Nobuaki Shime1, Graeme MacLaren2. 1. Department of Emergency and Critical Care Medicine, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan. shime@koto.kpu-m.ac.jp. 2. Cardiothoracic Intensive Care Unit, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore. gmaclaren@iinet.net.au.