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NAKANISHI Nobuto
Graduate School of Medicine / Faculty of Medical Sciences
Assistant Professor

  • Profile

    Specialty：Emergency medicine, Intensive care medicine

    Research field: Muscle atrophy, Rehabilitatoin, Respiratory care

Researcher basic information

■ Research Keyword
  • Humidification
  • ultrasound
  • Electrical muscular stimulation
  • rehabilitation
  • Muscle atrophy
■ Research Areas
  • Life sciences / Internal medicine - General / Intensive care medicine

Research activity information

■ Award
  • Jul. 2023 日本集中治療医学会第7回関西支部学術集会, 奨励賞, ICU入室時における超音波を用いた上腕筋厚測定はサルコペニア評価に有用か

  • Mar. 2023 Kobe University, Gove university Graduate student award

  • May 2022 [ASSMN & KSSMN 2022] KSSMN-JSSMN Travel Grant, The longitudinal change of muscle-localized neutrophils and their potential role in sepsis-induced muscle atrophy

  • May 2022 第36回日本Shock学会学術集会, 会長賞, 敗血症後の骨格筋萎縮における好中球の動態解析と機序解明へのアプローチ

  • Feb. 2020 日本集中治療医学会, Distinguished Paper Award, Urinary Titin Is a Novel Biomarker for Muscle Atrophy in Nonsurgical Critically Ill Patients: A Two-Center, Prospective Observational Study
    Nobuto Nakanishi, Rie Tsutsumi, Kanako Hara, Takuya Takashima, Emiko Nakataki, Taiga Itagaki, Masafumi Matsuo, Jun Oto, Hiroshi Sakaue

  • Mar. 2019 第46回 日本集中治療医学会学術集会, 優秀演題賞, 敗血症における代謝破綻と血中遊離アミノ酸の意義
    堤 理恵, 山本 智子, 中西 信人, 阪上 浩

  • Feb. 2018 第45回 日本集中治療医学会学術集会, 優秀演題賞, 重症患者におけるエネルギー代謝動態の解析
    井内 茉莉奈, 堤 理恵, 中西 信人, 山本 智子, 田中 志歩, 大藤 純, 中瀧 恵実子, 小野寺 睦雄, 阪上 浩, 西村 匡司

  • Oct. 2014 Japanese Association for Acute Medicine, 優秀演題賞, 血液培養手技における滅菌手袋の必要性についての研究
    Nobuto Nakanishi

■ Paper
  • Yoshimi Kawahara, Nobuto Nakanishi, Keiko Nomura, Satoshi Doi, Jun Oto
    Jun. 2025, Nursing Reports
    Scientific journal

  • Kano Ken-ichi, Ryo Yamamoto, Minoru Yoshida, Takeaki Sato, Yoshihiro Nishita, Jiro Ito, Kazuki Nagatomo, Hiroyuki Ohbe, Kanako Takahashi, Masayuki Kaku, Hideaki Sakuramoto, Nobuto Nakanishi, Kazushige Inoue, Junji Hatakeyama, Hidenori Kasuya, Minoru Hayashi, Takefumi Tsunemitsu, Hiroomi Tatsumi, Naoki Higashibeppu, Kensuke Nakamura
    Feb. 2025, Nutrients
    Scientific journal

  • Motohiro Shimizu, Shodai Yoshihiro, Shinichi Watanabe, Gen Aikawa, Yoshihisa Fujinami, Yusuke Kawamura, Ayaka Matsuoka, Nobuto Nakanishi, Haruka Shida, Kensuke Sugimoto, Shunsuke Taito, Shigeaki Inoue
    Springer Science and Business Media LLC, Dec. 2024, Cureus
    Scientific journal

  • Nobuto Nakanishi, Nagato Katsura, Jun Sugiyama, Joji Kotani
    Dec. 2024, Clinical Nutrition Open Science
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Mai Azumi, Yoshifumi Mizobuchi, Nobuto Nakanishi, Kohei Nakajima, Keijiro Hara, Toshitaka Fujihara, Manabu Ishihara, Jun Oto, Yasushi Takagi
    Sep. 2024, Clinical Neurology and Neurosurgery
    Scientific journal

  • Junji Hatakeyama, Kensuke Nakamura, Hidenori Sumita, Daisuke Kawakami, Nobuto Nakanishi, Shizuka Kashiwagi, Keibun Liu, Yutaka Kondo
    The importance of ongoing post-discharge follow-up to prevent functional impairment in patients discharged from intensive care units (ICUs) is being increasingly recognized. Therefore, we conducted a scoping review, which included existing ICU follow-up clinic methodologies using the CENTRAL, MEDLINE, and CINAHL databases from their inception to December 2022. Data were examined for country or region, outpatient name, location, opening days, lead profession, eligible patients, timing of the follow-up, and assessment tools. Twelve studies were included in our review. The results obtained revealed that the methods employed by ICU follow-up clinics varied among countries and regions. The names of outpatient follow-up clinics also varied; however, all were located within the facility. These clinics were mainly physician or nurse led; however, pharmacists, physical therapists, neuropsychologists, and social workers were also involved. Some clinics were limited to critically ill patients with sepsis or those requiring ventilation. Ten studies reported the first outpatient visit 1-3 months after discharge. All studies assessed physical function, cognitive function, mental health, and the health-related quality of life. This scoping review revealed that an optimal operating format for ICU follow-up clinics needs to be established according to the categories of critically ill patients.
    Aug. 2024, Journal of anesthesia, 38(4) (4), 542 - 555, English, Domestic magazine
    Scientific journal

  • Nobuto Nakanishi, Isao Miyajima, Takeshi Saijo, Takahiro Kudo, Kohei Tanaka, Yuta Arai, Manabu Ishihara, Kensuke Nakamura, Joji Kotani
    Jun. 2024, Clinical Nutrition Open Science
    Scientific journal

  • Rumiko Shimizu, Nobuto Nakanishi, Manabu Ishihara, Jun Oto, Joji Kotani
    Jan. 2024, Diseases
    Scientific journal

  • Nobuto Nakanishi, Keibun Liu, Junji Hatakeyama, Akira Kawauchi, Minoru Yoshida, Hidenori Sumita, Kyohei Miyamoto, Kensuke Nakamura
    BACKGROUND: Post-intensive care syndrome (PICS) is the long-lasting impairment of physical functions, cognitive functions, and mental health after intensive care. Although a long-term follow-up is essential for the successful management of PICS, few reviews have summarized evidence for the efficacy and management of the PICS follow-up system. MAIN TEXT: The PICS follow-up system includes a PICS follow-up clinic, home visitations, telephone or mail follow-ups, and telemedicine. The first PICS follow-up clinic was established in the U.K. in 1993 and its use spread thereafter. There are currently no consistent findings on the efficacy of PICS follow-up clinics. Under recent evidence and recommendations, attendance at a PICS follow-up clinic needs to start within three months after hospital discharge. A multidisciplinary team approach is important for the treatment of PICS from various aspects of impairments, including the nutritional status. We classified face-to-face and telephone-based assessments for a PICS follow-up from recent recommendations. Recent findings on medications, rehabilitation, and nutrition for the treatment of PICS were summarized. CONCLUSIONS: This narrative review aimed to summarize the PICS follow-up system after hospital discharge and provide a comprehensive approach for the prevention and treatment of PICS.
    Jan. 2024, Journal of intensive care, 12(1) (1), 2 - 2, English, International magazine
    Scientific journal

  • Kasumi Shirasaki, Toru Hifumi, Nobuto Nakanishi, Nobuyuki Nosaka, Kyohei Miyamoto, Miyuki H. Komachi, Junpei Haruna, Shigeaki Inoue, Norio Otani
    Jan. 2024, Acute Medicine & Surgery
    Scientific journal

  • Shigeaki Inoue, Nobuto Nakanishi, Fumimasa Amaya, Yoshihisa Fujinami, Junji Hatakeyama, Toru Hifumi, Yuki Iida, Daisuke Kawakami, Yusuke Kawai, Yutaka Kondo, Keibun Liu, Kensuke Nakamura, Takeshi Nishida, Hidenori Sumita, Shunsuke Taito, Shunsuke Takaki, Norihiko Tsuboi, Takeshi Unoki, Yasuyo Yoshino, Osamu Nishida
    Jan. 2024, Acute Medicine & Surgery
    Scientific journal

  • Miharu Arase, Nobuto Nakanishi, Rie Tsutsumi, Ayuka Kawakami, Yuta Arai, Hiroshi Sakaue, Jun Oto
    Jan. 2024, International Journal of Molecular Sciences
    Scientific journal

  • Nobuto Nakanishi, Keibun Liu, Akira Kawauchi, Masatsugu Okamura, Kohei Tanaka, Sho Katayama, Yuki Mitani, Kohei Ota, Shunsuke Taito, Kenichi Fudeyasu, Yuki Masuka, Shodai Yoshihiro, Shu Utsumi, Mitsuaki Nishikimi, Mamoru Masuda, Yuki Iida, Yusuke Kawai, Junji Hatakeyama, Toru Hifumi, Takeshi Unoki, Daisuke Kawakami, Kengo Obata, Hajime Katsukawa, Hidenori Sumita, Tomoyuki Morisawa, Masahiro Takahashi, Norihiko Tsuboi, Ryo Kozu, Shunsuke Takaki, Junpei Haruna, Yoshihisa Fujinami, Nobuyuki Nosaka, Kyohei Miyamoto, Kensuke Nakamura, Yutaka Kondo, Shigeaki Inoue, Osamu Nishida
    BACKGROUND: The assessment of post-intensive care syndrome (PICS) is challenging due to the numerous types of instruments. We herein attempted to identify and propose recommendations for instruments to assess PICS in intensive care unit (ICU) survivors. METHODS: We conducted a scoping review to identify PICS follow-up studies at and after hospital discharge between 2014 and 2022. Assessment instruments used more than two times were included in the modified Delphi consensus process. A modified Delphi meeting was conducted three times by the PICS committee of the Japanese Society of Intensive Care Medicine, and each score was rated as not important (score: 1-3), important, but not critical (4-6), and critical (7-9). We included instruments with ≥ 70% of respondents rating critical and ≤ 15% of respondents rating not important. RESULTS: In total, 6972 records were identified in this scoping review, and 754 studies were included in the analysis. After data extraction, 107 PICS assessment instruments were identified. The modified Delphi meeting reached 20 PICS assessment instrument recommendations: (1) in the physical domain: the 6-min walk test, MRC score, and grip strength, (2) in cognition: MoCA, MMSE, and SMQ, (3) in mental health: HADS, IES-R, and PHQ-9, (4) in the activities of daily living: the Barthel Index, IADL, and FIM, (5) in quality of life: SF-36, SF-12, EQ-5D-5L, 3L, and VAS (6), in sleep and pain: PSQI and Brief Pain Inventory, respectively, and (7) in the PICS-family domain: SF-36, HADS, and IES-R. CONCLUSION: Based on a scoping review and the modified Delphi method, 20 PICS assessment instruments are recommended to assess physical, cognitive, mental health, activities of daily living, quality of life, sleep, and pain in ICU survivors and their families.
    Nov. 2023, Critical care (London, England), 27(1) (1), 430 - 430, English, International magazine
    Scientific journal

  • Takeshi Unoki, Kei Hayashida, Yusuke Kawai, Shunsuke Taito, Morihide Ando, Yuki Iida, Fumihito Kasai, Tatsuya Kawasaki, Ryo Kozu, Yutaka Kondo, Masakazu Saitoh, Hideaki Sakuramoto, Nobuyuki Sasaki, Ryuichi Saura, Kensuke Nakamura, Akira Ouchi, Saiko Okamoto, Masatsugu Okamura, Tomoki Kuribara, Akira Kuriyama, Yujiro Matsuishi, Norimasa Yamamoto, Shodai Yoshihiro, Taisuke Yasaka, Ryo Abe, Takahito Iitsuka, Hiroyasu Inoue, Yuki Uchiyama, Satoshi Endo, Kazuki Okura, Kohei Ota, Takahisa Otsuka, Daisuke Okada, Kengo Obata, Yukiko Katayama, Naoki Kaneda, Mio Kitayama, Shunsuke Kina, Ryuichi Kusaba, Masanari Kuwabara, Naoki Sasanuma, Masahiro Takahashi, Chihiro Takayama, Naonori Tashiro, Junko Tatsuno, Takahiko Tamura, Mitsuhiro Tamoto, Asuka Tsuchiya, Yusuke Tsutsumi, Tadashi Nagato, Chihiro Narita, Tomohiro Nawa, Tadayoshi Nonoyama, Masatoshi Hanada, Kotaro Hirakawa, Akiko Makino, Hirotaka Masaki, Ryosuke Matsuki, Shinya Matsushima, Wataru Matsuda, Saori Miyagishima, Masaru Moromizato, Naoya Yanagi, Kota Yamauchi, Yuhei Yamashita, Natsuhiro Yamamoto, Keibun Liu, Yuki Wakabayashi, Shinichi Watanabe, Hiroshi Yonekura, Nobuto Nakanishi, Tetsuya Takahashi, Osamu Nishida
    Providing standardized, high-quality rehabilitation for critically ill patients is a crucial issue. In 2017, the Japanese Society of Intensive Care Medicine (JSICM) promulgated the "Evidence-Based Expert Consensus for Early Rehabilitation in the Intensive Care Unit" to advocate for the early initiation of rehabilitations in Japanese intensive care settings. Building upon this seminal work, JSICM has recently conducted a rigorous systematic review utilizing the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. This endeavor resulted in the formulation of Clinical Practice Guidelines (CPGs), designed to elucidate best practices in early ICU rehabilitation. The primary objective of this guideline is to augment clinical understanding and thereby facilitate evidence-based decision-making, ultimately contributing to the enhancement of patient outcomes in critical care settings. No previous CPGs in the world has focused specifically on rehabilitation of critically ill patients, using the GRADE approach. Multidisciplinary collaboration is extremely important in rehabilitation. Thus, the CPGs were developed by 73 members of a Guideline Development Group consisting of a working group, a systematic review group, and an academic guideline promotion group, with the Committee for the Clinical Practice Guidelines of Early Mobilization and Rehabilitation in Intensive Care of the JSICM at its core. Many members contributed to the development of the guideline, including physicians and healthcare professionals with multiple and diverse specialties, as well as a person who had been patients in ICU. Based on discussions among the group members, eight important clinical areas of focus for this CPG were identified. Fourteen important clinical questions (CQs) were then developed for each area. The public was invited to comment twice, and the answers to the CQs were presented in the form of 10 GRADE recommendations and commentary on the four background questions. In addition, information for each CQ has been created as a visual clinical flow to ensure that the positioning of each CQ can be easily understood. We hope that the CPGs will be a useful tool in the rehabilitation of critically ill patients for multiple professions.
    Nov. 2023, Journal of intensive care, 11(1) (1), 47 - 47, English, International magazine
    Scientific journal

