| Project/Area Number |
19K09418
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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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| Review Section |
Basic Section 55060:Emergency medicine-related
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| Research Institution | Yamaguchi University |
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Principal Investigator |
Tsuruta Ryosuke 山口大学, 大学院医学系研究科, 教授 (30263768)
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| Project Period (FY) |
2019-04-01 – 2022-03-31
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| Project Status |
Completed (Fiscal Year 2021)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2021: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2019: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
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| Keywords | 集中治療後症候群 / ADL / QOL / 炎症 / 炎症反応 / せん妄 / 睡眠 / 対光反射 / SF-36 / 集中治療 / アクチグラフィ / 瞳孔径 |
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| Outline of Research at the Start |
病気や怪我で重症になった患者は集中治療室（ICU）で濃厚な治療を行うが、回復の過程で一過性の認知症（せん妄）あるいは睡眠障害に陥る。これらの発現には、患者の年齢、重症度、炎症（感染）、神経伝達物質のバランス障害、鎮痛・鎮静薬の影響など様々な因子が複雑に絡み合っている。ICU退室前の、急性期から脱した回復期の患者において神経伝達物質の１つであるアセチルコリンに焦点を当てて、副交感神経支配の対光反射とせん妄発症、睡眠障害との関連を探究する。
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| Outline of Final Research Achievements |
[Objective] Patients discharged from the ICU, who were 1) older than 19 years of age, 2) staying for more than 4 days, and 3) obtained consent were included. [Methods] On 90 days after the ICU discharge, we evaluated the patient with or without physical post-intensive care syndrome (P-PICS) by using the SF-36 and compared the several parameters and laboratory data between 2 groups of with/without P-PICS.
[Results] Out of 49 consented, 42 patients were included because of 7 patients without answer of SF-36. Seventy-four percent of 42 patients were P-PICS group. P-PICS group were significantly older than non-P-PICS group [72 (66-76) vs 66 (58-72), p=0.04]. Serum albumin and C-reactive protein levels before ICU discharge in P-PICS group were significantly lower and higher than those in non-P-PICS group, respectively [2.5 (1.9-2.8) vs 3.1(2.6-3.2), p=0.01, 7.2 (2.8-11.0) vs 3.5 (1.2-4.2), p=0.01]. There were no significant differences between the other scores and measurements in 2 groups.
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| Academic Significance and Societal Importance of the Research Achievements |
重症な傷病でICUに入院してきた患者のICU退室前の栄養状態または炎症反応の結果がICUを退室し日常生活に戻った90日目の身体機能を予測できる可能性が判明した。今後は日常診療でICU退室前の血清アルブミンとC反応性蛋白の値に注目していきたい。
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