Research activity information

• Sep. 2024 Asia western pacific region congress 2024, The best presenter of oral presentation award, Effect of Neuromuscular Electrical Stimulation in Patients With Critical Illness: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials


• Jul. 2024 神戸大学, 前之園記念若手優秀論文賞, Instruments to assess post-intensive care syndrome assessment: a scoping review and modified Delphi method study. Crit Care 2023; 27:430.


• Apr. 2024 K, Excellent Academic Paper Award, School of Medicine, Kobe University, Instruments to assess post-intensive care syndrome assessment: a scoping review and modified Delphi method study. Crit Care 2023; 27:430.


• 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, Excellent Academic Paper Award, School of Medicine, Kobe University, Sepsis causes neutrophil infiltration in muscle leading to muscle atrophy and weakness in mice. Front Immunol 2022; 13:950646


• 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


• Mar. 2022 日本集中治療医学会, Promising Researcher Award, Nakanishi N, Oto J, Tsutsumi R, Yamamoto T, Ueno Y, Nakataki E, et al. Effect of electrical muscle stimulation on upper and lower limb muscles in critically ill patients: A two-center randomized controlled trial. Critical care medicine. 2020;48(11):e997-e1003.


• 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. Crit Care Med 48: 1327-1333, 2020

  Nobuto Nakanishi, Rie Tsutsumi, Kanako Hara, Takuya Takashima, Emiko Nakataki, Taiga Itagaki, Masafumi Matsuo, Jun Oto, Hiroshi Sakaue


• 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

• Sepsis-associated skeletal muscle wasting is ameliorated by pharmacological inhibition of the STAT3 signaling pathway in mice

  Yuko Ono, Masafumi Saito, Ikumi Yoshihara, Yutaka Kondo, Kazuho Sakamoto, Jun Sugiyama, Nobuto Nakanishi, Shigeaki Inoue, Joji Kotani

  Springer Science and Business Media LLC, Jan. 2026, Scientific Reports

  Scientific journal


• Response to “RE: Utility of Plasma Myostatin as a Predictive Biomarker for Post Intensive Care Syndrome in Patients With Sepsis”

  Ayaki Shirahata, Nobuto Nakanishi, Yuko Ono, Shigeaki Inoue, Joji Kotani

  Jan. 2026, Acute Medicine & Surgery

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 機械的心肺蘇生法のタイミングが救急救命士の末梢静脈路確保成功率に与える影響 地方消防機関における多施設後ろ向きコホート研究

  鵜澤 佑, 大野 雄康, 杉山 隼, 米田 龍平, 高山 和之, 中西 信人, 中村 謙介, 大島 拓, 落合 秀信, 小谷 穣治

  日本蘇生学会, Nov. 2025, 蘇生, 44(3) (3), 147 - 147, Japanese


• 自動胸骨圧迫装置の装着が救急救命士の末梢静脈路確保に与える影響 地方消防機関における多施後ろ向きコホート研究

  鵜澤 佑, 大野 雄康, 杉山 隼, 米田 龍平, 高山 和之, 中西 信人, 中村 謙介, 大島 拓, 落合 秀信, 小谷 穣治

  日本蘇生学会, Nov. 2025, 蘇生, 44(3) (3), 148 - 148, Japanese


• Longitudinal Changes in Symptoms of Post-Intensive Care Syndrome: A Secondary Analysis of a Scoping Review.

  Kohei Tanaka, Nobuto Nakanishi, Keibun Liu, Kyohei Miyamoto, Akira Kawauchi, Masatsugu Okamura, Sho Katayama, Kensuke Nakamura

  BACKGROUND: Since the increased interest in post-intensive care syndrome (PICS) and PICS-family, many studies have been conducted. However, the longitudinal changes in PICS symptoms are not clearly understood. This study aimed to summarize the longitudinal symptom changes in each PICS domain, including physical, cognitive, mental health, quality of life, and family. METHODS: In this secondary analysis study, we identified the studies that conducted longitudinal PICS assessments published between 2014 and 2022. The most frequently used assessment tools in each domain were defined as representative methods, and results of included studies were summarized by each PICS domain. The collected data were grouped by the following: within 3 months (baseline), at 3 months, 6 months, and annually thereafter. The Wilcoxon rank-sum test was used to compare changes from baseline. RESULTS: Of the 5,160 studies screened, 76 studies were selected in this study. The percentage predicted value of the 6-minute walk test as an indicator of physical function significantly improved from baseline to 6 months (median [interquartile range], from 45.9 [32.0-63.0] to 65.0 [57.8-72.8], p = 0.04), and continued to improve during the 5-year follow-up period. Montreal Cognitive Assessment for cognitive assessment and Impact of Event Scale-Revised for mental health assessment did not show statistically significant change. The anxiety score of the Hospital Anxiety and Depression Scale (HADS) improved from baseline to the 12-month follow-up (from 6.8 [4.0-8.5] to 4.3 [3.3-5.3], p = 0.04). The anxiety and depression scores of the HADS in family members did not show statistically significant change. The physical component summary of the Short Form-36 for quality of life assessment increased from baseline to the 12-month follow-up (from 31.3 [25.5-37.1] to 40.6 [36.9-50.0], p = 0.03); however, the mental component summary of the Short Form-36 was not changed with statistical significance. CONCLUSIONS: Although the physical and mental domains showed significant longitudinal improvements, PICS symptoms were long-lasting in all domains with varying severity.

  Oct. 2025, JMA journal, 8(4) (4), 1089 - 1097, English, Domestic magazine

  Scientific journal


• Myostatin antisense administration prevents sepsis-induced muscle atrophy and weakness in male mice.

  Nobuto Nakanishi, Kazuhiro Maeta, Yuko Ono, Takumi Hirabayashi, Daisuke Tatebayashi, Kensuke Nakamura, Shigeaki Inoue, Masafumi Matsuo, Joji Kotani

  Muscle atrophy and weakness are serious problems associated with sepsis. However, only a few pharmacological interventions are available to date. In this study, myostatin antisense was used to prevent sepsis-induced muscle atrophy and weakness. Sepsis was induced in 8-week-old male C57BL/6J mice via intraperitoneal injection of 1 mg/g cecal slurry (CS). Myostatin antisense was injected into the right tibialis anterior muscle. Myostatin mRNA was measured in the tibialis anterior and quadriceps femoris muscles on Day 1. The body weight, grip strength, and cross-sectional area of the tibialis anterior muscle were measured on Day 6. The administration of myostatin antisense decreased myostatin expression on Day 1 in the injected side (0.023 ± 0.010 in CS vs. 0.008 ± 0.002 in CS + antisense) as well as in the noninjected muscles. It also decreased the myostatin protein level (2.0 ± 0.3 in CS vs. 1.2 ± 0.5 in CS + antisense, p = 0.04). Body weight reduction (94.9% ± 2.0% vs. 98.2% ± 1.8%, p < 0.01) and grip strength reduction (77.0% ± 12.3%vs. 89.8% ± 8.3%, p = 0.04) were suppressed by the injection. The cross-sectional area of the right tibialis anterior muscle increased after the treatment (1116 ± 530 μm2 vs. 1435 ± 648 μm2, p < 0.01). Myostatin antisense suppressed the elevation of myostatin mRNA expression in whole muscles of mice with sepsis and prevented sepsis-induced muscle atrophy and weakness.

  Sep. 2025, Physiological reports, 13(17) (17), e70566, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 重症患者の離床有害事象評価ツールと離床リスクアセスメントツールの日本語版

  河内 章, 中西 信人, 矢坂 泰介, 小谷 祐樹, 藤田 雅子

  Sep. 2025, 早期離床, 11, 33 - 35, Japanese

  [Refereed]

  Scientific journal


• Intensive care unit-acquired muscle atrophy and weakness in critical illness: a review of long-term recovery strategies

  Nobuto Nakanishi

  Aug. 2025, Acute and Critical Care

  [Refereed][Invited]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Clinical utility of measuring temporal muscle volume by head computed tomography for Global Leadership Initiative on Malnutrition phenotypic criteria in critically ill patients.

  Shinya Suganuma, Kensuke Nakamura, Naoki Kanda, Nobuto Nakanishi, Minoru Yoshida, Tomoka Miyagi, Shunsuke Takaki

  BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) lacks endorsed criteria for a muscle mass assessment. Since a muscle mass assessment using trunk computed tomography (CT) cannot be performed on all patients, a temporal muscle evaluation may serve as an useful alternative. In the present study, we hypothesized that complementing a total skeletal muscle mass assessment with a temporal muscle evaluation may provide a viable strategy for the GLIM assessment in the intensive care unit (ICU). METHODS: This single-center retrospective cohort study analyzed adult ICU patients. We selected optimal cut-off values for temporal muscle mass, measured by head CT, to predict sarcopenia as defined by the total skeletal muscle mass index in patients who underwent both abdominal and head CT. A reduced muscle mass, a component of the phenotypic criteria, was then evaluated using abdominal and head CT images. Muscle mass was assessed using abdominal CT if the patient underwent abdominal CT imaging and head CT if the patient only underwent head CT imaging. Patients who met at least one GLIM phenotypic criterion and one etiologic criterion were diagnosed with malnutrition. Clinical outcomes, including in-hospital mortality, were compared between patients with and without malnutrition. RESULTS: A total of 270 patients were included. The optimal cut-off for temporal muscle area was 250.11, adopted as the threshold for a reduced muscle mass. The combination of head and abdominal CT enabled muscle mass assessments in 215 (80 %) patients, whereas abdominal CT alone allowed assessments in 149 (55 %) patients. Malnutrition was identified in 71 patients (33 %) with assessments using abdominal and head CT. In-hospital mortality was significantly higher in the malnutrition group (29.6 % vs. 9.7 %, p < 0.01). CONCLUSION: A muscle mass evaluation using both head and abdominal CT images enables the GLIM assessment in a larger patient population. This approach may support the GLIM assessment in ICU patients.

