Permissive hypotensive resuscitation during severe hemorrhagic shock: the basic research toward the clinical establishment

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K08929
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55060:Emergency medicine-related
• Research Institution: Osaka Medical and Pharmaceutical University
• Principal Investigator: Takasu Akira 大阪医科薬科大学, 医学部, 教授 (00536170)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 出血性ショック / 酸素代謝 / 生存時間 / 輸血 / ラット

Outline of Final Research Achievements

Objective: To test whether temporary blood administration improves oxygen metabolism and prolongs survival in a clinically relevant model of life-threatening hemorrhage. Methods: Hemorrhagic shock was induced by blood withdrawal, followed by tail amputation in 18 rats. Rats were randomized into three groups (n=6 each) and received the following resuscitation regimen for 20 min: Gr. 1 (9 mL shed blood) vs. Gr. 2 (a mixture of 4.5 mL normal saline (NS) and 4.5 mL shed blood) vs. Gr. 3 (9 mL NS solution). The rats were then monitored for hemodynamics and oxygen metabolism until death or a maximum of 180 min. Results: The regimen of Gr. 1 vs. Gr. 3 prompted a surge in blood pressure and improved metabolic indices. Four rats in Group 1, three in Group 2, and none in Group 3 survived up to 180 min. Conclusions: In a model of hemorrhagic shock in rats, a temporary resuscitation of whole blood administration compared with NS solution seemed to have a better effect on survival

Free Research Field

救急医学

Academic Significance and Societal Importance of the Research Achievements

生命を脅かす致死的出血ショックの治療において早期の輸血療法が組織や細胞への酸素供給力を向上させることを示し、その有用性を明らかにした。重症出血性ショック患者が心停止に至るとその転帰は極めて不良になるが、早期輸血によりそれを回避できることがが示唆された。特に救急搬送中の輸血療法について検討を行う必要はあるが、今後の救急医療の現場において、重症出血性ショックの対応に大きく影響を与えると考える。