| Project/Area Number |
16K10954
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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 | University of Fukui |
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Principal Investigator |
Shigemi Kenji 福井大学, 学術研究院医学系部門, 教授 (00206088)
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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 |
¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000)
Fiscal Year 2018: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Fiscal Year 2017: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
Fiscal Year 2016: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
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| Keywords | 左室動脈結合状態 / 動脈圧調節機序 / 左室前負荷 / 左室後負荷 / 左室収縮能 / 有効循環血液量 / 無負荷循環血液量 / 左心室大動脈結合状態 / 心前負荷 / 動脈圧波形 / 一回拍出量変動 / 脈圧変動 / 観血的動脈圧波形 / 左心室拡張末期容量 / 収縮末期動脈圧 / 臨床 / 生理学 / 麻酔科学 / 集中治療医学 / モニタ |
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| Outline of Final Research Achievements |
This study revealed that left ventricular end-systolic volume (Ved) can be monitored by the combination with normal clinical monitors (PEP, ET, Pes, Pad, and SV). However, there are large variations in the measured values due to the timing of picking up the heart sound (especially second sound), and it also clear that clinical application as a daily monitor requires specialized knowledge and skills in algorithms and programs for data processing, storage, calculation and display of results. Currently, joint research with Nihon Kohden Co., Ltd. has begun, and the measured values of Ved are always displayed on the electronic anesthesia recorder for daily medical care, but there is room for improvement in the dispersion of numerical values. It was also suggested that the mechanisms of arterial blood pressure (Pa) regulation could be classified by the relationship between Ees/Ea and Pa, and that changes in Ved were inversely correlated with changes in stroke volume variation (SVV).
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| Academic Significance and Societal Importance of the Research Achievements |
Vedは、左心前負荷の指標であり、循環動態安定に重要な要素である。特に全身麻酔中は、麻酔薬による交感神経系の弛緩が血管拡張をきたして前負荷を減少させ、手術侵襲の疼痛刺激は、交感神経系を賦活して血管収縮をきたし、後負荷も前負荷も増加させる。また、出血は循環血液量を減少させ前負荷を減少させる。このように、全身麻酔中は様々な状況が想定される。Vedがモニタできれば手術侵襲に応じて適切に麻酔薬が投与でき、循環血液量の過不足もモニタできる。このように、左心前負荷の革新的な指標となり、輸液・輸血のタイミングや投与量の指標となり、心臓大血管手術時の人工心肺離脱時のモニタとしても期待できる。
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