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MIYAZAKI Atsushi
University Hospital / Anesthesiology and Pain Clinic
Assistant Professor

Research activity information

■ Paper
  • Atsushi Miyazaki, Mai Hokka, Satoshi Mizobuchi
    BACKGROUND: Haptoglobin may reduce hemolysis-induced kidney injury in patients undergoing cardiovascular surgery with cardiopulmonary bypass (CPB). Haptoglobin may be given empirically when hemolytic urine is observed, or pre-emptively when detected by elevated free hemoglobin concentrations. In the present study, we investigated whether pre-emptive haptoglobin therapy guided by serum-free hemoglobin concentrations could prevent postoperative renal dysfunction in patients who underwent major cardiovascular surgery using CPB. METHODS: This study was a single-center, open-label, randomized controlled trial. Adult patients who underwent major cardiovascular surgery using CPB were included. Serum-free hemoglobin concentrations were measured in all patients who consented for this study. Patients with free hemoglobin concentrations that reached 0.05 g/dL were randomized to either (i) pre-emptive haptoglobin therapy group or (ii) standard of care group. Patients in the pre-emptive haptoglobin therapy group were administered 4000 U of haptoglobin when serum-free hemoglobin concentration reached 0.05 g/dL within 2 hours after the start of CPB. In the standard of care group, 4000 U of haptoglobin was administered when hemolytic urine was confirmed after the start of CPB. The primary outcome was the difference between the preoperative creatinine concentration and the maximum creatinine concentration within 48 hours after surgery (ΔCr). RESULTS: The study was terminated with the results of interim analysis due to patients' safety concerns. Finally, 34 patients in the pre-emptive haptoglobin therapy group and 33 in the standard of care group were included in the analysis. Median (interquartile range) ΔCr values were 0.20 (0.05-0.44) in the pre-emptive haptoglobin therapy group and 0.14 (0.04-0.19) in the standard of care group ( P = .05). Multiple linear regression analysis with ΔCr as objective variable and preoperative estimated glomerular filtration rate (eGFR), age, and randomize group as explanatory variables revealed that pre-emptive administration of haptoglobin significantly increased ΔCr ( P = .03). CONCLUSIONS: The interim study results demonstrated that in patients undergoing major cardiovascular surgery using CPB, pre-emptive haptoglobin administration worsened Cr values and independently associated with increased ΔCr.
    Jun. 2026, Anesthesia and analgesia, 142(6) (6), 1180 - 1188, English, International magazine
    Scientific journal

  • Kazuya Yashiro, Atsushi Miyazaki, Norihiko Obata
    Klippel-Trénaunay syndrome (KTS) is associated with complex venous malformations and a risk of massive intraoperative bleeding. We report a young woman with KTS who developed 2,710 mL of intraoperative bleeding during total knee arthroplasty despite prior sclerotherapy and tourniquet use, requiring postoperative ICU management for coagulopathy. Preoperative MRI demonstrated both extensive vascular involvement and intra-articular venous malformations. This case highlights the importance of preoperative risk assessment based on lesion extent and intra-articular involvement and suggests that hybrid operating room strategies may be considered in selected high-risk cases.
    Mar. 2026, Cureus, 18(3) (3), e105727, English, International magazine
    Scientific journal

  • Atsushi Miyazaki, Shohei Makino, Satoshi Mizobuchi
    Japanese Society of Intensive Care Medicine, Dec. 2025, Journal of the Japanese Society of Intensive Care Medicine, 32, n/a - n/a, Japanese

  • Atsushi Miyazaki, Mai Hokka, Satoshi Mizobuchi
    Purpose This study was conducted to compare the efficacy and safety of remimazolam with those of sevoflurane in patients undergoing off-pump coronary artery bypass (OPCAB) surgery. Methods This study was a single-center, retrospective observational study. Adult patients who underwent OPCAB surgery between April 2023 and July 2024 and received sevoflurane or remimazolam for maintenance of general anesthesia were included. The primary outcome was intraoperative average blood pressure (ABP). Secondary outcomes were amounts of norepinephrine and other vasopressors used during surgery, intraoperative heart rate (HR), fluid balance, central venous O2 saturation (SCVO2), score of Intensive Care Delirium Screening Checklist (ICD-SC) during the intensive care unit (ICU) stay, occurrence of postoperative acute kidney injury (AKI) and duration of ICU stay. All postoperative complications during the hospitalization period were evaluated. Results Thirty-six patients were included. Eighteen patients were administered remimazolam and 18 patients were administered sevoflurane for maintenance of general anesthesia. Intraoperative ABP was significantly higher in the remimazolam group than in the sevoflurane group (73±4 mmHg vs 69±6 mmHg, P=0.015). The amount of intraoperative norepinephrine was significantly smaller in the remimazolam group than in the sevoflurane group (910±638 μg vs 2041±927 μg, P<0.001). There were no differences in other outcomes and incidences of postoperative complications. Conclusion In OPCAB surgery, patients who received remimazolam for maintenance of general anesthesia achieved significantly higher average blood pressure than those who received sevoflurane, even though the amount of intraoperative norepinephrine was significantly smaller in the patients who received remimazolam than in the patients who received sevoflurane.
    Apr. 2025, Cureus, 17(4) (4), e82338, English, International magazine
    Scientific journal

