1997 Fiscal Year Final Research Report Summary
Clinical Significance of Endothelium-derived Vasoactive Substances on Surgical Stress
| Project/Area Number |
07671656
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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 | Kyoto University |
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Principal Investigator |
SHIRAKAMI Gotaro Kyoto University, Postgraduate School of Medicine, Instractor, 医学研究科, 助手 (20235740)
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| Co-Investigator(Kenkyū-buntansha) |
MORI Kenjiro Kyoto University, Postgraduate School of Medicine, Professor, 医学研究科, 教授 (20025620)
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| Project Period (FY) |
1995 – 1997
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| Keywords | endothelium-derived vasoactive substance / endothelin / C-type natriuretic peptide (CNP) / nitric oxide (NO) / adrenomedullin / prostanoid / surgical stress / inhaled anesthetic |
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| Research Abstract |
Plasma endothelin and CNP levels did not change significantly during relatively minor surgery. Changes in the levels during surgery had positive correlations with the duration of operation and intraoperative blood loss. In patients undergoing esophageal surgery the plasma endothelin level reached a peak within a few hours after surgery and decreased thereafter, although the plasma CNP level was elevated till postoperative day 7. During heart surgery arterial blood pressure decreased and plasma CNP level increased markedly after cardiopulmonary bypass induction. The plasma CNP level had significant negative correlation with peripheral vascular resistance during cardiopulmonary bypass, after cardiac surgery and in septic patients. In shock patients the plasma endothelin and CNP levels increased markedly approximately in parallel. Although the levels decreased in patients who recovered and survived, those in patients who consequently died sustained high. In septic shock patients the increase of plasma CNP levels was more prominent than that of plasma endothelin levels. After induction of endotoxin shock blood pressure decreased and the levels increased markedly in dogs. Plasma NOx levels decreased after donor liver reperfusion in patients undergoing liver transplantation. In patients undergoing esophageal surgery plasma NOx levels did not change significantly. ANP secretion from isolated perfused rat hearts was stimulated by PGF2alpha, TxA2 and PGD2. High dose of PGE2 decreased it. PGI2 did not influence it. High does of adrenomedullin inhibited ANP secretion. Basal secretion of endothelin from the isolated hearts was inhibited by inhaled anesthetics, although augmented endothelin secretion by endotoxin was not affected by them.
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