理学療法ジャーナル56巻6号

2022年06月発行

特集 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

著者： 中西信人¹

所属機関： ¹神戸大学大学院医学研究科外科系講座災害・救急医学分野

ページ範囲：P.678 - P.682

Point

●集中治療領域ではサルコペニア・フレイルは約30％に認められる

●サルコペニアの評価にはcomputed tomographyと超音波画像診断装置が有用である

●サルコペニア・フレイルの予防には早期リハビリテーションや神経筋電気刺激療法が有効である

参考文献

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2）Arai Y, et al：Ultrasound assessment of muscle mass has potential to identify patients with low muscularity at intensive care unit admission：a retrospective study. Clin Nutr ESPEN 2021；45：177-183

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5）Jaitovich A, et al：ICU admission body composition：skeletal muscle, bone, and fat effects on mortality and disability at hospital discharge—a prospective, cohort study. Crit Care 2020；24：566

6）Nakanishi N, et al：Upper and lower limb muscle atrophy in critically ill patients：an observational ultrasonography study. Intensive Care Med 2018；44：263-264

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11）Toledo DO, et al：The use of computed tomography images as a prognostic marker in critically ill cancer patients. Clin Nutr ESPEN 2018；25：114-120

12）Iritani S, et al：Skeletal muscle depletion is an independent prognostic factor for hepatocellular carcinoma. J Gastroenterol 2015；50：323-332

13）Zhuang CL, et al：Sarcopenia is an independent predictor of severe postoperative complications and long-term survival after radical gastrectomy for gastric cancer：analysis from a large-scale cohort. Medicine（Baltimore）2016；95：e3164

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15）Puthucheary ZA, et al：Rectus femoris cross-sectional area and muscle layer thickness：comparative markers of muscle wasting and weakness. Am J Respir Crit Care Med 2017；195：136-138

16）Nakanishi N, et al. Rectus femoris mimicking ultrasound phantom for muscle mass assessment：design, research, and training application. J Clin Med 2021；10：2721

17）日本集中治療医学会早期リハビリテーション検討委員会：集中治療における早期リハビリテーション—根拠に基づくエキスパートコンセンサス．日集中医誌2017；24：255-303

18）Hickmann CE, et al：Impact of very early physical therapy during septic shock on skeletal muscle：a randomized controlled trial. Crit Care Med 2018；46：1436-1443

19）Schujmann DS, et al：Impact of a progressive mobility program on the functional status, respiratory, and muscular systems of ICU patients：a：randomized and controlled trial. Crit Care Med 2020；48：491-497

20）Nakanishi N, et al：Effect of electrical muscle stimulation on upper and lower limb muscles in critically ill patients：a two-center randomized controlled trial. Crit Care Med 2020；48：e997-e1003

21）Lee Z-Y, et al：The effect of higher versus lower protein delivery in critically ill patients：a systematic review and meta-analysis of randomized controlled trials. Crit Care 2021；25：260