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Crosstalk between inflammation and coagulation: erythrocyte rheology during cardiac surgery with cardiopulmonary bypass

Research Project

Project/Area Number 26462373
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Anesthesiology
Research InstitutionTokyo Women's Medical University

Principal Investigator

Ichikawa Junko  東京女子医科大学, 医学部, 講師 (60318144)

Co-Investigator(Kenkyū-buntansha) 西山 圭子  東京女子医科大学, 医学部, 准教授 (00155532)
小森 万希子  東京女子医科大学, 医学部, 教授 (60178332)
小高 光晴  東京女子医科大学, 医学部, 臨床教授 (90280635)
Project Period (FY) 2014-04-01 – 2017-03-31
Project Status Completed (Fiscal Year 2016)
Budget Amount *help
¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000)
Fiscal Year 2016: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2015: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2014: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Keywords赤血球流動挙動 / 血液凝固機能 / 体外循環 / 心臓手術 / 赤血球変形能 / 濃厚赤血球製剤 / 赤血球濃厚液
Outline of Final Research Achievements

The present study showed that echinocytosis is induced without significant loss of deformability at the start of cardiopulmonary bypass (CPB). Loss of deformability did not occur in parallel with the morphological changes after initiation of CPB, but it was associated with administration of homologous blood at the end of CPB and the stored red blood cells themselves, accompanied by significantly smaller MCV and larger MCHC. After initiation of CPB and despite adequate anticoagulation with heparin, the F1+2 and TAT complex significantly increased compared with baseline. Thrombin formation at CPB initiation and the prolonged clotting lag time depending on the heparin concertation may lead to an underestimation of the fibrinogen level by the PT-derived method. Timely availability of ROTEM-based coagulation management during cardiac surgery has the potential to reduce overall blood product use and blood loss and the duration of hospitalization compared with empirical treatment.

Report

(4 results)
  • 2016 Annual Research Report   Final Research Report ( PDF )
  • 2015 Research-status Report
  • 2014 Research-status Report
  • Research Products

    (31 results)

All 2017 2016 2015 2014

All Journal Article (15 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 15 results,  Open Access: 8 results,  Acknowledgement Compliant: 1 results) Presentation (16 results) (of which Int'l Joint Research: 3 results,  Invited: 1 results)

  • [Journal Article] Introduction of thromboelastometry-guidance for the administration of fresh frozen plasma is associated with decreased allogeneic blood transfusions and postoperative blood loss in cardiopulmonary-bypass surgery.2017

    • Author(s)
      Ichikawa J, Marubuchi T, Nishiyama K, Kodaka M, Görlinger K, Ozaki M, and Komori M.
    • Journal Title

      Blood Transfus

      Volume: -

    • Related Report
      2016 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Changes in heparin dose-response slope during cardiac surgery possibly result in inaccuracy in predicting heparin bolus dose requirement to achieve target ACT.2017

    • Author(s)
      Ichikawa J, Mori T, Kodaka M, Nishiyama K, Ozaki M, Komori M.
    • Journal Title

      Perfusion.

      Volume: ^

    • Related Report
      2016 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Management of a patient with antiphospholipid syndrome undergoing aortic valve replacement using the Hepcon Hemostasis Management System Plus and rotational thromboelastometry2017

    • Author(s)
      Samejima Y, Kodaka M, Ichikawa J, Mori T, Ando K, Nishiyama K, Komori M.
    • Journal Title

      A A Case Rep.

      Volume: 1 Issue: 5 Pages: 100-104

    • DOI

      10.1213/xaa.0000000000000439

    • Related Report
      2016 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] 過去3年間における麻酔関連のインシデント・アクシデントのSHELL分析に基づく解析2017

    • Author(s)
      市川順子、西山圭子、小高光晴、小森 万希子.
    • Journal Title

      日臨麻会誌

      Volume: 37 Pages: 1-5

    • NAID

      130005345068

    • Related Report
      2016 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Influence of Heparin on the Fibrinogen Level Measured by the Prothrombin Time-Derived Method During Cardiac Surgery With Cardiopulmonary Bypass.2016

    • Author(s)
      Ichikawa J, Kodaka M, Nishiyama K, Komori M.
    • Journal Title

      J Cardiothorac Vasc Anesth.

