2012 Fiscal Year Final Research Report
Endothelial cell rescue therapy of multiorgan failure after severe sepsis
| Project/Area Number |
22390337
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Emergency medicine
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| Research Institution | Tokyo Women's Medical University (2011-2012)
Tokyo Medical and Dental University (2010) |
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Principal Investigator |
ISOTANI Eiji 東京女子医科大学, 医学部, 教授 (90251529)
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| Co-Investigator(Kenkyū-buntansha) |
OOTOMO Yasuhiro 東京医科歯科大学, 医歯(薬)学総合研究科, 教授 (40176946)
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| Project Period (FY) |
2010 – 2012
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| Keywords | 集中治療医学 |
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| Research Abstract |
Introduction: It is expected that recombinant human soluble thrombomodulin (rTM) not only reverses hyper-coagulative status through activating protein C but also prevents multiple organ failure. rTM may improve both physiological scores and the amount of mediators, and reduces the mortality of sepsis and DIC patients in 28 days. We started a new protocol by adding rTM for sepsis and disseminated intravascular coagulation patients. We introduce the preliminary report in this paper.Material & Methods: We enrolled and analyzed 21 patients who were treated for DIC accompanied by sepsis from May to October 2008. Our primary endpoint was mortality in 28 days. As composite outcomes, we followed Acute Physiology and Chronic Health Evaluation (APATCHE II) score, Sequential Organ Failure Assessment (SOFA) score, acute phase DIC score, and serum soluble thrombomodulin, TNF-α, IL-1β, IL-6, HMGB-1, protein C, protein S levels during 10 days. Statistical analysis was performed by Wilcoxon rank-sum test. P < 0.05 was regarded as statistically significant.Results: We found that all scores and mediators improved after administration of rTM in Day 10, but there was no significant improvement in at 28 days. Median of each score or mortality was as follows; APATCH II score: 32 at Day 1 to 26 at Day 10 (p=0.0048), SOFA score: 12 to 8 (p=0.0096), acute phase DIC score: 5 to 3 (p
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