Fujishima, Seitaro



School of Medicine, Center for General Medicine Education (Shinanomachi)


Associate Professor

External Links

Career 【 Display / hide

  • 1982.04


  • 1984.05


  • 1986.05


  • 1991.07


  • 1993.05


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Academic Background 【 Display / hide

  • 1982.03

    Keio University, School of Medicine

    University, Graduated

Academic Degrees 【 Display / hide

  • Analysis and evaluation of in vivo N-isopropyl-I-123-p-iodoamphetamine (IMP) dynamics in diffuse pulmonary diseases, Keio University, Dissertation, 1992.03


Research Areas 【 Display / hide

  • General internal medicine (including psychosomatic medicine)

  • Respiratory organ internal medicine

  • Infectious disease medicine

Research Keywords 【 Display / hide

  • Acute Respiratory Distress Syndrome

  • sepsis

  • inflammatory lung diseases

  • Hyperoxic lung injury


Books 【 Display / hide

  • 気管支肺胞洗浄(BAL)法の手引き.

    FUJISHIMA SEITARO, 克誠堂出版, 2017.10

    Scope: 170-172

  • 救急集中治療アドバンス:重症患者における炎症と凝固・線溶系反応.

    FUJISHIMA SEITARO, 中山書店, 2017.03

    Scope: 16-21

  • 呼吸器疾患最新の治療2016-2018.

    豊崎光信,藤島 清太郎, 南江堂, 2016.03

    Scope: 114-116

  • 新呼吸器専門医テキスト.

    多村知剛,藤島 清太郎, 南江堂, 2015.04

    Scope: 205-207

  • 呼吸器疾患診療最新ガイドライン.

    FUJISHIMA SEITARO, 最新医学社, 2014.09

    Scope: 158-164

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Papers 【 Display / hide

  • The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)

    Egi M., Ogura H., Yatabe T., Atagi K., Inoue S., Iba T., Kakihana Y., Kawasaki T., Kushimoto S., Kuroda Y., Kotani J., Shime N., Taniguchi T., Tsuruta R., Doi K., Doi M., Nakada T.a., Nakane M., Fujishima S., Hosokawa N., Masuda Y., Matsushima A., Matsuda N., Yamakawa K., Hara Y., Sakuraya M., Ohshimo S., Aoki Y., Inada M., Umemura Y., Kawai Y., Kondo Y., Saito H., Taito S., Takeda C., Terayama T., Tohira H., Hashimoto H., Hayashida K., Hifumi T., Hirose T., Fukuda T., Fujii T., Miura S., Yasuda H., Abe T., Andoh K., Iida Y., Ishihara T., Ide K., Ito K., Ito Y., Inata Y., Utsunomiya A., Unoki T., Endo K., Ouchi A., Ozaki M., Ono S., Katsura M., Kawaguchi A., Kawamura Y., Kudo D., Kubo K., Kurahashi K., Sakuramoto H., Shimoyama A., Suzuki T., Sekine S., Sekino M., Takahashi N., Takahashi S., Takahashi H., Tagami T., Tajima G., Tatsumi H., Tani M., Tsuchiya A., Tsutsumi Y., Naito T., Nagae M., Nagasawa I., Nakamura K., Nishimura T., Nunomiya S., Norisue Y., Hashimoto S., Hasegawa D., Hatakeyama J., Hara N., Higashibeppu N., Furushima N., Furusono H., Matsuishi Y., Matsuyama T., Minematsu Y., Miyashita R., Miyatake Y., Moriyasu M., Yamada T.

    Journal of Intensive Care (Journal of Intensive Care)  9 ( 1 )  2021.12

     View Summary

    The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J-SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.

  • The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020).