  • Nobuto Nakanishi, Shigeaki Inoue, Yuko Ono, Jun Sugiyama, Kazushi Takayama, Yuta Arai, Kensuke Nakamura, Jun Oto, Joji Kotani
    Elsevier BV, Oct. 2023, Clinical Nutrition ESPEN, 57, 569 - 574
    Scientific journal

  • Ayaka Matsuoka, Shodai Yoshihiro, Haruka Shida, Gen Aikawa, Yoshihisa Fujinami, Yusuke Kawamura, Nobuto Nakanishi, Motohiro Shimizu, Shinichi Watanabe, Kensuke Sugimoto, Shunsuke Taito, Shigeaki Inoue
    Sep. 2023, Journal of Clinical Medicine
    Scientific journal

  • Ayaka Matsuoka, Shodai Yoshihiro, Haruka Shida, Gen Aikawa, Yoshihisa Fujinami, Yusuke Kawamura, Nobuto Nakanishi, Motohiro Shimizu, Shinichi Watanabe, Kensuke Sugimoto, Shunsuke Taito, Shigeaki
    Sep. 2023, Journal of Clinical Medicine
    Scientific journal

  • Yuta Takahashi, Tomoyuki Morisawa, Hiroshi Okamoto, Nobuto Nakanishi, Noriko Matsumoto, Masakazu Saitoh, Tetsuya Takahashi, Toshiyuki Fujiwara
    Sepsis is a risk factor for diaphragm dysfunction and ICU-acquired weakness (ICU-AW); however, the impact of mechanical ventilation (MV) on these relationships has not been thoroughly investigated. This study aimed to compare the incidence of diaphragm dysfunction and ICU-AW in patients with septic shock, with and without MV. We conducted a single-center prospective observational study that included consecutive patients diagnosed with septic shock admitted to the ICU between March 2021 and February 2022. Ultrasound measurements of diaphragm thickness and manual measurements of limb muscle strength were repeated after ICU admission. The incidences of diaphragm dysfunction and ICU-AW, as well as their associations with clinical outcomes, were compared between patients with MV and without MV (non-MV). Twenty-four patients (11 in the MV group and 13 in the non-MV group) were analyzed. At the final measurements in the MV group, eight patients (72.7%) had diaphragm dysfunction, and six patients (54.5%) had ICU-AW. In the non-MV group, 10 patients (76.9%) had diaphragm dysfunction, and three (23.1%) had ICU-AW. No association was found between diaphragm dysfunction and clinical outcomes. Patients with ICU-AW in the MV group had longer ICU and hospital stays. Among patients with septic shock, the incidence of diaphragm dysfunction was higher than that of ICU-AW, irrespective of the use of MV. Further studies are warranted to examine the association between diaphragm dysfunction and clinical outcomes.
    Aug. 2023, Journal of clinical medicine, 12(16) (16), English, International magazine
    Scientific journal

  • Nobuto Nakanishi, Shodai Yoshihiro, Yusuke Kawamura, Gen Aikawa, Haruka Shida, Motohiro Shimizu, Yoshihisa Fujinami, Ayaka Matsuoka, Shinichi Watanabe, Shunsuke Taito, Shigeaki Inoue
    OBJECTIVES: Neuromuscular electrical stimulation (NMES) is used in the rehabilitation of patients with critical illness. However, it is unclear whether NMES prevents ICU-acquired weakness (ICU-AW). For this purpose, we conducted an updated systematic review and meta-analysis. DATA SOURCES: We searched the MEDLINE, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi databases from April 2019 to November 2022 to identify new randomized controlled trials to the previous meta-analysis. STUDY SELECTION: We systematically searched the literature for all randomized controlled trials on the effect of NMES in patients with critical illness. DATA EXTRACTION: Two authors independently selected the studies and extracted data. They calculated the pooled effect estimates associated with the occurrence of ICU-AW and adverse events as primary outcomes and muscle mass change, muscle strength, length of ICU stay, mortality, and quality of life as secondary outcomes. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. DATA SYNTHESIS: Overall, eight studies were added to the previous 10 studies. Evidence suggests that the use of NMES reduces the occurrence of ICU-AW (six trials; risk ratio [RR], 0.48; 95% CI, 0.32-0.72); however, NMES may have little to no effect on pricking sensation in patients (eight trials; RR, 6.87; 95% CI, 0.84-56.50). NMES is likely to reduce the change in muscle mass (four trials; mean difference, -10.01; 95% CI, -15.54 to -4.48) and may increase muscle strength (six trials; standardized mean difference, 0.43; 95% CI, 0.19-0.68). Further, NMES may result in little to no difference in the length of ICU stay, and the evidence is uncertain about the effect on mortality and quality of life. CONCLUSIONS: This updated meta-analysis revealed that the use of NMES may result in a lower occurrence of ICU-AW in patients with critical illness, but its use may have little to no effect on pricking sensation in patients.
    May 2023, Critical care medicine, English, International magazine
    Scientific journal

  • 鈴木 由紀, 堤 理恵, 中西 信人, 兵藤 瑞紗, 待田 京香, 大藤 純, 松尾 雅文, 阪上 浩
    (一社)日本病態栄養学会, Jan. 2023, 日本病態栄養学会誌, 26(Suppl.) (Suppl.), S - 4, Japanese

  • Jun Sugiyama, Shigeaki Inoue, Masami Inada, Yusuke Miyazaki, Nobuto Nakanishi, Yoshihisa Fujinami, Masafumi Saito, Yuko Ono, Kazushige Toyama, Futoshi Toda, Tohru Shirotsuki, Soushi Shiotani, Joji Kotani
    Wiley, Jan. 2023, Acute Medicine & Surgery, 10(1) (1)
    Scientific journal

  • Yuko Ono, Masafumi Saito, Kazuho Sakamoto, Yuko Maejima, Shingen Misaka, Kenju Shimomura, Nobuto Nakanishi, Shigeaki Inoue, Joji Kotani
    Burn injury is the leading cause of death and disability worldwide and places a tremendous economic burden on society. Systemic inflammatory responses induced by thermal burn injury can cause muscle wasting, a severe involuntary loss of skeletal muscle that adversely affects the survival and functional outcomes of these patients. Currently, no pharmacological interventions are available for the treatment of thermal burn-induced skeletal muscle wasting. Elevated levels of inflammatory cytokines, such as interleukin-6 (IL-6), are important hallmarks of severe burn injury. The levels of signal transducer and activator of transcription 3 (STAT3)—a downstream component of IL-6 inflammatory signaling—are elevated with muscle wasting in various pro-catabolic conditions, and STAT3 has been implicated in the regulation of skeletal muscle atrophy. Here, we tested the effects of the STAT3-specific signaling inhibitor C188-9 on thermal burn injury-induced skeletal muscle wasting in vivo and on C2C12 myotube atrophy in vitro after the administration of plasma from burn model mice. In mice, thermal burn injury severity dependently increased IL-6 in the plasma and tibialis anterior muscles and activated the STAT3 (increased ratio of phospho-STAT3/STAT3) and ubiquitin-proteasome proteolytic pathways (increased Atrogin-1/MAFbx and MuRF1). These effects resulted in skeletal muscle atrophy and reduced grip strength. In murine C2C12 myotubes, plasma from burn mice activated the same inflammatory and proteolytic pathways, leading to myotube atrophy. In mice with burn injury, the intraperitoneal injection of C188-9 (50 mg/kg) reduced activation of the STAT3 and ubiquitin-proteasome proteolytic pathways, reversed skeletal muscle atrophy, and increased grip strength. Similarly, pretreatment of murine C2C12 myotubes with C188-9 (10 µM) reduced activation of the same inflammatory and proteolytic pathways, and ameliorated myotube atrophy induced by plasma taken from burn model mice. Collectively, these results indicate that pharmacological inhibition of STAT3 signaling may be a novel therapeutic strategy for thermal burn-induced skeletal muscle wasting.
    Frontiers Media SA, Dec. 2022, Frontiers in Pharmacology, 13
    Scientific journal

  • Nobuto Nakanishi, Shinya Matsushima, Junko Tatsuno, Keibun Liu, Takahiko Tamura, Hiroshi Yonekura, Norimasa Yamamoto, Takeshi Unoki, Yutaka Kondo, Kensuke Nakamura
    Optimal energy and protein delivery goals for critically ill patients remain unknown. The purpose of this systematic review and meta-analysis was to compare the impact of energy and protein delivery during the first 4 to 10 days of an ICU stay on physical impairments. We performed a systematic literature search of MEDLINE, CENTRAL, and ICHUSHI to identify randomized controlled trials (RCTs) that compared energy delivery at a cut-off of 20 kcal/kg/day or 70% of estimated energy expenditure or protein delivery at 1 g/kg/day achieved within 4 to 10 days after admission to the ICU. The primary outcome was activities of daily living (ADL). Secondary outcomes were physical functions, changes in muscle mass, quality of life, mortality, length of hospital stay, and adverse events. Fifteen RCTs on energy delivery and 14 on protein were included in the analysis. No significant differences were observed in any of the outcomes included for energy delivery. However, regarding protein delivery, there was a slight improvement in ADL (odds ratio 21.55, 95% confidence interval (CI) -1.30 to 44.40, p = 0.06) and significantly attenuated muscle loss (mean difference 0.47, 95% CI 0.24 to 0.71, p < 0.0001). Limited numbers of RCTs were available to analyze the effects of physical impairments. In contrast to energy delivery, protein delivery ≥1 g/kg/day achieved within 4 to 10 days after admission to the ICU significantly attenuated muscle loss and slightly improved ADL in critically ill patients. Further RCTs are needed to investigate their effects on physical impairments.
    Nov. 2022, Nutrients, 14(22) (22), English, International magazine
    Scientific journal

  • Keishi Nawata, Nobuto Nakanishi, Shigeaki Inoue, Keibun Liu, Masafumi Nozoe, Yuko Ono, Isamu Yamada, Hajime Katsukawa, Joji Kotani
    Muscle mass is an important factor for surviving an illness. Ultrasound has gained increased attention as a muscle mass assessment method because of its noninvasiveness and portability. However, data on the frequency of ultrasound-based muscle mass assessment are limited, and there are some barriers to its implementation. Hence, a web-based cross-sectional survey was conducted on healthcare providers in Japan, which comprised four parts: 1) participant characteristics; 2) general muscle mass assessment; 3) ultrasound-based muscle mass assessment; and 4) the necessity of, interest in, and barriers to its implementation. Necessity and interest were assessed using an 11-point Likert scale, whereas barriers were assessed using a 5-point Likert scale, in which “Strongly agree” and “Agree” were counted for the analysis. Of the 1,058 responders, 1,026 participants, comprising 282 physicians, 489 physical therapists, 84 occupational therapists, 120 nurses, and 51 dieticians, were included in the analysis. In total, 93% of the participants were familiar with general muscle mass assessment, and 64% had conducted it. Ultrasound-based muscle mass assessment was performed by 21% of the participants. Necessity and interest scored 7 (6–8) and 8 (7–10), respectively for ultrasound-based muscle mass assessment. The barriers to its implementation included lack of relevant education (84%), limited staff (61%), and absence of fixed protocol (61%). Regardless of the necessity of and interest in ultrasound-based muscle mass assessment, it was only conducted by one-fifth of the healthcare providers, and the most important barrier to its implementation was lack of education.
    Public Library of Science (PLoS), Nov. 2022, PLOS ONE, 17(11) (11), e0276855 - e0276855
    Scientific journal

  • 急性心筋梗塞診断における尿中タイチンの有用性評価
    荒瀬 美晴, 中西 信人, 堤 理恵, 待田 京香, 新井 悠太, 阪上 浩, 大藤 純
    (一社)日本集中治療医学会, Nov. 2022, 日本集中治療医学会雑誌, 29(Suppl.1) (Suppl.1), 457 - 457, Japanese

  • 本邦での筋肉量評価における超音波検査の実施状況と障壁
    縄田 佳志, 中西 信人, 井上 茂亮, 劉 啓文, 野添 匡史, 大野 雄康, 曷川 元, 小谷 穣治
    (一社)日本集中治療医学会, Nov. 2022, 日本集中治療医学会雑誌, 29(Suppl.1) (Suppl.1), 562 - 562, Japanese

  • Yuko Ono, Eisuke Ueshima, Nobuto Nakanishi, Kazuaki Shinohara, Isamu Yamada, Joji Kotani
    Abstract Background Thyrocervical trunk rupture is an unusual, but critical, complication associated with central venous catheter (CVC) placement. The management of this complication has not been fully determined because it is rare. Case presentation A 53-year-old Japanese woman with anorexia nervosa developed refractory ventricular fibrillation. After returning spontaneous circulation, a CVC was successfully placed at the initial attempt in the right internal jugular vein using real-time ultrasound guidance. Immediately after CVC placement, she developed enlarging swelling around the neck. Contrast-enhanced computed tomography showed massive contrast media extravasation around the neck and mediastinum. Brachiocephalic artery angiography showed a “blush” appearance of the ruptured right thyrocervical trunk. After selective arterial embolization with 33% N-butyl-2-cyanoacrylate, the extravasation completely disappeared and hemostasis was achieved. Conclusion Our findings suggest that severe vascular complications arising from CVC placement can occur in patients with a fragile physiological state. Endovascular embolization is an effective treatment for such complications.
    Springer Science and Business Media LLC, Sep. 2022, JA Clinical Reports, 8(1) (1)
    Scientific journal