  • Atsushi Miyazaki, Mai Hokka, Norihiko Obata, Satoshi Mizobuchi
    BACKGROUND: Various factors can cause vascular endothelial damage during cardiovascular surgery (CVS) with cardiopulmonary bypass (CPB), which has been suggested to be associated with postoperative complications. However, few studies have specifically investigated the relationship between the degree of vascular endothelial damage and postoperative acute kidney injury (pAKI). The objectives of this study were to measure perioperative serum syndecan-1 concentrations in patients who underwent CVS with CPB, evaluate their trends, and determine their association with pAKI. METHODS: This was a descriptive and case‒control study conducted at the National University Hospital. Adult patients who underwent CVS with CPB at a national university hospital between March 15, 2016, and August 31, 2020, were included. Patients who were undergoing preoperative dialysis, had preoperative serum creatinine concentrations greater than 2.0 mg dl-1, who were undergoing surgery involving the descending aorta were excluded. The perioperative serum syndecan-1 concentration was measured, and its association with pAKI was investigated. RESULTS: Fifty-two patients were included. pAKI occurred in 18 (34.6%) of those patients. The serum syndecan-1 concentration increased after CPB initiation and exhibited bimodal peak values. The serum syndecan-1 concentration at all time points was significantly elevated compared to that after the induction of anesthesia. The serum syndecan-1 concentration at 30 min after weaning from CPB and on postoperative day 1 was associated with the occurrence of pAKI (OR = 1.10 [1.01 to 1.21], P = 0.03]; OR = 1.16 [1.01 to 1.34], P = 0.04]; and the cutoff values of the serum syndecan-1 concentration that resulted in pAKI were 101.0 ng ml-1 (sensitivity = 0.71, specificity = 0.62, area under the curve (AUC) = 0.67 (0.51 to 0.83)) and 57.1 ng ml-1 (sensitivity = 0.82, specificity = 0.56, AUC = 0.71 (0.57 to 0.86)). Multivariate logistic regression analysis revealed that the serum syndecan-1 concentration on postoperative day 1 was associated with the occurrence of pAKI (OR = 1.02 [1.00 to 1.03]; P = 0.03). CONCLUSION: The serum syndecan-1 concentration at all time points was significantly greater than that after the induction of anesthesia. The serum syndecan-1 concentration on postoperative day 1 was significantly associated with the occurrence of pAKI. TRIAL REGISTRATION: This study is not a clinical trial and is not registered with the registry.
    Apr. 2024, BMC anesthesiology, 24(1) (1), 154 - 154, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • 宮崎 純志, 西村 太一, 古島 夏奈, 巻野 将平, 牛尾 将洋, 岡田 雅子, 小幡 典彦, 溝渕 知司
    (一社)日本集中治療医学会, Jan. 2024, 日本集中治療医学会雑誌, 31(1) (1), 9 - 13, Japanese

  • 正田 康一郎, 巻野 将平, 宮崎 純志, 西村 太一, 古島 夏奈, 牛尾 将洋, 小幡 典彦, 溝渕 知司
    症例は2型糖尿病およびSLEの既往を有する60歳代男性で、ICUに入室しニューモシスチス肺炎(PCP)とサイトメガロウイルス(CMV)肺炎に対しプレドニゾロンとインスリン持続静注などで集中治療管理を行った。経過中に著明なインスリン抵抗性の増大を認め、高インスリン血症の存在からB型インスリン抵抗症の発症を強く疑った。その後もPCP・CMV肺炎に対する治療の継続によりインスリン抵抗性は改善し、B型インスリン抵抗症の発症に対するPCP・CMV肺炎の関与が示唆された。本邦でのB型インスリン抵抗症の報告は非常に稀で、今までに約40例である。
    (一社)日本集中治療医学会, Nov. 2023, 日本集中治療医学会雑誌, 30(6) (6), 463 - 464, Japanese

  • 宮崎 純志, 堀川 由夫, 樋口 恭子, 飯島 克博, 伊地 智和子
    日本臨床麻酔学会, Mar. 2021, 日本臨床麻酔学会誌, 41(2) (2), 140 - 144, Japanese