    Egi M, Ogura H, Yatabe T, Atagi K, Inoue S, Iba T, Kakihana Y, Kawasaki T, Kushimoto S, Kuroda Y, Kotani J, Shime N, Taniguchi T, Tsuruta R, Doi K, Doi M, Nakada TA, Nakane M, Fujishima S, Hosokawa N, Masuda Y, Matsushima A, Matsuda N, Yamakawa K, Hara Y, Sakuraya M, Ohshimo S, Aoki Y, Inada M, Umemura Y, Kawai Y, Kondo Y, Saito H, Taito S, Takeda C, Terayama T, Tohira H, Hashimoto H, Hayashida K, Hifumi T, Hirose T, Fukuda T, Fujii T, Miura S, Yasuda H, Abe T, Andoh K, Iida Y, Ishihara T, Ide K, Ito K, Ito Y, Inata Y, Utsunomiya A, Unoki T, Endo K, Ouchi A, Ozaki M, Ono S, Katsura M, Kawaguchi A, Kawamura Y, Kudo D, Kubo K, Kurahashi K, Sakuramoto H, Shimoyama A, Suzuki T, Sekine S, Sekino M, Takahashi N, Takahashi S, Takahashi H, Tagami T, Tajima G, Tatsumi H, Tani M, Tsuchiya A, Tsutsumi Y, Naito T, Nagae M, Nagasawa I, Nakamura K, Nishimura T, Nunomiya S, Norisue Y, Hashimoto S, Hasegawa D, Hatakeyama J, Hara N, Higashibeppu N, Furushima N, Furusono H, Matsuishi Y, Matsuyama T, Minematsu Y, Miyashita R, Miyatake Y, Moriyasu M, Yamada T, Yamada H, Yamamoto R, Yoshida T, Yoshida Y, Yoshimura J, Yotsumoto R, Yonekura H, Wada T, Watanabe E, Aoki M, Asai H, Abe T, Igarashi Y, Iguchi N, Ishikawa M, Ishimaru G, Isokawa S, Itakura R, Imahase H, Imura H, Irinoda T, Uehara K, Ushio N, Umegaki T, Egawa Y, Enomoto Y, Ota K, Ohchi Y, Ohno T, Ohbe H, Oka K, Okada N, Okada Y, Okano H, Okamoto J, Okuda H, Ogura T, Onodera Y, Oyama Y, Kainuma M, Kako E, Kashiura M, Kato H, Kanaya A, Kaneko T, Kanehata K, Kano KI, Kawano H, Kikutani K, Kikuchi H, Kido T, Kimura S, Koami H, Kobashi D, Saiki I, Sakai M, Sakamoto A, Sato T, Shiga Y, Shimoto M, Shimoyama S, Shoko T, Sugawara Y, Sugita A, Suzuki S, Suzuki Y, Suhara T, Sonota K, Takauji S, Takashima K, Takahashi S, Takahashi Y, Takeshita J, Tanaka Y, Tampo A, Tsunoyama T, Tetsuhara K, Tokunaga K, Tomioka Y, Tomita K, Tominaga N, Toyosaki M, Toyoda Y, Naito H, Nagata I, Nagato T, Nakamura Y, Nakamori Y, Nahara I, Naraba H, Narita C, Nishioka N, Nishimura T, Nishiyama K, Nomura T, Haga T, Hagiwara Y, Hashimoto K, Hatachi T, Hamasaki T, Hayashi T, Hayashi M, Hayamizu A, Haraguchi G, Hirano Y, Fujii R, Fujita M, Fujimura N, Funakoshi H, Horiguchi M, Maki J, Masunaga N, Matsumura Y, Mayumi T, Minami K, Miyazaki Y, Miyamoto K, Murata T, Yanai M, Yano T, Yamada K, Yamada N, Yamamoto T, Yoshihiro S, Tanaka H, Nishida O

    Journal of intensive care 9 ( 1 ) 53 2021.08

  • Association of frailty on treatment outcomes among patients with suspected infection treated at emergency departments.

    Ishikawa S, Miyagawa I, Kusanaga M, Abe T, Shiraishi A, Fujishima S, Ogura H, Saitoh D, Kushimoto S, Shiino Y, Hifumi T, Otomo Y, Okamoto K, Kotani J, Sakamoto Y, Sasaki J, Shiraishi SI, Takuma K, Hagiwara A, Yamakawa K, Takeyama N, Gando S, Mayumi T

    European journal of emergency medicine : official journal of the European Society for Emergency Medicine (European Journal of Emergency Medicine)  28 ( 4 ) 285 - 291 2021.08

    ISSN  0969-9546

     View Summary

    Background The clinical frailty scale (CFS) score has been validated as a predictor of adverse outcomes in community-dwelling older people. Older people are at a higher risk of sepsis and have a higher mortality rate. However, the association of frailty on outcomes in patients with sepsis has not been completely examined. Objective This study evaluated the association between CFS and outcomes in patients with sepsis. Design This was a multicenter prospective cohort substudy. Settings and participants The study included 37 emergency departments from across Japan. The patients (age ≥16 years) were included in this study if they had suspected infection at an emergency department during December 2017-February 2018. Outcome measure and analysis The primary outcome was 28-day mortality, stratified by the CFS score categories. The secondary outcomes were the duration of hospital stay, number of ICU-free days (ICUFDs) and number of ventilator-free days (VFDs). Main results A total of 917 patients were included. The median age was 79 years. The CFS score was associated with an increased risk of 28-day mortality and with a higher likelihood of long-term hospital stay and short-term VFDs and ICUFDs. Multivariate logistic regression analysis indicated that the CFS score was a predictor of 28-day mortality [odds ratio (OR), 1.26; 95% confidence interval (CI), 1.11-1.42]. Conclusions This study reported that in patients with suspected sepsis in the emergency department, frailty may be associated with poor prognosis and length of hospital stay.

