| Project/Area Number |
16K10948
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Anesthesiology
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| Research Institution | Tokyo Women's Medical University |
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Principal Investigator |
Komori Makiko 東京女子医科大学, 医学部, 教授 (60178332)
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| Co-Investigator(Kenkyū-buntansha) |
西山 圭子 東京女子医科大学, 医学部, 准教授 (00155532)
冨澤 康子 東京女子医科大学, 医学部, 助教 (00159047)
市川 順子 東京女子医科大学, 医学部, 講師 (60318144)
小高 光晴 東京女子医科大学, 医学部, 臨床教授 (90280635)
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| Project Period (FY) |
2016-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2016: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | 微小循環 / ショック / 輸液蘇生 / 出血性ショック / 敗血症 / 兎耳窓法 / 舌下微小循環 / 舌下粘膜 / 敗血症性ショック |
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| Outline of Final Research Achievements |
The effects of hydroxyethyl starch (HES) on microcirculation, central venous oxygen saturation (ScvO2), and the central venous-to-arterial carbon dioxide gap (dCO2) are studied in a rabbit model of hemorrhagic shock for elucidating the advantages and drawbacks of resuscitation with HES compared with crystalloids. An ear chamber and sublingual mucosa were used to examine blood vessels by intravital microscopy. Hemorrhagic shock was induced by removing nearly half of the blood volume. Rabbits received 100 mL of HES by intravenous infusion after blood letting. The other rabbits (control) were intravenously given 200 mL of normal saline solution (NSS).
Evaluation of the effects of the fluid therapy on the microcirculation, ScvO2, and dCO2 in a rabbit model of hemorrhagic shock showed that the intravenous infusion of HES maintains the peripheral circulation, adequate tissue oxygenation and perfusion better than does NSS infusion.
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| Academic Significance and Societal Importance of the Research Achievements |
兎急性大量出血モデルの輸液蘇生において、膠質液である中分子量ヒドロキシエチルデンプン(HES)を用いた場合の微小循環（兎舌下粘膜の毛細血管血流、兎耳透明窓の細動脈血流）、中心静脈血酸素飽和度(ScvO2)、中心静脈血と動脈血の二酸化炭素分圧較差（dCO2）について、晶質液と比較検討した。急性大量出血時の輸液蘇生で中分子量HESは生食に比し、血圧、ScvO2、dCO2、微小循環動態に改善がみられた。
微小循環が維持できないと、臓器への血流が絶たれ、多臓器不全に陥る。これを予防するには微小循環を維持し、ショック状態を改善することが重要である。
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