Vasopressor-induced attenuation of endothelial glycocalyx degradation by hydroxyethyl starch

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K09363
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Hyogo Medical University
• Principal Investigator: Tatara Tsuneo 兵庫医科大学, 医学部, 教授 (30207039)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: グリコカリックス / ヒドロキシエチルデンプン

Outline of Final Research Achievements

Hydroxyethyl starch (HES) solution, widely used to correct the decrease of blood volume during surgery, degrades the endothelial glycocalyx. This research aimed to test the hypothesis that vasopressor attenuates degradation of endothelial glycocalyx by HES. The HES increased storage and loss shear moduli of hyaluronate solution, suggesting that HES strengthens the transient hyaluronate network by creating new hydrogen bonds. Plasma volume increase following HES infusion after the induction of general anesthesia was larger in the vasopressor group. There were no clinically significant differences in plasma concentrations of hyaluronate between the groups. Increased volume expansion of circulating plasma following HES infusion in anesthesia-induced hypotension compared to when blood pressure is restored by phenylephrine may result from an attenuation of transcapillary fluid filtration, rather than the shedding of glycocalyx.

Free Research Field

臨床麻酔

Academic Significance and Societal Importance of the Research Achievements

本研究結果は、重症患者においてHES製剤の過剰投与を回避し、適切なタイミングでHES製剤を投与するためのHES製剤の安全かつ効果的な使用に新たな活路を見出したと考えている。この結果は、敗血症など致死率の高い重症患者の予後を改善する一助となるため、社会に大きく貢献すると期待される。