Control of intestinal ischemia in sepsis; Effects of vasoconstrictors and sedatives on intestinal perfusion

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K18328
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55060:Emergency medicine-related
• Research Institution: Nagasaki University
• Principal Investigator: Yokoyama Haruka (井上陽香) 長崎大学, 病院(医学系), 助教 (30452866)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 敗血症性ショック / 腸管血流 / 小腸粘膜細胞傷害

Outline of Final Research Achievements

Hypoperfusion injury of the enterocytes with septic shock destroys this barrier and triggers a systemic inflammatory response, which can lead to multiple organ dysfunction and poor outcomes. This study found that enterocyte injury at ICU admission was significantly correlated with fluid balance, particularly during the early period, but not with vasoconstrictors and sedatives. In patients with septic shock, enterocyte injury may contribute to excessive fluid accumulation during the early period after ICU admission.

Free Research Field

集中治療医学、麻酔科学

Academic Significance and Societal Importance of the Research Achievements

敗血症性ショックにおける救命率改善のためには、ガイドラインに基づいた敗血症診療のみならず、微小循環障害、特に腸管粘膜傷害によって生じる二次性の敗血症を契機とした多臓器不全への伸展を阻止することが重要である。本研究では、早期の過剰な体液バランスは小腸粘膜細胞傷害の併発と関連していた。敗血症性ショックにおいて早期に大量の輸液負荷を必要とする場合には、腸管血流を維持する管理を行うことが予後改善へつながる可能性が示唆された。