  • Shigeaki Inoue, Nobuto Nakanishi, Jun Sugiyama, Naoki Moriyama, Yusuke Miyazaki, Takashi Sugimoto, Yoshihisa Fujinami, Yuko Ono, Joji Kotani
    Post-intensive care syndrome (PICS) comprises physical, mental, and cognitive disorders following a severe illness. The impact of PICS on long-term prognosis has not been fully investigated. This study aimed to: (1) clarify the frequency and clinical characteristics of PICS in sepsis patients and (2) explore the relationship between PICS occurrence and 2-year survival. Patients with sepsis admitted to intensive care unit were enrolled. Data on patient background; clinical information since admission; physical, mental, and cognitive impairments at 3-, 6-, and 12-months post-sepsis onset; 2-year survival; and cause of death were obtained from electronic medical records and telephonic interviews with patients and their families. At 3 months, comparisons of variables were undertaken in the PICS group and the non-PICS group. Among the 77 participants, the in-hospital mortality rate was 11% and the 2-year mortality rate was 52%. The frequencies of PICS at 3, 6, and 12 months were 70%, 60%, and 35%, respectively. The 2-year survival was lower in the PICS group than in the non-PICS group (54% vs. 94%, p < 0.01). More than half of the survivors had PICS at 3 and 6 months after sepsis. Among survivors with sepsis, those who developed PICS after 3 months had a lower 2-year survival.
    MDPI AG, Sep. 2022, Journal of Clinical Medicine, 11(18) (18), 5257 - 5257
    Scientific journal

  • Ono Y, Nakanishi N, Yamada I, Kotani J
    Aug. 2022, Oxf Med Case Reports., 2022(8) (8), omac083 - omac083, English, International magazine
    [Refereed]

  • Shigeaki Inoue, Nobuto Nakanishi, Kensuke Nakamura
    Jul. 2022, Journal of Clinical Medicine
    Scientific journal

  • Kohei Tanaka, Sho Katayama, Kazuki Okura, Masatsugu Okamura, Keishi Nawata, Nobuto Nakanishi, Ayato Shinohara
    The Japanese Society of Strategies for Cancer Research and Therapy, Jul. 2022, Annals of Cancer Research and Therapy, 30(2) (2), 93 - 99
    Scientific journal

  • Shigeaki, Nobuto Nakanishi, Kensuke Nakamura
    Jul. 2022, Journal of Clinical Medicine
    Scientific journal

  • Nobuto Nakanishi, Yuko Ono, Isamu Yamada, Joji Kotani
    Wiley, Jun. 2022, Journal of the American College of Emergency Physicians Open, 3(3) (3)
    Scientific journal

  • 齋藤 雅史, 大野 雄康, 藤浪 好寿, 宮崎 勇輔, 中西 信人, 森山 直紀, 山下 公大, 井上 茂亮, 小谷 穣治
    (一社)日本Shock学会, May 2022, Shock: 日本Shock学会雑誌, 36(1) (1), 24 - 24, Japanese

  • 重症病態の骨格筋萎縮に認められた血中アミノ酸変動の意義
    待田 京香, 堤 理恵, 原 加奈子, 三島 優奈, 藤本 紗織, 黒田 雅士, 中西 信人, 阪上 浩
    (一社)日本病態栄養学会, Jan. 2022, 日本病態栄養学会誌, 24-25(Suppl.) (Suppl.), S - 96, Japanese

  • Ryo Ishizawa, Nobuto Nakanishi, Liu Keibun, Tomohiro Sonoo, Kensuke Nakamura, Tadahiro Goto
    AIM: Hip fracture is one of the most common fall-related injuries in the elderly population. Although falls may cause multiple types of injuries, no study has investigated the details of fall-related injuries accompanied by hip fractures. This study aimed to characterize the features of such injuries. METHODS: This is a cross-sectional study using data from four tertiary emergency departments in Japan. We identified patients diagnosed with hip fracture including femoral neck fracture, trochanter fracture, or subtrochanteric fracture from May 12, 2014 to July 12, 2021. Among patients with hip fracture, we included those with fall-related hip fracture. We excluded patients ages <40 years old and whose fall was high energy onset, defined as fall from more than three steps or 1 m. RESULTS: Among 326 emergency departments patients diagnosed with fall-related hip fracture, 288 patients were eligible for the analysis. Seventeen patients (6%) had injuries in addition to hip fractures. The most frequent injury was upper limb injury (e.g., distal radial fracture; n = 5, 30%), followed by head injury (e.g., subdural hematoma; n = 4, 24%), chest injury (e.g., pneumothorax; n = 2, 12%), and trunk injury (vertebral compression fracture; n = 2, 12%). There were no significantly different clinical characteristics between patients with hip injuries and those without. CONCLUSION: A total of 6% of patients diagnosed with hip fracture had other fall-related injuries. The most frequent were upper limb injury and head injury. Our findings underscore the importance of whole-body assessment in patients with fall-related hip fracture in the emergency department.
    2022, Acute medicine & surgery, 9(1) (1), e805, English, International magazine
    Scientific journal

  • Nobuto Nakanishi, Yuko Ono, Yusuke Miyazaki, Naoki Moriyama, Kazumichi Fujioka, Kimihiro Yamashita, Shigeaki Inoue, Joji Kotani
    Background: Sepsis-induced muscle atrophy leads to prolonged physical dysfunction. Although the interaction of muscle atrophy and macrophage has been reported in sepsis, the role of neutrophils in muscle atrophy has not been thoroughly investigated. This study sought to investigate the long-term changes in muscle-localized neutrophils after sepsis induction and their possible role in sepsis. Methods: Sepsis was induced in seven-week-old male C57BL/6J mice 8-12 (cecal slurry [CS] model) via intraperitoneal injection of 1 mg/g cecal slurry. The percentage change in body weight and grip strength was evaluated. The tibialis anterior muscles were dissected for microscopic examination of the cross-sectional area of myofibers or Fluorescence-activated cell sorting (FACS) analysis of immune cells. These changes were evaluated in the following conditions: (1) Longitudinal change until day 61, (2) CS concentration-dependent change on day 14 at the low (0.3 mg/g), middle (1.0 mg/g), and high (2.0 mg/g) concentrations, and (3) CS mice on day 14 treated with an anti-Ly6G antibody that depletes neutrophils. Results: Body weight and grip strength were significantly lower in the CS model until day 61 (body weight: 123.1% ± 1.8% vs. 130.3% ± 2.5%, p = 0.04; grip strength: 104.5% ± 3.8% vs. 119.3% ± 5.3%, p = 0.04). Likewise, cross-sectional muscle area gradually decreased until day 61 from the CS induction (895.6 [606.0-1304.9] μm2 vs. 718.8 [536.2-937.0] μm2, p < 0.01). The number of muscle-localized neutrophils increased from 2.3 ± 0.6 cell/mg on day 0 to 22.2 ± 13.0 cell/mg on day 14, and decreased thereafter. In terms of CS concentration-dependent change, cross-sectional area was smaller (484.4 ± 221.2 vs. 825.8 ± 436.2 μm2 [p < 0.001]) and grip strength was lower (71.4% ± 12.8% vs. 116.3% ± 7.4%, p = 0.01) in the CS High group compared with the control, with increased neutrophils (p = 0.03). Ly6G-depleted mice demonstrated significant increase of muscle cross-sectional area and grip strength compared with control mice (p < 0.01). Conclusions: Sepsis causes infiltration of neutrophils in muscles, leading to muscle atrophy and weakness. Depletion of neutrophils in muscle reverses sepsis-induced muscle atrophy and weakness. These results suggest that neutrophils may play a critical role in sepsis-induced muscle atrophy and weakness.
    2022, Frontiers in immunology, 13, 950646 - 950646, English, International magazine
    Scientific journal

  • 田中 孝平, 片山 翔, 大倉 和貴, 岡村 正嗣, 縄田 佳志, 中西 信人, 篠原 史都
    日本外科代謝栄養学会, Dec. 2021, 外科と代謝・栄養, 55(6) (6), 273 - 280, Japanese

  • Yuta Arai, Nobuto Nakanishi, Yuko Ono, Shigeaki Inoue, Joji Kotani, Masafumi Harada, Jun Oto
    Elsevier BV, Oct. 2021, Clinical Nutrition ESPEN, 45, 177 - 183
    Scientific journal

  • Satoshi Doi, Nobuto Nakanishi, Yoshimi Kawahara, Shizu Nakayama
    OBJECTIVES: To investigate the impact of oral care on thirst perception and dry mouth assessments. RESEARCH DESIGN: Single-centre observational study. SETTING: Intensive care unit in a university hospital. MAIN OUTCOME: We assessed thirst perception and dry mouth in adult patients before and after oral care. Thirst perception was assessed using a numerical rating scale and dry mouth was assessed using an oral moisture checking device and the modified Revised Oral Assessment Guide including tongue, mucous membranes and saliva. RESULTS: Eighty-six patients were included. After oral care, thirst scores decreased by 1 (0 to 3, p < 0.01) and remained low only for one hour. Oral moisture was maintained at a normal level ≥ 27.0%, and mROAG was at a low level ≤ 4 before and after the oral care. The numerical rating score did not correlate with oral moisture (ρ = -0.01, p = 0.96) or the modified revised oral assessment guide (ρ = 0.09, p = 0.42). Among patients with thirst, 60 (70%) patients complained of thirst at the assessment timepoints, but only 17 (20%) patients complained independently. CONCLUSION: Thirst perception was dissociated from dry mouth before and after oral care. Thirst must be frequently assessed and treated.
    Oct. 2021, Intensive & critical care nursing, 66, 103073 - 103073, English, International magazine
    Scientific journal

  • Nobuto Nakanishi, Keibun Liu, Daisuke Kawakami, Yusuke Kawai, Tomoyuki Morisawa, Takeshi Nishida, Hidenori Sumita, Takeshi Unoki, Toru Hifumi, Yuki Iida, Hajime Katsukawa, Kensuke Nakamura, Shinichiro Ohshimo, Junji Hatakeyama, Shigeaki Inoue, Osamu Nishida
    Intensive care unit survivors experience prolonged physical impairments, cognitive impairments, and mental health problems, commonly referred to as post-intensive care syndrome (PICS). Previous studies reported the prevalence, assessment, and prevention of PICS, including the ABCDEF bundle approach. Although the management of PICS has been advanced, the outbreak of coronavirus disease 2019 (COVID-19) posed an additional challenge to PICS. The prevalence of PICS after COVID-19 extensively varied with 28-87% of cases pertaining to physical impairments, 20-57% pertaining to cognitive impairments, and 6-60% pertaining to mental health problems after 1-6 months after discharge. Each component of the ABCDEF bundle is not sufficiently provided from 16% to 52% owing to the highly transmissible nature of the virus. However, new data are emerging about analgesia, sedation, delirium care, nursing care, early mobilization, nutrition, and family support. In this review, we summarize the recent data on PICS and its new challenge in PICS after COVID-19 infection.
    Aug. 2021, Journal of clinical medicine, 10(17) (17), English, International magazine
    Scientific journal

  • Sachiyo Fukushima, Nobuto Nakanishi, Kazumichi Fujioka, Kenichi Suga, Taku Shirakawa, Kayo Osawa, Kanako Hara, Rie Tsutsumi, Maki Urushihara, Ryuji Nakagawa, Hiroyuki Awano, Jun Oto, Hiroshi Sakaue, Kazumoto Iijima, Masafumi Matsuo
    BACKGROUND: Urinary titin N-fragment levels have been used to assess the catabolic state, and we used this biomarker to evaluate the catabolic state of infants. METHODS: We retrospectively measured urinary titin N-fragment levels of urinary samples. The primary outcome was its changes according to postmenstrual age. The secondary outcomes included differences between gestational age, longitudinal change after birth, influence on growth, and relationship with blood tests. RESULTS: This study included 219 patients with 414 measurements. Urinary titin N-fragment exponentially declined with postmenstrual age. These values were 12.5 (7.1-19.6), 8.1 (5.1-13.0), 12.8 (6.0-21.3), 26.4 (16.4-52.0), and 81.9 (63.3-106.4) pmol/mg creatinine in full, late, moderate, very, and extremely preterm infants, respectively (p < 0.01). After birth, urinary levels of titin N-fragment exponentially declined, and the maximum level within a week was associated with the time to return to birth weight in preterm infants (ρ = 0.39, p < 0.01). This was correlated with creatine kinase in full-term infants (ρ = 0.58, p < 0.01) and with blood urea nitrogen in preterm infants (ρ = 0.50, p < 0.01). CONCLUSIONS: The catabolic state was increased during the early course of the postmenstrual age and early preterm infants. IMPACT: Catabolic state in infants, especially in preterm infants, was expected to be increased, but no study has clearly verified this. In this retrospective study of 219 patients with 414 urinary titin measurements, the catabolic state was exponentially elevated during the early postmenstrual age. The use of the urinary titin N-fragment clarified catabolic state was prominently increased in very and extremely preterm infants.
    Jul. 2021, Pediatric research, English, International magazine
    Scientific journal

  • Nobuto Nakanishi, Shigeaki Inoue, Rie Tsutsumi, Yusuke Akimoto, Yuko Ono, Joji Kotani, Hiroshi Sakaue, Jun Oto
    Ultrasound has become widely used as a means to measure the rectus femoris muscle in the acute and chronic phases of critical illness. Despite its noninvasiveness and accessibility, its accuracy highly depends on the skills of the technician. However, few ultrasound phantoms for the confirmation of its accuracy or to improve technical skills exist. In this study, the authors created a novel phantom model and used it for investigating the accuracy of measurements and for training. Study 1 investigated how various conditions affect ultrasound measurements such as thickness, cross-sectional area, and echogenicity. Study 2 investigated if the phantom can be used for the training of various health care providers in vitro and in vivo. Study 1 showed that thickness, cross-sectional area, and echogenicity were affected by probe compression strength, probe angle, phantom compression, and varying equipment. Study 2 in vitro showed that using the phantom for training improved the accuracy of the measurements taken within the phantom, and Study 2 in vivo showed the phantom training had a short-term effect on improving the measurement accuracy in a human volunteer. The new ultrasound phantom model revealed that various conditions affected ultrasound measurements, and phantom training improved the measurement accuracy.
    Jun. 2021, Journal of clinical medicine, 10(12) (12), English, International magazine
    Scientific journal

