1996 Fiscal Year Final Research Report Summary
A STUDY ON THE TREATMENT FOR SEPTIC MULTIPLE ORGAN FAILURE THROUGH IMPROVEMENT OF TISSUE OXYGEN METABOLISM
| Project/Area Number |
06671506
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Anesthesiology/Resuscitation studies
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| Research Institution | CHIBA UNIVERSITY |
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Principal Investigator |
ODA Shigeto LECTURER,CHIBA UNIVERSITY HOSPITAL, 医学部・附属病院, 講師 (90204205)
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| Co-Investigator(Kenkyū-buntansha) |
MATSUDA Kenn-ichi ASSISTANT,CHIBA UNIVERSITY HOSPITAL, 医学部・附属病院, 助手 (60282480)
OHTAKE Yoshio LECTURER,CHIBA UNIVERSITY HOSPITAL, 医学部・附属病院, 講師 (50194189)
SUGAI Takao ASSOCIATO PROFESSOR CHIBA UNIVERSITY SCHOOL OF MEDICINE, 医学部, 助教授 (10187627)
HIRASAWA Hiroyuki PROFESSOR,CHIBA UNIVERSITY SCHOOL OF MEDICINE, 医学部, 教授 (80114320)
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| Project Period (FY) |
1994 – 1996
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| Keywords | Septic multiple organ failure / Tissue oxygen metabolism / Tonometer / Gastric pHi / Hemodynamic management |
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| Research Abstract |
This study was undertaken to investigate the treatment for septic multiple organ failure (MOF) through improvement of tissue oxygen metabolism. First, we investigated the clinically applicable methods for evaluation of tissue oxygen metabolism. Cellular injury score (CIS) measured simultaneously with oxygen delivery and oxygen consumption was a useful method to evaluate the disturbance of tissue oxygen metabolism in septic MOF patients. Gastric intramucosal pH (gastric pHi) measured by Tonometer, newly developed non-invasive device for monitoring of oxygen debt in visceral area, was also clinically useful method for early detection of the disturbance of tissue oxygen metabolism in critically ill patients. From these results, we next investigated the effective treatment for improvement of tissue oxygen metabolism in septic MOF.Hemodynamic management to achieve supranormal oxygen transport values with aggressive fluid resuscitation and catecholamine administration was carried out in patients with severe sepsis. These treatments were effective in early sepsis to improve relative tissue hypoxia and prevent organ dysfunction. However, in patients with extremely developed MOF,these treatments were failed to improve tissue oxygen metabolism, which supposed to be mainly due to decreased oxygen uptake affected by various humoral mediators in these patients. Thus, although approaches to improve tissue oxygen metabolism could be an new treatment for septic MOF,another approaches shoud be established to improve O_2 extraction as well as hemodynamic management to achieve supranormal oxygen transport values.
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