2023 Fiscal Year Final Research Report
Development of sedative drug management algorithm in the rewarming period of hypothermic cerebroprotection
| Project/Area Number |
21K09082
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 55060:Emergency medicine-related
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| Research Institution | Showa University |
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Principal Investigator |
Uchida Naoki 昭和大学, 医学部, 教授 (00286775)
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| Co-Investigator(Kenkyū-buntansha) |
土肥 謙二 昭和大学, 医学部, 教授 (20301509)
松山 高明 昭和大学, 医学部, 教授 (40349113)
八木 正晴 昭和大学, 医学部, 准教授 (40338520)
原野 康平 昭和大学, 医学部, 助教 (30914220)
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| Project Period (FY) |
2021-04-01 – 2024-03-31
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| Keywords | 脳低温療法 / 薬物代謝 / 鎮静薬 / ミダゾラム / 復温期 |
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| Outline of Final Research Achievements |
In brain cryotherapy aimed at protecting the brain in critical care, sedatives are administered continuously, and the administration of sedatives ends when the temperature returns to normal. Since there were reports of excessive blood concentration level of sedatives due to re-temperature, we investigated to explore for clinical factors caused by increases in blood concentrations.
There was no difference in the metabolic enzyme activity of sedatives in the temperature range during brain cryotherapy, and no association was found between age, body size, and main laboratory tests in patients with elevated blood levels after re-temperature.
This study suggests that the increase in blood levels during the re-temperature process is due to changes in the distribution of sedatives in the body. There are various factors that affect the distribution of drugs in the body. With the accumulation of more cases, it is necessary to conduct an analysis based on a sufficient number of cases.
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| Free Research Field |
臨床薬理
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| Academic Significance and Societal Importance of the Research Achievements |
救急医療において用いられる脳低温療法の対象は，治療適応となった経緯（外傷，脳血管障害など）や性別・年齢など多様性に富んでいる．鎮静薬の薬物動態に影響を与える臨床的な要因は多数存在することを勘案すると，臨床的な多様性を加味した復温時における適切な鎮静薬投与の管理方法の確立が必要である．復温時の鎮静薬の濃度変化を適格に予想し，安全で適切な投与量の決定に寄与する管理方法の策定のためには，多様な症例データの蓄積に基づいた検討を行っていくことが必須である．
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