Effects of intraoperative hypercapnia on postoperative recovery and outcomes

2022 Fiscal Year Final Research Report

• Project/Area Number: 20H03774
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Chiba University
• Principal Investigator: ISONO SHIROH 千葉大学, 大学院医学研究院, 教授 (80212968)
• Co-Investigator(Kenkyū-buntansha): 田口 奈津子 千葉大学, 大学院医学研究院, 准教授 (80282474) ; 佐藤 泰憲 慶應義塾大学, 医学部(信濃町), 准教授 (90536723)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 高炭酸ガス血症 / 術後運動機能 / 術後認知機能 / モニタリング / サルコペニア / 術後せん妄

Outline of Final Research Achievements

Reduced organ blood flow during surgery has been reported to worsen postoperative outcomes. Hypercapnia physiologically increases cardiac output and increases blood flow, especially to organs such as the brain. We hypothesize that hypercapnia during surgery may improve postoperative outcomes. Our retrospective analysis of 203 patients undergoing abdominal surgery supported this hypothesis, and observational study using non-contact and unrestrained biometric bed sensor monitor revealed weight loss at discharge, bed time of more than 20 hours, and sleep disturbances in 20 patients undergoing abdominal surgery, suggesting postoperative delirium and progression to sarcopenia. The randomized controlled trial completed as scheduled in 120 patients undergoing abdominal surgery just before the end of this funding support and we plan to analyze and publish the results in the near future.

Free Research Field

周術期管理学、呼吸生理学、臨床モニタリング

Academic Significance and Societal Importance of the Research Achievements

ランダム化比較試験で、術中高炭酸ガス血症がサルコペニアの進行や認知機能低下予防に貢献するという結果が得られた場合、本研究結果の科学的、臨床的、社会的インパクトは大きく、麻酔中の高炭酸ガス血症管理が世界中の臨床麻酔管理のスタンダードとなり、特に高齢者の手術治療の安全性を大きく向上させることが期待される。ランダム化比較試験による仮説支持の有無にかかわらず論文化し公表する意義がある。