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《The Journal of Clinical Anesthesiology》 2008-08
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Effects of lung protective ventilatory strategy on inflammatory responses in patients with abnormal lung function undergoing esophagectomy

LIN Wen-qian,LU Xiao-yun, CAO Long-hui, et al.Department of Anesthesiology, Cancer Center of Sun Yat-sen University and State Key Laboratory of Oncology of South China,Guangzhou 510060, China  
Objective To investigate the effect of lung protective ventilatory strategy on inflammatory responses in patients with abnormal lung function undergoing esophagectomy. Methods Forty ASA class Ⅰ or Ⅱ patients with abnormal lung function undergoing esophagectomy were randomly divided into protective ventilation(PV)group(n=20) and conventional ventilation(CV)group (n=20). In group PV, all patients received two-lung ventilation(TLV) and one-lung ventilation(OLV) with tidal volume of 5-6 ml/kg with PEEP 3-5 cmH2O. In group CV,all patients received TLV and OLV with tidal volume of 10 ml/kg without PEEP. After tracheal intubation (T1),at 120 min after OLV(T2),and 24 h(T3) after operation, the venous blood samples were taken for detecting interleukin (IL)-6 and IL-8. Arterial blood gas analysis, index of oxygenation (OI:OI=PaO2/FiO2),airway plateau pressure (Pplat),airway resistance (Raw),airway peak pressure (Ppeak) and dynamic compliance (Cdyn)were also recorded with side stream spirometry. Results Concentrations of IL-6 and IL-8 in both groups were increased significantly at T2 and T3 compared with those at T1(P0.05),but much lower in group PV than those in group CV(P0.05). Ppeak, Pplat,Raw were decreased significantly in group PV compared with those in group CV during OLV(P0.05). OI at T2 and T3 was increased significantly in group PV compared with that in group CV.Conclusion Protective ventilation can reduce the airway pressure and airway resistance during OLV in patients with abnormal lung function, decrease the release of IL-6 and IL-8 and inhibit inflammatory responses.
【Fund】: 广东省医学科研基金(基金号:A2003236)
【CateGory Index】: R614
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