Anesthesiology and Intensive Care Medicine
- Always respect clinical practice as the starting point of anesthesiologists and keep an exploratory mindset to solve questions arising from clinical practice
- Engage in the following three research areas with the goal of delivering “treatment” and “technology” developed in Osaka University to the world:
1. Ultimate respiratory physiology research to eliminate lung injury
2. Neuroscience research aiming to prevent perioperative neurocognitive disorders
3. Pioneering research leading to elucidation of the mechanism of chronic pain
The Department of Anesthesiology and Intensive Care Medicine will lead the world with unique research that can only be achieved by us
1. Pulmonary Physiology Research Group
・Proactive initiative for establishment and clinical application of lung stress mapping to visualize the risk of lung injury
With an innovative approach combining pulmonary physiology and imaging analysis, we are striving to establish lung stress mapping, a technology to visualize an infinite amount of information on lung stress in the entire lung area. This will enable evaluation and visualization of the “amount” and “site and pattern” of the areas at risk of lung injury (see figure below). In addition, by estimating patient prognosis from the evaluation of the areas at risk of lung injury using artificial intelligence, a patient group with higher risks can be extracted and “preemptive” personalized medicine provided. Our ultimate goal is to develop a next-generation ventilator incorporating lung stress mapping with automatic risk area reduction system to optimize the ventilating condition for patients automatically for 24 hours a day, 365 days a year, enabling provision of personalized medicine “anytime,” “anywhere,” and to “anyone.” This is expected to help destroy the preconceived notion that “ventilator management is a skilled technique based on experience” and become an innovative breakthrough for improvement of acute respiratory distress syndrome (ARDS) treatment outcome.
・Elucidation of the mechanism of spontaneous respiration-associated lung injury and establishment of comprehensive treatment
As diaphragmatic breathing is a physiological function, it has been recommended to preserve spontaneous breathing during mechanical ventilation. However, we found a phenomenon that lung injury worsens due to dependence on respiratory effort, which led to the development of the new concept of “spontaneous respiration-associated lung injury” in our department. After more than 10 years of consistent research, we revolutionized conventional ventilator management for ARDS. We reversed the existing perception that “spontaneous breathing should always be preserved,” and now cessation or suppression of respiratory effort using muscle relaxants, high positive end-expiratory pressure (PEEP), and prone position has become the standard of care for ARDS with high respiratory effort. We will further promote our research to elucidate the mechanism of spontaneous respiration-associated lung injury, aiming to develop an innovative treatment.
2. Neuroscience Research Group
・Elucidation of the mechanism of onset of perioperative neurocognitive disorders
Postoperative delirium is one of the perioperative neurocognitive disorders caused by surgery/anesthesia, and the most frequent postoperative complication in elderly patients. In addition, the onset of postoperative delirium is associated with poor long-term prognosis such as increased mortality, warranting early establishment of the prediction, prevention, and treatment methods. We found “decreased synaptic transmission” in prefrontal cortex (see left figure below) and “dysfunction of brain microvascular endothelial cells” in hippocampus (see right figure below) after surgery/anesthesia. Based on these findings we are promoting basic research and clinical research to further elucidate the mechanism of onset of postoperative delirium and discover a biomarker to predict the onset of postoperative delirium.
3. Pain Science Research Group
・Elucidation of the mechanism of analgesic action of peripheral nerve pulsed radiofrequency
Peripheral nerve pulsed radiofrequency has been attracting worldwide attention as a minimally invasive treatment to provide long-term pain relief to patients with refractory neuropathic pain and joint pain without causing neuropathy. However, the mechanism of analgesic action of this treatment remains largely unexplored. We are exploring to clarify the mechanism through animal experiments, aiming to further improve and optimize the quality of this promising treatment. We have conducted a study on the mechanism of action at peripheral and spinal level using an inflammatory pain mouse model and obtained a new finding that the treatment does not just act on the pain nervous system but also improves inflammation of peripheral tissues. We will continue our efforts for further breakthroughs in the treatment of chronic pain through animal experiments and clinical research.
