| Project/Area Number |
15591661
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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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 |
KOMORI Makiko Tokyo Women's Medical University, Department of Anesthesiology, Instructor, 医学部, 助手 (60178332)
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| Co-Investigator(Kenkyū-buntansha) |
TAKADA Katsumi Tokyo Women's Medical University, Department of Anesthesiology, Associate Professor, 医学部, 助教授 (20075609)
TOMIZAWA Yasuko Tokyo Women's Medical University, Department of Cardivasc Surg, Instructor, 医学部, 助手 (00159047)
OZAKI Makoto Tokyo Women's Medical University, Department of Anesthesiology, Professor, 医学部, 教授 (30160849)
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| Project Period (FY) |
2003 – 2004
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| Project Status |
Completed (Fiscal Year 2004)
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| Budget Amount *help |
¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 2004: ¥1,400,000 (Direct Cost: ¥1,400,000)
Fiscal Year 2003: ¥1,600,000 (Direct Cost: ¥1,600,000)
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| Keywords | microcirculation / anaphylaxis / UTI / hemorrhagic shock / infusion therapy / septic shock / NF-κB / rabbit ear / NF-κB / 透明窓 / Urinary Trypsin Inhibitor / REC法 / 血流量 |
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| Research Abstract |
The primary therapeutic goal of resuscitation in shock state is not only to reestablish an adequate circulation with sufficient arterial blood pressure and cardiac output, but also to restore tissue perfusion and oxygenation. Maintenance of the peripheral circulation is therefore a very important factor.
First, using intravital microscopy of the rabbit ear for quantitative studies of microvascular dynamics, we examined the impact of urinary trypsin inhibitor(UTI), a proteolytic enzyme inhibitor, on microvascular changes during immune complex-mediated anaphylaxis. The microcirculation was highly preserved in the UTI-treated groups during systemic anaphylactic shock. Moreover, increased airway pressure was prevented in the UTI-treated group. Second, we compared the effects of hydroxyethyl starch(HES) and lactated Ringer's solution(LR ; control) on the microcirculation, hemodynamics, and colloidal osmotic pressure in a rabbit model of hemorrhagic shock. Shock was induced by removing nearly half of the circulating blood volume. After the completion of infusion, arteriolar diameter significantly recovered to 90.8±10.2% of the baseline value in the HES group, as compared with only 62.6±10.7% in the LR group (p<0.005). Recovery of arterial blood flow velocity and blood flow rate was also significantly better in the HES group than in the LR group (p<0.005). Mean arteriolar pressure, central venous pressure, and plasma colloid osmotic pressure after the completion of infusion were significantly greater in the HES group than in the LR group (p<0.005). We conclude that intravenous infusion of HES effectively maintains the microcirculation, hemodynamics, and colloidal osmotic pressure in a rabbit model of hemorrhagic shock. Nuclear factor-κB (NF-κB) is a transcription factor that is rapidly activated at the site of inflammation and thus might have been involved in the progression of septic shock. Now we are studying whether an inhibitor of NF-κB is effective for septic shock.
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