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The effect of hepatic venous oxygen hemoglobin saturation on the patients' outcome

Research Project

Project/Area Number 09671589
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Anesthesiology/Resuscitation studies
Research InstitutionFujita Health University

Principal Investigator

KAINUMA Motoshi  Fujita Health University School of Medicine, Department of Anesthesiology, Associate Professor, 医学部, 助教授 (90135335)

Co-Investigator(Kenkyū-buntansha) MIYAKE Toshiyuki  Fujita Health University School of Medicine, Department of Anesthesiology, Profe, 医学部, 教授 (40093075)
Project Period (FY) 1997 – 1998
Project Status Completed (Fiscal Year 1998)
Budget Amount *help
¥2,500,000 (Direct Cost: ¥2,500,000)
Fiscal Year 1998: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 1997: ¥1,500,000 (Direct Cost: ¥1,500,000)
Keywordshepatic venous oxygen hemoglobinsaturation / hepatic blood flow / liver disturbance / blood pressure / oxygen metabolism / liver failure / liver resection surgery / oxygen consumption / 肝臓 / 救急医療 / 集中治療医学 / 酸素 / 肝循環 / 肝静脈カテーテル / 肝虚血 / 集中治療 / 多臓器不全
Research Abstract

We had developped hepatic venous oxygen hemoglobin saturation (Shvo_2) monitoring, which method had been widely applied to patients in operating room and critical care setting. Although the degree of the decrease in. shvo_2 was shown in the display of monitoring device, we could not know an accumilation of hypoxic events in the liver, simultaneously. This time, we developed the software to measure the accumulation of hypoxic event to integrate the decrease in Shvo_2 along time during the surgery.
After obtaning informed consent fron each patient, we inserterd oximeter catheter into the hepatic venous vein in 116 patients. Postoperative aminotransferases were significantly incresed in patients who showed high integral value exceeding a critical value.
In other patients, we measured ketone body ratio, interleukin 6 and 8, and GST- alpha. When Shvo_2 was low, ketone body ratio decreased, interleukin 6 and 8 and GST- alpha increased. Postoperative hiarulonic acid increased in patients who showed a low Shvo_2 perioperatively and high serum bilirubin postoperatively.
Next we determined a critical value of hyotension to deteriorate hepatic oxygen metabolism by the simulation method. Hepatic arterial buffer response proves to play a crucial role to maintein hepatic blood flow theoretically. This result could be applied to patients in emmegency or critical care settings.
Conclusion :
We developped a software to measure integral values of Shvo_2 alonf time during surgery. By this method, we measeured Shvo_2 in patients at critical care settings. Simultaneously we meaured ketone bodies, hiarulonic acid and interleukin 6 and 8, which changed in parallel with the degree of decrease in Shvo_2. These values predicts patients' outcome after postoperative period and critical care or emergency setting. Therefore Shvo_2 monitoring proves to play a rucial role in protecting the liver.

Report

(3 results)
  • 1998 Annual Research Report   Final Research Report Summary
  • 1997 Annual Research Report
  • Research Products

    (16 results)

All Other

All Publications (16 results)

  • [Publications] 貝沼〓志、山田守正、三宅聰行: "肝静脈血のケトン体・ケトン体比は動脈血にどのように反映されるか" 日本集中治療医学会雑誌. 4. 111-116 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 貝沼〓志、山田守正、三宅聰行 新井典久: "肝静脈血酸素飽和度モニタリングの方法と術中管理" 麻酔. 46. S61-S67 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 貝沼 〓志: "合併症を持つ患者の術前、術後の全身管理、肝硬変、肝機能障害" 臨床泌尿器科. 52. 391-396 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 貝沼 〓志: "肝静脈血酸素飽和度モニタリング" 日本臨床麻酔学会誌. 18. 476-482 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 貝沼 〓志: "血圧低下はどこまで容認できるか-肝臓から-" 循環制御. 20. 56-64 (1999)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Motoshi Kainuma, Morimasa Yamada, Toshiyuki Miyake: "The use of obtuse needles in aspirating drugs from ampules in the practice of anesthesia." J Anesth. 11. 244 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Naoki Sugiura, Morimasa Yamada, Motoshi Kainuma, Toshiyuki Miyake: "The use of a nasogastric tube as an aid in blind nasotracheal intubation : A postscript." Anesthesiology. 87. 449 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] M Kainuma, M Yamada, T Miyake, T Arai: "Hepatic venous hemoglobin oxygen saturation Monitoring in 147 liver resection surgery" Anesthesiology. 87. A473 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Motoshi Kainuma, Toshiyuki Miyake, Toyohisa Arai: "Hepatic venous hemoglobin oxygen saturation monitoring in 147 liver resection surgery" Annual Meeting of American Society of Anesthesiologists San Diego. (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 貝沼関志: "合併症を持つ患者の術前、術後の全身管理 肝硬変・肝機能障害" 臨床泌尿器科. 52. 391-396 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 貝沼関志: "肝静脈血酸素飽和度モニタリング" 日本臨床麻酔学会誌. 18. 476-482 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 貝沼関志: "麻酔と腎機能" 専門医のための麻酔科学レビュー98. 28-33 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 貝沼関志: "麻酔と腎機能" 専門医のための麻酔科学レビュー99. (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 貝沼関志、山田守正、三宅聰行: "肝静脈血のケトン体、ケトン体比は動脈血にどのように反映されるか" 日本集中治療医学会雑誌. 4・2. 111-116 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] 貝沼関志、山田守正、三宅聰行 他: "肝静脈血酸素飽和度モニタリングの方法と術中管理" 麻酔. 46・増刊号. S61-S67 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] 貝沼関志: "合併症を持つ患者の術前・術後の全身管理、肝硬変、肝機能障害" 臨床泌尿器科. (予定)・4. (1998)

    • Related Report
      1997 Annual Research Report

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Published: 1997-04-01   Modified: 2016-04-21  

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