循環器ジャーナル71巻3号

2023年07月発行

特集 心臓リハビリテーションのエビデンスを極める Ⅰ.ディベートで考える心臓リハビリテーション ［B．心臓リハビリテーションの醍醐味は急性期か回復期か？］

急性期

著者： 加藤祐子¹

所属機関： ¹心臓血管研究所付属病院循環器内科

ページ範囲：P.335 - P.339

POINT
・長期臥床は，紀元前400年ごろの昔から有害ととらえられていた．
・重症者の急性期心リハにゴールドスタンダードはない．
・急性期心リハの早期介入には，多職種による主体的な関わりが必要不可欠である．

参考文献

1）Hashem MD, Nelliot A, Needham DM. Early Mobilization and Rehabilitation in the ICU : Moving Back to the Future. Respir Care 2016 ; 61 : 971-9.

2）Saltin B, Blomqvist G, Mitchell JH, et al. Response to exercise after bed rest and after training. Circulation 1968 ; 38 : Ⅷ-78.

3）Dorfman TA, Levine BD, Tillery T, et al. Cardiac atrophy in women following bed rest. J Appl Physiol（1985）2007 ; 103 : 8-16.

4）Puthucheary ZA, Rawal J, McPhail M, et al. Acute skeletal muscle wasting in critical illness. JAMA 2013 ; 310 : 1591-600.

5）Marusic U, Kavcic V, Pisot R, et al. The Role of Enhanced Cognition to Counteract Detrimental Effects of Prolonged Bed Rest : Current Evidence and Perspectives. Front Physiol 2018 ; 9 : 1864.

6）Gao R, Chilibeck PD. Nutritional interventions during bed rest and spaceflight : prevention of muscle mass and strength loss, bone resorption, glucose intolerance, and cardiovascular problems. Nutr Res 2020 ; 82 : 11-24.

7）Hermans G, Van Mechelen H, Clerckx B, et al. Acute outcomes and 1-year mortality of intensive care unit-acquired weakness. A cohort study and propensity-matched analysis. Am J Respir Crit Care Med 2014 ; 190 : 410-20.

8）Herridge MS, Tansey CM, Matte A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 2011 ; 364 : 1293-304.

9）Kramer A, Gollhofer A, Armbrecht G, et al. How to prevent the detrimental effects of two months of bed-rest on muscle, bone and cardiovascular system : an RCT. Sci Rep 2017 ; 7 : 13177.

10）Kress JP. Clinical trials of early mobilization of critically ill patients. Crit Care Med 2009 ; 37 : S442-7.

11）Bailey P, Thomsen GE, Spuhler VJ, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med 2007 ; 35 : 139-45.

12）Sprague AE. The evolution of bed rest as a clinical intervention. J Obstet Gynecol Neonatal Nurs 2004 ; 33 : 542-9.

13）Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients : a randomised controlled trial. Lancet 2009 ; 373 : 1874-82.

14）Chen L, Ionescu-Ittu R, Romdhani H, et al. Disease Management and Outcomes in Patients Hospitalized for Acute Heart Failure in Japan. Cardiol Ther 2021 ; 10 : 211-28.

15）Pandey A, Kitzman D, Whellan DJ, et al. Frailty Among Older Decompensated Heart Failure Patients : Prevalence, Association With Patient-Centered Outcomes, and Efficient Detection Methods. JACC Heart Fail 2019 ; 7 : 1079-88.