  • Intensive care unit model and in-hospital mortality among patients with severe sepsis and septic shock: A secondary analysis of a multicenter prospective observational study.

    Nagata I, Abe T, Ogura H, Kushimoto S, Fujishima S, Gando S, JAAM FORECAST group.

    Medicine (Medicine)  100 ( 21 ) e26132 2021.05

    ISSN  0025-7974

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    ABSTRACT: We aimed to determine the association between the intensive care unit (ICU) model and in-hospital mortality of patients with severe sepsis and septic shock.This was a secondary analysis of a multicenter prospective observational study conducted in 59 ICUs in Japan from January 2016 to March 2017. We included adult patients (aged ≥16 years) with severe sepsis and septic shock based on the sepsis-2 criteria who were admitted to an ICU with a 1:2 nurse-to-patient ratio per shift. Patients were categorized into open or closed ICU groups, according to the ICU model. The primary outcome was in-hospital mortality.A total of 1018 patients from 45 ICUs were included in this study. Patients in the closed ICU group had a higher severity score and higher organ failure incidence than those in the open ICU group. The compliance rate for the sepsis care 3-h bundle was higher in the closed ICU group than in the open ICU group. In-hospital mortality was not significantly different between the closed and open ICU groups in a multilevel logistic regression analysis (odds ratio = 0.83, 95% confidence interval; 0.52-1.32, P = .43) and propensity score matching analysis (closed ICU, 21.2%; open ICU, 25.7%, P = .22).In-hospital mortality between the closed and open ICU groups was not significantly different after adjusting for ICU structure and compliance with the sepsis care bundle.

  • Disseminated intravascular coagulation immediately after trauma predicts a poor prognosis in severely injured patients.

    Wada T, Shiraishi A, Gando S, Yamakawa K, Fujishima S, Saitoh D, Kushimoto S, Ogura H, Abe T, Mayumi T, Sasaki J, Kotani J, Takeyama N, Tsuruta R, Takuma K, Yamashita N, Shiraishi SI, Ikeda H, Shiino Y, Tarui T, Nakada TA, Hifumi T, Okamoto K, Sakamoto Y, Hagiwara A, Masuno T, Ueyama M, Fujimi S, Umemura Y, Otomo Y

    Scientific reports (Scientific Reports)  11 ( 1 ) 11031 2021.05

    ISSN  2045-2322

     View Summary

    Trauma patients die from massive bleeding due to disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype in the early phase, which transforms to DIC with a thrombotic phenotype in the late phase of trauma, contributing to the development of multiple organ dysfunction syndrome (MODS) and a consequently poor outcome. This is a sub-analysis of a multicenter prospective descriptive cross-sectional study on DIC to evaluate the effect of a DIC diagnosis on the survival probability and predictive performance of DIC scores for massive transfusion, MODS, and hospital death in severely injured trauma patients. A DIC diagnosis on admission was associated with a lower survival probability (Log Rank P < 0.001), higher frequency of massive transfusion and MODS and a higher mortality rate than no such diagnosis. The DIC scores at 0 and 3 h significantly predicted massive transfusion, MODS, and hospital death. Markers of thrombin and plasmin generation and fibrinolysis inhibition also showed a good predictive ability for these three items. In conclusion, a DIC diagnosis on admission was associated with a low survival probability. DIC scores obtained immediately after trauma predicted a poor prognosis of severely injured trauma patients.

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Papers, etc., Registered in KOARA 【 Display / hide

Reviews, Commentaries, etc. 【 Display / hide

  • 敗血症患者の血糖管理

    松岡 義, 藤島 清太郎

    臨床麻酔 (真興交易(株)医書出版部)  45 ( 8 ) 1033 - 1039 2021.08

    ISSN  0387-3668

  • 【もっと知りたい、わかりたい 日本版敗血症診療ガイドライン2020】もっと知る、もっとわかるJ-SSCG2020 免疫グロブリン(IVIG)療法

    藤島 清太郎

    救急医学 ((株)へるす出版)  45 ( 9 ) 1111 - 1117 2021.08

    ISSN  0385-8162

  • 【もっと知りたい、わかりたい 日本版敗血症診療ガイドライン2020】もっと知る、もっとわかるJ-SSCG2020 敗血症の定義と診断

    松田 直之, 長江 正晴, 藤島 清太郎, 小倉 裕司

    救急医学 ((株)へるす出版)  45 ( 9 ) 1091 - 1093 2021.08

    ISSN  0385-8162

  • 臨床実習におけるバリエーション理論を用いたオンラインでの地域診断の教育の位置づけ

    春田 淳志, 安藤 崇之, 藤島 清太郎

    医学教育 ((一社)日本医学教育学会)  52 ( Suppl. ) 128 - 128 2021.07

    ISSN  0386-9644

  • 熱傷侵襲による過剰な全身・腸管免疫応答はプロバイオティクス製剤の投与により改善する 熱傷とlipopolysaccharideによるtwo-hitモデルでの解析

    関根 和彦, 山元 良, 佐藤 幸男, 本間 康一郎, 藤島 清太郎, 佐々木 淳一

    Shock: 日本Shock学会雑誌 ((一社)日本Shock学会)  35 ( 1 ) 25 - 26 2021.05

    ISSN  0919-8156

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Presentations 【 Display / hide

  • 炎症バイオマーカーのABC.