  Aug. 2025, Clinical nutrition (Edinburgh, Scotland), 53, 133 - 143, English, International magazine

  Scientific journal


• Optimal timing for assessing post-intensive care syndrome in clinical research: a scoping review and expert survey.

  Kohei Tanaka, Nobuto Nakanishi, Keibun Liu, Kyohei Miyamoto, Akira Kawauchi, Masatsugu Okamura, Sho Katayama, Yuki Iida, Yusuke Kawai, Junji Hatakeyama, Toru Hifumi, Takeshi Unoki, Daisuke Kawakami, Fumimasa Amaya, Kengo Obata, Hidenori Sumita, Tomoyuki Morisawa, Norihiko Tsuboi, Ryo Kozu, Shunsuke Takaki, Junpei Haruna, Kohei Ota, Yoshihisa Fujinami, Nobuyuki Nosaka, Kasumi Shirasaki, Shigeaki Inoue, Osamu Nishida, Kensuke Nakamura

  BACKGROUND: Since the concept of post-intensive care syndrome (PICS) was proposed, numerous studies have assessed patients and their family members. However, a wide range of assessment timings has been employed across previous studies. This study aimed to clarify how assessment timings have been implemented in existing PICS research through a scoping review, and to explore expert opinions on optimal assessment timing via an online survey. METHODS: We conducted a scoping review of studies assessing PICS-related outcomes, including physical, cognitive, and psychological impairments, as well as PICS in family members. Studies were retrieved from MEDLINE, CENTRAL, and CINAHL, and screened by two independent pairs of reviewers. Eligible studies were published between January 2014 and December 2022. Studies lacking a clear description of assessment timing were excluded. We analyzed the reference point used to determine assessment schedules, the assessment time points, and their frequency. Additionally, an online questionnaire was administered to 23 members of the Japanese Society of Intensive Care Medicine PICS committee and working group members to collect expert opinions on these three aspects for clinical research. RESULTS: A total of 657 studies were included. In prior studies, hospital discharge was the most commonly used reference point for determining assessment schedule (240 studies, 40%). However, ICU discharge was identified by experts as the ideal reference point (16 votes, 47%). The most frequently used assessment time points were 3 months (262, 23%), 6 months (212, 19%), and 12 months (206, 18%) post-discharge. Experts most commonly selected the period between 6 and 12 months as the optimal time point for assessment. While single assessments were most common in previous studies (337, 51%), experts considered three assessments to be ideal (12, 44%). CONCLUSIONS: This study revealed notable discrepancies between the assessment timing reported in previous studies and the opinions of experts regarding optimal timing. Standardization of assessment timing in PICS research is warranted to enhance methodological consistency and comparability.

  Aug. 2025, Journal of intensive care, 13(1) (1), 45 - 45, English, International magazine

  Scientific journal


• The Construct and Predictive Validity of the Japanese Version of the Intensive Care Unit Mobility Scale

  Kohei Tanaka, Nobuto Nakanishi, Shinichi Watanabe, Yasunari Morita, Seiya Sato, Yuko Ono, Kensuke Nakamura, Joji Kotani, Carol L. Hodgson, Hajime Katsukawa

  Corresponding, Aug. 2025, Journal of Clinical Medicine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Impact of seat position on survival outcomes and anatomically specific severe injury patterns in four-wheeled motor vehicle accidents: a retrospective cohort study at a community emergency department in Japan.

  Tasuku Uzawa, Yuko Ono, Jun Sugiyama, Kazushi Takayama, Nobuto Nakanishi, Takeyasu Kakamu, Tokiya Ishida, Nozomi Tomita, Kazuaki Shinohara, Joji Kotani

  BACKGROUND: Road traffic accidents are a major healthcare concern worldwide. To improve outcomes for patients injured in motor vehicle crashes, it is crucial to understand the factors associated with mortality and anatomically specific injury severity. Seat position is one of the possible determinants of road traffic injury fatality; however, evidence regarding which seat positions are linked to impaired survival outcomes and anatomically severe injuries remains scarce. METHODS: We conducted a retrospective cohort study of patients injured in four-wheeled vehicle accidents between 2000 and 2022 and admitted to a community teaching hospital in Japan. Seat position was classified as driver seat, front passenger seat, or rear passenger seat. The primary endpoint was in-hospital mortality. Other outcomes included severe trauma, defined as an Injury Severity Score (ISS) of > 15, and anatomically specific severe injuries of the head and neck, chest, abdomen, pelvis, and extremities, defined as an Abbreviated Injury Scale score of ≥ 3. RESULTS: Among 5,906 eligible patients, 4,104 (69.5%) were driver seat occupants, 1,009 (17.1%) were front passenger seat occupants, and 793 (13.4%) were rear passenger seat occupants. After adjusting for potential confounders such as age, sex, admission year, season, presentation time, presentation day, prehospital length of stay, vehicle configuration, collision type, seatbelt use, airbag deployment, and involvement in high-energy trauma using logistic regression analysis, rear passenger seat occupants had a lower risk of hospital mortality (adjusted odds ratio [AOR], 0.396; 95% confidence interval [CI], 0.216-0.727) and a lower risk of severe trauma with an ISS of > 15 (AOR, 0.428; 95% CI, 0.308-0.596) than driver seat occupants. Additionally, rear seat occupants were less likely to sustain serious injuries to the chest (AOR, 0.474; 95% CI, 0.333-0.673) and abdominal or pelvic contents (AOR, 0.373; 95% CI, 0.218-0.639) than driver seat occupants. CONCLUSION: Our results suggest that driver seat occupants require special attention because of their higher risk of adverse outcomes and anatomically severe injuries. These findings will be useful for vehicle occupants, emergency medical professionals, and automobile manufacturers. CLINICAL TRIAL NUMBER: Not applicable.

  Jul. 2025, BMC emergency medicine, 25(1) (1), 139 - 139, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• カリウム含有サプリメントの過量摂取により重度の高カリウム血症を呈した一例

  中西 信人, 加藤 ちはる, 高山 和之, 大島 拓, 山田 勇, 小谷 穣治

  (株)へるす出版, Jul. 2025, 中毒研究, 38(2) (2), 222 - 222, Japanese


• Nutrition Therapy for Physical Impairment in Critically Ill Patients: A Narrative Review of the Latest Evidence

  Minoru Yoshida, Ryo Yamamoto, Hiroo Izumino, Shinya Matsushima, Yudai Takatani, Junji Hatakeyama, Nobuto Nakanishi, Shinichi Watanabe, Akihisa Taguchi, Ken-ichi Kano, Akihito Tampo, Akira Ouchi, Hideaki Sakuramoto, Tomoka Miyagi, Masayuki Kaku, Hiroyasu Murata, Naoki Higashibeppu, Kensuke Nakamura, Joji Kotani

  Elsevier BV, Jul. 2025, Clinical Nutrition

  [Refereed]

  Scientific journal


• Changes in Physical Function, Cognitive Function, Mental Health, and Sleep Quality After Cardiac Surgeries and Procedures

  Yoshimi Kawahara, Nobuto Nakanishi, Keiko Nomura, Satoshi Doi, Jun Oto

  Corresponding, Jun. 2025, Nursing Reports

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 四輪自動車の乗車位置が交通事故患者の生存転帰及び解剖学的重症度に与える影響

  鵜澤 佑, 大野 雄康, 杉山 隼, 高山 和之, 中西 信人, 篠原 一彰, 小谷 穣治

  (一社)日本外傷学会, Apr. 2025, 日本外傷学会雑誌, 39(2) (2), 204 - 204, Japanese


• The Japanese Critical Care Nutrition Guideline 2024.

  Kensuke Nakamura, Ryo Yamamoto, Naoki Higashibeppu, Minoru Yoshida, Hiroomi Tatsumi, Yoshiyuki Shimizu, Hiroo Izumino, Taku Oshima, Junji Hatakeyama, Akira Ouchi, Rie Tsutsumi, Norihiko Tsuboi, Natsuhiro Yamamoto, Ayumu Nozaki, Sadaharu Asami, Yudai Takatani, Kohei Yamada, Yujiro Matsuishi, Shuhei Takauji, Akihito Tampo, Yusuke Terasaka, Takeaki Sato, Saiko Okamoto, Hideaki Sakuramoto, Tomoka Miyagi, Keisei Aki, Hidehito Ota, Taro Watanabe, Nobuto Nakanishi, Hiroyuki Ohbe, Chihiro Narita, Jun Takeshita, Masano Sagawa, Takefumi Tsunemitsu, Shinya Matsushima, Daisuke Kobashi, Yorihide Yanagita, Shinichi Watanabe, Hiroyasu Murata, Akihisa Taguchi, Takuya Hiramoto, Satomi Ichimaru, Muneyuki Takeuchi, Joji Kotani

  Nutrition therapy is important in the management of critically ill patients and is continuously evolving as new evidence emerges. The Japanese Critical Care Nutrition Guideline 2024 (JCCNG 2024) is specific to Japan and is the latest set of clinical practice guidelines for nutrition therapy in critical care that was revised from JCCNG 2016 by the Japanese Society of Intensive Care Medicine. An English version of these guidelines was created based on the contents of the original Japanese version. These guidelines were developed to help health care providers understand and provide nutrition therapy that will improve the outcomes of children and adults admitted to intensive care units or requiring intensive care, regardless of the disease. The intended users of these guidelines are all healthcare professionals involved in intensive care, including those who are not familiar with nutrition therapy. JCCNG 2024 consists of 37 clinical questions and 24 recommendations, covering immunomodulation therapy, nutrition therapy for special conditions, and nutrition therapy for children. These guidelines were developed in accordance with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system by experts from various healthcare professionals related to nutrition therapy and/or critical care. All GRADE-based recommendations, good practice statements (GPS), future research questions, and answers to background questions were finalized by consensus using the modified Delphi method. Strong recommendations for adults include early enteral nutrition (EN) within 48 h and the provision of pre/synbiotics. Weak recommendations for adults include the use of a nutrition protocol, EN rather than parenteral nutrition, the provision of higher protein doses, post-pyloric EN, continuous EN, omega-3 fatty acid-enriched EN, the provision of probiotics, and indirect calorimetry use. Weak recommendations for children include early EN within 48 h, bolus EN, and energy/protein-dense EN formulas. A nutritional assessment is recommended by GPS for both adults and children. JCCNG 2024 will be disseminated through educational activities mainly by the JCCNG Committee at various scientific meetings and seminars. Since studies on nutritional treatment for critically ill patients are being reported worldwide, these guidelines will be revised in 4 to 6 years. We hope that these guidelines will be used in clinical practice for critically ill patients and in future research.