■ MISC
  • 宮崎 純志, 法華 真衣, 小幡 典彦
    (一社)日本心臓血管麻酔学会, Sep. 2025, Cardiovascular Anesthesia, 29(Suppl.) (Suppl.), 313 - 313, Japanese

  • V-V ECMO管理中の呼吸不全患者にセボフルランを用いて鎮静を行った1例
    宮崎純志, 守田昂平, 西村太一, 溝渕知司
    2025, 日本集中治療医学会学術集会(Web), 52nd

  • 敗血症患者における早期経腸栄養とPersistent Inflammation Immunosuppression Catabolism Syndromeの関連
    宮崎純志, 真壁香菜, 小幡典彦, 溝渕知司
    2025, 日本集中治療医学会学術集会(Web), 52nd

  • 精神発達遅滞の既往のある患者に対してセボフルランを用いて安全に抜管できた1例
    吉田 東馬, 牛尾 将洋, 西村 太一, 巻野 将平, 宮崎 純志, 藤本 大地, 岡田 雅子, 小幡 典彦, 溝渕 知司
    (一社)日本集中治療医学会, Sep. 2024, 日本集中治療医学会雑誌, 31(Suppl.1) (Suppl.1), S879 - S879, Japanese

  • 術前絶飲食による飢餓性ケトアシドーシスが疑われた進行性筋力低下症患者の1例
    宮崎 純志, 西村 太一, 巻野 将平, 牛尾 将洋, 岡田 雅子, 小幡 典彦, 溝渕 知司
    (一社)日本集中治療医学会, Sep. 2024, 日本集中治療医学会雑誌, 31(Suppl.1) (Suppl.1), S912 - S912, Japanese

  • トラファイン挿入時に生じた気管損傷部の観察にラリンジアルマスクが有用であった1例
    巻野 将平, 吉田 東馬, 宮崎 純志, 藤本 大地, 西村 太一, 牛尾 将洋, 岡田 雅子, 小幡 典彦, 溝渕 知司
    (一社)日本集中治療医学会, Sep. 2024, 日本集中治療医学会雑誌, 31(Suppl.1) (Suppl.1), S937 - S937, Japanese

  • ICUでのレミフェンタニルの投与中止後にオピオイド離脱症候群が生じた1例
    崎山裕子, 牛尾将洋, 宮崎純志, 原翔平, 岡田雅子, 巻野将平, 小幡典彦, 溝渕知司
    2024, 日本集中治療医学会関西支部学術集会プログラム・抄録集(Web), 8th

  • 人工呼吸管理中のCOVID-19患者に対するセボフルランの使用経験
    宮崎 純志, 西村 太一, 巻野 将平, 牛尾 将洋, 小幡 典彦, 溝渕 知司
    (一社)日本集中治療医学会, Jun. 2023, 日本集中治療医学会雑誌, 30(Suppl.1) (Suppl.1), S749 - S749, Japanese

  • 集中治療室で高用量カテコラミン投与および人工呼吸管理が必要であった肝不全末期患者を自宅で看取る事ができた症例
    西村太一, 宮崎純志, 巻野将平, 牛尾将洋, 小幡典彦, 溝渕知司
    2023, 日本集中治療医学会関西支部学術集会プログラム・抄録集(Web), 7th

  • A case of strongly suspected type B insulin resistance syndrome which developed during intensive care management
    正田康一郎, 巻野将平, 宮崎純志, 西村太一, 古島夏奈, 牛尾将洋, 小幡典彦, 溝渕知司
    2023, 日本集中治療医学会雑誌(Web), 30(6) (6)

  • 植込型左室補助人工心臓装着術直後に判明した肺動脈カテーテル縫い込みに対して再開胸手術を行った一例
    原田みどり, 宮崎純志, 中山莉子, 岡田卓也, 法華真衣, 溝渕知司
    2022, Cardiovascular Anesthesia, 26(Suppl (CD-ROM)) (Suppl (CD-ROM))

  • 急速な胸水貯留を認めた慢性骨髄性白血病の1例
    田中 康博, 宮崎 純志
    (地独)神戸市民病院機構, Mar. 2020, 神戸市立病院紀要, (58) (58), 56 - 58, Japanese

  • 宮崎 純志, 堀川 由夫, 田中 修, 伊地智 和子, 飯島 克博, 盛房 槙子, 中山 莉子
    日本臨床麻酔学会, Oct. 2019, 日本臨床麻酔学会誌, 39(6) (6), S286 - S286, Japanese

