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Article ; Online: Current Practice and Barriers to the Implementation of Mobilization in ICUs in Japan

Hideaki Sakuramoto / Kensuke Nakamura / Akira Ouchi / Saiko Okamoto / Shinichi Watanabe / Keibun Liu / Yasunari Morita / Hajime Katsukawa / Toru Kotani

Journal of Clinical Medicine, Vol 12, Iss 3955, p

A Multicenter Prospective Cohort Study

2023 Volume 3955

Abstract: Background : Limited information is currently available on the barriers to implementing mobilization at the bedside for critically ill patients. Therefore, we investigated the current practice of and barriers to the implementation of mobilization in ... ...

Abstract	Background : Limited information is currently available on the barriers to implementing mobilization at the bedside for critically ill patients. Therefore, we investigated the current practice of and barriers to the implementation of mobilization in intensive care units (ICU). Methods : A multicenter prospective observational study was conducted at nine hospitals between June 2019 and December 2019. Consecutive patients admitted to the ICU for more than 48 h were enrolled. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically. Results : The 203 patients enrolled in the present study were divided into 69 elective surgical patients and 134 unplanned admission patients. The mean periods of time until the initiation of rehabilitation programs after ICU admission were 2.9 ± 7.7 and 1.7 ± 2.0 days, respectively. Median ICU mobility scales were five (Interquartile range: three and eight) and six (Interquartile range: three and nine), respectively. The most common barriers to mobilization in the ICU were circulatory instability (29.9%) and a physician’s order for postoperative bed rest (23.4%) in the unplanned admission and elective surgery groups, respectively. Conclusions : Rehabilitation programs were initiated later for unplanned admission patients and were less intense than those for elective surgical patients, irrespective of the time after ICU admission.
Keywords	mobilization ; barrier ; critical care ; intensive care ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Association Between Mobilization Level And Activity of Daily Living Independence in Critically Ill Patients

Shinichi Watanabe / Keibun Liu / Ryo Kozu / Daisetsu Yasumura / Kota Yamauchi / Hajime Katsukawa / Keisuke Suzuki / Takayasu Koike / Yasunari Morita

Annals of Rehabilitation Medicine, Vol 47, Iss 6, Pp 519-

2023 Volume 527

Abstract: Objective To examine the association between the mobilization level during intensive care unit (ICU) admission and independence in activity of daily living (ADL), defined as Barthel Index (BI)≥70. Methods This was a post-hoc analysis of the EMPICS study ... ...

Abstract	Objective To examine the association between the mobilization level during intensive care unit (ICU) admission and independence in activity of daily living (ADL), defined as Barthel Index (BI)≥70. Methods This was a post-hoc analysis of the EMPICS study involving nine hospitals. Consecutive patients who spend >48 hours in the ICU were eligible for inclusion. Mobilization was performed at each hospital according to the shared protocol and the highest ICU mobility score (IMS) during the ICU stay, baseline characteristics, and BI at hospital discharge. Multiple logistic regression analysis, adjusted for baseline characteristics, was used to deter-mine the association between the highest IMS (using the receiver operating characteristic [ROC]) and ADL. Results Of the 203 patients, 143 were assigned to the ADL independence group and 60 to the ADL dependence group. The highest IMS score was significantly higher in the ADL independence group than in the dependence group and was a predictor of ADL independence at hospital discharge (odds ratio, 1.22; 95% confidence interval, 1.07–1.38; adjusted p=0.002). The ROC cutoff value for the highest IMS was 6 (specificity, 0.67; sensitivity, 0.70; area under the curve, 0.69). Conclusion These results indicate that, in patients who were in the ICU for more than 48 hours, that patients with good function in the ICU also exhibit good function upon discharge. However, prospective, multicenter trials are needed to confirm this conclusion.
Keywords	intensive care units ; rehabilitation ; activities of daily living ; postintensive care syndrome ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Korean Academy of Rehabilitation Medicine
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Changes in temporal muscle dimensions and their clinical impact in out-of-hospital cardiac arrest survivors

Takashi Hongo / Hiromichi Naito / Keibun Liu / Yuya Murakami / Satoshi Nozaki / Hiroki Maeyama / Ayaka Matsuoka / Hisashi Dote / Kazumasa Inaba / Satoshi Miike / Shigeki Fujitani / Tomohiro Hiraoka / Takafumi Obara / Tsuyoshi Nojima / Atsunori Nakao / Tetsuya Yumoto

Resuscitation Plus, Vol 17, Iss , Pp 100527- (2024)

1481

Abstract: Objective: This study investigates temporal muscle atrophy in out-of-hospital cardiac arrest patients post-resuscitation, seeking associations with neurological outcomes and factors associated with atrophy. Methods: Using data from six Japanese intensive ...