  Mar. 2025, Journal of intensive care, 13(1) (1), 18 - 18, English, International magazine

  [Refereed]

  Scientific journal


• The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.

  Nobuaki Shime, Taka-Aki Nakada, Tomoaki Yatabe, Kazuma Yamakawa, Yoshitaka Aoki, Shigeaki Inoue, Toshiaki Iba, Hiroshi Ogura, Yusuke Kawai, Atsushi Kawaguchi, Tatsuya Kawasaki, Yutaka Kondo, Masaaki Sakuraya, Shunsuke Taito, Kent Doi, Hideki Hashimoto, Yoshitaka Hara, Tatsuma Fukuda, Asako Matsushima, Moritoki Egi, Shigeki Kushimoto, Takehiko Oami, Kazuya Kikutani, Yuki Kotani, Gen Aikawa, Makoto Aoki, Masayuki Akatsuka, Hideki Asai, Toshikazu Abe, Yu Amemiya, Ryo Ishizawa, Tadashi Ishihara, Tadayoshi Ishimaru, Yusuke Itosu, Hiroyasu Inoue, Hisashi Imahase, Haruki Imura, Naoya Iwasaki, Noritaka Ushio, Masatoshi Uchida, Michiko Uchi, Takeshi Umegaki, Yutaka Umemura, Akira Endo, Marina Oi, Akira Ouchi, Itsuki Osawa, Yoshiyasu Oshima, Kohei Ota, Takanori Ohno, Yohei Okada, Hiromu Okano, Yoshihito Ogawa, Masahiro Kashiura, Daisuke Kasugai, Ken-Ichi Kano, Ryo Kamidani, Akira Kawauchi, Sadatoshi Kawakami, Daisuke Kawakami, Yusuke Kawamura, Kenji Kandori, Yuki Kishihara, Sho Kimura, Kenji Kubo, Tomoki Kuribara, Hiroyuki Koami, Shigeru Koba, Takehito Sato, Ren Sato, Yusuke Sawada, Haruka Shida, Tadanaga Shimada, Motohiro Shimizu, Kazushige Shimizu, Takuto Shiraishi, Toru Shinkai, Akihito Tampo, Gaku Sugiura, Kensuke Sugimoto, Hiroshi Sugimoto, Tomohiro Suhara, Motohiro Sekino, Kenji Sonota, Mahoko Taito, Nozomi Takahashi, Jun Takeshita, Chikashi Takeda, Junko Tatsuno, Aiko Tanaka, Masanori Tani, Atsushi Tanikawa, Hao Chen, Takumi Tsuchida, Yusuke Tsutsumi, Takefumi Tsunemitsu, Ryo Deguchi, Kenichi Tetsuhara, Takero Terayama, Yuki Togami, Takaaki Totoki, Yoshinori Tomoda, Shunichiro Nakao, Hiroki Nagasawa, Yasuhisa Nakatani, Nobuto Nakanishi, Norihiro Nishioka, Mitsuaki Nishikimi, Satoko Noguchi, Suguru Nonami, Osamu Nomura, Katsuhiko Hashimoto, Junji Hatakeyama, Yasutaka Hamai, Mayu Hikone, Ryo Hisamune, Tomoya Hirose, Ryota Fuke, Ryo Fujii, Naoki Fujie, Jun Fujinaga, Yoshihisa Fujinami, Sho Fujiwara, Hiraku Funakoshi, Koichiro Homma, Yuto Makino, Hiroshi Matsuura, Ayaka Matsuoka, Tadashi Matsuoka, Yosuke Matsumura, Akito Mizuno, Sohma Miyamoto, Yukari Miyoshi, Satoshi Murata, Teppei Murata, Hiromasa Yakushiji, Shunsuke Yasuo, Kohei Yamada, Hiroyuki Yamada, Ryo Yamamoto, Ryohei Yamamoto, Tetsuya Yumoto, Yuji Yoshida, Shodai Yoshihiro, Satoshi Yoshimura, Jumpei Yoshimura, Hiroshi Yonekura, Yuki Wakabayashi, Takeshi Wada, Shinichi Watanabe, Atsuhiro Ijiri, Kei Ugata, Shuji Uda, Ryuta Onodera, Masaki Takahashi, Satoshi Nakajima, Junta Honda, Tsuguhiro Matsumoto

  The 2024 revised edition of the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock (J-SSCG 2024) is published by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine. This is the fourth revision since the first edition was published in 2012. The purpose of the guidelines is to assist healthcare providers in making appropriate decisions in the treatment of sepsis and septic shock, leading to improved patient outcomes. We aimed to create guidelines that are easy to understand and use for physicians who recognize sepsis and provide initial management, specialized physicians who take over the treatment, and multidisciplinary healthcare providers, including nurses, physical therapists, clinical engineers, and pharmacists. The J-SSCG 2024 covers the following nine areas: diagnosis of sepsis and source control, antimicrobial therapy, initial resuscitation, blood purification, disseminated intravascular coagulation, adjunctive therapy, post-intensive care syndrome, patient and family care, and pediatrics. In these areas, we extracted 78 important clinical issues. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 42 GRADE-based recommendations, 7 good practice statements, and 22 information-to-background questions were created as responses to clinical questions. We also described 12 future research questions.

  Mar. 2025, Journal of intensive care, 13(1) (1), 15 - 15, English, International magazine

  [Refereed]


• Strategies to Maximize the Benefits of Evidence-Based Enteral Nutrition: A Narrative Review

  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

  [Refereed]

  Scientific journal


• Efficacy of Enhanced Rehabilitation Initiated After Hospital Discharge to Improve Quality of Life in Survivors of Critical Care: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  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

  [Refereed]

  Scientific journal


• Application of bioelectrical impedance phase angle in mice: Comparison between young and old mice

  Nobuto Nakanishi, Nagato Katsura, Jun Sugiyama, Joji Kotani

  Dec. 2024, Clinical Nutrition Open Science

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 敗血症の基礎研究が熱い 敗血症はIL6/STAT3経路を活性化し骨格筋萎縮を誘導する

  大野 雄康, 斎藤 雅史, 高山 和之, 中西 信人, 井上 茂亮, 小谷 穣治

  (一社)日本救急医学会, Nov. 2024, 日本救急医学会雑誌, 35(11) (11), 591 - 591, Japanese


• Prevalence and Management of Oral Intake Restrictions in Critically Ill Patients: Insights from a Multicenter Point Prevalence Study.

  Takashi Hongo, Tetsuya Yumoto, Keibun Liu, Kensuke Nakamura, Akira Kawauchi, Takefumi Tsunemitsu, Nobuto Nakanishi, Atsunori Nakao, Hiromichi Naito

  Oral intake restrictions due to dysphagia in the intensive care unit (ICU) can increase morbidity, mortality, and negatively impact quality of life. The current oral intake practice and clinical management strategies for addressing dysphagia in the ICU are not well-defined. This study aimed to elucidate the clinical practices surrounding oral intake restrictions due to dysphagia and its management strategies in the ICU. A multicenter, prospective, cross-sectional, 2-day point prevalence study was conducted in Japan. Relevant data on the clinical circumstances surrounding oral intake practice and the implementation of strategies to prevent dysphagia for patients admitted to the ICU on November 1, 2023, and December 1, 2023, were collected. The primary outcome was the prevalence of oral intake restrictions in patients, defined by a Functional Oral Intake Scale score of less than 7 among eligible patients for oral intake. Out of 326 participants, 187 were eligible for the final analysis after excluding 139 patients who were not eligible for oral intake, primarily due to tracheal intubation. Among those eligible, 69.0% (129/187) encountered oral intake restrictions. About 52.4% (98/187) of patients underwent swallowing screenings; 36.7% (36/98) of these were suspected of having dysphagia. Compensatory and behavioral swallowing rehabilitation were provided to 21.9% (41/187) and 10.6% (20/187) of patients, respectively, from ICU admission to the survey date. Only 27.4% (14/51) of post-extubation and 9.3% (3/32) of post-stroke patients received swallowing rehabilitation. Notably, no ICUs had dedicated speech and language therapists, and most (85.7%, 18/21) lacked established swallowing rehabilitation protocols. This 2-point prevalence survey study revealed that oral intake restrictions due to dysphagia are common in ICUs, but few patients are screened for swallowing issues or receive rehabilitation. More clinical studies are needed to develop effective protocols for identifying and managing dysphagia, including screenings and rehabilitation in the ICU.

  Oct. 2024, Dysphagia, English, International magazine

  [Refereed]

  Scientific journal


• Evaluating optimal rehabilitation strategies in ICU: study protocol for a multicentre cohort study to assess Physical Activity dosing, Muscle mass, and physICal outcomeS (IPAMICS study).