      Volume: 16 Issue: 3 Pages: 30751-30751

    • DOI

      10.1053/j.jvca.2016.12.025

    • Related Report
      2016 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] n vitro and in vivo effects of hemodilution on kaolin-based activated clotting time predicted heparin requirement using a heparin dose-response technique.2016

    • Author(s)
      Ichikawa J, Hagihira S, Mori T, Kodaka M, Nishiyama K, Ozaki M, Komori M.
    • Journal Title

      J Anesth.

      Volume: 30 Issue: 6 Pages: 923-928

    • DOI

      10.1007/s00540-016-2227-9

    • Related Report
      2016 Annual Research Report
    • Peer Reviewed
  • [Journal Article] トロンボモジュリンの組織プラスミノゲン活性化因子による線溶亢進に対する調節作用.2016

    • Author(s)
      市川順子、鮫島由梨子、市村健人、小高光晴、西山圭子、小森万希子.
    • Journal Title

      日本血栓止血学会誌

      Volume: 27 Pages: 70-75

    • NAID

      130005127666

    • Related Report
      2016 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 開心術の止血に大容量の新鮮凍結血漿を要し、術後肺障害をきたした1症例.2016

    • Author(s)
      岡村圭子、市川順子、小高光晴、金子吾朗、大野まり子、小森万希子.
    • Journal Title

      日臨麻会誌

      Volume: 36 Pages: 297-304

    • NAID

      130005163277

    • Related Report
      2016 Annual Research Report
    • Peer Reviewed
  • [Journal Article] トロンボモジュリンの組織プラスミノゲン活性化因子による線溶亢進に対する調節作用2016

    • Author(s)
      市川順子,鮫島由梨子,市村健人,小高光晴,西山圭子,小森万希子.
    • Journal Title

      日本血栓止血学会誌

      Volume: 27 Pages: 70-75

    • NAID

      130005127666

    • Related Report
      2015 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Relations between preoperative glycated albumin levels and co-morbidity in patients undergoing surgery.2015

    • Author(s)
      Makiko Komori,keiko nishiyama, junko ichikawa,Mitsuharu Kodaka
    • Journal Title

      Journal of Japanese college of surgeons.

      Volume: 40 Pages: 656-662

    • NAID

      130005261913

    • Related Report
      2015 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] 開心術における周術期の出血量,血液製剤使用に対してトラネキサム酸およびトロンボエラストメトリー(ROTEMR)使用の有用性.2015

    • Author(s)
      市川順子、小高光晴、北原智子、佐藤敦彦、西山圭子、中野清治、小森万希子
    • Journal Title

      麻酔

      Volume: 64 Pages: 131-138

    • Related Report
      2015 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] 開心術における周術期の出血量、血液製剤使用に対してトラネキサム酸およびトロンボエラストメトリー(ROTEM)使用の有用性2015

    • Author(s)
      市川順子、小高光晴、北原智子、佐藤敦彦、西山圭子、中野清治、小森万希子
    • Journal Title

      麻酔

      Volume: 64 Pages: 131-8

    • Related Report
      2014 Research-status Report
    • Peer Reviewed / Acknowledgement Compliant
  • [Journal Article] Reappearance of Circulating Heparin in Whole Blood Heparin Concentration-Based Management Does Not Correlate With Postoperative Bleeding After Cardiac Surgery2014

    • Author(s)
      Ichikawa J, Kodaka M, Nishiyama K, Hirasaki Y, Ozaki M, Komori M.
    • Journal Title

      J Cardiothorac Vasc Anesth

      Volume: Feb 5 Issue: 4 Pages: 2015-9

    • DOI

      10.1053/j.jvca.2013.10.010

    • Related Report
      2014 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Intracardiac mass of the LAA during CPB for MVR.2014

    • Author(s)
      Ichikawa J, Kodaka M, Ando K.
    • Journal Title

      J Anesth.