  • Nobuto Nakanishi, Kazuki Okura, Masatsugu Okamura, Keishi Nawata, Ayato Shinohara, Kohei Tanaka, Sho Katayama
    OBJECTIVES: Muscle mass at admission is important to survive stroke, and stroke-induced sarcopenia is a serious problem because of its poor prognosis. Muscle mass measurement and monitoring are essential for appropriate rehabilitation and nutrition management. However, few reviews are available about the muscle mass measurement and monitoring after stroke. MATERIAL AND METHODS: Several methods are used to assess skeletal muscle mass in stroke, such as computed tomography (CT), ultrasound, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, biomarkers, and anthropometrics. We summarized the current methods and clinical applications in stroke. RESULTS: In stroke, a head CT is used to estimate muscle mass by measuring the temporal muscle. However, it can be conducted retrospectively due to radiation exposure. After stroke, limb muscle atrophy and diaphragm dysfunction are observed using ultrasound. However, ultrasound requires an understanding of the methods and skill. A bioelectrical impedance analysis can be used to assess muscle mass in patients after a stroke unless they have dynamic fluid changes. Dual-energy X-ray absorptiometry is used for follow-up after hospital discharge. Urinary titin N-fragment and serum C-terminal agrin fragment reflect muscle atrophy after stroke. Anthropometrics may be useful with limited resources. CONCLUSIONS: We summarized the features of each measurement and proved the recent evidence to properly measure and monitor skeletal muscle mass after stroke.
    Jun. 2021, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 30(6) (6), 105736 - 105736, English, International magazine
    Scientific journal

  • Nobuto Nakanishi, Satoshi Doi, Yoshimi Kawahara, Mie Shiraishi, Jun Oto
    INTRODUCTION: Vibration therapy has been used as an additional approach in passive rehabilitation. Recently, it has been demonstrated to be feasible and safe for critically ill patients, whose muscle weakness and intensive care unit (ICU)-acquired weakness are serious problems. However, the effectiveness of vibration therapy in this population is unclear. METHODS AND ANALYSIS: This study will enrol 188 adult critically ill patients who require further ICU stay after they can achieve sitting at the edge of the bed or wheelchair. The sample size calculation is based on a 15% improvement of Functional Status Score for the ICU. They will be randomised to vibration therapy coupled with protocolised mobilisation or to protocolised mobilisation alone; outcomes will be compared between the two groups. Therapy will be administered using a low-frequency vibration device (5.6-13 Hz) for 15 min/day from when the patient first achieves a sitting position and onward until discharge from the ICU. Outcome assessments will be blinded to the intervention. Primary outcome will be measured using the Functional Status Score for the ICU during discharge. Secondary outcomes will be identified as follows: delirium, Medical Research Council Score, ICU-acquired weakness, the change of biceps brachii and rectus femoris muscle mass measured by ultrasound, ICU mobility scale and ventilator-free and ICU-free days (number of free days during 28 days after admission). For safety assessment, vital signs will be monitored during the intervention. ETHICS AND DISSEMINATION: This study has been approved by the Clinical Research Ethics Committee of Tokushima University Hospital. Results will be disseminated through publication in a peer-reviewed journal and presented at conferences. TRIAL REGISTRATION NUMBER: UMIN000039616.
    Mar. 2021, BMJ open, 11(3) (3), e043348, English, International magazine
    Scientific journal

  • Nobuto Nakanishi, Rie Tsutsumi, Kanako Hara, Masafumi Matsuo, Hiroshi Sakaue, Jun Oto
    Titin is a giant protein that functions as a molecular spring in sarcomeres. Titin interconnects the contraction of actin-containing thin filaments and myosin-containing thick filaments. Titin breaks down to form urinary titin N-fragments, which are measurable in urine. Urinary titin N-fragment was originally reported to be a useful biomarker in the diagnosis of muscle dystrophy. Recently, the urinary titin N-fragment has been increasingly gaining attention as a novel biomarker of muscle atrophy and intensive care unit-acquired weakness in critically ill patients, in whom titin loss is a possible pathophysiology. Furthermore, several studies have reported that the urinary titin N-fragment also reflected muscle atrophy and weakness in patients with chronic illnesses. It may be used to predict the risk of post-intensive care syndrome or to monitor patients' condition after hospital discharge for better nutritional and rehabilitation management. We provide several tips on the use of this promising biomarker in post-intensive care syndrome.
    Feb. 2021, Journal of clinical medicine, 10(4) (4), English, International magazine
    Scientific journal

  • Takuya Takashima, Nobuto Nakanishi, Yuta Arai, Jun Oto
    Background : Diaphragm dysfunction is a serious problem. However, a few management techniques exist for diaphragm dysfunction. Methods : Adult patients treated with high-flow nasal cannula (HFNC) in the intensive care unit were included in this study. The diaphragm function was evaluated using ultrasound measurement of thickening fraction before and after HFNC liberation. Normal diaphragm contraction was defined as thickening fraction ≥ 15% without HFNC, whereas decreased or paradoxical diaphragm contractions were 0%-15% or < 0%, respectively. Results : Forty patients were enrolled, and 16 (40%) had normal diaphragm contraction, whereas 19 (48%) or 5 (13%) had decreased or paradoxical diaphragm contractions, respectively. Thickening fraction increased after HFNC liberation (27.0% ± 25.7% vs. 38.8% ± 34.5%,  p = 0.03 in HFNC vs. no HFNC) in patients without diaphragm dysfunction. In patients with decreased diaphragm contraction, thickening fraction did not change with or without HFNC (8.9% ± 11.7% vs. 6.7% ± 5.2%,  p = 0.35), whereas paradoxical contraction decreased with HFNC (1.0% ± 10.2% vs. -10.3% ± 2.7%,  p = 0.04) in patients with paradoxical diaphragm contraction. Conclusions : The work of breathing decreased with HFNC in patients without diaphragm dysfunction, but did not decrease in patients with decreased diaphragm contraction. Paradoxical diaphragm contraction decreased with HFNC. J. Med. Invest. 68 : 159-164, February, 2021.
    2021, The journal of medical investigation : JMI, 68(1.2) (1.2), 159 - 164, English, Domestic magazine
    Scientific journal

  • Manabu Ishihara, Nobuto Nakanishi, Rie Tsutsumi, Kanako Hara, Kyoka Machida, Nobuaki Yamamoto, Yasuhisa Kanematsu, Hiroshi Sakaue, Jun Oto, Yasushi Takagi
    INTRODUCTION: Urinary titin is a biomarker of muscle atrophy, which is a serious complication after stroke. However, there are currently no clinical data regarding urinary titin in stroke patients. METHODS: Consecutive stroke patients admitted to the stroke care unit were included. Spot urine samples were collected immediately after admission, and on days 3, 5, and 7. The primary outcome was the trend of urinary titin in patients after acute stroke. The secondary outcomes included the association between the peak urinary titin level and the modified Rankin Scale (mRS) score, the National Institutes of Health Stroke Scale (NIHSS) score, and the Barthel index (BI) upon hospital discharge. Multivariate analysis was adjusted for age, sex, NIHSS at admission, and the peak urinary titin to predict poor outcome (mRS 3-6). RESULTS: Forty-one patients were included (29 male; age, 68 ± 15 years), 29 had ischemic stroke, 8 had intracerebral hemorrhage, and 4 had subarachnoid hemorrhage. The levels of urinary titin on days 1, 3, 5, and 7 were 9.9 (4.7-21.1), 16.2 (8.6-22.0), 8.9 (4.8-15.2), and 8.7 (3.6-16.2) pmol/mg Cr, respectively. The peak urinary titin level was associated with the mRS score (r = 0.55, p < 0.01), the NIHSS score (r = 0.72, p < 0.01), and the BI (r = -0.59, p < 0.01) upon hospital discharge. In multivariate analysis, the peak urinary titin was associated with poor outcome (p = 0.03). CONCLUSIONS: Urinary titin rapidly increased after stroke and was associated with impaired functional outcomes at hospital discharge.
    Dec. 2020, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 30(3) (3), 105561 - 105561, English, International magazine
    Scientific journal

  • Nobuto Nakanishi, Jun Oto, Rie Tsutsumi, Yusuke Akimoto, Yuki Nakano, Masaji Nishimura
    BACKGROUND: Lower limb muscle atrophy is often observed in critically ill patients. Although upper limb muscles can undergo atrophy, it remains unclear how this atrophy is associated with clinical outcomes. We hypothesized that this atrophy is associated with mortality and impairments in physical function. METHODS: In this two-center prospective observational study, we included adult patients who were expected to require mechanical ventilation for > 48 h and remain in the intensive care unit (ICU) for > 5 days. We used ultrasound to evaluate the cross-sectional area of the biceps brachii on days 1, 3, 5, and 7 and upon ICU discharge along with assessment of physical functions. The primary outcome was the relationship between muscle atrophy ratio and in-hospital mortality on each measurement day, which was assessed using multivariate analysis. The secondary outcomes were the relationships between upper limb muscle atrophy and Medical Research Council (MRC) score, handgrip strength, ICU Mobility Scale (IMS) score, and Functional Status Score for the ICU (FSS-ICU). RESULTS: Sixty-four patients (43 males; aged 70 ± 13 years) were enrolled. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was 27 (22-30), and in-hospital mortality occurred in 21 (33%) patients. The decreased cross-sectional area of the biceps brachii was not associated with in-hospital mortality on day 3 (p = 0.43) but was associated on days 5 (p = 0.01) and 7 (p < 0.01), which was confirmed after adjusting for sex, age, and APACHE II score. In 27 patients in whom physical functions were assessed, the decrease of the cross-sectional area of the biceps brachii was associated with MRC score (r = 0.47, p = 0.01), handgrip strength (r = 0.50, p = 0.01), and FSS-ICU (r = 0.56, p < 0.01), but not with IMS score (r = 0.35, p = 0.07) upon ICU discharge. CONCLUSIONS: Upper limb muscle atrophy was associated with in-hospital mortality and physical function impairments; thus, it is prudent to monitor it. (321 words) TRIAL REGISTRATION: UMIN 000031316 . Retrospectively registered on 15 February 2018.
    Nov. 2020, Journal of intensive care, 8(1) (1), 87 - 87, English, International magazine
    Scientific journal

  • 重症患者の栄養代謝病態と栄養療法の実際 重症病態における糖・アミノ酸代謝動態の解明
    堤 理恵, 山本 智子, 橘高 久未子, 中西 信人, 阪上 浩
    (一社)日本臨床栄養代謝学会, Nov. 2020, 学会誌JSPEN, 2(Suppl.1) (Suppl.1), 187 - 187, Japanese

  • Nobuto Nakanishi, Jun Oto, Rie Tsutsumi, Tomoko Yamamoto, Yoshitoyo Ueno, Emiko Nakataki, Taiga Itagaki, Hiroshi Sakaue, Masaji Nishimura
    OBJECTIVES: Electrical muscle stimulation is widely used to enhance lower limb mobilization. Although upper limb muscle atrophy is common in critically ill patients, electrical muscle stimulation application for the upper limbs has been rarely reported. The purpose of this study was to investigate whether electrical muscle stimulation prevents upper and lower limb muscle atrophy and improves physical function. DESIGN: Randomized controlled trial. SETTING: Two-center, mixed medical/surgical ICU. PATIENTS: Adult patients who were expected to be mechanically ventilated for greater than 48 hours and stay in the ICU for greater than 5 days. INTERVENTIONS: Forty-two patients were randomly assigned to the electrical muscle stimulation (n = 17) or control group (n = 19). MEASUREMENTS AND MAIN RESULTS: Primary outcomes were change in muscle thickness and cross-sectional area of the biceps brachii and rectus femoris from day 1 to 5. Secondary outcomes included occurrence of ICU-acquired weakness, ICU mobility scale, length of hospitalization, and amino acid levels. The change in biceps brachii muscle thickness was -1.9% versus -11.2% in the electrical muscle stimulation and control (p = 0.007) groups, and the change in cross-sectional area was -2.7% versus -10.0% (p = 0.03). The change in rectus femoris muscle thickness was -0.9% versus -14.7% (p = 0.003) and cross-sectional area was -1.7% versus -10.4% (p = 0.04). No significant difference was found in ICU-acquired weakness (13% vs 40%; p = 0.20) and ICU mobility scale (3 vs 2; p = 0.42) between the groups. The length of hospitalization was shorter in the electrical muscle stimulation group (23 d [19-34 d] vs 40 d [26-64 d]) (p = 0.04). On day 3, the change in the branched-chain amino acid level was lower in the electrical muscle stimulation group (40.5% vs 71.5%; p = 0.04). CONCLUSIONS: In critically ill patients, electrical muscle stimulation prevented upper and lower limb muscle atrophy and attenuated proteolysis and decreased the length of hospitalization.
    Nov. 2020, Critical care medicine, 48(11) (11), e997-e1003, English, International magazine
    Scientific journal

  • 侵襲時における臓器障害連関を科学する〜基礎から臨床まで〜 侵襲時における臓器連関による糖・アミノ酸代謝制御機構の解明
    堤 理恵, 山本 智子, 中西 信人, 阪上 浩
    (一社)日本集中治療医学会, Sep. 2020, 日本集中治療医学会雑誌, 27(Suppl.) (Suppl.), 277 - 277, Japanese

  • 侵襲時における臓器障害連関を科学する〜基礎から臨床まで〜 ICU入室患者における筋萎縮と尿中タイチン濃度に関する検討
    中西 信人, 堤 理恵, 原 加奈子, 山本 智子, 綱野 祐美子, 中瀧 恵実子, 板垣 大雅, 松尾 雅文, 阪上 浩, 大藤 純
    (一社)日本集中治療医学会, Sep. 2020, 日本集中治療医学会雑誌, 27(Suppl.) (Suppl.), 277 - 277, Japanese

  • 重症患者に対する栄養療法の工夫と実践 重症患者の栄養管理におけるBIAの意義と活用の検討
    堤 理恵, 山本 智子, 中西 信人, 阪上 浩
    (一社)日本集中治療医学会, Sep. 2020, 日本集中治療医学会雑誌, 27(Suppl.) (Suppl.), 317 - 317, Japanese