  Yasunari Morita, Shinichi Watanabe, Nobuto Nakanishi, Akihito Tampo, Kenzo Ishii, Keisuke Suzuki, Yoshie Hirota, Yuji Naito, Naoya Sato, Hiroyoshi Yano, Tomohiro Yoshikawa, Atsushi Ishihara, Hiroyasu Inoue, Keibun Liu, Shigeru Koba, Kasumi Satoh, Kensuke Nakamura

  BACKGROUND: Many patients who get discharged from the intensive care unit experience physical dysfunction that persists even after discharge. Physical dysfunction is associated with skeletal muscle atrophy and accompanying intensive care unit-acquired weakness in the early stages of intensive care unit admission, and early diagnosis and prevention with early mobilization are crucial. However, the amount of physical activity required for early mobilization remains controversial in critically ill patients. This study aims to reveal the optimal mobilization quantification score dose associated with physical dysfunction after hospital discharge. METHODS: This is a multicenter prospective cohort study planned in 22 facilities; all consecutive patients admitted to the participating facilities between June 2024 and May 2025 will be included. Adult patients on ventilator management for at least 2 days and who will consent to this study will be included. Patients' mobility level and duration will be documented by the mobilization quantification score during their intensive care unit stay, and physical dysfunction will be assessed using muscle mass changes from day one to seven with ultrasonography and the Short-Form 12 Health Survey at 3 months after hospital discharge. The primary outcome is physical dysfunction at 3 months. RESULTS AND CONCLUSION: Mobilization quantification score dose and muscle mass evaluation with ultrasonography will enable the quantification of the early mobilization intervention. This study will lay the foundation for future randomised studies.

  Oct. 2024, Annals of clinical epidemiology, 6(4) (4), 97 - 105, English, Domestic magazine

  [Refereed]

  Scientific journal


• Effect of intravenous thiamine administration on critically ill patients: A systematic review and meta-analysis of randomized controlled trials.

  Nobuto Nakanishi, Yoshinobu Abe, Mizue Matsuo, Akihito Tampo, Kohei Yamada, Junji Hatakeyama, Minoru Yoshida, Ryo Yamamoto, Naoki Higashibeppu, Kensuke Nakamura, Joji Kotani

  BACKGROUND &AIMS: Thiamine is an essential micronutrient for energy metabolism. Thiamine deficiency is frequently observed in critically ill patients. However, the effect of thiamine administration is unclear in critically ill patients. METHODS: We conducted a systematic review and meta-analysis. To identify randomized controlled trials on the effect of thiamine administration in critically ill patients, a literature search was conducted in MEDLINE, CENTRAL, and ICHUSHI databases from inception to April 2023. Pooled effect estimates were calculated about mortality as the primary outcome and shock duration, lactate level, Sequential Organ Failure Assessment (SOFA) score, delirium, length of mechanical ventilation, length of intensive care unit (ICU) stay, infection rate, all adverse events, and Short-Form Health Survey (SF-36) as the secondary outcomes. The certainty of evidence (CoE) was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS: Overall, 35 studies (3494 patients) were included. Evidence suggested that thiamine administration resulted in little to no difference in mortality (risk ratio [RR], 0.89; 95% confidence interval [CI], 0.75 to 1.06; Low CoE); however, thiamine administration may reduce shock duration (mean difference [MD], -11.43 h; 95% CI, -20.16 to -2.69 h; Low CoE), lactate level (MD, -0.34 mmol/L; 95% CI, -0.63 to -0.05 mmol/L; Low CoE), and SOFA score (MD, -1.29; 95% CI, -1.91 to -0.66; Low CoE). Conversely, thiamine administration resulted in a slight increase in the length of ICU stay (MD, 0.40 days; 95% CI, 0.01-0.79 days; High CoE). CONCLUSIONS: Although thiamine administration may reduce shock state, it may not reduce mortality, and slightly increases the length of ICU stay.

  Sep. 2024, Clinical nutrition (Edinburgh, Scotland), 43(11) (11), 1 - 9, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 原因不明の多臓器不全から悪性リンパ腫を診断した一例

  陳 美仁子, 大野 雄康, 稲田 雅美, 庄司 忠生, 高田 健司, 杉本 貴史, 兼田 圭介, 中西 信人, 高山 和之, 関 恒慶, 遠山 一成, 山田 勇, 小谷 穣治

  (一社)日本集中治療医学会, Sep. 2024, 日本集中治療医学会雑誌, 31(Suppl.1) (Suppl.1), S986 - S986, Japanese


• Value of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in predicting hospital mortality for postoperative brain tumor patients in intensive care units in Japan: A retrospective case-control study

  Mai Azumi, Yoshifumi Mizobuchi, Nobuto Nakanishi, Kohei Nakajima, Keijiro Hara, Toshitaka Fujihara, Manabu Ishihara, Jun Oto, Yasushi Takagi

  Sep. 2024, Clinical Neurology and Neurosurgery

  [Refereed]

  Scientific journal


• Intensive care unit follow-up clinic activities: a scoping review.

  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

  [Refereed]

  Scientific journal


• Effects of Vibration Therapy on the Physical Function of Critically Ill Adults Trial: A Randomized Controlled Trial.

  Satoshi Doi, Nobuto Nakanishi, Yoshimi Kawahara, Keiko Nomura, Mamiko Shima, Mie Shiraishi, Jun Oto

  OBJECTIVES: Vibration therapy uses vibration to rehabilitate physical functions. Recently, it has been demonstrated to be safe for critically ill patients. However, its effects on physical functions are unclear. DESIGN: Randomized controlled trial. SETTING: A single-center, ICU. PATIENTS: Patients were randomly assigned to either vibration therapy coupled with protocolized mobilization or protocolized mobilization alone. We included patients who could sit at the edge of the bed or in a wheelchair during their ICU stay. The exclusion criteria were based on the early mobilization inhibition criteria. INTERVENTIONS: The primary outcome was the Functional Status Score for the ICU (FSS-ICU) at ICU discharge. Secondary outcomes were the Medical Research Council score, ICU-acquired weakness, delirium, ICU Mobility Scale (IMS), and ventilator- and ICU-free days. For safety assessment, vital signs were monitored during the intervention. MEASUREMENTS AND MAIN RESULTS: Among 180 patients, 86 and 90 patients remained in the vibration therapy and control groups, respectively. The mean age was 69 ± 13 vs. 67 ± 16 years in the vibration therapy and control groups, and the Acute Physiology and Chronic Health Evaluation (APACHE) II score was 19 (14-25) vs. 18 (13-23). The total FSS-ICU at ICU discharge was 24 (18-27) and 21 (17-26) in the intervention and control groups, respectively ( p = 0.09), and the supine-to-sit ability significantly improved in the intervention group ( p < 0.01). The secondary outcomes were not significantly different. Vital signs remained stable during vibration therapy. In the predefined subgroup analysis, FSS-ICU improved in the population with a higher body mass index (≥ 23 kg/m 2 ), lower APACHE II scores (< 19), and higher IMS scores (≥ 6). CONCLUSIONS: Vibration therapy did not improve the total FSS-ICU. However, the supine-to-sit ability in the FSS-ICU improved without any adverse event.

  Corresponding, Jun. 2024, Critical care medicine, 52(6) (6), 910 - 919, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Cut-off values for an ultrasound-based muscle mass assessment at intensive care unit admission: A retrospective study

  Nobuto Nakanishi, Isao Miyajima, Takeshi Saijo, Takahiro Kudo, Kohei Tanaka, Yuta Arai, Manabu Ishihara, Kensuke Nakamura, Joji Kotani

  Jun. 2024, Clinical Nutrition Open Science

  [Refereed]

  Scientific journal


• Acute muscle loss assessed using panoramic ultrasound in critically ill adults: a prospective observational study.

  Daisuke Ikechi, Hidehiko Nakano, Nobuto Nakanishi, Takahiro Fujita, Naho Watanabe, Yasuaki Koyama, Hideki Hashimoto, Kensuke Nakamura

  PURPOSE: Panoramic ultrasound is one of the recently introduced ultrasound evaluation techniques. We herein examined the relationship between the cross-sectional area of the rectus femoris muscle on panoramic ultrasound and its volume based on the gold standard computed tomography (CT) evaluation. METHODS: This was a single-center prospective observational study. A panoramic ultrasound assessment of the cross-sectional area of the rectus femoris muscle and a simple CT evaluation of its volume were performed on days 1 and 7 of hospitalization. Physical functions were assessed at discharge. RESULTS: Twenty patients were examined. The rate of change in the cross-sectional area of the rectus femoris muscle on panoramic ultrasound correlated with that in its volume on CT (correlation coefficient 0.59, p = 0.0061). In addition, a correlation was observed between the absolute value for the rectus femoris muscle cross-sectional area on panoramic ultrasound and physical functions at discharge. Rectus femoris muscle distances did not correlate with either. CONCLUSION: In the acute phase of critical illness, the cross-sectional area of the rectus femoris muscle on panoramic images correlated with its volume on CT and, thus, it is a valid method for assessing muscle mass.

  Apr. 2024, Journal of medical ultrasonics (2001), 51(2) (2), 355 - 362, English, Domestic magazine

  [Refereed]

  Scientific journal


• Utility of Lean Body Mass Equations and Body Mass Index for Predicting Outcomes in Critically Ill Adults with Sepsis: A Retrospective Study

  Rumiko Shimizu, Nobuto Nakanishi, Manabu Ishihara, Jun Oto, Joji Kotani

  Corresponding, Jan. 2024, Diseases

  [Refereed]

  Scientific journal


• Post-intensive care syndrome follow-up system after hospital discharge: a narrative review.

