Strategy for brain protection following hypoxic brain damage

• Project/Area Number: 15K10524
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Anesthesiology
• Research Institution: Jikei University School of Medicine
• Principal Investigator: Uezono Shoichi 東京慈恵会医科大学, 医学部, 教授 (10291676)
• Co-Investigator(Kenkyū-buntansha): 木田 康太郎 東京慈恵会医科大学, 医学部, 講師 (70385318)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2017: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2016: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2015: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
• Keywords: 心停止 / 心肺蘇生 / 蘇生後脳症 / イソフルラン / プロポフォール / セボフルラン / 麻酔薬

Outline of Final Research Achievements

Sudden cardiac arrest is a leading cause of death worldwide. Despite advances in cardiopulmonary resuscitation (CPR) methods, only about 10 % of adult out-of-hospital cardiac arrest victims survive to hospital discharge. No pharmacological agent is available to improve outcome from post-cardiac arrest syndrome. Sedatives have been a part of medications post-cardiacarrest patients may receive during their recovery phase. However, the impact of such sedatives on brain protection has not been well examined. Theobjective of this study was to examine whether administration of either propofol or isoflurane improves survival after cardiac arrest in mice.
Mice treated with isoflurane had increased 10-day survival (50% versus 8.3%, P<0.01) when compared to the control mice. On the other hand, propofol did not exhibit such protective effects.

Academic Significance and Societal Importance of the Research Achievements

心停止・心肺蘇生後の患者に対し、低体温療法によるシバリングの予防、痙攣発作の治療、気管挿管の苦痛緩和などのために、しばしば鎮静剤が投与される。しかし、蘇生後患者に対する鎮静剤の使用に関して、確立されたガイドラインはない。ましてや蘇生後患者の鎮静に適した鎮静剤は不明である。心停止・心肺蘇生のマウスモデルにおいては、生存率の観点からみると、イソフルランによる鎮静のほうがプロポフォールによる鎮静よりもすぐれているようである。