  • Nobuto Nakanishi, Yuri Okamoto, Tetsuya Okahisa, Jun Oto
    Patients with acute respiratory distress syndrome (ARDS) exhibit prominent muscle atrophy and weakness. Although these patients often require deep sedation to perform lung-protective ventilation, extracorporeal membrane oxygenation (ECMO) can keep patients awake and make mobilization possible. A 60-year-old man was treated with ECMO due to ARDS. A multidisciplinary team conducted mobilization with standing on day 3. During intensive care unit (ICU) stay, catabolism was ongoing (urinary titin: 24.1-38.4 pmol/mg Cr), but the rectus femoris muscle, measured by ultrasound, moderately decreased by 5.3%, 10.8%, and 13.0% on days 3, 5, and 7, respectively, with maintained Medical Research Council score of 58-60. Diaphragm thickness remained unchanged. On day 5, he was separated from ECMO. After ambulation training, he was discharged from ICU on day 7. He returned home without prominent physical dysfunction. Our experience indicates early initiation of awake ECMO can accompany mobilization and attenuate muscle atrophy and weakness in ARDS.
    Aug. 2020, Cureus, 12(8) (8), e9926, English, International magazine

  • 原 加奈子, 堤 理恵, 中西 信人, 阪上 浩
    日本外科代謝栄養学会, Aug. 2020, 外科と代謝・栄養, 54(3) (3), 143 - 146, Japanese

  • Nobuto Nakanishi, Rie Tsutsumi, Kanako Hara, Takuya Takashima, Emiko Nakataki, Taiga Itagaki, Masafumi Matsuo, Jun Oto, Hiroshi Sakaue
    OBJECTIVES: Although skeletal muscle atrophy is common in critically ill patients, biomarkers associated with muscle atrophy have not been identified reliably. Titin is a spring-like protein found in muscles and has become a measurable biomarker for muscle breakdown. We hypothesized that urinary titin is useful for monitoring muscle atrophy in critically ill patients. Therefore, we investigated urinary titin level and its association with muscle atrophy in critically ill patients. DESIGN: Two-center, prospective observational study. SETTING: Mixed medical/surgical ICU in Japan. PATIENTS: Nonsurgical adult patients who were expected to remain in ICU for greater than 5 days. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Urine samples were collected on days 1, 2, 3, 5, and 7 of ICU admission. To assess muscle atrophy, rectus femoris cross-sectional area and diaphragm thickness were measured with ultrasound on days 1, 3, 5, and 7. Secondary outcomes included its relationship with ICU-acquired weakness, ICU Mobility Scale, and ICU mortality. Fifty-six patients and 232 urinary titin measurements were included. Urinary titin (normal range: 1-3 pmol/mg creatinine) was 27.9 (16.8-59.6), 47.6 (23.5-82.4), 46.6 (24.4-97.6), 38.4 (23.6-83.0), and 49.3 (27.4-92.6) pmol/mg creatinine on days 1, 2, 3, 5, and 7, respectively. Cumulative urinary titin level was significantly associated with rectus femoris muscle atrophy on days 3-7 (p ≤ 0.03), although urinary titin level was not associated with change in diaphragm thickness (p = 0.31-0.45). Furthermore, cumulative urinary titin level was associated with occurrence of ICU-acquired weakness (p = 0.01) and ICU mortality (p = 0.02) but not with ICU Mobility Scale (p = 0.18). CONCLUSIONS: In nonsurgical critically ill patients, urinary titin level increased 10-30 times compared with the normal level. The increased urinary titin level was associated with lower limb muscle atrophy, occurrence of ICU-acquired weakness, and ICU mortality.
    Jul. 2020, Critical care medicine, 48(9) (9), 1327 - 1333, English, International magazine
    [Refereed]
    Scientific journal

  • Nobuto Nakanishi, Yasuhiro Suzuki, Manabu Ishihara, Yoshitoyo Ueno, Natsuki Tane, Yumiko Tsunano, Taiga Itagaki, Jun Oto
    Jul. 2020, CUREUS, 12(7) (7), English
    [Refereed]
    Scientific journal

  • Yoshimi Kawahara, Nobuto Nakanishi, Keiko Nomura, Jun Oto
    Wiley, Jan. 2020, Acute Medicine & Surgery, 7(1) (1)
    Scientific journal

  • 重症病態における血中遊離アミノ酸の意義
    橘高 久未子, 山本 智子, 堤 理恵, 中西 信人, 阪上 浩
    (一社)日本病態栄養学会, Jan. 2020, 日本病態栄養学会誌, 23(Suppl.) (Suppl.), S - 57, Japanese

  • Taiga Itagaki, Nobuto Nakanishi, Takuya Takashima, Yoshitoyo Ueno, Natsuki Tane, Yumiko Tsunano, Toshiyuki Nunomura, Jun Oto
    Background : Since diaphragm passivity induces oxidative stress that leads to rapid atrophy of diaphragm, we investigated the effect of controlled ventilation on diaphragm thickness during assist-control ventilation (ACV). Methods : Previously, we measured end-expiratory diaphragm thickness (Tdiee) of patients mechanically ventilated for more than 48 hours on days 1, 3, 5 and 7 after the start of ventilation. We retrospectively investigated the proportion of controlled ventilation during the initial 48-hour ACV (CV48%). Patients were classified according to CV48% : Low group, less than 25% ; High group, higher than 25%. Results : Of 56 patients under pressure-control ACV, Tdiee increased more than 10% in 6 patients (11%), unchanged in 8 patients (14%) and decreased more than 10% in 42 patients (75%). During the first week of ventilation, Tdiee decreased in both groups : Low (difference, -7.4% ; 95% confidence interval [CI], -10.1% to -4.6% ; p < 0.001) and High group (difference, -5.2% ; 95% CI, -8.5% to -2.0% ; p = 0.049). Maximum Tdiee variation from baseline did not differ between Low (-15.8% ; interquartile range [IQR], -22.3 to -1.5) and High group (-16.7% ; IQR, -22.6 to -11.1, p = 0.676). Conclusions : During ACV, maximum variation in Tdiee was not associated with proportion of controlled ventilation higher than 25%. J. Med. Invest. 67 : 332-337, August, 2020.
    2020, The journal of medical investigation : JMI, 67(3.4) (3.4), 332 - 337, English, Domestic magazine
    Scientific journal

  • Nobuto Nakanishi
    Critically ill patients exhibit prominent muscle atrophy, which occurs rapidly after ICU admission and leads to poor clinical outcomes. The extent of atrophy differs among muscles as follows: upper limb: 0.7%-2.4% per day, lower limb: 1.2%-3.0% per day, and diaphragm 1.1%-10.9% per day. This atrophy is caused by numerous risk factors such as inflammation, immobilization, nutrition, hyperglycemia, medication, and mechanical ventilation. Muscle atrophy should be monitored noninvasively by ultrasound at the bedside. Ultrasound can assess muscle mass in most patients, although physical assessment is limited to almost half of all critically ill patients due to impaired consciousness. Important strategies to prevent muscle atrophy are physical therapy and electrical muscular stimulation. Electrical muscular stimulation is especially effective for patients with limited physical therapy. Regarding diaphragm atrophy, mechanical ventilation should be adjusted to maintain spontaneous breathing and titrate inspiratory pressure. However, the sufficient timing and amount of nutritional intervention remain unclear. Further investigation is necessary to prevent muscle atrophy and improve long-term outcomes. J. Med. Invest. 67 : 1-10, February, 2020.
    Jan. 2020, The journal of medical investigation : JMI, Vol.64(No.1, 2) (No.1, 2), English
    [Refereed]
    Scientific journal

  • Nobuto Nakanishi, Jun Oto, Yoshitoyo Ueno, Emiko Nakataki, Taiga Itagaki, Masaji Nishimura
    Background: Diaphragm atrophy is observed in mechanically ventilated patients. However, the atrophy is not investigated in other respiratory muscles. Therefore, we conducted a two-center prospective observational study to evaluate changes in diaphragm and intercostal muscle thickness in mechanically ventilated patients. Methods: Consecutive adult patients who were expected to be mechanically ventilated longer than 48 h in the ICU were enrolled. Diaphragm and intercostal muscle thickness were measured on days 1, 3, 5, and 7 with ultrasonography. The primary outcome was the direction of change in muscle thickness, and the secondary outcomes were the relationship of changes in muscle thickness with patient characteristics. Results: Eighty patients (54 males and 26 females; mean age, 68 ± 14 years) were enrolled. Diaphragm muscle thickness decreased, increased, and remained unchanged in 50 (63%), 15 (19%), and 15 (19%) patients, respectively. Intercostal muscle thickness decreased, increased, and remained unchanged in 48 (60%), 15 (19%), and 17 (21%) patients, respectively. Decreased diaphragm or intercostal muscle thickness was associated with prolonged mechanical ventilation (median difference (MD), 3 days; 95% CI (confidence interval), 1-7 and MD, 3 days; 95% CI, 1-7, respectively) and length of ICU stay (MD, 3 days; 95% CI, 1-7 and MD, 3 days; 95% CI, 1-7, respectively) compared with the unchanged group. After adjusting for sex, age, and APACHE II score, they were still associated with prolonged mechanical ventilation (hazard ratio (HR), 4.19; 95% CI, 2.14-7.93 and HR, 2.87; 95% CI, 1.53-5.21, respectively) and length of ICU stay (HR, 3.44; 95% CI, 1.77-6.45 and HR, 2.58; 95% CI, 1.39-4.63, respectively) compared with the unchanged group. Conclusions: Decreased diaphragm and intercostal muscle thickness were frequently seen in patients under mechanical ventilation. They were associated with prolonged mechanical ventilation and length of ICU stay. Trial registration: UMIN000031316. Registered on 15 February 2018.
    Dec. 2019, Journal of intensive care, 7, 56 - 56, English, International magazine
    [Refereed]

  • Nobuto Nakanishi, Rie Tsutsumi, Yoshihiro Okayama, Takuya Takashima, Yoshitoyo Ueno, Taiga Itagaki, Yasuo Tsutsumi, Hiroshi Sakaue, Jun Oto
    Background: Skeletal muscle atrophy commonly occurs in critically ill patients, and decreased muscle mass is associated with worse clinical outcomes. Muscle mass can be assessed using various tools, including ultrasound and bioelectrical impedance analysis (BIA). However, the effectiveness of muscle mass monitoring is unclear in critically ill patients. This study was conducted to compare ultrasound and BIA for the monitoring of muscle mass in critically ill patients. Methods: We recruited adult patients who were expected to undergo mechanical ventilation for > 48 h and to remain in the intensive care unit (ICU) for > 5 days. On days 1, 3, 5, 7, and 10, muscle mass was evaluated using an ultrasound and two BIA devices (Bioscan: Malton International, England; Physion: Nippon Shooter, Japan). The influence of fluid balance was also evaluated between each measurement day. Results: We analyzed 93 images in 21 patients. The age of the patients was 69 (interquartile range, IQR, 59-74) years, with 16 men and 5 women. The length of ICU stay was 11 days (IQR, 9-25 days). The muscle mass, monitored by ultrasound, decreased progressively by 9.2% (95% confidence interval (CI), 5.9-12.5%), 12.7% (95% CI, 9.3-16.1%), 18.2% (95% CI, 14.7-21.6%), and 21.8% (95% CI, 17.9-25.7%) on days 3, 5, 7, and 10 (p <  0.01), respectively, with no influence of fluid balance (r = 0.04, p = 0.74). The muscle mass did not decrease significantly in both the BIA devices (Bioscan, p = 0.14; Physion, p = 0.60), and an influence of fluid balance was observed (Bioscan, r = 0.37, p <  0.01; Physion, r = 0.51, p <  0.01). The muscle mass assessment at one point between ultrasound and BIA was moderately correlated (Bioscan, r = 0.51, p <  0.01; Physion, r = 0.37, p <  0.01), but the change of muscle mass in the same patient did not correlate between these two devices (Bioscan, r = - 0.05, p = 0.69; Physion, r = 0.23, p = 0.07). Conclusions: Ultrasound is suitable for sequential monitoring of muscle atrophy in critically ill patients. Monitoring by BIA should be carefully interpreted owing to the influence of fluid change. Trial registration: UMIN000031316. Retrospectively registered on 15 February 2018.
    Dec. 2019, Journal of intensive care, 7, 61 - 61, English, International magazine
    [Refereed]
    Scientific journal

  • エビデンスを超えた外科・集中治療と代謝栄養 重症病態における代謝解析からみるアミノ酸の新しい意義
    堤 理恵, 山本 智子, 中西 信人, 阪上 浩
    日本外科代謝栄養学会, Jun. 2019, 外科と代謝・栄養, 53(3) (3), 75 - 75, Japanese
    [Refereed]

  • Electrocardiogram interpretation by paramedics improve reperfusion time in acute coronary syndrome
    Nobuto Nakanishi, Morimichi Setsuda
    Jun. 2019, Journal of Japanese Society for Emergency Medicine, Japanese
    [Refereed]
    Scientific journal

  • Long-term mobilization by a multidisciplinary team liberated a case of an acute respiratory distress syndrome (ARDS) from prolonged mechanical ventilation.
    Nobuto Nakanishi, Takashima Takuya, Nishikawa Marie, Okahisa Tetsuya, Doi Satoshi, Nomura Keiko, Fukuoka Chika, Kawahara Yoshimi, Yoshida Naomi, Nakayama Shizu, Emiko Nakataki, Taiga Itagaki, Jun Oto
    Apr. 2019, Shikoku Acta Medica, Vol.75(No.3, 4) (No.3, 4), Japanese
    [Refereed]
    Scientific journal

  • Nobuto Nakanishi
    Bacterial contamination of inner surfaces of the circuit after high-flow oxygen therapy was relatively high.
    Feb. 2019, Respiratory care, Vol.64(No.5) (No.5), 545 - 549, English
    [Refereed]
    Scientific journal

  • 敗血症における代謝破綻と血中遊離アミノ酸の意義
    堤 理恵, 山本 智子, 中西 信人, 阪上 浩
    (一社)日本集中治療医学会, Feb. 2019, 日本集中治療医学会雑誌, 26(Suppl.) (Suppl.), [O75 - 1], Japanese

  • Nobuto Nakanishi
    In spontaneously breathing subjects with tracheostomy, an heated-and-humidified high-flow system achieved higher absolute humidity than did an HME.
    Sep. 2018, Respiratory care, Vol.64(No.2) (No.2), 130 - 135, English
    [Refereed]
    Scientific journal

  • Nobuto Nakanishi
    After cardiac surgery, HFNC oxygen therapy at 2 L/kg/min improved thoraco-abdominal synchrony and decreased breathing frequency in pediatric subjects. (Clinical trial registration: UMIN000023426.).
    Sep. 2018, Respiratory care, Vol.64(No.1) (No.1), 10 - 16, English
    [Refereed]
    Scientific journal

