2005 Fiscal Year Final Research Report Summary
Intracardiac effects of massive transfusion in fetal sheep
Project/Area Number |
16591073
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Research Category |
Grant-in-Aid for Scientific Research (C)
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Allocation Type | Single-year Grants |
Section | 一般 |
Research Field |
Embryonic/Neonatal medicine
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Research Institution | The University of Tokyo |
Principal Investigator |
KOZUMA Shiro The University of Tokyo, Faculty of Medicine, Associate Professor, 医学部附属病院, 助教授 (10272569)
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Co-Investigator(Kenkyū-buntansha) |
FUJII Tomoyuki The University of Tokyo, Faculty of Medicine, Associate Professor, 医学部附属病院, 助教授 (40209010)
KAMEI Yoshimasa The University of Tokyo, Faculty of Medicine, Research Associate, 医学部附属病院, 助手 (00251265)
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Project Period (FY) |
2004 – 2005
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Keywords | fetus / conductance catheter / cardiac function |
Research Abstract |
The fetus depends on its cardiovascular system for adaptation to various perinatal stresses and disruption of these adaptation mechanisms in the cardiovascular system is closely related to poor perinatal outcome, perinatal death and brain damage. Therefore, studies on cardiovascular adaptation to the stresses and its disruption are very important from a clinical stand-point. To date, however, intracardiac changes produced by the stresses have not been fully investigated. The purpose of this study is to investigate intracardiac reactions to massive transfusion in fetal sheep by using a conductance catheter. Regarding intracardiac effects of massive transfusion in fetal sheep, Kilby et al. have reported that massive transfusion into the inferior vena cava increased both end-diastolic pressure and. volume of the left ventricle in anemic fetal sheep. The volume remained to be elevated after the transfusion, whereas the pressure gradually decreased and returned to control 30 minutes after th
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e transfusion. We used pregnant sheep at 135.8 days of gestation. A cesarean section was performed under general anesthesia. 1gr thiopental sodium intravenously for induction and 2% halothane in oxygen for maintenance. The upper half of fetal body was withdrawn through a uterine incision and a 6F conductance catheter and a 2F catheter-tip pressure transducer were introduced through the left carotid artery and advanced into the left ventricle with ultrasound guidance. Thirty minutes before transfusion, halothane was turned off and Ketamine chloride was administered intravenously. Blood was transfused at a speed of 200ml/20 minutes with an infusion pump into the right carotid vein. Pressure-volume loops of the left ventricle were continuously recorded from the onset of transfusion untill 40 minutes after transfusion. pH, PCO2, PO2 showed no significant changes by the transfusion. Hematocrit, hemoglobin concentration and heart rate were significantly higher during and after the transfusion, compared to the control level. End-diastolic pressure of the left ventricle increased significantly during the second half of the transfusion period. After the transfusion, it quickly returned to the control level. End-diastolic volume of the left ventricle tended to decrease during the transfusion and reached to the significant level of decrease after the transfusion. Transfusion into the superior vena cava had the opposite effect on end-diastolic volume to transfusion into the inferior vena cava. In summary, the two ways of transfusion into the right atrium ; via superior and inferior vena cava, produced different effects on end-diastolic volume of the left ventricle. Ventricular interaction is important to understand intracardiac changes in the fetal heart. Less
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Research Products
(2 results)