysis function, jointly with Pioneer Corporation, followed by a novel device for continuous visual monitoring of respiratory sounds in the operating room and intensive care units (AMED-adopted research project). We are also developing a device that can monitor respiratory sounds remotely (AMED-adopted research topic: novel coronavirus-related). In collaboration with the Department of Neuroanatomy, we are analyzing the mechanism of septic encephalopathy/other organ failures. We have also been conducting research to utilize DPC data and databases of new coronavirus-related and ventilator-associated events (VAE). We have presented our achievements in the field of critical care, infectious disease and respiratory care in a number of symposiums and educational lectures of domestic and international medical congresses.

Profiles of Faculty and Research Scholars

The main research/educational program is the emergency and critical care medicine for pediatric and adult patients including disaster and radiation medicine. We have training in the special management of critically ill patients, such as sepsis, ARDS, extracorporeal membrane assisted ventilation (ECMO), pediatric intensive care, and severe burns, and can conduct research in these areas. We also conduct research on socially relevant topics such as novel coronaviruses, telemedicine, ICT, and aeromedicine. Hiroshima University Hospital is the single advanced emergency and critical care center owning air ambulance in Hiroshima. There are only 4 advanced emergency and critical care centers with air ambulance in Chugoku and Shikoku Districts. We predominantly treat patients with critically-ill emergencies and injuries, and provide high-quality cares as the last stand of the tertiary emergency medical center. A wealth of experience in managing sepsis and ECMO (extracorporeal membrane oxygenation) enables us a highly effective treatment for in- and out-hospital patients with sepsis or ARDS. The number of ECMO run in our hospital is top-level in Japan, which can be well cooperated with a medical team consisting of various specialists. Doctors can train special managements for severe burn injury and pediatric critical care in Hiroshima University. In addition, we have collaborations with various facilities in and outside of the prefecture and Japan, and students can study there.

Collaborative institutes in Hiroshima: Hiroshima Prefectural Hospital, Hiroshima City Hospital, JA Hiroshima General Hospital, JA Onomichi General Hospital, Hiroshima City Asa Citizens Hospital, NHO Kure Medicacl Center, Chugoku Rosai Hospital, Kure Kyosai Hospital, NHO Higashihiroshima Medical Center, Kousei General Hospital, Ohchi Hospital, etc.

Collaborative institutes outside Hiroshima:
1) Specialist training: Kyoto Prefectural University of Medicine, 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 Cardiopulmonary Hospital, Univeristy of Occupational and Enviromental Health.
2)Joint research: Kyoto Prefectural University of Medicine, Shinshu University, National Institute of Biomedical Innovation,
3) Overseas training: Children's hospital of Philadelphia, Children's hospital of Los Angeles

・Single center/ multicenter clinical researches (COIVD-19, ventilator-associated pneumonia/events (VAP/VAE), antibiotic therapy for critically-ill, antibiotic therapy against drug-resistant pathogens including MRSA, catheter-related infections, atrial fibrillaiton, tracheal intubation, etc)
・Basic researches for pneumonia including COVID-19, ARDS, septic encephalopathy and sepsis (utility of veno-venous ECMO, utility of mechanical ventilation, genetic diagnosis of infectious diseases, mechanism of septic encephalopathy, etc)
・Novel development of medical devices in the emergency and critical care medicine (computer-assisted electronic stethoscope, respiratory sound monitoring, etc)
・Novel development of telemedicine and information and communication technology (ICT) in the emergency and critical care medicine
・Research on improvement of pre-hospital care and evaluation of treatment for critically-illnesses using big data (social epidemiological research)

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