Abstract	Objective: This study investigates temporal muscle atrophy in out-of-hospital cardiac arrest patients post-resuscitation, seeking associations with neurological outcomes and factors associated with atrophy. Methods: Using data from six Japanese intensive care units, adult patients’ post-resuscitation who underwent head computed tomography scans on admission and two to five days post-admission were assessed. Temporal muscle area, thickness, and density were quantified from a single cross-sectional image. Patients were categorized into 'atrophy' or 'no atrophy' groups based on median daily temporal muscle atrophy rates. The primary outcome was changes in temporal muscle dimensions between admission and follow-up two to five days later. Secondary outcomes included assessing the impact of temporal muscle atrophy on 30-day survival, as well as identifying any clinical factors associated with temporal muscle atrophy. Results: A total of 185 patients were analyzed. Measurements at follow-up revealed significant decreases in temporal muscle area (214 vs. 191 mm2, p < 0.001), thickness (4.9 vs. 4.7 mm, p < 0.001), and density (46 vs. 44 HU, p < 0.001) compared to those at admission. The median daily rate for temporal muscle area atrophy was 2.0% per day. There was no significant association between temporal muscle atrophy and 30-day survival (hazard ratios, 0.71; 95% CI, 0.41–1.23, p = 0.231). Multivariable logistic regression found no clinical factors significantly associated with temporal muscle atrophy. Conclusions: Temporal muscle atrophy in post-resuscitation patients occurs rapidly at 2.0% per day. However, there was no significant association with 30-day mortality or any identified clinical factors. Further investigation into its long-term functional implications is warranted.
Keywords	Cardiac arrest ; Computed tomography ; Muscle atrophy ; Post-cardiac arrest syndrome ; Temporal muscle ; Specialties of internal medicine ; RC581-951
Language	English
Publishing date	2024-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Characteristics of patients with hip fractures and comorbid fall-related injuries in the emergency department.

Ishizawa, Ryo / Nakanishi, Nobuto / Keibun, Liu / Sonoo, Tomohiro / Nakamura, Kensuke / Goto, Tadahiro

Acute medicine & surgery

2022 Volume 9, Issue 1, Page(s) e805

Abstract: 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 ... ...

Abstract	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; 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.
Language	English
Publishing date	2022-10-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2751184-4
ISSN	2052-8817 ; 2052-8817
ISSN (online)	2052-8817
ISSN	2052-8817
DOI	10.1002/ams2.805
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Current practice and barriers in the implementation of ultrasound-based assessment of muscle mass in Japan

Keishi Nawata / Nobuto Nakanishi / Shigeaki Inoue / Keibun Liu / Masafumi Nozoe / Yuko Ono / Isamu Yamada / Hajime Katsukawa / Joji Kotani

PLoS ONE, Vol 17, Iss 11, p e

A nationwide, web-based cross-sectional study.

2022 Volume 0276855

Abstract: 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 ... ...

Abstract	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.
Keywords	Medicine ; R ; Science ; Q
Subject code	796
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Current practice and barriers in the implementation of ultrasound-based assessment of muscle mass in Japan

Keishi Nawata / Nobuto Nakanishi / Shigeaki Inoue / Keibun Liu / Masafumi Nozoe / Yuko Ono / Isamu Yamada / Hajime Katsukawa / Joji Kotani

PLoS ONE, Vol 17, Iss

A nationwide, web-based cross-sectional study

2022 Volume 11

Abstract	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.
Keywords	Medicine ; R ; Science ; Q
Subject code	796
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Current animal models of extracorporeal cardiopulmonary resuscitation

Shinichi Ijuin / Keibun Liu / Denzil Gill / Sun Kyun Ro / Jana Vukovic / Satoshi Ishihara / Jan Belohlavek / Gianluigi Li Bassi / Jacky Y Suen / John F Fraser

Resuscitation Plus, Vol 15, Iss , Pp 100426- (2023)

A scoping review

2023

Abstract: Aim: Animal models of Extracorporeal Cardiopulmonary Resuscitation (ECPR) focusing on neurological outcomes are required to further the development of this potentially life-saving technology. The aim of this review is to summarize current animal models ... ...

Abstract	Aim: Animal models of Extracorporeal Cardiopulmonary Resuscitation (ECPR) focusing on neurological outcomes are required to further the development of this potentially life-saving technology. The aim of this review is to summarize current animal models of ECPR. Methods: A comprehensive database search of PubMed, EMBASE, and Web of Science was undertaken. Full-text publications describing animal models of ECPR between January 1, 2000, and June 30, 2022, were identified and included in the review. Data describing the conduct of the animal models of ECPR, measured variables, and outcomes were extracted according to pre-defined definitions. Results: The search strategy yielded 805 unique reports of which 37 studies were included in the final analysis. Most studies (95%) described using a pig model of ECPR with the remainder (5%) describing a rat model. The most common method for induction of cardiac arrest was a fatal ventricular arrhythmia through electrical stimulation (70%). 10 studies reported neurological assessment of animals using physical examination, serum biomarkers, or electrophysiological findings, however, only two studies described a multimodal assessment. No studies reported the use of brain imaging as part of the neurological assessment. Return of spontaneous circulation was the most reported primary outcome, and no studies described the neurological status of the animal as the primary outcome. Conclusion: Current animal models of ECPR do not describe clinically relevant neurological outcomes after cardiac arrest. Further work is needed to develop models that more accurately mimic clinical scenarios and can test innovations that can be translated to the application of ECPR in clinical medicine.
Keywords	Extracorporeal cardiopulmonary resuscitation ; Cardiac arrest ; Animal model ; Neurological assessment ; Scoping review ; Specialties of internal medicine ; RC581-951
Subject code	630
Language	English
Publishing date	2023-09-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Association between Early Mobilization in the ICU and Psychiatric Symptoms after Surviving a Critical Illness