      Volume: 28 Issue: 4 Pages: 645-645

    • DOI

      10.1007/s00540-013-1760-z

    • Related Report
      2014 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Use of ROTEM and MEA in a cardiac surgical patient with ITP.2014

    • Author(s)
      Ichikawa J, Kodaka M, Kaneko G.
    • Journal Title

      J Anesth.

      Volume: 28 Issue: 2 Pages: 310-310

    • DOI

      10.1007/s00540-013-1690-9

    • Related Report
      2014 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] 当院の過去3年間の麻酔関連アクシデント2が関与したヒューマンエラーの要因分析.2016

    • Author(s)
      市川 順子, 西山 圭子,小高 光晴, 小森 万希子.
    • Organizer
      日本臨床麻酔学会第36回学術集会
    • Place of Presentation
      ホテル日航高知旭ロイヤルザクラウンパレス新阪急高知, (高知県高知市)
    • Year and Date
      2016-11-03
    • Related Report
      2016 Annual Research Report
  • [Presentation] Transfusion of stored allogeneic blood is associated with dose-dependent adverse effects on RBC deformability. American Society of anesthesiologists Annual meeting2016

    • Author(s)
      Junko Ichikawa, Ichiro Koshino, Kazuyoshi Ando, Mitsuharu Kodaka, Makiko Komori.
    • Organizer
      American Society of anesthesiologists Annual meeting
    • Place of Presentation
      Chicago, Illinoi,USA
    • Year and Date
      2016-10-23
    • Related Report
      2016 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Anticoagulation based on heparin dose-response technique did not predict accurately heparin bolus dose requirement to achieve target ACT during cardiac surgery.2016

    • Author(s)
      Junko Ichikawa, Testu Mori, Mitsuharu Kodaka, Keiko Nishiyama, Makoto Ozaki Makiko Komori.
    • Organizer
      American Society of anesthesiologists Annual meeting
    • Place of Presentation
      Chicago, Illnoi,USA
    • Year and Date
      2016-10-23
    • Related Report
      2016 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] ヘプコンHMSの使用は人工心肺下の心臓手術において、ヘパリン必要量を的確に予想できるか?2016

    • Author(s)
      市川 順子, 森 哲, 小高 光晴, 金子 吾郎、小森 万希子.
    • Organizer
      心臓血管麻酔学会第21回学術集会
    • Place of Presentation
      横浜ベイホテル東急(神奈川県、横浜市)
    • Year and Date
      2016-09-16
    • Related Report
      2016 Annual Research Report
  • [Presentation] Activated clotting time can be used to monitor residual heparin after discontinuing intravenous heparin for antithrombotic prophylaxis.2016

    • Author(s)
      Junko Ichikawa, Keiko Okamura, Goro Kaneko, Keiko Nishiyama, Makiko Komori.
    • Organizer
      Euroanaesthesia
    • Place of Presentation
      London, UK
    • Year and Date
      2016-05-28
    • Related Report
      2016 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 心臓手術中に濃厚赤血球製剤の投与により、赤血球が小型化、密度上昇、変形能が低下する。2016

    • Author(s)
      市川 順子, 越野 一郎, 伊藤 実紀子,小高 光晴 ,小森 万希子.
    • Organizer
      日本麻酔科学会第63回学術集会
    • Place of Presentation
      福岡国際会議場(福岡県、福岡市)
    • Year and Date
      2016-05-26
    • Related Report
      2016 Annual Research Report
  • [Presentation] Transfusion of stored allogenic blood decreased deformability, increased density and miniaturized erythrocytes during cardiac surger increased density and miniaturized erythrocytes during cardiac surgery2015

    • Author(s)
      Junko Ichikawa,Ichiro Koshino, Kazuyoshi Ando, Mitsuharu Kodaka, Makiko Komori.
    • Organizer
      米国麻酔学会
    • Place of Presentation
      San Diego(California,USA)
    • Year and Date
      2015-10-24
    • Related Report
      2015 Research-status Report
  • [Presentation] 当院における過去3年間の麻酔関連のインシデント・アクシデント報告2015

