著者

Tetsuya TAKAHASHI Michitaka KATO Kengo OBATA Ryo KOZU Toru FUJIMOTO Koji YAMASHITA Morihide ANDO Yusuke KAWAI Noriaki KOJIMA Hiroshi KOMATSU Kensuke NAKAMURA Yuhei YAMASHITA Shane PATMAN Akemi UTSUNOMIYA Osamu NISHIDA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10060, (Released:2020-11-25)

参考文献数

22

被引用文献数

6

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Objective: Early mobilization and rehabilitation has become common and expectations for physical therapists working in intensive care units have increased in Japan. The objective of this study was to establish consensus-based minimum clinical practice standards for physical therapists working in intensive care units in Japan. It also aimed to make an international comparison of minimum clinical practice standards in this area. Methods: In total, 54 experienced physical therapists gave informed consent and participated in this study. A modified Delphi method with questionnaires was used over three rounds. Participants rated 272 items as "essential/unknown/non-essential". Consensus was considered to be reached on items that over 70% of physical therapists rated as "essential" to clinical practice in the intensive care unit. Results: Of the 272 items in the first round, 188 were deemed essential. In round 2, 11 of the 62 items that failed to reach consensus in round 1 were additionally deemed essential. No item was added to the "essential" consensus in round 3. In total, 199 items were therefore deemed essential as a minimum standard of clinical practice. Participants agreed that 42 items were not essential and failed to reach agreement on 31 others. Identified 199 items were different from those in the UK and Australia due to national laws, cultural and historical backgrounds. Conclusions: This is the first study to develop a consensus-based minimum clinical practice standard for physical therapists working in intensive care units in Japan.

著者

Yasuyoshi Kurimoto Yasuyo Shimomura Kazuhiro Moriyama Tomoyuki Nakamura Naohide Kuriyama Yoshitaka Hara Hidefumi Komura Daisuke Hasegawa Takahiro Kawaji Osamu Nishida

出版者

藤田学園医学会

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2019-002, (Released:2019-11-02)

参考文献数

11

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Objective: Sivelestat sodium hydrate (Siv) is expected to be an effective therapy for acute respiratory distress syndrome, although its mechanism of action is not understood. In this study, we investigated which myeloid cells-derived cytokines were suppressed by Siv.Methods: Continuous hemofiltration was performed by circulating fresh porcine blood through a semi-closed circuit. To ensure that leukocytes survived for 360 min, 5% glucose, heparin, and air were continuously injected. The control group received continuous administration of lipopolysaccharide (LPS) only, whereas the Siv group received LPS and Siv. Complete blood count, levels of various cytokines, and other variables were compared between the groups.Results: Interleukin (IL)-1β level was significantly suppressed in the Siv group compared with that in the control group (p<0.05).Conclusions: The results suggested that Siv suppressed the production of IL-1β and possibly other cytokines by myeloid cells. Whether this suppression of cytokine production is caused directly by Siv or mediated via suppression of granulocyte elastase should be evaluated in the future.