  • 家兎真菌性角膜炎でのボリコナゾール角膜実質注射の効果
    宮崎純志, 宮本龍郎, 江口洋, 伊藤浩太郎, 宮下領介, TSERENNADMID Enkhmaa, 赤岩慶, 仁木昌徳, 堀田芙美香, 三田村佳典
    2014, 日本角膜学会総会・日本角膜移植学会プログラム・抄録集, 38th-30th

  • ボリコナゾール角膜実質注射の適正濃度の検討
    仁木昌徳, 江口洋, 宮崎純志, 宮本龍郎, 堀田芙美香, 樋端透史, 伊藤浩太郎, 宮下領介, 三田村佳典
    2013, 日本眼感染症学会・日本眼炎症学会・日本コンタクトレンズ学会総会・日本涙道・涙液学会プログラム・講演抄録集, 50th-47th-56th-2nd

■ Lectures, oral presentations, etc.
  • V-V ECMO管理中の呼吸不全患者にセボフルランを用いて鎮静を行った1例
    宮崎純志, 守田昂平, 西村太一, 溝渕知司
    日本集中治療医学会学術集会(Web), 2025

  • 敗血症患者における早期経腸栄養とPersistent Inflammation Immunosuppression Catabolism Syndromeの関連
    宮崎純志, 真壁香菜, 小幡典彦, 溝渕知司
    日本集中治療医学会学術集会(Web), 2025

  • 精神発達遅滞の既往のある患者に対してセボフルランを用いて安全に抜管できた1例
    吉田東馬, 牛尾将洋, 西村太一, 巻野将平, 宮崎純志, 藤本大地, 岡田雅子, 小幡典彦, 溝渕知司
    日本集中治療医学会学術集会(Web), 2024

  • トラファイン挿入時に生じた気管損傷部の観察にラリンジアルマスクが有用であった1例
    巻野将平, 吉田東馬, 宮崎純志, 藤本大地, 西村太一, 牛尾将洋, 岡田雅子, 小幡典彦, 溝渕知司
    日本集中治療医学会学術集会(Web), 2024

  • 術前絶飲食による飢餓性ケトアシドーシスが疑われた進行性筋力低下症患者の1例
    宮崎純志, 西村太一, 巻野将平, 牛尾将洋, 岡田雅子, 小幡典彦, 溝渕知司
    日本集中治療医学会学術集会(Web), 2024

  • 当院ICUにおけるセボフルランを用いた小児患者の鎮静管理
    宮崎純志, 巻野将平, 牛尾将洋, 小幡典彦, 溝渕知司
    日本集中治療医学会関西支部学術集会プログラム・抄録集(Web), 2024

  • ICUでのレミフェンタニルの投与中止後にオピオイド離脱症候群が生じた1例
    崎山裕子, 牛尾将洋, 宮崎純志, 原翔平, 岡田雅子, 巻野将平, 小幡典彦, 溝渕知司
    日本集中治療医学会関西支部学術集会プログラム・抄録集(Web), 2024

  • 人工呼吸管理中のCOVID-19患者に対するセボフルランの使用経験
    宮崎 純志, 西村 太一, 巻野 将平, 牛尾 将洋, 小幡 典彦, 溝渕 知司
    日本集中治療医学会雑誌, Jun. 2023, Japanese, (一社)日本集中治療医学会

  • 集中治療室で高用量カテコラミン投与および人工呼吸管理が必要であった肝不全末期患者を自宅で看取る事ができた症例
    西村太一, 宮崎純志, 巻野将平, 牛尾将洋, 小幡典彦, 溝渕知司
    日本集中治療医学会関西支部学術集会プログラム・抄録集(Web), 2023

  • A case of strongly suspected type B insulin resistance syndrome which developed during intensive care management
    正田康一郎, 巻野将平, 宮崎純志, 西村太一, 古島夏奈, 牛尾将洋, 小幡典彦, 溝渕知司
    日本集中治療医学会雑誌(Web), 2023

  • 植込型左室補助人工心臓装着術直後に判明した肺動脈カテーテル縫い込みに対して再開胸手術を行った一例
    原田 みどり, 宮崎 純志, 中山 莉子, 岡田 卓也, 法華 真衣, 溝渕 知司
    Cardiovascular Anesthesia, Sep. 2022, Japanese, (一社)日本心臓血管麻酔学会

  • デスフルラン気化器を用いた全身麻酔中に酸素濃度低下を来した1例
    宮崎 純志, 堀川 由夫, 田中 修, 伊地智 和子, 飯島 克博, 盛房 槙子, 中山 莉子
    日本臨床麻酔学会誌, Oct. 2019, Japanese, 日本臨床麻酔学会

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