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A STUDY ON THE TREATMENT FOR SEPTIC MULTIPLE ORGAN FAILURE THROUGH IMPROVEMENT OF TISSUE OXYGEN METABOLISM

Research Project

Project/Area Number 06671506
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Anesthesiology/Resuscitation studies
Research InstitutionCHIBA UNIVERSITY

Principal Investigator

ODA Shigeto  LECTURER,CHIBA UNIVERSITY HOSPITAL, 医学部・附属病院, 講師 (90204205)

Co-Investigator(Kenkyū-buntansha) MATSUDA Kenn-ichi  ASSISTANT,CHIBA UNIVERSITY HOSPITAL, 医学部・附属病院, 助手 (60282480)
OHTAKE Yoshio  LECTURER,CHIBA UNIVERSITY HOSPITAL, 医学部・附属病院, 講師 (50194189)
SUGAI Takao  ASSOCIATO PROFESSOR CHIBA UNIVERSITY SCHOOL OF MEDICINE, 医学部, 助教授 (10187627)
HIRASAWA Hiroyuki  PROFESSOR,CHIBA UNIVERSITY SCHOOL OF MEDICINE, 医学部, 教授 (80114320)
中西 加寿也  千葉大学, 医学部・附属病院, 助手
Project Period (FY) 1994 – 1996
Project Status Completed (Fiscal Year 1996)
Budget Amount *help
¥2,000,000 (Direct Cost: ¥2,000,000)
Fiscal Year 1996: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1995: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1994: ¥1,000,000 (Direct Cost: ¥1,000,000)
KeywordsSeptic multiple organ failure / Tissue oxygen metabolism / Tonometer / Gastric pHi / Hemodynamic management / 酸素供給能 / 酸素消費量
Research Abstract

This study was undertaken to investigate the treatment for septic multiple organ failure (MOF) through improvement of tissue oxygen metabolism. First, we investigated the clinically applicable methods for evaluation of tissue oxygen metabolism. Cellular injury score (CIS) measured simultaneously with oxygen delivery and oxygen consumption was a useful method to evaluate the disturbance of tissue oxygen metabolism in septic MOF patients. Gastric intramucosal pH (gastric pHi) measured by Tonometer, newly developed non-invasive device for monitoring of oxygen debt in visceral area, was also clinically useful method for early detection of the disturbance of tissue oxygen metabolism in critically ill patients. From these results, we next investigated the effective treatment for improvement of tissue oxygen metabolism in septic MOF.Hemodynamic management to achieve supranormal oxygen transport values with aggressive fluid resuscitation and catecholamine administration was carried out in patients with severe sepsis. These treatments were effective in early sepsis to improve relative tissue hypoxia and prevent organ dysfunction. However, in patients with extremely developed MOF,these treatments were failed to improve tissue oxygen metabolism, which supposed to be mainly due to decreased oxygen uptake affected by various humoral mediators in these patients. Thus, although approaches to improve tissue oxygen metabolism could be an new treatment for septic MOF,another approaches shoud be established to improve O_2 extraction as well as hemodynamic management to achieve supranormal oxygen transport values.

Report

(4 results)
  • 1996 Annual Research Report   Final Research Report Summary
  • 1995 Annual Research Report
  • 1994 Annual Research Report
  • Research Products

    (22 results)

All Other

All Publications (22 results)

  • [Publications] 中西 加寿也、他: "胃粘膜内pHよりみた組織酸素代謝障害の評価" Therapeutic Research. 15. 1855-1858 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] 平澤 博之: "敗血症性多臓器不全の病態に関する最近の知見とそれに立脚した治療" 日救急医会誌. 5. 225-250 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] 中西 加寿也、他: "胃粘膜内pHによる組織酸素代謝障害のモニタリング(第2報)" 集中治療. 6. 869-870 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] 平澤 博之、他: "臓器血流、酸素拡散ならびに細胞代謝の制御" 集中治療. 7. 388-407 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] 中西 加寿也、他: "重症患者における胃粘膜内pH(gostric pHi)を用いた組織酸素代謝の検討" 日救急医会誌. 6. 337-348 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] 中西加寿也、他: "胃粘膜内pHと酸素供給量係数、酸素消費量係数の比較検討" 集中治療. 7. 979-980 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] 平澤 博之: "敗血症および敗血症性多臓器不全の病態に関する最近の知見" 外科治療. 72. 211-222 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] 平澤博之: "組織酸素代謝の失調からみた敗血症性多臓器障害とその対策" PTM. 8. 5-(5) (1996)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] 志賀英敏、他: "Compensated shockとgastric pHi" 集中治療. 9. 131-132 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Nakanishi K,et al: "Evaluation of impairment in tissue oxygen metabolism using gastric intramucosal pH." Therapeutic Research. 15. 1855-1858 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Hirasawa H: "Recent advances in pathophysiologic and therapeutic considerations for septic multiple organ failure (SMOF)." Journal of Japanese Association for Acute Medicine. 5. 225-50 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Nakanishi K,et al: "Monitoring of tissue oxygen metabolism with gastric intramucosal pH-second report." Intensive and Critical Care Medicine. 6. 869-70 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Hirasawa H,et al: "Regulation of tissue perfusion, oxygen diffusion and cellular metabolism." Intensive and Critical Care Medicine. 7. 338-407 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Nakanishi K,et al: "A study on tissue oxygen metabolism using gastric intramucosal pH (gastric pHi) in critically ill patients." Journal of Japanese Association for Acute Medicine. 6. 337-48 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Nakanishi K,et al: "A comparison of gastric intramucosal pH with oxygen delivery and oxygen consumption." Intensive and Critical Care Medicine. 7. 979-80 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Hirasawa H: "Recent advances on pathophysiology of sepsis and septic multiple organ failure." Surgical Treatment. 72. 211-22 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Hirasawa H: "Impairment of tissue oxygen metabolism in septic multiple organ failure and its countermeasures." PTM. 8. 5 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Shiga H,et al: "Gastric pHi and compensated shock." Intensive and Critical Care Medicine. 9. 131-32 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] 平澤博之: "組織酸素代謝の失調からみた敗血症性多臓器障害とその対策" PTM. 8(5). 5 (1996)

    • Related Report
      1996 Annual Research Report
  • [Publications] 志賀英敏,他: "Compensated shockeとgastric pHi" 集中治療. 9. 131-132 (1997)

    • Related Report
      1996 Annual Research Report
  • [Publications] 中西加寿也、他: "胃粘膜内pHよりみた組織酸素代謝障害の評価" Therapeutic Research. 15. 1855-1858 (1994)

    • Related Report
      1995 Annual Research Report
  • [Publications] 中西加寿也、他: "重症患者における胃粘膜内pH(gastric pHi)を用いた組織酸素代謝の検討" 日救急医会誌. 6. 337-348 (1995)

    • Related Report
      1995 Annual Research Report

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Published: 1994-04-01   Modified: 2016-04-21  

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