    • Author(s)
      市川順子、西山圭子、小高光晴、小森万希子
    • Organizer
      日本臨床麻酔学会 第35回
    • Place of Presentation
      パシフィコ横浜(神奈川県横浜市)
    • Year and Date
      2015-10-21
    • Related Report
      2015 Research-status Report
  • [Presentation] 長時間の人工心肺および再手術により血液凝固機能異常、循環不全、乳酸アシドーシス2015

    • Author(s)
      市川順子、小高光晴、森哲、西山圭子
    • Organizer
      日本心臓血管麻酔学会 第20回
    • Place of Presentation
      アクロス福岡(福岡県福岡市)
    • Year and Date
      2015-10-09
    • Related Report
      2015 Research-status Report
  • [Presentation] Thromboelastometry–guided administration of fresh frozen plasma during cardiopulmonary surgery is associated with decreased perioperative allogeneic blood transfusion and postoperative blood loss.2015

    • Author(s)
      Junko Ichikawa,Yuriko Samejima, Goro Kaneko, Mitsuharu Kodaka, Makiko Komori
    • Organizer
      Euroanaesthesia
    • Place of Presentation
      Berlin(Germany)
    • Year and Date
      2015-05-30
    • Related Report
      2015 Research-status Report
  • [Presentation] 術前のヘパリンによる抗凝固療法中止後の活性化凝固時間(ACT)による残存ヘパリンの検出2015

    • Author(s)
      市川順子、岡村圭子、金子吾朗、北原智子、西山圭子、小森万希子
    • Organizer
      日本麻酔学会第62回学術集会
    • Place of Presentation
      神戸ポートピアホテル(兵庫県神戸市)
    • Year and Date
      2015-05-28
    • Related Report
      2015 Research-status Report
  • [Presentation] トロンボモジュリンの組織プラスミノーゲン活性化因子による線溶亢進に対する調節作用2015

    • Author(s)
      市川順子、鮫島由梨子、市村 健人、大野 まり子、塚本 加奈子、小森 万希子
    • Organizer
      日本麻酔学会第62回学術集会
    • Place of Presentation
      神戸ポートピアホテル(兵庫県神戸市)
    • Year and Date
      2015-05-28
    • Related Report
      2015 Research-status Report
  • [Presentation] A successful case of conventional treatment for systolic anterior motion without left ventricular outflow tract obstruction following mitral valve plasty2015

    • Author(s)
      Junko Ichikawa,Mitsuharu Kodaka,Yuriko Samejima,Goro kaneko,Makiko Komori.
    • Organizer
      IARS annual Meeting and International Science Symposium
    • Place of Presentation
      Honolulu,Hawai(USA)
    • Year and Date
      2015-03-21
    • Related Report
      2014 Research-status Report
  • [Presentation] The use of thromboelastometry during surgery reduces perioperative blood loss and transfusion requirements in cardiac surgery with cardiopulmonary bypass2014

    • Author(s)
      Junko Ichikawa, Mitsuharu Kodaka, Goro Kaneko, Mariko Oono, Keiko Nishiyama, Makiko Komori
    • Organizer
      ASA Annual Meeting American Society of Anesthesiologists
    • Place of Presentation
      New Orleans(USA)
    • Year and Date
      2014-10-13
    • Related Report
      2014 Research-status Report
  • [Presentation] 人工腱索の長さの決定に経食道心エコーが有用であった症例2014

    • Author(s)
      市川順子, 小高光晴, 金子吾朗、西山圭子、小森万希子
    • Organizer
      日本心臓血管麻酔学会第19回学術大会
    • Place of Presentation
      ホテル阪急エキスポパーク(大阪府吹田市)
    • Year and Date
      2014-09-20
    • Related Report
      2014 Research-status Report
  • [Presentation] 心臓手術中の希釈によるアンチトロンビンⅢ減少がHepcon-HMS上のヘパリン必要量に及ぼす影響2014

    • Author(s)
      市川順子、小高光晴、西山圭子、黒川桂子、小森万希子
    • Organizer
      日本麻酔学会第61回学術集会
    • Place of Presentation
      パシフィコ横浜(神奈川県、横浜市)
    • Year and Date
      2014-05-15
    • Related Report
      2014 Research-status Report

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Published: 2014-04-04   Modified: 2018-03-22  

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