Şükran Geze1, Celal Tekinbaş2, Hülya Ulusoy1, Ahmet Menteşe3, Murat Topbaş4, Mesut Karaca5. 1. Department of Anesthesiology and Critical Care, Karadeniz Technical University Faculty of Medicine Farabi Hospital, Trabzon, Turkey. 2. Department of Thoracic Surgery, Karadeniz Technical University Faculty of Medicine Farabi Hospital, Trabzon, Turkey. 3. Program of Medical Laboratory Techniques, Karadeniz Technical University, Health Services Vocational School, Trabzon, Turkey. 4. Department of Public Health, Karadeniz Technical University Faculty of Medicine Farabi Hospital, Trabzon, Turkey. 5. Department of Anesthesiology and Reanimation, Simav Hospital, Kütahya, Turkey.
Abstract
BACKGROUND: This study aims to investigate the effect of ventilation of the non-ventilated lung in patients undergoing one-lung ventilation by a separate low-tidal-volume (1 mL/kg) ventilator at high frequency (30/min) on preventing the effect of one-lung ventilation-associated oxidative damage. METHODS: The study included 45 patients (24 males, 21 females; mean age 54.6±7.7 years; range, 18 to 65 years) with an American Society of Anesthesiologists risk group of 1 to 2 and scheduled for elective thoracotomy. Patients were randomly divided into three groups as those due for thoracotomy without one-lung ventilation (group 1, n=15), those due for thoracotomy with one-lung ventilation (group 2, n=15), and those due for thoracotomy in whom both lungs were ventilated (group 3, n=15). Blood specimens were collected for ischemia-modified albumin, malondialdehyde, and lactate measurements one minute before one-lung ventilation (t0), 30 minutes after one-lung ventilation (t1), 60 minutes after one-lung ventilation (t2), and at postoperative 24th hour (t3). For group 1, t0 was defined as the time at which the thorax was opened. RESULTS: A statistically significant increase in ischemia-modified albumin, malondialdehyde, and lactate levels occurred in group 2 as the duration of one-lung ventilation increased (p<0.01). Plasma ischemia-modified albumin and malondialdehyde levels in group 3 were statistically significantly lower at t1, t2, and t3 compared with group 2 (p<0.01). Plasma lactate levels were significantly lower in group 3 at t1 (p<0.05) and t3 compared with group 2 (p<0.01). CONCLUSION: Separate ventilation of the non-ventilated lung with low tidal volume and high frequency reduces the response to one-lung ventilation-associated oxidative stress in thoracic surgery.
BACKGROUND: This study aims to investigate the effect of ventilation of the non-ventilated lung in patients undergoing one-lung ventilation by a separate low-tidal-volume (1 mL/kg) ventilator at high frequency (30/min) on preventing the effect of one-lung ventilation-associated oxidative damage. METHODS: The study included 45 patients (24 males, 21 females; mean age 54.6±7.7 years; range, 18 to 65 years) with an American Society of Anesthesiologists risk group of 1 to 2 and scheduled for elective thoracotomy. Patients were randomly divided into three groups as those due for thoracotomy without one-lung ventilation (group 1, n=15), those due for thoracotomy with one-lung ventilation (group 2, n=15), and those due for thoracotomy in whom both lungs were ventilated (group 3, n=15). Blood specimens were collected for ischemia-modified albumin, malondialdehyde, and lactate measurements one minute before one-lung ventilation (t0), 30 minutes after one-lung ventilation (t1), 60 minutes after one-lung ventilation (t2), and at postoperative 24th hour (t3). For group 1, t0 was defined as the time at which the thorax was opened. RESULTS: A statistically significant increase in ischemia-modified albumin, malondialdehyde, and lactate levels occurred in group 2 as the duration of one-lung ventilation increased (p<0.01). Plasma ischemia-modified albumin and malondialdehyde levels in group 3 were statistically significantly lower at t1, t2, and t3 compared with group 2 (p<0.01). Plasma lactate levels were significantly lower in group 3 at t1 (p<0.05) and t3 compared with group 2 (p<0.01). CONCLUSION: Separate ventilation of the non-ventilated lung with low tidal volume and high frequency reduces the response to one-lung ventilation-associated oxidative stress in thoracic surgery.
Authors: Patricia Cruz Pardos; Ignacio Garutti; Patricia Piñeiro; Luis Olmedilla; Francisco de la Gala Journal: J Cardiothorac Vasc Anesth Date: 2009-08-22 Impact factor: 2.628
Authors: Debashis Roy; Juan Quiles; Rajan Sharma; Manas Sinha; Pablo Avanzas; David Gaze; Juan Carlos Kaski Journal: Clin Chem Date: 2004-07-20 Impact factor: 8.327