  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.

  Lead, Jan. 2024, Journal of intensive care, 12(1) (1), 2 - 2, English, International magazine

  [Refereed]

  Scientific journal


• Postintensive care syndrome family: A comprehensive review

  Kasumi Shirasaki, Toru Hifumi, Nobuto Nakanishi, Nobuyuki Nosaka, Kyohei Miyamoto, Miyuki H. Komachi, Junpei Haruna, Shigeaki Inoue, Norio Otani

  Jan. 2024, Acute Medicine & Surgery

  [Refereed]

  Scientific journal


• Post‐intensive care syndrome: Recent advances and future directions

  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

  [Refereed]

  Scientific journal


• The Utility of Urinary Titin to Diagnose and Predict the Prognosis of Acute Myocardial Infarction

  Miharu Arase, Nobuto Nakanishi, Rie Tsutsumi, Ayuka Kawakami, Yuta Arai, Hiroshi Sakaue, Jun Oto

  Jan. 2024, International Journal of Molecular Sciences

  [Refereed]

  Scientific journal


• 敗血症患者におけるPersistent inflammation,immunosuppression,and catabolism syndromeのインパクトを探る

  井上 茂亮, 中西 信人, 高山 和之, 杉山 隼, 大野 雄康, 小谷 穣治

  (一社)日本救急医学会, Dec. 2023, 日本救急医学会雑誌, 34(12) (12), 698 - 698, Japanese


• COVID-19流行期における救急搬送困難因子の探索 神戸市消防救急搬送データベースを用いた後ろ向き観察研究

  高山 和之, 杉山 隼, 中西 信人, 大野 雄康, 井上 茂亮, 小谷 穣治

  (一社)日本救急医学会, Dec. 2023, 日本救急医学会雑誌, 34(12) (12), 874 - 874, Japanese


• 重症患者リハビリテーション診療ガイドライン2023

  卯野木 健, 林田 敬, 河合 佑亮, 對東 俊介, 安藤 守秀, 飯田 有輝, 笠井 史人, 川崎 達也, 神津 玲, 近藤 豊, 齊藤 正和, 櫻本 秀明, 佐々木 信幸, 佐浦 隆一, 中村 謙介, 大内 玲, 岡本 菜子, 岡村 正嗣, 栗原 知己, 栗山 明, 松石 雄二朗, 山本 憲督, 吉廣 尚大, 矢坂 泰介, 安部 諒, 飯塚 崇仁, 井上 拓保, 内山 侑紀, 遠藤 聡, 大倉 和貴, 太田 浩平, 大塚 貴久, 岡田 大輔, 小幡 賢吾, 片山 雪子, 金田 直樹, 北山 未央, 喜納 俊介, 草葉 隆一, 桑原 政成, 笹沼 直樹, 高橋 正浩, 高山 千尋, 田代 尚範, 立野 淳子, 田村 貴彦, 田本 光拡, 土谷 飛鳥, 堤 悠介, 長門 直, 成田 知大, 名和 智裕, 野々山 忠芳, 花田 匡利, 平川 功太郎, 牧野 晃子, 正木 宏享, 松木 良介, 松嶋 真哉, 松田 航, 宮城島 沙織, 諸見里 勝, 柳 尚弥, 山内 康太, 山下 遊平, 山本 夏啓, 劉 啓文, 若林 侑起, 渡辺 伸一, 米倉 寛, 中西 信人, 高橋 哲也, 西田 修, 日本集中治療医学会集中治療早期リハビリテーション委員会

  (一社)日本集中治療医学会, Dec. 2023, 日本集中治療医学会雑誌, 30(Suppl.2) (Suppl.2), S905 - S972, Japanese

  [Refereed]


• Instruments to assess post-intensive care syndrome assessment: a scoping review and modified Delphi method study.

  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.

  Lead, Nov. 2023, Critical care (London, England), 27(1) (1), 430 - 430, English, International magazine

  [Refereed]

  Scientific journal


• Japanese Clinical Practice Guidelines for Rehabilitation in Critically Ill Patients 2023 (J-ReCIP 2023).

  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

  [Refereed]

  Scientific journal


• Ultrasound-based upper limb muscle thickness is useful for screening low muscularity during intensive care unit admission: A retrospective study

  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

  [Refereed]

  Scientific journal


• Effects of Mobilization within 72 h of ICU Admission in Critically Ill Patients: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

  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

  [Refereed]

  Scientific journal


• Diaphragm Dysfunction and ICU-Acquired Weakness in Septic Shock Patients with or without Mechanical Ventilation: A Pilot Prospective Observational Study.

  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

  [Refereed]

  Scientific journal


• Assessment and Prevention of Respiratory Muscle Atrophy and Dysfunction

  中西信人

  Aug. 2023, Jpn J Respir Care, 40, 143 - 149

  [Refereed][Invited]


• Effect of Neuromuscular Electrical Stimulation in Patients With Critical Illness: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.

  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.

  Lead, May 2023, Critical care medicine, English, International magazine

  [Refereed]

  Scientific journal


• ICU-AWとその後

  中西信人

  Japanese Society for Surgical Metabolism and Nutrition, Apr. 2023, The Japanese Journal of SURGICAL METABOLISM and NUTRITION, 57(2) (2), 48 - 52

  [Refereed][Invited]

  Scientific journal


• Impact of the coronavirus disease 2019 pandemic on the operational efficiency of emergency medical services and its association with out of hospital cardiac arrest survival rates: A population based cohort study in Kobe, Japan

  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)

  [Refereed]

  Scientific journal


• C188-9, a specific inhibitor of STAT3 signaling, prevents thermal burn-induced skeletal muscle wasting in mice

  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

  [Refereed]

  Scientific journal


• 救急・集中治療領域 重症患者における栄養管理

  中西信人, 小谷穣治

  Lead, Japanese Society for Surgical Metabolism and Nutrition, Dec. 2022, The Japanese Journal of SURGICAL METABOLISM and NUTRITION, 56(6) (6), 229 - 234

  [Refereed][Invited]

  Scientific journal


• Impact of Energy and Protein Delivery to Critically Ill Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

  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.

  Lead, Nov. 2022, Nutrients, 14(22) (22), English, International magazine

  [Refereed]

  Scientific journal


• Current practice and barriers in the implementation of ultrasound-based assessment of muscle mass in Japan: A nationwide, web-based cross-sectional study

  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.

  Corresponding, Public Library of Science (PLoS), Nov. 2022, PLOS ONE, 17(11) (11), e0276855 - e0276855

  [Refereed]

  Scientific journal


• Right thyrocervical trunk rupture after right internal jugular vein puncture: a case report and systematic review of the literature

  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)

  [Refereed]

  Scientific journal


• Prevalence and Long-Term Prognosis of Post-Intensive Care Syndrome after Sepsis: A Single-Center Prospective Observational Study

  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

  [Refereed]

  Scientific journal


• Oropharyngeal pleomorphic adenoma causing complete airway obstruction and cardiopulmonary arrest.

  Ono Y, Nakanishi N, Yamada I, Kotani J

  Aug. 2022, Oxf Med Case Reports., 2022(8) (8), omac083 - omac083, English, International magazine

  [Refereed]


• Post-Intensive Care Syndrome—10 Years after Its Proposal and Future Directions

  Shigeaki Inoue, Nobuto Nakanishi, Kensuke Nakamura

  Jul. 2022, Journal of Clinical Medicine

  [Refereed]

  Scientific journal


• Skeletal muscle mass assessment in critically ill patients: method and application

  Kohei Tanaka, Sho Katayama, Kazuki Okura, Masatsugu Okamura, Keishi Nawata, Nobuto Nakanishi, Ayato Shinohara

  Corresponding, The Japanese Society of Strategies for Cancer Research and Therapy, Jul. 2022, Annals of Cancer Research and Therapy, 30(2) (2), 93 - 99

  [Refereed]

  Scientific journal


• Man with shortness of breath after meal

  Nobuto Nakanishi, Yuko Ono, Isamu Yamada, Joji Kotani

  Wiley, Jun. 2022, Journal of the American College of Emergency Physicians Open, 3(3) (3)

  [Refereed]

  Scientific journal


• A questionnaire survey regarding follow-up after ICU discharge in Japan

  日本集中治療医学会Pics対策, 生活の質改善検討委員会

  Japanese Society of Intensive Care Medicine, Mar. 2022, Journal of the Japanese Society of Intensive Care Medicine, 29(2) (2), 165 - 176

  [Refereed]

  Scientific journal


• Characteristics of patients with hip fractures and comorbid fall-related injuries in the emergency department.

  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

  [Refereed]

  Scientific journal


• Sepsis causes neutrophil infiltration in muscle leading to muscle atrophy and weakness in mice.

  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.

  Lead, 2022, Frontiers in immunology, 13, 950646 - 950646, English, International magazine

  [Refereed]

  Scientific journal


• 重症患者における骨格筋量評価 方法と実践

  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

  Corresponding, 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

  [Refereed]


• Ultrasound assessment of muscle mass has potential to identify patients with low muscularity at intensive care unit admission: A retrospective study

  Yuta Arai, Nobuto Nakanishi, Yuko Ono, Shigeaki Inoue, Joji Kotani, Masafumi Harada, Jun Oto

  Elsevier BV, Oct. 2021, Clinical Nutrition ESPEN, 45, 177 - 183

  [Refereed]

  Scientific journal


• Impact of oral care on thirst perception and dry mouth assessments in intensive care patients: An observational study.

  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.

  Corresponding, Oct. 2021, Intensive & critical care nursing, 66, 103073 - 103073, English, International magazine

  [Refereed]

  Scientific journal


• Post-Intensive Care Syndrome and Its New Challenges in Coronavirus Disease 2019 (COVID-19) Pandemic: A Review of Recent Advances and Perspectives.

