The prevention effect of different one-lung ventilation time on acute respiratory failure after esophageal cancer operation
Tang Xing-song;He Ming-xue;Dazhou Hospital of integrated Traditional and Western Medicine;
Objective To investigate the prevention effect of different one-lung ventilation(OLV) time on acute respiratory failure after esophageal cancer operation. Methods From April 2014 to April 2016, the clinical data of 87 patients undergoing left thoracotomy and esophagectomy, ASA grade I-II, were retrospectively analyzed. All patients were treated with OLV during operation. According to the ventilation time, they were divided into A1 group( 2h, n=26), A2 group(2~3h, n=39) and A3group( 3h, n=22). The arterial partial pressure of carbon dioxide(Pa CO2) and arterial partial pressure of oxygen(Pa O2) were monitored before OLV(T1), after 30 min of OLV(T2), after 90 min of OLV(T3), 30 min after recovering two-lung ventilation(T4). The serum superoxide dismutase(SOD) activity, concentration of malondialdehyde(MDA), levels of interleukin-8(IL-8) and tumor necrosis factor α(TNF-α) were compared, and the incidence rates of postoperative pulmonary complications and acute respiratory failure were recorded. Results There were no significant differences in Pa CO2 and Pa O2 between groups at different time points. Compared with T1, the Pa O2 was lower at T2 and compared with T2, Pa O2 was higher at T3~4. Compared with T1, SOD was lower at T2~3 while MDA, IL-8 and TNF-α were higher. Compared with T2~3, SOD was higher at T4 while MDA, IL-8 and TNF-α were lower. The differences in SOD, MDA, IL-8 and TNF-α between groups were significant at T4. The incidence rates of pneumonia and pulmonary atelectasis in A1 group were higher than those in A3 group while there was no significant difference in the incidence of acute respiratory failure. Conclusion Long OLV time, especially longer than 3h will increase the oxygen free radical generation and inflammation level, which will increase the incidence of postoperative pulmonary complications.
【CateGory Index】： R614;R735.1