    日本集中治療医学会第2回東海北陸支部学術集会 (石川県金沢市) , 2018.06, Oral Presentation(guest/special), 日本集中治療医学会

  • 日本におけるARDSの解析関連多施設共同研究


    第58回日本呼吸器学会学術集会 (大阪府大阪市) , 2018.04, Oral Presentation(guest/special)

  • 最新のガイドラインに基づくARDSの診療.


    第45回日本救急医学会総会・学術集会, 2017.10, Oral Presentation(guest/special)

  • 日本救急医学会多施設共同研究JAAM FORECAST報告:劇症型感染症研究


    第45回日本救急医学会総会・学術集会 (大阪府大阪市) , 2017.10

  • 日本救急医学会多施設共同研究JAAM FORECAST報告:ARDS研究


    第45回日本救急医学会総会・学術集会 (大阪府大阪市) , 2017.10, Oral Presentation(guest/special)

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Research Projects of Competitive Funds, etc. 【 Display / hide

  • Approach to inflammatory lung diseases by improving paracellular enviroment


    MEXT,JSPS, Grant-in-Aid for Scientific Research, 藤島 清太郎, Grant-in-Aid for Scientific Research (C), Principal Investigator

     View Summary

    1) We exposed human vascular endothelial cells to hyperoxia, and found the induction of interleukin-8 gene expression. This response was exacerbated under the co-incubation with tumor necrosis factor alpha or lipopolysaccharide, suggesting the exaggerated toxicity of hyperoxia in patients under critical condition. We further found the involvement of intracellular pattern-recognition receptors in this mechanism. 2) We found that differentiation of human embryonic stem cells into lung epithelial cells was facilitated by an air-liquid interface method. 3) We previously found the exaggerated bleomycin-induced acute lung injury in interleukin-17 deficient mice. By the current analysis, involvement of pathways not including dendritic cells or interleukin-12 were suggested. 4) We comprehensively analyzed lung cytokines in patients with acute respiratory distress syndrome, and found the involvement of interleukin-1beta, interferon-gamma, and interleukin-17.

Works 【 Display / hide

  • 卒後臨床研修センター副センター長



Awards 【 Display / hide

  • 日本ワックスマン財団学術研究助成奨励賞

    1992, Waxman Foundation of Japan INC.

    Type of Award: Awards of Publisher, Newspaper Company and Foundation

  • 第13回RMCB 研究会賞

    Fujishima Seitarou, Aiso Sadakazu, Sayama Kouichi, Yamasawa Fumihiro, Nakamura Morio, Soejima Kenzou, Waki Yasuhiro, Nakamura Hidetoshi, Hori Shingo, Aikawa Naoki, Kawashiro Takeo, Kanazawa Minoru, 1997.01, RMCB研究会, 高濃度酸素暴露によるヒト臍帯静脈内皮細胞のInterleukin-8遺伝子発現の検討

  • 慶應義塾大学医学研究奨励特別奨励研究賞

    Fujishima Seitarou, 1997, 慶應義塾医学研究奨励事業委員会, ケモカインの炎症性肺疾患病態に果たす役割の解明とこれに基づく新規治療法の開発

  • JIC Award 2014

    Fujishima S, Gando S, Saitoh D, et al. and Japanese Association for Acute Medicine Sepsis Registry (JAAM SR) Study Group, 2015.04, 日本感染症学会/日本化学療法学会, A multicenter, prospective evaluation of quality of care and mortality in Japan based on the Surviving Sepsis Campaign guidelines

    Type of Award: Awards of National Conference, Council and Symposium


Courses Taught 【 Display / hide









Courses Previously Taught 【 Display / hide

  • 救急医学

    慶應義塾大学医学部, 2018

  • 感染症学

    慶應義塾大学医学部, 2018

  • General Medicine Clinical Clerkship

    Keio University, 2015, Full academic year, Major subject, Laboratory work/practical work/exercise, Within own faculty, 1h, 10people

  • General Medicine

    Keio University, 2015, Spring Semester, Major subject, Lecture, Within own faculty, 1h, 110people

  • Emergency and Critical Care Medicine

    Keio University, 2013, Full academic year, Major subject, Lecture, Within own faculty, 1h, 110people

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