  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.

  Lead, Aug. 2021, Journal of clinical medicine, 10(17) (17), English, International magazine

  [Refereed]

  Scientific journal


• Assessment of catabolic state in infants with the use of urinary titin N-fragment.

  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

  [Refereed]

  Scientific journal


• Rectus Femoris Mimicking Ultrasound Phantom for Muscle Mass Assessment: Design, Research, and Training Application.

  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

  [Refereed]

  Scientific journal


• Measuring and Monitoring Skeletal Muscle Mass after Stroke: A Review of Current Methods and Clinical Applications.

  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

  [Refereed]

  Scientific journal


• Effect of vibration therapy on physical function in critically ill adults (VTICIA trial): protocol for a single-blinded randomised controlled trial.

  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

  [Refereed]

  Scientific journal


• Urinary Titin N-Fragment as a Biomarker of Muscle Atrophy, Intensive Care Unit-Acquired Weakness, and Possible Application for Post-Intensive Care Syndrome.

  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

  [Refereed]

  Scientific journal


• The effect of high-flow nasal cannula on diaphragm dysfunction including paradoxical diaphragmatic contraction in the intensive care unit.

  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.

  Corresponding, 2021, The journal of medical investigation : JMI, 68(1.2) (1.2), 159 - 164, English, Domestic magazine

  [Refereed]

  Scientific journal


• Elevated Urinary Titin and its Associated Clinical Outcomes after Acute Stroke.

  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.

  Corresponding, Dec. 2020, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 30(3) (3), 105561 - 105561, English, International magazine

  [Refereed]

  Scientific journal


• Upper limb muscle atrophy associated with in-hospital mortality and physical function impairments in mechanically ventilated critically ill adults: a two-center prospective observational study.

  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

  [Refereed]

  Scientific journal


• Effect of Electrical Muscle Stimulation on Upper and Lower Limb Muscles in Critically Ill Patients: A Two-Center Randomized Controlled Trial.

  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

  [Refereed]

  Scientific journal


• Early Initiation of Awake Veno-Venous Extracorporeal Membrane Oxygenation Can Attenuate Muscle Atrophy and Weakness in Acute Respiratory Distress Syndrome.

  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


• 重症病態における代謝変化とアミノ酸代謝の見解

  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

  [Refereed]


• 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

  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.

  Lead, Jul. 2020, Critical care medicine, 48(9) (9), 1327 - 1333, English, International magazine

  [Refereed]

  Scientific journal


• Effect of High-Flow Nasal Cannula on Sleep-disordered Breathing and Sleep Quality in Patients With Acute Stroke

  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


• Comparison of noninvasive positive pressure ventilation and high-flow nasal cannula for immunocompromised patients with acute respiratory failure

  タカシマ, タクヤ, イタガキ, タイガ, ウエノ, ヨシトヨ, ナカニシ, ノブト, タネ, ナツキ, ツナノ, ユミコ, オオトウ, ジュン

  Background : Non-invasive positive pressure ventilation （NPPV） is highly recommended for immunocompromised patients with acute respiratory failure. In this population it remains uncertain, however, whether high flow nasal canula（HFNC）is as beneficial as NPPV. Methods : We retrospectively studied immunocompromised patients with acute respiratory failure admitted to our ICU from ２０１１ to ２０１８. The background and clinical outcomes of patients initially treated with HFNC and NPPV were compared. Results : Upon admission, １２ patients were treated with HFNC and １０ with NPPV. While the length of ICU stay was significantly shorter in HFNC group （HFNC４．６days vs. NPPV１３．８days, p=０．０２）, no intergroup difference was seen in ICU mortality （１６．７％ vs.３０．０％, p=０．４６）or intubation rate（３３．３％ vs.５０．０％, p=０．４３）. Conclusions : For immunocompromised patients with acute respiratory failure, HFNC may be an alternative to NPPV. Further prospective investigation is warranted.

  徳島医学会, Apr. 2020, Shikoku Acta Medica, 76(1-2) (1-2), 55 - 60, Japanese

  Scientific journal


• Upper limb movements and the risk of unplanned device removal in mechanically ventilated patients

  Yoshimi Kawahara, Nobuto Nakanishi, Keiko Nomura, Jun Oto

  Corresponding, Wiley, Jan. 2020, Acute Medicine & Surgery, 7(1) (1)

  [Refereed]

  Scientific journal


• Immobilization hypercalcemia during prolonged respiratory management for ARDS: A case report

  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

  2020, 四国医学雑誌, 76(5-6) (5-6)

  [Refereed]


• 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

  2020, 四国医学雑誌, 76(5-6) (5-6)

  [Refereed]


• Utilization of crowdfunding in the intensive care field: Muscle atrophy zero project and a questionnaire survey

  中西信人, 小出静代, 橋爪太, 大藤純

  2020, 四国医学雑誌, 76(5-6) (5-6)

  [Refereed]


• Effect of controlled ventilation during assist-control ventilation on diaphragm thickness : a post hoc analysis of an observational study.

  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

  [Refereed]

  Scientific journal


• Muscle atrophy in critically ill patients : a review of its cause, evaluation, and prevention.

  Nobuto Nakanishi, Takuya Takashima, Jun Oto

  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.

  Lead, Jan. 2020, The journal of medical investigation : JMI, Vol.64(No.1, 2) (No.1, 2), English

  [Refereed]

  Scientific journal


• Change in diaphragm and intercostal muscle thickness in mechanically ventilated patients: a prospective observational ultrasonography study.

  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]


• Monitoring of muscle mass in critically ill patients: comparison of ultrasound and two bioelectrical impedance analysis devices.

  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.

  Lead, Dec. 2019, Journal of intensive care, 7, 61 - 61, English, International magazine

  [Refereed]

  Scientific journal


• Electrocardiogram interpretation by paramedics improve reperfusion time in acute coronary syndrome

  Nobuto Nakanishi, Morimichi Setsuda

  Lead, 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

  Lead, Apr. 2019, Shikoku Acta Medica, Vol.75(No.3, 4) (No.3, 4), Japanese

  [Refereed]

  Scientific journal


• Bacterial Contamination of Circuit Inner Surfaces After High-Flow Oxygen Therapy.

  Mutsuo Onodera, Emiko Nakataki, Nobuto Nakanishi, Taiga Itagaki, Masami Sato, Jun Oto, Masaji Nishimura

  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


• Humidification Performance of Passive and Active Humidification Devices Within a Spontaneously Breathing Tracheostomized Cohort

  Nobuto Nakanishi, Jun Oto, Taiga Itagaki, Emiko Nakataki, Mutsuo Onodera, Masaji Nishimura

  Lead, Mary Ann Liebert Inc, Feb. 2019, Respiratory Care, 64(2) (2), 130 - 135

  [Refereed]

  Scientific journal


• Effect of High-Flow Nasal Cannula on Thoraco-Abdominal Synchrony in Pediatric Subjects After Cardiac Surgery

  Taiga Itagaki, Nobuto Nakanishi, Nao Okuda, Emiko Nakataki, Mutsuo Onodera, Jun Oto, Masaji Nishimura

  Mary Ann Liebert Inc, Jan. 2019, Respiratory Care, 64(1) (1), 10 - 16

  [Refereed]

  Scientific journal


• Reverse triggering induced by endotracheal tube leak in lightly sedated ARDS patient

  Taiga Itagaki, Yoshitoyo Ueno, Nobuto Nakanishi, Jun Oto

  Springer Science and Business Media LLC, Jul. 2018, Journal of Intensive Care, 6(1) (1)

  [Refereed]

  Scientific journal


• Upper and lower limb muscle atrophy in critically ill patients: an observational ultrasonography study

  Nobuto Nakanishi, Jun Oto, Rie Tsutsumi, Marina Iuchi, Mutsuo Onodera, Masaji Nishimura

  Lead, Springer Verlag, Feb. 2018, Intensive Care Medicine, 44(2) (2), 263 - 264, English

  [Refereed]

  Scientific journal


• 小児穿孔性虫垂炎の臨床的特徴

  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


• 上部消化管造影検査後の結腸穿孔にてバリウム腹膜炎からGrey Turner徴候を呈し，腹壁壊死に至った一例

  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


• Does T wave inversion in lead aVL predict mid-segment left anterior descending lesions in acute coronary syndrome? A retrospective study

  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


• Effect of leak on patient-ventilator dyssynchrony during noninvasive positive pressure ventilation: comparison among ventilator brand

  Nobuto Nakanishi, Yoshitoyo Ueno, Hideaki Imanaka, Masaji Nishimura

  Lead, Jul. 2012, Journal of the Japanese Society of Intensive Care Medicine, Vol.19(No.3) (No.3), 423 - 424

  [Refereed]

  Scientific journal


• A Bench Study of the Effects of Leak on Ventilator Performance During Noninvasive Ventilation

  Yoshitoyo Ueno, Nobuto Nakanishi, Jun Oto, Hideaki Imanaka, Masaji Nishimura

  Nov. 2011, Respiratory Care, 56(11) (11), 1758 - 1764

  [Refereed]

  Scientific journal

• 重症患者の病態＆栄養管理Next Step：なぜ、重症患者に対する栄養管理は重要なの？

  中西信人

  Feb. 2026, Nutrition Care（ニュートリションケア）, Japanese

  [Invited]

  Introduction commerce magazine


• ICUでの骨格筋評価とリハビリテーション

  中西信人

  Lead, Sep. 2025, 救急・集中治療, 37(3) (3), Japanese

  [Invited]

  Introduction commerce magazine


• 重症病態における筋萎縮・筋力低下・PICSとタイチン

  中西信人

  Jul. 2025, ICUとCCU, 49(7) (7)


