Elucidation of the effects of gut bacteria on the immune control mechanism in sepsis

2020 Fiscal Year Final Research Report

• Project/Area Number: 17K17851
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Anesthesiology; Emergency medicine
• Research Institution: Osaka University
• Principal Investigator: SAKAGUCHI RYOTA 大阪大学, 医学部附属病院, 助教 (50464871)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Keywords: 重症心不全 / 補助人工心臓 / 一酸化窒素 / 右心不全

Outline of Final Research Achievements

Right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation increases morbidity and mortality. Nitric oxide inhalation (NOi) is frequently used to prevent and treat RVF. However, the criteria to wean of and stop NOi are not fully standardized.
We analyzed the risk factors of re-start of NO inhalation after LVAD implantation. We clarified that CVP (central venous pressure) and CVP/dPAP (diastolic pulmonary pressure) ratio were the risk factors of re-start of NOi (recurrence of RVF). Also, we showed that restart of NOi decreases ventilator-free days within 28 days and increases ICU length of stay.

Free Research Field

集中治療、重症心不全、心臓血管外科麻酔

Academic Significance and Societal Importance of the Research Achievements

左室補助人工心臓（Left Ventricular Assist Device: LVAD）装着術後の右心不全はICU滞在期間を延長し、臓器機能の悪化をもたらし、患者の予後を悪化させる。右心不全の治療や予防目的で、一酸化窒素（Nitric Oxide: NO）が使用されているが、本研究により、今まで曖昧にされていたNOの中止基準が示された。患者の予後を改善させるのはもちろんのこと、NOの適切な使用により、医療コストの削減効果も期待できる。右心不全はLVAD装着術を含む心臓外科手術だけでなく、重症呼吸不全でも起こりうるため、本中止基準の適応を今後も検討していく必要がある。