  • Nobuto Nakanishi
    Reverse triggering is respiratory entrainment triggered by the ventilator especially seen among heavily sedated patients. We confirmed reverse triggering induced by auto-triggering in lightly sedated patient through an esophageal pressure monitoring. The reverse triggering frequently caused breath stacking with increased tidal volume. Physicians should be aware, even at an optimal level of sedation, that reverse triggering can develop, possibly caused by auto-triggering.
    Jul. 2018, Journal of intensive care, Vol.6, English
    [Refereed]
    Scientific journal

  • Nobuto Nakanishi, Jun Oto, Rie Tsutsumi, Marina Iuchi, Mutsuo Onodera, Masaji Nishimura
    Springer Verlag, Feb. 2018, Intensive Care Medicine, 44(2) (2), 263 - 264, English
    [Refereed]
    Scientific journal

  • Nobuto Nakanishi, 森 翔, 赤尾 希美, 田村 佳久, 藤井 幸治, 馬路 智昭, 楠田 司, 東川 正宗
    背景:小児虫垂炎は穿孔に至りやすく，穿孔性虫垂炎の診断は容易ではない．穿孔の有無により臨床経過が異なるため，穿孔の判別は重要であるが，術前の穿孔の判別は臨床所見から経験的に行われている．目的:虫垂穿孔を予測するために経験的に用いている臨床所見が，穿孔の判別に有用であることを明らかとする．方法:2004年から2014年に当院で手術が施行された虫垂炎患者のうち15歳以下の135(穿孔29，非穿孔106)人を対象とした．穿孔例と非穿孔例の患者背景，自覚症状，身体所見および検査所見について二項ロジスティック回帰分析を用いて比較検討した．結果:穿孔性虫垂炎は非穿孔例に比べて有症状日数が長く，反跳痛陰性，筋性防御陽性，CRPが高値であった．結論:従来から経験的に用いられてきた虫垂穿孔を予測する臨床所見は穿孔の判別に有用であった．(著者抄録)
    Oct. 2017, 日本小児救急医学会雑誌, Vol.16(No.3) (No.3), 403 - 405, Japanese
    [Refereed]
    Scientific journal

  • 血液培養検体採取時の滅菌手袋着用がコンタミネーションに及ぼす影響 予備的調査
    Nobuto Nakanishi, 水野 光規, 説田 守道
    血液培養検査では，意図せぬ汚染菌の混入(コンタミネーション)を防ぐために無菌操作が重要である．無菌操作の一つである検体採取時の滅菌手袋着用については，常時着用の必要性は確立されていない．滅菌手袋着用の必要性を検討するために，採血時に滅菌手袋を着用する事が未滅菌手袋着用による場合に比してコンタミネーション率を低減させるかどうか，手袋着用以外の因子も検討しながら無作為割り付け試験を実施した．滅菌手袋着用群50例，未滅菌手袋着用群50例の結果では，滅菌手袋着用群で4例(8.0
    [日本救急医学会中部地方会], Nov. 2016, 日本救急医学会中部地方会誌, Vol.12, 1 - 3, Japanese
    [Refereed]
    Scientific journal

  • 田村 佳久, Nobuto Nakanishi
    64歳男性．健診でのバリウムによる上部消化管造影の翌朝，腹痛が出現し前医を受診，入院となるも同日夜に全身状態が悪化したため，著者らの施設へ紹介となった．臨床経過およびCT所見よりバリウム腹膜炎から生じたS状結腸穿孔と診断され，緊急手術となった．手術は穿孔部を中心にS状結腸を部分切除して人工肛門を造設したが，術中よりseptic shockの状態で，ICU入室後にDICと診断後は人工呼吸管理下で集学的治療を開始した．その結果，治療により全身状態は改善傾向にあったものの，第2病日目に左側腹部にGrey Turner徴候が出現，左側腹部腹壁は徐々に壊死を生じた．そこで，第10病日目に左側腹部の壊死部を切開したところ，腹壁全層の広範な壊死が疑われたため，第18病日に全身麻酔下で左側腹部の左下部肋骨から左腎臓までに至る腹壁全層の壊死組織を除去し，VPCによる閉腹を施行した．以後，2日おきにVPCの交換を行い，第48病日に植皮術によるplanned ventral herniaとして閉創した．植皮後の経過は良好で，最終的に患者は第70病日目に独歩退院となった．
    The Japanese Society of Intensive Care Medicine, May 2016, 日本集中治療医学会雑誌, Vol.23(No.3) (No.3), 341 - 342, Japanese
    [Refereed]
    Scientific journal

  • Nobuto Nakanishi, Tadahiro Goto, Tomoya Ikeda, Atsunobu Kasai
    2016, BMJ OPEN, 6(2) (2), English
    [Refereed]
    Scientific journal

  • 当院で経験したエイ刺傷の7例 出血性ショックを来した2例を中心に
    伊藤 拓也, Nobuto Nakanishi, 説田 守道
    エイによる刺傷は一般に致命傷となることは少ないとされている．しかし重篤な臓器損傷や感染症などによる死亡例も報告されており慎重な初期対応が必要である．我々は2014年6月から9月の間に7例のエイ刺傷例を経験し，うち2例では大量出血による入院治療が必要となり，初期対応の重要性をあらためて認識する機会となった．エイ刺傷に関する国内報告例は少なく貴重な症例と考えられた．(著者抄録)
    [日本救急医学会中部地方会], Dec. 2015, 日本救急医学会中部地方会誌, Vol.11, 41 - 43, Japanese
    [Refereed]
    Scientific journal

  • Nobuto Nakanishi, Yoshitoyo Ueno, Hideaki Imanaka, Masaji Nishimura
    Jul. 2012, Journal of the Japanese Society of Intensive Care Medicine, Vol.19(No.3) (No.3), 423 - 424
    [Refereed]
    Scientific journal

  • Yoshitoyo Ueno, Nobuto Nakanishi, Jun Oto, Hideaki Imanaka, Masaji Nishimura
    Nov. 2011, RESPIRATORY CARE, 56(11) (11), 1758 - 1764, English
    [Refereed]
    Scientific journal

  • Nobuto Nakanishi

■ MISC
  • 【もう迷わない!ICUでの考え方、動き方 薬剤や機器の使い方、循環・呼吸管理まで、全体像を掴めるICU研修の地図】(第1章)総論 ICUとはどんなところ? ICUで行っている理学療法について教えてください。
    中西 信人
    (株)羊土社, Oct. 2023, レジデントノート, 25(11) (11), 1924 - 1931, Japanese
    Introduction commerce magazine

  • 【徹底ガイド 栄養療法-研修医からの質問380-】エネルギー・蛋白の投与量 異化亢進に伴う筋蛋白崩壊を止められるか?
    中西 信人
    (株)総合医学社, Oct. 2023, 救急・集中治療, 35(3) (3), 723 - 728, Japanese

  • 井上 茂亮, 中西 信人, 藤浪 好寿, 杉山 隼, 大野 雄康, 小谷 穣治
    (一社)日本Shock学会, Jul. 2023, Shock: 日本Shock学会雑誌, 37(1) (1), 61 - 61, Japanese

  • 杉山 隼, 井上 茂亮, 中西 信人, 藤浪 好寿, 齋藤 雅史, 大野 雄康, 戸田 太, 城月 徹, 塩谷 壮史, 小谷 穣治
    (一社)日本Shock学会, Jul. 2023, Shock: 日本Shock学会雑誌, 37(1) (1), 99 - 99, Japanese

  • 【FIX PICS 集中治療後症候群の予防と治療】PICSを防ぐ/治す 早期リハビリテーション,神経筋電気刺激療法
    中西 信人
    (株)へるす出版, Jun. 2023, 救急医学, 47(6) (6), 685 - 691, Japanese

  • 徹底討論!ICU-AWの正体は一体何なのか? 高齢敗血症患者ではPICS発症率が上昇し,長期予後が不良である 単施設前向き観察研究
    井上 茂亮, 中西 信人, 大野 雄康, 小谷 穣治
    (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), S297 - S297, Japanese

  • PICSのエビデンスをもとめて 高齢敗血症患者ではPICS発症率は上昇し長期予後は不良である 単施設前向き観察研究
    井上 茂亮, 中西 信人, 大野 雄康, 小谷 穣治
    (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), S328 - S328, Japanese

  • ICU長期入室患者に対する振動療法の有効性の検証
    土肥 智史, 中西 信人, 野村 慶子, 島 麻美子, 河原 良美, 白石 美恵, 大藤 純
    (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), S826 - S826, Japanese

  • Dr中西・会長曷川の離床面白エビデンス 2023学会スペシャル
    中西 信人, 曷川 元
    日本離床学会, Jun. 2023, 早期離床, 9(2) (2), 2 - 2, Japanese

  • 中西 信人
    日本外科代謝栄養学会, Apr. 2023, 外科と代謝・栄養, 57(2) (2), 48 - 52, Japanese

  • 中西 信人, 小谷 穣治
    医学図書出版(株), Mar. 2023, ICUとCCU, 47(3) (3), 191 - 196, Japanese

  • COVID-19感染拡大期における搬送先での医療廃棄物処理システムが救急隊業務効率と院外心肺停止患者予後へ与える影響
    杉山隼, 杉山隼, 井上茂亮, 高山和之, 中西信人, 藤浪好寿, 齋藤雅史, 大野雄康, 小谷穣治
    2023, 日本病院前救急診療医学会誌, 18(1) (1)

  • 頸部リンパ節を除去した敗血症マウスでは,脳へのT細胞の浸潤が抑制され,敗血症に伴う精神障害の回復が遅れる
    齋藤雅史, 齋藤雅史, 大野雄康, 中西信人, 小谷穣治
    2023, 日本エンドトキシン・自然免疫研究会プログラム・抄録集, 28th

  • C188-9, a specific inhibitor of STAT3 signaling, ameliorates thermal burn-induced skeletal muscle wasting in mice
    大野雄康, 大野雄康, 斎藤雅史, 坂本多穂, 中西信人, 井上茂亮, 小谷穣治
    2023, 日本麻酔科学会学術集会(Web), 70th

  • マウス敗血症モデルの骨格筋萎縮と重症度にOncostatin Mが関連する
    大野雄康, 斎藤雅史, 杉山隼, 高山和之, 中西信人, 井上茂亮, 小谷穣治
    2023, 日本エンドトキシン・自然免疫研究会プログラム・抄録集, 28th

  • 重症病態における栄養療法～ベッドサイドで感じるものは何か、考えることは何か 亜急性期におけるカロリーおよびタンパク質の経口摂取不足は敗血症後のPICS発症率と関連する 単一施設の前向き観察研究
    井上 茂亮, 中西 信人, 藤浪 好寿, 大野 雄康, 小谷 穣治
    日本外科代謝栄養学会, 2023, 外科と代謝・栄養, 57(3) (3), 90 - 90, Japanese

  • 敗血症による骨格筋萎縮と好中球の動態
    中西 信人, 大野 雄康, 井上 茂亮, 小谷 穣治
    日本外科代謝栄養学会, 2023, 外科と代謝・栄養, 57(3) (3), 158 - 158, Japanese

  • 中西 信人, 小谷 穣治
    日本外科代謝栄養学会, Dec. 2022, 外科と代謝・栄養, 56(6) (6), 229 - 234, Japanese

  • 早期回復のために神経筋電気刺激療法はどのように使用するべきか? 上肢における神経筋電気刺激療法
    中西 信人
    (一社)日本集中治療医学会, Nov. 2022, 日本集中治療医学会雑誌, 29(Suppl.1) (Suppl.1), 310 - 310, Japanese

  • 敗血症/敗血症性ショックの基礎研究 敗血症モデルマウスにおける前脛骨筋、横隔膜および心筋の萎縮に関する検討
    中西 信人, 斎藤 雅史, 大野 雄康, 森山 直紀, 宮崎 勇輔, 藤浪 好寿, 井上 茂亮, 小谷 穣治
    (一社)日本集中治療医学会, Nov. 2022, 日本集中治療医学会雑誌, 29(Suppl.1) (Suppl.1), 333 - 333, Japanese

  • ICU入室時の筋エコーによるサルコペニアの評価
    新井 悠太, 中西 信人, 原田 雅史, 大藤 純
    (一社)日本集中治療医学会, Nov. 2022, 日本集中治療医学会雑誌, 29(Suppl.1) (Suppl.1), 670 - 670, Japanese

  • コロナ波は救急活動における不能時間とレスポンスタイムを延長させ,院外心肺停止患者の予後を増悪させる
    杉山 隼, 井上 茂亮, 斎藤 雅史, 中西 信人, 大野 雄康, 藤浪 好寿, 戸田 太, 城月 徹, 塩谷 壮史, 小谷 穣治
    (一社)日本救急医学会, Oct. 2022, 日本救急医学会雑誌, 33(10) (10), 837 - 837, Japanese

  • 中西 信人
    日本外科代謝栄養学会, Jun. 2022, 外科と代謝・栄養, 56(3) (3), 48 - 48, Japanese

  • 藤浪 好寿, 斎藤 雅史, 大野 雄康, 中西 信人, 森山 直紀, 宮崎 勇輔, 切田 学, 井上 茂亮, 小谷 穣治
    日本外科代謝栄養学会, Jun. 2022, 外科と代謝・栄養, 56(3) (3), 91 - 91, Japanese

  • 藤浪 好寿, 斎藤 雅史, 大野 雄康, 中西 信人, 森山 直紀, 宮崎 勇輔, 井上 茂亮, 小谷 穣治
    (一社)日本Shock学会, May 2022, Shock: 日本Shock学会雑誌, 36(1) (1), 27 - 27, Japanese

  • 中西 信人, 斎藤 雅史, 大野 雄康, 森山 直紀, 宮崎 勇輔, 井上 茂亮, 小谷 穣治
    (一社)日本Shock学会, May 2022, Shock: 日本Shock学会雑誌, 36(1) (1), 35 - 35, Japanese

  • 河合 佑亮, 一二三 亨, 小幡 賢吾, 飯田 有輝, 畠山 淳司, 山川 一馬, 中村 謙介, 卯野木 健, 川上 大裕, 中西 信人, 劉 啓文, 新谷 歩, 井上 茂亮, 西田 修, 日本集中治療医学会PICS対策・生活の質改善検討委員会
    (一社)日本集中治療医学会, Mar. 2022, 日本集中治療医学会雑誌, 29(2) (2), 165 - 176, Japanese