• 栄養障害を見逃さない!臨床栄養の新戦略と実践テクニック ここがポイント!病態別栄養管理と栄養療法 集中治療室の栄養障害・栄養管理

  中西信人

  2025, 月刊薬事, 67(7) (7)


• ICU・Post ICU栄養の最前線-ひろがる重症患者の栄養管理【ICU・Post ICU栄養の最新トピック】ICU患者における筋萎縮予防のための評価・介入

  中西信人

  2025, 臨床栄養, 146(5) (5)


• Physical impairments in PICS

  中西信人

  2025, 医学のあゆみ, 292(6) (6)


• 超急性期におけるリハビリテーション診療マニュアル ベッド上からの集中治療後症候群(PICS)予防-神経筋電気刺激療法(NMES)-

  中西信人

  2025, Monthly Book Medical Rehabilitation, (313) (313)


• ICU入室患者における振動療法の効果:前向き無作為化比較試験

  土肥智史, 中西信人, 河原良美, 島麻美子, 野村慶子, 白石美恵, 大藤純

  2024, 日本集中治療医学会学術集会(Web), 51st


• 「特殊組成と併用療法」におけるガイドラインの改訂ポイント:国際ガイドラインとの比較

  吉田稔, 吉田稔, 畠山淳司, 畠山淳司, 野崎歩, 野崎歩, 丹保亜希仁, 丹保亜希仁, 櫻本秀明, 櫻本秀明, 成田知大, 成田知大, 大邊寛幸, 大邊寛幸, 中西信人, 中西信人, 山田浩平, 山田浩平, 山田浩平, 山元良, 東別府直紀, 中村謙介, 小谷穣治, 小谷穣治

  2024, 日本集中治療医学会学術集会(Web), 51st


• PICS measures

  中西信人

  2024, 救急医学, 48(10) (10)


• 【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


• 【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


• 【集中治療:進歩と未来～50年を振りかえって～】マイクロバイオータとCritical Care Nutrition 栄養管理のパラダイムシフトと未来

  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


• 骨格筋萎縮のバイオマーカーとしての尿中タイチン測定の有用性

  兵藤瑞紗, 堤理恵, 中西信人, 大藤純, 鈴木由紀, 待田京香, 原加奈子, 和泉優奈, 松尾雅文, 阪上浩

  2023, 日本筋学会学術集会プログラム・抄録集, 9th


• 医療現場におけるサルコペニア・フレイル 集中治療領域におけるサルコペニア・フレイル

  中西信人

  2022, 理学療法ジャーナル, 56(6) (6)


• 本邦ICUにおける心臓血管外科術後患者の疫学調査-JIPADデータ解析-

  秋本雄祐, 中西信人, 中野勇希, 高島拓也, 上野義豊, 田根なつ紀, 綱野祐美子, 石原学, 板垣大雅, 大藤純

  2021, 日本集中治療医学会学術集会(Web), 48th


• 目標換気量の表示が人工呼吸患者の低一回換気量/肺保護換気の順守率に与える影響

  高島拓也, 上野義豊, 石原学, 中西信人, 田根なつ紀, 田根なつ紀, 綱野祐美子, 板垣大雅, 板垣大雅, 大藤純, 大藤純

  2021, 日本集中治療医学会学術集会(Web), 48th


• 目標換気量の表示が人工呼吸患者の低一回換気量/肺保護換気の順守率に与える影響

  高島拓也, 上野義豊, 石原学, 中西信人, 田根なつ紀, 綱野祐美子, 板垣大雅, 大藤純

  2021, 日本集中治療医学会学術集会(Web), 48th


• 【PADISガイドライン-わが国の現状と未来への展望】ICUにおけるリハビリの現状と未来への展望

  中西 信人

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


• 人工呼吸開始後早期の患者-人工呼吸器非同調が横隔膜厚の変化に与える影響

  板垣大雅, 高島拓也, 上野義豊, 中西信人, 田根なつ紀, 綱野祐美子, 大藤純

  2020, 日本集中治療医学会学術集会(Web), 47th


• 目標換気量の表示が人工呼吸患者の低一回換気量/肺保護換気の順守率に与える影響

  高島拓也, 上野義豊, 石原学, 中西信人, 田根なつ紀, 綱野祐美子, 板垣大雅, 大藤純

  2020, 日本集中治療医学会学術集会(Web), 47th


• Comparison of noninvasive positive pressure ventilation and high flow nasal cannula for immunocompromised patients with acute respiratory failure

  高島拓也, 板垣大雅, 上野義豊, 中西信人, 田根なつ紀, 綱野祐美子, 大藤純

  2020, 四国医学雑誌, 76(1-2) (1-2)


• 側弯矯正固定術後の急性換気不全に対し気管支鏡による選択的気管支拡張術が奏功した1例

  秋本雄祐, 上野義豊, 高島拓也, 石原学, 中西信人, 田根なつ紀, 綱野祐美子, 板垣大雅, 大藤純

  2020, 日本集中治療医学会中国・四国支部学術集会プログラム・抄録集(Web), 4th


• ICU特有の病態・合併症 2.ARDSの病態と治療

  中西信人, 西村匡司

  2020, 集中治療医学レビュー, 2020-2021


• Hemodynamic Assessment in Intensive Care Noninvasive Monitoring

  Nobuto Nakanishi, Masaji Nishimura

  Igaku Tosho Shuppan LTD., Mar. 2019, Japanese


• 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

  2019, 日本集中治療医学会学術集会(Web), 46th


• 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

  板垣大雅, 上野義豊, 中西信人, 奥田菜緒, 中瀧恵実子, 大藤純

  2019, 日本集中治療医学会学術集会(Web), 46th


• 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

  大藤純, 上野義豊, 中西信人, 高島拓也, 板垣大雅

  2019, 日本集中治療医学会学術集会(Web), 46th


• High Flow Nasal Cannulaの横隔膜機能に対する効果

  高島拓也, 中西信人, 鈴木康大, 上野義豊, 西川真理恵, 田根なつ紀, 奥田菜緒, 中瀧恵実子, 板垣大雅, 大藤純

  2019, 日本集中治療医学会学術集会(Web), 46th


• 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, 板垣大雅, 中西信人, 大藤純

  2019, 日本集中治療医学会学術集会(Web), 46th


• 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, 板垣大雅, 鈴木康大, 上野義豊, 中西信人, 西川真理恵, 田根なつ紀, 奥田菜緒, 中瀧恵実子, 大藤純

  2019, 日本集中治療医学会学術集会(Web), 46th


• 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, 中西信人, 野寺裕之, 上野義豊, 板垣大雅, 中瀧恵実子, 大藤純

  2019, 日本集中治療医学会学術集会(Web), 46th


• 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

  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, 奥田菜緒, 中瀧恵実子, 板垣大雅, 大藤純

  2019, 日本集中治療医学会学術集会(Web), 46th


• 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, 上野義豊, 中西信人, 田根なつ紀, 奥田菜緒, 中瀧恵実子, 板垣大雅, 大藤純

  2019, 日本集中治療医学会学術集会(Web), 46th


• 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


• 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, 大藤純, 中西信人, 田根なつ紀, 奥田菜緒, 綱野祐美子, 中瀧恵実子, 板垣大雅, 小野寺睦雄, 西村匡司

  2018, 日本集中治療医学会学術集会(Web), 45th


• 人工呼吸管理を要するICU患者の横隔膜萎縮

  中西信人, 大藤純, 板垣大雅, 中瀧恵実子, 小野寺睦雄, 西村匡司

  2018, 日本集中治療医学会学術集会(Web), 45th


• RAM cannulaを用いた新生児非侵襲的人工換気の経験

  板垣大雅, 上野義豊, 中西信人, 西川真理恵, 田根なつ紀, 奥田菜緒, 中瀧恵実子, 大藤純

  2018, 日本呼吸療法医学会学術集会プログラム・抄録集, 40th


• 【侵襲時の生体反応を改善する新しい試み】 重症病態におけるエネルギー代謝破綻と栄養学的アプローチの思索

  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


• 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


• 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

  綱野祐美子, 上野義豊, 中西信人, 西川真理恵, 井澤眞代, 中瀧恵実子, 板垣大雅, 大藤純, 小野寺陸雄, 西村匡司

  2017, 日本集中治療医学会学術集会(Web), 44th


• 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

  中瀧恵実子, 上野義豊, 中西信人, 西川真理恵, 綱野祐美子, 井澤眞代, 板垣大雅, 大藤純, 小野寺睦雄, 西村匡司

  2017, 日本集中治療医学会学術集会(Web), 44th


• 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・ICU栄養療法ステップアップー病態から理解する重症患者の栄養管理

  中村謙介, 工藤雄洋, 西條豪, 宮島功, 中西信人

  Joint work, 筋肉量の評価, 三輪書店, Feb. 2026, ISBN: 9784895908665


• みんなの急性期リハビリテーション・栄養療法

  中西, 信人, 三谷, 雄己

  中外医学社, Jun. 2025, Japanese, ISBN: 9784498067523


• 誰でもできる筋肉評価 : 医師、看護師、栄養士、理学療法士に必要なサルコペニア、リハビリ、栄養の評価

  中西, 信人

  日本医事新報社, Jun. 2024, Japanese, ISBN: 9784784924851


• ICUが変わる!PICS診療実践マニュアル : 入院時から退院後まで、予後改善のためのスタンダード

  中村謙介

  Joint work, 羊土社, Mar. 2024, Japanese, ISBN: 9784758124126


• エキスパートが伝授する早期離床・リハビリテーションの理論と実践

  曷川, 元, 中村, 謙介 (救急医学), 日本離床学会

  Joint work, 日本離床学会,三輪書店 (発売), Dec. 2023, Japanese, ISBN: 9784895908047


• 理学療法士集中治療テキスト

  日本集中治療医学会

  Joint work, シービーアール, Mar. 2023, Japanese, ISBN: 9784908083884


• 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

  井上茂亮

  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


• 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


• 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

• 骨格筋量の評価

  中西信人

  第11回日本栄養・嚥下理学療法学会, Sep. 2025, Japanese

  [Invited]

