1995 Fiscal Year Final Research Report Summary
Role of Adhesion molecule in respiratory failure after surgery for dissecing thoracic aortic aneurysms or coronary artery bypass graft surgery
| Project/Area Number |
06454438
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Anesthesiology/Resuscitation studies
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| Research Institution | Hokkaido University |
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Principal Investigator |
MAYUMI Takahisa Hokkaido University School of Medicine, Department of Anesthesiology Associate professor, 医学部, 助教授 (90231604)
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| Co-Investigator(Kenkyū-buntansha) |
UEDE Tosimitsu Hokkaido University, Institute of Immunological Science, Professor, 免疫科学研究所, 教授 (00160185)
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| Project Period (FY) |
1994 – 1995
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| Keywords | Adhesion Molecule / Respiratory Failure / Dissecing Thoracic Aortic Aneurysm / Coronary Artery Bypass Graft / Cardiopulmonary Bypass / Volatile Anesthetics |
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| Research Abstract |
1) We investigated 14 postoperative patients with reconstruction of aortic arch and/or descending aorta in our intensive Care Unit. Patient consisted of 5 males and 9 females with mean age of 61 years old. Highly qualified patient care could achieve good outcome after emergency surgery for acute dissecting thoracic aortic aneurysm. Plasma levels of Tumor Necrosis Factor in the patients with postoperative respiratory failure were not significantly different to those of normal respiratory function. On the other hand, alveolar concentartions of Tumor Necrosis Factor in the patients with postoperative respiratory failure were significantly higher than those of normal respiartory function. Also neutr ophilic LFA-1 was detected in the patients with postoperative respiratory failure.
2) Judged from the arterial concentration of anesthetics, washin and washouot of enflurane is more rapid than those of isoflurane and sevoflurane in 0.5 and 1 MAC group, respectively. Same MAC of isoflurane and sevoflurane showed almost same rate of washin and washout.
3) 0.5 MAC of isoflurane or sevoflurane and 1 MAC of isoflurane used for CABG did not aggravate the renal function on the patients with impaired renal function. These concentrations of isoflurane and sevoflurane could be selected as a safe and reliable anethetic agents for open cardiac surgery in the patients with impaired renal function.
4) LFA-1 treatment as well as ICAM-1 treatment resulted in improvement in postischemic cardiacfunction, myocardial tissue edema and myocardial energy status. Theses results suggest that LFA/ICAM-1 dependent neutrophil-endothelial cell interaction plays a critical role in myocardial injury following global ischemia.
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