  • Frailtyと心臓手術・血行再建:Frail評価や周術期管理(リハビリ・栄養)・術式選択になにが重要か 心臓血管外科術後の筋萎縮評価と予防
    中西 信人
    (NPO)日本心臓血管外科学会, Mar. 2022, 日本心臓血管外科学会学術総会抄録集, 52回, PD10 - 6, Japanese

  • 高齢者におけるPost-intensive care syndrome/ICU-acquired weaknessとその対策
    井上茂亮, 斎藤雅史, 宮崎勇輔, 大野雄康, 中西信人, 森山直紀, 藤浪好寿, 小谷穣治
    2021, 外科と代謝・栄養, 55(4) (4)

  • 転倒による大腿骨骨折に合併する外傷の検討
    石澤嶺, 石澤嶺, 中西信人, 中西信人, 伊藤ほのか, 劉啓文, 劉啓文, 園生智弘, 園生智弘, 中村謙介, 後藤匡啓
    2021, 日本救急医学会雑誌, 32(12 (Web)) (12 (Web))

  • 原 加奈子, 堤 理恵, 中西 信人, 三島 優奈, 待田 京香, 黒田 雅士, 大藤 純, 阪上 浩
    徳島医学会, Dec. 2020, 四国医学雑誌, 76(5-6) (5-6), 267 - 272, Japanese

  • 重症患者における筋萎縮と尿中タイチン濃度に関する検討
    原 加奈子, 堤 理恵, 三島 優奈, 待田 京香, 阪上 浩, 中西 信人, 大藤 純
    徳島医学会, Dec. 2020, 四国医学雑誌, 76(5-6) (5-6), 341 - 341, Japanese

  • 高島 拓也, 西川 真理恵, 上野 義豊, 中西 信人, 田根 なつ紀, 綱野 祐美子, 板垣 大雅, 大藤 純
    徳島医学会, Dec. 2020, 四国医学雑誌, 76(5-6) (5-6), 307 - 310, Japanese

  • 中西 信人, 小出 静代, 橋爪 太, 大藤 純
    徳島医学会, Dec. 2020, 四国医学雑誌, 76(5-6) (5-6), 327 - 330, Japanese

  • 中西 信人
    医学図書出版(株), Oct. 2020, ICUとCCU, 44(10) (10), 627 - 636, Japanese

  • 重症患者におけるエネルギー代謝動態の解析
    井内 茉莉奈, 堤 理恵, 中西 信人, 山本 智子, 田中 志歩, 大藤 純, 中瀧 恵実子, 小野寺 睦雄, 阪上 浩, 西村 匡司
    (一社)日本集中治療医学会, Feb. 2018, 日本集中治療医学会雑誌, 25(Suppl.) (Suppl.), [O3 - 1], Japanese

  • 疾患の体組成と栄養管理 重症患者における体組成評価の有用性と限界
    堤 理恵, 井内 茉莉奈, 瀬部 真由, 中西 信人, 西村 匡司, 阪上 浩
    (一社)日本病態栄養学会, Jan. 2018, 日本病態栄養学会誌, 21(Suppl.) (Suppl.), S - 22, Japanese

  • 重症病態におけるエネルギー代謝倹約メカニズムの解明
    井内 茉莉奈, 堤 理恵, 山本 智子, 田中 志歩, 中西 信人, 原田 永勝, 大藤 純, 西村 匡司, 阪上 浩
    (一社)日本病態栄養学会, Jan. 2018, 日本病態栄養学会誌, 21(Suppl.) (Suppl.), S - 73, Japanese

  • 堤 理恵, 井内 茉莉奈, 中西 信人, 西村 匡司, 阪上 浩
    日本外科代謝栄養学会, Aug. 2017, 外科と代謝・栄養, 51(4) (4), 145 - 150, Japanese

  • 超音波によるICU患者の上肢・下肢筋萎縮評価
    中西 信人, 堤 理恵, 大藤 純, 井内 茉莉奈, 上野 義豊, 西川 真理恵, 綱野 祐美子, 中瀧 恵実子, 小野寺 睦雄, 西村 匡司
    (一社)日本集中治療医学会, Feb. 2017, 日本集中治療医学会雑誌, 24(Suppl.) (Suppl.), DP121 - 6, Japanese

  • 重症患者における栄養投与開始時期と体組成変化の関連性の検討
    井内 茉莉奈, 堤 理恵, 中西 信人, 大藤 純, 中瀧 恵実子, 小野寺 睦雄, 阪上 浩, 西村 匡司
    (一社)日本集中治療医学会, Feb. 2017, 日本集中治療医学会雑誌, 24(Suppl.) (Suppl.), O31 - 4, Japanese

  • 重症患者の栄養投与開始時期による体組成の継時的変化の検討
    井内 茉莉奈, 堤 理恵, 中西 信人, 大藤 純, 瀬部 真由, 松島 里那, 梶川 美百合, 原田 永勝, 西村 匡司, 阪上 浩
    (一社)日本病態栄養学会, Dec. 2016, 日本病態栄養学会誌, 20(Suppl.) (Suppl.), S - 125, Japanese

  • 救急隊による病院前心電図判断は急性心筋梗塞への対応時間を短縮するか
    中西 信人, 水野 光規, 説田 守道, Nobuto NAKANISHI
    日本赤十字社医学会, 01 Sep. 2014, 日赤医学 = The Japanese Red Cross Medical Journal, 66(1) (1), 236 - 236, Japanese

  • 血液培養手技における滅菌手袋の必要性についての研究
    中西 信人, 水野 光規, 説田 守道, Nobuto NAKANISHI
    日本赤十字社医学会, 01 Sep. 2014, 日赤医学 = The Japanese Red Cross Medical Journal, 66(1) (1), 277 - 277, Japanese

■ Books And Other Publications
  • もう迷わない!ICUでの考え方、動き方 : 薬剤や機器の使い方、循環・呼吸管理まで、全体像を摑めるICU研修の地図
    中西信人
    Joint work, 羊土社, Oct. 2023, Japanese, ISBN: 9784758127059

  • 敗血症―感染症と臓器障害への対応＜救急・集中治療アドバンス＞
    松田, 直之
    Joint work, 中山書店, Jan. 2023, Japanese, ISBN: 4521743366

  • 症例から学ぶPICSの予防と早期介入
    中西信人
    Joint work, 日本医事新報社, Oct. 2022, Japanese, ISBN: 9784784959716

  • 神経麻酔と神経集中治療の基礎と実践
    川口, 昌彦, 飯田, 宏樹
    Joint work, 日本医事新報社, Jun. 2022, Japanese, ISBN: 9784784959396

  • ＩＣＵとＣＣＵ 集中治療医学 Ｖｏｌ．４４Ｎｏ．１０（２０２０−１０） ＰＡＤＩＳガイドライン−わが国の現状と未来への展望
    中西信人
    Joint work, ICUにおけるリハビリの現状と未来への展望, Oct. 2020

  • 集中治療医学レビュー : 最新主要文献と解説 2020-'21
    大塚, 将秀, 佐藤, 直樹, 松田, 直之, 岡元, 和文, 中西 信人, 西村 匡司
    III章 ICU特有の病態・合併症 ARDSの病態と治療, 総合医学社, Apr. 2020, Japanese, ISBN: 9784883786596

  • Hemodynamic Assessment in Intensive Care Noninvasive Monitoring
    Nobuto Nakanishi, Masaji Nishimura
    Igaku Tosho Shuppan LTD., Mar. 2019, Japanese

  • 急性呼吸窮迫症候群(ARDS)患者の人工呼吸法とケアを教えて?
    Nobuto Nakanishi, 西村 匡司
    Jul. 2017, Japanese

■ Lectures, oral presentations, etc.
  • シンポジウム：重症患者における電気刺激療法（EMS）：適応と可能性
    中西信人
    第43回⽇本呼吸療法医学会学術集会, Jul. 2021
    [Invited]
    Nominated symposium

  • Approach to prevent muscle atrophy
    日本離床医学会, May 2021
    [Invited]

  • Muscle mass assessment in the acute phase
    中西信人
    日本離床医学会, Mar. 2021
    [Invited]

  • Muscle atrophy zero project: the project to prevent PICS
    中西信人
    Feb. 2021
    Public symposium

  • Upper and lower limb muscle atrophy are associated with mortality and impaired physical functions in critically ill patients
    中西信人
    シンポジウム：重症患者の上下肢筋萎縮は院内死亡・身体機能障害と関連する, Feb. 2021
    Public symposium

  • シンポジウム：ICUにおけるサルコペニア対策 私たちの取り組み ICU入室患者の上下肢電気刺激療法 2施設前向き無作為化比較試験
    中西 信人, 大藤 純, 川下 陽一郎, 板垣 大雅, 中瀧 恵実子, 西村 匡司
    日本集中治療医学会雑誌, Feb. 2019, Japanese, Domestic conference
    Public symposium

  • 小児人工呼吸患者の鎮痛・鎮静レベルの評価 COMFORT-Bスケールの使用経験
    Natsuki Tane, 高島 拓也, 鈴木 康大, Yoshitoyo Ueno, Nobuto Nakanishi, 西川 真理恵, Nao Okuda, Emiko Nakataki, Taiga Itagaki, Jun Oto
    Journal of the Japanese Society of Intensive Care Medicine, Feb. 2019, (一社)日本集中治療医学会, Domestic conference

  • ICU患者における上下肢筋萎縮の定性的評価 超音波画像のテクスチャ解析
    白神 壮洋, Nobuto Nakanishi, Hiroyuki Nodera, Yoshitoyo Ueno, Taiga Itagaki, Emiko Nakataki, Jun Oto
    Journal of the Japanese Society of Intensive Care Medicine, Feb. 2019, Japanese, (一社)日本集中治療医学会, Domestic conference

  • 補助-調節換気における調節呼吸が横隔膜厚の変化に与える影響
    大井 貴裕, Taiga Itagaki, Nobuto Nakanishi, Jun Oto
    Journal of the Japanese Society of Intensive Care Medicine, Feb. 2019, Japanese, (一社)日本集中治療医学会, Domestic conference

  • High Flow Nasal Cannulaの横隔膜機能に対する効果
    高島 拓也, Nobuto Nakanishi, 鈴木 康大, Yoshitoyo Ueno, 西川 真理恵, Natsuki Tane, Nao Okuda, Emiko Nakataki, Taiga Itagaki, Jun Oto
    Journal of the Japanese Society of Intensive Care Medicine, Feb. 2019, Japanese, (一社)日本集中治療医学会, Domestic conference

  • 免疫不全患者の急性呼吸不全における呼吸療法 HFNCとNPPVの比較
    高島 拓也, Taiga Itagaki, 鈴木 康大, Yoshitoyo Ueno, Nobuto Nakanishi, 西川 真理恵, Natsuki Tane, Nao Okuda, Emiko Nakataki, Jun Oto
    Journal of the Japanese Society of Intensive Care Medicine, Feb. 2019, Japanese, (一社)日本集中治療医学会, Domestic conference

  • 敗血症における代謝破綻と血中遊離アミノ酸の意義
    Rie Tsutsumi, 山本 智子, Nobuto Nakanishi, Hiroshi Sakaue
    Journal of the Japanese Society of Intensive Care Medicine, Feb. 2019, Japanese, (一社)日本集中治療医学会, Domestic conference

  • ウイルス性気管支肺炎によりair leak syndromeを呈し2度のVenovenous ECMOを要した小児の一例
    西川 真理恵, 高島 拓也, 鈴木 康大, Yoshitoyo Ueno, Nobuto Nakanishi, Natsuki Tane, Nao Okuda, Emiko Nakataki, Taiga Itagaki, Jun Oto
    日本集中治療医学会雑誌, Feb. 2019, Japanese, (一社)日本集中治療医学会, Domestic conference

  • 重症患者における血漿中オレキシン濃度と急性脳機能障害との関連
    Jun Oto, Yoshitoyo Ueno, Nobuto Nakanishi, 高島 拓也, Taiga Itagaki
    Journal of the Japanese Society of Intensive Care Medicine, Feb. 2019, Japanese, (一社)日本集中治療医学会, Domestic conference

  • チューブリークに起因したリバーストリガを認めたARDS症例
    Taiga Itagaki, Yoshitoyo Ueno, Nobuto Nakanishi, Nao Okuda, Emiko Nakataki, Jun Oto
    日本集中治療医学会雑誌, Feb. 2019, Japanese, (一社)日本集中治療医学会, Domestic conference

  • 重症ARDSによる長期人工呼吸中に廃用性高Ca血症を呈した一症例
    高島 拓也, 西川 真理恵, 鈴木 康大, 上野 義豊, 中西 信人, 田根 なつ紀, 奥田 奈緒, 中瀧 恵実子, 板垣 大雅, 大藤 純
    日本救急医学会雑誌, Oct. 2018, Japanese, Domestic conference

  • 気管チューブの固定により屈曲し内腔の狭窄を起こした一症例
    田根 なつ紀, 高島 拓也, 鈴木 康大, 上野 義豊, 中西 信人, 西川 真理恵, 綱野 祐美子, 奥田 菜緒, 中瀧 恵実子, 板垣 大雅, 大藤 純
    日本救急医学会雑誌, Oct. 2018, Japanese, Domestic conference

  • Heated and humidified high-flow system for tracheostomized patients with spontaneous breathing.
    Nobuto Nakanishi, Jun Oto, Taiga Itagaki, Emiko Nakataki, Mutsuo Onodera, Masaji Nishimura
    47th Society of Critical Care Medicine (SCCM) Critical Care Congress, Feb. 2018, Japanese, San Antonio, International conference

  • シンポジウム:ICU-AWの病態生理とその対策 up to date「人工呼吸管理を要するICU患者の横隔膜萎縮」
    Nobuto Nakanishi, Jun Oto, Masaji Nishimura, Taiga Itagaki, Emiko Nakataki, Mutsuo Onodera, Masaji Nishimura
    第45回日本集中治療医学会学術集会, Feb. 2018, Japanese, Chiba, Domestic conference

  • 重症患者におけるエネルギー代謝動態の解析．
    井内 茉莉奈, Rie Tsutsumi, Nobuto Nakanishi, 山本 智子, 田中 志歩, Jun Oto, Emiko Nakataki, Mutsuo Onodera, Hiroshi Sakaue, Masaji Nishimura
    第45回日本集中治療医学会学術集会, Feb. 2018, Japanese, Chiba, Domestic conference

