Understanding the pathophysiology and establishing the therapeutic strategy for trauma-induced coagulopathy in patients with severe trauma
| Project/Area Number |
25462810
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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 |
Emergency medicine
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| Research Institution | Tohoku University |
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Principal Investigator |
Kushimoto Shigeki 東北大学, 医学(系)研究科(研究院), 教授 (50195434)
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| Co-Investigator(Kenkyū-buntansha) |
YAMANOUCHI SATOSHI 東北大学, 大学院医学系研究科, 講師 (00307638)
YAMADA MITSUHIRO 東北大学, 大学院医学系研究科, 助教 (00396483)
FURUKAWA HAJIME 東北大学, 病院, 助教 (30624853)
KUDO DAISUKE 東北大学, 大学院医学系研究科, 助教 (30455844)
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| Project Period (FY) |
2013-04-01 – 2016-03-31
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| Project Status |
Completed (Fiscal Year 2015)
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| Budget Amount *help |
¥5,070,000 (Direct Cost: ¥3,900,000、Indirect Cost: ¥1,170,000)
Fiscal Year 2015: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2014: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2013: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
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| Keywords | 外傷 / 血液凝固異常 / 集中治療 / ダメージ関連分子パターン / 凝固障害 / DIC / 凝固線溶異常 / alarmins / damage control / ミトコンドリア |
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| Outline of Final Research Achievements |
Hemorrhage is the most important contributor of acute-phase mortality in trauma patients, and coagulopathy is present at the time of admission in 25% of patients. Understanding the pathophysiology of coagulopathy and establishing the therapeutic strategy are the critical issue for the management of patients with severe trauma.
We revealed that mitochondrial DNA, one of alarmins, play an important role in the pathophysiology of inflammatory, coagulation response, leading to organ dysfunction syndrome, in patients with severe trauma. We also demonstrated that administration of tranexamic acid within 3 hr of injury, and high plasma/red blood cell transufusion ratio within 6 hr may contribute to decreasing mortality in patients with severe trauma from multi-institutional observational study.
Trauma-induced coagulopathy is multifactorial,and is definitively the most important issue for the management of severe trauma patients. Our findinsg may provide new aspects for this critical issue.
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Report
(4 results)
Research Products
(47 results)
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[Journal Article] HIGH D-DIMER LEVELS PREDICT A POOR OUTCOME IN PATIENTS WITH SEVERE TRAUMA, EVEN WITH HIGH FIBRINOGEN LEVELS ON ARRIVAL: A MULTICENTER RETROSPECTIVE STUDY.2016
Author(s)
Hayakawa M, Maekawa K, Kushimoto S, Kato H, Sasaki J, Ogura H, Matauoka T, Uejima T, Morimura N, Ishikura H, Hagiwara A, Takeda M, Kaneko N, Saitoh D, Kudo D, Kanemura T, Shibusawa T, Furugori S, Nakamura Y, Shiraishi A, Murata K, Mayama G, Yaguchi A, Kim S, Takasu O, Nishiyama K.
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Journal Title
SHOCK
Volume: 45
Issue: 3
Pages: 308-314
DOI
NAID
Related Report
Peer Reviewed / Int'l Joint Research
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[Journal Article] Can Early Aggressive Administration of Fresh Frozen Plasma Improve Outcomes in Patients with Severe Blunt Trauma? - A Report by the Japanese Association for the Surgery of Trauma.2016
Author(s)
Hagiwara A, Kushimoto S, Kato H, Sasaki J, Ogura H, Matsuoka T, Uejima T, Hayakawa M, Takeda M, Kaneko N, Saitoh D, Otomo Y, Yokota H, Sakamoto T, Tanaka H, Shiraishi A, Morimura N.
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Journal Title
Related Report
Peer Reviewed / Open Access / Acknowledgement Compliant
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[Journal Article] Development of novel criteria of the “lethal triad” as an indicator of decision making in current trauma care: a retrospective multicenter observational study in Japan2016
Author(s)
Endo A, Shiraishi A, Kushimoto S, Otomo Y, Saitoh D, Hayakawa M, Ogura H, Murata K, Hagiwara A, Sasaki J, Matsuoka T, Uejima T, Morimura N, Ishikura H, Takeda M, Kaneko N, Kato H, Kudo D, Kanemura T, Shibusawa T, Hagiwara Y, Furugori S, Nakamura Y, Maekawa K, Mayama G, Yaguchi A, Kim S,Takasu O, Nishiyama K
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Journal Title
Related Report
Peer Reviewed / Open Access
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[Journal Article] Efficacy of a high FFP:PRBC transfusion ratio on the survival of severely injured patients: a retrospective study in a single tertiary emergency center in Japan.2014
Author(s)
Kudo D, Sasaki J, Akaishi S, Yamanouchi S, Koakutsu T, Endo T, Sato T, Nomura R, Yuzawa H, Kobayashi M, Shinozawa Y, Kushimoto S
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Journal Title
Surg Today
Volume: 44
Pages: 653-661
Related Report
Peer Reviewed
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