  Invited oral presentation


• 筋萎縮ゼロへ―神経筋電気刺激で挑む急性期介入の最前線―

  中西信人

  第47回 日本呼吸療法医学会学術集会, Aug. 2025, Japanese

  [Invited]

  Public symposium


• “その先”を見据えた急性期リハ栄養 ～社会復帰のための第一歩～

  中西信人

  帯広急性期栄養セミナー, Aug. 2025, Japanese

  [Invited]

  Public discourse


• 歩いて帰れる集中治療を目指して；ICU-AWを予防するには

  中西信人

  第9回関西支部学術集会, Jul. 2025

  [Invited]

  Nominated symposium


• 知っておきたい重症患者の栄養とリハビリテーション

  中西信人

  日本クリティカルケア看護学会, Jul. 2025

  [Invited]

  Invited oral presentation


• Early Rehabilitation to Prevent Muscle Atrophy and Post Intensive Care Syndrome after Critical Illness

  Nobuto Nakanishi

  the 25th anniversary of the Joint Congress between the KSCCM and the Japanese Society of Intensive Care Medicine (JSICM,, Apr. 2025

  [Invited]

  Nominated symposium


• 重症患者における経静脈的ビタミンB1投与の効果:システマティックレビューとメタアナリシス

  中西信人, 阿部良伸, 松尾瑞恵, 丹保亜希仁, 吉田稔, 畠山淳司, 中村謙介, 小谷穣治

  日本栄養治療学会学術集会抄録集(Web), 2025


• 急性期の筋肉量評価は栄養治療のサロゲート・マーカーに重要

  中西信人

  日本栄養治療学会学術集会抄録集(Web), 2025

  [Invited]

  Nominated symposium


• 最新のリハビリテーションガイドラインと高機能ICUベッドの活用

  中西信人

  日本集中治療医学会学術集会(Web), 2025


• 面白い研究のアイデアは自分の過去の研究にあり

  中西信人

  日本集中治療医学会学術集会(Web), 2025

  [Invited]


• リハビリと栄養から社会復帰を目指す集中治療に憧れて-私はこうして自己実現した-

  中西信人

  日本集中治療医学会学術集会(Web), 2025

  [Invited]


• Effect of neuromuscular electrical stimulation in critically ill patients with: An updated systematic review and meta-analysis of randomized controlled trials

  Nobuto Nakanishi, Shodai Yoshihiro, Yusuke Kawamura, Gen Aikawa, Haruka Shida, Motohiro Shimizu, Yoshihisa Fujinami, Ayaka Matsuoka, Shinichi Watanabe, Shunsuke Taito, Shigeaki Inoue

  Asia western pacific region congress 2024, Sep. 2024

  Oral presentation


• The pathophysiology of ICU-acquired weakness in patients with sepsis

  中西信人

  日本外科感染症学会雑誌(Web), 2024

  [Invited]


• 重症患者における神経筋電気刺激装置の効果

  中西信人, 吉廣尚大, 川村雄介, 相川玄, 志田瑶, 志水元洋, 藤浪好寿, 松岡綾華, 渡辺伸一, 對東俊介, 井上茂亮

  医工学治療(Web), 2024


• ICU-AW予防のための超音波を用いた栄養状態評価

  中西信人, 高田健司, 杉本貴史, 高山和之, 杉山隼, 大野雄康, 小谷穣治

  日本集中治療医学会学術集会(Web), 2024

  [Invited]

  Nominated symposium


• スコーピングレビューとデルファイ会議によるPICS評価方法の推奨

  中西信人, 劉啓文, 河内章, 岡村正嗣, 田中孝平, 片山翔, 中村謙介, 近藤豊, 井上茂亮, 西田修

  日本集中治療医学会学術集会(Web), 2024

  [Invited]

  Nominated symposium


• Sepsis causes muscle atrophy and weakness in mice through neutrophil infiltration in muscle. 46th Annual Conference on Shock

  Nobuto Nakanishi, Yuko Ono, Shigeaki Inoue, Joji Kotani

  46th Annual Conference on Shock, Jun. 2023

  [Invited]

  Invited oral presentation


• 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

  中西信人, 高山和之, 杉山隼, 大野雄康, 井上茂亮, 小谷穣治

  日本集中治療医学会関西支部学術集会プログラム・抄録集(Web), 2023


• The longitudinal change of muscle-localized neutrophils;heir potential role in;epsis-induced muscle atrophy

  Nobuto Nakanishi, Yuko Ono, Shigeaki Inoue, Joji Kotani

  ASSMN & KSSMN 2022, May 2022


• 心臓血管外科術後の筋萎縮評価と予防

  中西信人

  日本心臓血管外科学会学術総会(Web), 2022

  [Invited]

  Invited oral presentation


• Tibialis anterior muscle, diaphragm, and cardiac muscle atrophy in septic mice

  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

  日本集中治療医学会学術集会(Web), 2022


• 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

  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

  Shock, 2022


• 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]

  Public discourse


• Muscle mass assessment in the acute phase

  中西信人

  日本離床医学会, Mar. 2021

  [Invited]

  Public discourse


• Muscle atrophy zero project: the project to prevent PICS

  中西信人

  日本集中治療医学会学術集会(Web), 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

  第48回日本集中治療医学会学術集会, Feb. 2021

  Public symposium


• 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, Feb. 2021

  [Invited]

  Public discourse


• 大腿直筋ファントムモデルの作成と筋エコー測定精度の評価,教育への応用

  中西信人, 井上茂亮, 森山直紀, 宮崎勇輔, 藤浪好寿, 大野雄康, 小谷穣治

  外科と代謝・栄養, 2021


• ICUにおける骨格筋評価:CT,超音波,体組成計,バイオマーカー

  中西信人

  日本集中治療医学会学術集会(Web), 2021


• 上下肢筋萎縮は院内死亡・身体機能障害と関連する

  中西信人, 大藤純, 秋本雄祐, 中野勇希, 高島拓也, 石原学, 中瀧恵実子, 西村匡司

  日本集中治療医学会学術集会(Web), 2021


• Urinary titin is a novel biomarker of muscle atrophy in non-surgical 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

  The 33th annual congress of European Society of Intensive Care Medicine, Dec. 2020

  Oral presentation


• Electrical muscle stimulation on upper and lower limb muscle in critically ill patients

  N. Nakanishi, J. Oto, R. Tsutsumi, T. Yamamoto, Y. Ueno, E. Nakataki, I. Taiga, M. Nishimura

  The 32th annual congress of European Society of Intensive Care Medicine, Oct. 2019


• Diaphragm and intercostal muscle atrophy in mechanically ventilated patients: an observational ultrasonography study

  N. Nakanishi, J. Oto, T. Itagaki, E. Nakataki, M. Nishimura

  The 48th Society of Critical Care Medicine (SCCM) Critical Care Congress, Feb. 2019

  Oral presentation


• 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


• 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


• Diaphragm atrophy in mechanically ventilated patients in the ICU

  N. Nakanishi, E. Nakataki, T. Itagaki, J. Oto, M. Nishimura

  The 37th Korean Society of Critical Care Medicine (KSCCM) Annual Congress and Asian Critical Care Conference, Apr. 2018

  Oral presentation


• 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


• :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


• 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


• 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


• 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


• 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


• 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


• 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

  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


• 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


• 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

• Japanese Society for Respiratory Care Medicine

  Jun. 2023 - Present


• 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

• 超音波画像による横隔膜機能評価の自動計測ソフトウェアの開発と導入による意義検証

  渡辺 伸一, 飯田有輝, 鈴木啓介, 中村謙介, 中西信人

  日本学術振興会, 科学研究費助成事業, 基盤研究(C), 岐阜保健大学, Apr. 2024 - Mar. 2028


• 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


• リアルタイムフィードバック機能を活用した応急手当教育と映像通報システムがバイスタンダーCPRの質に与える影響に関する研究

  杉山 隼, 小谷 穣治, 大野 雄康, 中西 信人, 高山 和之

  一般財団法人救急振興財団「救急に関する調査研究事業助成」, 神戸大学, Apr. 2025 - Mar. 2026, Coinvestigator


• 敗血症による筋萎縮・PICS予防のためのマイオスタチンアンチセンスの効果

  中西 信人

  日本学術振興会, 科学研究費助成事業, 若手研究, 神戸大学, Apr. 2024 - Mar. 2026


• 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。


• Crowd funding: Muscle atrophy Zero project

  Nobuto Nakanishi

  OTSUCLE, Cause, diagnosis, treatment of muscle atrophy in critically ill patients., Tokushima University Hospital, Feb. 2020

• 重症肺炎患者の筋萎縮予防研究 尿のタンパク質との関連分析 徳島大院・中西信人助教

  徳島新聞, Jun. 2020, 新型コロナウイルスの影響が長引く中、徳島大大学院医歯薬学研究部の中西信人助教(徳島大学病院医師)が、集中治療室(ICU)で治療を受ける重症肺炎患者らの筋肉の萎縮を予防する研究を進めている。尿に含まれるタンパク質を調べて筋萎縮との関連性を分析し、効果的なリハビリや栄養補給につなげるのが狙い。効果的に筋力を維持し、患者の社会復帰を後押しする。

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• 筋肉量 社会復帰への道

  朝日新聞, Mar. 2020

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• Muscle atrophy Zero project

  Company and University, Feb. 2020, Challenge to croudfunding

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