  • 脳卒中患者における睡眠時呼吸障害に対するHigh Flow Nasal Cannulaの効果について．
    鈴木 康大, Jun Oto, Nobuto Nakanishi, Natsuki Tane, Nao Okuda, Yumiko Tsunano, Emiko Nakataki, Taiga Itagaki, Mutsuo Onodera, Masaji Nishimura
    第45回日本集中治療医学会学術集会, Feb. 2018, Japanese, Chiba, Domestic conference

  • 当院ICUにおける低血小板血症に対する抗凝固療法の実施状況と出血性合併症．
    西川 真理恵, 鈴木 康大, 上野 義豊, Nobuto Nakanishi, Natsuki Tane, Yumiko Tsunano, Nao Okuda, Taiga Itagaki, Mutsuo Onodera, Jun Oto, Masaji Nishimura
    日本集中治療医学会第2回中国・四国支部学術集会, Jan. 2018, Japanese, Okayama, Domestic conference

  • 片側痙攣片側てんかん症候群(HHE症候群)の1例．
    Mutsuo Onodera, Yoshitoyo Ueno, Nobuto Nakanishi, 西川 真理恵, Natsuki Tane, Yumiko Tsunano, Emiko Nakataki, Taiga Itagaki, Jun Oto, Masaji Nishimura
    第33回日本救急医学会中国四国地方会学術集会, May 2017, Japanese, Yonago, Domestic conference

  • 肝血管腫のコイル塞栓後に敗血症で死亡した1症例．
    Natsuki Tane, Yoshitoyo Ueno, Nobuto Nakanishi, Yumiko Tsunano, Masayo Izawa, Emiko Nakataki, Taiga Itagaki, Mutsuo Onodera, Jun Oto, Masaji Nishimura
    第33回日本救急医学会中国四国地方会学術集会, May 2017, Japanese, Yonago, Domestic conference

  • RSV感染による縦隔気腫を発症しvenovenous ECMOを導入した小児例．
    Emiko Nakataki, Yoshitoyo Ueno, Nobuto Nakanishi, 西川 真理恵, Natsuki Tane, Yumiko Tsunano, Taiga Itagaki, Mutsuo Onodera, Jun Oto, Masaji Nishimura
    第33回日本救急医学会中国四国地方会学術集会, May 2017, Japanese, Yonago, Domestic conference

  • Ultrasound measurement of the upper and lower limb muscle atrophy in intensive care patitens.
    Nobuto Nakanishi, Jun Oto, Taiga Itagaki, Emiko Nakataki, Mutsuo Onodera, Masaji Nishimura
    EuroAsia, Apr. 2017, English, Hong Kong, International conference

  • 当院ICUにおける心原性肺水腫患者へのHigh flow nasal cannulaの使用状況．
    Yumiko Tsunano, 上野 義豊, Jun Oto, Nobuto Nakanishi, 西川 真理恵, Masayo Izawa, Emiko Nakataki, Taiga Itagaki, Jun Oto, Mutsuo Onodera, Masaji Nishimura
    第44回日本集中治療医学会学術集会, Mar. 2017, Japanese, Sapporo, Domestic conference

  • 超音波によるICU患者の上肢・下肢筋委縮評価．
    Nobuto Nakanishi, Rie Tsutsumi, Jun Oto, 井内 茉莉奈, 上野 義豊, 西川 真理恵, Yumiko Tsunano, Emiko Nakataki, Mutsuo Onodera, Masaji Nishimura
    第44回日本集中治療医学会学術集会, Mar. 2017, Japanese, Sapporo, Domestic conference

  • 人工呼吸中の気道感染患者における抗菌薬投与前後の吸引痰のグラム染色像の変化と抗菌薬有効性との関係．
    Emiko Nakataki, 上野 義豊, Nobuto Nakanishi, 西川 真理恵, Yumiko Tsunano, Masayo Izawa, Taiga Itagaki, Jun Oto, Mutsuo Onodera, Masaji Nishimura
    第44回日本集中治療医学会学術集会, Mar. 2017, Japanese, Sapporo, Domestic conference

  • 重症患者における栄養投与開始時期と体組成変化の関連性の検討．
    井内 茉莉奈, Rie Tsutsumi, Nobuto Nakanishi, Jun Oto, Emiko Nakataki, Mutsuo Onodera, Hiroshi Sakaue, Masaji Nishimura
    第44回日本集中治療医学会学術集会, Mar. 2017, Japanese, Sapporo, Domestic conference

  • 赤血球輸血を必要とした乳児重症肺炎の1例．
    Nobuto Nakanishi, Emiko Nakataki, Mutsuo Onodera, Jun Oto, Masaji Nishimura
    日本集中治療医学会第1回中国四国支部学術集会, Feb. 2017, Japanese, Takamatsu, Domestic conference

  • 穿孔性虫垂炎の診断に有用な超音波所見について
    大辻 幹, 長谷川 珠央, 宮武 真弓, 小林 千明, 日置 俊, 別當 勝紀, Nobuto Nakanishi, 村林 桃士
    日赤医学, Sep. 2016, Japanese, Domestic conference

  • 三重県ドクターヘリは急性期脳卒中患者の予後を改善したか
    説田 守道, Nobuto Nakanishi, 藤井 幸治, 森 一樹, 田村 佳久, 山川 徹, 渡邉 文亮, 水野 光規
    日本航空医療学会雑誌, Oct. 2015, Japanese, Domestic conference

  • 離島住民からの要請により早期治療に成功した1急性心筋梗塞例
    説田 守道, 石倉 健, Nobuto Nakanishi, 藤井 孝治, 森 一樹, 田村 佳久, 山川 徹, 水野 光規, 渡邉 文亮
    日本航空医療学会雑誌, Oct. 2015, Japanese, Domestic conference

  • 治療に難渋するも二度の心肺停止から社会復帰し得た川崎病疑いの心室細動例
    井上 良哉, 説田 守道, Nobuto Nakanishi
    日赤医学, Sep. 2015, Japanese, Domestic conference

  • 急性期脳卒中に対する病院前救急診療の効果 医療過疎地域における調査
    Nobuto Nakanishi, 説田 守道
    日赤医学, Sep. 2015, Japanese, Domestic conference

  • Clinical characteristics and diagnosis in children with perforated appendicitis.
    Nobuto Nakanishi, Mori Shou, Akao Nozomi, Higashigawa Masamune
    Asian Conference for Emergency Medicine, Sep. 2015, English, International conference

  • 地方救命救急センターにおけるOn call体制の外傷チームは重症外傷の予後を改善するか
    田村 佳久, Nobuto Nakanishi, 藤井 幸治, 説田 守道
    Journal of Japanese Association for Acute Medicine, Aug. 2015, Japanese, Domestic conference

  • 急性期脳卒中に対する病院前救急診療の効果 医療過疎地域における調査
    Nobuto Nakanishi, 説田 守道
    Journal of Japanese Association for Acute Medicine, Aug. 2015, Domestic conference

  • 多発外傷に合併した外傷性横隔膜損傷の1救命例
    井上 良哉, 田村 佳久, Nobuto Nakanishi, 藤井 幸治, 説田 守道
    Journal of Japanese Association for Acute Medicine, Aug. 2015, Japanese, Domestic conference

  • Does enhancement of prehospital medical care improve clinical outcomes of patients with acute coronary syndromes?
    Nobuto Nakanishi, 説田 守道
    Journal of Japanese Association for Acute Medicine, Aug. 2015, International conference

  • 血液培養手技における滅菌手袋の必要性についての研究
    Nobuto Nakanishi, 水野 光規, 説田 守道
    日赤医学, Sep. 2014, Japanese, Domestic conference

  • 救急隊による病院前心電図判断は急性心筋梗塞への対応時間を短縮するか
    Nobuto Nakanishi, 水野 光規, 説田 守道
    日赤医学, Sep. 2014, Japanese, Domestic conference

  • 三重県志摩地域/高齢化・医療過疎地域の救急医療 消防法改正とドクターヘリは救急医療の崩壊を救ったか
    森本 真之助, 水野 光規, Nobuto Nakanishi, 説田 守道
    Journal of Japanese Association for Acute Medicine, Aug. 2014, Japanese, Domestic conference

  • 救急隊による病院前心電図判断は急性心筋梗塞への対応時間を短縮するか
    Nobuto Nakanishi, 水野 光規, 説田 守道
    Journal of Japanese Association for Acute Medicine, Aug. 2014, Japanese, Domestic conference

  • 血液培養手技における滅菌手袋の必要性についての研究
    Nobuto Nakanishi, 水野 光規, 説田 守道
    Journal of Japanese Association for Acute Medicine, Aug. 2014, Japanese, Domestic conference

  • 医療過疎化の進む地域における救急搬送の広域化の影響
    森本 真之助, 水野 光規, Nobuto Nakanishi, 説田 守道
    Journal of Japanese Association for Acute Medicine, Aug. 2014, Japanese, Domestic conference

  • 整体にて発症した脳脊髄液減少症の1例
    Nobuto Nakanishi, 山崎 正禎, 島田 拓弥, 柴田 益成, 内藤 寛
    Clinical Neurology, Mar. 2014, Japanese, Domestic conference

  • 志摩地域における救急医療の現状調査 高齢化と病院機能縮小による影響
    森本 真之助, 水野 光規, Nobuto Nakanishi, 説田 守道
    日赤医学, Sep. 2013, Japanese, Domestic conference

  • 伊勢赤十字病院救命救急センターにおける血液培養コンタミネーションの調査
    Nobuto Nakanishi, 水野 光規, 森本 真之介, 青木 悦子, 谷口 忍, 大西 和夫, 説田 守道
    日赤医学, Sep. 2013, Japanese, Domestic conference

  • Effects of leak on patient-ventilator dyssynchrony during noninvasive positive pressure ventilation.
    Nobuto Nakanishi, Ueno Yoshitoyo, Nakataki Emiko, Imanaka Hideaki, Nishimura Masaji
    May 2010, English, The 10th Joint Scientific Congress of KSCCM and JSICM, International conference

  • 非侵襲的陽圧換気中のリークが患者-人工呼吸器間の同調性に及ぼす影響
    Nobuto Nakanishi, 上野 義豊, Rie Ono, Daisuke Inui, Emiko Nakataki, 眞野 暁子, Daisuke Inui, Jun Oto, Hideaki Imanaka, Masaji Nishimura
    第37回 日本集中治療医学会学術集会, Mar. 2010, Japanese, Hiroshima, Domestic conference

  • 非侵襲的陽圧換気中のリークが患者-人工呼吸器間の同調性に及ぼす影響
    Nobuto Nakanishi, 上野 義豊, Rie Ono, Emiko Nakataki, 眞野 暁子, Daisuke Inui, Jun Oto, 西村 匡司
    Journal of the Japanese Society of Intensive Care Medicine, Jan. 2010, Japanese, Domestic conference

  • Skeletal muscle evaluation in the intensive care unit: CT, Ultrasound, Bioelectrical impedance analysis, and Biomarker
    中西信人
    第48回日本集中治療医学会学術集会

■ Affiliated Academic Society
  • Japanese Society for Parenteral and Enteral Nutrition
    Oct. 2021

  • 日本外科代謝栄養学会
    Jul. 2021

  • Japanese Society for Early Mobilization
    Apr. 2021

  • The Japanese Society of Intensive Care Medicine

  • Japanese Association for Acute Medicine

■ Research Themes
  • 急性期領域におけるフレキシブル超音波プローブによる大腿筋肉量評価の開発
    宮崎 敦, 富井 直輝, 中西 信人, 中村 謙介
    日本学術振興会, 科学研究費助成事業, 基盤研究(C), 横浜市立大学, 01 Apr. 2024 - 31 Mar. 2027

  • 高齢敗血症患者における筋委縮の病態解明とマイオカインを活用したPICS治療法の探索
    井上 茂亮, 大野 雄康, 中西 信人, 宮本 恭兵
    日本学術振興会, 科学研究費助成事業, 基盤研究(C), 和歌山県立医科大学, 01 Apr. 2024 - 31 Mar. 2027

  • ICU入室患者の上下肢神経筋電気刺激療法：筋力、代謝、長期予後に与える影響
    中西 信人
    日本学術振興会, 科学研究費助成事業, 若手研究, 01 Apr. 2020 - 31 Mar. 2024
    集中治療室での神経筋電気刺激療法の介入と長期予後調査の研究は順調に進行しており、神経筋電気刺激療法は安全に集中治療室で使用できている。長期的な身体機能調査のためにICUに入室した患者に予め退院数ヵ月後に身体機能の状態を調査する旨を説明し、携帯電話のショートメッセージサービスにアンケートを送りオンラインで状態を記入して頂いている。神経筋電気刺激療法は集中治療室での筋萎縮予防、身体機能改善、代謝機能改善に寄与することが明らかとなってきており、長期的な影響を引き続き調べていく。筋萎縮予防の評価としては超音波を用いた筋肉量評価が有効であり、理学療法士などのスタッフなどと超音波を用いた筋肉量評価の方法を共有して、上腕と下肢の筋肉の適切な評価に努めている。また尿中のタイチンという物質が筋肉の崩壊を評価するのに有効であり尿中のタイチンが神経筋電気刺激療法でどのようになるかなども調べている。代謝機能としてはメタボローム解析を用いて血液中のアミノ酸がどのように変化するかを引き続き調べている。身体機能評価としては理学療法士と協力してICU退室時に身体機能がどのようになるか、CPAx (The Chelsea Critical Care Physical Assessment Tool) などの身体機能評価のスケールを用いて評価している。神戸大学のデータを調査した研究では70%、60%、35%の患者が退院3ヵ月、6ヵ月、1年後に集中治療症候群というICU退室後の機能障害に至っていることを論文で報告した（PMID: 36142904）。さらにメタアナリシスなどの方法も用いて神経筋電気刺激療法が重症患者に有効であるかの検討も行っている。

  • Muscle atrophy Zero project
    Nobuto Nakanishi
    OTSUCLE, Cause, diagnosis, treatment of muscle atrophy in critically ill patients., Tokushima University Hospital, Feb. 2020

■ Media Coverage
  • Muscle atrophy Zero project
    Company and University, Feb. 2020, Challenge to croudfunding
    Paper

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