{"created":"2023-06-20T16:58:31.988422+00:00","id":17311,"links":{},"metadata":{"_buckets":{"deposit":"b8654af7-0c55-4a7d-82c3-2573b18213a4"},"_deposit":{"created_by":3,"id":"17311","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"17311"},"status":"published"},"_oai":{"id":"oai:twinkle.repo.nii.ac.jp:00017311","sets":["140:1307:1308:1924:1932"]},"author_link":["262131","262134","262138","262133","262136","262137","262135","262132"],"item_10001_alternative_title_1":{"attribute_name":"別タイトル","attribute_value_mlt":[{"subitem_alternative_title":"敗血症症例における緊急手術後のエンドトキシン吸着療法の有用性について"}]},"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"1998-10-25","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"10","bibliographicPageEnd":"771","bibliographicPageStart":"765","bibliographicVolumeNumber":"68","bibliographic_titles":[{"bibliographic_title":"東京女子医科大学雑誌"}]}]},"item_10001_creator_2":{"attribute_name":"著者名","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"YAGUCHI, Arino"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"ISHIKAWA, Masatake"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SOGA, Yukihiro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SUZUKI, Tadashi"}],"nameIdentifiers":[{}]}]},"item_10001_date_25":{"attribute_name":"受付日付","attribute_value_mlt":[{"subitem_date_issued_datetime":"2010-08-10","subitem_date_issued_type":"Created"}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"敗血症症例における緊急手術後のエンドトキシン吸着除去療法の有用性について検討した.対象は,当科ICUに入院し,SIRS(systemic inflammatory response syndrome)の診断基準で敗血症と診断され,緊急手術後にエンドトキシン吸着除去療法を施行した全25症例である.対象症例に対し,エンドトキシン吸着除去療法前後におけるスワンガンツカテーテルによる循環動態(平均血圧MBP,全末梢血管抵抗係数SVRI,心係数CI),酸素消費量(V^^・O_2),酸素供給量(D^^・O_2),酸素摂取率(O_2ER)および血中エンドトキシン濃度(エンドスペシー法,トキシカラー法)を測定し,その有用性について検討した.25症例の平均年齢は61.4歳,男性15例,女性10例であった.25例中15例が死亡し死亡率は60%であった.1)循環動態では,吸着前後の平均血圧は,生存例では上昇したが,死亡例では低下した.心係数は,hypodynamic stateの症例では有意に上昇したが,hyperdynamic stateの症例では減少した.全末梢血管抵抗は,生存例で有意に上昇したが,死亡例では変化が認められなかった.2)組織酸素代謝では,生存例,死亡例のいずれも有意な変化は認められなかった.3)血中エンドトキシン濃度は,エンドスペシー法およびトキシカラー法のいずれの測定でも統計学上,有意な変化はなかつた.エンドトキシン吸着除去療法の前後において,血中のエンドトキシン濃度の変化は認められなかったが,測定法の問題と考えられる.一方,平均血圧,全末梢血管抵抗係数の有意な増加が認められ,循環動態の改善にエンドトキシン吸着除去療法は有用と思われた.血圧の改善に末梢血管抵抗の上昇が関与しており,エンドトキシン吸着除去療法は,敗血症患者に対し,原疾患に対する手術後で末梢血管抵抗が低下し始める早期に施行するのが最も望ましいと考えられる.","subitem_description_type":"Abstract"},{"subitem_description":"Circulating endotoxin in the blood is considered to be a serious pathogenic factor for septic shock and multiple systemic failure. We have been treating septic patients using blood purification cartridges which consist of polymyxin B immobilized (PMX-20R) to eliminate endotoxin from the blood circulation. We surveyed blood pressure, cardiac index (CI), systemic vascular resistance index (SVRI), oxygen delivery (D^^・O_2), oxygen consumption (V^^・O_2), oxygen extraction ratio (O_2ER) and concentration of endotoxin in the blood, before and after PMX-20R therapy for 25 septic surgical patients after emergency operation. The blood pressure, CI and SVRI showed statistically significant differences before and after PMX-20R, but DO_2, VO_2 and O_2ER and the concentration of endotoxin did not. Further, comparing survivors with non survivors, SVRI had increased in the former but not in the latter. For septic patients, the adsorption of endotoxin is very efficacious to improve the circulatory state after the elimination of this procedure, when the operation is performed immediately. The optimal time is at the hyperdynamic state, at the beginning of the fall in SVRI, because its increase plays a part in elevating the blood pressure.","subitem_description_type":"Abstract"}]},"item_10001_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"262135","nameIdentifierScheme":"WEKO"}],"names":[{"name":"矢口, 有乃"}]},{"nameIdentifiers":[{"nameIdentifier":"262136","nameIdentifierScheme":"WEKO"}],"names":[{"name":"石川, 雅健"}]},{"nameIdentifiers":[{"nameIdentifier":"262137","nameIdentifierScheme":"WEKO"}],"names":[{"name":"曽我, 幸弘"}]},{"nameIdentifiers":[{"nameIdentifier":"262138","nameIdentifierScheme":"WEKO"}],"names":[{"name":"鈴木, 忠"}]}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"東京女子医科大学学会"}]},"item_10001_source_id_11":{"attribute_name":"NCID","attribute_value_mlt":[{"subitem_source_identifier":"AN00161368","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0040-9022","subitem_source_identifier_type":"ISSN"}]},"item_10001_text_35":{"attribute_name":"著者所属","attribute_value_mlt":[{"subitem_text_value":"Department of Emergency and Critical Care Medicine, Tokyo Women's Medical University"},{"subitem_text_value":"Department of Emergency and Critical Care Medicine, Tokyo Women's Medical University"},{"subitem_text_value":"Department of Emergency and Critical Care Medicine, Tokyo Women's Medical University"},{"subitem_text_value":"Department of Emergency and Critical Care Medicine, Tokyo Women's Medical University"},{"subitem_text_value":"東京女子医科大学救急医学"},{"subitem_text_value":"東京女子医科大学救急医学"},{"subitem_text_value":"東京女子医科大学救急医学"},{"subitem_text_value":"東京女子医科大学救急医学"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2017-03-27"}],"displaytype":"detail","filename":"KJ00006024882.pdf","filesize":[{"value":"466.6 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"KJ00006024882.pdf","url":"https://twinkle.repo.nii.ac.jp/record/17311/files/KJ00006024882.pdf"},"version_id":"6fdcf677-ebb4-4136-97d4-861786656b14"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"eng"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"The Efficacy of Endotoxin Adsorption for Sepsis after Emergency Operations","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"The Efficacy of Endotoxin Adsorption for Sepsis after Emergency Operations"}]},"item_type_id":"10001","owner":"3","path":["1932"],"pubdate":{"attribute_name":"公開日","attribute_value":"2010-08-10"},"publish_date":"2010-08-10","publish_status":"0","recid":"17311","relation_version_is_last":true,"title":["The Efficacy of Endotoxin Adsorption for Sepsis after Emergency Operations"],"weko_creator_id":"3","weko_shared_id":-1},"updated":"2023-06-20T22:52:18.440296+00:00"}