1998 Fiscal Year Final Research Report Summary
The effect of hepatic venous oxygen hemoglobin saturation on the patients' outcome
| Project/Area Number |
09671589
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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 | Fujita Health University |
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Principal Investigator |
KAINUMA Motoshi Fujita Health University School of Medicine, Department of Anesthesiology, Associate Professor, 医学部, 助教授 (90135335)
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| Co-Investigator(Kenkyū-buntansha) |
MIYAKE Toshiyuki Fujita Health University School of Medicine, Department of Anesthesiology, Profe, 医学部, 教授 (40093075)
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| Project Period (FY) |
1997 – 1998
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| Keywords | hepatic venous oxygen hemoglobinsaturation / hepatic blood flow / liver disturbance / blood pressure / oxygen metabolism / liver failure / liver resection surgery / oxygen consumption |
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| Research Abstract |
We had developped hepatic venous oxygen hemoglobin saturation (Shvo_2) monitoring, which method had been widely applied to patients in operating room and critical care setting. Although the degree of the decrease in. shvo_2 was shown in the display of monitoring device, we could not know an accumilation of hypoxic events in the liver, simultaneously. This time, we developed the software to measure the accumulation of hypoxic event to integrate the decrease in Shvo_2 along time during the surgery.
After obtaning informed consent fron each patient, we inserterd oximeter catheter into the hepatic venous vein in 116 patients. Postoperative aminotransferases were significantly incresed in patients who showed high integral value exceeding a critical value.
In other patients, we measured ketone body ratio, interleukin 6 and 8, and GST- alpha. When Shvo_2 was low, ketone body ratio decreased, interleukin 6 and 8 and GST- alpha increased. Postoperative hiarulonic acid increased in patients who showed a low Shvo_2 perioperatively and high serum bilirubin postoperatively.
Next we determined a critical value of hyotension to deteriorate hepatic oxygen metabolism by the simulation method. Hepatic arterial buffer response proves to play a crucial role to maintein hepatic blood flow theoretically. This result could be applied to patients in emmegency or critical care settings.
Conclusion :
We developped a software to measure integral values of Shvo_2 alonf time during surgery. By this method, we measeured Shvo_2 in patients at critical care settings. Simultaneously we meaured ketone bodies, hiarulonic acid and interleukin 6 and 8, which changed in parallel with the degree of decrease in Shvo_2. These values predicts patients' outcome after postoperative period and critical care or emergency setting. Therefore Shvo_2 monitoring proves to play a rucial role in protecting the liver.
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