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A STUDY FROM THE CELLULAR ASPECT ON THE PATHOPHYSIOLOGY AND TREATMENT OF MULTIPLE ORGAN FAILURE

Research Project

Project/Area Number 02454351
Research Category

Grant-in-Aid for General Scientific Research (B)

Allocation TypeSingle-year Grants
Research Field 麻酔学
Research InstitutionChiba University School of Medicine Medical Center

Principal Investigator

HIRASAWA Hiroyuki  Department of Emergency and Critical Care Medicine, Chiba University Medical Center Associate Professor, 医学部, 助教授 (80114320)

Co-Investigator(Kenkyū-buntansha) ODA Shigeto  Department of Emergency and Critical Care Medicine, Chiba University Medical Cen, 医学部, 助手 (90204205)
OHTAKE Yoshio  Department of Emergency and Critical Care Medicine, Chiba University Medical Cen, 医学部, 助手 (50194189)
SUGAI Takao  Department of Emergency and Critical Care Medicine, Chiba University Medical Cen, 医学部, 講師 (10187627)
Project Period (FY) 1990 – 1992
Project Status Completed (Fiscal Year 1992)
Budget Amount *help
¥6,700,000 (Direct Cost: ¥6,700,000)
Fiscal Year 1992: ¥1,400,000 (Direct Cost: ¥1,400,000)
Fiscal Year 1991: ¥2,200,000 (Direct Cost: ¥2,200,000)
Fiscal Year 1990: ¥3,100,000 (Direct Cost: ¥3,100,000)
Keywordsmultiple organ failure (MOF) / cellular dysfunction / cellular injury score (CIS) / tissue oxygen metabolism / humoral mediators / catecholamine / continuous hemofiltration (CHF) / continuous hemodiafiltration (CHDF) / 酸素供給量 / 酸素消費量 / 細胞機能不全 / osmolality gap / AKBR / 血中lactate / CIS / humoral mediator
Research Abstract

We have claimed that multiple organ failure (MOF) is the summation of the cellular injury in vital organs. Therefore therapeutic approaches to the MOF should be considered through the improvement of cellular dysfunction in the vital organs. For such approach the parameters which can express the severity of cellular injury is essential. The cellular injury score (CIS), which is derived from three different cellular metabolic sequences, arterial ketone body ratio (AKBR), serum osmolality gap and blood lactate and is proposed by us is found to be a good index to evaluate the severity of the patients with MOF. The impairment of cellular function following various insults such as sepsis, trauma, and shock can be caused through two mechanism: derangement in tissue oxygen metabolism and humoral mediators. Therefore for the treatment and/or prevention of cellular injury in the critically ill should be achieved through the improvement of tissue oxygen metabolism and the counter-measures for the humoral mediators. We have found that continuous hemofiltration (CHF)/continuous hemodiafiltration(CHDF) effectively remove the various humoral mediators and that those continuous blood purifications are also effective in the improvement of tissue oxygen metabolism following the administration of catecholamines. These results suggest that improvement of cellular dysfunction is an effective treatment/prophylaxis for MOF.

Report

(4 results)
  • 1992 Annual Research Report   Final Research Report Summary
  • 1991 Annual Research Report
  • 1990 Annual Research Report
  • Research Products

    (28 results)

All Other

All Publications (28 results)

  • [Publications] 平澤 博之: "侵襲の重症度の指標" 外科治療. 63. 621-629 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] 平澤 博之: "外傷後多臓器不全(MOF)ーその病態と治療ー" 日本外傷研究会誌. 6. 84-96 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] 平澤 博之: "Septic ShockとMOF" 集中治療. 4. 435-443 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] 平澤 博之: "ショックにおける微少循環" 代謝. 29. 431-439 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] 志賀 英敏: "MOF患者の全身状態評価法としてのAPACHE II、CISおよびAPACHE Hの比較" 外科と代謝・栄養. 27. 21-28 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] 織田 成人: "敗血症性多臓器不全症例における組織酸素代謝と細胞障害の検討" 日本外科学会雑誌.

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] 平澤 博之: "新外科大系5 (分担執筆)「ショックに伴う多臓器不全」" 中山書店, 30 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] 平澤 博之: "今日の診断指針(分担執筆)「多臓器不全」" 医学書院, 3 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] Hirasawa H et al: "Posttraumatic multiple organ failure. -Pathophysiology and treatment." J Jpn Assoc Surg Trauma. Vol 6 No 2. 84-96 (1992)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] Oda S et al: "Tissue oxygen metabolism and cellular injury in patients with septic multiple organ failure (SMOF)" J Jpn Surg Soc.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] 平澤 博之: "MOF治療 -最近の動向-" 綜合臨牀. 40. 2629-2636 (1991)

    • Related Report
      1992 Annual Research Report
  • [Publications] 平澤 博之: "外傷後多臓器不全(MOF) -その病態と治療-" 日本外傷研究会誌. 6. 84-96 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] 平澤 博之: "Septic ShockとMOF" 集中治療. 4. 435-443 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] 平澤 博之: "ショックにおける微少循環" 代謝. 29. 431-439 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] 志賀 英敏: "MOF患者の全身状態評価法としてのAPACHEII、CISおよびAPACHE Hの比較" 外科と代謝・栄養. 27. 21-28 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] 織田 成人: "敗血症性多臓器不全症例における組織酸素代謝と細胞障害の検討" 日本外科学会雑誌.

    • Related Report
      1992 Annual Research Report
  • [Publications] 平澤 博之: "臨床医のためのハンドブックショックQ&A(分担執筆) 「MOFの予防法は?」" メディカルビュー社, 2 (1991)

    • Related Report
      1992 Annual Research Report
  • [Publications] 平澤 博之: "今日の診断指針(分担執筆) 「多臓器不全」" 医学書院, 3 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] 平澤 博之: "侵襲の重症度の指標" 外科治療. 63. 621-629 (1990)

    • Related Report
      1991 Annual Research Report
  • [Publications] 平澤 博之: "敗血症性多臓器不全" 循環制御. 11. 197-202 (1990)

    • Related Report
      1991 Annual Research Report
  • [Publications] 平澤 博之: "敗血症性多臓器不全症例における細胞酸素代謝と細胞障害の検討" 日本外科学会雑誌. (1992)

    • Related Report
      1991 Annual Research Report
  • [Publications] 平澤 博之: "外傷後多臓器不全(MOF)ーその病態と治療ー" 日本外傷研究会雑誌. (1992)

    • Related Report
      1991 Annual Research Report
  • [Publications] 平澤 博之: "細胞レベルからみた細胞障害とその対策 分担執筆「臓器障害と細胞代謝」" メジカルビュ-社, 10 (1990)

    • Related Report
      1991 Annual Research Report
  • [Publications] 平澤 博之: "新外科学大系5 分担執筆「ショックに伴う多臓器不全」" 中山書店, 30 (1990)

    • Related Report
      1991 Annual Research Report
  • [Publications] 平澤 博之: "敗血症性多臓器不全" 循環制御. 11. 197-202 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] 平澤 博之: "侵襲の重症度の指標" 外科治療. 63. 621-629 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] 平澤 博之: "細胞レベルからみた細胞障害とその対策 分担執筆 「臓器障害と細胞代謝」" メジカルビュ-社, 10 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] 平澤 博之: "新外科学大系5 分担執筆 「ショックに伴う多臓器不全」" 中山書店, 30 (1990)

    • Related Report
      1990 Annual Research Report

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Published: 1990-04-01   Modified: 2016-04-21  

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