Shinichi Watanabe / Keibun Liu / Kensuke Nakamura / Ryo Kozu / Tatsuya Horibe / Kenzo Ishii / Daisetsu Yasumura / You Takahashi / Tomoya Nanba / Yasunari Morita / Takahiro Kanaya / Shuichi Suzuki / Alan Kawarai Lefor / Hajime Katsukawa / Toru Kotani

Journal of Clinical Medicine, Vol 11, Iss 2587, p

A Multi-Center Prospective Cohort Study

2022 Volume 2587

Abstract: This is a prospective multicenter cohort study aiming to investigate the association between early mobilization (EM), defined as a rehabilitation level of sitting at the edge of the bed or higher within 72 h of ICU admission, and psychiatric outcome. ... ...

Abstract	This is a prospective multicenter cohort study aiming to investigate the association between early mobilization (EM), defined as a rehabilitation level of sitting at the edge of the bed or higher within 72 h of ICU admission, and psychiatric outcome. Consecutive patients, admitted to the ICU for more than 48 h, were enrolled. The primary outcome was the incidence of psychiatric symptoms at 3 months after hospital discharge defined as the presence of any of three symptoms: depression, anxiety, or post-traumatic stress disorder (PTSD). Risk ratio (RR) and multiple logistic regression analysis were used. As a sensitivity analysis, two methods for inverse probability of treatment weighting statistics were performed. Of the 192 discharged patients, 99 (52%) were assessed. The patients who achieved EM had a lower incidence of psychiatric symptoms compared to those who did not (25% vs. 51%, p -value 0.008, odds ratio (OR) 0.27, adjusted p = 0.032). The RR for psychiatric symptoms in the EM group was 0.49 [95% Confidence Interval, 0.29–0.83]. Sensitivity analysis accounting for the influence of death, loss to follow-up (OR 0.28, adjusted p = 0.008), or potential confounders (OR 0.49, adjusted p = 0.046) consistently showed a lower incidence of psychiatric symptoms in the EM group. EM was consistently associated with fewer psychiatric symptoms.
Keywords	anxiety ; early mobilization ; depression ; ICU care ; mental health ; post-traumatic stress disorder ; Medicine ; R
Subject code	150 ; 310
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Risk Factors of Patient-Related Safety Events during Active Mobilization for Intubated Patients in Intensive Care Units—A Multi-Center Retrospective Observational Study

Hajime Katsukawa / Kohei Ota / Keibun Liu / Yasunari Morita / Shinichi Watanabe / Kazuhiro Sato / Kenzo Ishii / Daisetsu Yasumura / Yo Takahashi / Takafumi Tani / Hitoshi Oosaki / Tomoya Nanba / Ryo Kozu / Toru Kotani

Journal of Clinical Medicine, Vol 10, Iss 2607, p

2021 Volume 2607

Abstract: The aim of this study is to clarify the incidence and risk factors of patient-related safety events (PSE) in situations limited to intubated patients in which active mobilization, such as sitting on the edge of the bed/standing/walking, was carried out. ... ...

Abstract	The aim of this study is to clarify the incidence and risk factors of patient-related safety events (PSE) in situations limited to intubated patients in which active mobilization, such as sitting on the edge of the bed/standing/walking, was carried out. A multi-center retrospective observational study was conducted at nine hospitals between January 2017 and March 2018. The safety profiles and PSE of 87 patients were analyzed. PSE occurred in 10 out of 87 patients (11.5%) and 13 out of 198 sessions (6.6%). The types of PSE that occurred were hypotension (8, 62%), heart rate instability (3, 23%), and desaturation (2, 15%). Circulation-related events occurred in 85% of overall cases. No accidents, such as line/tube removal or falls, were observed. The highest incidence of PSE was observed during the mobilization level of standing (8 out of 39 sessions, 20.5%). The occurrence of PSE correlated with the highest activity level under logistic regression analysis. Close vigilance is required for intubated patients during active mobilization in the standing position with regard to circulatory dynamics.
Keywords	early mobilization ; rehabilitation ; safety ; adverse event ; mechanical ventilation ; tracheally intubated patient ; Medicine ; R
Subject code	616
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Post-Intensive Care Syndrome and Its New Challenges in Coronavirus Disease 2019 (COVID-19) Pandemic

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

Journal of Clinical Medicine, Vol 10, Iss 3870, p

A Review of Recent Advances and Perspectives

2021 Volume 3870

Abstract: 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 ... ...

Abstract	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.
Keywords	PICS ; physical impairments ; cognitive impairments ; mental health problems ; family ; COVID-19 ; Medicine ; R
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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