| Project/Area Number |
11470328
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Anesthesiology/Resuscitation studies
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| Research Institution | Tokyo Women's Medical University |
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Principal Investigator |
OZAKI Makoto Tokyo Women's Medical University, Anesthesiology, Professor, 医学部, 教授 (30160849)
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| Co-Investigator(Kenkyū-buntansha) |
ATARASHI Kenji Tokyo Women's Medical University, Anesthesiology, Clinical Instructor, 医学部, 助手 (60184181)
OZAKI Kyoko Tokyo Women's Medical University, Anesthesiology, Clinical Instructor, 医学部, 助手 (00162561)
NEGISHI Chiharu Tokyo Women's Medical University, Anesthesiology, Clinical Instructor, 医学部, 講師 (40189361)
MORIOKA Nobutaka Tokyo Women's Medical University, Anesthesiology, Clinical Instructor, 医学部, 助手 (60256518)
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| Project Period (FY) |
1999 – 2002
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| Project Status |
Completed (Fiscal Year 2002)
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| Budget Amount *help |
¥8,900,000 (Direct Cost: ¥8,900,000)
Fiscal Year 2002: ¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 2001: ¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 2000: ¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 1999: ¥3,200,000 (Direct Cost: ¥3,200,000)
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| Keywords | hyperthermia / surgery / thermoregulation / cytokines / MIP-1(aβ) / 炎症伝達因子 / IL-1 (aβ) IL-6, TNFα, INFα, MIP-1 (α,β) / MIP-1(αβ) / IL-1(α、β)、IL-6、TNFα、INFα / MIP-1(α、β) / 炎症 / 麻酔 / 外科的ストレス / 発熱 / 炎症性伝達物質 / 急性炎症応答 / IL-1(α、β) / IL-6 / TNFα / INFα |
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| Research Abstract |
The mechanism and clinical relevance of increased core temperature (Tc) after surgery are poorly understood. Because fever is used as a diagnostic sign of infection, it is important to recognize what constitutes the normal postoperative thermoregulatory response. In the current study the authors tested the hypothesis that a regulated increase in Tc setpoint occurs after surgery. We studied 271 patients in the first 24 h after a variety of vascular, abdominal, and thoracic surgical procedures. Tc measured in the urinary bladder, skin-surface temperatures, thermoregulatory responses (vasoconstriction and shivering), and total leukocyte counts were assessed. In a subset of 34 patients, plasma concentrations of tumor necrosis factor, interleukin (IL)-6, and IL-8 were measured before and after surgery. In the early postoperative period, the maximum increase in Tc above the preoperative baseline averaged 1.4 ± 0.8°C (2.5 ± 1.4°F), with the Tc peak occurring 11.1 ± 5.8 h after surgery. Fifty percent of patients had a maximum Tc greater than or equal to 38.0°C (100.4°F) and 25% had a maximum Tc greater than or equal to 38.5°C (101.3°F). The progressive postoperative increase in Tc was clearly associated with cutaneous vasoconstriction and shivering, indicating a regulated elevation in Tc setpoint. The elevated Tc was associated with an increased IL-6 response but not with leukocytosis. Maximum postoperative Tc was positively correlated with duration and extent of the surgical procedure. A regulated elevation in Tc setpoint (fever) occurs normally after surgery. The association between Tc elevation, extent and duration of surgery, and the cytokine response suggests that early postoperative fever is a manifestation of perioperative stress.
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